Subject(s)
Lenses, Intraocular/history , Cataract Extraction , History, 20th Century , Humans , United KingdomABSTRACT
Day-case cataract surgery and the need for local anaesthesia are likely to increase. Retrobulbar (and peribulbar) anaesthetic injection is a common technique in cataract surgery, but serious complications are persistently reported. Subconjunctival injection is an alternative that avoids these risks. This retrospective study compares two groups of patients that underwent extracapsular cataract surgery under local anaesthetic. One group (retrobulbar) had uncomplicated retrobulbar injection with bupivicaine and hyaluronidase. The other group (non-retrobulbar) had superior bulbar, subconjunctival infiltration with bupivicaine and hyaluronidase. The operative complications and postoperative visual outcomes were similar in both groups. These results may encourage the investigation and adoption of the subconjunctival alternative to retrobulbar anaesthetic injection in cataract surgery.
Subject(s)
Anesthesia, Local/methods , Cataract Extraction , Aged , Aged, 80 and over , Bupivacaine/administration & dosage , Conjunctiva , Female , Humans , Hyaluronoglucosaminidase/administration & dosage , Injections , Male , Middle Aged , Orbit , Postoperative Complications/etiology , Retrospective Studies , Visual AcuityABSTRACT
Ninety-two eyes with newly-diagnosed chronic open angle glaucoma (COAG) were treated in a randomised prospective trial with either timolol or pilocarpine. Their visual field survival was monitored on a 3-monthly basis over 2 years using both Goldmann and Friedmann perimetry. Concomitant tonometric data was derived by applanation. Fields were assessed and quantified using algorithms designed to give the greatest sensitivity for glaucomatous field loss. Microcomputer programmes specifically designed for this purpose were used in the data collection and subsequent analysis.
Subject(s)
Glaucoma, Open-Angle/drug therapy , Pilocarpine/therapeutic use , Timolol/therapeutic use , Aged , Clinical Trials as Topic , Female , Humans , Male , Middle Aged , Tonometry, Ocular , Visual Field TestsABSTRACT
An automated system for comprehensively monitoring glaucoma patients is described. This economic and practical microcomputer data system has been designed to be thoroughly 'clinician oriented' through the collaborative efforts of ophthalmological and computer specialists. It incorporates novel and efficient methods for transferring both automated and manually recorded perimetry data into analysable digital form. The system is inexpensive, simple to use, maintains safe records, allows thorough analysis of patient data, and can considerably reduce the administrative load on ophthalmological clinics.
Subject(s)
Computers , Glaucoma/diagnosis , Microcomputers , Data Display , Electronic Data Processing , Humans , Intraocular Pressure , Monitoring, Physiologic , Visual Field Tests , Visual FieldsABSTRACT
A simple method for quantifying visual field survival was devised to assess the progress of chronic simple glaucoma in 36 patients treated with timolol maleate over a 3-year period. Routine tonometric monitoring of the intraocular pressure (IOP) was carried out in conjunction with these Goldmann field studies. Statistical analysis revealed that field survival measurement provided a more consistent clinical guide to the progress of glaucoma under treatment than did IOP (p much less than 0.001). Timolol therapy was associated with sustained IOP reductions of 24.3-34.5%, and 63% of those treated who were monitored for field survival showed no significant field loss. The observed relationships of IOP to field survival are discussed.
Subject(s)
Glaucoma, Open-Angle/drug therapy , Propanolamines/therapeutic use , Timolol/therapeutic use , Visual Fields/drug effects , Aged , Female , Glaucoma, Open-Angle/physiopathology , Humans , Intraocular Pressure/drug effects , Male , Microcomputers , Middle Aged , Visual Field Tests/methodsABSTRACT
This short paper is not designed to show any new techniques and will not present any large scale statistical evidence. Rather it will, I hope, show a trend in the way intraocular implant surgery is progressing. I believe the problems are rarely due to the intraocular lens itself, but are more often due to a poor selection of cases and, all too often, an inadequately trained surgeon.
