Ophthalmology
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Case Reports
Management of visual loss after optic nerve sheath decompression in patients with pseudotumor cerebri.
To determine the appropriate management of patients with pseudotumor cerebri with early, progressive visual loss after optic nerve sheath decompression (ONSD). ⋯ Avoidance of bleeding during ONSD may prevent fibrous occlusion of the surgical site. Patients with no identifiable cause for visual loss after ONSD, who do not respond to intravenous corticosteroids, should be evaluated for emergency lumboperitoneal shunting. Postoperative infectious optic neuropathy should be considered in the differential diagnosis of abrupt visual loss after ONSD.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intraocular irrigating solutions. A randomized clinical trial of balanced salt solution plus and dextrose bicarbonate lactated Ringer's solution.
Two intraocular irrigating solutions which differ principally by the presence of oxidized glutathione were compared in this randomized, masked, prospective study to discern differences in preservation of endothelial cell size. ⋯ The presence of glutathione in BSS Plus and other minor electrolyte differences between the solutions is not more advantageous with regard to endothelial cell size than dextrose bicarbonate lactated Ringer's solution for standard extracapsular cataract surgery. Cost per 500-microliters bottle of BSS plus is $62 compared with $9.80 for dextrose bicarbonate lactated Ringer's solution.
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Clinical Trial
The use of propofol and mivacurium anesthetic technique for the immediate postoperative adjustment of sutures in strabismus surgery.
Adjustable suture techniques have become increasingly popular over the last decade and may reduce the re-operation rate after strabismus surgery. The adjustment usually is made in the hospital or office 5 to 24 hours after surgery, when the patient has fully recovered from general anesthesia. The ability to perform suture adjustment in the operating room, immediately after completion of surgery, would be an attractive alternative with respect to patient monitoring, sterility, comfort, and timing. The purpose of this study is to compare the alignment of patients in the operating room adjusted immediately after surgery with their alignment the morning after surgery. ⋯ For some adult patients with strabismus, a total intravenous general anesthesia technique using an infusion of propofol and mivacurium may provide the opportunity for accurate suture adjustment in the operating room, immediately after completion of surgery.