[Medication error following intraocular surgery at a tertiary eye care center]

To evaluate the incidence of medication error in patients who underwent intraocular surgery based on different methods of drug instruction [hand-written versus orally explained] at Labbafinejad Medical Center. During a 6-month period, we evaluated 204 postoperative patients who underwent cataract or glaucoma surgery. Patients were randomly assigned to two groups; in group I, patients and their attendants received oral and written instruction in addition to the prescription, while the patients and their attendants in group II only received oral instruction besides the prescription. One to 3 days after the operation, the overall incidence of medication errors was determined and compared between the groups using Fisher's exact test. Overall 204 patients including 114 [55.9%] male and 90 [44.1%] female subjects were studied. Mean age of the patients and their attendants was 53.5+22.1 [range 1-90] years and 39.1+12.2 [range 19-79] years, respectively. Actual medication errors occurred in 7 patients including 3 [3%] in the group with written instruction and 4 [3.9%] in the group with oral instruction [P=0.511]. Dispensing errors were the cause in 5 [71.4%] patients including 3 in group I and 2 in group II [P=0.491] but the 2 [28.6%] other cases were due to misconsumption [all in group II]. Overall, 3 medication errors were detected and corrected [intercepted errors] by the patients or their attendants [all in group I] thus; nonintercepted errors were 4 [all in group II]. Cases of actual medication errors were female in 6 [85.7%] and illiterates in 4 [57.1%]. It seems that using a written instruction in addition to the prescription may reduce the incidence of medication errors following ocular surgery

Causes and results of vitrectomy for spontaneous non-diabetic vitreous hemorrhage

To determine the visual and anatomical outcomes and complications of vitrectomy for non-traumatic non-diabetic vitreous hemorrhage [NDVH] and to report the causes of the condition among patients at Labbafinejad Medical Center, Tehran-Iran, from 1993 to 2003. Records of patients who underwent vitrectomy for non-traumatic NDVH with 6 months follow up were reviewed for demographic characteristics, causes of NDVH and results of surgery. Fifty eyes [54.2% right eyes] of 49 patients [51% male] with mean age of 62.7 +/- 10.3 years were enrolled in the study. Mean visual acuity [VA] was 2.36 +/- 0.52 LogMAR and relative afferent pupillary defect [RAPD] was positive in 91.7% of the eyes, preoperatively. Causes of non-traumatic NDVH detected intraoperatively were: branch retinal vein occlusion [56%], central retinal vein occlusion [16%], choroidal neovascularization [12%], and posterior vitreous detachment with break, Eales disease, familial exudative vitreoretinopathy, and Terson syndrome [each in 4%]. Mean VA increased significantly at 6th month [1.38 +/- 0.72 IogMAR] compared to preoperative value. [P<0.0001] The most common causes of decreased VA were: macular pigmentary derangement [26%], optic atrophy [16%], severe lens opacity [12%], and epiretinal membrane [8%]. Despite the statistically significant increase in mean VA following vitrectomy, underlying macular pathology limits significant improvement of central VA in most cases of non-traumatic NDVH

Results of vitrectomy in idiopathic Macular Hole

To evaluate the visual and anatomical outcomes and complications of vitrectomy with or without removal of internal limiting membrane [ILM] in idiopathic macular hole [IMH] at Labbafinejad Medical Center, Tehran-Iran, 1993-2003. Hospital records of patients who had undergone vitrectomy for IMH and completed 6 months of follow up were reviewed for demographic data and outcomes of surgery .The study was conducted on 30 eyes [46.7% right eyes] of 29 patients [69% female] with mean age of 65.2 +/- 5.6 years. Mean duration of symptoms was 3.2 +/- 3.7 months [66.7% less than 6 months]. Preoperatively macular holes were in stages 2, 3, and 4 in 3.0%, 36.7%, and 33.3%, respectively. ILM removal was performed in 21 eyes [70%]. Mean visual acuity was 099 +/- 0.6 LogMAR preoperatively which reached to 0.87 +/- 0.39 LogMAR postoperatively [P=0.05]. Single operation anatomical success rate was 80% [24 eyes] and final success rate was 86.7% [26 eyes]. Retinal breaks developed in 3 eyes [10%] intraoperatively. ILM removal had no effect on increasing the rate of macular hole closure. ILM removal has no significant role on closure of IMH with less than 6 months of duration