RESUMEN
PURPOSE: To determine the success rate of revision endoscopic dacryocystorhinostomy (DCR) with an injection of intraoperative betamethasone under local anaesthetic. METHODS: In a prospective, nonrandomized consecutive case series, 16 adult patients (19 eyes) with failed primary endoscopic DCR underwent revision surgery under assisted local anaesthetic. During revision endoscopic DCR, 1mg of betamethasone was injected into the lacrimal sac and scar tissue surrounding the surgical osteum. The surgical success rate was then determined based on anatomical patency and resolution of patient symptoms. RESULTS: There were 16 patients (12 female, 4 male) and 3 had bilateral surgery. Patient ages ranged from 43 to 92 (mean 67). Follow up ranged from 1 to 15 months (mean 9). Anatomical patency was achieved in 16 cases (84%) and patient symptoms had improved in 17 cases (89%). Of the two cases that continued to have symptoms 1 achieved anatomical patency and the other had not. CONCLUSIONS: Revision endoscopic DCR, under assisted local anaesthetic, had a high success rate (89%) when an injection of betamethasone was administered intraoperatively.
Asunto(s)
Anestésicos Locales/administración & dosificación , Betametasona/administración & dosificación , Dacriocistorrinostomía/métodos , Endoscopía , Glucocorticoides/administración & dosificación , Conducto Nasolagrimal/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Anestesia Local/métodos , Femenino , Humanos , Inyecciones , Aparato Lagrimal/efectos de los fármacos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Reoperación , Resultado del TratamientoAsunto(s)
Implantación de Lentes Intraoculares , Lentes Intraoculares , Facoemulsificación , Trastornos de la Visión/cirugía , Anciano , Antihipertensivos/uso terapéutico , Catarata/complicaciones , Quimioterapia Combinada , Femenino , Glaucoma de Ángulo Abierto/complicaciones , Glaucoma de Ángulo Abierto/tratamiento farmacológico , Humanos , Latanoprost , Prostaglandinas F Sintéticas/uso terapéutico , Timolol/uso terapéutico , Trastornos de la Visión/etiología , Trastornos de la Visión/fisiopatología , Agudeza Visual/fisiologíaRESUMEN
We report the case of a 72-year-old woman who experienced transient complete visual loss and a partial third nerve palsy in 1 eye following cataract surgery under local anesthesia in the fellow eye. Symptoms and signs were determined to result from the administration of a peribulbar block, which was presumably associated with ipsilateral transoptic nerve sheath spread. We believe this is the first report of contralateral amaurosis and oculomotor nerve palsy following peribulbar anesthesia.
Asunto(s)
Anestesia Local/efectos adversos , Ceguera/etiología , Extracción de Catarata , Enfermedades del Nervio Oculomotor/etiología , Anciano , Amidas/administración & dosificación , Anestésicos Locales/administración & dosificación , Ceguera/fisiopatología , Femenino , Lateralidad Funcional , Humanos , Enfermedades del Nervio Oculomotor/fisiopatología , Órbita , RopivacaínaRESUMEN
A case is reported of a 72-year-old man with an intruded scleral buckle presenting 30 years after retinal detachment repair. The lesion was noted incidentally and occupied the superotemporal retinal periphery. The diagnosis was confirmed by B-scan ultrasonography and external examination of the globe. The patient was treated conservatively. No clinical change was evident after 12 months follow up.
Asunto(s)
Cuerpos Extraños en el Ojo/etiología , Migración de Cuerpo Extraño/etiología , Enfermedades de la Retina/etiología , Curvatura de la Esclerótica/efectos adversos , Anciano , Cuerpos Extraños en el Ojo/diagnóstico por imagen , Cuerpos Extraños en el Ojo/cirugía , Migración de Cuerpo Extraño/diagnóstico por imagen , Migración de Cuerpo Extraño/cirugía , Humanos , Masculino , Desprendimiento de Retina/cirugía , Enfermedades de la Retina/diagnóstico por imagen , Enfermedades de la Retina/cirugía , UltrasonografíaRESUMEN
A 37-year-old woman presented with flashes in her left eye and bilateral visual distortion. Fundal examination revealed a reticular 'fishnet' pattern of retinal pigmentation in both eyes consistent with reticular dystrophy of the retinal pigment epithelium. In the left eye there was a small haemorrhage and a shallow serous macular detachment. Fluorescein angiography demonstrated subfoveal choroidal neovascularization. Indocyanine green angiography (ICG) revealed more extensive involvement than fluorescein angiography, with small areas of intense hyperfluorescence amongst reticular areas of hypofluorescence. These changes, as interpreted in light of the known histopathological localization of ICG, are consistent with varying stages of dysfunction of the retinal pigment epithelium in this disease.
Asunto(s)
Neovascularización Coroidal/complicaciones , Colorantes , Angiografía con Fluoresceína , Verde de Indocianina , Epitelio Pigmentado Ocular/patología , Degeneración Retiniana/diagnóstico , Adulto , Neovascularización Coroidal/diagnóstico , Femenino , Humanos , Degeneración Retiniana/etiologíaRESUMEN
PURPOSE: To examine the safety and efficacy of limited macular translocation followed by laser photocoagulation in the management of subfoveal choroidal neovascularization (CNV) in age-related macular degeneration (AMD). METHODS: A prospective study was conducted on eight consecutive patients undergoing limited macular translocation followed by laser photocoagulation for the treatment of subfoveal classic CNV form of AMD. Patients were followed up for a minimum of 12 months. The magnitude of foveal translocation, visual outcomes and complications were assessed. RESULTS: In all cases the fovea was successfully translocated inferiorly, with a median displacement of 1.1 mm. Thermal laser photocoagulation was subsequently performed in all cases. Visual acuity improved in five eyes, remained unchanged in two eyes and worsened in one eye. The mean improvement in visual acuity was by 0.19 logMAR. At 12 months, six of the eight patients (75%) achieved Snellen visual acuity of at least 6/15, with four patients (50%) achieving Snellen visual acuity of 6/9. CONCLUSION: In this small case series, limited macular translocation was found to be an effective and reproducible means of treating small well-defined subfoveal CNV.