bluuebunny/crossref_metadata_2025 huggingface dataset:
Single-donor Platelet Concentrates Stored in Synthetic Medium. In Vitro and in Vivo Studies
Authors: Bertolini F. , Marangoni F. , Loy A. , Marconi M. , Almini D. , Rebulla P. , Sirchia G.
Published: April 2018

Single-donor platelet concentrates (PC) were prepared in 80-120 ml plasma and stored in two polyolefin bags after addition of 250 ml plasmalyte, a simple, glucose-free synthetic medium that was previously used for platelet storage; when compared to PC stored in plasma, PC stored in plasmalyte, showed similar platelet quality, morphology and function after 5 days of storage. In vivo incrementes observed after transfusion of PC stored for 5 days in plasmalyte were similar to those observed after transfusion of 1-2 day old PC stored in plasma. Moreover, transfusion of 5-day old PC stored in plasmalyte was associated with correction of prolonged bleeding times in all 3 of the 3 patients evaluated. It is concluded that plasmalyte seems to be promising as a medium for single-donor PC storage.
Donor Plasmapheresis: Plasma Membrane Separators
Authors: Baldini G.M. , Baldini E. , De Palma M.
Published: April 2018

Performance of plasma membrane separators, employed for donor plasmapheresis, is evaluated by considering collection efficiency, quality of collected plasma and biocompatibility.
Overview of Plasmapheresis in Italy
Authors: Tomasini I.
Published: April 2018

The national law, concerning Blood Transfusion and Blood derivatives in Italy, aims at achieving self-sufficiency and assuring safety of blood, plasma and plasma derivatives, according to EEC ((EE-Directive 89/381) and to the Council of Europe (R-88/4)).

According to this law it is the task of the Central National Authority, (ie Istituto Superiore di Sanità (ISS)), to coordinate the transfusion system nationwide. The adoption and the transmission to the ISS of Regional Blood Registers containing information about the local use of blood and blood derivatives is in progress.

Up to now the data are collected from a network among Blood Centers by Società italiana di lm-munoematologia e Trasfusione del Sangue - Associazione Italiana Centri Trasfusionali (SIITS - AICT) and these results show that in Italy the incorrect use of plasma and albumin and the insufficient practice of plasmapheresis are the major obstacles to the achievement of self-sufficiency.
Hemapheresis and Plasma Plan
Authors: Fornasari P.M.
Published: April 2018

The Italian Authorities have recently presented the National Blood and Plasma plan for the period 1993-1995. One of the main topics is the regional and national plasmaderivatives self-sufficiency by whole blood fractionated plasma increase and donor plasmapheresis activation. Plasmapheresis will follow efficiency and efficacy criteria.
Plasma Exchange in Systemic Lupus Erythematosus. Experience in Thirty-seven Patients
Authors: Lombardo R. , Cepparrone F. , Di Pietro G. , Franco C. , Graziani G. , Avanzi G.
Published: April 2018

Thirty-seven (37) SLE patients submitted to therapeutic plasmapheresis were examined. The results were good in the active stage of the disease. Various types of antibody, anti-DNA, anti nucleus, anti-cardiolipine, I.C. (Clq and C3d) were removed. The values of IgG, coagulation factors, creatinine and proteinuria were assessed.

Close collaboration with the clinicians is urged, with the aim of applying immunosuppressive therapy immediately after P.E. to consolidate the results obtained.
Medico-legal Reflexes of Nurse and Technician Activity in Hemapheresis Practice
Authors: Flores A.
Published: April 2018

The Author analyzes the role of nurse and technician in an hemapheresis équipe. Juridical and medico-legal aspects are evaluated on the basis of civil law and specific regulations now in force. The active role of physician in effective control of the apheretic treatment and also in a continuous up to date information and technical training of auxiliary personnel is emphasized.
Yield and Collection Efficiency
Authors: Dimonte D. , Cazzato L. , Poliseno G. , Paglionico N.
Published: April 2018

Yield and collection efficiency are two important and strictly related aspects of an apheresis system. We have examined the various formulas, dwelling upon a few particular aspects of the collection of platelets, granulocytes and stem cells.
Multicomponent Collection (Mcc): An Overview
Authors: Valbonesi M. , Bruni R. , Giannini G. , Florio G. , Frisoni R. , Lercari G. , Carlier P. , Ruzzenenti M.R.
Published: April 2018

Collection of multiple products, including single and double units of platelets (SDP, DPP), plasma and RBC is progressively improving donor utilization and is leading to more cost-effective apheresis. Cell separators such as the Fresenius AS 204, the Dideco Excel version 97 and the Baxter Amicus are newcomers to the family of the last generation apparatuses used for MCC such as the AS 104, the Vivacell and the MCS 3p. The Cobe Spectra is for the moment the only apparatus unable to collect packed RBC along with platelets but Cobe too is moving in the direction of MCC. The next step is triple product apheresis.
Validation of the MedUseQ: A Self-Administered Screener for Older Adults to Assess Medication Use Problems
Authors: Berman Rebecca L. , Iris Madelyn , Conrad Kendon J. , Robinson Carrie
Published: April 2018

Background:

Older adults taking multiple prescription and nonprescription drugs are at risk for medication use problems, yet there are few brief, self-administered screening tools designed specifically for them.

Objective:

The study objective was to develop and validate a patient-centered screener for community-dwelling older adults.

Methods:

In phase 1, a convenience sample of 57 stakeholders (older adults, pharmacists, nurses, and physicians) participated in concept mapping, using Concept System® Global MAXTM, to identify items for a questionnaire. In phase 2, a 40-item questionnaire was tested with a convenience sample of 377 adults and a 24-item version was tested with 306 older adults, aged 55 and older, using Rasch methodology. In phase 3, stakeholder focus groups provided feedback on the format of questionnaire materials and recommended strategies for addressing problems.

Results:

The concept map contained 72 statements organized into 6 conceptual clusters or domains. The 24-item screener was unidimensional. Cronbach's alpha was .87, person reliability was acceptable (.74), and item reliability was high (.96).

Conclusion:

The MedUseQ is a validated, patient-centered tool targeting older adults that can be used to assess a wide range of medication use problems in clinical and community settings and to identify areas for education, intervention, or further assessment.
Finite element evaluation of the newest ISO testing standard for polyethylene total knee replacement liners
Authors: Mell Steven P , Fullam Spencer , Wimmer Markus A , Lundberg Hannah J
Published: April 2018

Current treatment for end-stage osteoarthritis is total knee replacement. Given that the number of total knee replacement surgeries is expected to approach 3.48 million by 2030, understanding long-term failure is important. One of the preclinical tests for total knee replacements is carried out using mechanical wear testing under generic walking conditions. Used for this purpose is the International Standards Organization’s generic walking profile. Recently this standard was updated by reversing the direction of anterior/posterior translation and internal/external rotation. The effects of this change have not been investigated, and therefore, it is unknown if comparisons between wear tests utilizing the old and new version of the standard are valid. In this study, we used a finite element model along with a frictional energy–based wear model to compare the kinematic inputs, contact conditions, and wear from the older and newer versions of the ISO standard. Simulator-tested components were used to validate the computational model. We found that there were no visible similarities in the contact conditions between the old and new versions of the standard. The new version of the standard had a lower wear rate but covered a larger portion of the articular surface. Locations of wear also varied considerably. The results of the study suggest that major differences between the old and new standard exist, and therefore, historical wear results should be compared with caution to newly obtained results.
Phenomenon of moral distress through the aspect of interpretive interactionism
Authors: Ko Hsun-Kuei , Chin Chi-Chun , Hsu Min-Tao , Lee Shu-Li
Published: April 2018

Background:

Most previous studies on moral distress focused on the factors that cause moral distress, paying inadequate attention to the moral conflict of nurses’ values, the physician–nurse power hierarchy, and the influence of the culture.

Research objective:

To analyze the main causes for moral distress with interpretive interactionism.

Research design:

A qualitative study was adopted.

Participants:

Through purposeful sampling, 32 nurses from 12 different departments were chosen as the samples.

Ethical considerations:

Approval from the Institutional Review Board of the Kaohsiung Medical University Hospital.

Findings:

Moral distress is likely to occur in the following clinical situations: patients have no idea about their diseases; the medical decisions fail to meet the optimum benefit of patients; and patients with terminal cancers are not given a proper death. The reason why nurses become trapped in moral distress is that they fail to achieve moral goodness. Inadequate confidence, the physician–nurse power hierarchy, and the Oriental culture affect nurses’ goodness-based intention for patients, which deteriorates moral distress.

Discussion:

The main cause for moral distress is the moral goodness of nurses. If nurses’ goodness-based intention for patients is inconsistent with the moral objective of achieving optimum benefit for patients, it leads to moral distress. Culture is an essential background factor of care for patients. In the Oriental culture, family members influence patients’ right to know about their diseases, the choice of treatment, and patients’ autonomy of not receiving cardio-pulmonary resuscitation. This results in moral distress in medical care.

Conclusion:

The occurrence of moral distress demonstrates that nurses have moral characteristics such as goodness and caring. It is suggested that appropriate educational strategies can be adopted to weaken the power hierarchy between physicians and nurses and enhance nurses’ confidence and cultural sensitivity, so as to reduce the moral distress of nurses.
Effects of Enoxaparin on Intravascular Sclerostin Release in Healthy Men
Authors: Borawski Jacek , Zoltko Justyna , Labij-Reduta Barbara , Koc-Zorawska Ewa , Naumnik Beata
Published: April 2018

Sclerostin (Scl) is implicated in vascular calcification and angiogenesis and localizes within vasculature. Its molecule incorporates a heparin-binding site that implies also binding to endothelial glycocalyx. We preliminary tested whether intravenous (IV) low-molecular-weight heparin enoxaparin can stimulate intravascular release of this calcification inhibitor in humans. Sixteen male volunteers were injected with a bolus of 1 mg/kg body weight of enoxaparin. After 10 minutes, plasma immunoreactive Scl levels increased uniformly by a mean of 184% versus baseline level of 0.56 ± 0.17 ng/mL ( P = .0004). Plasma Scl levels were found still elevated after 2 and 6 hours (with a median of 20.9% and 8.69%, respectively) and became normal after 24 hours. The percentage of increase (Δ) in plasma Scl after 10 minutes was directly correlated with enoxaparin dose per kg/m2 of body mass index (ρ = 0.587, P = .017) and strongly inversely correlated with the preinjection Scl levels (ρ = −0.747, P = .0008). A robust negative association between the ΔScl increase after 10 minutes and the ΔScl decrease after 2 hours versus 10 minutes was observed (ρ = −0.835, P < .0001). Complementary in vitro spiking experiment showed no effects of enoxaparin addition and whole blood incubation on plasma Scl levels when measured with the immunoassay. This study shows that enoxaparin has a stimulating effect on the intravascular release of calcification inhibitor Scl in healthy men. This novel pharmacological action of the popular anticoagulant drug seems important in cardiovascular medicine.
A New Autosomal Dominant Vascular Retinopathy Syndrome
Authors: Storimans C.W.J.M. , Van Schooneveld M.J. , Oosterhuis J.A. , Bos P.J.M.
Published: April 2018

We describe a new syndrome with autosomal dominant transmission whose most striking feature is vascular retinopathy. The retinopathy is often associated with migraine, Raynaud's phenomenon and mental changes, mainly forgetfulness, aggression and depression. To define this syndrome we collected medical data on 110 family members. General ophthalmological examination and fluorescein angiography were performed in 61 persons. The retinopathy, as diagnosed in 22 persons, is characterized by central and peripheral microangiopathy, areas of capillary non-perfusion, haemorrhages, cotton wool spots and, in a more advanced stage, occlusion of large retinal vessels, which can induce a neovascular response. A vascular occlusive disorder may be the common aetiological factor of the various manifestation of this syndrome.
Retinal Microcirculation as Revealed by SEM Corrosion Casts in the Rat
Authors: Pannarale L. , Onori P. , Ripani M. , Gaudio E.
Published: April 2018

The morphology of the retinal microcirculation has been extensively studied by different techniques. Nevertheless, some problems concerning the capillary bed lamination and pre- and postcapillary patterns have not yet been clarified. In the present study the SEM corrosion cast technique was employed to study the three-dimensional relationships of rat retinal vessels and to follow the smallest vascular branches. Rat retina is considered a useful experimental model for a number of pathologies which affect the microvascular bed deeply.

Two precapillary patterns have been observed. Precapillary arterioles gave rise to capillaries both as terminal branches or as collaterals. The former pattern of ramification allows only a regulation of flow in a whole group of capillaries downstream, the latter pattern could provide a finer regulation of blood flow. SEM corrosion casts have shown very well the lamination of the capillary bed: one can easily realize this by seeing the overlapped meshes of the two different planes, vessels in between the two capillary laminae can always be followed from one meshwork to the other.

This three-dimensional organization is an interesting model for retinal circulation because it shows many features in common with the retina of humans and primates
Treatment of Calcific Band Keratopathy by Nd: YAG Laser
Authors: Baltatzis S. , Papaefthimiou J.
Published: April 2018

A new technique is presented for the treatment of secondary calcific band keratopathy. The Nd:YAG laser was used for the disruption and removal of corneal calcium deposits. This technique was used in seven cases with satisfying results.
Rickettsial keratitis in a Case of Mediterranean spotted fever
Authors: Alio J. , Ruiz-Beltran R. , Herrera I. , Artola A. , Ruiz-Moreno J.M.
Published: April 2018

The first documented case of infectious keratitis (an ameboid-like corneal ulcer) caused by Rickettsia conorii is described. Corneal infection was probably caused by contamination through the tears during systemic rickettsial dissemination. Topical tetracyclin ointment was effective. Rickettsial keratitis should be considered in the differential diagnosis of ameboid-like corneal ulcers in areas where Mediterranean spotted fever is endemic.
Laser Treatment of Diffuse Retinal Pigment Epitheliopathy
Authors: Yannuzzi L.A. , Slakter J.S. , Kaufman S.R. , Gupta K.
Published: April 2018

The Authors report laser treatment of 18 eyes (14 patients) with a variant of central serous chorioretinopathy associated with widespread decompensation of the retinal pigment epithelium (RPE) in the macula, diffuse retinal pigment epitheliopathy (DRPE). All eighteen eyes with DRPE were treated with Krypton red laser photocoagulation in a grid pattern to leaking RPE in areas of neurosensory retinal detachment. All eyes showed anatomic improvement with resolution of the serous macular detachment and lipid exudation. The visual acuity was stabilized in 15 eyes (83%) at 6 months’ follow-up, but only 3 eyes (17%) demonstrated improved visual acuity in the same time interval. At eighteen months, 2 of 15 eyes (13%) retained improved visual acuity, 11 eyes (74%) remained unchanged, and 2 eyes (13%) had visual loss. In this series of patients with DRPE, grid laser photocoagulation treatment was uniformly successful in producing an anatomic improvement in the exudative manifestations of the macula and in preventing or slowing progression of vision loss.
Surgical Management of Exudative Maculopathies: Preliminary Report
Authors: Krasnov M.M. , Stolyarenko G.E.
Published: April 2018

A new surgical approach to the management of exudative maculopathies has been developed including the transvitreal route. As a result of surgery the subretinal spaces are drained and their viscous content removed. A special tool was designed for this operation. The method has been clinically tested on 32 patients (32 eyes) with different forms of age-related macular degeneration in the phase of complicated pigment epithelium detachment and on six patients (six eyes) with myopic exudative maculopathy. The follow-up ranged from 6 to 32 months.

No fluid reappeared in the macular zone in patients with age-related macular degeneration, except one; visual function improved in 26 out of 32 cases (81.3%). Similar results were obtained in all six patients with myopic exudative maculopathy.
Is the Type of Vdt Work Important in Asthenopia?
Authors: Scullica L. , Rechichi C.
Published: April 2018

The Authors studied the relationship between visual fatigue (or asthenopia) and different types of work with display units on about 30,000 videoterminal (VDT) operators of the Italian telecommunication company. Visual fatigue was reported with data entry, data checking, word processing, dialogue enquiry, and various services. The Chi-square test showed that asthenopia was not related to any particular type of VDT work, comparing subjects working at the VDT for similar times each week. These findings provide further confirmation that the main factor determining visual fatigue in VDT operators is the amount of time spent at the display units.
Fibrin Reaction after Extracapsular Cataract Extraction: A Statistical Evaluation
Authors: Baltatzis S. , Georgopoulos G. , Theodossiadis P.
Published: April 2018

As part of a retrospective sudy, 1056 eyes of 940 patients who had undergone extracapsular cataract surgery and posterior chamber IOL implantation were studied using statistical methods (chi-squared test). We studied the presence of fibrin reaction in three subgroups: diabetics without retinopathy (102 eyes), previously operated for primary open angle glaucoma “POAG” (78 eyes) and exfoliation syndrome without glaucoma (43 eyes). The results were compared for these three groups and for a group of normal individuals. The incidence of fibrin reaction was 13.7% in the diabetics, 44.8% in the group of previously operated POAG and 27.9% in the group of exfoliation syndrome without glaucoma. All the groups studied had this complication much more often than the controls (p < 0.0001). The incidence among previously operated eyes for POAG was higher than in diabetic eyes without retinopathy (p < 0.0005) and in exfoliation syndrome without glaucoma eyes (0.05 < p < 0.1). Fibrin reaction was more common in exfoliation syndrome without glaucoma than in diabetic eyes without retinopathy (p < 0.05).
Spontaneous Hyphaema Arising from a Strand of Persistent Pupillary Membrane
Authors: Laidlaw D.A.H. , Bloom P.A.
Published: April 2018

A case is reported of spontaneous hyphaema arising from a persistent strand of vascularised pupillary membrane. This strand, and an aneurysmal dilatation from which haemorrhage occurred, were illustrated by fluorescein angiography. The embryogenesis of pupillary membranes is discussed and the literature is reviewed with reference to spontaneous hyphaema.
Treatment of Retinal Detachment with Giant Tear by Pneumatic Retinopexy
Authors: Ando F. , Hirose H. , Nagasaka T. , Takahashi K. , Sekiryu T.
Published: April 2018

Nine eyes suffering from retinal detachment with giant tear were treated successfully by pneumatic retinopexy, followed by conventional buckling procedures and cryopexy. The retina in six of the nine eyes reattached after initial operation, whereas two required additional injection of SF6 gas. The remaining eye, having developed low-grade proliferative vitreoretinopathy (PVR C1), was treated successfully with vitrectomy. Visual outcome was rather poor immediately after the procedures due to vitreous opacity caused by gas injection. However, all cases showed excellent visual acuity five months after surgery. Visual field examined in six cases after surgery showed no significant constriction. If the retinal flap is mobile, pneumatic retinopexy may be effective in treating retinal detachment with giant tear.
Group Comparative Trial of 2% Nedocromil Sodium with Placebo in the Treatment of Seasonal Allergic Conjunctivitis
Authors: Stockwell A. , Easty D.L.
Published: April 2018

A double blind group comparative trial comparing 2% nedocromil sodium with placebo in treating seasonal allergic conjunctivitis over a four week period is reported. Sixty-four patients were analysed. During the period of peak pollen challenge, statistically significant differences in favour of nedocromil sodium for itching and soreness were demonstrated. During a longer period of a less high pollen count, a significant difference in favour of nedocromil sodium was shown only for the symptom of soreness.
Influence of Nifedipine on the Visual Fields of Patients with Optic-Nerve-Head Diseases
Authors: Gaspar A.Z. , Flammer J. , Hendrickson PH.
Published: April 2018

Calcium-channel blockers have long been employed in coronary disease, and recent investigations have indicated their efficacy in improving the visual field in low-tension glaucoma or presumed vasospasm, possibly by enhancing ocular circulation. We evaluated the short-term influence of a typical calcium-channel blocker, nifedipine, on 59 patients with visual-field defects, some with optic-nerve-head pathology (n = 38) and some with normal-appearing optic nerve heads (n = 21). On the average, a statistically significant improvement of 1.2 dB was observed. Different types of patients, however, behaved quite differently. The younger the patient, the greater the improvement. Patients with normal optic nerve heads improved by 1.54 dB, whereas patients with optic-nerve-head excavation improved by only 0.66 dB. No response was observed in patients with anterior ischemic neuropathy. Marked deterioration was noted in one glaucoma patient with low systemic blood pressure. The visual-field changes were observed in the scotomatous and non-scotomatous areas. Thus, the calcium-channel blocker nifedipine can be effective in some selected diseases whose pathogenesis probably involves vascular dysregulation though it may even be contraindicated in others
Long-term Results of Pars Plana Vitrectomy and Silicone Oil for Complications of Diabetic Retinopathy
Authors: Karel I. , Kalvodová B.
Published: April 2018

Pars plana vitrectomy (PPV) with silicone oil implantation (SOI) was performed for advanced proliferative diabetic retinopathy (PDR) in 110 eyes of 98 diabetic patients. In, 77 eyes (70%) it was a primary SOI as part of the initial operation; in 33 eyes (30%) it was a secondary SOI in reoperations. Indications for SOI were traction retinal detachment of the posterior pole, combined traction and rhegmatogenous detachment, vitreous haemorrhage with florid vascularised fibrous proliferations, and recurrent vitreous haemorrhage after PPV. The patients were followed up for 24 to 72 months, with a mean of 53 months. At the end of follow-up, anatomical success was achieved in 63 eyes (57%), and functional success with visual acuity 0.01 and better in 35 eyes (32%). Functional failures were caused by retinal redetachment in 47 eyes (43%), by secondary glaucoma in 10 eyes (9%), retinal ischemia in 15 eyes (13%) and keratopathy in three eyes (3%). The functional success rate decreased with follow-up from 67% after six months to 50% by 60 months after SOI. Silicone oil bubble in the anterior chamber, rubeosis iridis, cataract, and glaucoma were the most frequent postoperative complications. PPV with SOI was highly effective in many serious complications of advanced PDR. Functional success was mostly lasting and markedly improved the quality of life of these patients.
Surgical Results for Proliferative Vitreoretinopathy
Authors: McDonald H.R. , Johnson R.N. , Madeira D. , Schatz H.
Published: April 2018

We reviewed 88 consecutive eyes that underwent vitrectomy for retinal detachment with proliferative vitreoretinopathy (PVR) and were followed a minimum of six months. A primary goal of the surgery was the meticulous trimming of the vitreous base in hopes of decreasing the incidence of postoperative reproliferation and anterior PVR. Those eyes with anterior PVR had aggressive release of vitreous base contraction (anteroposterior and circumferential) with intraocular scissors. All posterior tractional membranes were removed. All eyes received long-acting gas for postoperative retinal tamponade. Macular reattachment was achieved in 78 (88.6%) eyes. Forty-six (52.3%) obtained at least 5/200 vision. Seventeen (19%) eyes were re-operated at least once. We compared the importance of initial lens status (pseudophakic, aphakic, phakic), need for relaxing retinotomy, presence of anterior PVR, and history of previous vitrectomy on the anatomic and visual results. No single factor was responsible for a statistically significant effect on either vision or anatomic success, except for the need for a relaxing retinotomy, which carried with it a decreased chance of an eye obtaining 5/200 vision (Fisher's exact test, p=0.03).
Prognostic Value of Preoperative Flash and Pattern Visual Evoked Potentials for Diabetic Retinopathy Vitrectomy
Authors: Gribomont A.C. , Guerit J.M.
Published: April 2018

In view of the continuing controversy about the prognostic value of preoperative visual evoked potentials in diabetic vitrectomy, we retrospectively studied 31 eyes undergoing vitrectomy for diabetic retinopathy after recording pattern and/or flash visual evoked potential recording. Preoperative pattern visual evoked potentials were of no prognostic value in these eyes but a decrease in the amplitude of preoperative flash visual evoked potentials was significantly correlated with unchanged or worsened postoperative visual acuity when compared with preoperative visual acuity (P = 0.0156, Fisher's exact test). Therefore, while acknowledging that diabetic vitrectomy functional prognosis is actually multifactorial, we still recommend recording preoperative flash visual evoked potentials for diabetic patients in whom significant opacities of the intraocular media preclude correct examination of the ocular fundus, because a decrease in peak III amplitude may indicate a guarded vitrectomy functional prognosis.
Management of Posterior Segment Foreign Bodies and Long-Term Results
Authors: Karel I. , DiblíK P.
Published: April 2018

The management of 158 posterior segment intraocular foreign bodies (IOFB) was retrospectively analyzed: transscleral magnet extraction via the pars plana was used for 40 magnetic IOFB, transscleral extraction via the IOFB bed for 35 magnetic and 4 nonmagnetic IOFB, pars plana vitrectomy (PPV) for 44 magnetic and 32 non-magnetic IOFB, and open-sky vitrectomy for 3 non-magnetic IOFB. Final visual acuity of 0.02 and better was achieved in 104 out of 119 magnetic IOFB (87%) and 24 out of 39 non-magnetic IOFB (62%), and final visual acuity 0.05 and better in 79 magnetic IOFB (66%) and 17 non-magnetic IOFB (44%). Transscleral extraction via the IOFB bed under ophthalmoscopic control and IOFB removal by PPV proved to be the operations of choice for an increasing number of IOFB. For magnetic IOFB, these techniques yielded better final functional results than transscleral magnet extraction via the pars plana. Final visual acuity did not depend on the interval between injury and IOFB removal, and with regard to the risk of endophthalmitis, IOFB need not be considered an absolute indication for immediate intervention. IOFB size up to 5 mm2 and initial visual acuity of 0.5 and better were significant positive factors for both magnetic and non-magnetic IOFB.
Local Excision of Retinal Metastasis from Cutaneous Melanoma
Authors: Balestrazzi E. , Blasi M.A. , Marullo M. , Greco I.M. , Spadea L.
Published: April 2018

The incidence of cutaneous melanoma is constantly rising. Ocular involvement is rare and the choroid is the most accessible structure to metastatic emboli.

The case described is noteworthy on account of several particular features:

1) the missed diagnosis of the primary malignancy. This might be because either cutaneous melanoma or cutaneous nevi show several common features;

2) the rarity of the retinal metastatic site. Unlike the choroid, the retina is an unusual metastatic site but, regardless of organ blood flow, the metastatic efficiency may be related to interactions between tumour cells and host tissue;

3) the treatment of the retinal metastasis, excised conservatively. As far as we know, this is the first report of a retinal metastasis being treated by local resection.
Oculoplastic Surgery with a Contact Nd:YAG Laser Silica Scalpel. A Case Report
Authors: Fankhauser F. , Piffaretti J.-M. , Henchoz P.-D. , England C. , Kwasniewska S. , Van Der Zypen E.
Published: April 2018

Baso-cellular carcinomas involving the medial canthal regions of both eyes were resected using a 10 W cw-Nd: YAG laser scalpel.

The wound bed was repaired one side by a free, split-thickness graft and on the other by a frontal pedicle flap. Surgery was, for the most part, virtually bloodless. Since laser radiation immediately seals both capillaries and lymphatics, the incidence of postoperative hemorrhage and edema was significantly less than after cold scalpel surgery. Healing was uneventful. The advantages of laser-assisted surgery are worthy of consideration: not only is the operation time markedly curtailed, but the wound healing response is excellent, with only a minimal inflammatory reaction.
A Cross-Over Trial Comparing Once Daily Levobunolol with Once and twice Daily Timolol
Authors: Akafo S.K. , Thompson J.R. , Rosenthal A.R.
Published: April 2018

The intraocular pressure (IOP) lowering efficacy of once-daily levobunolol 0.5% was compared with timolol 0.5% twice-daily and timolol 0.5% once-daily in 20 chronic open angle glaucoma and 5 ocular hypertensive patients. The design used was a randomised double blind cross-over trial with three periods each of 8 weeks separated by 2 weeks of no treatment.

We found that following levobunolol a two week washout was not sufficient for the IOP to return to its original baseline level suggesting that levobunolol is a longer acting drug than timolol. Adjusting for this carryover effect, we found no significant difference in the IOP lowering effect among the three regimes (p=0.53). Reduced cost, less ocular discomfort and better compliance are the main potential advantages of the once daily treatments.
General Anesthesia with Endotracheal Intubation for Cryotherapy for Retinopathy of Prematurity
Authors: Sullivan T.J. , Clarke M.P. , Tuli R. , Devenyi R. , Harvey P.
Published: April 2018

We present a technique for treating retinopathy of prematurity (ROP) with cryotherapy under general anesthesia, administered and monitored by a neonatologist, with endotracheal intubation in the neonatal intensive care unit that avoids the serious systemic complications associated with the administration of local anesthetics. Although no significant complications arose in this series, having the intubated infant monitored by trained neonatology staff allows appropriate management should complications arise. We have used this technique to treat 20 eyes with threshold ROP. The mean time to extubation was 40.2 hours. The systemic status and discharge from the neonatal intensive care unit were not influenced by the general anesthesia. This technique allows quick and accurate application of the cryotherapy in a stable and controlled setting. We recommend that physicians consider cryotherapy under general anesthesia with endotracheal intubation for infants with ROP. This technique allows ROP to be treated adequately with minimal risk to the infant.
Copper Intraocular Foreign Body: Diagnosis and Treatment
Authors: Billi B. , Lesnoni G. , Scassa C. , Giuliano M.A. , Coppè A.M. , Rossi T.
Published: April 2018

Copper intraocular foreign bodies (IOFB) are relatively common after penetrating eye injuries. Ocular signs and symptoms vary greatly in relation to the copper content, ranging from chronic uveitis and severe visual loss for IOFB containing more than 85% copper, to local copper deposits with no severe ocular damage for less toxic alloys.

Reported here is the case of a ten-year-old boy who suffered from recurrent chronic uveitis five months after a perforating eye injury due to copper wire. Diagnostic ultrasound and computerized tomography revealed an IOFB within the lens and X-ray spectrometry (DXS) indicated the nature of the IOFB as copper, and accurately measured the dissolution of the metal.

The patient underwent cataract extraction and standard three-port pars plana vitrectomy with gas-fluid exchange. Twelve months after surgery the retina was flat and visual acuity had risen to 20/60. Undiluted vitreous samples obtained in the course of the intervention, studied by immunohistochemical techniques, showed an inflammatory reaction with a prevalence of PMN-N and CD3 T-lymphocytes.

DXS thus appears to be a new and reliable diagnostic tool for the early detection and management of copper and other toxic metal IOFB.
Hemorrhagic Retinopathy in Newborns: Frequency, form of Presentation, associated Factors and Significance
Authors: Viejo I. Gonzalez , Novella C. Ferrer , Subias M. Pueyo , Oms J.M. Ronchera , Lozano J. Bueno , Novella E. Ferrer , Aznar E. Vicente , Lopez F.M. Honrubia
Published: April 2018

During the first 72 hours of their lives, 420 neonates were checked for retinal hemorrhages and macular affection. The neonate's gestational age, birth weight, and Apgar scores and maternal data (nulliparty, fetal presentation, duration of labor and delivery, induction of labor and obstetric technique) were all recorded. In 81 cases (19.2%), retinal hemorrhages were found. No significant relation was established with any of the associated factors, except for a significantly lower frequency of hemorrhages in cases of cesarean delivery (p<0.01) and a significantly longer expulsive phase in the group with hemorrhages (p<0.05). In follow-up examination 3 to 4 months later, neither the infants with hemorrhages nor the control group presented alterations.
Rhegmatogenous Retinal Detachment with Posteriorly Located Break Treated with Temporary Buckle. A Case Report
Authors: Ferrara V. , Marcoli F. , Misan D. , Ghisolfi A.
Published: April 2018

A rhegmatogenous retinal detachment with a break 19 mm from the limbus in the nasal quadrant was treated with a temporary balloon buckle. This technique was applied to avoid the surgical trauma of vitreous surgery. The operation was successful and the procedure appears to be valid for buckling posterior breaks.
Patterns of Corneal Topography after Penetrating Keratoplasty
Authors: Ibrahim O. , Bogan S. , Waring G.O.
Published: April 2018

Background

The topography of corneas after penetrating keratoplasty is highly variable. We classify the topography into five groups.

Methods

We performed videokeratography on 45 clear compact penetrating keratoplasties, with all sutures removed. Three ophthalmologists classified the keratographs independently into five previously defined topographic groups, based on the pattern of the normalized color-coded videokeratograph.

Results

The five topographic patterns included: prolate bow tie, 14 (30%); oblate bow tie, 14 (30%); mixed prolate and oblate bow tie, 8 (17%); asymmetric, 3 (9%); and steep/flat, 6 (14%). The three ophthalmologists agreed in their initial classification in 87% of the cases and after discussion, in 96%.

Conclusion

The topography of the cornea after penetrating keratoplasty can be classified into five qualitative groups by trained observers, with good clinical reliability.
Treatment of Inferior Oblique Muscle Overaction with Myectomy Or with Anterior Transposition
Authors: Chimonidou E. , Chatzistefanou K. , Theodossiadis G.
Published: April 2018

This paper presents a comparative study of the effectiveness of myectomy and anterior transposition in the treatment of inferior oblique muscle overaction. We operated 160 patients with overaction of the inferior oblique muscle. Eighty patients (148 eyes) were operated by myectomy at the insertion and 80 patients (151 eyes) by anterior transposition of the insertion of the inferior oblique near the temporal side of the insertion of the inferior rectus muscle. Comparison of the two methods, using the chi-squared test, showed that:

1) both surgical procedures were equally effective (χ2=0.26) for correcting overaction of the inferior oblique muscle and V-phenomenon;

2) weakening of the inferior oblique muscle of both eyes was almost always required (in 115 out of 116 cases) in cases with V-phenomenon and often (24 out of 44 cases) in cases of congenital paresis of the superior oblique muscle. We conclude that both procedures are equally effective and equally easy to perform.
Fixed Combination of Carteolol and Pilocarpine Eye-Drops: A Double-Blind Randomized Cross-Over Trial versus Carteolol Alone on Intra-Ocular Pressure
Authors: Hostyn P. , Le Rebeller M.J. , Trinquand C. ,   The Study Group
Published: April 2018

The effects of carteolol 2% and a fixed combination of carteolol 2% and pilocarpine 2% (CBS 341 A) eye-drops on intraocular pressure (I.O.P.) were compared in a multicenter double-blind, cross-over prospective trial. Twenty-eight patients were initially selected after at least three weeks of carteolol 2%, with a morning I.O.P. greater than 21-mmHg. They received 2 drops a day (b.i.d.), in a random order, alternating two weeks of carteolol 2% alone or two weeks of CBS 341 A. After each two-week period a 12-h I.O.P. curve was plotted. Compared to carteolol the combination reduced I.O.P. on average by around 20% (4 mmHg), with maximum effect 4h after instillation. The effectiveness was confirmed after twelve hours. Some side effects were reported with CBS 341 A, due to the well known pharmacological effects of pilocarpine. The new combination could be useful for second-line therapy in glaucoma.
Indocyanine Green Angiography (Icga) in Pathological Myopia
Authors: Brancato R. , Trabucchi G. , Introini U. , Avanza P. , Pece A.
Published: April 2018

One hundred and fifty patients (300 eyes), mean age 49±15 years, with degenerative myopia underwent fluorescein and indocyanine green angiography (ICGA). Fluorescence of choroidal neovascularization (CNV) on ICGA was less evident than with fluorescein angiography (FA). FA revealed CNV in 98 eyes; ICGA showed CNV with different angiographic patterns in 82 eyes. ICGA permitted CNV diagnosis when retinal hemorrhages were present. ICGA allowed a more precise evaluation of lacquer cracks which appeared more numerous than the ones identified by FA. ICGA visualized the retrobulbar vasculature.

This study shows that ICGA has a useful role for diagnosing and managing pathological myopia.
The Dacron Felt Colonizable Keratoprosthesis: After 15 Years
Authors: Pintucci S. , Pintucci F. , Caiazza S. , Cecconi M.
Published: April 2018

Keratoprostheses (KP) are made of an optical cylinder integrated with a supporting element which governs their biocompatibility. The Pintucci KP with a Dacron tissue three-dimensionally colonizable support was designed in 1979 and has since been improved in order to reduce the complications associated with the use of KP. The biological background (in vivo and in vitro), electron microscopy observations and the surgical technique will be discussed.

Sixty-three patients were operated from 1979 with different surgical techniques and Dacron tissues. Twenty transoral mucous KP were implanted with our most recent technique in severely vascularized corneas from 1985 to 1991, with a follow-up ranging from 48 to 85 months. The favorable results may be indicative of their better reliability.
Effects and Side Effects of Mydriatic Eyedrops in Neonates
Authors: Öğüt M.S. , Bozkurt N. , Özek E. , Bírgen H. , Kazokoğlú H. , Öğüt M.
Published: April 2018

The pupils of neonates and premature infants often need to be dilated for retinal examination. The drops used for this purpose have some known side effects. This study investigated the effects and side effects of these drops.

In this prospective randomized study, 80 healthy neonates were randomly assigned to eight groups. In Group A 1% cyclopentolate was used; in Group B 1% tropicamide; in Group C 2.5% phenylephrine; in Group D 1% cyclopentolate and 1% tropicamide; in Group E 2.5% phenylephrine and 1% tropicamide; in Group F 0.5% cyclopentolate, 0.5% tropicamide and 2.5% phenylephrine; in Group G 1% cyclopentolate and 2.5% phenylephrine and in Group H 0.9% NaCl. Heart rate, systolic and diastolic blood pressures were recorded before, and 5, 10, 15, 30, 45, 60 minutes after instillation of the drops. Pupillary size was measured at baseline, 30 and 60 minutes. To stimulate the conditions of indirect ophthalmoscopic examination, the pupil sizes were measured under the intense beam of a halogen light. The results were analyzed statistically.

Maximum side effects were seen in group C; the safest was group B and maximum mydriasis was achieved in group F.
Endothelial Morphological and Functional Evaluation after Cataract Surgery
Authors: Díaz-Valle D. , Del Castillo Sanchez J.M. Benítez , Toledano N. , Castillo A. , Pérez-Torregrosa V. , García-Sanchez J.
Published: April 2018

Purpose

To assess endothelial barrier function, morphological appearance and corneal thickness three months after cataract surgery in order to evaluate intraoperative endothelial damage.

Methods

Endothelial permeability was examined by fluorophotometry, and contact specular microscopy and corneal pachymetry measurements were made in 40 patients (40 eyes) with senile, non-complicated cataracts one month before and three months after cataract surgery. Twenty eyes underwent uneventful phacoemulsification (Group 1) and 20 uneventful extracapsular cataract extraction (ECCE) with continous curvilinear capsulotomy (Group 2). Results were analyzed using the two-tailed Student's t test, analysis of variance, and multifactorial and regression analysis.

Results

There was a significant postoperative increase in endothelial permeability in both groups (p<0.001), but no real differences between the postoperative values (p=0.07). Mean cell loss was 15.2% in ECCE and 18.3% in phacoemulsification (p=0.4). There was a significant linear correlation between ultrasound time, cell loss and functional damage. Postoperative pachymetric measurements were not significant.

Conclusions

Endothelial response showed no differences between the surgical techniques. Endothelial barrier function remained disturbed in spite of the apparent morphological stabilization. Corneal pachymetry is not useful for assessing postoperative endothelial changes.
The Alteration of Extraocular Muscle Arc after Hang-Back Recession in Animal Experiments
Authors: Lee J. , Kim S.
Published: April 2018

We did an animal experimental study to investigate the extraocular muscle arc after hang-back recession on horizontal rectus muscles of five dogs. Two tiny sutures using 8-0 nylon were made on the sclera 8-10 mm posterior to the muscle insertion along the upper and lower margins of the right lateral rectus and left medial rectus to compare the altered muscle arc with the original muscle arc. Hang-back recession was performed on the horizontal rectus muscles and three months later we investigated the change in the muscle arc. Four of the 10 muscles operated showed no change, four were displaced upward (mean ± SD; 1.00 ± 0.16 mm) and two were displaced downward (1.00 ± 0.00 mm). The average displacement was 0.60 ± 0.52 mm. The alteration of muscle arc after hang-back recession thus seems insignificant.
Reduction of Retinal Exudates in Diabetic Retinopathy after Heparin-Induced Extracorporal Ldl-Precipitation (Help). A Case Report
Authors: Janknecht P. , Schumann M. , Hansen L.L.
Published: April 2018

Introduction

Exudative diabetic retinopathy is difficult to treat. We describe a patient in whom we believe extracorporeal LDL-precipitation (HELP) improved visual acuity.

Methods

HELP is a variant of extracorporeal dialysis which reduces low-density lipoprotein and fibrinogen levels.

Case report.

A heavily overweight patient with massive exudative diabetic retinopathy was administered HELP. Four months after starting HELP, and after vitrectomy and panretinal photocoagulation, the massive exudation was drastically lower. Visual acuity improved from 0.03 (0.02) OD (OS) to 0.25 (0.13) OD (OS).

Discussion

The role of vitrectomy and panretinal photocoagulation is discussed. HELP seems to be the most probable explanation for our patient's gain in visual acuity.
Combined Surgery and Cryotherapy for Melanoma of the Conjunctiva: 37 Months’ Follow-Up
Authors: Cagini C. , Menduno P. , Ignagni S.
Published: April 2018

A patient with large conjunctival melanoma in the superior fornix is described. The disease was treated by excision of the mass combined with cryotherapy delivered to the surrounding flat intraepithelial areas of involvement. The patient was free from local recurrence and metastatic spread for 37 months after surgery
Intraocular Lens Implantation in Myopic Eyes
Authors: Malukiewicz-Wiśniewska G. , Kalużny J. , Lesiewska-Junk H.
Published: April 2018

Purpose.

To assess the results of posterior chamber lens implantation in myopic eyes with cataract.

Methods.

Retrospective study of postoperative results ranging from 4 to 89 months (mean 35 months) in 54 myopic patients (62 eyes with axial length of 26 mm or more) who had undergone PC IOL implantation in the Department of Ophthalmology, Medical Academy of Bydgoszcz, Poland.

Outcome measure.

Best corrected distance and near visual acuity, operative complications, early and late postoperative complications.

Results.

in 95% of patients with eye length 26–28 mm visual acuity of 0.5 or more was achieved. The mean postoperative spherical equivalent was -0.8 D. Posterior capsule opacification which required Nd:YAG capsulotomy developed in 19% of eyes, on average after one year of follow-up. No complications such as retinal detachment, glaucoma or corneal dystrophy were observed.

Conclusions.

PC IOL implantation in myopic eyes with cataract appears to be an efficacious, satisfactory and safe procedure.