Publications by authors named "Armando Belfort"

2 Publications

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Local anesthesia with intravenous sedation for surgical repair of selected open globe injuries.

Am J Ophthalmol 2002 Nov;134(5):707-11

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, School of Medicine, Miami, Florida 33101, USA.

Purpose: To report factors associated with the use of local anesthesia with intravenous sedation (local anesthesia/sedation) rather than general anesthesia for surgery for open globe injuries in adult reparable eyes.

Design: Retrospective, nonrandomized, comparative case series.

Methods: Medical records were reviewed of all patients with open globe injuries repaired at Bascom Palmer Eye Institute between 1995 and 1999. "Adult reparable eyes" (eyes in patients >/=18 years of age, not treated with primary enucleation or evisceration, followed up >/=2 months) were included.

Results: In all, 220 eyes of 218 patients met inclusion criteria. General anesthesia was employed in 80 of 200 (36%) and local anesthesia/sedation in 140 of 220 (64%). Patients who had local anesthesia/sedation were significantly more likely to have an intraocular foreign body (31% vs 14%; P =.010, chi-square test), better presenting visual acuity (1.8 logMAR [logarithm of the minimum angle of resolution] units vs 2.5 logMAR units; P <.001, t test), more anterior wound location (75% corneal/limbal vs 65%; P =.003, chi-square), shorter wound length (6.3mm vs 10.8mm; P <.001, t test), and dehiscence of previous surgical wound (26% vs 12%; P =.021, chi-square) and were significantly less likely to have an afferent pupillary defect (22% vs 51%; P <.001, chi-square). There was no anesthesia-related complication in either group. The local anesthesia/sedation group had a shorter mean operating time than did the general anesthesia group (78 minutes vs 117 minutes; P <.001, t test). The general anesthesia group had a longer mean follow-up than the local anesthesia/sedation group (20.2 months vs 13.9 months, respectively; P =.002, t test). Change in visual acuity between the presenting and final examinations was similar for open globe injuries repaired with general anesthesia compared with local anesthesia/sedation (0.94 vs 0.72 logMAR units of visual acuity, respectively; P =.16, t test).

Conclusions: Local anesthesia/sedation is a reasonable alternative to general anesthesia for selected patients with open globe injuries.
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http://dx.doi.org/10.1016/s0002-9394(02)01692-6DOI Listing
November 2002

Combined cataract surgery and vitrectomy for breakthrough vitreous hemorrhage from age-related macular degeneration.

Ophthalmic Surg Lasers 2002 Jan-Feb;33(1):16-8

Department of Opthalmology Bascom Palmer Eye Institute, University of Miami School of Medicine, Florida, USA.

Purpose: To report combined cataract extraction (CE), posterior chamber intraocular lens (PCIOL) implantation, and pars plana vitrectomy (PPV) for concurrent cataract and breakthrough vitreous hemorrhage from age-related macular degeneration (AMD).

Methods: Retrospective case series.

Results: Six eyes were included in the study. The postoperative follow-up interval ranged from 3 to 22 months (mean 8 months). Preoperative visual acuity (VA) ranged from 20/400 to hand motion. Postoperatively, 5/6 eyes had 2 or more lines of visual improvement. Three eyes were better than 20/200.

Conclusions: Combined CE, PCIOL insertion, and PPV in selected patients with cataract and breakthrough vitreous hemorrhage from AMD was successful in improving VA in the majority of patients.
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August 2002