Journal Contents
| |||
General OphthalmologyTopical anesthesia with pH-adjusted versus standard lidocaine 4% for clear corneal cataract surgery. Zehetmayer M; Menapace R; Skorpik C; Turnheim K; Rainer G J Cataract Refract Surg 1997 Nov;23(9):1390-3 PURPOSE: To evaluate and compare the efficacy of a sodium-bicarbonate-adjusted preparation of lidocaine 4% (pH = 7.2) and standard lidocaine (pH = 5.2) for topical anesthesia in clear corneal cataract surgery. SETTING: Department of Ophthalmology, University of Vienna, Austria. METHODS: In a prospective, randomized, double-blind clinical trial, clear corneal cataract surgery was performed under topical anesthesia in 44 eyes of 34 patients. In 22 eyes, pH-adjusted lidocaine 4% was administered; in the other 22, standard lidocaine 4%. Aqueous and serum concentrations of lidocaine were measured by high-performance liquid chromatography and ultraviolet detection. Subjective pain was assessed using a visual analog scale of no pain (0%) to worst imaginable pain (100%). On the first postoperative day, visual acuity, intraocular pressure, and corneal staining with fluorescein were examined. RESULTS: In the pH-adjusted lidocaine group, significantly higher lidocai +/- 8.2 [SD] versus 4.75 +/- 3.5 microg/mL; P < .0001). In all samples (n = 8), serum lidocaine concentrations were below a minimum detectable level of 0.02 microg/mL. Subjective pain ratings were similar in the pH-adjusted and standard lidocaine groups (mean 9.73 +/- 10.4% and 10.0 +/- 15.4%, respectively). There was no significant between-group difference in intraoperative and postoperative outcomes. CONCLUSIONS: In this study, pH-adjusted lidocaine 4% was a safe, effective topical anesthetic for clear corneal surgery and had minimal local and systemic toxicity. Administration of pH-adjusted lidocaine 4% resulted in significantly higher aqueous humor lidocaine concentrations than administration of standard lidocaine 4%.
General OphthalmologySilicone punctal plug migration resulting in dacryocystitis and canaliculitis. Rumelt S, Remulla H, Rubin PA Cornea 1997 May;16(3):377-379 PURPOSE: One of the modalities of treating dry eyes is punctal plugs. They are usually used for temporary occlusion of the lacrimal drainage system. Among the complications associated with silicone punctal plugs are extrusion, downward migration, irritation, and epiphora. To our knowledge, this is the first report of dacryocystitis and canaliculitis as a result of spontaneous migration of punctal plugs into the lacrimal drainage system. METHODS: We describe the sequelae of spontaneous migration of silicone punctal plugs into the lacrimal drainage system in two patients with dry eyes. RESULTS: In two patients, spontaneous migration of silicone punctal plugs into the canaliculus or the lacrimal sac, respectively, resulted in canaliculitis or dacryocystitis. CONCLUSION: Smaller sized newer generation punctal plugs were designed to facilitate insertion; however, this design also increases the likelihood of proximal migration within the lacrimal drainage system. The importance of monitoring patients after punctal-plug placement cannot be over-emphasized.
General OphthalmologyIdentification of genes causing photoreceptor degenerations leading to blindness. Farber DB, Danciger M Curr Opin Neurobiol 1997 Oct;7(5):666-73 At least 15 genes with defects responsible for various forms of inherited retinal disease involving photoreceptor loss have been identified over the past eight years. Several of the genes were first considered as candidates for study because of their involvement in murine retinal disease, others because of their chromosomal loci. In two cases, novel genes were uncovered by positional cloning. Based on reports of disease loci for which no gene has yet been found, more than twice as many genes remain to be identified in this genetically heterogeneous group of diseases.
General OphthalmologyCataract Surgery and Lens Implantation in Eyes with Exfoliation Syndrome Avramides et al JCRS 1997; 23:583-587 This is a prospective study of 84 patients with pseudoexfoliation syndrome undergoing cataract surgery (ECCE with IOL). None of these patient had glaucoma. Their results:
This study does not have a control group. To speak of visual acuity results, the patients need to be grouped according to pre-op vision, associated disease conditions and operative complications. The sample size is too small to draw any conclusions other than there is an increased risk for problems in PXE patients undergoing cataract surgery. Finally, to make any sense of the actual results, one would need to know what the outcomes were for the operating surgeons for non-PXE patients.
General OphthalmologyPathology of ocular lesions in free-living moose (Alces alces) from Saskatchewan. Kuiken T; Grahn B; Wobeser G J Wildl Dis 1997 Jan;33(1):87-94 Clinical signs of impaired vision or neurological disease occurred in seven of 74 free-living moose (Alces alces) from Saskatchewan, Canada, submitted for necropsy between 1969 and 1994. Several lesions were found in each eye, including retinal degeneration (seven cases), cataract (six cases), lymphocytic-plasmacytic anterior uveitis (six cases), corneal scars (six cases), keratitis (four cases), and microphthalmia (one case), but their cause was not determined. Moraxella bovis was isolated from the cornea of one moose. Lesions in the brain and spinal cord were mild or absent.
General OphthalmologyINTRAOCULAR PRESSURE CHANGE AFTER NEODYMIUM-YAG CAPSULOTOMY Holweger RR and Marefat B. Journal of Cataract & Refractive Surgery. 23(1):115-121, 1997 Jan-Feb
Purpose: Setting: Methods: Results: Conclusion:
|