Vitrectomy with complete internal limiting membrane peeling resulted in comparable outcomes to those achieved with preservation of the epi-foveal membrane in treating cases with myopic foveoschisis. There was no statistically significant difference in final visual acuity between the two groups. No macular holes were recorded in either group.
Intraoperative subconjunctival bevacizumab following primary pterygium surgical excision is not helpful and possibly harmful. Larger studies are needed.
Objective. To evaluate the potential immediate analgesic effect of addition of 5% dextrose water (D5W) during local steroid injection for treatment of plantar fasciitis (PF). Methods. In this single blind study, 122 patients with PF were randomly assigned to receive either 40 mg triamcinolone acetonide/1ml + 0.5ml. lidocaine 2% (group A: 61 patients; 73 heels) or 40mg triamcinolone acetonide/1ml+0.5ml. lidocaine2%+ 0.5ml. buffered D5W (group B: 61 patients; 69 heels) as a local injection using the medial approach. Visual analogue scale (VAS 0-10) was used to assess the degree of pain intensity during the injection. Results. The mean for age was 42.56 years in group A and 43.39 years in group B (P = 0.86), the female to male ratio was 2.8-1 in both groups and the mean for BMI was 31.49 in group A and 30.86 in group B (P=0.51). A significant difference in VAS was observed; the mean was 8.26±2.00 in group A and 4.25±2.05 in group B (P <0.0001) with a confidence interval (95% CI) of 7.78 -8.74 for group A and 3.76 -4.72 for group B. Conclusions. The addition of 0.5 ml. D5W can decrease the pain associated with local steroid injection for treatment of PF.
BACKGROUND AND OBJECTIVE:
To compare between trimanual and unimanual vitrectomy in complicated proliferative diabetic retinopathy (PDR).
PATIENTS AND METHODS:
A prospective, non-randomized, comparative study including patients with tractional retinal detachment (TRD), vitreous hemorrhage with TRD, and combined TRD with rhegmatogenous retinal detachment. The patients were allocated into two groups: the unimanual group with three-port vitrectomy and the trimanual group with added fourth sclerotomy, through which the endoillumination probe was guided by the assistant. The primary outcomes included the intraoperative feasibility, operative time, and complications.
RESULTS:
Eighty-two eyes were categorized into the two groups: 44 eyes in the unimanual group and 38 eyes in the trimanual group. Operative time was significantly shorter in the trimanual group (
P
< .005). The incidence of iatrogenic breaks and intraoperative bleeding was significantly higher in the unimanual group (
P
= .034 and
P
= .044, respectively). Primary anatomic success was achieved in 90.9% and 94.7% in unimanual and trimanual groups, respectively, without significant difference (
P
= .411). There was no significant difference in the postoperative complications.
CONCLUSIONS:
Trimanual vitrectomy was proven to be a safe and effective technique in managing complicated PDR. It results in anatomical outcomes comparable to standard unimanual vitrectomy with fewer intraoperative complications.
[
Ophthalmic Surg Lasers Imaging Retina.
2019;50:42–49.]
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