Subject(s)
Angiogenesis Inhibitors/therapeutic use , Antibodies, Monoclonal, Humanized/therapeutic use , Angiogenesis Inhibitors/adverse effects , Antibodies, Monoclonal, Humanized/adverse effects , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Bevacizumab , Gastrointestinal Hemorrhage/chemically induced , Humans , Neoplasms/drug therapy , Randomized Controlled Trials as Topic , Ranibizumab , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Visual Acuity/drug effects , Wet Macular Degeneration/drug therapySubject(s)
Blindness/etiology , Meningeal Neoplasms/complications , Meningioma/complications , Nerve Compression Syndromes/etiology , Optic Chiasm/pathology , Optic Nerve Diseases/etiology , Acute Disease , Adult , Humans , Magnetic Resonance Imaging , Male , Meningeal Neoplasms/diagnosis , Meningeal Neoplasms/surgery , Meningioma/diagnosis , Meningioma/surgery , Nerve Compression Syndromes/diagnosis , Olfaction Disorders/etiology , Optic Nerve Diseases/diagnosis , Visual Acuity , Visual Field Tests , Visual FieldsABSTRACT
BACKGROUND: Disposable devices are increasingly becoming the preferred choice where possible in contact medical equipment. AIM: To evaluate the accuracy of the disposable applanation tonometer head as a potential substitute to the standard Goldmann applanation head. METHODS: The study was prospective. The intraocular pressure recordings in 80 eyes of 42 patients were compared using the disposable and standard Goldmann applanator heads. The Bland and Altman method of assessing agreement between two methods of clinical measurement was used in the analysis. RESULTS: The difference in the readings between the two types of tonometer heads was highly variable (mean difference=0.78 mm Hg, range=-1 to 11 mm Hg). This was because of the distortions on the applanating surface of the disposable device. When the readings associated with the defective heads were excluded, very strong agreement was obtained (mean=0.07 mm Hg, range=-1 to 2 mm Hg). CONCLUSION: Good agreement with standard Goldmann applanation is achieved with the disposable heads except where surface distortions induce significant errors. Careful inspection to ensure well-structured disposable units is imperative in disposable applanation tonometry.
Subject(s)
Disposable Equipment , Tonometry, Ocular/instrumentation , Adult , Cross Infection/prevention & control , Equipment Design , Humans , Intraocular Pressure , Prospective Studies , Reproducibility of ResultsABSTRACT
AIMS: To examine the intraoperative characteristics of phacoemulsification in eyes that had undergone pars plana vitrectomy and to determine complication rates and visual outcomes. METHODS: A prospective study of 45 consecutive cataract operations on vitrectomised eyes performed over a 9-month period by a single surgeon. Data were collected on preoperative characteristics, intraoperative observations and complications, postoperative complications, and visual acuities. RESULTS: Zonular laxity with abnormal deepening of the anterior chamber and mydriasis was noted in six eyes that had undergone extensive vitreous removal for the treatment of retinal detachment or proliferative diabetic retinopathy, but not in eyes that had had limited 'core vitrectomy' such as for macular hole or epiretinal membrane. In two eyes, the initial deepening of the anterior chamber was accompanied by paradoxical shallowing with miosis (the 'infusion deviation syndrome'). Sight-threatening complications were rare. Snellen visual acuity improved in 84.6% of eyes previously treated for 'macular hole, 85.7% of eyes treated for 'macula-on' retinal detachment, 66.7% of eyes treated for 'macula-off' retinal detachment, and 57.1% of eyes treated for diabetic retinopathy. CONCLUSIONS: Surgeons need to be aware of additional challenges arising from zonular instability in eyes that have had extensive vitreous removal. A lower infusion bottle height may guard against sudden changes in anterior chamber depth. The use of a corneal tunnel avoids difficulties associated with an unusually deep anterior chamber. Visual acuity is less likely to improve in patients previously treated for diabetic retinopathy or for macula-off retinal detachment.
