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Biomedical subjects

G Rebolleda

Publications and source records attributed to G Rebolleda.

18 recordsLinked to original sources
PubMed2001

Topical plus intracameral lidocaine versus retrobulbar anesthesia in phacotrabeculectomy: prospective randomized study.

PURPOSE: To compare the efficacy and safety of topical and retrobulbar anesthesia for phacotrabeculectomy. SETTING: Hospital Ramón y Cajal, Madrid, Spain. METHODS: This prospective study comprised 60 patients (60 eyes) having phacotrabeculectomy surgery. Patients were randomly assigned to 1 of 2 groups receiving topical anesthesia plus intracameral lidocaine 1% or retrobulbar anesthesia. Patients were asked to document the discomfort they experienced during the administration of the anesthetic agent, during surgery, and postoperatively using a numeric pain scale. Complications and surgical conditions were also evaluated. RESULTS: The retrobulbar group reported significantly more discomfort during administration of the anesthetic agent than the topical group (P < .001). The topical group reported significantly more discomfort intraoperatively (P < .01). Eyelid squeezing and eyeball movement were more common in the topical group; however, neither was a problem to the surgeon. There was no difference in surgical conditions (P = .38) or the postoperative pain scores between the 2 groups (P = .06). One patient receiving topical anesthesia developed a suprachoroidal hemorrhage intraoperatively. CONCLUSIONS: Topical anesthesia supplemented with intracameral lidocaine was an effective alternative to retrobulbar anesthesia for phacotrabeculectomy. Although the degree of patient discomfort was significantly higher during surgery under topical anesthesia, the method avoids the pain and complications associated with a retrobulbar injection.

Administration, Topical↗
PubMed2001

[Glaucoma related with photoreceptor outer segments in aqueous humor. Schwartz-Matsuo syndrome].

CASE REPORT: We present the case of a patient who was initially diagnosed of hypertensive uveitis with marked fluctuation that was resistant to the common treatment. After a systematic examination, retinal detachment of the ora serrata in the inferotemporal quadrant was diagnosed. The sample of aqueous humor showed melanic pigment and degenerated photoreceptor outer segments. After retinal detachment surgery, the intraocular pressure returned to normal levels without antiglaucoma medication. DISCUSSION: The presence of photoreceptor outer segments in aqueous humor confirms the diagnosis of Schwartz-Matsuo syndrome, which should be considered as a differential diagnosis of iritis and glaucoma.

Adult↗
PubMed2001

[Neuroretinitis in an HIV-infected patient].

CASE REPORT: We present a 35 year-old man, suffering from HIV infection with a left neuroretinitis and bilateral multifocal inner retinitis. A systematic approach supported the presumed diagnosis of cat-scratch disease. The patient was treated with oral azytromicine following a full-clinical recovery. DISCUSSION: We discuss the differential diagnosis of this clinical entity, treatment and clinical evolution.

Adult↗
PubMed2001

[Intra-bleb pigmentation after phacoemulsification].

CASE REPORT: We report the finding of an intense intra-bleb pigmentation 24 hours after uncomplicated phacoemulsification in an eye with previous trabeculectomy. In the follow-up, considerable reduction in degree of pigmentation was observed and intraocular pressure remained under control without medication. DISCUSSION: Intra-bleb pigmentation after trabeculectomy or phacotrabeculectomy has been recently reported by Wanichwecharungruang; however it has never been mentioned after isolated phacoemulsification. It is usually related with intraoperative pigment dispersion. A preexisting thin bleb provides a clear view of intra-bleb pigmentation, that appears associated with a successful filtration.

Aged↗
PubMed2000

[Diabetic papillopathy and type 2 diabetes].

CASE REPORT: We report a case of a 62-year-old man with type II diabetes mellitus and mild impairment of visual acuity with bilateral optic disc edema. Visual field examination showed enlargement of right blind spot and an inferior arcuate defect in the left eye. Blood pressure, neuroimaging evaluation and cerebrospinal fluid analysis were normal. Spontaneous resolution was observed six weeks later. DISCUSSION: Although the diabetic papillopathy was initially described in juvenile diabetics, recently an afflicted older subpopulation with type II diabetes has been reported to develop this condition. We discuss the clinical characteristics, pathogenesis and differential diagnosis of this clinical entity.

Diabetes Mellitus, Type 2↗
PubMed2000

[Intraocular pressure evolution after phacoemulsification in eyes with filtering blebs].

PURPOSE: To evaluate the effect of phacoemulsification in functioning filtered glaucoma eyes, on intraocular pressure (IOP) and the use of antiglaucomatous medication. To determine the influence of time lapsed between surgeries on the results. METHOD: 20 eyes of 20 patients treated by phacoemulsification in 1997, who had undergone previous glaucoma filtering surgery in which IOP was well controlled, were retrospectively evaluated. RESULTS: Mean preoperative IOP was 13.2+/-4.1 mmHg (range: 5-21). Mean IOP increased after phacoemulsification in every postoperative control (0.9-2.6 mm Hg), the differences were not significant. Mean score medication increased (0.2-1) after surgery, but the difference was not significant. Mean preoperative IOP was 5.7 mm Hg lower in patients whose phacoemulsification was performed before 18 months after trabeculectomy than those whose surgery was performed later (P<0.001). Moreover, the patients operated earlier showed an IOP increase after phacoemusification (3.2-3.9 mm Hg) during the first six postoperative months (P<0.05). However, the patients who underwent filtering surgery later, did not show any significant change in postoperative IOP. Visual acuity (VA) significantly improved after cataract surgery (P<0.05). VA was equal or better than 0.5 in 43.75% of the patients, six months postoperatively. CONCLUSIONS: We have found a slight increase in IOP after phacoemulsification in filtered glaucoma eyes. To reduce the time lapsed between trabeculectomy and phacoemulsification could be a risk factor predisposing to failure of previously functioning filtering blebs.

Aged↗
PubMed1999

Audible pops during cyclodiode procedures.

PURPOSE: This study was conducted to determine the incidence of intraocular uveal microexplosions ("pops") during contact diode laser transscleral cyclophotocoagulation (cyclodiode) and to analyze the influence of pop occurrence on results and postoperative complications. METHODS: Cyclodiode treatment (1.5-2 W x 2 seconds over 270 degrees) was performed in 43 consecutive patients (43 eyes) with uncontrolled glaucoma who had not undergone previous ciliary ablation. Mean duration of follow-up evaluation was 12.7 months (range, 9-18 months). These eyes included 31 seeing eyes, in which intraocular pressure (IOP) reduction was indicated to preserve visual acuity (therapeutic group) and 12 blind eyes, in which IOP reduction was advisable to relieve pain (palliative group). Success was defined as a final IOP > or = 5 mmHg and < or = 21 mmHg in seeing eyes, and as the resolution of pain in blind eyes. Potential factors evaluated for intraoperative pop occurrence included patient age, gender, iris color, glaucoma diagnosis, preoperative IOP, and number of previous surgical procedures used to treat glaucoma. RESULTS: In the group receiving therapeutic treatment, mean +/- standard deviation (SD) IOP was 41.8 +/- 12.7 mmHg before surgery and 19.2 +/- 8.3 mmHg after surgery; the success rate in this group was 83.9%. In the group receiving palliative treatment, mean IOP was 55.4 +/- 13.7 mmHg before surgery and 21.1 +/- 13.4 mmHg after surgery; success rate was 83.3% in this group. Intraoperative microdisruptions occurred in 48.8% of the cases during the first laser application; 67.5% of these occurred in the superior half of the eye. No significant difference in rate of intraoperative pop was observed between patients after one cyclodiode session and those eyes that underwent additional sessions. Mean baseline IOP was significantly higher in patients with intraoperative occurrence of pops. An audible pop was more common in the group undergoing palliative treatment. Intraoperative occurrence of pops was associated with a greater severity of postoperative iridocyclitis. All patients with postoperative hyphema also had pops during surgery. No significant difference in the success rate was found between patients in whom intraoperative pops did and did not occur. CONCLUSION: Choroidal vaporization is significantly more common in patients with higher baseline IOP. Occurrence of pops also is associated with more severe postoperative inflammation and with a greater risk of postoperative hyphema.

Aged↗
PubMed1992

Effects of pupillary dilation on automated perimetry in glaucoma patients receiving pilocarpine.

The authors studied 18 glaucoma patients receiving pilocarpine 2% therapy with automated static threshold perimetry using the Humphrey Field Analyzer 30-2 and STATPAC programs before and after instillation of 10% phenylephrine. The mean defect improved by an average of 3.14 decibels (dB) (standard deviation, 1.89 dB0 after administration of phenylephrine (P less than 0.001). The pattern standard deviation and the corrected pattern standard deviation also improved with dilation by 1.42 dB (P less than 0.01) and 1.73 dB (P less than 0.05), respectively, after dilation with phenylephrine. Comparisons of the unweighted means of threshold values in three zones of increasing eccentricity showed that the outer zone of the visual field had the greatest improvement after dilation. These findings indicate that pupillary dilation in glaucoma patients receiving pilocarpine therapy produces a nonuniform increase in threshold sensitivities and support the importance of consistent pupillary diameters on serial automated visual field examinations.

Adult↗
PubMedDate not supplied

Hypothyroidism and primary open-angle glaucoma.

OBJECTIVE: To test if there is an association between hypothyroidism and primary open-angle glaucoma (POAG) and the utility of routine study of thyroid function in these patients. METHODS: The study was conducted in a case-control fashion. Seventy-five consecutive patients with a previous diagnosis of POAG and 75 control patients were prospectively evaluated for hypothyroidism. The levels of thyroid-stimulating hormone and free thyroxin were measured. RESULTS: Hypothyroidism was revealed in only 2 patients with previous diagnosis of POAG (2.67%) and 3 patients of the control group (4%). CONCLUSIONS: As we have not been able to demonstrate the previously reported relationship between hypothyroidism and POAG, we cannot recommend the systematic screening for hypothyroidism in patients with POAG.

Adult↗
PubMedDate not supplied

Magnetic resonance imaging in cavitary choroidal melanoma.

PURPOSE: To report the development of a cavitary choroidal melanoma in a patient with nevus of Ota and describe its magnetic resonance imaging (MRI) features. PATIENT: A 66-year-old man with right oculodermal melanocytosis and an ipsilateral choroidal cavitary melanoma was seen. Diagnosis was suspected on the clinical, ultrasonographic and MRI findings. RESULTS: T1-weighted image showed a hyperintense solid mass containing hypointense cystic-like spaces delineated by hyperintense septa with respect to the vitreous. The reverse image was observed on T2-weighted images. A choroidal melanoma comprising epithelioid and spindle cells with multilocular cavities was documented histopathologically. CONCLUSIONS: There may be an association between cavitary melanoma and nevus of Ota. Characteristic MRI findings could be helpful in the differential diagnosis of cavitary uveal melanoma.

Aged↗
PubMedDate not supplied

Botulinum toxin treatment of Hertwig-Magendie sign.

Hypertropia, not due to the usual causes and associated with a central nervous system disorder, should be suspected as being a skew deviation (Hertwig-Magendie sign). We describe a new case of this supranuclear disorder, presumably related to cocaine-induced stroke. This disorder was treated by botulinum A toxin (Oculinum) injection into the superior rectus muscle. Follow-up one year later found the vertical deviation resolved.

Adult↗