bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcome Study of Bilateral Lateral Rectus Recession for Intermittent Exotropia in Children
Authors: Ing Malcolm R , Nishimura Julie , Okino Lisa
Published: April 2021

* BACKGROUND AND OBJECTIVE: The purpose of this paper is to report a statistical analysis of the surgical results in a consecutive series of 52 children treated by bilateral lateral rectus recession for intermittent exotropia when the operating surgeon was confronted by an increase in manifestation of the strabismus.

* PATIENTS AND METHODS: The charts were abstracted for age at initial surgery, quantity of initial deviation, initial refraction, motor alignment at one week, six months, and at the end of the study. The incidence and result of secondary surgery and the incidence of the monofixation syndrome result was also determined.

* RESULTS: Thirty-two (62%) of the patients were successfully aligned at six months by the initial surgery performed for a mean of 25 prism diopters (PD) of preoperative deviation at a mean age of 4 years 8 months. Eleven patients (21%) were undercorrected and 9 patients (17%) were overcorrected at the six month exam. The patients were followed for a mean of 4 years, 4 months. Alignment at 6 months postoperatively was predictive of success by the end of the study, but the age at initial surgery, the size of the deviation, esotropia at 1 week, and initial refraction were not predictive of success. Secondary surgery was performed in 11 patients and the monofìxation syndrome result was found in 5 patients.

* CONCLUSION: Successful alignment was achieved in the majority of children treated by an initial bilateral lateral rectus recession utilizing a currently popular surgical dosage table.10 Long term alignment success was not predicted by esotropia during the first postoperative week or the age at initial surgery but was correlated with the 6-month data. Secondary surgery was performed in 20% and the incidence of the monofixation syndrome was approximately 10% at the end of the study.

[Ophthalmic Surg and Lasers 1999;30:110-117.]
Oral Prednisone in Guarded Filtration Procedures Supplemented with Antimetabolites
Authors: Azuara-Blanco Auguszto , Spaeth George L , Augsburger James J
Published: April 2021

* BACKGROUND AND OBJECTIVE: To evaluate whether a three-day course of oral prednisone perioperatively improves the surgical outcome of guarded filtering procedures supplemented with antifibrosis agents.

* DESIGN, MATERIALS AND METHODS: A prospective, randomized, double-masked, placebo-controlled, clinical trial was designed. Adult patients with non-inflammatory glaucoma undergoing a guarded filtration procedure supplemented with antimetabolite were enrolled. Patients received a three-day course of prednisone (50 mg BID) or placebo perioperatively. The main outcome measures were intraocular pressure (IOP) and number of antiglaucoma medications. Surgical success was defined before data collection according to two different criteria: "success-I": IOP level ≤15 mmHg with no more than one anti-glaucoma medication, and "success-II": IOP reduction of at least 20% of baseline level with no more than one antiglaucoma medication.

* RESULTS: Thirty-five subjects were enrolled. Seventeen patients were treated with prednisone and eighteen with placebo. Mean follow-up was 9.2 months±6.2 months. The probability of success-I at 9 months was 63-0% in the study group and 65-6% in the control groups (p>0.05). The probability of success-II at 9 months was 60.2% in the study group and 55.0% in the control groups, (p>0.05). The difference in frequency of postoperative complications between groups was not statistically significant. The most common complication was choroidal detachment (n=2) in the prednisone-treated group and bleb leak (n=2) in the control group.

* CONCLUSION: The perioperative use of oral prednisone did not alter the surgical outcome of filtering procedures associated with antifibrosis agents in this population of glaucoma patients.

[Ophthalmic Surg and Users 1999;30: 126-132.]
Late Bleb-Related Endophthalmitis after Trabeculectomy with Mitomycin C
Authors: Akova Yonca A , Bulut Selçuk , Dabil Hümeyra , Duman Sunay
Published: April 2021

Abstract. To present two cases of delayed-onset post-operative endophthalmitis following trabeculectomy combined with mitomycin C for secondary glaucoma after penetrating keratoplasty. We retrospectively evaluated two patients with late endophthalmitis after trabeculectorny combined with intraoperative mitomycin C application. Both patients underwent trabeculectorny for uncontrolled glaucoma following penetrating keratoplasty and they developed thin-walled cystic blebs. Intraocular pressure was normal, and grafts remained clear postoperatively. Severe endophthalmitis with hypopyon developed at 3 and 7 months postoperatively. Both patients had concomitant bleb infection. They underwent vitreous sampling and intravitreal injection of vancomydn and amikacin and were given topical fortified and systemic antibiotic therapy. Intravitreal injection was repeated once in both patients. Cultures grew Streptococcus pneumonias in one and Staphylococcus aureus in the other. Although the treatment of endophthalmitis was successful in both patients, only one of them achieved useful vision (20/40). For the other patient who had been infected with S. pneumoniae, vision was light perception. Delayed-onset endophthalmitis following trabeculectorny with mitomycin C application is a severe and vision threatening complication. It seems that the development of thin cystic filtering blebs secondary to intraoperative mitomycin C application may be a predisposing factor for bleb-related late endophthalmitis. [Ophthalmic Surgery and Lasers 1999;30:146-151.]
Circumferential Perilimbal Anesthesia for Combined Cataract Glaucoma Surgery
Authors: Anderson Charles Joseph
Published: April 2021

* BACKGROUND AND OBJECTIVES: A topical-subconjunctival anesthesia technique named circumferential perilimbal anesthesia was tested in a consecutive series of 34 combined cataract and glaucoma cases to determine effectiveness in long duration anterior segment surgery.

* PATIENTS AND METHODS: The circumferential perilimbal technique for combined surgery involved administration of 4% topical Xylocaine drops and injection of 0.25 cc of 4% Xylocaine subconjunctivally 3-4 mm inferior to the limbus. The inferior subconjunctival anesthesia was then spread 360° around the limbus circumferentially with a smooth forceps. The topical and local anesthetic was supplemented by intravenous preoperative and intraoperative sedative and analgesic medications.

* RESULTS: All patients had successful phacoemulsification cataract extraction with intraocular lens combined with rrabeculectomy. Medical records and postoperative interviews of the combined cataractglaucoma cases revealed an average surgery time of 46 minutes (range 35rninutes-60 minutes) and only one incident of patient intraoperative pain.

* CONCLUSION: The circumferential perilimbal technique was an effective anesthesia technique for long duration combined cataract and glaucoma surgery.

[Ophthalmic Surg Lasers 1999;30:205-207.]
The Effects of Compression Sutures On Filtering Blebs in Rabbit Eyes
Authors: Chen Philip P , Takahashi Yasuko , Leen Martha M , Bhandari Anuja , Li Yi , Mills Richard P
Published: April 2021

* PURPOSE: To investigate the effect of compression sutures on filtering bleb cellularity in rabbit eyes.

* METHODS: Six New Zealand rabbits had bilateral filtering surgery. In the study eye, on postoperative day 1 4 a 1 0-0 nylon suture was placed that compressed the bleb. Five-bromo-2'-deoxyuridine (BrdU) was injected intravenously on days 15, 16, and 18. On day 21 histologie sections of the blebs were obtained. The total cell count was compared to the number of actively dividing cells (marked by anti-BrdU antibody).

* RESULTS: Study eyes had higher total cell counts (/"=.004) on postoperative day 21, but the proportion of proliferating cells was not significantly different (P=. II).

* CONCLUSION: In rabbit eyes, bleb compression sutures were associated with more cellular components in the bleb compared to control eyes, but did not induce a higher level of cellular proliferation.

[Ophthalmic Surg Lasers 1998;30:2 16-220.]
Surgical Removal of a Free Floating Cyst of the Iris Pigment Epithelium Causing Disturbing Visual Symptoms
Authors: Verma Lalit , Venkatesh Pradeep , Sen Seema , Lakshmaiah NC , Tewari Hem K
Published: April 2021

Abstract. Pigmented cysts in the anterior chamber, fixed or free floating, are considered to be unusual but not very infrequent.1"4 However, most of these cases usually do not need any treatment other than a periodic observation.5 We report the surgical removal of an iris pigment epithelial cyst floating freely in the anterior chamber. The reason for surgical removal was, disturbance in near vision being caused by movement of the cyst across the visual axis. This specific symptom of disturbed near vision, to the best of our knowledge, is a rare indication for surgery that has not been pointed out earlier. Histo pathological confirmation of the clinical diagnosis was also obtained. [Ophthalmic Surg Lasers 1999;30:223-225-]
Retinal Venous Macroaneurysm Associated With Premacular Hemorrhage
Authors: Khairallah Moncef , Ladjimi Ahmed , Messaoud Riadh , Yahia Selim Ben , Hmidi Kamel , Jenzeri Salah
Published: April 2021

Abstract. To report an unusual association of a retinal venous macroaneurysm with premacular hemorrhage in a 50-year-old man, using a case report method. The patient exhibited a dense premacular hemorrhage in the left eye. Fluorescein angiography demonstrated that the source of bleeding was an isolated retinal venous macroaneurysm. The anterior surface of the hematoma was opened with an argon green laser, resulting in rapid clearing of the premacular hemorrhage and improvement in vision. Treatment of the retina surrounding the macroaneurysm to prevent recurrence of bleeding was ineffective to achieve occlusion of the lesion. No recurrent hemorrhage occurred during the observation period. Retinal venous macroaneurysm, a quite rare condition, may be complicated by premacular hemorrhage. Argon green laser may be useful in treating such hemorrhage.

Hemorrhagic detachment of the internal limiting membrane or subhyaloid hemorrhage in the macula may occur after retinal vessel rupture with physical exertion (Valsalva retinopathy) or in retinal vascular diseases, such as proliferative diabetic retinopathy, and retinal arterial macroaneurysm.1 Arterial macroaneurysms are a common, well-described retinal vascular disorder.1 In contrast to retinal arterial macroaneurysms, retinal venous macroaneurysms are quite rare.2,3 In this article we describe a patient who presented with premacular hemorrhage that was caused by a retinal venous macroaneurysm. The hematoma and the macroaneurysm were treated with argon green laser. [Ophthalmic Surg Lasers 199930:226-228.]
A Case of an Intraocular Foreign Body due to Graphite Pencil Lead Complicated by Endophthalmitis
Authors: Hamanaka Noriko , Ikeda Tsunehiko , Inokuchi Naoki , Shirai Setuko , Uchihori Yasutaka
Published: April 2021

Abstract. We report a case of an 8-year-old boy who presented with an intraocular foreign body composed of graphite pencil lead. The patient had been accidentally poked in the right eye with a graphite pencil. Primary care consisted of corneal suturing and lens extraction. Two pieces of the pencil lead remained in the vitreous caviry following surgery, and 2 days later the patient developed endophthalrnitis. Pars plana vitrectomy was performed immediately and the intraocular foreign bodies were removed through the scierai wound. Cultures of the vitreous fluid revealed no bacterial organisms. X-ray fluoroscopic analysis of the vitreous detected 1 ppm of aluminum (a constituent of the pencil lead). Although the clinical presentation indicated probable bacterial endophthalmitis, the detection of elemental aluminum within the vitreous cavity also suggested the possibility of further retinal toxicity due to some dissolving of the pencil lead. [Ophthalmic Surg Lasers 1999;30:229-231.]
Phacotrabeculectomy Versus Two-Stage Operation: A Matched Study
Authors: El-Sayyad Fathi F , Helal Magdi H , Khalil Mohamed M , El-Maghraby Mohamed A
Published: April 2021

* BACKGROUND AND OBJECTIVE: To evaluate the efficacy and safety of phacoemulsification and foldable intraocular lens, combined with trabeculectomy (phacotrabeculectomy) in patients with coexisting cataract and glaucoma.

* PATIENTS AND METHODS: A total of 53 consecutive eyes which underwent phacotrabeculectomy and posterior chamber intraocular lens (PCIOL) were matched and compared with 53 eyes that had trabeculectomy followed by phacoemulsification and posterior chamber intraocular lens (mean interval 3.2 month). The 2 groups were first matched by diagnostic group and subsequently for the closest possible match with other successive variables, including age, gender, race and preoperative glaucoma medications. Mean intraocular pressure (IOP) reduction, visual acuity, antiglaucoma medications, and surgical success as well as complications were compared in both groups.

* RESULTS: Mean IOP reduction was 14.5±4.1 mmHg in the two-stage group compared to 15.1±3.9 in the phacotrabeculectomy group at 6 months followup (P<0.1) and 13.8±3.9 and 14.6±3.7 respectively at 1 year (P<0.1). Visual acuity and complications were comparable.

* CONCLUSION: Phacotrabeculectomy provides IOP control statistically comparable to two-stage surgery with earlier visual rehabilitation.

[Ophthalmic Surg Lasers 1999;30:260-265.]
Results of Medical Management and Mitomycin C-Augmented Excisional Bleb Revision for Encapsulated Filtering Blebs
Authors: Mandal Anil K
Published: April 2021

* BACKGROUND AND OBJECTIVE: To assess the outcome of medical management and mitomycin C (MMC)-augmented excisional bleb revision (EBR) for encapsulated filtering blebs.

* PATIENTS AND METHODS: The author conducted a retrospective study of 503 patients who had undergone trabeculectomy performed over a 5 year period, followed up for at least one year, in order to identify the encapsulated filtering blebs. Mitomycin C-augmented (0.4mg/ml for 3 minutes) EBR was performed in cases of failed medical therapy for managing encapsulated blebs consisting of antiglaucoma medications, topical steroids, and digital compression.

* RESULTS: An encapsulated bleb developed in 18 eyes (3.6%) of 503 patients. Identification of bleb encapsulation occurred at a mean follow-up time of 24.2 ± 10.4 days after surgery. The mean intraocular pressure (IOP) at that point was 30.4 ± 11.7 mmHg in the affected eyes. Fifteen (83.3%) of 18 eyes responded to conservative management and 3 eyes (16.7%) required MMC augmented EBR. The mean IOP reduced from 30.4 ± 11.7 mmHg to 14.2 ± 4.2 mmHg after a mean follow-up of 37.6 ± 11.4 months in the conservative management group, while it reduced from 37.3 ± 23.4 mmHg to 12.0 ± 4.4 mmHg after a mean follow-up of 42 ± 6 months in the surgically treated group. None of the surgically treated eyes developed MMC-related complications.

* CONCLUSION: Conservative management is very effective in the treatment of encapsulated filtering blebs. The intraoperative use of MMC is a safe and effective adjunct in EBR in cases where conservative management has failed.

[Ophthalmic Surg Lasers 1999;30:276-284.]
Combined Central Retinal Artery and Central Retinal Vein Occlusion Following Pars Plana Vitrectomy
Authors: Verma Lalit , Venkatesh Pradeep , Tewari Hem K
Published: April 2021

Abstract. Combined occlusion of the central retinal artery and central retinal vein is an infrequently encountered clinical entity. Although there are reports in the literature of a combined occlusion of the central retinal artery and vein,1,4,9 its occurrence following pars plana vitrectomy has not been described. We report the case of an elderly patient who developed this unusual occurrence following an uneventful pars plana vitrectomy for a posteriorly dislocated IOL.

[Ophthalmic Surg Lasers 1999;30:317-319.]
Combined Cataract Surgery, Intraocular Lens Insertion, and Vitrectomy in Eyes with Idiopathic Epiretinal Membrane
Authors: Alexandrakis George , Chaudhry Nauman A , Flynn Harry W , Murray Timothy G
Published: April 2021

Abstract. To report the surgical outcomes of combined cataract surgery and pars plana vitrectomy in eyes with idiopathic epiretinal membrane. This is a retrospective review of 8 consecutive patients with concurrent cataract and idiopathic epiretinal membrane who underwent the combined procedure. At a mean follow-up of 22 months, the visual acuity improved by 2 or more Snellen lines in 7 patients (88%). Median pre-operative and postoperative best-corrected visual acquities were 20/200 and 20/50 respectively. Simultaneous cataract surgery and vitrectomy for idiopathic epiretinal membrane removal resulted in visual improvement in the majority of patients. [Ophthalmic Surg Lasers 1999;30:327-328.]
Refractive Results of Post Penetrating Keratoplasty Photorefractive Keratectomy
Authors: Yoshida Kenji , Tazawa Yutaka , Demong Thaddeus T
Published: April 2021

* BACKGROUND AND OBJECTIVE: The aim of this study was to evaluate the safety, effectiveness, and predictability of photorefractive keratectomy (PRK) for severe myopia and astigmatism following penetrating keratoplasty.

* PATIENTS AND METHODS: PRK was performed on 42 eyes, and 33 eyes were followed up for at least 6 months.

* RESULTS: Mean preoperative spherical equivalent was -8.29 ± 4.01 diopters (D), which decreased to - 2.96±3.26D in manifest refraction at 6 months. Keratometric power reduced from 48.06±3.32D preoperatively to 43.97±3.40D. Refractive and keratometric astigmatism attained the reduction of 31.0% and 13.56% in average respectively. Twenty three eyes had improved uncorrected visual acuity.

* CONCLUSION: PRK was effective in reducing post-keratoplasty myopia and astigmatism, but the predictability was not as good as in the non-grafted eye.

[Ophthalmic Surg Lasers 1999;30:354-359.]
Acquired Pseudo-Brown's Syndrome Immediately Following Ahmed Valve Glaucoma Implant
Authors: Coats David K , Paysse Evelyn A , Orenga-Nania Silvia
Published: April 2021

Abstract. A 76-year-old woman noted vertical and horizontal diplopia one day following placement of an Ahmed valve in the superonasal quadrant of her left eye. She was unable to elevate her left eye, especially in adduction. She refused implant removal and strabismus surgery alone failed to satisfactorily resolve her problem. On forced duction testing, the implant became wedged between the globe and orbit superonasally. Subsequent repositioning of the valve resulted in resolution of her motility problem. Implantdisproportion can produce a pseudo-Brown's syndrome. Surgeons are encouraged to perform forced duction testing at the time of glaucoma implant placement to detect and prevent this complication. [Ophthalmic Surg Lasers 1999;30:396-397.]
Matching Set of Enucleation Retractor and Scissors
Authors: Custer Philip L
Published: April 2021

Abstract. Many surgeons encounter difficulty transecting the optic nerve during the enucleation procedure. An inadequate specimen may be obtained or the surrounding orbital tissue may be traumatized. A matching set of enucleation instruments have been developed to improve the visualization and division of the optic nerve while protecting the nearby orbital structures. The new enucleation instruments have been employed in 130 consecutive enucleation procedures. There have been no complications associated with these instruments. These instruments have facilitated the visualization and transection of the optic nerve during the enucleation procedure. [Ophthalmic Surg Lasers 1999;30:408-409.]
Management of Traumatic Cyclodialysis Cleft Associated With Ocular Hypotony
Authors: Kato Tsuyoshi , Hayasaka Seiji , Nagaki Yasunori , Matsumoto Masayuki
Published: April 2021

* BACKGROUND AND OBJECTIVE: To evaluate the efficacy of direct cyclopexy for treatment of traumatic cyclodialysis cleft associated with ocular hypotony.

* PATIENTS AND METHODS: Eyes with traumatic cyclodialysis cleft were treated with direct cyclopexy or 1.0% atropine eyedrop.

* RESULTS: Five eyes with a large cyclodialysis cleft were treated with direct cyclopexy. Postoperatively, these eyes obtained normal intraocular pressure. Four of the 5 eyes had good visual acuity, and 1 eye that had preoperative subretinal hemorrhage in the macula had poor visual acuity. Of the 3 eyes treated with 1.0 % atropine eyedrops, 1 had good visual acuity, and 2 with retinal folds had fairly good and poor visual acuity.

* CONCLUSION: The present study showed that direct cyclopexy is useful for the treatment of traumatic cyclodialysis cleft associated with ocular hypotony, and that the cyclodialysis should be surgically treated before irreversible retinal folds develop.

[Ophthalmic Surg Lasers 1999;30:469-472.]
Three-Dimensional Characteristics of Macular Pseudoholes Using Confocal Laser Tomography
Authors: Akiba Jun , Yanagiya Norihiko , Konno Suguru , Hikichi Taiichi , Yoshida Akitoshi
Published: April 2021

* BACKGROUND: Epiretinal membranes with macular pseudoholes are sometimes confused with full-thickness macular holes. Because both the natural course and clinical management of the two differ, an accurate differential diagnosis is needed.

* PATIENTS AND METHODS: We obtained three-dimensional images of macular pseudoholes in 12 eyes using the Heidelberg retina tomograph (HRT). Another 15 eyes with a full-thickness macular hole were also studied. In addition, we measured the area and the maximum depth of both types of holes.

* RESULTS: Irregular rippling undulations were frequently observed on the three-dimensional topographic maps around the pseudoholes, whereas elevated cuffs were observed around the full-thickness holes. The maximum depth of the macular pseudoholes (mean, 57 u,m) was significantly shallower than that of the full-thickness macular holes (mean, 156 µ?a; P< 0.01).

* CONCLUSION: Three-dimensional images obtained by the HRT and the measurement of the maximum depth may be useful in differentiating macular pseudoholes from full-thickness macular holes.

[Ophthalmic Surg Lasers 1999;30:513-517.]
Treatment of Macular Disease with a Binocular Indirect Ophthalmoscope Laser Delivery System
Authors: Friberg Thomas R
Published: April 2021

* BACKGROUND AND OBJECTIVE: Some patients with macular disease, because of physical infirmity or disability, cannot be treated with laser photocoagulation using a typical slit lamp delivery system. The purpose of this study was to determine whether the binocular indirect ophthalmoscope could be used to deliver treatment to the macula when photocoagulation would otherwise be very difficult, if not impossible, to perform.

* MATERIALS AND METHODS: Ten eyes of 10 patients who could not sit for slit lamp laser delivery were treated with binocular indirect ophthalmoscope laser photocoagulation over a 36 month period. Eight had subfoveal choroidal neovascularization (CNV) from age-related macular degeneration (AMD), and 2 patients had clinically significant macular edema (CSME) from diabetes mellitus. Argon laser photocoagulation was delivered to the choroidal neovascular membrane in patients with exudative AMD, and a grid treatment was given to eyes with diabetic macular edema.

* RESULTS: Six of 8 patients with exudative AMD were successfully treated with eradication of the CNV. Two required retreatment within 6 months of original treatment. Both patients with CSME had resolution of their edema at 3 and 6 months after treatment. Best corrected visual acuity did not change by more than 2 Snellen lines in any patient with CNV and 1 Snellen line in patients with CSME. No complications of treatment were encountered.

* CONCLUSION: In certain circumstances, laser photocoagulation of the macula using the indirect ophthalmoscope laser delivery system should be considered when more conventional treatment strategies cannot be implemented.

[Ophthalmic Surg Lasers 1999;30:518-522.]
Outcome of Laser Peripheral Iridotomy in Chronic Primary Angle Closure Glaucoma
Authors: Thomas Ravi , Arun Triveni , Muliyil Jayaprakash , George Ronnie
Published: April 2021

* BACKGROUND AND OBJECTIVES: To report the effect of laser peripheral iridotomy on the angles of eyes with chronic angle closure glaucoma.

* PATIENTS AND METHODS: The hospital records of 171 consecutive patients with chronic primary angle closure glaucoma (CPACG) seen between October 1994 and March 1997 were analyzed to study the gonioscopic outcome of laser peripheral iridotomy (LPI). Success was defined as open angles (with or without medications for intraocular pressure (IOP) control) following LPI at the 1 month follow-up.

* RESULTS: Forty-seven eyes of 34 patients had chronic appositional angle closure glaucoma (CAACG), and 186 eyes of 124 patients had chronic synechial angle closure glaucoma (CSACG). Seventy eyes of 57 patients that underwent primary trabeculectomy for advanced disease were excluded from the study Two hundred thirty- three eyes of 158 patients underwent LPI; the angles could be opened in 171 eyes (73.4%; confidence interval 67.7% to 79.1%) of 117 patients. Medications to control the IOP were required in 25 eyes (10.7%) of 19 patients. Fifty-four eyes of 34 patients that did not respond to LPI underwent argon laser gonioplasty. Gonioplasty was successful in opening at least 1 80° of the angle in all eyes. There was no significant difference in success between CAACG (74.5%) and CSACG (73.1%). Age, IOP, and field loss were not predictors of outcome. There was perfect concordance of results between the 2 eyes of patients who had bilateral LPI.

* CONCLUSIONS: In this series, laser iridotomy was successful in opening the angle in 73.4% of eyes. Gonioplasty opened the angle in all eyes that underwent this procedure. The effect of iridotomy on one eye was predictive of the effect on the fellow eye.

[Ophthalmic Surg Lasers 1999;30:547-553.]
Late-Onset Unilateral Primary Developmental Glaucoma Associated With Iridotrabecular Dysgenesis, Congenital Ectropion Uveae and Thickened Corneal Nerves: A New Neural Crest Syndrome?
Authors: Mandal Anil K
Published: April 2021

Abstract. The association of unilateral primary developmental glaucoma with iridotrabecular dysgenesis and congenital ectropion uveae has been well documented in the literature. The glaucoma in this entity may present at birth, infancy or may develop at a later stage in life. I report the case of a child with late-onset unilateral primary developmental glaucoma due to iridotrabecular dysgenesis, congenital ectropion uveae, and who had a previously undescribed association with ipsilateral thickened corneal nerves in the stroma. [Ophthalmic Surg Lasers 1999;30:567-570.]
The Use of Scleral Transillumination to Localize the Extent of a Cyclodialysis Cleft
Authors: Jewelewicz Daniel A , Liebmann Jeffrey M , Ritch Robert
Published: April 2021

Abstract. Several techniques have been described to localize and repair cyclodialysis clefts. We describe a technique that may be used to easily and accurately localize a cyclodialysis cleft using scleral transillumination. We have verified the accuracy of this technique using high frequency ultrasound biomicroscopy. The location of the cleft was verified using high frequency ultrasound biomicroscopy. Scleral transillumination may facilitate the accurate location of cyclodialysis and may be a useful adjunct in planning the surgical repair of a cyclodialysis cleft. [Ophthalmic Surg Lasers 1999;30:571-574.]
Orbital Leiomyosarcoma After Retinoblastoma
Authors: Klippenstein Kimberly A , Wesley Ralph E , Glick Alan D
Published: April 2021

Abstract. Patients with the inherited, bilateral form of retinoblastoma have an increased incidence of osteogenic sarcoma such that the mortality from the secondary tumor exceeds that of the initial bilateral retinoblastoma. We report a 29-year-old male survivor of bilateral retinoblastomas originally diagnosed at 8 months of age, whose treatment eventually included bilateral enucleation, bilateral orbital radiation, and systemic chemotherapy. At age 26, a tumor removed from his right maxillary sinus was diagnosed as fibroma. At age 29, he developed an inferior orbital mass that extended into the right maxillary sinus. A biopsy and comparison with the previous maxillary sinus mass revealed both lesions to be leiomyosarcoma. Both light and electron microscpy supported the diagnosis. The patient has survived treatment with orbital exenteration and maxillectomy combined with postoperative radiation to the right orbital-maxillary area. This appears to be the fourth case of leiomyosarcoma in the third decade of life in a male patient with a previously irradiated orbit after enucleation for bilateral retinoblastoma. Leiomyosarcoma appears to be another orbital tumor associated with bilateral retinoblastoma. [Ophthalmic Surg Lasers 1999;30:579-583.]
Pyogenic Granuloma: A Rare Complication of Silicone Punctal Plugs
Authors: Akova Yonca Aydin , Demirhan Beyhan , Çakmakçi Safak , Aydin Pinar
Published: April 2021

Abstract. To describe pyogenic granuloma formation associated with silicone punctal plugs. A 65-year-old woman with severe dry eye was treated with silicone punctal plugs in both upper and lower puncta. After 14 months of success with the plugs, the patient presented with a fleshy ampullary lesion overlying the plugged superior punctum of her right eye. It was clinically diagnosed as a pyogenic granuloma, and the silicone plug was removed. Since the lesion persisted for 1 month, it was surgically removed. Histopathologic examination confirmed the diagnosis of pyogenic granuloma. A new plug was inserted and tolerated well. The routine use of silicone plugs are recommended as long as patients are informed of possible rare complications. [Ophthalmic Surg Lasers 1999;30:584-585.]
Combined Scleral Buckle and Pars Plana Vitrectomy as a Primary Procedure for Pseudophakic Retinal Detachments
Authors: Devenyi Robert G , Nakamura Hudson de Carvalho
Published: April 2021

* BACKGROUND AND OBJECTIVE: Pseudophakic and aphakic retinal detachments are associated with a lower percentage of successful primary repair with standard scleral buckling surgery, than phakic retinal detachments. The objective of this study was to determine whether a combined scleral buckle and vitrectomy, as a primary procedure, offers any advantage over conventional scleral buckling in primary pseudophakic and aphakic retinal detachments, without proliferative vitreoretinopathy.

* MATERIALS AND METHODS: This was a prospective, non-randomized clinical study. Ninety-four consecutive pseudophakic and aphakic retinal detachments were included in the study. All patients were operated upon by the same surgeon. Each patient underwent a combined scleral buckle and pars plana vitrectomy with perfluorocarbon injection and air-fluid exchange. Each patient was followed by the operating surgeon for a minimum of 6 months. Patients were followed with respect to anatomic reattachment, visual acuity improvement, and surgical complications.

* RESULTS: All eyes were anatomically reattached after a single operation. All demonstrated an increase in their visual acuity, and there were no complications attributable to the vitrectomy procedure.

* CONCLUSIONS: We conclude that such a combined approach to primary pseudophakic and aphakic retinal detachments offers significant benefits to scleral buckling alone. We believe that the improved success rate is a function of vitrectomy contributing to both an improved peripheral visibility, resulting in fewer missed peripheral breaks, and a lower likelihood of proliferative vitreoretinopathy. We recommend this combined surgical approach for all primary pseudophakic and aphakic retinal detachments.

[Ophthalmic Surg Lasers 1999;30:615-618.]
Phacotrabeculectomy Without Peripheral Iridectomy
Authors: Manners Timothy D , Mireskandari Kamiar
Published: April 2021

* BACKGROUND AND OBJECTIVE: Peripheral iridectomy has been a long established part of glaucoma drainage surgery. This series examines the potential to dispense with iridectomy when trabeculectomy Is combined with modern small-incision cataract surgery.

* PATIENTS AND METHODS: Twenty-five unselecced consecutive patients underwent a standardized phacotrabeculectomy by a single surgeon. Outcome measures included visual acuity, intraocular pressure control, and complication rates. Mean follow-up was 12.2 months.

* RESULTS: There were no complications related to lack of peripheral iridectomy. Intraocular pressure was reduced from a mean of 23.4 mm Hg (SD 5.1) to 15.9 (SD 3.8) at 6 months, and 15.4 (SD 3.5) at 12.2 months. There were 2 relative failures of surgery whose IOP reached preoperative targets with additional medical treatment. Best Snellen acuity improved by a mean of 1.5 lines.

* CONCLUSIONS: Phacotrabeculectomy without peripheral iridectomy appears to be safe, although we consider that a corneal fístula and careful control of postoperative overdrainage is necessary to allow this. The success rate and lack of complications is good by comparison with other series. This could be related to the absence of release of factors influencing healing at the time of an iridectomy.

[Ophthalmic Surg Lasers 1999;30:631-635.]
Traumatic Subconjunctival Dislocation of the Crystalline Lens and Its Surgical Management
Authors: Sathish Srinivasan , Chakrabarti Arup , Prajna Venkatesh
Published: April 2021

Abstract. The authors report a case of a 40-year-old female who had sustained a blunt ocular trauma resulting in anterior scierai rupture and subconjunctival dislocation of the crystalline lens. Anterior segment ultrasound aided in the diagnosis. Surgical exploration revealed a 6 mm long anterior scierai rupture which was repaired. Postoperatively the patient had a best corrected visual acuity of 6/18. [Ophthalmic Surg Lasers 1999',30:684-686.]
Subthreshold (Invisible) Modified Grid Diode Laser Photocoagulation in Diffuse Diabetic Macular Edema (DDME)
Authors: Akduman Levent , Olk R Joseph
Published: April 2021

* BACKGROUND AND OBJECTIVE: To determine the effectiveness of subthreshold (invisible) diode laser (810 nm) modified grid photocoagulation for the treatment of diffuse diabetic macular edema (DDME).

* METHODS: Fifty eyes of 29 patients were treated with subthreshold (invisible) diode laser modified grid photocoagulation for DDME in a prospective pilot clinical trial. Follow-up was conducted for a minimum of 6 months (average: 14.11 ± 6.15 months). Retreatment was performed for residual edema involving the foveal avascular zone. Ten patients were tested with Goldman visual field pre- and post-treatment. Visual improvement, visual loss, visual field, reduction/elimination of macular edema, and the number of treatments per eye were studied.

* RESULTS: Reduction/elimination of DDME was observed in 39% of the eyes after 1 to 3 treatments (2.22 ± 0.84 treatments) in 6 to 12 months; and in 74% of eyes after 1 to 5 treatments (2.90 ± 1.02 treatments) 15-24 months follow-up. The presence of cystoid macular edema, initial poor visual acuity, or a history of systemic hypertension did not affect the outcome. Patients without a history of systemic vascular diseases had a better chance of visual stabilization or improvement. Eighty-eight percent of the patients had at least stable vision at the last follow-up. Two out of 10 visual field tests showed a decrease in paracentral scotomas; no post-treatment subjective complaints of increased paracentral scotomas were encountered.

* CONCLUSION: Subthreshold (invisible) diode laser modified grid photocoagulation is effective in reducing/eliminating DDME, although resolution of edema may be slightly prolonged. However, this method may be advantageous in that it appears to reduce the objective and subjective effect on the paracentral visual field. Subthreshold (invisible) diode laser modified grid photocoagulation substantially reduces the post-treatment atrophie scarring.

[Ophthalmic Surg Lasers 1999:30:706-714.]
Rheumatic Fever and Rheumatic Heart Disease in the United States
Authors: de Loizaga Sarah R. , Beaton Andrea Z.
Published: April 2021

During the 1920s, acute rheumatic fever (ARF) was the leading cause of mortality in children in the United States. By the 1980s, many felt ARF had all but disappeared from the US. However, although ARF and rheumatic heart disease (RHD) rates remain low in the US today, disease burden is unequal and tracks along other disparities of cardiovascular health. It is estimated that 1% to 3% of patients with untreated group A streptococcus (GAS) infection, most typically GAS pharyngitis, will develop ARF, and of these, up to 60% of cases will result in chronic RHD. This article reviews the epidemiology, pathogenesis, diagnosis, and management of ARF/RHD to increase awareness of ARF/RHD for clinicians based in the US.

[
Pediatr Ann.
2021;50(3):e98–e104.]
The Role of Anti-VEGF Therapy in the Treatment of Diabetic Macular Edema
Authors: Moshfeghi Darius M. , Kaiser Peter K. , Michels Stephan , Midena Edoardo , Kitchens John W. , Prenner Jonathan L. , Regillo Carl D. , Reichel Elias
Published: April 2021

Diabetic retinopathy (DR) is the leading cause of blindness among working-age adults. DR often leads to diabetic macular edema (DME), which often goes unnoticed until a patient presents with vision loss. However, treatment options and data for DME are continually improving. We know that vascular endothelial growth factor (VEGF) plays a key role in DME progression; therapies that act by inhibiting VEGF production seem to improve visual acuity in patients with DME. Of the anti-VEGF therapies available, two have been approved by the U.S. Food and Drug Administration to treat DME: ranibizumab (Lucentis; Genentech, South San Francisco, CA) and aflibercept (Eylea; Regeneron, Tarrytown, NY). Bevacizumab (Avastin; Genentech, South San Francisco, CA), which is approved for the treatment of certain types of cancer, is occasionally used off-label to treat DME. Anti-VEGF therapy can stop vision loss and even improve visual acuity. Other treatments remain effective, and these various treatment options fuel a need for new data and discussion. This roundtable discussion, which took place during the 2015 annual meeting of the American Academy of Ophthalmology, outlines the current protocols used to treat DME and provides clinical opinions about selecting and treating with an appropriate anti-VEGF therapy.

[
Ophthalmic Surg Lasers Imaging Retina.
2016;47:S5–14.]
Racial Differences in Anti-VEGF Intravitreal Injections Among Commercially Insured Beneficiaries
Authors: Al-Moujahed Ahmad , Vail Daniel , Do Diana V.
Published: April 2021

BACKGROUND AND OBJECTIVE:

This study assessed racial and ethnic differences in receiving anti-vascular endothelial growth factor (VEGF) intravitreal injections among commercially insured patients.

PATIENTS AND METHODS:

A retrospective cohort study of 104,430 patients diagnosed with wet age-related macular degeneration (AMD), diabetic retinopathy, central retinal vein occlusion (CRVO), and branch retinal vein occlusion (BRVO) in the Optum Research Database between 2011 and 2016. Main outcomes included receiving an intravitreal anti-VEGF treatment; the first type of treatment received, if any; and subsequent treatment with ranibizumab or aflibercept among patients who were first treated with bevacizumab.

RESULTS:

In a logistic regression model in all 104,430 patients, Asian patients were significantly less likely to receive an anti-VEGF treatment compared to white patients (odds ratio [OR] = 0.725; 95% confidence interval [CI], 0.667–0.789;
P
< .001), but Black and Hispanic patients were not. Overall, 19.9% (n = 20,753) of all included patients received treatment with intravitreal injections of anti-VEGF or steroids. In multinomial logistic models of treatment type among all patients who received intravitreal injections, Hispanic patients were less likely than white patients to initially be treated with ranibizumab (relative risk ratio [RRR] = 0.776; 95% CI, 0.647–0.929;
P
= .006) or aflibercept (RRR = 0.794; 95% CI, 0.654–0.964;
P
= .020). Black and Asian patients were not significantly more or less likely to receive different types of first-line injections compared to white patients. Among 17,092 patients who received bevacizumab as first-line therapy, Hispanic patients were less likely to subsequently transition to aflibercept than their white counterparts (RRR = 0.756; 95% CI, 0.634–0.903;
P
= .002).

CONCLUSIONS:

The authors found minimal racial and ethnic differences in receiving anti-VEGF treatment among commercially insured patients with wet AMD, diabetic retinopathy, CRVO, and BRVO. These results are limited by the fact that all of the patients included were commercially insured, and there are limited data on the socioeconomic status of the patients in their sample.

[
Ophthalmic Surg Lasers Imaging Retina.
2021;52:208–217.]
La liminalité d’un contre-public sur YouTube
Authors: Mesangeau Julien , Morin Céline
Published: April 2021

Comment les contre-publics se consolident-ils en ligne, et comment mobilisent-ils l’espace public numérique comme arène symbolique pour la production du lien social et la publicisation de leurs idéologies ? Cet article propose de comprendre les « rites de marge » dans les conversations en ligne comme des rituels qui visent tant l’identification et l’allégeance à une communauté que le cadrage discursif des participants. Le terrain est celui de la manosphère, soit le contre-public antiféministe défendant le retour à un régime politique patriarcal, dont la valeur principale est sa relation contre le sens commun. À cet égard, les traces en ligne doivent à la fois être saisies en elles-mêmes, et dans le cadre d’une stratégie politique largement pensée hors ligne. Cet article exploite la notion de « chambre d’écho » afin de construire un outil de sélection des commentateurs, faisant passer la manosphère de « big-data » à un réseau de taille modérée, et permettant de dérouler une enquête à la fois quantitative et qualitative dans le réseau des commentaires. Ce faisant, la visualisation de données crée un cadrage méthodologique solide pour, d’abord, l’identification des acteurs-clés d’une contre-culture, et, ensuite, la démarche ethnographique visant, elle, la compréhension des rituels liminaires et des ré-ordonnancements des discours.
Les nouveaux outils technologiques dans le milieu du sport
Authors: Phomsoupha Michael , Truedic François Le , Bars Hervé Le
Published: April 2021

La science du sport a permis de comprendre les adaptations de l’humain face à des efforts extrêmes. Pour obtenir des informations précises, la technologie a ouvert le champ des possibles. Avec l’arrivée du microscope, on a pu voir les virus et les microbes invisibles à l’œil nu. Cependant, ces outils scientifiques onéreux ne peuvent être utilisés sans compréhension des résultats. L’apparition de la chronophotographie a favorisé la quantification du mouvement et le développement de la cinématique moderne. Ces nouvelles méthodes ont fait apparaître de nouvelles informations amenant à d’autres perspectives. Toutefois, la capture cinématique en laboratoire est contraignante pour le sportif et celui-ci ne se retrouve plus dans son « milieu naturel ». Pour répondre à cela, scientifiques et ingénieurs ont mis au point, à l’aide des technologies actuelles, des systèmes afin de recueillir des données sur le terrain. À travers l’arrivée des smartphones et des appareils photos intégrés, ils ont amélioré la portabilité du système et l’obtention des variables. De cela, de nouvelles données émergent et complètent les connaissances déjà obtenues. Ainsi, la quantité d’informations devient importante et le choix de la pertinence ou des variable(s) clé(s) peut être altérée.
Deconstructing opera for opera’s sake: an interview with Opera Queer (Argentina)
Authors: Tiscornia Jazmín María , Araceli Méndez Giselle
Published: April 2021

Ópera Queer is a queer lyric company that emerged in Buenos Aires, Argentina. In this interview we talk to its members, Ferni and Luchi, to know how they carry out the militancy for LGBTIQ+ rights in relation to opera.
Deconstruyendo la ópera para que no muera: entrevista a Ópera Queer
Authors: Tiscornia Jazmín María , Araceli Méndez Giselle
Published: April 2021

Ópera Queer es una compañía lírica disidente surgida en la Ciudad Autónoma de Buenos Aires. Entrevistamos a sus integrantes, Luchi y Ferni de Gyldenfeldt, con el objeto de explorar los modos en que el espectáculo lleva a cabo una sentida militancia en pos de la visibilización de las disidencias dentro del mundo la ópera, desde un posicionamiento latinoamericano que asimismo invita a reflexionar sobre la intersección entre música, género y sexualidad.
Learning Design Thinking Through a Hands-On Learning Model
Authors: Gwangwava Norman
Published: April 2021

Design thinking is a human-centered, team-based, creative, and iterative process for problem-solving. The process focuses on the end-user and applies empathy skills to gain an understanding of the problem. Unlike other design methodologies, design thinking dwells much on the most prominent user of the design solution. Industry 4.0 is characterized by fast-changing technology, which requires quick time-to-market solutions. Industry 4.0 applications involve more end-user interaction. In order to design products, applications, and systems that end-users will be comfortable to use, designers should engage users throughout the design process. Design thinking brings together key parameters for achieving innovative user-centered design solutions. In addition to bringing together designers to work as multidisciplinary teams, the process factors in a creative environment under which the teams work. The article presents a case study for hands-on learning of design thinking where groups of students were engaged in solving pressing problems encountered by skilled craftsmen in the digital era.
Black flies (Diptera: Simuliidae) of central and northeastern Washington, United States of America, with cytogenetic emphasis on the Simulium arcticum complex
Authors: Shields Gerald F. , Shields John P.
Published: April 2021

We made 28 collections of black flies (Diptera: Simuliidae) at 24 locations in central and northeastern Washington state, United States of America, and identified 10 species in three genera, including Simulium arcticum Malloch, which we studied cytogenetically. We analysed 745 larvae of S. arcticum cytogenetically from nine of the 11 sites where it occurred; five sites had small sample sizes. For the collections with large sample sizes, the distribution of S. arcticum may have a geographic pattern. Larvae in western tributaries of the Columbia River have the sex-linked IIL-2 inversion and heterozygotes for the IS-1 autosomal polymorphism in abundance but lack the IIL-21 sex-linked inversion, whereas larvae in eastern tributaries of the Columbia River possess the IIL-21 inversion but lack IIL-2 and the IS-1 inversions. A cytotype new to science, S. arcticum IIL-81, occurs in some larvae at the Methow River in the eastern Cascades region. All females, regardless of location, possess enhanced (Ce Ce) centromere bands in their IIL-chromosomes, whereas all males possess the enhanced, thin (Ce Ct) centromere band dimorphism. The Methow River had nine types of chromosomally identified males in 2019 and eight types in 2020.