Journal of cataract and refractive surgery
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J Cataract Refract Surg · Jan 1999
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialEfficacy and safety of nonpreserved ketorolac ophthalmic solution in postoperative ocular pain following radial keratotomy.
To investigate the efficacy and safety of nonpreserved ketorolac tromethamine 0.5% ophthalmic solution in relieving pain following radial keratotomy (RK). ⋯ Nonpreserved ketorolac tromethamine 0.5% ophthalmic solution was significantly more effective than, and as safe as, the vehicle in alleviating the postoperative pain associated with RK. This resulted in significant improvements in patient quality of life and less need for oral analgesics, suggesting that topical ketorolac is an appropriate treatment option for ocular pain following RK.
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J Cataract Refract Surg · Jan 1999
Ultrasonic localization of anesthetic fluid in sub-Tenon's, peribulbar, and retrobulbar techniques.
To determine the distribution of anesthetic fluid during 3 regional anesthetic techniques routinely used for phacoemulsification. ⋯ B-scan ultrasonography was a suitable method of identifying the needle position and the distribution of anesthetic fluid in regional ocular anesthesia. The sub-Tenon's technique appears to be the safest method of introducing anesthetic fluid into the retrobulbar space without the potential complications of sharp-needle techniques.
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J Cataract Refract Surg · Dec 1998
Randomized Controlled Trial Comparative Study Clinical TrialTopical tetracaine versus topical tetracaine plus intracameral lidocaine for cataract surgery.
To compare topical tetracaine 0.5% alone and with intracameral lidocaine 1% as a local anesthetic agent in phacoemulsification with intraocular lens (IOL) implantation. ⋯ Topical tetracaine 0.5% with intracameral lidocaine was safe and effective in patients having phacoemulsification with IOL implantation. The advantage of using intracameral lidocaine 1% over a placebo was a significant decrease in the patients' subjective experience of pain and in the surgeon's satisfaction with the anesthesia used. None of the other parameters measured in this study differed significantly between the 2 groups.
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J Cataract Refract Surg · Dec 1998
Randomized Controlled Trial Comparative Study Clinical TrialPain in scleral pocket incision cataract surgery using topical and peribulbar anesthesia.
To evaluate the pain produced during different phases of phacoemulsification cataract surgery using a scleral pocket incision under topical versus peribulbar anesthesia. ⋯ Considering the entire procedure, total pain using topical anesthesia was acceptable and equal to that using peribulbar anesthesia for phacoemulsification with a scleral pocket incision. Pain during phacoemulsification was greater under topical anesthesia but not significantly different from the pain during the peribulbar injection.
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A 49-year-old woman developed corneal epithelial defects and stromal infiltration shortly after a 4-cut radial keratotomy (RK) for myopia. Although cultures grew staphylococci and appropriate antibiotic treatment was applied, the epithelial defects increased in size. ⋯ Despite repeated questioning, the patient did not admit until 18 months after her initial surgery that she had begun self-treatment with dilute proparacaine shortly after RK and continued it after her keratoplasties. The elective use of topical anesthetics to control pain after refractive surgery should be approached with caution, and patients should be warned of the possible consequences of their misuse.