Aged and senile patients with primary glaucoma usually suffer from polypathy (on average, they have 6.3±0.6 concurrent somatic diseases). To reduce the risk of polypharmacy and the frequency of side effects in the treatment of POAG and AH patients, it is advised that the treatment includes oral selective beta-blockers able to provide target levels of arterial pressure and IOP. In this study, oral beta-blockers in POAG and AH patients enabled IOP reduction as great as 18.5%-26% of baseline values over a 1-year follow-up period.
Лечение отслойки сетчатки у ВИЧ-инфицированных больных с цитомегаловирусным ретинитом
abstraCtHIV infection -is a socially significant problem for many countries, as the infected die in an average of 10-11 years due to the immunodeficiency virus. Up to 20% of patients with AIDS lose their sight because of cytomegalovirus retinitis (CMV retinitis), which occurs in 70% of HIV-infected people. In some patients with HIV infection blindness occurs because of acute retinal necrosis of CMV etiology. The algorithm of CMV retinitis treatment in HIV-infected patients is described in modern manuals (ganciclovir, valganciclovir, foscarnet and others on the background of antiretroviral therapy), but the tactics of treatment of retinal separation in these patients is not clearly defined. It may be "wait and see", providing conservative treatment with antiviral drugs, and the active tacticsvitreoretinal surgery. In this article the authors present their personal clinical observations of three HIV-infected patients with CMV retinitis at the age of 8 to 36 years with a detailed analysis of the clinical data and the results of the laboratory tests. In particular, ophthalmology in russia. 2017;14(1):84-87
Purpose. Currently cataract surgery is a high-tech procedure that is usually performed on an outpatient basis under local anesthesia. To perform anesthesia, novocaine, lidocaine, bupivokaine, and others are used. The recently published articles suggest a ropivacaine as a new anesthetic in ophthalmology. In connection with this, the purpose of the present paper was to study the efficacy of ropivacaine in subtenon anesthesia with Phaco.Patients and methods.We have examined 318 patients (318 eyes) with age-related cataracts, which have been operated by Phaco on the “Infinity” (“Alcon”) device using standard methods. During the operation, 156 patients have been under subtenon anesthesia by administering 1.5 ml of ropivacaine solution (0.75 mg/ml). 162 patients underwent subtenon anesthesia with 1.5 ml of a 1% solution of lidocaine. The distribution of patients by groups was carried out using a random number generator. Results.144 patients did not feel pain during the operation. Among them, most patients were anesthetized with ropivacaine (68%). Only 32% of patients operated with lidocaine anesthesia did not feel pain (p < 0.05). Ropivacaine anesthesia had pain intensity averaged 2.1 ± 1.6 points, median 2 points (1–2), lidocaine –3.1 ± 1.5 points, median 3 points (2–4) (U = 4,714, p < 0.001). The risk of pain syndrome when using lidocaine in comparison with ropivacaine is twice as high. We have found that the intensity of pain during Phaco surgery did not have gender and age differences. There was no dependence of the pain syndrome on the predominant type of cataract — cortical (n = 181) or nuclear (137) ((χ2 = 1.066, p = 0.302), as well as the cataract stage.
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