Vitreous loss during phacoemulsification by residents.
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Biomedical subjects
Publications and source records attributed to R W Allinson.
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The incidence of vitreous loss among third-year residents learning phacoemulsification was retrospectively evaluated. One hundred thirty-six cases of phacoemulsification were performed by six different third-year residents with the same attending physician supervising all cases. The incidence of vitreous loss was 14.7%. This study demonstrates that the rate of vitreous loss among residents learning phacoemulsification is higher than the reported incidence of vitreous loss for residents learning planned extracapsular cataract surgery with expression of the lens nucleus.
We report the case of a patient with recurrent hemorrhagic choroidal detachments after combined cataract and filtering surgery associated with exacerbation of chronic disseminated intravascular coagulation (DIC). It was postulated that the formation and drainage of the hemorrhagic choroidal detachments induced thrombin generation and consequently coagulation factor and platelet consumption. Fibrinolysis resulted in the release of fibrin-degradation products (FDP). Consumption of clotting factors and platelets combined with FDP release may result in decompensation of a chronic DIC state and cause a bleeding diathesis. This case shows the need for complete hematologic evaluation of patients with hemostatic abnormalities.
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When a Molteno implant is being inserted, the silicone tube occasionally can be misdirected anteriorly, bringing the end of the tube dangerously close to the corneal endothelium. A paralimbal compression suture of 8-0 nylon may redirect the tube more posteriorly, preventing such contact.
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The effect of topical dapiprazole, an alpha-adrenergic receptor blocker, in reversing mydriasis was studied in 50 subjects who received tropicamide 1% and phenylephrine 2.5%. There was a significant difference in the decrease in pupil size between the eye that received dapiprazole and the control eye. This study suggests that dapiprazole 0.5% eye drops are effective and safe in reversing mydriasis after instillation of tropicamide 1% and phenylephrine 2.5%.
To help ensure proper placement of an iris fixation suture, a peripheral iridectomy can be performed to allow visualization of the superior haptic of a posterior chamber intraocular lens (PC-IOL). In cases where support for the PC-IOL is in question, an iris fixation suture using this technique provides an easy way of ensuring adequate support.
Foreign body forceps were used to stabilize a hard lens nucleus during phacofragmentation in the posterior segment. This technique allows removal of the hard lens nucleus with minimal manipulation and without the need for a larger incision.
We describe the case of a patient with acquired immunodeficiency syndrome (AIDS) who had internuclear ophthalmoplegia (INO) and subsequent rapid neurologic deterioration. To our knowledge, this is the first report of a patient with AIDS and INO.
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