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Preoperative Data (preoperative + data)
Selected AbstractsTrabeculectomy with OloGen versus trabeculectomy for the treatment of glaucoma: a pilot studyACTA OPHTHALMOLOGICA, Issue 1 2010Dimitris Papaconstantinou Abstract. Purpose:, To present the preliminary results of our study comparing the outcomes of trabeculectomy with or without OloGen implant in patients requiring glaucoma surgery for uncontrolled intraocular pressure (IOP). Methods:, Forty eyes of 40 patients were assigned randomly to undergo trabeculectomy either with OloGen implant (study group) or without implant (control group). Preoperative data included age, gender, type of glaucoma, IOP and number of preoperative glaucoma medications. Postoperative IOP, number of postoperative glaucoma medications and postoperative complications were recorded. Each patient was followed up for at least 6 months. Results:, There were no significant differences between the groups in terms of age, gender, type of glaucoma, preoperative IOP and number of antiglaucoma medications. Mean IOPs for both groups were significantly lower than preoperative levels at all intervals (P < 0.05) The number of glaucoma medications used dropped from a preoperative mean of 3.5 ± 0.7 to a 6-month postoperative mean of 0.3 ± 0.7 (P < 0.001) in the study group and from 3.7 ± 0.4 to 0.5 ± 1.1 (P < 0.001) in the control group. No statistically significant differences between the two groups were observed in terms of postoperative complications. Conclusion:, In this pilot study it appears that trabeculectomy with OloGen does not seem to offer any significant advantages compared with trabeculectomy alone. Additionally, even though there were no statistical differences between the two groups as far as complications were concerned, one eye from the study group developed endophthalmitis 10 days after surgery and two eyes presented with positive Seidel test and flat anterior chamber and required additional suturing. Studies with larger numbers of patients and longer follow-ups are required to confirm these findings and to examine the safety and long-term outcomes of trabeculectomy with OloGen. [source] Lymphoscintigraphy for sentinel node mapping using a hybrid single photon emission CT (SPECT)/CT system in oral cavity squamous cell carcinomaHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 10 2006Avi Khafif MD Abstract Background. We assessed the added clinical value of fused single photon emission computed tomography (SPECT) and low-dose CT images compared with planar images for sentinel node (SN) mapping in patients with oral cavity squamous cell carcinoma (SCC). Methods. Twenty consecutive patients with newly diagnosed biopsy-proven SCC of the oral cavity were enrolled. Scintigraphy was performed using a hybrid gamma-camera/low-dose CT system. Planar images and fused SPECT/CT images were interpreted separately. All patients underwent a sentinel node biopsy (SNB) followed by a neck dissection. All SNs underwent meticulous pathologic examination and immunohistochemistry staining (cytokeratin complex) in addition to routine pathologic examinations of the neck dissection specimen. Results. The sensitivity for the detection of nodal metastases was 87.5%. SPECT/CT improved SN identification and/or localization compared with planar images in 6 patients (30%). Conclusions. SPECT/CT SN mapping provides additional preoperative data of clinical relevance to SNB in patients with oral cavity SCC. © 2006 Wiley Periodicals, Inc. Head Neck, 2006 [source] (217) Selective Nerve Root Injections Can Accurately Predict Level of Nerve Impairment and Outcome for Surgical Decompression: A Retrospective AnalysisPAIN MEDICINE, Issue 3 2001Kevin Macadaeg There remains significant controversy regarding the use of a vertebral selective nerve root injection (SNI) as a diagnostic and therapeutic tool. In addition, the frequency of use of such procedures in patients with radiculopathy has increased dramatically in the last few years. Based on a Medline review there has been no studies combining cervical and lumbar SNI results and comparing preoperative diagnosis to surgical findings and outcome. The purpose of this paper is to retrospectively examine and compare the sensitivity, specificity and predictive value of a good surgical outcome in patients who had an SNI and subsequent surgical intervention. 101 patients from a 1996 thru 1999 database, who were referred to 10 spine surgeons (2 orthopedic and 8 neurosurgeon) for either cervical or lumbar radiculopathy, and had SNI and various imagery studies and subsequent surgery. Patients receive SNIs at our institution if there is a discrepancy between physical exam and radiologic imagery or to confirm a putative pain generator in multilevel pathology. These patients were then retrospectively analyzed with regard to correlation to surgical level and surgical outcome. SNIs were performed by one of three pain specialists in our clinic. Approximation of the appropriate nerve root sleeve was performed using fluoroscopic imagery, a nerve stimulator and contrast. After nerve root stimulation and neurography, 0.5,0.75 cc of lidocaine 2% was injected. Pre- and post-procedural visual analog scale (VAS) pain scores were obtained from the non-sedated patient. A SNI was considered positive or negative if the patient had immediate appendicular pain relief of greater or less then ninety percent respectively. The study was designed to include only those patients that had a SNI, regardless of result, and subsequently had surgical decompression in an attempt to treat the pain that initially prompted the SNI. A statistical analysis was then performed comparing preoperative data to surgical findings and outcome. Overall, 101 patients had SNIs who subsequently underwent surgical decompression. Average duration of symptoms prior to SNI was 1.5,12 months (4 months mean). Fifteen patients presented with cervical and 86 with lumbar radiculopathy. There were a total of 110 procedures performed on these patients. VAS scores of <2 and overall pain reduction openface> 90% with respect to their pre-procedural appendicular were used to determine if a SNI was positive, negative or indeterminate. All of these patients had an MRI or CT with or without a myelogram and all went to surgery. The results yield that SNIs are able to predict surgical findings with 94% and 90% sensitivity and specificity, respectively. A good surgical outcome was determined if the patient would do the surgery again, if they were satisfied or very satisfied and had a VAS of <3 at 6- and 12-month intervals. Our data revealed that a positive SNI was able to predict a good 6-month outcome with 95% and 64% sensitivity and specificity, respectively. At 12-months, similar results were obtained of 95% and 56%. Preoperative MRI results were also evaluated and revealed a 92% sensitivity in predicting surgical findings. We had 24 false positive MRI results and 0 true negatives. Interestingly we had 8 diabetic (IDDM or NIDDM) patients or nearly 8% of our total. The odds ratio of a diabetic having a bad outcome at 12 months was 5.4 to 1. Diabetics had a 50% likelihood of having a bad 12-month outcome versus 16% for non-diabetics with a p value of 0.066. We also looked at gender, smoking history and presence of cardiovascular disease and found no significant relationship with outcomes. Our data indicate that SNIs, when performed under rigorous method, is a highly valuable tool that can accurately determine level of nerve root impairment and outcome in patients being considered for surgical decompression. With a sensitivity of 94% and a specificity of 90%, SNIs offer a major advantage over other diagnostic modalities in patients with difficult-to-diagnose radiculopathies. [source] Longterm results after phacovitrectomy and foldable intraocular lens implantationACTA OPHTHALMOLOGICA, Issue 8 2009Wensheng Li Abstract. Purpose:, This study aimed to evaluate the longterm results of phacovitrectomy and foldable intraocular lens (IOL) implantation in eyes with significant cataract and co-existing vitreoretinal diseases. Methods:, We carried out a retrospective study of 186 eyes of 149 patients with various vitreoretinal abnormalities and visually significant cataracts. Vitreoretinal surgery was combined with phacoemulsification and foldable IOL implantation. Main outcome measures were visual acuity (VA), preoperative data, and intraoperative and postoperative complications. Results:, The most common indications for surgery were non-diabetic vitreous haemorrhage and proliferative diabetic retinopathy. Preoperative vision ranged from 0.6 to light perception; postoperative vision ranged from 1.2 to no light perception. Postoperatively, in 162 eyes (87.1%) VA improved by , 3 lines on the decimal chart. In 14 eyes (7.5%), vision remained within 3 lines of preoperative levels and in 10 eyes (5.3%), vision had decreased by the last follow-up. Postoperative complications included elevated intraocular pressure and posterior capsule opacification, corneal edema, macular edema, fibrinous reaction, vitreous hemorrhage, corneal epithelial defects, anterior chamber hyphema, choroidal detachment, persistent macular hole, posterior synechiae, recurrent retinal detachment, rubeosis iridis, neovascular glaucoma. Conclusions:, Combined vitreoretinal surgery and phacoemulsification with foldable IOL implantation is safe and effective in treating vitreoretinal abnormalities co-existing with cataract. Based on extensive experience with the combined procedure, we suggest that combined surgery is recommended in selected patients with simultaneous vitreoretinal pathological changes and cataract. [source] | ||||||||||