Vibration Exposure Safety Guidelines for Surgeons Using Power-Assisted Liposuction (PAL).

BACKGROUND: As power-assisted liposuction (PAL) gains in popularity, plastic surgeons operating these devices experience occupational exposure to hand-transmitted vibration, which can result in hand-arm vibration syndrome, a debilitating neurovasculopathy. OBJECTIVES: The objective of the study was to determine vibration exposure from the utilization of a PAL device during surgery to generate recommendations for safe use. METHODS: Vibration emission of a commonly utilized PAL system (MicroAire-650, Surgical Instruments, Charlottesville, VA) was examined employing a vibration data logger under both controlled laboratory conditions and during 13 typical liposuction cases. Data were analyzed and compared with established safety limits of vibration exposure. RESULTS: The experiments demonstrated a mean vibration magnitude of typical liposuction surgeries to be 5.69 ±â€…0.77 m/s2 (range, 4.59-6.27 m/s2), which is significantly higher than the manufacturer declared value of 3.77 m/s2. Cannula size was shown to be the most significant contributor to vibration magnitude, with larger cannulas causing more vibration transmission. CONCLUSIONS: These results indicate that recommendations must be made to prevent undue occupational exposure to vibration from PAL. The MicroAire-650 can generally be safely utilized for less than 1.5 h/d. At exposure levels >1.5 h/d, there is increased risk of developing vibration-related injuries, and vibration-reducing strategies should be implemented. At exposure levels >6 h/d, the safety limit is exceeded and there is significantly increased risk of developing hand-arm vibration syndrome and vibration exposure should be halted.

Risk Factors for the Development of Fellow Eye Horseshoe Retinal Tears Following Horseshoe Retinal Tear in the Presenting Eye.

BACKGROUND: This study investigated factors associated with fellow eye horseshoe retinal tear (HST) development in consecutive patients with a presenting eye HST. MATERIALS AND METHODS: Medical records were reviewed for patients with initial HSTs between 2015 and 2017 and 24 factors were analyzed. Logistic regression was used to assess factors associated with fellow eye HST development. RESULTS: In total, 242 patients with an HST were identified with mean follow-up of 68.3 months. Four associations with fellow eye HST development were identified: (1) presence of fellow eye lattice degeneration, (2) subsequent presenting eye HSTs, (3) fellow eye vitreous hemorrhage at presenting eye HST occurrence, (4) OCT-determined stage 3 fellow eye posterior vitreous detachment at presenting eye HST occurrence. CONCLUSION: Four clinical findings associated with fellow eye HST development following presenting eye HST were identified. These factors may be important considerations during management patients with HST. [Ophthalmic Surg Lasers Imaging Retina 2023;54:338-345.].

Quantifying burden of intravitreal injections: questionnaire assessment of life impact of treatment by intravitreal injections (QUALITII).

AIM: To quantify the areas of burden experienced by patients requiring repeated intravitreal injections (IVI) in the management of exudative retinal diseases. METHODS: The validated Questionnaire to Assess Life Impact of Treatment by Intravitreal Injections survey was administered to patients at four retina clinical practices across four US states. The primary outcome measure was Treatment Burden Score (TBS), a single score assessing overall burden. RESULTS: Of 1416 (n=657 age-related macular degeneration; n=360 diabetic macular oedema/diabetic retinopathy; n=221 retinal vein occlusion; n=178 other/uncertain) patients, 55% were women with an average age of 70 years. Patients most frequently reported receiving IVI every 4-5 weeks (40%). The mean TBS was 16.1±9.2 (range 1-48; scale of 1-54), and the TBS was higher in patients with diabetic macular oedema and/or diabetic retinopathy (DMO/DR) (17.1) compared with those with age-related macular degeneration (15.5) or retinal venous occlusive (15.3) (p=0.028). Though the mean level of discomfort was quite low (1.86) (scale 0-6), 50% of patients reported experiencing side effects more than half of the visits. Patients having received fewer than 5 IVI reported higher mean anxiety levels before (p=0.026), during (p=0.050) and after (p=0.016) treatment compared with patients having received more than 50 IVI. After the procedure, 42% of patients reported restrictions from usual activities due to discomfort. Patients reported a high mean satisfaction rating of 5.46 (scale 0-6) with the care of their diseases. CONCLUSIONS: The mean TBS was moderate and highest among patients with DMO/DR. Patients with more total injections reported lower levels of discomfort and anxiety but higher disruption to daily life. Despite the challenges related to IVI, the overall satisfaction with treatment remained high.