Severe decompression retinopathy after medical treatment of acute primary angle closure.
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Acute Disease↗
Biomedical subjects
A Rotchford
Publications and source records attributed to A Rotchford.
A novel use of amniotic membrane in the management of tube exposure following glaucoma tube shunt surgery.
AIM: To report a novel technique using amniotic membrane to cover exposed glaucoma tube shunts. METHODS: A consecutive series of three cases that underwent drainage tube shunt surgery with the Ahmed valve for intractable glaucoma. All three patients developed exposure of the tube secondary to necrosis of the overlying bovine pericardial patch and conjunctiva. Repair of the defect was carried out with a double layer of amniotic membrane, the inner one acting as a graft and the outer as a patch. Autologous serum was used to promote epithelial growth. RESULTS: Successful lasting closure of the conjunctival defect was achieved in all cases. CONCLUSION: Erosion of the drainage tube following shunt surgery is a potentially serious problem. It can be successfully managed using a double layer of amniotic membrane.
Aged↗
What is practical in glaucoma management?
This article addresses some important issues in the detection and management of glaucoma using examples from the developing world, particularly drawing on experiences and research in sub-Saharan Africa.
Africa South of the Sahara↗
First day review after uncomplicated phacoemulsification: is it necessary?
PURPOSE: To determine whether first day follow-up is necessary after routine uncomplicated phacoemulsification cataract surgery. METHODS: Data collected prospectively at day 1 postoperative review. RESULTS: In 510 consecutive cases, serious complications occurred in 8 (1.6%) (wound leak [4], corneal abrasion [2], iris prolapse [1], hyphema [1]). Intraocular pressure (IOP) >30 mmHg was found in 26 (5.1%) and was strongly associated with a diagnosis of pre-existing glaucoma or ocular hypertension (odds ratio [OR] 7.7). Symptoms of headache or ocular discomfort occurred in 40 (7.8%), mostly in association with raised IOP, and were also associated with pre-existing glaucoma or ocular hypertension (OR 4.7). Central corneal edema was found in 61 (12.0%). In the absence of corneal edema, IOP was >30 mmHg in only two cases (0.39%). CONCLUSIONS: Few sight-threatening complications were detected on the morning after an uncomplicated procedure. First day follow-up may be safely omitted if adequate patient counseling is undertaken and there is provision of adequate access to eye services. Review prior to discharge on the day of surgery would provide an opportunity to detect these few surgical complications and for counseling. A diagnosis of glaucoma or ocular hypertension is a risk factor for significantly raised next day IOP and these patients are more likely to experience postoperative discomfort. They may benefit from prophylactic treatment.
Aftercare↗