Arch Ophthalmol Chic
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Arch Ophthalmol Chic · Aug 2000
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialA comparative study of topical vs retrobulbar anesthesia in complicated cataract surgery.
To evaluate and compare levels of patient discomfort and perioperative complications during phacoemulsification and implantation of a foldable intraocular lens under topical lidocaine hydrochloride and retrobulbar anesthesia in patients with cataract who also had exfoliation syndrome, uveitis, posterior synechia, phacodonesis, or previous intraocular surgery. ⋯ Surgery-related complications and patient discomfort were similar for the 2 methods of anesthesia. Topical anesthesia is justified as a means of improving safety without causing discomfort to the patient even in complicated cases of cataract surgery. Arch Ophthalmol. 2000;118:1037-1043
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Arch Ophthalmol Chic · Jul 1998
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialEarly worsening of diabetic retinopathy in the Diabetes Control and Complications Trial.
To document the frequency, importance of, and risk factors for "early worsening" of diabetic retinopathy in the Diabetes Control and Complications Trial (DCCT). ⋯ In the DCCT, the long-term benefits of intensive insulin treatment greatly outweighed the risks of early worsening. Although no case of early worsening was associated with serious visual loss, our results are consistent with previous reports of sight-threatening worsening when intensive treatment is initiated in patients with long-standing poor glycemic control, particularly if retinopathy is at or past the moderate nonproliferative stage. Ophthalmologic monitoring before initiation of intensive treatment and at 3-month intervals for 6 to 12 months thereafter seems appropriate for such patients. In patients whose retinopathy is already approaching the high-risk stage, it may be prudent to delay the initiation of intensive treatment until photocoagulation can be completed, particularly if hemoglobin A1c is high.
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Arch Ophthalmol Chic · Jun 1993
Randomized Controlled Trial Comparative Study Clinical TrialA randomized trial of vitamin A and vitamin E supplementation for retinitis pigmentosa.
To determine whether supplements of vitamin A or vitamin E alone or in combination affect the course of retinitis pigmentosa. ⋯ These results support a beneficial effect of 15,000 IU/d of vitamin A and suggest an adverse effect of 400 IU/d of vitamin E on the course of retinitis pigmentosa.
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Arch Ophthalmol Chic · Jan 1986
Randomized Controlled Trial Clinical TrialArgon laser scatter photocoagulation for prevention of neovascularization and vitreous hemorrhage in branch vein occlusion. A randomized clinical trial. Branch Vein Occlusion Study Group.
The Branch Vein Occlusion Study is a multicenter, randomized, controlled clinical trial designed to answer several questions regarding the management of complications of branch vein occlusion. This report addresses the questions, "Can peripheral scatter argon laser photocoagulation prevent the development of neovascularization?" and "Can peripheral scatter argon laser photocoagulation prevent vitreous hemorrhage?" To answer the first question, 319 eyes were assigned randomly to either a treated or an untreated control group. Comparing treated patients with control patients (average follow-up time, 3.7 years), the development of neovascularization was significantly less in treated eyes (P = .009, log rank test). ⋯ Comparing treated patients with control patients (average follow-up time, 2.8 years), the development of vitreous hemorrhage was significantly less in treated eyes (P = .005, log rank test). Although the Branch Vein Occlusion Study was not designed to determine whether peripheral scatter treatment should be applied before rather than after the development of neovascularization, data accumulated in this study suggest that peripheral scatter treatment should be applied after the development of neovascularization rather than before the development of neovascularization. Because the occurrence of vitreous hemorrhage was lessened by peripheral scatter argon laser photocoagulation, we recommend laser photocoagulation for patients with branch vein occlusion who have developed neovascularization and who meet the eligibility criteria of this study.
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Arch Ophthalmol Chic · May 1984
Randomized Controlled Trial Clinical TrialChemical preparation of the eye in ophthalmic surgery. III. Effect of povidone-iodine on the conjunctiva.
A half-strength povidone-iodine (Betadine) solution was used topically as part of the preoperative chemical preparation of the eye. Aerobic and anaerobic bacterial cultures of the conjunctiva were taken before and after the chemical preparation in 30 consecutive patients; the second eye served as a control. ⋯ In the povidone-iodine-treated eyes, the numbers of colonies decreased 91% and the number of species decreased 50% (statistically significant). We therefore recommend that a half-strength povidone-iodine solution be used as part of the chemical preparation of the eye for surgery.