Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0086543 (cataract)
 29,165 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 61-year-old man with progressive, bilateral Mooren's ulcer had subjective symptoms of pain, discomfort, and blurred vision. Biomicroscopic examination showed 360 degrees of peripheral ulceration of the cornea. There were 1+ cells in the anterior chamber, and nuclear sclerosis of the lens was present. He was treated with topical and systemic steroids, perilimbal conjunctival resection, and systemic cyclophosphamide therapy. After the complete control of inflammation, the patient remained in remission for 14 months. When a cataract developed in the right eye, reducing the visual acuity to light perception, the authors performed a scleral tunnel incision and phacoemulsification with intraocular lens implantation. After 18 months of postoperative follow-up, the vision improved to 20/30, and the eye was stable. Phacoemulsification and scleral tunnel incision with intraocular lens implantation can be successfully performed after the complete control of inflammation with medical therapy.
 ...
PMID:Phacoemulsification and intraocular lens implantation in a patient with Mooren's ulcer. 930 42

We present a comparison of one quadrant sub-Tenon's anaesthesia and peribulbar anaesthesia. Patient discomfort during injection of anaesthetic and during cataract surgery was assessed using a 10-point visual analogue scale ranging from no pain to the worst pain imaginable. Data are available for 74 patients undergoing cataract surgery under peribulbar anaesthesia and for 55 patients in whom sub-Tenon's anaesthesia was used. Pain scores for administration of anaesthetic were significantly lower (Kruskal-Wallis H-test, p < 0.01) for sub-Tenon's anaesthesia (mean 1.4) compared with the peribulbar technique (mean 2.4). However, a similar number of patients experienced pain of greater than 3 for the two techniques (10 (18.5%) for sub-Tenon's and 14 (18.9%) for peribulbar). Per-operative pain scores for sub-Tenon's anaesthesia (mean 0.5) were lower than those for peribulbar anaesthesia (mean 1.2) but not significantly so (Kruskal-Wallis H-test, p = 0.073). Significantly fewer patients, however, experienced pain of greater than 3 (Fisher exact test, p < 0.05) in the sub-Tenon's group. In addition less anaesthetic solution and a shorter interval from administration to surgery was required in the sub-Tenon's group. Sub-Tenon's anaesthesia appears to be a more effective method of anaesthesia than the peribulbar method.
 ...
PMID:Sub-Tenon's versus peribulbar anaesthesia for cataract surgery. 977 59

Peribulbar anaesthesia is now established as an alternative to retrobulbar anaesthesia for cataract surgery. However, the larger volume of anaesthetic solution in the extraconal orbit with the peribulbar technique might carry a higher risk of systemic side-effects. To assess this risk we carried out a prospective randomised comparison of plasma catecholamine and pressor effects between the two methods of anaesthesia in 40 patients. Plasma adrenaline and noradrenaline, heart rate, blood pressure, pain and anxiety were documented before and after local anaesthesia and during surgery. There were no statistically significant differences between the responses of the two groups. Both groups demonstrated a statistically significant rise in plasma adrenaline and heart rate. However, this change was minimal compared with the effects reported after severe stress or general anaesthesia, emphasising the importance of allaying patient anxiety during local anaesthesia. We have therefore shown that the larger volume of extraconal orbital anaesthetic solution with the peribulbar technique produces no greater risk of systemic pressor effects.
 ...
PMID:Comparison of catecholamine and pressor effects in peribulbar and retrobulbar anaesthesia in cataract surgery. 947 11

It is possible to remove a cataract and insert an intraocular lens under topical anaesthesia (lignocaine 4% preservative-free eye drops) with a van Lint block. This study was performed to evaluate this anaesthetic technique. Nineteen patients having cataract surgery with topical anaesthesia and a van Lint block were compared with 21 patients who received a retrobulbar block and a van Lint block. There were no significant differences between the two groups in patient characteristics, mean cardiovascular stress of the procedure, experience of pain during the operation or willingness to have the same anaesthetic technique again. Topical anaesthesia with a van Lint block is feasible for cataract surgery and is potentially safer than other regional anaesthetic techniques.
 ...
PMID:A comparison of topical anaesthesia and retrobulbar block for cataract surgery. 953 46

We have evaluated the effects of the volume and speed of administration of local anaesthetic during peribulbar anaesthesia. One hundred and forty patients scheduled for cataract surgery were randomly allocated to one of four groups of 35. Each patient received an injection of the same mixture of lignocaine, bupivacaine and hyaluronidase. Patients in group A were given 9 ml at a speed of 5 ml.min-1, group B were given the same volume at 12 ml.min-1, group C were given 13.5 ml at 5 ml.min-1 and group D were given 13.5 ml at 12 ml.min-1. A significantly higher incidence of satisfactory akinesia was found in group D, whose pain score at injection was no higher than for the other groups. Large volumes of local anaesthetic significantly affected intra-ocular pressure. The incidences of early and late ptosis or diplopia were not affected by either the rate of injection or the volume of local anaesthetic.
 ...
PMID:The effects of volume and speed of injection in peribulbar anaesthesia. 965 24

A 68-year-old man with lung carcinoma and no systemic metastasis presented with a blind, painful right eye. Examination showed no perception of light in the affected eye, elevated intraocular pressure, marked epibulbar hyperemia, and a white placoid mass in the conjunctiva nasally. Although a cataract precluded a clear view of the fundus, ultrasonography disclosed a total retinal detachment and a diffuse thickening of the choroid. Metastatic carcinoma was suspected clinically and the eye was enucleated because of severe, intractable pain. Pathologic examination demonstrated extensively necrotic metastatic adenocarcinoma involving the conjunctiva, peripheral cornea, sclera, iris, ciliary body, choroid, optic nerve, subarachnoid space, and orbit. Metastatic disease usually affects a singular ocular tissue, and it is highly unusual for such widespread ocular involvement to be the first sign of systemic metastasis from a primary neoplasm.
 ...
PMID:Diffuse ocular metastases as an initial sign of metastatic lung cancer. 967 12

A 49-year-old woman developed corneal epithelial defects and stromal infiltration shortly after a 4-cut radial keratotomy (RK) for myopia. Although cultures grew staphylococci and appropriate antibiotic treatment was applied, the epithelial defects increased in size. The corneal epithelium did not heal fully for more than 2 months. Penetrating keratoplasty 1 year later was followed by epithelial breakdown and perforation, as was a second keratoplasty. Despite repeated questioning, the patient did not admit until 18 months after her initial surgery that she had begun self-treatment with dilute proparacaine shortly after RK and continued it after her keratoplasties. The elective use of topical anesthetics to control pain after refractive surgery should be approached with caution, and patients should be warned of the possible consequences of their misuse.
J Cataract Refract Surg 1998 Nov
PMID:Topical anesthetic abuse after radial keratotomy. 981 48

In a single centre, randomised, double-blind study 50 patients scheduled for intra-ocular surgery received 0.75% levobupivacaine or 0.75% racemic bupivacaine for peribulbar anaesthesia. There were no significant differences in the mean (SD) volume of levobupivacaine (11 (2.7) ml) or racemic bupivacaine (10 (2.6) ml) required, time to satisfactory block (levobupivacaine-13 (5.6) min; racemic bupivacaine-11 (4.4) min), peri-operative pain scores or frequency of adverse events between levobupivacaine and racemic bupivacaine. The safer side-effect profile of levobupivacaine may offer significant advantages in the elderly population undergoing cataract extraction in whom intercurrent disease is common.
 ...
PMID:Comparison of 0.75% levobupivacaine with 0.75% racemic bupivacaine for peribulbar anaesthesia. 1040 87

A prospective, randomised, double-blinded study comparing three agents for peribulbar anaesthesia is reported. Sixty patients undergoing extracapsular cataract extraction under local anaesthesia were randomly allocated to receive peribulbar anaesthesia with lignocaine 2% with adrenaline; prilocaine 3% with felypressin 0.03 IU.ml-1 or 2% lignocaine and 0.5% bupivacaine in a ratio of 1:1, using a standardised two-injection technique. The pain of injection, time of onset of the block and the operating conditions at the start and finish of surgery were assessed. Peribulbar anaesthesia using lignocaine 2% was significantly more painful than the other solutions. The onset of anaesthesia adequate for surgery was similar in all three groups. Prilocaine 3% with felypressin was associated with the greatest number of blocks providing total akinesia of the eye. Inadequate duration of anaesthesia was seen in only one case; the solution used for this block was 2% lignocaine.
 ...
PMID:Peribulbar anaesthesia: a double-blind comparison of three local anaesthetic solutions. 1020 73

Aspirin was first synthesised 100 years ago and its preparation and marketing is generally reckoned to have been the foundation of the pharmaceutical industry. For most of the time since then it has been used for the relief of pain and fever. The modern phase of aspirin use commenced with the reporting in 1974 of a randomised controlled trial in the secondary prevention of death by low-dose aspirin given to patients who had suffered a myocardial infarct. Reports of other trials followed and an overview of the first six trials was presented to the inaugural meeting of the Society for Clinical Trials in Philadelphia in 1980. There have been two further major overviews and the most recent, based on 145 trials, established that low-dose aspirin reduces vascular events by around one third. It has been estimated that, used appropriately, aspirin could prevent 100,000 premature deaths each year worldwide, at a cost of about 250 Pounds ($400) per life saved, and about 80 Pounds ($130) per cardiovascular event prevented. The evidence indicates that it is seriously underused at present. The aspirin story continues and trials are in progress to test other possible uses of aspirin, in vascular dementia, colorectal cancer, and cataract.
 ...
PMID:Platelets, aspirin, and cardiovascular disease. 1021 50


<< Previous 1 2 3 4 5 6 7 8 9 10