Non-Toxic Anesthesia for Cataract Surgery

Background: To study the safety and efficacy provided by a minimal and localized anesthesia in cataract surgery. Methods: Randomized controlled trial. A total of 100 patients undergoing cataract surgery were randomly divided into two groups of 50, which respecitvely received conventional topical anesthesia consisting of preservative-free Oxibuprocaine hydrochloride 0.4% drops or minimal localized anesthesia, administered with a cotton bud soaked in preservative-free Oxibuprocaine hydrochloride 0.4% applied to clear cornea on the access sites for 10 s immediately before surgery. The mean outcome measures were intraoperative pain and the incidence of postoperative ocular discomfort. Results: All patients tolerated well the procedure, giving patin scores between 1–3. Fifteen patients (30%) of group 1 and ten of group 2 (25%) required supplemental anesthesia. No intraoperative complications were recorded. No eyes had epithelial defects at the end of the surgery or at postoperative check-ups. Conclusions: Minimal anesthesia in cataract surgery resulted quick, safe and non-invasive.

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Outcomes of coaxial microincision cataract surgery versus conventional phacoemulsification surgery

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v16i3.458 ◽

2019 ◽

Vol 16 (3) ◽

pp. 168-178

Author(s):

Anu Malik ◽

Smruti Ranjan Dethi ◽

Yogesh Kumar Gupta ◽

Alka Gupta

Keyword(s):

Cataract Surgery ◽

Randomized Study ◽

Corrected Visual Acuity ◽

Age Related ◽

Significant Difference ◽

Induced Astigmatism ◽

The Mean ◽

Group 2 ◽

Surgically Induced ◽

Group 1

Aim: To compare surgical parameters and visual outcomes of coaxial microincision cataract surgery (MICS) with standard phacoemulsification. Methods: A prospective randomized study was conducted on 60 eyes of 60 patients with age-related uncomplicated cataract who underwent: standard phacoemulsification surgery (30 eyes) i.e., Group 1, or coaxial MICS (30 eyes) i.e., Group 2. Intraoperative parameters were mean effective phacoemulsification power (EPP), effective phacoemulsification time (EPT), and total volume of balanced salt solution (BSS) used. Best-corrected visual acuity (BCVA) and surgically induced astigmatism (SIA) were evaluated pre- and postoperatively. Results: Mean BCVA at 6 weeks was 0.04 ± 0.07 in Group 1 and 0.05 ± 0.08 in Group 2. No significant difference was observed in SIA between the two groups. Mean EPT was 29.80 ± 3.67 seconds in Group 1 and 31.93 ± 4.08 seconds in Group 2. The mean total EPP in Group 1 was 35.77 ± 5.17%, whereas it was 33.70 ± 3.05% in Group 2. There was a significant statistical difference between mean EPP and EPT in the two groups. Mean total BSS volume used in Group 1 was 128.83 ± 19.81 ml, whereas it was 139.33 ± 13.57 ml in Group 2. Conclusion: Although EPT and BSS volume used were significantly higher in coaxial MICS, the postoperative results of the two techniques were comparable.

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‘Comparison of Safety and Performance of Two Ophthalmic Viscosurgical Devices in Cataract Surgery’

10.21203/rs.3.rs-236975/v1 ◽

2021 ◽

Author(s):

öznur işcan ◽

Banu Torun Acar ◽

Burcu Nurozler Tarakcı

Keyword(s):

Endothelial Cell ◽

Cataract Surgery ◽

Corneal Thickness ◽

Anterior Chamber Depth ◽

Sodium Hyaluronate ◽

Significant Difference ◽

The Mean ◽

Group 2 ◽

And Performance ◽

Group 1

Abstract Purpose: To compare the safety and performance of two ophthalmic viscosurgical devices (OVDs) Bio-Hyalur SV (Sodium Hyaluronate 3.0%) (Biotech Healthcare Group, Luzern, Switzerland) and Protectalon (sodium hyaluronate 2.0%) (VSY Biotechnology, Turkey) in cataract surgery. Methods: One hundred twenty eyes of one hundred twenty patients who underwent phacoemulsification surgery were included in the study. Postoperatively sixty eyes using Bio-Hyalur-SV were classified as Group 1, and sixty eyes using Protectalon as Group 2. Patients aged 45 and over, Grade I, II or III unilateral / double stained cataract, healthy eyes creating cataract inclueded in this study . Endothelial cell morphological parameters including endothelial cell density (ECD), cell number, cell area, coefficient of variation (CV) in cell size, cell hexagonality and central corneal thickness (CCT) were measured preoperatively and at postoperative first week, first and third month visits.Intraocular pressure (IOP) was measured with an applanation tonometer at every visit. Results: . There was a statistically significant decrease in the mean ECD all follow-up times when compared with the preoperative visit (p=0.000). In terms of mean ECD levels there was no significant difference between the two groups within three months postoperatively (p=0.616) In the first week after surgery, there was an significant increase in CCT in Group 1 and Group 2 respectively (p=0.000). The IOP was <23 mmHg in all of the patients on the first day after surgery. There was no significant difference in the incidence of IOP peaks between the two groups in every vizits. In both groups, a significant increase was observed in the mean IOP at first day, first week, and first month after surgery compared to preoperative values (p=0.000). But no significant difference in IOP increase in Group 1 (P=0.092), Group 2 (P=0.013) compared to preoperative values at third month postoperatively (p <0.001 significant with Bonferrotti correction). Conclusion: The two OVD’s used in this study during cataract surgery were safe and effective. Both OVD’s resulted in similar rates of transient IOP increases and corneal endothelial damage also provided good anterior chamber depth and were fairly easy to remove.

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Long-term Analysis of Surgically Induced Astigmatism after Combined Vitrectomy and Cataract Surgery versus Cataract Surgery Alone

Journal of the Korean Ophthalmological Society ◽

10.3341/jkos.2021.62.8.1029 ◽

2021 ◽

Vol 62 (8) ◽

pp. 1029-1035

Author(s):

Zee Yoon Byun ◽

Jung Hyun Lee ◽

Sang-Mok Lee ◽

Daniel Duck-Jin Hwang

Keyword(s):

Cataract Surgery ◽

Significant Difference ◽

Induced Astigmatism ◽

The Mean ◽

Group 2 ◽

23 Gauge ◽

Surgically Induced ◽

Sutureless Vitrectomy ◽

Group 1

Purpose: To compare the long-term changes in surgically induced astigmatism (SIA) in patients who underwent 23-gauge sutureless vitrectomy and cataract surgery together with patients who underwent cataract surgery only.Methods: We retrospectively reviewed SIA changes for 1 year after surgery in patients who received only cataract surgery using phacoemulsification (group 1) and patients who underwent 23-gauge sutureless vitrectomy and cataract surgery together (group 2). Flat keratometry (K1), steep keratometry (K2), and astigmatism axis were measured with automatic keratometry before and after the surgery. Vector analysis was used to calculate SIA at 1, 3, 6, and 12 months postoperatively. We then examined whether the SIA values at each time point were different between the two groups.Results: A total of 86 eyes were included in this study (group 1, n = 45; group 2, n = 41). The mean SIA values calculated at 1, 3, 6, and 12 months after surgery in group 1 were 0.83 ± 0.37, 0.69 ± 0.39, 0.60 ± 0.33, and 0.59 ± 0.33, respectively. In group 2, the values were 0.82 ± 0.47, 0.69 ± 0.38, 0.62 ± 0.28, and 0.61 ± 0.30, respectively. Over time, SIA decreased in both groups (all p < 0.001). There was no significant difference in the mean SIA between the two groups at each follow-up time point after surgery (p = 0.296, p = 0.728, p = 0.361, and p = 0.356, respectively).Conclusions: When 23-gauge sutureless vitrectomy and cataract surgery were performed together, the astigmatism change caused by surgery did not show a significant difference compared with that of the group who received cataract surgery only. Thus, 23-gauge sutureless vitrectomy may not significantly affect corneal astigmatism.

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Compare frequency of wound infection with ceftriaxone versus amoxicillin in females undergoing C section

10.53350/pjmhs211571607 ◽

2021 ◽

Vol 15 (7) ◽

pp. 1607-1609

Author(s):

Aneeqa Ilyas ◽

Bilal Rafique Malik ◽

Rehan Anwar

Keyword(s):

Cesarean Section ◽

Wound Infection ◽

Gestational Age ◽

Bacterial Infections ◽

Controlled Trial ◽

P Value ◽

The Mean ◽

Group 2 ◽

Trial Setting ◽

Group 1

Background:Post-caesarean wound infection is a frightful complication of cesarean delivery and increase burden on health care system. Prevention of post-cesarean wound infection must be the priority in any healthcare center in developing countries. Amoxicillin is an antibiotic often used for the treatment of a number of bacterial infections. Aim: To compare the frequency of wound infection with ceftriaxone versus amoxicillin in females undergoing cesarean section at term Study design: Randomized Controlled Trial Setting & duration: Department of Medicine and Gynecology, SIMS, Lahore from 01-07-2020 to 31-12- 2020. Methods: After fulfilling the selection criteria, 250 females were enrolled and were divided randomly into two equal groups. Group 1 was given intravenous amoxicillin and group 2 was given intravenous ceftriaxone. Then cesarean was done under spinal anesthesia. Post-op wound infection was noted in all the females. The data was analyzed in SPSS. Results: The mean age of the females of amoxicillin group was 28.09±6.01 years whereas the mean age of the ceftriaxone group females was 29.38 ± 6.41 years. The mean gestational age of the females in amoxicillin group was 38.98 ± 0.85 weeks whereas the mean gestational age in ceftriaxone group was 38.94±0.79 weeks. The mean BMI of the females in amoxicillin group was 26.58 ± 6.27 kg/m2 whereas the mean BMI in ceftriaxone group was 29.32±6.36kg/m2. The post-cesarean wound infection was found in 2(1.6%) females in amoxicillin group while in 8(6.4%) females in ceftriaxone group. This difference was statistically insignificant i.e. p-value=0.0.053. Conclusion: The amoxicillin is more effective from prevention of post-op wound infection than to ceftriaxone in females underwent cesarean section. Keywords: Amoxicillin, Ceftriaxone, cesarean section, post-cesarean wound infection

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A Controlled Trial of Combined Therapy for Newly Diagnosed Severe Childhood IgA Nephropathy

Journal of the American Society of Nephrology ◽

10.1681/asn.v101101 ◽

1999 ◽

Vol 10 (1) ◽

pp. 101-109

Author(s):

NORISHIGE YOSHIKAWA ◽

HIROSHI ITO ◽

TADASU SAKAI ◽

YASUO TAKEKOSHI ◽

MASATAKA HONDA ◽

...

Keyword(s):

Iga Nephropathy ◽

Renal Injury ◽

Controlled Trial ◽

Combined Therapy ◽

Newly Diagnosed ◽

Course Of Disease ◽

The Mean ◽

Group 2 ◽

Mesangial Iga Deposits ◽

Group 1

Abstract. The most appropriate treatment for patients with IgA nephropathy is controversial. Treatment with prednisolone, azathioprine, heparin-warfarin, and dipyridamole early in the course of disease may prevent immunologic renal injury in children with severe IgA nephropathy. To determine whether similar results can be obtained with a combination of just heparin-warfarin and dipyridamole, the effects of such treatment were compared to those of treatment with prednisolone, azathioprine, heparin-warfarin, and dipyridamole in 78 children with newly diagnosed IgA nephropathy showing diffuse mesangial proliferation. The patients were randomly assigned to receive either prednisolone, azathioprine, heparin-warfarin, and dipyridamole for 2 yr (group 1) or heparin-warfarin and dipyridamole for 2 yr (group 2). All of the 40 patients in group 1 and 34 of the 38 patients in group 2 completed the trial. The mean urinary protein excretion fell in group 1 patients (P < 0.0001), but remained unchanged in group 2 patients. The mean serum IgA concentration was reduced in group 1 patients (P = 0.0002), but was unchanged in group 2 patients. BP and creatinine clearance were normal at the end of the trial in all but one group 2 patient, who developed chronic renal insufficiency. The percentage of glomeruli showing sclerosis was unchanged in group 1 patients, but increased in group 2 patients (P = 0.006). The intensity of mesangial IgA deposits decreased in group 1 patients (P = 0.02), but remained unchanged in group 2 patients. In conclusion, the present study shows that treatment of children with severe IgA nephropathy with prednisolone, azathioprine, heparin-warfarin, and dipyridamole for 2 yr early in the course of disease reduces immunologic renal injury and prevents increase of sclerosed glomeruli.

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Relationship between disease severity and D-dimer levels measured with two different methods in pulmonary embolism patients

Multidisciplinary Respiratory Medicine ◽

10.4081/mrm.2010.524 ◽

2010 ◽

Vol 5 ◽

Cited By ~ 1

Author(s):

Funda Coskun ◽

Dilber Yilmaz ◽

Ahmet Ursavas ◽

Esra Uzaslan ◽

Ercument Ege

Keyword(s):

Pulmonary Embolism ◽

Disease Severity ◽

Diagnostic Procedures ◽

Diagnostic Methods ◽

Non Invasive ◽

Antibody Method ◽

The Mean ◽

Group 2 ◽

D Dimer ◽

Group 1

Pulmonary embolism (PE) is diagnosed with increasing fre- quency nowadays due to advances in the diagnostic methods and the increased awareness of the disease. There is a tenden- cy to use non invasive diagnostic methods for all diseases. D-dimer is a fibrin degradation product. We aimed to detect the relationship between disease severity and the D-dimer levels measured with two different methods. We compared D-dimer levels in cases of massive vs. non-massive PE. A total of 89 patients who were diagnosed between 2006 and 2008 were included in the study. Group 1 included patients whose D-dimer levels were measured with the immunoturbidimetric polyclonal antibody method (D-dimerPLUS®), while Group 2 patients made use of the immunoturbidimetric monoclonal antibody method (InnovanceD-DIMER®). In each group, the D-dimer levels of those with massive and non-massive PE were compared, using the Mann Whitney U test. The mean age of Group 1 (25F/26M) was 56.0 ± 17.9 years, and that of Group 2 (22F/16M) was 52.9 ± 17.9 years. There was no sta- tistical difference in gender and mean age between the two groups (p > 0.05). In Group 1, the mean D-dimer level of mas- sive cases (n = 7) was 1444.9 ± 657.9 μg/L and that of non- massive PE (n = 34) was 1304.7 ± 350.5 μg/L (p > 0.05). In Group 2, the mean D-dimer level of massive cases (n = 6) was 9.7 ± 2.2 mg/L and that of non-massive PE (n = 32) was 5.9 ± 1.3 mg/L (p < 0.05). The mean D-dimer levels of massive cases as measured with the immunoturbidimetric monoclonal anti- body method were significantly higher. Pulmonary embolism patients whose D-dimer levels are higher (especially higher than 6.6 mg/L) should be considered as possibly having massive embolism. Diagnostic procedures and management can be planned according to this finding.

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Intraocular Pressure Changes during Femtosecond Laser-Assisted Cataract Surgery: A Comparison between Two Different Patient Interfaces

Journal of Ophthalmology ◽

10.1155/2019/5986895 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Chiara De Giacinto ◽

Rossella D’Aloisio ◽

Alessandro Bova ◽

Tommaso Candian ◽

Alberto Armando Perrotta ◽

...

Keyword(s):

Intraocular Pressure ◽

Femtosecond Laser ◽

Cataract Surgery ◽

Soft Contact ◽

Soft Contact Lens ◽

Significant Difference ◽

The Mean ◽

Group 2 ◽

Pressure Changes ◽

Group 1

Purpose. The aim of this retrospective cohort study was to evaluate intraocular pressure (IOP) changes during femtosecond laser-assisted cataract surgery (FLACS) using two different patient interface systems. Methods. 116 eyes of 116 patients scheduled for cataract surgery were divided into 2 groups: group 1 (61 eyes) and group 2 (55 eyes) underwent FLACS using Catalys Laser with fluid interface (liquid optics interface, LOI) and LenSx Laser with curved interface and soft contact lens (SoftFit), respectively. IOP was assessed using a portable rebound tonometer (Icare®) preoperatively, after docking, immediately after surgery, at one and seven days postoperatively. Results. In group 1, the mean IOP (±SD) was 14.1 ± 0.4 mmHg before surgery, 33.2 ± 1.1 mmHg after docking, and 21.4 ± 0.9 mmHg immediately after surgery. In group 2, the mean IOP was 13.8 ± 0.4 mmHg before surgery, 24.2 ± 1.4 mmHg after docking, and 20.2 ± 1.2 mmHg immediately after surgery. After the docking procedure, a statistically significant increase in IOP from the baseline was found in both groups (p<0.001). Moreover, no statistically significant difference in IOP measured at 1 and 7 days postoperatively was observed compared with the preoperative values (p>0.05) using both laser platforms. No intraoperative and postoperative complications were observed. Conclusions. FLACS suction phase resulted in a transient increase of IOP in both groups, especially with the LOI system, and it is probably related to the greater pressure of a suction ring and suction generated through the vacuum, independently from the effect of femtosecond laser itself.

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Comparison of ocular discomfort after three different epithelial debridement techniques for corneal collagen cross-linking in keratoconus treatment

Therapeutic Advances in Ophthalmology ◽

10.1177/25158414211020147 ◽

2021 ◽

Vol 13 ◽

pp. 251584142110201

Author(s):

Hosamadden Alkayid ◽

Leyla Asena ◽

Aslihan Yüce ◽

Meriç Yavuz Çolak ◽

Dilek Dursun Altınörs

Keyword(s):

Foreign Body ◽

Cross Linking ◽

Body Sensation ◽

Ocular Discomfort ◽

Group 3 ◽

The Mean ◽

Group 2 ◽

Collagen Cross Linking ◽

Corneal Collagen ◽

Group 1

Purpose: To compare the severity and duration of ocular discomfort after three different epithelial debridement techniques for corneal collagen cross-linking in the treatment of keratoconus. Methods: Fifty-five patients (65 eyes) known to have keratoconus were enrolled in this retrospective study. The eyes were divided into three groups based on the technique used for epithelial debridement for corneal collagen cross-linking procedure; excimer laser transepithelial phototherapeutic keratectomy was used in group 1 (18 eyes), alcohol-assisted epithelial removal was used in group 2 (27 eyes), and mechanical epithelial debridement was used in group 3 (20 eyes). Preoperative and postoperative (third month) best-corrected visual acuity (BCVA) using Snellen chart, objective refraction, and keratometry results were recorded. The results of the questionnaire obtained from the patient’s medical records were reviewed regarding their subjective evaluation of postoperative symptoms including foreign body sensation, tearing, photophobia, and burning at the end of the first postoperative week. Paired-samples t test was used to compare preoperative and postoperative clinical findings. One-way analysis of variance (ANOVA) was used to analyze the differences between three independent groups. Results: BCVA improved from 0.51 ± 0.27 to 0.58 ± 0.21 ( p = 0.05). Objective mean spherical and cylindrical refraction decreased from −5.08 ± 2.78D to −4.46 ± 2.91D ( p = 0.22) and from −3.45 ± 2.73D to −3.03 ± 1.97D ( p = 0.25). Mean maximum keratometry reading ( Kmax) decreased from 57.63 ± 4.73D to 56.13 ± 4.47D ( p = 0.001). The mean score for foreign body sensation was the highest in group 3 (4.50 ± 0.53) and the lowest in group 1 (2.10 ± 1.85) ( p = 0.01). The mean scores for tearing, photophobia, and burning sensation were comparable in three groups ( p = 0.84, p = 0.13, and p = 0.61, respectively). The duration of photophobia was the shortest in group 1 (1.50 ± 2.37 days), followed by group 3 (2.00 ± 1.31 days) and group 2 (4.00 ± 1.83 days) ( p = 0.04). Conclusions: The severity and duration of adverse subjective symptoms during the first postoperative week after corneal collagen cross-linking appear to be milder with epithelial debridement using excimer laser transepithelial technique compared with -assisted debridement and mechanical debridement.

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Rotator Cuff Calcific Tendinitis: Ultrasound-Guided Needling and Lavage Versus Subacromial Corticosteroids: Five-Year Outcomes of a Randomized Controlled Trial

The American Journal of Sports Medicine ◽

10.1177/0363546517721686 ◽

2017 ◽

Vol 45 (14) ◽

pp. 3305-3314 ◽

Cited By ~ 13

Author(s):

Pieter Bas de Witte ◽

Arjen Kolk ◽

Ferdinand Overes ◽

Rob G.H.H. Nelissen ◽

Monique Reijnierse

Keyword(s):

Randomized Controlled Trial ◽

Rotator Cuff ◽

Repeated Measures ◽

Mixed Model ◽

Controlled Trial ◽

Randomized Controlled ◽

The Mean ◽

Group 2 ◽

Group 1

Background: Barbotage (needling and lavage) is often applied in the treatment of calcific tendinitis of the rotator cuff (RCCT). In a previously published randomized controlled trial, we reported superior clinical and radiological 1-year outcomes for barbotage combined with a corticosteroid injection in the subacromial bursa (SAIC) compared with an isolated SAIC. There are no trials with a midterm or long-term follow-up of barbotage available. Purpose: To compare the 5-year results of 2 regularly applied treatments of RCCT: ultrasound (US)–guided barbotage combined with a SAIC (group 1) versus an isolated US-guided SAIC (group 2). Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Patients were randomly assigned to group 1 or 2 and evaluated before and after treatment at regular time points until 12 months and also at 5 years using the Constant score (CS), the Western Ontario Rotator Cuff Index (WORC), and the Disabilities of the Arm, Shoulder and Hand (DASH). The calcification location and size and Gärtner classification were assessed on radiographs. The rotator cuff condition was evaluated with US. Results were analyzed using t tests, linear regression, and a mixed model for repeated measures. Results: Forty-eight patients were included (mean age, 52.0 ± 7.3 years; 25 [52%] female) with a mean baseline CS of 68.7 ± 11.9. After a mean follow-up of 5.1 ± 0.5 years, the mean CS was 90 (95% CI, 83.0-95.9) in group 1 versus 87 (95% CI, 80.5-93.5) in group 2 ( P = .58). The mean improvement in the CS in group 1 was 18 (95% CI, 12.3-23.0) versus 21 (95% CI, 16.2-26.2) in group 2 ( P = .32). There was total resorption in 62% of group 1 and 73% of group 2 ( P = .45). The US evaluation of the rotator cuff condition showed no significant differences between the groups. With the mixed model for repeated measures, taking into account the baseline CS and Gärtner classification, the mean treatment effect for barbotage was 6 (95% CI, –8.9 to 21.5), but without statistical significance. Follow-up scores were significantly associated with baseline scores and the duration of follow-up. Results for the DASH and WORC were similar. There were no significant complications, but 4 patients in group 1 and 16 in group 2 underwent additional treatment during the follow-up period ( P < .001). Conclusion: No more significant differences were found in the clinical and radiological outcomes between barbotage combined with a SAIC versus an isolated SAIC after 5 years of follow-up. Registration: NTR2282 (Dutch Trial Registry).

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COMPARISON OF THE EFFECT OF TOPICAL BROMFENAC AND TOPICAL FLURBIPROFEN IN MAINTAINING MYDRIASIS DURING CATARACT SURGERY

INDIAN DRUGS ◽

10.53879/id.57.12.12678 ◽

2021 ◽

Vol 57 (12) ◽

pp. 56-60

Author(s):

Deepika T.H. ◽

N.G. Chandan ◽

Manjula T.R.

Keyword(s):

Postoperative Complications ◽

Cataract Surgery ◽

Pupillary Dilatation ◽

Prophylactic Administration ◽

Percentage Loss ◽

The Mean ◽

Group 2 ◽

Group 1

At the time of cataract surgery, one of the challenges a surgeon encounters is intraoperative miosis. This might increase the chances of intraoperative and postoperative complications. Thus, maintainence of adequate pupillary dilatation is necessary during cataract surgery. Aim of the study was to compare the effectiveness of prophylactic administration of topical bromfenac (0.09 % w/V) and topical flurbiprofen (0.03 % w/V) in maintaining mydriasis during the cataract surgery. A total of 100 patients were randomly divided into two groups of 50 each. Group 1 received topical bromfenac (0.09 %) and Group 2 received topical flurbiprofen (0.03 %). The mean percentage loss of mydriasis from the baseline was lesser in bromfenac group compared to flurbiprofen group (p < 0.001). Topical bromfenac was found to be more effective in maintaining mydriasis during the cataract surgery when compared to the topical flurbiprofen.

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