bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Role Conception and Role Deprivation in LPN-Transition Students and Traditional ADN Students in a Specially Designed Associate Program
Authors: Lengacher Cecile A , Keller Rosemary
Published: April 2021

ABSTRACT

This study compared differences in role orientation and role deprivation between 41 LPN-transition students and 123 basic traditional associate degree nursing (ADN) students upon entry and exit to a specially designed ADN program. The Corwin Role Conception Scale was used to assess role conception and deprivation. Statistically significant differences were noted upon entry between LPN-transition students and traditional ADN students in professional and service role conceptions and in role deprivation, upon exit in professional role conception and role deprivation between LPN-transition and traditional ADN students, and in professional role conception within the LPN-transition students. No differences were found within traditional ADN students from entry to exit of the program.
Competencies of Novice Nurse Educators
Authors: Davis Debra C , Dearman Catherine , Schwab Charlene , Kitchens Edeth
Published: April 2021

ABSTRACT

Appropriate preparation for the nurse faculty role has been debated for many years. Currently, the master of science in nursing (MSN) is considered to be the minimal acceptable preparation. The focus of most MSN programs, however, is advanced knowledge and skill in clinical nursing. The purpose of this study is to identify the perceptions of novice nurse faculty concerning nurse faculty competencies, to ascertain the extent to which novice nurse faculty demonstrate the competencies, and to determine mechanisms through which competencies are obtained. The findings indicate that many novice nurse faculty are not educationally prepared for the faculty role.
The Affective Outcomes of Course Work on Computer Technology in Nursing
Authors: Thomas Barbara S , Delaney Connie White , Weiler Kay
Published: April 2021

ABSTRACT

At the University of Iowa, nursing students are introduced to computer technology as one unit in a course designed to explore nursing as a profession. A single group, pretest/posttest design was used to evaluate changes in attitudes associated with the course work. Relationships of attitudes scores and eight background variables were studied. Posttest attitudes scores were significantly higher than pretest scores. The attitudes scores were positively related to skills scores at a statistically significant level of .05, with no significant relationship between attitudes scores and knowledge base scores. Four of the eight background factors were related to the attitudes scores at a statistically significant level of .05.
Leadership Behaviors of Deans of Top-Ranked Schools of Nursing
Authors: Gevedon Sherry L
Published: April 2021

ABSTRACT

Deans of the top-ranked schools of nursing in the United States were surveyed and asked to describe leadership behaviors. Mean scores indicated that values was reported as the most important transformative leadership theme followed by the themes of vision, people, motivation, and influence. The most important leadership attribute reported was a commitment to a higher code of ethical behavior. This study adds to the research literature on the nursing deanship and has important implications for the identification, selection, and training of exemplary leaders in nursing.
Baccalaureate Nursing Students' Perspectives of Their Clinical Nursing Leadership Experience
Authors: Reider Joan A , Riley-Giomariso Oma
Published: April 2021

ABSTRACT

This qualitative study using Colaizzi's (1978) method of protocol analysis describes baccalaureate nursing students' perspectives of a clinical nursing leadership experience. Students participated in pre- and postexperience focused interviews and completed logs during their experience. Findings revealed that although students felt preexperience anxiety, they held positive expectations and anticipated acquiring skills for the clinical leadership role. During the process, students experienced emerging clarification of the leadership/management role and became aware of support systems. As a result of the clinical leadership activity, students experienced an emerging sense of confidence, developed a value system prizing professional nursing needed for managing care for a group of patients, and added desirable leadership qualities to their repertoire of skills. Gaining entrance into the nursing care delivery system and being actively involved in leadership activities were necessary for acquisition of skills.
Registered Nurses' Perceptions of Liberal Education
Authors: Hagerty Bonnie , Early Steven L
Published: April 2021

ABSTRACT

Educators in higher education and nursing stress the importance of liberal education in helping professionals address the complexity, ambiguity, and rapid change inherent in current practice. Yet, little is known about nurses' perceptions and use of liberal education either personally or professionally. This article explores RN^ perceptions of liberal education, including its personal and professional impact and its acquisition. Based on interviews with 17 practicing nurses, important themes about liberal education were derived using phenomenological analysis. The findings suggest issues that educators might examine to improve the acquisition of liberal education and its integration with professional practice.
Information Science for the Future: An Innovative Nursing Informatics Curriculum
Authors: Travis Lucille , Brennan Patricia Flatley
Published: April 2021

ABSTRACT

Health care is increasingly driven by information, and consequently, patient care will demand effective management of information. The report of the Priority Expert Panel E: Nursing Informatics and Enhancing Clinical Care Through Nursing Informatics challenges faculty to produce baccalaureate graduates who use information technologies to improve the patient care process and change health care. The challenge is to construct an evolving nursing informatics curriculum to provide nursing professionals with the foundation for affecting health care delivery. This article discusses the design, implementation, and evaluation of an innovative nursing informatics curriculum incorporated into a baccalaureate nursing program. The basic components of the curriculum framework are information, technology, and clinical care process. The presented integrated curriculum is effective in familiarizing students with informatics and encouraging them to think critically about using informatics in practice. The two groups of students who completed the four-course sequence will be discussed.
Factors Influencing the Publishing Efforts of Graduate Students in Nursing
Authors: Whitley Georgia G , Oddi Lorys F , Terrell Deborah
Published: April 2021

ABSTRACT

The purposes of this study were to identify factors influencing publication efforts of graduate students in nursing and determine the extent to which graduate students' scholarly activities contribute to the creation and dissemination of knowledge in nursing, as evidenced by publication in a professional journal. Authors of articles in Nursing Research were surveyed to assess their status as graduate students during the conceptualization, development, and publication of nursing research studies. The sample consisted of 633 authors of manuscripts published in Nursing Research from 1987 to 1991. The study design was descriptive. A survey questionnaire elicited data on graduate student status and factors that influenced the initiation and completion of the project. The data were analyzed using descriptive statistical techniques. The results of the study suggest that graduate students in nursing make important contributions to the advancement and dissemination of nursing knowledge. Factors that influence graduate students to engage in the process include academic requirements (e.g., thesis, dissertation, coursework), faculty involvement and support, and the ability to self-select the research topic.
Improving Nursing Education Classroom Environments
Authors: Fisher Darrell L , Parkinson Camillus-Anthony
Published: April 2021

ABSTRACT

This study describes the first use of a classroom environment questionnaire with a class in nursing education. An instructor of nursing studente monitored classes using such a questionnaire. The questionnaire used was the College and University Classroom Environment Inventory and it was used to obtain practical and useful information about the learning environment in two different classes. Collaborative changes were made in the classes to improve the classroom environment and consequently the learning situation. Any instructor of nursing students could use this same process with this instrument.
Nurse Practitioner Preferences for Distance Education Methods Related to Learning Style, Course Content, and Achievement
Authors: Andrusyszyn Mary-Anne , Cragg C E (Betty) , Humbert Jennie
Published: April 2021

ABSTRACT

The relationships among multiple distance delivery methods, preferred learning style, content, and achievement was sought for primary care nurse practitioner students. A researcher-designed questionnaire was completed by 86 (71%) participants, while 6 engaged in follow-up interviews. The results of the study included: participants preferred learning by "considering the big picture"; "setting own learning plans"; and "focusing on concrete examples." Several positive associations were found: learning on own with learning by reading, and setting own learning plans; small group with learning through discussion; large group with learning new things through hearing and with having learning plans set by others. The most preferred method was print-based material and the least preferred method was audio tape. The most suited method for content included video teleconferencing for counseling, political action, and transcultural issues; and video tape for physical assessment. Convenience, selfdirection, and timing of learning were more important than delivery method or learning style. Preferred order of learning was reading, discussing, observing, doing, and reflecting. Recommended considerations when designing distance courses include a mix of delivery methods, specific content, outcomes, learner characteristics, and state of technology.
Influence of a Persuasive Strategy on Nursing Students' Beliefs and Attitudes Toward Provision of Care to People Living With HIV/AIDS
Authors: Valois Pierre , Turgeon Helene , Godin Gaston , Blondeau Danielle , Cote Francoise
Published: April 2021

ABSTRACT

Based on the theory of planned behavior and the elaboration likelihood model, the aim of this study was to verify the effect of persuasive messages on nursing students' beliefs and attitudes regarding provision of care to people living with HIV/AIDS. The assumption was that a persuasive communication strategy induces a constructive change in beliefs and attitudes regarding provision of care. Baseline data collection was performed among a group of 74 nursing students (experimental group = 27; control group = 47). The questionnaire assessed the variables of the theory of planned behavior (i.e., beliefs, attitudes, perceived behavioral control). The results confirmed that persuasive messages generated a change in beliefs and attitudes of the nursing students concerning providing care to people living with HIV/ AIDS. It appears that this strategy of modifying behavioral predispositions is effective and generates cognitive and affective changes. Therefore, educational programs should take these observations into consideration to ensure that future nurses are better prepared to provide appropriate care to people living with HIV/AIDS.
Innovation in Learning: PhD and DNP Student Collaborations
Authors: Eaton Linda H. , Gordon Debra B. , Doorenbos Ardith Z.
Published: April 2021

Background:

Working together, PhD and Doctor of Nursing Practice (DNP) students can advance knowledge creation and the translation of knowledge into practice. Although different in purpose and education, PhD and DNP programs should prepare students to collaborate throughout their careers. This article describes an innovative pilot project that partnered PhD and DNP students during their graduate programs.

Method:

Group meetings were used to facilitate collaboration among 12 PhD and DNP students interested in pain management. Using a five-stage collaboration process model, students worked together on dissertation and capstone projects.

Results:

PhD and DNP students collaborated on the completion of dissertation and capstone projects, as well as on publications and presentations. A case example of an effective partnership is included.

Conclusion:

Partnering of PhD and DNP students can further the development of new nursing knowledge and evidence-based practice. Successful collaboration can be facilitated by PhD and DNP faculty. [
J Nurs Educ.
2017;56(9):556–559.]
Head Posture Measurement
Authors: Young James D H
Published: April 2021

ABSTRACT

A technique is needed that will accurately measure head posture at all ages and without instrument artifact. A simple photographic method that allows such quantitative measurements is described. Studies have confirmed that it provides an accurate record of the three components of head posture. The advantages and limitations in clinical use are discussed.
Screening of School-aged Hearing Impaired Children
Authors: Rogers G L , Fillman R D , Bremer D L , Leguire L E
Published: April 2021

ABSTRACT

Three hundred sixty hearing-impaired students were screened for visual problems, including Usher's syndrome, with a complete ophthalmologic exam and electroretinography (ERG). Over 25% were found to have a significant refractive error, and approximately 32% had one or more pathologic findings. Overall, 43% either had a significant refractive error or pathologic finding. The incidence of Usher's syndrome was estimated to be between 1.1% and 1.9% En the hearing impaired student population. The results emphasize the need for a complete ophthalmologic examination, and possible ERG testing, in the hearing impaired student population.
The Schedule of Recent Events: A Measure of Stress Due to Life Change Events Translated for the Spanish-Speaking
Authors: Timmreck Thomas C , Stratton Lorum H
Published: April 2021

ABSTRACT

Subcultures in the United States have expressed concern about being dealt with through their own culture and language. Organizations of helping professions have responded by suggesting policy addressing this desire. A further response would be to incorporate mental health instruments translated and validated for use in subcultures.

The Schedule of Recent Events (SRE) is an instrument which measures stress from life experiences. An increase in stress due to life events is associated with illness onset. The development of this phenomenon and the SRE is presented including cross-culture validation. The English version with the Spanish translation is also provided.
Psychiatric Nursing Therapy: Philosophy and Methods
Authors: del Campo E Jean Hartigan
Published: April 2021

ABSTRACT

The current mental health needs demand that a closer look be taken into what constitutes and who should perform therapy with the emotionally disturbed. The psychiatric nurse given the attitude of commitment and caring is in a position to use her psychotherapeutic skills to restore, maintain and promote mental health. This paper explores the elements of nursing therapy including prerequisite philosophical attitudes and a methodology through which therapeutic goals may be formulated and pursued. It is postulated that if this therapeutic learning which is facilitated by a team effort is transferred to the individual's living situation his growth toward mental health will be enhanced.
Mental Health Consultation in a Home Care Agency
Authors: Palermo Eleanor
Published: April 2021

ABSTRACT

A mental health nurse, educationally and clinically prepared as a specialist, can be effectively utilized as a consultant to aid nurse generalists in assessment and intervention of patients in a home health care agency. An individual staff nurse consulting with the specialist or a group of nurses provides the setting for consultant led case discussions. Consultation is a highly efficient use of a specialist's knowledge and skills in health care delivery, and also provides learning opportunities for staff.
Communicating with Developmentally Disabled Patients
Authors: Mansheim Paul , Cohen Claire M
Published: April 2021

ABSTRACT

Patience, tolerance, and an unhurried manner are important in communicating with the mentally retarded and developmentally disabled. Sensitivity to nonverbal communication modes such as gesture, facial expression, sign, and touch also is helpful.
ADVANCED LICENSURE: Mistake or Necessity?
Authors: Bittle Sheila , Maurin Judith T
Published: April 2021

Setting Standards for Specialty Practice
COURT SHOULD APPOINT
Authors: Anonymous
Published: April 2021

EXPERT WITNESSES
"FEELINGS"
Authors: Anonymous
Published: April 2021

PATIENT RELATIONS
EDUCATIONAL VIDEO
Authors: Anonymous
Published: April 2021

NURSING NEGLIGENCE
A CONCEPTUAL MODEL FOR GROUP TREATMENT
Authors: Reed Gwen , Sech Eithel Partlow
Published: April 2021

Guilt brought on the cleansing and purifying act of purging, which, like an orgasm, resulted in relaxation and a sense of calm - a tryst with food.
BURNOUT
Authors: Cronin-Stubbs Diane , Brophy Elizabeth B
Published: April 2021

Can Social Support Save the Psych Nurse?
Psychiatric Clinical Specialists Surveyed
Authors: Anonymous
Published: April 2021

New ANA Publication
Anti-Psychotic Drug Reported Superior in Treatment of Borderline Patients
Authors: Anonymous
Published: April 2021

Haloperidol May be "Treatment of Choice"
Court Upholds Nursing Education Ruling
Authors: Anonymous
Published: April 2021

Nursing Board Free to Set Licensure/Degree Requirements
IMPROVING RELATIONSHIPS
Authors: Pollack Linda E
Published: April 2021

Groups for Inpatients with Bipolar Disorder
A Discharge Group for Chronically Mentally Ill: Easing the way
Authors: Hochberger Judith M , Fisher-James Lisa
Published: April 2021

Lacking preparation for community roles, many patients have failed to survive in the community.
How To Reduce the Risk of HIV Infection for the Seriously Mentally Ill
Authors: Graham Linda L , Cates Jim A
Published: April 2021

The single most effective means to combat the spread of HIV infection is a reduction in the frequency of at-risk behaviors.
The Same Path
Authors: Cramer Carol
Published: April 2021

What path had he walked that led him to us in this state?
Spousal Caregiving When the Adult Day Services Center Is Closed
Authors: Campell Dia D , Travis Shirley S
Published: April 2021

Twenty-seven spousal caregivers between the ages of 55 and 85 who had been in a caregiver role for at least 3 months and were current users of adult day services were recruited from adult day services programs in the Southwest to learn how these caregivers managed weekend care for persons with dementia when the adult day services programs were closed.

Results demonstrate that these spouses carry the brunt of caregiving demands with little informal support. Surprisingly, caregivers reported that they did not miss day services on the weekends and, even if the services were available, they would not use weekend adult day care.
Recovery at Your Own PACE
Authors: Ahern Laurie , Fisher Daniel
Published: April 2021

(Personal Assistance in Community Existence)
Training Consumers to Collect Data in Mental Health Service System Evaluation Research
Authors: Howard Patricia B , El-Mallakh Peggy
Published: April 2021

ABSTRACT

Consumer satisfaction with services is an outcome measure. This report describes The Consumer Satisfaction Research Associate Training Program00, which was designed for the education and supervision of recovered consumers who collected data during four studies at three psychiatric hospitals. The educational program had didactic and laboratory components. Consumer research associates collected quantitative and qualitative data using a survey tool for face-to-face interviews. Participant recruitment and management of confidential records were included in the role. Data collected by research associates from consumers who are in treatment can enhance the validity and trustworthiness of satisfaction surveys. Nurses can play an important role in the research process by serving as staff resources for consumers who collect data in various service system settings.
A Model of Group Treatment to Facilitate Recovery From Chemical Dependence
Authors: Washington Olivia G M , Moxley David P
Published: April 2021

ABSTRACT

In this article, a model of group treatment is proposed that incorporates four different group approaches (i.e., experiential, physiological-cognitive-behavioral, mutual support, advocacy) sequentially to achieve recovery outcomes among people coping with chemical dependence. The model identifies two strategies (i.e., reflection and restoration, action and support) as overarching frameworks guiding the use of these four treatment approaches. The first strategy of reflection and restoration incorporates experiential and physological-cognitive-behavioral group approaches to promote precontemplation, contemplation, preparation, and tentative action among group members. The second strategy of action and support uses mutual support and advocacy approaches to help group members achieve and maintain treatment gains, learn from setbacks, and adopt new personal and social roles.
Self-Perceived Effects of SEXUAL TRAUMA Among Women Who Smoke Crack
Authors: Young Amy M , Boyd Carol , Hubbell Amy
Published: April 2021

ABSTRACT

This descriptive study examined how Black women who smoke crack cocaine spoke about their experiences of sexual trauma, drug use, and the implications of these experiences for their lives. The authors also explored whether the women's perceptions of the effects of sexual abuse were related to objective indicators of mental health and drug use. The most commonly reported effects of sexual trauma were feeling dirty or ashamed or blaming self, having negative feelings toward the perpetrator, experiencing a general dislike of men or sex, and reporting a conscious reluctance to cope with the incident. In addition, conscious or unconscious denial of the effects of sexual trauma was associated with use of drugs to cope with intrapersonal and interpersonal feelings, inwardly directed responses to the trauma (e.g., self-blaming, feeling ashamed) were positively related to depression, and outwardly directed responses to the trauma (e.g., anger at the perpetrator) were positively related to self-esteem. These findings are discussed in terms of their implications for the self-medication model of substance use, treatment implications for women who have been sexually abused, and the role of self-perception in the relationship between sexual trauma and long-term outcomes.
Bovine Corneal Stroma Ablation Rate With 193-nm Excimer Laser Radiation: Quantitative Measurement
Authors: Van Saarloos Paul P , Constable Ian J
Published: April 2021

ABSTRACT: Excimer lasers operating at 193 nm may become important surgical instruments in ophthalmology because of their ability to ablate tissue with excellent precision and minimal damage to adjacent tissue. However, the precision is limited by the accuracy of the measurement of the amount of tissue ablated per pulse at the fluence used. A measurement of the ablation rate of bovine corneal stroma over the range of fluences most likely to be useful for corneal surgery (50-400 mJ/cm2) is presented. The technique used produced reproducible results, the data from 47 animal eyes being averaged to further increase the precision. For this range of fluences, these results show a more precise measurement than previously published tissue ablation rate data. These results should be useful in accurately predicting the result of corneal surgery using the excimer laser if species differences are not major. [Refractive and Corneal Surgery 1990;6:424429.]
Correction of Hyperopia with Non-contact Ho:YAG Laser Thermal Keratoplasty
Authors: Alió Jorge L , Ismail Mahmoud M , Pego J Luis Sanchéz
Published: April 2021

ABSTRACT

PURPOSE: To assess the potential of non-contact holmium:YAG laser thermal keratoplasty to safely and effectively correct hyperopia up to +5.00 diopters (D).

METHODS: Non-contact laser thermal keratoplasty with a holmium:YAG laser using energies ranging from 215 to 255 mJ with 6, 7, and 8-mm ablation zone diameters, was applied to 57 sighted eyes of 42 hyperopic patients in a controlled study. All patients were followed for 15 months after surgery.

RESULTS: Preoperative spectacle-corrected visual acuity returned to baseline levels from 2 to 6 weeks after treatment. Regression of effect was evident in all eyes, and after 15 months was total in 18 eyes (31.5%). The mean cycloplegic refraction before surgery was +3.80 ± 0.22 D (range, +1.50 to +5.00 D); after surgery, it was +1.40 ± 0.12 at 3 months, +1.69 ± 0.19 D at 6 to 8 months, and +1.73 ± 0.16 D at 15 months. At the end of the study, 41 eyes (71.9%) had an uncorrected visual acuity of 20/40 or better. Thirty-two eyes (58.8%) were within ± 1.00 D of the intended refraction. Patient age and central pachymetric values were significantly correlated with regression (ANOVA, p less than .005).

CONCLUSION: Regression of initial effect can be large with non-contact holmium:YAG laser thermal keratoplasty. We think the technique works best up to +3.00 D in older individuals with central corneal thickness less than 525 µm. Algorithms to improve the final results should include an initial calculated overcorrection adjusted on variables that influence regression such as patient age and corneal thickness.[J Refract Surg 1997;13:17-22]
Management of Aniseikonia after Intraocular Lens Implantation or Refractive Surgery
Authors: Enoch Jay M
Published: April 2021

ABSTRACT

BACKGROUND: Aniseikonia is a difference in perceived image size in the two eyes resulting in asthenopic symptoms and distortions of binocular space perception. This is a complication of refractive and implant surgery in patients with binocular vision. While many individuals adapt readily to modest aniseikonic errors, quite a number do not.

METHOD AND RESULTS: Few instruments exist to adequately test for aniseikonia. A means is described to determine if aniseikonia exists and a series of simple steps is suggested to minimize aniseikonia induced by refractive surgery or by surgery for removal of cataract and intraocular lens insertion. Also, using the proposed protocol, it is possible to determine if existing image size differences resulting from prior and/or induced aniseikonia are predominantly refractive or axial. A case report is presented.

CONCLUSIONS: The techniques described are not costly, provide no risk, take little time, and resolve or meaningfully reduce aniseikonia in many patients having non-extreme errors of this type. [J Refract Surg 1997;13:79-82]
Calibration of Trephine Blade Depth
Authors: Schor Paulo , Rocha Eduardo , Cheema Devinder P , Miller David
Published: April 2021

ABSTRACT

PURPOSE: To assess the accuracy and precision of the Barron radial vacuum trephine as an instrument for corneal lamellar dissection.

METHODS: We describe a practical method to calibrate individual trephines prior to lamellar corneal procedures using the calibration microscope designed for diamond knives.

RESULTS: We observed that one turn (360°) of the trephine produced a mean blade displacement of 0.25mm. However, individual trephines demonstrated a significant range of variability.

CONCLUSION: For highly accurate trephination, it is useful to calibrate each individual trephine using the calibration microscope. [J Refract Surg 1997;13:89-90]
Effects of Topical Ketorolac and Diclofenac on Normal Corneal Sensation
Authors: Sun Ran , Gimbel Howard V
Published: April 2021

ABSTRACT

BACKGROUND: A randomized, double-masked study was conducted to investigate the effects of 0.5% ketorolac tromethamine (Acular) and 0.1% diclofenac sodium (Voltaren) on normal human corneal sensation.

METHODS: Thirty normal volunteers were divided into two groups, (1) two-drop group, and (2) multiple-drop group. In the two-drop group, 15 volunteers randomly received two drops of 0.5% ketorolac tromethamine on one eye and two drops of 0.1% diclofenac sodium on the fellow eye. A masked investigator measured corneal sensation with the Cochet-Bonnet esthesiometer before applying the drops, and at 15, 30, and 60 minutes after using the eye drops. In the multiple-drop group, another 15 volunteers were randomly administered one drop of 0.5% ketorolac tromethamine or 0.1% diclofenac sodium in each eye, and the procedure was repeated every 5 minutes for 20 minutes. Corneal sensation was measured before, and 0, 15, 30 and 60 minutes after applying the drops.

RESULTS: In the two-drop group, neither of the eye drops had any effect on corneal sensation when only two drops were applied. In the multiple-drop group, corneal sensation was significantly reduced after multiple drops (p<0.05) and was subsequently effective for at least 1 hour.

CONCLUSION: Both 0.5% ketorolac and 0.1% diclofenac can significantly decrease corneal sensation in normal eyes when multiple drops are used. [J Refract Surg 1997;13:158-161]
Nocardial Keratitis after Laser in situ Keratomileusis
Authors: Pérez-Santonja Juan J , Sakla Hani F , Abad José L , Zorraquino Alfredo , Esteban Jaime , Alió Jorge L
Published: April 2021

ABSTRACT

PURPOSE AND METHODS: Corneal interface central nodules appeared in a patient who underwent uncomplicated laser in situ keratomileusis (LASDX) retreatment for residual myopia.

RESULTS/CONCLUSIONS: Nocardia asteroides keratitis was confirmed by microbiologic studies, which guided treatment. Six months after the appearance of the keratitis, the patient's uncorrected visual acuity was 20/45, and spectacle-corrected visual acuity was 20/40. The postoperative refraction was +0.75 -0.75 X 95°, and slit-lamp examination revealed a clear cornea with a mild rounded scar in the central area. Night halos and starbursts were the main complaints in this patient. The immediate management of lifting the corneal flap for stromal bed scraping, fast microbial identification, and proper treatment was the key for the results in this patient. [J Refract Surg 1997;13:314-317]
The Suction Bridge for Radial Keratotomy May Avoid Late Hyperopic Shift
Authors: Krumeich Jorg H , Daniel Jan , Gast Robert
Published: April 2021

ABSTRACT

BACKGROUND: Radial keratotomy may induce late hyperopic shift. We present data on 140 consecutive eyes with a follow-up of up to 3 years that underwent radial keratotomy with the RK suction bridge.

METHODS: We conducted a retrospective study of 140 consecutive eyes that had radial keratotomy between 1987 and 1994. Mean preoperative spherical equivalent was -5.21 D (range -2.00 to -9.75 D). All operations were performed by one surgeon (JHK) with the RK suction bridge. A suction ring maintaining physiological intraocular pressure immobilized the eye and left a peripheral rim of uncut cornea. The ring incorporated an eccentric bridge that guided the radial keratotomy knife. The knife setting was 90% of the central corneal thickness, measured by pachymetry. Spherical equivalent refraction and spectacle corrected visual acuity were measured at 1 week, 1, 3, 6 months, 1 year, and 3 years after radial keratotomy.

RESULTS: The mean preoperative spherical equivalent refraction of -5.21 D dropped to -0.43 D at 1 week (n=136), -0.71 D at 1 month (n=120), -0.85 D at 3 months (n=95), -0.74 D at 6 months (n=73), -0.77 D at 12 months (n=79), and -0.85 D at 3 years (n=67). Compared to 1 month spherical equivalent, at 3 years three eyes (4.4%) had moved > 1.00 D toward hyperopia. One eye (1.4%) shifted by 1.25 D. Paired f-tests of mean spherical equivalent refraction did not reveal significant shifts toward hyperopia. Mean preoperative spectacle-corrected visual acuity was slightly diminished at 1 week and was equal or better thereafter.

CONCLUSIONS; Our 3-year data suggest that a late hyperopic shift following radial keratotomy may be prevented if an intact peripheral rim is maintained and cutting depth does not exceed 90% of the lowest corneal thickness. [J Refract Surg 1997,13:367-373]
Radial Keratotomy Enhancements for Residual Myopia
Authors: Gayton Johnny L , Van Der Karr Michelle , Sanders Valerie
Published: April 2021

ABSTRACT

BACKGROUND: A systematic method of performing radial keratotomy enhancements in undercorrected eyes may increase accuracy and predictability and decrease the number of procedures required. A consecutive series of 372 radial keratotomy procedures, including 110 eyes that received enhancements under a systematic protocol, was evaluated.

METHODS: Radial keratotomy was performed using the Reliable Keratotomy software, which uses the Thornton nomogram for primary radial keratotomy and provides a systematic method of performing enhancements.

RESULTS: Ninety eyes (24%) received one enhancement, 16 eyes (4%) received two enhancements, and four eyes (1%) received three enhancements. Mean final spherical equivalent refraction was -0.44 D (-4.00 to +1.875 D, SD 0.86) for eyes that did not receive enhancements and -0.44 D (-2.50 to +1.00 D, SD 0.61) for eyes that had enhancements. Mean final residual myopia for the entire cohort was -0.44 D (-4.00 to +1,875 D, SD 0.79). At final examination, 242 (65%) eyes had a refraction within ±0.50 D and 298 (80%) within ±1.00. Among eyes that received enhancements, 75 (68%) had a refraction within ±0.50 D, and 89 (81%) within ±1.00 D; 40 eyes (36%) had uncorrected visual acuity of 20/20 or better, 99 eyes (90%) 20/40 or better, and all but one eye (99%) 20/80 or better at the final postoperative examination. Among the entire cohort, 130 eyes (35%) had uncorrected visual acuity of 20/20 or better, 312 (84%) had 20/40 or better, and 350 (94%) had 20/80 or better. No eye lost more than one line of spectacle-corrected visual acuity.

CONCLUSION: A systematic approach to enhancement of undereorrected eyes after radial keratotomy, combined with accurate surgery, may reduce the need for multiple enhancements as well as the overcorrection rate, and provide improved uncorrected visual acuity. [J Refract Surg 1997;13:374-381]
Bilateral Cataract after Phakic Posterior Chamber Top Hat-style Silicone Intraocular Lens
Authors: Wiechens Burkhard , Winter Martin , Haigis Wolfgang , Happe Wilhelm , Behrendt Stephan , Rochels Rainer
Published: April 2021

ABSTRACT

BACKGROUND: New strategies have been developed for surgical treatment of high myopia. Recently, implantation of minus power posterior chamber intraocular lenses (IOL) into phakic eyes has been introduced.

METHODS: We report a 37 year-old female patient who developed bilateral anterior subcapsular cataract 7 years after minus-power, top hat-style silicone posterior chamber IOL implantation in Russia. The corrected visual acuity was right eye 20/200 and left eye 20/63. Because of the high myopia and the posterior chamber IOL in her phakic eyes, biometry for IOL calculation gave contradictory results. Both posterior chamber IOLs were found to be adherent to the crystalline lenses. After posterior chamber IOL explantation and phacoemulsification, intraoperative retinoscopy was performed. With this aphakic refraction, the IOL power was calculated and implanted. The explanted posterior chamber IOLs were examined by scanning electron microscopy.

RESULTS: After bilateral operation the corrected visual acuity increased to right eye 20/32 and left eye 20/40, respectively. On scanning electron microscopy, a membranous structure of unknown origin was noted on the entire surface of the explanted posterior chamber IOLS.

CONCLUSION: There is a potential risk of cataract formation after implantation of this top hat-style silicone posterior chamber IOL. If cataract extraction in this specific situation is needed, a different approach for calculating the aphakic IOL power is necessary, such as intraoperative retinoscopy. [J Refract Surg 1997;13:392-397]
Hyperopic Shift Induced by High Altitude after Radial Keratotomy
Authors: Creel Donnell J , Crandall Alan S , Swartz Mano
Published: April 2021

ABSTRACT

BACKGROUND: The collagen fibrils embedded in the ground substance of the stromal lamellae provide the structural support for the cornea. When the stromal lamellae are cut in a radial keratotomy surgical procedure, the remaining uncut lamellae carry the tensile forces.

METHODS: We studied two expert climbers who had bilateral radial keratotomy before participating in six climbs of extreme altitude, including Mount McKinley and above 7500 m (24,606 ft) on Mount Everest.

RESULTS: Whenever either climber was exposed to altitudes greater than approximately 5000 m (16,405 ft) for more than a day, their refraction would become +3.00 D or more hyperopic and remain so as long as they were at or above this altitude. Visual acuity slowly returned to normal after descent.

CONCLUSION: It appears that in the presence of significantly reduced atmospheric pressure and/or oxygen there is a greater effect of radial keratotomy in some patients, making the cornea more vulnerable to changes in shape. The cornea appears to respond by further flattening, exacerbating the intended surgical effect and producing a refractive shift toward hyperopia. [J Refract Surg 1997;13:398400]
Photorefractive Keratectomy for Myopia and Photoastigmatic Keratectomy for Astigmatism
Authors: Ohashi Yuichi , Takahashi Keizo , Yorii Hidaki
Published: April 2021

ABSTRACT

BACKGROUND: We conducted a clinical trial to evaluate the efficacy and safety of excimer laser photorefractive keratectomy (PRK) and photoastigmatic refractive keratectomy (PARK) using the Nidek EC-5000 excimer laser.

METHODS: A total of 67 eyes from 47 patients whose average age was 35 years were enrolled in the study. The mean spherical equivalent of the manifest refraction before surgery was -7.50 diopters (D). Patients were followed for at least 6 months. One year after surgery, uncorrected visual acuity improved in 98% of the eyes, while spectaclecorrected visual acuity had not deteriorated in any patient. The achieved corrections were within ±1.00 D of attempted correction in 72.5% of eyes. Predictability was poor in eyes in which the correction was more than 10.00 D. Subepithelial haze occurred in all eyes to minimal extent, and disappeared gradually.

CONCLUSION: Photorefractive keratectomy and photoastigmatic refractive keratectomy, performed with the Nidek EC-5000 excimer laser, is a reliable and adequately safe procedure to correct myopia of a limited range. [J Refract Surg 1997;13(suppl):S452-S453]
Effects of Topical Corticosteroids after Photorefractive Keratectomy
Authors: Chatterjee Anupam , Shah Sunil , Galway Gavin
Published: April 2021

ABSTRACT

PURPOSE: To assess the effects of topical corticosteroids (fluoromethalone) following photorefractive keratectomy (PRK).

METHODS: Both eyes of 654 patients had PRK with a minimum of 4 months between treatments. Topical corticosteroids were prescribed for one eye only. Endpoints were assessed by comparing the ratio of intended to actual refractive change in the corticosteroid treated eye with the fellow eye (no corticosteroid use).

RESULTS: The corticosteroid treated eyes showed a mean percentage correction of 95.7% compared to the untreated fellow eyes, which achieved a percentage correction of 103.3%- statistical significance of ? = 0.00001. There was more of a trend toward regression in the corticosteroid treated eyes despite intervention with fluoromethalone.

CONCLUSION: Topical corticosteroids showed very little positive effect on regression of effect after PRK [J Refract Surg 1997;13(suppl):S454-S455]
Photorefractive Keratectomy for Hyperopia after Radial Keratotomy
Authors: Venter Jan A
Published: April 2021

ABSTRACT

BACKGROUND: Progressive hyperopia is a common complication following radial keratotomy.

METHODS: Ten eyes of ten consecutive patients with hyperopia after radial keratotomy between +1.75 and +4.00 diopters (D) were treated with the hyperopia module of the Nidek Model EC-5000 excimer laser. The mean preoperative uncorrected visual acuity was 0.38 (20/60+).

RESULTS: After excimer laser photorefractive keratectomy (PRK), mean uncorrected visual acuity improved to .72 (20/30+). No complications occurred with the exception of one eye with haze greater than 2+.

CONCLUSION: PRK for hyperopia is a valuable method for correcting hyperopia after radial keratotomy. [J Refract Surg 1997;13(suppl):S456]
Excimer Laser in situ Keratomileusis for Myopia
Authors: Pesando Paolo M , Ghiringhello Maria P , Tagliavacche Paolo
Published: April 2021

ABSTRACT

PURPOSE: To evaluate the efficacy, safety, and predictability of excimer laser in situ keratomileusis (LASIK) for the correction of myopia.

METHODS: Forty-six consecutive eyes that had LASIK with the VISX 20/20B laser and Chiron corneal shaper were evaluated. Mean spherical equivalent of the preoperative manifest refraction was -9.40 ± 3.78 diopters (D) (range, -3.50 to -19.75 D). The refractive effect (postoperative refraction minus baseline refraction), residual refractive error (refractive effect minus planned correction) and uncorrected and spectaclecorrected visual acuity were examined.

RESULTS: Mean follow-up was 6.1 months (range, 3 to 9 mo). Spectacle-corrected visual acuity was unchanged in 39 eyes (84.78%), significantly improved in five eyes (10.86%), and worse in two eyes (4.34%). Uncorrected visual acuity was 20/20 or better in 15 eyes (32.6%) and 20/40 or better in 39 eyes (84.78%). Thirteen eyes (28.26%) had a postoperative spherical equivalent refraction within ±0.50 D and 36 eyes (78.26%) within ±1.00 D of attempted correction. No intraoperative complication occurred. Postoperative complications were few and not severe: three eyes (6.52%) developed regular astigmatism, two eyes (4.34%) had interface deposits, and three eyes (6.52%) had small epithelial cysts in the interface.

CONCLUSION: LASIK with the VISX 20/20B laser is safe, moderately effective, and relatively predictable for correcting myopia from -3.50 to -19.50 D. Predictability decreases with increasing myopia. [J Refract Surg 1997;13:521-527]
Three Multizone Photorefractive Keratectomy Algorithms for Myopia
Authors: Alpins Noel A , Taylor Hugh R , Kent David G , Lu Yi , Liew Mary , Couper Terry , McGough Virginia
Published: April 2021

ABSTRACT

OBJECTIVE: To compare the efficacy and complications of three different excimer laser algorithms for multizone photorefractive and photoastigmatic keratectomy.

METHODS: Three different software algorithms were applied to treat myopia and myopic astigmatism with the VTSX 20/20 excimer laser. Each algorithm had a maximum ablation zone of 6 mm but differed in the number of zones employed, the proportion of the total treatment allocated to each ablation zone, and the treatment of astigmatism. The Melbourne multizone technique equally divided myopia correction into a maximum of three ablation zones. The Pop multizone technique biased myopia treatment into the smaller diameter zones to a maximum of six ablation zones, with one central island pretreatment. The Alpins multizone technique equally divided myopia treatment through all zones up to a maximum of six, with one central island pretreatment.

RESULTS: A total of 585 patients (780 eyes) were treated and 625 eyes (80%) were followed for more than 6 months. The mean baseline spherical equivalent refractive error was -5.63 D (-1.00 to -19.50 D). Between 71 and 79% of eyes were treated for astigmatism. There was no statistically significant difference in baseline refractive error or other characteristics among the three groups. At 6 months, the Alpins multizone algorithm had more eyes with a refractive error within ±1.00 D of emmetropia (p=0.01) and more within ±2.00 D of emmetropia (p<0.01). This new algorithm produced more eyes with an uncorrected visual acuity of 20/20 or better at 6 months (p<0.01). When multiple logistic regression was used to correct for any differences in baseline myopia among the three groups, this algorithm also had a higher odds ratio for achieving 20/20 or better uncorrected visual acuity (OR=1.58).

CONCLUSION: At 6 months, all three algorithms were effective in the reduction of myopia. Significantly better visual acuity and refractive results were achieved with the Alpins multizone algorithm that spread the total treatment over a larger number of ablation zones, with an equal number of diopters of treatment in each zone. [J Refract Surg 1997,13:535-544]
Iris Claw Phakic Intraocular Lens for High Myopia
Authors: Menezo José L , Aviño Juan A , Cisneros Angel , Rodriguez-Salvador Vicente , Martinez-Costa Rafael
Published: April 2021

ABSTRACT

BACKGROUND: The implantation of a WorstFechner iris claw intraocular lens (IOL) is one of the surgical procedures used for the correction of high myopia. This technique reduces myopia with stähle refractive results; however, its potential long-term risks have not been evaluated. We report results in 94 eyes with a minimum follow -up of 3 years.

METHODS: We studied 94 eyes of 62 patients with myopia 5= -7.00 diopters (D) who underwent Worst-Fechner IOL implantation. Lens decentration, permeability of the blood-aqueous barrier by iris angiography, and changes in corneal endothelial density were analyzed.

RESULTS: Mean follow-up time was 48.9 months (range 36 to 72 mo). Three years after surgery, 58 eyes (61%) had an uncorrected visual acuity s* 20/40, and 77 eyes (82%) gained two or more lines of spectacle-corrected visual acuity with respect to the preoperative value; 75 eyes (79%) were within ±1.00 D of emmetropia and 46 eyes (48%) were within ±0.50 D of emmetropia. The mean endothelial cell loss was 17.9% at 5 years after surgery, while the percentage of hexagonality and the coefficient of cell variation tended toward preoperative levels. No vision threatening complications were seen.

CONCLUSIONS: The implantation of a WorstFechner iris claw phakic IOL reduced high myopia with a stable refractive outcome. Endothelial cell damage was within acceptable limits. The absence of major complications makes this procedure an acceptable method for correcting high myopia. [J Refract Surg 1997;13:545-555]
The Effect of Topical Corticosteroids on Refractive Outcome and Corneal Haze after Photorefractive Keratectomy
Authors: Baek Seung-Hee , Chang Jin-Ho , Choi Sang-Yul , Kim Woo-Jung , Lee Jin-Hak
Published: April 2021

ABSTRACT

BACKGROUND: The effect of topical corticosteroids after excimer laser photorefractive keratectomy (PRK) remains a matter of some controversy. Refractive effects may be different according to the amount of myopia and timing of instillation.

METHODS: Two groups of patients were studied: Study A consisted of 215 eyes (128 patients) with PRK (mean baseline myopia, -6.53 ± 2.22 D) that received no corticosteroids (No Corticosteroid Group) unless significant regression or corneal haze appeared (Delayed Corticosteroid Group), and in Study B, we randomly assigned eyes to the Initial Corticosteroid Group (mean baseline myopia, -6.39 ± 1.84 D) or the No/delayed Corticosteroid Group (mean baseline myopia -5.78 ± 2.02 D). Clinical results after PRK for low-to-moderate and high myopia were compared.

RESULTS: In the first group, 70.9% (73 eyes) of moderately myopic eyes (mean, -4.56 ± 1.10 D) belonged to the No Corticosteroid Group that had a mean refraction of -5.39 ± 1.77 D. Delayed Corticosteroid Group eyes were more myopic (mean, -7.52 ± 2.10 D), and showed more severe haze than those in the No Corticosteroid Group. In study B, only in high myopes with more than -6.00 D (mean, -7.76 ± 1.15 D) did refraction and corneal haze outcomes show significant difference between the Initial Corticosteroid Group and the No/delayed Corticosteroid Group.

CONCLUSIONS: The effects of topical corticosteroids after PRK were less in moderate myopes compared to high myopes. Delayed instillation of corticosteroids did not reverse the regression or haze whereas initial instillation showed a beneficial effect on high myopes but not on moderate myopes. [J Refract Surg 1997;13:644-652]