ABSTRACT
BACKGROUND: Patients scheduled to undergo radial keratotomy in both eyes received redeepening incisions in one eye and single pass incisions in the other. Eye and order of surgery were assigned randomly and surgical parameters were otherwise identical in the two eyes. METHODS: This study was designed to measured the improvements in myopia obtained by radial keratotomy, with and without redeepening incisions. RESULTS: There was a greater decrease in spherical equivalent manifest refraction in the redeepening group than in the control group at 1 week (0.41 D) and 1 month (0.36 D) after surgery, as measured by keratometry. The difference in change between groups was 0.41 D at one week, 0.36 D at 1 month, and 0.26 D at 3 months. Change in spherical equivalent was significantly more in the redeepened group at 3 months after surgery (0.37 D); however, the improvement constituted only 8.8 percent of the decrease in myopia achieved by radial keratotomy without redeepening (3.87 D). CONCLUSIONS: Although redeepening yields an incremental effect in the correction of myopia, the technical difficulties of redeepening and the increased chance of perforation of the cornea with redeepening outweigh the benefits of the procedure.
Subject(s)
Cornea/surgery , Keratotomy, Radial , Myopia/surgery , Adult , Female , Humans , Male , Treatment OutcomeSubject(s)
Brain/drug effects , Peroxidases/pharmacology , Animals , Basement Membrane/pathology , Blood-Brain Barrier , Brain/pathology , Brain Injuries , Capillaries/pathology , Corpus Callosum/pathology , Extracellular Space , Freezing , Inclusion Bodies , Mice , Microscopy, Electron , Peroxidases/administration & dosage , Phagocytosis , Staining and LabelingSubject(s)
Blood Proteins/analysis , Brain Edema/metabolism , Brain/pathology , Freezing , Animals , Blood Proteins/metabolism , Brain/blood supply , Brain Chemistry , Brain Edema/etiology , Brain Edema/pathology , Brain Injuries/complications , Brain Injuries/etiology , Capillaries , Capillary Permeability , Cerebral Cortex/analysis , Extracellular Space , Histocytochemistry , Mice , Microscopy, Electron , Neuroglia/metabolism , Neurons/metabolism , Peroxidases/analysis , Peroxides , Pinocytosis , Subarachnoid SpaceSubject(s)
Heat Exhaustion/diagnosis , Neurologic Manifestations , Amnesia , Ankle , Cerebellar Diseases , Cerebrovascular Disorders/diagnosis , Follow-Up Studies , Forearm , Humans , Male , Middle Aged , Muscular Atrophy , Paralysis , Prognosis , Speech Disorders , Time Factors , ToesSubject(s)
Ischemic Attack, Transient/diagnosis , Adult , Age Factors , Aged , Cerebrovascular Disorders/complications , Disability Evaluation , Follow-Up Studies , Heart Diseases/complications , Humans , Hypertension/complications , Ischemic Attack, Transient/complications , Ischemic Attack, Transient/mortality , Male , Middle Aged , Prognosis , Prospective StudiesSubject(s)
Cerebrovascular Disorders/mortality , Ischemic Attack, Transient/mortality , Age Factors , Aged , Cerebrovascular Disorders/complications , Disability Evaluation , Electrocardiography , Electroencephalography , Follow-Up Studies , Humans , Hypertension/complications , Ischemic Attack, Transient/complications , Middle Aged , Myocardial Infarction/complications , Prognosis , Prospective StudiesSubject(s)
1-Propanol/blood , Acetaldehyde/blood , Acetone/blood , Alcoholism/blood , Coma/blood , Ethanol/blood , Methanol/blood , Chromatography, Gas , Humans , Methods , Nitriles/bloodSubject(s)
Diffuse Cerebral Sclerosis of Schilder/etiology , Diffuse Cerebral Sclerosis of Schilder/pathology , Virus Diseases , Adult , Brain/pathology , Diffuse Cerebral Sclerosis of Schilder/complications , Humans , Inclusion Bodies, Viral , Leukemia, Myeloid/complications , Male , Microscopy, Electron , Neuroglia , Papillomaviridae/isolation & purification , PolyomaviridaeABSTRACT
Transient ischemic attacks (TIAs) are brief reversible episodes of neurological dysfunction due to temporary focal cerebral ischemia. Angiography should be performed only when operation is indicated or when the diagnosis is in doubt. Surgical treatment is recommended when the patient is a good surgical risk, when the stenosis is more than 70 per cent in the appropriate vessel and in certain patients with less severe stenotic lesions that appear to be a probable source of emboli. Anticoagulant therapy is indicated when there are recurrent TIAs, when the patient is not a good surgical candidate and when no appropriate surgically remediable lesion is found by angiography. If there is any significant contraindication to anticoagulants they should not be given. Discontinuance of anticoagulant therapy when the patient has been symptom-free for six months is recommended. In the experience of the authors the TIA syndrome is more benign in its course than was originally suspected and a conservative approach to surgical and anticoagulant therapy is recommended.
