6 research outputs found
Effects of Metoclopramide Hydrochloride, a D2-Selective Dopamine Receptor Antagonist, on the Fast Oscillation of the Electrooculogram
Fast oscillation (FO) of an electrooculogram (EOG) was recorded in both eyes of 10 healthy volunteers before and after administration of metoclopramide hydrochloride (MTCL), a D2-selective dopamine receptor antagonist, paying particular attention to sex concerning sensitivity to dopamine in young subjects. Healthy volunteers were divided into male and female groups; 5 males (10 eyes) aged 21 to 23 years (average, 21.8 years) and 5 females (10 eyes) aged 19 to 25 years (average, 21.8 years). As an FO parameter, the dfFO (the averaged difference in ?V between maximum amplitude in the dark period and minimum amplitude in the light period during FO measurement) was evaluated. The mean level of dfFO significantly increased between phase A (the initial 10 min before intravenous injection of 10 mg of MTCL) and phase B (10 min after the injection) in the male and female groups (P < 0.01 and P < 0.025) and between phase A and phase C (the additional 10 min after the injection) in both groups (P < 0.01 and P < 0.05). The mean level of dfFO in the female group was significantly higher than that of the male group in phase B (P < 0.05). As a control, the experimental procedure was performed with physiological saline administration, and no changes were observed. The data suggest that there exists some difference between young males and females generation concerning sensitivity to dopamine and that young females may show a higher-than-male sensitivity to dopamine in the occurrence of FO potential
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Survey of complications and recommendations for management in dissatisfied patients seeking a consultation after refractive surgery
To review complications associated with and management options for dissatisfied patients seeking a consultation after refractive surgery performed elsewhere.
Refractive Eye Surgery Center, The Wilmer Institute, Lutherville, Maryland, USA.
In this retrospective review, charts of consecutive dissatisfied patients who sought a refractive consultation between June 1999 and January 2003 after refractive surgery performed elsewhere were reviewed and the following parameters were analyzed: visual acuity (uncorrected and best spectacle corrected), prior manifest refraction, complications, and recommendations. The subjective complaints, complications, and visual acuity were reviewed, and the associated historical or visual risk factors as well as treatment options were analyzed.
One hundred sixty-one eyes in 101 patients with ocular complaints were identified. One hundred thirty-four eyes (83.2%) had had laser in situ keratomileusis; 22 eyes, photorefractive keratectomy; 4 eyes, radial keratotomy; and 1 eye, laser thermokeratoplasty. The most common subjective complaints were blurred distance vision (59.0%), glare and night-vision disturbances (43.5%), and dry eyes (21.1%). The most common complications were overcorrection (30.4%), irregular astigmatism (29.8%), dry eyes (29.8%), glare (26.1%), difficulty with night driving (16.7%), and corneal haze (16.7%). The most common cause identified in eyes with best spectacle-corrected visual acuity worse than 20/40 was irregular astigmatism (10 of 18 eyes [55.5%]). The most common recommendation for management was medical treatment or observation (68.3%). Medical therapies recommended included lubrication, punctal plugs, topical and systemic pharmaceutical agents to modulate ocular surface, spectacles, and contact lenses. Keratoplasty (lamellar or penetrating) was recommended in 4 patients (4 eyes [2.5%]). The diagnoses included corneal ectasia in 3 eyes and severe flap complication with irregular astigmatism in 1 eye. Nine patients (5.6% eyes) required nonkeratoplasty surgery. In other patients, waiting for advances in technology, including wavefront-guided customized retreatment, was recommended.
A spectrum of complications associated with refractive surgery may result in patient dissatisfaction. Proper patient selection, prevention strategies, and prompt diagnosis and medical or surgical intervention may be beneficial in managing complications and improving patient satisfaction
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