ABSTRACT
The use of oxygen increases the risk of fire during ophthalmic surgery. A prospective clinical study was conducted involving 100 patients without pulmonary disease who had cataract surgery under local anesthesia using either oxygen or compressed air. No clinically significant difference in oxygen saturation between the two groups was found. There was no statistically significant difference in the net change in saturation, and the significant difference found in overall mean saturation between the two groups was invalidated by inherent machine error. Using compressed air instead of oxygen is suggested to reduce fire hazard during ophthalmic surgery.
Subject(s)
Air , Cataract Extraction , Fires/prevention & control , Oxygen/administration & dosage , Humans , Prospective Studies , Surgical Procedures, OperativeABSTRACT
An 87-year-old woman, who had undergone cataract surgery and vitrectomy OD two years previously, had a blind, painful right eye secondary to intraocular hemorrhage and glaucoma. At the initial examination, a flat area of darkly pigmented tissue was noted at the wound site of the previous cataract surgery, and uveal prolapse was diagnosed. One year later, pigmented tissue was also seen at the inferior limbus. Intraocular malignant melanoma was considered, and the eye was enucleated. Histologic study revealed areas of hemorrhage and epithelioid malignant melanoma. It is important to recognize that prolapse of tissue at a surgical wound site may represent an extension of an intraocular malignancy.
Subject(s)
Eye Neoplasms/diagnosis , Melanoma/diagnosis , Uveal Diseases/diagnosis , Aged , Aged, 80 and over , Diagnosis, Differential , Eye Neoplasms/pathology , Female , Humans , Melanoma/pathology , ProlapseABSTRACT
A plastic surgical drape was ignited by a disposable cautery during cataract surgery performed under local anesthesia. The flame was quickly extinguished, and the procedure was completed without complications. The patient did well postoperatively and attained a corrected visual acuity of 20/25. Precautions should be taken to minimize the possibility of fire occurring during ophthalmic surgery.
Subject(s)
Electrocoagulation , Fires/prevention & control , Cataract Extraction , Cellulose , Female , Humans , Middle Aged , Oxygen , PlasticsABSTRACT
A 50-year-old man sustained severe head injury, including a brief loss of consciousness, in an automobile accident. Skull X-ray films disclosed a fracture of the right superior orbit. Computed tomography demonstrated pneumocephalus and extension of the fracture into the sella turcica. Perimetric testing disclosed a bitemporal hemianopia along the vertical meridian. Visual acuity was 6/6 (20/20) in both eyes. Right macular sparing and left macular splitting were demonstrated by Amsler grid analysis as well as by the patient's description of target grids projected onto his maculas. Diplopia was attributed to direct grids projected onto his maculas. Diplopia was attributed to direct injury of the right superior rectus muscle and to the effect of bitemporal field loss. There was no evidence of pituitary dysfunction. No treatment of the patient's visual loss was undertaken. A six-month follow-up examination disclosed no change in the patient's visual field abnormalities.
Subject(s)
Hemianopsia/etiology , Pneumocephalus/complications , Sella Turcica/injuries , Skull Fractures/complications , Accidents, Traffic , Humans , Male , Middle Aged , Orbit/injuries , Pneumocephalus/diagnostic imaging , Sella Turcica/diagnostic imaging , Tomography, X-Ray Computed , Visual FieldsABSTRACT
A case of visual loss associated with surgical repair of a zygomatic-orbital floor fracture is presented. A review of the literature indicates relatively few cases of blindness reported in association with surgical intervention for these fractures; however, it must be recognized that this serious complication does occur. The patient's ocular status should be evaluated before, during, and after orbital surgery.
