ABSTRACT
The Posner-Schlossman syndrome (PSS) is an elusive disease that can lead to serious consequences such as glaucomatous damage. Deep sclerectomy has been proven thus far to be the most effective surgical intervention to keep intraocular pressure (IOP) elevation under control compared with other surgical techniques, because it presents the least amount of postoperative complications. The aim of this case report is to demonstrate the efficacy of deep sclerectomy with T-Flux and the long-lasting effects that persist after 7â years in an eye affected by PSS. This case report demonstrates that an intervention of deep sclerectomy can lead to excellent results in terms of visual acuity as well as IOP lowering early in the history of the patient affected by PSS so that it can preclude establishment of glaucomatous damage.
Subject(s)
Eye Diseases/surgery , Intraocular Pressure , Iridocyclitis , Ophthalmologic Surgical Procedures , Sclera/surgery , Adult , Eye Diseases/complications , Eye Diseases/diagnosis , Eye Diseases/pathology , Female , Glaucoma/surgery , Humans , Iridocyclitis/diagnosis , Iridocyclitis/etiology , Iridocyclitis/surgery , Syndrome , Treatment Outcome , Visual AcuityABSTRACT
INTRODUCTION: Retinal vein occlusion (RVO) is a common cause of unilateral visual loss. Evidence based treatment recommendations for patients with RVO cannot be made because of the lack of adequate clinical trials. To compare the efficacy and safety of aspirin and of a low molecular weight heparin, parnaparin, in the treatment of RVO. MATERIALS AND METHODS: In a multicenter, randomized, double blind, controlled trial eligible patients with a delay between symptoms onset and objective diagnosis of less than 15 days were randomized to aspirin 100 mg/day for 3 months or to a fixed daily dose of parnaparin, 12.800 IU for 7 days followed by 6.400 IU for a total of 3 months. Primary end-point of the study was the incidence of functional worsening of the eye with RVO at 6 months, as assessed by fluorescein angiography, visual acuity, and visual field. Study end-points were adjudicated by an independent committee. RESULTS: Sixty-seven patients were enrolled in the study and 58 of them (28 treated with parnaparin, 30 with aspirin) were evaluable for the analysis. Baseline characteristics were well balanced between groups. Functional worsening was adjudicated in 20.7% of patients treated with parnaparin and in 59.4% of patients treated with ASA (p=0.002). Recurrent RVO was diagnosed in 3 patients, all treated with ASA (p=n.s.). Bleeding rates were similar between the two groups. CONCLUSIONS: Parnaparin appears to be more effective than aspirin in preventing functional worsening in patients with RVO. The results of this study need to be confirmed in a larger clinical trial.
Subject(s)
Aspirin/therapeutic use , Fibrinolytic Agents/therapeutic use , Heparin, Low-Molecular-Weight/therapeutic use , Platelet Aggregation Inhibitors/therapeutic use , Retinal Vein Occlusion/drug therapy , Aspirin/adverse effects , Dose-Response Relationship, Drug , Double-Blind Method , Drug Administration Schedule , Female , Hemorrhage , Heparin, Low-Molecular-Weight/adverse effects , Humans , Male , Middle Aged , Platelet Function Tests , Treatment OutcomeABSTRACT
We evaluated the efficacy and safety of a single injection technique with a small volume of anesthetic for ocular peribulbar anesthesia. We included 857 patients undergoing various ophthalmic procedures. Anesthesia consisted of a medial percutaneous injection of 5-6.5 mL of 2% lidocaine. At 2 min 85.6% of the patients had a motor block of at least 50% and at 5 min 78.6% had a motor block >80%. After 5 min 100% of the patients had adequate surgical anesthesia. There were no serious block-related complications. The described technique is a simple and satisfactory alternative to the classical techniques.
