1/8. Bilateral massive choroidal hemorrhage secondary to Glanzmann's syndrome.Characteristics of intraocular bleeding and its management in association with blood dyscrasias are discussed. We present a patient with massive bilateral choroidal hemorrhage secondary to Glanzmann's syndrome. magnetic resonance imaging and ultrasonographic findings were ordered. During the clinical course, bilateral intravitreal hemorrhage and tractional retinal detachment occurred. Left pars plana vitrectomy was performed under general anaesthesia. The procedure was unsuccessful because of intraoperative uncontrolled bleeding.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/8. Use of nitrous oxide causing severe visual loss 37 days after retinal surgery.A case of severe visual loss following nitrous oxide anaesthesia in the presence of an intraocular perfluoropropane (C3F8) gas bubble is described. The diabetic patient had previously undergone vitreoretinal surgery at which time the gas had been inserted. The case highlights the use of long-acting intraocular gases in modern vitreoretinal surgery, and the measures that can be taken to prevent further such episodes.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
3/8. Diffuse choroidal haemangioma in sturge-weber syndrome treated with photodynamic therapy under general anaesthesia.PURPOSE: To report the treatment outcome of photodynamic therapy with verteporfin (PDT) for exudative retinal detachment associated with diffuse choroidal haemangioma in sturge-weber syndrome. methods: An interventional case report of a 12-year-old girl with sturge-weber syndrome who developed an exudative retinal detachment (visual acuity 20/400) that was treated with PDT under general anaesthesia. PDT was performed according to the standard (macular degeneration) protocol, using three nonoverlapping spots of 4,000 microm. RESULTS: subretinal fluid resolved completely over a period of 5 months and visual acuity increased to 20/50. No side effects of the PDT treatment were encountered during 9 months' follow-up. CONCLUSION: In our patient PDT with verteporfin effectively resolved the exudative retinal detachment associated with a diffuse choroidal haemangioma. Resolution of subretinal fluid occurred over several months without retreatment. We noted no side effects of the combination PDT and general anaesthesia, nor did we encounter ocular side effects of the treatment.- - - - - - - - - - ranking = 6keywords = anaesthesia (Clic here for more details about this article) |
4/8. 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) |
5/8. Perforation of the globe--a complication of peribulbar anaesthesia.Peribulbar anaesthesia has been recommended as a safer alternative to retrobulbar anaesthesia. We report a case of perforation of the globe sustained during peribulbar anaesthesia which resulted in blindness. Orbital injections are potentially dangerous, be they peribulbar or retrobulbar. To minimise the risk, short, blunt needles are advocated for the peribulbar route.- - - - - - - - - - ranking = 7keywords = anaesthesia (Clic here for more details about this article) |
6/8. Ocular perforation during peribulbar anaesthesia.Six cases of ocular perforation after peribulbar anaesthesia are reported. They were referred to our vitreoretinal unit from other hospitals over a 6 week period. Some recent reports of ocular perforation with peribulbar anaesthesia suggest a good prognosis. In this series all six required surgical intervention and most cases associated with a retinal detachment had a poor outcome. This study highlights the dangers of ocular perforation and emphasises the need for supervised training of peribulbar anaesthesia and early referral should ocular perforation occur.- - - - - - - - - - ranking = 7keywords = anaesthesia (Clic here for more details about this article) |
7/8. 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) |
8/8. Primary use of silicone oil tamponade in the management of perforating globe injury secondary to inadvertent local anaesthesia injection for ophthalmic surgery.Perforating and penetrating globe injuries secondary to peribulbar and retrobulbar anaesthesia are often complicated by vitreous haemorrhage and retinal detachment. We describe the effectiveness of primary silicone oil tamponade in the repair of three perforated globes secondary to local anaesthesia for ophthalmic surgery. Three patients with axial myopia had peribulbar and retrobulbar anaesthesia for extracapsular cataract extraction (two patients) and cryotherapy (one patient). All eyes sustained a vitreous haemorrhage obscuring the view to the fundus. Retinal detachments were detected by B-scan ultrasound. In all eyes, scleral buckling, pars plana vitrectomy and silicone oil tamponade were performed as a primary surgical procedure. All the patients had complete anatomic reposition. In two patients, after two years follow-up, visual acuity was between 6/12 to 6/36 with the retina attached and no proliferative vitreoretinopathy (PVR). The third patient had blind painful eye and enucleation was performed. Primary use of silicone oil tamponade, in the management of perforated globe with retinal detachment due to local anaesthesia injection, is recommended.- - - - - - - - - - ranking = 8keywords = anaesthesia (Clic here for more details about this article) |