Clinical and Radiologic Outcome of Intertrochanteric Fracture Treatment Using TFNA (Trochanteric Fixation Nail-Advanced)

Purpose@#This study evaluated the clinical and radiological outcomes of TFNA (Trochanteric Fixation NailAdvanced; Depuy Synthes) for the treatment of proximal femur fractures. @*Materials and Methods@#This was a retrospective study of 64 patients diagnosed with a proximal femur fracture from January 2019 to November 2019. The patient’s demographic data, preoperatively and postoperatively Koval grade, modified Harris hip score, EQ-5D (Euro-Qol-5 Dimension), sliding and advancement of the blade, radiologic outcome, and complications were investigated. @*Results@#Fifty patients were available for evaluation at one year postoperatively. The patients reported the following: the Koval grade decreased after surgery; the modified Harris hip score decreased from 78.56±8.88 to 72.74±6.59 (p=0.149); the mean EQ-5D decreased from 0.75±0.09 to 0.72±0.06 (p=0.000). Satisfactory reduction was achieved on a postoperative radiographic examination in 47 patients in six months. Complications occurred in seven cases. @*Conclusion@#TFNA is considered an appropriate implant for treating intertrochanteric fractures of the femur with a minimum follow-up of one year.

Clinical and Radiologic Outcome of Intertrochanteric Fracture Treatment Using TFNA (Trochanteric Fixation Nail-Advanced)

Purpose@#This study evaluated the clinical and radiological outcomes of TFNA (Trochanteric Fixation NailAdvanced; Depuy Synthes) for the treatment of proximal femur fractures. @*Materials and Methods@#This was a retrospective study of 64 patients diagnosed with a proximal femur fracture from January 2019 to November 2019. The patient’s demographic data, preoperatively and postoperatively Koval grade, modified Harris hip score, EQ-5D (Euro-Qol-5 Dimension), sliding and advancement of the blade, radiologic outcome, and complications were investigated. @*Results@#Fifty patients were available for evaluation at one year postoperatively. The patients reported the following: the Koval grade decreased after surgery; the modified Harris hip score decreased from 78.56±8.88 to 72.74±6.59 (p=0.149); the mean EQ-5D decreased from 0.75±0.09 to 0.72±0.06 (p=0.000). Satisfactory reduction was achieved on a postoperative radiographic examination in 47 patients in six months. Complications occurred in seven cases. @*Conclusion@#TFNA is considered an appropriate implant for treating intertrochanteric fractures of the femur with a minimum follow-up of one year.

Diffuse Lamellar Keratitis after Trabeculectomy in a Patient with Laser in situ Keratomileusis

PURPOSE: In the present study, a case of diffuse lamellar keratitis after trabeculectomy in a patient who had received laser in situ keratomileusis many years prior is reported. CASE SUMMARY: A 54-year-old male diagnosed with binocular primary open-angle glaucoma underwent trabeculectomy in the left eye because of poor intraocular pressure control and visual field defect progression even with maximal medical treatments. Faint, non-progressing subepithelial opacities pre-existed in the left cornea but no treatment was administered. The patient had a history of laser in situ keratomileusis in both eyes 12 years prior. On the first postoperative day, conjunctival buttonhole was found and because leaking from the hole continued, topical steroid was discontinued on the fourth postoperative day. On the seventh postoperative day, diffuse lamellar keratitis developed on the central cornea without intraocular pressure elevation, and diffuse infiltration under the corneal flap was observed in the anterior segment on optical coherence tomography. The patient was treated with topical steroid eye drops every 3 hours for the first 2 days and the frequency was increased to every hour because the keratitis did not improve. On the ninth postoperative day, keratitis began to improve and 2 months postoperatively, subepithelial lamellar infiltration improved significantly but did not show complete remission. CONCLUSIONS: Diffuse lamellar keratitis can develop in an eye with laser in situ keratomileusis after trabeculectomy if appropriate treatment with topical steroid eye drops is not administered.

The Effect of Caffeinated Energy Drink Consumption on Intraocular Pressure in Young Adults

PURPOSE: Several energy drinks containing a high content of caffeine are widely consumed among young adults. We examined the effects of caffeinated energy drinks on intraocular pressure (IOP) and blood pressure (BP) in healthy young subjects. METHODS: In this prospective randomized, case-controlled cross over study conducted, from August to September of 2014, 40 healthy young volunteers (80 eyes) in their 20's and 30's drank 2 types of beverage each consumed after a 3-month washout period. The study participants were randomly given the caffeinated energy drink (group I, n = 20) or caffeine-free drink (group II, n = 20), IOP and BP were measured at 0, 30, 60, 90, and 120 minutes and 12 and 24 hours after beverage consumption. RESULTS: In group I, the mean +/- standard deviation (SD) of IOP at baseline was 13.2 +/- 1.56 mm Hg and the IOP increased until 24 hours after drink consumption. IOPs at 30, 60, 90, and 120 minutes and 12 and 24 hours after drinking caffeinated energy drink were 14.45 +/- 2.12, 14.93 +/- 2.02, 14.85 +/- 1.55, 14.2 +/- 1.34, 14.25 +/- 1.74, and 13.35 +/- 1.61, respectively and statistically significant at 30, 60, 90, 120 minutes and 12 hours (p < 0.05). A corresponding increase in BP after drinking the caffeinated energy drink was observed but without statistical significance. Drinking the caffeine-free beverage did not affect IOP or BP significantly. CONCLUSIONS: IOP increases after consuming the caffeinated energy drink were statistically significant at 30, 60, 90, and 120 minutes and 12 hours. Therefore, caffeinated energy drinks may not be recommended for glaucoma patients or glaucoma suspects.

The Effect of Caffeinated Energy Drink Consumption on Intraocular Pressure in Young Adults

PURPOSE: Several energy drinks containing a high content of caffeine are widely consumed among young adults. We examined the effects of caffeinated energy drinks on intraocular pressure (IOP) and blood pressure (BP) in healthy young subjects. METHODS: In this prospective randomized, case-controlled cross over study conducted, from August to September of 2014, 40 healthy young volunteers (80 eyes) in their 20's and 30's drank 2 types of beverage each consumed after a 3-month washout period. The study participants were randomly given the caffeinated energy drink (group I, n = 20) or caffeine-free drink (group II, n = 20), IOP and BP were measured at 0, 30, 60, 90, and 120 minutes and 12 and 24 hours after beverage consumption. RESULTS: In group I, the mean +/- standard deviation (SD) of IOP at baseline was 13.2 +/- 1.56 mm Hg and the IOP increased until 24 hours after drink consumption. IOPs at 30, 60, 90, and 120 minutes and 12 and 24 hours after drinking caffeinated energy drink were 14.45 +/- 2.12, 14.93 +/- 2.02, 14.85 +/- 1.55, 14.2 +/- 1.34, 14.25 +/- 1.74, and 13.35 +/- 1.61, respectively and statistically significant at 30, 60, 90, 120 minutes and 12 hours (p < 0.05). A corresponding increase in BP after drinking the caffeinated energy drink was observed but without statistical significance. Drinking the caffeine-free beverage did not affect IOP or BP significantly. CONCLUSIONS: IOP increases after consuming the caffeinated energy drink were statistically significant at 30, 60, 90, and 120 minutes and 12 hours. Therefore, caffeinated energy drinks may not be recommended for glaucoma patients or glaucoma suspects.

A Case of Pediatric Medial-Orbital Wall Fracture with Extraocular Muscle Entrapment

PURPOSE: To report a case of pediatric medial wall blowout fracture with entrapment of medial rectus muscle which can be easily misdiagnosed as a cerebral lesion. CASE SUMMARY: A 16-year-old male visited our clinic with headache, severe restriction of his right eye movement, and diplopia after a head injury due to falling occurring 1 day before evaluation. The patient was inebriated at the time of the accident and could not recall the event but occipital hematoma was palpable. Periorbital ecchymosis or edema was not observed with minimal soft tissue injury except mild conjunctival injection on slit-lamp examination. The patient had an 18 prism diopter exodeviation at primary position and severe medial and mild lateral gaze limitation in his right eye. Brain magnetic resonance imaging (MRI) showed no specific cerebral findings although trapdoor orbital medial wall fracture with incarceration of soft tissue and medial rectus muscle at the medial wall fracture site of his right eye was observed. Within 48 hours from the first evaluation, the blowout fracture was repaired and 50 days postoperatively, right eye gaze limitation and diplopia were nearly recovered. CONCLUSIONS: A case of pediatric blowout fracture with uncertain injury location, periocular ecchymosis, or edema absent could be misdiagnosed as a cerebral lesion. If a pediatric patient is experiencing gaze limitation, diplopia, nausea, or vomiting after trauma, neurological examination as well as evaluation for blowout fracture should be performed.