Retrobulbar steroid injection

Posterior capsular opacification, also known as after-cataract, is a condition in which months or years after successful cataract surgery, vision deteriorates or problems with glare and light scattering recur, usually due to thickening of the back or posterior capsule surrounding the implanted lens, so-called 'posterior lens capsule opacification'. Growth of natural lens cells remaining after the natural lens was removed may be the cause, and the younger the patient, the greater the chance of this occurring. Management involves cutting a small, circular area in the posterior capsule with targeted beams of energy from a laser, called Nd:YAG laser capsulotomy, after the type of laser used. The laser can be aimed very accurately, and the small part of the capsule which is cut falls harmlessly to the bottom of the inside of the eye. This procedure leaves sufficient capsule to hold the lens in place, but removes enough to allow light to pass directly through to the retina. Serious side effects are rare. [56] Posterior capsular opacification is common and occurs following up to one in four operations, but these rates are decreasing following the introduction of modern intraocular lenses together with a better understanding of the causes.

Christo et al (2007) stated that epidural corticosteroids have not been shown to provide effective analgesia for PHN.  Furthermore, Wu and Raja (2008) stated that the majority of interventional therapies show equivocal analgesic efficacy although some data indicate that intrathecal methylprednisolone may be effective.  The author stated that further randomized, controlled trials will be needed to confirm the analgesic efficacy of analgesic and interventional therapies (., sympathetic nerve blocks/other nerve blocks, intrathecal methylprednisolone, and spinal cord stimulation) to determine their role in the overall treatment of patients with PHN.

Some evidence from non-randomized small trials suggests that intravenous pulse steroid therapy twice a week may be associated with fewer side effects and may be more effective than oral steroid therapy for the treatment of Graves' eye disease. See High-dose intravenous corticosteroid therapy for Graves' ophthalmopathy. J Endocrinol Invest. 2001 Mar;24(3):152-8. and Graves' orbitopathy activation after radioactive iodine therapy with and without steroid prophylaxis J Clin Endocrinol Metab. 2009 Sep;94(9):3381-6 . Furthermore, weekly intravenous steroid therapy appeared to be associated with a better treatment outcome compared to daily therapy with oral steroid tablets, as described in Randomized, single blind trial of intravenous vs. oral steroid monotherap In Graves' orbitopathy. J Clin Endocrinol Metab. 2005 Jul 5; [Epub ahead of print] . In contrast, treatment with steroids does not seem to adversely impact the success of the treatment for hyperthyroidism Glucocorticoids do not influence the effect of radioiodine therapy in Graves' disease. Eur J Endocrinol. 2005 Jul;153(1):15-21.

Retrobulbar steroid injection

retrobulbar steroid injection

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