Ophthalmic surgery
-
Randomized Controlled Trial Comparative Study Clinical Trial
Evaluation of local anesthesia agents using a new force-sensitive lid speculum.
Three commonly used injection anesthetics, bupivacaine .75%, mepivacaine 2%, and lidocaine 2% were evaluated for onset, completeness and duration of akinesia following modified O'Brien facial nerve block, using a new force-sensitive lid speculum. All three agents provided facial akinesia that was profound within six minutes of the time of injection. The onset and the depth of anesthesia were roughly the same with all three agents. ⋯ Akinesia produced by mepivacaine was adequate for about 90 minutes, and lidocaine for 15-30 minutes. A newly-described force-sensitive speculum was utilized in this study. It is an effective instrument for measuring completeness of akinesia, and may have clinical usefulness.
-
The usual management of traumatic hyphemas in our institution has been to avoid or delay surgery until absolutely demanded by the clinical course. Despite this, most (73%) of our in-patients with total hyphema underwent surgery before leaving the hospital. In those who required surgery, 43% developed corneal staining. ⋯ The usual procedure used in this series was a trabeculectomy with iridectomy and gentle irrigation of the anterior chamber, and no surgical complications occurred. We believe that surgery, being relatively safe, should be performed early in cases of total hyphema unless the elevated intraocular pressure is controlled medically and spontaneous resolution is clearly imminent. For cases in which surgery is nearly inevitable, we suggest that earlier surgery might reduce the incidence of optic nerve damage and corneal staining.
-
One hundred fifty elderly female patients undergoing cataract extraction were divided into three groups. Fifty patients were premedicated with droperidol, pethidine and atropine; another group of 50 patients with pethidine and atropine. ⋯ Postoperative nausea and vomiting were registered until noon the next day. Comparison of different groups showed that droperidol decreases the occurrence of postoperative sickness.
-
A 19-year-old white male developed blindness in the left eye following a motor vehicle accident. Orbital echography and computerized axial tomography established the diagnosis of subperiosteal hematoma of the orbit. ⋯ Vision returned to 6/7.5 following decompression. This is the first report illustrating that orbital decompression can reverse complete visual loss from a subperiosteal hematoma of the orbit.
-
Traumatic arteriovenous malformations (AVM) are formed by an abnormal and usually complex communication between arteries and veins. In contrast to congenital AVMs which occur most commonly in the head and neck, traumatic AVMs are usually reported in the extremities and are commonly the result of military conflicts. ⋯ Only two cases of acquired AVMs of the eyelid region have been reported--one of a post inflammatory origin and one which developed spontaneously. This paper presents the case of a large traumatic AVM of the right lower eyelid along with a discussion of the principles and management of these vascular lesions.