RESUMEN
The aim of this study was to evaluate the effectiveness of topical dorzolamide versus systemic acetazolamide in preventing the intraocular pressure (IOP) spike, following routine phacoemulsification surgery. In this prospective study, 59 eyes (59 patients), undergoing routine phacoemulsification surgery with posterior intraocular implant, were divided into three groups. Group 1 received acetazolamide 250 mg SR orally, immediately post-operatively. Group 2 received one drop of dorzolamide immediately after surgery. Group 3 or control, received neither. The IOP, was checked 4 h, 24 h and 2 weeks post-operatively. When compared with mean baseline pre-operative IOP, the 4 h mean post-operative IOP was slightly higher in the dorzolamide group by a mean of +2.49 mmHg (P = 0.2502). It was significantly higher in the acetazolamide group by a mean of +6.13 mmHg (P = 0.0034) and in the control group by a mean of +11.81 mmHg (P = 0.000). At 24 h the mean IOP in the control group remained significantly elevated by a mean of +5.87 mmHg (P = 0.003). Topical dorzolamide is effective in reducing the early IOP rise during the first 24 h following routine uncomplicated phacoemulsification surgery.
Asunto(s)
Acetazolamida/administración & dosificación , Inhibidores de Anhidrasa Carbónica/administración & dosificación , Hipertensión Ocular/prevención & control , Facoemulsificación , Sulfonamidas/administración & dosificación , Tiofenos/administración & dosificación , Administración Oral , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Presión Intraocular/efectos de los fármacos , Implantación de Lentes Intraoculares , Masculino , Persona de Mediana Edad , Hipertensión Ocular/etiología , Soluciones Oftálmicas , Facoemulsificación/efectos adversos , Cuidados Posoperatorios , Estudios ProspectivosRESUMEN
PURPOSE: To evaluate the effectiveness of punch trabeculectomy in controlling intraocular pressure (IOP) in patients with uncontrolled chronic open-angle glaucoma (COAG) undergoing medical treatment. METHODS: This prospective study included 22 patients (27 eyes) with uncontrolled COAC on medical treatment undergoing punch trabeculectomy through a scleral tunnel. The tunnel was created with a 3.5 mm keratome, the tunnel mouth was not sutured but the conjunctival flap was sutured by 8/0 vicryl. The mean surgical time from opening the conjunctiva to closing the conjunctiva was 8 m 59 s. IOP and other parameters were checked on day 1 and subsequently at intervals appropriate to the individual. RESULTS: After a mean period of 22.2 months follow-up the mean IOP was 13.3 mmHg (SD 5.2). There were few transient early post-operative complications; two eyes had a shallow anterior chamber (AC) due to excess drainage, five had IOP above 21 mmHg, which responded to ocular massage, ten eyes had hyphaema less than 1.5 mm and two eyes had no filtration bleb. CONCLUSIONS: Punch trabeculectomy is a rapid and effective method of controlling IOP. The complication rate is moderate and mainly transient.
Asunto(s)
Glaucoma de Ángulo Abierto/cirugía , Trabeculectomía/métodos , Anciano , Anciano de 80 o más Años , Enfermedad Crónica , Femenino , Humanos , Presión Intraocular , Masculino , Estudios Prospectivos , Colgajos Quirúrgicos , Técnicas de Sutura , Resultado del Tratamiento , Agudeza VisualRESUMEN
A postal survey was conducted to determine the use of eye protection and incidence of ocular trauma in orthodontic practice. One-hundred-and-fifty-nine NHS orthodontic consultants and 203 specialist orthodontic practitioners were surveyed. Two-hundred-and-forty-one (66.5 per cent) replies were received. Some form of eye protection was routinely worn by 66.8 per cent of orthodontists, 64.3 per cent of patients, but only 33.6 per cent of DSAs. Eye protection was not offered to DSAs in 31.9 per cent of practices or to patients in 22.1 per cent. Forty-three per cent of orthodontists reported instances of ocular injury in their practices. The majority of these injuries (n = 104) occurred during debonding or trimming acrylic. Other incidents involved ligating materials, intra-oral polishing, and acid etching. Most injuries (83.5 per cent) were treated in the surgery without any long-term effects. The routine use of goggles or spectacles with side-pieces and plastic lenses, which conform to British Standard BS 2092, is recommended for staff and patients during all operative procedures in orthodontic practice.
Asunto(s)
Equipo Dental/efectos adversos , Materiales Dentales/efectos adversos , Cuerpos Extraños en el Ojo/etiología , Dispositivos de Protección de los Ojos/estadística & datos numéricos , Ortodoncia , Accidentes de Trabajo/estadística & datos numéricos , Distribución de Chi-Cuadrado , Atención Odontológica/efectos adversos , Desconsolidación Dental/efectos adversos , Personal de Odontología , Cuerpos Extraños en el Ojo/epidemiología , Cuerpos Extraños en el Ojo/prevención & control , Anteojos , Humanos , Incidencia , Ortodoncia/instrumentación , Encuestas y Cuestionarios , Reino Unido/epidemiologíaRESUMEN
Six cases are presented in which hard contact lenses have migrated into the periocular soft tissues, four into the eyelid, one into the orbit and one which spontaneously reappeared on the cornea 12 years after the patient had last worn contact lenses. Some possible mechanisms of this phenomenon and a review of the literature are presented.
Asunto(s)
Lentes de Contacto/efectos adversos , Migración de Cuerpo Extraño/patología , Adulto , Anciano , Párpados/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Órbita/patologíaRESUMEN
We have analysed the cost of disposable equipment used during cataract surgery by eight different surgeons over a six-month period in the same hospital. By comparing the costs of single-use items used by each surgeon we highlight how significant savings can be made by change of technique (without an adverse effect on surgical outcome).
Asunto(s)
Extracción de Catarata/economía , Equipos Desechables/economía , Auditoría Financiera , Servicio de Cirugía en Hospital/economía , Extracción de Catarata/instrumentación , Control de Costos/estadística & datos numéricos , Humanos , Londres , Calidad de la Atención de SaludRESUMEN
Dental surgeons, dental surgery assistants and patients are at risk of eye injury during certain dental procedures. We have reviewed the literature to reemphasise these hazards and have conducted a survey to determine how often injuries occur and what measures are taken to prevent them.