scholarly journals Evaluating the Variation of Intraocular Pressure With Positional Change During Colorectal Laparoscopic Surgery: Observational Study (Preprint)

2018 ◽  
Author(s):  
Parveen Vitish-Sharma ◽  
Anthony J King ◽  
Richard Stead ◽  
John Sharp ◽  
Ali Abbas ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Colorectal Surgery ◽  
Correlation Coefficient ◽  
Laparoscopic Colorectal Surgery ◽  
Average Length ◽  
Operating Table ◽  
The Mean ◽  
Group 2 ◽  
Perioperative Visual Loss ◽  
Group 1

BACKGROUND The incidence of perioperative visual loss following colorectal surgery in the US is quoted as 1.24 per 10,000. Raised intraocular pressure (IOP) during extreme Trendelenburg position leading to reduced optic nerve perfusion is thought to be a cause. OBJECTIVE To assess the effect of the degree of Trendelenburg tilt and time spent in Trendelenburg on IOP during laparoscopic colorectal surgery. METHODS Fifty patients undergoing laparoscopic colorectal surgery were recruited. A Tonopen XL applanation tonometer was used to take IOP measurements hourly during surgery, and each time the operating table was tilted. A correlation coefficient for the degree of Trendelenburg tilt and IOP was calculated for each patient. Group 1 included patients undergoing a right-sided colonic procedure, and Group 2 included all left-sided colonic operations. RESULTS The mean age of Group 1 participants (n=25) was 69 years (SD 14), and Group 2 (n=25) was 63 years (SD 16; P>.05). The average length of surgery for Group 1 was 142 minutes (SD 48), and Group 2 was 268 minutes (SD 99; P≤.05). The mean maximum degree of Trendelenburg tilt in Group 1 was 10 (SD 7) and Group 2 was 19 (SD 6; P≤.05). The mean IOP increase was 9 mm Hg (SD 5) for Group 1 and 15 mm Hg (SD 5) in Group 2 (P≤.05). An overall correlation coefficient for the degree of Trendelenburg tilt and IOP change (n=48) was .78. CONCLUSIONS There is a strong correlation between IOP elevation during laparoscopic colorectal surgery and the degree of Trendelenburg tilt. This may be significant for patients undergoing prolonged surgery and especially those with glaucoma.

scholarly journals The Results of Trabeculectomy with Antimetabolites in Elderly Patients: A Retrospective Study

Acta Medica ◽  
2021 ◽  
pp. 1-5
Author(s):  
Özlem Dikmetaş ◽  
Sepideh Lotfisadigh, ◽  
Merve Kaşıkçı ◽  
Ali Bülent Çankaya ◽  
Sibel Kocabeyoğlu
Keyword(s):  
Intraocular Pressure ◽  
Retrospective Study ◽  
Elderly Patients ◽  
Mitomycin C ◽  
Open Angle Glaucoma ◽  
Success Rates ◽  
Topical Medication ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Objective: To examine the effectiveness and results of primary trabeculectomy with 5-fluorouracil (group 1) or mitomycin-C (group 2) in elderly patients. Materials and Methods: This was a retrospective study including 67 eyes with primary open-angle glaucoma that underwent primary trabeculectomy with group 1 or group 2. Patients who were followed up for less than 1 year or were under 55 years of age were excluded from the study. Surgical success was evaluated according to a decrease in cup/disk ratio and reduction of intraocular pressure without any topical medication. Results: The mean ages of participants were 65.7 years (range 59–88) and 65.9 years (range 59–74) in groups 1 and 2, respectively. The mean preoperative and postoperative intraocular pressure values were 31.3 ± 5.7 mmHg (range 17–46) and 14.8 ± 0.4 mmHg (range 10–21) in group 1 (p < 0.001) and 31.5 ± 7.4 mmHg (range 18–52) and 14.8 ± 2.9 mmHg (range 10–21) in group 2 (p < 0.001). Conclusion: The use of 5-fluorouracil or mitomycin-C during primary trabeculectomy is associated with high postoperative success rates. There were no significant differences between 5-fluorouracil and mitomycin-C in terms of intraocular pressure reduction.

scholarly journals Intraocular Pressure Changes during Femtosecond Laser-Assisted Cataract Surgery: A Comparison between Two Different Patient Interfaces

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Chiara De Giacinto ◽  
Rossella D’Aloisio ◽  
Alessandro Bova ◽  
Tommaso Candian ◽  
Alberto Armando Perrotta ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Soft Contact ◽  
Soft Contact Lens ◽  
Significant Difference ◽  
The Mean ◽  
Group 2 ◽  
Pressure Changes ◽  
Group 1

Purpose. The aim of this retrospective cohort study was to evaluate intraocular pressure (IOP) changes during femtosecond laser-assisted cataract surgery (FLACS) using two different patient interface systems. Methods. 116 eyes of 116 patients scheduled for cataract surgery were divided into 2 groups: group 1 (61 eyes) and group 2 (55 eyes) underwent FLACS using Catalys Laser with fluid interface (liquid optics interface, LOI) and LenSx Laser with curved interface and soft contact lens (SoftFit), respectively. IOP was assessed using a portable rebound tonometer (Icare®) preoperatively, after docking, immediately after surgery, at one and seven days postoperatively. Results. In group 1, the mean IOP (±SD) was 14.1 ± 0.4 mmHg before surgery, 33.2 ± 1.1 mmHg after docking, and 21.4 ± 0.9 mmHg immediately after surgery. In group 2, the mean IOP was 13.8 ± 0.4 mmHg before surgery, 24.2 ± 1.4 mmHg after docking, and 20.2 ± 1.2 mmHg immediately after surgery. After the docking procedure, a statistically significant increase in IOP from the baseline was found in both groups (p<0.001). Moreover, no statistically significant difference in IOP measured at 1 and 7 days postoperatively was observed compared with the preoperative values (p>0.05) using both laser platforms. No intraoperative and postoperative complications were observed. Conclusions. FLACS suction phase resulted in a transient increase of IOP in both groups, especially with the LOI system, and it is probably related to the greater pressure of a suction ring and suction generated through the vacuum, independently from the effect of femtosecond laser itself.

scholarly journals Higher Intraocular Pressure Levels Associated With Lower Hysteresis In Type 2 Diabetes

2018 ◽  
Vol 12 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Sinan Bekmez ◽  
Tolga Kocaturk
Keyword(s):  
Intraocular Pressure ◽  
P Value ◽  
Diabetic Patients ◽  
Type 2 Diabetics ◽  
Kolmogorov Smirnov ◽  
The Mean ◽  
Group 2 ◽  
Group 1 ◽  
Smirnov Test

Aim: To investigate the differences of corneal biomechanic characteristics using Ocular Response Analyzer (ORA, Reichert; USA) on type 2 diabetics and healthy subjects. Methods: One hundred eyes of 100 subjects (between the ages of 17-91) who applied to Adnan Menderes University’s Ophthalmology Clinic between January-March 2015 were included in this study, 50 diabetics (Group 1) and 50 healthy controls (Group 2). The eyes included in the study were randomly chosen. Corneal Hysteresis (CH), Corneal Resistance Factor (CRF), Goldmann correlated Intraocular Pressure (IOPg) and corneal compensated Intraocular Pressure (IOPcc) of patients were measured by ORA. Detailed ophthalmological examinations were done for every subject. Kolmogorov-Smirnov test was used to analyze the distribution of quantitative variables and t test was used for the data that were normally distributed. Any p value <0.05 was considered as statistically significant. Results: The mean ages were 63.3±9.0 and 61.7±11.6 in Group 1 and 2, respectively (p=0.459). 25 (50.0%) were female, 25 (50.0%) were male in Group 1 and 26 (52.0%) were female, 24 (48.0%) were male in Group 2 (p=1.000). Mean IOPcc values were 17.8±3.6 (12.1-29.0) and 16.0±3.1 (10.9-23.8) mmHg (p=0.006); mean IOPg values were 16.9±3.5 (10.9-25.9) and 15.4±2.9 (9.0-24.7) mmHg (p=0.032); mean CH values were 9.9±1.5 (6.1-13.3) and 10.5±1.7 (6.5-15.7) (p=0.080) and mean CRF values were 10.4±1.6 (7.5-14.0) and 10.5±1.7 (6.6-15.4) (p=0.730) in Groups 1 and 2, respectively. Conclusions: There was no any statistical difference between the groups in terms of CH and CRF. However, mean CH and CRF values were found less in diabetic group. Corneal biomechanical differences seen in diabetic patients may be associated with a statistically significantly higher IOP measurements.

scholarly journals Effect of Varying Duration of Ocular Compression on Raised Intraocular Pressure following Fractionated Peribulbar Anaesthesia for Cataract Surgery

1970 ◽  
Vol 12 (4) ◽  
pp. 197-200
Author(s):  
Jaichandran Venkatakrishnan ◽  
Lingam Vijaya ◽  
Ronnie J. George ◽  
Thennarasu Maruthamuthu
Keyword(s):  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Local Anaesthetic ◽  
Ocular Surgery ◽  
Peribulbar Anaesthesia ◽  
Peribulbar Block ◽  
Digital Compression ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Aim: To evaluate the effect of fractionated peribulbar anaesthesia and varying digital ocular compression time on intraocular pressure.Methods: Forty non-glaucomatous patients aged 40 years and older planned for cataract surgery were randomly divided into 2 groups based on the duration for which the globe was compressed digitally following each injection. Patients with a history of glaucoma or those who had had previous ocular surgery were excluded. Group 1 underwent 1 minute of compression and group 2 underwent 2 minutes of compression. Local anaesthetic (2% lidocaine 5 mL, 0.5% bupivacaine 5 mL, and hyaluronidase 25 IU/mL) was injected into the inferotemporal and superomedial quadrants. Intraocular pressure was measured (3 readings with <5% SD) before peribulbar block, after inferotemporal injection, following digital compression, after superomedial injection, following digital compression again, and at 1-minute intervals without compression until the globe attained normotension.Results: The mean (SD) intraocular pressure in group 1 was significantly elevated compared with the baseline mean intraocular pressure of 19.21 mm Hg (SD, 2.82 mm Hg) throughout the procedure (p < 0.0001). In group 2, the mean intraocular pressure was not significantly elevated from the baseline mean intraocular pressure of 19.13 mm Hg (SD, 3.27 mm Hg) following compression after each injection.Conclusions: Intraocular pressure rises significantly following each 5 mL of local anaesthetic injected into the peribulbar space at both the inferotemporal and superomedial sites. Digital ocular compression given for 2 minutes after each injection makes the globe normotensive.

scholarly journals An observational comparative study of intraocular pressure changes in post-operative cataract patients treated with dexamethasone and difluprednate

2020 ◽  
Vol 9 (7) ◽  
pp. 1079
Author(s):  
Sadhana K. Hingorani ◽  
Anupama S. Desai ◽  
Manisha B. Shastri
Keyword(s):  
Intraocular Pressure ◽  
Adverse Effects ◽  
Topical Steroids ◽  
Intra Ocular Pressure ◽  
Ocular Pressure ◽  
The Mean ◽  
Group 2 ◽  
Pressure Changes ◽  
Cataract Patients ◽  
Group 1

Background: Cataract is the leading cause of blindness worldwide. Treatment of cataract is surgical. Topical corticosteroids are routinely used in the treatment of post-operative inflammation following cataract surgery. This study aims to compare the intraocular pressure changes caused by topical steroids (dexamethasone and difluprednate) and to detect adverse effects.Methods: All patients operated by phacoemulsification in ophthalmology Department of SMIMER Surat were taken as subjects. Depending on topical steroids prescribed after surgery, subjects were separated into 2 groups, group 1 - difluprednate and group 2 - dexamethasone. Changes in intra-ocular pressure (IOP) of patients were collected from the data available pre-operative, 1st ,2nd ,3rd ,4th week after surgery and were analyzed. Other parameters whose data were collected are-adverse effects and compliance of patients.Results: In group 1 preoperative mean IOP was 15.5. At the end of 1st week, the mean IOP was significantly increased to 15.8. There was equal rise in IOP during 3rd week and 4th week which means that after 3rd week IOP remains stable. In group 2 preoperative mean IOP was 15.4. At the end of 1st, 2nd, 3rd and 4th there was significant increase in IOP as compared to preoperative mean IOP. Adverse effects were reported more in group 2.Conclusions: In group 1 there was a rise in IOP up to three weeks but after 3rd week IOP remained stable. In group 2 rise in IOP was seen throughout 4 weeks of treatment. Adverse effects seen more in group 2. Compliance of patients was better in group 1.

Creation of physiologic rhythm by closed loop stimulation in heart failure patients with severe chronotropic incompetence: worldwide first results of a pilot study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Proff ◽  
B Merkely ◽  
R Papp ◽  
C Lenz ◽  
P.J Nordbeck ◽  
...  
Keyword(s):  
Heart Rate ◽  
Closed Loop ◽  
Funding Source ◽  
Chronotropic Incompetence ◽  
First Results ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Background The prevalence of chronotropic incompetence (CI) in heart failure (HF) population is high and negatively impacts prognosis. In HF patients with an implanted cardiac resynchronisation therapy (CRT) device and severe CI, the effect of rate adaptive pacing on patient outcomes is unclear. Closed loop stimulation (CLS) based on cardiac impedance measurement may be an optimal method of heart rate adaptation according to metabolic need in HF patients with severe CI. Purpose This is the first study evaluating the effect of CLS on the established prognostic parameters assessed by the cardio-pulmonary exercise (CPX) testing and on quality of life (QoL) of the patients. Methods A randomised, controlled, double-blind and crossover pilot study has been performed in CRT patients with severe CI defined as the inability to achieve 70% of the age-predicted maximum heart rate (APMHR). After baseline assessment, patients were randomised to either DDD-CLS pacing (group 1) or DDD pacing at 40 bpm (group 2) for a 1-month period, followed by crossover for another month. At baseline and at 1- and 2-month follow-ups, a CPX was performed and QoL was assessed using the EQ-5D-5L questionnaire. The main endpoints were the effect of CLS on ventilatory efficiency (VE) slope (evaluated by an independent CPX expert), the responder rate defined as an improvement (decrease) of the VE slope by at least 5%, percentage of maximal predicted heart rate reserve (HRR) achieved, and QoL. Results Of the 36 patients enrolled in the study, 20 fulfilled the criterion for severe CI and entered the study follow-up (mean age 68.9±7.4 years, 70% men, LVEF=41.8±9.3%, 40%/60% NYHA class II/III). Full baseline and follow-up datasets were obtained in 17 patients. The mean VE slope and HRR at baseline were 34.4±4.4 and 49.6±23.8%, respectively, in group 1 (n=7) and 34.5±12.2 and 54.2±16.1% in group 2 (n=10). After completing the 2-month CPX, the mean difference between DDD-CLS and DDD-40 modes was −2.4±8.3 (group 1) and −1.2±3.5 (group 2) for VE slope, and 17.1±15.5% (group 1) and 8.7±18.8% (group 2) for HRR. Altogether, VE slope improved by −1.8±2.95 (p=0.31) in DDD-CLS versus DDD-40, and HRR improved by 12.9±8.8% (p=0.01). The VE slope decreased by ≥5% in 47% of patients (“responders to CLS”). The mean difference in the QoL between DDD-CLS and DDD-40 was 0.16±0.25 in group 1 and −0.01±0.05 in group 2, resulting in an overall increase by 0.08±0.08 in the DDD-CLS mode (p=0.13). Conclusion First results of the evaluation of the effectiveness of CLS in CRT patients with severe CI revealed that CLS generated an overall positive effect on well-established surrogate parameters for prognosis. About one half of the patients showed CLS response in terms of improved VE slope. In addition, CLS improved quality of life. Further clinical research is needed to identify predictors that can increase the responder rate and to confirm improvement in clinical outcomes. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Biotronik SE & Co. KG

Comparison of the ATRIA, CHA2DS2-VASc, and Modified Scores ATRIA-HSV, CHA2DS2-VASc-HS, for the Prediction of Coronary Artery Disease Severity

Angiology ◽  
2021 ◽  
pp. 000331972199141
Author(s):  
Arafat Yildirim ◽  
Mehmet Kucukosmanoglu ◽  
Fethi Yavuz ◽  
Nermin Yildiz Koyunsever ◽  
Yusuf Cekici ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Vascular Disease ◽  
Operating Characteristics ◽  
Coronary Artery Disease Severity ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

Many parameters included in the Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) and CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke, vascular disease, age 65-74 years, sex category) scores also predict coronary artery disease (CAD). We modified the ATRIA score (ATRIA-HSV) by adding hyperlipidemia, smoking, and vascular disease and also male sex instead of female. We evaluated whether the CHA2DS2-VASc, CHA2DS2-VASc-HS, ATRIA, and ATRIA-HSV scores predict severe CAD. Consecutive patients with coronary angiography were prospectively included. A ≥50% stenosis in ≥1epicardial coronary artery (CA) was defined as severe CAD. Patient with normal CA (n = 210) were defined as group 1, with <50% CA stenosis (n = 178) as group 2, and with ≥50% stenosis (n = 297) as group 3. The mean ATRIA, ATRIA-HSV, CHA2DS2-VASc, and CHA2DS2VASc-HS scores increased from group 1 to group 3. A correlation was found between the Synergy between PCI with Taxus and Cardiac Surgery score and ATRIA ( r = 0.570), ATRIA-HSV ( r = 0.614), CHA2DS2-VASc ( r = 0.428), and CHA2DS2-VASc-HS ( r = 0.500) scores ( Ps < .005). Pairwise comparisons of receiver operating characteristics curves showed that ATRIA-HSV (>3 area under curve [AUC]: 0.874) and ATRIA (>3, AUC: 0.854) have a better performance than CHA2DS2-VASc (>1, AUC: 0.746) and CHA2DS2-VASc-HS (>2, AUC: 0.769). In conclusion, the ATRIA and ATRIA-HSV scores are simple and may be useful to predict severe CAD.

Does Presurgical Nasoalveolar Molding Have a Long-Term Effect on Nasal and Upper Airway Dimensions?

2020 ◽  
pp. 105566562098023
Author(s):  
Ashwina S. Banari ◽  
Sanjeev Datana ◽  
Shiv Shankar Agarwal ◽  
Sujit Kumar Bhandari
Keyword(s):  
Upper Airway ◽  
P Value ◽  
Airway Patency ◽  
The Mean ◽  
Group 2 ◽  
Acoustic Pharyngometry ◽  
Nasoalveolar Molding ◽  
Area And Volume ◽  
Group 1

Objectives: To compare nasal and upper airway dimensions in patients with cleft lip and palate (CLP) who underwent nasoalveolar molding (NAM) with those without NAM during infancy using acoustic pharyngometry and rhinometry. Materials and Methods: Eccovision acoustic pharyngometry and rhinometry (Sleep Group Solutions) was used for assessment of mean area and volume of nasal and upper airway in patients with complete unilateral CLP (age range 16-21 years) treated with NAM (group 1, n = 19) versus without NAM (group 2, n = 22). Results: The mean nasal cross-sectional areas and volume were higher in group 1 compared to group 2 on both cleft ( P value <.001) and noncleft side ( P value >.05). The mean area and volume of upper airway were also significantly higher in group 1 compared to group 2 ( P value <.05). Conclusions: Nasoalveolar molding being one of the first interventions in chronology of treatment of patients with CLP, its long-term outcome on nasal and upper airway patency needs to be ascertained. The results of the present study show that the patients with CLP who have undergone NAM during infancy have better improvement in nasal and upper airway patency compared with those who had not undergone NAM procedure. The basic advantages of being noninvasive, nonionizing and providing dynamic assessment of nasal and upper airway patency make acoustic pharyngometry and rhinometry a diagnostic tool of choice to be used in patients with CLP.

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