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Purpose@#The purpose of this study was to determine whether deoxyhemoglobin changes were associated with admission duration in carbon monoxide (CO)-poisoned patients. @*Methods@#This retrospective study included 181 patients who were able to breathe by themselves after CO poisoning. Arterial blood gas analysis was performed to measure their deoxyhemoglobin levels. Their baseline characteristics and clinical outcomes during hospitalization in the emergency department (ED) were collected and compared. To assess changes in deoxyhemoglobin levels, blood samples were taken immediately after patients presented to the ED and then again after 6 hours. For statistical analysis, logistic regression was utilized to determine the effect of deoxyhemoglobin changes on admission duration. @*Results@#The incidence rates of hypocapnia and hypoxemia at presentation after acute CO poisoning were 28.7% and 43.6%, respectively. Moreover, the magnitude of increasing deoxyhemoglobin levels in patients with hypoxemia (2.1 [1.7–3.1], p<0.001) and changes in deoxyhemoglobin levels appeared to have an impact on the length of hospitalization in the ED (odds ratio, 1.722; 95% confidence interval, 0.547–0.952; p<0.001). @*Conclusion@#In patients with acute CO poisoning, deoxyhemoglobin levels appeared to increase in those with hypoxemia, which in turn was associated with prolonged hospitalization.
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Objective@#The purpose of this study was to compare the physical work intensity of emergency medicine (EM) and non-EM residents during a 24-hour work duty cycle using a smartwatch. @*Methods@#This study was conducted for a month from 7 May to 4 June 2021. A total of 27 residents submitted their consent to be recruited as subjects for the study. We distributed a smartwatch to each of the participants and measured their physical work intensity. Twenty non-EM residents wore a smartwatch for a week. Also, seven EM residents wore a watch during the time they were on 24-hour duty for the whole research period. After finishing their 24-hour duty, participants took off the smartwatch and stopped recording their physical activities. Sixty-five samples were matched for comparison between the non-EM and EM residents. Each of the samples comprised a pair of 24-hour records of EM and non-EM residents. The data were matched to ensure the same date and grade and thus control the variables. @*Results@#The results of this study showed that the maximum heart rate of the EM residents was 129.7±3.8 beats/min, which was higher than that of the non-EM residents. A comparison of the sleep hours during the 24-hour duty showed that the average sleep time of the EM residents was 156.9±84.8 minutes, which was significantly lower than that of the non-EM residents. However, calorie consumption, moving distance, and step count during the 24-hour duty cycle showed no significant difference between the EM and non-EM residents. @*Conclusion@#The maximum heart rate was higher among EM residents during their 24-hour work duty compared to the non-EM residents. In addition, the sleep time of the EM residents was significantly lower than that of the non-EM residents.
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Objective@#When rescuers move from ambulance to resuscitation area, they press the chest with one-hand by the stretchers. The purpose of this study was to investigate the effect of one-hand chest compression on unfolded stretchers and analyze the characteristics of rescuers that affect compression. @*Methods@#A manikin simulation study was planned. A total of 28 participants performed one-hand chest compression for one minute to a manikin on the unfolded stretchers. The depth of compression, the extent of recoil and compression frequency were measured, and the results were analyzed. Correlation analysis was done between participant characteristics and depth and frequency of compression. Linear regression analysis was done for variables with significant correlation. @*Results@#Four participants were excluded due to wrist or shoulder pain. A total of 24 participants (13 male; 11 female) were enrolled. The mean depth of compression was 34.88±11.06 cm; the mean extent of recoil was 50.00±0 cm. The mean frequency of compression was 104.71±11.07 per minute. The extent of recoil and frequency of compression were satisfied with cardiopulmonary resuscitation (CPR) guidelines. The depth of compression was highly correlated with participants’ sex (r=-0.88), height (r=0.86), and weight (r=0.78). When adjusted for sex, the depth of compression increased as height and weight increased. @*Conclusion@#Mechanical chest compression device should be used when CPR is required while moving a cardiac arrest patient by the stretchers. If CPR needs to be done manually, moving distance should be minimized. Finally, a new type of stretcher that fits the body shape of Koreans should be developed.
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Purpose@#The purpose of this study is to find out the current status of toxicology laboratory operated by six locations nationwide and to investigate the satisfaction of emergency medical professionals who working at local and regional emergency medical centers. @*Methods@#This survey was conducted prospective. It was conducted on 665 emergency medical professionals working at regional and regional emergency medical centers across the South Korea. Among them, the analysis was conducted with data that 510 emergency medical professionals who respond to this survey. The questionnaire was conducted on an online basis for a month. To ensure statistical significance, consider a dropout rate of 10% based on a minimum response recovery rate of 70%. 506 people were selected for the survey. @*Results@#According to a survey on the status of addiction analysis room usage, the average monthly usage of addiction test rooms among respondents were 406 cases.71.0 cases (17.4%) of toxicology laboratory in Seoul and 71 cases (17.4%) in Gwangju. 32 cases (7.8%), 118 cases (29.0%) requested by toxicology laboratory in Busan, and the toxicology laboratory in Daegu. Eighty two cases (20.1%), Daejeon area 25 cases (6.1%), Wonju area toxicology laboratory was 78 (19.6%). According to a survey on the satisfaction of the addiction analysis room,Seoul (4.9±2.71) and Gwangju (4.8±2.52) showed high satisfaction. @*Conclusion@#Due to the limited operation time of the four addiction analysis rooms currently in operation, the satisfaction level of addiction analysis by emergency medical professionals in the area is low due to the delay until the result is notified.
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Objective@#Although several studies have been conducted on the use of ultrasound to assist in arterial punctures, its utility is controversial and it is also inconvenient to use the equipment in the emergency room. Therefore, we developed a radial artery puncture assistive device for use in the emergency room and evaluated its utility. @*Methods@#The operator attempted the procedure on a mannequin, both with and without the device. We recorded the first-attempt success rate, the number of punctures, the time to success, and the failure rate. We conducted a survey to assess pre-experiment expectation and post-experiment satisfaction. @*Results@#The first-attempt success rate was 78% with no device and 66% with the device (P=0.105). The failure rate was 5% both when the device was not worn and worn (P>0.99). The number of attempts was 2.18 with no device and 2.10 with the device (P=0.765). The time to success was 40.81 seconds without the device and 54.08 seconds with the device (P=0.307). The responses to the pre-experiment survey were 5% for ‘Not wearing the device seems to be more helpful’, 75% for ‘Wearing the device seems to be more helpful’, and 20% for ‘There seems to be no difference’. In the postexperiment survey, the responses were 30% for ‘Not wearing the device was more helpful’, 55% for ‘Wearing the device was more helpful’, and 15% for ‘There was no difference’. @*Conclusion@#There were no significant results from the experiments. But respondents felt that wearing the device was better in both the pre-experiment and post-experiment survey.
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Objective@#Although several studies have been conducted on the use of ultrasound to assist in arterial punctures, its utility is controversial and it is also inconvenient to use the equipment in the emergency room. Therefore, we developed a radial artery puncture assistive device for use in the emergency room and evaluated its utility. @*Methods@#The operator attempted the procedure on a mannequin, both with and without the device. We recorded the first-attempt success rate, the number of punctures, the time to success, and the failure rate. We conducted a survey to assess pre-experiment expectation and post-experiment satisfaction. @*Results@#The first-attempt success rate was 78% with no device and 66% with the device (P=0.105). The failure rate was 5% both when the device was not worn and worn (P>0.99). The number of attempts was 2.18 with no device and 2.10 with the device (P=0.765). The time to success was 40.81 seconds without the device and 54.08 seconds with the device (P=0.307). The responses to the pre-experiment survey were 5% for ‘Not wearing the device seems to be more helpful’, 75% for ‘Wearing the device seems to be more helpful’, and 20% for ‘There seems to be no difference’. In the postexperiment survey, the responses were 30% for ‘Not wearing the device was more helpful’, 55% for ‘Wearing the device was more helpful’, and 15% for ‘There was no difference’. @*Conclusion@#There were no significant results from the experiments. But respondents felt that wearing the device was better in both the pre-experiment and post-experiment survey.
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Objective@#This study examined the clinical manifestations, treatment, and prognostic factors of hydrogen sulfide intoxication. @*Methods@#Twelve cases of hydrogen sulfide leaking from a wastewater treatment company in Sasang-gu, Busan were reviewed. The demographic characteristics, initial symptoms, treatment, complications, and long-term prognosis were reviewed. The Life Science Ethics Review Committee approved this study. @*Results@#The majority of the 12 cases were male (83%) with an average age of 38 years. Three of the 12 cases, who had been exposed to hydrogen sulfide, died (25%), and four had poor outcomes (33%). The incidence of pulmonary edema was significantly higher in the poor prognosis group, but the incidence of conjunctivitis and pre-hospital cardiac arrest was similar. The lactic acid concentration in the poor prognosis group was higher than the good prognosis group. In the poor prognosis group, the Glasgow coma scale was lower than that in the good prognosis group. @*Conclusion@#A poor outcome occurred in 33% of the 12 people exposed to hydrogen sulfide in Busan 2018. In the poor outcome group, the initial Glasgow Coma Scale was lower, the pulmonary edema rate and the initial serum lactate level were higher than in the good outcome group.
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OBJECTIVE: This study examined the incidence and amount of air inflow during central venous catheter (CVC) insertion. METHODS: This study was an experimental study aimed at designing an apparatus to implement blood vessel and blood flow in the human body. A 1.5-m long core tube with a Teflon tube, suction rubber tube, and polyvinyl chloride tube were made. This core tube was assumed to be the blood vessel of the human body. Blood was replaced with a saline solution. The saline solution was placed higher than the core tube and flowed into the inside of the tube by gravity. The CVC was injected 15-cm deep into the core tube. The air was collected through a 3-way valve into the upper tube. The experiments were carried out by differentiating the pressure in the tube, CVC insertion step, and diameter of the end of the catheter. The experiment was repeated 10 times under the same conditions. RESULTS: The amount of air decreased with increasing pressure applied to the tube. Air was not generated when the syringe needle was injected, and the amount of air increased with increasing size of the distal end catheter. CONCLUSION: To minimize the possibility of air embolism, it is necessary to close the distal end catheter at the earliest point as soon as possible.
Subject(s)
Blood Vessels , Catheters , Central Venous Catheters , Embolism, Air , Gravitation , Human Body , Incidence , Jugular Veins , Needles , Polytetrafluoroethylene , Polyvinyl Chloride , Rubber , Sodium Chloride , Suction , SyringesABSTRACT
OBJECTIVE: Charcoal is the first-line treatment in drug intoxication. Prediction of the time required for charcoal to pass in patients with constipation using radio-opaque markers (Kolomark) will facilitate the treatment, progression, and discharge of patients. METHODS: From October 2017 to April 2018, we compared constipation and non-constipation groups of patients aged 15 years old and over who were treated with drug intoxication at the emergency department. To accomplish this, a radiopaque marker, Kolomark, was administered after administration of charcoal and X-rays were taken to confirm the location of the Kolomark. The rectosigmoid colon arrival time of charcoal and charcoal passing time was then measured. RESULTS: Based on 48 charcoal passing times, 56 hours 42 minutes was required for its passage. The Kolomark arrival time at the rectosigmoid colon was delayed by about 47 hours in the constipation group. Additionally, the time of evacuation of the charcoal from rectosigmoid colon to stool was 15 hours 42 minutes in the constipation group, while it was 13 hours 10 minutes in the non-constipation group (P < 0.05). CONCLUSION: The results revealed that charcoal is released in 13 hours 52 minutes after Kolomark arrives at the rectosigmoid colonic position. These findings may help predict the release of charcoal during treatment of patients and facilitate patient's treatment, progress, and discharge.
Subject(s)
Humans , Charcoal , Colon , Constipation , Emergency Service, Hospital , Gastrointestinal TractABSTRACT
PURPOSE: When a criminal act occurs during emergency care, it becomes fatal to both the patient and doctor. Criminal acts during emergency care and judged by the Supreme Court of Korea were analyzed and investigated to decrease and prevent medical malpractice. METHODS: After assessing the Medical Act in Korea and Act on Emergency Care in Korea, a pattern of emergency care was categorized and applicable provisions were analyzed. Emergency medical malpractice cases were collected from previous reports and an internet site managed by the Supreme Court of Korea (http://glaw.scourt.go.kr). RESULTS: The patterns of emergency care can be categorized into "general emergency care", "interhospital patient transfer", and the "request for medical treatment sent to another department or hospital". Furthermore, inerthospiatl patient transfer can be categorized into "after request for emergency care" and "after medical treatment." There were ten medical malpractice cases in emergency care in which criminal responsibility occurred. There were six cases related to general emergency care and four related to interhospital patient transfer. CONCLUSION: Though the emergency care cases in which criminal responsibility occurred were few, the results critically impacted the patient and doctor. Therefore, emergency physicians must do their best to decrease and prevent medical negligence. In addition, a nation has a primary responsibility to save lives and must support emergency care.
Subject(s)
Humans , Criminals , Emergencies , Emergency Medical Services , Internet , Korea , Malpractice , Patient TransferABSTRACT
PURPOSE: When a criminal act occurs during emergency care, it becomes fatal to both the patient and doctor. Criminal acts during emergency care and judged by the Supreme Court of Korea were analyzed and investigated to decrease and prevent medical malpractice. METHODS: After assessing the Medical Act in Korea and Act on Emergency Care in Korea, a pattern of emergency care was categorized and applicable provisions were analyzed. Emergency medical malpractice cases were collected from previous reports and an internet site managed by the Supreme Court of Korea (http://glaw.scourt.go.kr). RESULTS: The patterns of emergency care can be categorized into "general emergency care", "interhospital patient transfer", and the "request for medical treatment sent to another department or hospital". Furthermore, inerthospiatl patient transfer can be categorized into "after request for emergency care" and "after medical treatment." There were ten medical malpractice cases in emergency care in which criminal responsibility occurred. There were six cases related to general emergency care and four related to interhospital patient transfer. CONCLUSION: Though the emergency care cases in which criminal responsibility occurred were few, the results critically impacted the patient and doctor. Therefore, emergency physicians must do their best to decrease and prevent medical negligence. In addition, a nation has a primary responsibility to save lives and must support emergency care.
Subject(s)
Humans , Criminals , Emergencies , Emergency Medical Services , Internet , Korea , Malpractice , Patient TransferABSTRACT
BACKGROUND AND OBJECTIVES: Speech in the noise test has been known to reflect the distortion component of hearing impairment originated not only from the cochlea but also from the central auditory system. For communication with language, a proper cognitive function of the cerebral cortex is essential. In the present study, we aimed to evaluate the correlation between the cognitive function and the speech recognition ability against background noise. SUBJECTS AND METHOD: Thirty one listeners with sensorineural hearing loss in both ear participated in this study. We performed pure a tone audiometry, a speech recognition test with and without multitalker babble noise, a computerized cognitive function test and the Mini-Mental Status Examination-Korea. RESULTS: Speech recognition score in noise showed significant correlations with the results of both computerized cognitive function test and Mini-Mental Status Examination-Korea, whereas, the pure tone average and speech recognition score in the quiet background did not. CONCLUSION: These results support that speech recognition ability in background noise reflects the cognitive function.
Subject(s)
Audiometry , Cerebral Cortex , Cochlea , Cognition , Ear , Hearing , Hearing Loss , Hearing Loss, Sensorineural , NoiseABSTRACT
OBJECTIVES: To compare tinnitus patients who have normal hearing between 250 Hz and 8 kHz with normal controls with regard to the ability of each group to hear extended high-frequency pure tone thresholds. METHODS: We enrolled 18 tinnitus patients, each of whom had a threshold of HL <25 dB and threshold differences of <10 dB between ears at frequencies of 250 and 500 Hz and 1, 2, 4, and 8 kHz. We also enrolled age- and gender-matched normal volunteers (10 ears), for each patient. Extended high frequency pure tone audiometry was performed, and the mean hearing thresholds at 10, 12, 14, and 16 kHz of each tinnitus ear were compared with those of the 10 age- and sex-matched normal ears. RESULTS: Of the 18 patients with tinnitus, 12 had significantly increased hearing thresholds at more than one of the four high frequencies, compared with the normal group. When we assessed results according to frequency, we found that 8 patients had decreased hearing ability at 10 kHz, 10 at 12 kHz, 8 at 14 kHz, and 4 at 16 kHz. CONCLUSION: Some patients with tinnitus who have normal hearing below 8 kHz have decreased hearing ability at extended high-frequencies. Thus, the proportion of patients with tinnitus who have normal hearing over the entire audible range is smaller than in previous reports.
Subject(s)
Humans , Audiometry , Ear , Hearing , Hearing Loss , TinnitusABSTRACT
Lingual tonsillar hypertrophy can result in obstructive sleep apnea, chronic infection, and rarely, dysphagia, chronic cough, and globus sensation. In children with obstructive sleep apnea who do not respond to medical therapy, adenotonsillectomy is the main surgical option and reduction of lingual tonsils can be supplemented. Lingual tonsillectomy may be a difficult and excessively morbid procedure in the sleep apnea population because of difficult exposure, slow dissection, poor visualization, difficult hemostasis, airway edema and postoperative pain. This case report describes successful treatment of children with severe obstructive sleep apnea by lingual tonsillectomy for those who already have had adenotonsillectomy.
Subject(s)
Child , Humans , Cough , Deglutition Disorders , Edema , Hemostasis , Hypertrophy , Pain, Postoperative , Palatine Tonsil , Sensation , Sleep Apnea Syndromes , Sleep Apnea, Obstructive , TonsillectomyABSTRACT
BACKGROUND AND OBJECTIVES: The most common complaint of individuals with hearing impairment is the difficulty in understanding speech against background noise. In our previous study, we carried out a speech-in-noise test using multi-talker babble noise and spondee words. In the present study, we compared 50%-signal to noise ratios (SNRs) of hearing-impairment group with that of normal-hearing group, and analyze the effects of age and noise intensity affecting the results. SUBJECTS AND METHOD: Thirty listeners (of which each 10 listeners are in their forties, fifties, and sixties) with normal hearing and thirty listeners (each ten listeners in their forties, fifties, and sixties) with hearing impairment participated. Spondee words and multi-talker babble noise made from recording the voices of 10 males and 10 females were presented by a loudspeaker at a distance of one meter in front of the subject. Fifty percent-SNRs were measured at 50 dB HL, 60 dB HL, 70 dB HL, and 80 dB HL of noise intensity. RESULTS: The mean 50% SNR for normal-hearing listeners in the forties, fifties and sixties of age were -13.4+/-2.1 dB, -11.5+/-2.3 dB, and -12.6+/-2.0 dB, respectively. The mean 50% SNR for hearing-impairment listeners in the forties, fifties and sixties of age were -11.2+/-3.4 dB, -9.5+/-3.0 dB, -8.7+/-2.7 dB, respectively. Hearing-impairment group showed significantly worse results than the normal- hearing group in all ages. CONCLUSION: These results support that our word-in-noise test using multi-talker babble noise is useful in measuring audibility against background noise for individuals with hearing-impairment.
Subject(s)
Female , Humans , Male , Hearing , Hearing Loss , Hearing Tests , Noise , Signal-To-Noise Ratio , VoiceABSTRACT
BACKGROUND: Chronic pain after thoracotomy has been recently reproduced in a rat model that allows investigating the effect of potentially beneficial drugs that might reduce the incidence of allodynia or alleviate pain. Local anesthetics produce antinociception in normal animals and alleviate mechanical allodynia in animals with nerve injury although their mechanisms of action may differ in these situations. Our purpose of this study was to test whether the preoperative intercostal nerve block of bupivacaine could prevent the development of allodynia in a rat model of chronic postthoracotomy pain. METHODS: All male Sprague-Dawley rats were anesthetized and the right 4th and 5th ribs were exposed surgically. The pleura were opened between the ribs to which a retractor was placed and was opened 10 mm in width. Retraction was maintained for one hour. Total 1 mg of 0.5% bupivacaine was injected at the intercostal nerves before (n = 17) or after (n = 16) surgery. A control group (n = 25) that underwent rib retraction did not receive any drug. Rats were tested for mechanical allodynia using calibrated von Frey filaments applied around the incision site during the three weeks following surgery. RESULTS: The incidence of development of mechanical allodynia in the group that received intercostal injection with bupivacaine before surgery was significantly lower than that in the control group (P < 0.05). CONCLUSIONS: Preoperative intercostal nerves block around the surgical incision before thoracotomy may decrease the incidence of postthoracotomy pain syndrome.
Subject(s)
Animals , Humans , Male , Rats , Anesthetics, Local , Bupivacaine , Chronic Pain , Hyperalgesia , Incidence , Intercostal Nerves , Pleura , Rats, Sprague-Dawley , Ribs , ThoracotomyABSTRACT
BACKGROUND: Central sensitization of neuropathic pain is associated with an influx of extracellular calcium via the opening of N-methyl-D-aspartate (NMDA) receptor-gated ion channels, which is usually blocked by a magnesium plug. Many studies have found that intrathecal or intraperitoneal magnesium suppress neuropathic pain. Therefore, it is possible that serum and cerebrospinal fluid Ca2+, Mg2+, and Ca2+/Mg2+ ratio are changed in neuropathic pain. The purpose of this study was evaluated changes in serum and cerebrospinal fluid Ca2+, Mg2+, and Ca2+/Mg2+ ratio in neuropathic rats. METHODS: Male Sprague-Dawley rats were prepared with tight ligation of the left lumbar 5th and 6th spinal nerves to produce neuropathic pain. The threshold of mechanical allodynia was evaluated by the up-down method using withdrawal response to a von Frey filaments stimulus on the 3rd, 7th, and 14th day. Rats with a threshold of less than 4 gram were selected as the experimental group. On the 16th day, serum and cerebrospinal fluid Ca2+, Mg2+, and Ca2+/Mg2+ ratio were measured. Experimental group data were then compared with those of an unoperated control group and an unligated sham group; each group contained 10 animals. RESULTS: No statistic differences were found between groups. CONCLUSIONS: Our results suggest that serum and cerebrospinal fluid Ca2+, Mg2+, and Ca2+/Mg2+ ratio in neuropathic rats do not differ from those of normal rats because of physiologic homeostasis is maintained by active transport through the blood-brain-barrier despite of activation of NMDA receptor-gated ion channels. However, we believe that the Mg2+ ion-dependent voltage-gating in rats with neuropathic pain may be deficient in a chronic condition due to a decreased Mg2+ binding affinity of the NMDA receptor-gated channel, as has been found in hippocampal granule cells in epileptic rats.
Subject(s)
Animals , Humans , Male , Rats , Biological Transport, Active , Calcium , Central Nervous System Sensitization , Cerebrospinal Fluid , Homeostasis , Hyperalgesia , Ion Channels , Ligation , Magnesium , N-Methylaspartate , Neuralgia , Rats, Sprague-Dawley , Spinal NervesABSTRACT
Citrullinemia is an autosomal recessive disorder resulting in a deficiency of the urea cycle enzyme, argininosuccinate synthetase, which is mainly found in the liver. Despite the improvement in a dietary therapy during the past 20 years for the treatment of urea cycle disorders with the systematic adjunction of sodium benzoate, sodium phenylbutyrate and arginine, the overall outcome of severe forms of hyperammonemia often remains disappointing. As the liver is the only organ in which ammonia is transformed into urea, liver transplantation has been considered as an elegant and radical alternative therapy to classical dietetic and medical therapy. A child with classical citrullinemia was treated at age 34 months by a living related liver transplantation. The levels of plasma and urinary citrulline decreased slightly after transplantation, but serum ammonia levels and amino acid concentrations returned to the normal range without protein restriction. We describe this case and include a brief review of the literature.
Subject(s)
Child , Humans , Ammonia , Anesthesia , Arginine , Argininosuccinate Synthase , Citrulline , Citrullinemia , Hyperammonemia , Liver Transplantation , Liver , Plasma , Reference Values , Sodium , Sodium Benzoate , Urea , Urea Cycle Disorders, InbornABSTRACT
To evaluate the status of glaucoma in leprosy, ophthalmic examinations including a measurement of intraocular pressure, optic disc and gonioscopic examinations were performed in 86 eyes of 43 leprosy patients. Mean intraocular presur was 12.6mmHg and 74 eyes (86%) revealed open-angle by gonioscopy. Peripheral anterior synechiae were found in 10.5%, and posterior synechiae in 29.6% which showed no relation to the intraocular pressure. The prevalence of glaucoma was 3.5% (3 eyes), 2 eyes with secondary open-angle glaucoma and 1 eye with primary angle-closure glaucoma. Duration of disease showed no correlation with the intraocular pressure and the peripheral anterior synechiae. The degree of intraocular pressure and angle width showed no statistically significant difference between the type of disease. As the glaucoma in leprosy has no apparent relation to duration of disease, degree of uveitis and posterior synechiae, a regular evaluation of intraocular pressure and optic disc examination are recommended for early detection of glaucoma in leprosy patients.
Subject(s)
Humans , Glaucoma , Glaucoma, Angle-Closure , Glaucoma, Open-Angle , Gonioscopy , Intraocular Pressure , Leprosy , Prevalence , UveitisABSTRACT
We performed the prospective study on the clinical result of sutureless phacotrabeculectomy using 3.0mm ~ 6.5mm self-sealing scleral tunnel incision. This study included 9 eyes of 8 patients who have been suffering from chronic angle-closure glaucoma or chronic open-angle glaucoma with coexisting cataract. The mean preoperative intraocular pressure(IOP) was 28.55mmHg and mean postoperative IOP was 15.55mmHg. The IOP maintained below 19mmHg in all cases after 6 months. The number of medications decreased from 1.77 preoperatively to 0.33 postoperatively. No medication needed in 7 eyes postoperatively. The mean preoperative cup-disc ratio was 0.64. Visual acuity improved in 8 eyes and 5 eyes recovered to 20/40 or better. The blebs were visible in 8 cases which shows low diffuse in character in most cases. Postoperative complications were hypotony in 5 cases, hyphema in 1 case, partial posterior capsular rupture in 1 case and posterior capsular opacification in 1 case respectively. This result suggests that sutureless phacotrabeculectomy may be performed as safe and effective combined procedure in the management of coexisting cataract and glaucoma.