Oftalmologia (Bucharest, Romania : 1990)
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To compare the results and the complications of cataract surgery by phacoemulsification in eyes with pseudoexfoliation syndrome (PEX) and without pseudoexfoliation syndrome. ⋯ Phacoemulsification represents a safe method in cataract surgery in eyes with pseudoexfoliation syndrome in the presence of careful surgical technique: maximal mydriasis, circular continuous curvilinear capsulorhexis, adequate hydrodissection. On the long run, the postoperative results were comparable between eyes with PEX and the control group (without PEX).
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Ophthalmologic surgical interventions are performed in numerous cases under general anaesthesia with halothane, many of which requiring a preoperatory mydriasis. Neosinerfin is alpha-adrenoceptive sympathomimetic. Local use, in a 10% concentration produces a strong mydriasis, resistant to the opening of the aqueous chamber during the intervention. ⋯ The ophthalmologist: preoperatory, the optimal pupillary dilatation may be obtained with tropicamide and diclofenac 0.1%, preoperatory, if the general anesthesia must be combined with local anesthesia, anesthetics in association with adrenalin should not be used; immediately postoperatory local use of atropine should be applied with cautiousness. The anesthesiologist: preoperatory he will not interrupt anti-hypertensive, anti-arrhythmia, anti-angina medication, with the mention that adrenoceptive alpha blockers (Prazosin) are indicated in comparison to adrenoceptive beta blockers because they diminish the risk of rhythm disorders; the use of clonidine and avoiding of phenobarbital in the premedication of the patient. As far as it is possible, it is recommended that halothane is replaced with izofluran or enfluran or enfluran which have a great tolerance to exogenous adrenoceptives.
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Giant cell (temporal) arteritis remains an enigmatic but a very serious systemic vasculitis which can lead to total, irreversible blindness if not diagnosed and treated swiftly. The characteristic granulomatous inflammation of the vessel wall of large and medium-sized arteries is present. To maintain high standards of management, ophthalmologists need to be aware of the clinical available diagnostic tests and treatment strategies. Corticosteroids remain the treatment of choice.
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Comparative Study Clinical Trial
[Potentiated loco-regional anesthesia in ophthalmological surgery].
A clinical study on 46 patients, who were operated on for ophthalmologic diseases under local anaesthesia, is presented. Midazolam, diazepam and/or pethidine, given to the patients 5-10 minutes before the operation improved the classical local anaesthesia; they ensured hypnosis, analgesia, anterograde amnesia and vegetative protection, thus offering a high surgical comfort and diminishing considerably the rate of the well known incidences and complications of the local anaesthesia.