RESUMO
The use of simple, flexible, efficient eye departments which make good use of available personnel and appropriate technology can be a very effective method of offering eye care and cataract surgery to large numbers of patients in the tropics and elsewhere. Such a department in a village hospital in Pakistan is described as an example of how effective such an approach can be in the delivery of cataract surgery and other eye care.
Assuntos
Extração de Catarata , Países em Desenvolvimento , Atenção à Saúde , Hospitais Rurais , Humanos , Paquistão/epidemiologiaRESUMO
A randomized, controlled, prospective comparison of the effectiveness of anterior and posterior injections of antibiotics in the prevention of endophthalmitis following cataract extraction was carried out in a village hospital in Pakistan. The study involved 77,015 cataract operations performed mainly by two surgeons. Anterior subTenon injections ("subconjunctival") and posterior subTenon injections ("retrobulbar") were equally effective in preventing postoperative infection.
Assuntos
Ampicilina/uso terapêutico , Extração de Catarata , Endoftalmite/prevenção & controle , Penicilina G/uso terapêutico , Complicações Pós-Operatórias/prevenção & controle , Pré-Medicação , Ampicilina/administração & dosagem , Ensaios Clínicos como Assunto , Humanos , Injeções , Penicilina G/administração & dosagem , Estudos Prospectivos , Distribuição AleatóriaRESUMO
Between 1978 and 1983, 13,890 cataract extractions were performed in Baltimore at JHH and the GBMC with 14 expulsive hemorrhages for an incidence of 0.10%. In the years 1963 through 1983, 180,690 cataract extractions were performed in Taxila, Pakistan with 87 expulsive hemorrhages for an incidence of 0.05%. Reasons for the significant differences in incidence are presented. The six reported cases of bilateral expulsive hemorrhage are reviewed. Four more cases are added. A classification of choroidal hemorrhage is presented.
Assuntos
Extração de Catarata/efeitos adversos , Corioide , Hemorragia/etiologia , Idoso , Feminino , Angiofluoresceinografia , Seguimentos , Hemorragia/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Terminologia como Assunto , Fatores de Tempo , Doenças da Úvea/diagnóstico , Doenças da Úvea/etiologiaRESUMO
Nonconcurrent analysis of 45,954 cataract operations performed by a single surgeon indicates that periocular injection of penicillin combined with multiple preoperative applications of topical chloramphenicol-sulphadimidine reduced the incidence of postoperative endophthalmitis by 72%. Periocular penicillin alone was ineffective. A concurrent masked randomized study of 6,618 cataract operations confirms the efficacy of combined prophylaxis and demonstrates that the topical regimen, by itself, is as ineffective as isolated penicillin prophylaxis.
