bluuebunny/crossref_metadata_2025 huggingface dataset:
Diffuse Iris Nevus in Oculodermal Melanocytosis: A Light and Electron Microscopic Study
Authors: Ticho Benjamin H , Tso Mark O M , Kishi Shoji
Published: April 2021

ABSTRACT

We studied by light and electron microscopy the diffuse iris nevus of an eye in a 16-year-old patient with oculodermal melanocytosis and choroidal malignant melanoma. The nevus cells in the anterior border layer of the iris appeared to be poorly differentiated, showing moderate infolding of the nuclear membrane with heterochromatin clumping, watery cytoplasm, abundant mitochondria, fine filaments, rough endoplasmic reticulum, and numerous pinocytotic vesicles. Small scattered immature melanosomes and occasional giant meianosomes were observed in these cells. Deep in the iris stroma, however, nevus cells were found singly or in small groups, and were associated with an increasing number of melanized melanosomes and cytoplasmic filaments and reduced numbers of other cytoplasmic organelles, such as mitochondria and free ribosomes. Differentiation of the iris nevus cells appeared to progress from the anterior border layer toward the iris stroma. This observation suggests that intrastromal nevi may be more benign than nevi with surface plaque. The ultrastructural characteristics of the diffuse nevi of oculodermal melanocytosis were compared with those of other iris nevi.
Magnetic Resonance Imaging in Retinoblastoma and Retinocytoma: A Case Report
Authors: Benhamou Elias , Borges Jose , Tso Mark O M
Published: April 2021

ABSTRACT

Magnetic resonance imaging (MRI) is playing a growing role in the evaluation of ocular and orbital tumors. We report the case of a 26-month-old child presenting an undifferentiated retinoblastoma with a differentiated retinocytoma component in his left eye. After the eye was enucleated, we could correlate the clinicopathologic findings with the MRI scans. Both the undifferentiated retinoblastoma and the differentiated retinocytoma components could be determined on magnetic resonance imaging. Because different levels of metabolic activity within a tumor mass may influence largely T
1
and T
2
parameters, accurate determination of these values may be useful in determining the differentiation of a retinoblastoma, enabling a better therapeutic approach and assessment of the response to treatment.
Intraocular Histiocytic Lymphoma: A Pediatric Case Presentation
Authors: Stephenson P Dee G , Duffey Richard J , Ferguson James G
Published: April 2021

ABSTRACT

An 11 -year-old white ternate with a 5-month history ot stage IV systemic histiocytic lymphoma presented in relapse with a red, painful left eye with a decrease in visual acuity- A diagnostic anterior chamber paracentesis was performed revealing cells consistent with the systemic diagnosis of histiocytic lymphoma. Also, at that time, central nervous system involvement was found. This is the youngest patient to our knowledge to have documented intraocular involvement from histiocytic lymphoma. She is also unusual in that the ocular involvement was predominantly localized to the anterior segment.
Synergistic Divergence: Saccadic Velocity Analysis and Surgical Results
Authors: Hamed Latif M , Lingua Robert W , Fanous Maher M , Saunders Timothy G , Lusby Franklin W
Published: April 2021

ABSTRACT

The clinical findings are described in four patients with Synergistic divergence (SD), an ocular motility disorder which is considered to be a variant of Duane retraction syndrome (DRS). Saccadic velocity studies in three patients demonstrated preserved abducting saccades in the affected eye with equally reduced amplitudes on both attempted abduction and adduction. The preserved saccades on attempted abduction of the affected eye, coupled with electromyographic evidence that shows maintenance of normal reciprocal innervation with respect to gaze on attempted abduction as dictated by Sherrington's law, strongly suggest that the abducens nerve is not necessarily absent or severely hypoplastic in this condition. One patient showed typical DRS in the contralateral eye and had a son with bilateral DRS, attesting to a possible genetic and etiologic relationship between SD and DRS. Three patients underwent strabismus surgery. Review of our surgical results and an analysis of the literature indicate that a crippling procedure to the ipsi lateral lateral rectus muscle, such as extirpation, may be necessary to eliminate simultaneous abduction. Over-correction did not occur following lateral rectus extirpation.
Traumatic Cataract Surgery With Intraocular Lens Implantation in Children
Authors: Gupta Ashok K , Grover Ashok K , Gurha Nita
Published: April 2021

ABSTRACT

We evaluated our experience of intraocular lens implantation in 22 children with uniocular traumatic cataract. Good visual acuity was achieved in a large proportion of the children despite associated corneal opacities and several intraoperative and postoperative complications. Our study suggests that intraocular lens implantation may have a major role in management of monocular cataracts in children.
Changes in Astigmatism After Surgery for Congenital Ptosis
Authors: Cadera W , Orton R B , Hakim O
Published: April 2021

ABSTRACT

To determine the effect of ptosis surgery on the astigmatic refractive error in pediatrie patients, we assessed 88 eyes postoperatively at 3, 6, and 12 months. Thirty-six eyes of unilateral cases were used as controls. There was an overall increase in average astigmatic refractive error of the study group by 0.30 diopters, while the control group decreased 0.15 D. Thirty-six percent of study eyes changed by more than 0.75 D.

Results were similar for both fascia lata slings and levator resections. Those patients older than 4 years showed an increase in average cylinder (0.50 D), while those younger than 4 years decreased their average cylinder (0.20 D). Careful monitoring with postoperative refractions is required in pediatrie ptosis patients.
Visual Acuity After Successful Treatment of Large Macular Retinoblastoma
Authors: Buckley Edward G , Heath Heather
Published: April 2021

ABSTRACT

Recent trends in the treatment of retinobiastoma have favored radiation therapy as opposed to enucleation. A major determining factor in selecting radiation therapy is the possibility of useful posttreatment visual function. While the treatment of nonmacular tumors seems reasonable, little information is available about the posttreatment visual outcome of large posterior pole tumors. We treated 17 patients (20 eyes) with group IU-V retinobiastoma and large posterior pole tumors with external beam radiation. Visual acuity after treatment ranged from 5/200 to 20/50. Potential posttreatment visual function was difficult to predict using such pretreatment factors as age at diagnosis, funduscopic appearance, and the number, size, and location of the tumors. Surprising visual function was obtained in some patients with multiple large macular tumors. Follow up ranged from 1 to 8 years. No patient developed metastatic disease; however, four patients required subsequent cataract extraction. This study supports the consideration of radiation therapy as the primary treatment in eyes previously felt to have a poor visual outcome.
Cine Magnetic Resonance Imaging of Ocular Motility
Authors: Cadera W , Viirre E , Karlik S
Published: April 2021

ABSTRACT

We describe a technique of generation of a cine motion picture of ocular movements in a patient with Duane Type Il exotropia. With the magnetic resonance scanning unit, multiple scans can be sequenced to give a graphic animation to the eyes as targets are fixated across the visual field.

With this technique, we were able to clearly view the contractility of the extraocular muscles and note the changes in pulling directions of the muscles in this patient. The restriction of movement due to the cocontraction of the horizontal rectus muscles was readily apparent.
Intraoperative Succinylcholine and the Postoperative Eye Alignment
Authors: Lingua Robert W , Feuer William
Published: April 2021

ABSTRACT

In 99 patients undergoing strabismus surgery, an intravenous bolus of succinylcholine (Sen) was given after completion of the strabismus procedure. Reliable data were obtained in 53 patients. The interlimbal distance measured at 60 seconds after injection (VR60) was compared to the interlimbal distance at 1 and 6 weeks postoperatively, to evaluate the correlation between the drug-induced eye position under anesthesia and the awake-eye alignment postoperatively. Correlations were highest in patients undergoing symmetric recessions of the medial or lateral recti in primary horizontal strabismus. Confidence intervals of 0.8 to 1.2 were noted for both the esotropia and exotropia groups. Two patients experienced Sch-related complications of masseter spasm and prolonged apnea. Although infrequent, the potential gravity of the complications from Sch use and the currently enjoyed high rate of success in primary strabismus surgery suggest that these formulas not be used clinically. Nonetheless, the high correlations between the drug-induced and awake ocular position provide further support to the premise that the Sch sensitive fibers provide an important motor component to the awake eye position.
Periodic Alternating Esotropia
Authors: Hamed Latif M , Silbiger Jonathan
Published: April 2021

ABSTRACT

Periodic alternating esotropia (PAE) is a rare ocular motility disturbance observed in association with periodic alternating gaze deviation (PAG) or periodic alternating nystagmus. We examined a 9-month-old developmental^ delayed girl who showed PAE occurring synchronously with PAG. The ocular motility disorder consisted of rhythmic alternating fixation with the right eye in abduction, a left face turn and esotropia of the left eye (90 seconds), a changeover phase (10 to 15 seconds) during which the eyes are straight and the head is upright, then fixation with the left eye in abduction, a right face turn, and esotropia of the left eye (90 seconds). There was no spontaneous jerk nystagmus present. These findings continued incessantly during a follow-up period of 18 months. Magnetic resonance imaging revealed pronounced cerebellar vermis hypoplasia. Only three clinically similar cases have been previously reported, but none had been studied with modern neuroimaging techniques.
Rigid Gas Permeable Contact Lens Correction of Aphakia Following Congenital Cataract Removal During Infancy
Authors: Amos Christopher F , Lambert Scott R , Ward Michael A
Published: April 2021

ABSTRACT

Rigid gas permeable (RGP) contact lenses were prescribed and worn with little difficulty by 10 consecutive aphakic infants. Fluoroperm 92 lenses were used instead of silicone lenses (Bausch & Lomb) because of their lower cost, ease in handling, flexibility in design, and better neutralization of astigmatism. Lenses were worn on a daily wear basis (with occasional overnight wear) to reduce the risk of keratitis. Keratometry readings were taken at the time of surgery with the patient in a supine position. Trial lens fitting was performed 1 to 7 days later using a Burton Lamp.

None of the patients developed keratitis, corneal neovascularization, or the sucked-on-lens syndrome. The lenses were well tolerated and the parents soon became adept at handling them. We now use RGP lenses as our lens of choice when treating aphakic infants.
Synthetic Polypeptide Sleeve for Strabismus Surgery
Authors: Elsas Frederick J , Gowda D Channe , Urry Dan W
Published: April 2021

ABSTRACT

A synthetic polypentapeptide sleeve was placed around the superior rectus muscle of five New Zealand white rabbits in hopes of preventing postoperative fibrous scarring. Two forms of the polypentapeptide were used. No significant inflammation or scarring occurred with either form of the polypentapeptide when compared to controls. One form elicited a fibrous membrane surrounding the sleeve within 2 weeks. The other elicited no such reaction after 2 months. The latter form of the polypentapeptide may be useful in preventing scarring following strabismus surgery.
Visual Hand Display (VHD) as an Introductory Procedure for Measuring Vision in Infants and Young Children With Visual Impairment
Authors: Kronheim Jane K , Katsumi Osamu , Matsui Yoshie , Tetsuka Hitomi , Hirose Tatsuo
Published: April 2021

ABSTRACT

We developed the Visual Hand Display (VHD) to measure vision in visually impaired Infants and young children. The VHD is a circular fabric mitten, which is held easily by inserting the hand between the two surfaces. Black-and-white stripes are attached to one surface, 25, 15, 10, 4, and 2 mm per stripe. The VHD acuity is determined by the shortest test distance and the smallest stripes that the patient can detect. The VHD acuities were compared with preferential looking (PL) staircase acuities in 1 30 patients (53 males, 77 females; age range, 2 to 13 years; median, 21.0 months). Of these, 107 (82.3%) had various degrees of ret i nopal hy of prematurity. The correlation between the VHD and the PL acuities was high (R2 = 0.849). PL acuities were better than the VHD acuities in 98/130 patients (75.4%), with an average difference of 0.51 (SD = 0.70) octave. The visual acuity differences were more pronounced in subjects with slight visual impairment and much less in subjects with severe visual impairment. The VHD seems to be an effective introductory method to evaluate visual acuity in severely visually impaired infants and young children. This method also would be effective with severely mentally and physically disabled patients who cannot undergo PL testing.
Severe Visual Deficits in Infancy in Northern Israel: An Epidemiological Perspective
Authors: Tirosh Emanuel , Schnitzer Malka Rudolph , Atar Shaul , Jaffe Michael
Published: April 2021

ABSTRACT

The characteristics of 193 legally blind children ranging in ages from birth to 4 years were analyzed. The overall incidence was 1/1000 live births; however, the ethnic specific incidence varies. All children were diagnosed before the age of 20 months and the most frequent alerting sign was lack of visual tracking. In 33.3%, the deficit was first suspected by a family member. A genetic etiology accounted for 38% of the cohort. The relative risk for an associated handicap was significant as well as the rate of hospitalizations for apparently unassociated diseases. It appears that both prevention and early detection could be achieved by a risk index.
Peters' Anomaly: A Clinicopathologic Study
Authors: Myles W Michael , Flanders Michael E , Chitayat David , Brownstein Seymour
Published: April 2021

ABSTRACT

Two infants were born with bilateral Peters' anomaly. The first baby was a girl, born prematurely at 35 weeks of gestation and who died 8 days later. The second infant was a boy, born at 38 weeks of gestation, who had severe conotruncal abnormality of the heart. Both babies had distinctive facial dysmorphism and severe central nervous system abnormalities including partial or complete absence of the corpus callosum and cerebral calcifications. Biochemical and genetic investigations showed no abnormalities in either child and there was no family history of genetic disorders. Neither case showed evidence of an intrauterine infection. Postmortem ocular findings in the first infant included bilateral herniation of the ruptured cataractous lens into the posterior corneal defect, iridocorneal adhesions, persistent hyperplastic primary vitreous, and total retinal detachment. The left eye of the second infant was eviscerated at 11 months of age because of recurrent, spontaneous perforation. Pathologic ocular findings included large fragments of lens material adherent to the posterior corneal stroma through a large central defect in Descemet's membrane and endothelium, fibrovascular proliferation of the adjacent corneal stroma, and iridocorneal adhesions.
The Use of Hyaluronic Acid During Adjustable Suture Surgery
Authors: Granet David B , Hertle Richard W , Ziylan Sule
Published: April 2021

ABSTRACT

We prospectively studied the force required to move an extraocular muscle after adjustable suture surgery with and without the perioperative use of hyaluronic acid (Healon). The 15 muscles that received hyaluronic acid averaged 15.0 g of force to move the muscle 2.0 mm which was significantly different than the average force of 36.15 g required for the 13 control muscles. The decreased force required to adjust the muscle along with potential anti inflammatory properties of hyaluronic acid make this a useful adjunct during adjustable suture surgery.
Polish Americans
Authors: Knab Sophie
Published: April 2021

Historical and Cultural Perspectives of Influence in the Use of Mental Health Services
UPDATE: NSGAE Nursing Adaptation Evaluation
Authors: Stuart Gail Wiscarz
Published: April 2021

Is the Proposed Axis VI of DMS III Really Nursing Science, or is it just Nursing Tradition?
Buspirone Found Less Sedating Than Clorazepate
Authors: Anonymous
Published: April 2021

Study Shows Two Drugs' Anti-Anxiety Effectiveness Equal
Seasonality of Symptoms Noted in Depression and Affective Disease
Authors: Anonymous
Published: April 2021

Researcher Says Depression Worsens in Winter - Manic Depression Peaks in Summer
Room Restriction: A Therapeutic Prescription
Authors: Gentilin Jill
Published: April 2021

The use of room restriction as a disciplinary measure on an adolescent unit often triggers conflict among the nursing staff. As author JILL GENTILIN, BSN, RNC, reports, it should! But properly used, the adolescent with few internal controls may benefit from the increased external structure room restriction provides.
Study Shows Changes in Immune System During Bereavement
Authors: Anonymous
Published: April 2021

Grief may have physical, as well as psychological effects
Water Intoxication and Psychosis Syndrome: Clinical Cautions
Authors: Prim Roberta G
Published: April 2021

The side effects of antipsychotic drugs can lead to self-induced water intoxication in institutionalized clients. Methods for handling this syndrome are described in this article by ROBERTA G. PRIM, MA, RN.
What to Expect as a Graduate Student
Authors: Critchley Deane L
Published: April 2021

Graduate Psychiatric Nursing Education
NIH Offers Research Awards
Authors: Anonymous
Published: April 2021

Nursing Awards
The Terminally Ill Patient on an Acute Psychiatric Unit: A Case Study
Authors: Stecker Enid
Published: April 2021

medically compromised patients, some with terminal diagnoses, present a unique challenge to the psychiatric nurse.
Kaufman's Theory of Shame and Identity in Treating Childhood Sexual Abuse in Adults
Authors: Ridley Pamela J
Published: April 2021

Competence in treating the victims of sexual abuse and exploitation requires an understanding of shame.
Celebrating Our PAST
Authors: Forchuk Cheryl , Tweedell Donna
Published: April 2021

The History of Hamilton Psychiatric Hospital
Epithelial Downgrowth-Fistula Repair and Keratoplasty
Authors: Anseth Arvid , Dohlman Claes H , Albert Daniel M
Published: April 2021

ABSTRACT: Eight patients with leaking fistulas from epithelial downgrowth were repaired by various techniques. Wide excision of the fistula and replacement with a graft, followed by a conjunctival flap, proved to be the most satisfactory technique for dealing with the fistula. However, this subset of patients responded to fistula closure with a much worse secondary glaucoma than downgrowth patients in general.

Fifteen patients with proven epithelial downgrowth received penetrating keratoplasty. Eleven of these grafts failed within a year, but there was no regrowth of epithelium on the back of the graft in at least two patients.

In spite of generally discouraging results, we recommend immediate closure of epithelialized fistula to avoid even more severe complications in the future. We also recommend keratoplasty, repeated if necessary, in severe corneal edema. Both situations may eventually require radical glaucoma surgery and/or keratoprosthesis. [Refractive and Corneal Surgery 1991;7:23-27.]
Update on Epikeratoplasty
Authors: Fouraker Bradley D , Schanzlin David J
Published: April 2021

ABSTRACT: Epikeratoplasty is a surgical procedure which modifies the surface topography of the cornea by the addition of a tissue lens. This procedure has been applied to patients with keratoconus, myopia, and aphakia. Several large studies of epikeratoplasty have been conducted which suggest that the procedure be limited to keratoconus and aphakic patients who are contact and spectacle lens intolerant.[Refractive and Corneal Surgery 1991;7:57-59.]
Topography and Raytracing Analysis of Patients With Excellent Visual Acuity 3 Months After Excimer Laser Photorefractive Keratectomy for Myopia
Authors: Maguire Leo J , Zabel Ralph W , Parker Paula , Lindstrom Richard L
Published: April 2021

ABSTRACT: We performed topography and raytracing analysis 3 months after surgery on five consecutive eyes of five patients, which had excimer laser photorefractive keratectomy for myopia. Three of the five eyes had uncorrected postoperative visual acuity of 20/20 or better. Two eyes had an uncorrected vision of 20/40.

In three of five eyes, the area of excimer ablation was centered within 1.0 mm of the optical axis. Three other eyes showed decentration that ranged from 1.1 to 1.5 mm. The range of surface power seen within 2 mm of the central keratoscope ring was as follows: patient CK = 37.50 to 39.50 diopters; patient CA = 40.50 D to 44.80 D; patient CW = 37.90 D to 42.20 D; patient AC = 35.50 D to 39.00 D; patient DT = 34.50 D to 41 .40 D. Topography patterns differed from eye to eye.

A raytracing program modeled refraction of 20/80 and 20/20 "E" of 100%, 50%, 25%, 12.5% and 6.25% contrast through all measured points on the central 10 keratoscope rings of the five postoperative corneas. The five computer-derived images were ranked subjectively according to the observed degree of image degradation by three observers. Two eyes showed discernible 20/20 E's even at the 1 2.5% contrast level. Little to no ghost image was seen. Two eyes showed degraded but discernible 20/20 letters at higher levels of contrast only. These eyes showed moderate ghost images that were most apparent in the high-contrast 20/ 80 letters. One eye showed poor resolution of the 100% contrast 20/20 letter and moderately severe ghost images. The amount of image degradation correlated with the percentage of the total point spread function that fell within a 9 ? 9 pixel patch around the visual axis in the image plane of best focus (r = -1.0O1P= .01).

These results suggest that excellent uncorrected Snellen visual acuity may occur in patients after excimer laser photorefractive keratectomy for myopia even when the postoperative surface shows a moderate amount of irregular astigmatism and moderate decentration of the area of ablation relative to the optical axis. Raytracing analysis suggests that differences in postoperative topography lead to differences in image quality that can be reproducibly ranked by independent observers. (Refract Corneal Surg 1991 ;7: 122- 128.)
Intraocular Drugs Used in Cataract Surgery and Their Effect on the Corneal Endothelium
Authors: MacRae Scott
Published: April 2021

ABSTRACT: Cataract surgery has evolved dramatically over the last 20 years largely because of developments in intraocular drugs and solutions, as well as intraocular mechanical devices used for removing cataracts. These include viscoelastic materials, intraocular miotics, intraocular irrigating solutions, and intraoperative mydriatics. It also involves attention to subtle details which may cause idiopathic postoperative corneal edema such as the avoidance of using surfactant cleaners or soaps on instruments that are used in the eye. The following discussion briefly outlines some of the intraocular drug issues of which cataract surgeons need to be aware.(Refracf Cornea/ Surg 1991;7:249-251.)
Topography-controlled Excimer Laser Photorefractive Keratectomy
Authors: Dausch Dieter , Schröder Eckhard , Dausch Sabine
Published: April 2021

ABSTRACT

PURPOSE: To assess whether photorefractive keratectomy (PRK) controlled by videokeratography can successfully treat refractive errors in eyes with corneal irregularities and improve spectacle-corrected visual acuity.

METHODS: In a prospective clinical study, PRK was performed in 10 eyes of 10 patients. Reason for surgery was irregular astigmatism after penetrating keratoplasty, corneal irregularity after corneal scarring, corneal astigmatism in keratoconus, and decentration after myopic and hyperopic PRK. Excimer ablation was controlled by preoperative videokeratography (Orbscan II, Orbtek) using the MEL- 70 system from Aesculap Méditée. Follow-up was 6 months.

RESULTS: Concerning manifest refraction, the sphere was reduced on average from +1.92 to +0.57 D, 6 months postoperatively. Cylinder changed from -1.95 D on average to -0.30 D at 6 months postoperatively. There was improvement of uncorrected visual acuity of 2 or more lines in 5 eyes and no change in 5 eyes 6 months postoperatively. Spectacle-corrected visual acuity improved in 2 eyes by 2 to 3 lines, in 9 eyes by 1 to 3 lines, and showed no change in 1 eye.

CONCLUSION: Videokeratography-controlled PRK improved refractive errors in irregular corneas with improvement of spectacle-corrected visual acuity. [J Refract Surg 2000;16:13-22]
Mathematical Models of Picosecond Laser Keratomileusis for High Myopia
Authors: Bryant Michael R , Marchi Vincenzo , Juhasz Tibor
Published: April 2021

ABSTRACT

PURPOSE: Picosecond laser keratomileusis (PLK) is a refractive surgical procedure in which an intrastromal lenticle is created using the NdrYLF picosecond laser and removed by lifting the anterior flap in the cornea. The purpose of this study was to assess the predictability of picosecond laser keratomileusis for high myopia.

METHODS: The results from a recent clinical series of non-sighted patients who had undergone picosecond laser keratomileusis with the NdrYLF picosecond laser were retrospectively simulated with two mathematical models. In one model, the change in corneal curvature resulting from the collapse of a lenticular intrastromal cavity was predicted from a geometric analysis. A second model was developed using the finite element method. The results of both predictive models were compared to the clinical results at 1 and 6 months following surgery.

RESULTS: An average -13.30 D of flattening (range, -6.80 to -20.50 D) was measured at 6 months. The geometric model predicted an average correction of -23.10 D (range, -18.00 to -34.00 D), whereas the finite element model predicted an average curvature change of -17.40 D (range, -14.50 to -22.50 D). An average decrease in central pachymetry of 91 µm was measured at 6 months, as compared to a predicted decrease in thickness of 112 µm.

CONCLUSIONS: The outcome of picosecond laser keratomileusis for high myopia predicted using a finite element based model shows greater change in the corneal curvature and corneal thickness compared to clinical results. The relatively thick lenticules that are removed for high myopia cause considerable deformational changes in the cornea, which preclude the use of a purely geometric/optical approach for predicting the resultant corneal curvature changes. [J Refract Surg 2000,16:155-162]
Fine Tuning Excimer Laser Correction After Intraocular Lens Implantation and Corneal Transplantation
Authors: Pershin Kirill B , Pashinova Nadezhda F
Published: April 2021

ABSTRACT

PURPOSE: To conduct an analysis of laser in situ keratomileusis (LASDS) results in patients with artiphakia, after phakic posterior chamber intraocular lens implantation, and after corneal transplantation.

METHODS: We analyzed the results of 57 eyes with an IOL that had LASDi: 22 eyes- artiphakia after ECCE with IOL implantation; 8 eyes had phacoemulsification with IOL implantation; 9 eyesartiphakia after removal of transparent lens with IOL implantation in patients with the high myopia (ß eyes) and high hyperopia (3 eyes); 3 eyes- phakic posterior chamber IOL (2 with hyperopia, 1 with myopia); and 15 eyes after corneal transplantation. LASDS correction was performed not earlier than 6 months after IOL implantation and not earlier than 18 months after corneal transplantation. Follow-up ranged from 6 to 12 months after LASDS using the Nidek EC-5000 excimer laser. A thorough ophthalmic examination preceded and followed laser correction.

RESULTS: Mean deviation from emmetropia before LASDS was 3.50 D (range, -6.00 to +4.00 D), and astigmatism averaged 2.75 D (range, 0 to 5.00 D). Before LASDS, mean uncorrected visual acuity was 0.2 and mean spectacle-corrected visual acuity was 6 (range, 0.4 to 1.0). After LASDS, mean deviation from emmetropia was 0.50 D (range, -1.50 to +0.75 D) and average astigmatism was -0.75 D (range, 0 to 1.50 D). Mean uncorrected visual acuity was 0.7 (range, 0.4 to 1.0).

CONCLUSION: LASIK in patients with artiphakia, phakic posterior chamber intraocular lens implantation, and after corneal transplantation was atraumatic, predictable, and efficient. The best results were seen in patients with a myopic refractive error and myopic astigmatism. For hyperopia, LASDS was our method of choice in eyes with "piggy-back" IOLs. J Refract Surg 2000;16(suppl):S257-S260]
Premacular Subhyaloid Hemorrhage Following Laser in situ Keratomileusis
Authors: Mansour Ahmad M , Ojeimi Ghassan K
Published: April 2021

ABSTRACT

PURPOSE: To report a case of premacular subhyaloid hemorrhage following laser in situ keratomileusis (LASIK).

METHODS: Case report.

RESULTS: The subhyaloid hemorrhage did not resolve over 1 month of observation, necessitating Nd:YAG posterior hyaloidotomy.

CONCLUSION: The LASIK procedure can be associated with postoperative subhyaloid hemorrhage, presumably from rapid release of the microkeratome vacuum pressure. [J Refract Surg 2000;16:371-372]
Clinical Experience With the Tracey Technology Wavefront Device
Authors: Pallikaris Ioannis G , Panagopoulo Sophia I , Molebny Vasyl V
Published: April 2021

ABSTRACT

PURPOSE: In refractive surgery, measuring the total ocular profile of refraction gives more vital information than measuring the cornea alone. We report the first clinical experiments with spatially resolved refractometry using ray tracking principles. Tracey technology was developed in Ukraine by the Institute of Biomedical Engineering in cooperation with the Vardinoyannion Eye Institute of Crete.

METHODS: The Tracey- 1 device was evaluated in comparison with conventional videokeratoscopes. Seven Pseudophakie eyes of 7 patients and two phakic eyes were measured thirty (30) consecutive times (consecutively) each to test reproducibility. Measurements were provided in zones 0 to 5 (6) mm. For each zone, parameters of astigmatism were calculated and mean value and standard deviation were derived.

RESULTS: Standard deviation on the order of 0.14 D was derived.

CONCLUSION: The Tracey Technology wavefront device provides information on the refraction distribution at the first principal plane of the ocular optical system. For the instrument to provide measurements that are directly applicable to clinical practice, the data should be transposed to the corneal plane. The Tracey device can be utilized for the measurement of accommodative amplitude and range. Further development of the instrument is requred to increase its accuracy. [J Refract Surg 2000;16:S588-S591|
New Paradigm for the Treatment of Myopia By Refractive Surgery
Authors: Munger Rejean
Published: April 2021

ABSTRACT

It is proposed that refractive surgery visual outcomes will be significantly improved when using refractive surgery profiles that maintain preoperative corneal aberrations following surgery. An equation to calculate postoperative corneal shapes is presented. [J Refract Surg 2000;16:S651-S653]
Photorefractive Keratectomy for Myopia With the Meditec MEL 70^sub G-Scan^ Flying Spot Laser
Authors: Nagy Zoltán Zsolt , Fekete Orsolya , Süveges Ildikó
Published: April 2021

ABSTRACT

PURPOSE: To evaluate the efficacy, predictability, stability, and safety of the Meditec MEL 70^sub G-Scan^ flying spot excimer laser.

METHODS: One hundred thirty myopic eyes were treated with the Aesculap Meditec Mel 70^sub G-Scan^ ArF flying spot excimer laser with photorefractive keratectomy (PRK). Patient groups: low myopia (Group 1) from -1.50 to -6.00 D (90 eyes), medium myopia (Group 2) from -6.10 to -9.00 D (31 eyes), high myopia (Group 3) from -9.10 to -14.00 D (9 eyes).

RESULTS: At 12 months in the low myopia group, uncorrected visual acuity (UCVA) of 20/40 or better was achieved in 95.5% (86 eyes), 20/20 or better in 77.7% (70 eyes); 2.2% (two eyes) lost two or more lines of best spectacle-corrected visual acuity (BSCVA); 73.3% (66 eyes) were within ±0.50 D of the target correction and 98.8% (89 eyes) were within ±1.00 D. In the medium myopia group, UCVA of 20/40 or better was achieved in 74.2% (23 eyes), 20/20 or better in 25.8% (eight eyes); 3.2% (one eye) lost two lines, 61% (19 eyes) were within ±0.50 D of desired correction and 83.8% (26 eyes) were within ±1.00 D. In the high myopia group, UCVA of 20/40 or better was achieved in 22.2% (two eyes); 20/25 or better in 11.1% (one eye); none of the eyes achieved 20/20 UCVA; 22.2% (two eyes) lost two lines of BSCVA; 44.4% (four eyes) were within ±0.50 D and 66.6% (six eyes) were within ±1.00 D of the target correction. Refractive stability was achieved between 3 and 6 months. Increased intraocular pressure was detected overall in 7.69%.

CONCLUSIONS: The results of predictability, safety, and efficacy in low and medium myopia with the Meditec MEL 70^sub G-Scan^ flying spot excimer laser were good, but poorer predictability, regression, and a significant loss of BSCVA were observed in the high myopia group. J Refract Surg 2001;17: 319-326]
Coefficient of Friction of Ocular Surface Lubricants for Laser in situ Keratomileusis
Authors: Lenton Lee M , Albietz Julie M
Published: April 2021

ABSTRACT

PURPOSE: The coefficient of friction was empirically derived for a series of commercially available ophthalmic lubricants having potential use during laser in situ keratomileusis (LASIK).

METHODS: Measurements were obtained using a modified tensile testing machine. Solutions tested included the artificial tear supplements Polytears-free, Bion Tears, Genteal, Refresh, Cellufresh, Celluvisc, Theratears, and Viscotears gel; and balanced salt solution (BSS).

RESULTS: Viscotears carbomer gel had a significantly lower mean coefficient of friction compared to other ophthalmic lubricants tested (P=.002) and the dry plate (P=.005). Addition of 0.1 ml of BSS to 0.025 ml of Celluvisc significantly reduced the coefficent of friction of Celluvisc (P=.01). Polytears, Bion Tears, Genteal, Refresh, Celluvisc, Theratears, and BSS had coefficients of friction significantly higher than that of the dry plate.

CONCLUSION: A range of values were obtained for the coefficient of the ophthalmic lubricants tested. Viscotears gel (0.1 ml), and Celluvisc (0.025 ml) + BSS (0.1 ml) had coefficients of friction significantly lower than that of the dry plate. [J Refract Surg 2001;17:327-333]
Reduction of Glare After Radial Keratotomy: An Experimental Study
Authors: Peyman Gholam A , Spigelman Alan V
Published: April 2021

SUMMARY

Radial keratotomy was performed on 19 rabbit eyes. To reduce light scatter due to the corneal scars, India ink and other tattoo dyes were introduced into the corneal incisions in 13 of these eyes, while the remaining six served as controls. It was found that the pigments were nontoxic, of no consequence tothe healing process, and stable in intensity after the first postoperative week. Retro-illumination photography demonstrated that the pigmented scars had a qualitative decrease in light dispersion when compared with the controls.
Erosion of the Orbital Plate (Frontal Bone) by a Benign Tumor of the Lacrimal Gland
Authors: Hornblass Albert , Friedman Alan H , Yagoda Arnold
Published: April 2021

SUMMARY

A benign mixed tumor of the lacrimal gland of long standing duration caused complete erosion of the orbital roof and dura. At the time of surgery, a large cerebrospinal fluid leak communicated into the orbit after removal of the tumor.

This was treated with gelfoam, bed rest and antibiotics. The patient had a complete recovery.
Pupillary Abnormalities Associated with Posterior Chamber Lens Implantation
Authors: Lippman Jay I
Published: April 2021

SUMMARY

Posterior chamber lenses often allow for freely dilatable, round rather than square pupils, Abnormal pupillary configurations do occur, however, especially in conjunction with piano surface-up insertion techniques. Three case reports illustrating abnormal pupillary configurations are presented. Two variations on presently available posterior chamber intraocular lenses are described.
Experience With Dermis-Fat Grafting: An Analysis of Early Postoperative Complications and Methods of Prevention
Authors: Aguilar Gary L , Shannon Gerard M , Flanagan Joseph C
Published: April 2021

SUMMARY

During the past 18 months at Wills Eye Hospital we have performed autogenous dermis-fat grafts to anophthalmic orbits in 16 patients. Six early postoperative complications of dermis-fat grafting are presented and discussed, as are the modifications of surgical technique that we feel may minimize early postoperative complications.
Techniques in Eyelid Wound Closure
Authors: Divine Richard D , Anderson Richard L
Published: April 2021

SUMMARY

While one of the most basic techniques in eyelid surgery is the repair of an eyelid defect that involves the margin, many eyelid defects are still poorly repaired; and much confusion still exists in this area. Based upon sound anatomic and surgical principles, we suggest several modifications of classically described techniques: (1) The greyline suture is replaced by a tarsal suture through the meibomian gland orifices to provide a stronger closure and better alignment. (2) All tension of closure is supported by the deep tarsal sutures rather than by the margin sutures to avoid notch formation or unsightly scars. (3) A two-layered closure where orbicularis and tarsus is closed in a single layer is technically easier and gives results comparable to the classically taught three-layered closure. Conjunctival sutures in the tarsal portion of the eyelid are unnecessary and frequently cause corneal irritation. (4) When lid resection is performed, a pentagonal excision rather than a "V" or wedge resection should be used to minimize tension on the margin when closed. We present in an illustrated step-by-step fashion our preferred technique which gives consistently good results.
Foveal Pathology in Ciliary Body Melanoma
Authors: Wolter J Reimer
Published: April 2021

SUMMARY

The histological features of cystoid macular edema in an early stage are demonstrated in the eye of a 54-year-old patient with an active ciliary body melanoma. Separation of the posterior vitreous face and the inner limiting membrane with accumulation of an exudate in the resulting space, petaloid folding of the inner retinal layers, swelling as well as microcystoid degeneration of Henle's fiber layer, and vertical folding of the outer retinal layers with separation of the central cones from the pigment epithelium are observed.
Awl-Needle for Insertion of Posterior Fixation Suture (Fadenoperation)
Authors: Jones Samuel T
Published: April 2021

SUMMARY

The characteristics of a new needle (awl-needle) are described. The method of using this needle to insert a posterior fixation suture is outlined. This method has made the "fadenoperation" safer.
Two New Uses for the Gentian Violet Marker
Authors: Frank Marvin G
Published: April 2021

SUMMARY

The surgeon is always seeking ways to facilitate his surgery without compromising the end result. The gentian violet marking pen is a readily available device that can aid the ophthalmologist in dyeing white sutures and aligning the corneoscleral wound to aid in reducing postoperative astigmatism.
Exposed Scleral Buckle: A Case Report in an Eleven-Year Course
Authors: Schmidt Christopher W , Cohen Howard B
Published: April 2021

SUMMARY

One patient with an exposed scleral buckling element in the left eye was initially followed conservatively. Soon after exposure, he developed a retinal detachment in the fellow eye, resulting in loss of useful vision. Because of concern over possible redetachment and loss of vision in the remaining eye, the patient has been followed with the exposed element for more than 11 years. Treatment has consisted solely of prophylactic topical antibiotics.
Pseudophakic Endophthalmitis
Authors: Nirankari Verinder S , Karesh James W , Lakhanpal Vinod , Schocket Stanley S
Published: April 2021

SUMMARY

Two cases of Pseudophakic endophthalmitis following extracapsular surgery and insertion of posterior chamber lenses were managed with removal of the lens, vitrectomy, and intravitreal antibiotics. Removal of the intraocular lens, posterior capsule, and associated inflammatory membranes was easily accomplished maintaining a clear cornea, improving fundus visualization, and eliminating a possible source of infection. The rationale and results of this approach are discussed.
Cataract Surgery With Intraocular Lens Implantation by Ophthalmology Resident Surgeons
Authors: Neuhaus Russell W , Straatsma Bradley R
Published: April 2021

SUMMARY

Cataract surgery with intraocular lens implantation (cataract-IOL surgery) performed by ophthalmology residents under supervision of experienced surgeons in 1974-1978 was analyzed. Retrospective evaluation of 32 cases noted patient age and sex distribution, preoperative ophthalmic examination findings, technique for cataract surgery with implantation of iris support intraocular lenses, postoperative complications, and visual acuity with best correction 30 months after surgery as well as on the last examination. Postoperative follow-up, ranging from one to 84 months, recorded a visual acuity with best correction of 20/40 or better in 87.5% of cases. Excluding two cases in which decreased visual acuity resulted from macular degeneration, visual acuity with best correction was 20/40 or better in 94% of cases.
Pupillary Block Following Nd:YAG Laser Capsulotomy
Authors: Ruderman Jon M , Mitchell Paul G , Kraff Manus
Published: April 2021

SUMMARY

A patient who developed opacification of the posterior lens capsule three years after phacoemulsification was treated with a Nd:YAG laser capsulotomy. Five hours later he developed pupillary block, elevated intraocular pressure, and transient loss of vision. To our knowledge, this major complication following Nd:YAG laser surgery has not previously been reported.
Compressive Optic Neuropathy Following Use of Intracranial Oxidized Cellulose Hemostat
Authors: Dutton Jonathan J , Tse David T , Anderson Richard L
Published: April 2021

SUMMARY

A 35-year-old white male sustained head injuries in a motor vehicle accident. He underwent neurosurgical repair of a frontotemporal skull fracture and lacerated left frontal lobe; regenerated oxidized cellulose (Surgicel) was placed into the anterior cranial fossa for hemostasis. Forty-eight hours after surgery he suffered rapid deterioration of vision to no light perception from optic nerve compression. Radiologic and echographic evaluation demonstrated a subperiosteal soft tissue density in the orbital apex consistent with hematoma. At surgery for optic canal decompression, the cellulose hemostat was found in the apex of the left orbit, having migrated through orbital roof fractures, and had apparently caused the compressive optic neuropathy. Decompression resulted in return of vision to the level of counting fingers.
A Simple and Easy Drain for Surgical Procedures
Authors: Blanksma Lieuwe J
Published: April 2021

SUMMARY

Asimple drain, made of a small tape of woven cotten, is stretched out in the lower fornix to remove the overflow of saline that is used to keep the cornea wet during surgical procedures.
Nocardia Asteroides Endophthalmitis
Authors: Chen Ching J
Published: April 2021

SUMMARY

A case of exogenous Nocardia asteroides endophthalmitis with impending corneal perforation was diagnosed by culture and successfully treated with vitrectomy, penetrating keratoplasty, and intraocular, topical, and systemic antimicrobial therapy. The patient regained excellent vision.
Repair of the Lacerated Canaliculus Using a Modified Silver Wire Lacrimal Rod
Authors: Nasr Amin M , Johnson Carl C , Beyer-Machule Charles K
Published: April 2021

SUMMARY

Several techniques have been used to repair lacerated canaliculi with varying success in achieving functional results. In this communique, we describe a new procedure using a modified Johnson silver wire lacrimal rod.
Vein Grafting in Nasolacrimal System Reconstruction
Authors: Soll David B
Published: April 2021

SUMMARY

Obliteration of the tract after conjunctivodacryocystorhinostomy is one of the main complications associated with the procedure.

The use of a saphenous vein graft which covers the tube may aid in establishing an immediate lined tract for the tube when performing a conjunctivodacryocystorhinostomy.

Another possible use for the vein graft is in anastomosing the parotid duct to the inferior cul-de-sac when performing a parotid duct transfer. The vein graft makes parotid duct transfer easier and helps control the amount of saliva delivered to the eye. A case report is presented.
Evaluation of the Neodymium-YAG Laser for Treatment of Ocular Opacities
Authors: Riggins James , Pedrotti Leno S , Keates Richard H
Published: April 2021

SUMMARY

The Neodymium:YAG Laser was used to find damage thresholds for glass and PMMA IOLs. In addition, optimal cone angles of the laser in regard to laser safety was determined along with consideration of suitability of other laser wavelengths. Lastly, investigation of substitute solutions for optical breakdown compared to vitreous was evaluated.
A Simple, Inexpensive Sterile Vitreous Specimen Collection Device With Peyman Vitreophage
Authors: Chen Ching J , Gillespie William
Published: April 2021

SUMMARY

A simple and inexpensive vitreous specimen collection device is described. This device can be connected to the Peyman Vitreophage System to obtain a sterile intraocular specimen during a pars plana vitrectomy.
Clinical and Ultrastructural Analysis of Variable Speed Corneal Trephination
Authors: Schanzlin David J , Robin Jeffrey B , Spence David J
Published: April 2021

SUMMARY

An automated, variable speed trephine was utilized to study the effects of rotation velocity on corneal trephination. Scanning electron microscopy revealed that the higher velocity (800 RPM) specimens had less stromal lamellar disruption, producing a smoother interface than either the lower velocity (100 RPM) automated trephinations or manual trephinations.
Keratophakia With Lyophilized Cornea Lathed at Room Temperature: New Techniques and Experimental Surgical Results
Authors: Maguen Ezra , Pinhas Simon , Verity Steven M , Nesburn Anthony B
Published: April 2021

SUMMARY

A modified method of prelathing lyophilized corneal tissue at room temperature for refractive keratoplasty is described. This method allows perfect centration of a lyophilized corneal button on the plastic base and thus more accurate lathing. Keratophakia was performed with lenticules prepared in this fashion on a series of eight cats which were followed for 30 weeks postoperatively. All lenticules were clear ten weeks following surgery and the final optical correction obtained varied ± 2.5 D from the intended correction.
Accessory Lacrimal Gland Fistula Secondary to Ptosis Surgery
Authors: Beyer-Machule Charles K , Tyers Anthony G , Bathrick Marie E , Arrigg Claudia A
Published: April 2021

SUMMARY

This is a case report of the development of a lacrimal fistula following repeated anterior levator resections for severe ptosis. The fistula was excised and pathologically traced to an accessory lacrimal gland. This patient represented the first documented case following an accessory lacrimal gland as the source for a fistula following levator resections for ptosis.