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Amar Alwitry

Publications and source records attributed to Amar Alwitry.

5 recordsLinked to original sources
PubMed2002

Effect of hyaluronidase on ocular motility in sub-Tenon's anesthesia: randomized controlled trial.

PURPOSE: To assess the effect of hyaluronidase additive on the onset and degree of ocular akinesia in sub-Tenon's anesthesia for cataract surgery. SETTING: Routine cataract operating list. METHOD: This double-blind randomized controlled study comprised 100 patients who had phacoemulsification cataract surgery. Patients were randomized to 1 of 2 groups. For sub-Tenon's anesthesia, Group A received 5 mL lignocaine 2% with sodium hyaluronidase 150 IU/mL and Group B, 5 mL plain lignocaine 2%. Akinesia was assessed by scoring movement in the 6 positions of gaze. Scores ranged from 0 (complete akinesia) to 3 (no akinesia). Movements were measured at 30 seconds and 1, 3, 5, and 10 minutes. Changes in motility scores were compared by the Mann-Whitney U test. RESULTS: There was no significant difference in akinesia between the 2 groups 30 seconds after the injection (P =.224); however, at 1 and 3 minutes, Group A achieved significantly better akinesia than Group B (P =.003 and P =.023, respectively). The median score after 3 minutes was 3.5 (interquartile range 0 to 7.5) in Group A and 7.0 (interquartile range 2.5 to 10.0) in Group B. There was no significant difference between the groups at 5 and 10 minutes (P =.225 and P =.831, respectively). CONCLUSIONS: The addition of hyaluronidase in sub-Tenon's anesthesia significantly improved the rapidity of the onset of akinesia. This benefit disappeared over time; after 5 minutes the akinesia observed in the group receiving hyaluronidase was similar to that in the group receiving lignocaine alone. Thus, there appears to be no benefit to adding hyaluronidase to the anesthetic solution in terms of final ocular akinesia.

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PubMed2002

Role of intraocular pressure measurement on the day of phacoemulsification cataract surgery.

PURPOSE: To determine whether measurement of intraocular pressure (IOP) preoperatively or in the early postoperative period is an accurate predictor of raised IOP 24 hours after cataract surgery. SETTING: Department of Ophthalmology, Queen's Medical Centre, Nottingham, United Kingdom. METHODS: This prospective study comprised 101 eyes of 101 patients having phacoemulsification cataract surgery. The IOP was measured by Goldmann applanation tonometry preoperatively and 2 to 3 hours, 6 to 8 hours, and 22 to 24 hours postoperatively. The relationship between the same-day and next-day IOP readings was examined. RESULTS: One hundred patients completed the study. The IOP at 22 to 24 hours was significantly correlated with the IOP preoperatively (correlation coefficient [r] 0.54; 95% confidence interval [CI], 0.38-0.67) and at 6 to 8 hours (r = 0.56; 95% CI, 0.41-0.68). In contrast, the IOP measurement at 2 to 3 hours correlated relatively poorly with the next-day IOP (r = 0.33; 95% CI, 0.14-0.49). Twelve patients had an IOP of 26 mm Hg or higher at 22 to 24 hours. The risk of this outcome increased significantly with higher IOP values preoperatively and, to a lesser extent, with a raised IOP at 6 to 8 hours. Glaucoma and ocular hypertension were associated with a 2.9-fold increased risk (95% CI, 0.67-12.8) of a next-day IOP of 26 mm Hg or higher. CONCLUSIONS: Preoperative IOP or a diagnosis of glaucoma or ocular hypertension were significant risk factors for raised next-day IOP after small-incision phacoemulsification. It may be possible to select patients at greater risk of prolonged ocular hypertension before surgery for prophylactic IOP-lowering treatment. This would minimize patient morbidity and reduce the number of patients requiring next-day review, resulting in significant health economic savings.

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