Ophthalmology
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The Singapore Corneal Transplant Study (SCTS) is a 16-year prospective study of 2100 consecutive corneal transplants performed between January 1991 and November 2006 in patients from Southeast Asia at a single tertiary center. The indications, complications, long-term survival rates, and risk factors for graft failure of penetrating keratoplasty (PK) performed in Asian eyes are reported. ⋯ The long-term outcome for optical indications in Asian eyes follows a trend in endothelium-related attrition similar to that seen in the West. Tectonic and therapeutic keratoplasty for corneal infections and perforation, however, constitute a significant proportion of corneal transplantation performed in Asia and carry a graver prognosis in terms of graft survival.
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Meta Analysis Comparative Study
Supplementary intracameral lidocaine for phacoemulsification under topical anesthesia. A meta-analysis of randomized controlled trials.
We consider a meta-analysis of randomized controlled trials (RCTs) comparing topical anesthesia alone with topical and intracameral anesthesia for phacoemulsification. ⋯ Intraoperative pain during cataract surgery under topical anaesthetic is reduced by intracameral lidocaine. Possible adverse effects of intracameral lidocaine cannot be excluded due to significant heterogeneity in outcome measures between different RCTs. Although a statistically significant reduction in intraoperative pain has been demonstrated, it is not yet possible to recommend this additional intervention without reservations.
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To identify the most popular forms of complementary and alternative medicine (CAM) for glaucoma on the Internet and to assess the quality of the most popular Web sites addressing CAM for glaucoma. ⋯ Medical information conveyed over the Internet is of variable quality and is not subject to regulation. Many sources of information contain advice on therapies that have no evidence base and may put patients at risk. It is important that researchers and health care providers be aware of the content and quality of this information so as to offer advice to patients about the evidence and potential risks of CAM therapies. This can only be achieved by increasing awareness among ophthalmologists of the range of products and quality of information available for CAM therapies for glaucoma.
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To determine the incidence and to explore the risk factors for traumatic graft dehiscence after penetrating keratoplasty. ⋯ This case series indicates that there is long-term risk of traumatic wound dehiscence after penetrating keratoplasty. Younger patients, especially males, should be made aware that their eye, after keratoplasty, will always be vulnerable to injury. High-risk situations should be avoided if possible. Older patients at particular risk should have adequate risk reduction strategies, social support, and supervision, in particular to minimize the risk of falls.
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The role of the zoster vaccine in the prevention of herpes zoster and its sequelae, including postherpetic neuralgia (PHN) and herpes zoster ophthalmicus. ⋯ The zoster vaccine promises to reduce the morbidity and mortality of herpes zoster. Administering the vaccine at the younger end of the age range may offer a greater cost benefit.