bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of Use of Home Health Nurses to Decrease Burden & Depression of ELDERLY CAREGIVERS
Authors: Mignor Deolinda
Published: April 2021

ABSTRACT: The purpose of this research was to investigate the impact of home health nursing intervention on burden and depression of elderly caregivers who were caring for an ill relative in their home. Two groups of caregivers were compared for differences in caregiver burden and depression. The caregivers in the control group did not use the services of home health nurses, whereas the caregivers in the experimental group did use these services. Data were analyzed using the Burden Interview and the Center for Epidemiologic Studies Depression Scale. Multiple analysis of variance confirmed that caregivers who used the services of home health nurses were significantly less burdened and less depressed than caregivers who did not use these services.
Intraoperative Pachometry During Automated Lamellar Keratoplasty: A Preliminary Report
Authors: Casebeer J Charles , Slade Stephen G , Dybbs Alexander , Mahanti Robert L
Published: April 2021

ABSTRACT

BACKGROUND: The hinge technique greatly improves the results of automated lamellar keratoplasty but makes it impossible to measure the thickness of the corneal cap with a micrometer. We developed a technique of measuring cap and stromal disc thickness with a pachometer and compared the results with those obtained with a micrometer.

METHODS: Measurements of the thickness of the stromal disc and/or corneal cap were taken with the Mitutoyo micrometer and the Chiron ComeoGage System III pachometer in five myopic and three hyperopic cases undergoing automated lamellar keratoplasty with complete cap resection. The intended postoperative refraction was piano. Postoperative refractions were taken at two months.

RESULTS: In most cases, the corneal cap measured thinner while the stromal disc measured thicker by the micrometer than by the pachometer because of the hydration status of the stromal bed. In both myopic and hyperopic cases, the thickness measurements taken with the pachometer correlated better with the postoperative spherical equivalent values than those taken with the micrometer.

CONCLUSIONS: The thickness measurement of corneal resections by both micrometry and pachometry is greatly influenced by tissue hydration status. When hydration is similar, the pachometer provides more accurate thickness readings than does the micrometer, as determined by correlations with intended refractive results. (Refract Corneal Surg. 1994;10:41-43.)
Excimer Laser Photorefractive Keratectomy for Myopia: Comparison of 4.00- and 5.00-Millimeter Ablation Zones
Authors: O'Brart David P S , Gartry David S , Lohmann Chris P , Muir Malcolm G Kerr , Marshall John
Published: April 2021

ABSTRACT

BACKGROUND: To date, there has been no systematic study of the effects of ablation zone diameter on the outcome of photorefractive keratectomy. To address these issues, we examined a series of eyes with bilateral corrections using different-sized ablation zones.

METHODS: Thirty-three patients underwent bilateral photorefractive keratectomy (Summit Excimed UV200, Waltham, Mass) with identical dioptric corrections in both eyes, except first eyes had 4.00-millimeter and second eyes had 5.00-millimeter ablation zones. Identical postoperative eyedrop regimens were used in both eyes of each subject and the interval between treatments was 12 months. The mean depth of the programmed central ablation was 24 µp? in eyes treated with 4.00-millimeter and 39 µp? with 5.00-millimeter zones.

RESULTS: There was no statistically significant difference in the preoperative refraction between first and second eyes. Mean changes in refraction at 1, 3, 6, 9, and 12 months were significantly greater in eyes treated with 5.00-millimeter ablation diameters (p < .001). No eyes treated with 4.00-millimeter zones were overcorrected, but five eyes (15%) treated with 5.00-millimeter beams had a refraction greater than + 1.00 diopter (D) at 12 months postoperatively. There was no significant difference in the amount of anterior stromal haze between the two eyes at any stage. In 14 patents, less night halo was noticed in the eye treated with a 5.00-millimeter zone. Using a computer program, halo measurements were made in both eyes of 12 patients whose pre- and postoperative refractions were within 0.50 D. The magnitude of halo was significantly less in eyes treated with 5.00-millimeter zones (p < .01).

CONCLUSIONS: Despite greater depths of stromal ablation with 5.00-millimeter diameters, there was no increased anterior stromal haze or postoperative regression of refraction. The biological and physical constraints governing the optimum size of the photorefractive keratectomy ablation zone are discussed. [J Refract Corneal Surg. 1994;10:87-94.]

RESUME

INTRODUCTION: Il n'existe aucune étude systématique des effets du diamètre de la zone d'ablation sur le résultat de la kératectomie photorefractive. Nous avons examiné une série de patients traités avec ablation de diamètres différents dans les deux yeux.

MÉTHODES: Trente-trois patients ont subi la kératectomie photo-réfractive bilatérale avec correction dioptrique identique dans les deux yeux, mais avec une ablation de 4,00 mm dans l'oeil traité le premier et une ablation de 5,00 mm dans le deuxième. Le programme de gouttes thérapeutiques fut identique dans les deux yeux, et l'intervalle entre les deux chirurgie fut de 12 mois. La profondeur de l'ablation centrale programmée fut 24 µp? dans lex yeux traités avec une ablation de 4,00 mm et 39 µ?? chez les yeux traités avec une ablation de 5,00 mm.
Retreatment of Undercorrected Photorefractive Keratectomy for Myopia
Authors: Lawless Michael A , Cohen Peter R , Rogers Christopher M
Published: April 2021

ABSTRACT

Fourteen eyes treated by photorefractive keratectomy (PRK) for myopia required retreatment because of undercorrection. The mean preoperative refraction of these eyes had been -9.82 D (range 5.25 to 17.13). No eyes before photorefractive keratectomy had low myopia, three eyes had myopia between -3.10 and -6.00 D, four were between -6.10 and -10.00 D, and seven had more than -10.00 D of myopia.

Retreatment was required for manifest scars in association with regression, unresponsive to topical corticosteroids. The retreatments were performed using a Summit ExciMed UV200LA excimer laser with a dual ablation technique utilizing a phototherapeutic keratectomy followed by a photorefractive keratectomy. Follow-up ranged from 1 to 9 months. Eight eyes followed more than 3 months had a mean spherical equivalent refraction of -0.58 D (range -7.35 to +1.25). [J Refract Corneal Surg. 1994;10:S174-S177.]
Short-Term Corneal Endothelial Changes after Photorefractive Keratectomy
Authors: Perez-Santonja Juan J , Meza Jenny , Moreno Eva , Garcia-Hernandez Maria R , Zato Miguel A
Published: April 2021

ABSTRACT

Clinical results show that photorefractive keratectomy (PRK) offers good predictability, efficacy, and safety. However, its potential risks on the human corneal endothelium are poorly known. We report the results of a prospective study conducted to evaluate the corneal endothelium changes after photorefractive keratectomy.

Preoperative and serial postoperative specular microscopy was performed in 14 eyes undergoing excimer laser photorefractive keratectomy. The endothelium was analyzed for a variety of parameters, including cell density, coefficient of variation in cell size, and hexagonality. The follow-up was 6 months.

The mean cell density was unchanged from 2463 cells/mm
p 2
to 2498 cells/mm
p 2
at 6 months after photorefractive keratectomy. The coefficient of variation of cell size (polymegathism) changed from 0.303 to 0.280 at 1 month, to 0.293 at 3 months, and to 0.290 at 6 months after surgery. The changes in this parameter were statistically significant when comparing pre- versus 1 month postoperative values. The hexagonality was unchanged from 72.08% at baseline to 73.35% at 6 months.

No endothelial abnormalities were found after photorefractive keratectomy. Our results suggest a cell migration from the peripheral to central cornea after photorefractive keratectomy in contact lens wearing patients prior to photorefractive keratectomy. [J Refract Corneal Surg 1994;10:S194-S198.]
Measurement of Corneal Thickness by Ultrasound After Photorefractive Keratectomy in High Myopia
Authors: Sabetti Lelio , Spadea Liopoldo , Furcese Nicola , Balestrazzi Emillo
Published: April 2021

ABSTRACT

BACKGROUND: Photorefractive keratectomy (PRK) has been used to treat myopia in human eyes since 1988.

METHODS: We evaluated corneal ablation depth after excimer laser myopic photorefractive keratectomy with the Summit Technology ExciMed UV200LA laser. Preoperative refraction was: mean 9.58 diopters (D) +/- 2.01, (range 6 to 17), We used ultrasound pachometry (1640 m/sec) in 40 eyes of 33 patients. Mean follow-up was of 49.5 weeks (range 16 to 76).

RESULTS: The measurement of the corneal thickness showed a reduction of the initial thickness followed by an inconsistent increase caused by wound healing and tissue proliferation.

CONCLUSION: The data showed no direct correlation between diopters of refractive correction and the change in corneal thickness. [e7 Refract Corneal Surg. 1994;10:S211-S216.]
The Treatment of Pain Following Photorefractive Keratectomy
Authors: Cherry Paul M H , Tutton Miles K , Adhikary Hari , Banerjee Dipak , Garston Bernard , Hayward J Michael , Ramsell Terry , Tolia Jitendra , Chipman Mary L , Bell Andrew , Neave Christopher , Fichte Claus
Published: April 2021

ABSTRACT

The most effective management of the pain that follows excimer laser photorefractive keratectomy (PRK) appears to be the use of topical nonsteroidal anti-inflammatory agents. A bandage contact lens for 2 days after photorefractive keratectomy is additive to pain relief. The helpfulness of patching was not confirmed. Surprisingly, drops of local anesthetic were not an efficacious means of managing the pain. This was possibly because they were not used frequently enough. The findings showed trends, but were not statistically significant. [J Refract Corneal Surg. 1994;10:S222-S225.1
Cooling the Cornea to Prevent Side Effects of Photorefractive Keratectomy
Authors: Niizuma Takuya , Ito Seiji , Hayashi Masayasu , Futemma Minoru , Utsumi Toru , Ohashi Kohji
Published: April 2021

ABSTRACT

Complaints after photorefractive keratectomy (PRK) include both severe pain and a decrease in quality of vision due to corneal subepithelial haze.

We suspect that one of the causes of these troubles is a temperature rise at the corneal surface during ablation. We cooled down the eye with cold balanced salt solution before and after photorefractive keratectomy. Postoperatively, this reduced severe pain, subepithelial corneal haze and any damage to the corneal endothelium. [J Refract Corneal Surg. 1994;10:S262-S266.]
Scraping of Epithelium for Treatment of Undercorrection and Haze After Photorefractive Keratectomy
Authors: Loewenstein Anat , Lipshitz lsaak , Lazar Moshe
Published: April 2021

ABSTRACT

We report an easy, safe technique to treat regression and haze after excimer laser photorefractive keratectomy (PRK), in which the hyperplastic epithelium is removed manually. The results of scraping of epithelium in 21 eyes of 20 patients are presented. Mean follow-up time was 3 months (range 1 to 7). The mean spherical equivalent refraction before photorefractive keratectomy was -9.93 + /- 2.95 diopters (D); the mean spherical equivalent refraction before epithelial scraping was -3.82 +/2.87 D; after scraping it declined to -2.63 +/- 4.04 D.

The uncorrected visual acuity after scraping was 20/50 or better in 6 eyes. In 5 others it was between 20/60 and 20/100, and in 10 eyes it was worse than 20/100. The corrected visual acuity after scraping was 20/30 or better in 8 eyes, between 20/40 and 20/60 in 8 eyes, and between 20/60 and 20/100 in 5 eyes. [J Refract Corneal Surg. 1994; 10:S274-S276.]
Discrimination Between the Origins and Functional Implications of Haze and Halo at Night After Photorefractive Keratectomy
Authors: O'Brart David P S , Lohmann Chris P , Fitzke Fred W , KIonos Gregory , Corbett Melanie C , Kerr-Muir Malcolm G , Marshall John
Published: April 2021

ABSTRACT

A series of 84 eyes with up to -6.00 diopters (D) of myopia were treated by photorefractive keratectomy (PRK) using a 5.00 mm ablation zone. Three months postoperatively, 43 eyes (51%) complained of disturbed night vision, compared to 12 (14%) preoperatively. Ten (12%) had significant problems, ie, interference with driving at night. At 12 months, there were 32 patients (38%) with minor disturbances of night vision, 4 (5%) with significant problems. [J Refract Corneal Surg. 1994;10:S281.]
Phototherapeutic Keratectomy in the Treatment of Corneal Scarring From Trachoma
Authors: Goldstein Michaela , Loewenstein Anat , Rosner Mordechai , Lipshitz Isaak , Lazar Moshe
Published: April 2021

ABSTRACT

Trachoma is still one of the world's major blinding diseases. Characteristically, trachoma causes deep scarring of the conjunctiva and tarsus that can result in tear deficiency, trichiasis, and entropion. Another common finding is a diffused corneal opacity that is the end stage of peripheral and central corneal infiltrates. The conventional treatment of the corneal opacities is keratoplasty, which has a guarded prognosis because of severe dryness and trichiasis. We report on our experience in treating patients with corneal trachoma with phototherapeutic keratectomy (PTK) with the excimer laser. [J Refract Corneal Surg. 1994;10:S290-S292.]
Effect of Nitrogen Flow on Recovery of Vision After Excimer Laser Photorefractive Keratectomy Without Nitrogen Flow
Authors: Maguen Ezra , Nesburn Anthony B , Papaioannou Thanassis , Salz James J , Macy Jonathan I , Warren Cathy
Published: April 2021

ABSTRACT

BACKGROUND: Excimer laser (VISX) photorefractive keratectomy was performed using nitrogen flowing through the ocular fixation ring. It was felt that eliminating nitrogen flow may provide faster early visual rehabilitation.

METHODS: Two groups of 50 consecutive eyes underwent photorefractive keratectomy with (N
2
flow) and without (no N
2
flow) nitrogen flow, and were evaluated at 1 month postoperatively.

RESULTS: There were more under- or overcorrections exceeding 1.00 diopter (D) in the N
2
flow than in the no N
2
flow groups. Eighteen eyes in the N
2
flow and 11 in no N
2
flow groups saw 20/50 or less, without correction. Fourteen eyes in the N
2
flow and nine eyes in the no N
2
flow groups lost two or more lines of best spectacle-corrected visual acuity. Four eyes in the N
2
flow and none in the no N
2
flow groups increased more than 1.00 D of astigmatism.

CONCLUSION: The elimination of nitrogen flow in photorefractive keratectomy performed with the VISX laser appears to improve visual results in the early postoperative period. [J Refract Corneal Surg. 1994;10:321-326.]

RÉSUMÉ

INTRODUCTION: La kératectomie photo-refractive au laser excimer (VISX) fut réalisée avec et sans la projection de nitrogène par l'anneau de fixation de l'oeil a fin de préciser l'effet du nitrogène sur le début de la récupération visuelle.

MÉTHODES: Deux groupes de 50 yeux consécutifs suites ont subi la kératectomie photo-réfractive avec et sans la projection de nitrogène, et ont été évalués un mois après la chirurgie.

RÉSULTATS: On a constaté plus d'yeux sur- et sous-corrigés d'au moins 1,0 dioptrie dans le groupe traité avec le coulement du nitrogène que dans l'autre groupe. Dix-huit yeux traités avec nitrogène et 11 yeux traités sans nitrogène ont di montre une acuité visuelle égale à ou inférieure à 20/50. Quatorze yeux traités avec nitrogène et 9 yeux traités sans nitrogène ont perdu au moins deux lignes de meilleure acuité corrigée sur l'échelle de Snellen. Quatre yeux dans le groupe traité avec le nitrogène et aucun dex yeux dans l'autre groupe ont éprouvé une augmentation de l'astigmatisme d'au moins, 1,0 dioptrie.

CONCLUSION: L'élimination du coulement du nitrogène dans la kératectomie photorefractive au laser excimer de VISX pourrait améliorer les résultats visuels dans le début de la période postopératoire. (Translated by Rob Mack, MD, Iowa City, Iowa.)

SOMMARIO

PREMESSA: La cheratectomia fotore fratti va (PRK) mediante laser ad Eccimeri (VISX) e' stata effettuata utilizzando un flusso di nitrogeno attraverso l'anello di fissazione oculare. Si riteneva che eliminando tale flusso di nitrogeno si potesse ottenere un recupero funzionale piu' rapido.
Excimer Laser Photorefractive Keratectomy for Treatment of Keratoconus
Authors: Mortensen Jes , Öhrström Arne
Published: April 2021

ABSTRACT

BACKGROUND: Five eyes with keratoconus that were scheduled for penetrating keratoplasty were treated instead with excimer laser photorefractive keratectomy to reduce the steepness of the cone. The follow up after 6 to 12 months is reported here.

METHODS: A 193-nanometer excimer laser system VISX 20/20 was used for correction of myopia or astigmatism. The patients had a complete ophthalmological examination including slit-lamp microscopy and videokeratography. The patients were followed with six examinations during a period of at least 6 months.

RESULTS: In four eyes, a reduction of the astigmatism was achieved with an increase of visual acuity. There were no problems with wound healing or any signs that the excimer adversely affected the cornea or activated the keratoconus disease process.

CONCLUSION: The treatment of keratoconus with excimer laser has been regarded as seriously contraindicated on a speculative basis. This risk seems to be exaggerated. [J Refract Corneal Surg. 1994;10:368-372.]
Radial Keratotomy and Excimer Laser Photorefractive Keratectomy for the Correction of Myopia
Authors: Binder Perry S
Published: April 2021

ABSTRACT

PURPOSE: To compare our current knowledge of the two most common current refractive surgical procedures for the correction of myopia.

METHODS: I reviewed the scientific literature and my personal experience with radial keratotomy and excimer laser photorefractive keratectomy to compare these two modalities.

RESULTS: Both radial keratotomy and photorefractive keratectomy are capable of permanently correcting myopic refractive errors. However, each procedure has its individual advantages and disadvantages, with the greatest concern currently being the effect of wound healing on refractive outcome. The procedures are not mutually exclusive.

CONCLUSIONS: Both radial keratotomy and photorefractive keratectomy will be used to surgically correct myopia for the next several years until newer technology is developed to improve the predictability and stability of refractive results currently achieved with each procedure. [J Refract Corneal Surg. 1994;10:443-464.]
Presumed Epithelial Cyst in the Anterior Chamber Following Refractive Keratotomy
Authors: Zamora Rene L , Goldberg Marc A , Pepose Jay S
Published: April 2021

ABSTRACT

BACKGROUND: A free floating cyst in the anterior chamber was observed 10 days after a 35-yearold woman underwent an eight-incision radial keratotomy and two-incision transverse keratotomy of the left eye.

METHODS: A single self-sealing microperforation had occurred on the inferotemporal incision during the initial surgery, which used a two direction incision technique.

RESULTS: A free floating cystic structure was first noted by the surgeon 10 days after surgery, when the patient returned for repeated surgery for residual myopia. After 18 months, there was little change in the size or appearance of the cyst. The patient, who was informed of the complication, remained asymptomatic with uncorrected visual acuity of 20/25 + 2 bilaterally. Because of the lack of growth of the cyst, continued observation was chosen instead of surgical removal. The cause of the cyst is unknown.

CONCLUSION: A free floating cyst in the anterior chamber may occur after refractive keratotomy. [Refract Corneal Surg. 1994;10:xx-xx.]
Photorefractive Keratectomy in Ophthalmic Residents
Authors: Moilanen Jukka A O , Vesaluoma Minna H , Vesti Eija T , Vaajoensuu Timo P J , Partinen Markku M , Tervo Timo M T
Published: April 2021

ABSTRACT

PURPOSE: To find out how ophthalmologists themselves experience the correction of myopia after photorefractive keratectomy. Visuomotor functions were of special interest.

METHODS: Four ophthalmology residents and one medical engineer underwent photorefractive keratectomy for myopia. Objective measurements including refraction, corneal topography, perimetry, contrast sensitivity, pattern visual evoked potentials, in vivo confocal microscopy, and a car driving simulator test were performed preoperatively, postoperatively, and at 6 months. Subjective evaluation was reported.

RESULTS Performing upmnaimoiogicai examinations and microsurgery without spectacles was easier postoperatively and was appreciated by the four ophthalmology residents. Minimal haze formation, good accuracy, and normal performance in the car driving simulator were also observed. Visual fields, contrast sensitivity, and pattern visual evoked potentials did not show changes. Negative observations included postoperative pain for 2 to 4 days, dry eye symptoms, a period of anisometropia between operations, and hypersensitivity of the lids.

CONCLUSIONS: The four ophthalmic residents were satisfied with the outcome of their refractive surgery. Low to moderate myopic correction did not affect the objective measurements of high and low contrast sensitivity, pattern visual evoked potentials, or simulated car driving in dark illumination. [J Refract Surg 2000;16:731-738]
Transfixion of Foldable Intraocular Lens With Polytetrafluoroethylene Suture for Scleral Fixation
Authors: Pineda-Fernández Angel , Chen Yan , Rodriguez Leonidas
Published: April 2021

PURPOSE:

To describe a new scleral fixation technique potentially usable for every acrylic foldable intraocular lens (IOL) available in the market, regardless of whether it is a three-piece, single-piece, or haptic shape.

METHODS:

Before surgery, the authors performed the transfixion of the IOL optic in four points with the polytetrafluoroethylene suture under a surgical microscope. Four sclerotomy sites were marked 2 mm from the limbus, and two scleral grooves were created in between. The IOL was introduced into the posterior chamber. The four ends of the needleless polytetrafluoroethylene sutures were externalized through the sclerotomies, tightened for optimum IOL centration, and tied. The exposed sutures were placed within the scleral grooves, and the knots were buried within the sclerotomies. This technique was performed uneventfully in 7 cases.

RESULTS:

The foldable IOL was stable in all eyes 6 months after surgery, with no signs of IOL subluxation, dislocation, tilt, or suture-related complications, such as erosion or infection.

CONCLUSIONS:

The transfixion of the foldable posterior chamber IOL for stable four-point scleral fixation using a polytetrafluoroethylene suture provides excellent stability and prevents IOL tilt and decentration. This technique can immensely benefit patients requiring secondary foldable posterior chamber IOL implantation in the absence of capsular support.

[
J Refract Surg.
2021;37(3):180–185.)
Surgical Management of Traumatic Incision Dehiscence Following Penetrating Keratoplasty
Authors: Boutros George , Insler Michael S
Published: April 2021

ABSTRACT

Three patients sustained a traumatic incision rupture of their cornea transplant; six weeks, four months, and seven months postoperatively. The cases included a phakic, aphakic, and Pseudophakie keratoplasty; all did well with clear grafts following primary suture repair. Our report confirms the preferred management of such cases with primary resuturing.
The Lid Crease Approach to the Superomedial Orbit
Authors: Wolfley Darrell E
Published: April 2021

ABSTRACT

The lid crease incision of the upper lid allows direct exposure of the orbital septum and levator aponeurosis and can be used to dissect dermoid tumors or any tumor of the middle orbit space from the medial horn of the levator aponeurosis and the tendon of the superior oblique muscle. One advantage of the lid crease incision is its location in the normal eyelid crease, which provides a "front door" approach familiar to the ophthalmic surgeon. Also, the distensibility of the eyelid skin allows for marked retraction of tissues and exposure of large orbital masses well beyond the medial extent of the incision. In addition, the Ud crease incision offers significant advantages in completing the dissection of the poorly-defined plane between dermoid tumors and the medial horn of the levator aponeurosis. Finally, with this approach, if there is direct damage to the lid structures, primary repair can be easily accomplished.
Surgical Revision of Oriental Eyelids
Authors: Doxanas Marcos T , Serra Fabrice
Published: April 2021

ABSTRACT

A modified upper eyelid blepharoplasty to convert oriental to occidental-appearing eyelids is presented. The primary goal of the procedure is the creation of an eyelid crease. The recognition of the distinct anatomic features of the oriental eyelid permits the formation of a predictable and permanent eyelid crease. Satisfactory cosmetic results were produced in 14 eyelids. No complications were encountered.
Record Form for Eye Examination Under Anesthesia
Authors: Jabbour Nabil M , Hirose Tatsuo , Schepens Charles L
Published: April 2021

ABSTRACT

We designed a record sheet for eye examination under anesthesia, which is often required in children or babies with suspected ocular pathology and in adults with severe mental retardation. The form is both complete and concise, allows for schematic illustrations, and has proven very helpful in more than 200 examinations performed over the past year.
The Management of the Ptosis Patient: Part I
Authors: Leone Charles R , Shore John W
Published: April 2021

ABSTRACT

The various types of congenital and acquired ptosis are discussed as well as the findings on history and examination. From this information the appropriate operation can be chosen. Emphasis is placed on obtaining accurate and reproducible measurements in addition to assessing visual acuity, extraocular muscle movement. Bell's phenomenon, and tear secretion, especially in older patients. The operations described are the tarsal-Muller's muscle resection, levator aponeurosis advancement, levator resection, and frontalis suspension. Since the aim in ptosis surgery is symmetry in the primary position, overcorrections and undercorrections must occasionally be dealt with to achieve a satisfactory result.
Dacryoscintigraphy in Children
Authors: Heyman Sydney , Katowitz James A , Smoger Barry
Published: April 2021

ABSTRACT

Dacryoscintigraphy was performed in 34 pediatric patients aged between 13 months and 20 years. Twenty-six were 12 years of age or younger. The study is easy to perform and provides useful information regarding the function of the nasolacrimal system. The radiation dose to the lens of the eye, estimated to be 4-14m rads/100 uCi of technetium pertechnetate, is considerably less than that of a skull x-ray or dacryocystography. Of the 74 nasolacrimal systems studied, the findings were in agreement with the clinical observations and other methods of testing in 63. In nine instances, the findings altered the clinical management while the results were inconclusive or misleading in the remaining two. Dacryoscintigraphy was found to be a useful physiological test in the evaluation of children with epiphora.
Pars Plana Lensectomy and Vitrectomy by Ultrasonic Fragmentation: Part III - Results in Eyes Without Other Ocular Pathology or an Implant
Authors: Girard Louis J , Monasterio Remberto , Rodriguez Jorge , Mailman Mary L , Romano Tami Jo
Published: April 2021

ABSTRACT

The records of 320 eyes without other ocular pathology undergoing pars plana lensectomy and vitrectomy by ultrasonic fragmentation for routine cataract extraction without an implant were reviewed retrospectively. Three hundred two (302/320-94.4%) had vision between 20/20-20/40. Reasons for vision less than 20/40 in 18/320 (5.6%) eyes included 5/320 (1.5%) with retinal detachments, 11/320 (3.4%) with clinically apparent cystoid maculopathy, 1/320 (0.3%) with a macular hole, and 1/320 (0.3%) with retained lens material.

Comparison was made between 184 lensectomies performed by the original technique and 136 pars plana lensectomies performed by the modified technique. Vision between 20/20-20/40 was achieved by 168/184 (91.3%) of the original technique group versus 134/136 (98.5%) of the modified technique group. In the latter group, there was one retinal detachment (0.7%), one macular hole (0.7%) and no clinical cystoid maculopathy. Fluorescein angiography performed three months postoperatively in eyes having vision of 20/20-20/40 of the modified lensectomy group showed cystoid maculopathy in one eye which had undergone trauma-induced wound dehiscence.
A Combined Facial, Orbital and Intracranial Resection of Extensive Basal Cell Carcinoma Arising in the Eyelid
Authors: Hornblass Albert , Roen Janet L
Published: April 2021

ABSTRACT

We report a single stage en bloc surgical excision and repair of extensive recurrent basal cell carcinoma arising in the eyelids. It combines the advantages of an en Woe dissection, direct visual evaluation of intracranial extension and immediate reconstruction. A team of surgeons, ophthalmic plastic, neurologic, and plastic, employed both an anterior facial and intracranial approach to excise the tumor.
Nontraumatic Ghost Cell Glaucoma - A Case Report
Authors: Mansour Ahmad M , Chess Jeremy , Starita Richard
Published: April 2021

ABSTRACT

Ghost cell glaucoma (GCG) has recently been described following vitrectomy, cataract extraction, and penetrating or blunt trauma. We describe the occurrence of GCG in a phakic eye with no prior ocular trauma or surgery following vitreous hemorrhage from diabetic retinopathy. We postulate the occurrence of a spontaneous rupture of the anterior hyaloid face which allowed passage of ghost cells into the anterior chamber. A therapeutic vitrectomy was complicated by intraoperative vitreous hemorrhage. Two weeks postvitrectomy, GCG recurred and was successfully controlled by irrigation through an anterior chamber approach. This is the procedure of choice in GCG following vitrectomy and may eliminate the need for a second vitrectomy.
Toxicity of Intravitreal Interferon
Authors: Vegh Sara , Peyman Gholam A , Vernot Jackie , Fiscella Richard
Published: April 2021

ABSTRACT

We evaluated the toxicity of injecting human fibreblast Interferon intravitreally in rabbit eyes. A single intravitreal injection of 166,660 units/0.1 ml was nontoxic to ocular structures, as demonstrated by electroretinographic and histologie examination.
Posterior Chamber Pseudophakes in Glaucoma Patients
Authors: McMahan Lynn B , Monica Monica L , Zimmerman Thom J
Published: April 2021

ABSTRACT

In the past, glaucoma has been considered a relative contraindication to the use of an intraocular lens (IOL) in a patient undergoing cataract extraction. In this study, we examined postoperative intraocular pressure (IOP) control for three months postoperatively in 46 eyes with glaucoma undergoing cataract extraction with implantation of a posterior chamber IOL. Twenty-six eyes or 56.5% could be classified as having improved IOP control three months postoperatively. At the same time, 19 eyes or 41.3% demonstrated the same IOP control after lens implantation. Thus, 45 of the total of 46 eyes had as good or better postoperative IOP control. Of the 46 eyes, 100% required preoperative glaucoma medication, while postoperatively only 41% required medication.
Mucoepidermoid Carcinoma of the Conjunctiva: Report of a Case in a 36-Year-Old With Paranasal Sinus Invasion
Authors: Margo Curtis E , Weitzenkorn Dan E
Published: April 2021

ABSTRACT

Mucoepidermoid carcinoma is a rare, highly invasive tumor of the conjunctiva that occurs in elderly persons. Although clinically indistinguishable from squamous cell carcinoma, mucoepidermoid carcinoma is more likely to recur following excision and to invade the eye. The following case report describes a 36-year-old man with mucoepidermoid carcinoma of the right caruncle that invaded orbit, paranasal sinuses, and nasal cavity. The patient is the youngest person known to have had this tumor, and represents the first reported case in which mucoepidermoid carcinoma of the conjunctiva has extended beyond the orbit. This case emphasizes the importance of prompt and adequate primary treatment.
Finger in His Eye
Authors: O'Keefe Michael , Levick Paul
Published: April 2021

ABSTRACT

A 21-year-old soldier sustained a schrapnel blast injury during an accident with a mortar fuse. Surgical repair included the use of one of his reconstructed metacarpal bones to repair the orbital floor. The remainder of the orbital floor was repaired using maxillary bone. It proved an excellent method of repairing this patients orbital floor.
Transfer from Ophthalmology to Another Service is a Marker of High Risk Medical Events
Authors: Wu Wilson C S , Schachat Andrew P
Published: April 2021

ABSTRACT

Of 3632 consecutive admissions to the Wilmer Ophthalmological Institute between July 1, 1987 and June 30, 1989, 27 patients required transfer to a medical or surgical service (0.74%). The major reasons for transfer included acute or decompensated cardiac disease (26%), poorly controlled diabetes mellitus (19%), acute renal failure (11%), coagulopathy, stroke, and hypertension (7% each). Only one transfer was a direct result of an anesthesia complication. The highest rates of transfers were associated with orbital (4.3%), enucleation/evisceration (3.1%), and glaucoma (2.3%) surgeries, while vitreoretinal surgery had the lowest rate of transfer (0.3%). Most of the transfers of patients with orbital disease were for management of related problems such as sinusitis or increased intracranial pressure.
Results of Treatment of Persistent Hyperplastic Primary Vitreous
Authors: Pollard Zane F
Published: April 2021

ABSTRACT

The records of 48 patients with persistent hyperplastic primary vitreous (PHPV) were reviewed. Approximately 17% had vision of 20/100 or better after surgery, contact lens fitting, and amblyopia therapy. Only eyes with a purely anterior presentation had successful visual outcomes. Lensectomy alone prevented glaucoma, but a membranectomy as well was required to ensure a successful visual result. Eyes with a posterior PHPV had poor visual results because of posterior pole abnormalities. I recommend that an attempt be made to visually salvage eyes with an anterior presentation. Eyes with a posterior or a combination anterior-posterior PHPV can be successfully treated for glaucoma, but the visual results will be poor.
Long-Term Comparison of Novafil and Nylon in Corneoscleral Sections
Authors: McClellan Kathleen A , Billson Frank A
Published: April 2021

ABSTRACT

To compare the long-term degradation of Novafil (polybutester, American Cyanamid Company) and nylon suture material, we examined corneoscleral sections of nine rabbits 23 months after the placement of sutures. Only two nylon sutures remained, one in each wound of two rabbits; all the Novafil sutures were still present. However, examination of the Novafil sutures with scanning electron microscopy revealed signs of disintegration.
The Use of Releasable Sutures in Molteno Glaucoma Implant Procedures to Reduce Postoperative Hypotony
Authors: El-Sayyad F , El-Maghraby A , Helal M , Amayem A
Published: April 2021

ABSTRACT

We used releasable sutures to minimize immediate postoperative hypotony and flat anterior chamber in 19 cases of refractory glaucoma requiring insertion of a single-plate Molteno implant in a one-stage procedure. A slip knot using 7-0 nylon suture was fashioned around the Molteno tube under a lamellar scleral flap. In 18 of the 19 eyes, anterior chamber depth was normal immediately after surgery.
Adrenal Suppression and Growth Retardation After Injection of Periocular Capillary Hemangioma With Corticosteroids
Authors: Glatt Herbert J , Putterman Allen M , Van Aalst John J , Levine Mark R
Published: April 2021

ABSTRACT

Adrenal suppression and/or growth retardation were noted in two patients after injection of periocular capillary hemangiomas with corticosteroids. Parents should be warned of these two potential complications of intralesional corticosteroid therapy. Baseline and posttreatment adrenal function should be monitored. If iatrogenic adrenal suppression occurs, supplemental systemic corticosteroids may be necessary in situations involving systemic stress such as infection or surgery.
Tears of the Retinal Pigment Epithelium: Occurrence in Association With Choroidal Effusion
Authors: Serels Scott R , Liebmann Jeffrey M , Ritch Robert , Milch Florence , Eisenberg William
Published: April 2021

ABSTRACT

Two patients developed large tears of the retinal pigment epithelium associated with choroidal effusion. One tear occurred after combined cataract/ filtration surgery complicated by postoperative choroidal detachment; the second developed in a patient with idiopathic uveal effusion syndrome. Weakness of the junctions of the pigment epithelial cells secondary to the accumulation of fluid in the subretinal or suprachoroidal space may result in tearing of the retinal pigment epithelium as it is stretched.
Crescentic Resection for the Treatment of Pellucid Corneal Marginal Degeneration
Authors: Durán Juan A , Rodriguez-Ares M Teresa , Torres Diego
Published: April 2021

ABSTRACT

The left eye of a patient with bilateral pellucid marginal corneal degeneration was treated by crescentic resection of the affected part. The treatment, while it has not been monitored over the long term, appears to have many advantages over penetrating keratoplasty.
Goniotomy Technique for Removal of Anterior Chamber Intraocular Lenses
Authors: Caldwell Delmar R , Miller Douglas G
Published: April 2021

ABSTRACT

Removal off an anterior chamber intraocular lens is often impeded by formation of peripheral anterior synechiae around one or more off the lens haptics. We describe a method off lysing adhesions under direct visualization through a contact gonioprism lens. This method is relatively atraumatic to vital anteriorchamber-angle structures.
Phacoemulsification Combined With Pars Plana Vitrectomy
Authors: Mamalis Nick , Teske Michael P , Kreisler Kenneth R , Zimmerman Paul L , Crandall Alan S , Olson Randall J
Published: April 2021

ABSTRACT

Phacoemulsification combined with pars plana vitrectomy was performed on seven patients with both cataracts and vitreoretinal disease. Six of the seven had a posterior chamber intraocular lens (PC-IOL) placed in the capsular bag following cataract extraction. Visual acuities ranging from light perception to hand movement preoperatively, postoperatively ranged from hand movement to 20/25. There were no perioperative complications. During an average follow-up of more than 6 months, neovascular glaucoma developed in one patient, and a conjunctival cyst in another. The PC-IOLs were well tolerated.

The small limbal incision used in phacoemulsification allows better control during the vitrectomy procedure and ensures a water-tight wound. In addition, with the limbal approach, the posterior lens capsule is maintained, with ail the attendant advantages.
Subconjunctival Anesthesia: An Alternative to Retrobulbar and Peribulbar Techniques
Authors: Petersen Walter C , Yanoff Myron
Published: April 2021

ABSTRACT

We present a method of anesthesia for intraocular surgery of the anterior segment of the eye that avoids the risks of the potential complications associated with retrobulbar and peribulbar anesthesia. The method consists of topical anesthesia plus 0.5 cc of lidocaine (with hyaluronidase and epinephrine) injected beneath the superior conjunctiva. We have demonstrated the safety and effectiveness of this technique in 431 consecutive cases.
A Prospective Evaluation of Anterior Retinal Cryoablation in Neovascular Glaucoma
Authors: Sihota R , Sandramouli S , Sood N N
Published: April 2021

ABSTRACT

We report a prospective evaluation of the effect of anterior retinal cryopexy on 62 eyes with neovascular glaucoma. Pain was relieved and anterior chamber inflammatory reaction regressed dramatically in 95%. Iris neovascularization was reduced or regressed in 93.5%. Control of intraocular pressure was clinically significant in 82.3% 1 year after the procedure, especially in patients with pretreatment pressures less than 40 mm Hg on maximal medical therapy. Anterior retinal cryopexy is recommended in eyes with media opacities and as a preliminary procedure for filtering surgery in eyes with neovascular glaucoma.
A New Contact Neodymium:YAG Laser for Cyclophotocoagulation
Authors: Iwach Andrew G , Drake Michael V , Hoskins H Dunbar , Schuster Bradley L , Vassiliadis Arthur , Crawford J Brooks , Hennings David R
Published: April 2021

ABSTRACT

A newly developed compact (40 kg), self-contained contact Neodymium:YAG laser produces high-peak, high-energy (800 mJ/pulse), short (1.0 millisecond) pulses with 1 to 3 pulses/exposure. Energy is delivered via a 320- µm cleaved quartz fiber optic probe. Cyclophotocoagulation was performed in five eyes of three medium-sized Dutch-pigmented rabbits. The eyes received exposures of 1 to 3 pulses/exposure. Energy delivered ranged from 100 to 800 mJ/pulse. Histopathology revealed ciliary body disruption and hemorrhage with no damage to overlying sclera. When used for transscleral cyclodiathermy in the rabbit, the laser created significant ciliary body disruption with minimal scleral injury.
Multilevel Full-Thickness Eyelid Resection for the Correction of Severe Acquired Ptosis in the Poorly Functioning Eyelid
Authors: Karesh James W
Published: April 2021

ABSTRACT

Six eyelids (4 patients) with severe myogenic (4 eyelids), neurogenic (1 eyelid), or mechanical (1 eyelid) ptosis underwent surgical correction with a multilevel full-thickness resection of eyelid tissue combined with a plication of the levator aponeurosisMüller's muscle complex. All eyelids had poor levator function, fair to poor orbicularis function, and a poor Bell's phenomenon. In all cases, the upper eyelids were elevated to an acceptable functional level without exposure keratopathy. This resection procedure preserves orbicularis function while allowing correction of severely ptotic eyelids with poor levator function, providing an acceptable alternative to other techniques for correcting this problem.
The Use of 5-Fluorouracil in Patients Following Combined Trabeculectomy and Cataract Extraction
Authors: Hennis Hugh L , Stewart William C
Published: April 2021

ABSTRACT

We studied the effect of postoperative administration of subconjunctival 5-fluorouracil in maintaining postoperative filtration following combined trabeculectomy and extracapsular cataract extraction with posterior chamber lens implantation. Three months postoperatively, the mean intraocular pressure in 15 patients who had received 5-fluorouracil was 13.1 ± 3.2 mm Hg; in 17 control patients, it was 13.0 ± 3.0 mm Hg (P > .05). The mean number of postoperative medicines in the study patients was 0.7; in the control patients, 0.8 (P > .05). Bleb appearance and improvement in visual acuity were similar in the two groups. This study does not support the routine use of 5-fluorouracil in patients who have undergone combined trabeculectomy and extracapsular cataract extraction.
The Management of Sclerosing Nonspecific Orbital Inflammation
Authors: Kennerdell John S
Published: April 2021

ABSTRACT

Five cases representing varied presentation and treatment of the sclerosing type of nonspecific orbital inflammation are presented. Rapid identification and vigorous, individualized treatment are recommended: for local lesions, removal; for diffuse lesions, debulking, and/or steroid treatment, followed by radiation therapy.
Anterior Segment Complications in Diabetic Patients Following Extracapsular Cataract Extraction and Posterior Chamber Intraocular Lens Implantation
Authors: Krupsky S a , Zalish M a , Oliver M a , Pollack A a
Published: April 2021

ABSTRACT

Recovery of the anterior segment following extracapsular cataract extraction and posterior chamber intraocular lens implantation in 112 diabetic eyes was compared to that in 108 eyes of nondiabetic patients who underwent a similar procedure. The incidence of postoperative anterior segment complications was significantly higher in the diabetic than in the nondiabetic patients. The main complications were pigment dispersion, appearance of fibrin, development of posterior synechiae, and - rarely, and only in diabetic patients - pupillary block and transient iridai vascular congestion. The fibrin resolved following increased administration of steroids by means of eye drops and subconjunctival injections, with or without the addition of systemic steroids. Women were found to be at greater risk for development of posterior synechiae (P < .025). Accumulation of fibrin was seen more often in women and in patients with preexisting diabetic retinopathy than in other patients, although the difference was not significant.
Vitreoretinal Surgery Performed Through a 60-Diopter Lens
Authors: Malbran Enrique S , Lombardi Atilio , Malbran Enrique
Published: April 2021

ABSTRACT

For vitreoretinal surgery, we recommend using a 60-diopter lens for indirect ophthalmoscopy through the operating microscope without internal illumination. This device has undergone extensive clinical testing since 1986 with excellent results.
Intraoperative Mitomycin-C Versus Postoperative Topical Mitomycin-C Drops for the Treatment of Pterygium
Authors: Helal Magdi , Messiha Nabil , Amayem Ashraf , El-Maghraby Akef , Elsherif Zakaria , Dabees Mostafa
Published: April 2021

* BACKGROUND AND OBJECTIVE: To evaluate the safety and efficacy of two different regimens of mitomycin-C (MMC) application as adjunctive chemotherapy in the treatment of pterygia.

* PATIENTS AND METHODS: One hundred fifty-six patients underwent pterygium excision using the bare sclera technique. They were randomly assigned to have either 0.1 mg/ml of MMC applied to the bare sclera for 3 minutes intraoperatively, or 0.05-mg/ml drops applied topically for 2 weeks postoperatively. The mean follow-up period was 11 months (range 7 to 17).

* RESULTS: Complications with the intraoperative MMC included 5 cases of recurrence (5.75%), 2 cases of superficial punctate keratitis (SPK), and 3 cases of delayed conjunctival wound healing. Topical MMC led to 6 cases of recurrence (6.9%), 5 cases of SPK, 4 cases of delayed conjunctival wound healing, and 2 cases of mild iritis.

* CONCLUSION: A single, intraoperative application of MMC is a simple, effective alternative adjunctive treatment for pterygium.

[Ophthalmic Surg Lasers 1996;27:674-678.]
Lacrimal Bone Thickness at the Lacrimal Sac Fossa
Authors: Hartikainen Jouko , Aho Heikki J , Seppä Heikki , Grenman Reidar
Published: April 2021

* BACKGROUND AND OBJECTIVE: Because laser dacryocystorhinostomy techniques have become more popular during the past few years, interest has grown concerning the anatomic structures that need to be penetrated in these procedures. The authors therefore studied the thickness and the histologic type of the lacrimal bone at the lacrimal sac fossa.

* PATIENTS AND METHODS: The thickness of 69 lacrimal bones at the lacrimal sac fossa from 48 patients was measured.

* RESULTS: The mean thickness was 106 pm. In 67% of the patients the mean thickness of individual lacrimal bone was less than 100 µm and in 4% it was more than 300 µm. The thinnest measured cross section of the lacrimal bone sample was 11 pm and the thickest was 722 µm. The lacrimal bone was composed of a thin plate of lamellar bone.

* CONCLUSION: In most cases the lacrimal bone at the lacrimal sac fossa is so thin that it can be easily penetrated with most surgical instruments.

[Ophthalmic Surg Lasers 1996;27:679-684.]