bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical Management of Incarcerated Retina in the Sclerotomy
Authors: Peyman Gholam A , Alturki Walid A , Nelson Norman C
Published: April 2021

ABSTRACT

We used perfluoroperhydrophenanthrene (Vitreon®) to release an incarcerated retina successfully from the pars plana sclerotomy site.
Biopsy Technique for Nasolacrimal Duct Obstruction
Authors: Hormozi Darab , Hyde Kenneth J
Published: April 2021

ABSTRACT

We describe a technique using instrumentation readily available in any operating room by which a nasolacrimal duct specimen can easily be obtained to evaluate the possibility that a duct obstruction is being caused by a tumor.
Comparative Efficacy of Diclofenac and Flurbiprofen for Maintenance of Pupillary Dilatation During Cataract Surgery
Authors: Sachdev Mahipal S , Singh Kirti , Talwar Dinesh , Gupta S K , Dada V K
Published: April 2021

ABSTRACT

A double-blind, prospective, randomized clinical study was undertaken to evaluate the relative efficacy of flurbiprofen 0.03% and diclofenac 0.1% eye drops, in combination with routinely used mydriatics, in maintaining pupillary dilatation during extracapsular cataract surgery with intraocular lens implantation. The effectiveness of administering systemic flurbiprofen along with the topical drugs in enhancing maintenance of pupillary dilatation also was assessed. Pupillary diameter, as measured at various surgical stages, was significantly greater in the patients receiving diclofenac or flurbiprofen eye drops as compared with those in a control group who did not (P < .001). While the maintenance of pupillary dilatation was consistently better with diclofenac than with flurbiprofen, the difference was not statistically significant. Furthermore, though maintenance of pupillary dilatation was better in cases in which systemic flurbiprofen was added to the preoperative drug regime, again, the difference was not significant.
Hepatocellular Carcinoma Metastatic to the Orbit in an African Patient
Authors: Schwab Larry , Doshi Himanshu , Shields Jerry A , Kagame Kenneth , Chana Harginder
Published: April 2021

ABSTRACT

Primary hepatocellular carcinoma rarely metastasizes to the orbit. We report a 19-year-old black man from Zimbabwe who had hepatomegaly and an orbital mass. An orbital biopsy suggested a diagnosis of hepatocellular carcinoma. Immunohistochemical stains supported the diagnosis. To our knowledge, this is only the second reported case of hepatocellular carcinoma metastasizing to the orbit and the first such reported case from Africa.
New Lid Speculum for Glaucoma Filtering Surgery
Authors: Yamabayashi Shigeki , Tsukahara
Published: April 2021

ABSTRACT

Successful bleb formation in glaucoma filtering surgery depends on adequate intraoperative visualization and atraumatic handling and preservation of normal conjunctiva and Tenon's capsule in order to avoid unnecessary stimulation and fibrous tissue formation. With these requirements in mind, we designed a new lid speculum that offers the following advantages: (1) wide surgical field exposure; (2) simultaneous globe fixation; (3) obviation of placing a bridle suture; (4) minimal damage to the superior rectus muscle, conjunctiva, and Tenon's capsule; (5) conjunctival incision placement far from the limbus; and (6) reduced operating time.
Clinical Utility of the Barrett Keratoscope With Astigmatic Dial
Authors: Morlet Nigel
Published: April 2021

ABSTRACT

Intraoperative keratometry allows some degree of control over corneal astigmatism during cataract surgery. I describe the clinical use of the Barrett keratoscope combined with an astigmatic dial that quantifies the information obtained by this simple, inexpensive, hand-held surgical keratometer.

Based on a comparison of intraoperative measurements with those taken after extracapsular cataract surgery with an automated keratometer, I conclude that intraoperative keratometry reliably predicted the postoperative astigmatism. For those who had the intraocular pressure (IOP) set between 15 and 20 mm Hg intraoperatively, the mean deviation of the first postoperative measurement from the intraoperative measurement of astigmatism was ± 1.03 D (standard error, 1.56 diopters; 95% confidence interval 0.712 to 1.35 D). When the IOP was not set, the postoperative astigmatism differed from the intraoperative reading by more than 2.00 D for 50% of the cases. Setting the IOP prior to intraoperative keratometry significantly improved the reliability of the measurement.

Intraoperative keratometry by the simple device used in this study is of sufficient utility to allow the surgeon to adjust for the predicted changes in the corneal astigmatism at the time of surgery.
Recalcitrant Diplopia After Implantation of a Krupin Valve With Disc
Authors: Çardakli U Füsun , Perkins Todd W
Published: April 2021

ABSTRACT

We report, to our knowledge, the first case of a patient experiencing recalcitrant diplopia after implantation of a Krupin valve with disc for uncontrolled glaucoma. Despite multiple surgeries and adjustments in her glasses, the patient was left with residual and intolerable diplopia.
Single Tarsoconjunctival Flap (Lower Eyelid) for Upper Eyelid Reconstruction ("Reverse" Modified Hughes Procedure)
Authors: Mauriello Joseph A , Antonacci Robin
Published: April 2021

ABSTRACT

We present a two-stage reconstruction of partial or total full-thickness upper eyelid defects. In the first stage, a single tarsoconjunctival flap from the donor lower eyelid reconstitutes the posterior lamella, and a full-thickness skin graft reconstructs the anterior lamella. In the second stage, 5 to 8 weeks later, the skin tarsoconjunctival flap is severed.

The single tarsoconjunctival flap we describe is analogous to the modified Hughes reconstruction for full-thickness lower eyelid defects and thus may be termed a "reverse" modified Hughes procedure.

In the lid-sharing Cutler-Beard procedure, the popular alternative, the full-thickness lower lid is advanced into the upper eyelid defect. Our procedure provides greater stability due to the increased amount of vertical tarsus in the reconstructed eyelid. Also, in our procedure, the tarsoconjunctival flap is incised 1.5 to 2 mm from the lower eyelid margin rather than the 4 to 6 mm necessary to preserve the marginal artery in the Cutler-Beard procedure.

With a follow up ranging from at least 6 months to over 2 years, the only complications among the 10 patients in our series were pyogenic granuloma at the edge of the donor lower eyelid, and mild, medial upper eyelid blepharoptosis. There were no cases of cicatriciel entropion of the upper eyelid, a known complication of the Cutler-Beard procedure.
Radial Suture Stabilized by Fibrin Glue to Correct Preoperative Against-the-Rule Astigmatism During Cataract Surgery
Authors: Grewing Ralf , Mester Ulrich
Published: April 2021

ABSTRACT

We evaluated the efficacy of using a modified woundclosure technique in cataract surgery to reduce presurgical against-the-rule (ATR) astigmatism. Seventy-seven eyes received a radial 10-0 nylon suture in the axis of the preexisting ATR cylinder, combined with an application of fibrin glue to stabilize the wound. A control group of 76 patients with comparable preoperative ATR astigmatism was operated on in the same manner, but only fibrin glue and no suture was used for wound closure. The mean induced astigmatism in these two groups differed by 0.42 diopters, a significant difference (P < .05). In the cases with preoperative astigmatism greater than 1.00 D, the difference between the two groups, again a significant one, was 0.73 (P < .05).
A Randomized, Prospective Study on the Use of Sodium Hyaluronate (Healon) in Trabeculectomy
Authors: Raitta Christina , Lehto Ilkka , Puska Päivi , Vesti Eija , Harju Mika
Published: April 2021

ABSTRACT

The effect of injecting sodium hyaluronate (Healon) before fistulization in trabeculectomy was investigated in a prospective, randomized study of 107 consecutive eyes. Fifty-two eyes were operated on with the viscoelastic and 55 without. An early postoperative intraocular pressure (IOP) peak of 21 mm Hg or more occurred in 27% of the study eyes versus 17% of the control eyes, an insignificant difference. The mean peak IOPs of the study and the control eyes did not differ significantly (29.8 ± 9.0 mm Hg versus 32.7 ± 10.2 mm Hg), nor did the mean IOPs and the need for glaucoma medications 1 month after surgery. Shallow/flat anterior chamber and choroidal detachment were equally frequent in both groups, but hyphema occurred significantly more often in the study group (40%) than in the control group (18%).
Surgical Removal of Congenital Pupillary-lris-Lens Membrane
Authors: Cibis Gerhard W , Tripathi Ramesh C , Tripathi Brenda J
Published: April 2021

ABSTRACT

A pupillary membrane in a case of congenital pupillary-iris-lens membrane with goniodysgenesis was surgically peeled from the lens without causing cataract formation. Histopathology revealed ectopic iris. The ectopic iris found in this condition differentiates congenital pupillary-iris-lens membrane with goniodysgenesis as an entity from persistent pupillary membrane, hereditary goniodysgenesis, and Rieger's anomaly. We suggest that congenital pupillary-iris-lens membrane with goniodysgenesis is a neurocristopathy. The finding of ectopic iris muscle is consistent with avian chimera experiments that have suggested that iris sphincter muscle is derived from the neural crest, not neural ectoderm. Membranes in this condition can be successfully removed when they cause vision loss and amblyopia.
Herpes Simplex Keratitis Following Argon Laser Trabeculoplasty
Authors: Reed Stephen Y , Shin Dong H , Birt Catherine M , Rhee Robert K
Published: April 2021

ABSTRACT

Many complications have been reported with argon laser trabeculoplasty (ALT). In the following article, we report the first case of Herpes simplex keratitis recurrence being triggered after ALT.
Limbal Autograft Transplantation for Recurrent and Advanced Pterygia
Authors: Shimazaki Jun , Yang Hao-Yung , Tsubota Kazuo
Published: April 2021

* BACKGROUND AND OBJECTIVE: This study was conducted to examine the usefulness of limbal autograft transplantation in the treatment of recurrent and advanced pterygia.

* PATIENTS AND METHODS: Eleven patients with recurrent and 1 6 with advanced pterygia (a total of 27 pterygia) were treated with limbal autograft transplantation. Once a pterygium had been excised, superior limbal tissue was taken with conjunctival flap and transferred to the excised area.

* RESULTS: All the grafts were planted promptly, and donor sites were re-epithelialized with no excessive scar tissue formation. Although slight recurrence was noted in 2 eyes (7.4%), subconjunctival tissue invasions were limited to less than 1 mm, and no further surgical interventions were needed.

* CONCLUSION: These results indicate that limbal autograft transplantation may be effective for the treatment of recurrent and advanced pterygia.

[Ophthalmic Surg Lasers 1996;27:917-923.]
Sequential Lamellar and Penetrating Keratoplasty for Multiple Limbal Choristomas
Authors: Mullaney Paul B , Teichmann Klaus D , Huaman Antonio , Weatherhead Robert R
Published: April 2021

Abstract. Large choristomas that straddle the cornea and Iimbus can be removed and a lamellar graft sutured to the excision site. A central penetrating keratoplasty performed later can restore a clear visual axis. [Ophthalmic Surg Lasers 1996;27:952-954.]
Mitomycin-C in Laser Sclerostomy: Benefit and Complications
Authors: Schmidt-Erfurth Ursula , Wetzel Wolfgang , Dröge Gerit , Birngruber Reginald
Published: April 2021

* BACKGROUND AND OBJECTIVE: The authors studied the effect of topical mitomycin-C administration on the maintenance of filter function and intraocular pressure (IOP) following laser sclerostomy.

* PATIENTS AND METHODS: Twenty-six patients with a presumed high risk of episcleral scarring were treated intraoperatively with topical mitomycinC (0.5 mg/ml) for 3 to 5 minutes. Their IOPs were monitored for at least 2 years. The IOP data of these patients were compared with the results for 46 patients who underwent the identical procedure without antimetabolite.

* RESULTS: IOPs below 23 mm Hg were achieved in 70% of the mitomycin-C-treated patients. Compared with the non-mitomycin-C group, the rate and duration of early postoperative hypotony was significandy increased in the mitomycin-C- treated group.

* CONCLUSION: Mitomycin-C is useful for maintaining successful filter function in patients with unfavorable prognoses. However, severe and persistent hypotony may occur.

[Ophthalmie Surg Lasers 1997;28:14-20.]
Impact of Cultures on Management Decisions Following Surgical Repair of Penetrating Ocular Trauma
Authors: Rubsamen Patrick E , Cousins Scott W , Martinez Jose A
Published: April 2021

*BACKGROUND AND OBJECTIVE: The purpose of this study was to evaluate the utility of routine bacterial and fungal cultures in the diagnosis of endophthalmitis and in the subsequent management of patients following penetrating ocular trauma.

* PATIENTS AND METHODS: The medical records of 70 consecutive patients with penetrating ocular trauma for whom intraoperative bacterial and fungal cultures had been obtained from the wound, aqueous, vitreous, and/or intraocular foreign body (IOFB) were retrospectively reviewed. The incidences of infection among eyes with and without a clinical diagnosis of infection were compared. A determination as to change in clinical management (change of antibiotic, length of treatment) was made.

* RESULTS: Twenty of 70 patients (29%) had positive cultures of the wound, aqueous, vitreous, and/or IOFB. Nine (13%) of the 70 patients were diagnosed as having endophthalmitis, based on clinical findings at presentation and during the subsequent clinical course. Seven (78%) of these 9 patients with a clinical diagnosis of endophthalmitis had positive cultures. The remaining 61 eyes showed no evidence of clinically apparent infections, despite positive cultures from 13 eyes (21%). Microbiologic data derived from the culture results influenced the clinical management of all 7 patients with endophthalmitis. Culture results (positive or negative) did not alter clinical decisions in eyes without clinical evidence of infection.

* CONCLUSION: Bacterial or fungal cultures obtained from the eye in the setting of penetrating trauma often had growth of organisms without clinical signs of infection. Positive culture results direcdy influenced management decisions in cases with clinically evident endophthalmitis. However, routine intraoperative bacterial cultures did not help to identify patients in whom endophthalmitis would develop, nor did they assist in directing management decisions in eyes without clinical suspicion of infection.

[Ophthalmic Surg Lasers 1997;28:43-49.]
Severe Visual Loss After Autologous Blood Injection for Mitomycin-C-Associated Hypotonous Maculopathy
Authors: Lu Da-Wen , Azuara-Blanco Augusto , Katz L Jay
Published: April 2021

Abstract. It has been shown that mitomycin-C increases the success rate of trabeculectomy; however, a rise in the incidence of postoperative complications has also been reported. Consequently, the use of antimetabolite is usually reserved for patients who are at high risk of surgical failure or for patients with advanced glaucoma in whom low intraocular pressure is desired. This report describes a patient who suffered severe visual loss which was a direct result of hypotonous maculopathy after trabeculectomy with mitomycin-C and various other complications from the subsequent interventions. [Ophthalmic Surg Lasers 1997;28:244-245.]
A Full-Thickness Scleral Graft for the Surgical Management of a Late Filtration Bleb Leak
Authors: Kosmin Alan S , Wishart Peter K
Published: April 2021

BACKGROUND AND OBJECTIVES: Late bleb leak may follow months to years after filtration surgery. This article describes the surgical repair of eight leaking blebs using a full-thickness scleral graft and analyzes the efficacy of the procedure and its effect on intraocular pressure (IOP) control.

PATIENTS AND METHODS: The indications for surgical bleb revision were hypotony maculopathy (2 eyes), endophthalmitis (2 eyes), bleb infection (2 eyes), and chronic epiphora and blurring of vision (2 eyes). All eyes were treated surgically through bleb excision and repair of the scleral defect with a full-thickness scleral graft. Conjunctival closure was performed either by its advancement to the limbus or by free conjunctival autograft. Follow-up ranged from 4 months to 7 years.

RESULTS: Surgery stopped the leak in all cases, and hypotony was relieved without loss of long-term IOP control. However, early postoperative IOP rises (> 30 mm Hg) occurred in 2 eyes, and a pressure-lowering medication was necessary to achieve long-term IOP control (IOP < 22 mm Hg) in 3 eyes.

CONCLUSIONS: The technique described is an effective procedure for the treatment of late bleb leaks and is especially useful for the treatment of leaks found in association with full-thickness scleral defects. IOP spikes in the early postoperative period may occur, but long-term IOP control can be expected without the need for further filtration surgery.

[Ophthalmic Surg Lasers 1997;28:461-468.]
Hypopyon Uveitis Following Panretinal Photocoagulation
Authors: Lee Bailey L , van Heuven W A J
Published: April 2021

Abstract. The authors describe the rare complication of hypopyon uveitis following panretinal photocoagulation. A 55-year-old man with a history of diabetes mellitus and previous repair of a retinal detachment by scleral buckle and vitrectomy was referred to the authors after a hypopyon uveitis developed following supplemental panretinal photocoagulation. The patient was treated with frequent topical steroids in addition to periocular injection of steroids with resolution of the inflammation. Risk factors for anterior segment ischemia, such as a history of a scleral buckle, may predispose diabetic patients to the complication of hypopyon uveitis following panretinal photocoagulation. [Ophthalmic Surg Lasers 1997;28: 505-507.]
The Iris Cerclage Suture for Permanent Mydriasis: A Running Suture Technique
Authors: Ogawa Gregory S H
Published: April 2021

Abstract. Permanent mydriasis can be a disabling condition. The author describes an iris cerclage running suture technique for the treatment of permanent mydriasis caused by diffuse iris sphincter damage. A long, curved transchamber needle on 10-0 polypropylene is passed in and out of the anterior chamber through limbal paracentesis openings while weaving the needle through the iris near the pupillary margin to form the cerclage. The technique minimizes stretching and distortion of the iris and creates a pupil that is precisely sized and rather round. [Ophthalmic Surg Lasers 1998;29:1001-1009.]
Phacoemulsification and Opaque Intraocular Lens Implantation for the Treatment of Intractable Diplopia
Authors: Sandy Charles J , Wilson Sarah , Page A Brian , Frazer David G , McGinnity Francis G , Lee John P
Published: April 2021

Abstract. Intractable diplopia secondary to paralytic strabismus may be treated with the occlusion of the affected eye. Established treatments include occlusion with a patch, opaque spectacles or contact lenses, and perfoming upper lid lowering procedures or tarsorrhaphies. Two cases are presented in which intractable diplopia was resolved by performing clear lens phacoemulsification and the insertion of an opaque intraocular lens. Both patients reported a resolution of their diplopia having been dissatisfied with other forms of treatment. Although opaque intraocular lens insertion is not recommended as the initial treatment of choice in such cases, it offers a valuable treatment option for those patients in whom other forms of therapy have failed. [Ophthalmic Surg Lasers 2000;31:429-431]
Ketorolac-Tobramycin Combination vs Fluorometholone-Tobramycin Combination in Reducing Inflammation Following Phacoemulsification Cataract Extraction With Scleral Tunnel Incision
Authors: Guzey Mustafa , Karadede Sezin , Dogan Zeki , Satici Ahmet
Published: April 2021

* OBJECTIVE: The objective of this study was to compare the efficacy of ketorolac-tobramycin combination with fluorometholone-tobramycin combination in the control of ocular inflammation after endocapsular phacoemulsification cataract surgery with scleral tunnel incision.

* PATIENTS AND METHODS: This was a prospective, randomized, investigator masked, 2-week, single-center study. Ocular examinations were carried out preoperatively and postoperatively on days 1 (baseline), 2, 3, 7, and 14. There were 60 patients (30 in each treatment group) undergoing uncomplicated cataract-lens implant surgery enrolled and randomized in the study. The baseline parameters were similar in the two study groups. At each visit comprehensive ocular examinations were performed and a 4-point (0 to 3) grading system was used to record findings of the burning/stinging sensation, blurred vision, ocular discomfort, conjunctival hyperemia, anterior chamber flare, and anterior chamber cells.

* RESULTS: There was no statistically significant difference between the treatment groups in the findings of the ocular inflammation at any of the postoperative visits. Both treatments were equally well tolerated.

* CONCLUSIONS: This study suggests that ketorolac may be an alternative to some corticosteroids (fluorometholone). It is generally accepted that fluorometholone is not as potent an anti-inflammatory as prednisolone the most commonly used steroid following cataract extraction.

[Ophthalmic Surg Lasers 2000;31:451-456]
Increases in Intraocular Pressure During Hemodialysis in Eyes During Early Postvitrectomy Period
Authors: Yoon Young H , Sohn Joon-Hong , Lee Song E , Lee Yong B , Kim Jae Y , Kook Michael S
Published: April 2021

* BACKGROUND AND OBJECTIVES: To identify risk factors for intraocular pressure (IOP) increases during hemodialysis (HD) in the early postoperative period following pars plana vitrectomy (PPV).

* PATIENTS AND METHODS: Comparisons of 36 vitrectomized eyes of 22 diabetics undergoing maintenance HD with those of 138 eyes of 69 nonoperated patients. Serial IOPs were measured before PPV, after PPV/before dialysis, and during dialysis. Serum osmolarity and blood pressure were also recorded.

* RESULTS: In 20 of 36 operated eyes (55.6%) and 18 of 138 nonoperated eyes (13.0%) IOP was increased (≥ 4 mm Hg) during HD. In the operated group, marked increases (≥ 7 mm Hg) were noted in 9 eyes and ocular pain in 5 eyes. Eyes with pre-existing outflow obstruction and/or acute postoperative outflow compromise carried high risks. No correlation with changes in serum osmolarity or blood pressure was found.

* CONCLUSION: Monitoring of IOP during HD seems warranted when diabetics with pre-existing outflow obstruction and/or postoperative outflow compromise, undergo HD following PPV.

[Ophthalmic Surg Lasers 2000;31:467-473]
Management of Hypotony Maculopathy and a Large Filtering Bleb After Trabeculectomy With Mitomycin C: Success With Argon Laser Therapy
Authors: Akova Yonca A , Dursun Dilek , Aydin Pinar , Akbatur Haluk , Duman Sunay
Published: April 2021

Abstract. We report a patient with postkeratoplasty glaucoma that developed a large, filtering bleb following trabeculectomy with intraoperative antimetabolite treatment. The hypotony and the bleb were managed using argon laser photocoagulation. A 26-year-old female patient underwent penetrating keratoplasty in the left eye for keratoconus. Postoperatively, her elevated intraocular pressure could not be controlled medically, and the patient underwent a trabeculectomy with intraoperative antimetabolite application. Two months later, hypotony maculopathy, optic disc edema, and choroidal folds developed, and her vision dropped. Steroid treatment and soft contact lenses did not help. Photocoagulation was applied twice to the surface of the bleb and the surrounding area. After the photocoagulation therapy, the patients vision improved, intraocular pressure increased, and the optic disc edema and macular folds had resolved. Argon laser photocoagulation applied to a large filtering bleb associated with hypotony maculopathy is a useful treatment for bleb remodeling and elevating intraocular pressure. [Ophthalmic Surg Lasers 2000;31:491-494]
Retinal Detachment 7 Years After Prophylactic Schisis Cavity Excision in Juvenile X-linked Retinoschisis
Authors: Sobrin Lucia , Berrocal Audina M , Murray Timothy G
Published: April 2021

Abstract. A 7-year-old boy with X-linked juvenile retinoschisis developed a retinal detachment at the site of previous prophylactic excision of a schisis cavity. The patient underwent a scierai buckle procedure, pars plana vitrectomy, membrane peel, and silicone oil injection with successful reattachment. At last followup, the visual acuity was 20/400 and the retina was attached. Prophylactic excision of a schisis cavity may be complicated by retinal detachment several years after the surgery. Given the favorable natural history of schisis cavities in X-linked juvenile retinoschisis, the decision to perform prophylactic excision should be undertaken cautiously after full consideration of the potential complications. [Ophthalmic Surg Lasers Imaging 2003;34:401-402.]
In Vivo Confocal Microscopy in the Acute Phase of Corneal Inflammation
Authors: Kobayashi Akira , Maeda Ari , Sugiyama Kazuhisa
Published: April 2021

Abstract. Two cases of noninfectious keratitis were studied using in vivo corneal confocal microscopy in addition to routine slit-lamp biomicroscopy. A 10-year-old boy suffered from keratitis in his left eye due to a bee sting and a 20-year-old man had keratitis following corneal blunt trauma. In both cases, we found a honeycomb pattern at the anterior and mid-stromal level of the middle cornea. This honeycomb pattern disappeared in 1 week with steroid treatment. This pattern might be caused by syncytial cell bodies of activated keratocytes, by focal corneal strema edema, or by polymorphonuclear leukocyte infiltration along with the keratocytes or along preformed channels within the corneal stroma known as Bowman channels. Further analysis in a large number of patients may aid in further understanding in vivo human corneal inflammation. [Ophthalmic Surg Lasers Imaging 2003;34:433-436.]
Comparison of the Efficacy and Longevity of Nonpenetrating Glaucoma Surgery With and Without a New, Nonabsorbable Hydrophilic Implant
Authors: Dahan Elie , Ravinet Emilie , Ben-Simon Guy J , Mermoud Andre
Published: April 2021

* BACKGROUND AND OBJECTIVE: To compare the efficacy and longevity of nonpenetrating glaucoma surgery with and without the use of a nonabsorbable hydrophilic implant at the Oxford Eye Centre, Johannesburg, South Africa, and the Glaucoma Unit, Jules Gonin Ophthalmic Hospital, Lausanne, Switzerland.

* PATIENTS AND METHODS: In a nonrandomized, prospective study between March 1997 and December 2001, 48 eyes of 32 patients aged 18 to 86 years with primary open-angle glaucoma underwent nonpenetrating glaucoma surgery; 25 eyes with the implant and 23 eyes without it. Intraocular pressure (IOP) was recorded preoperatively and postoperativeIy at 1, 7, and 14 days, at 1, 3, and 6 months, and thereafter every 6 months.

* RESULTS: The mean preoperative IOP was 27.5 ± 11.8 mm Hg (range, 20 to 64 mm Hg) in the implant group and 24.8 ±7.1 mm Hg (range, 16 to 38 mm Hg) in the control group. During the first 1 8 months of follow-up, both groups showed identical IOP progression and the mean IOP remained less than 14 mm Hg. After 2 years of follow-up, the IOP started to rise in the control group but remained stable in the impiant group. After 30 months, the mean IOP was 12.4 ± 2 mm Hg and the IOP decrease in percentage was 62% ± 6% in the implant group (n = 13) versus 16.1 ±3 mm Hg and 34% ± 13% in the control group (n = 15) (mean IOP, P = .0022; mean IOP decrease in percentage, P = .01).

* CONCLUSIONS: During the first 18 months, there was no difference in the outcomes between the two groups. After 2 years of follow-up, the mean IOP was lower and the IOP decrease in percentage was greater in the implant group compared with the control group.

[Ophthalmic Surg Lasers Imaging 2003;34:457463.]
Internal Ophthalmomyiasis Presenting as Endophthalmitis Associated With an Intraocular Foreign Body
Authors: Gözüm Nilüfer , Kir Nur , Ovali Tunç
Published: April 2021

Abstract. Ophthalmomyiasis interna infestation by fly larva can present in various forms. A 3-year-old girl with a 15-day history of pain, redness, and tearing of the right eye was referred to our clinic with the diagnosis of endophthalmitis associated with an intraocular foreign body, based on clinical and ultrasonographic findings. The patient underwent pars plana vitrectomy, during which an 8-mm long larva was encountered within the vitreous cavity. It was removed and identified as a cattle botfly. The parient developed a retinal detachment 1 month postoperatively, but the family refused further treatment and the patient was lost to follow-up. Ophthalmomyiasis should be included in the differential diagnosis of endophthalmitis and intraocular foreign bodies in patients from rural areas. [Ophthalmic Surg Lasers Imaging 2003;34:472-474.3
Non-Mydriatic Panoramic Fundus Imaging Using a Non-Contact Scanning Laser-Based System
Authors: Friberg Thomas R , Pandya Angana , Eller Andrew W
Published: April 2021

* BACKGROUND AND OBJECTIVE: A non contact scanning laser-based retinal imaging system produces a 200° wide-field panoramic image of the fundus through the novel use of a large elliptical mirror. The authors investigated whether accurate diagnoses could be made from these images alone.

* PATIENTS AND METHODS: Images were obtained from both eyes of arbitrarily selected patients and were retrospectively reviewed by retinal specialists. Each physician made a diagnosis, suggested the follow-up interval, and determined whether any intervention was needed based solely on image review. Diabetic retinopathy was categorized as background retinopathy only, preprolìferative retinopathy, maculopathy, and proliferative retinopathy. The results of the image review were then compared with the results of clinical examination, and the sensitivity and specificity of the review were calculated.

* RESULTS: The correct overall diagnosis was made by the two specialists in 87% and 77% of cases, respectively; the specificity and sensitivity each averaged 76%. Follow-up interval recommendations from image review matched those made on clinical examination in 86% of cases. Diabetic retinopathy was correctly identified as a general diagnosis with a sensitivity of 94% and the follow-up recommendations corresponded to the clinical recommendations in 82%. Sixty-two percent of the images were judged to be of good quality or better, with only 6.4% deemed unreadable. Iris color did not influence image quality.

* CONCLUSION: The non-contact scanning laser-based retinal imaging system provides images of sufficient resolution and clarity to make accurate general diagnoses in a high percentage of cases. Its use as a screening device for specific diseases is feasible and merits further study.

[Ophthalmic Surg Lasers Imaging 2003;34:488497.]
Adjunctive Bevacizumab in Patients Undergoing Ahmed Valve Implantation: A Pilot Study
Authors: Rojo-Arnao María , Albis-Donado Oscar D. , Lliteras-Cardin Manuel , Kahook Malik Y. , Gil-Carrasco Félix
Published: April 2021

Background and Objective:

To report on preliminary findings of adjunctive subconjunctival bevacizumab (SCB) injections in patients undergoing Ahmed valve implantation (AVI) (New World Medical, Rancho Cucamonga, CA).

Patients and Methods:

The study was approved by the institution’s ethics committee. Patients were prospectively recruited during a 1-month period and randomized to receive AVI with postoperative SCB (days 1 and 7, n = 7) or AVI without SCB (n = 6).

Results:

Baseline intraocular pressure (IOP) in the treatment (AVI+SCB) group was 19.4 ± 8.6 mm Hg, whereas baseline IOP in the control (AVI) group was 32.1 ± 17.7 mm Hg (
P
= .119). Final IOP was 13.8 mm Hg (n = 7) for the treatment group and 12.7 mm Hg for the control group (n = 5,
P
= .790). One eye in the control group required further glaucoma intervention at day 45 and was considered a failure. The pre-massage postoperative IOP was significantly lower for the treatment group only at day 45 (16.1 vs 26.0 mm Hg,
P
= .012). Mean post-massage IOP was significantly lower in the treatment group at day 15 (11.28 vs 17.16 mm Hg,
P
= .004), day 30 (11.28 vs 20.83 mm Hg,
P
= .015), and day 45 (12.16 vs 21.33 mm Hg,
P
= .001), and similar at month 3. Mean change in bleb area was 11.4 mm
2
in the treatment group and −0.4 mm
2
in the control group (
P
= .036 and
P
= .361, respectively, Student’s paired samples
t
test).

Conclusion:

Bevacizumab was associated with a less aggressive hypertensive period as measured by post-massage IOP measurements, postoperative glaucoma medications, and cross-sectional bleb area by ultrasound. Further prospective studies are needed to better understand the utility of SCB at the time of AVI surgery.
Multiple solutions for Schrödinger lattice systems with asymptotically linear terms and perturbed terms
Authors: Chen Guanwei , Schechter Martin
Published: April 2021

In infinite \begin{document}$ m $\end{document}-dimensional lattices, we obtain the existence of two nontrivial solutions for a class of non-periodic Schrödinger lattice systems with perturbed terms, where the potentials are coercive and the nonlinearities are asymptotically linear at infinity. In addition, examples are given to illustrate our results.
A conforming-nonconforming mixed immersed finite element method for unsteady Stokes equations with moving interfaces
Authors: Jones Derrick , Zhang Xu
Published: April 2021

In this article, we develop a new mixed immersed finite element discretization for two-dimensional unsteady Stokes interface problems with unfitted meshes. The proposed IFE spaces use conforming linear elements for one velocity component and non-conforming linear elements for the other velocity component. The pressure is approximated by piecewise constant. Unisolvency, among other fundamental properties of the new vector-valued IFE functions, is analyzed. Based on the new IFE spaces, semi-discrete and full-discrete schemes are developed for solving the unsteady Stokes equations with a stationary or a moving interface. Re-meshing is not required in our numerical scheme for solving the moving-interface problem. Numerical experiments are carried out to demonstrate the performance of this new IFE method.
Enhancement of gamma oscillations in E/I neural networks by increase of difference between external inputs
Authors: Gu Xiaochun , Han Fang , Wang Zhijie , Kashif Kaleem , Lu Wenlian
Published: April 2021

Experimental observations suggest that gamma oscillations are enhanced by the increase of the difference between the components of external stimuli. To explain these experimental observations, we firstly construct a small excitatory/inhibitory (E/I) neural network of IAF neurons with external current input to E-neuron population differing from that to I-neuron population. Simulation results show that the greater the difference between the external inputs to excitatory and inhibitory neurons, the stronger gamma oscillations in the small E/I neural network. Furthermore, we construct a large-scale complicated neural network with multi-layer columns to explore gamma oscillations regulated by external stimuli which are simulated by using a novel CUDA-based algorithm. It is further found that gamma oscillations can be caused and enhanced by the difference between the external inputs in a large-scale neural network with a complicated structure. These results are consistent with the existing experimental findings well.
Holtzheim « Am Schluesselberg » (Bas-Rhin) : un habitat hallstattien de bord de terrasse lœssique dans la Plaine du Rhin supérieur
Authors: Kuhnle Gertrud , Tesnier-Hermetey Corinne
Published: April 2021

Le petit habitat de plaine d’Holtzheim du Ha D3 témoigne entre autres par l’absence de tout matériel d’importation d’une communauté qui vivait en autarcie. Le lot de faune, faible en quantité mais riche en espèces, suggère que la chasse jouait un rôle important à côté de l’exploitation agricole.
AUTOMATIC SEGMENTATION AND INDICATORS MEASUREMENT OF THE VOCAL FOLDS AND GLOTTAL IN LARYNGEAL ENDOSCOPY IMAGES USING MASK R-CNN
Authors: Chin Chiun-Li , Chang Chun-Lung , Liu Yu-Chieh , Lin Yong-Long
Published: April 2021

In present clinic practice of otolaryngology, otolaryngologists utilized laryngoscopy to diagnose the larynx lesion of patients preliminarily. Nevertheless, it was challenging for otolaryngologists to interpret the detailed information from laryngoscopy videos comprehensively. In this paper, we proposed Mask R-CNN deep learning algorithm to segment the regions of the vocal folds and glottal from laryngoscopy videos, and self-built algorithm to calculate measured indicators including the length and curvature of vocal folds, the angle of glottal, the area of vocal folds and glottal, and the triangle type composed of vocal folds and glottal. Moreover, in order to provide otolaryngologists critical and immediate medical information during diagnosis, we also provided visualized information, which is labeled on the laryngoscopy images to meet all the needs in clinical practice. From the result of this research, the precision of segmentation has reached a high rate of 90.4% on average. It shows that the model not only achieves great performance in segmentation, but also further proved the indicators are accurate enough to be considered in practical diagnosis. In the future, it is possible for the proposed model to be applied in more kinds of laryngoscopy analyses for more comprehensive diagnosis, which would make a positive influence toward the clinical practice of otolaryngology.
A Model to Enhance the Economic Growth Rate and Literacy Rate of the Rural and Urban Area
Authors: Hasan Mashhood , Medabesh Ali , Mobarki Muhammad , Alhazmi Waleed Hassan
Published: April 2021

A model Mistry training center (MTC) is proposed here to enhance the economic growth rate and literacy rate of the rural and urban areas. It is based on a teacher, Mistry, and eduworker. This is a combination of school and small industries into a single educational setting. In this model, the teacher teaches the general course whereas Mistry means a technical person who has skill in particular fields. Moreover, eduworker means students who take education with part-time work. This model is developed an algorithm to understand basic three mode such as primary mode accomplishment (PMA), apprentice mode accomplishment (AMA), and finally, optional mode (OM) of the proposed model. While role and responsibilities of the teacher, Mistry, and eduworker are given in detail under profitable condition and non-profitable conditions, a comparative data of the per capita income, literacy rate, and gross domestic product (GDP) are presented to distinguish how the proposed model is a good option.
A Review of Image Analysis Techniques for Adult Content Detection
Authors: Appati Justice Kwame , Lodonu Kennedy Yaw , Chris-Koka Richmond
Published: April 2021

The fast growth of internet access globally without boundary has led to some negative impacts among children who are exposed to pornographic contents daily. Many parental control strategies have been put in place to protect these children; however, these strategies are usually inspired by political and social interventions. With the availability of computational tools, many automated explicit content detection methods though having their flaws have been proposed to support these social interventions. In this study, a review of the current automated adult content detectors is presented with open issues for future research work.
Development of a Prone Team and Exploration of Staff Perceptions During COVID-19
Authors: Miguel Karen , Snydeman Colleen , Capasso Virginia , Walsh Mary Ann , Murphy John , Wang Xianghong Sean
Published: April 2021

Objective:

As intensive care unit bed capacity doubled because of COVID-19 cases, nursing leaders created a prone team to support labor-intensive prone positioning of patients with COVID-related acute respiratory distress syndrome. The goal of the prone team was to reduce workload on intensive care teams, standardize the proning process, mitigate pressure injuries and turning-related adverse events, and ensure prone team safety.

Methods:

Staff were trained using a hybrid learning model focused on prone-positioning techniques, pressure injury prevention, and turning-related adverse events.

Results:

No adverse events occurred to patients or members of the prone team. The prone team mitigated pressure injuries using prevention strategies. The prone team and intensive care unit staff were highly satisfied with their experience.

Conclusion:

The prone team provided support for critically ill patients, and team members reported feeling supported and empowered. Intensive care unit staff were highly satisfied with the prone team.
Blood indices, in-hospital outcome and short-term prognosis in patients with COVID-19 pneumonia
Authors: Al-Buthabhak Karrar , Nafakhi Hussein , Shukur Mohammed H. , Nafakhi Ahmed , Alareedh Mohammed , Shaghee Foaad
Published: April 2021

The predictive role of blood indices in coronavirus disease 2019 (COVID-19) related in-hospital adverse outcomes and post-recovery status is not fully defined. The main aim was to assess the association of complete blood indices measured at baseline with COVID-19 related in-hospital clinical outcomes, including length of hospital and intensive care unit (ICU) stay, receiving mechanical ventilation, degree of lung injury and in-hospital death, and post-recovery status. This retrospective study included patients with newly diagnosed COVID-19 infection from August 20, to September 25, 2020. The initial study cohort included 127 patients with newly diagnosed COVID-19. Of whom 26 patients were excluded, leaving 101 patients for final analysis. low lymphocytes % [Odds ratio and confidence intervals = OR (CI)] [0.2(0.0-0.2, p=0.03] increased the odds of ICU stay length while high platelet mean volume (PMV) [0.9 (1.1-5, p<0.00], high platelet distribution width (PDW) [0.3(0.4-1.9), p<0.00], and low lymphocytes % [0.2 (0.0-0.2), p=0.02] increased the odds of length of hospital stay. Decreased lymphocytes % showed significant independent association with increased risk for mechanical ventilation use [0.9 (0.9-1), p=0.04], extensive degree of lung injury [0.2 (0.1-0.7), p<0.00], and in-hospital death [0.5 (0.3-0.8), p=0.01]. High lymphocytes %[0.9 (0.9-1), p<0.00] and high PMV [0.3 (0.3-0.8), p=0.02] were significantly associated with complete recovery while increased neutrophil % [1 (1-1.1), p=0.04] was associated with increased risk for post recovery fatigue. In conclusion, low lymphocytes % and high neutrophil % are useful markers for predicting adverse in-hospital outcome and post-recovery persistent fatigue, respectively. High PMV and lymphocyte % showed significant association with favorable short-term prognosis.
Performance After Concussion in National Hockey League Players
Authors: Neustadtl Aidan L. , Bukowski William K. , Neustadtl Alan , Milzman David
Published: April 2021

Context

Concussions in ice hockey players are an interesting area of study due to the fast-paced and high-impact nature of the sport. Recently, researchers have focused on player performance after return from concussion to evaluate subclinical deficits that were previously missed.

Objective

To examine National Hockey League (NHL) player performance from 2013 to 2019 and compare performance before a concussion with performance immediately after recovering to assess the current NHL return-to-play protocol.

Design

Cross-sectional study.

Setting

The NHL Injury Viz and sports reporting websites.

Patients or Other Participants

Players in the NHL who sustained concussions from 2013 to 2019.

Main Outcome Measure(s)

Goals, assists, points, plus-minus, time on ice (TOI), and hits.

Results

When goals, assists, points, plus-minus, TOI, and hits were examined, only TOI was different after the players returned from injury, and this TOI difference was not substantively important.

Conclusions

After concussion, NHL player performance did not change.
Risk Factors for Mortality in an Older Veteran Population With Infective Endocarditis
Authors: Mergenhagen Kari A. , Polanski Kyle , Conway Erin , Tito Alexander , Cheung Fiona , Sellick John , Wattengel Bethany
Published: April 2021

Objective To determine 30-day and 1-year mortality in patients treated for infective endocarditis (IE) in a VA population. The secondary objective was to identify risk factors for increased risk of mortality in veterans diagnosed with IE. Design A retrospective
cohort study. Setting Veterans Affairs Western New York Healthcare System Participants Patients who had a diagnosis of IE between the years 2005 and 2016. Patients were identified via International Classification of Diseases (ICD) codes. Interventions
None. Main Outcome Measures Factors for death and survival were compared using a bivariate analysis. Significant factors were built into a multivariate logistic regression analysis to determine risk factors for death at 30 days and 1 year. Results Between
2005 and 2016, there were 153 patients with IE. All-cause mortality at 30 days was 14% versus 39% at 1 year. Patients were more likely to die at 1 year with higher Pitt Bacteremia Scores, older age, and lower number of minor criteria according to Duke Criteria. Comorbidities were similar between
groups. Conclusions Older patients with higher Pitt Bacteremia Scores and lower numbers of minor criteria are more likely to experience mortality at one year. Given the high rates of death at one year, close monitoring, even after completion of therapy may be necessary in
older patients. Senior care pharmacists are in a unique position to monitor these patients.
The Global Case-Fatality Rate of COVID-19 Has Been Declining Since May 2020
Authors: Hasan Mohammad Nayeem , Haider Najmul , Stigler Florian L. , Khan Rumi Ahmed , McCoy David , Zumla Alimuddin , Kock Richard A. , Uddin Md. Jamal
Published: April 2021

The objective of this study was to evaluate the trend of reported case fatality rate (rCFR) of COVID-19 over time, using globally reported COVID-19 cases and mortality data. We collected daily COVID-19 diagnoses and mortality data from the WHO’s daily situation reports dated January 1 to December 31, 2020. We performed three time-series models [simple exponential smoothing, auto-regressive integrated moving average, and automatic forecasting time-series (Prophet)] to identify the global trend of rCFR for COVID-19. We used beta regression models to investigate the association between the rCFR and potential predictors of each country and reported incidence rate ratios (IRRs) of each variable. The weekly global cumulative COVID-19 rCFR reached a peak at 7.23% during the 17th week (April 22–28, 2020). We found a positive and increasing trend for global daily rCFR values of COVID-19 until the 17th week (pre-peak period) and then a strong declining trend up until the 53rd week (post-peak period) toward 2.2% (December 29–31, 2020). In pre-peak of rCFR, the percentage of people aged 65 and above and the prevalence of obesity were significantly associated with the COVID-19 rCFR. The declining trend of global COVID-19 rCFR was not merely because of increased COVID-19 testing, because COVID-19 tests per 1,000 population had poor predictive value. Decreasing rCFR could be explained by an increased rate of infection in younger people or by the improvement of health care management, shielding from infection, and/or repurposing of several drugs that had shown a beneficial effect on reducing fatality because of COVID-19.