bluuebunny/crossref_metadata_2025 huggingface dataset:
A New Technique for Repositioning a Posteriorly Dislocated Intraocular Lens
Authors: Seo Man-Seong , Yoon Kyung-Chul , Yang Kun-Jin , Park Yeoung-Geol
Published: April 2021

Abstract. Pars plana vitrectomy was performed to treat a complete posterior dislocation of an intraocular lens in seven patients. The method that the authors have developed appears to be safer and simpler than those previously described. The haptics are externalized for a secure tie at the proper site, and are then reinternalized back through the pars plana sclerotomies. Only two small needle perforations are made for the scleral fixation of the intraocular lens in the ciliary sulcus. Perfluorocarbon liquid is used to prevent intraoperative retinal damage. [Ophthalmic Surg Lasers 1998;29:147-150.]
Erbium:YAG Laser-Assisted Cataract Surgery
Authors: Stevens Garth , Long Byron , Hamann Janna M , Allen Robert C
Published: April 2021

* BACKGROUND AND OBJECTIVE: To assess the safety and efficacy of erbium:YAG laser-assisted cataract removal.

* PATIENTS AND METHODS: A total of 15 patients underwent cataractous lens removal. All the patients had a visual acuity of 20/50 or worse secondary to senile cataract. The endothelial cell count was calculated preoperatively and at 6 weeks postoperatively. A 2. 94-µm-wavelength erbium:YAG laser with a zirconium-fluoride fiber optic and silica tip was used to fracture and emulsify the nucleus. The erbium: YAG laser was chosen due to its high absorption in water, a primary component of a cataractous lens.

* RESULTS: The postoperative visual acuity was 20/30 or better in all the eyes that were treated with surgery. The endothelial cell loss at 3 months was 0% to 10%. No laser-related complications were noted. A conversion to an ultrasound surgical technique was utilized in six cases. Vitreous loss occurred in one case due to the posterior extension of an anterior capsulotomy tear.

* CONCLUSION: This study demonstrated the ability of an erbium:YAG laser system to safely and effectively emulsify the lens nucleus. Laser-assisted cataract surgery is a promising new clinical procedure.

[Ophthalmic Surg Lasers 1998;29:185-189.]
Oculocardiac Reflex During Retinal Surgery Using Peribulbar Block and Nitrous Narcotic Anesthesia
Authors: Grover V K , Bhardwaj N , Shobana N , Grewal S P S
Published: April 2021

* BACKGROUND AND OBJECTIVES: This study was designed to examine the effects of local and general anesthesia on the oculocardiac reflex (OCR) in adults during retinal detachment surgery, with an aim of determining the safest type of anesthesia and on which extraocular muscle traction causes a higher incidence of OCR.

* PATIENTS AND METHODS: The study was performed on 30 American Society of Anesthesiologists-I patients (age range 40-60 years) who were undergoing retinal detachment surgery. Fifteen patients underwent surgery with general anesthesia and 15 were given a local peribulbar block. A fixed traction of 400 g was applied to all the extraocular muscles, and the heart rate, rhythm, and electrocardiogram of each patient was monitored.

* RESULTS: The overall incidence of OCR was higher with general anesthesia (63.3%) than with local anesthesia (14.4%). There was a significant decrease in heart rate for the rectus muscles (P < .0005) as well as the oblique muscles P < .005) during traction with general anesthesia. All four rectus muscles were equally sensitive in eliciting the reflex. The incidence of dysrhythmias was 20% with general anesthesia and 6.67% with local anesthesia.

* CONCLUSION: This study showed that local anesthesia produces less bradycardia and ectopic arrhythmias and, therefore, may be safer and better than general anesthesia for surgeries in which traction of extraocular muscles is required.

[Ophthalmic Surg Lasers 1998;29:207-212.]
Chorioretinal Folds Following Glaucoma Valve Implantation
Authors: Sibayan Santiago Antonio B , Latina Mark A
Published: April 2021

Abstract. Glaucoma valve implants have been observed to cause scleral indentation and flattening. The authors report the case of a 79-year-old woman who had previously undergone glaucoma valve implantation, and who subsequently developed chorioretinal folds that corresponded to the implant in location and configuration. Accumulation of fluid behind the implant, as documented by B-scan ultrasonography, appeared to result in the observed scleral and chorioretinal changes. The authors conclude that chorioretinal folds can result following glaucoma valve implantation. [Ophthalmic Surg Lasers 1998; 29:242-243.]
The Use of Pneumatic Retinopexy to Delay Surgical Repair of a Retinal Detachment Associated With the Ganciclovir Intraocular Device
Authors: McAuliffe Priscilla F , Heinemann Murk-Hein
Published: April 2021

Abstract. Rhegmatogenous retinal detachments are associated with cytomegalovirus (CMV) retinitis and the use of the ganciclovir intraocular device. Pars plana vitrectomy with silicone oil tamponade is the preferred technique to repair such detachments. The authors describe the use of pneumatic retinopexy as part of a treatment strategy in the management of multiple retinal detachments in a patient with CMV retinitis treated with ganciclovir implants. Pneumatic retinopexy may benefit patients when the causative retinal break is superior and is located in an area of retina uninvolved with CMV infection, because it can be used to delay surgical intervention. [Ophthalmic Surg Lasers 1998;29:244-246.]
Monopolar Electrosurgical Flash Fire
Authors: Lucarelli Mark J , Lemke Bradley N
Published: April 2021

Abstract. A 78-year-old man underwent ectropion repair with a monopolar electrosurgical unit. A flash fire occurred, resulting in a loss of eyelashes of the left upper and lower eyelids. A retrospective analysis of the case was conducted, including a review of the relevant literature. Although rare, the possibility of a flash fire should be considered when performing surgery with an electrosurgical unit. Minimizing supplemental oxygen and electrosurgical power settings may help to avoid such an incident. [Ophthalmic Surg Lasers 1998;29:249-250.]
Dislocation of the Mandible During the Course of Cataract Surgery
Authors: Moore Charles A , Ellis Brian
Published: April 2021

Abstract. Spontaneous dislocation of the mandible is a well-described clinical entity with which the ophthalmologist may not be familiar. However, the widespread use of intravenous sedation places susceptible individuals at risk for the development of dislocation of the mandible. The authors describe a patient who underwent routine cataract surgery and suffered a dislocation of the mandible that initially went unrecognized. Ophthalmic surgeons who use intravenous sedation need to be aware of this complication and need to recognize the symptoms so that patients may receive timely attention. [Ophthalmic Surg Lasers 1998;29:251-252.]
Evaluation of Endothelial Function in Postkeratoplasty Eyes
Authors: Saini Jagjit S , Mittal Sangeet , Jain A K
Published: April 2021

* BACKGROUND AND OBJECTIVE: To evaluate corneal endothelium function in postkeratoplasty eyes.

* PATIENTS AND METHODS: Endothelial function was assessed in 23 clear corneal grafts. After a measurable corneal edema was induced by soft contact lens wear, serial pachometric readings were taken for 3 hours to arrive at the percentage recovery per hour (PRPH) index.

* RESULTS: The assessed PRPH values of the clear corneal grafts ranged from 24.6% to 73.0%, with a mean value of 51.8% ± 12.2%. Of the six corneal grafts that demonstrated an initial PRPH value of less than 47.5%, four became edematous within 6 months of follow-up.

* CONCLUSIONS: Assessed PRPH, as an in vivo-measured index of endothelial function, is a valuable method for monitoring endothelial function in postkeratoplasty eyes. The low PRPH index identifies eyes at risk of spontaneous nonimmunologic failures.

[Ophthalmic Surg Lasers 1998;29:300-304.]
A Comparison of Corneal Autografts With Homografts
Authors: Oplinger Nancy L , Zaidman Gerald W , Buxton Donald F
Published: April 2021

* BACKGROUND AND OBJECTIVE: To determine whether ensured graft acceptance through the use of corneal autografts yields a better outcome than when standard homografts are used.

* PATIENTS AND METHODS: Four patients who needed a corneal transplant in one eye and who had a blind fellow eye underwent a corneal autograft in the eye with corneal pathology.

* RESULTS: Three of the four patients had clear grafts on long-term follow-up, and no patient experienced immunologic graft rejection. However, two of the four patients had large amounts of astigmatism postoperatively.

* CONCLUSION: Autografts provided protection against immunologic graft rejection. However, because corneal autografts yielded unpredictable amounts of astigmatism, their outcomes are not necessarily better than those of homografts.

[Ophthalmic Surg Lasers 1998;29:305-308.]
Corneal Melting and Scleromalacia Perforans in a Patient With Pyoderma Gangrenosum and Acute Myeloid Leukemia
Authors: Ayyala Ramesh S , Armstrong Stewart
Published: April 2021

Abstract. Postoperative endophthalmitis may present in an atypical fashion (absent or minimal anterior chamber reaction) in the presence of underlying immunosuppressive disorder. The authors describe an apparently healthy 58-year-old man who displayed endophthalmitis with minimal anterior chamber reaction following penetrating keratoplasty for granular corneal dystrophy with underlying acute myeloid leukemia. Scleromalacia perforans in association with pyoderma gangrenosum subsequently developed, leading to ciliary staphyloma and corneal melting. Pyoderma gangrenosum is an uncommon, idiopathic skin disease that may also have ocular manifestations. [Ophthalmic Surg Lasers 1998;29:328-331.]
Intraocular Pressure During Pneumatic Retinopexy
Authors: Abe Tohru , Nakajima Ako , Nakamura Hideo , Ishikawa Makoto , Sakuragi Shozo
Published: April 2021

* BACKGROUND AND OBJECTIVE: A simplified method of monitoring intraocular pressure (IOP) during pneumatic retinopexy was devised and used clinically to decrease the risk of complications associated with unnecessary IOP elevation.

* PATIENTS AND METHODS: Intraoperative IOP and IOP immediately after sulfur hexafluoride (SF
6
) injection were monitored during pneumatic retinopexy in 22 eyes with rhegmatogenous retinal detachment. Intraoperative IOP was measured with a sphygmomanometer connected to the side of a gasfilled syringe.

* RESULTS: Intraoperative IOP and IOP immediately after gas injection were 97.2 ± 28.5 (mean ± SD) and 46.5 ± 19.6 mm Hg, respectively. Two eyes temporarily lost light perception immediately after the gas injection. The intraoperative IOP and the IOP immediately after the gas injection were 130 and 80 mm Hg, respectively, in one eye, and 180 and 90 mm Hg, respectively, in the other.

* CONCLUSIONS: In general, to ensure effective and safe results of pneumatic retinopexy, the authors recommend that the gas be injected either to approximately 90 mm Hg of intraoperative IOP or to the maximum acceptable volume (2.0 to 2.5 ml of 100% SF
6
).

[Ophthalmic Surg Lasers 1998;29:391-396.]
Comparison of Pain, Motility, and Preoperative Sedation in Cataract Phacoemulsification Patients Receiving Peribulbar or Sub-Tenon's Anesthesia
Authors: Kollarits Carol R , Jaweed Saif , Kollarits Frank J
Published: April 2021

* BACKGROUND AND OBJECTIVES: The authors hoped to reduce the need for preoperative sedation and intravenous pain medication during cataract surgery by converting from peribulbar anesthesia to sub-Tenon's anesthesia.

* PATIENTS AND METHODS: A consecutive series of 2453 cataract patients' charts were reviewed. Each patient had previously watched a videotape explaining the anesthetic method to be used. Requests for preoperative sedation were compared between patients who received peribulbar or sub-Tenon's anesthesia. A sample of 200 charts of nonsedated patients were reviewed to compare intraoperative pain and motility.

* RESULTS: Intraoperative freedom from pain was reported by 91% of the peribulbar patients and 99% of the sub-Tenon's patients. Preoperative sedation was reduced from 26% of the peribulbar patients to 6.7% of the sub-Tenon's patients.

* CONCLUSIONS: Sub-Tenon's anesthesia provided excellent intraoperative pain relief and reduced the need for preoperative sedation, making it a satisfactory anesthetic technique for patients undergoing cataract phacoemulsification in an ambulatory surgery facility.

[Ophthalmic Surg Lasers 1998;29:462-465.]
The Effect of 1 % Apraclonidine on Intraocular Pressure After Cataract Surgery
Authors: Sterk Caesar C , Renzenbrink-Bubberman Ariette C , van Best Jaap A
Published: April 2021

* BACKGROUND AND OBJECTIVE: To measure the effect of 1% apraclonidine hydrochloride eyedrops on intraocular pressure (IOP) after cataract surgery. The effects of two different dosage regimens, once before surgery or once before and after surgery, were studied.

* PATIENTS AND METHODS: Patients scheduled for extracapsular cataract extraction and artificial lens implantation were randomly assigned to three groups: group A had a placebo treatment (n = 18), group B had one drop of 1% apraclonidine 1 hour before surgery (n = 16), and group C had one drop of 1% apraclonidine 1 hour before surgery and 1 drop at the end of surgery (n = 17). Two percent hydroxy-propylmethyl-cellulose was used as the viscoelastic substance. The preoperative IOP and the IOP 6 hours postoperatively in each patient were compared. The paired Student's t test was used to compare IOP before and after surgery. The study design was a randomly assigned, double-masked controlled clinical trial.

* RESULTS: In group A (placebo) and group B

(apraclonidine before surgery), there was a significant increase in IOP (mean IOP increase 11.2 ± 9.9 mm Hg SD, range -4 to 32, P= .00017, and 9.4 ± 7.4 mm Hg SD, range -3 to 24, P = .00014, respectively). In group C (apraclonidine 1 hour before and immediately after surgery), the increase in IOP was not significant (mean IOP increase 5.1 ± 11.5 mm Hg SD, range -10 to 28, P = .084). A postoperative IOP of more than 40 mm Hg applanation tension was reached by two patients in group A, one patient in group B, and two patients in group C.

* CONCLUSION: Although 1% apraclonidine eyedrops instilled 1 hour before and immediately after extracapsular cataract extraction with artificial lens implantation may help prevent a statistically significant increase in IOP after the operation, 2 of the 17 patients still had IOPs greater than 40 mm Hg 6 hours postoperatively. Apraclonidine applied only before surgery did not prevent a statistically significant increase in IOP.

[Ophthalmic Surg Lasers 1998;29:472-475.]
Long-Term Results of Excimer Laser Photorefractive Keratectomy in High Myopia: A Preliminary Report
Authors: Spadea Leopoldo , Colucci Silvia , Bianco Guido , Balestrazzi Emilio
Published: April 2021

* BACKGROUND AND OBJECTIVE: To evaluate the results of 193-nm excimer laser photorefractive keratectomy (PRK) performed on highly myopic eyes with a follow-up of at least 2 years.

* PATIENTS AND METHODS: Fifty-three eyes of 41 patients were treated with a myopic PRK for an attempted correction ranging between -8 and -17 D (mean -10.9 ± 2.8 SD).

* RESULTS: The follow-up ranged from 24 to 60 months (mean 34.1 months ±10 SD). Fifty-three percent of the eyes achieved a refraction within ± 2 D of the planned correction, with a refractive error greater than 4 D in 21% of the treated eyes. The uncorrected visual acuity was 20/40 or better in 45% of the eyes. There were no significant opacities in 85% of the eyes examined. A second treatment was performed on 5 eyes.

* CONCLUSION: The results suggest that excimer laser PRK is a safe and relatively effective alternative for treating highly myopic eyes, and its effects are stable over a long period of time.

[Ophthalmic Surg Lasers 1998;29:490-496.]
Blinding Eye Injury During a Rock Concert
Authors: Ing Edsel
Published: April 2021

Abstract. A 17-year-old girl attended a rock concert where promotional compact discs were being thrown into the audience as prizes. She suffered an extensive corneoscleral laceration with vitreous hemorrhage and retinal detachment when a compact disc struck her in the eye. An alternative, safer method must be used for distributing compact discs as prizes. [Ophthalmic Surg Lasers 1998;29:518.]
Involutional Lower Eyelid Entropion: Results of a Combined Approach
Authors: van den Bosch Willem A , Rosman Malou , Stijnen Theo
Published: April 2021

* BACKGROUND AND OBJECTIVE: To evaluate the effect of adding horizontal eyelid tightening and the removal of orbital fat to reinsertion of the lower eyelid retractors to correct involutional entropion.

* PATIENTS AND METHODS: During 6 consecutive years, 266 cases (229 patients) were treated. Of these, 240 cases (207 patients) showed horizontal laxity, in which reinsertion of the lower eyelid retractors was combined with lower eyelid tightening in the lateral canthal angle. In 60 of these cases (47 patients), prolapsing orbital fat was removed during the operation. In 26 cases (22 patients), no horizontal laxity was found. Their treatment consisted of reinserting the lower eyelid retractors without eyelid tightening. Follow-up of 28 weeks postoperatively was available in all cases. In 213 cases (178 patients), follow-up of 5 months or longer (range 5 to 80 months, average 42 months) was available.

* RESULTS: The most common complication of surgery was persistent ectropion, which occurred in 12 cases (5.6%). It occurred significantly more often after reinsertion without horizontal eyelid tightening than after combined reinsertion and horizontal tightening (P = .04). Adding the excision of orbital fat to the latter procedure did not significantly influence the results. Transient ectropion also occurred significantly more often after retractor reinsertion alone than after combined retractor reinsertion and horizontal tightening (P = .01). The entropion recurred in 9 cases (3.3%), 5 of which within 24 months (2.4%). The authors found no difference in recurrence rate between the three groups. A disadvantage of eyelid tightening is tenderness, which was reported by 42 (29%) of the patients. In 9 patients this had persisted longer than 4 months.

* CONCLUSION: Horizontal eyelid laxity is common in involutional entropion. Tightening of the lower eyelid in the lateral canthus, added to reinsertion of the lower eyelid retractors, significantly lowers the incidence of surgical overcorrection, but has no effect on the recurrence rate. A disadvantage of eyelid tightening in the lateral canthus is that it may lead to mostly transient eyelid tenderness.

[Ophthalmic Surg Lasers 1998;29:581-586.]
The Use of Sodium Hyaluronate as a Lubricant in Brow Suspension Ptosis Surgery Using Polyester Fiber Mesh
Authors: Lim Boon-Ang , Choo Chai-Teck
Published: April 2021

Abstract. Polyester fiber is used as an alternative to autologous fascia lata for brow suspension ptosis surgery. The authors found it difficult to pass the polyester compound through the submuscular plane during brow suspension surgery. They used sodium hyaluronate as a lubricant to aid the passage of polyester fiber mesh. In 14 cases of brow suspension surgery with polyester fiber mesh, the authors found sodium hyaluronate to be useful in reducing tissue resistance and without untoward effect. [Ophthalmic Surg Lasers 1998;29:606-607.]
Salvaged Viscoelastic Reduces Irrigation Frequency During Cataract Surgery
Authors: Wessels Izak F , DeBarge Raymond , Wessels Delia A
Published: April 2021

Abstract. A more viscous solution may decrease the need for frequent irrigations to maintain a clear cornea during cataract surgery. Fifty-four consecutive cataract patients were prospectively randomized to receive a drop of viscoelastic or saline on the cornea at the start of surgery. The surgical scrub nurse was instructed to irrigate only when the cornea appeared hazy or at the surgeon's request. The number of irrigations, ultrasound time and energy, and surgery times were compared using the Student's t test. Only one ampoule of viscoelastic was used for each case. When the patients who received viscoelastic were compared with the patients who received saline, the mean numbers of irrigations were 2 and 18, whereas the mean numbers of irrigations per minute were 0.17 and 1.21, highly significant (P < .0001) differences. The duration of surgery, ultrasound time, and ultrasound energy were less with viscoelastic, but were not statistically significant. Viscoelastic on the cornea reduces the frequency of irrigation without increasing cost. [Ophthalmic Surg Lasers 1998;29:688-691.]
A Pre-swedged Silicone Tube to Simplify Pigtail Canaliculoplasty
Authors: Goldberg Robert Alan
Published: April 2021

Abstract. Silicone intubation of the canalicular system is indicated for stenting following canalicular trauma or surgery, or to dilate chronic stenosis of the punctum or canaliculus. Monocanalicular systems are available, but bicanalicular intubation is generally more stable and is particularly suitable for disease involving both the upper and the lower punctae or canaliculae. Bicanalicular intubation can be accomplished by intubating the entire lacrimal outflow system into the nose, or more simply by intubating the canalicular system alone using a pigtail probe. To use the pigtail probe to pass and fixate a segment of silicone tubing, the silicone tube is passed using a monofilament suture. A pre-swedged silicone tube segment on a monofilament suture has been designed to simplify the process of pigtail probe intubation of the canlicular system. [Ophthalmic Surg Lasers 1998;29:770-771.]
Subconjunctival Cephalosporin Anaphylaxis
Authors: Berrocal Audina M , Schuman Joel S
Published: April 2021

Abstract. This case describes a patient who developed a systemic anaphylactic reaction to a subconjunctival injection of cephalosporin. The patient did well, but required intensive therapy, including airway intubation. She had a history of penicillin allergy. Even 50 mg of cephalosporin antibiotic injected locally can produce a life threatening anaphylactic reaction. [Ophthalmic Surg Lasers 2001;32:79-80]
A Simple Closed Chamber Technique for Repair of Traumatic Iridodialysis in Phakic Eyes
Authors: Erakgun Tansu , Kaskaloglu Mahmut , Kayikcioglu Ozcan
Published: April 2021

Abstract. A surgical technique was developed for traumatic iridodialysis repair using a small partial-thickness scleral flap and a 24-gauge disposible hypodermic needle. This procedure is a "direct iridodialysis-site approach" closed chamber technique with minimal surgical trauma that can be used in phakic, Pseudophakie, or aphakic eyes. [Ophthalmic Surg Lasers 2001;32:83-85]
A Simple Treatment for Chronic Postoperative Hypotony of Unknown Etiology: The Injection of Balanced Salt Solution into the Anterior Chamber
Authors: Mantel Irmela , Schipper Isaak
Published: April 2021

Abstract. Postoperative hypotony is not rare. When it occurs, effective treatment must be initiated to avoid secondary complications. We report two cases of postoperative hypotony that have been treated successfully with a single injection of balanced salt solution (BSS) into the anterior chamber. One patient developed hypotony three months after combined cataract surgery and trabeculectomy with the use of Mitomycin C (MMC). The cause of hypotony remained unknown. Leakage, hyperfiltration, cyclodialysis, and other possible causes had been excluded. With a single injection of BSS into the anterior chamber the long-standing hypotony was successfully managed. A second patient with hypotony after pars plana vitrectomy was also treated successfully with an injection of BSS into the anterior chamber. We conclude that an injection of BSS into the anterior chamber is an inexpensive and efficacious remedy for postoperative hypotony of unknown etiology. [Ophthalmic Surg Lasers 2001;32:250-254]
Subconjunctival Anesthesia in Contact Diode Laser Cyclophotocoagulation
Authors: Schlote Torsten , Derse Matthias
Published: April 2021

* BACKGROUND: Retro- or peribulbar anesthesia are the standard procedures for cyclodestructive surgery. Because these methods of anesthesia may further compromise optic nerve function, especially in advanced glaucoma, subconjunctival anesthesia was evaluated as an alternative procedure in contact diode laser cyclophotocoagulation (CPC).

* PATIENTS AND METHODS: A prospective study concerning diode laser CPC in advanced glaucoma was started using subconjunctival anesthesia with 2% mepivacaine. Complications and pain during CPC (5 point rating scale) and on the first postoperative day were recorded. Only the first CPC in every patient was included for evaluation.

* RESULTS: Included in the study were 120 eyes of 120 patients. During CPC, 82.5% of patients experienced no pain, 1 1.7% mild pain, and 5.8% moderate pain. No instances of pain or excess motion occurred that required peribulbar anesthesia or discontinuation of the procedure.

* CONCLUSION: Most of the patients experienced no pain during diode laser CPC using subconjunctival anesthesia. Therefore, risks and side effects of retro- or peribulbar anesthesia can be successfully avoided by this simple modification.

[Ophthalmic Surg Lasers 2001;32:289-293]
Fundus Autofluorescence in Macular Hole Surgery
Authors: Framme Carsten , Roider Johann
Published: April 2021

* BACKGROUND: Macular holes usually are diagnosed by biomicroscopy. Fluorescence angiography (FLA) is helpful especially for judging early stages or pseudoforamina. The importance of fundus-autofluorescence in macular hole surgery was studied.

* PATIENTS AND METHODS: Twenty-five consecutive patients with macular holes (n = 21) and clinically-similar appearances (n = 4) were examined biomicroscopically. In addition, fundus-autofluorescence and FLA were determined by Heidelberg-Retina-Angiograph (HRA, Heidelberg, Germany). A vitrectomy was performed on 16 patients with macular hole stage II, III, and IV, and membrane peeling was performed if necessary. Platelet-concentrate as an adjuvant agent was used in all surgeries, and all 16 patients were examined afterward.

RESULTS: In all patients with macular hole stage III and IV (n = 18), fundus-autofluorescence revealed a marked hyperfluorescent spot in the foveolar region and also a hyperfluorescence in FLA. Patients with macular hole stage II (n = 3) showed a slight punctured hyperautofluorescence and a subtle window-defect in the FLA. Postoperatively, the autofluorescence was normal in all eyes with a closed macular hole (87.5%). In some patients, a variable punctured hyperautofluorescence was noticed (n = 3). In eyes with pseudoforamina, the autofluorescence was normal (n = 4).

* CONCLUSION: In macular hole diagnostics, fundus-autofluorescence is able to replace invasive fluorescence angiography. The autofluorescence is helpful for the examination of pseudoforamina and might be useful for estimating therapeutic success.

[Ophthalmic Surg Lasers 2001;32:383-390]
Efficacy of Various Laser Wavelengths in the Treatment of Clinically Significant Macular Edema in Diabetics
Authors: Gupta Vishali , Gupta Amod , Kaur Ravinder , Narang Subina , Dogra Mangat R
Published: April 2021

* BACKGROUND AND OBJECTIVE: To compare various laser wavelengths: argon green (514 nm), vs krypton red (647 nm), vs frequency doubled Nd:YAG (532 nm), and vs diode (810 nm), for laser photocoagulation treatment in clinically significant macular edema (CSME) in diabetics.

* PATIENTS AND METHODS: Four different wavelengths were used to sequentially treat 271 eyes of 164 diabetic patients with CSME. Follow up was conducted for a minimum of 6 months (9.8 ± 1.3 months). Retreatment was performed if residual edema involving the foveal avascular zone persisted at 3 months.

* RESULTS: Reduction/elimination of CSME was observed in 93.3% of argon-treated eyes, 88.5% in krypton red group, 92.9% with frequency doubled Nd:YAG, and 84.8% with diode laser with no statistically significant difference between the groups (P > 0.05 for all groups). The number of eyes requiring retreatment was highest with the diode laser having 44.3% of eyes requiring retreatment and least with frequency doubled Nd:YAG having only 15.5% of eyes requiring retreatment (P = 0.0002).

* CONCLUSIONS: All lasers are equally effective in reducing/eliminating CSME. However, Nd:YAG may have an advantage because of requiring fewer retreatments.

[Ophthalmic Surg Lasers 2001;32:397-405]
Repair of a Late-Onset Filtering Bleb Leak Using a Corneal Graft Shaped With an Excimer Laser
Authors: Mistlberger Andrea , Biowski Robert , Grabner Guenther
Published: April 2021

Abstract. A new method for repairing an area of late scleral necrosis and bleb leak after glaucoma-filtering surgery using mitomycin C (MMC) is described. In a 33-year-old female patient diagnosed with bilateral juvenile glaucoma, a bleb leak occurred 41 months after trabeculectomy with MMC in the left eye. A corneal stromal patch-graft shaped to the desired size using an excimer laser (Excimer-Laser-CornealShaping-System, ELCS-S) was used to cover the scleral defect. This step was followed by water-tight closure of the conjunctiva. During the follow-up period of 12 months the leak remained successfully repaired and the intraocular pressure stayed between 8 and 14 mm Hg without medication. This technique that uses lamellar grafts of very large size should be considered when a surgical repair of a large leaking bleb is required, especially in cases with scleral tissue necrosis. [Ophthalmic Surg Lasers 2001;32:428-431]
Illuminated Lens Fixator for Bimanual Pars Plana Lensectomy
Authors: Arroyo Jorge G , You Timothy , Bossi Karen E
Published: April 2021

Abstract. Pars plana vitrectomy and lensectomy are effective methods for removing posteriorly dislocated lens material. We describe an illuminated nucleus fixator that assists in the removal of posteriorly dislocated lens fragments. We tested the efficacy of the illuminated nucleus fixator compared to a standard endoilluminator in removing lens nuclei from the vitreous cavity of a cadaveric eye model. Use of the illuminated nucleus fixator as compared to a standard endoilluminator significandy reduced the time needed to remove lens nuclei from the vitreous cavity. This instrument could penetrate and fixate lens nuclei and could safely stabilize small and intermediate-sized lens fragments against the activated fragmatome. Bimanual lensectomy using the illuminated nucleus fixator significantly shortens the surgical time needed to remove posteriorly dislocated lens fragments. Shortening the surgical time for lensectomy may minimize such complications as retinal tears, trauma, and phototoxicity. [Ophthalmic Surg Lasers 2001;32:438-440]
High Volume Sutureless Intraocular Lens Surgery in a Rural Eye Camp in India
Authors: Balent Linda Civerchia , Narendrum Kalpana , Patel Surekha , Kar Sumit , Patterson David A
Published: April 2021

* BACKGROUND AND OBJECTIVE: To describe the use of small incision sutureless cataract surgery (SISCS) that permits high-volume, high-quality, and low-cost surgery.

* PATIENTS AND METHODS: We compared the speed, safety, and visual results of 1 1 90 surgical techniques performed in a public eye camp in India. Intraocular lenses were received by 97% of patients (1154). Surgical techniques used were SISCS, phacoemulsification, and standard extracapsular cataract extraction (ECCE) technique.

* RESULTS: Postoperatively, 60.0% attained uncorrected vision of 6/24 or better. There was little difference in visual results or complication rates among the three techniques. The most striking finding is the speed of SISCS, which enables experienced surgeons to perform the technique in 3.8 to 4.2 minutes.

* CONCLUSION: We believe this surgical technique is of major importance especially in developing nations facing enormous surgical volumes and limited resources.

[Ophthalmic Surg Lasers 2001;32:446-455]
Subretinal, Viscoelastic-Assisted, Endoscope-Guided Photothermal Ablation of Choroidal Neovascular Membranes by Erbium:YAG Laser
Authors: Quiroz-Mercado Hugo , Yeshurun Itamar , Sanchez-Buefil Ermilo , Guerrero-Naranjo Jose L , Luloh Peter , Mercellino George R
Published: April 2021

* BACKGROUND AND OBJECTIVE: The effi cacy of endoscope-guided erbium: YAG laser, assisted by viscoelastic macular detachment, in subretinal ablation of choroidal neovascular membranes (CNVs) is evaluated.

* PATIENTS AND METHODS: A high-repetition, midinfrared erbium:YAG laser was used subretinally to ablate CNVs in 2 patients. Ablation followed pars plana vitrectomy and macular retinal detachment using a viscoelastic substance, and was guided by a high resolution endoscope.

* RESULTS: Visual acuity improved from 6/90 to 6/20, six months after treatment in 1 patient, and from finger counting from 1 meter to 6/30, three months after treatment in the other. The membranes showed no angiographic signs of activity postoperatively. However, a zone of stippled hyperfluorescence appeared in both patients, corresponding with the macular detachment area. This gradually diminished in size in both patients.

* CONCLUSIONS: The surgical procedure was found effective in our preliminary research. The use of viscoelastic substance and endoscope is felt to contribute to the favorable outcome. The cause and significance of the retinal pigment epithelium damage are yet to be determined.

[Ophthalmic Surg Lasers 2001;32:456-463]
Extraocular Muscle Metastasis 16 Years Following Primary Prostate Carcinoma
Authors: Scott Ingrid U , Tanenbaum Myron , Kay Matthew D , Gould Edwin
Published: April 2021

Abstract. An 83-year-old man with a history of localized prostate carcinoma treated 16 years prior with transurethral partial prostatectomy and radioactive seed implants presented with a 2-month history of right globe proptosis. Computed tomography demonstrated a right medial rectus mass. Serum prostate specific antigen (PSA) level was normal. Tumor biopsy revealed poorly differentiated carcinoma with diffuse staining of tumor cells with PSA and prostatic acid phosphatase. This case demonstrates that prostate carcinoma may metastasize to an extraocular muscle many years after treatment of the primary tumor and may not be accompanied by elevated serum PSA. Immunohistochemical stains are helpful in establishing the diagnosis. [Ophthalmie Surg Lasers 2001;32:479-480]
Sinus Fracture-Phacoemulsification Technique for Dense Cataracts
Authors: Dada V K , Sharma Namrata , Dada Tanuj , Vajpayee Rasik B
Published: April 2021

Abstract. A method of performing phacofracture of hard nuclei is presented. Following a central horizontal fracture into 2 hemisections, the phacoprobe is plunged into the inferior hemisection to create a sinus within its dense wall. The chopper/second instrument is placed into the sinus and force is applied along the lateral walls of the sinus. The phacoemulsification probe breaks it and splits the inferior hemisection into two quadrants. A similar method is employed for the superior-nuclear hemisection. [Ophthalmic Surg Lasers 2001;32:503-504]
Combined Cataract Surgery and Vitrectomy for Breakthrough Vitreous Hemorrhage from Age-Related Macular Degeneration
Authors: Chaudhry Nauman A , Flynn Harry W , Murray Timothy G , Belfort Armando
Published: April 2021

PURPOSE: To report combined cataract extraction (CE), posterior chamber intraocular lens (PCIOL) implantation, and pars plana vitrectomy (PPV) for concurrent cataract and breakthrough vitreous hemorrhage from age-related macular degeneration (AMD).

METHODS: Retrospective case series.

RESULTS: Six eyes were included in the study. The postoperative follow-up interval ranged from 3 to 22 months (mean 8 months). Preoperative visual acuity (VA) ranged from 20/400 to hand motion. Postoperatively, 5/6 eyes had 2 or more lines of visual improvement. Three eyes were better than 20/200.

CONCLUSIONS: Combined CE, PCIOL insertion, and PPV in selected patients with cataract and breakthrough vitreous hemorrhage from AMD was successful in improving VA in the majority of patients.

[OphtJaalmic Surg Lasers 2002;33:16-18]
Comparison of Double-Plate Molteno and Ahmed Glaucoma Valve in Patients With Advanced Uncontrolled Glaucoma
Authors: Ayyala Ramesh S , Zurakowski David , Monshizadeh R , Hong Chian-Huey , Richards David , Layden William E , Hutchinson B T , Bellows A R
Published: April 2021

* BACKGROUND AND OBJECTIVE: To compare double-plate Molteno (DPM) with the Ahmed glaucoma valve (AGV) in the treatment of eyes with complicated glaucoma.

* PATIENTS AND METHODS: This matched, retrospective, case-controi study was based on diagnosis, number of previous operations, and age. There were 30 patients in each group and only patients with a minimum of 6 months follow up were included. Doubleplate Molteno or Ahmed glaucoma valve insertion was performed on each patient to control intractable glaucoma. Success was defined as IOP <22 mm Hg and >4 mm Hg on the last two visits, a decrease of no more than 2 lines in the visual acuity, and no additional surgical intervention to control IOP.

* RESULTS: The Kaplan-Meier estimated probability of success at 12 and 24 months was 73% and 56% with DPM and 60% and 50% for AGV (P = 0.72). Mean IOP measured 13.36 ± 5.2 mm Hg following DPM and 16.7 ± 5.6 mm Hg following AGV at 12 months (P = 0.026) and 13.3 ± 5.1 mm Hg with DPM and 19 ± 5.8 mm Hg with AGV at 24 months (P - 0.009). Of the patients involved in the study, 83.5% exhibited hypertensive phase (HP) of AGV vs 43.5% of DPM (P = 0.04). AGV had a tendency to fail earlier (5 months ± 7 following AGV vs 13 months ± 13 following DPM, P = 0.07, t-test). Patients with either a second valve insertion or valve removal were 7/30 of AGV vs 1/30 in DPM (P = 0.05). Stent removal was needed by 10/30 DPM and 8/30 AGV had needling/5-FU.

* CONCLUSIONS: The percentage of patients free from failure was similar between the two groups at 36 months. DPM is associated with lower mean IOP in the long term compared to AGV.

[Ophthalmic Surg Lasers 2002:33:94-101]
Topographic Mapping of Glaucomatous Visual Field Defects to Scanning Laser Polarimetry of the Peripapillary Nerve Fiber Layer
Authors: Shields Jerry R , Chen Philip P , Mills Richard P
Published: April 2021

BACKGROUND AND OBJECTIVE: To map retinal sensitivity values within glaucomatous visual field defects (VFD) to corresponding values of scanning laser polarimetry (SLP) of the peripapillary retinal nerve fiber layer using the Wirtschafter disc sector classification.

METHODS: Eyes with glaucomatous VFD (N = 28) underwent SLP and Humphrey automated perimetry. The Wirtschafter disc sector classification was used to obtain SLP values corresponding to VFD. The average and modulated SLP values were calculated and correlated with VFD.

RESULTS: No significant correlation was found between retinal sensitivity and the Wirtschafter disc sector SLP values, using average values (P =.904) or modulated values (P =.409).

CONCLUSION: Despite use of modulation parameters customized to correspond with the Wirtschafter disc sector classification, topographic mapping of retinal sensitivity levels within glaucomatous VFD to corresponding SLP values was not possible in this group of glaucomatous eyes.

[Ophthalmic Surg Lasers 2002;33:123-126]
Bilateral Macular Hole Formation in a Patient With Retinitis Pigmentosa
Authors: Rao P Kumar , Shah Gaurav , Blinder Kevin J
Published: April 2021

Abstract. A 47-year-old woman known to have retinitis pigmentosa (RP) developed macular holes in each eye. Examination and fluorescein angiography demonstrated a partial thickness macular hole in the right eye and a full thickness one in the left eye. It was concluded that macular hole formation can occur in patients with RP, but the exact cause of macular hole development in these patients is uncertain.

[Ophthalmic Surg Lasers 2002;33:152-154]
Endophotocoagulation to Retinal Pigment Epithelium as an Adjuvant Therapy in the Management of Retinal Detachment Caused by a Highly Myopic Macular Hole
Authors: Kwof Alvin K H , Lam S W , Lai Jimothy Y Y , Lam Dennis S C
Published: April 2021

Abstract. Retinal detachment secondary to a highly myopic macular hole remains a particular surgical challenge. Pars plana vitrectomy, endophotocoagulation at the base of a macular hole m conjunction with fluid-gas exchange was performed in 4 consecutive patients with a mean refraction of -13.8D (range, - 8D- -18D). Mean axial length was 27.5 mm (range, 26.0-29.0 mm). Mild atrophy of the retinal pigment epithelium was present in 3 patients while 1 patient had moderate atrophy. The mean follow-up period was 12 months (range, 6-18 months). The overall primary anatomical success rate was 75%. All 3 eyes with mild retinal pigment epithelium atrophy had retinal reattachment after one operation. [Ophthalmic Surg Lasers 2002;33:155-157]
Acute Lymphocytic Leukemia Presenting as Masquerade Syndrome
Authors: Dadeya Subhash , Malik K P S , Guliani B P , Dewan Sumita , Mehta Rajesh , Gupta V S
Published: April 2021

Abstract. An 11-year-old child presented with plastic iridocyclitis and hypopyon. Subsequent paracentesis revealed leukemic infiltrates. A bone marrow biopsy confirmed the diagnosis of acute lymphocytic leukemia. Because of this unusual case of leukemic hypopyon, we advocate anterior chamber paracentesis and pediatrician referral in all cases of refractory uveitis. [Ophthalmic Surg Lasers 2002;33:163-165]
Filtering Bleb Modification With a THC:YAG (Holmium) Laser
Authors: Iwach Andrew G , Delgado Maria F , Adachi Misato , Makarewycz Motryja , Wong Patricia , Nguyen Ngoc
Published: April 2021

* OBJECTIVE: To present a method for remodeling oversized blebs using the THC: YAG laser and describe its use in treating hypotony and bleb leaks.

* METHODS: Retrospective medical record review of 13 patients who underwent holmium laser bleb revision.

* RESULTS: Thirteen eyes of 13 patients were analyzed. All the patients had an oversized bleb and 2 patients presented an associated late-onset leaking bleb. Mean preoperative IOP was 4.1 mm Hg. THCYAG laser energy was applied to the bleb to remodel and/or close the leak. After a mean follow up of 17.3 months, the mean IOP was 7.84 mm Hg ± 2.3. Postsurgery complications included hyphema and the inadvertent rupture of a conjunctival microcyst. Visual acuity improved in 9 of the eyes and remained stable in 4 of the eyes.

* CONCLUSION: The THCYAG laser can be used effectively to sculpt large blebs, reduce symptoms associated with large blebs, increase IOP in hypotonous eyes, and under specific circumstances, close bleb leaks. [Ophthalmic Surg Lasers 2002;33:181-187]
Results of Vitrectomy in Terson Syndrome
Authors: Sharma Tarun , Gopal Lingam , Biswas Jyotirmay , Shanmugam Mahesh P , Bhende Pramod S , Agrawal Rajat , Shetty Nitin S , Sanduja Neeraj
Published: April 2021

* BACKGROUND: To report visual results of vitrectomy in Terson syndrome

* MATERIALS AND METHODS: In 11 patients, 15 eyes underwent vitreous surgery for Terson syndrome. The mean follow up was 1 8.3 months.

* RESULTS: An incomplete posterior vitreous separation was noted in 10 eyes (66.7%). An epiretinal membrane was present in 4 eyes (26.7%), and in 3 eyes, a retinal fold along the arcade was noticed. Significant visual improvement occurred in all eyes; visual acuity of 20/40 or better was achieved in 14 eyes (93.3%). Only 3 eyes developed lens opacity after surgery.

* CONCLUSION: Vitrectomy in Terson syndrome provides excellent visual recovery. The complication rate, including the development of cataract, is low.

[Ophthamic Surg Lasers 2002;33:195-199]
An Investigation of CO2 Laser Scleral Buckling Using Moiré Interferometry
Authors: Maswadi Saher M , Dyer Peter E , Verma Dinesh , Jalabi Wadah , Dave Dinesh
Published: April 2021

* BACKGROUND AND OBJECTIVE: To demonstrate suitability of moiré interferometry to assess and quantify laser-induced shrinkage of scleral collagen for buckling procedures.

* MATERIALS AND METHODS: Scleral buckling of human cadaver eyes was investigated using a Coherent Ultrapulse CO2 laser. Projection moiré interferometry was employed to determine the out-of plane displacement produced by laser exposure, and in-situ optical microscopy of reference markers on the eye was used to measure in-plane shrinkage.

* RESULTS: Measurements based on moiré interferometry allow a three dimensional view of shape changes in the eye surface as laser treatment proceeds. Out-of-plane displacement reaches up to 1.5 mm with a single laser spot exposure. In-plane shrinkage reached a maximum of around 30%, which is similar to that reported by Sasoh et al Ophthalmic Surg Lasers. 1998;29:410) for a Tm: YAG laser.

* CONCLUSION: The moiré technique is found to be suitable for quantifying the effects of CO2 laser scleral shrinkage and buckling. This can be further developed to provide a standardized method for experimental investigations of other laser sources for scleral shrinkage.

[Ophthalmic Surg Lasers 2002;33:221-227]
Placement of a Collagen Glaucoma Drainage Device to Control Intraocular Pressure and Chronic Iritis Secondary to Juvenile Rheumatoid Arthritis
Authors: Price Francis W , Ziemba Steven L
Published: April 2021

Abstract. A patient with juvenile rheumatoid arthritis and chronic iritis is reported with intraocular pressure near 30 mm Hg and previous episodes of intraocular pressure as high as 50 mm Hg despite maximally tolerated medical therapy. Because of the potential risk involved with a full-thickness filtration procedure, it was decided that a nonpenetrating deep sclerectomy would be appropriate, followed by placement of a collagen glaucoma drainage device to maintain aqueous outflow. Immediately postoperatively, intraocular pressure was stabilized. At 24 months postoperatively, intraocular pressure was well controlled at 1 5 mm Hg with patient receiving only Lotemax. No significant complications were noted at any point in the postoperative course. Because of the patient's predisposition for serious complications frequently associated with trabeculectomy, nonpenetrating deep sclerectomy with the collagen glaucoma drainage device was an effective alternative for this patient. [Ophthalmic Surg Lasers 2002;33:233-236]
Unilateral Acute Retinal Necrosis Occurring 2 Years After Herpes Simplex Type 1 Encephalitis
Authors: Kim Changkook , Yoon Young H
Published: April 2021

Abstraer, Acute retinal necrosis (ARN) syndrome is known to occur occasionally in association with or shortly after herpetic encephalitis. We describe a patient with unilateral ARN occurring 2 years after herpes simplex virus (HSV) type 1 encephalitis. A 49year-old man presented with unilateral visual loss. He had a history of HSV-I encephalitis 2 years previously, and had been successfully treated without a subsequent recurrence. The ophthalmologic finding were all consistent with the ARN syndrome. The same type 1 HSV was identified from ocular fluid as was identified from the patient's cerebrospinal fluid 2 years ago. There was no evidence of a recurrence of encephalitis. This case suggests that following encephalitis retinal neurons may function as a reservoir for latent HSV-I, that can be reactivated to cause ARN in situ several years later. [Ophthalmic Surg Lasers 2002;33:250252]
Two Cases of Stenotrophomonas Maltophilia Endophthalmitis
Authors: Benian Ömer , Alimgil Levent , Erda Nazan
Published: April 2021

Abstract. Two cases of Stenotrophomonas maltophilia endophthalmitis, a rare cause of postoperative endophthalmitis, are reported in this study. Both of the patients underwent vitreus tap and intravitreal antibiotic injection. The therapy was augmented with systemic and subconjunctival injections. The response to this therapy protocol was excellent and the final visual acuity in both of the patients was 10/10. The results are discussed and the literature, which consists of only 8 reported cases of Stenotrophomonas maltophilia endophthalmitis, is reviewed. Although endophthalmitis caused by this pathogen is a rare but important cataract surgery complication, with appropriate therapy, this clinical presentation can be cured without risk of reoccurrence. [Ophthalmic Surg Lasers 2002; 33:253-256]