bluuebunny/crossref_metadata_2025 huggingface dataset:
Dacryocystectomy for the Treatment of Dacryocystitis Patients With Wegener's Granulomatosis
Authors: Holds John B , Anderson Richard L , Wolin Mitchell J
Published: April 2021

ABSTRACT

We evaluated a woman with Wegener's granulomatosis who was experiencing recurrent dacryocystitis. Nasolacrimal duct obstruction had been present for many years and epiphora was not a significant concern. Our experience with the development of nasalcutaneous fistulas following dacryocystorhinostomy in several patients with Wegener's granulomatosis led us to perform a dacryocystectomy. The functional result was good, and there were no problems with wound healing. Dacryocystectomy should be considered as an alternative to dacryocystorhinostomy for dacryocystitis in patients with Wegener's granulomatosis and similar disorders in whom epiphora is not a major complaint.
Nonabsorbable Suture Material in Corneoscleral Sections-A Comparison of Novafil and Nylon
Authors: McClellan Kathleen A , Knol Anita , Billson Frank A
Published: April 2021

ABSTRACT

We compared a newly available nonabsorbable monofilament ophthalmic suture, 9/0 Novafil (Davis & Geck), with 10/0 nylon (Alcon), currently the most popular suture for closure of corneoscleral sections. Surgery was performed on nine rats and ten rabbits. In each case a 120° corneoscleral section was made in each eye and closed with interrupted sutures of 9/0 Novafil in one eye and 10/0 nylon in the other. We compared their handling qualities during surgery, as well as their effect on postoperative wound inflammation. In addition we examined the suture material from each eye of the rats by scanning electron microscopy (SEM) after 3 months, and we compared the surgically induced astigmatism in the rabbits in the two suture groups. Both suture materials were easy to handle and well tolerated. Nylon sutures from six of the eight rat eyes studied showed SEM evidence of surface disintegration after 3 months, whereas all the Novafil sutures remained intact.
An Unusual Complication of Nasolacrimal Duct Probing
Authors: Yeatts R Patrick , Crum Bryan
Published: April 2021

ABSTRACT

A 4-mm segment of the tip of a 0000 probe broke off inside the nasolacrimal duct of an 11-month-old girl during probing for congenital nasolacrimal duct obstruction. Despite numerous attempts, the tip could not be extracted. Examination of the 000 end of the double-ended probe showed a narrow neck approximately 4 mm from the bulbous tip. Choosing an appropriate probe design, inspecting the probe before use, and selecting the appropriate probe size will help prevent this unusual complication.
Treatment of Pterygium Using Thermal Cautery
Authors: Ling Richard Tak-Kam
Published: April 2021

ABSTRACT

Reported therapies for primary pterygium have included surgical excision with or without adjunct radiation, antimitotic agents, and conjunctival transplants. The effectiveness of these strategies may be limited by recurrences, side effects of the treatment, or expensive and time-consuming procedures. We report the results of using thermal cautery to treat primary pterygium in three patients. In all cases the pterygia were successfully eliminated without recurrence.
Bandage Contact Lens Augmentation of 5-Fluorouracil Treatment in Glaucoma Filtration Surgery
Authors: Beckman Richard L , Sofinski Sandra J , Greff Linda J , Oates Dale C , Smith Thomas J , Simmons Richard J
Published: April 2021

ABSTRACT

The use of 5-Fluorouracil (5-FU) to inhibit scarring following filtration surgery has been hampered by corneal epithelial defects and their accompanying inflammation. This toxicity, which occurs during the crucial period in which the risk of bleb failure is highest, has previously been a relative contraindication to further 5-FU use. We have found the early placement of a therapeutic bandage contact lens permits extended administration of 5-FU during this period, minimizing discomfort and inflammation as well as enhancing bleb survival.
Corneal Decompensation After Argon Laser Iridectomy-A Delayed Complication
Authors: Jeng Shyun , Lee Jiahn-Shing , Huang Samuel C M
Published: April 2021

ABSTRACT

We report six eyes in six patients in which corneal decompensation developed 18 or more months after argon laser iridectomy (ALI). In addition to the level of laser energy used, other risk factors included performing ALI during an attack, diabetes, and a cornea damaged by glaucomatous attack. The interval between the ALI and corneal decompensation ranged from 18 months to 3 ½ years.
Tissue Plasminogen Activating Factor Assisted Removal of Subretinal Hemorrhage
Authors: Peyman Gholam A , Nelson Norman C , Alturki Walid , Blinder Kevin J , Paris Christopher L , Desai Uday R , Harper C Armitage
Published: April 2021

ABSTRACT

We used tissue plasminogen activator (tPA) to aid in the surgical evacuation of subretinal hemorrhages. Subretinal hemorrhage secondary to a ruptured retinal macroaneurysm was treated in two patients. The surgical technique involved using a micropipette to fashion a small retinotomy through which tPA was injected into the subretinal space and through which the dissolved clot was removed. Visual acuity improved from counts fingers to 20/50 in one patient and from counts fingers to 20/70 in the other. Three additional patients, with massive subretinal hemorrhages secondary to age-related macular degeneration, were similarly treated. In one, visual acuity improved from counts fingers to 20/400; in two others, visual acuity was stabilized; in the first patient, at 20/300, and in the second patient at 20/400. The use of tPA minimizes surgical manipulation of the sensory retina and greatly reduces the size of the retinotomy required for evacuation of subretinal blood.
Sclera-Directed Knot Technique for Securing an Encircling Band in Retinal Surgery
Authors: Bartov Elisha , Ginsburg Leonard H , Ashkenazi Isaac , Treister Giora
Published: April 2021

ABSTRACT

The protruding ends of sutures used to secure the ends of the silicone rubber band placed during many retinal surgical procedures may cause postsurgical irritation, since with presently used suturing techniques, the knot of the suture remains on top of the band, facing the conjunctiva. We describe a suturing technique which, by inverting the band when suturing its ends and then allowing the band to return to its original position, places the knot on the undersurface of the band, against the sclera. Thus, no protruding suture ends are left facing the conjunctiva and the irritation resulting from such a protrusion is averted.
A New Technique of Local Anesthesia for Panretinal Photocoagulation
Authors: Friedberg Mark A , Palmer Richard M
Published: April 2021

ABSTRACT

We report a technique of local anesthetic administration used in 26 consecutive patients undergoing panretinal photocoagulation. A blunt-tipped irrigating cannula delivered 3 cc of anesthetic into the posterior sub-Tenon's space through a small opening in conjunctiva and Tenon's capsule. Immediate anesthesia, with no serious complications, was obtained in 38 of 40 eyes, facilitating administration of rapid, high-intensity laser burns. Although our experience with it is limited, we believe that this technique allows avoidance of many of the potential complications associated with the passage of a needle into the retrobulbar space.
Pharmacologic Alteration of Corneal Topography After Radial Keratotomy
Authors: Kwitko Sergio , Sinbawy Abdelhamid , Lee Martha , McDonnell Peter J
Published: April 2021

ABSTRACT

Contraction of corneal wounds as the incisions heal may account for changes in corneal topography after radial keratotomy; such contractility of avascular corneal wounds has been demonstrated in vitro. Using a cat model of radial keratotomy, we demonstrated in vivo contractility of radial keratotomy incisions. In eight eyes of adult female cats, four-incision radial keratotomies were performed, producing central corneal flattening. After 3 and 8 days, serotonin (1 mg/mL) was applied. On day 3, application of topical serotonin resulted in corneal steepening (P < .0001); serotonin produced no topographic changes when applied on day 8 and had no effect on normal unoperated corneas. Vehicle produced no change in corneal curvature before or at any time after radial keratotomy. Fluorescence microscopy revealed cells with myofibroblastic differentiation at the incisions. These data suggest that cells with contractile abilities play a role in determining corneal topography after radial keratotomy.
Visual, Astigmatic, and Inflammatory Results With the Staar AA-4203 Single-Piece Foldable IOL: A Randomized, Prospective Study
Authors: Martin Robert G , Sanders Donald R
Published: April 2021

ABSTRACT

One hundred twelve unilateral cataract extraction patients were randomly assigned to receive either a one-piece Staar Model AA-4203 silicone intraocular lens (IOL) implanted through a 3.2-millimeter incision, or a one-piece polymethylmethacrylate IOL implanted through a 6.0-millimeter incision. Follow up was 96% at 1 day postoperatively, 90% at 3 months, and 70% at 1 year. Fifty-three percent of the eyes that received a smaller incision could see 20/40 or better uncorrected at 1 day, as compared with 19% of the eyes that received a 6-millimeter incision (P < .01). At 3 months, significantly more smaller-incision eyes could still see 20/40 or better (P = .03). The smaller-incision eyes also had significantly less surgically-induced astigmatism at both 1 day (P < .01) and 3 months (P = .02), and had significantly less flare (P < .01) and cellular reaction (P = .04) at 1 day.
Surgical Treatment and Desensitization Therapy of Giant Papillary Allergic Conjunctivitis
Authors: Del Prete A , Chiosi E , Magli A , Calandriello M , Bernardo B , Bracale G
Published: April 2021

ABSTRACT

We found that three cases of giant papillary conjunctivitis responded well to local specific desensitization therapy and transplantation of the conjunctiva with saphenous vein tissue.
Adjunctive Viscoelastic Therapy for Postoperative Ciliary Block
Authors: Juzych Mark S , Parrow Kyle A , Shin Dong H , Swendris Ronald P , Ramocki John M
Published: April 2021

ABSTRACT

Following Molteno device implantation, trabeculectomy, or needling revision of trabeculectomy, six eyes of six chronic glaucoma patients developed a flat anterior chamber without hypotony, ciliochoroidal detachment, pupillary block, or external wound leak. The ciliary block did not respond to vigorous medical and laser therapy. We performed an intracameral injection of sodium hyaluronate, which resulted in maintenance of a full anterior chamber and normal intraocular pressure in all of the six eyes. The use of intracameral viscoelastic appears to be a reasonable adjunct for management of ciliary block not responsive to vigorous medical therapy and intracameral air injection trial, before attempting more extensive surgery.
Nasal Secretions in Ocular Surgery Under General and Local Anesthesia
Authors: Nagle F , Cooper R L
Published: April 2021

ABSTRACT

To investigate the etiology of nasopharyngeal secretion reflux under anesthesia, which could contaminate the conjunctiva, we photographed, after preoperative nasal instillation of fluorescein, the faces of 224 consecutive patients having cataract surgery under general (n = 78) and local (n = 146) anesthesia. In 10 patients, extension of the neck and facial contour caused fluid to drain from the nose directly into the conjunctival cul-de-sac. Nine of the 78 patients under general anesthesia had nasal secretions on the face at the end of surgery, usually due to leaking around the endotracheal tube. Adjusting head posture by moderate neck flexion and taking care to prevent leakage around the endotracheal tube, together with antiseptic preparation of the nose, may prevent contamination of the operative field by nasal secretions.
Measured and Predicted Anterior Chamber Depth for Transscleral Suture-Fixated Posterior Chamber Intraocular Lenses
Authors: Corder Donna M , McDermott Mark L , Shin Dong H , Parrow Kyle A , Lau-Sickon Laurie K
Published: April 2021

ABSTRACT

Variables in intraocular lens (10L) power calculations include axial length, average dioptric power of the cornea, and an assumed Pseudophakie anterior chamber depth (ACD). In the case of transscleral suturefixated posterior chamber (PC) IO Ls, ACD depends on the placement of the suture and thus might be expected to vary more than it does in eyes with capsular-fixated IOLs. To assess the degree of this variation, we determined the postoperative Pseudophakie ACD using ?-scan ultrasonography in 15 patients with transscleral suture-fixated PC-IOLs. The mean Pseudophakie ACD (posterior corneal vertex to anterior pseudophakos) was 3.47 ± 0.69 mm. The mean absolute discrepancies in ACD between these measured values and those predicted by the original Binkhorst and the most recent Holladay formulas were 0.579 ± 0.513 mm and 0.639 ± 0.519 mm, respectively. In 11 of 15 eyes, the measured ACD was within 1 mm of that predicted by either the Binkhorst or Holladay formula, suggesting that either will provide reasonable estimates of ACD for IOL power calculations for suture-fixated PC-IOLs.
Surgical Management of a Long-Standing Subfoveal Neovascular Membrane Secondary to Ocular Histoplasmosis
Authors: Wind Brian E , Sobol Warren M
Published: April 2021

ABSTRACT

Subretinal neovascular membranes located under the fovea typically lead to significant visual loss. Laser treatment has been limited due to the anatomic location of the neovascular process, but surgical removal has been reported with promising results. We surgically removed a long-standing, presumed ocular histoplasmosis syndrome (POHS) subfoveal neovascular membrane that had been present for 10 months in a patient's only functional eye, with unexpected good results. This case suggests that the good visual outcomes achieved by surgically excising smaller subfoveal neovascular membranes early in their natural history also can be achieved in selected patients with more chronic and severe subfoveal neovascular processes.
A New Method for Posterior Sub-Tenon's Drug Administration
Authors: Nesterov Arkady P , Basinsky Sergey N , Isaev Ajubkhan
Published: April 2021

ABSTRACT

We describe a technique of sub-Tenon's drug administration involving the use of a strip of collagen sponge connected with a silicone tube. The strip is implanted in the sub-Tenon's space and the free end of the tube "is attached to the patient's forehead. Medication is infused through the tube two to four times a day for 7 to 10 days; then the tube is removed. We have used this technique, without serious complications, in the treatment of 230 patients with various diseases of the posterior segment and the anterior part of the optic nerve.
Mersilene Mesh and Fascia Lata in Brow Suspension: A Comparative Study
Authors: Elder Mark J
Published: April 2021

ABSTRACT

I retrospectively compared 34 brow suspension procedures: 17 using Mersilene mesh and 17 using stored, irradiated fascia lata. Good results were obtained with both materials. Since Mersilene mesh is inexpensive, easy to prepare and work with, and can be sterilized and guaranteed free of infectious diseases, it is an acceptable alternative if fascia lata is unavailable.
Curved, Sub-Tenon Cannula for Local Anesthesia
Authors: Stevens Julian D
Published: April 2021

ABSTRACT

I describe a new cannula for delivery of sub-Tenon's local anesthetic solution. The cannula has a rigid structure, a 19-gauge diameter, and a shaft with a gentle curve, specifically designed to follow the contour of the globe. Anteroposterior flattening of the tip facilitates advancement of the cannula within the potential Tenon's-space tissue plane. Without the acute angulation of the shaft of the Bishop-Harmonstyle cannula, it is easier to follow the gtobe contour and create less tenting-up of conjunctiva.
Mitomycin as Adjunct Therapy in Correcting Iatrogenic Punctal Stenosis
Authors: Lam Sheridan , Tessler Howard H
Published: April 2021

ABSTRACT

A 52-year-old woman developed persistent epiphora in her left eye after undergoing occlusion of the left puncta. Two attempts to reopen the puncta with a one-snip procedure and placement of punctal sii icone plugs failed. The epiphora resolved and the puncta remained patent after the patient underwent a third one-snip procedure, supplemented with topical mitomycin during and after surgery.
Systemic Herpetic Infection Diagnosed by Retinal Biopsy
Authors: Friedberg Mark A , Schwartz Joseph C , Feinman Mitchell C , Pilkerton A Raymond , Barth Werner F , Perman Kevin I
Published: April 2021

ABSTRACT

We describe a patient with systemic lupus erythematosus who developed myelopathy, optic neuropathy, retinopathy, and aseptic meningitis unresponsive to immunosuppressive and antimicrobial therapy. Although cultures and brain biopsy were unrevealing, a Herpes virus was suggested by retinal biopsy. The patient recovered dramatically after institution of acyclovir therapy and optic-nerve-sheath decompression. This case demonstrates that herpetic retinitis can occur in an iatrogenically suppressed host and underscores the value of tissue diagnosis.
Versatility of the cw-Nd:YAG and Diode Lasers in Ocular Surgery
Authors: Fankhauser Franz , Kwasniewska Sylwia , Henchoz Pierre-David , van der Zypen Eugen , England Ceri
Published: April 2021

ABSTRACT

The effectiveness of cw-Nd:YAG and diode laser light in performing transscleral chorioretinal coagulation is demonstrated in cadaver porcine eyes using a new contact probe that facilitates irradiation of these layers. Both radiation sources also may be viable alternatives to argon laser light in effecting chorioretinal and cycloendocoagulation.
Automated Perimetric Changes Following Panretinal Photocoagulation in Diabetic Retinopathy
Authors: Khosla P K , Gupta Vivek , Tewari H K , Kumar Atul
Published: April 2021

ABSTRACT

Sixty eyes - 30 with severe nonproliferative diabetic retinopathy (NPDR) and 30 with proliferative diabetic retinopathy (PDR) - underwent argon laser panretinal photocoagulation (PRP). Static perimetry (Humphrey automated visual field analyzer 630, Threshold Prog Central 30-1 and Peri 30/60-1) was done 1 day before and 6 weeks after the initial laser treatment. One day before treatment, the fields of the NPDR and PDR eyes differed mainly in the central field affection: the PDR eyes had more localized areas of markedly decreased retinal sensitivity and, therefore, a higher initial mean deviation value and higher corrected pattern standard deviation values. However, peripheral retinal sensitivity was equally depressed in the NPDR and PDR eyes. Six weeks after treatment, central retinal sensitivity had significantly improved in all of the eyes, although more so in the eyes with severe NPDR. This study suggests that static-perimetry-guided PRP is an effective treatment for diabetic retinopathy, especially severe NPDR.
Posttrabeculectomy Anterior Subcapsular Cataract Formation Induced by Anterior Chamber Air
Authors: Asamoto Ayako , Yablonski Michael E
Published: April 2021

ABSTRACT

We retrospectively examined the effect of air, as contrasted with balanced salt solution (BSS), sodium hyaluronate, or no substance at all, used to reform the anterior chamber at the end of trabeculectomy on subsequent cataract formation in 141 consecutive patients (173 phakic eyes). The minimum follow up was 120 days. The use of air increased the incidence of anterior subcapsular cataract formation significantly. Also, the eyes that had a large air bubble on postoperative day 1 had a higher incidence of anterior subcapsular cataract than the eyes with less air on that day. We suggest that the toxicity to the lens of the oxygen in the air increased the incidence of anterior subcapsular cataract in the eyes in which air was used. We recommend that BSS or sodium hyaluronate be used instead of air to reform the anterior chamber following trabeculectomy.
Surgical Correction of Upper Eyelid Retraction
Authors: Liu Don
Published: April 2021

ABSTRACT

Over the last 7 years, I have used a "central aponeurosis disinsertion" technique to correct dysthyroid upper eyelid retraction in nine patients. Consistent and predictable results were achieved and maintained over follow-up periods ranging from 18 to 72 months. The technique is simple and effective, and does not involve extensive dissection or the use of a spacer.
Combined Extracapsular Cataract Extraction, Posterior Chamber Intraocular Lens Implantation, and Pars Plana Vitrectomy
Authors: Foster Robert E , Lowder Careen Y , Meisler David M , Zakov Z Nicholas , Meyers Sanford M , Ambler John S
Published: April 2021

ABSTRACT

The surgical management of coexisting cataract and vitreoretinal disease has been controversial, particularly for eyes with a history of proliferative diabetic retinopathy (PDR) or chronic uveitis. We retrospectively studied the results of combined extracapsular cataract extraction (ECCE), posterior chamber intraocular lens (PC-IOL) implantation, and pars plana vitrectomy in 20 eyes of 16 patients. The indications for combined vitrectomy included dense, nonclearing vitreous hemorrhage attributed to PDR in 10 eyes, age-related macular degeneration in 2, and trauma in 1. The remaining 7 eyes had pars plana vitrectomy to remove inflammatory vitreous cell and debris associated with chronic uveitis. Follow up ranged from 4 to 32 months (average, 17.4 months). Visual acuity improved in 19 eyes (95%)- to 20/100 or better in 12 (60%). The improvement ranged from 1 to 13 Snellen lines (average, 4.9 lines). Postoperative visual acuity improvement averaged 7.5 Snellen lines for eyes with chronic uveitis, 7.0 lines for those with age-related macular degeneration, and 3.3 lines for those with a history of PDR. Postoperative visual acuity was less than 20/100 in 8 eyes (40%). In most cases, these latter results were attributed to macular changes associated with the underlying ocular disease. Our results confirm previous studies that have shown that combined ECCE/PC-IOL implantation and pars plana vitrectomy is a well-tolerated surgical procedure for diabetics, which can provide clear anterior and posterior segment media. In addition, our results suggest that this combined procedure can be useful in restoring vision in certain eyes with uveitis in the short-term postoperative period.
A New Technique for Combined Cataract/Glaucoma Procedures in Patients on Chronic Miotics
Authors: Whitsett Jeffrey C , Stewart Robert H
Published: April 2021

ABSTRACT

We describe a combined cataract/glaucoma procedure for patients on chronic miotics that includes smallincision phacoemulsrfication to provide increased predictability of visual outcome and early visual rehabilitation, and an inferior pupilloplasty to facilitate intraoperative visualization. To date, 42 procedures have been performed with excellent results. Complications, although minimal, have included iridolenticular/ iridocapsular adhesions, diplopia, rupture of 10-0 polypropylene sutures, peripheral anterior synechia, hyphema, and fibrinoid aqueous.
Nd:YAG "Sweeping"-An Indirect Technique for Clearing Intraocular Lens Deposits
Authors: Vajpayee Rasik B , Angra Surendra K , Honavar Santosh G , Kumar Harsh
Published: April 2021

ABSTRACT

Corticosteroid-resistant deposits on the anterior surface of intraocular lenses (1OLs) in 11 patients who had complained of poor vision were "swept" with a Neodymium:YAG laser beam. As contrasted with previous "direct hit" methods, our method is indirect, using a low-power, defocused beam to generate an acoustic shock-wave, which then sweeps the lens surface clear of deposits. The deposits were cleared in all 11 patients, with no damage to the IOL or any other postlaser complications. Improvement in visual acuity ranged from 1 to 3 lines, and all the patients reported alleviation of symptoms.
Orbital Retractors for Posterior Segment Surgery
Authors: Spaide Richard F
Published: April 2021

ABSTRACT

Successful retinal detachment surgery is greatly aided by proper visualization of and access to the intended surgical field. Two retractors, one having a single blade and the other a double blade, have been developed to aid retinal detachment surgery.
Focal and Diffuse Visual Field Defects: Their Relationship to Intraocular Pressure
Authors: Samuelson Thomas W , Spaeth George L
Published: April 2021

ABSTRACT

The view that visual field loss in "low-tension" glaucoma (LTG) is more focal than in ordinary or "high-tension" glaucoma (HTG) is controversial. The basis of the controversy may be the inappropriate presupposition that an arbitrary intraocular pressure (IOP) level effectively differentiates these entities. We attempted to determine whether meaningful differences exist between glaucoma patients classified on the basis of pattern of visual field loss rather than IOR One hundred consecutive glaucomatous visual fields were classified as focal or diffuse by two independent observers masked to all other clinical information. Several clinical parameters were then evaluated, comparing patients with focal visual field loss, with those with diffuse loss. Maximal pretreatment IOP was significantly lower among the patients with focal visual field loss than it was among those with diffuse loss (21.5 mm Hg ± 5.7 vs 25.9 mm Hg ± 4.7; P < .01). There was no difference between the two groups in terms of age, blood pressure, visual acuity, or color vision. We conclude that focal glaucomatous visual field loss occurs at a lower IOP than diffuse loss and, as such, may be a marker by which to identify patients whose optic nerves are abnormally susceptible to glaucomatous injury.
Transscleral Neodymium:YAG Laser Cyclophotocoagulation for End-Stage Glaucoma, Refractory Glaucoma, and Painful Blind Eyes
Authors: Al-Ghamdi Saleh , Al-Obeidan Saleh , Tomey Karim F , Al-Jadaan Ibrahim
Published: April 2021

ABSTRACT

We used transscleral NeodymiunrYAG laser cyclophotocoagulation (TSYLCC) to treat 47 patients (47 eyes! with end-stage, refractory, or absolute glaucoma. The mean pretreatment intraocular pressure (IOP), 40.5 ± 10.8 mm Hg, decreased a mean of 13 ± 8 months following treatment to 15.6 ± 10.6 mm Hg, a statistically significant change (P < .05). Our overall rate of success (final IOP « 25 mm Hg, with or without medications) was 79% (37 eyes). Early complications included pain (11 eyes) and inflammation (13 eyes); late complications included hypotony (7 eyes), high IOP (5 eyes), and decreased visual acuity (4 eyes). TSYLCC seems to be a safe, effective, and convenient outpatient procedure.
Use of Perfluoroperhydrophenanthrene in the Management of Posteriorly Dislocated Crystalline and Intraocular Lenses
Authors: Greve Mark D J , Peyman Gholam A , Mehta Nalin J , Millsap C Mark
Published: April 2021

ABSTRACT

We describe a series of 28 patients in whom a posteriorly dislocated crystalline or intraocular lens was successfully removed with the intraoperative use of perfluoroperhydrophenanthrene (Vitreon), a heavy liquid perfluorocarbon. The Vitreon was used to float the lens into the midvitreous cavity, thereby avoiding hazardous micromanipulation with intraocular instruments in the macular area. In addition, the Vitreon served to protect the posterior retina by keeping the posteriorly dislocated lens fragments from falling backward onto the posterior pole as the lens was being removed from the eye. Postoperative visual acuity improved in 73% of the patients, remained the same in 15%, and worsened in 12%.
Silicone Oil Tamponade for Retinal Detachment and Delayed Treatment of Retinal Tears
Authors: Zauberman Hanan , Hemo Itzhak
Published: April 2021

ABSTRACT

Four patients underwent a vitrectomy procedure for retinal detachment associated with anterior and posterior proliferative vitreoretinopathy (D-1 type). In each patient, an internal tamponade was achieved with 1000-centistoke silicone oil. Preretinal and/or subretinal hemorrhage that was difficult to remove during surgery, as well as remnants of subretinal fluid, prevented complete intraoperative treatment of the retinal tears or the retinotomy with endolaser photocoagulation. The silicone oil tamponade kept the retina flat until laser treatment was applied to the retinal tears several weeks later, when the retinal blood and subretinal fluid had reabsorbed.

When circumstances make achieving intraoperative laser marks difficult, silicone oil tamponade appears to be superior to a long-lasting gas tamponade. It provides a more permanent tamponade than gas and excellent visualization of the fundus several weeks after surgery, at which time laser marks can be completed.
Migration of Solid Silicone Encircling Element Through Four Rectus Muscles
Authors: Maguire Albert M , Zarbin Marco A , Eliott Dean
Published: April 2021

ABSTRACT

Anterior migration of an encircling element through a rectus muscle is an unusual complication of scierai buckling surgery. We describe two patients with migration of a solid silicone encircling element through the insertions of all four rectus muscles after retinal detachment surgery. Buckle migration was associated with elevated intraocular pressure and glaucomatous optic atrophy. Rectus muscle function was preserved in both patients. Despite transsection of the anterior ciliary blood supply, anterior segment ischemia did not develop.
Pseudo-Brown's Syndrome as a Complication of Glaucoma Drainage Implant Surgery
Authors: Prata João Antonio , Minckler Donald S , Green Ronald L
Published: April 2021

ABSTRACT

Two cases of pseudo-Brown's syndrome occurring after superior nasal implantation of glaucoma filtering devices are described. We hypothesize that this restriction in ocular motitity was due to the mechanical effects of large filtering blebs or increased inflammation and scar formation in the superior nasal quadrant. Serial ultrasound examinations of our patients demonstrated development of a large bleb, coincidental with the disturbance in motility. Because of the risk of strabismus, we no longer recommend placing large implant devices in the superior nasal quadrant in eyes that have good vision.
Repair of Iridodialysis Using a 17-Millimeter Straight Needle
Authors: Nunziata B Richard
Published: April 2021

ABSTRACT

A technique for repair of an iridodialysis using a 17-millimeter straight needle is described. Using this needle greatly facilitates the surgery and enables maintenance of a closed system, without loss of the anterior chamber or trauma to the cornea.
The Necessity of Long-Term Follow Up After Surgery for Basal Cell Carcinomas of the Eyelid
Authors: Steinkogler Franz Josef , Scholda C D
Published: April 2021

ABSTRACT

Both diagnostic and therapeutic problems remain in the treatment of basal cell carcinomas of the eyelid. Incorrect initial diagnosis and resulting inadequate treatment can lead to the loss of the bulbus. Inadequate follow up may result in failure to detect a recurrent tumor. We retrospectively studied 226 patients with basal cell carcinoma of the eyelid who had surgery some time between 1980 and 1989. In 179 patients, a primary lid tumor was removed; the recurrence rate for these patients was 6.1%. Forty-seven patients had surgery for secondary eyelid basaliomas; the recurrence rate for these patients was 14.8%. These recurrence rates correlated clearly with the horizontal extent and depth of the tumor, and with the appearance of the sclerodermiform type. The fact that recurrences were found after 3 years demonstrates the importance of long-term follow up in these patients, especially in those with secondary tumors and tumors of exceptional height.
Perfluoroperhydrophenanthrene (Vitreon) in the Management of Giant Retinal Tears: Results of a Collaborative Study*
Authors: Millsap C Mark , Peyman Gholam A , Mehta Nalin J , Greve Mark D J , Lee Kwang J , Ma Patrick E , Dunlap Weldon A
Published: April 2021

ABSTRACT

Fifty cases of retinal detachment with a giant retinal tear were managed using perfluoroperhydrophenanthrene (Vitreon) as an intraoperative and postoperative tool. The giant tear was less than 180° in 76% of the eyes, greater than 180° in 22%, and greater than 270° in 2%. Proliferative vitreoretinopathy was present in 40%. Vitreon was used only intraoperatively in 84% of the eyes, and was left in 16% for up to 4 weeks. Intraoperative retinal reattachment was achieved in 98%. Retinal attachment was maintained in 88%, with a mean follow up of 8.6 months. Postoperative visual acuity was better than 20/400 in 52%. Postoperative complications included cataract in 23%, choroidal effusion in 2%, hypotony in 4%, and recurrent retinal detachment with proliferative vitreoretinopathy in 26%.
Subconjunctival Dislocation of Posterior Chamber Intraocular Lens
Authors: Sandramouli S , Kumar Atul , Rao Venkateshwar , Khosla Amit
Published: April 2021

ABSTRACT

A posterior chamber intraocular lens (PC-IOL) dislocated into the subconjunctival space following a concussion injury in a 24-year-old man who had gained good visual acuity following extracapsular cataract extraction and PC-IOL implantation for a steroid-induced cataract. Except for long-term use of topical steroid therapy for vernal catarrh, the patient had no systemic or ocular predisposing factors for wound dehiscence. Given the risk of endophthalmitis, the PC-IOL was removed and anterior vitrectomy was performed on an emergency basis. To our knowledge, this is the second documented case of a subconjunctivally dislocated PC-IOL.
THC:YAG Nasolacrimal Duct Recanalization
Authors: Silkiss Rona Z
Published: April 2021

ABSTRACT

In an early exploration of a new technique for creating a patent nasolacrimal duct system, a chromium-sensitized and thulium- and holmium-doped YAG laser was used to canalize the nasolacrimal duct of a fresh-frozen bisected human cadaver head. The laser-long-pulsed (300 milliseconds), compact, self-contained, and solid-state-operates in the near infrared range (2.1 µm). The technique involved passing a 550-micrometer quartz fiberoptic through the dilated superior punctum and canalicular system, down through the nasolacrimal duct. The quartz fiberoptic was then withdrawn into the area of the lacrimal sac. Pulse energies of 500 mJ were used at a repetition rate of five pulses per second to ablate the duct lining. The nasolacrimal duct was then unroofed and the epithelial lining of the duct histopathologically evaluated.
The Pupil Stretch Technique for Miotic Pupils in Cataract Surgery
Authors: Shepherd David M
Published: April 2021

ABSTRACT

I describe a safe, simple, and effective method of opening a miotic pupil for cataract surgery.
Total Choroidal Detachment Complicating Dural Arteriovenous Sinus Fistula
Authors: Wang Michael L , Seiff Stuart R , Halbach Van V , Christenbury Jonathan D , Jaben Scott L
Published: April 2021

ABSTRACT

We present the first (to our knowledge) angiographically documented case of total lobular choroidal detachment as a complication of a dural arteriovenous fistula, in which sequential management led to improved vision.
Orbital Hemorrhage After the Administration of Sub-Tenon's Infusion Anesthesia
Authors: Olitsky Scott E , Juneja Rashmi O
Published: April 2021

Abstract. Administration of a sub-Tenon's anesthetic induced an orbital hemorrhage in a patient who underwent strabismus surgery. This report is the first case of this sight-threatening complication after sub-Tenon's infusion anesthesia. [Ophthalmic Surg Lasers 1997;28: 145-146.]
Performing Peripheral Iridectomy via a Scleral Tunnel Incision: A New Approach
Authors: Blumenthal Michael , Cahane Michael
Published: April 2021

Abstract. A peripheral iridectomy (PI) is sometimes difficult to perform through a sclero-corneal tunnel. This study evaluated the efFectiveness and safety of a newly proposed technique for performing a PI. The results showed that a PI can be easily performed through a sclero-corneal tunnel, employing this technique. [Ophthalmic Surg Lasers 1997;28:162-164.]
Diode Laser-Pumped, Frequency-Doubled Neodymium:YAG Laser Peripheral Iridotomy
Authors: Abreu Mario Marc , Siera Rafael A , Netland Peter A
Published: April 2021

* BACKGROUND AND OBJECTIVE: The solid state, continuous-wave, frequency-doubled neodymium:yttrium-aluminum-garnet (Nd:YAG) laser pumped by a diode laser has several advantages, including air cooling, higher electrical to optical efficiency ratios, portability, and the use of standard 110-V AC electrical service. The authors wanted to evaluate the use of the frequency-doubled Nd:YAG laser for peripheral iridotomy and to compare the tissue interactions of this laser with those of the argon laser.

* MATERIALS AND METHODS: The authors developed a diode laser-pumped, solid-state, and portable frequency-doubled Nd:YAG laser with a wavelength of 532 nm. The effects of peripheral iridotomy with the frequency-doubled Nd:YAG laser and the argon laser were evaluated in pig eyes in vitro and in rabbit eyes in vivo. Specimens were prepared for light microscopy and scanning electron microscopy.

* RESULTS: The frequency-doubled Nd:YAG laser successfully created patent iridotomies in all animal eyes treated. The following parameters were used to create penetrating burns: duration of 0.1 second, spot size of 100 um, and power of 500 mW. In rabbit eyes, the mean number of pulses (P= .16) and die total energy required [P= .21) for iridotomy were not significandy different for the argon laser compared with the frequency-doubled Nd: YAG laser. Gross and histologic evaluation showed similar thermal effects in iris tissues for both the frequency-doubled Nd: YAG laser and the argon laser. The mean zone of thermal damage was 178 ± 19 urn for the frequency-doubled Nd:YAG laser and 163 ± 24 pm for tlie argon laser (P = .14). Scanning electron microscopy showed less disruption of tJhe surface of the lesion for the frequency-doubled Nd: YAG laser compared with the argon laser.

* CONCLUSIONS: Successful peripheral iridotomy can be performed with the frequency-doubled Nd: YAG laser. Coagulative effects with the frequency-doubled Nd: YAG were similar to those with the argon laser, and the thermal damage zones were comparable in size.

[Ophthalmic Surg Lasers 1997;28:305-310.]
The Use of Processed Pericardium in the Repair of Corneo-Scleral Fistulas
Authors: Sibayan Santiago Antonio B , Latina Mark A
Published: April 2021

Abstract. Explantation of glaucoma valve implants may be complicated by wound closure problems. Prolonged implantation of these valves can lead to development of corneo-scleral fistulas that may not be adequately sealed with the use of sutures alone. The authors report the use of processed pericardium as tissue replacement material for the repair of such fistulas. A 45-year-old woman underwent explantation of a Baerveldt glaucoma valve implant, resulting in the development of a corneo-scleral fistula. To repair the fistula, processed pericardium was inserted into it and secured with 10-0 nylon sutures. Postoperatively, a good wound seal was achieved with no leakage of aqueous humor from the anterior chamber, nor any inflammation. Processed pericardium appears to be an effective tissue replacement material for sealing corneo-scleral fistulas. [Ophthalmic Surg Lasers 1997;28:334-335.]
Symmetrical Marking of Both Donor and Recipient Corneas in Penetrating Keratoplasty
Authors: Lanier Jeffrey Day
Published: April 2021

Abstract. The symmetrical marking of both the donor and the recipient corneas aids in the proper alignment of the donor cornea within the recipient opening. The second stitch in a penetrating keratoplasty ís the most important stitch for the proper alignment of the donor cornea within the recipient opening. If the second stitch is placed too far to the right or left, there will be a gap on one side and an override on the other side. This misalignment is likely to result in a distortion of the corneal surface contour. The proper alignment can be made even more difficult if the recipient opening is distorted. The proper alignment can be facilitated by symmetrically marking both donor and recipient corneas. A simple surgical technique is described to clarify and emphasize this very important principle of penetrating keratoplasty - the alignment of the donor cornea within the recipient opening. [Ophthalmic Surg Lasers 1997;28:338-342.]
Treatment of Convergence Insufficiency by Single Medial Rectus Muscle Slanting Resection
Authors: Biedner B
Published: April 2021

Abstract. A method of treatment of convergence insufficiency is described. The author describes three patients who underwent single medial rectus muscle slanting resection with successful alignment in all fields of gaze. [Ophthalmic Surg Lasers 1997;28: 347-348.]
Intraoperative Mitomycin-C for Glaucoma Associated With Ocular Inflammation
Authors: Wright Martha M , McGehee Read F , Pederson Jonathan E
Published: April 2021

* BACKGROUND AND OBJECTIVE: The authors studied the efficacy and complications of intraoperative mitomycin-C in glaucoma associated with ocular inflammation.

* PATIENTS AND METHODS: The authors retrospectively reviewed the medical records of 24 consecutive patients (24 eyes) with glaucoma and ocular inflammation who had been treated with trabeculectomy and intraoperative mitomycin-C. Patient ages ranged from 10 to 83 years (mean 43 years). All patients were observed for at least 6 months.

* RESULTS: With a mean follow-up time of 14.6 months, 18 of the 24 patients (75%) retained vision and had an intraocular pressure of 21 mm Hg or lower with or without medications (range 4 to 21 mm Hg; mean 13.4 mm Hg). Fifteen of 24 patients (62%) had an intraocular pressure of 21 mm Hg or lower with no medications. Three patients required tube shunt implants. One patient had a retinal detachment and lost light perception. One patient had endophthalmitis 14 months after surgery. Seven of 24 patients lost two or more lines of Snellen acuity.

* CONCLUSION: Trabeculectomy with mitomycin-C can control intraocular pressure in glaucoma associated with ocular inflammation, but complications are frequent.

[Ophthalmic Surg Lasers 1997;28:370-376.]
Photodynamic Therapy for Choriocapillaris Using Tin Ethyl Etiopurpurin (SnET2)
Authors: Peyman Gholam A , Moshfeghi Darius M , Moshfeghi Andrew , Khoobehi Bahram , Doiron Daniel R , Primbs George B , Crean David H
Published: April 2021

* BACKGROUND AND OBJECTIVE: To investigate the use of photodynamic therapy (PDT) using tin ethyl etiopurpurin (SnET2) for occluding the choriocapillaris in the eyes of pigmented rabbits.

* MATERIALS AND METHODS: Following intravenous injection of SnET2 (0.5 and 1 mg/kg) or lipid emulsion alone, the fundus of pigmented rabbits (n = 21) was irradiated starting 15 to 45 minutes after photosensitizer injection using 664-nm light at a fluence of 300 mW/cm
p 2
and light doses of 5 to 20 J/cm
p 2
. Funduscopy, fluorescein angiography, and light and electron microscopy were performed at 1, 14, and 28 days after PDT.

* RESULTS: Following SnET2 and PDT, closure of the choriocapillaris was achieved with light doses as low as 5 J/cm
p 2
(17 seconds) and a drug dose of 0.5 mg/kg of SnET2. Vascular occlusion was documented by fluorescein angiography and histology. Photodynamic damage was noted in the choriocapillary endothelial cells. Retinal pigment epithelial damage and outer retinal damage were also observed. No funduscopic, angiographic, or histologic findings were present in the eyes of pigmented control rabbits.

* CONCLUSIONS: PDT with SnET2 was effective in this animal model, using low levels of activating light for the occlusion of the choriocapillaris. This has clinical implications for the treatment of choroidal neovascularization and could be a more selective therapy than thermal laser photocoagulation.

[Ophthalmic Surg Lasers 1997;28:409-417.]
Silicone Oil Removal Using a Self-Sealing Corneal Incision Under Topical Anesthesia
Authors: Yildirim Rengin , Aras Cengiz , Ozdamar Akif , Bahcecioglu Halil
Published: April 2021

* BACKGROUND AND OBJECTIVE: To report the results of silicone oil removal from aphakic eyes using a self-sealing clear corneal incision under topical anesthesia.

* PATIENTS AND METHODS: Twenty-two eyes of 22 patients who had pars plana vitrectomy combined with silicone oil injection underwent silicone oil removal under topical anesthesia using a self-sealing clear corneal incision. Mean time between silicone oil injection and removal was 3.1 ± 1.42 months. Fourteen eyes were filled with 1300 cs of silicone oil and 8 eyes were filled with 5700 cs of silicone oil. The removal was performed with passive washout in the eyes filled with 1300 cs of silicone oil and with active aspiration in the eyes filled with 5700 cs of silicone oil.

* RESULTS: All of the 22 silicone oil removal procedures performed under topical anesthesia had clear corneal incisions that did not require suturing at the end of surgery. Three cases that had 1300 cs of silicone oil required aspiration because of residual silicone oil bubbles.

* CONCLUSION: Silicone oil can be removed from the aphakic eye Using a self-sealing corneal tunnel incision under topical anesthesia.

[Ophthalmic Surg Lasers 1999; 30: 24-26.]
Lacrimal Sac Dilatation in Balloon Dacryocystoplasty
Authors: Zilelioglu Guler , Ugurbas Suat Hayri
Published: April 2021

Abstract. The authors report a case of balloon dacryocystoplasty in a patient who had a dilated lacrimal sac found in conventional surgery. A 52-year-old woman presented with persistent epiphora after a failed balloon dacryocystoplasty. She underwent an external dacryocystorhinostomy. The lacrimal sac was found to be dilated at its lower part, adjacent to the nasolacrimal ductus. Flaps were created more superiorly than usual. The operation was unsuccessful after 3 months. Previous balloon dacryocystoplasty, which is reported to be a harmless procedure, may pose some difficulty in subsequent conventional surgery. [Ophthalmic Surg Lasers 1999; 30: 61-62.]
Quantitative Image Sequence Analysis of Fundus Fluorescein Angiography
Authors: Berger Jeffrey W
Published: April 2021

Abstract. Interpretation of retinal angiographic studies has heretofore been largely qualitative. The temporal properties associated with fluorescein fluorescence of normal and pathologic fundus features are quantified to potentiate pixel assignment and fundus feature quantitation for clinical studies where precise image metrology is vital. Fluorescein angiography studies were digitized, and temporally sequential images were spatially registered with polynomial warping algorithms, allowing for the construction of a three-dimensional angiogram vector. Temporal profiles through spatially registered, temporally sequential pixels were computed. Fundus feature fluorescence behavior was quantified. Fundus features may be discriminated on the basis of spatio-temporal fluorescein fluorescence properties. Pixel assignment based on spatio-temporal relationships will facilitate fundus feature quantitation. [Ophthalmic Surg and Lasers 1999;30:72-73.]