Publications by authors named "Paris G Tranos"

21 Publications

  • Page 1 of 1

Optical coherence tomography biomarkers for visual acuity in patients with idiopathic epiretinal membrane.

Eur J Ophthalmol 2020 Dec 14:1120672120980951. Epub 2020 Dec 14.

Vitreoretinal and Uveitis Department, Ophthalmica Clinic, Thessaloniki, Greece.

Purpose: To investigate the correlation between outer and inner retina optical coherence tomography (OCT) biomarkers and visual acuity in patients with idiopathic epiretinal membrane (iERM) and identify which of them may be predictive of visual function.

Methods: A retrospective cross-sectional single-center study was conducted that included patients diagnosed with iERM. Spectral domain OCT images were obtained and assessed qualitatively and quantitatively. The association of OCT parameters with best corrected visual acuity was analyzed.

Results: Charts of 97 eyes of 97 patients were reviewed. Central foveal thickness, maximal retinal thickness (MRT), photoreceptor outer segment length, outer foveal thickness, ganglion cell-inner plexiform layer complex thickening, inner retinal thickness and inner retinal layer irregularity index were among the major outcome measures. OCT scans were also assessed for the presence of cotton ball sign, ellipsoid zone disruption, ectopic inner foveal layer, disorganization of retinal inner layers (DRIL), intraretinal fluid, subretinal fluid (SRF) and epimacular membrane rip. Univariate analysis showed statistically significant association between all the aforementioned parameters with worse vision, except for cotton ball sign and SRF. Multivariate analysis found that MRT and severe DRIL were strongly correlated with worse vision ( < 0.001).

Conclusion: MRT and severe DRIL should be considered as negative prognostic factors for visual acuity.
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http://dx.doi.org/10.1177/1120672120980951DOI Listing
December 2020

Comparison of postoperative refractive outcome in eyes undergoing combined phacovitrectomy vs cataract surgery following vitrectomy.

Graefes Arch Clin Exp Ophthalmol 2020 May 10;258(5):987-993. Epub 2020 Jan 10.

Department of Ophthalmology, University of Patras Medical School, Patras, Greece.

Background: To investigate the accuracy of preoperative biometry in eyes undergoing combined phacovitrectomy and to compare it with eyes having cataract surgery at a later point in time following vitrectomy.

Methods: Patients with epiretinal membrane or macular hole who underwent combined phacovitrectomy (group 1) or phacoemulsification following pars plana vitrectomy (PPV) (group 2) were included in this retrospective, comparative, interventional case series. The primary outcome measures were the intraocular lens power prediction error (PE) and the percentage of eyes with PE > ± 0.5D in the two groups. Secondary outcome measures included the correlation between epidemiological, clinical, or surgical factors and dioptric shift. In addition, the influence of optical coherence tomography characteristics to the PE was investigated.

Results: Group 1 and 2 consisted of 55 and 54 eyes, respectively, for a total of 109 eyes included in the study. The mean absolute PE was 0.59 D (range + 1.4 to - 2.5D) in group 1 and 0.35 (range + 1.0 to - 1.45D) in group 2 (p = 0.01). PE greater than 0.5D was observed in 47% of eyes in group 1 as opposed to 16.6% of eyes in group 2 (p = 0.027). The PE was associated with shallower anterior chamber depth (ACD), increased central macular thickness (> 300 μ), and worse baseline best-corrected visual acuity. Photoreceptor ellipsoid zone or external limiting membrane disruption was not associated with significantly greater postoperative refractive deviations.

Conclusion: Combined phacovitrectomy may result in greater postoperative refractive prediction error compared to phacoemulsification alone following vitrectomy. Patients with worse vision, greater central macular thickness, and shallow anterior chambers require more caution since they are prone to inaccurate preoperative biometry.
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http://dx.doi.org/10.1007/s00417-019-04583-wDOI Listing
May 2020

How Successful is Switching from Bevacizumab or Ranibizumab to Aflibercept in Age-Related Macular Degeneration? A Systematic Overview.

Adv Ther 2019 07 17;36(7):1532-1548. Epub 2019 May 17.

1st and 3rd University Departments of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Emerging anti-vascular endothelial growth factor (anti-VEGF) therapies for neovascular age-related macular degeneration (nAMD) have revolutionised medical retina practice and the management and eventual outcome of nAMD. Recent research has focused on evaluating and comparing the efficacy of the two most widely employed anti-VEGF agents, bevacizumab and ranibizumab; however, a subgroup of patients with nAMD demonstrates a suboptimal response to standard therapy. We have therefore conducted a review of pertinent studies published until August 2018 which have documented the clinical efficacy when switching to a different anti-VEGF. Evidence on baseline disease characteristics, injection frequency and disease outcome has been obtained for patients treated with ranibizumab 0.5 mg and/or bevacizumab 1.25 mg and were switched to aflibercept 2 mg. Our review identified 45 studies investigating switching to aflibercept. Our review showed a clear anatomical benefit after the switch in terms of central retinal thickness and pigment epithelium detachment characteristics, whereas the functional outcomes were variable. Remarkable heterogeneity was documented among the relevant studies with regard to several factors including the baseline characteristics of the cohorts, the non-response definition and previous treatment protocols. Larger prospective trials with appropriate control arms are therefore required to elucidate the potential benefit when switching between anti-VEGF agents in refractory nAMD.
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http://dx.doi.org/10.1007/s12325-019-00971-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6824395PMC
July 2019

Update in treatment of uveitic macular edema.

Drug Des Devel Ther 2019 19;13:667-680. Epub 2019 Feb 19.

Ophthalmica Eye Institute, Thessaloniki, Greece,

Macular edema (ME) represents the most common cause for visual loss among uveitis patients. The management of uveitic macular edema (UME) may be challenging, due to its often recalcitrant nature. Corticosteroids remain the mainstay of treatment, through their capability of effectively controlling inflammation and the associated ME. Topical steroids may be effective in milder cases of UME, particularly in edema associated with anterior uveitis. Posterior sub-Tenon and orbital floor steroids, as well as intravitreal steroids often induce rapid regression of UME, although this may be followed by recurrence of the pathology. Intra-vitreal corticosteroid implants provide sustained release of steroids facilitating regression of ME with less frequent injections. Topical nonsteroidal anti-inflammatory drugs may provide a safe alternative or adjuvant therapy to topical steroids in mild UME, predominantly in cases with underlying anterior uveitis. Immunomodulators including methotrexate, mycophenolate mofetil, tacrolimus, azathioprine, and cyclosporine, as well as biologic agents, notably the anti-tumor necrosis factor-α monoclonal antibodies adalimumab and infliximab, may accomplish the control of inflammation and associated ME in refractory cases, or enable the tapering of steroids. Newer biotherapies have demonstrated promising outcomes and may be considered in persisting cases of UME.
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http://dx.doi.org/10.2147/DDDT.S166092DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6387597PMC
July 2019

Valsalva retinopathy associated with intranasal cocaine abuse: A case report.

Eur J Ophthalmol 2019 May 12;29(3):NP5-NP8. Epub 2018 Sep 12.

4 Vitreoretinal & Uveitis Department, Ophthalmica Clinic, Thessaloniki, Greece.

Introduction: The purpose of this report is to describe a case of Valsalva retinopathy in an intranasal cocaine user.

Case Report: A 49-year-old male presented with a history of sudden loss of vision and inferior visual field defect in his left eye. Clinical evaluation of the affected eye showed best corrected visual acuity of 20/25 and fundus examination revealed a preretinal hemorrhage superior to the disk with multiple intraretinal hemorrhages in and around the posterior pole. On further questioning, the patient revealed intranasal cocaine use the day before the onset of his visual symptoms. Blood tests were requested to exclude blood dyscrasias or predisposition to vascular occlusive disorders and no further treatment measures were taken. The patient was reviewed a month later when his hemorrhages had completely resolved and his visual acuity had improved to 20/20. His blood results were within normal limits.

Conclusion: Although never been reported before, Valsalva retinopathy can be associated with intranasal cocaine abuse and should be considered in the differential diagnosis of visual reduction in such population.
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http://dx.doi.org/10.1177/1120672118799627DOI Listing
May 2019

A Review of Minimally Invasive Strabismus Surgery (MISS): Is This the Way Forward?

Adv Ther 2017 04 1;34(4):826-833. Epub 2017 Mar 1.

1st and 3rd University Departments of Ophthalmology, Aristotle University of Thessaloniki, AHEPA Hospital, 1 Kyriakidi Street, 546 36, Thessaloniki, Greece.

Minimally invasive surgery is rapidly becoming the norm in medicine, as it often leads to better outcomes and earlier rehabilitation. This article reviews the principles and different techniques employed to perform minimally invasive strabismus surgery (MISS). In these techniques, strabismus surgery is performed through keyhole openings, thus reducing the risk of postoperative corneal complications, minimizing postoperative discomfort, and better preserving muscle function. MISS can be used to perform all types of strabismus surgery, namely rectus muscle recessions, resections, plications, reoperations, retroequatorial myopexy, transpositions, oblique muscle recessions, or plications even in the presence of limited motility. Of note, ocular alignment outcomes with MISS versus more traditional techniques have not been compared in randomized trials. Consequently, more controlled evidence is still needed to better delineate the future role and value of MISS in clinical management.
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http://dx.doi.org/10.1007/s12325-017-0498-7DOI Listing
April 2017

Twenty-four hour efficacy of glaucoma medications.

Prog Brain Res 2015 9;221:297-318. Epub 2015 Sep 9.

Universidad de Alcalá, Alcalá de Henares, Madrid, Spain.

Current medical therapy of glaucoma aims to attain a meaningful and consistent reduction of intraocular pressure (IOP) to a predetermined level of target IOP, which will commensurate with either stability, or delayed progression of visual loss. Glaucoma is a 24-h disease and the damaging effect of elevated IOP is continuous. Therefore, it is reasonable that we should endeavor to identify the true efficacy of currently available and future antiglaucoma medications throughout the 24-h period. This review chapter deals first with the concept and value of diurnal and 24-h pressure monitoring. It then evaluates existing evidence on the 24-h efficacy of medical therapy options. Unfortunately, significant gaps exist in our present understanding of the short-term and particularly the long-term 24-h efficacy of most antiglaucoma medications. More long-term controlled evidence is needed in the future to improve our understanding of the 24-h efficacy of current medical glaucoma therapy, the ideal 24-h target pressure and the precise impact of IOP characteristics upon the different stages of the various forms of glaucoma.
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http://dx.doi.org/10.1016/bs.pbr.2015.06.010DOI Listing
December 2016

Persistent Subretinal Fluid After Successful Full-Thickness Macular Hole Surgery: Prognostic Factors, Morphological Features and Implications on Functional Recovery.

Adv Ther 2015 Jul 17;32(7):705-14. Epub 2015 Jul 17.

Ophthalmica Eye Institute, Thessaloniki, Greece.

Introduction: The present study aimed to identify preoperative factors that predispose the development of subretinal fluid (SRF) following successful macular hole (MH) surgery.

Methods: Thirty-four eyes of 33 consecutive patients that underwent pars plana vitrectomy for idiopathic full-thickness MH surgery were included in this retrospective study. Best corrected visual acuity (BCVA), and spectral domain-optical coherence tomography (OCT) images were evaluated pre- and postoperatively in all cases. Patient's demographic characteristics, stage of MH, measurements of base diameter and minimum aperture diameter of the MH, preoperative foveal vitreomacular traction and selected intra-operative parameters were correlated with the development of postoperative SRF.

Results: Postoperative SRF was observed in 15 cases (48%). Total absorption of SRF was observed in 73% of affected eyes and was most commonly seen between the third and the fifth postoperative month. One patient developed lamellar hole leading to full-thickness MH. Postoperative BCVA was similar between the eyes that did and the eyes that did not develop postoperative SRF (0.31 ± 0.2 vs 0.35 ± 0.2; p ≥ 0.05). Development of postoperative SRF was significantly associated with the presence of preoperative foveal vitreomacular traction (p = 0.048), stage II MH (p = 0.017) and smaller size of the closest distance between the MH edges (p = 0.046).

Conclusions: Postoperative SRF is a common occurrence following successful MH surgery. Meticulous evaluation of preoperative clinical and OCT findings may disclose risk factors associated with this condition. Based on our observations, idiopathic holes of early stage appear to be at a higher risk of developing postoperative SRF. This could be a point of interest with the advancing use of enzymatic proteolysis.
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http://dx.doi.org/10.1007/s12325-015-0227-zDOI Listing
July 2015

Long-term follow-up of inflammatory cystoid macular edema.

Retina 2012 Sep;32(8):1624-8

Thessaloniki Retina Center, Uveitis Service, Thessaloniki, Greece.

Purpose: To determine the long-term functional and anatomical outcome of idiopathic uveitic cystoid macular edema (UCME).

Methods: A longitudinal retrospective study was undertaken of the medical records of patients with UCME. All individuals were examined in the uveitis Service at the Moorfields Eye Hospital. The main outcome measures were change in visual acuity and anatomical outcome of UCME at diverse time points.

Results: A total of 109 eyes (92 patients) with UCME were included in the analysis. Mean follow-up was 60 ± 45 months (median, 48 months). Mean logarithm of the minimum angle of resolution visual acuity 1 month after the intervention improved significantly (P < 0.001) by 0.21 ± 0.27 and maintained at similar levels throughout the follow-up period. Visual acuity at the final follow-up improved in 75 eyes (69%), was deteriorated in 21 eyes (19%), and remained unchanged in 13 eyes (12%). Younger age and better visual acuity at baseline were associated with more favorable visual outcome (P < 0.001). Optical coherence tomography documentation of improvement or total resolution of UCME was observed in 84 eyes (77%) at the final follow-up.

Conclusion: Cystoid macular edema is a major complication in uveitis. Current management provides satisfactory long-term results for the majority of those individuals. Visual acuity 1 month after the intervention is usually indicative of the final functional outcome.
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http://dx.doi.org/10.1097/IAE.0b013e3182483348DOI Listing
September 2012

Pseudovasculitis associated with vitreoretinal traction.

Retin Cases Brief Rep 2012 ;6(2):219-21

*Moorfields Eye Hospital, London, United Kingdom †Thessaloniki Retina Consultants, Thessaloniki, Greece.

Purpose: The purpose of this study was to report a case of vitreoretinal traction masqueraded as retinal vasculitis.

Methods: An 81-year-old woman with exudative age-related macular degeneration was treated with intravitreal injections of ranibizumab. During routine follow-up, angiographic evidence of focal, segmental, retinal vasculitis, involving both arteries and veins, was noticed in the fellow eye. Clinical examination revealed no sign of ocular inflammation in either eye.

Results: Spectralis optical coherence tomography revealed partial posterior vitreous detachment with multiple areas of persisting vitreoretinal adhesion. Focal vasculitis on fluorescein angiography showed absolute correspondence with sites of vitreoretinal traction on optical coherence tomography. Patient was managed by observation and 6 months later, despite persisting fluorescein leak, she was still asymptomatic with no evidence of anterior chamber or vitreous activity.

Conclusion: This is an exceptional case of pseudovasculitis associated with mechanical traction, representing a variant of vitreomacular traction syndrome. Clinicians should be aware of this unusual manifestation, which may mimic true vasculitis associated with uveitis.
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http://dx.doi.org/10.1097/ICB.0b013e31823c4485DOI Listing
November 2014

Diagnostic and therapeutic challenges.

Retina 2012 Jan;32(1):191-6

Moorfields Eye Hospital, London, United Kingdom.

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http://dx.doi.org/10.1097/IAE.0b013e31821aec3eDOI Listing
January 2012

Cytomegalovirus retinitis presenting as vasculitis in a patient with Wegener's granulomatosis.

Clin Ophthalmol 2008 Dec;2(4):961-3

Papageorgiou University Hospital, Thessaloniki, Greece.

Purpose: To present an unusual case of cytomegalovirus (CMV) retinitis in a patient with Wegener's granulomatosis.

Results: A 54-year-old lady with Wegener's granulomatosis presented with decreased vision in her left eye. Wegener's retinal vasculitis was diagnosed initially and the patient received treatment with oral steroids. Three days later the patient developed typical CMV retinitis.

Conclusion: The likelihood of CMV retinitis in patients with Wegener's granulomatosis should not be overlooked. Increased awareness in such cases is very important since CMV retinitis may present with less typical manifestations, which makes the correct diagnosis more challenging.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699776PMC
http://dx.doi.org/10.2147/opth.s4022DOI Listing
December 2008

Visual perceptions during cataract surgery.

Acta Ophthalmol Scand 2006 Jun;84(3):444

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http://dx.doi.org/10.1111/j.1600-0420.2005.00536.xDOI Listing
June 2006

Visual function and subjective perception of visual ability after macular hole surgery.

Am J Ophthalmol 2004 Dec;138(6):995-1002

Moorfields Eye Hospital, London, United Kingdom.

Purpose: To evaluate the functional and anatomical results of macular hole surgery and to explore its effect on patients' Health-Related Quality Of Life (HR-QOL) and to investigate the associations between self-reported HR-QOL and conventional measures of visual function.

Design: Case series.

Methods: The National Eye Institute 25-Item Visual Function Questionnaire (VFQ-25) and the 36-Item Short-Form Health Survey (SF-36) were self-administered by 30 patients before and 4 months after macular hole surgery. Preoperative, intraoperative, and postoperative clinical data were collected including visual acuity, contrast sensitivity, and metamorphopsia. Multi-item scales rating different aspects of HR-QOL were compared before and after surgery, and their correlation with traditional methods of outcome evaluation was analyzed.

Results: Macular hole closure was achieved in 26 patients (87%). Mean LogMAR visual acuity improved by 6 +/- 10 letters for distance and 7 +/- 12 letters for near. Metamorphopsia was reduced by a mean of 35 +/- 70 squares on Amsler chart, and Pelli-Robson contrast sensitivity decreased by a mean of -0.09 +/- 0.3 log units postoperatively. The VFQ-25 composite score as well as scale scores associated with general vision, near vision, vision-related mental health, and role difficulties were significantly improved (P < .05) after successful closure of macular hole. Conversely out of the eight SF-36 health concepts, limitation in usual role activities because of emotional problems was the only one that significantly improved postoperatively. Both baseline and postoperative best-corrected visual acuity significantly correlated with most of the VFQ subscale scores before and after surgery, respectively.

Conclusions: In this case-series, macular hole surgery appears to have a beneficial effect on patients' subjective perception of visual function. The use of vision-targeted health status questionnaires in conjunction with detailed clinical examination provides a more comprehensive overview of individuals' daily well-being after surgical intervention. Further controlled studies are required to confirm our findings.
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http://dx.doi.org/10.1016/j.ajo.2004.07.049DOI Listing
December 2004

Macular edema.

Surv Ophthalmol 2004 Sep-Oct;49(5):470-90

Moorfields Eye Hospital, London, United Kingdom.

Macular edema is the final common pathway of many intraocular and systemic insults. It may develop in a diffuse pattern where the macula appears generally thickened or it may acquire the characteristic petaloid appearance referred to as cystoid macular edema. Although macular edema may be associated with protean underlying conditions, it is most commonly seen following intraocular surgery, venous occlusive disease, diabetic retinopathy, and posterior segment inflammatory disease. As well as clinical suspicion, a wide range of investigations may lead to the diagnosis of macular edema. Fluorescein angiography and optical coherence tomography provide enhanced visualization of the geometry and distribution of macular edema. A variety of approaches to the treatment of macular edema have been attempted, with a variable degree of success. These options have included topical and systemic steroids, topical and oral non-steroidal anti-inflammatory agents and laser photocoagulation treatment. More recently other therapeutic modalities, including immunomodulators, intravitreal injection of triamcinolone, and pars plana vitrectomy have also been employed. Clinical trials are currently looking into the use of a steroid slow-release intravitreal device for the management of macular edema secondary to uveitis and diabetes. This article reviews the clinical entity of macular edema focusing on the current therapeutic strategies for its management.
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http://dx.doi.org/10.1016/j.survophthal.2004.06.002DOI Listing
November 2004

Efficacy of anterior chamber decompression in controlling early intraocular pressure spikes after uneventful phacoemulsification.

J Cataract Refract Surg 2003 Jun;29(6):1087-92

Department of Ophthalmology, Royal Free Hospital, London, United Kingdom

Purpose: To determine the efficacy of anterior chamber decompression in the management of intraocular pressure (IOP) spikes in the early period after uneventful phacoemulsification.

Setting: Royal Free Hospital, Department of Ophthalmology, Royal Free and University College London Medical School, London, United Kingdom.

Methods: This prospective case series comprised 11 consecutive patients with otherwise healthy eyes who an IOP of at least 40 mm Hg 4 to 6 hours after phacoemulsification. After anterior chamber decompression, the IOP was measured at 0, 15, 30, 45, and 60 minutes or until it exceeded 40 mm Hg.

Results: The mean IOP 4 to 6 hours postoperatively was 47.09 mm Hg +/- 7.92 (SD) (range 40 to 68 mm Hg). After decompression, the IOP dropped significantly to a mean of 4.73 +/- 3.00 mm Hg at 0 minutes (P<.001) and then increased progressively to 23.36 +/- 10.80 mm Hg at 15 minutes (P<.001), 33.82 +/- 11.74 mm Hg at 30 minutes (P=.005), 35.00 +/- 6.53 mm Hg at 45 minutes (P=.015), and 38.50 +/- 2.51 mm Hg at 60 minutes (P=.041).

Conclusions: Marked IOP spikes developed in eyes without glaucoma or ocular hypertension after uneventful phacoemulsification. Anterior chamber decompression immediately lowered IOP, but the effect was transient.
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http://dx.doi.org/10.1016/s0886-3350(02)01891-6DOI Listing
June 2003

Visual perception during phacoemulsification cataract surgery under topical and regional anaesthesia.

Acta Ophthalmol Scand 2003 Apr;81(2):118-22

Department of Ophthalmology, Royal Free Hampstead NHS Trust, London, UK.

Purpose: To compare the subjective visual experiences of patients during phacoemulsification and intraocular lens (IOL) implantation using regional and topical anaesthesia.

Design: A prospective, cohort, questionnaire-based study.

Methods: The study cohort consisted of 247 patients without pre-existing ocular pathology who underwent routine phacoemulsification and IOL implantation. The mean age of the subjects was 75.4 +/- 9.4 years and 34.5% of them had a history of cataract surgery. Three different methods of local anaesthesia were used: 66 (26.7%) of the patients were given topical anaesthesia (TA); 74 (30.0%) were given sub-Tenon's anaesthesia (SA), and 107(43.3%) were given peribulbar anaesthesia (PA). The patients were interviewed immediately after surgery by theatre staff using a standardized questionnaire that investigated their intraoperative visual experiences.

Results: There was no significant difference between the three methods of anaesthesia regarding light perception during the surgery. However, patients undergoing surgery under TA experienced brighter light intensity levels (78.3%) than those given SA (50.0%) and PA (55.7%) (p = 0.02). A total of 69.6% of subjects who received TA reported visual perception of colours during surgery, as opposed to 56.8% of SA recipients and 49.0% of PA recipients (p = 0.02). In addition, patients under TA were more aware of surgical instruments (26.1%) than those under SA (10.8%) and PA (15.9%) (p = 0.08). The vast majority of patients in all three groups found the visual experience to be non-frightening. There were no associations between intraoperative visual impression and age or sex. Although not statistically significant (p = 0.06), prior cataract surgery appeared to alleviate some of the anxiety associated with the visual experience.

Conclusion: Patients undergoing regional and topical anaesthesia experience a wide variety of visual sensations during surgery. The differences in visual impressions between the groups may reflect the varying degrees of optic nerve blockade that result from the different anaesthetics.
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http://dx.doi.org/10.1034/j.1600-0420.2003.00029.xDOI Listing
April 2003

Same-day versus first-day review of intraocular pressure after uneventful phacoemulsification.

J Cataract Refract Surg 2003 Mar;29(3):508-12

Department of Ophthalmology, Royal Free Hampstead NHS Trust, (Tranos, Wickremasinghe, Hildebrand, Little), London, United Kingdom.

Purpose: To compare the incidence and the spectrum of postoperative complications detected when the intraocular pressure (IOP) is reviewed 4 to 6 hours or the day after uneventful phacoemulsification cataract extraction and intraocular lens (IOL) implantation.

Setting: Royal Free Hospital, London, United Kingdom.

Methods: The study cohort consisted of 141 patients who had uneventful phacoemulsification and IOL implantation under regional (peribulbar/topical) or general anesthesia. Postoperative evaluation of the patients was performed by an ophthalmologist using a standard form at 4 to 6 hours or 24 hours.

Results: The mean IOP at 4 to 6 hours and 24 hours was 22.85 mm Hg +/- 9.56 (SD) and 19.44 +/- 7.04 mm Hg, respectively. The IOP was more likely to be greater than 30 mm Hg when measured on the same day, resulting in a significantly higher intervention rate than on the first day (P =.037). The best corrected visual acuity was significantly better at 24 hours than at the same-day review (P <.001). There was no significant difference in the extent of anterior chamber activity, patient comfort, or state of the wound between the same- or next-day follow-up. All patients attended a follow-up appointment 3 weeks after surgery, had an IOP of 21 mm Hg or less, and were subsequently discharged.

Conclusions: The results indicate that moderate IOP spikes (<40 mm Hg) can be left untreated if they are not associated with corneal edema or patient discomfort as they decline spontaneously. Before they are discharged, patients with compromised optic discs or predisposed to retinal or optic nerve pathology should be carefully evaluated the day after surgery to treat IOP elevations.
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http://dx.doi.org/10.1016/s0886-3350(02)01649-8DOI Listing
March 2003

Pseudohypopyon as a feature of multiple myeloma.

Arch Ophthalmol 2002 Jan;120(1):87-8

Department of Ophthalmology, Royal Free Hospital Medical School, Pond Street, London NW3 2QG, England.

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January 2002