1/8. Successful use of recombinant factor viia in a haemophiliac with inhibitor undergoing cataract surgery.A 40-year-old patient with severe haemophilia A and an inhibitor against factor viii underwent a cataract extraction under local anaesthesia. Recombinant activated factor VII was use to achieve haemostasis. The procedure was successful. Neither bleeding complications nor side effects occurred.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/8. Undiagnosed cardiomyopathy in a neonate: significance of low oxygen saturation during anaesthesia.A case study is described of a 7-day-old full term baby with bilateral congenital cataracts who underwent surgical removal of both cataracts 2 days apart. Problems with oxygen saturation during and after the first anaesthetic prompted further investigation that revealed a non-obstructive hypertrophic cardiomyopathy. The significance and possible causes of low oxygen saturation in a previously healthy neonate during anaesthesia are discussed. The likely diagnosis of Sengers syndrome, and the evaluation of asymptomatic babies with cardiac pathology are discussed.- - - - - - - - - - ranking = 5keywords = anaesthesia (Clic here for more details about this article) |
3/8. Coats' disease and bilateral cataract in a child with turner syndrome: a case report.PURPOSE: To report the first case in which Coats' disease was observed with infantile cataract in a girl with turner syndrome (TS). MATERIALS AND methods: We examined a 4-year-old female infant with TS who was referred with a diagnosis of leukocoria in the left eye. RESULTS AND DISCUSSION: Examination under anaesthesia revealed a bilateral punctate cataract and left eye fundus showed vascular retinal abnormalities typical of Coats' disease. cryotherapy was performed on the telangiectatic vessels and the child was followed up for a period of 12 months. Despite cryotherapy resulting in regression of the peripheral exudates, an exudative maculopathy persisted with poor visual outcome. We suggest that Coats' disease should be considered as a rare ocular manifestation in TS.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
4/8. Short-course use of recombinant factor viia in a haemophilia patient with inhibitor undergoing cataract surgeries.A 36 year-old patient with severe haemophilia A and high-titre inhibitor underwent cataract surgery under topical anaesthesia. Recombinant factor viia was used only three times, once before and twice following surgery. tranexamic acid was given concomitantly. One month after the first successful procedure on the right eye, a second operation was performed on the left eye in the same manner. Both procedures were uneventful. Neither bleeding complications nor any other side effects occurred.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
5/8. Bilateral cataract: extraction in classic haemophilia with retrobulbar anaesthesia and peripheral iridectomy.A 47-year-old factor viii deficient haemophiliac successfully underwent bilateral cataract extraction. The use of cryoprecipitates to achieve haemostasis permitted retrobulbar anaesthesia and a peripheral iridectomy without complication. We consider that the use of cryoprecipitated factor viii concentrate allows safe elective ocular surgery in patients with classic haemophilia.- - - - - - - - - - ranking = 5keywords = anaesthesia (Clic here for more details about this article) |
6/8. Lens injury in children treated with irido-capsula supported intra-ocular lenses.The treatment of lens injury in children with irido-capsula supported intraocular lenses is described. A consecutive series of 73 children is analyzed as to the functional results and complications. Surgery and anaesthesia are discussed in detail. Guidelines are given for future straightforward management of eye injury in children, using this promising possibility of visual rehabilitation.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
7/8. Ophthalmic management of Cockayne's syndrome.Cockayne's syndrome is a rare, autosomal recessive condition which usually presents in early childhood, and is characterised by dwarfism, premature ageing, mental retardation and a typical facial appearance and body habitus. Retinal dystrophy, enophthalmos, strabismus, cataract, nystagmus and corneal opacities are associated ocular features. At a genetic level, a defect occurs in the pathway for the repair of transcriptionally active dna, and the most common form of Cockayne's is associated with mutations in the human repair gene ERCC6. These patients pose a difficult management problem. A significant proportion will require cataract extraction at an early age, which may present technical difficulties due to enophthalmos, which is a constant finding, poor pupillary dilation and growth retardation. Also, the fitting and assessment of aphakic contact lenses during the post-operative period requires great skill. General anaesthesia in these patients may be hazardous. In particular, difficulty with endotracheal intubation should be anticipated. Two patients with Cockayne's syndrome requiring bilateral cataract extraction in early infancy are presented. The problems associated with surgery, anaesthesia and subsequent follow-up in these mentally retarded infants are discussed.- - - - - - - - - - ranking = 2keywords = anaesthesia (Clic here for more details about this article) |
8/8. Endoresection of choroidal melanoma.AIMS: The results of 52 endoresections for choroidal melanoma are reported. methods: The current technique involves vitrectomy, retinal incision over or peripheral to the tumour, haemostasis by raising intraocular pressure and by moderate hypotensive anaesthesia, choroidal incision around tumour, endoresection with vitrector, endodiathermy to bleeding points and residual tumour, fluid-air exchange to reattach retina, endolaser to achieve retinal adhesion around the coloboma and destroy residual tumour in the sclera, silicone oil injection with removal after 12 weeks, cryotherapy to the sclerotomies, and adjunctive ruthenium plaque radiotherapy in selected cases. RESULTS: patients receiving primary endoresection had a mean age of 53 years, a mean largest basal tumour diameter of 8.2 mm, and a mean tumour thickness of 3.9 mm. 40 tumours extended to within 2 disc diameters of the optic disc, with 17 involving disc. Follow up ranged from 40 days to 7 years (median 20 months). At the last visit, 90% of eyes were retained, with vision of 6/6-6/12 (two), 6/18-6/36 (three), 6/60 to counting fingers (18), hand movements (nine), and light perception (four). The main complications were retinal detachment in 16 and cataract in 25. Secondary endoresection (11) was performed after plaque radiotherapy (four), photocoagulation (four), trans-scleral local resection (two), and proton beam radiotherapy (one), with retention of the eye in nine cases. By the close of the study, no patients developed definite local tumour recurrence but one died of metastatic disease 41 months postoperatively. CONCLUSION: Depending on tumour location, endoresection may conserve central vision or temporal field when radiotherapy would be expected to cause optic neuropathy. Longer follow up is necessary to establish the efficacy of tumour control.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |