AAO Journal Archive
- Classification of Vitreous Seeds in Retinoblastoma
- Topical 5-Fluorouracil 1% as Primary Treatment for Ocular Surface Squamous Neoplasia
- Individualized Stabilization Criteria–Driven Ranibizumab versus Laser in Branch Retinal Vein Occlusion
- Correlation of Histologic Features with In Vivo Imaging of Reticular Pseudodrusen
- Pseudodrusen and Incidence of Late Age-Related Macular Degeneration in Fellow Eyes in the Comparison of Age-Related Macular Degeneration Treatments Trials
- Pharmacotherapies for Retinal Detachment
- Can Automated Imaging for Optic Disc and Retinal Nerve Fiber Layer Analysis Aid Glaucoma Detection?
- Suture Colonization Rate in Adjustable Strabismus Surgery
- Genetic and Dietary Factors Influencing the Progression of Nuclear Cataract
- Diagnostic Accuracy of Optical Coherence Tomography and Scanning Laser Tomography for Identifying Glaucoma in Myopic Eyes
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The article by Koolwijk et al1 is welcomed, but we believe the title should be reworded. The authors looked at nearly 7000 consecutive cataract operations using topical/intracameral anesthesia without sedation, and concluded that “Cataract surgery can be safely performed in an outpatient clinic, in the absence of the anesthesia service and with limited workup and monitoring. Basic first aid and basic life support skills seem to be sufficient in case of an adverse event. A medical emergency team provides a generous fail-safe for this low-risk procedure.” We generally agree with this conclusion, but disagree with the title, which states that “Incident and Procedural Risk Analysis Do Not Support Current Clinical Ophthalmology Guidelines.”
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We thank Eke et al for their critical appraisal of our article. Also we are delighted to learn that they, as co-chairs of the committee that produced the 2012 guideline “Local Anesthesia (LA) for Ophthalmic Surgery” find our work a welcome addition to the body of evidence for future clinical guidelines.1
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Liu y otros (p. 2243), utilizaron la tomografía de coherencia óptica de dominio espectral (SD OCT) para examinar si el adelgazamiento progresivo de la capa de fibras nerviosas de la retina (RNFL) se presenta en el ojo contralateral de pacientes con glaucoma con progresión unilateral diagnosticada originalmente mediante campos visuales o fotografía del disco óptico. Observaron pérdida de la RNFL en los ojos contralaterales de un número sustancial de pacientes. Este estudio de cohorte prospectivo longitudinal incluyó 346 ojos de 173 pacientes (118 ojos con glaucoma y 228 ojos con sospecha de glaucoma a la determinación de la línea de base).
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Liu 等(p. 2243) 对青光眼单眼进展患者的对侧眼进行研究，通过频域光学相干断层扫描（spectral-domain optical coherence tomography [SD OCT]）观察其视网膜神经纤维层（retinal nerve fiber layer [RNFL]）是否进展性变薄；这些病例均通过视野或视神经照片诊断。研究者发现对侧眼RNFL缺失见于大多数患者。该前瞻性纵向队列研究共纳入173名患者的346例眼（基线时118例为青光眼，228例为可疑青光眼）。平均随访时间为3.5±0.7年。在其中39名患者，传统诊断方法发现单眼进展，而SD OCT发现对侧眼平均RNFL厚度下降（−0.71±0.09 μm/年）。另一方面，传统诊断方法并未发现其余134名患者出现进展——然而其RNFL厚度在随访期变薄（−0.71±0.09 μm/年）。