Sub-Tenon S Block Versus Topical Anesthesia in Complicated Cataract Surgery
|
|
- Meagan Singleton
- 5 years ago
- Views:
Transcription
1 Med. J. Cairo Univ., Vol. 77, No. 3, June: , Sub-Tenon S Block Versus Anesthesia in Comlicated Cataract Surgery GHADA A. EL-AWADY M.D.* and SHERIF R. GOHAR, F.R.C.S.** The Deartments of Anesthesiology, Intensive Care and Pain Relief, National Cancer Institute, Cairo University* and Ohthalmology, Dhahran Eye Secialist Hosital, Dammam City, Saudi Arabia**. Abstract Purose: This is a rosective randomized comarative blind study designed to comare erioerative ain control, comlications and efficacy of sub-tenon's versus toical in corneal hacoemulsification surgery and foldable intraocular lens (IOL) imlantation in comlicated cataract atients. Methods: Ninety-eight atients were allocated randomly to either sub-tenon's or toical grou with reset criteria after obtaining a written informed consent. All surgeries were erformed by one surgeon. Perioerative ain was assessed using a visual analog ain scale (VAS) and comared for both techniques, related events and comlications together with intraoerative surgical comlications were comared. Visual exerience of atients during hacoemulsification cataract surgery was assessed; atient as well as surgeon satisfaction was also noted. Results: Ninety seven out of ninety eight atients comleted the study after exclusion of one case. The data of the two grous were comarable in terms of age, sex, ASA (American Society of Anesthesiologists) state, axial length of the eye and duration of surgery. There were no statistical differences between the 2 study grous in the reoerative eye comlications. Forty five atients out of 49 atients in toical grou and four atients out of 48 in subtenon's grou exerienced no ain during administration of < There was significant difference in ain intensity during surgery, immediately and 3 h after surgery <0.05. Sub-tenon grou had significantly more related comlications than toical grou <0.05. There was no significant difference in the intraoerative comlications between the two grous under study. About 16 atients of the sub-tenon's grou had absolute akinesia during surgery as comared to none in toical grou < aears to result in greater visual awareness than sub-tenon's block = Sub-tenon's block was found satisfactory by 46 atients of cases and they would Author corresondence: Dr. Ghada A. El-Awady, Assistant rofessor, National Cancer Institute, Cairo University, Kasr El-Aini St. Fom El-Khalig, Cairo, Egyt, ghada elawady@yahoo.com choose the same anaesthesia for another rocedure while thirty two atients of atients subjected to toical were satisfied < Surgical conditions were graded to be otimal by the surgeon (none-minimal difficulties) in 46 atients subjected to sub-tenon's block and in 32 atients subjected to toical < Conclusion: In comlicated cataract cases undergoing corneal hacoemulsification and foldable lens imlantation, sub-tenon's was suerior to toical. Our results showed that more significant and analgesia was achieved with the sub-tenon's block, led to more convenient surgical conditions and enhanced atient and surgeon satisfaction without comromising atient's safety. Key Words: Cataract surgery Phacoemulsification Subtenon's anaesthesia anaesthesia Pain score Comlications. Introduction THE technique of sub-tenon's, using a blunt needle, rovides a safe yet reliable alternative, and has raidly become the rocedure of choice for ohthalmic anesthetists and surgeons as well. In 1992, Stevens [1] described a single quadrant aroach for administering local anaesthetic into the sub-tenon s sace. has become widely racticed throughout the world. It is a safe and reliable technique which is very well tolerated by atients. It can rovide adequate for a number of ohthalmic rocedures ranging from cataract surgery to vitreoretinal surgery. The sensory comonent of the block is often very effective; however, total akinesia may not always be obtained. Significant comlications are rare, but many atients will exerience a degree of sub-conjunctival hemorrhage and swelling. was first roosed by Fichman [2] as an attractive alternative to the traditional invasive eye blocks, resulting in faster visual recovery and high atient satisfaction. The advan- 237
2 238 Sub-Tenon s Block Versus Anesthesia tages of toical include its ease of alication, minimal or even absent discomfort on administration, raid onset of and elimination of the otential risks associated with other regional blocks [2-6]. In addition to all of these advantages, the technique is economical, with no cosmetic adverse effects, and allows immediate visual rehabilitation. However, toical only blocks the trigeminal nerve endings, roviding comlete analgesia of the eye, the atient's otic nerve and motor neurons are not affected, resulting in reserved ocular motility. Patient reference for toical is increasing steadily and enhancing all efforts to move away from more invasive forms of so that cataract surgery can be described as "minimally invasive". Patients are also, imressed with toical and 'no-atch' surgery. Although revious reorts [2-7] indicate that toical is safe and effective in most uncomlicated cataract rocedures, various studies [3,8] suggest that toical should not be considered in eyes with severe concomitant ocular athological features. Maniulation of the iris or stretching of the ciliary and zonular tissues, which may be inevitable during surgery in comlicated cases, could irritate the unanesthetized ciliary nerve endings and result in atient discomfort and inadvertent eye movements, comromising the overall safety of the rocedure. While this has led an increasing number of surgeons to administer sulemental anesthetic agents by intracameral injection or by addition to the irrigation fluid used during the intraocular hase of surgery, [5,6,9,10] this drawback has forced others [11] to abandon toical in favor of other regional block. Aim of the work: Our study was designed to analyze the outcome of Sub-tenon's Vs. toical alone without sedation in atients with comlicated cataract undergoing corneal hacoemulsification and foldable intraocular lens (IOL) imlantation. Patients and Methods After aroval of the Local Ethics Committee of Dhahran eye secialist hosital (Tertiary centre), Damam city, Saudi Arabia, a randomized comarative blind study encountered 98 surgical rocedures erformed by one surgeon from March 2007 to December Eligible Patients were over 30 years old and less than 85 years American Society of Anesthesiologists hysical status (ASA) class I III, undergoing elective cataract surgery under local anaesthesia were recruited in the study. Those with active ocular infection, allergies to hyaluronidase or local anesthetics, re-existing extraocular muscle alsies, communication difficulties, over anxious atients and those with acute resiratory disease, atients refusing local anaesthesia or when the decubitus was imossible were excluded from the study. After obtaining written informed consent, articiants were allocated into two grous using sealed enveloe method; sub-tenon's block grou (STB) 49 atients or toical grou (TA) 49 atients. All the atients articiated in the study had 0ne of the eye comorbidities as: axial hyeroia (<21.0 mm), axial myoia ( >_26 mm), osterior synechia, oor uillary dilation ( < 3 mm), uveitis or revious intraocular surgery (glaucoma surgery, eriheral iridectomy, or membrane eeling and ars lana vitrectomy). At the room, monitoring included ECG, ulse oxymeter, and non-invasive arterial blood ressure. No sedation was used. The conjunctiva and area surrounding the eye were ainted with an aqueous iodine solution. All sub-tenon's blocks used the inferonasal route and were erformed using a 19 G Visitec sub-tenon cannula. After draing, a lid seculum was alied and two dros of toical 4% amethocaine were instilled. The atient was asked to look uwards and outwards. Blunt Westcott's scissors were used to make a small nick on both, the conjunctiva and the tenon s casule in the inferonasal quadrant, five to six mm from limbus, and then the scissor created a ath in the subtenon sace through the nick. Conjunctival forces were used to gri the conjunctiva and a subtenon cannula was then inserted on to the sclera guided along with the contour of the globe. 4-5ml of a mixture of 2ml of 2% lidocaine hydrochloride with einehrine 1:10 000, 2ml of 5% buivacaine and hyaluronidase 30 units/ ml was injected slowly in the osterior subtenon sace. After the sub-tenon's injection, the eye was closed and a digital massage was alied for 5 min, then globe akinesia was assessed. was achieved by instilling four dros of amethocaine 1% over a 30 minute- Interval reoeratively, the surgeon injected 0.2ml rilocaine 2% subconjunctivally at the incision site immediately before surgery. All atients in both grous did not receive any erioerative sedation or drugs that might imair their cognitive function. The Surgeon used a scleral tunnel incision, continuous curvilinear casulorhexis, bimanual nucleofractis hacoemulsification, asiration of cortical remnants, and insertion of a 5.0 mm olymethylmethacrylate intraocular lens into the ca-
3 Ghada A. El-Awady & Sherif R. Gohar 239 sular bag. The oerating microscoe emloyed coaxial illumination with two light sources (Zeiss system). Intraocular ressure (IOP) was measured before and 1 and 10 minutes after. The motility of the rectus muscles was evaluated before and minutes after the sub-tenon injection, and the atient's anxiety level was recorded immediately after. Age, sex, ASA PS, gender, axial length of the eye, and duration of surgery were recorded. Surgery and related comlications and the sulemental analgesia for the eye used by the surgeon were also recorded. Pain was assessed during conduction of, intraoeratively, immediately and 3 hours ostoeratively using Visual analog sore. Patients were asked to grade ain intensity from 0 (no ain) to 10 (worst imaginable ain). Visual awareness during surgery was assessed by asking the atients 10 minutes after the comletion of surgery to describe their visual exerience and the accetability of this exerience. Patient satisfaction after surgery was assessed by asking whether the alied tye of would be their referred tye in further eye surgery. The surgeon also graded the difficulties' he exerienced during surgery; none, minimal, moderate, difficult, and extremely difficult (surgery not ossible). Outcome measures were the number of comlications and adverse events arising erioeratively, ain scores (VAS), visual exerience during surgery and intraoerative conditions as judged by the surgeon. In addition, after comletion of the rocedure, atients were asked to what extent they were satisfied with the alied tye of, and would it be their choice in the future eye surgery if any. All atients were blinded to the tye of local they received, eye atch was alied for all the atients articiating in the study. Statistical analysis was done using SPSS 15 (SPSS Inc., Chicago IL, U.S.A.). Outcome measures were comared using unaired t test, Nominal data were analyzed using Chi square and Fisher s exact tests as aroriate. Data were resented as number of atients, ercentage, mean ± SD as indicated, <0.05 was considered statistically significant. Results We rosectively enrolled 98 atients in the study, who were randomized into grous: 49 in the STB. grou and 49 in the TA. grou there was no statistically significant difference between the grous in terms of age, sex, ASA (American Society of Anesthesiologists) state, axial length of the oerating eye or surgery duration (Table 1). One atient was excluded after failure of administrating the sub-tenon's block. Table (1): Patients' characteristics in the two grous under study. Age (y) 69± ± M/F 29/ 19 33/ ASA I/II/III 11/34/3 10/37/2 NS Duration of surgery 28±8.4 33± Axial length of the eye 23.2± ± Data were resented as mean ± SD or number of atients as aroriate. There were no statistical differences between the two study grous in the reoerative eye comlications as shown in (Table 2). Table (2): Preoerative eye comlications in the two grous under study. Preoerative comlications Posterior synechia High myoia Axial length >26 High hyeroia Axial length <21 Uveitis Poor uillary dilatation Previous surgery Pars lana vitrectomy, membrane eeling (PPV, MP) Glaucoma surgery Periheral iridectomy Data were resented as number of atient. We found a mean 3mmHg ±.21 ost-anesthetic rise in intraocular ressure in the STB grou, and no rise in the TA grou (Table 3).
4 240 Sub-Tenon s Block Versus Anesthesia Table (3): Anesthesia related events in the two grous under study. VAS (cm) Absolute akinesia (16) 33% (0) 0% <0.001 Limited globe movement (32) 67% (0) 0% <0.001 Rise of intraocular ressure 3±0.21 0±00 <0.001 Data were resented as number of atients and ercentage or mean±sd as aroriate. Forty five (92%) of atients who received toical and 4ts (8%) of atients who received sub-tenon's reorted no ain during delivery of the anesthetic agents, the mean ain score was 0.44±0.32 in the toical grou and 2.12±0.52 in the sub-tenon grou. The difference between grous was statistically significant < One case had been excluded from the study after difficulty in delivering the anesthetic agents to the sub-tenon's sace accomanied with sever ain that we had to sedate the atients. Thirty two atients (65%) of atients in the toical grou and 45 atients 94% in the sub-tenon's grou reorted no ain or minimal discomfort during surgery (mean score 2.17 ± 1.89, 0.38± 1.11 resectively < forty three atients (88%) of toical atients and 48 atients (100%) of sub-tenon's atients reorted no ain or minimal discomfort immediately ostoeratively (mean score 1.80 ±0.73, 0.13 ±0.24, resectively) <0.001 twenty four atients (49%) of the toical grou and 48 atients (100%) of the sub-tenon's grou reorted no ain 3 hours ostoeratively (mean ain 0.45 ±0.27, 0 resectively) <0.001 (Fig. 1). STA TA 1 st 2nd 3 rd 4th Data Were resented as mean±sd. 1 st = VAS during delivery. 2nd = VAS during surgery. 3rd = VAS immediately ostoerative. 4th = VAS 3hrs ostoeratively. Fig. (1): Visual analog score for ain (VAS). Anesthesia related comlications including rolonged akinesia of the globe, sub-conjunctival hemorrhage and conjunctival swelling occurred significantly more frequently in the sub-tenon's than in the toical grou, sulemental eye analgesia during surgery was indicated in 5 cases subjected to toical (Table 4). Table (4): Anesthesia related comlications in the two grous under study. Conjunctival hemorrhage Conjunctival swelling (chemosis) Prolonged akinesia of the globe Sulemental (24) 50% (0) 0% <0.001 (19) 40% (0) 0% <0.001 (5) 10% (0) 0% (0) 0% (5) 10% Data were resented as number of atients, ercentage. Seventy five ercent of the sub-tenon grou (36 atients) and 96% (46 atients) in the TA grou exerienced visual awareness. On questioning, the majority 91.5% (75 atients out of 82 atients) found the visual exerience accetable, only 8.5% (7 atients out of 82 atients) felt it unleasant, two atients in the sub-tenon grou and five atients in the toical grou which was statistically nonsignificant =0.436 (Table 5). Patients exerienced a wide variety of visual sensations during surgery under sub-tenon's as well as toical anaesthesia. aears to result in more visual awareness than sub-tenon's. Seven atients found their visual exerience during surgery unleasant. Table (5): Visual exerience during surgery in the two grous under study. No light ercetion (12) 25% (3) 4% Visual awareness (36) 75% (46) 96% Unleasant visual awareness exerience (2) 2.4% (5) 6.1% Data were resented as number of atients and ercentage. There were no statistical differences between the 2 study grous in the intraoerative surgical comlications as shown in (Table 6).
5 Ghada A. El-Awady & Sherif R. Gohar 241 Table (6): Intraoerative surgical comlications in the two grous under study. Casular tear Vitreous loss Iris rolase Anterior chamber IOL 0 0 NS Zonular tear Data were resented as number of atients. Sub-tenon's infiltration was found satisfactory by 46atients 96% of atients and they would choose the same for another rocedure. The only comlaint was a moderate discomfort during injection in some cases, 32 atients 65% of atients subjected to toical were satisfied with the whole rocedure < Surgical conditions were graded to be otimal by the surgeon (none-minimal difficulties) in 46 atients (96%) subjected to sub-tenon's block and in 32 atients (65%) subjected to toical <0.001 (Table 7). Table (7): Anesthesia-related intraoerative difficulties as judged by the surgeon in the two grous under study. None <0.001 Minimal 5 18 =0.004 Moderate 2 11 =0.015 Difficult 0 6 =0.027 Extremely difficult 0 0 NS Data were resented as number of atients. Discussion has become increasingly oular, as indicated by the annual survey of the ractice styles and references of members of the American Society of Cataract and Refractive Surgery however, its use varied with the volume of surgery, increasing by 22% for surgeons doing 0 to 5 cataract rocedures er month and by 63% for those doing more than 51 [12]. On the other hand, toical can in certain circumstances be more demanding for the surgeon and seems to be articularly difficult in atients requiring more intraocular maniulation than usual, as in those with small uils or any other risk factors. This study showed that comlicated cataract surgery can be erformed under toical without comromising the safety of the rocedure. While surgery-related comlications under toical were similar to those occurring when subtenon's block was used. Anesthesiarelated comlications were seen exclusively in the sub-tenon's grou. Although our results of ain assessment during delivery favored the toical technique, atient assessments of ain during surgery, immediately and 3h ostoeratively were statistically significant favoring the sub-tenon's block. More -related difficulties encountered by the surgeons during cataract surgery in the toical grou led us to conclude that difficult cases of cataract surgery is more demanding for the surgeon using toical. "Globe akinesia is commonly not achieved with toical, making cataract surgery in demanding cases ossibly even more difficult for the surgeon. As exected, overall surgical conditions assessed by the surgeon favored the use of sub-tenon's block. The intergrou difference in surgeon's assessment was statistically significant. These results is similar to the findings of a study [13] comaring toical with sub-tenon's, but contradict the results of Uusitalo et al, [14] who found araocular injection significantly less difficult, surgeon's evaluation of the technique has been favorable as demonstrated by the fact that atients' cooeration was good in majority of cases (87.5%). In most of the atients, there were no unwanted eye movements (83%). With toical, there is no rise in intraocular ressure as comared with eribulbar. This is because the lacement of 5 ml of anesthetic cocktail in the orbit increases the intraocular ressure. Thus, even without the use of ocular ressure, the anterior chamber stability is good in toical. Thus, combining toical with intracameral 0.5% lignocaine makes cataract management better in every resect. This study however has its own limitations. Being a noncomarative study, conclusive evidence of sueriority of toical over local for cataract surgery is not available. A revious study concluded that Patients having cataract surgery under toical had more intraoerative and ostoerative discomfort than atients receiving sub-tenon's. However, atients having toical reorted less
6 242 Sub-Tenon s Block Versus Anesthesia ain during its administration and had fewer comlications. They concluded that both methods rovided high levels of ain control without additional sedation [15]. The surgeon in the current study observed that some atients under toical had inadvertent eye movements during surgery. The surgeon found minimizing eye movements during casulorhexis is crucial secially in such comlicated cases. Ninety six ercent of atients exerienced a wide variety of visual sensations during surgery under toical anaesthesia. Patients comrised oerating microscoe light, colours, vague movements, surgical instruments or surgeon hands, during surgery, change in colours during surgery and some visual alteration during corneal irrigation. anaesthesia aears to result in greater visual awareness than subtenon, 96% and 75% of the study atients under both anesthetic techniques resectively however; the majority of the atients 91.5% did not fined their visual exerience during surgery unleasant, though the oerating lights were uncomfortable for 7 atients. Fichman has investigated the blood ressure, ulse rate, and resiration rate of atients during surgery under toical and has found no major changes in these arameters [16]. There is no significant change in the lasma cortisol levels during surgery under toical, indicating that the rocedure is well tolerated and does not ose stress to the atient [17]. Thus, with all the advantages of toical, it may be the referred technique [18-20]. The clear corneal aroach for MSICS has the roblem that an attemt to kee the incision size small, so that it is selfsealing will cause stretching of the wound during delivery of the nucleus and will cause ain leading to unaccetability by atients [21]. Therefore in some studies they have used 2% lignocaine gel in lace of dros, as the gel formulation is suerior in roviding [22,23]. has additional benefits like not interfering with visual function, immediate visual recovery, absence of ain due to injection, unlimited ocular motility, and absence of an increase in orbital volume [24]. Various studies regarding the ain ercetion and atients' accetability for anesthetic technique have been done and they concluded that the atients' satisfaction for is comarable for toical versus other techniques [18-21]. We believe that toical is justified to imrove the safety and comfort of the atient in ordinary cases of cataract surgery and is likely to become the referred tye of in small-incision hacoemulsification and foldable IOL imlantation, articularly for socalled high-volume surgeons. Conclusion: Patients with comlicated cataract surgery under toical had more intraoerative and ostoerative discomfort than atients receiving sub-tenon's. However, atients having toical reorted less ain during its administration and had fewer related comlications. Sub-tenon's was suerior to toical in the management of comlicated cataract cases. References 1- LEARNING D.V.: Practice styles and references of ASCRS members survey. J. Cataract Refract Surg., 17: , FICHMAN R.A.: Use of toical alone in cataract surgery. J. Cataract Refract Surg., 22: , PATEL E.A., CARLSON T.A., CRANDALL A., et al.: A comarison of toical versus retrobulbar for cataract surgery. Ohthalmology, 103: , ZEHETMAYER M., RADAX U., SKORPIK C., et al.: versus retrobulbar in clear corneal cataract surgery. J. Cataract Refract Surg., 22: , KOCH P.S.: Efficacy of lidocaine 2% jelly as a toical agent in cataract surgery. J. Cataract Refract Surg., 25: , TSENG S.H. and CHEN F.K.: A randomized clinical trial of combined toical-intracameral in cataract surgery. Ohthalmology, 105: , MACLEAN H., BURTON T. and MURRAY A.: Patient discomfort during cataract surgery with modified toical and eribulbar. J. Cataract Refract Surg., 23: , DAVIS D.B. and MANDEL M.R.: Anesthesia for cataract extraction. Int. Ohthalmol. Clin., 34: 13-30, GILLS J.P., CHERICHIO M. and RAANAN M.G.: Unreserved lidocaine to control discomfort during cataract surgery using toical. J. Cataract Refract Surg., 23: , KOCH P.S.: Anterior chamber irrigation with unreserved lidocaine 1% for during cataract surgery. J. Cataract Refract Surg., 23: , FUKASAKU H. and MARRON J.A.: Pinoint : a new aroach to local ocular. J. Cataract Refract Surg., 20: , LEAMING D.V.: Practice styles and references of ASCRS members: 1998 survey. J. Cataract Refract Surg., 25: , RODRIGUES P.A., VALE P.J., CRUZ L.M., CARVALHO R.P., RIBEIRO I.M. and MARTINS J.L.: versus sub-tenon block for cataract surgery: Surgical
7 Ghada A. El-Awady & Sherif R. Gohar 243 conditions and atient satisfaction. Eur. J. Ohthalmol. May-Jun., 18 (3): , UUSITALO R.J., MAUNUKSELA E.L., PALOHEIMO M., et al.: Converting to toical in cataract surgery. J. Cataract Refract Surg., 25: , ZAFIRAKIS PANAYOTIS, VOUDOURI ADAMANTIA, et al.: versus sub-tenon's without sedation in cataract surgery Journal of cataract and refractive surgery, vol. 27, , FICHMAN R.A.: Use of toical alone in cataract surgery. J. Cataract Refract Surg., 22: 612-4, GOZUM N., ALTAN-YAYCIOGLU R., GUCUKOGLU A. and ARSLAN O.: Does toical increase atient's serum cortisol level? Int. J. Ohthalmol. Visual Sci., 2: 2, NIELSEN P.J.: A rosective evaluation of anxiety and ain with toical or retrobulbar for small incision cataract surgery. Eur. J. Imlant Ref. Surg., 7: 6-10, MACLEAN H., BURTON T. and MURRAY A.: Patient comfort during cataract surgery with modified toical and eribulbar. J. Cataract Refract Surg., 23: , ZEHETMAYER M., RADAX U., SKORPIK C., MENA- PACE R., SCHEMPER M., WEGHAUPT H., et al.: versus eribulbar in clear corneal cataract surgery. J. Cataract Refract Surg., 22: 480-4, JOHNSTON R.L., WHITEFIELD L.A., GIRALT J., HARRUN S., AKERELE T., BRYAN S.J., et al.: versus eribulbar, without sedation, for clear corneal hacoemulsification. J. Cataract Refract Surg., 24: , BAREQUET I.S., SORIANO E.S., GREEN W.R. and O'BRIEN T.P.: Provision of anaesthesia with single alication of lidocaine 2% gel. J. Cataract Refract Surg., 25: , ASSIA E.I., PRAS E., YEHEZKEL M., ROTENSTREICH Y. and JAGER-ROSHU S.: using lidocaine gel for cataract surgery. J. Cataract Refract Surg., 25: 635-9, NIELSEN P.J.: Immediate visual caability after cataract surgery: versus retrobulbar. J. Cataract Refract Surg., 21: 302-4, 1995.
Effect of topical ketorolac tromethamine and topical nepafenac on maintaining pupillary dilation during phacoemulsification
PHILIPPINE JOURNAL OF Ohthalmology Vol. 36 No. 1 Ja n ua r y June 2011 ORIGINAL ARTICLE Richard Atanis, MD Prosero Ma. Tuaño, MD Jay Vicencio, MD Jose Ma. Martinez, MD Lee Verzosa, MD International Eye
More informationOutcomes of manual small incision cataract surgery under topical anesthesia with lignocaine 2% jelly
Original articles Outcomes of manual small incision cataract surgery under topical anesthesia with lignocaine 2% jelly Mithal C, Agarwal P, Mithal N Upgraded Department of Ophthalmology LLRM Medical College
More informationSub-Tenon Versus Peribulbar Anaesthesia for Cataract Surgery
Bahrain Medical Bulletin, Vol. 25, No.3, September 2003 Sub-Tenon Versus Peribulbar Anaesthesia for Cataract Surgery Nada Al-Yousuf, FRCSEd * Purpose: The aim of this study is to compare the efficacy of
More informationCLINICAL SCIENCES. A Comparative Study of Topical vs Retrobulbar Anesthesia in Complicated Cataract Surgery
CLINICAL SCIENCES A Comparative Study of Topical vs Retrobulbar Anesthesia in Complicated Cataract Surgery Philipp C. Jacobi, MD; Thomas S. Dietlein, MD; Felix K. Jacobi, MD Objectives: To evaluate and
More informationISSN: (Paper) eissn: (Online) JOURNAL OF ADVANCED ACADEMIC RESEARCH (JAAR) April 2017
Topical proparacaine vs combined topical-intracameral lidocaine anesthesia in phacoemulsification surgery with preoperative counseling about intraoperative visual fear Kiran Shakya 1, Sangita Shakya 2,
More informationComparison of topical versus peribulbar anaesthesia for manual small incision cataract surgery with intraocular lens implantation
International Journal of Research in Medical Sciences Joseph B et al. Int J Res Med Sci. 2016 Nov;4(11):4862-4866 www.msjonline.org pissn 2320-6071 eissn 2320-6012 Original Research Article DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20163781
More informationAn Evaluation of Topical and Local Anesthesia in Phacoemulsification
An Evaluation of Topical and Local Anesthesia in Phacoemulsification Z. Rizvi,T. Rehman,S. Malik,A. Qureshi,L. Paul,K. Qureshi,S. Memon,S Rafi,A. Ali ( Final Year Medical Students and Department of Ophthalmology*,
More informationA Comparative Study of Topical Versus Peribulbar Anesthesia in Phacoemulsification and Implantation of Foldable Intraocular Lens in Cataract Surgery
ISPUB.COM The Internet Journal of Ophthalmology and Visual Science Volume 2 Number 1 A Comparative Study of Topical Versus Peribulbar Anesthesia in Phacoemulsification and Implantation of K Said, M Hassan,
More informationA prospective, randomized comparison of Nd:YAG and sequential argon-yag laser iridotomy in Filipino eyes
VOL. 29 NO. 3 PHILIPPINE JOURNAL OF Ohthalmology JULY ORIGINAL ARTICLE - SEPTEMBER 2004 Manuel B. Agulto, MD Kristine Margaret E. Bacsal, MD Ma. Margarita L. Lat-Luna MD Deartment of Ohthalmology and Visual
More informationMelatonin Versus Ketorolac as an Adjuvant in Lidocaine Intravenous Regional Anesthesia
Med. J. Cairo Univ., Vol. 82, No. 1, June: 419-425, 2014 www.medicaljournalofcairouniversity.net Melatonin Versus Ketorolac as an Adjuvant in Lidocaine Intravenous Regional Anesthesia HOSAM M. ATEF, M.D.
More informationIsoflurane and postoperative respiratory depression following laparoscopic surgery: A retrospective propensity-matched analysis
BOSNIAN JOURNAL OF BASIC MEDICAL SCIENCES RESEARCH ARTICLE WWW.BJBMS.ORG and ostoerative resiratory deression following laaroscoic surgery: A retrosective roensity-matched analysis Alexandre N. Cavalcante,
More informationImpact of Severe Postoperative Complications after Cardiac Surgery on Mortality in Patients Aged over 80 Years
Ann Thorac Cardiovasc Surg 2014; 20: 383 389 Online July 31, 2013 doi: 10.5761/atcs.oa.13-02268 Original Article Imact of Severe Postoerative Comlications after Cardiac Surgery on Mortality in Patients
More informationThis was a randomised, double-blind, vehicle-controlled, with intra-individual comparison, single centre study.
Final Reort No. MCB 0202 FRI October 24 111,2003 2 SYNOPSIS Study title: Reeat insult atch test with Daivobet!Dovobet Ointment - A Protocol number: Studied eriod: First subject in (inclusion): First study-drug
More informationAbstract. Med. J. Cairo Univ., Vol. 84, No. 1, March: 77-83,
Med. J. Cairo Univ., Vol. 84, No. 1, March: 77-83, 2016 www.medicaljournalofcairouniversity.net Effects on the Maternal Nausea and Vomiting after Giving Prohylactic Ehedrine Versus Phenylehrine for Prevention
More informationOriginal Articles: Clinical Sciences
Medical Journal of the Islamic Reublic of! ran Volume 19 Number4 Winter 1384 February 2006 Original Articles: Clinical Sciences ASSESSMENT OF THE EFFICACY OF PARA CERVICAL BLOCK IN CONJUNCTION WITH COCIOUS
More informationDiathermy versus scalpel incisions in elective abdominal surgery: a comparative study
International Surgery Journal Nandurkar VS et al. Int Surg J. 2018 Se;5(9):3124-3128 htt://www.ijsurgery.com ISSN 2349-3305 eissn 2349-2902 Original Research Article DOI: htt://dx.doi.org/10.18203/2349-2902.isj20183734
More informationPenetrating keratoplsty (PKP) is traditionally performed under
CLINICAL SCIENCES Combined Topical and Intracameral Anesthesia in Penetrating Keratoplasty Fani Segev, MD,* Aristotle N. Voineskos,* Gladwin Hui,* Michael S. H. Law, MD,* Robert Paul, MD,* Frances Chung,
More informationTherapeutic Bronchoscopy Interventions Before Surgical Resection of Lung Cancer
Theraeutic Bronchoscoy Interventions Before Surgical Resection of Lung Cancer Prashant N. Chhajed, MD, Ralf Eberhardt, MD, Hendrik Dienemann, MD, Andrea Azzola, MD, Martin H. Brutsche, MD, Michael Tamm,
More informationPROSTATE BRACHYTHERAPY CAN BE PERFORMED IN SELECTED PATIENTS AFTER TRANSURETHRAL RESECTION OF THE PROSTATE
doi:10.1016/j.ijrob.2003.10.013 Int. J. Radiation Oncology Biol. Phys., Vol. 59, No. 2,. 392 396, 2004 Coyright 2004 Elsevier Inc. Printed in the USA. All rights reserved 0360-3016/04/$ see front matter
More informationComparison of Water Seal and Suction After Pulmonary Lobectomy: A Prospective, Randomized Trial
GENERAL THORACIC Comarison of Water Seal and Suction After Pulmonary Lobectomy: A Prosective, Randomized Trial Alessandro Brunelli, MD, Marco Monteverde, MD, Alessandro Borri, MD, Michele Salati, MD, Rita
More informationPhacoemulsification with topical anesthesia: Resident experience
J CATARACT REFRACT SURG - VOL 32, AUGUST 2006 Phacoemulsification with topical anesthesia: Resident experience Mustafa Ünal, MD, _Iclal Yücel, MD, Ahmet Sarıcı, MD, Özgür Artunay, MD, Kazım Devranoğlu,
More informationSingle Injection versus Double Injection Peribulbar Anaesthesia in Eye Camp Surgery: a Comparative evaluation of Akinesia and Anaesthesia
ISPUB.COM The Internet Journal of Anesthesiology Volume 18 Number 2 Single Injection versus Double Injection Peribulbar Anaesthesia in Eye Camp Surgery: a Comparative P Singh, A Jadon, B Singh Citation
More informationThe Efficacy of Tranexamic Acid Versus Epsilon Amino Caproic Acid in Decreasing Blood Loss in Patients Undergoing Mitral Valve Replacement Surgery
Journal of Anesthesiology 2017; 5(2): 11-18 htt://www.scienceublishinggrou.com/j/ja doi: 10.11648/j.ja.20170502.12 ISSN: 2376-7766(Print); ISSN: 2376-7774(Online) The Efficacy of Tranexamic Acid Versus
More informationTension-Free Vaginal Tape and Associated Procedures: A Case Control Study
Euroean Urology Euroean Urology 45 (2004) 356 361 Tension-Free Vaginal Tae and Associated Procedures: A Case Control Study Arash Rafii a, Xavier Paoletti b, François Haab c, Michel Levardon a, Bruno Deval
More informationA double-masked study to compare the efficacy and safety of topical cromolyn for the treatment of allergic conjunctivitis
Journal of the Formosan Medical Association (2011) 110, 690e694 Available online at www.sciencedirect.com journal homeage: www.jfma-online.com ORIGINAL ARTICLE A double-masked study to comare the efficacy
More informationEffects of Chewing Gum on Recovery of Bowel Motility after Laparoscopic Colorectal Surgery in South Korea
,.95-102 htt://dx.doi.org/10.14257/ijunesst.2015.8.10.10 Effects of Chewing Gum on Recovery of Bowel Motility after Laaroscoic Colorectal Surgery in South Korea JiWoo Hong 1, Hee Jung Jang 2 and Soon-Ok
More informationAssociation of surgeon factors with outcome scores after total knee arthroplasty
Journal of Orthoaedic Surgery 2014;22(3):378-82 Association of surgeon factors with outcome scores after total knee arthrolasty Sok-Chuen Tan, Yiong-Huak Chan, Hwei-Chi Chong, Pak-Lin Chin, Andy Yew, Shi-Lu
More informationArticle 4 Comparison of Amplitude of Accommodation in Different Vertical Viewing Angles
Article 4 Comarison of Amlitude of Accommodation in Different Vertical Viewing Angles Chiranjib Majumder, M. Otom, Twintech International University College of Technology, Kuala Lumur, Malaysia Lee Shin
More informationComparing Clinical Outcomes in High-Volume and Low-Volume Off-Pump Coronary Bypass Operation Programs
Comaring Clinical Outcomes in High-Volume and Low-Volume Off-Pum Coronary Byass Oeration Programs Philli P. Brown, MD, Michael J. Mack, MD, Aril W. Simon, MSN, Salvatore L. Battaglia, BS, Lynn G. Tarkington,
More informationOriginal Article INTRODUCTION. Abstract
Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2018/95 Comparative Evaluation of Ropivacaine and Lignocaine with Ropivacaine, Lignocaine, and Clonidine Combination during
More informationNeurological Outcomes in Coronary Surgery: Independent Effect of Avoiding Cardiopulmonary Bypass
Neurological Outcomes in Coronary Surgery: Indeendent Effect of Avoiding Cardioulmonary Byass Nirav C. Patel, FRCS(C-Th), Anand P. Deodhar, MCh, Antony D. Grayson, BS, D. Mark Pullan, FRCS(C-Th), Daniel
More informationA Randomized Controlled Prospective Study to Assess the role of Subconjunctival Bevacizumab in Preventing Recurrence in Primary Pterygium Excision
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS e-issn: 227-53, -ISSN: 227-61.Volume 15, Iss 11 Ver. IX (November. 216, PP 21-25 www.iosrjournals.org A Randomized Controlled Prosective Study to
More informationEye (2008) 22, & 2008 Nature Publishing Group All rights reserved X/08 $30.00
(2008) 22, 425 429 & 2008 Nature Publishing Group All rights reserved 0950-222X/08 $30.00 www.nature.com/eye Comparative clinical trial of topical anaesthetic agents for cataract surgery with phacoemulsification:
More informationNon-small cell lung cancer (NSCLC) is the most common
ORIGINAL ARTICLE Elevated Preoerative C-reactive Protein Predicts Poor Cancer Secific Survival in Patients Undergoing Resection for Non-small Cell Lung Cancer Caroline O Dowd, MBChB, MRCP,* Laura A. McRae,
More informationAlthough heart valve replacement is a safe and commonly
Mitral Valve Relacement: Randomized Trial of St. Jude and Medtronic Hall Prostheses Andrew C. Fiore, MD, Hendrick B. Barner, MD, Marc T. Swartz, BA, Lawrence R. McBride, MD, Arthur J. Labovitz, MD, Kathy
More informationOptometric Postoperative Cataract Surgery Management
Financial Disclosures Optometric Postoperative Cataract Surgery Management David Dinh, OD Oak Cliff Eye Clinic Dallas Eye Consultants March 10, 2015 Comanagement Joint cooperation between two or more specialists
More informationVisual perception during phacoemulsification cataract surgery under subtenons anaesthesia
(23) 17, 51 55 & 23 Nature Publishing Group All rights reserved 95-222X/3 $25. www.nature.com/eye Visual perception during phacoemulsification cataract surgery under subtenons anaesthesia SS Wickremasinghe,
More informationJournal of the American College of Cardiology Vol. 36, No. 4, by the American College of Cardiology ISSN /00/$20.
Journal of the American College of Cardiology Vol. 36, No. 4, 2000 2000 by the American College of Cardiology ISSN 0735-1097/00/$20.00 Published by Elsevier Science Inc. PII S0735-1097(00)00823-8 Diabetes
More informationSurgical resection is the primary curative treatment modality
ORIGINAL ARTICLE Use of a Surgical Secimen-Collection Kit to Imrove Mediastinal Lymh-Node Examination of Resectable Lung Cancer Raymond U. Osarogiagbon, MBBS, FACP,* Laura E. Miller, MD, Robert A. Ramirez,
More informationJMSCR Vol 05 Issue 07 Page July 2017
www.jmscr.igmublication.org Imact Factor 5.84 Index Coernicus Value: 83.27 ISSN (e)-2347-176x ISSN () 2455-0450 DOI: htts://dx.doi.org/10.18535/jmscr/v5i7.107 A Comarative Study on the Incidence and Severity
More informationAutomatic System for Retinal Disease Screening
Automatic System for Retinal Disease Screening Arathy.T College Of Engineering Karunagaally Abstract This work investigates discrimination caabilities in the texture of fundus images to differentiate between
More information2/26/2017. Sameh Galal. M.D, FRCS Glasgow. Lecturer of Ophthalmology Research Institute of Ophthalmology
Sameh Galal M.D, FRCS Glasgow Lecturer of Ophthalmology Research Institute of Ophthalmology No financial interest in the subject presented 1 Managing cataracts in children remains a challenge. Treatment
More informationEffect of Camel s Milk Intake on Control of Diabetes: A Randomized Controlled Trial
Med. J. Cairo Univ., Vol. 82, No. 2, December: 53-59, 2014 www.medicaljournalofcairouniversity.net Effect of Camel s Milk Intake on Control of Diabetes: A Randomized Controlled Trial OSSAMA A. MOSTAFA,
More informationEvaluation of the Coping Strategies Used by Knee Osteoarthritis Patients for Pain and Their Effect on the Disease-Specific Quality of Life
January Aril 2016 Volume 9 Issue 1 Page 80 Original Article Evaluation of the Coing Strategies Used by Knee Osteoarthritis Patients for Pain and Their Effect on the DiseaseSecific Quality of Life Semra
More informationRichard M H Lee 1, John R Thompson 2, Tom Eke 3. 1 Department of Ocular Biology and Therapeutics, Institute of Ophthalmology, London
Severe adverse events associated with local anaesthesia in cataract surgery: one year national survey of practice and complications in the United Kingdom. Richard M H Lee 1, John R Thompson 2, Tom Eke
More informationAcne Itch: Do Acne Patients Suffer From Itching?
Acta Derm Venereol 2008; 88: 38 42 CLINICAL REPORT Acne Itch: Do Acne Patients Suffer From Itching? Adam Reich, Katarzyna Trybucka, Anna Tracinska, Dominik Samotij, Blazej Jasiuk, Marek Srama and Jacek
More informationRetrograde cardioplegia could provide better myocardial. Evaluation of 7,000 Patients With Two Different Routes of Cardioplegia
Evaluation of 7,000 Patients With Two Different Routes of Cardiolegia Kit V. Arom, MD, PhD, Robert W. Emery, MD, Rebecca J. Petersen, RN, and Joseh W. Bero, MS Minneaolis Heart Institute, Minneaolis, Minnesota
More informationHyperglycemia or High Hemoglobin A1C: Which One is More Associated with Morbidity and Mortality after Coronary Artery Bypass Graft Surgery?
doi: 10.5761/atcs.oa.13.02282 Original Article Hyerglycemia or High Hemoglobin A1C: Which One is More Associated with Morbidity and Mortality after Coronary Artery Byass Graft Surgery? Zahra Faritous,
More informationWith the wide acceptance of off-pump bypass procedures,
Twelve-Month Patency With the Proximal Connector Device: A Single Center Prosective Randomized Trial Jörg Kemfert, MD, Ulrich T. Ofermann, MD, Markus Richter, MD, PhD, Torsten Bossert, MD, Friedrich W.
More informationResearch Article Effects of Pectus Excavatum on the Spine of Pectus Excavatum Patients with Scoliosis
Hindawi Healthcare Engineering Volume 2017, Article ID 5048625, 6 ages htts://doi.org/10.1155/2017/5048625 Research Article Effects of Pectus Excavatum on the Sine of Pectus Excavatum Patients with Scoliosis
More informationPrimary palmar hyperhidrosis is a common disorder
Bilateral Thoracoscoic T2 to T3 Symathectomy Versus Injection in Palmar Hyerhidrosis Vincenzo Ambrogi, MD, Elena Camione, MD, Davide Mineo, MD, Evelin Jasmine Paternò, MD, Eugenio Pomeo, MD, and Tommaso
More informationRecurrence of Angina After Coronary Artery Bypass Surgery: Predictors and Prognosis (CASS Registry)
JACC Vol. 26, No. 4 895 Recurrence of Angina After Coronary Artery Byass Surgery: Predictors and Prognosis (CASS Registry) AIRLIE A. C. CAMERON, MD, FACC, KATHRYN B. DAVIS, PHD, FACC,* WILLIAM J. ROGERS,
More informationThrombocytopenia After Aortic Valve Replacement With Freedom Solo Bioprosthesis: A Propensity Study
Thrombocytoenia After Aortic Valve Relacement With Freedom Biorosthesis: A Proensity Study Alessandro Piccardo, MD, Dan Rusinaru, MD, Benoit Petitrez, MD, Paul Marticho, MD, Ioana Vaida, MD, Christohe
More informationEffect of corticosteroids on phlebitis induced by intravenous infusion of antineoplastic agents in rabbits
218 Research Paer International Journal of Medical Sciences 2009; 6(4): 218-223 Ivysring International Publisher. All rights reserved Effect of corticosteroids on hlebitis induced by intravenous infusion
More informationRisk factors for post-colectomy adhesive small bowel obstruction
Original article Acta Medica Academica 2016;45(2):121-127 DOI: 10.5644/ama2006-124.167 Risk factors for ost-colectomy adhesive small bowel obstruction Edin Husarić 1, Šefik Hasukić 1, Nešad Hotić 1, Amir
More informationRegional anaesthesia for intraocular surgery
Regional anaesthesia for intraocular surgery Gavin Parness BSc MB BCh Simon Underhill MB ChB FRCA The first recorded use of local anaesthesia for surgery was the instillation of cocaine into the conjunctival
More informationRandomized controlled trials: who fails run-in?
Rees et al. Trials (2016) 17:374 DOI 10.1186/s13063-016-1451-9 RESEARCH Oen Access Randomized controlled trials: who fails run-in? Judy R. Rees 1, Leila A. Mott 1, Elizabeth L. Barry 1, John A. Baron 1,2,
More informationA Randomized Comparison of Percutaneous Transluminal Coronary Angioplasty by the Radial, Brachial and Femoral Approaches: The Access Study
1269 INTERVENTIONAL CARDIOLOGY A Randomized Comarison of Percutaneous Transluminal Coronary Angiolasty by the, and Aroaches: The Access Study FERDINAND KIEMENEIJ, MD, PHD, GERT JAN LAARMAN, MD, PHD, DIEGO
More informationEngineered. Simplicity. for. VISTHESIA : The unique combination of OVD and ancillary anesthesia.
Supplement to July/August 2010 Engineered for Simplicity VISTHESIA : The unique combination of OVD and ancillary anesthesia. Sponsored by an educational grant from Carl Zeiss Meditec VISTHESIA The unique
More informationSTAB INCISION GLAUCOMA SURGERY (SIGS)
STAB INCISION GLAUCOMA SURGERY (SIGS) Dr. Soosan Jacob, MS, FRCS, DNB Senior Consultant Ophthalmologist, Dr. Agarwal's Eye Hospital, Chennai, India dr_soosanj@hotmail.com Videos available in Youtube channel:
More informationMigraine headache is one of the most debilitating RECONSTRUCTIVE
RECONSTRUCTIVE Positive Botulinum Toxin Tye A Resonse Is a Prognosticator for Migraine Surgery Success Michelle Lee, M.D. Mikhal A. Monson, B.S. Mengyuan T. Liu, B.S. Deborah Reed, M.D. Bahman Guyuron,
More informationOUTCOMES AFTER DEFINITIVE TREATMENT FOR CUTANEOUS ANGIOSARCOMA OF THE FACE AND SCALP
ORIGINAL ARTICLE OUTCOMES AFTER DEFINITIVE TREATMENT FOR CUTANEOUS ANGIOSARCOMA OF THE FACE AND SCALP B. Ashleigh Guadagnolo, MD, MPH, 1 Gunar K. Zagars, MD, 1 Dejka Araujo, MD, 2 Vinod Ravi, MD, 2 Thomas
More informationRisk Scores Do Not Predict High Mortality After Coronary Artery Bypass Surgery in the Presence of Diastolic Dysfunction
Risk Scores Do Not Predict High Mortality After Coronary Artery Byass Surgery in the Presence of Diastolic Dysfunction Lorenzo Merello, MD, Erick Riesle, MD, Javier Alburquerque, MD, Humberto Torres, MD,
More informationOriginal paper Videosurgery. Łukasz Kaska, Monika Proczko, Jarek Kobiela, Tomasz Jerzy Stefaniak, Zbigniew Śledziński
Original aer Videosurgery Dynamics of tye 2 diabetes mellitus laboratory remission after Roux-en-Y gastric byass in atients with body mass index lower than 35 kg/m 2 and higher than 35 kg/m 2 in a 3-year
More informationProspective, Randomized Clinical Trial of the FloSeal Matrix Sealant in Cardiac Surgery
Prosective, Randomized Clinical Trial of the Matrix Sealant in Cardiac Surgery Giusee Nasso, MD, Felice Piancone, MD, Raffaele Bonifazi, MD, Vito Romano, MD, Giusee Visicchio, MD, Carlo Maria De Filio,
More informationThe effect of pseudophakia on retinal and cortical functions
ORIGINAL ARTICLE The effect of seudohakia on retinal and cortical functions Fahrettin Akay 1, Fatih M. Mutlu 2, Fatih C. Gundogan 3, Gungor Sobaci 2 1 Deartment of Ohthalmology, Izmir Military Hosital,
More information3/23/2016. Phaco vs. Angle Surgery. Car Analogy. 10 Essential Steps of Perioperative Gonioscopy. Intraoperative Gonioscopy: A Key to Angle Surgery
Intraoperative Gonioscopy: A Key to Angle Surgery Shakeel Shareef, MD Wallace Alward, MD Alan Crandall, MD Steven Vold, MD Ike Ahmed, MD No financial conflicts of interest 10 Essential Steps of Perioperative
More informationEffect of Focused Ultrasound on Abdominal Fat During Menopause
International Journal of ChemTech Research CODEN (USA): IJCRGG, ISSN: 0974-4290, ISSN(Online):2455-9555 Vol.10 No.5, 379-383, 2017 Effect of Focused Ultrasound on Abdominal Fat During Menoause Noha El
More informationElderly patients have an increased risk of neurologic
Craniocervical and Aortic Atherosclerosis as Neurologic Risk Factors in Coronary Surgery Tomoko Goto, MD, Tomoko Baba, MD, Atsushi Yoshitake, MD, Yoshihiro Shibata, MD, Masashi Ura, MD, and Ryuzo Sakata,
More informationComparison between Results of Surgical and Conservative Treatment for Diabetic Peripheral Neuropathy
Med. J. Cairo Univ., Vol. 3, No. 1, Setember: 739-75, 215 www.medicaljournalofcairouniversity.net Comarison between Results of Surgical and Conservative Treatment for Diabetic Periheral Neuroathy AMR M.
More informationComparison of ropivacaine 0.75% and bupivacaine 0.5% in peribulbar block for cataract surgery.
ISPUB.COM The Internet Journal of Anesthesiology Volume 23 Number 2 Comparison of ropivacaine 0.75% and bupivacaine 0.5% in peribulbar block for cataract surgery. L Trivedi, H Trivedi, D Tripathi, P Jha,
More informationPatient comfort and surgeon satisfaction during cataract surgery using topical anesthesia with or without dexmedetomidine sedation
361-367 Erdurmus:Shoja 7-04-2008 16:33 Pagina 361 European Journal of Ophthalmology / Vol. 18 no. 3, 2008 / pp. 361-367 Patient comfort and surgeon satisfaction during cataract surgery using topical anesthesia
More informationIntrascleral-fixated intraocular lenses for aphakic correction in the absence of capsular support
European Journal of Ophthalmology / Vol. 17 no. 5, 2007 / pp. 714-719 Intrascleral-fixated intraocular lenses for aphakic correction in the absence of capsular support R.A. AZNABAYEV, I.S. ZAIDULLIN, M.S.H.
More informationEffects of Single Dose, Postinduction Dexamethasone on Recovery After Cardiac Surgery
Effects of Single Dose, Postinduction on Recovery After Cardiac Surgery Jean-Pierre Yared, MD, Norman J. Starr, MD, Frederick K. Torres, MD, C. Allen Bashour, MD, Gregory Bourdakos, MD, Marion Piedmonte,
More informationContemporary Perioperative Results of Isolated Aortic Valve Replacement for Aortic Stenosis
Contemorary Perioerative Results of Isolated Aortic Valve Relacement for Aortic Stenosis S. Chris Malaisrie, MD, Patrick M. McCarthy, MD, Edwin C. McGee, MD, Richard Lee, MD, Vera H. Rigolin, MD, Charles
More informationPeribulbar Versus Retrobulbar Anaesthesia
Eye (1990) 4, 445449 Peribulbar Versus Retrobulbar Anaesthesia I. E. MURDOCH London Summary A prospective clinical trial comparing peribulbar with retrobulbar anaesthesia is reported. Ninety-nine consecutive
More informationDo cleft lip and palate patients opt for secondary corrective surgery of upper lip and nose, frequently?
Nkenke et al. Head & Face Medicine 2013, 9:38 HEAD & FACE MEDICINE SHORT REPORT Oen Access Do cleft li and alate atients ot for secondary corrective surgery of uer li and nose, frequently? Emeka Nkenke
More information84 Year Old with Rosacea
84 Year Old with Rosacea S/p tap and injection of intravitreal vancomycin, ceftazidime, dexamethasone Post-injection day#1 Va HM IOP 14 mmhg Post-injection week#3 BCVA 20/20-3 (plano +0.50 x 180) IOP 23
More informationThey are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see:
bring together everything NICE says on a topic in an interactive flowchart. are interactive and designed to be used online. They are updated regularly as new NICE guidance is published. To view the latest
More informationInteractions between Symptoms and Motor and Visceral Sensory Responses of Irritable Bowel Syndrome Patients to Spasmolytics (Antispasmodics)
Interactions between Symtoms and Motor and Visceral Sensory Resonses of Irritable Bowel Syndrome Patients to Sasmolytics (Antisasmodics) Igor L.Khalif 1, Eamonn M.M.Quigley 2, P.A.Makarchuk 1, O.V.Golovenko
More informationCost Advantages of an Ad Hoc Angioplasty Strategy
321 Cost Advantages of an Angiolasty Strategy CHITURU ADELE, MD,* PAUL T. VAITKUS, MD, FACC,* SUSANNAH K. WELLS, JONATHAN B. ZEHNACKER Burlington, Vermont Objectives. We sought to determine the cost advantage
More informationTrends in Anesthesia Use in Cataract Extraction with Lens Insertion: AAAHC Institute for Quality Improvement Study Results
Trends in Anesthesia Use in Cataract Extraction with Lens Insertion: 2010 2015 AAAHC Institute for Quality Improvement Study Results BK Lerner, NJ Kuznets & K Kilgore Abstract Aim: To examine the trend
More informationIntraoperative Gonioscopy: A Key to Angle Surgery
Intraoperative Gonioscopy: A Key to Angle Surgery Shakeel Shareef, MD Associate Professor Flaum Eye Institute Univ. of Rochester School of Med. Rochester, NY Phaco vs. MIGS PHACO MIGS Viewing Full corneal
More informationSevere Psychiatric Disorders in Mid-Life and Risk of Dementia in Late- Life (Age Years): A Population Based Case-Control Study
Send Orders for Rerints to rerints@benthamscience.net Current Alzheimer Research, 2014, 11, 681-693 681 Severe Psychiatric Disorders in Mid-Life and Risk of Dementia in Late- Life (Age 65-84 Years): A
More informationAvailable online at Journal of the Chinese Medical Association 76 (2013) 20e24. Original Article
Available online at www.sciencedirect.com Journal of the Chinese Medical Association 76 (2013) 20e24 Original Article Combining rostrate-secific antigen and Gleason score increases the diagnostic ower
More informationComparative study of anxiety and depression following maxillofacial and orthopedic injuries. Study from a Nigerian University Teaching Hospital
Received: 16 June 2017 Revised: 12 Setember 2017 Acceted: 14 Setember 2017 DOI: 10.1002/cre2.90 ORIGINAL ARTICLE Comarative study of anxiety and deression following maxillofacial and orthoedic injuries.
More informationA step-down unit transfer protocol for low-risk aneurysmal subarachnoid hemorrhage
NEUROSURGICAL FOCUS Neurosurg Focus 43 (5):E15, 2017 A ste-down unit transfer rotocol for low-risk aneurysmal subarachnoid hemorrhage Alexander G. Chartrain, BS, 1 Ahmed J. Awad, MD, 1 Christoher A. Sarkiss,
More informationAuthor's personal copy
Vision Research 48 (2008) 1837 1851 Contents lists available at ScienceDirect Vision Research journal homeage: www.elsevier.com/locate/visres Bias and sensitivity in two-interval forced choice rocedures:
More informationThe saphenous vein harvest wound is well recognized
Occlusive Wra Dressing Reduces Infection Rate in Sahenous Vein Harvest Site Franklin L. Rosenfeldt, FRACS, Justin Negri, FRACS, Damien Holdaway, FRACS, Bruce B. Davis, FRACS, Julie Mack, BS, Michael J.
More informationMeasure #192: Cataracts: Complications within 30 Days Following Cataract Surgery Requiring Additional Surgical Procedures
Measure #192: Cataracts: Complications within 30 Days Following Cataract Surgery Requiring Additional Surgical Procedures 2012 PHYSICIAN QUALITY REPORTING OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY
More informationProspective Evaluation of the Effect of Short-Term Oral Vitamin D Supplementation on Peripheral Neuropathy in Type 2 Diabetes Mellitus
Original Paer Received: December 3, 2013 Acceted: January 18, 2015 Published online: February 26, 2015 Prosective Evaluation of the Effect of Short-Term Oral Vitamin D Sulementation on Periheral Neuroathy
More informationThe effect of anterior chamber lidocaine injection on pain reduction after cataract surgery under general anesthesia
The effect of anterior chamber lidocaine injection on pain reduction after cataract surgery under general anesthesia Ahmareza Mouhtadi, MD Gholamreaza Khateminia, MD Reza Akhondzadeh, MD Farahzad Jannatmakan,
More informationSee the corresponding editorial in this issue, pp J Neurosurg Spine 18: , 2013 AANS, 2013
See the corresonding editorial in this issue, 109 111. J Neurosurg Sine 18:112 121, 2013 AANS, 2013 Retrograde ejaculation following single-level anterior lumbar surgery with or without recombinant human
More informationRisk factors for superficial wound complications in hip and knee arthroplasty
ORIGINAL ARTICLE INFECTIOUS DISEASES Risk factors for suerficial wound comlications in hi and knee arthrolasty K. Carroll 1, M. Dowsey 1,2, P. Choong 1,2 and T. Peel 2,3 1) Deartment of Orthoaedics, St
More informationOne-Time versus Staged Multivessel Intervention in Intermediate to Very High-Risk Patients with Non-ST-Segment Elevation Acute Coronary Syndromes
Original Article Print ISSN 1738-55 On-line ISSN 1738-5555 Korean Circulation Journal One-Time versus Staged Multivessel Intervention in Intermediate to Very High-Risk Patients with Non-ST-Segment Elevation
More informationAnesthesiologist intervention during cataract surgery under topical or peribulbar anesthesia: a propensity model comparison
Eur J Ophthalmol 2010; 20 ( 4) : 687-693 Original Article Anesthesiologist intervention during cataract surgery under topical or peribulbar anesthesia: a propensity model comparison Marco Gemma 1, Luigi
More informationKing s Research Portal
King s Research Portal Document Version Peer reviewed version Link to ublication record in King's Research Portal Citation for ublished version (APA): Murrells, T., Ball, J., Maben, J., Lee, G., Cookson,
More informationJ of Evolution of Med and Dent Sci/ eissn , pissn / Vol. 4/ Issue 78/ Sept 28, 2015 Page 13570
SAFETY AND EFFECTIVENESS OF 20G SUTURELESS PARS PLANA VITRECTOMY: A PROSPECTIVE STUDY AT SAROJINI DEVI HOSPITAL, HYDERABAD Rajalingam Vairagyam 1, Karunakar B 2, Pasyanthi B 3, B. Y. Babu Rao 4, Rita Bahadur
More informationMedial Canthus Episcleral (Sub-Tenon s) Anesthesia Compared With Single Injection Peribulbar Anesthesia For Cataract Surgery
49 Medial Canthus Episcleral (Sub-Tenon s) Anesthesia Compared With Single Injection Peribulbar Anesthesia For Cataract Surgery Dowider A.M. and Hoda E. Ezz Anesthesia Department, Faculty of Medicine,
More informationSutureless Intrascleral Pocket Technique of Transscleral Fixation of Intraocular Lens in Previous Vitrectomized Eyes
pissn: 1011-8942 eissn: 2092-9382 Korean J Ophthalmol 2014;28(2):181-185 http://dx.doi.org/10.3341/kjo.2014.28.2.181 Case Report Sutureless Intrascleral Pocket Technique of Transscleral Fixation of Intraocular
More information