Ophthalmic surgery
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A corneal perforation developed in the right eye of a 46-year-old man after removal of a corneal foreign body. Two attempts to seal the perforation with cyanoacrylate glue failed. The patient subsequently underwent lamellar corneal autograft, which successfully closed the perforation. To the best of our knowledge, this is the first report of repairing a corneal perforation with lamellar corneal autograft.
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Randomized Controlled Trial Clinical Trial
O2 administration by a nasal probe improves respiration in cataract surgery after retrobulbar anesthesia.
We measured certain respiratory conditions (respiratory rate [RR], oxygen saturation [SO2], and end-expiratory carbon dioxide partial pressure [pCO2]) of 31 patients undergoing planned cataract surgery using local anesthesia in order to determine the effects of administering pure oxygen (3 L/min) by a nasal probe in 10 of them. In the patients who did not receive pure oxygen, at the end of surgery the mean RR was 15.8 +/- 4.4/min (maximum, 21; minimum, 6.4/min); the mean SO2 was 86.9% +/- 6.6% (maximum, 98%; minimum, 74%; in 11/25 patients, the SO2 was lower than 90%); and the mean pCO2 was 34.9 +/- 7.7 mm Hg (maximum, 46.5; minimum, 12.15; in 4/25 patients, the pCO2 was greater than 45 mm Hg). In the patients who received pure oxygen by a nasal probe, the mean SO2 increased intraoperatively from 80.6% +/- 5.8% to 96.9 +/- 2.9% (in no patients was SO2 lower than 90%). Therefore we recommend an intraoperative administration of pure oxygen by a nasal probe.
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The records of 48 patients with persistent hyperplastic primary vitreous (PHPV) were reviewed. Approximately 17% had vision of 20/100 or better after surgery, contact lens fitting, and amblyopia therapy. Only eyes with a purely anterior presentation had successful visual outcomes. ⋯ Eyes with a posterior PHPV had poor visual results because of posterior pole abnormalities. I recommend that an attempt be made to visually salvage eyes with an anterior presentation. Eyes with a posterior or a combination anterior-posterior PHPV can be successfully treated for glaucoma, but the visual results will be poor.
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Comment Letter Comparative Study Historical Article
Preferred practice patterns.
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Case Reports
Transient central retinal artery occlusion and contralateral amaurosis after retrobulbar anesthetic injection.
A transient, ipsilateral central retinal artery occlusion and contralateral amaurosis developed following retrobulbar injection of 2% lidocaine and 0.75% bupivacaine. A computerized tomography scan obtained 1 1/2 hours following the injection demonstrated an air bubble within the ipsilateral optic nerve sheath. This case further supports the view that intranerve sheath injection can cause these two complications associated with retrobulbar anesthesia.