bluuebunny/crossref_metadata_2025 huggingface dataset:
Longitudinal Evaluation of Optical Aberrations Following Laser in situ Keratomileusis Surgery
Authors: Hong Xin , Thibos Larry N
Published: April 2021

ABSTRACT

Objective measurements of the optical aberrations of an eye were taken with a Shack-Hartmann aberrometer immediately before, immediately after, and at regular intervals over a two month recovery period following LASIK refractive surgery. Results indicate that the surgery induced large amounts of positive spherical aberration which regressed slightly during recovery. Computed point-spread functions for various pupil diameters indicate that retinal image quality was the same before and after surgery for small and medium sized pupils (<4 mm diameter) but was significantly degraded for large pupils (>4 mm). [J Refract Surg 2000;16:S647-S650]
Reference Axis Selection: Subcommittee Report of the OSA Working Group to Establish Standards for Measurement and Reporting of Optical Aberrations of the Eye
Authors: Applegate Raymond A , Thibos Larry N , Bradley Arthur , Marcos Susana , Roorda Austin , Salmon Thomas O , Atchison David A
Published: April 2021

ABSTRACT

It is the committee's recommendation that the ophthalmic community use the line of sight as the reference axis for the purposes of calculating and measuring the ocular optical aberrations. [J Refract Surg 2000;16:S656-S658]
Immunohistochemical Study of Subepithelial Haze After Phototherapeutic Keratectomy
Authors: Lee Yuan-Chieh , Wang I-Jong , Hu Fung-Rong , Kao Winston W-Y
Published: April 2021

ABSTRACT

PURPOSE: Subepithelial haze is a frequent complication and is often the cause of regression after photorefractive keratectomy (PRK). The lack of understanding of this undesirable complication following PRK is in part due to the limited availability of suitable tissues for pathological studies.

METHODS: We examined the expression of various extracellular components in the cornea of a 46-year-old man who underwent phototherapeutic keratectomy (PTK) to remove a central corneal scar secondary to trauma. The patient subsequently underwent penetrating keratoplasty. A scar-free region containing an area of slight subepithelial haze adjacent to normal cornea was used for immunohistochemical staining with antibodies directed against cytoskeletal proteins, ie, vimentin, desmin and smooth muscle actin, and the extracellular components, laminin, heparan sulfate, keratan sulfate, and collagen types III, IV, V, and VII.

RESULTS: Immunohistochemistry revealed that basal epithelial cells expressed components of basement membrane. The stromal fibroblasts within the haze tissue were labeled by anti-smooth muscle actin antibodies, a characteristic of myofibroblasts, which synthesized and secreted extracellular matrix components that contributed to the formation of the disorganized collagenous matrix and may account for subepithelial haze.

CONCLUSIONS: The expression patterns for the cytoskeletal proteins and extracellular components indicated that the formation of subepithelial haze is a process of tissue remodeling, involving both corneal basal epithelial cells and keratocytes during wound repair. [J Refract Surg 2001;17:334-341]
Surgery in an Attempt to Change Corneal Curvature
Authors: Szuniewicz Waclaw , Fasanella R M
Published: April 2021

SUMMARY

An historical review up to 1952 of surgical methods intended to change the refractive power of the eye is given.

Experimental work at Yale utilizing 49 rabbits and dogs includes repeated prior studies done by others. This work incorporated:

1. Procedures on the anterior surface of the cornea,

2. Procedures on the posterior surface of the cornea, and

3. Procedures through all corneal layers (total segmented corneal resection) (SCR).

In obtaining desired refractive changes, SCR created relatively higher refractive changes, assured stability and a more accurate calibration and calculation in advance of surgical procedures. However, even though total segmented corneal resection seemed superior, it was often complicated in animals.
Epigard in the Management of Eyelid Neoplasms
Authors: La Piana Francis G
Published: April 2021

SUMMARY

Definitive repair of a surgical wound of the anterior lamella of an eyelid should be delayed in some cases until the surgeon is sure of the histopathologic diagnosis of the lesion and the adequacy of his resection. Epigard is a polyurethane-polypropylene barrier dressing that can be sutured to wound edges, protecting underlying tissues until definitive repair is undertaken. It is well tolerated, cosmetically acceptable, easily removed and does not impair definitive repair of the wound.
The Contact Lens Corneal Cutter: Accuracy and Reproducibility
Authors: Olson Randall J
Published: April 2021

SUMMARY

The contact lens corneal cutter was used on ten freshly enucleated pig eyes in an attempt to determine its accuracy and reproducibility. We felt that a circular opening could be obtained; however, there was variability in the size of the tissue cut and a disparity between the internal and external openings, which was caused by the sharp angle of the cutting blade.
Surgical Management of Congenital Eyelid Coloboma
Authors: Patipa Michael , Wilkins Robert B , Guelzow Kurt W L
Published: April 2021

SUMMARY

Congenital eyelid colobomas are a partial or total absence of eyelid structures. The degree of severity determines the surgical techniques employed for repairing the eyelid. We feel that early surgical treatment reduces the risk of ocular scarring with satisfactory results.

We present four cases of congenital upper eyelid colobomas of differing severity and discuss surgical approaches to these lid abnormalities.
Evaluation of Sources of Variation on the Accuracy and Reproducibility of Microkeratome Sections with the Modified Artificial Anterior Chamber
Authors: Maguen Ezra , Azen Stanley P , Pinhas Simon , Villaseñor Richard A , Nesburn Anthony B
Published: April 2021

SUMMARY

A study was carried out to evaluate effects of various sources of variation on the accuracy and reproducibility of the modified artificial anterior chamber in obtaining lamellar sections from rabbit cornea. Sources of variation included a) measurement error, inter-cornea and inter-session variation, b) length of storage time in M-K medium, and c) choice of preselected values of thickness and diameter. The findings indicated that a) measurement error, inter-cornea, and inter-session variations were of nominal magnitude; b) the length of storage time up to 10 days did not affect the precision of the procedure; c) the precision of diameter determinations did not depend on the preselected value of the diameter; d) the precision of thickness determinations did depend on preselected parameter values; and e) parameter values tended to be underestimated, Regression equations therefore are provided to adjust for the underestimation of thickness and diameter. Based on these findings, it was concluded that the modified artificial anterior chamber is adequate for use in experimental refractive keratoplasty since it provides adequate diameter values and is reproducible.
A Three-Dial Biometer
Authors: Drews Robert C
Published: April 2021

SUMMARY

A three-dial Biometer permits rapid and easy calculation of all intraocular lens power parameters. The results are less accurate for extreme values of axial length or K, but are clinically quite useful. While lacking the glamour of a calculator, the three-dial Biometer is very practical.
A Method for Preventing Suture Entrapment on the Iliff-Park Eyelid Speculum
Authors: Roper Daniel L
Published: April 2021

SUMMARY

Snagging of suture on the adjustment posts of the Iliff-Park and Maumenee-Park specula can be prevented by attaching a 1/2-inch SteriStrip between the posts and the drape.
Malignant Glaucoma Following Cataract Extraction and Intraocular Lens Implant
Authors: Hanish Sidney J , Lamberg Robert L , Gordon James M
Published: April 2021

SUMMARY

A 72-year-old woman developed malignant glaucoma following a routine intracapsular cataract extraction with intraocular lens insertion. The eye was not previously glaucomatous, nor was the anterior chamber angle previously shallow.
Pocket Computers, IOL Equations, and Errors
Authors: Schuetz Perry N
Published: April 2021

SUMMARY

A new variety of hand-held computers, using basic computer language, is available in the marketplace. Two programs are submitted containing several commonly used IOL equations for one such computer. Errors contained both in equation formulation and data collection are tolerable.
Pigment in Cellular Membranes on Intraocular Lens Implants
Authors: Wolter J Reimer
Published: April 2021

SUMMARY

Cells with protoplasmic pigment granules on the surface of intraocular lens implants can be divided by their basic nature into histiocytes, epithelioid cells, giant cells, small fibroblast-like cells, iris melanocytes, pigment epithelium, and probably corneal endothelium. All these cells are part of a cellular membranes that have been observed on lens implants at times between eight months and three and a half years after lens implantation.
Long-Term Study of Iris Sutures in Rabbits
Authors: Allen Molly V , Jones Ed , Snow Ronald , Peiffer Robert L
Published: April 2021

SUMMARY

A review of the literature of iris suture studies in rabbits, monkeys, and man reveals that all studies have been limited to six months or less. This project addresses the longevity of 10-0 prolene as an iris suture in vivo in the rabbit over a two-year period. Light and scanning electron microscopy examination demonstrated 10-0 prolene as relatively non-degradable and inert.
An Unusual Intranasal Anomaly of the Lacrimal Drainage System
Authors: Raflo Gary T , Horton Joseph A , Sprinkle Philip M
Published: April 2021

SUMMARY

A newborn infant presented with a mass in the medial canthal area. Radiologic evaluation demonstrated this to be an abnormality in the nasolacrimal system. Examination of the nose showed a large cystic structure totally occluding the right naris. Surgical excision of the entire cyst was required to alleviate the patient's recurrent mucoceles of the lacrimal sac and epiphora. The need for nasal examination and more thorough evaluation in cases of recurrent obstruction is emphasized in evaluating patients with congenital obstruction of the nasolacrimal drainage system.
Central Cornea Involvement in Terrien's Degeneration
Authors: Nirankari Verinder S , Kelman Shalom E , Richards Richard D
Published: April 2021

SUMMARY

A 15-year-old female showed classical signs of Terrien's corneal degeneration including peripheral corneal thinning, vascularization, lipid deposition, and ectasia. She also showed episodes of conjunctival inflammation and perforation following minor trauma, all in the presence of an intact epithelium. She also showed progressive central corneal thinning and opacification, features not reported in the literature in the last 30 years.
Complications of the Simcoe Flexible Loop Phacoprosthesis in the Anterior Chamber
Authors: Girard Louis J , Madero Roberto , Monasterio Remberto
Published: April 2021

SUMMARY

A preliminary study of the use of a Simcoe 101-J implant in the anterior chamber after pars plana lensectomy by ultrasonic fragmentation showed initially good results. Further observations of these and additional eyes showed 20/20-20/40 vision in 86.9%, retinal detachment in 3.5%, retinal hole in 1.5%, clinical cystoid maculopathy in 13%, and socalled UGH syndrome in 5%.

Pars plana lensectomy alone in the last 136 eyes resulted in vision of 20/20-20/40 in 98.5%; a retinal detachment rate of 0.73%, retinal hole rate of 0.73%, no UGH syndrome, and no clinical cystoid maculopathy. Pars plana lensectomy alone appears to be a far safer procedure than pars plana lensectomy plus a Simcoe implant in the anterior chamber.

Implantation of the Simcoe 101-J manufactured by IOLAB Corp. in the anterior chamber is not recommended.
Correction of Postkeratoplasty Astigmatism by Razor Blade and V-Shaped Knife Wedge Resection
Authors: van Rij G , Vijfvinkel G
Published: April 2021

SUMMARY

Improvement in microsurgical techniques and tissue storage has resulted in a higher rate of clear grafts after penetrating keratoplasty. The postoperative astigmatism however still remains a major problem. If a high corneal astigmatism cannot be managed successfully with glasses or contact lenses, a surgical approach may be indicated. We developed a V-shaped knife which makes a crescentic wedge resection easier to perform. Before the introduction of the V-shaped knife we obtained an average reduction in corneal astigmatism of 6.6 diopters. With the V-shaped knife the reduction was 8.0 diopters.

We think that the V-shaped knife makes a wedge resection easier and safer.
Preparation of the Eye for Microsurgery
Authors: Ellsworth Roy J
Published: April 2021

SUMMARY

The proper preparation of the eye for a microsurgical procedure is important. This paper illustrates the step-by-step method worked out by the author to provide maximum exposure with no pressure from the eyelids and without the use of the speculum.
Late Ocular Hypotony Following Intracapsular Cataract Extraction: Probable Relation to Premature Resorption of Polyglactin 910 Sutures
Authors: Sanitato James J , Sacks Joel G
Published: April 2021

SUMMARY

We have recently had a series of seven patients who developed late ocular hypotony, flat anterior chambers, and choroidal detachments following cataract surgery. In each case, there was evidence of premature dissolution of the polyglactin 910 sutures that were used for closure. From this experience we propose steps that can be taken to minimize such problems.
Experimental Evaluation of a Posterior Drainage System
Authors: Haas Joseph S , Peyman Gholam A , Lim Jin
Published: April 2021

SUMMARY

We have evaluated an experimental artificial shunt to drain intraocular fluid into the retrobulbar space. The device consists of a hollow needle for insertion into the eye, a slit valve to regulate the drainage pressure, and a dome-shaped outflow system. The device was inserted through the sclera, choroid, and retina into the eyes of cynomolgus monkeys. The system was tolerated without producing retinal detachment. A localized foreign body reaction occurred in the retina, choroid, and sclera adjacent to the device. The intraocular pressure was lowered until fibrous encapsulation of the outflow system occurred.
Simulated Blowout Fracture of the Orbit
Authors: Brinkley James R , Acomb Thomas
Published: April 2021

SUMMARY

A case of probable traumatic simulated Brown's syndrome, in which there was a false positive orbital tomogram, is presented. To our knowledge, this combination of findings has not been previously reported. The deceptive clinical signs combined with the false positive radiologic data led to the erroneous diagnosis of blowout fracture of the orbital floor and to a subsequent negative surgical exploration. Surgeons should be aware that these two infrequent findings may occur together. When there is any doubt about the diagnosis of blowout fracture of the orbital floor with muscle entrapment, conservative management may be indicated.
A New Technique of Threading Fascia Lata Strip
Authors: Liu Don , Safran Thomas M , Stasior Orkan George
Published: April 2021

SUMMARY

By using disposable needles, we have developed a new technique of threading the fascia lata strip through the stripper or through the eye of a needle. The technique is simple, effective, and needs no special instruments.
Vacuum Trephination of the Hypotonous Eye
Authors: Phillips Robert L
Published: April 2021

SUMMARY

Removal of the recipient cornea in therapeutic keratoplasties is made more difficult by the hypotonous eye. A deep and symmetrical cut can be obtained by use of the vacuum trephine without unduly endangering the iris or lens. This technique may be preferred to other more time-consuming methods of pre-pressurizing the eye, and allows a better removal of the recipient cornea than with scissors removal following an epithelial mark.
A Retained Retrobulbar Catheter for Repetitive Injection of Anesthetics During Ophthalmic Surgery
Authors: Tamai Makoto
Published: April 2021

SUMMARY

For extending the period of retrobulbar anesthesia, an Angiocath was retrobulbarly retained for repetitive delivery of local anesthetics. The retrobulbar placement of the cannula made possible easy and safe addition of local anesthetics by any time, amount and frequency.
A New Hook for Improved Muscle Handling
Authors: May Donald R
Published: April 2021

SUMMARY

I have designed a new muscle hook which offers increased ease and stability of muscle handling during surgical procedures.
A Useful Alternative to Silicone Intubation in Congenital Nasolacrimal Duct Obstructions
Authors: Havins Weldon E , Wilkins Robert B
Published: April 2021

SUMMARY

Initial treatment of congenital nasolacrimal duct obstructions, by a variety of methods, is highly successful. However, a small percentage of obstructions either are not cleared or recur. Silicone intubation has been reported highly successful in treatment of these obstructions. This paper describes our experience with infracturing the inferior turbinate (described originally by Jones and Wobig) as being at least as highly successful, safe, and easy to perform.
Penetrating Ocular Injury Caused by Nylon Cord Fragment From Electric Lawn Trimmer
Authors: Barr Charles C , Mitchell Dean
Published: April 2021

SUMMARY

A 58-year-old man sustained a penetrating injury in the left eye from a nylon cord fragment from an electric rotary weed trimmer. Repair of the corneal laceration, foreign body extraction, and anterior vitrectomy were performed. One year post injury the visual acuity was stable at 6/60. The need for protective eyewear when using power tools is emphasized.
"Silicone-Octopus Repair" of Lacrimal Obstructions in Children
Authors: Nagashima Koji
Published: April 2021

SUMMARY

Nineteen pediatric cases of lacrimal obstruction due to acquired disorders were repaired by a modification of the conventional silicone intubation procedure. This new operation employs an increased number of silicone strands within the lower excretory system. Sixteen patients had very good results and two were improved; there was one failure. This procedure is indicated in children with combined common canalicular and nasolacrimal duct obstruction.
Vitreoretinal Changes Associated With Rise in Intraocular Pressure After Nd:YAG Capsulotomy
Authors: Schubert Hermann D
Published: April 2021

ABSTRACT

In a chart review of 100 consecutive Nd:YAG laser capsulotomies, six presumed risk factors of the rise in intraocular pressure (IOP) after capsulotomy were identified. A group of 15 patients in which the pressure rose to at least 10 mmHg above baseline postoperatively showed a significant (P ≤ 0.01) association with myopia, vitreoretinal disease, and vitreous prolapse into the anterior chamber. The previously known association of high pressures with glaucoma, a large capsular opening, or absence of a posterior chamber lens were also confirmed. There was no correlation between the energy used and IOP.

These retrospective findings are suggestively consistent with the concept that injury to a liquefied vitreous may contribute to the IOP rise after capsulotomy.
Overcoming Difficulties in Trephining Donor Corneas for Penetrating Keratoplasty
Authors: Alfonso Eduardo
Published: April 2021

ABSTRACT

The complication of the donor button becoming trapped inside the barrel of the trephine blade can become a frustrating situation for the surgeon who is trying to recover it. The use of a sterile medicine dropper to apply slight suction to the epithelial side of the button allows for easy and secure removal of the trapped button without the risk of distortion or direct trauma to the endothelium as could occur with other methods.
Autogenous Dermis-Fat "Baseball" Orbital Implant
Authors: Bullock John D
Published: April 2021

ABSTRACT

A new procedure has been devised for the construction of an autogenous dermis-fat orbital implant, in which two figure-eight-shaped dermis-fat grafts are sutured together into a baseball shape. Correct implant size can be determined by preplacement of different-sized Mule spheres and testing for accurate fit. The "baseball" implant eliminates deep orbital fat which is distant from a vascular supply, and because it is covered with dermis, it maximizes graft vascularization, thus promoting survival of the implanted tissues. In eight patients, followed postoperatively for as long as 28 months, baseball implants have produced highly satisfactory results.
New Techniques in Suture-Aided Tear Duct Intubation
Authors: Hedges Charles C
Published: April 2021

ABSTRACT

Modifications in the technique of nasolacrimal duct intubation by suture pull-through are presented, improving suture accessability within the nose. A method of joining the tubing ends without the disadvantages of a knot is described.
Orbital Cellulitis Following Strabismus Surgery
Authors: Wilson M Edward , Paul T Otis
Published: April 2021

ABSTRACT

Orbital cellulitis is a rare complication of extraocular muscle surgery. Two cases have been reported since 1935. No report of this sight-threatening and life-threatening complication of strabismus surgery has appeared since computerized tomography became readily available. The following is a report of a case of orbital cellulitis occurring unilaterally following bilateral strabismus surgery in which computerized tomography was helpful in verfication and management. Early antibiotics resulted in a favorable outcome. The case is compared to those reported by von Noorden.
Orbital Histiocytic Lymphoma Arising From the Ethmoid Sinus
Authors: Cheij George , Cooper John L , Wesley Ralph E
Published: April 2021

ABSTRACT

Histiocytic lymphoma has been reported previously as an orbital manifestation of systemic malignancy. We report herein a 49-year-old white male with orbital involvement from a sclerosing lesion in the ethmoid sinus that initially caused a biopsy-proven orbital inflammatory mass. This report of an orbito-sinus histiocytic lymphoma underscores the need to re-biopsy symptomatic orbital inflammatory lesions that continue to enlarge.
Mycobacterium Fortuitum as a Cause for Nasolacrimal Obstruction and Granulomatous Eyelid Disease
Authors: Katowitz James A , Kropp Thomas M
Published: April 2021

ABSTRACT

A case of dacryocystitis due to Mycobacterium fortuitum is reported with secondary chronic granulomatous abscess of the eyelid. Mycobacterium fortuitum is an atypical Mycobacterium rarely encountered in ophthalmic practice. The clinical course of the abscess caused by Mycobacterium is reviewed and the successful management of this problem by cryotherapy discussed.
Argon Laser Treatment of Periocular Lesions: An Experimental Study
Authors: Summers C Gail , Hordinsky Maria D
Published: April 2021

ABSTRACT

Argon laser photocoagulation is a promising alternative in the treatment of vascular lesions of the lid and periocular tissues. Experimental argon laser treatment of feline ocular and oral mucosa was undertaken to identify a protective shield that was satisfactory in preventing ocular damage and to identify a power that would be effective but avoid significant side effects.
Modified "Double-Z-Plasty" in the Closure of Medial Canthal Defects
Authors: Harvey John
Published: April 2021

ABSTRACT

The correction of medial canthal defects following tumor resection is a very common problem in oculoplastic surgery, and consequently, many surgical techniques have been devised to accomplish this. Limberg's "rhomboid flap" is a technique which has been modified especially to suit the particular anatomy of the medial canthus. This technique embodies mobilization of thin eyelid skin as opposed to thicker nose, brow, or facial skin. A representative case is presented.
Complications of Subconjunctival 5-Fluorouracil Following Glaucoma Filtering Surgery
Authors: Lee David A , Hersh Peter , Kersten Diane , Melamed Shlomo
Published: April 2021

ABSTRACT

The antimetabolite 5-fluorouracil (5-FU) has been used to inhibit fibroblastic growth to increase the success rate in glaucoma nitration surgery. Subconjunctival 5-FU can have adverse side effects. This paper describes two cases in detail of the ocular side effects of 5-FU. The first case is representative of the ocular surface problems. The second case deals with bleb leaks. Relative contraindications to 5-FU treatment are pre-existing ocular surface problems, early postoperative bleb leaks and fornlx-based conjunctiva! flaps in filtering procedures. New drug delivery methods are presently being investigated to help decrease the adverse side effects and increase the efficacy of 5-FU.
Antibiotic Resistance of Crystalline Bacterial Ingrowth in a Corneal Graft
Authors: Kincaid Marilyn C , Snip Robert C
Published: April 2021

ABSTRACT

Four recent reports have described the clinical appearance of fine needle-like opacities in the corneal stroma of six patients. In five of these patients these developed in a corneal graft. Histologically, all the corneal buttons had bacterial ingrowth between the stromal lamellae, with a striking lack of inflammatory response. We report a patient in whom this process occurred following penetrating keratoplasty. Intensive topical antibiotic treatment failed, and she underwent a second, successful, penetrating keratoplasty. Postoperatively, this patient has maintained good vision with no recurrence for over three years. Histologic and ultrastructural study of the corneal button revealed viable and nonviable gram-positive cocci with a marked paucity of inflammatory infiltrate.
Whitnall's Ligament Eyelid Suspension for Severe Blepharoptosis
Authors: Leibsohn Joel M
Published: April 2021

ABSTRACT

A new procedure is presented for repair of severe blepharoptosis using Whitnall's ligament as the site upon which to suspend the eyelid.
Giant Cysts of the Conjunctiva Following Scleral Buckling
Authors: Newton James C , Pruett Ronald C , Merhige Kenneth E , Maris Peter J
Published: April 2021

ABSTRACT

Four patients developed giant conjunctiva! cysts following scierai buckling for retinal detachment. Histologically these cysts showed a core of fibrous tissue lined by stratified, non-keratinizing epithelium and with goblet cells. They probably arose from inadvertent implantation of epithelium during surgery. In three cases the cysts were surgically excised without recurrence. Alternate modes of therapy are discussed.
Review of Choroidal Osteoma: Successful Krypton Red Laser Photocoagulation of an Associated Subretinal Neovascular Membrane Involving the Fovea
Authors: Morrison Debra L , Magargal Larry E , Ehrlich Dion R , Goldberg Richard E , Robb-Doyle Eileen
Published: April 2021

ABSTRACT

Laser treatment of a subretinal neovascular membrane associated with a unilateral choroidal osteoma in a 28-year-old woman is described. To our knowledge, this is the first reported use of krypton red laser photocoagulation for the initial treatment of a subfoveal neovascular membrane in this setting. Early recognition of the membrane allowed treatment prior to involvement of the central fovea. Follow-up has shown obliteration of the membrane without recurrence and 20/20 vision. We emphasize recognition of this unusual tumor, self-monitoring with an Amsler grid, and early treatment of subretinal neovascularization in this high risk group of young patients.
Pseudophakic Keratoplasty: Posterior Chamber Lens Implantation in the Presence of Ruptured Capsule
Authors: Smith Ronald E , Beatty Richard F , Clifford William S
Published: April 2021

ABSTRACT

A technique is described for implantation of a posterior chamber intraocular lens during keratoplasty for bullous keratopathy when a large capsulotomy and vitreous prolapse are present. Seven cases of Pseudophakic or aphakic bullous keratopathy with anterior chamber, iris-fixated, or no intraocular lens in place are reported.

A completely intact posterior capsule is not necessary to support safely a sulcus-fixated posterior chamber lens. Anterior segment reconstruction, careful removal of existing intraocular lenses (except a posterior chamber lens), vitrectomy through the ruptured posterior capsule, and assessment of the remaining posterior capsule rim are important surgical objectives.
Blue Field Entoptoscopy in the Preoperative Evaluation of Vitrectomy Candidates
Authors: Mittl Rainer N , Green Donald H
Published: April 2021

ABSTRACT

Twenty-four patients with vitreous hemorrhage scheduled for pars plana vitrectomy were evaluated with the blue field entoptoscope. Correlation of preand postoperative findings in patients with and without macular pathology was highly irregular, apparently due to mechanical obstruction of light transmission by the vitreous hemorrhage. Blue field entoptoscopy is therefore not recommended as a tool in the preoperative evaluation of vitrectomy patients.
The Use of Thiphenamil Hydrochloride (Trocinate) to Control Wound Contraction After Radial Keratotomy
Authors: Garrett Charles , Presley Elizabeth , Prager Thomas C , Moorhead Louise C
Published: April 2021

ABSTRACT

We studied the efficacy of a topical smooth muscle antagonist, thiphenamil hydrochloride (Trocinate), in inhibiting wound contraction in ocular tissue. Fifteen New Zealand white rabbits underwent standard eightincision radial keratotomy (RK), and eyes were randomly assigned to treatment or control groups. As demonstrated by slit lamp corneal photographs and by ocular histology, transient inhibition of wound contraction lasted approximately one week in all treatment eyes. We conclude that thiphenamil has a temporary, but specific, effect in controlling wound contraction after ocular surgery. Smooth muscle antagonists may be useful for managing cicatricial conditions of the eye.
Correction of Hyperopia Following Radial Keratotomy: Quantification in Human Cadaver Eyes
Authors: Lindquist Thomas D , Rubenstein Jonathan B , Lindstrom Richard L
Published: April 2021

ABSTRACT

Overcorrection is a significant complication following radial keratotomy (RK). This study using human cadaver eyes demonstrates that the use of interrupted sutures placed across radial incisions coincident with a 7-mm optical zone mark can induce a wide range of central corneal steepening and can therefore correct varying amounts of hyperopia following RK. A case presentation confirms the effectiveness of using interrupted sutures to steepen the cornea following RK, but it also shows that significant regression of the effect must be considered at the time of suture placement. Since placement of interrupted corneal sutures is a routine procedure, it is a very convenient technique for treating overcorrection following RK.
Preventing Conjunctival Prolapse and Tarsal Eversion Following Large Excisions of Levator Muscle and Aponeurosis for Correction of Congenital Ptosis
Authors: Wolfley Darrell E
Published: April 2021

ABSTRACT

Mattress sutures placed from the superior fornix conjunctiva through levator muscle and aponeurosis can be used to reconstruct the superior fornix following extensive dissection and resection of levator muscle and aponeurosis for severe congenital ptosis. This placement of sutures differs from the full-thickness mattress sutures from conjunctiva through skin commonly recommended by many textbooks in oculoplastic surgery, and appears to be more successful in preventing some of the complications that follow this type of oculoplastic surgery.
Scleral Reinforcement Two Case Reports
Authors: Whitmore Wayne G , Curtin Brian J
Published: April 2021

ABSTRACT

We report two cases of unilateral scleral reinforcement undergone for progressive pathologie myopia. Examination ten years after the operations showed the supportive effect of the scleral grafts. The effect, however, was localized and did not appear to block the overall progression of posterior staphyloma formation significantly.
Trabeculectomy Flap Suture Lysis With Endolaser Probe
Authors: Salamon Samuel M
Published: April 2021

ABSTRACT

Enhancing filtration after trabeculectomy with scleral flap sometimes requires cutting of the nylon suture. A new use of the endolaser probe to cut the nylon suture through hemorrhagic and edematous conjunctiva and Tenon's capsule is described. The probe compresses the tissue so that it is close to the suture for delivery of the laser energy. This application of the endolaser probe as an "ecto-laser" succeeded in enhancing filtration, raising the conjunctival bleb, and lowering intraocular pressure.
Lack of Beneficial Effect of Intensive Topical Steroids and Beta Irradiation of Eyes Undergoing Repeat Trabeculectomy
Authors: Miller M H , Joseph N H , Wishart P K , Hitchings R A
Published: April 2021

ABSTRACT

Sixteen eyes (14 patients) that had previous failed trabeculectomy underwent a further trabeculectomy. In the postoperative period they were treated with intensive topical steroids (hourly) for several months. At the end of one year the overall results of surgery were not improved using this regime when compared with a previously reported series of similar patients who were treated with less steroid. It appeared that the addition of more intensive topical steroid usage was no more successful than steroids given in a four-time-aday program.

Additionally, some eyes were treated with beta irradiation, which did not appear to influence the results.

Eyes that had a limbus-based conjunctival flap at reoperation had a more favorable outcome than those having fornix-based flaps.
Pasteurella multocida Endophthalmitis After a Cat Bite
Authors: Yokoyama Takahiko , Hara Satoshi , Funakubo Hiroto , Sato Nobuko
Published: April 2021

ABSTRACT

We treated a patient with Pasteurella multocida endophthalmitis associated with a retinal detachment resulting from a cat bite. To our knowledge, endophthalmitis from an animal bite has not been described previously.

Organisms were directly inoculated from a perforated wound through the globe. The patient was vigorously treated with intensive systemic antimicrobial chemotherapy and pars plana vitrectomy. The inflammation subsided after repeated vitrectomies. A subsequent retinal detachment was treated with fluid-gas exchange and 360 scleral buckling with a silicone implant. Eight months after surgery the visual acuity was 40/200.
Corneal Epithelial Healing After Penetrating Keratoplasty Using Topical Healon Versus Balanced Salt Solution
Authors: Reed D Brent , Mannis Mark J , Hills John F , Johnson Chris A
Published: April 2021

ABSTRACT

The authors conducted a prospective study of 38 consecutive corneal transplant patients over a fiveand-one-half month period in order to evaluate the effect of intraoperative hydration with topical Healon® versus balanced salt solution on postoperative epithelial healing in the corneal graft. Eight independent variables, including patient age, sex, operating room time, donor age, donor time in McCareyKaufman media, intraoperative hydration with balanced salt solution versus Healon, and the amount of postoperative punctate epithelial keratitis measured on postoperative day 1, day 2, and at one week were compared using a multiple linear regression method. While the correlation between donor age (p= .060) and patient age (p=.088) with the amount of punctate epithelial keratitis at one week post graft approached statistical significance, only the Healon-treated group showed a high correlation to more complete graft healing one week postoperatively (p=0.002). Topical Healon during keratoplasty may foster epithelial healing, but it also may present technical challenges of which the surgeon should be aware.
Removal of Lens Epithelial Cells by Ultrasound in Endocapsular Cataract Surgery
Authors: Nishi Okihiro
Published: April 2021

ABSTRACT

A new method was developed to remove lens epithelial cells during endocapsular cataract surgery using a device with a tip that resembles the irrigatingaspirating tip for cortex removal by extracapsular cataract extraction. The tip has an opening on the side and end, both 0.20 mm in diameter, for aspiration. The opening at the end serves to remove the cells at the equator. The top of the tip is sandblasted to provide an abrasive surface. This tip is connected to a phacoemulsifier handle. After nucleus delivery and cortex removal, the tip is inserted beneath the inner surface of the anterior capsule. The cells are detached by the abrasive tip, which vibrates by ultrasound; and then aspirated. Histologic examination revealed that the cells can be removed completely, and that this method is more effective than vacuum cleaning.
Prediction of Aphakic Refractive Error in Children
Authors: Arffa Robert C , Donzis Paul B , Morgan Keith S , Zhou Yu Jing
Published: April 2021

ABSTRACT

Formulas created to predict the optical requirements of the aphakic eye have been tested mainly in adult eyes. The accuracy of these formulas in shorter pediatric aphakic eyes was examined using retrospective analysis of 17 aphakic pediatric patients. The Sanders-Retzlaff-Kraff contact lens formula, used previously to predict required lens powers for epikeratophakia, consistently underestimated the required aphakic correction in the shorter eyes, which may have been responsible in part for the large undercorrections obtained previously in patients under one year of age. The Hoffer-Colenbrander and Binkhorst theoretical formulas, Donzis-Kastl-Gordon percentage change formula, and a linear regression formula derived from the present data (LIN), were significantly more accurate. The differences between these formulas were not significant. The use of one of these formulas should facilitate prediction of required epikeratophakia lenticule power or intraocular lens power in young children.
Panretinal Photocoagulation for Radiation-Induced Ocular Ischemia
Authors: Augsburger James J , Roth Susan E , Magargal Larry E , Shields Jerry A
Published: April 2021

ABSTRACT

We present preliminary findings on the effectiveness of panretinal photocoagulation in preventing neovascular glaucoma in eyes with radiation-induced ocular ischemia. Our study group consisted of 20 patients who developed radiation-induced ocular ischemia following cobalt-60 plaque radiotherapy for a choroidal or ciliary body melanoma. Eleven of the 20 patients were treated by panretinal photocoagulation shortly after the diagnosis of ocular ischemia, but nine patients were left untreated. In this non-randomized study, the rate of development of neovascular glaucoma was significantly lower (p = 0.024) for the 11 photocoagulated patients than for the nine who were left untreated.
Postoperative Astigmatism Using the McIntyre Needle
Authors: House Philip H
Published: April 2021

ABSTRACT

We performed 30 consecutive cataract extractions using two different needle types to assess postoperative astigmatism. In each case, we used a standard corneal incision followed by an extracapsular cataract extraction and the insertion of a posterior chamber intraocular lens. The incisions in group A were closed with the McIntyre needle and in group B with a standard curve needle. We compared the postoperative astigmatism in each group with sutures in at 3 weeks, and when removed selectively by 12 weeks, and found no significant difference.
Delayed Nonexpulsive Suprachoroidal Hemorrhage After Trabeculectomy
Authors: Ariano Maria L , Ball Stuart F
Published: April 2021

ABSTRACT

Five cases of delayed nonexpulsive suprachoroidal hemorrhage after trabeculectomy in aphakic eyes are reported. Four cases were done under general anesthesia and in three there was straining and bucking at extubation. The most common presentation was sudden severe ocular pain one day postoperatively, associated with marked decrease in vision and low intraocular pressure. The prognosis was related to the extent of the hemorrhage; where suprachoroidal hemorrhage was extensive, surgical drainage appeared to help. Our last two patients, both with massive postoperative nonexpulsive suprachoroidal hemorrhage, underwent surgical drainage of suprachoroidal blood and recovered preoperative visual acuity.
Macular Pucker and Retinal Angioma
Authors: Schwartz Peter L , Trubowitsch Gregory , Fastenberg David M , Stein Mark
Published: April 2021

ABSTRACT

A 44-year-old white female had a macular pucker associated with a peripheral retinal capillary angioma. Following successful destruction of the angioma with cryotherapy, the macular pucker regressed and visual acuity returned to normal. This is the first report documenting the regression of a macular pucker following successful treatment of a peripheral retinal angioma.
A Clinical Comparison of Two Methods of Glare Testing
Authors: Smith Patricia W , Pratzer Kimberly A , Webster Nancy , Fenton Jane , Bonham Roger D
Published: April 2021

ABSTRACT

We evaluated two methods of glare testing, the Miller-Nadler™ Glare Tester (M-NGT, Titmus Optical, Inc.) and the Brightness Acuity Tester (BAT, Mentor O & O, Inc.). Resulting Snellen visual acuities both for a control group of normal volunteers and for a study group with cataract or posterior capsule opacification were compared using the two glare testers. The decreases in Snellen visual acuities were comparable in the eyes with cataract. No glare disability was measured in the control group. There was greater glare disability using the BAT compared with the Miller-Nadler test when eyes with posterior capsule opacities were compared.
Laser Trabeculoplasty Retreatment
Authors: Weber Paul A , Burton Gary D , Epitropoulos Alice T
Published: April 2021

ABSTRACT

Thirty-seven eyes of 30 patients classified as late treatment failures following 360° of argon laser trabeculoptasty (ALT) underwent retreatment of the trabecular meshwork. Retreatment was considered successful if the intraocular pressure was maintained at 21 mm Hg or below and if the visual fields and optic nerve remained stable. By the Kaplan-Meier survival analysis the rates of success were: 100% at 3 months, 91% at 6 months, 77% at 9 months; 70% at 1 year, and 47% at 16 and 20 months. The mean decrease in intraocular pressure 1 month after retreatment was 6.5 ± 4.9 mm Hg (from 23.9 to 17.5). Three patients followed for 3 years or longer had a mean decrease of -5.67 mm Hg. Repeat argon laser trabeculoplasty appears to be a reasonable treatment option for selected patients who are late failures after initial treatment.
Semiconductor Diode Laser Endophotocoagulation
Authors: Duker Jay S , Federman Jay L , Schubert Hermann , Talbot Christopher
Published: April 2021

ABSTRACT

We successfully used a semiconductor diode laser to deliver endophotocoagulation burns to the retina of a rabbit. The diode laser employed emits light at a wavelength of 817 nm (near infrared). It has a power output of up to 1.0 W in the continuous-wave mode, equivalent to the capability of current argon laser endophotocoagulators. A standard, commercially available fiberoptic endophotocoagulation probe was used to deliver the laser burns. We used power settings ranging from 300 m W to 400 m W and exposure times of 0.1 to 0.2 seconds to produce chorioretinal bums that appeared clinically and histopathologically indistinguishable from those induced with conventional wavelengths. This new laser system has the decided advantages over traditional endophotocoagulators of being much smaller, less costly, and requiring no water cooling, without sacrificing power output or ease of delivery.
Avulsion of the Canalicular System
Authors: Hurwitz Jeffrey J , Avram Darrell , Kratky Vladimir
Published: April 2021

ABSTRACT

Avulsion of the common canaliculus from its attachment to the lacrimal sac should be suspected in cases involving either deep lacerations on the lateral side of the nose or traumatic telecanthus in midfacial trauma. Blunting of the canalicular angle and founding of the inner canthus are confirming signs. A canaliculodacryocystorhinostomy can be performed to reanastomize the lacrimal drainage pathways and relieve epiphora.
Polypropylene Ligatures as a Means of Controlling Intraocular Pressure with Molteno Implants
Authors: Price Francis W , Whitson William E
Published: April 2021

ABSTRACT

A technique for controlling intraocular pressure in the immediate postoperative period with Molteno implants is described. Filtration tubes were closed with polypropylene sutures in 13 patients. Filtration tubes closed with 7-0 sutures provided the most satisfactory partial to complete lumen closure. The ligatures in six patients later were opened by argon laser.
The Effect of Chronic Miotic Therapy on the Results of Posterior Chamber Intraocular Lens Implantation and Trabeculectomy in Patients with Glaucoma
Authors: Chen Henry Shen-Lih , Steinmann William C , Spaeth George L
Published: April 2021

ABSTRACT

We reviewed the charts of 18 patients 20 glaucomatous eyes) who had not used pilocarpine prior to undergoing trabeculectomy combined with or performed later with posterior chamber lens implantation. We then compared postoperative results and complications in these patients with those in 35 other patients (40 glaucomatous eyes) in two age- and stage-matched groups who had used pilocarpine prior to undergoing the same procedures. All patients had a minimum follow-up of 6 months. There was no significant difference between these groups in terms of postoperative intraocular pressure and required glaucoma medications. However, in the pilocarpine-treated groups, there was a significantly higher incidence of complications, especially intraocular lens capture (P<0.05), and of worse visual outcomes (P<0.01).
Shadow Photogrammetric Apparatus for the Quantitative Evaluation of Corneal Buttons
Authors: Denham David , Mandelbaum Sid , Parel Jean-Marie , Holland Simon , Pflugfelder Steve
Published: April 2021

ABSTRACT

We have developed a technique for the accurate, quantitative, geometric evaluation of trephined and punched corneal buttons. A magnified shadow of the frontal and edge views of a corneal button mounted on the rotary stage of a modified optical comparator is projected onto the screen of the comparator and photographed. This process takes approximately three minutes. The diameters and edge profile at any meridian photographed can subsequently be analyzed from the film. The precision in measuring the diameters of well cut corneal buttons is ±23 microns, and in measuring the angle of the edge profile is ±G. Statistical analysis of inter observer variability indicated excellent reproducibiltty of measurements. Shadow photogrammetry offers a standardized, accurate, and reproducible method for analysis of corneal trephination.
Eyelid Complications in Trachoma I. Cicatricial Entropion
Authors: Nasr Amin M
Published: April 2021

ABSTRACT

Trachoma is an infectious disease affecting the conjunctival membranes of the eye that results in scarring of the conjunctiva with secondary eyelid malformations and lacrimal pathology. Of the four eyelid complications secondary to trachoma - cicatriciel entropio n, eyelid retraction, secondary blepharospasm, and brow ptosis - by far, cicatricial entropica is the most common. One thousand two hundred patients with cicatricial entropion underwent surgery at the King Khaled Eye Specialist Hospital between 1984 and 1988. The classification and management of these cases are discussed, emphasizing the various surgical techniques used.
Primary Mucinous Sweat Gland Carcinoma of the Eyelid
Authors: Shuster Alan R , Maskin Steven L , Leone Charles R
Published: April 2021

ABSTRACT

A 76-year-old woman had a slowly enlarging lesion of the right lower eyelid. After obtaining incisional biopsy results consistent with adenocarcinoma, we removed the tumor and made a final diagnosis of primary mutinous adenocarcinoma of the sweat gland. The defect was repaired using ipsilateral upper lid transpositional tarso-conjunctival and skin-muscle flaps. No evidence of recurrence or metastasis was noted 42 months postoperatively. Consideration of such tumors is clinically important, since they have full metastatic potential. We therefore suggest consideration of sweat gland primary mucinous adenocarcinoma in the differential diagnosis of red or violaceous eyelid masses.