scholarly journals Comparison of the Effect of Removing Bandage Contact Lens on the Days 3 and 5 Following Photorefractive  Keratectomy

2021 ◽  
Author(s):  
Seyed-Hashem Daryabari ◽  
Khosrow Jadidi ◽  
Seyed Aliasghar Mosavi ◽  
Mostafa Naderi
Keyword(s):  
Contact Lens ◽  
Mixed Model ◽  
Major Complication ◽  
Corneal Epithelial ◽  
Mixed Model Analysis ◽  
Bandage Contact Lens ◽  
Corneal Epithelial Defect ◽  
Group 2 ◽  
The Right ◽  
Group 1

Abstract AIM: To compare the outcomes of removing bandage contact lens (BCL) on days 3and 5 after photorefractive keratectomy (PRK).Methods: One hundred patients underwent PRK (totally 200 eyes) were enrolled in the present study. The subjects were assigned to two groups. BCL removal was performed in group 1 on the day 3 after PRK from the right eye, but the removal in the group 2 was performed 5 days after the surgery from the left eye. Then, data obtained from both groups were compared. To evaluate complications, the subjects underwent slit-lamp examination in all visits.Results: Filamentary keratitis (FK) was observed in one eye in both groups. The frequency of haze was higherin group 1; however, it was not significant between two group. Using mixed model analysis, significant differences were observed in the rate of complications as well as pain and eye discomfort scores between the groups (P <0.05). No major complication was reported.Conclusion: Majority of post PRK corneal epithelial defect is healed on day 3. However, keeping BCL for 5 days postoperatively, instead of the three days produces slightly lower rate of total complication.

scholarly journals Study of the Efficacy and Safety of Contact Lens Used in Trabeculectomy

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Bin Li ◽  
Miaomiao Zhang ◽  
Zhen Yang
Keyword(s):  
Life Table ◽  
Contact Lens ◽  
Outcome Measurement ◽  
Efficacy And Safety ◽  
Surgical Success ◽  
Antiglaucoma Medication ◽  
Bandage Contact Lens ◽  
Group 2 ◽  
Group 1

Purpose. To investigate the efficacy and safety of soft bandage contact lens used in trabeculectomy. Methods. This was a prospective, randomized study which enrolled 200 glaucoma patients (200 eyes). Patients were randomized into Group 1, using contact lens after trabeculectomy, and Group 2, without contact lens. The primary outcome measurement was the comparison of success rates at 12 months after surgery. Qualified surgical success was defined as a postoperative intraocular pressure (IOP) value of 6–21 mmHg with or without topical antiglaucoma medication use at the last follow-up visit. Complete success was defined as the IOP between 6 and 21 mmHg without any antiglaucoma medication at the last follow-up visit. Postoperative data included IOP values, best-corrected visual acuity (BCVA), number of antiglaucoma medications, complications related to surgery, and bleb characteristics. Results. There were statistically significant differences between Groups 1 and 2 in mean IOP values at 3, 6, and 12 months after surgery (P<0.05). The 12-month life table rates for qualified surgical success were 94.7% and 86.3% in Groups 1 and 2, respectively (P=0.045). The 12-month life table rates for complete surgical success were 89.6% and 80.0% in Groups 1 and 2, respectively (P=0.042). At 12 months after surgery, the mean numbers of antiglaucoma medications were 0.3 ± 0.4 and 0.5 ± 0.6, respectively. (P=0.001). At the 12-month visit, the maximal bleb area was significantly different between groups (P=0.044), with Group 1 exhibiting a more diffused bleb area. Encysted blebs were observed in 7 (7%) eyes in Group 1 and 17 (17%) eyes in Group 2, with statistically significant differences (P=0.030). The 12-month life table rates for qualified surgical success were 94.7% (91 eyes) and 86.3% (82 eyes) in Groups 1 and 2, respectively (P=0.045). Conclusions. Bandage contact lens is a safe and effective device after fornix-based trabeculectomy.

scholarly journals Minimising radiation exposure in catheter ablation of ventricular arrhythmias

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Matevž Jan ◽  
David Žižek ◽  
Tine Prolič Kalinšek ◽  
Dimitrij Kuhelj ◽  
Primož Trunk ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Radiation Exposure ◽  
Ventricular Arrhythmias ◽  
Major Complication ◽  
Structural Heart Disease ◽  
Left Ventricular ◽  
Complex Nature ◽  
Group 2 ◽  
Procedural Outcomes ◽  
Group 1

Abstract Background Conventional fluoroscopy guided catheter ablation (CA) is an established treatment option for ventricular arrhythmias (VAs). However, with the complex nature of most procedures, patients and staff bare an increased radiation exposure. Near-zero or zero-fluoroscopy CA is an alternative method which could substantially reduce or even eliminate the radiation dose. Our aim was to analyse procedural outcomes with fluoroscopy minimising approach for treatment of VAs in patients with structurally normal hearts (SNH) and structural heart disease (SHD). Methods Fifty-two (age 53.4 ± 17.8 years, 38 male, 14 female) consecutive patients who underwent CA of VAs in our institution between May 2018 and December 2019 were included. Procedures were performed primarily with the aid of the three-dimensional electro-anatomical mapping system and intra-cardiac echocardiography. Fluoroscopy was considered only in left ventricular (LV) summit mapping for coronary angiography and when epicardial approach was planned. Acute and long-term procedural outcomes were analysed. Results Sixty CA procedures were performed. Twenty-five patients had SHD-related VAs (Group 1) and 27 patients had SNH (Group 2). While Group 1 had significantly higher total procedural time (256.9 ± 71.7 vs 123.6 ± 42.2 min; p < 0.001) compared to Group 2, overall procedural success rate [77.4% (24/31) vs 89.7% (26/29); p = 0.20)] and recurrence rate after the first procedure [8/25, (32%) vs 8/27, (29.6%); p = 0.85] were similar in both groups. Fluoroscopy was used in 3 procedures in Group 1 where epicardial approach was needed and in 4 procedures in Group 2 where LV summit VAs were ablated. Overall procedure-related major complication rate was 5%. Conclusions Fluoroscopy minimising approach for CA of VAs is feasible and safe in patients with SHD and SNH. Fluoroscopy could not be completely abolished in VAs with epicardial and LV summit substrate location.

scholarly journals A tissue-engineered urinary conduit in a porcine urinary diversion model

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Arkadiusz Jundziłł ◽  
Piotr Kwieciński ◽  
Daria Balcerczyk ◽  
Tomasz Kloskowski ◽  
Dariusz Grzanka ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Urinary Diversion ◽  
Porcine Model ◽  
Histological Evaluation ◽  
Metabolic Complications ◽  
Group 3 ◽  
Group 2 ◽  
The Right ◽  
Group 1

AbstractThe use of an ileal segment is a standard method for urinary diversion after radical cystectomy. Unfortunately, utilization of this method can lead to numerous surgical and metabolic complications. This study aimed to assess the tissue-engineered artificial conduit for urinary diversion in a porcine model. Tissue-engineered tubular polypropylene mesh scaffolds were used for the right ureter incontinent urostomy model. Eighteen male pigs were divided into three equal groups: Group 1 (control ureterocutaneostomy), Group 2 (the right ureter-artificial conduit-skin anastomoses), and Group 3 (4 weeks before urostomy reconstruction, the artificial conduit was implanted between abdomen muscles). Follow-up was 6 months. Computed tomography, ultrasound examination, and pyelogram were used to confirm the patency of created diversions. Morphological and histological analyses were used to evaluate the tissue-engineered urinary diversion. All animals survived the experimental procedures and follow-up. The longest average patency was observed in the 3rd Group (15.8 weeks) compared to the 2nd Group (10 weeks) and the 1st Group (5.8 weeks). The implant’s remnants created a retroperitoneal post-inflammation tunnel confirmed by computed tomography and histological evaluation, which constitutes urostomy. The simultaneous urinary diversion using a tissue-engineered scaffold connected directly with the skin is inappropriate for clinical application.

Dematiaceous fungal invasion of a bandage contact lens

2021 ◽  
Vol 14 (2) ◽  
pp. e240029
Author(s):  
Anirban Dutta ◽  
Sujata Das ◽  
Himanshu Sekhara Behera ◽  
Ruchi Mittal
Keyword(s):  
Contact Lens ◽  
Periodic Acid ◽  
Significant Risk ◽  
Dematiaceous Fungi ◽  
Periodic Acid Schiff ◽  
Bandage Contact Lens ◽  
History Of ◽  
Eye Examination ◽  
The Right

A 61-year-old man presented with a 1-month history of reduced vision, redness and pain in the right eye. Examination revealed a bandage contact lens (BCL) in situ with diffuse, pigmented deposits. On removal, the underlying cornea was found to be clear. He had been prescribed the BCL 6 months ago following a deep-seated corneal foreign body removal and was unable to follow-up subsequently.The BCL was sent for microbiological and histopathological evaluation. The culture revealed growth of Cladosporium spp, a dematiaceous fungi. Periodic acid–Schiff staining revealed infiltration of pigmented fungal filaments into the substance of the BCL.While contact lens deposits are a frequent finding, fungal deposits are seldom noted. Irregular follow-up and improper lens maintenance are significant risk factors for the same. Early identification and subsequent removal of the lens is vital to prevent infection of the underlying ocular structures.

scholarly journals Efficacy and Safety of Non-Anesthesiologist Administration of Propofol Sedation in Endoscopic Ultrasound: A Propensity Score Analysis

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 791
Author(s):  
Antonio Facciorusso ◽  
Antonio Turco ◽  
Carlo Barnabà ◽  
Grazia Longo ◽  
Graziano Dipasquale ◽  
...  
Keyword(s):  
Propensity Score ◽  
Endoscopic Ultrasound ◽  
Primary Outcome ◽  
Propensity Score Analysis ◽  
Major Complication ◽  
Control Group ◽  
Propofol Sedation ◽  
Score Analysis ◽  
Group 2 ◽  
Group 1

In spite of promising preliminary results, evidence supporting the use of non-anesthesiologist-administered propofol sedation (NAAP) in endoscopic ultrasound (EUS) procedures is still limited. The aim of this manuscript was to examine the safety and efficacy of NAAP as compared to anesthesiologist-administered propofol sedation in EUS procedures performed in a referral center. Out of 832 patients referred to our center between 2016 and 2019, after propensity score matching two groups were compared: 305 treated with NAAP and 305 controls who underwent anesthesiologist-administered propofol sedation. The primary outcome was the rate of major complications. The median age was 67 years and the proportion of patients with comorbidities was 31.8% in both groups. One patient in each group (0.3%) experienced a major complication, whereas minor complications were observed in 13 patients in the NAAP group (4.2%) and 10 patients in the control group (3.2%; p = 0.52). Overall pain during the procedure was 2.3 ± 1 in group 1 and 1.8 ± 1 in group 2 (p = 0.67), whereas pain/discomfort upon awakening was rated as 1 ± 0.5 in both groups (p = 0.72). NAAP is safe and effective even in advanced EUS procedures. Further randomized-controlled trials (RCTs) are warranted to confirm these findings.

Changes in the Rate of Postoperative Flexor Tendon Rupture in Patients with Distal Radius Fractures

2020 ◽  
Vol 25 (04) ◽  
pp. 481-488
Author(s):  
Rui Hirasawa ◽  
Eichi Itadera ◽  
Seiji Okamoto
Keyword(s):  
Distal Radius ◽  
Tendon Rupture ◽  
Flexor Tendon ◽  
Major Complication ◽  
Significant Difference ◽  
Flexor Tendon Rupture ◽  
Tendon Ruptures ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Background: Flexor tendon rupture is a major complication after volar locking plating for distal radius fracture (DRF). Few studies have investigated changes in the rate of postoperative flexor tendon rupture in patients with DRFs. The present study aimed to investigate the changes in the rate of postoperative flexor tendon rupture and to assess plate placement and reduction positions. Methods: We retrospectively reviewed patients in whom more than 24 months had passed since DRF surgery. The patients were interviewed by telephone. Forty-nine patients (50 fractures; 2007–2009) from institution A were included in group 1 and 81 patients (84 fractures; 2013–2016) from institution B were included in group 2. The DRF surgery method was similar between the two groups. The rate of flexor tendon rupture, Soong classification grade, and radiological index (i.e., volar tilt [VT], radial inclination [RI], and ulnar variance [UV]) were statistically investigated in both groups. Results: Patient epidemiology was not significantly different between the two groups. The flexor tendon rupture rates were 2% and 0% in groups 1 and 2, respectively, without a significant difference. With regard to the Soong grade, 44 fractures were grade 2 and 6 were grade 1 in group 1, whereas 18 were grade 2, 38 were grade 1, and 28 were grade 0 in group 2, with a significant difference (p < 0.05). With regard to the radiological index, the mean VT values were 5° and 11° in groups 1 and 2, respectively, with a significant difference (p < 0.05). However, RI and UV showed no significant difference. Conclusions: Plate placement and reduction positions, which are risk factors for flexor tendon ruptures after DRFs, have improved recently when compared with previous findings. With these changes, the rate of flexor tendon rupture is presumed to have decreased.

scholarly journals Fixation of Ankle Fractures

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0008
Author(s):  
Andrew Molloy ◽  
Samantha Whitehouse ◽  
Lyndon Mason
Keyword(s):  
Complication Rate ◽  
Major Complication ◽  
Ankle Fractures ◽  
Complication Rates ◽  
Junior Staff ◽  
System Changes ◽  
Major Complication Rate ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Category: Trauma Introduction/Purpose: Ankle fractures are one of the most common fractures. Historically these have been frequently treated by non-specialists and junior staff. In 2011 we presented high malunion rates, which have been mirrored in other departments work. We present the results of system changes to improve the results of ankle fracture fixation Methods: Image intensifier films were reviewed on PACS and scored based on the criteria published by Pettrone et al. At least two blinded assessors assigned scores independently. Patients clinical data was collected from medical records. In 2011 we presented the results of fixation in 94 consecutive patients (Group 1) from 2009. Following this there was period of education in the department to allow change. 68 patients (Group 2) were then reviewed from a 7 month period in 2014 Multiple system changes were introduced in the department including; new treatment algorithms, dedicated foot and ankle trauma lists and clinics, and next day review of all intra-operative radiographs by independent attending. Prospective data was collected on 205 consecutive cases (Group 3) from 01/01/15 – 09/30/16 Results: Patients in group 1 had a malreduction rate of 33%. The major complication rate in this group was 8.5% (8 patients); with only one of these occurred in a correctly reduced fracture. These complications included 4 revision fixations, 2 deep infections and 1 amputation. Following the period of re-education, in Group 2, the mal-reduction rate deteriorated to 43.8%. In this group the major complication rate was 10.9%; including 6 revision fixations and 1 ankle fusion. In Group 3, following overall system changes, the malreduction rate was 2.4%. This result is statistically significant. The major complication rate fell to 0.98%; 1deep infection and 1 amputation (in a polytrauma patient with vascular injury). This result is again statistically significant. Conclusion: Our initial results show that very poor results are a consequence when sufficient attention is not given to what are frequently considered to be ‘simple’ fractures. In group 2 we demonstrated that soft educational changes (eg presentations, emails) are ineffective in improving results. We have demonstrated that hard (institutional system) changes in our department provided statistically significant improvements. These changes allowed the correct surgeon for the fracture in both determining the treatment plan and operating. With these changes, malreduction rates fell from 43.8% to 2.4% and major complication rates from 10.9% to 0.98%

Systemic to Pulmonary Collaterals in Extremely Low Birth Weight Infants: Incidence, Clinical Significance, and Hemodynamic Features

2019 ◽  
Author(s):  
Cynthia Hayek ◽  
Rowena Cayabyab ◽  
Ima Thompson ◽  
Mahmood Ebrahimi ◽  
Bijan Siassi ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Clinical Outcomes ◽  
Left Ventricular ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Echocardiographic Parameters ◽  
Group 2 ◽  
The Right ◽  
Group 1

Abstract Objective To determine the incidence of systemic to pulmonary collaterals (SPCs) in extremely low birth weight infants and to assess its clinical and hemodynamic significance beyond the neonatal period. Study Design Retrospective cohort study was conducted on 61 infants with echocardiogram performed at the time of discharge to determine the presence of SPC and to measure the right and left ventricular outputs and left atrium to aortic ratio. We compared two groups: small or no SPC (Group 1) to moderate or large SPC (Group 2) on demographics, clinical outcomes, and echocardiographic parameters. Results Sixty-one infants were included. The incidence of SPC was 57%; 21% of infants had moderate or large shunts and 31% had small SPC. Demographics, clinical outcomes, and echocardiographic parameters were not significantly different between small or no SPC and moderate to large SPC. Conclusion More than half of the infants had SPC. The size of the shunt did not affect the clinical outcomes nor the echocardiographic parameters measured. All infants had cardiac output above the normative mean.

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