RESUMEN
Despite the fact that the majority of eyelid tumors are benign, proper management in daily practice requires detection of the malignant ones. Several clinical criteria are usually proposed to support or reject a hypothesis of malignancy; however, most are of limited reliability. In any case of doubt, outpatient biopsy is recommended, so as to establish the correct diagnosis and formulate the most appropriate treatment plan. In all facial malignancies, the first (and absolutely mandatory) consideration is control of the cancer. Then, restoration of eyelid function can be addressed, in the following order: protection of the globe by complete dynamic eyelid closure and opening, visual function (and prevention of possible deprivation amblyopia) by insuring a clear visual axis, correction of the tear film, efficient lachrymal drainage, and only then the role of the eyelids in facial expression and esthetics. For most malignant eyelid tumors, the best assurance of complete excision is obtained by extemporaneous examination of the resection margins by frozen section (by Mohs' micrographic surgery techniques, or a variation thereof). Currently, advancement and transposition flaps, possibly in combination with tarso-conjunctival or skin grafts, are the most utilised techniques. Despite the lack of histological verification, new treatment modalities, including topical chemotherapy, photodynamic therapy and cryotherapy, may provide interesting treatment options, particularly in collaboration with the dermatologist.
Asunto(s)
Carcinoma/terapia , Neoplasias de los Párpados/terapia , Edad de Inicio , Carcinoma/diagnóstico , Carcinoma/epidemiología , Carcinoma/etiología , Terapia Combinada/métodos , Criocirugía/métodos , Técnicas de Diagnóstico Oftalmológico , Neoplasias de los Párpados/diagnóstico , Neoplasias de los Párpados/epidemiología , Neoplasias de los Párpados/etiología , Humanos , Terapia por Láser/métodos , Procedimientos Quirúrgicos Oftalmológicos/métodos , Procedimientos Quirúrgicos Oftalmológicos/tendencias , Fototerapia/métodos , Factores de RiesgoRESUMEN
La anestesia subtenoniana es una técnica efectiva y bien tolerada que permite realizar intervenciones de la cámara anterior y posterior del ojo. Ofrece similares ventajas que la anestesia peribulbar y retrobulbar al tiempo que minimiza sus complicaciones. La anestesia subtenoniana proporciona mejor analgesia que aquinesia. Frente a las anestesias tópica e intracamerular, la mayoría de estudios aboga por la anestesia subtenoniana como la técnica de elección, ya que disminuye los potenciales efectos adversos de las otras técnicas regionales y proporciona mejor analgesia y aquinesia(AU)
Sub-Tenon anesthesia is an effective, well-tolerated technique for surgery in the anterior or posterior compartments of the eye. The advantages of this block are comparable to those of peribulbar and retrobulbar anesthesia and complications are minimal. Sub-Tenon anesthesia provides better analgesia than akinesia. Most studies suggest that sub-Tenon anesthesia is a good technique to choose, given that potential adverse effects are fewer than for other regional blocks and analgesia and akinesia are superior(AU)
Asunto(s)
Humanos , Masculino , Femenino , Anestesia de Conducción/instrumentación , Anestesia de Conducción/métodos , Procedimientos Quirúrgicos Oftalmológicos/métodos , Procedimientos Quirúrgicos Oftalmológicos/tendencias , Anestesia Local/tendencias , Anestesia Local , Extracción de Catarata/métodos , Extracción de Catarata/tendencias , Hemorragia Retrobulbar/complicaciones , Hemorragia Retrobulbar/epidemiología , Anestesia de Conducción/tendencias , Anestesia de Conducción , Procedimientos Quirúrgicos Oftalmológicos , Anestesia/efectos adversosRESUMEN
A fifth annual survey was carried out by mail in February 1997 to investigate the current trends in cataract and refractive surgery in Japan. A questionnaire was sent to 867 ophthalmologist members of the Japanese Society of Cataract and Refractive Surgery. Data received from 440 (50.7%) of the recipients were cross-analyzed and compared with those from the previous surveys. For cataract surgery, there have been trends toward more surgical procedures performed by a surgeon, shorter period of hospitalization, and increased number of outpatient surgery. Ninety percent of respondents preferred phacoemulsification, 42% employed the self-sealing wound closure technique, and 26% used topical anesthesia for phacoemulsification. As for refractive surgery, surgeons remained rather conservative, with 26% and 6% of surgeons doing astigmatic keratotomy and refractive keratotomy, respectively.