No abstract

* BACKGROUND AND OBJECTIVE: To evaluate the incidence of hyperglycemia and hypoglycemia in diabetic patients on the morning of eye surgery scheduled under local anesthesia in an ambulatory surgery facility. * PATIENTS AND METHODS: A retrospective analysis of fasting blood glucose levels in 216 diabetic patients on 326 admissions. * RESULTS: The fasting blood glucose level was 80 mg/dL or lower in 10 patient admissions (3%). Hyperglycemia (fasting blood glucose level of greater than 300 mg/dL) was present on 8 admissions (2.4%). * CONCLUSIONS: Blood glucose levels need to be monitored in diabetic patients undergoing even short surgical procedures. The dosage of long-acting insulins or oral hypoglycemics given the night prior to surgery may have to be reduced to prevent hypoglycemia on the morning of surgery. [Ophthalmic Surg Lasers Imaging 2004;35:185-188.]

* BACKGROUND AND OBJECTIVE: When cataract surgery and glaucoma surgery are combined, the theoretical advantages of pressure control, removal of the visual impairment, and protection against an increase in intraocular pressure (IOP) in the immediate postoperative period are gained. The authors' objective was to determine whether ab interno laser thermal sclerostomy (LTS) combined with cataract surgery would be as effective as trabeculectomy combined with cataract surgery. * PATIENTS AND METHODS: Ab interno LTS was compared with trabeculectomy, retrospectively, for patients who had undergone combined cataract and glaucoma surgery. * RESULTS: There was no significant difference in the numbers of patients using no medications or fewer medications at 6 and 12 months. There was a greater reduction in IOP in the LTS group. * CONCLUSIONS: LTS may be better than trabeculectomy in combined cataract and glaucoma surgery because it reduces the IOP more. Compared with trabeculectomy, LTS is simpler to perform and adds less operating time to cataract surgery. Continued follow-up is recommended. [Ophthalmic Surg Lasers 1996;27:583-586.]

We describe a simple method of combined cataract-glaucoma surgery, involving use of the THC:YAG (holmium) laser ab interno, without gonioscopy, in which the initial cataract incision remains small and the glaucoma filtering procedure can be completed relatively quickly, with minimal surgical manipulation of the conjunctiva. In a series of 15 eyes (13 patients) with visually significant cataracts and medically uncontrolled glaucoma, followed for an average of 14 weeks (range, 1 to 26 weeks), 13 of the 15 eyes had decreased IOR Visual acuity was improved in 9 eyes, remained the same in 4 eyes (with age-related macular degeneration), and was worse in 2 eyes (with opacification of the posterior capsule sufficient to account for the decrease in acuity).