Adjunctive local application of lidocaine during scleral buckling under general anesthesia

To evaluate the effect of local lidocaine application on the incidence of the oculocardiac reflex [OCR] during scleral buckling [SB] for rhegmatogenous retinal detachment [RRD] under general anesthesia. In a randomized clinical trial, eyes with RRD scheduled for SB under general anesthesia were randomized to adjunctive local application of 1 ml lidocaine 2% versus normal saline to the muscles after conjunctival opening. Surgical stimulation was initiated 5 minutes afterwards. Additionally, 100 mg of lidocaine 2% was added to 50 ml of normal saline in the treatment group which was used for irrigation during surgery; control eyes were irrigated with normal saline. The incidence of the OCR, rate of postoperative nausea/vomiting [PONV], total intravenous [IV] analgesic dose, duration of surgery, and period of hospitalization were compared between the study groups. Thirty eyes of 30 patients including 22 [73.3%] male and 8 [26.7%] subjects with mean age of 49.4 +/- 16.3 years were operated. OCR and PONV occurred less frequently, and total intravenous analgesic dose was significantly lower in the lidocaine group [P < 0.05 for all comparisons]. However, no significant difference was noted between the study groups in terms of duration of surgery and period of hospitalization. Adjunctive local application of lidocaine during SB under GA for RRD decreases the rate of OCR and PONV, reduces the intravenous analgesic dose, but does not affect the duration of surgery or hospitalization

Artiflex versus STAAR[registered] implantable contact lenses for correction of high myopia

To compare two phakic intraocular lenses, Artiflex and STAAR[registered] implantable contact lens [ICL], in high myopia. Isfahan Ophthalmology Clinic, Iran. In a randomized, prospective clinical trial study, 40 eyes of 20 patients who came to Isfahan ophthalmology clinic to correct their refractive error were examined. Artiflex was inserted in 20 eyes and ICL in the other 20 eyes. After 1 year, uncorrected visual acuity [UCVA], best corrected visual acuity [BCVA], contrast sensitivity, intraocular pressure [IOP], and specular microscopy of corneal endothelium were assessed in both the groups. In this study, there was no statistical difference between UCVA, BCVA, IOP, cataract incidence, contrast sensitivity, and specular microscopy, 1 year after surgery. 40% of eyes in the Artiflex group developed anterior chamber cell and flare reaction 1 year postoperatively, but no patient in the ICL group developed the same. So, there is obvious difference in the rate of anterior chamber cell and flare reaction between these two groups. These two lenses have similar outcomes except in the incidence rate of anterior chamber cell and flare reaction that is greater in the Artiflex group. So, these two lenses are safe with predictable outcome in treating high myopia