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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We preformed radial keratotomy for myopia on 126 eyes of 102 patients. We observed as much as 12 diopters of early postoperative refractive corneal flattening, but a mean of only 5.16 diopters of refractive change can be expected after one year. Among the many complications observed were corneal scarring, an endothelial cell loss of 220 cells/mm2 (6.9%), epithelial ingrowth in 18 eyes (14%), corneal vascularization in one of 126 patients (1%), pain, Cogan's corneal dystrophy, overcorrections in 18 patients (14%), anisometropia, perforations of the anterior chamber in 12 patients (10%), iatrogenic astigmatism, corticosteroid glaucoma, night glare in 99 patients (79%), and fluctuating vision in 95 (75%). We studied the following factors to determine if they had predictive value: the patient's age, diopters of myopia, corneal diameter, corneal thickness, anterior chamber depth, axial length, scleral rigidity, keratometric readings, and the size of the optical zone. We found that no preoperative factor can be used to estimate precisely the postoperative result. The only consistent variable was the size of the optical zone. The smaller the optical zone, the larger the refractive change. This lack of predictability is the most serious shortcoming of radial keratotomy.
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PMID:Preliminary results and complications of radial keratotomy. 617 27

We treated 12 eyes with advanced neovascular glaucoma with a modification of drainage implant surgery. All 12 eyes had rubeosis iridis and severe pain and nine had undergone previous glaucoma surgery. After follow-up periods of two to 24 months (mean, 11.3 months), nine of 12 eyes had intraocular pressures of less than 24 mm Hg (mean preoperative value, 49.5 +/- 8.2 mm Hg; mean postoperative value, 22.2 +/- 12.9 mm Hg). Surgery was unsuccessful in three eyes, in two because the anterior chamber remained flat postoperatively and in one because a large hyphema blocked the tube 15 months postoperatively. Our procedure, which uses a Y-shaped Teflon tube, is easy to perform, is well tolerated by the eye, and is associated with a low risk of serious complications.
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PMID:Draining implant for neovascular glaucoma. 619 13

Sclera-laminating goniotrepanation is a modification of the Elliot-Fronimopoulos operation. In this procedure the scleral flap is removed, so that a shallow depression is formed in the sclera; this helps to prevent an ectatic bleb. No cicatrization of the trephine hole was observed in the authors' cases. The modification is only used by them in glaucoma cases with poor prognosis. Forty-six patients, 39 of whom were suffering from neovascular glaucoma associated with occlusion of the central retinal vein or diabetic retinopathy, underwent the operation and the results were followed up. As far as regulation of intraocular pressure and elimination of pain are concerned, the results were encouraging. Severe hemorrhage into the anterior chamber without spontaneous absorption only occurred in 2 cases.
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PMID:[Results of sclera-laminating goniotrephination in neovascular glaucoma]. 619 92

Six eyes developed angle-closure glaucoma secondary to total hemorrhagic retinal detachment that occurred as a rare complication of senile disciform macular degeneration. The patients were all elderly with known senile macular choroidal degeneration. They had no history of eye surgery and experienced sudden loss of vision followed by pain. Balloons of retinal detachment were pushed tightly against the lens in a characteristic "Y suture" appearance causing shallowing of the anterior chamber and glaucoma. Pathologic examination of three eyes revealed that the choroid was not detached but that a massive subretinal hemorrhage was present. Neovascular tissue in macular disciform lesions was found in every case and was the probable source of hemorrhage. Sheets of avulsed retinal outer segments were seen incarcerated in subretinal blood in two cases, and drainage of this subretinal blood in three cases did not restore useful vision.
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PMID:Senile disciform macular degeneration complicated by massive hemorrhagic retinal detachment and angle closure glaucoma. 620 73

Three cases of neovascular glaucoma associated with ocular hypoperfusion secondary to carotid artery disease are reported. In two cases, anastomosis of the internal and external carotid artery systems via a superficial temporal artery to the middle cerebral artery (Yasargil procedure) resulted in resolution of the rubeosis, relief of the ocular pain and improvement of the circulation of the globe. The third case, which did not have this procedure, resulted in a blind eye with severe rubeotic glaucoma.
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PMID:Neovascular glaucoma associated with ocular hypoperfusion secondary to carotid artery disease. 620 4

A 36-year-old white man abruptly developed painless visual loss in his left eye. Fundoscopic evaluation revealed a shallow left superotemporal retinal detachment with an underlying yellowish choroidal infiltrate. Fluorescein angiography disclosed indistinct choroidal leakage, and both B-scan ultrasonography and computed tomography demonstrated superotemporal thickening of the choroid and the sclera. The patient was diagnosed clinically as having a scleritis and an associated exudative retinal detachment. He was placed on a several months' course of systemic prednisone, and despite this regimen, his condition worsened with the appearance of severe pain, proptosis and displacement of the eye, glaucoma, and intense episcleral and scleral injection. The eye was enucleated and displayed externally a massively thickened sclera superotemporally. Light microscopic evaluation of the enucleated globe revealed an extensively necrotic tumor growing diffusely within the choroid; infiltrating viable tumor cells were discovered within the sclera and episclera. The tumor cells had the characteristics of a well-differentiated, mucin-producing adenocarcinoma. Electron microscopic studies demonstrated lumen-forming tumor cells with apical villi, cytoplasmic pseudolumens, pools of cytoplasmic glycogen, and multiple types of inclusions, including mucin, lipid, and electron-dense secretory granules similar to those in pulmonary Clara cells. These findings were consistent with a bronchiolo-alveolar carcinoma. The patient subsequently developed bilateral reticulo-nodular pulmonary infiltrates, also typical of this tumor. The unusual clinical features of this case of "malignant scleritis" are discussed in light of the final diagnosis.
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PMID:Metastatic carcinoma masquerading as scleritis. 630 88

In a randomised, double-blind, controlled trial, 40 patients with zoster of short duration (rash present for less than three days) were given either 10 mg/kg acyclovir (20) or placebo (20) intravenously three times daily for five days. Pain was reduced in the treatment group both in the acute phase and at follow-up, when compared with the placebo group, but this difference did not reach statistically significant levels. Healing of the lesions was also better, but not significantly so, in the acyclovir group. No complications of the disease were seen in the six cases of ophthalmic zoster given acyclovir whereas, of the four cases in the placebo group, two developed seventh cranial nerve palsies and one secondary glaucoma. No evidence of renal or other major toxicity was detected in the acyclovir group, although three patients developed mild thrombophlebitis. We conclude that acyclovir, given by the route and in the dose and frequency as used in this study, is free from major side effects, but is only of marginal benefit in the treatment of zoster.
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PMID:High-dose intravenous acyclovir in the treatment of zoster: a double-blind, placebo-controlled trial. 635 Apr 73

A controlled release system utilizes a polymer matrix or pump as a rate-controlling device to deliver the drug in a fixed, predetermined pattern for a desired time period. These systems have the following advantages compared to other methods of administration: 1) plasma drug levels are continuously maintained in a therapeutically desirable range, 2) harmful side effects from systemic administration can be reduced or eliminated by local administration from a controlled release system, 3) drug administration may be improved and facilitated in underpriviledged areas where good medical supervision is not available, 4) administration of drugs that have short in vivo half lives may be greatly facilitated, 5) continuous small amounts of drug may be less painful than several large doses, 6) patient compliance may be improved, and 7) this method is relatively less expensive and less wasteful of the drug. Disadvantages include possible toxicity, need for surgery to implant the system, possible pain, and difficulty in shutting off release if necessary. Two types of diffusion-controlled systems have been developed. The reservoir is a core of drug surrounded with a polymer film. The 2nd type, the matrix, is one in which the drug is uniformly distributed through a polymer. In chemically controlled systems, the rate of drug release is regulated by a chemical reaction with the polymer. In solvent activated systems a swelling or osmotic mechanism is involved. Pharmaceutical applications have been made in ocular disease with the Ocusert, a reservoir system for glaucoma therapy and which is not widely used, and in contraception with 4 systems. These systems are: 1) subdermal implants of nonbiodegradable polymers such as Norplant, 6 capsules of 36 mg levonorgestrel; 2) subdermal implant of biodegradable polymers; 3) steroid releasing IUD; and 4) vaginal rings, which are silicone-coated. Other applications have been made in the areas of dentistry, immunization, anticoagulation, cancer, narcotic antogonists, and insulin delivery. Transdermal delivery involves placing a polymeric system containing a contact adhesive on the skin.
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PMID:Implantable controlled release systems. 635 38

Eight patients with chronic open-angle glaucoma treated regularly with different drugs (mainly timolol) and having a mean IOP of 20,4+/-1,2 mm Hg were subsequently treated for 9 months with Suprexon eye drops (guanethidine 1% + epinephrine 0,2%). At the end of the study the mean IOP was 17,6+/-1,3 mm Hg. Suprexon eye drops were found to have a long-lasting hypotensive effect. The straight-line regression test utilizing all the IOP measurements - 7 within the 9 months of the trial - showed no statistically significant tachyphylaxis (p less than 0.03). As a consequence no other drugs had to be added to control the IOP. Moreover, this treatment proved to be significantly more potent than timolol (p less than 0.05). While under treatment the patients suffered from conjunctival hyperemia and ocular pain, but these diminished in the course of time. No systemic side effects were observed.
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PMID:[Behavior of intraocular pressure during long-term treatment with a guanethidine-adrenaline combination]. 641 61

A 75 year woman with chronic vitreous hemorrhage underwent extraction of a senile cataract. Surgery was complicated by the flow of brown fluid from the vitreous to the anterior chamber, which was not entirely removed. Post-operatively there was pain, 2 mm of brown hypopyon and intraocular pressure elevation to 60 mm Hg with the preoperative diagnosis of endophthalmitis, a pars plana vitreous tap and instillation of intravitreal antibiotics was performed. Bacterial cultures were negative and the presence of erythrocyte "ghost cells" established the diagnosis of hemolytic glaucoma. As medical management proved ineffective, a pars plana vitrectomy was performed. One year post-operatively the patient had a visual acuity of 0.4-0.5, normal intraocular pressure without medication and evidence of an old branch retinal vein occlusion. The mechanism of hemolytic "ghost-cell" glaucoma in this case is discussed.
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PMID:[A case of secondary ghost cell glaucoma with pseudohypopyon after cataract extraction]. 647 Apr 16


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