Porous polyethylene implant motility without muscle attachment

The clinical objective of this study was to evaluate a simple technique for porous polyethylene spherical implants after enucleation and to review literature to compare this technique with the classic technique. This study included 32 eyes but 7 cases could not be followed postoperatively, so only 25 cases were reported. The patients were not age or gender matched. Patients included in this study were patients coming for enucleation of their blind disfiguring, blind painful eye or blind disfiguring painful eye. No case of intraocular tumors was present in this study. Exclusion criteria were marked ocular motility defect, shallow contracted fornices, ocular infection, severe orbital vascular disorder or severe conjunctival fibrosis and dryness. Patients with lax lower lids underwent lid tightening surgery. All patients were operated under general anesthesia after a written consent was made. Patients were given systemic antibiotics for five days and local antibiotic drops for at least four weeks. Fitting of the prosthesis starts after four weeks. Outcome is assessed subjectively from patient satisfaction and reporting pain, if present. Objectively motility was assessed by reporting implant movement in the four cardinal position of gaze. Motility was described as good [15 degrees or more], fair [less than 15 degrees] or no motility. Follow up ranged from 6 months to 25 months. The average follow up period was 14.8 months. Good motility was achieved in 22 cases and fair motility in 3 cases. No pain was reported in 14 cases, tolerable pain in 9 cases and severe pain in 2 cases. Patients were satisfied in 18 cases, partially satisfied in 6 cases and unsatisfied in one case

Phakic anterior chamber lenses for the correction of high myopia

This study aimed to evaluate the clinical and refractive outcome of angle supported phakic intraocular lenses [PIOLs] in the correction of high myopia. Thirty-one eyes of 17 highly myopic patients with a mean age of 27.9 [ +/- 5.1 SD] years were implanted with PIOLs [phakic 6 IOL, OII]. Mean preoperative spherical equivalent [SE] was -16.9 diopters [ +/- 3.84 SD]. Preoperative evaluation included subjective refraction, slit lamp biomicroscopy, tonometry and dilated fundus examination for all patients. PIOL power calculation was based on subjective refraction, AC depth and keratometry using the nomogram supplied by the PIOL manufacturer. Mean follow up period was 11.8 months [range 6-18 months]. The results revealed that mean preoperative best-corrected visual acuity [BCVA] was 0.8 [ +/- 13 SD]. Mean postoperative SE was -0.86 [ +/- 0.75 SD]. Mean postoperative uncorrected visual acuity [UCVA] was 0.67 [ +/- 0.27]. Mean postoperative BCVA was 0.97 [ +/- 0.04 SD]. Specular microscopy was performed on 15 patients preoperatively and at 12 months postoperative. It showed a mean reduction of endothelial cell density of 5.6% one year after surgery. Postoperative anterior uveitis occurred in 2 patients [6.4%]. Pupil ovalization occurred in 2 patients [6.4%] at 12 months postoperative. Steroid induced ocular hypertension occurred in 3 patients [9.6%] at one week postoperative and resolved on adding a topical beta blocker until topical steroids were tapered then discontinued. The study concluded that PIOL implantation is a relatively simple, potentially reversible and a precise procedure for correction of high myopia. It has a predictable and stable refractive outcome. Longer follow up, however, is necessary to evaluate long-term complications such as endothelial cell loss, cataract formation, iris retraction and retinal changes

effect of various pressure by elbow supporting band on pain in tennis elbow

This study was conducted to investigate the effect of the pneumatic forearm support band on elbow pain. It also investigated the effect of varying the pressure of the forearm support band on the common extensor origin. Thirty subjects [14 males, and 16 females] participated in this study. They were diagnosed by an orthopedist as grade II lateral epicondylitis. Subjects were seated in the test chair and the tests were done without the using of the forearm support band and with the band at varying pressures. Pain was measured using a 10 cm visual analogue scale. By using the Biodex system 3 isokinetic dynamometer, patient was asked to hold the handle firmly and move it from full flexion to full extension exerting his maximum effort. The test was performed in two speeds 90°/sec and 240°/sec. Five minutes of rest were allowed, then the band was applied without fitting it snugly, then the cuff was inflated to the desired pressure [20, 30, or 40 mm Hg]. The whole test procedure was repeated for each pressure. The order of testing [without band, with pressure 20, 30, and 40 mmHg] was randomized. Results of this study showed that the band caused a significant decrease in pain at wrist extensors origin. Varying the pressure of the band on the forearm by means of modifying the pressure inside the air cell of the pneumatic band did not have a significant effect on pain at wrist extensors origin. According to the results of the current study, the band was efficient in decreasing pain of the common extensor origin with test speed 90°/sec at pressure 20 and 30 mmHg. and with test speed 240°/sec at all of the three tested pressures. Within the limits of the pressures used in the current study, varying the pressure of the band had no significant effect on pain scores

use of various serum indicators as markers for the extent of muscle necrosis in acute limb ischaemia; an experimental study

This experimental study aimed at the determination of an objective parameter that could help differentiate between severe but reversible acute limb ischaemia and irreversible muscle damage. The experiment included 16 dogs that were divided into 4 groups [plus a control group of 7 dogs]. These dogs were subjected to acute ischaemia of one pelvic limb. The duration of ischaemia was considered as followed; group [1] 3 hours, group [2] 6 hours, group [3] 12 hours and group [4] 21 hours. A systemic venous sample was obtained at the end of the duration of ischaemia and was assessed for the following; myoglobin, creatine kinase [CK], lactate dehydrogenase [LDH] and aspartate aminotransferase [AST]. At the end of duration of ischaemia, a gastrocnemius muscle biopsy was also taken from each of the ischaemic limbs for assessment of the extent of muscle ischaemia and necrosis. Comparisons were made between various marker levels at different intervals and their control levels. For each marker, levels at various ischaemic intervals were also compared to one another. The results revealed increase in levels of the markers at different intervals with a peak value at 6 hours [of statistical significance for all with the exception of LDH], followed by a subsequent decline to lower levels mostly comparable to the 3- hour ischaemic period levels