RESUMO
Retrobulbar haemorrhage is a rare and potentially sight threatening complication after peribulbar local anaesthetic injection for cataract surgery. A case is reported of a woman who developed this complication and was subsequently found to have been taking Gingko biloba extract tablets which may have predisposed her to developing the haemorrhage.
Assuntos
Ginkgo biloba/efeitos adversos , Hemorragia Retrobulbar/induzido quimicamente , Idoso , Anestésicos Combinados/administração & dosagem , Bupivacaína/administração & dosagem , Interações Medicamentosas , Feminino , Humanos , Lidocaína/administração & dosagem , Facoemulsificação , Extratos Vegetais/efeitos adversos , Hemorragia Pós-Operatória/etiologia , ComprimidosRESUMO
PURPOSE: The aim of the study was to assess and compare the degree of capsulorhexis phymosis following uncomplicated phacoemulsification cataract surgery in polymethylmethacrylate (PMMA) and silicone lens implants. METHOD: Sixty-four patients were evaluated 1 day, 6 weeks and 6 months following phacoemulsification cataract extraction. The anterior capsular diameters were measured with the illuminated beam of the slit lamp at 45 degrees and 135 degrees and the surface area of the opening calculated. We have measured and compared the change in the capsulorhexis size for both lens types and assessed its statistical significance with a paired Student's t-test. RESULTS: A statistically significant contraction of the capsulorhexis was noted in all patients within the first 6 weeks (p < 0.001). Capsular contraction continued between 6 weeks and 6 months post-operatively but to a lesser extent (p < 0.05). The difference in the degree of phymosis between the first period (1 day to 6 weeks) and the second (6 weeks to 6 months) was statistically highly significant for all patients (p < 0.001). The capsular areas for the silicone lens implants were significantly smaller than for the PMMA implants at 6 weeks and 6 months. None of our patients had a clinically significant capsular contracture requiring Nd:YAG laser capsulotomy. CONCLUSION: Anterior capsular contraction is commonly observed following capsulorhexis in phacoemulsification surgery. This study demonstrates that the maximum rate of contraction occurs in the first 6 weeks following surgery and is more pronounced with silicone lens implants.
Assuntos
Capsulorrexe/efeitos adversos , Contratura/etiologia , Cápsula do Cristalino/patologia , Facoemulsificação/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Contratura/patologia , Feminino , Seguimentos , Humanos , Doenças do Cristalino/etiologia , Lentes Intraoculares , Masculino , Pessoa de Meia-Idade , Polimetil Metacrilato , SiliconesRESUMO
This study of 20 patients undergoing elective cataract surgery was performed to investigate the change in intraocular pressure that accompanies extraconal peribulbar anaesthesia. We have demonstrated that each injection during peribulbar anaesthesia causes a small rise in intraocular pressure. The routine use of conventional external ocular compression overcomes this pressure rise and safely provides a satisfactory and progressive reduction in intraocular pressure prior to surgery. Our findings suggest that the volumes of anaesthetic solutions used in fractional peribulbar anaesthesia, if used in conjunction with external compression devices, result in intraocular pressures acceptable for intraocular surgery.
Assuntos
Anestésicos Locais/efeitos adversos , Pressão Intraocular/efeitos dos fármacos , Idoso , Idoso de 80 Anos ou mais , Extração de Catarata , Feminino , Humanos , Pressão Intraocular/fisiologia , Período Intraoperatório , Masculino , Pessoa de Meia-IdadeRESUMO
A patient presented with a posterior uveitis. An inferior plaque of retinal exudation was seen. Full investigation failed to establish a cause until six weeks later, when cryptococcal meningitis developed. The patient was immunocompetent. Exudation in relation to retinal vessels is unusual in idiopathic posterior uveitis, and cryptococcosis should be considered in the differential. Diagnosis is by lumbar puncture or vitreous aspiration.
Assuntos
Criptococose/complicações , Meningite/complicações , Uveíte/etiologia , Adulto , Encéfalo/diagnóstico por imagem , Criptococose/diagnóstico , Criptococose/diagnóstico por imagem , Diagnóstico Diferencial , Exsudatos e Transudatos , Humanos , Masculino , Meningite/diagnóstico por imagem , Vasos Retinianos , Tomografia Computadorizada por Raios X , Uveíte/diagnósticoRESUMO
Four cases of albinism with haemorrhagic diathesis (Hermansky-Pudlak syndrome) are presented. The cases displayed wide phenotypic variation. Electroretinography was performed on all four patients and was found to be normal. One patient developed a cutaneous malignant melanoma.
Assuntos
Albinismo/complicações , Transtornos Hemorrágicos/complicações , Adulto , Albinismo/fisiopatologia , Eletrorretinografia , Feminino , Transtornos Hemorrágicos/fisiopatologia , Humanos , Masculino , Melanoma/complicações , Pessoa de Meia-Idade , Fenótipo , Neoplasias Cutâneas/complicações , SíndromeRESUMO
Albinism is the term applied to a heterogeneous group of genetically determined disorders characterized by hypopigmentation and affecting the eyes. After describing the clinical features of albinism in general, the authors discuss the various forms of oculocutaneous albinism, ocular albinism, and albinoidism that are of interest to the ophthalmologist. Emphasis is placed on the ocular features of each form. The visual pathway abnormalities and the clinical management of albinism are discussed.
