The cataract surgery is most common among the major eye operations and nearly almost has been performed under local anesthesia. We has been censidered that emotional condition of patient during operation and the blood pressure is variable according to emotional condition. So, in order to evaluate the relationship of blood pressure change during operation and complication of cataract surgery, we began this survey. From Dec. 1979 'to Dec. 1980, we had collected the 70 cases that were performed lens extraction under the local anestbesia (retrobulbar injection and akinesia with 2% lidocaine) at our oph. department. The 70 cases were observed in the respect of B.P. change before, during and after operation. 1. Of the 70 cases, 21 cases (30%) were resulted in increased B.P.. 2. There are 4 cases (6%) that were increased B.P. over 20 mmHg. 3. There was no complication due to increased RP..
Anesthesia, Local ; Blood Pressure* ; Cataract* ; Humans

Of the complictions of cataract extraction, it is well known that hemorrhage, infection and delayed wound healing are more frequent in diabetics than in nondiabetics. But if the extraction was performed after diabetes has adequately controlled for several weeks prior to operation, the visual results are almost as good in diabetics as in non-diabetics. However, with precautions for these complications, the aut hers carefully performed cataract extraction in two juvenile diabetics, whose blood sugar level had been poorly controlled in spited of diabetic diet and subcutaneous injection of the insulin before and after operation. The visual results were very good in spite of high blood sugar level before operation.
Blood Glucose ; Cataract Extraction ; Cataract* ; Diet, Diabetic ; Hemorrhage ; Injections, Subcutaneous ; Insulin ; Wound Healing

A review has been made of 500 cases of which had been undertaken fundoscopic and slit lamp examination. Senile cataract in diabetics tends to be associated with diabetes of long duration. They were analyzed according to sex, age, duration, fasting blood sugar level, visual acuity and fundus findings. The results are obtained as follows. 1. Incidence of cataract among 500 cases of diabetics is 41%. 2. Prevalence of cataract is significantly associated with duration of diabetes(P<0.005). 3. Prevalence of cataract is significantly associated with age over 40. 4. Prevalence of cataract is significantly correlated with FBS level with duration of diabetes of under 5 years(r=0.8). 5. prevalence of cataract is significantly associated with visual acuity(p<0.005). 6. Diabetic Retinopathy was found in 50% of those with cataract
Blood Glucose ; Cataract* ; Diabetic Retinopathy ; Fasting ; Incidence ; Prevalence ; Visual Acuity

It is difficult to analyze the chemical compositions of aqueous humor because of the impossibility of collection of aqueous humor in normal situation, lack of analyzing technique, limited amount of aqueous humor. We measured the glucose concentration of aqueous humor both in cataractous patients with diabetes mellitus and in cataractous patients without diabetes mellitus, thus we compared and analyzed glucose concentration in aqueous humor and correlation between blood glucose con centration and aqueous humor glucose concentration in cataractous patients with diabetes. The mean concentration of glucose in aqueous houmor in diabetics was 92.81 +/- 35.58mg/dl and that of non-diabetics was 53.62 +/- 34.42mg/dl. Aqueous glucose concentration in diabetics was statistically significantly higher than that in non-diabetics.
Aqueous Humor* ; Blood Glucose ; Cataract* ; Diabetes Mellitus ; Glucose* ; Humans

PURPOSE: This study was conducted to develop effective timeout protocol in coordination with current practice and test its clinical effectiveness in pursuit of safety management for patients undergoing cataract surgery. METHODS: A total of subjects were 60 women, 50~65 years old, who visit C ophthalmology clinic in D city. They were assigned to 30 experimental group and 30 control group, respectively. Based on the comprehensive literature review, timeout protocol that was suitable for patients undergoing cataract surgery was developed, and then test its effectiveness by measuring blood pressure, pulse, anxiety and sense of well-being among surgical patients. RESULTS: The timeout protocol was found to reduce blood pressure, pulse, and anxiety and increase well-being among surgical patients. CONCLUSION: As a results, it is necessary to introduce an effective timeout protocol giving positive responses to surgical patients, hence it should be develop a timeout protocol and explore the effectiveness of the protocol.
Anxiety ; Blood Pressure ; Cataract* ; Female ; Humans ; Ophthalmology ; Safety Management

The course of diabetic retinopathy following cataract extraction was studied prospectively in 45 eyes of 33 diabetics for 4-50 weeks(average duration: 20 weeks). The results were as follows: 1. Twenty two(81.4%) of the 29 eyes with preoperative existence of diabetic retinopathy showed a statistically higher incidence of postoperative progression of diabetic retinopathy than eight(50%) of the 16 eyes with no pre-existing diabetic retinopathy(p<0.05). 2. Ten(83.3%) of the 12 eyes with posterior chamber lens in the sulcus showed a statistically higher incidence of postoperative progression of diabetic retinopathy than sixteen(55.2%) of the 23 eyes with posterior chamber lens in the bag(p<0.05). 3. The final corrected visual acuity of better than 20/40 was achieved in eleven(68.7%) of the 16 eyes with no pre-existing diabetic retinopathy and in ten(58.8%) of the 17 eyes with nonproliferative diabetic retinopathy. It revealed no significant difference between them(p>0.05). 4. Nephropathy is the most common preoperative systemic disease and eighteen of the 19 eyes showed the postoperative progression of diabetic retinopathy. There was no statistically significant difference regarding fasting blood sugar, pp2hr, HbA1c, total cholesterol, triglyceride, or the presence of hypertension, atherosclerosis, cardiac disease, and anemia. The only significant difference was related to the presence of nephropathy(p<0.05).
Anemia ; Atherosclerosis ; Blood Glucose ; Cataract Extraction ; Cataract* ; Cholesterol ; Diabetic Retinopathy* ; Fasting ; Heart Diseases ; Hypertension ; Incidence ; Prospective Studies ; Triglycerides ; Visual Acuity

The maintenance of balance between water and electrolyte is essential for keeping the lens transparent. The outflow of the Na+ ion from the membrane and inflow of the K+ ion both of which are sustained by the Na+ - K+ - ATPase, play an important role in maintaining this balance. In this study, by comparing the lens Na+ - K+ - ATPase activity in Spontaneous Hypertensive Rat(SHR) and Sprague-Dawley Rat (SDR), we determined the significance of increase in blood pressure and the change in the enzyme activity after control of blood pressure by administration of Inderal, an anti-hypertensive drug. The Na+ - K+ - ATPase activity was significantly lowered(P<0.01) in the lens of SHR compared to that of SDR. The longer the anti-hypertensive drug was administered and then controlled the blood pressure, the higher the recovery rate of the lowered Na+ - K+ - ATPase activity of SHR, rising up to about 50%. From the results of this study, it is suggested that the activity of lens Na+ - K+ - ATPase may be reversibly recovered after blood pressure control, and that the pathogenesis of high blood pressure-associated cataract may be partially prevented by controlling the blood pressure.
Adenosine Triphosphatases* ; Animals ; Blood Pressure* ; Cataract ; Membranes ; Propranolol ; Rats* ; Rats, Sprague-Dawley

BACKGROUND: This study was designed to compare the effects of remifentanil, alfentanil, and fentanyl on the hemodynamic changes, sedation, and analgesia when administered with small doses of midazolam in patients undergoing a retrobulbar block for cataract surgery. METHODS: Sixty patients scheduled for cataract surgery were divided into 4 groups (n = 15 for each group). Firstly, group C received 5 ml of a normal saline solution, 3 min before a retrobulbar block. Next, group R received remifentanil 0.3g/kg. Furthermore, group A received a 4.5g/kg dose of alfentanil, 90 s before a retrobulbar block, and group F received fentanyl 0.6g/kg, 210 s before a retrobulbar block. All solutions were mixed with normal saline to a 5 ml volume. In group R, A, and F, midazolam (0.5 mg for patients over the age of 65 years; 1.0 mg in patients under the age of 65 years) was injected 3 min before the retrobulbar block. RESULTS: The systolic blood pressure in patients significantly increased at 1 or 2 minutes after a retrobulbar block in group C and at 1 minute in group F. For group R, the systolic blood pressure decreased significantly at 3, 4, 5, and 10 minutes, and at 2, 3, 4, 5, and 10 minute in group A. The mean OAA/S scale during a retrobulbar block significantly declined in groups R and A. The VAS score for pain was significantly lower in groups R and A, whereas the VAS anxiety index was significantly lower in groups R, A, F compared to group C (P 0.05). CONCLUSIONS: We found that the combination of remifentanil or alfentanil with midazolam showed better hemodynamic stability, sedative, and analgesic effects compared to fentanyl with midazolam in the retrobulbar block for cataract surgery.
Alfentanil* ; Analgesia* ; Anxiety ; Blood Pressure ; Cataract* ; Fentanyl* ; Hemodynamics* ; Humans ; Midazolam ; Sodium Chloride

PURPOSE: To compare pain levels in cataract surgery under topical anesthesia only and topical anesthesia under monitored anesthesia care. METHODS: We recruited 243 patients who were scheduled to undergo cataract surgery under topical anesthesia only or topical anesthesia with monitored anesthesia care (MAC) using fentanyl and midazolam. Anesthesia methods were selected based on the patient's preference. All patients completed an anxiety and information scale survey preoperatively. Vital signs during the operations were recorded. A 0-to-10 visual analog scale pain score survey was conducted immediately and at 2 hours, 6 hours, and 1 day after surgery. RESULTS: Of the 237 patients who completed the study, 183 patients selected topical anesthesia, and 54 patients selected MAC. Mean pain scores according to the aforementioned time points after surgery were 0.50, 0.58, 0.29, and 0.12 in the topical anesthesia group, and 0.22, 0.16, 0.06, and 0.09 in the MAC group, respectively. The differences in pain score between the two groups was statistically significant at 2 hours (p = 0.019) and 6 hours (p = 0.040) after surgery. The mean patient anxiety score for anesthesia was 10.50 in the topical anesthesia group and 11.41 in the MAC group (p = 0.280). Mean systolic blood pressure at the start of surgery was 140.6 mm Hg in the topical anesthesia group, and 158.2 mmHg in the MAC group. CONCLUSIONS: Monitored anesthesia care consistently resulted in less pain throughout the post-operative period. However, transient systolic blood pressure should be carefully monitored for a rise related to intravenous anesthetics.
Anesthesia* ; Anesthetics, Intravenous ; Anxiety ; Blood Pressure ; Cataract* ; Fentanyl ; Humans ; Midazolam ; Visual Analog Scale ; Vital Signs

BACKGROUND: Although the effect of clonidine, an alpha2 adrenoreceptor agonist, is well established, there is no study to evaluate the effects of addition of clonidine to ldegrees Cal anesthetics in elderly hypertensive patients. The aim of this study is to evaluate the effects of addition of clonidine to ldegrees Cal anesthetics in elderly hypertensive patients undergoing senile cataract surgery. METHODS: Forty elderly hypertensive patients who scheduled for elective senile cataract surgery were divided into two groups. The control group (n=20) received oral diazepam 0.1 mg/kg 60 min before surgery and the clonidine group (n=20) did not received premedication. A mixture of 2% liddegrees Caine and 0.5% bupivacaine with normal saline 0.7 ml (control group) or clonidine 100 ug (clonidine group) was used as a ldegrees Cal anesthetics. Perioperative blood pressure, heart rate, sedation score, and intradegrees Cular pressure were measured. RESULTS: After anesthesia, there was a significant fall in blood pressure and intradegrees Cular pressure in clonidine group, and increase in sedation score in clonidine group than control group. There was no difference in the perioperative heart rate between the two groups. CONCLUSIONS: The above results show that addition of clonidine to ldegrees Cal anesthetics in elderly hypertensive patients undergoing senile cataract surgery produced reduction in blood pressure, intradegrees Cular pressure and produced intraoperative sedation.
Aged ; Anesthesia ; Anesthetics* ; Blood Pressure ; Bupivacaine ; Cataract* ; Clonidine* ; Diazepam ; Heart Rate ; Humans ; Premedication