bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Laser in situ Keratomileusis and Photorefractive Keratectomy to Correct Myopia from -1.25 to -6.00 Diopters
Authors: Wang Zheng , Chen Jiaqi , Yang Bin
Published: April 2021

ABSTRACT

BACKGROUND: We evaluated the safety and efficacy of laser in situ keratomileusis (LASIK) for the correction of low to moderate amounts of myopia (-1.25 to -6.00 D).

METHODS: Photorefractive keratectomy (PRK) was performed on 432 eyes and LASEK on 137 eyes with a Chiron Keracor 116 excimer laser. Uncorrected and corrected visual acuity, corneal sensitivity, contrast sensitivity, and corneal topography were examined before and after surgery.

RESULTS: One-year follow-up of 307 eyes in the PRK group and 103 eyes in the LASLK group was achieved. At 1 year, 83% (85 of 103) of LASLK eyes and 72% (221 of 307) of PRK eyes had an uncorrected visual acuity of 1.0 or better. Eighty-nine percent (92 of 103) of LASLK eyes and 83% (255 of 307) of PRK eyes had a refractive error within ±1.00 D of emmetropia; 71% (73 of 103) of LASLK eyes and 61% (188 of 307) of PRK eyes were within ±0.50 D of emmetropia. Contrast sensitivity and corneal sensitivity were reduced in both groups at the early postoperative stage but gradually returned to preoperative values; their recovery took about 3 months in LASIK eyes and 6 to 12 months in PRK eyes.

CONCLUSION: LASIK is safe and more predictable than PRK to correct low to moderate amounts of myopia. Recovery from LASLK is faster than after PRK. [J Refract Surg 1997;13:528-534]
Mesopic Contrast Sensitivity Function After Excimer Laser Photorefractive Keratectomy
Authors: Montés-Micó Robert , Charman W Neil
Published: April 2021

ABSTRACT

PURPOSE: To evaluate contrast sensitivity under mesopic conditions in patients who had undergone uncomplicated excimer laser photorefractive keratectomy (PRK) for myopia.

METHODS: Monocular contrast sensitivity function was measured with the Stereo Optical ?A.C.T. chart in 26 patients who had received PRK using the Nidek EC-5000 excimer laser system. Mean preoperative refractive error was -6.23 ? 1.69 D (range, -4.00 to -8.25 D); postoperatively, mean refractive error was -0.36 ? 0.58 D (range, -0.75 to +0.50 D). Contrast sensitivity function was measured 6 months after surgery using four different chart luminances: 85, 5.0, 2.5, and 0.1 cd/m2, the first being a photopic level and the rest mesopic. A control group of eight emmetropic subjects was also studied to allow comparison of results for statistical purposes.

RESULTS: Logarithmic values of contrast sensitivity at each spatial frequency were used for statistical analysis and normalized values were used for graphical representation. The results showed a statistically significant reduction (P<.01) in contrast sensitivity for the PRK patients in comparison with the control group under mesopic conditions for each spatial frequency tested (1.5, 3, 6, 12, and 18 c/deg), although no significant contrast sensitivity differences were observed between PRK and control groups at the photopic (85 cd/m2) level (P>.01 for all frequencies).

CONCLUSION: Photorefractive keratectomy can induce significant reductions in contrast sensitivity under mesopic conditions, even though the photopic contrast sensitivity function is normal. [J Refract Surg 2002;18:9-13]
Image Quality and Visual Performance in the Peripheral Visual Field Following Photorefractive Keratectomy
Authors: Montés-Micó Robert , Charman W Neil
Published: April 2021

ABSTRACT

PURPOSE: A theoretical and experimental study was performed to assess the possible effects of photorefractive keratectomy (PRK) on retinal image quality and thresholds in the peripheral visual field.

METHODS: Simple optical calculations suggest that although the quality of the retinal image at the fovea of the postoperative PRK eye may be comparable to that in an emmetropic eye, images in the peripheral field may be markedly worse, since peripheral ray bundles may pass partly through ablated and partly through unablated cornea, giving a simultaneous-vision bifocal effect. This would be expected to create an annular zone of confusion, so that light from two different directions in object space arrives at the same point on the retina. The position of this zone and its width are a function of the ablation zone geometry, the attempted correction, and the pupil diameter, but the major effects typically occur at field angles between about 40° and 60°. To explore this effect, Goldmann static quantitative perimetry was carried out along the 0° to 180° meridian in six patients who had undergone myopic PRK and eight emmetropes.

RESULTS: The results showed that thresholds for the PRK group at field angles from 40° to 60° were significantly higher than those of the emmetropic group (P<.01). These findings arise because the retinal images in the peripheral field of originally myopic, postoperative PRK patients are, in general, significantly degraded in comparison with those of emmetropes.

CONCLUSION: Although under photopic conditions, retinal image quality close to the visual axis in patients who have been corrected by PRK is similar to that in emmetropes, it may be markedly worse in the peripheral visual field. [J Refract Surg 2002;18:14-22]
Management of Corneal Ectasia After Laser in situ Keratomileusis With INTACS
Authors: Siganos Charalambos S , Kymionis George D , Astyrakakis Nikos , Pallikaris Ioannis G
Published: April 2021

ABSTRACT

PURPOSE: To evaluate the safety and efficacy of intrastromal corneal ring segments (ICRS, INTACS, Keravision) for the correction of corneal ectasia after laser in situ keratomileusis (LASIK).

METHODS: In this prospective, noncomparative case series, INTACS were implanted in three eyes (two patients) that were ectatic after LASIK. Mean follow-up was 8.7 months (range, 8 to 10 mo).

RESULTS: No intraoperative complications occurred. After INTACS implantation, uncorrected visual acuity ranged from 20/20 to 20/25 at 6 months and remained stable until 9 months. Mean postoperative spherical equivalent refraction was 0.50 D at 1 month and no significant changes appeared up to 9 months after LNTACS implantation. After INTACS implantation, no eye lost any lines of Snellen spectacle-corrected visual acuity and two eyes gained from one to two lines. There was an increase in topographical regularity in all three eyes.

CONCLUSION: Implantation of LNTACS in eyes with corneal ectasia after LASLK resulted in good refractive outcome, absence of complications, and improvement in visual acuity. [J Refract Surg 2002;18:43-46]
Tear Secretion Following Excimer Laser in situ Keratomileusis
Authors: Siganos Dimitrios S , Popescu Corina N , Siganos Charalambos S , Pistola Georgia
Published: April 2021

ABSTRACT

PURPOSE: To evaluate the effect of laser in situ keratomileusis (LASIK) on tear secretion.

METHODS: A non-consecutive series of 42 eyes of 42 patients had LASIK for the correction of myopia and myopic astigmatism. The fellow eye served as a control. The mean preoperative spherical equivalent refraction was -5.25 ? 1.00 D (range, -1.75 to -11.00 D). Attempted correction aimed at emmetropia. Schirmer I and II, and tear break-up time (BUT) tests were performed preoperatively and at 1, 3, and 6 months postoperatively. All tests were correlated to the amount of the attempted correction.

RESULTS: Preoperatively, mean values were Schirmer 1: 16.2 mm, Schirmer II: 11.6 mm, and BUT. 16.3 sec. One month after LASEK, mean values were Schirmer 1: 12.8 mm, Schirmer II: 9.2 mm, and BUT: 13.3 sec. At 3 months, mean values were Schirmer I: 15.76 mm, Schirmer II: 11.3 mm, and BUT: 14.15 sec. At 6 months, mean values were Schirmer I: 15.96 mm, Schirmer II: 11.66 mm, and BUT: 16.3 sec. No correlation to the amount of attempted correction was found. Fellow eye tests were not affected at any interval.

CONCLUSIONS: Tear secretion following LASIK was decreased during 3 months after surgery and was normalized by 6 months. [J Refract Surg 2002;18:124-126]
Comparison of TGF-β1 in Tears Following Laser Subepithelial Keratomileusis and Photorefractive Keratectomy
Authors: Lee Jae Bum , Choe Chul-Myong , Kim Hyon S , Seo Kyoung Yul , Seong Gong Je , Kim Eung Kweon
Published: April 2021

ABSTRACT

PURPOSE: To compare the release of tear fluid transforming growth factor-?l (TGF-?l) of 15 patients who underwent photorefractive keratectomy (PRK) in one eye and laser subepithelial keratomileusis (LASEK) in the other eye.

METHODS: Tear fluid samples were collected with scaled microcapUlary tubes preoperatively (day 0) and on the first, second, and seventh postoperative days. We calculated the release of TGF-β1 (tear fluid flow-corrected concentrations of TGF-β1) by multiplying the concentration by capillary tear fluid flow and also evaluated corneal haze at 1, 3, and ? months after PRK or LASEK.

RESULTS: The median TGF-βl release values were: Day 0: 50.6 pg/min (range 0 to 101.6 pg/min) for PRK and 56.7 pg/min (range 0 to 121.8 pg/min) for LASEK (P=.496); Day 1: 240.6 pg/min (range 56.6 to 1120.2 pg/min) for PRK and 155.2 pg/min (range 45.1 to 480.4 pg/min) for LASEK, which showed a significant difference between the two procedures (P=.041); Day 2: 395.7 pg/min (range 92.3 to 1150.7 pg/min) for PRK and 185.2 pg/min (range 41.4 to 872.5 pg/min) for LASEK (P=.004); and Day 7: 91.3 pg/min (range 0 to 225.4 pg/min) for PRK and 74.3 pg/min (range 0 to 187.1 pg/min) for LASEK, (P=.244). The mean corneal haze score at 1 month after PRK was 0.88 ± 0.50 and 0.53 ± 0.29 after LASEK, and a statistically significant difference was noted between the two groups (P=.005). At 3 months (P=.083) and 6 months (P=.157) after the procedures, there were no statistically significant differences.

CONCLUSIONS: A lower amount of tear fluid transforming growth factor-?l was released in the early postoperative days following LASEK than in PRK. The lower grade of corneal haze seen in LASEK than PRK in the early postoperative period may come from a decreased release of TGF-?l, which may have a role in wound healing. [J Refract Surg 2002;18:130-134]
Laser in situ Keratomileusis for Hyperopia and Hyperopic Astigmatism Using the Meditec MEL 70 Spot Scanner
Authors: Ditzen Klaus , Fiedler Joachim , Pieger Stefan
Published: April 2021

ABSTRACT

PURPOSE: To evaluate safety, predictability, efficacy, and stability of laser in situ keratomileusis (LASIK) for spherical hyperopia and hyperopia with astigmatism

METHODS: In this retrospective study we analyzed the results of 23 eyes of 23 patients who had LASIK for spherical hyperopia (preoperative cylinder SS0.75 D) and 44 eyes of 44 patients who had LASIK for hyperopia with astigmatism; (Bausch & Lomb Hansatome microkeratome with a 180-/*m plate and a suction ring for a 9.5-mm flap diameter; Asclepion-Meditec MEL 70 G-scan flying spot laser with a 1.8-mm Gaussian beam).

RESULTS: In Group 1 (spherical hyperopia), mean preoperative spherical equivalent refraction was +4.88 ? 2.13 D (range +2.13 to +9.63 D); in Group 2 (hyperopic astigmatism), +4.33 ? 2.15 D (range +0.50 to +9.50 D). One year after LASIK, mean spherical equivalent refraction was +0.30 ? 0.90 D (range -0.75 to +2.50 D) in Group 1 and +0.29 ? 1.27 D (range -3.25 to +3.25 D) in Group 2. In Group 1, 78%, and in Group 2, 42% were within ?0.50 D. In Group 1, no eyes lost two or more lines, and one eye (6%) lost one line of best spectacle-corrected visual acuity at 1 year. In Group 2, one eye (4%) lost one line and one eye (4%) lost more than two lines at 1 year. Uncorrected visual acuity of 20/40 or better was achieved in 83% (Group 1) vs. 62% (Group 2) at 1 year; these values improved to 100% vs. 71% for corrections up to +6.00 D.

CONCLUSIONS: LASBK with the M?dit?e MEL 70 G-Sean flying spot laser seemed to be safe and effective for hyperopia and hyperopia with astigmatism for corrections up to +6.00 D. Large flap diameters are necessary to avoid epithelial ingrowth. [J Refract Surg 2002;18:430-434]
An Informal Satisfaction Survey of 200 Patients After Laser in situ Keratomileusis
Authors: Hill John C
Published: April 2021

ABSTRACT

PURPOSE: Patient satisfaction following laser in situ keratomileusis (LASIK) is commonly reported as high. This paper reviews the outcome of LASIK both in terms of visual results and satisfaction.

METHODS: Two-hundred patients were surveyed telephonically to establish their degree of satisfaction with LASIK and to enquire about postoperative use of glasses, and symptoms of light sensitivity and of night vision problems. Patient anonymity was assured.

RESULTS: The majority of patients (95%) never wore distance glasses after LASIK. Reading glasses were used by 49 (24.5%), related to age and presbyopia. Light sensitivity was not a problem or was unchanged from baseline in 73% of patients; 27% said they were worse; a few (5J>%) said their symptoms were better. Night vision was not a problem or was unchanged from baseline in 76% of patients; 24% said they were worse; 17% said their symptoms were better. One hundred ninety-five patients (97.5%) were extremely happy with their results and 197 (98.5%) would have the procedure again.

CONCLUSION: After LASErL 95% of 200 patients wore no distance optical correction; 99% would have the procedure again; and light sensitivity and night vision problems bothered a significant number of patients. [J Refract Surg 2002;18:454-459]
Anterior Lamellar Keratoplasty With a Microkeratome: A Method for Managing Complications After Refractive Surgery
Authors: Hafezi Farhad , Mrochen Michael , Fankhauser Franz , Seiler Theo
Published: April 2021

ABSTRACT

PURPOSE: To demonstrate a technique of anterior lamellar keratoplasty with standardized and automated preparation of surface-parallel cuts in both donor and recipient appropriate for addressing several problems after laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK).

METHODS: We report a noncomparative series of ten eyes with complications after LASIK and PRK. Lamellar cuts were performed in donor and recipient eyes by means of an automated microkeratome. Lamellar grafts were fixed by only four single sutures. In two eyes, a re-lift LASLK was performed after 6 months.

RESULTS: Surgery was uneventful and visual acuity was improved in all eyes. Residual irregular astigmatism and refractive error were corrected in two eyes by means of excimer laser computerassisted ablation and resulted in a further improvement of uncorrected and best spectaclecorrected visual acuity.

CONCLUSIONS: Anterior lamellar keratoplasty with a microkeratome can be used for the management of certain complications of PRK and LASIK. [J Refract Surg 2003;19:52-57]
Laser in situ Keratomileusis for Compound Myopic Astigmatism Using the Meditec MEL 70 G-Scan Excimer Laser
Authors: Uçakhan Ömür Ö
Published: April 2021

ABSTRACT

PURPOSE: To determine the safety, efficacy, predictability, and stability of laser in situ keratomileusis (LASIK) in treating patients with myopic astigmatism using the Meditec MEL 70 G-Scan excimer laser.

METHODS: Seventy-four eyes of 42 patients with myopia ranging from -4.50 to -9.88 D and astigmatism ranging from 0.50 to 4.00 D who underwent LASIK with the Meditec MEL 70 G-Scan excimer laser and the Summit Krumeich-Barraquer microkeratome were studied. Patients were followed for 1 year.

RESULTS: Mean baseline spherical equivalent refraction was -7.12 ± 1.70 D and cylinder was 1.62 ± 1.72 D. At 12 months, mean postoperative spherical equivalent refraction was -0.49 ± 0.57 D and mean refractive cylinder was 0.59 ± 0.32 D. Mean change in spherical equivalent refraction between 1 and 12 months after surgery was -0.09 ± 0.31 D, toward myopia. At baseline, no eyes had best spectaclecorrected visual acuity (BSCVA) of 20/20 or better, and 65% had 20/40 or better. At 12 months after surgery, 10% of eyes had BSCVA of 20/20 or better and 88% of eyes had 20/40 or better. The unusually low postoperative BSCVA results were thought to be due to amblyopia or existence of a higher percentage of some optical aberrations in this group of eyes. Mean uncorrected visual acuity was -1.38 ± 0.42 LogMAR units (20/400) at baseline and -0.29 ± 0.25 LogMAR units (20/40) at the 12-month postoperative examination. No eyes lost two or more lines of spectacle-corrected visual acuity. No vision threatening complications were observed.

CONCLUSIONS: LASIK with the Meditec MEL 70 G-Scan excimer laser appeared to be safe, effective, reasonably predictable, and stable for correction of myopic astigmatism with a spherical component between -4.25 and -8.25 D and a cylindrical component between 0.50 and 4.00 D. However, astigmatism was slightly undercorrected with the algorithm used. [J Refract Surg 2003;19:124-130]
Bilateral Marginal Sterile Infiltrates and Diffuse Lamellar Keratitis After Laser in situ Keratomileusis
Authors: Ambrósio Renato , Periman Laura M , Netto Marcelo V , Wilson Steven E
Published: April 2021

ABSTRACT

PURPOSE: To report cases of acute bilateral catarrhal infiltrates in the early postoperative period after laser in situ keratomileusis (LASIK).

METHODS: Retrospective review of both eyes of two patients.

RESULTS: Two patients developed acute bilateral, marginal, catarrhal infiltrates in the early postoperative period after LASIK. Both patients had moderate to severe chronic meibomian gland dysfunction preoperatively. One patient (both eyes) developed grade 3 diffuse lamellar keratitis (DLK) that required both flaps to be lifted for irrigation and cleaning on postoperative day 5. Fungal and bacterial cultures were negative in both eyes of both patients. The condition resolved with intensive topical corticosteroids and fortified antibiotics. Regression of refractive error and the need for enhancement was encountered in all eyes. There was mild recurrence in one eye of each patient with pretreatment with topical corticosteroids prior to enhancement.

CONCLUSIONS: Endogenous factors such as chronic blepharitis and meibomian gland dysfunction may trigger inflammation resulting in sporadic cases of catarrhal infiltrates after LASIK. These patients may have chronic inflammatory milieus that can trigger sporadic cases of catarrhal infiltrates after LASIK, with accompanying diffuse lamellar keratitis. (J Refract Surg 2003;19:154-158)
Outcomes After Laser in situ Keratomileusis Retreatment in High Myopes
Authors: Rani Alka , Balasubramanya Ramamurthy , Sharma Namrata , Tandon Radhika , Vajpayee Rasik B , Dada Vijay K , Singh Rajvir
Published: April 2021

ABSTRACT

PURPOSE: To evaluate the refractive and visual performance after laser in situ keratomileusis (LASIK) retreatment.

METHODS: A retrospective study was performed on 33 eyes of 23 patients who underwent LASIK (Bausch & Lomb Technolas 217C) retreatment for residual myopia with or without astigmatism. Parameters evaluated were uncorrected and best spectacle-corrected visual acuity, spherical equivalent refraction, contrast sensitivity, glare acuity, and pachymetry, preoperatively and at 1, 3, and 6 months postoperatively.

RESULTS: The mean spherical equivalent refraction before primary LASIK was -9.89 ± 4.00 D and before retreatment was -2.85 ±2.17 D. Although contrast sensitivity and glare acuity decreased significantly after primary LASIK (P<.05), no significant change in these parameters was observed after retreatment. Smaller ablation zones were associated with decreased contrast sensitivity and glare acuity after primary LASIK as well as following retreatment. Contrast sensitivity and glare acuity following primary LASIK were significantly better in eyes with ablation zones 5=5 mm than those with <5 mm (P<.05). Eyes in which the ablation zone was the same as that for primary LASIK had significantly better contrast sensitivity than those with different ablation zones (increased or decreased) during retreatment. Attempted refractive correction during primary LASIK and retreatment had a significant negative correlation with contrast sensitivity and glare acuity following primary LASIK as well as retreatment.

CONCLUSION: The ablation zones following primary LASIK and retreatment should be 5=5.00 mm and remain unchanged to improve visual performance. [J Refract Surg 2003;19:159-164]
Reduction of Spherical Aberration With the Nidek NAVEX Customized Ablation System
Authors: Vinciguerra Paolo , Camesasca Fabrizio I , Urso Rosario
Published: April 2021

ABSTRACT

PURPOSE: Spherical aberration is the most frequent optical aberration induced by refractive surgery, reducing visual acuity and causing halos. We present preliminary results of Custom Ablation Transition Zone (CATz), which we developed for Nidek's Final Fit software, part of the Nidek NAVEX customized ablation system.

METHODS: We studied 55 eyes of 51 patients (31 males, 20 females) who underwent refractive surgery. Mean preoperative spherical equivalent refraction was -5.50 ± 3.30 D (range -12.00 to +4.50 D). Mean age was 35 years (range 23 to 47 yr). All patients underwent complete preoperative ophthalmologic examination, including aberrometry and topography, then surgery with laser epithelial keratomileusis, and OPD-based refractive treatment with the Nidek EC-5000 excimer laser. The Nidek Final Fit software with the CATz feature was always used. Postoperatively, all patients repeated the ophthalmologic examination inclusive of aberrometry at day 30, 60, and 90.

RESULTS: The 3-month follow-up rate was 21.8%. Mean postoperative spherical equivalent refraction was -0.33 ± 0.91 D (range -0.75 to +0.75 D), with a mean sphere of -0.23 ± 0.78 D (range -2.50 to +0.75 D) and a mean cylinder of -0.21 ± 0.33 (range -1.00 to 0 D). At 3 months, 43% of eyes achieved 20/15 or better UCVA, and 43% achieved 20/20 or better UCVA; 63% achieved 20/15 or better BSCVA and 25% achieved 20/20 or better BSCVA. Postoperative spherical aberration was unchanged for a 3-mm pupil.

CONCLUSION: Customized ablation with the Nidek NAVEX system provided excellent refractive results. The CATz algorithm of the Nidek Final Fit software appeared to prevent induction of spherical aberration. [J Refract Surg 2003;19(suppl): S195-S201]
Comparison of Conventional Versus Wavefront-guided Laser in situ Keratomileusis in the Same Patient
Authors: Phusitphoykai Nutharin , Tungsiripat Tulaya , Siriboonkoom Janpen , Vongthongsri Anun
Published: April 2021

ABSTRACT

PURPOSE: To verify whether there is any difference in visual outcome, including higher order aberrations, after performing laser in situ keratomileusis (LASEK) with conventional ablation and wavefront-guided ablation in myopic eyes of the same patient.

METHODS: This was a prospective randomized study of 20 myopic eyes (10 patients) who had LASIK using the Nidek NAVEX excimer laser system. Wavefront-guided customized ablation was used in the first eye of the patient (study group) and the other eye of the same patient was operated with conventional ablation (control group). Mean refractive error was similar between left and right eyes of the same patient. Preoperative examination included higher order aberration by Nidek OPDScan. Uncorrected and best spectacle-corrected visual acuity and higher order aberrations were recorded postoperatively.

RESULTS: Preoperative and postoperative best spectacle-corrected visual acuity was better than 20/40 (100%) after LASEK in both the conventional ablation and wavefront-guided customized ablation groups. Postoperative refraction was within ±0.50 D of emmetropia: 90% in the conventional group and 100% in the wavefront-guided group. No statistically significant difference in postoperative higher order aberrations was found between groups.

CONCLUSION: Postoperative visual outcome with both conventional LASIK and wavefrontguided customized ablation was not significantly different. Higher order aberrations did not significantly increase postoperatively in either group. [J Refract Surg 2003;19(suppl):S217-S220]
Proper Positioning of the Plume Evacuator in the VISX Star3 Excimer Laser Minimizes Central Island Formation in Patients Undergoing Laser in situ Keratomileusis
Authors: Cua Irwin Y , Pepose Jay S
Published: April 2021

ABSTRACT

PURPOSE: To identify risk factors in a series of patients who developed steep central islands after laser in situ keratomileusis (LASIK).

METHODS: We analyzed and compared the refractive and topographic outcome of a study group composed of 83 eyes of 44 patients who underwent LASIK using the VISX Star3 excimer laser with a refraction-matched control group of 83 eyes treated later. The vacuum aspirator of the excimer laser was abnormally positioned during the surgeries performed in the study group.

RESULTS: Mean preoperative spherical equivalent refraction in the study group was -6.75 ± 2.50 D. Four eyes with a mean preoperative spherical equivalent refraction of -9.27 ± 2.29 D developed steep central islands. Thirty-three (38%) of 83 eyes treated needed retreatment for residual myopia or myopic astigmatism. In the control group, mean preoperative spherical equivalent refraction was -6.76 ± 2.50 D. Ninety-three percent of eyes were within ±1.00 D of target refraction. Five (6.02%) of 83 eyes required retreatment and no eyes developed central islands.

CONCLUSION: The abnormally positioned vacuum aspirator coupled with the higher preoperative refractive correction were the likely causative factors for central island formation and the increased incidence of undercorrection in these patients. [J Refract Surg 2003;19:309-315]
Fungal Keratitis After Photorefractive Keratectomy: Delayed Diagnosis and Treatment in a Co-managed Setting
Authors: Periman Laura M , Harrison Devin A , Kim Jeehee
Published: April 2021

ABSTRACT

PURPOSE: To report a ease of fungal keratitis following photorefractive keratectomy (PRK) in a co-managed setting.

METHODS: A 35-year-old man with a preoperative refraction of -13.00 +3.75 x 18° OD, and -12.50 +2.50 x 70° OS underwent bilateral simultaneous PRK. On postoperative day 16, the patient presented with complaints of decreased vision and foreign body sensation. Examination by the co-managing optometrist revealed a visual acuity of 20/200, and a central corneal ulcer. Cultures were not taken and the patient was started on topical ofloxacin and prednisolone acetate 1% every hour. The patient was instructed to follow-up with another optometrist closer to the patient's home Tobradex (tobramycin 0.3% combined with dexamethasone 0.1%) was added to the treatment regimen on postoperative day 23, but the ulcer continued to worsen. The patient was then referred to an ophthalmologist where corneal cultures were performed, but came back negative.

RESULTS: Despite treatment with fortified antibiotics, the ulcer perforated, requiring penetrating keratoplasty. Bacterial and fungal cultures were negative. Pathology examination of the specimen revealed fungal hyphae.

CONCLUSIONS: Although co-management of refractive patients may be a common practice, it is not without risks. In this case, delayed diagnosis and inappropriate treatment resulted in a poor final outcome. [J Refract Surg 2003;19:364-366]
A Rapid Aphakic Visual Acuity Screening Device
Authors: Schulze Richard R , Oliver John G
Published: April 2021

SUMMARY

Inexpensive, rapid and convenient multi-pinhole aphakic visual acuity screening spectacles are described.
Vasodilation and the Etiology of Diabetic Retinopathy: A New Model
Authors: Wolbarsht M L , Landers M B , Stefansson E
Published: April 2021

SUMMARY

The evidence in support of the theory that retinal vascular stretching leads to leakage, formation of microaneurysms, and neovascularization is reviewed. The efficacy of photocoagulation and vitrectomy in controlling retinal microangiopathy accompanying diabetes is shown to depend upon reduction of the vascular dilatation. It is possible that the vascular dilatation in diabetes results from high blood glucose levels increasing oxygen consumption in the inner retina, with a resulting vascular dilatation to supply increased oxygen to the retina. This retinal vascular dilatation is the initial cause of the vascular pathology in diabetes.
A Disposable Surgical Drape Elevator
Authors: Nevvas Herbert J
Published: April 2021

SUMMARY

A disposable plasticized paper drape elevator whose ends are adhesive-backed is described. It is simple to use and effective in maintaining patient comfort by preserving an air space over the nose and mouth of the patient during surgery.
Orbital Cysts Following Enucleation: The Use of Absolute Alcohol
Authors: Hornblass Albert , Bosniak Stephen
Published: April 2021

SUMMARY

Orbital cysts are a serious, disfiguring complication of enucleation surgery. We have presented four cases of orbital cysts, summarized their management, and reviewed the literature. Two were treated by surgical excision and two with alcohol injection. All were cured; therefore, alcohol injection is an effective alternative to surgery.
Cosmetic Eye Modified to Retain Vision
Authors: Wesley Ralph E , Cotton Angela
Published: April 2021

SUMMARY

A patient with bilateral ocular injuries with hypotony and light perception vision was fitted with scleral shells modified to allow light to pass through the central 4-mm area. This modification, allowing the patient to retain light perception with the prosthesis in place, aided in the rehabilitation of this patient by encouraging his independent ambulation, providing clues to time, place, and direction, and offering an enhanced cosmetic effect.
6/0 Sutures for Eyelid Skin
Authors: White James H , Stephens George M
Published: April 2021

SUMMARY

Experiments measuring the cut-out values of sutures in eyelid skin indicate that 6/0 suture is the best choice.
A Simple Iris Protector
Authors: Mizuno K
Published: April 2021

SUMMARY

Iris prolapse during intraocular surgery can be successfully prevented with the use of a simple iris protector made from a piece of polyethylene sheet. When employed during a peripheral iridotomy, the protector is particularly helpful in extracting dislocated lenses without causing vitreous loss.
A System for Slit-Lamp Polaroid Photography
Authors: Miller David , Taube John , Miller Roger , Gleason William , Babyn Paul , Moon Jon , Weiss Jeffrey N
Published: April 2021

SUMMARY

A system is described in which a SX-70, Alpha Model II, Polaroid, single lens reflex camera, and photoflash unit can be quickly and sturdily mounted to a slit lamp.

Such a system can take sharp anterior segment prints of the eye at all slit-lamp magnifications, with white light and in the flourescein mode.

The heart of the unit is the modification of an assembly initially designed to attach the camera to a light microscope. The small flash unit and power supply were designed specifically for slit lamp usage.

Examples of "instant" photos of the anterior segment at different magnifications are presented.
The Message of a Bony Lens
Authors: Wolter J Reimer
Published: April 2021

SUMMARY

Bone has replaced the lens substance and maintained size, shape and zonular attachments of the preserved lens capsule in a degenerated eye twenty-three years after a childhood endophthalmitis. This unusual observation allows for some futuristic thoughts about "the ideal intraocular lens implant."
Upper Lid Blepharoplasty: Skin Closure Achieved with Butyl-2-Cyanoacrylate
Authors: Kosko Paul I
Published: April 2021

SUMMARY

A technique is described for closing a blepharoplasty incision after using a modified pinch method. A butyl-2-cyanoacrylate adhesive is employed.
Use of Anti-Fogging Agents in the Operating Room
Authors: Perlstein Seymour H , Chubak Gary S
Published: April 2021

SUMMARY

The use of commercial anti-fogging agents for prevention of fogging of lens surfaces in the operating room is described.
Vitreous Wick Syndrome Following a Corneal Relaxing Incision
Authors: Stainer Gregory A , Binder Perry S
Published: April 2021

SUMMARY

A 55-year-old white female underwent a 7.5 mm penetrating keratoplasty for stromal scarring secondary to herpex simplex keratitis. Postoperatively, stromal vascularization and a prolonged graft rejection forced premature suture removal and a prolonged course of topical and systemic glucocorticoids. A mild anterior wound gape spontaneously closed with reduction of steroid therapy. Eighteen months after the original surgery, the patient underwent a relaxing corneal incision to correct 12 diopters of corneal astigmatism. During an inferior incision a small microperforation was noted and the procedure was terminated. Eleven days after the relaxing incision, the patient returned with a "vitreous wick" syndrome through the superior incision. The wound dehiscence and vitreous wick were repaired without incident and the astigmatism was reduced to 7 diopters. Incisions more than 3/4 depth in aphakic patients.or in patients who have required intense steroid therapy should be monitored closely for several days after surgery for microperforations or a wound dehiscence which may lead to a "vitreous wick" syndrome.
Anterior Segment Biopsy Using Vitreous Surgical Instruments
Authors: Slusher M Madison
Published: April 2021

SUMMARY

An unusual pupillary membrane was removed using closed microsurgical techniques and vitreous instruments. The recent development of automated intraocular scissors, as an addition to vitreous surgical instruments, provided the means of membrane biopsy and the establishment of the rare diagnosis of stromalization of the anterior chamber. The introduction of this concept and technical capability into the management of this and related cases suggests a means of obtaining certain types of intraocular tissue for pathological study en bloc.
Intubation with Cannulated Lacrimal Probe
Authors: Hedges Charles C
Published: April 2021

SUMMARY

Lacrimal drainage tract intubation can be performed more easily by pulling the tubing up through the nasal ostium with sutures. The difficulty of retrieving metal probes from the nose is avoided. The tubing cannot be displaced and has open lumen for drainage.
Blue Field Entoptoscopy and VER in Preoperative Cataract Evaluation
Authors: Skalka Harold W
Published: April 2021

SUMMARY

Blue field entoptoscopy (BFE) has been described as an effective method for evaluating macular function in patients with dense cataracts. We evaluated 150 preoperative cataract patients with BFE, and found the commercially-available instrument (MIRA BFE 100) to be accurate in patients with 20/400 or better preoperative acuity. There was a high percentage of false negative BFE results in patients with dense cataracts, and light flash VER testing was found to correlate better with attainable postoperative acuity in these patients.
A Measuring Suture for Large Strabismus Surgical Measurements
Authors: Kushner Burton J
Published: April 2021

SUMMARY

The use of a suture for large measurements during strabismus surgery is described. A piece of suture material cut to a length equal to the desired measurement is placed on the globe and used as a ruler.
The Results of 1000 Intracapsular Cataract Extractions with the Suture-Fixated Medallion Lens Implant
Authors: Kaufer Gunther
Published: April 2021

SUMMARY

One thousand intracapsular medallion implants, performed between August 1975 and July 1980, were anlayzed for complications (minimum follow-up 6 months): cystoid macular edema, 6.5%; retinal detachment, 2.8%; corneal edema, 0.9%; aphakic glaucoma, 2.5%; suture failure, 9%; implant subluxation, 3.7%; implant dislocation, 2%; and implant removal, 0.6%. Visual acuity of 20/40 or better was achieved in 93.4% of the cases, excluding non-implant related causes of low visual acuity.
Closure of a Fornix-Based Flap
Authors: Shulman Julius , Coles Robert S
Published: April 2021

SUMMARY

This paper is a review of two hundred cases of fornix-based conjunctival flaps, closed without suture or wetfield coaptation. The technique proved easy to perform and gave increased patient comfort, good wound closure and less irritation.
Surgical Management of Black Ball Hyphema with Sodium Hyaluronate
Authors: Sholiton David B , Solomon O David
Published: April 2021

SUMMARY

A surgical technique for removing black ball hyphema in a Pseudophakic patient is described. Three days after a total postoperative hyphema developed, a solution of sodium hyaluronate, Healon, was injected into the anterior chamber through a 160° limbal cataract incision. Healon dissected the clotted blood off the underlying iris and intraocular lens, maintained the anterior chamber, and expressed the clot in toto out of the eye. Postoperatively the patient had no further bleeding, the intraocular pressure remained normal, the pseudophakos remained clear and well positioned, and the cornea remained clear.
A Simple Base Plate for Stabilization of Older Weck Operating Microscopes
Authors: Seibold Horst , Freeman Melvin I
Published: April 2021

SUMMARY

A simple aluminum base plate for stabilizing older Week operating microscopes al lows the attachment of additional accessories without risk of instability when moving the microscope.
Near Disasters with the Operating Microscope and A Solution
Authors: Marchese Anthony L , Olijnyk Irene , Kelertas Algimantas , Daily Mark J , McDonald James E
Published: April 2021

SUMMARY

We report the sudden separation of two different Zeiss OPMI6 operating microscopes from their attaching brackets. This was the result of the failure of the three safety features which normally provide security. We, in turn, have designed and made a safety belt which will restrain the microscope in case it falls.
Intraocular Extraction of a Magnetic Foreign Body
Authors: Meyers Sanford M
Published: April 2021

SUMMARY

An intraocular magnetic foreign body, unable to be removed with an external magnet, was extracted by an external magnet only after a core vitrectomy and partial lysis of the encapsulating material.
The Natural and Modified Course of Post-Cataract Astigmatism
Authors: Stainer Gregory A , Binder Perry S , Parker William T , Perl Theodore
Published: April 2021

SUMMARY

We performed sequential central keratometry on 52 cataract patients for six months. We found no statistically significant difference in the induced postoperative astigmatism between wound closure with interrupted and double shoelace running closure with 1 0-0 monofilament nylon. In 31 patients, the postoperative astigmatism was a !ways with-therule. In 21 patients who underwent wound closure with 8-0 polyglactin suture, we documented a postoperative shift in induced astigmatism from with- to against-the-rule which took place between the fourth and fifth postoperative week. Based on our present study of the natural and modified course of post-cataract astigmatism and based upon previous research, we feel the cataract surgeon now has the appropriate means to reduce and/or control post-cataract astigmatism.
Wills Eye Hospital Residents' Intraocular Lens Experience
Authors: Wong Michael Y , Kline Oram R
Published: April 2021

SUMMARY

Intraocular lens (IOL) operations performed by Wills Eye Hospital residents over a three-year period were reviewed retrospectively. The growing numbers of implants performed, the trends in methods of cataract extraction, the trends in types of intraocular lenses, and the relative safety of the procedure were examined. The estimate for the total number of intraocular lenses implanted by Wills Eye Hospital residents this past year was 600, or 60 per senior resident, and the percent of patients seeing 6/12 or better was 93.2%.

There has been a great increase in the number of intraocular lenses implanted by residents at Wills Eye Hospital, with planned extracapsular cataract extractions and posterior chamber lenses currently favored. This analysis documents a very high visual success rate and acceptably low complication rate in closely supervised residents' surgery.
An Improved Intraocular Lens Power Calculator
Authors: Sheingorn Larry
Published: April 2021

SUMMARY

An easily operated, self-prompting, hand-held computer system simultaneously uses various prediction methods to print estimated intraocular lens implant powers. Predictions for specific lens styles are generated without requiring knowledge on the user's part of implant characteristics.
Laser Trabeculoplasty in a Residency Program
Authors: Cahn Peter H
Published: April 2021

SUMMARY

Guidelines are presented to facilitate resident training in argon laser trabeculoplasty. In addition to competence with the laser, emphasis is placed upon the need for skill with the gonio lens, with frequent use of it urged long before the first surgical application.
A Model for the Pathogenesis of Retrolental Fibroplasia Based on the Metabolic Control of Blood Vessel Development
Authors: Weiter John J , Zuckerman Ralph , Schepens Charles L
Published: April 2021

SUMMARY

We postulate that the pathogenesis of retrolental fibroplasia (RLF) is related to the disruption of the normally coordinated ocular development and maturation in which there is an interplay between function, metabolism, and blood vessel development. The normal retina is avascular until the fourth month of gestation, at which time vascularization proceeds from the optic disk towards the peripheral retina. Until this time, the underlying choroidal circulation provides for full-thickness retinal oxygenation. We hypothesize that the centrifugal maturation of the retina, including the retinal photoreceptors (the major oxygen-consuming cell type of the adult retina), precedes this vascular outgrowth. The maturation of the photoreceptors and the concomitant increased oxygen consumption would make it impossible for the choroid to provide adequate full-thickness retinal oxygenation. The resulting progressive change in the inner retinal metabolism thus provides an orderly, controlled stimulus for the subsequent progression of retinal vascularization from the optic disk to the peripheral retina. Exposure of the premature neonate to abnormal oxygen levels would selectively retard inner retinal blood vessel development while the photoreceptors continue to mature and increase their oxygen consumption. Thus, when the infant is removed from abnormal oxygen, a neovascular proliferative stimulus will develop in direct relation to the mass of non-vascularized but metabolically active retina, initiating uncoordinated vessel growth in the inner retina.
Recurrent Angle Closure Glaucoma Following A Patent 75-Micron Laser Iridotomy: A Case Report
Authors: Brainard Jay O , Landers James H , Shock John P
Published: April 2021

SUMMARY

Laser iridotomy is becoming increasingly popularasan effective alternative therapyto surgical iridectomy; however, we report a case of recurrent angle closure glaucoma following laser treatment that produced a patent iridotomy. Possible mechanisms for the failure and its implications are discussed.
Formation of Proteinaceous Capsules on Plastic Lens Implants-By Mouse Macrophages Under Tissue Culture Conditions
Authors: Wolter J Reimer , Kunkel Steven L
Published: April 2021

SUMMARY

Formation of continuous proteinaceous capsule-like layers is demonstrated in tissue culture on plastic lens implants as part of cellular membranes created by mouse macrophages after 48, 56, and 96 hours of incubation. The capsules resemble similar formations seen on lens implants removed from human eyes and their existence is considered part of a clinically beneficial adaptation of man-made materials to the inner eye.
Cellular Membranes on Glass Lens Implants-Formed in Tissue Culture by Mouse Macrophages
Authors: Wolter J Reimer , Kunkel Steven L
Published: April 2021

SUMMARY

Intraocular lens implants made of glass were exposed to a suspension of mouse macrophages in tissue culture for 48 and 96 hours. After 48 hours the macrophages had formed a dense cellular membrane on the glass surface and some of them had changed into fibroblast-like cells, epithelioid cells, and early stages of giant cells. After 96 hours a firm and continuous proteinaceous capsule had formed on the glass in the interspaces between the cells. The membranes on glass implants were more cellular and more firmly adherent than those seen on plastic implants under the same conditions.
Retinopathy of Prematurity: A New Look at an Old Disease
Authors: Wolbarsht M L , George G S , Shearin W A , Kylstra J A , Landers M B
Published: April 2021

SUMMARY

The neovascular changes of the retinopathy of prematurity can occur in premature infants in three settings: (1) when high levels of supplemental oxygen are administered, neovascularization usually commences shortly after cessation of oxygen therapy; (2) when supplemental oxygen is given for long periods of time, neovascularization can develop while the infant is still receiving oxygen; and (3) neovascularization can occur without exposure to any supplemental oxygen. We propose a model which can explain the occurrence of the retinopathy of prematurity in all these settings.

Our model demonstrates that whenever the retinopathy of prematurity occurs, arterial oxygen levels are inappropriately high in relation to the stage of retinal vessel development, even in premature neonates not given supplemental oxygen. The inhibitory effect of these elevated oxygen tensions upon carbon dioxide removal is indicated as a possible cause of neovascularization by leading to tissue acidosis and vasodilatation.
Acute Glaucoma Following Nd:YAG Laser Membranotomy
Authors: Shrader C Eric , Belcher C Davis , Thomas John V , Simmons Richard J
Published: April 2021

SUMMARY

A 65-year-old aphake with a functioning filtration bleb underwent neodymiumiYAG laser membranotomy. Shortly thereafter, he acutely developed pain, nausea, and visual blur with an intraocular pressure of 42 mm Hg. The mechanism of the acute glaucoma is believed to be occlusion of the fistula by herniated vitreous.
The Treatment of Necrotizing Scleritis with an Autogenous Periosteal Graft
Authors: Koenig Steven B , Kaufman Herbert E
Published: April 2021

SUMMARY

We used autogenous periosteum to reinforce scierai defects in two patients with necrotizing scleritis. This technique produced good anatomical results and maintained useful vision in each case. Autogenous periosteum offers advantages over other tissues as a tectonic graft for necrotizing scleritis, since it is easy to harvest and handle, it is strong and vascular, and is not subject to immunologie rejection.
Limitations of Blue Field Entoptoscopy In Evaluating Macular Function
Authors: Murphy Gates E
Published: April 2021

SUMMARY

Evaluation of macular function in cataract patients using blue field entoptoscopy (BFE) has been reported as useful in all cases by some authors; another found it useful only in patients with moderate visual acuity loss due to cataract.

This paper reports findings in 101 cataractous eyes evaluated consecutively with BFE. A strong correlation was found between cataract type and percentage of false negatives, but the correlation between the preoperative acuity level and percentage of false negatives was poor. BFE was also poor in detecting moderate macular dysfunction (20/60 - 20/80).

Four cases with profound visual acuity loss due to macular holes had normal perception of BFE.
Multiple Complications Following Radial Keratotomy in an Elderly Patient: A Case Report
Authors: Salz James J
Published: April 2021

ABSTRACT

A 68-year-old female underwent a 16-incision radial keratotomy in 1980. Her post-op course was complicated by marked overcorrection (+11.00), irregular astigmatism, and endothelial cell loss of almost 50%. Radial keratotomy in the elderly should be approached with caution because of the apparent increased effect of the surgery that occurs with increasing age.
A Randomized, Controlled Comparison of Anterior and Posterior Periocular Injection of Antibiotic in the Prevention of Postoperative Endophthalmitis
Authors: Christy Norval E , Lall Pramila
Published: April 2021

ABSTRACT

A randomized, controlled, prospective comparison of the effectiveness of anterior and posterior injections of antibiotics in the prevention of endophthalmitis following cataract extraction was carried out in a village hospital in Pakistan. The study involved 77,015 cataract operations performed mainly by two surgeons. Anterior subTenon injections ("subconjunctival") and posterior subTenon injections ("retrobulbar") were equally effective in preventing postoperative infection.