bluuebunny/crossref_metadata_2025 huggingface dataset:
Single Stage Molteno Implant With Combination Internal Occlusion and External Ligature
Authors: Latina Mark A
Published: April 2021

ABSTRACT

A variety of techniques have been devised to reduce postoperative hypotony following a single-stage Molteno implant procedure. Although they effectively reduce hypotony, these techniques may result in a prolonged increase of intraocular pressure (IOP). I present a technique, consisting of placement of a 5-0 nylon internal occlusion suture combined with an external polyglactin (Vicryl) ligature around the Molteno tube, to prevent both hypotony and elevated IOP after implantation.
Transscleral Contact Retinal Photocoagulation With an 810nm Semiconductor Diode Laser
Authors: Jennings Tom , Fuller Terry , Vukich John A , Lam Tim T , Joondeph Brian C , Ticho Ben , Blair Norman P , Edward Deepak P
Published: April 2021

ABSTRACT

Since the 810-nm wavelength has marked transmissibility through the sclera and absorption by melanin, ft would be ideal for transscleral photocoagulation. We performed experiments to determine if consistent transscleral chorioretinal lesions could be produced in Dutch belted pigmented rabbits using the 810-nm laser, and if this modality caused less blood-retinal barrier disruption than retinal cryopexy of clinically equivalent treatment areas. The laser applications produced whitish to grayish-white retinal lesions when the surgeon, under direct visualization, used low powers and long durations (5 to 10 seconds), and controlled the treatment duration. Histopathologic evaluation of a lesion demonstrated an intact sclera overlying the chorioretinal lesion. Vitreous protein concentration, which was measured to assess bloodretinal barrier disruption, was significantly less in eyes treated with transscleral photocoagulation than in eyes treated with cryopexy of clinically equivalent treatment areas. We conclude that transscleral 810nm laser treatment may be a viable clinical alternative to retinal cryopexy.
Acute Angle-Closure Glaucoma in a Patient With Acquired Immunodeficiency Syndrome Successfully Treated With Argon Laser Peripheral Iridoplasty
Authors: Koster Harry R , Liebmann Jeffrey M , Ritch Robert , Hudock Stephen
Published: April 2021

ABSTRACT

Laser iridectomy relieves pupillary block and is the procedure of choice for angle-closure glaucoma. Since not all cases of angle closure glaucoma are due to this mechanism, iridectomy is not always curative. Argon laser peripheral iridoplasty causes a contraction of peripheral iris away from the trabecular meshwork, and is useful in these circumstances. We successfully treated bilateral acute angle-closure glaucoma in a patient with acquired immunodeficiency syndrome with this procedure.
Reduced Mydriasis From Repeated Doses of Tropicamide and Cyclopentolate
Authors: McCormack Donald L
Published: April 2021

ABSTRACT

Pupils are often dilated for examination the day before surgery and again on the day of surgery. The following experiment was performed to determine the effect of serial doses of two commonly used mydriatic agents: on two consecutive days the pupil of one of the eyes of 28 subjects was dilated with tropicamide 1%, and the pupil of one of the eyes of 30 subjects was dilated with cyclopentolate hydrochloride 1%. The other eyes in both groups were dilated only on the second day, and thus served as controls. Pupil sizes were measured from photographs before and after dilation. The pupils of the eyes treated twice with either drug did not dilate as well after the second dose as those of the control eyes (P < .005 for tropicamide, P < .001 for cyclopentolate). The pupils of the eyes twice-treated with tropicamide were an average of 0.15 mm smaller than the control pupils; those twice-treated with cyclopentolate were 0.36 mm smaller. For subjects treated with cyclopentolate, this decreased mydriasis was related to age (P < .05) and to eye color (P < .025): the younger and blue-eyed subjects dilated less on the second day than the older and brown-eyed subjects.

If full mydriasis is required at surgery, pupils should probably not be dilated with either tropicamide or cyclopentolate the day before surgery.
Management of Macular Puckers Associated With Retinal Angiomas
Authors: Schwartz Peter L , Fastenberg David M , Shakin Jeffrey L
Published: April 2021

ABSTRACT

Monocular visual loss in four patients was caused by epiretinal macular membranes associated with peripheral retinal capillary angiomas or angioma-like lesions. Three patients had solitary vascular lesions and one had two discrete vascular lesions. All patients were in good health, with no evidence of the von Hippel-Lindau syndrome. In three patients, spontaneous peeling of the macular membranes and visual improvement occurred 2 to 6 months after obliteration of the angioma-like lesions with cryotherapy (two patients), or cryotherapy combined with argon laser (one patient). The fourth patient underwent a vitrectomy 8 months after the macular pucker had foiled to respond to treatment of the vascular lesion.
Management of Postoperative Inflammation: Dexamethasone Versus Flurbiprofen, a Quantitative Study Using the New Flare Cell Meter
Authors: Drews Robert C
Published: April 2021

ABSTRACT

A consecutive, random, prospective study was conducted to compare the effect of topical dexamethasone and flurbiprofen drops on postoperative inflammation in patients undergoing extracapsular cataract extraction with lens implantation. Objective, quantitative measurements were made postoperatively, using the Kowa FC-1000 Rare Cell Meter. The two treatments were equally effective.
Retinal Toxicity of Intravitreal Ticarcillin
Authors: Heigle Thomas J , Peyman Gholam A
Published: April 2021

ABSTRACT

The retinal toxicity of the penicillin derivative, ticarcillin, was tested in albino rabbits by injecting the animals intravitreally with doses ranging from 50 to 3,000 µg, and monitoring them for 4 weeks. A second confirmatory study was performed by repeating the high-dose injections in e different set of rabbits and monitoring them for 3 weeks. Histologic examination and electroretinography of both groups showed that dosages up to 3000 µ-g produced no detectable damage to the retina. A dosage of 3000 pg of ticarcillin, which is 38 times the minimal inhibitory concentration for Pseudomonas aeruginosa, appears safe.
Evaluation of Peribulbar Anesthesia in Eye Camps
Authors: Kishore Kamal , Agarwal Harish C , Sood N N , Betharia S M , Sihota Ramanjit , War N , Chhabra V K
Published: April 2021

ABSTRACT

Modified peribulbar anesthesia was administered with a 26-gauge, half-inch, insulin needle to 367 eyes off 360 patients in three eye camps in India. The intraocular procedures consisted of cataract extraction in 348 eyes, trabeculectomy in 11 eyes, and combined cataract extraction and trabeculectomy in seven eyes. The overall success rate of the anesthesia technique was 90.2% (supplemental anesthesia was required in 36 eyes). There was good lid and globe akinesia and anesthesia, adequate pupillary dilatation for intracapsular cataract extraction, and excellent hypotony. No significant focal or systemic complications were observed, except for mild to moderate Chemosis in some eyes, which did not produce any intraoperative or postoperative problems. We found this technique easy to learn, relatively safe, effective, and well tolerated by our patients.
Flexible Endoscopy in Primary Dye Testing of the Lacrimal System
Authors: Becker Bruce B
Published: April 2021

ABSTRACT

The Olympus PF-22 angioscope was used to examine the inferior meatus during primary dye testing in 80 lacrimal systems in 48 patients. Dye testing was done bilaterally in 32 subjects with no known abnormalities of lacrimal excretory function; it also was performed on the apparently normal contralateral side of 16 patients with unilateral epiphora. Dye was observed in the nose in 79 of 80 lacrimal systems (99%). Dye was not observed in one patient, who appeared to have a dysfunctional lacrimal excretory system. Primary dye testing of the lacrimal system is reliable when the Olympus PF-22 angioscope is used to examine the inferior meatus.
Use of a Carbon Dioxide Laser for Lesions Extending Into the Lashes
Authors: Korn Elliot
Published: April 2021

ABSTRACT

Thirty-six patients with benign lesions extending into the lashes treated with the carbon dioxide laser are reported. Histopathologically adequate specimens and cosmetically acceptable results were obtained in all cases.
Subconjunctival THC: YAG Laser Limbal Sclerostomy Ab Externo in the Rabbit
Authors: Hoskins H Dunbar , Iwach Andrew G , Drake Michael V , Schuster Bradley L , Vassiliadis Arthur , Crawford J Brooks , Hennings David R
Published: April 2021

ABSTRACT

A chromium-sensitized, and thulium and holmiumdoped YAG laser (THC:YAG laser) was used to create bilateral limbal sclerostomies in six Dutch pigmented rabbits. The laser is a long-pulsed (300 ms), compact, self-contained, solid-state laser operating in the near infrared (2-Vm). A 1-mm conjunctival stab incision was made 12 mm away from the sclerostomy site to allow entry of a specially designed 26-gauge (480µ??) optic probe that delivers energy at right angles to the long axis of the fiber. Probe insertion minimally disturbed the conjunctiva. Pulse energies of 60 to 150 mJ were used with a repetition rate of 5 pulses/s. Energy levels ranging from 1.35 to 6.6 J produced full-thickness sclerostomies. Histopathology showed a sharply defined perforating limbal wound at all energy levels. The overlying conjunctiva was intact, with swelling of the adjacent cornea. A peripheral iridectomy was intentionally created with the laser through the peripheral limbus, resulting in a sharply defined perforating tract through the iris/ciliary body. This technique may simplify filtering sclerostomy surgery, without anterior chamber instrumentation and with minimal conjunctival trauma.
Visual Results and Complications of Transsclerally Sutured Intraocular Lenses in Penetrating Keratoplasty
Authors: Heidemann David G , Dunn Steven P
Published: April 2021

ABSTRACT

We retrospectively reviewed the charts of 56 consecutive patients who had undergone penetrating keratoplasty with transscierai fixation of a posterior chamber intraocular lens, follow-up ranged from 3 to 28 months (mean, 11.1 months). Postoperative visual acuity improved in 46 patients (82%), remained the same in eight (14%), and worsened in two (3.6%). In 32 patients with at least 10 months' follow-up, best corrected visual acuity as measured with a pinhole or hard contact lens was 20/40 or better in 12 (38%), 20/50 to 20/10 in 10 (31%), and 20/200 or worse in 10 (31%). Problems with lens decentration, tilt, or scleral suture-related infections were minimal. Glaucoma was the most common cause of decreased vision in patients with 10 or more months' follow-up. Three patients (5.4%) developed rhegmatogenous retinal detachments early in the postoperative course.
Ocular Trauma Caused by Exploding Glass Bottles Containing Dry Ice and Water
Authors: Dunn James P , Berger Steven T , Mondino Bartly J , Goodwin Lawrence T
Published: April 2021

ABSTRACT

We treated three patients with severe ocular injuries caused by exploding glass bottles containing a mixture of dry ice chips and water. One patient had a corneal laceration and traumatic cataract with several retained intraocular glass fragments. The second had a scleral laceration without corneal or lenticular involvement. The third suffered a corneal-scleral laceration, with a total retinal detachment. Following surgery, two patients recovered 20/20 vision; the third patient regained only light perception.
Phacofragmentation of a Hard Lens Nucleus in the Posterior Segment
Authors: Allinson Richard W , Allinson Francis W
Published: April 2021

ABSTRACT

Foreign body forceps were used to stabilize a hard lens nucleus during phacofragmentation in the posterior segment. This technique allows removal of the hard lens nucleus with minimal manipulation and without the need for a larger incision.
A New Anterior Capsular Opening: Dumbbell Opening-Its Efficacy in the Human Eye
Authors: Hara Tsutomu , Hara Takako
Published: April 2021

ABSTRACT

Using excised pig eyes and a human eye-bank eye, we demonstrated the efficacy of our new anterior capsular opening, the dumbbell opening, especially for the human eye. The opening consists of two microcircular holes made by an automated electric microtrephine, connected by a straight cut made with scissors. The 3.5-mm-long dumbbell opening fully retained its original shape after cataract removal and posterior-chamber intraocular lens insertion.
The Irrigating Knife: An Ultrasharp Surgical Blade With Irrigating System
Authors: Worst Jan G F , Los Leonoor I
Published: April 2021

ABSTRACT

We present an irrigating microsurgical knife for ocular surgery. Irrigation of balanced salt solution through the knife tip during sectioning removes hemorrhages continuously, allowing uninterrupted sectioning, without cauterization of bleeding vessels. The "zero degree" knife can be bent in any required position.
The Viscous Fluid Pump
Authors: Davidorf Frederick , Chambers Robert B , Reimels Harry
Published: April 2021

ABSTRACT

We describe a device useful for injection of viscoelastic material into the vitreous cavity for internal tamponade. The instrument has proven to be reliable and "user friendly" in a clinical setting.
Current Trends in Suture Fixation of Posterior Chamber Intraocular Lenses
Authors: Sen Harsha A , Smith Patricia W
Published: April 2021

ABSTRACT

Corneal surgeons were surveyed with regard to their technique of suture fixation of posterior chamber intraocular lenses in the absence of posterior capsular support. Fifty-nine percent of the 260 respondents stated they perform the procedure almost exclusively during penetrating keratoplasty. Scleral fixation was marginally favored over iris fixation by these surgeons. Most intraoperative problems reported were related to the relative technical difficulty of the procedure, although transient hemorrhage from the ciliary body was also mentioned. Postoperative complications cited included mechanical problems involving the tens and iris, cystoid macular edema, glaucoma, and endophthalmitis.
Use of a Symblepharon Ring for Treatment of Over-Filtration and Leaking Blebs After Glaucoma Filtration Surgery
Authors: Hill Richard A , Aminlari Ali , Sassani Joseph W , Michalski Marge
Published: April 2021

ABSTRACT

We report the use of a Symblepharon ring in the treatment of seven cases of flat anterior chamber (six cases of total iridocorneal touch, and one of corneallens touch) secondary to overfiltration orto bleb leak. In all cases, the anterior chamber reformed within 24 hours after the Symblepharon ring was used. Advantages of using the ring are: (a) it permits testing of visual acuity, tonometry, and intraocular examination without removing it; (b) it does not require suturing to the conjunctiva; (c) it does not disturb the corneal epithelium; (d) it may be available at institutions lacking other shells; and (e) it is cost-effective.
Glaucoma Triple Procedures: Efficacy of Intraocular Pressure Control and Visual Outcome
Authors: Longstaff Simon , Wormald Richard P L , Mazover Amos , Hitchings Roger A
Published: April 2021

ABSTRACT

Sixty-three glaucoma triple surgeries [combined trabeculectomy, extracapsular cataract extraction (ECCE), and posterior-chamber intraocular lens (PCIOL) implantation] were reviewed. Intraocular pressure (IOP) was controlled satisfactorily in all cases; 25% required additional glaucoma therapy but fewer glaucoma medications. Eighty-six percent achieved 6/12 or better visual acuity. Postoperative IOP and visual acuity results were similar to those achieved by trabeculectomy or ECCE/PC-IOL, respectively. Cumulative years of preoperative glaucoma therapy had an adverse effect on postoperative IOP control.
Update of the Subconjunctival THC:YAG (Holmium) Laser Sclerostomy Ab Externo Clinical Trial: 30-Month Report
Authors: Iwach Andrew G , Hoskins H Dunbar , Drake Michael V , Dickens Christopher J
Published: April 2021

ABSTRACT

A THC:YAG laser (thulium, holmium, chromium-doped YAG crystal) was used to create 93 thermal sclerostomies ab externo in 81 glaucomatous eyes of 76 patients. Pulse energies of 80 to 120 mJ were used, with a repetition rate of 5 pulses per second. Total energy levels to produce full-thickness sclerostomies ranged from 1.4 to 7.2 J. Estimated probability of success was 0.66 at 12 months and 0.57 up to 30 months. The mean intraocular pressure in the successful cases was 12.8 ± 4.0 mm Hg.
Hydroexpression of Subluxated Lenses Using a Glide
Authors: Blumenthal Michael , Kurtz Shimon , Assia Ehud I
Published: April 2021

ABSTRACT

During the past 8 years, 15 patients (20 eyes) underwent a variety of operations to remove a subluxated lens. In six of these eyes, a new technique, featuring an anterior chamber maintainer and a plastic glide, was used for intracapsular cataract extraction (ICCE). The results achieved in these eyes were compared with those in 8 eyes in which cryo extraction was used, in 1 in which pars plana lensectomy was used, in 4 in which aspiration of lens material and peeling of the capsule was used, and in 1 in which a viscoelastic material and spatula were used. Using the glide, the lens is extracted through a scierai tunnel incision or a limbal opening. The length of the opening is somewhat smaller than the diameter of the lens and is significantly smaller than that used in traditional ICCE. The visual outcomes achieved with these various techniques were essentially identical. The proposed technique is simple and relatively safe for these complicated cases.
Laser Indirect Ophthalmoscope Photocoagulation in an Incubator for the Treatment of Retinopathy of Prematurity
Authors: Tanaka Sumiyoshi
Published: April 2021

ABSTRACT

Argon blue-green or diode laser indirect ophthalmoscope photocoagulation, performed through the transparent wall of an incubator, was used to treat threshold retinopathy of prematurity in two premature infants who were in poor systemic condition and could not be treated out of the incubator. Despite technical difficulties posed in one or both cases by their lateral position, small pupils, persistent tunica vasculosa lentis, and hazy cornea, there were no systemic complications and the retinopathy regressed in both cases.
Evaluation of a Tapered, Blunt, Bipolar Cautery Tip for Trabeculectomy
Authors: Shields M Bruce
Published: April 2021

ABSTRACT

A bipolar cautery instrument with a tapered, blunt tip has been developed for glaucoma filtering surgery. Evaluated in 30 consecutive trabeculectomy procedures, the instrument proved suitable for all aspects of the operation. The narrow, 23-gauge shaft and tapered, blunt tip allowed gentle, pin-point coagulation of individual bleeders, as well as cauterization of tracks of tissue in a continuous motion. The unit was effective for external cauterization of conjunctival and scierai vessels, as well as for internal cauterization of anterior uveal tissue.
Contoured, Atraumatic Lacrimal Retractor
Authors: Custer Philip L
Published: April 2021

ABSTRACT

A new lacrimal retractor has been designed for use in external dacryocystorhinostomy. This low-profile, self -retaining instrument incorporates solid blades, affording optimal exposure while protecting nearby tissue.
Masquerades of Macular Holes
Authors: Smiddy William E , Gass J Donald M
Published: April 2021

ABSTRACT

Surgery is now an option in the treatment of macular holes. However, their clinical features may be subtle and many conditions may masquerade as fullthickness macular holes. To promote diagnostic accuracy and thereby avoid incorrect or unnecessary surgery, we present several cases of entities misdiagnosed as full-thickness macular holes in an effort to determine which clinical features likely led to the inaccurate diagnosis. Among these were epiretinal membranes with pseudoholes, impending macular holes, lamellar macular holes, and macular degeneration. Important features allowing for a more certain diagnosis included: fine, drusen-like yellowish deposits in the base of the hole; a surrounding cuff of subretinal fluid; a distinct and circular margin around the hole; and an overlying operculum. Also, visual acuity was often relatively good in non-macular hole cases, while with true macular holes, vision is usually 20/80 or worse, or deteriorates to this level over a few weeks.

Many entities falsely diagnosed as macular holes have a favorable natural history, are not amenable to surgical efforts, or require slightly different surgical maneuvers. Misdiagnosis and wrongful treatment may be minimized by limiting macular hole surgery to cases in which visual acuity is 20/80 or worse or by waiting for clinical changes sufficient to permit distinguishing false from early or atypical true cases.
Congenital Absence of the Lacrimal Puncta
Authors: Boerner Mark , Seiff Stuart R , Arroyo Jorge
Published: April 2021

ABSTRACT

We report seven cases of congenital absence of the lacrimal puncta, a condition that may be either an isolated finding or associated with other developmental anomalies. General pediatric evaluation of two patients with punctal agenesis revealed no additional abnormalities; these cases were managed by probing and silicone intubation. The other five cases were associated with other significant, clinically obvious abnormalities; several of these patients required more aggressive management of their lacrimal disorders, including dacryocystorhinostomy and conjunctivo-dacryocystorhinostomy. Previous reports support the impression generated by this series that otherwise normal appearing children with congenital absence of the lacrimal puncta do not require an extensive work-up. Probably many children with absent puncta are asymptomatic and remain undiagnosed.
Trabeculectomy in Pseudophakie Patients: Postoperative 5-Fluorouracil Versus Intraoperative Mitomycin C Antiproliferative Therapy
Authors: Prata Joáo Antonio , Minckler Donald S , Baerveldt George , Lee Paul P , LaBree Laurie , Heuer Dale K
Published: April 2021

ABSTRACT

Trabeculectomy outcome in Pseudophakie glaucoma patients treated with mitomycin C (MMC) or 5fluorouracil (5-FU) was analyzed retrospectively in 46 cases (46 eyes). Thirty patients received intraoperative MMC; 16, 5-FU. There were no significant differences between the two groups in terms of preoperative data (demographics, number of previous filtering procedures, visual acuity, and intraocular pressure [1OP]). After a mean follow up of 13.4 ± 8.1 and 11.5 ± 5.8 months for the 5-FU and MMC groups, respectively, 12 5-FU eyes (75%) and 21 MMC eyes (70%) were deemed at least qualified successes (IOP =s 21 mm Hg with or without antiglaucoma medications). Six (37.5%) of the 5-FU eyes and 13 (43.3%) of the MMC eyes were complete successes (IOP « 21 mm Hg without antiglaucoma medications). There were no significant differences between the two groups in terms of duration of follow up, number of qualified successes, and number of complete successes (P s .35, .9, and .7, respectively). Nor were there any significant differences in the mean final IOPs and visual acuities. Excluding transient corneal effects associated with 5-FU therapy, there were no significant differences in the frequency of postoperative complications.

These results suggest that 5-FU and MMC antiproliferative therapy are associated with similar shortterm success rates and postoperative complications.
Knotless Scleral Fixation for Implanting a Posterior Chamber Intraocular Lens
Authors: Eryildirim Ahmet
Published: April 2021

ABSTRACT

I describe a technique for implanting an intraocular lens by scleral fixation sutures that has the advantages of knotless fixation of the haptics and an out-in approach for passing the needle through the sclera.
Mersilene Sutures for Corneal Surgery
Authors: Frucht-Pery Joseph
Published: April 2021

ABSTRACT

We studied the complications resulting from using running Mersilene suture in 14 patients who underwent penetrating keratoplasty for keratoconus. 11-0 Mersilene running suture and 12 interrupted 10-0 nylon stitches were used in each procedure and the patients were followed for 22 to 48 months. None of the Mersilene sutures broke, but four were removed in two patients: in one, due to astigmatism or loosening of the suture as a result of sterile ulceration, and in the other, due to herpetic keratitis. Marked scarring manifested along the (oops of the sutures in 11 of the Mersilene sutures. Despite these problems, we conclude that the use of Mersilene sutures, alone or combined with nylon sutures, in penetrating keratoplasty is sufficiently advantageous to warrant further study.
Argon Laser Trabeculoplasty: Long-Term Results
Authors: Lotti Raffaella , Traverso Carlo E , Murialdo Ugo , Frau Barbara , Calabria Giovanni A , Zingirian Mario
Published: April 2021

ABSTRACT

We analyzed the long-term success of argon laser trabeculoplasty (ALT) performed in 237 eyes of 175 patients diagnosed with primary open-angle glaucoma and followed for up to 11 years (maximum, 132 months) after treatment. The cumulative proportion of success, defined as the avoidance of glaucoma surgery or an intraocular pressure never exceeding 22 mm Hg, was calculated throughout follow up using the KaplanMeier life-table analysis. The success rates were: 78% at 1 year (n =205), 71% at 3 years (n = 139), 61% at 5 years (n = 73), and 40% at 10.5 years (n = 19). Our data confirm previous reports of the high initial success rate of ALT, followed by a time-dependent decrease in its efficacy.
Long-Term Results of Molteno Implants
Authors: Price Francis W , Wellemeyer Mark
Published: April 2021

ABSTRACT

We retrospectively reviewed 76 Molteno implants in 72 eyes, with a minimum of 18 months' follow up. Double-plate implants were used initially in 64 of these eyes. After a mean follow up of 33.27 months, the mean intraocular pressure (IOP) was 14.0 mm Hg, as compared with 35.31 mm Hg preoperatively. With success defined as an IOP greater than 5 mm Hg but no greater than 21 mm Hg at the last visit, the success rate was 74%. If the four cases of chronic hypotony without loss of best-corrected vision are included, the success rate was 79%. The most frequent complications included corneal graft failure, filtration tube blockage, choroidal effusion, and hyphema/vitreous hemorrhage.
Low-Power Intraocular Lens Implantation in Patients With Cataracts and Age-Related Macular Degeneration
Authors: Boutros George J E , Boutros Haifa Nabali
Published: April 2021

ABSTRACT

Three patients with age-related macular degeneration for whom cataract surgery was indicated received low-power intraocular lenses (IOLs) calculated to produce an end spectacle refraction of approximately +6 diopters, producing a magnification of about 12%. Our experience with these three cases suggests that use of low-power implants in such patients may yield better results than emmetropic IOLs.
Securing Silicone Stents in Dacryocystorhinostomy
Authors: Jordan David R , Bellan Lorne D
Published: April 2021

ABSTRACT

Silicone stents are commonly used in dacryocystorhinostomy to help maintain a patent mucosal passage-way into the nose. It is not unusual for a tube to become displaced and migrate laterally (stent prolapse), and, at times, it may be difficult to reposition it. We describe how stent prolapse may be prevented by using aneurysm clips to secure the silicone stents once they are in place.
Painless Wakeful Peribulbar Block Achieved Safely With a Single Transconjunctival Injection
Authors: Hulquist C Richard
Published: April 2021

ABSTRACT

This single-injection, peribulbar technique provides a painless and efficacious block without the need for intravenous supplements. One hundred consecutive patients achieved lid akinesia and complete akinesia and anesthesia of the globe by the transconjunctival route. Only 1% needed a supplemental injection, and complications were minor end infrequent.
Pars Plana Molteno Implantation in Complicated Inflammatory Glaucoma
Authors: Sheppard John D , Shrum K Ray
Published: April 2021

ABSTRACT

We retrospectively studied pars plana Molteno implantation in seven patients who had previously undergone multiple attempts, both medical and surgical, to control intraocular pressure (IOP), to no avail. In an effort to avoid further anterior chamber complications, a Molteno implant was inserted through the superior temporal vitrectomy port, following a complete pars plana vitrectomy. Acuity decreased in two of the seven patients due to preexisting conditions and one patient lost vision. Preoperative IOPs ranged from 29 to 57 mm Hg (mean 41 mm Hg) and postoperative IOPs ranged from 7 to 20 mm Hg (mean 12 mm Hg).
A Retrospective Study of the Effects of Laser Suture Lysis on the Long-term Results of Trabeculectomy
Authors: Asamoto Ayako , Yablonski Michael E , Matsushita Misuzu
Published: April 2021

ABSTRACT

We retrospectively examined the effects of laser suture lysis on the long-term results of initial trabeculectomies in 130 consecutive eyes that had an intraocular pressure greater than 21 mm Hg during the first 4 postoperative weeks. After the high intraocular pressure was noted, 46 eyes underwent laser suture lysis; the other 84 did not. The 2-year cumulative probability of success in the laser suture lysis group was .84 and, in the control group, .82 (P >.05). Intraocular pressures in the two groups 1 and 2 years after trabeculectomy were similar. Laser suture lysis had no discernible effect on the long-term success rate of trabeculectomy in these patients.
Effects of Intraoperative Topical Mitomycin-C on Strabismus Surgery in the Rabbit: A Preliminary Study
Authors: Cruz Oscar A , Matkovich Lydia
Published: April 2021

ABSTRACT

The effect of intraoperative topical exposure of mitomycin-C (MMC) on muscle reattachment and scarring in strabismus surgery was prospectively investigated in the rabbit by performing bilateral recession surgery in which one eye was treated with topical MMC (0.2 mg/mL) and the other eye served as the control. One week postoperatively, in random, masked fashion, the severity of postoperative adhesions was rated lower in the MMC-treated eyes. Also, histology demonstrated decreased fibrosis in the muscle reattachment sites in the MMC-treated eyes. The muscle tension in the reattached muscles was greater than 100 g in all of the eyes. This preliminary study indicates that topical MMC exposure may inhibit scarring in strabismus surgery without inhibiting muscle reattachment or causing other obvious adverse effects.
Orbital Inflammatory Syndrome: An Unusual Presentation
Authors: Loff Howard , Levine Mark R
Published: April 2021

ABSTRACT

A 22-year-old woman had right unilateral proptosis. Evaluation revealed a large intraconal orbital mass, consistent with cavernous hemangioma. The mass was removed via a lateral orbitotomy. Histopathology, confirmed by electron microscopy, demonstrated fibroblasts with inflammatory histiocytes, but there was no evidence of cavernous hemangioma. To our knowledge, this is the first description of a well-circumscribed intraconal mass diagnosed as orbital inflammatory syndrome.
Temporal Corneal Phacoemulsification Combined With Separate-Incision Superior Trabeculectomy
Authors: Weitzman Marc , Caprioli Joseph
Published: April 2021

ABSTRACT

We describe our present method of combined cataract surgery and trabeculectomy, which involves temporal clear corneal phacoemulsification with foldable intraocular lens implant combined with a separate-incision superior limbus-based trabeculectomy. The potential advantages over combined surgery through a single incision include reduced manipulation of conjunctival and scierai flaps, improved visibility for phacoernulsification, and a slightly shorter tunnel.
Astigmatic and Refractive Stabilization After Cataract Surgery
Authors: Oshika Tetsuro , Tsuboi Shunji
Published: April 2021

ABSTRACT

We assessed the timing of astigmatic and refractive stabilization following six cataract surgery procedures with intraocular lens implantation in 229 eyes divided into six groups in the following incision sizes and methods of wound closure:

* 11-mm incision with running suture closure (26 eyes)

* 6.5-mm incision with running suture closure (29 eyes)

* 6.5-mm incision with single horizontal suture closure (25 eyes)

* 6.5-mm incision without suture closure (46 eyes)

* 5.5-mm incision without suture closure (51 eyes)

* 3.2-mm incision without suture closure (52 eyes).

Analyzed up to 6 months postoperatively were:

* the mean and standard deviation of axis-based keratometric cylinders

* the absolute value of the induced-cylinder vector

* the spherical equivalent of the refractive power.

In the 11- and 6.5-mm incision running suture groups, these parameters did not stabilize during the study period. In the 6.5-mm incision horizontal suture and sutureless groups, the values stabilized at 3 months postoperatively; in the 5.5-mm incision group, at 1 month; and in the 3.2-mm incision group, at 2 weeks. These results indicate that the appropriate point at which to prescribe postoperative correction spectacles differs significantly depending on the procedure, and that smaller incisions with wound-closure methods that do not exert vertical force are associated with fewer postoperative refractive changes.
Combined Phacoemulsification, Endoscopic Ciliary Process Photocoagulation, and Intraocular Lens Implantation in Glaucoma Management
Authors: Uram Martin
Published: April 2021

ABSTRACT

The safety and efficacy of combined cataract extraction and intraocular lens (IOL) implantation with endoscopie ciliary process photocoagulation in glaucoma management was evaluated. Ten patients with uncontrolled open-angle glaucoma and cataract prospectively underwent concomitant phacoemulstfication, endoscopie ciliary process photocoagulation, and posterior chamber IOL implantation.

With a mean follow up of 19.2 months, the mean intraocular pressure (IOP) decreased from 31.4 mm Hg preoperatively to 13.5 mm Hg postoperatively, an absolute decrease of 57%. This represented a significant decrease for each of the patients. The visual acuity of each also improved. Transient vitreous hemorrhage developed in one patient, but no cystoid macular edema or any other significant complications occurred and all eyes were quiet. There were no lens implant dislocations. There was no progressive visual field loss at 1 month post surgery, but such loss was noted in one patient 1 year after treatment. Good IOP control on no medical therapy was attained in one half of the patients. It may be concluded that this combined procedure provided effective management of cataract and glaucoma with a minimum of postoperative care. The safety and efficacy of this approach as compared with cataract surgery combined with filtration remains to be determined.
A Central Dystonia Causes Spastic Lower Eyelid Entropion: A Hypothesis
Authors: Zolli Christine L
Published: April 2021

ABSTRACT

This article presents a novel hypothesis on what causes an involutional entropion. The theory herein proposes that the pathophysiology of entropion is that of an idiopathic dystonia with the locus of dysfunction posed in the rostral brain stem and with stimuli for its causation mediated through the seventh cranial nerve-the facial nerve-by a cord of fibers making its path to the upper, ie, temporooculo-zygomatic ramus of the nerve. In a word, involutional entropion is but a variant of essential blepharospasm and one of the clinical entities within the oculo-oro-facial-cervical family of dystonia disorders.
Indocyanine Green Angiography for Recurrent Choroidal Neovascularization in Age-related Macular Degeneration
Authors: Reichel Elias , Pollock David A , Duker Jay S , Puliafito Carmen A
Published: April 2021

* BACKGROUND AND OBJECTIVE: Recurrence of choroidal neovascular membranes (CNV) occurs frequently following laser photocoagulation. Recurrent CNV can be difficult to treat because they may not be well defined by fluorescein angiography.

* PATIENTS AND METHODS: The fluorescein and indocyanine green (ICG) angiograms of 58 eyes of 57 patients who presented with clinically suspected recurrence were evaluated retrospectively.

* RESULTS: In 14 eyes (24%), a well-defined recurrent CNV could be identified by evaluating the fluorescein angiogram. In 6 (14%) of the remaining 44 eyes, a well-defined recurrent CNV was identifiable by ICG angiography.

* CONCLUSION: A role for ICG angiography in the care of patients with suspected recurrent CNV is discussed.

[Ophthalmic Surg Lasers 1995;26:513-518.]
Ocular Injuries Related to Air Bag Inflation
Authors: Vichnin Michael C , Jaeger Edward A , Gault Janice A , Jeffers John B
Published: April 2021

* BACKGROUND AND OBJECTIVES: The effectiveness of air bags as a safety device in decreasing fatalities and reducing morbidity in frontal impact motor vehicle accidents has been well established. However, case reports have surfaced documenting ocular injuries related to air bag inflation. The purpose of this study was to identify and analyze ocular injuries sustained during air bag inflation.

* PATIENTS AND METHODS: Hospital emergency room records were reviewed retrospectively for a period of 4 years for patients who had sustained ocular injuries in motor vehicle accidents. Those injuries associated with air bag inflation were analyzed as to the nature of the injury, type of vehicle, speed, and visual morbidity.

* RESULTS: Fourteen cases of ocular injury related to air bag inflation were identified. Hyphema (nine cases) and cornea abrasion (eight cases) were the most common. Three cases, all patients who had been wearing glasses, sustained serious and permanent ocular damage.

* CONCLUSION: While air bags are an unequivocal safety feature, ocular injuries do occur that are related to air bag inflation. Eyeglass wear may present an additional risk factor.

[Ophthalmic Surg Lasers 1995;26:542-548.]
Penetration of Topical 0.3% Ciprofloxacin Into Human Aqueous Humor
Authors: Kalayci Defne , Basci Nursabah , Akpek Esen , Hasiripi Hikmet , Bozkurt Atilla
Published: April 2021

* BACKGROUND AND OBJECTIVE: Investigation of the penetration of topical ciprofloxacin into aqueous humor.

* PATIENTS AND METHODS: Topical 0.3% ciprofloxacin drops were administered to 17 patients with cataracts before lens extraction surgery. The time interval between the first dose and sampling was 3 hours in 9 patients (group A) and 6 hours in 8 (group B). In both groups, aqueous samples were collected 30 minutes after the last ciprofloxacin application. Ciprofloxacin concentration was determined by highperformance liquid chromatography-fluorescence detection.

* RESULTS: Mean aqueous concentration was 0.83 ± 0.48 pg/ml in group A and 2.42 ± 1.42 ug/ml in group B.

* CONCLUSION: Topical 0.3% ciprofloxacin penetrates into the aqueous in a significant concentration.

[Ophthalmic Surg Lasers 1996;27:21-24.]
Anterior Chamber Fluid Cultures Following Phacoemulsification and Posterior Chamber Lens Implantation
Authors: Gimbel Howard V , Sun Ran , DeBroff Brian M , Yang Hui-ming
Published: April 2021

* BACKGROUND AND OBJECTIVE: A randomized, prospective study was undertaken to evaluate the incidence of positive cultures in the anterior chamber following cataract surgery when using intracameral gentamicin compared with no antibiotic.

* PATIENTS AND METHODS: A total of 97 patients were enrolled-48 receiving gentamicin in the irrigating solution and 49 receiving no intracameral antibiotics (control group). Each cataract extraction was accomplished by phacoemulsification followed by intraocular lens implantation. At the end of surgery, 0.1 ml of anterior chamber fluid from each case was collected and cultured.

* RESULTS: All cultures were negative in the group receiving gentamicin. However, one positive culture occurred in the control group. There was no significant difference in the positive culture rate between the two groups (P= .52).

* CONCLUSION: This study suggests that cataract extraction with phacoemulsification and intraocular lens implantation has gready reduced the incidence of bacterial contamination of anterior chamber fluid, with or without the use of intracameral antibiotic.

[Ophthalmic Surg Lasers 1996;27:121-126.]
Silicone Intubation With Tissue Glue Anastomosis in the Treatment of Congenital Nasolacrimal Duct Obstruction
Authors: Liao Chiu L , Kao Shine C S , Lin Pi R , Wu Kuo C , Hou Ping K
Published: April 2021

* BACKGROUND AND OBJECTIVE: To evaluate the advantages of tissue glue application for the anastomosis of silicone intubation in congenital nasolacrimal duct obstruction.

* PATIENTS AND METHODS: Patients with con genital nasolacrimal duct obstruction were treated with silicone intubation with the aid of tissue glue for end-to-end anastomosis. The recurrence rate, complications, and the need for general anesthesia at tube removal were recorded.

* RESULTS: The silicone tubes for all 18 eyes studied were removed smoothly on an outpatient basis. Early extrusion was noted in 3 eyes. No recurrence of epiphora was noted in any eye after more than 6 months of follow-up.

* CONCLUSION: Tissue glue anastomosis is a beneficial modification that avoids the need for general anesthesia during stent removal in children and allows removal to be easily performed in an outpatient clinic.

[Ophthalmic Surg Lasers 1996;27:197-199.]
High-volume Intraocular Lens Surgery in a Rural Eye Camp in India
Authors: Civerchia Linda , Ravindran R D , Apoorvananda S W , Ramakrishnan R , Balent Alvan , Spencer Martin H , Green David
Published: April 2021

* BACKGROUND AND OBJECTIVE: The appropriate surgical treatment for the enormous number of patients in developing nations who are blind due to cataract is a hody debated issue. The authors' objective is to demonstrate that modern surgical techniques (extracapsular cataract extraction and intraocular lens implantation, phacoemulsification and intraocular lens implantation) can be performed in a high-volume, costeffective manner, even in temporary settings. The authors believe that the approach to cataract blindness is not simple intracapsular cataract extraction, but rather the challenge of (1) training all ophthalmic personnel in modern techniques (microsurgery, biometry), (2) training managers in higher levels of organizational skill, and (3) doing these things in the face of limited resources.

* PATIENTS AND METHODS: A total of 1298 surgeries were performed in a public eye camp in Ganeshpuri, India (50 miles north of Bombay). Of these, 1214 (93.5%) of the patients received intraocular lens (IOL) implants. Ninety-three percent (1032/1 108) of the patients who underwent extracapsular cataract extraction (ECCE) and IOL implantation and 89% (83/93) of the patients who underwent phacoemulsification and IOL implantation returned for follow-up.

* RESULTS: Postoperatively, 48% (498/1032) of the patients who underwent ECCE and IOL implantation achieved corrected vision of 6/12 or better and 65% (671/1032) attained corrected vision of 6/ 1 8 or better. Of the patients who underwent phacoemulsification and IOL implantation, 59 of 83 (71%) attained vision of 6/12 or better with correction and 68 of 83 (79%) achieved vision of 6/18 or better with correction. These results are almost identical to those obtained by the authors in their Ganeshpuri 1991 camp. Surgical complication rates were comparable to those reported in hospitalbased studies.

* CONCLUSION: For this type of camp to operate efficiently, there must be standardization of skills among ophthalmic personnel, costs must be contained, and the organizational skills necessary to ensure smooth functioning of the camp must exist. However, on the basis of their data, these authors believe that with suitable organizational and surgical facilities, IOL implantation can be successfully performed in high-volume surgical eye camps.

[Ophthalmic Surg Lasers 1996;27:200-208.]
Hodgkin's Disease of the Orbit With Intracranial Extension
Authors: Sahjpaul Ramesh , Elisevich Kost , Allen Larry
Published: April 2021

Abstract. A rare presentation of intraorbital Hodgkin's lymphoma in a patient without prior history of systemic disease who complained of episodic monocular visual loss with minimal proptosis is reviewed. The case is further distinguished by intracranial extension of the tumor. A literature review highlights such an unusual event against the background of prior experience. [Ophthalmic Surg Lasers 1996;27: 239-242.]
An Eyelash in the Vitreous Cavity Without Apparent Etiology
Authors: Oh Kean T , Oh Kong T , Singerman Lawrence J
Published: April 2021

Abstract. Intraocular eyelashes are an infrequent complication of trauma to the eye. Intraocular cilia have a variable prognosis ranging from acute inflammation to remaining dormant within the vitreous for several years. However, intraocular cilia in the anterior chamber have been associated with delayed inflammatory responses, while intravitreal cilia may cause rhegmatogenous retinal detachment. All cases reported in the literature to this point have been able to identify some history of trauma, be it acute or remote. In this report a case is described in which intravitreal cilia were not associated with a history of trauma. [Ophthalmic Surg Lasers 1996;27:243-245.]
Experimental Evaluation of a Hydroxylapatite Reservoir Tube Shunt in Rabbits
Authors: Pandya A D , Rich C , Eifrig D E , Hanker J , Peiffer R L
Published: April 2021

* BACKGROUND AND OBJECTIVES: Anterior chamber tube shunts of various design are of increasing importance in the surgical management of refractory glaucoma. However, the reservoirs that are commonly used today are made of a silicone or an acrylic material that may become enveloped by a fibrous capsule, which in turn may impede aqueous resorption. In this study, the authors investigated the properties of hydroxylapatite (HA) as a reservoir in gonioimplants, using three different types of HA reservoir designs. It has been demonstrated that HA orbital implants become vascularized, and the authors hypothesized that this feature of HA might modify the development of the fibrous capsule, enhancing the efficacy and decreasing the size of the implants.

* MATERIALS AND METHODS: HA reservoirs with Silastic tube shunts were implanted in the right eyes of six Dutch-belted rabbits. Clinical examinations were performed and intraocular pressure was measured periodically for 16 weeks postoperatively. Prior to euthanasia, fluorescein-labeled latex microspheres were injected into the anterior chamber to demonstrate implant patency. Light microscopy was used to study the tissue response to the implants and the pathways of aqueous flow.

* RESULTS: In general, the authors found a granulomatous inflammatory response to the HA accompanied by neovascularization into the implant and minimal fibrous encapsulation of the reservoir.

* CONCLUSIONS: The use of HA as a suprascleral reservoir has several advantages, the major one being a theoretical increase in the functional lifetime of the implant.

[Ophthalmic Surg Lasers 1996;27:308-314.]
A Fixation Aid for Slit-Lamp Biomicroscopic Examination of the Optic Nerve
Authors: Chalfin Steven
Published: April 2021

Abstract. The traditional articulated fixation light used on slit lamps is somewhat inconvenient, requiring repositioning for each eye. A simple, inexpensive fixation aid is described, which allows examination of both optic nerves without repositioning. [Ophthalmic Surg Lasers 1996;27:326.]