Ophthalmology
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Randomized Controlled Trial Clinical Trial
An analysis of risk for secondary hemorrhage in traumatic hyphema.
Factors such as size of hyphema, intraocular pressure, initial visual acuity, and use of steroids or antifibrinolytic drugs may be associated with the likelihood of rebleeding in traumatic hyphema. The association of the visual outcome with secondary hemorrhage has been questioned. ⋯ High intraocular pressure and low vision at the time of first examination may be associated with increased chance of rebleeding. Retinal damage, secondary hemorrhage, male gender, and initial poor vision are associated with a worse visual outcome in patients with traumatic hyphema.
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To evaluate the accuracy and repeatability of the widely used comparison method of measuring pupil size. ⋯ Results indicate that although the mean difference in techniques was small, the range of the agreement between the Rosenbaum and the infrared techniques was large. The Rosenbaum method consistently overestimated pupil diameters and was subject to inter-rater repeatability bias. Rosenbaum pupillometry may not be appropriate when accurate pupil measurements are required. The results have implications for many clinical trials in ophthalmology, including those evaluating refractive surgery that use Rosenbaum comparison pupillometry.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of patient comfort during cataract surgery with topical anesthesia versus topical anesthesia and intracameral lidocaine.
To determine whether intraocular lidocaine increases patient comfort during cataract surgery while under topical anesthesia. ⋯ Both topical anesthesia alone and topical anesthesia plus intracameral lidocaine provide good operative conditions for the surgeon and comfortable surgical circumstances for the patient. Injection of intraocular lidocaine increases patient cooperation and decreases the degree to which patients are bothered by tissue manipulation, two outcomes that justify its use.
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Multicenter Study
Intraoperative clinical practice and risk of early complications after cataract extraction in the United States, Canada, Denmark, and Spain.
To examine variation in intraoperative clinical practice and rates of adverse events after cataract surgery across four different healthcare systems. ⋯ The observed variation in clinical practice might represent a general trend of a slower diffusion of new medical technology in Europe compared with that of North America. Rates of intraoperative and early postoperative events varied significantly across sites.
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Case Reports
Orbital computed tomographic characteristics of globe subluxation in thyroid orbitopathy.
Axial globe subluxation may complicate thyroid orbitopathy. This acute event is defined by anterior displacement of the globe equator beyond the orbital rim, lid retraction behind the equator, and tethering of the optic nerve. The authors explored the factors leading to spontaneous globe subluxation in patients with thyroid orbitopathy. ⋯ Globe subluxation in thyroid orbitopathy requires compliance of the orbital soft tissues and extensibility of the extraocular muscles. These are characteristics of type-I orbitopathy. The increased fat content results in more compliance of the soft tissues, and the normal caliber of the muscles allows them to become more extensible. This permits the acute contraction of the eyelids posterior to the equator of the globe. Patients with type-I orbitopathy and extensive proptosis may be at relatively greater risk of having globe subluxation develop.