bluuebunny/crossref_metadata_2025 huggingface dataset:
In Vitro Effects of Mitomycin-C on Human Keratocytes
Authors: Sadeghi H Mehrdad , Seitz Berthold , Hayashi Seiji , LaBree Laurie , McDonnell Peter J
Published: April 2021

ABSTRACT

BACKGROUND: The purpose of the present study is to quantify the in vitro antiproliferative and cytotoxic effects of mitomycin-C on human keratocytes for their potential to modulate corneal stromal wound healing.

METHODS: Cultured human keratocytes were exposed to various concentrations of mitomycin-C for periods of 5 minutes and 1 hour. Keratocyte proliferation and viability were assessed by phase-contrast microscopy, 3H-thymidine uptake, and electronic cell counting.

RESULTS: Cytotoxic changes and inhibition of keratocyte proliferation exhibited after exposure to mitomycin-C were both dose- and time-dependent. The lowest concentrations to significantly (>50%) inhibit keratocyte proliferation after 5minute exposures were 0.05 mg/ml (P<.005) and after 1-hour exposures were 0.005 mg/ml (J°<.001). At 5 minutes, ID30 was 0.038 mg/ml and LD50 was much higher than the greatest concentration tested (0.5 mg/ml). Mitomycin-C's median inhibitory dose (ID
50
) and median lethal dose (LD50) after 1 hour of exposure differed by a magnitude of 50 (0.0048 vs. 0.28 mg/ml).

CONCLUSIONS: Mitomycin-C has antiproliferative effects at concentrations below those cytotoxic to human keratocytes. If used after photorefractive keratectomy, the drug should be administered at antiproliferative rather than cytotoxic concentrations. [J Refract Surg 1998;14:534-540]
The Shape of Bowman's Layer in the Human Cornea
Authors: Patel Sudi , Reinstein Daniel Z , Silverman R H , Coleman MD
Published: April 2021

ABSTRACT

PURPOSE: The aim of this investigation was to derive a mathematical model for Bowman's layer, the interface between the epithelium and stroma, in the human cornea.

METHODS: The central epithelial thickness distribution within 14 normal human corneas was measured in vivo using high frequency ultrasonic digital signal processing with a measurement precision of 2 µm. The results per eye were averaged and incorporated into existing algorithms for the estimation of the shape of the anterior surface of Bowman's layer using terminology in accordance with Baker's equation.

RESULTS: The average radius of Bowman's layer was 7.34 mm (SE ±0.17 mm). Descriptions of this boundary ranged from a steepening or prolate ellipse to a hyperbola. However, the typical Bowman's layer is hyperbolic with a shape factor, p = -0.22 (SE ±1.81).

CONCLUSION: The results support previous cadaver studies where Bowman's layer was found to be steeper than the anterior corneal surface but disagree with the concept that the average Bowman's layer is akin to a prolate ellipse. The hyperbolic nature of the average Bowman's layer has the potential to influence the optical performance of the eye. [J Refract Surg 1998;14:636-640]
Central Necrotic Lamellar Inflammation After Laser in situ Keratomileusis
Authors: Parolini Barbara , Marcon Giovanni , Panozzo Giacomo A
Published: April 2021

ABSTRACT

PURPOSE: To report four cases of corneal interface complications that occurred after excimer laser in situ keratomileusis (LASIK).

METHODS: Four eyes of three patients underwent technically uneventful LASIK.

RESULTS: One day after LASIK, patients presented with severe pain, blurred vision, conjunctival infection, and diffuse opacity at the interface. Two days after LASIK, significant features were central opacity, striae in the flap, loss of uncorrected and best spectacle-corrected visual acuity, and corneal sensitivity. The findings did not improve by using drugs or by lifting the flap and irrigating the bed. The central opacity partially resolved over 8 to 12 months, leaving a hyperopic shift (one patient), striae (one patient), and loss of two or more lines of best spectacle-corrected visual acuity (three patients).

CONCLUSION: This severe central inflammation after LASLK could be an extreme manifestation of diffuse lamellar keratitis. [J Refract Surg 2001;17:110-112]
The Sense of Self-concept Change in Patients After Radial Keratotomy
Authors: Toczolowski Jerzy , Oles Piotr , Zagórski Zbigniew , Szymona Katarzyna U , Baltaziak Lucyna , Rymgayllo-Jankowska Beata
Published: April 2021

ABSTRACT

PURPOSE: The study focuses on the problem of self-concept change in patients after radial keratotomy.

METHODS: Twenty-five patients (17 female, 8 male) were studied from 6 to 18 months after radial keratotomy using the Adjective Check List by Gough and Heilbrun with the application of double instruction. It concerned self-concept change over a period of observation after surgery, as compared to retrospective (preoperative) self-concept.

RESULTS: For current self-concept, patients obtained significantly higher results in the following measures: the number of positive words used for self-description (P < .05); need scales, like affiliation (P < .005), heterosexuality (P < .01), and intraception or insight (P < .05); self-confidence (P < .01); military leadership (P < .05), logical decision making (P < .05); two measures concerning logical-analytical thinking (P < .05).

CONCLUSIONS: The results indicate that after radial keratotomy, patients perceived themselves in a more positive way than before surgery, especially as more self-confident in interpersonal functioning. [J Refract Surg 2001;17:134-137]
Polymicrobial Keratitis After Laser in situ Keratomileusis
Authors: Gupta Vishal , Dada Tanuj , Vajpayee Rasik B , Sharma Namrata , Dada Vijay K
Published: April 2021

ABSTRACT

PURPOSE: To report a case of polymicrobial infectious keratitis in one eye of a patient who had undergone bilateral simultaneous laser in situ keratomileusis (LASIK).

METHODS: A 21-year-old healthy female developed infectious keratitis in her right eye after bilateral LASEK surgery. Material obtained from the infective foci was sent for bacterial and fungal cultures and herpes simplex virus antigen detection, and broad spectrum antimicrobial therapy was instituted.

RESULTS: Staphylococcus epidermidis and Fusarium solani were detected on culture and herpes simplex virus antigen was found to be positive. The patient did not respond to medical therapy and subsequently the ulcer perforated. A therapeutic keratoplasty was performed and the final best-corrected visual acuity was 20/40, 1 month after keratoplasty.

CONCLUSION: Polymicrobial infectious keratitis, although rare, is a potential sight-threatening complication of LASIK [J Refract Surg 2001;17: 147-148]
Unexpected Corneal Flattening After Laser in situ Keratomileusis
Authors: González F , Ortiz D , Saiz J M , Moreno F , del Cotero J N Fernández
Published: April 2021

ABSTRACT

PURPOSE: To perform a statistical study of the variation (flattening) from the surgical radius (sculpted in the corneal stroma) to the final radius of the first surface of the cornea after laser in situ keratomileusis (LASIK) for correction of myopia.

METHODS: The study included 387 eyes with myopia or myopic astigmatism that underwent LASLK using the Nidek EC-5000 excimer laser. Mean age was 34 years (range, 19 to 75 yr). Mean myopia was -5.19 D (range, 0 to -19.00 D) and mean astigmatism was -1.22 D (range, 0 to -5.00 D). The flattening coefficient was defined as: (f) = (R^sub post^ . R^sub s^)/R^sub s^ where R^sub post^ was the corneal radius after surgery (topography performed 1 month after surgery) and R^sub s^ was the surgical radius sculpted in the stroma. Mean values and standard deviations of the flattening coefficient were calculated for the 387 eyes for four myopic ranges (0 to -3.00 D, -3.00 to -6.00 D, -6.00 to -9.00 D, and more than -9.00 D), and for three astigmatic ranges (0, -0.25 to -2.00 D, and more than -2.00 D). The correlations between the flattening coefficient and several preoperative ocular variables were obtained.

RESULTS: A linear combination of quasiindependent ocular variables (age, anterior corneal radius, corneal thickness, sphere and cylinder) was found in order to maximize the correlation with the flattening for every range. Values for the correlations between 0.4 to 0.5 were obtained.

CONCLUSION: The flattening phenomenon was characterized by a flattening coefficient (f). According to the results, flattening may be reliably predicted in certain ranges. This knowledge could be relevant for the planning of surgery. [J Refract Surg 2001;17(suppl):S180-Sl86]
A Retrospective Study of Laser in situ Keratomileusis After Radial Keratotomy
Authors: Clausse Marc A , Boutros George , Khanjian Garbis , Wagner Claudia , Garabet Antoine L
Published: April 2021

ABSTRACT

PURPOSE: This is a retrospective study designed to present results of laser in situ keratomileusis (LASIK) after radial keratotomy (RK).

METHODS: Eighty eyes of 56 patients underwent LASIK for residual myopia, astigmatism, and hyperopia after RK. Absolute mean preoperative spherical equivalent refraction was 2.36 ± 1.17 D. Best spectacle-corrected visual acuity (BSCVA) was 20/20 in 56% of eyes, 20/25 in 25%, 20/30 in 13%, 20/40 in 5%, and 20/60 in 1%. Uncorrected visual acuity was better than 20/40 in four eyes. Follow-up ranged from a mjniniutn of 1 day after surgery to a maximum of 2 years, with an average of 6 months.

RESULTS: Mean final absolute spherical equivalent refraction was 0.62 ± 0.611 D. Six eyes experienced a loss of BSCVA of one line, one eye lost two lines, and one lost more than two lines. Three eyes had one line of improvement and one eye had two lines of improvement. Uncorrected visual acuity was 20/20 in 21 eyes, 20/25 in 20 eyes, and 20/30 in 19 eyes. There was stromal opacity in two eyes, epithelial defects in two eyes, and epithelial ingrowth in four eyes.

CONCLUSION: LASLK may be an effective treatment for myopia, astigmatism, and hyperopia in patients with residual refractive error after RK. Extreme caution should be exercised due to the complexity of this group of patients. [J Refract Surg 2001;17(suppl):S200-S201]
Super Vision: Dream or Reality
Authors: Arbelaez Maria C
Published: April 2021

ABSTRACT

PURPOSE: To present and evaluate the early clinical experience of laser in situ keratomileusis (LASIK) using the custom guided corneal ablation system by NTOEK, which includes an OPD-Scan, Final Fit program, and Nidek Multipoint EC-5000 excimer laser.

METHODS: The OPD-Scan diagnostic system containing a scanning slit refractometer using skiascopic technology with simultaneous Placido disc corneal topography is described. The Final Fit program that converts the refractive error and topography data into custom algorithms to couple with the Nidek EC-5000 Multipoint excimer laser is explained. Thirty-eight cases of LASK using the Nidek MK-2000 microkeratome and the Nidek Multipoint excimer laser with custom and conventional treatments are presented. Eyes were divided into two groups: LASIK custom group and LASDX conventional group.

RESULTS: Predictability and attempted correction were similar in both groups. One month after surgery, all eyes were between ±1 line of visual acuity. In the custom LASK group there was a gain of one line in 50% and two lines of visual acuity in 25% of patients at 1 month after surgery. In the conventional LASDX group there was no gain of lines of visual acuity at 1 month. In the comparative group (one eye custom LASDX and the other eye conventional LASIK) there was data available for six patients (75%). At one month, all patients preferred the vision in their custom LASDX-treated eye.

CONCLUSION: The Nidek LASDX custom and conventional treatments were safe and predictable. There was more accuracy, better visual acuity, and more subjective satisfaction in the custom LASDX custom treatment group. [J Refract Surg 2001; 17(suppl):S211-S218]
Laser in situ Keratomileusis vs. Laser Epithelial Keratomileusis (LASIK vs. LASEK)
Authors: Scerrati Ermanno
Published: April 2021

ABSTRACT

PURPOSE: To compare results of laser in situ keratomileusis (LASIK) and laser epithelial keratomileusis (LASEK) for the treatment of myopia.

METHODS: Two groups of fifteen patients (30 eyes) each were assigned to either the LASLK group or the LASEK group. LASLK procedure: A Hansatome microkeratome with the ring at 9.5 mm was used to create the corneal flap (depth, 160 µm). The myopic correction was then registered on the Nidek EC-5000 excimer laser and the appropriate ablation performed. LASEK procedure: Twenty percent ethyl alcohol was placed within the corneal epithelial ring. An intact epithelial flap was retracted. The Nidek EC-5000 excimer laser was applied in a similar manner to the LASLK procedure. Patients from both groups were followed postoperatively for 6 months, measuring best spectacle-corrected visual acuity, contrast sensitivity, and corneal topographic meridians of 3 mm, 5 mm, and 7 mm.

RESULTS: Comparing corneal topography, best spectacle-corrected visual acuity, and contrast sensitivity data, refractive results in the LASEK group were better than the LASLK group.

CONCLUSION: Objective data show that with the Nidek EC-5000 excimer laser, the LASEK method of corneal splitting may prove superior to the LASLK method. [J Refract Surg 2001;17(suppl): S219-S221]
Effectiveness of Laser in situ Keratomileusis With the Nidek EC-5000 Excimer Laser for Pediatric Correction of Spherical Anisometropia
Authors: Rybintseva Ludmila V , Sheludchenko Viatcheslav M
Published: April 2021

ABSTRACT

PURPOSE: To determine the effectiveness of laser in situ keratomileusis (LASLK) for correction of spherical anisometropia in patients under 18 years of age.

METHODS: Thirty-eight patients (58 eyes) with myopic spherical anisometropia and spherical antimetropia were treated. Group 1 included 31 eyes of 20 children (9 to 15 yr) and Group 2 included 27 eyes of 18 children under 18 years old (16 to 17 yr). The difference in refraction between the two eyes in Group 1 was an average 5.95 D and in Group 2, 6.92 D. The operations were performed with the Nidek EC-5000 eximer laser and the Hansatome Chiron Vision HT-230 microkeratome. The procedure was performed under local anesthesia. Patients were followed for 18 months. Occlusion therapy was started 2 weeks postoperatively and continued for 3 to 4 months. Ten patients suffered from strabismus; they received orthoptic therapy.

RESULTS: Uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA) improved after LASLK. The difference in refraction between the two eyes was reduced as was the angle of strabismus. Binocular vision improved in one patient and simultaneous vision improved in three patients (vision in these patients was monocular before treatment).

CONCLUSIONS: LASLK with the Nidek EC-5000 excimer laser and the Hansatome Chiron Vision HT-230 microkeratome, together with occlusion and orthoptic therapy for pediatric correction of spherical anisometropia, may be an effective procedure that facilitates increased visual acuity and improved binocular vision. LASLK appears to be a safe surgical procedure for children over 9 years of age. [J Refract Surg 2001;17(suppl):S224-S228]
The Nidek MK-2000 Microkeratome System
Authors: Schumer D James , Bains Harkaran S
Published: April 2021

ABSTRACT

PURPOSE: To assess flap thickness and the performance of the Nidek MK-2000 microkeratome during laser in situ keratomileusis (LASBK).

METHODS: Three hundred seventy consecutive eyes of patients undergoing LASIE had the depth of flaps measured via subtractive pachymetry. All flaps were created using two different model numbers of the Nidek MK-2000 microkeratome. Both 130-/tm and 160-/nn depth plates were evaluated. Microkeratome-induced complications were also recorded.

RESULTS: Buttonhole ñaps and free flaps were not seen in this study. One short flap occurred and suction could not be obtained in two eyes. The mean flap thickness obtained using the 130-µm depth plate for model number 121 was 129 ± 21.8 µm. The mean flap thickness obtained using the 160-µm depth plate for model number 121 was 150 ± 29.6 µm. The mean flap thickness obtained using the 130-µm depth plate for model number 65 was 152 ± 25 µm. The mean flap thickness obtained using the 160-µm depth plate for model number 65 was 173 ±26.9 µm.

CONCLUSION: The Nidek MK-2000 microkeratome is safe and creates flaps of predictable thickness. [J Refract Surg 2001;17(suppl):S250-S251]
Visual Rehabilitation With Contact Lenses After Laser in situ Keratomileusis
Authors: Ward Michael A
Published: April 2021

ABSTRACT

PURPOSE: Laser in situ keratomileusis (LASIK) has become the surgical treatment of choice for moderate myopia and is in widespread use globally. Visual potential is sometimes limited due to irregular corneal topography following surgery.

METHODS: A retrospective chart review of 35 eyes of 22 patients requiring visual rehabilitation following LASIK was performed. Four contact lens designs were used and evaluated for appropriate cornea-contact lens fitting relationship.

RESULTS: Mean best contact lens-corrected visual acuity of 20/25 was significantly better than best spectacle-corrected visual acuity of 20/40. The average time from surgery to contact lens fitting was 8 months, with almost half (10/22) being fitted at 4 months. An aspheric design with 0.17 mm of axial edge lift was used most commonly. Lens diameters ranged from 9.2 to 10.9 mm, with a mean diameter of 10.2 nun. The contact lens base curve to cornea relationship would suggest an initial base curve selection to be approximately 2.1 D steeper than the mean postoperative keratometric power.

CONCLUSIONS: Rigid gas permeable contact lenses can improve visual function in patients with irregular corneal topography after LASIK!. [J Refract Surg 2001;17:433-440]
Reversal of Myopic Anisometropic Amblyopia With Phakic Intraocular Lens Implantation
Authors: Chipont Enrique M , García-Hermosa Pedro , Alió Jorge L
Published: April 2021

ABSTRACT

PURPOSE: To report a case of reversal of myopic anisometropia amblyopia with phakic intraocular lens implantation.

METHODS: A 6-year-old boy with anisometropic amblyopia with spherical equivalent refraction of right eye: -14.00 -3.00 x 100°, left eye: -0.50 -3.25 x 90°, was treated for 2 years with occlusion to the left eye, with poor results. Refractive surgery was planned because of contact lens intolerance at age 8 years. A -15.00-D iris claw Artisan intraocular lens (IOL) was implanted.

RESULTS: Following surgery, treatment of the amblyopia and spectacle correction of -4.00 D cylinder at 85° in the right eye and -3.50 D cylinder at 90° in the left eye was necessary. Visual acuity ? months after surgery was 20/25 in the right eye and 20/20 in the left eye, and has remained stable 18 months after surgery.

CONCLUSION: Myopic anisometropic amblyopia in an 8-year-old boy was treated successfully with implantation of an Artisan iris claw phakic anterior chamber IOL, combined with occlusion therapy, and resulted in reversal of amblyopia. [J Refract Surg 2001;17:460-462]
Photorefractive Keratectomy for Hyperopia in 800 Eyes With the Meditec MEL 60 Laser
Authors: Nagy Zoltán Z , Krueger Ronald R , Hamberg-Nyström Helen , Füst Agnes , Kovács Andrea , Kelemen Edit , Süveges Ildikó
Published: April 2021

ABSTRACT

PURPOSE: To evaluate the refractive results of 800 hyperopic eyes undergoing PRK treatment.

METHODS: Eight hundred hyperopic eyes were treated with PRK. An Aesculap-Meditec MEL 60 scanning ArF excimer laser used. Treatment Group 1 consisted of eyes with a preoperative refractive error of +3.50 D or less (n = 482) and Group 2, of +3.75 D or more (n = 318).

RESULTS: Preoperatively, Group 1 required an average correction of +2.88 ± 1.34 D and Group 2 required +5.64 ± 2.96 D. One year after PRK, average residual correction was +1.26 ± 1.24 D in Group 1, and in Group 2, +2.46 ± 1.84 D. In Group 1, uncorrected visual acuity (UCVA) was 20/40 or better in 88.4% (426/482); 20/20 or better in 75.7% (365); 2.1% (10/482) of eyes lost 2 lines, 2.1% (10/482) gained 2 lines; 3.1% (15/482) gained 2 or more lines of BSCVA; 74.4% (359/482) of eyes were within ±0.50 D of target correction and 84.8% (408/482) were within ±1.00 D. In Group 2, 47.57< (151/318) had UCVA of 20/40 or better; 34.2% (109/318) saw 20/20 or better uncorrected; 19.1% (61/318) lost 2 lines; 11.6% (37/318) lost 3 lines; none of the eyes gained 2 or more lines of BSCVA; 22.3% (71/318) were within ±0.50 D and 46.80Í (149/318) were within ±1.00 D of target correction. Refractive stability was achieved after 6 months; a slight regression after 6 months was still observed. In Group 1, 10.5% (42/482) and in Group 2, 21.6% (69/318) complained of problems with daytime vision (glare and ghost image); during night-driving in Group 1, 17.6C7( (85/482) and in Group 2, 40.5% (129/318) had problems.

CONCLUSION: PRK with the Aesculap-Meditec MEL 60 scanning ArF excimer laser offered the best long-term results with +3.50 D or less preoperative refractive error. With higher corrections, regression, decrease in BSCVA, and daytime visual problems were encountered. [J Refract Surg 2001; 17:525-533]
Effect of Hyaluronic Acid on Corneal Haze in a Photorefractive Keratectomy Experimental Model
Authors: Gómez Silvia , Herreras José M , Merayo Jesús , García Margarita , Argüeso Pablo , Cuevas Juan
Published: April 2021

ABSTRACT

PURPOSE: To evaluate the ability of topical hyaluronic acid to decrease corneal opacity after excimer laser photorefractive keratectomy (PRK) in hens.

METHODS: Twenty-four white hens underwent bilateral 193-nm excimer laser PRK to correct -9.00 D of myopia. One eye received postoperative treatment with topical 1% hyaluronic acid six times daily for 3 days; the other eye received phosphate buffered saline. Slit-lamp evaluation by a masked observer was performed for 6 months after PRK, and electron microscopy was carried out at the end of the study.

RESULTS: There were no significant differences in postoperative haze between the eyes treated with hyaluronic acid and those treated with phosphate buffered saline.

CONCLUSION: Topical administration of hyaluronic acid had no effect on the development of corneal haze following PRK in hens. [J Refract Surg 2001;17:549-554]
Influence of Corneal Curvature on Calculation of Ablation Patterns Used in Photorefractive Laser Surgery
Authors: Mrochen Michael , Seiler Theo
Published: April 2021

ABSTRACT

PURPOSE: The aim of this work was to clarify the influence of the effective illumination area and possible reflection losses that occur during lasertissue interaction on the modeling of profiles for customized corneal ablation, such as wavefrontguided treatments.

METHODS: The changes of the ablation depth per laser pulse due to the projection of a laser spot onto the corneal front surface and reflection losses at the air-tissue interface were calculated.

RESULTS: Moving with a scanning-spot from the center of the cornea toward the limbus resulted in an increase of the effective illumination area and reflection losses, which led to a decrease in the ablation depth per laser pulse. The decrease of the ablation depth was strongly related to the initial radiant exposure and the corneal curvature radius.

CONCLUSIONS: The corneal front surface must be taken into consideration for ablation profile calculations, especially in customized treatments, due to the strong dependence of the ablation depth on the corneal curvature. [J Refract Surg 2001; 17: S584-S587]
Wavefront-supported Photorefractive Keratectomy: 12-month Follow-up
Authors: Dausch Dieter , Dausch Sabine , Schröder Eckhard
Published: April 2021

ABSTRACT

PURPOSE: To evaluate safety, efficacy, predictability, and stability of wavefront-supported photorefractive keratectomy (PRK) for correction of myopia and myopic astigmatism, with 12-month follow-up.

METHODS: Thirty eyes of 23 patients with myopia less than -8.00 D (mean -3.76 ± 1.90 D) and cylinder less than -3.50 D (mean -0.81 ± 0.71 D) were selected. Aberrometry measurements were taken with the Asclepion aberrometer in order to perform customized wavefront-supported PRK. Eyes were treated with the Asclepion MEL 70 excimer laser and were followed for 12 months.

RESULTS: UCVA of 20/16 or better was achieved by 47% (14 eyes) at 1 month, 67% (20 eyes) at 3 months, 77% (23 eyes) at 6 months, 90% (27 eyes) at 9 months, and 83% (25 eyes) after 1 year. No eye lost more than 1 line of BSCVA at 3, 6, 9, or 12 months. Two eyes (7%) gained more than 2 lines 1 month postoperatively, and 13% (4 eyes) gained more than 2 lines at 6, 9, and 12 months postoperatively. BSCVA of 20/10 or better was achieved in nine eyes (30%) at 1 and 12 months. Visual acuity under low contrast at 3 and 12 months after PRK was unchanged in 87% (26 eyes). Visual acuity under glare remained unchanged at 3 months after PRK in 86% (26 eyes) and at 12 months in 83% (25 eyes).

CONCLUSION: Excimer laser wavefrontsupported PRK with the Asclepion MEL 70 laser was safe and effective for the treatment of myopia and myopic astigmatism. Daylight visual acuity and mesopic visual acuity outcomes remained stable over 1 year. [J Refract Surg 2003;19:405-411]
Laser in situ Keratomileusis for Correction of Induced Astigmatism From Cataract Surgery
Authors: Norouzi Hamid , Rahmati-Kamel Mohsen
Published: April 2021

ABSTRACT

PURPOSE: To evaluate the efficacy, predictability, stability, and safety of laser in situ keratomileusis (LASIK) to correct residual astigmatism after cataract surgery.

METHODS: LASIK was performed on 20 eyes of 20 patients with refractive myopic or mixed astigmatism (3.00 to 6.00 D) at least 1 year after extracapsular cataract extraction with posterior chamber intraocular lens implantation without complication. Each eye received bitoric LASIK with the Nidek EC-5000 excimer laser and the Automated Corneal Shaper microkeratome.

RESULTS: At 6 months after LASIK, mean refractive cylinder decreased from 4.64*0.63 D to 0.44±0.24 D (P<.001). Mean percent reduction of astigmatism was 90.4*5.0% (range 80% to 100%). Mean spherical equivalent refraction decreased from -2.19±0.88 D (range -1.00 to -3.88 D) to -0.32±0.34 D (range -1.25 to +0.38 D) (P<.001). Vector analysis showed that the mean amount of axis deviation was 0.7±1.2° (range 0° to 4.3°) and the mean percent correction of preoperative astigmatism was 92.1*5.9% (range 85.6% to 108%). Eighty-five percent of all eyes had a mean spherical equivalent refraction and mean cylinder within ±0.50 D of emmetropia. Change in spherical equivalent refraction and cylinder from 2 weeks to 6 months was =S0.50 D in 90% (18 eyes) and 95% (19 eyes), respectively. Spectacle-corrected visual acuity was not reduced in any eye. Diffuse lamellar keratitis occurred in three eyes (15%) after LASIK, and were treated successfully with eyedrops.

CONCLUSION: LASIK was an effective, predictable, stable, and safe procedure for correction of residual myopic or mixed astigmatism ranging from 3.00 to 6.00 D with a low spherical component after cataract surgery. [J Refract Surg 2003;19: 416-424]
The Duet-Kelman Lens: A New Exchangeable Angle-supported Phakic Intraocular Lens
Authors: Alió Jorge L , Kelman Charles
Published: April 2021

ABSTRACT

PURPOSE: We describe a new model of anglesupported phakic intraocular lens, the DuetKelman lens, the design of which incorporates two separate supporting parts. The haptic and the optic are separately implanted and then fixed together inside the eye. The lens allows optic or haptic exchange depending on the anatomical, refractive, and visual outcome of the patient. Results of the initial pilot study are presented.

METHODS: Three patients (three eyes) were implanted with the Duet-Kelman lens and were followed for a minimum of 6 months. Surgery was performed under topical anesthesia.

RESULTS: Surgery was feasible through a 2.5 -mm incision, without complications. Refractive and visual results were stable in all eyes. Haptic exchange was done in one eye that developed pupil ovalization.

CONCLUSION: In this pilot study of three eyes, the Duet-Kelman phakic intraocular lens offered small incision size and potential exchange of the haptic or the optic. [J Refract Surg 2003;19:488-495]
Topography-guided Laser in situ Keratomileusis (TOPOLINK) to Correct Irregular Astigmatism After Previous Refractive Surgery
Authors: Alió Jorge L , Belda Jose I , Osman Amr A , Shalaby Ahmad M M
Published: April 2021

ABSTRACT

PURPOSE: To assess whether topography-driven laser in situ keratomileusis (LASIK) can correct induced corneal irregular astigmatism.

METHODS: A prospective non-comparative case series of 41 eyes (38 patients) with irregular astigmatism following corneal refractive surgery, included two groups: Group 1 (26 eyes) with a defined topographic pattern and Group 2 (15 eyes) with no pattern. Ablation was performed using the Technolas 217C excimer laser with a software ablation program (TOPOLINK) based on corneal topography. Uncorrected and best spectacle-corrected visual acuity, manifest and cycloplegic refraction, corneal topography, superficial corneal surface quality, and image distortion were measured.

RESULTS: At 6 months follow-up in Group 1 eyes (defined topographic pattern) mean preoperative BSCVA improved from 0.16 ± 0.11 LogMAR (0.4 to 0) to 0.09 ± 0.10 LogMAR (0.2 to 0) (P=.001) (safety index of 1.1). In Group 2 eyes (no pattern), mean preoperative BSCVA was 0.18 ± 0.11 LogMAR (0.4 to 0), similar to the postoperative BSCVA of 0.17 ± 0.10 LogMAR (0.3 to 0) (safety index of 0.98). Mean postoperative UCVA was 3*0.3 LogMAR in 25 eyes (96.2%) in Group 1 (efficacy index of 0.8) and 7 eyes (46.6%) in Group 2 (efficacy index of 0.5). Both superficial corneal surface quality and image distortion significantly improved in Group 1; there were no significant changes in Group 2. We reoperated nine eyes (21.9%).

CONCLUSIONS: Topographic-assisted LASIK was helpful in selected cases where irregular astigmatism showed a pattern. It was ineffective in undefined irregular astigmatism. Partial correction of the irregularity and regression of the obtained effect was common. [J Refract Surg 2003;19:516-527]
Nomogram Considerations With the Technolas 217A for Treatment of Myopia
Authors: Anderson Nicole J , Hardten David R , Davis Elizabeth A , Schneider Timothy L , Samuelson Thomas W , Lindstrom Richard L
Published: April 2021

ABSTRACT

PURPOSE: To determine whether surgeonspecific nomogram adjustments are useful when using the Technolas 217Aexcimer laser for treating myopia and myopic astigmatism.

METHODS: We conducted a prospective evaluation of 216 consecutive eyes with 6 months followup after treatment of myopia or myopic astigmatism with the Technolas 217A laser. Attempted vs. achieved change in refraction was analyzed with a statistical analysis software program. Factors such as age, corneal thickness (pachymetry), preoperative spherical equivalent refraction, preoperative cylinder, and optical zone were studied to evaluate their role in predicting refractive outcome at 6 months after LASIK.

RESULTS: The mean value of attempted spherical equivalent refraction was -5.32 ± 2.72 D. The mean achieved refractive correction at 6 months was -5.55 ± 2.78 D, with a mean spherical equivalent of 0.13 ± 0.54 D. The percent achieved effect at 1 month was 105%, and at 6 months, 103%. Preoperative spherical equivalent refraction and optical zone size were strong predictors of 6-month LASIK outcome. There was a 9% difference in the percent achieved effect between a 4 and 7-mm optical zone. There was no correlation between age, preoperative cylinder, or surgeon and 6-month outcome.

CONCLUSIONS: Surgeons using the planoscan software on the Technolas 21 7A may experience a small initial overcorrection. There may be a benefit to reducing the treatment given with larger optical zones and smaller corrections. [J Refract Surg 2003; 19:654-660]
First 100 CustomCornea Commercial Eyes
Authors: Durrie Daniel S
Published: April 2021

ABSTRACT

PURPOSE: With the advent of wavefront-guided custom abalation we not only try to reach a target of 20/20 vision, but strive for improvement in what has always been most important - the quality of this vision.

METHODS AND RESULTS: Insights are presented, based on clinical experience at Durrie Vision with our first 100 commercial CustomCornea eyes. We highlight key points for preparing a clinical practice for this new technology, such as staff training, marketing, and pricing. We discuss technical aspects such as patient selection and target adjustment as they relate to the Alcon LADARWave system.

CONCLUSION: In our practice we have thus far had clinical success with CustomCornea; patient acceptance has been high, and by closely monitoring our first few patients we were able to reduce the number of future enhancements. [J Refract Surg 2003;19:S687-S690]
Effect of Antineoplastic Drugs on Cell Proliferation - Individually and in Combination
Authors: Litin Bradley S , Kwong Erna M , Jones Mark A , Herschler Jonathan
Published: April 2021

ABSTRACT

Three antineoplastic agents, bleomycin, cytosine arabinoside and 5-fluorouracil, were studied individually and in combination to determine their effectiveness in controlling cell growth in the presence of fetal bovine serum. All three drugs were effective individually in specifically controlling proliferation (as measured by 3H-thymidine uptake) of human Tenons capsule fibroblasts while bleomycin is effective at the lowest concentration. However, bleomycin alone rather than in combination with cytosine arabinoside or 5-fluorouracil was most effective in preventing division by these fibroblasts.
Scleral Reinforcement for High Myopia
Authors: Thompson Frank B
Published: April 2021

ABSTRACT

This paper reviews the scleral reinforcement procedure for high myopia. A discussion of the indications and operative technique is presented with postoperative results and complications in 191 cases performed by one surgeon over the last 14 years. A discussion of the history of scleral reinforcement, modification of technique, and pathogenesis of high myopia is presented.
Postoperative Subretinal Neovascular Membrane at the Drain Site of a Scleral Buckle
Authors: Holland Peter M
Published: April 2021

ABSTRACT

A 57-year-old patient underwent a scleral buckle operation for a rhegmatogenous bullous retinal detachment. An episcleral buckle and cryotherapy were used. Drainage of subretinal fluid was performed beneath the buckle as well as posterior to the buckle, close to the posterior pole. The postoperative course was unremarkable. Eight months later, the patient developed a subretinal neovascular membrane at the drain site posterior to the buckle. This was documented by fluorescein angiography. Such membranes have not been previously documented at retinal drain sites in an ophthalmic journal.
In Vitro Evaluation of Cellular Inhibitory Potential of Various Antineoplastic Drugs and Dexamethasone
Authors: Fiscella Richard , Peyman Gholan A , Elvart Judy , Yue Beatrice
Published: April 2021

ABSTRACT

We evaluated the in vitro cellular inhibitory rates of eight antineoplastic agents and dexamethasone for rabbit retinal pigment epithelial cells and rabbit corneal fibroblasts. Doxorubicin was the most effective chemotherapeutic agent to inhibit cellular proliferation ( - 90%). Compared to the controls, the percentage variation in cell number for single agents ranged from +26% to -90%. Chemotherapy drugs in combination also were evaluated and found to be not superior to the single agents. Cellular inhibitory rates for combination agents ranged from -34% to -72%. Dexamethasone in the concentrations used did not significantly inhibit or stimulate cellular proliferation.
Emergency Orbital Decompression
Authors: Bedrossian Robert H
Published: April 2021

ABSTRACT

Blindness from orbital hemorrhage following surgery, direct trauma, and remote trauma is not common. Compression cyanosis is a rare condition which may cause blindness. Non-ocular injuries may direct attention elsewhere and emergency surgical procedures may be necessary to save life. Orbital decompression can be carried out simultaneously with the other surgery. One case of blindness from abdominal compression and another with orbital, chest, and arm trauma are presented of patients who had emergency orbital decompression along with their other surgical procedures.
The Slipped Rectus Muscle
Authors: Hiller Tyrie Lee , Nelson Leonard B , Brown Gary C , Fischer David H
Published: April 2021

ABSTRACT

A slipped rectus muscle may occur as a result of ophthalmic surgery or ocular trauma. We reviewed seven cases of slipped rectus muscles following retinal detachment surgery, strabismus surgery, or trauma. Diagnosis, etiology, treatment, and prevention are discussed.
Inferior Turbinate Fracture in the Treatment of Congenital Nasolacrimal Duct Obstruction and Congenital Nasolacrimal Duct Anomaly
Authors: Wesley Ralph E
Published: April 2021

ABSTRACT

A group of 52 pediatric patients with lacrimal obstruction were considered to be high risk since they had been previously probed (27 patients) or were older (average age 23 months). At the time of probe and irrigation, a small, straight hemostat was placed into the nose to grasp the inferior turbinate and rotate it a full 90° inward. AU cases of congenital nasolacrimal duct obstruction (49) resolved following this maneuver. A small muscle hook with the tip directed upward was placed underneath the inferior turbinate to identify three patients with congenital nasolacrimal duct anomaly (absence or atresia of the nasolacrimal duct) who would not have benefitted from further probings and responded to dacryocystorhinostomy.

Even though the results of our uncontrolled surgical trial cannot be compared to other treatment methods, the data suggest that even very difficult cases of congenital nasolacrimal duct obstruction will respond to a simple turbinate fracture with a hemostat without the necessity of complicated tubes or stents. A small muscle hook can be used to identify those rare cases of congenital nasolacrimal duct anomaly who may require specialized procedures such as dacryocystorhinostomy or inferior turbinectomy.
Painful Bullous Keratopathy Following Pediatric Cataract Surgery With Intraocular Lens Implantation
Authors: Rozenman Yascov , Folberg Robert , Nelson Leonard B , Cohen Elisabeth J
Published: April 2021

ABSTRACT

A child with a history of a monocular congenital cataract, cataract surgery and intraocular lens implantation at age three developed Pseudophakie bullous keratopathy which persisted following intraocular lens removal and vitrectomy two years later. At age nine she presented to the Cornea Service at Wills Eye Hospital with painful bullous keratopathy and underwent a penetrating keratoplasty and anterior vitrectomy. The case is presented to bring attention to potential long-term corneal complications of pediatric cataract surgery with intraocular lens implantation.
The Significance of Normal Angle Vessels
Authors: Shihab Zuhair M , Lee Pei-Fei
Published: April 2021

ABSTRACT

One hundred patients (200 eyes) were examined over a one-year period for the presence of normal anterior chamber angle vessels. Normal vessels were observed in the angle in 21% of eyes examined. The types, location, and number of normal vessels are documented. The significance of these vessels in two eyes with anterior chamber angle fixated lenses is discussed.
A Study of 200 Cases of Anterior Chamber Implants
Authors: Ciccarelli Eugene C
Published: April 2021

ABSTRACT

In a series of 200 eyes with Choyce or Leiske style anterior chamber implants followed for an average of 19 months, final visual acuity averaged 20/30. Eighty-four percent of patients were 20/40 or better and 8% 20/100 or worse at the end of the period of observation. Cystoid macular edema occurred in 17% with most cases occurring during the first seven months. Visual loss averaged two lines and duration averaged eight months. All but one patient with adequate follow-up recovered. Cystoid macular edema appeared to be more frequent in patients who were "blinkers." The incidence of "new" glaucoma in this study was 2%. Ovalling of the pupil occurred in 46% of eyes, more frequently late than early. Early development of ovalling was more likely to be associated with imperfect implant positioning than was late.

Imperfect implant position occurred in 40% of cases and inadequate early fixation resulting in propellering or rotation in 16%. Rotation was not associated with imperfect implant position. No cases of severe iritis were encountered. Pigment dispersion and vitreous herniating anterior to the optic were observed in a few eyes. No cases of corneal decompensation occurred although two eyes had minor to moderate changes.

The incidence of subsequent procedures was a low 6%, helping to contribute to the high ratio of patient satisfaction. Mild tenderness and glare were the chief postoperative symptoms.
The Use of the Single Stage Molteno Long Tube Seton in Treating Resistant Cases of Glaucoma
Authors: Freedman Jeffrey
Published: April 2021

ABSTRACT

The Molteno long tube seton was used in 12 eyes with glaucoma. The seton was inserted in one stage. Seven of the 12 eyes had previous filtration surgery which had failed. All the eyes had intraocular pressures below 24 mm Hg over an average follow-up period of 14 months. Prolonged postoperative hypotony was the biggest problem following seton implantation as a one-stage procedure. One of the eyes became pthisical. The Molteno seton may be used to treat neovascular glaucoma, or glaucoma which has failed to respond to previous filtration surgery.
Delayed Socket Granuloma Formation Following Evisceration
Authors: Weinstein Gary S , Anderson Richard L
Published: April 2021

ABSTRACT

We report a rare granuloma of the socket that simulated a conjunctival squamous cell carcinoma in a patient treated with evisceration six and a half years earlier. An excisional biopsy revealed loose connective tissue with marked capillary proliferation and lymphocytic infiltration. The cut end of a silicone exoplant, used to treat a preceding traumatic retinal detachment, was found at the base of the lesion. Prior operative procedures should be reviewed in patients presenting with socket lesions to exclude the presence of an iatrogenic foreign body.
Possible Intraocular Lens Contamination by Surgical Glove Powder
Authors: Bene Catherine , Kranias George
Published: April 2021

ABSTRACT

Contamination of the operative field by glove powders, even after washing and wiping, is a well-described entity. We present a case of presumed secondary intraocular lens contamination by surgical glove powder. This complication can be avoided by being sure that no intraocular surgical instruments or implants are directly handled by the fingers.
Argon Laser Trabeculoplasty in a Residency Program
Authors: Khan Kassim A , Lederer Charles M , Willoughby Lee
Published: April 2021

ABSTRACT

The following article discusses the outcome of 60 eyes with various forms of glaucoma undergoing resident-performed argon laser trabeculoplasty (ALT). The majority (46/60) of eyes had primary open-angle glaucoma. Decrease in intraocular pressure (IOP) was not as great as reported in the literature. Our results suggest that initially treating 180° of the angle is associated with improved overall results. ALT has proved to be a safe and effective alternative to conventional surgery for glaucoma in a residency training setting.
Treatment of Chalazia with Corticosteroid Injections
Authors: King Robert A , Ellis Philip P
Published: April 2021

ABSTRACT

Of 34 chalazia injected with triamcinolone acetate, 29 resolved after one or two injections. Larger lesions frequently required a second injection. During a six-month follow-up period, there were five recurrences; all occurred in lesions originally measuring larger than 36 sq mm. The response to intralesional corticosteroid injection was similar in all age groups and in lesions of short and long duration. Intralesional injection of triamcinolone acetate offers an acceptable alternative or adjunct to incision and curettage in the management of chalazia.
Surgical Techniques for Giant Retinal Tears With Retinal Tacks
Authors: Ando Fumitaka , Kondo Junko
Published: April 2021

ABSTRACT

In order to repair an inverted retinal flap on the choroid in case of retinal detachment with giant tears, the authors have developed a retinal tack made of acetalcopoly meri sate. The tack is very durable and should remain inactive in the human body, owing to its stability under conditions of heat, alkali and acid.

Manipulating the tack is adequately easy; the procedure and the tacks themselves appear to be well tolerated by the eye. The detailed design of the tack and its method of use are described in this report.
Prostaglandin Release Following Nd: YAG Iridotomy in Rabbits
Authors: Gailitis Ray , Peyman Gholam A , Pulido Jose , Mitchell Murray D , Weinreb Robert M
Published: April 2021

ABSTRACT

In this study, iridotomies were performed in nine rabbit eyes using an Nd: YAG laser at 5.2 ml, three pulses/burst, for one burst. Prostaglandin E2 (PGE2) in aqueous humor obtained at timed intervals after treatment was then measured using a sensitive and specific radioimmunoassay. Concentrations of PGE2 (mean ± SD pg/ml) were: pretreatment, 377±89; 30 minutes, 1858 ±241; 120 minutes, 735+308; and 240 minutes, 401±59, postoperatively. The release of PGE2 into the aqueous humor parallels the rise in intraocular pressure following Nd: YAG iridotomies in rabbits and thus may contribute to this phenomenon.
Factors Affecting the Results of Argon Laser Trabeculoplasty in Open-Angle Glaucoma
Authors: Traverso Carlo E , Spaeth George L , Starita Richard J , Fellman Ronald L , Greenidge Kevin C , Poryzees Effie
Published: April 2021

ABSTRACT

Argon laser trabeculoplasty (ALT) was performed in 232 eyes of 180 patients affected by uncontrolled primary open-angle glaucoma (POAG), exfoliation syndrome glaucoma (ESG) or pigment dispersion syndrome glaucoma (PDSG). Mean follow-up was 9 months (3-22). Mean IOP change was -21.6% (±19) from the initial value. The effect of IOP was larger in patients with ESG, PDSG, and in POAG cases with more pigmented trabecular meshwork. No relationship was found between IOP changes and age or refraction of patients; the association with iridoplasty did not influence final results. An Octopus computerized perimeter was used for pre and post-treatment visual field tests. In 113 eyes Octopus exams met the requirements for quantitative analysis. In this group 17% of visual field improved, 64% remained stable and 19% worsened. A good functional response was more frequent among the eyes with less advanced disease.
Ocular Findings in Juvenile Nasopharyngeal Angiofibroma
Authors: Stern Robert M , Beauchamp George R , Berlin A Jan
Published: April 2021

ABSTRACT

Juvenile nasopharyngeal angiofibroma (JNA) is the most common benign neoplasm of the nasopharynx. While histologically benign, it has the propensity for aggressive local growth. This highly vascular tumor predominantly occurs in adolescent males. The literature fails to provide a thorough description of ocular complications and their incidence in JNA. This report summarizes the data from those clinical series detailing ocular findings in a total of 218 JNA cases. Exophthalmos was found in 14% of all cases. Decreased visual acuity and partial ophthalmoplegia occurred in 5% and 2% respectively. Recognition of ocular involvement in JNA is of the utmost importance, for it is often a manifestation of orbital or intracranial extension or both. We describe the diagnosis and management of a case of JNA in a five-year-old white male. The patient developed ocular findings of marked exophthalmos and optic atrophy. Early multidisciplinary diagnostic evaluation (otolaryngological, neurosurgical, and ophthalmological) followed by a team surgical approach to excision is most likely to yield efficacious results.
The Use of a Pedal Extensor Tendon in Frontalis Suspension Surgery
Authors: Dickson James B
Published: April 2021

ABSTRACT

This article describes the use of an autogenous tendon in frontalis suspension correction of blepharoptosis. The author discusses selection and methods of harvesting tendons and the advantages of tendons over other materials used in frontalis suspension surgery.