ABSTRACT
Anterior capsulotomy is a key step in cataract surgery. Here we report our experience with two techniques, namely can-opener capsulotomy [COC] and continuous curvilinear capsulorhexis [CCC]. Which technique is chosen is partly influenced by the type of cataract present: it was mature in 52.1%, immature in 42.2%, and associated with pseudoexfoliation in 5.8% of cases. Posterior capsular tears occurred in 7% of all operations [7.8% of all 90 cases of COC, and 5.8% of all 52 cases of CCC]. Five of the total of 10 posterior capsular breaks occurred in eyes with mature cataract [a rate of 6.8%], 2 in eyes with immature cataract [a rate of 3.3%], and 3 in eyes with pseudoexfoliation [a rate of 37.5%]; this stresses the significance of local population factors among the causes for the relatively high rate of capsular rupture experienced by us. Of all posterior capsular breaks, 70% happened during the phase of irrigation and aspiration of cortical material. This step was most dangerous in the group operated using the COC technique. Six out of seven cases [85.7%] of posterior capsular rupture in this group happened during irrigation and aspiration of cortex. While in the group operated using the CCC technique, the risk of posterior capsular rupture was equally divided between nucleus delivery, irrigation/aspiration and intra -ocular lens implantation [one case for each step]
Subject(s)
Humans , Male , Female , Anterior Capsule of the Lens/surgery , Postoperative ComplicationsABSTRACT
The analgesic efficacy and tolerability of diclofenac-potassium 50 mg were compared with those of glafenine 200 mg in 109 outpatients suffering from moderate to severe dental pain. Throughout the four-day trial period, patients [Diclofenac-potassium: n=58, mean age=32.84 +/- 12.0 yrs. Glafenine n = 51, mean age=34.12 +/- 14.0 yrs.] were randomized, in a double-blind fashion, to receive one tablet of either medications three times daily, together with an antibiotic, ampicillin, 500 mg, 8 hourly. Half an hour following the administration of the first analgesic dose, both treatment groups showed highly statistically significant [P < 0.001] reductions in the mean pain level when compared with their baseline values. The mean decrease of pain level in diclofenac-potassium group after half hour was significantly [P < 0.01] greater than that in the glafenine group. Moreover, the percent of pain free patients after 1/2 hour in the diclofenac-potassium group was significantly higher [P = 0.05] compared with those in the glafenine group. The mean decreases in pain and tenderness on the second and fourth days, in relation to their initial values, were greater in the diclofenac-potassium treated patients than the glafenine treated ones. The overall evaluation of therapeutic effect was considered excellent in 72 percent of the diclofenac- potassium patients compared with 57 percent of the glafenine patients. Furthermore, 95 percent of the diclofenac-potassium patients, compared with 90 percent of the glafenine ones, expressed their willingness to use the trial medication again in similar conditions. None of the patients in both treatment groups discontinued the trial due to unwanted effects. Both therapies were well tolerated. Only one patient [1.72 percent] in the diclofenac-potassium treatment group experienced slight diarrhea. It can be concluded from this study that both medications are effective and well tolerated in the management of dental pain. However, diclofenac-potassium with its fast onset of effect is particularly suitable in the management of acute painful conditions