Effects of Topical Prostaglandin Analog on Macular Thickness Following Cataract Surgery with Postoperative Topical Bromfenac Treatment

Purpose: To evaluate changes in macular thickness in patients continuing prostaglandin analog (PGA) treatment during the perioperative period involving bromfenac treatment. Methods: Patients with glaucoma who were using a topical PGA were randomly assigned to two groups in this randomized controlled trial: PGA continuing study group and PGA discontinued glaucoma control group. Patients without ocular diseases other than cataract were enrolled into the non-glaucomatous group. After the cataract surgery, the patients used bromfenac twice per day for 4 weeks. Optical coherence tomography was performed in all patients preoperatively and at 1 month postoperatively. Changes in macular thickness were compared among the three groups. Results: There were 32 eyes in the study group, 33 eyes in the glaucoma control group, and 58 eyes in the non-glaucomatous group. We found statistically significant postoperative changes in central macular thickness in all groups (4.30 ± 8.01 μm in the PGA continuing group, 9.20 ± 13.88 μm in the PGA discontinued group, and 7.06 ± 7.02 μm in the non-glaucomatous group, all p < 0.008), but no significant difference among the three groups (p = 0.161). Cystoid macular edema occurred in only one patient in the non-glaucomatous group (p = 0.568). Conclusions: Continuous use of PGAs during the perioperative period was not significantly associated with increased macular thickness after uncomplicated cataract surgery. In the absence of other risk factors (e.g., capsular rupture, uveitis, or diabetic retinopathy), discontinuing PGAs for the prevention of macular edema after cataract surgery with postoperative bromfenac treatment is unnecessary in patients with glaucoma.

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Prophylaxis of macular edema after cataract surgery in diabetic patients, topical Nepafenac versus intravitreal Ranibizumab

European Journal of Ophthalmology ◽

10.1177/11206721211001275 ◽

2021 ◽

pp. 112067212110012

Author(s):

Ahmed Howaidy ◽

Zeiad H Eldaly ◽

Mohamed Anis ◽

Tageldin M Othman

Keyword(s):

Cataract Surgery ◽

Macular Edema ◽

Study Groups ◽

Macular Thickness ◽

Controlled Study ◽

Control Group ◽

Diabetic Patients ◽

Intravitreal Ranibizumab ◽

Significant Difference ◽

And Control

Purpose: To compare effect of topical Nepafenac versus intravitreal Ranibizumab on macular thickness after cataract surgery in diabetic patients with no preoperative macular edema. Patients and methods: A prospective randomized controlled study recruited diabetic patients with visually significant cataract and no diabetic macular edema (DME). Patient underwent uncomplicated phacoemulsification with IOL implantation and were randomly assigned to receive post-operative topical Nepafenac, intra-operative intravitreal Ranibizumab, or no prophylactic treatment. Changes in subfoveal and perifoveal macular thickness were assessed by SD-OCT. Results: The mean central macular thickness showed a significant increase in all study groups 1 week and 1 month postoperative when compared to baseline. At 3 months postoperative, there was a significant difference between Nepafenac and Control group ( p = 0.017), Ranibizumab and Control groups ( p = 0.009) with no significant difference between Nepafenac and Ranibizumab group ( p = 0.545) regarding CMT. Comparable results could be detected as regarding peri-foveal macular thickness changes. Concerning BCVA, there was a significant difference between topical Nepafenac/control ( p = 0.001) and intravitreal Ranibizumab/control ( p = 0.004) at 1-week visit. No significant difference in BCVA was observed between Nepafenac and Ranibizumab group throughout the whole study period. In postoperative visits, cystoid macular edema occurred in three patients (7.9%) in Nepafenac group, one patient (2.7%) in Ranibizumab group, and seven patients (17.07%) in control group. Conclusion: Both postoperative topical Nepafenac and intra-operative intra-vitreal Ranibizumab are effective adjunctive to phacoemulsification in diabetic patients for prophylaxis of macular edema.

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Effectiveness of Antipyretic with Tepid Sponging Versus Antipyretic Alone in Febrile Children: A Randomized Controlled Trial

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v37i2.16879 ◽

2018 ◽

Vol 37 (2) ◽

pp. 129-133

Author(s):

Chetak Kadbasal Basavaraj ◽

Shyamala Gowri Pocha ◽

Ravi Mandyam Dhati

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Control Group ◽

Study Group ◽

Axillary Temperature ◽

Medical College ◽

Randomized Controlled ◽

Significant Difference

Introduction: Fever is the most common presenting complain for which children are brought to the paediatrician.Physical methods are widely used in treating febrile children, tepid sponging being commonly practiced in hospitals along with antipyretics. The objectives of this study were to compare the effectiveness of tepid sponging and antipyretic drug versus antipyretic drug alone in febrile children.Material and Methods: This was a Randomized controlled trial done in JSS Medical College and Hospital. All children under the age of 6 months to 12 years, admitted with axillary temperature of >99oF were included in the study. A total of 500 children were included over two years study period. Children with recorded axillary temperature of >990F were randomized into control and study group by computer generated randomisation. Children in the control group received only paracetamol (15mg/kg) at 5 minutes and combined group received paracetamol and tepid sponging at five minutes. Axillary temperature was monitored every 15 minutes for a period of 2 hours in both the groups.Results: There is no significant difference in reduction of temperature between the two groups by the end of two hours. Children in combined group had a higher level of discomfort than those in only antipyretic group.Conclusion: Tepid sponging does not add to the efficacy of paracetamol in antipyresis and that addition of tepid sponging to antipyretic, results in additional discomfort for the child. This study, therefore, endorses the view that antipyretic alone without tepid sponging should be the modality of therapy in children with fever.

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The effectiveness of preoperative individual information on reducing anxiety and pain after hysterectomy: A randomized controlled trial

Journal of Nursing Education and Practice ◽

10.5430/jnep.v10n1p67 ◽

2019 ◽

Vol 10 (1) ◽

pp. 67

Author(s):

Hrønn Thorn ◽

Lisbeth Uhrenfeldt

Keyword(s):

Randomized Controlled Trial ◽

Postoperative Pain ◽

Controlled Trial ◽

Anxiety Level ◽

Preoperative Anxiety ◽

Control Group ◽

Study Group ◽

Randomized Controlled ◽

Significant Difference ◽

Individual Information

Background and objective: Preoperative anxiety among gynecological patients is well-known and has a direct correlation with postoperative pain. By minimizing preoperative anxiety, the level of postoperative pain may decrease. The purpose of this study was to evaluate the effect of preoperative structured information and dialogue on patients' anxiety and postoperative pain.Methods: A single-center non-blinded randomized controlled trial. Forty-six women scheduled for hysterectomy were allocated either to the study group or the control group. The study group was given individual information at a preoperative consultation while the control group was given information at admittance. The main outcome was anxiety level and postoperative pain.Results: Forty participants (study group = 20; control group = 20) were analyzed. No statistically significant difference was found in anxiety level within the first 24 h postoperatively or in postoperative pain within four weeks between the groups.Conclusions: Preoperative individual information and dialogue did not result in significant effects in reducing anxiety level nor did it result in lower postoperative pain score.

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CHOROIDAL THICKNESS IN PATIENTS WITH DIABETIC MACULAR EDEMA

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i2.3286 ◽

2021 ◽

Vol 71 (2) ◽

pp. 433-37

Author(s):

Amash Aqil ◽

Muhammad Moin ◽

Khadijah Abid ◽

Ahsan Mehmood

Keyword(s):

Diabetic Retinopathy ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Choroidal Thickness ◽

Macular Thickness ◽

Control Group ◽

Central Macular Thickness ◽

Department Of Ophthalmology ◽

Significant Difference ◽

The Mean

Objective: To evaluate central macular thickness and choroidal thickness in patients with macular edema due to diabetic retinopathy versus controls. Study Design: Cross-sectional comparative study. Place and Duration of Study: Department of Ophthalmology, Lahore General Hospital, Lahore, from Jan to Jul 2018. Methodology: A retrospective data of 100 eyes from 50 patients having with diabetic macular edema associated with diabetic retinopathy was extracted from hospital registry. Additionally, 100 eyes of 50 individuals without any preexisting ocular conditions, comprising a control group was included in the study. Choroidal thickness measurements were made from the posterior edge of the retinal pigment epithelium to the choroid/sclera junction at subfoveal level using optical coherence tomography. Central macular thickness was also measured for all the enrolled patients. Results: One hundred patients fulfilling the inclusion criteria were enrolled in our study. The mean age was 56.27 ± 14.41 years. The mean Central macular thickness of all the patients were reported as 270.49 ± 72.38 μm, while the choroidal thickness was 284.89 ± 96.51 μm. There was statistically significant difference in central macular thickness between both healthy and diabetic retinopathy with diabetic macular edema groups (p=0.001), whereas insignificant difference existed between the two groups forchoroidal thickness (p=0.735). Conclusion: In patients with diabetic macular edema no significant change in choroidal thickness was observed compared with healthy controls, while the thickness of the retina was high in patients with macular edema due to diabetes.

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Effects of Intra-vitreal Injection of Bevacizumab as an Adjunct during Phacoemulsification in Diabetic Maculopathy

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v37i1.1122 ◽

2020 ◽

Vol 37 (1) ◽

Author(s):

Ali Afzal Bodla ◽

Syeda Minahil Kazmi ◽

Noor Tariq ◽

Ayema Moazzam ◽

Muhammad Muneeb Aman

Keyword(s):

Diabetic Retinopathy ◽

Macular Edema ◽

Proliferative Diabetic Retinopathy ◽

Macular Thickness ◽

Control Group ◽

Key Words Diabetes Mellitus ◽

Diabetic Patients ◽

Key Words Diabetes ◽

Post Surgery ◽

Significant Difference

Purpose: To study the effects of Intra-vitreal injection of Bevacizumab as an adjunct during phacoemulsification in patients with diabetic retinopathy. Study Design: Quasi experimental study. Methods: Hundred diabetic patients who were scheduled to undergo phacoemulsification were included in the study. They were equally divided into two groups; Bevacizumab and control group. Complete ocular examination and macular thickness and volume were determined using an OPTOVUE-OCT machine. The patients in the Bevacizumab group were given intra-vitreal injection of 1.25 mg/0.05ml of Bevacizumab at the time of Phacoemulsification. A written ethical approval was obtained and the study was conducted according to principles of declaration of Helsinki. Results: The bevacizumab group manifested low value of CMT one month post-surgery as compared to the control group (262.2 ± 32.2 and 288.5 ± 54.1, respectively) with P = 0.01. The Total Macular volume, and Best-corrected visual acuity in the two groups showed no significant difference one month after surgery. Amongst the patients who developed postsurgical macular edema, four patients did not possess a positive history for diabetic retinopathy and 3 of them had Non Proliferative Diabetic Retinopathy. We found no significant relationship between the post-surgical macula edema with the presence of mild Non Proliferative Diabetic Retinopathy. (Fisher's test, P = 0.321). Conclusion: The ocular anti-VEGF therapy substantially reduces macular edema secondary to post-surgical inflammation in diabetic patients. It effectively reduces the central macular thickness although the results are not found to be statistically significant when compared with the control group. Key Words: Diabetes mellitus; diabetic macular edema; diabetic retinopathy: Bevacizumab.

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Tear Film Osmolarity of the Eye after Cataract Surgery. Summary of the Doctoral Thesis

10.25143/prom-rsu_2021-17_dts ◽

2021 ◽

Author(s):

◽

Ēriks Elksnis ◽

Keyword(s):

Cataract Surgery ◽

Postoperative Period ◽

Ocular Surface ◽

Tear Film ◽

Visual Outcome ◽

Early Postoperative Period ◽

University Hospital ◽

Control Group ◽

Study Group ◽

Significant Difference

Almost every cataract surgeon has encountered a situation during the postoperative period when, even though, the primary goal – improvement of visual acuity – has been achieved, yet the patient felt frustrated because of subjective discomfort in the operated eye. Sometimes this issue is more disturbing for the patient than the hope for a perfect visual outcome. Although it has been established that the ocular surface is affected during the postoperative period, there is still no generally accepted opinion about the changes in tear osmolarity after cataract surgery despite several studies dedicated to evaluation of these changes. The present study was designed to elucidate the effect of cataract surgery on the characteristic feature of ocular surface homeostasis – tear film osmolarity in the early postoperative period. Aim. The aim of the study was to evaluate the changes in tear film osmolarity after a cataract surgery in a healthy ocular surface. Methods. For this purpose two examination groups were formed. The study group included voluntary patients undergoing cataract surgery not having any complaints about subjective symptoms typical of dry eye disease. In order to correspond to the criteria of healthy ocular surface, the study group excludes the following types of patients and conditions: contact lens wearers, patients with diabetes, pseudoexfoliation, pterygia and eye drop users. The eye that has not undergone the surgery was classified as the control group. This single–center, prospective study was held at Ophthalmology department of Pauls Stradins Clinical university hospital. All cataract surgeries were done by the same surgeon. The tear osmolarity tests were evaluated with TearLab Osmolarity System (TearLab Corporation, San Diego, CA, the USA) before surgery, in the next morning, one week and one month after the surgery. Results. No statistically significant difference was observed between the groups before operation when comparing the mean tear osmolarity – in the study group it was 296.87 mOsm/L, and in the control group it was 297.27 mOsm/L (p = 0.84). The tear osmolarity results changed significantly during early postoperative period in the study group (p < 0.001), while in non–operated eye no significant tear film osmolarity changes were observed (p = 0.86). Significant changes were recognized on the next day after the surgery – the tears became hypoosmolar (< 275 mOsm/L). One week later the tear osmolarity increased significantly, and the tears became hyperosmolar (312.64 mOsm/L). Over the course of one month, the test values for the study and control groups equalized (297.87 in the study group and 298.93 in the control group (p = 0.66)), when compared to preoperative tear osmolarity results. Conclusion. The results achieved lead towards a more detailed understanding of the changes in the ocular surface homeostasis after a cataract surgery. The obtained data indicate that tear osmolarity changes considerably during the first postoperative month after a cataract surgery. Also, there is a huge difference in measurements between operated and non–operated eye on the next day and one week after the surgery. One month after the surgery tear osmolarity returns to preoperative test results, and there is no difference determined between the eyes.

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The Effectiveness of Online Course Intervention to Improve Knowledge of Antimicrobial Resistance among Dental Students, in Comparison to Reference Group Using a Randomized Controlled Trial

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.723 ◽

2019 ◽

Vol 7 (17) ◽

pp. 2917-2923

Author(s):

Khalid T. Aboalshamat ◽

Assim M. Banjar ◽

Mahmoud I. Al-Jaber ◽

Noor M. Turkistani ◽

Mohammed T. Al-Amoudi

Keyword(s):

Randomised Controlled Trial ◽

Controlled Trial ◽

Dental Students ◽

Online Course ◽

Control Group ◽

Study Group ◽

Control Groups ◽

Significant Difference ◽

Randomised Controlled ◽

And Control

AIM: This study aimed to assess the effectiveness of a recognised antimicrobial resistance (AMR) online module on knowledge and perception among dental students, using a randomised controlled trial study design. METHODS: Dental students (n = 64, aged 21-25 years) in clinical years agreed to participate in this triple-blinded, parallel, randomised controlled trial. There were 34 students in the study group and 30 students in the control group. The study group participated in an online course covering information about AMR, while students in the control group received another online course about microorganisms in dentistry. Both groups were assessed three times using online questionnaires: before the intervention (T1), after the intervention (T2), and two months later (T3). Each one of T1, T2 and T3 had 22 questions. The questions were repeated each time in T1, T2, and T3 asking about AMR but with different question format, to avoid the possibility of students to memorise the answers. RESULTS: The mean (m) of correct answers for all students on T1 was 12.56, with standard deviation (SD) of 3.2. On T2, m = 14.03 and SD = 3.85, and on T3, m = 14.36 and SD = 3.71. Scores ranged from 0 to 22. The participants in the study and control groups showed significant score improvements from T1 to T2, immediately after the intervention, but there was no significant difference between T2 and T3. The study group students’ scores did not improve significantly from T1 to T3, in contrast to the control group students’ scores. More importantly, there was no significant difference in improvement from T1 to T2 when comparing the study and control groups. CONCLUSION: Online courses might not be reliable learning methods for ensuring the optimal levels of AMR knowledge that are needed by dental practitioners.

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Does Acupuncture Have Any Benefit in the IVF Treatment of Couples with Unexplained Infertility; A Prospective Randomized Controlled Trial

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2019.872 ◽

2019 ◽

pp. 1

Author(s):

Songul Ece Gonen ◽

Pınar Kadirogullari ◽

Kerem Doga Seckin ◽

Bunyamin Borekci

Keyword(s):

In Vitro Fertilization ◽

Embryo Transfer ◽

Controlled Trial ◽

Unexplained Infertility ◽

Controlled Study ◽

Control Group ◽

Study Group ◽

Vitro Fertilization ◽

Significant Difference

Objective: We aimed to investigate the effect of acupuncture performed as an adjuvant therapy to in vitro fertilization, on pregnancy rates by performing acupuncture on the day of embryo transfer, one hour before the procedure and one hour after the procedure.Study Design: In this open-label randomized prospective controlled study, 60 unexplained infertility patients enrolled for in vitro fertilization treatment were randomized by a computer-based number generator for acupuncture performance and no-treatment. All patients received rFSH (Gonal-F®) for ovulation induction and the antagonist Cetrorelix (Cetrotide®) to prevent premature ovulation. Ovulation was triggered by using hCG (Ovitrelle®) and egg collection was done after 36-48 hours. In the study group, acupuncture was performed by intradermal needling, bilaterally with a sterile needle, both one hour before and one hour after the embryo transfer. Acupuncture was not performed on the control group. The results of the treatment were evaluated 12 days after embryo transfer.Results: Thirty patients were randomized into the study group and 30 patients were randomly placed in the control group. Although there was no statistically significant difference between groups in terms of β-hCG positivity, it was 43.3% in the study group and 36.7% in the control group (p>0.05).Conclusion: The success rate of in vitro fertilization was higher in terms of pregnancy rate in the patient group who received acupuncture procedure as well, but the difference was not statistically significant. This may be due to the type of acupuncture procedure selected or insufficient sample size. As a result, further studies involving larger numbers of participants and using different acupuncture techniques are needed.

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Scleral Concave Pool Trabeculectomy Combined Phacoemulsification in Primary Open-Angle Glaucoma with Cataract.

10.21203/rs.2.19458/v2 ◽

2020 ◽

Author(s):

Xiangxiang Ye ◽

Yongjun Qi ◽

Jianhua Deng ◽

Yang Yang ◽

Ting Mo ◽

...

Keyword(s):

Adverse Events ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Case Series ◽

Control Group ◽

Study Group ◽

Open Angle ◽

Postoperative Changes ◽

Significant Difference ◽

Group 5

Abstract Background: To investigate the safety and efficacy of scleral concave pool trabeculectomy (SCPT) combined phacoemulsification for eyes with coexisting cataract and primary open-angle glaucoma (POAG).Methods: This was a retrospective, controlled, interventional case series. Thirty patients (30 eyes) were diagnosed with coexisting cataract and POAG between May 2015 and April 2018. Fourteen eyes underwent SCPT combined phacoemulsification were set as the study group, and 16 eyes received conventional phacotrabeculectomy were set as the control group. All patients were followed up for at least 6 months. The preoperative to postoperative changes in IOP, glaucoma medication requirements, BCVA, blebs functions, and adverse events were recorded. Results: The groups were matched for baseline age, BCVA, IOP and types of IOP-lowering medications (all P>0.05). At 6-month visit, there were no significant difference between control and study group in the improvement of BCVA (0.22±0.24 versus 0.18±0.26, P=0.718), reduction of IOP (-11.21±8.61mmHg versus -9.19±9.18mmHg, P=0.540) and the number of eyes that needed IOP-lowering medications (2 versus 3, P=0.743). At the last visit, the rate of forming functioning blebs was significantly different between the study and control groups, (92.9% versus 68.7% respectively, P=0.007). In the study group, 5 eyes developed hypotony，and 1 eye showed limited choroidal detachment, whereas in the control group 1 eye developed malignant glaucoma. All adverse events were successfully managed. Conclusion: The SCPT combined phacoemulsification is a safe and effective alternative to conventional phacotrabeculectomy for patients with POAG and visually significant cataract.

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Safety and Efficacy of Scleral Concave Pool Trabeculectomy Combined Phacoemulsification for Eyes with Coexisting Cataract and Primary Open Angle Glaucoma.

10.21203/rs.2.19458/v1 ◽

2019 ◽

Author(s):

Xiangxiang Ye ◽

Yongjun Qi ◽

Jianhua Deng ◽

Yang Yang ◽

Ting Mo ◽

...

Keyword(s):

Adverse Events ◽

Primary Open Angle Glaucoma ◽

Open Angle Glaucoma ◽

Case Series ◽

Control Group ◽

Study Group ◽

Open Angle ◽

Safety And Efficacy ◽

Postoperative Changes ◽

Significant Difference

Abstract Purpose To investigate the safety and efficacy of scleral concave pool trabeculectomy (SCPT) combined phacoemulsification for eyes with coexisting cataract and primary open angle glaucoma (POAG).Methods This was a retrospective, controlled, interventional case series. Thirty patients (30 eyes) were diagnosed with coexisting cataract and POAG between May 2015 and April 2018. Fourteen eyes underwent SCPT combined phacoemulsification were set as the study group, and 16 eyes received conventional phacotrabeculectomy were set as the control group. All patients were followed up for at least 6 months. The preoperative to postoperative changes in IOP, glaucoma medication requirements, BCVA, blebs functions, and adverse events were recorded.Results The groups were matched for baseline age, BCVA, IOP and types of IOP-lowering medications (all P>0.05). At 6-month visit, there were no significant difference between control and study group in the improvement of BCVA (0.22±0.24 versus 0.18±0.26, P=0.718), reduction of IOP (-11.21±8.61mmHg versus -9.19±9.18mmHg, P=0.540) and the number of eyes that needed IOP-lowering medications (2 versus 3, P=0.743). At the last visit, the rate of forming functioning blebs was significantly different between the study and control groups, (92.9% versus 68.7% respectively, P=0.007). In the study group, 5 eyes developed shallow anterior chamber,and 1 eye showed limited choroidal detachment, whereas in the control group 1 eye developed malignant glaucoma. All adverse events were successfully managed.Conclusion The SCPT combined phacoemulsification is a safe and effective alternative to conventional phacotrabeculectomy for patients with POAG and visually significant cataract.

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