ABSTRACT
Epiretinal membrane (ERM) is a relatively common macular disease that forms along the surface of the internal limiting membrane (ILM) of the retina to some reason.The pathogenesis is not clear.Microincision vitrectomy surgery has been confirmed as a minimally invasive and very safe modality of treatment.Deciding when to perform a vitrectomy can be difficult.There are many factors which can affect the postoperative visual acuity,such as age,the thickness of macular,integrity of photoreceptor inner segment/outer segment (IS/OS) junction.
ABSTRACT
INTRODUCCIÓN: La colecistitis aguda es la inflamación aguda de la vesícula biliar, cuya resolución es mayoritariamente mediante colecistectomía laparoscópica (CL), siendo el momento de intervención aún controvertido. OBJETIVO: Determinar la relación entre el momento de intervención y la estadía postoperatoria de los pacientes colecistectomizados. PACIENTES Y MÉTODOS: Estudio observacional, retrospectivo, analítico. Se analizaron las fichas clínicas de pacientes intervenidos por colecistectomía laparoscópica en el Hospital Dr. Gustavo Fricke de Viña del Mar, entre Enero y Octubre de 2011. Criterios de inclusión: Edad entre 18 a 80 años, diagnóstico de colecistitis aguda e indicación de colecistectomía laparoscópica. Criterios de Exclusión: Pacientes según clasificación American Society of Anesthesiologists (ASA) IV ó V. Las variables consideradas fueron: edad, género, ASA, cirugía abdominal previa, estadía hospitalaria, tiempo operatorio y complicaciones. RESULTADOS: Se analizaron los datos de 88 pacientes, 57 de ellos fueron intervenidos posterior a 72 horas de iniciados sus síntomas (CL tardía) y 31 pacientes antes de 72 horas desde el inicio de su sintomatología (CL temprana). La mediana de la estadía hospitalaria en el grupo CL tardía fue de nueve días y en el grupo CL temprana de tres días, diferencia estadísticamente significativa (p=0,00001). No se encontraron diferencias estadísticamente significativas en relación a las características demográficas, clínicas, tiempo operatorio, complicaciones, ni estadía postoperatoria. DISCUSIÓN: Dada la menor estadía hospitalaria total, no influyendo en la estadía postoperatoria, tiempo operatorio ni complicaciones parece conveniente la realización de una CL antes de 72 horas iniciados los síntomas de los pacientes con colecistitis aguda.
BACKGROUND: Acute cholecystitis is an acute inflammation of the gallbladder, with laparoscopic cholecystectomy (LC) being the treatment of choice, although, timing of the intervention still remains controversial. OBJECTIVE: To determine the relationship between timing of intervention and postoperative stay of patients who underwent laparoscopic cholecystectomy. PATIENTS AND METHODS: Cross-sectional study. Medical records of patients undergoing laparoscopic cholecystectomy at Dr. Gustavo Fricke Hospital in Viña del Mar, Chile between January and October 2011 were analized. Inclusion criteria: Age between 18 and 80 years old; diagnosis of acute cholecystitis and indication of laparoscopic cholecystectomy. Exclusion criteria: Patient according to American Society of Anesthesiologists physical status classification system (ASA) 4 or 5. The variables considered were: age, gender, ASA score, previous abdominal surgery, hospital stay, operative time and occurrence of complications. RESULTS: Data of 88 patients was analyzed. 31 of them were operated within 72 hours of beginning of symptoms (late LC) and 57 patients after 72 hours (early LC). The median hospital stay in late LC group was nine days and in the early LC group three days (IQR 2-4), which was statistically significant (p = 0.00001). No other significant differences were found in relation to demographic and clinical characteristics, operative time, complications, and postoperative stay. DISCUSSION: Regardless a lack of difference in postoperative stay, operative time and complication rate, it seems advisable to perform LC within72 hours of symptom onset in patients with acute cholecystitis, given the reduction of total hospital stay.
Subject(s)
Humans , Male , Adolescent , Adult , Female , Young Adult , Middle Aged , Aged, 80 and over , Cholecystectomy, Laparoscopic/methods , Cholecystitis, Acute/surgery , Decision Making , Intraoperative Complications , Length of Stay , Longitudinal Studies , Postoperative Complications , Retrospective Studies , Time FactorsABSTRACT
PURPOSE: To compare intraocular straylight in normal and cataractous eyes as the morphology and to compare straylight as the result of subjective symptoms in early cataract cases using the C-quant straylight meter, the only tool to measure light scattering in media. METHODS: Straylight values were measured in 217 normal eyes and 138 cataractous eyes. Cataractous eyes were classified into posterior subcapsular opacity, anterior subcapsular opacity and nucleosclerosis. Straylight values of each group were measured. The 56 early cataractous eyes were categorized into two groups, depending on the presence of subjective symptoms, and each straylight value was measured. The preoperative and postoperative straylight values of early cataracts were also compared. RESULTS: The mean straylight values of normal and cataractous eyes were 1.34 and 2.46, respectively. The value of posterior subcapsular opacity (2.81) was significantly higher than that of anterior subcapsular opacity (2.33) and nucleosclerosis (1.99). The straylight values of early cataracts were significantly higher in the group with subjective symptoms (2.02) than in the group without subjective symptoms (1.56). The postoperative straylight value decreased to 1.42. CONCLUSIONS: The posterior subcapsular cataract showed significantly high intraocular straylight, indicating that light scattering occurred to a greater extent in this group. Light scattering occurred more in early cataractous eyes with subjective symptoms than in eyes without symptoms, and light scattering was reduced after surgery. The C-quant straylight meter, which measures the light scattering in media, can be a useful tool to determine the time of cataract surgery and to evaluate the quality of vision.