bluuebunny/crossref_metadata_2025 huggingface dataset:
Photorefractive Keratectomy for Myopia: One-year Follow-Up in 97 Eyes
Authors: Shimizu Kimiya , Amano Shiro , Tanaka Shunichi
Published: April 2021

ABSTRACT

We made a comprehensive study of 97 eyes that received photorefractive keratectomy (PRK) for myopia and followed them for one year. In 95 eyes, uncorrected visual acuity improved and bestcorrected acuity remained unchanged. In eyes with myopia of more than -3.0 diopters (D), the postoperative refraction was within -1.0 D of attempted correction. Predictability decreased with higher myopia. We also examined the changes of both epithelium and endothelium with the specular microscope and found no significant changes after photorefractive keratectomy.

Videokeratography showed an average of inferior decentration in most eyes by 0.51 mm + /- 0.31 (n = 60); only one clinical problem was noted - one eye experienced monocular diplopia for seven months. Pachometry showed a small percentage had corneal thinning - the amount depended on the degree of myopia. A rise in intraocular pressure over 21 mm Hg was observed in 8.9% of eyes but it was controlled without surgery. Haze was observed in most eyes, but faded gradually without significant problems. Reduced contrast sensitivity in night vision was noted and some patients experienced glare. Day vision contrast sensitivity was related to corneal haze. [J Refract Corneal Surg. 1994;10:S178-S187.]
Photorefractive Keratectomy in 176 Eyes: One Year Follow-up
Authors: Orssaud C , Ganem S , Binaghi M , Patarin D , Putterman M , Viens-Bitker C , Boye A , Dufier J L
Published: April 2021

ABSTRACT

Beginning in March 1992, 176 eyes from 176 patients underwent photorefractive keratectomy with the Summit Technology Eximed UV200LA. This study was designed to evaluate the efficacy of this method. [J Refract Corneal Surg. 1994;10:S199S205.1
Some Problems After Photorefractive Keratectomy
Authors: Kim Jae Ho , Sah Woo Jin , Hahn Tae Won , Lee Young Chun
Published: April 2021

ABSTRACT

We analyzed the data from 1821 patients (2920 eyes) who received photorefractive keratectomy (PRK) to investigate the postoperative complications which cause a significant decrease in visual acuity.

A corneal haze of grade 2 or more developed in 9 patients (11 eyes, 0.38%) and corticosteroid-induced ocular hypertension occurred in 3 patients (4 eyes, 0.14%). Three patients (4 eyes) who had corneal haze of grade 2 or more underwent repeated photorefractive keratectomy and one patient (2 eyes) with steroid-induced ocular hypertension underwent trabeculectomies.

A decrease of best spectacle corrected visual acuity of two lines or more was detected in 7 patients (8 eyes, 0.27%), caused by irregular astigmatism, steroid-induced cataract, incidental choroidal neovascular membrane, and an unknown origin.

Good predictability and stabilization after photorefractive keratectomy was maintained at the 2 year follow-up. However, some subjective symptoms were reported by many patients and some complications occurred in a minority of eyes despite the excellent visual outcome in a large majority. [J Refract Corneal Surg 1994;10:S226-S230.]
Photorefractive Keratectomy for Residual Myopia After Previous Refractive Keratotomy
Authors: Durrie Daniel S , Schumer D James , Cavanaugh Timothy B
Published: April 2021

ABSTRACT

Photorefractive keratectomy (PRK) was performed on 91 eyes of 71 patients who had previous radial keratotomy, radial combined with astigmatic keratotomy or astigmatic keratotomy alone (refractive keratotomy). Residual myopia, prior to photorefractive keratectomy, ranged from -1.50 to -8.00 D (mean -3.62) and cylinder from 0 to 2.25 D (mean 0.78). Uncorrected visual acuity was 20/40 or better in 89.7% at one year. At the 12 month follow-up 75.9% of patients were within +/- 1.00 D of intended correction. [J Refract Corneal Surg. 1994;10:S235S238.1
Astigmatic Keratotomy Followed by Photorefractive Keratectomy in the Treatment of Compound Myopic Astigmatism
Authors: Lipshitz Isaak , Lowenstein Anat , Lazar Moshe
Published: April 2021

ABSTRACT

Eleven eyes of 9 patients that had compound myopic astigmatism were treated by astigmatic keratotmy followed 1 month later by photorefractive keratectomy (PRK). In 9 eyes arcuate incisions were performed, in 1 eye a modified Ruiz procedure was performed, and in 1 eye radial T cuts were done. The mean spherical equivalent was -8.26 +/- 2.51 diopters (D) after the astigmatic keratotomy but before photorefractive keratectomy, and -0.36 +/- 0.93 D after photorefractive keratectomy. The mean cylinder was -3.11 +/- 1.16 D preoperatively, and -0.14 +/0.9 D postoperatively. Combined astigmatic keratotomy and photorefractive keratectomy are effective treatments for compound myopic astigmatism. [J Refract Corneal Surg. 1994; 10:S282-S284.]
Use of Topical Nonsteroidal Anti-inflammatory Drugs after Photorefractive Keratectomy
Authors: Ferrari Massimo
Published: April 2021

ABSTRACT

BACKGROUND. Photorefractive keratectomy (PRK) requires a careful pharmacologic regimen during the postoperative period to reduce corneal haze and refractive myopic regression. Noncorticosteroidal anti-inflammatory drugs limit postablative corneal inflammation without the complications that may occur during corticosteroid treatment.

METHODS. Twenty consecutive eyes of 10 patients with attempted correction ranging from 4.00 to 9.00 D of myopia were studied. During the postoperative period, corticosteroid drops (dexamethosone 0.1%) were instilled in the first eye of each patient, and the second eye was treated with diclofenac sodium ophthalmic solution 0.1% (Voltaren). Follow-up was 12 months after surgery.

RESULTS. Corneal haze and refraction were studied. Six of the 10 eyes treated with noncorticosteroidal anti-inflammatory drugs did not show any significant difference in corneal haze and refractive evolution compared to the contralateral eyes treated with corticosteroids. Two eyes (20%) showed less corneal haze and more refractive stability than the contralateral eyes. In two eyes (20%), we observed similar corneal haze but more refractive regression than in the contralateral eyes.

CONCLUSIONS. Eyes treated with topical diclofenac sodium had a similar postoperative course as those treated with corticosteroids, but without the adverse effects of corticosteroids.

Topical nonsteroidal anti-inflammatory drugs are represented by diclofenac (Voltaren), which has significant ocular penetration. This permits reduction of the possibility of general and ocular complications that frequently occur with corticosteroids. The aim of this study was to evaluate the efficacy of topical nonsteroidal antiinflammatory drugs vs. corticosteroidal eyedrops after photorefractive keratectomy (PRK) to reduce moderate and high myopia. [J Refract Corneal Sui-g. 1994; 10:S287-S289.]
A Surgical Technique for the Treatment of Central Corneal Perforations
Authors: Vrabec Michael P , Jordan Jeffrey J
Published: April 2021

ABSTRACT

BACKGROUND: Generally, corneal perforations of 2 mm in diameter or greater are treated using graft material for tectonic support. A surgical technique for the primary repair of such perforations without the use of any additional tissue is presented.

METHODS: This procedure is demonstrated by a case report. The technique involves creation of an elliptical defect out of a circular one, thus allowing for primary closure, with the addition of glue. A definitive penetrating keratoplasty was subsequently performed with several important modifications described herein.

RESULTS: A water-tight closure was obtained with this technique for 1 month while the inflammation subsided. Preoperative visual acuity was light perception. One year postoperatively, it was count fingers at 8 feet with mild irregular astigmatism.

CONCLUSION: This technique is useful for perforations which are central, larger than 2 mm in diameter, and when corneal or scleral material is not readily available for patch grafting. [J Refract Corneal Surg. 1994;10:365-367.]
Accommodation of an Endocapsular Silicone Lens (Phaco-Ersatz) in the Aging Rhesus Monkey
Authors: Haefliger Eduard , Parel Jeah-Marie
Published: April 2021

ABSTRACT

BACKGROUND: After accommodative changes of endocapsular silicone lenses in presenile nonhuman primates had been confirmed by several authors, this pilot study was designed to evaluate the ability of an artificial lens to restore accommodation in the senile eye of a rhesus monkey that had previously lost most of its accommodative capability.

METHODS: An injectable silicone lens was implanted in one eye of six rhesus monkeys who were older than 17 years. Accommodation was documented as the amount of decrease of anterior chamber depth after pilocarpine stimulation.

RESULTS: Four months after surgery, the decrease of anterior chamber depth was higher in the operated eye with the silicone intraocular lens in the two monkeys who had marked presbyopic changes in the natural lens. One monkey was kept for more than 4 years, retaining a decrease of at least 0.5 nun with the silicone lens, whereas the natural lens failed to show any accommodative change.

CONCLUSIONS: These findings support recent reports that presbyopia is primarily a consequence of lenticular aging rather than ciliary muscle factors. A pliable injected lens may therefore have the potential to restore accommodation in the senile primate eye. [J Refract Corneal Surg. 1994;10:550555.]

RESUME

INTRODUCTION: Après confirmation des compte-rendus d'accommodation des lentilles intraoculaires injectables (LIO) faites en silicone, nous avons étudié la restoration du pouvoir accommodateur par un cristallin artificiel comme projetpilote chez le singe âgé.

METHODES: Six singes rhésus plus âgés de 17 ans ont subi l'injection d'une LIO en silicone. L'accommodation était identifiée comme la diminuation de la profondeur de la chambre antérieure après l'instillation de pilocarpine.

RESULTATS: Après 4 mois, la diminution de la profondeur de Ia chambre antérieure était plus importante sur l'oeil opéré que sur l'oeil témoin chez le singe presbyte. Chez le singe observé sur une période de 4 ans, la diminution de 0,5 mm restait, tandis que le cristallin naturel ne montrait pas de changement accomodatili

CONCLUSION: Nos résultats sont en accord avec les compte-rendus qui présentent la presbytie comme effet du viellissement du cristallin lui-même et non pas du muscle ciliaire. Une lentille injectée et pliable à injection servirait peut-être à restorer l'accommodation chez l'oeil du primate âgé. (Translated by Robert Mack, MD, Kansas City, Mo.)

SOMMARIO

PREMESSA: Le modifiche conseguenti ad un impianto endocapsulare di una lente al silicone in un occhio di un primate in etáavanzata, sono già state sottolineate da diversi autori; questo studio ha lo scopo di valutare la capacità di una lente artificíale di ristabilire l'accomodazione in un occhio senile di scimpanzé, che aveva precedentemente ridotto la maggior parte della sua capacità di accomodazione.
Cleaning of Ophthalmic Diamond Scalpels
Authors: Beran Robin F
Published: April 2021

ABSTRACT

BACKGROUND: To ensure optimal performance, it is imperative to properly maintain the condition of ophthalmic diamond scalpels. Refractive surgeons are often confronted with conflicting cleaning recommendations from manufacturers. The problem encountered is to maximize cleaning while minimizing trauma to the diamond to maintain its longevity.

METHODS: The author describes a flexible graded approach to cleaning and maintaining diamond scalpels. The principle of this approach was the development of four successive levels of cleaning based on an increasing risk of trauma to the diamond: Level I - irrigation with distilled water, Level II - hydrogen peroxide or enzyme cleaning, Level III - ultrasonic and detergent cleaning, and Level IV - mechanical styrofoam block cleaning. The protocol was performed prospectively on 50 consecutive radial keratotomy cases, inspecting the blade microscopically after each cleaning step, and determining the level at which cleanliness of the blade was achieved.

RESULTS: The effectiveness (clean/dirty) of each cleaning level was evaluated by the author and an experienced surgical assistant. The difficulty in accurately measuring the amount of debris and the force necessary to remove it, limited the judgments made to subjective observation. Only 2 of 50 blades were cleaned at Level I, while 41 of 48 at Level III, and 7 of 7 at Level IV.

CONCLUSIONS: A multi-leveled systematic process for cleaning maintenance appears most effective for maximal performance and longevity of diamond scalpels used for refractive keratotomy surgery. [J Refract Corneal Surg. 1994;10:582-586.]
Cut Edges and Surface Characteristics Produced by Different Microkeratomes
Authors: Wilhelm Frank W , Giessmann Thomas , Hanschke Renate , Duncker Gernot I W , Wilhelm Lutz H
Published: April 2021

ABSTRACT

PURPOSE: To determine the cutting characteristics of seven different microkeratomes and to compare the cut edges and surface characteristics of the corneas with respect to different keratome parameters, ie, blade oscillation frequencies and keratome speed.

METHODS: Lamellar keratectomies were performed using each microkeratome on eight freshly enucleated porcine corneas. The freshly cut corneal bed was then examined using scanning electron microscopy. A scoring system was used to evaluate the serration of the cut edge and the regularity of the corneal wound bed.

RESULTS: Serrated cut edges were produced by the Microtech microkeratome, the Automatic Corneal Shaper, the Draeger rotor keratome, and the Schwind microkeratome. The other tested cutting devices generally yielded a smooth cut edge. Smooth and regular wound surfaces were obtained with the Schwind microkeratome, the Automatic Corneal Shaper, the Microtech microkeratome, and the MKM set. The specimens cut with the Schwind microkeratome showed particularly regular surface characteristics.

CONCLUSION: The relationship between keratome propulsion speed, blade oscillation frequency, and blade material appears crucial for the quality of the microkeratome cut. Our results favor a low advancement/Oscillation ratio among automated microkeratomes. [J Refract Surg 2000; 16: 690-700]
Comparison of Photorefractive Keratectomy and Laser in situ Keratomileusis for Myopia of -6 D or Less Using the Nidek EC-5000 Laser
Authors: Fernández Angel Pineda , Jaramillo Jorge M , Jaramillo Miguel M
Published: April 2021

ABSTRACT

PURPOSE: We compared the efficacy, predictability, and safety of photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) for the surgical correction of low and moderate myopia.

METHODS: A retrospective study was performed to evaluate uncorrected and spectacle-corrected visual acuity, and manifest refraction 1 year after PRK or LASIK. All procedures were done using an automatic microkeratome (Chiron Ophthalmic) and the Nidek EC-5000 excimer laser.

RESULTS: PRK was performed in 75 eyes of 45 patients and LASIK in 133 eyes of 77 patients. Mean age for PRK patients was 32.8 years (range, 18 to 52 yr) and LASIK patients was 29.6 years (range, 18 to 49 yr). Mean preoperative spherical equivalent refraction for PRK patients was -3.28 D (range, *1.00 to -6.00 D) and LASDI, -3.86 D (range, -1.00 to -6.00 D). One year after surgery, mean spherical equivalent refraction for Group 1 (baseline, -1.00 to -3.00 D) PRK eyes was -0.18 ± 0.61 D (range, -1.50 to +0.75 D) and for LASIK eyes, -0.08 ± 0.61 D (range, *1.50 to +1.62 D), with no statistically significant difference. For Group 2 eyes (baseline, -3.E5 to -6.00 D), mean spherical equivalent refraction for PRK eyes was -0.44 ± 0.87 D (range, -2.00 to +2.12 D) and for LASDI eyes, -0.09 ± 0.83 D (range, -1.50 to +1.75 D), with no statistically significant difference. The antilogarithm of the mean UCVA (antilogUCVA) in Group 1 for PRK was 0.79 ± 0.21 (20/25) and for LASDI was 0.87 ± 0.19 (20/23), with no statistically significant difference. The antilogUCVA in Group 2 for PRK eyes was 0.70 ± 0.24 (20/28) and for LASDI eyes was 0.83 ± 0.18 (20/24), with a statistically significant difference (0.7 vs. 0.83, P < .005). The percentage of eyes with a postoperative UCVA>20/40 in Group 1 for PRK was 91.5% (38 eyes) and for LASDI was 95% (50 eyes) (no statistically significant differenee), and in Group 2 for PRK eyes, it was 82% (27 eyes) and 97.5% (78 eyes) for LASDI (statistically significant difference, P < .05).

CONCLUSION: PRK and LASDI with the Nidek EC-5000 excimer laser are effective and safe for correcting low to moderate myopia, but LASDI eyes showed better results for moderate myopia in terms of uncorrected visual acuity. [J Refract Surg 2000;16:711-715]
Diffuse Lamellar Keratitis Induced by Trauma 6 Months After Laser in situ Keratomileusis
Authors: Weisenthal Robert W
Published: April 2021

ABSTRACT

This case report illustrates an unusual presentation of diffuse lamellar keratitis triggered by a foreign body striking the eye 6 months after laser in situ keratomileusis (LASIK). The etiology of diffuse lamellar keratitis is unclear. The infiltrate within the plane of the flap after removal of the foreign body supports the theory that diffuse lamellar keratitis is an inflammatory reaction. [J Refract Surg 2000;16:749-751]
Effect of Capsular Tension Ring on Refractive Outcomes in Patients With Implantation of the Quadrifocal Acrysof PanOptix TFNT00 IOL
Authors: Kwon Hyunggoo , Choi Ayoung , Kim Boyun , Jeon Sohee
Published: April 2021

PURPOSE:

To evaluate the effect of a capsular tension ring (CTR) on refractive outcomes in eyes undergoing implantation of the quadrifocal Acrysof PanOptix TFNT00 intraocular lens (IOL) (Alcon Laboratories, Inc).

METHODS:

A retrospective case–control study was undertaken of 91 eyes implanted with the TFNT00 IOL. Of these 91 eyes, a CTR was implanted in 33 and these eyes were compared to the 58 eyes in which a CTR was not implanted. The main outcome measure was the mean absolute error (MAE) of the refractive prediction error. To evaluate the consistency of refractive outcomes, variance of MAE was measured. Using a swept-source optical coherence tomography device, postoperative aqueous depth (AQD) was measured to estimate the position of the IOL.

RESULTS:

Eyes with a CTR showed a significantly smaller MAE when compared with eyes without a CTR (
P
= .038 at 1 m,
P
= .003 at 2 m, and
P
= .001 at 6 m). There was a lower variance of MAE in the eyes implanted with a CTR, with higher precision of refraction (
P
= .058 at 1 m,
P
= .007 at 2 m, and
P
= .001 at 6 m). There was a significant difference in the percentage of the eyes showing more than 0.50 D from the estimated target of the Barrett Universal II formula (
P
= .007 at 1 m,
P
= .064 at 2 m, and
P
= .004 at 6 m, respectively). AQD was significantly shallower in eyes with a CTR than in eyes without a CTR (
P
= .006).

CONCLUSIONS:

Use of the CTR enhanced the accuracy of postoperative refractive outcomes after TFNT00 IOL implantation by preventing the posterior bowing of the optic–haptic junction.

[
J Refract Surg
. 2021;37(3):174–179.]
Comparison of Wavefront-Guided Femtosecond LASIK and Optimized SMILE for Correction of Moderate-to-High Astigmatism
Authors: Zhao Xinheng , Zhang Lin , Ma Jiaonan , Li Mengdi , Zhang Jiamei , Zhao Xing , Wang Yan
Published: April 2021

PURPOSE:

To compare refractive outcomes, higher order aberrations (HOAs), and the changes in contrast sensitivity after wavefront-guided femtosecond laser–assisted in situ keratomileusis (WFG LASIK) and optimized small incision lenticule extraction (SMILE) for moderate-to-high astigmatism correction.

METHODS:

This prospective, randomized study included 87 eyes: 40 eyes in the WFG LASIK group and 47 eyes in the SMILE group. Manual cyclotorsion compensation by marking the horizontal axis before SMILE surgery was used for optimized SMILE. Refractive diopter, aberrations, and contrast sensitivity were assessed 3 months postoperatively. The Alpins vector analysis method was used to analyze the astigmatic changes after surgery.

RESULTS:

There were no significant differences in the corrected distance visual acuity and refraction between the two groups after surgery. The fitted curve of surgically induced astigmatism versus target induced astigmatism was described as y = 0.9905 x + 0.0009 in the WFG LASIK group and y = 0.9672 x + 0.0026 in the SMILE group. The percentage of corneal astigmatism axis change within 5 degrees was statistically significant (chi-square test: 10.632,
P
= .001). HOAs increased in both the WFG LASIK and SMILE groups after surgery (
t
= −3.655,
P
= .001,
t
= −3.784,
P
= .001, respectively). However, comparison of the changes of HOAs between both groups was not significant (
t
= −0.565,
P
= .575). The improvement in contrast sensitivity in the WFG LASIK group was significantly higher than that in the SMILE group.

CONCLUSIONS:

WFG LASIK and optimized SMILE can achieve similar outcomes for astigmatism correction. Optimized SMILE with marking could achieve good astigmatism correction, even without an eye tracking system.

[
J Refract Surg
. 2021;37(3):166–173.]
Carbon Dioxide Laser in Ophthalmic Plastic and Orbital Surgery
Authors: Wesley Ralph E , Bond J Brent
Published: April 2021

ABSTRACT

The CO2 laser cuts tissue by flash boiling extracellular or intracellular water molecules in contact with the beam. This vaporization sterilizes the tissue and seals capillaries. The CO2 laser seems most useful in ophthalmology to vaporize lymphangiomas and capillary hemangiomas and to provide hemostasis in patients with bleeding disorders. The cutting beam of the CO2 laser can be attached to the operating microscope to facilitate surgery deep within the orbit. The effectiveness of the CO2 cutting action depends upon water content of the tissue rather than tissue color as with argon and krypton lasers. Skin incisions show less scarring when made with conventional scalpel, but more precise surface cutting lasers may allow more precise microsurgical excision of eyelid tumors than can now be accomplished with a scalpel.
Silicone Intubation for Lacerated Lacrimal Canaliculi
Authors: Dortzbach Richard K , Angrist Richard A
Published: April 2021

ABSTRACT

Twenty-two cases of lacerated canaliculi were repaired with the use of silicone tube stents. Of the 18 patients having early repair, 17 (94%) had a good result and one (6%) fair. The four patients with late repair yielded three (75%) with a poor result and one (25%) fair. Primary repair of lacerated canaliculi by this method has a good prognosis. Secondary repair is more difficult, and the outcome is likely to be poor.
Potential Hazards of Blepharopigmentation
Authors: Kreter James K , Sall Kenneth N , Keates Richard H
Published: April 2021

ABSTRACT

Blepharopigmentation, or deposition of various colored particles near the lash line in a linear fashion, is becoming an increasingly popular form of cosmetic periocular surgery. This technique was employed on human cadaver globes and New Zealand white rabbits to evaluate several potential hazards to the globe. The lesions were noted and examined by histopathology.
Modified Kinosian Dacryocystorhinostomy: A Review of 122 Cases
Authors: Burns John A , Cahill Kenneth V
Published: April 2021

ABSTRACT

A consecutive series of 122 dacryocystorhinostomies is reviewed, and a surgical technique which preserves the anterior lacrimal crest and eliminates the need to create mucosal flaps is described.

The success rate of this simplified technique is 89%. The success rate rises to 94% following secondary revisions. This is comparable to more complicated procedures. Canalicular and common punctal stenosis are not found to be contraindications to dacryocystorhinostomy for obstruction of the nasolacrimal duct but do lower the success rate. Eighty-one percent of patients with concomitant canalicular disease and nasolacrimal duct obstruction were cured by dacryocystorhinostomy with silicone intubation. A success rate of 98% was achieved in patients without preoperative canalicular disease.
Silicone Oil Injection in Aphakic Eyes: A Modified Technique
Authors: deCorral Luis R , Peyman Gholam A
Published: April 2021

ABSTRACT

To fill the vitreous cavity completely with silicone oil has been difficult in aphakic eyes. This procedure has been simplified with the use of an air pump system combined with a 30-gauge needle to tap the anterior chamber. In this manner, the silicone oil bubble reaches the pupillary margin and does not flow out of the sclerotomy sites.
Results of a Double Running Suture in Penetrating Keratoplasty Performed on Keratoconus Patients
Authors: Young Steven R , Olson Randall J
Published: April 2021

ABSTRACT

Parallel running 10-0 and 11-0 nylon sutures were used in 76 consecutive penetrating keratoplasties on patients with keratoconus. Removal of the 10-0 suture at eight to 12 weeks allowed for early visual rehabilitation postoperatively. The use of various trephine sizes and the use of a bridle suture versus a scleral ring were evaluated by several visual parameters. The incidence of complications with the double running suture was not greater than that obtained with other suture techniques.
The Place of Sodium Hyaluronate in Glaucoma Surgery
Authors: Wilson Richard P , Lloyd Janet
Published: April 2021

ABSTRACT

The advantages of sodium hyaluronate (Healon™) in filtering surgery have been mostly theoretical, with no study of sufficient numbers to justify its use. The authors used sodium hyaluronate in 119 consecutive trabeculectomies. These were compared to a control group of 122 cases. The long-term intraocular pressure and visual acuity results between the two groups were indistinguishable. The only definite benefit noted with the use of sodium hyaluronate was the lower incidence of hyphemas. No side-effects were seen. Its ability to maintain a deep anterior chamber and encourage hemostasis makes sodium hyaluronate useful in teaching goniotomies as well as performing trabeculectomies in congenital glaucoma. Sodium hyaluronate can also be used to evacuate hyphemas and dissect adhesions with minimal trauma, and may be healthier for the corneal endothelium than air in anterior chamber reformations.
Computerized Tomographic Demonstration of Intraorbital Bone Fragments Caused by Penetrating Trauma
Authors: Avrahami Elieser , Sperber Fani , MD Dan F
Published: April 2021

ABSTRACT

Three patients with fragments of bones lodged in the orbit from apparently non-penetrating trauma, associated with cranio-cerebral injury, are reported. In all three cases the initial symptoms and signs of intraorbital or retrobulbar injury were minimal. The bone fragments were not demonstrable on plain x-ray films of the skull but were clearly shown on computerized tomographic (CT) scans of the orbit. They could easily have been overlooked had reliance been placed on plain x-ray films alone. In patients with suspected non-penetrating orbital trauma, axial and coronal CT views of the orbit are recommended.
A New Type of Irrigating Cannula for Lens Nucleus Delivery by Extracapsular Extraction
Authors: Nishi Okihiro
Published: April 2021

ABSTRACT

Simple expression is the conventional nucleus delivery method; however, the high tension exerted on the posterior capsule and zonules during this procedure poses a risk of rupturing these structures. This report describes a new type of irrigating cannula for lens nucleus delivery. It consists of a 20-gauge needle and a flat insertion plate with a flow outlet. The apex, with the flow outlet, is inserted beneath the nucleus during continuous irrigation; the nucleus is thus expelled by the irrigating solution.
Differences Between Men and Women as Related to Intraocular Lens Implantation
Authors: Richards Scott C , Olson Randall J , Brodstein David E , Richards Winn L
Published: April 2021

ABSTRACT

We examined 291 cases of IOL implantation in order to evaluate différences between males and females for several factors. We found that women have shorter axial lengths, older age at time of surgery, greater preoperative corneal curvature, higher power of IOL implanted, more surgically induced astigmatism, and a higher rate of complications. Insignificant differences between the two groups included pre- and postoperative refraction, preoperative astigmatism, visual acuity, type of IOL implanted, corneal thickness, endothellal cell count, and percent of patients requiring discissione.
Trapezoidal Relaxing Incision for Post Keratoplasty Astigmatism
Authors: Maxwell W Andrew , Nordan Lee T
Published: April 2021

ABSTRACT

Eleven patients with high astigmatism after penetrating keratoplasty underwent a new form of relaxing keratotomy, the trapezoidal relaxing keratotomy, originally described by Ruiz. The average preoperative astigmatism was 7.89 diopters (range 4.25 to 12.50 diopters) with an average reduction in cylinder of 5.00 diopters (range 0-9.5 diopters). No complications were experienced.
The Effects of Graves' Eye Disease on Levator Muscle Function
Authors: Frueh Bartley R , Garber Frank W , Musch David C
Published: April 2021

ABSTRACT

The levator function and exophthalmometer reading were measured on each side of 81 patients with Graves' eye disease (GED) and 111 normal subjects. There was a significant positive correlation between the levator function and exophthalmometer reading for both GED patients and normal subjects. This indicates that the forward position of the eye chronically stretches the levator muscle by the addition of sarcomeres which increases the range of movement of the lid. The range of movement may be decreased in patients with Graves' eye disease, from inflammation, such as is seen with other extraocular muscles. This effect is most likely to be marked in the patient with compressive optic neuropathy.
Experiences With the Neodymium: YAG Laser: Interruption of Anterior Hyaloid Membrane of the Vitreous and Cystoid Macular Edema
Authors: Alpar John J
Published: April 2021

ABSTRACT

Patients who needed posterior capsulectomy at different times following cataract surgery were treated with:

A. The Méditée OPL3 mode-locked Nd: YAG laser

B. The LASAG Microruptor 2 Q-switched Nd:YAG laser.

Random selection determined which instrument should be used for which patient. Further random selection determined the use of placebo with topical steroids vs. topical Indomethacin and topical steroid treatment.

The results showed that there is a connection between (a) the time the posterior capsulectomy is performed after cataract surgery, (b) the number of applications used to interrupt the membrane, and (c) the integrity of the anterior hyaloid membrane.
Surgical Treatment of Overcorrection Following Radial Keratotomy: Evaluation of Clinical Effectiveness
Authors: Lindquist Thomas D , Williams Patricia A , Lindstrom Richard L
Published: April 2021

ABSTRACT

Secondary hyperopia following radial keratotomy (RK) may result from an initial overcorrection or from a continued effect of the procedure with time. We retrospectively evaluated the effect of surgical intervention for the management of overcorrection following RK in six patients who had undergone reopening of all RK incisions, followed by irrigation and closure of the incisions with 10-0 mersilene sutures. Three patients with prior 4-incision RK, with follow-up of 4 to 26 months, were steepened a mean of 1.63 diopters keratometrically; three patients with prior 8-incision RK, with follow-up of 3 to 12 months, were steepened a mean of 1.46 D keratometrically. Comparison of intraoperative with postoperative keratometry demonstrated a substantial loss of effect with time, which stabilized by 2 months in 4-incision RK patients and by 3 months in 8-incision RK patients. Nevertheless, placement of interrupted sutures across reopened radial incisions consistently induced central corneal steepening in these six patients.
Posterior Chamber IOL Implantation With Suboptimal Posterior Capsular Support
Authors: Smiddy William E , Avery Robert
Published: April 2021

ABSTRACT

A posterior chamber intraocular lens (PC/IOL) was implanted in 24 patients with suboptimal posterior capsular support due to preoperative or intraoperative rupture of the posterior capsule or zonules in which at least six clock hours of peripheral zonular support remained. The PC/IOLs were implanted, with ciliary sulcus haptic placement, with special attention to sulcus fixation of the haptics over the zone of residual zonular support. All of the IOLs have remained centered after a mean follow-up 10.5 months. We conclude that a PC/IOL can be successfully implanted and its position maintained if at least six clock hours of peripheral zonules remain.
Cyclophotocoagulation With the Transscleral Contact Neodymium:YAG Laser Versus Cyclocryotherapy in Rabbits
Authors: Higginbotham Eve J , Harrison Michael , Zou Xiaolian
Published: April 2021

ABSTRACT

Either transscleral cyclophotocoagulation with the contact neodymium:YAG (Nd:YAG) laser or cyclocryotherapy (CCT) was performed in rabbits to compare the efficacy of these procedures in reducing intraocular pressure (IOP) as well as the histologic changes they induced. The difference in mean maximum reduction of IOP in the two groups was statistically insignificant, but the Nd:YAG laser irradiation, using 2.5 J, destroyed less tissue than the CCT.
Argon Laser Trabeculoplasty Medical Therapy to Prevent the Intraocular Pressure Rise Associated With Argon Laser Trabeculoplasty
Authors: Robin Alan L
Published: April 2021

ABSTRACT

A prospective, randomized, investigator-masked, parallel study compared the capability of five different intraocular pressure (IOP) lowering agents to prevent acute IOP elevations following argon laser trabeculoplasty. Two hundred sixty eyes (patients) received either apraclonidine 1% (125 eyes), pilocarpine hydrochloride 4% (37 eyes), timolol maleate 0.5% (35 eyes), dipivefrin 0.1% (32 eyes), or acetazolamide 250 mg (31 eyes) both 1 hour before and immediately following 360-degree argon laser trabeculoplasty. Apraclonidine was the only medication that significantly decreased mean IOP from baseline. Only 4 (3%) of the apraclonidine-treated eyes had IOP rises greater than 5 mm Hg. This frequency was significantly lower than that found in eyes treated with acetazolamide (39%), dipivefrin (38%), pilocarpine (33%), or timolol (32%).
Surface-Wrinkling Maculopathy as a Potential Complication of Trabeculectomy: A Case Report
Authors: Detry-Morel M , Kittel B , Lemagne J M
Published: April 2021

ABSTRACT

We report a case of "crinkled cellophane maculopathy" which developed during the first few days following an uneventful trabeculectomy in a high myopic patient with primary open-angle glaucoma. We suggest pathogenic mechanisms that may have induced such premacular lesions, emphasizing the patient's high myopia combined with a postoperative inflammatory reaction.
Infection Following Strabismus Surgery
Authors: Ing Malcolm R
Published: April 2021

ABSTRACT

Sixty-three strabismus surgeons were surveyed regarding the incidence of infection they found following strabismus surgery and their use of preoperative and postoperative antibiotics to prevent or treat such infections. Cellulitis was rare (1 per 1900 cases) and endophthalmitis was even rarer (1 per 30 000 cases). Infection was not entirely prevented by either preoperative or postoperative topical antibiotics. Twelve surgeons reported using no antibiotics but did not report higher rates of infection than those who did use them.
The Effect of Aminoguanidine on the Blood- Retinal Barrier in Streptozocin- Induced Diabetic Rats
Authors: Cho Ho Kyun , Kozu Hitoshi , Peyman Gholam A , Parry Gareth J , Khoobehi Bahram
Published: April 2021

ABSTRACT

The effect of aminoguanidine hydrochloride (AG) on the blood-retinal barrier was studied in rats with streptozocin-induced diabetes. Half of the rats were given AG (100 mg/kg/day) while the remainder received no treatment. Vitreous fluorophotometry was performed on ad rats before STZ infection and 2 weeks after induction of diabetes mellitus. Two weeks after STZ injection the mean 60-minute vitreous fluorescein concentration following dye injection had increased more in the nontreated group than in the AG-treated group, suggesting that AG may have some beneficial effect on the breakdown of the blood-retinal barrier.
Intravitreal Suture: A Complication of Pterygium Surgery
Authors: Solomon Arieh , Rosen Nachum , Treister Giora , Bartov Elisha
Published: April 2021

ABSTRACT

Among the complications associated with pterygium surgery, scleral perforation is mentioned in cases where subconjunctival tissue must be separated from the sclera.1,2 We present a case in which such a perforation and consequent suturing resulted in an intravitreous migration of a suture. We believe this is the first report of such a complication following pterygium surgery.
Combined Vitrectomy, Cataract Extraction, and Posterior Chamber Intraocular Lens Implantation in Diabetic Patients
Authors: Menchini Ugo , Azzolini Claudio , Camesasca Fabrizio I , Brancato Rosario
Published: April 2021

ABSTRACT

Combined extracapsular cataract extraction, pars plana vitrectomy, and posterior chamber intraocular lens implantation was performed in six eyes with proliferative diabetic retinopathy. These eyes all had minimal iris vascular changes and were at reasonably low risk for developing intraoperative and postoperative complications. The surgery must be relatively brief and the endophotocoagulation accurate. Initial visual acuities ranged from light perception to 4/200. With an average follow-up of 9.7 months, final acuities ranged from 4/200 to 20/40.
Errors in IOL Power Calculations for Axial High Myopia
Authors: Kora Yukiko , Koike Masanao , Suzuki Youichi , Inatomi Makoto , Fukado Yoshinao , Ozawa Tetsuma
Published: April 2021

ABSTRACT

We studied 115 eyes with axial lengths of 27 mm or more after implantation of a posterior chamber intraocular lens in order to determine discrepancies between the predicted refractions and the actual postoperative refractions. We then reviewed the three major variables used to predict refractions in these eyes-corneal curvature, anterior chamber depth, and axial length measurements-in an attempt to determine whether any of these variables were correlated with the discrepancies. We found that the main reason for postoperative refractive error was inaccurate measurements of preoperative axial length.
Surgical Treatment of Thyroid Related Lid Retraction: A New Variation
Authors: Levine Mark R , Chu Alfredo
Published: April 2021

ABSTRACT

We describe a cutaneous approach for retraction of the upper eyelid which incorporates a levator aponeurotic/Mueller's muscle recession with maintenance of the normal orbital septum levator aponeurosis anatomy. With success defined as asymmetry between the two eyelids of 1 mm or less, with a marginal reflex distance as dose to 4 mm as possible, this technique was successful in 87% of 15 consecutive patients. All patients reported improved comfort. This approach is quick and easy, bleeding is minimal, height and contour are predictable, the upper eyelid crease is preserved, and spacers are avoided, with less postoperative eyelid thickening and reaction.
Combined Relaxing Incisions and Epikeratophakia for the Correction of Aphakia and High Postkeratoplasty Degree Astigmatism
Authors: Busin Massimo
Published: April 2021

ABSTRACT

A combined surgical procedure consisting of corneal relaxing incisions and epikeratophakia was used to correct high-degree postkeratoplasty astigmatism and aphakia in two patients. Both patients achieved their final refractive result as soon as 1 month after suture removal (2 and 3 months after surgery, respectively). Keratometric readings showed a reduction of approximately 20.00 diopters in one case and 10.00 D in the other, while the spherical equivalent changed from +10.00 D to +0.50 D in one eye and from +7.50 D to +1.75 D in the other. Spectacle correction was prescribed for both patients. At the last follow-up visit, about 2 years after surgery, these values were unchanged. The main advantage of the combined technique over two separate procedures was that postoperative visual rehabilitation was faster. Equally important was the stability of the refractive result over a long period of time after surgery, as well as the absence of negative effects on the preexisting corneal graft. In spite of the technical complexity of a combined surgical procedure, this approach probably represents the best choice in rare cases such as the ones reported here.
Nocardia Asteroides Infection Following Scleral Buckling
Authors: King Lowrey P , Furlong William B , Gilbert William S , Levy Charles
Published: April 2021

ABSTRACT

We report a case of delayed external ocular Nocardia asteroides infection following scleral buckling for rhegmatogenous detachment. Surgical removal of the exoplant material allowed isolation and identification of the organism. Topical and systemic antibiotic therapy following exoplant removal yielded a favorable result.
Pigmented Pupillary Pseudomembranes as a Complication of Argon Laser Iridotomy
Authors: Geyer Orna , Mayron Yoram , Rothkoff Leonard , Lazar Moshe
Published: April 2021

ABSTRACT

Two cases are reported in which pupillary pigment occlusion occurred after argon laser iridotomy, reducing visual acuity and preventing fundus visualization. Laser-induced inflammation and subsequent long-term miotic therapy are probably responsible for this complication. Periodic pupillary dilatation is recommended in eyes that require miotics to control their intraocular pressure after laser iridotomy.
An Aqueous Paracentesis Pipet
Authors: O'Rourke James , Taylor Daniel M , McDonald Patricia , Kreutzer Donald L
Published: April 2021

ABSTRACT

We describe a glass pipet tipped with a short, sharp, 30-gauge needle for performing aqueous paracentesis. The design eliminates the possibility of needle bending and minimizes frictional resistance during limbus penetration; it also allows quicker recovery of aqueous samples. A small plastic bulb at the upper end facilitates removal of aqueous samples from the pipet.
Visual Outcome in Pseudophakic Eyes With Clinical Cystoid Macular Edema
Authors: Ruiz Richard S , Saatci Osman A
Published: April 2021

ABSTRACT

Thirty-nine eyes with clinical cystoid macular edema (CME) following extracapsular cataract extraction and intraocular lens (IOL) implantation were reviewed retrospectively. Chronic CME, defined as clinically symptomatic CME persisting more than 6 months, developed in 14 of the 39 eyes (36%): in 5 of the 7 (71%) eyes in which vitreous loss occurred and anterior chamber IOLs were implanted; and in 9 of 32 (28%) eyes in which no complications occurred and posterior chamber IOLs were implanted. The mean duration between diagnosis and last follow-up visit was 34 months. Only 4 of the 14 eyes (29%) with chronic CME achieved a visual acuity better than 20/40. Vitreous loss did not affect long-term visual prognosis.
Cystoid Macular Edema Secondary to Juxtafoveolar Telangiectasis in Coats' Disease
Authors: Lee Soon T , Friedman Scott M , Rubin Melvin L
Published: April 2021

ABSTRACT

A 28-year-old man with unilateral Coats' disease and cystoid macular edema secondary to juxtafoveolar telangiectasis underwent successful juxtafoveolar argon green laser photocoagulation therapy with resolution of the edema and improvement in metamorphopsia and visual acuity. Despite this success, the effect of laser therapy in these patients remains uncertain. It should be considered only after detailed discussion with the patient about the possibility of posttreatment paracentral scotomata and the alternative of a reasonable period of observation for possible spontaneous resolution of the edema.
Methylene Blue Stain Guiding Layered Excision in Mohs' Micrographic Surgery
Authors: Yu David D , Yeatts Patrick , Leshin Barry
Published: April 2021

ABSTRACT

Resection of a continuous layer of tissue by means of Mobs' micrographic surgery is problematic at several periorbital sites. We describe a technique in which methylene blue is used to identify instances of incomplete specimen removal and thus facilitate subsequent complete removal.
The Effect of Glaucoma Filtering Surgery on Corneal Endothelial Cell Density
Authors: Smith David L , Skuta Gregory L , Lindenmuth Kim A , Musch David C , Bergstrom Terry J
Published: April 2021

ABSTRACT

Corneal endothelial cell counts were obtained preoperatively and 3 months postoperatively in 46 eyes undergoing glaucoma filtering surgery. Average central endothelial cell loss in eyes without postoperative iridocorneal touch was 1.6%. In eyes with iridocorneal touch (Spaeth's grades 1 and 2), the average cell counts decreased by 7.1% and 9.3%, respectively. The average loss for combined grades 1 and 2 (8.1%) approached statistical significance (P ± .06). The average loss in two patients with corneolenticular touch (Spaeth's grade 3) was greater than 50%. These findings suggest that early postoperative iridocorneal touch is unlikely to lead to corneal compromise in most eyes, but that corneolenticular touch can result in severe endothelial cell loss.
Maintaining Nearly Physiologic Intraocular Pressure Levels Prior to Tying the Sutures During Cataract Surgery Reduces Surgically-Induced Astigmatism
Authors: Ashkenazi Isaac , Avni Isaac , Blumenthal Michael
Published: April 2021

ABSTRACT

We sought to determine whether maintaining nearly physiologic levels of intraocular pressure (IOP) before the final tying of sutures in cataract surgery can help minimize postoperative-induced astigmatism. We compared the postoperative astigmatic decay curves of two similar groups of 18 patients who had undergone cataract surgery, in one of which IOP had been maintained at 17 mm Hg prior to the final tying of sutures, and in the other of which the eyes were hypotonus (3 mm Hg) at this point. Initial with-therule cylinder change was significantly less and astigmatic decay occurred earlier in the former group.
Magnetic Resonance Imaging of Intraocular Tamponades
Authors: Yoshida Akitoshi , Cheng Hong-Ming , Kwong Kenneth K , Ogasawara Hironobu , Garrido Leoncio , McMeel J Wallace
Published: April 2021

ABSTRACT

The efficacy of proton magnetic resonance imaging in differentiating vitreous from C3F8 gas and silicone oil tamponades, and in detecting fresh hemorrhages and condensed vitreous was tested in rabbits in vivo. The results suggest that this imaging method could provide a useful alternative to ultrasonography, especially in eyes with opaque media.
Orbital Exenteration With Eyelid Sparing: Indications, Technique, and Results
Authors: Shields Jerry A , Shields Carol L , Suvarnamani Chanet , Tantisira Melanie , Shah Pankajkumar
Published: April 2021

ABSTRACT

Of 22 orbital exenterations performed from January 1980 to December 1989, 16 were performed by an eyelid-sparing technique, and six were allowed to heal by spontaneous granulation. Reviewing these procedures, we conclude that the eyelid-sparing method is indicated mainly for advanced primary orbital malignancies and for certain secondary orbital malignancies such as orbital extension of uveal melanoma, conjunctival melanoma, and conjunctival squamous cell carcinoma. It is not usually applicable to orbital invasion of malignant eyelid tumors such as basal cell carcinoma and sebaceous gland carcinoma. Advantages of the eyelid-sparing method are more rapid healing and earlier fitting of a prosthesis.
Modified Levator Aponeurosis Recession for Upper Eyelid Retraction in Graves' Disease
Authors: Harvey John T , Corin Scott , Nixon Donald , Veloudios Angela
Published: April 2021

ABSTRACT

Recession of the levator aponeurosis has proved to be an excellent operation to correct upper eyelid retraction in Graves' disease. Harvey and Anderson's original description1 included recession of the levator aponeurosis along its entire width and complete extirpation of Müller's muscle. In a modification of the technique, we recess only the lateral two thirds of the levator/Müller's complex. Also, rather than excising Müller's muscle, we simply recess it en bloc with the levator aponeurosis. The lateral horn of the levator is cut, as previously advocated, to relieve the marked temporal elevation of the eyelid characteristic of Graves' lid retraction. This modified procedure provides good upper lid lengthening, with less surgical manipulation, less bleeding, and avoids medial overcorrections. Of 22 upper lids (12 patients) treated with this procedure, 19 (86.3%) were considered "good" after the operation.