Wound strength of experimental corneal perforations sealed with fibrin glue in cadaver porcine eyes

Objectives: This is a study to determine the relative wound strength of a commercial fibrin tissue adhesive (Beriplast P, Aventis Behring) compared to 10-0 nylon sutures in sealing experimentally induced corneal perforations in cadaver porcine eyes. Methodology: Single Blind Completely Randomized Design. Sixty freshly enucleatedporcine eyes with an average corneal diameter of 11.5 mm were used. These were randomly allocated into the 3.2 mm perforation group (n = 30) and the 5.2 mm perforation group (n = 30). All perforations were made perpendicular to the corneal surface with a standard preset metal keratome at the central portion of the cornea. Fifteen corneal perforations in each group were again randomly sealed with either interrupted nylon 10-0 sutures or Beriplast P (65-115 mg/mL). Intraocular pressure was raised by injecting normal saline into the anterior chamber and determined by a manometer attached to it. The presealing and postsealing leaking pressures were recorded. Wound leak was determined by Seidels test Results: The mean leaking pressure of the 3.2 mm group sealed with nylon suture was 237.47 mm Hg and 237.33 mm Hg for those sealed with fibrin tissue adhesive. The mean leaking pressures of the 5.2-mm group was 1984 mm Hg for both sealing techniques. The difference in leakingpressures of both sealing techniques was not significant using a power of 80 percent to detect a difference of 30 mm Hg Conclusion: The wound strength of corneal perforations sealed with fibrin tissue adhesive, as measured by the leaking pressures, is comparable to that of those sealed with nylon 10-0 sutures in cadaveric porcine eyes. (Author)

Terson's syndrome: Not a prognosticating factor of aneurysmal subarachnoid hemorrhage

Terson's syndrome has been implicated by previous studies as a strong predictor of poor outcome of patients with subarachnoid hemorrhage. There was even a recommendation to place patients with the syndrome in the next less favorable category. Hence this study was designed to provide a general profile of patients with Terson's syndrome and investigate whether the syndrome correlates with poor outcome. This study was done using a prospective cohort of patients seen at the Philippine General Hospital pay and charity wards from July 1, 1999 to June 30, 2000 diagnosed to have aneurysmal subarachnoid hemorrhage. Detailed ophthalmological examination was done and data were collected using a standard database. Patients were then followed up at 2 weeks, 1 month and 3 months to determine outcome (using Glasgow Outcome Score). Data collected were subjected to univariate analysis using chi square and/or Fisher test to determine significant correlation of variables with Terson's syndrome and to determine significance of Terson's syndrome as a predictor of poor outcome. A total of 52 patients were included in the study. The general demographic profile of patients with Terson's syndrome was comparable to that of the study population. The frequency of Terson's syndrome was 13.4 percent. There were no statistically significant differences in outcomes among patients with and without Terson's syndrome. However, positive correlation between laterality of Terson's syndrome with the side of aneurysm was shown. Although results were not significant, funduscopic examination remains to be warranted as an important part of diagnostic work-up of aneurysmal subarachnoid hemorrhage patients. When present, the laterality of Terson's syndrome may give a clue to the presence and side of the aneurysm.

Tersons syndrome as a prognosticating factor in aneurysmal subarachnoid hemorrhage

This is a descriptive study of Tersons syndrome among patients with aneurysmal subarachnoid hemorrhage at the Philippine General Hospital. The incidence of Tersons syndrome was 13.4 percent. There were no statistically significant differences in outcomes among patients with and without Tersons syndrome. (Author)