Evaluation of the Orssengo-Pye IOP corrective algorithm in LASIK patients with thick corneas.

BACKGROUND: The objective of this study was to evaluate the Orssengo-Pye central corneal thickness (CCT) Goldmann applanation tonometry (GAT) corrective algorithm by observing changes in GAT and CCT before and after laser in situ keratomileusis (LASIK) surgery in patients with CCT that remains greater than 545 microm postoperatively. METHODS: Tonometric and pachymetric measurements were made on 14 patients (28 eyes) before and after LASIK surgery. The selected patients were required to have average or above average postoperative central corneal thickness values in both eyes (not less than 545 microm). Preoperatively, all patients had CCT and GAT measurements taken. Postoperatively patients had CCT, GAT, and dynamic contour tonometric (DCT) measurements taken. RESULTS: Preoperatively, median CCT values were 589.536 microm. Median GAT values were 16.750 mmHg. Median corrected preoperative GAT values were 14.450 mmHg. After LASIK treatment, median CCT values were 559.417 microm. The decrease in median CCT was 30.119 microm. Median postoperative GAT values were 11.500 mmHg (decrease, 5.250 mmHg). Median corrected postoperative GAT values were 10.775 mmHg (decrease, 3.675 mmHg). Median postoperative DCT values were 17.858 mmHg. CONCLUSIONS: LASIK treatment causes a significant reduction in measured GAT intraocular pressure (IOP) values. The Orssengo-Pye formula, which attempts to correct for GAT error associated with individual variation in CCT, appears to yield misleading results in these circumstances. An unexpected 3.675-mmHg decrease in "corrected IOP" by the Orssengo-Pye method seen in this study may be attributed to some limitation or error in the formula. After adjusting for the approximate1.7-mmHg difference, which has been demonstrated between DCT and GAT, postoperative DCT values were similar to preoperative measured GAT values.

Chemotherapy-induced nausea and vomiting in routine practice: a European perspective.

GOALS OF WORK: The aim of this study was to evaluate the occurrence of chemotherapy-induced nausea and vomiting (CINV) and its effect on patients' ability to carry out daily life activities following moderately to highly emetogenic, first-cycle chemotherapy in routine practice in cancer centers of four different European countries. PATIENTS AND METHODS: This was a prospective, cross-sectional, nonrandomized, self-assessment study in 249 patients enrolled from cancer centers in Spain, Austria, Germany, and Switzerland. The study population consisted of 78% women, with a mean age of 54. Breast, lung, and ovarian cancers made up 75% of all cancers in the study. Patients received a mean of 2.0 chemotherapy agents and 2.5 antiemetic drugs. MAIN RESULTS: A total of 450 emetic episodes experienced by 243 patients was recorded over 5 days following chemotherapy, with an average of 1.8 episodes per patient (range: 0-28). A higher percentage of patients (38%) suffered from delayed compared to acute emesis (13%). Between 42% and 52% of all patients suffered from nausea (visual analogue scale > or = 5 mm) on any one day, peaking at day 3. Using the Functional Living Index for Emesis (FLIE) questionnaire, 75% of patients with nausea and 50% with vomiting reported a negative impact of these conditions on performance of daily living. CONCLUSIONS: CINV remains a significant problem in routine practice, particularly in the delayed phase posttreatment. Overall, CINV had a negative impact on patients' daily life.