Anillo de Malyugin para miosis intraoperatoria en femtofacovitrectomía / Malyugin ring for intraoperative miosis in femtosecond laser phacovitrectomy

OBJETIVO: Evaluar la utilidad del anillo de Malyugin transoperatorio en escasa dilatación pupilar durante facoemulsificación asistida con láser de Fs combinado con vitrectomía pars plana 23 G (femtofacovitrectomía). MÉTODO: Se presenta una mujer de 57 años con catarata y hemorragia vítrea, dilatación pupilar de 5,5 mm. Se realiza facoemulsificación asistida con láser de femtosegundo, colocando anillo de Malyugin posterior a extracción de cápsula anterior, seguido de vitrectomía pars plana y retirándolo al final. RESULTADOS: Se logró una dilatación pupilar transoperatoria adecuada, sin complicaciones, con una agudeza visual posoperatoria de 20/40. CONCLUSIONES: El uso del anillo de Malyugin puede ser una alternativa útil en casos con escasa dilatación pupilar en femtofacovitrectomía, conservando la integridad anatómica-funcional pupilar

OBJECTIVE: To evaluate the usefulness of the Malyugin ring in poor pupil dilation during phacoemulsification assisted with femtosecond laser with 23 gauge pars plana vitrectomy. METHOD: A 57-year-old female with cataract and vitreous hemorrhage, and poor pupil dilation (5.5 mm). The phacoemulsification assisted with femtosecond laser, using Malyugin ring after capsulorrhexis, followed by pars plana vitrectomy, and removing at the end without complications. RESULTS: A successfull intraoperative pupil dilation was achieved without complications, with a final BCVA of 20/40. CONCLUSIONS: The Malyugin ring is an effective alternative in cases with poor pupil dilation in femtophacovitrectomy, preserving the anatomical and functional integrity

Síndrome de Stickler. Epidemiología del desprendimiento de la retina / Stickler syndrome. Epidemiology of retinal detachment

OBJETIVO: Revisión de todos los pacientes con síndrome de Stickler que se han tratado en nuestro centro desde su descripción, para valorar el riesgo de padecer desprendimiento de la retina (DR). MÉTODOS: Un total de 14 pacientes, diagnosticados por criterios clínicos, en los que hemos valorado las siguientes variables: sexo, edad, antecedentes oculares, seguimiento, agudeza visual (AV) inicial y final, refracción, tratamiento profiláctico, cirugías y la técnica empleada. Mediante el análisis de curva de supervivencia de Kaplan-Meier hemos determinado la edad riesgo de padecer DR así como cataratas. RESULTADOS: En total fueron 5 hombres y 9 mujeres. La AV mediana inicial fue de 0,35, igual que la AV final. Refracción mediana de −9,5 dioptrías de miopía. La mediana de seguimiento de 7 años. Los antecedentes oculares fueron 4 DR y 2 Lasik. Las cirugías que realizamos han sido 8 DR, 12 cataratas, 2 glaucomas, 2 agujeros maculares y una endotropía. La mediana de años en el que sucedió el DR fue de 20 y las cataratas a los 34. La técnica quirúrgica utilizada en 4 casos ha sido el cerclaje y en los otros 4 restantes cerclaje con vitrectomía vía pars plana. Un total de 6 ojos han sido tratados profilácticamente: uno con cerclaje, 4 con fotocoagulación láser y otro con criocoagulación; de estos, 2 han presentado DR. CONCLUSIONES: En nuestra serie, el DR en esta dolencia se desarrolla mayoritariamente en la segunda década de la vida. Las cataratas, fundamentalmente en la cuarta década

OBJECTIVE: A review was performed on all patients with Stickler syndrome that had been treated in our Centre since it was diagnosed, in order to evaluate the risk of suffering a retinal detachment (RD). METHODS: A total of 14 patients, diagnosed by clinical criteria, were included. The following variables were evaluated: age, gender, ocular background, follow-up, initial and final visual acuity (VA), optical prescription, prophylactic treatment, surgery and techniques performed. The risk age to suffer a RD, as well as cataracts, was determined by using the Kaplan-Meier survival curve analysis. RESULTS: From a total of 5 men and 9 women, the median initial VA was 0.35, which was the same as the final VA. The median optical prescription was -9.5 D myopia. The median of follow-up was 7 years. Ocular background was 4 RD cases and 2 Lasik surgeries. The operations performed were 8 RD, 12 cataract, 2 glaucoma, 2 macular hole, and one endotropia. The median age of RD was 20 years and cataract 34 years. As regards surgical tecnique, 4 scleral buckle cases, and 4 scleral buckle + pars plana vitrectomy cases were formed. The prophylactic treatments performed were: one scleral buckle case, 4 endolaser photocoagulation, and one cryotherapy. Two of which presented with RD. CONCLUSION: In the series presented, retinal detachment in Stickler syndrome mainly occurs in the second decade of life, with cataracts mainly developing in the fourth decade

Effects of aromatherapy massage on face-down posture-related pain after vitrectomy: a randomized controlled trial.

Postoperative face-down posturing (FDP) is recommended to optimize the effects of intraocular gas tamponade after vitrectomy. However, patients undergoing FDP usually experience physical and psychological burdens. This 3-armed, randomized, single-center trial investigated the effects of aromatherapy on FDP-related physical pain. Sixty-three patients under FDP were randomly allocated to one of three treatment groups: aromatherapy massage with essential oil (AT), oil massage without essential oil (OT), and a control group. The AT and OT groups received 10 minutes of massage by ward nurses trained by an aromatherapist, while the control group received usual care. Outcomes were assessed as short-term (pre- to post-intervention) and long-term (first to third postoperative day) changes in physical pain in five body regions using face-scale. The AT and OT groups both revealed similar short-term pain reductions after intervention, compared with the control group. Regarding long-term effects, neither group experienced significant effects until the second day. Significantly more pain reduction compared with usual care occurred on the third day, mainly in the AT group, though there were few significant differences between the AT and OT groups. In conclusion, this study suggests that simple oil massage is an effective strategy for immediate pain reduction in patients undergoing FDP, while aromatherapy may have a long-term effect on pain reduction.

Coordination skills during vitrectomy in treatment of proliferative diabetic retinopathy.

PURPOSE: To discuss effective nursing and coordination skills for vitrectomy in the treatment of diabetic retinopathy. METHODS: Fifty patients (51 eyes) with diabetic retinopathy required vitrectomy were enrolled in this study. Individual nursing service was delivered by strengthening preoperative preparation, providing psychological nursing, and intraoperative observation of the severity of diseases by circulating nurses; meticulous nursing was given postoperatively. RESULTS: All 50 patients underwent surgery successfully. Intraoperatively, patients had stable physical signs. Five patients had postoperative visual acuity < 0.05, 14 with 0.05 to 0.1, 20 with 0.1 to 0.3 and 16 with > 0.3. No complicated infection was seen. CONCLUSION: For patients diagnosed with proliferative diabetic retinopathy requiring vitrectomy, full preparations should be made and psychological nursing should be delivered preoperatively, the severity of diseases and clinical reactions should be closely observed intraoperatively, and proper processing and nursing measures should be taken postoperatively, which collectively enhance surgical success rate, decrease surgical complications, and attain favorable treatment efficacy.

Ocular complications associated with diabetes mellitus.

Diabetes is a progressive disease that may adversely affect healthy functioning of the body. The eyes are often indicators of systemic disease and are particularly vulnerable to the pathophysiological changes that occur as a result of diabetes. This article provides an overview of five main ocular complications associated with diabetes, cataract, diabetic retinopathy, central retinal vein occlusion, central retinal artery occlusion and neovascular glaucoma. The assessment and treatment of such complications and the role of the nurse in the care and management of patients are discussed.

Using research to improve ophthalmic nursing care.

This article focuses on the way in which the nursing care of patients undergoing vitreoretinal surgery was developed as a result of an action research project. The research project is described and the following practice developments are discussed: the preoperative preparation of patients; the physiological effects of posturing; communication between patients, staff and the multidisciplinary team; and the knowledge base and clinical skills of nurses. These developments are evaluated and suggestions for future practice are made.

Diabetic retinopathy.

The risk of blindness is 25 times greater in diabetics than nondiabetics. Medical, laser, and surgical interventions have the potential to enhance greatly the prognosis of maintaining useful vision throughout life. Patient education is paramount to improve comprehension of the condition, recommended treatment modalities, and compliance with prescribed regimens. Nursing assessments and interventions related to anxiety, discomfort, ineffective coping mechanisms, and immobility add a quality link in the multidisciplinary approach surrounding the delivery of care to patients with diabetic retinopathies.