bluuebunny/crossref_metadata_2025 huggingface dataset:
An Experiential Method for Teaching Research to Graduate Nursing Students
Authors: Fazzone Patricia A
Published: April 2021

ABSTRACT

This article provides a creative and interactive method for teaching a metaparadigm of inquiry that values and embraces both naturalistic and positivistic approaches to research. The author outlines an experiential method for teaching graduate level research that blends opportunities to meet the needs of students with either global or analytic information processing styles, as well as varying student learning styles. The method involves a semesterlong journey whereby students cognitively and viscerally begin to understand the interconnectedness of all research knowledge, and consists of five elements: 1) creating a nonthreatening environment; 2) using guided imagery; 3) teaching research along the "Continuum of Inquiry"; 4) take-home and midterm exams based on hypothetical clinical situations; and (5) developing a written research proposal.
Today's Nursing Education in the People's Republic of China
Authors: ShuZhen Li
Published: April 2021

ABSTRACT

This article describes the history of nursing education in China and focuses mainly on its future, its role, its characteristics, and the job of nursing educators. According to the Chinese Nursing Association, in 1999 there were 67 university nursing schools, 35 college nursing schools, 500 secondary nursing schools, and master's degree programs in 15 universities. Continuing nursing education, life-long learning, has swept over the whole country as a result of an increased pace of a reform drive. Nursing education faces formidable challenges in helping students develop the competencies needed to survive the changing system's care. The struggles and realities of the changes are discussed, and how they affected and influenced the nursing system that is entering a new era.
Bridges and Barriers: Educational Mobility of Hispanic Nurses
Authors: Villarruel Antonia M , Canales Mary , Torres Sara
Published: April 2021

ABSTRACT

The lack of data on the educational mobility of the Hispanic nurse presents major barriers in designing effective strategies to diversify the nursing work force. However, such data are necessary to ensure parity of representation of Hispanice in nursing. The purpose of this project was to identify barriers and bridges to educational mobility experienced by Hispanic nurses. Focus groups were conducted in six sites throughout the country. Separate groups were conducted with Hispanic ADN nurses who had completed their BSN and with BSN nurses who had completed their MSN. Barriers encountered and identified by participants included financial burdens, institutional barriers, perceived discrimination by faculty and peers, and cultural values such as the importance of the family and prescribed gender roles. Conversely, bridges to completing degree requirements included family, peers, and faculty. Recommendations to facilitate educational mobility of Hispanic nurses are provided.
Computer Versus Lecture: A Comparison of Two Methods of Teaching Oral Medication Administration in a Nursing Skills Laboratory
Authors: Jeffries Pamela R
Published: April 2021

ABSTRACT

The purpose of this study was to compare the effectiveness of both an interactive, multimedia CD-ROM and a traditional lecture for teaching oral medication administration to nursing students. A randomized pretest/posttest experimental design was used. Fortytwo junior baccalaureate nursing students beginning their fundamentals nursing course were recruited for this study at a large university in the midwestern United States. The students ranged in age from 19 to 45. Seventy-three percent reported having average computer skills and experience, while 15% reported poor to below average skills. Two methods were compared for teaching oral medication administration- a scripted lecture with black and white overhead transparencies, in addition to an 18-minute videotape on medication administration, and an interactive, multimedia CD-ROM program, covering the same content. There were no significant (p < .05} baseline differences between the computer and lecture groups by education or computer skills. Results showed significant differences between the two groups in cognitive gains and student satisfaction (p = .01), with the computer group demonstrating higher student satisfaction and more cognitive gains than the lecture group. The groups were similar in their ability to demonstrate the skill correctly. Importantly, time on task using the CD-ROM was less, with 96% of the learners completing the program in 2 hours or less, compared to 3 hours of class time for the lecture group.
Novice Faculty: Encountering Expectations in Academia
Authors: Siler Bobbie B , Kleiner Catherine
Published: April 2021

ABSTRACT

New faculty rarely are prepared educationally or experientially for multiple roles and expectations. This phenomenological study was designed to uncover the meaning of the new faculty experience. A purposeful sample of nursing faculty, who were in their first year in a new position, were interviewed to gain an understanding of their experience. A hermenéutica! method of data analysis revealed common meaning in the experience of new faculty. The focus of this article is on one theme- expectations- from the distinct perspective of the novice faculty participants. Novice faculty had expectations of what their new role would involve from their prior experience as students, and they perceived expectations of them by other faculty and students. With limited experience in academia, novice faculty described how they tried to put their own and others' expectations into perspective. The stories of these novice faculty reveal inadequacies in the ways new faculty are prepared and mentored. Implications arising from this study encourage revisiting the practices surrounding the preparation and retention of new nursing faculty.
Student Outcomes of the Healing Web: Evaluation of a Transformative Model for Nursing Education
Authors: Nelson Margot L , Howell Jacquelyn K , Larson June C , Karpiuk Kathryn L
Published: April 2021

ABSTRACT

The Healing Web is a transformative nursing model, bridging gaps between nursing education and practice, baccalaureate and associate degree education, and public and private educational institutions. It is an educational prototype in which nursing students experience collaborative clinical practice in a differentiated practice model. Based on the Healing Web framework, it was hypothesized that the educational partnership model would influence specific student competencies (i.e., caring abilities, leadership skills, assertiveness, and professional nursing behaviors). Students in the Healing Web program scored higher in caring knowing, caring courage, leadership, and assertiveness than their counterparts who participated in traditional clinical experiences. Students identified collaboration, partnership with students and staff, and learning to value different nureing roles as primary benefits of the experience. Findings support the contribution of Healing Web experiences to selected student outcomes, but the research is limited by instrumentation, small numbers, and the question of adequate "dosage." Future research will emphasize qualitative methods to explicate significant concepts more completely.
A New Perspective on Competencies for Self-Directed Learning
Authors: Patterson Chris , Crooks Dauna , Lunyk-Child Ola
Published: April 2021

ABSTRACT

In baccalaureate in nursing programs, self-directed methods of education have been used for many decades. A major goal of this type of approach to education is to provide students with the necessary competencies to become lifelong learners. Students must be exposed to self-directed learning competencies to obtain the knowledge, skills, and attributes unique to their personal and professional growth. It has been proposed that six competencies are required for students to become self-directed learners: self-assessment of learning gaps; evaluation of self and others; reflection; information management; critical thinking; and critical appraisal. Each of these skills are not mutually exclusive but are interrelated in such a way that students use all or a combination of them simultaneously to direct and control their learning.
Violence-Related Content in the Nursing Curriculum: A Follow-Up National Survey
Authors: Woodtli M Anne , Breslin Eileen T
Published: April 2021

ABSTRACT

Appropriate educational preparation about violence prevention, assessment, and treatment provides critical knowledge and skills that enable nurses to provide competent care to violence survivors. This follow-up national survey examined changes in the extent, placement, and faculty responsible for violence-related content in baccalaureate nursing curricula since the original 1995 survey was conducted. This national study used a 31-item mailed questionnaire that requested demographic information; data related to course content, clinical experiences, curriculum and faculty development, and curriculum evaluation; and recommendations. Usable questionnaires were returned from 395 (61%) of 648 programs surveyed. Findinge indicated content related to women, children, and suicide and self-destructive behavior was taught primarily in 2 to 4 hours; 46% of schools presented sexual and elder abuse content in 1 hour or in readings only; and related clinical experiences were primarily coincidental. The majority of schools (63%) reported no violence-related faculty development activities during the past 4 years despite previous indication of need. More than two thirds of programs (68%) did not systematically evaluate violence content, and 75% had not developed violence-focused student competencies. Although small gains were found in hours of presentation in some content, little has changed in the nursing curriculum overall. The significance of this study is related to the relevance of nursing education to preparing students and faculty to address the social and health problems of increasing violence and abuse.
Reinnervation of the Nerve to the Inferior Oblique After Iatrogenic Denervation
Authors: Gonzalez Caleb
Published: April 2021

Abstract

A case is reported of a young adult female with a traumatic superior oblique palsy treated with a denervation of the inferior oblique muscle. In addition to the denervation, email Week Hemoclips were placed at both ends of the severed nerve. In spite of this, the inferior oblique muscle reinnervated, necessitating a redenervation plus large myectomy to obtain a permanent cure. A two-year follow-up revealed normal ocular motility.
Optic Glioma Masquerading As Spasmus Nutans
Authors: Koenig Steven B , Naidich Thomas P , Zaparackas Zibute
Published: April 2021

Abstract

An eight-month-old child who presented with signs of spasmus nutans subsequently developed obstructive hydrocephalus, bilateral optic atrophy, andlossof vision due to a juvenile pilocytic astrocytoma involving the optic nerves, chiasm, and anterior third ventricle. It appears that gliomas arising from this region may produce signs that imitate spasmus nutans.
Motion Aftereffect Transfer in the Monofixation Syndrome
Authors: Price Ronald L , Keck Max J
Published: April 2021

Abstract

If one adapts to a moving repetitive stimulus of stripes that is suddenly stopped, the stripes will appear to move backward. This apparent backward motion is the motion aftereffect (MAE), and its duration is a measure of its magnitude. If one eye adapts to the moving stimulus and the other eye experiences the aftereffect to the stationary stimulus, the aftereffect has been transferred from one eye to the other and is termed the interocular transfer of the MAE.

Experimental evidence indicates that the degree of MAE transfer correlates with clinical binocularity. This study compares the MAE transfer in six subjects with the monofixation syndrome to five normal subjects. The stimuli used are sinusoidal stripes generated on two cathode-ray tubes, subtending either 8° or 2° of visual angle with a periodicity of either 0.5 or 3 cycles/degree presented haploscopically.

Subjects with the monofixation syndrome differed significantly from normal subjects in the amount of MAE transferred, implying a lack of central neuronal connections in addition to those mediating conscious central fusion in clinical sensory testing.
Saccadic Velocities of Horizontal Rectus Muscles in Twenty-Five Normal Humans
Authors: Mims James Luther , Treff Gaye
Published: April 2021

Abstract

We measured horizontal saccadic velocities for 20° saccades in 25 normal humans. Percent differences for various muscle pairs were calculated for each subject. For example, percent differences of the antagonist muscles averaged +4,9 ± 10% and percent differences of symmetrical muscles averaged -9.2 ± 9%. This percent difference type of data, previously unreported, allows more accurate detection of pathology in a given patient than comparison of a single saccadic velocity with an average of normals because of large intersubject variability.

We also found ways to make the performance of the test more convenient and the calculations significantly more accurate (0.001). These will be described. The average speed of a horizontal rectus saccade was 396 ± 53 degrees/sec.
Increase in Retinal Surface Area During Infancy and Childhood
Authors: Robb Richard M
Published: April 2021

Abstract

Retinal surface area was calculated from measurements made on the eyes of 33 patients ranging in age from six-months of gestation to six-postnatal years. Retinal surface area increased dramatically during the last months of gestation and more gradually in the first two postnatal years. Thereafter the rate of increase was small. These data provide a background against which regional shifts in the cell density of the retina and retinal pigmented epithelium can be studied.
Vertical Strabismus Associated With Plagiocephaly
Authors: Robb Richard M , Boger William P
Published: April 2021

Abstract

Thirty-three patients with plagiocephaly due to unilateral coronal synostosis have been studied because of a high incidence of vertical strabismus. Twenty-seven of the 33 patients were found to have an ipsilateral hypertropia. In two patients the hypertropia disappeared after early neurosurgical correction of the coronal synostosis, but in most patients the hypertropia persisted, mimicking a fourth cranial nerve palsy with overaction of the inferior oblique muscle and a head tilt to the opposite shoulder. We think the vertical muscle imbalance is due to structural abnormalities of the orbit induced by the cranial synostosis. Appropriate strabismus surgery reduced the ocular deviation in five patients.
Congenital Glaucoma Unresponsive to Conventional Therapy: A Clinicopathological Case Presentation
Authors: Wright John D , Robb Richard M , Dueker David K , Boger William P
Published: April 2021

ABSTRACT

A clinicopathological case report of a black male with congenital glaucoma is presented. The child died at age three months of the Sudden Infant Death Syndrome. The clinical course was characterized by persistent corneal clouding and elevated intraocular pressure in spite of vigorous medical and surgical therapy. Histopathological findings included corneal enlargement, marked hypoplasia of the canal of Schlemm, poorly developed scierai spur, insertion of the ciliary musculature directly into the trabecular meshwork anterior to the scleral spur, and anterior displacement of the iris root. There was also anomalous dispersion of the sphincter muscle of the iris from the pupillary margin almost to the iris root, and attachment of some ciliary processes to the posterior surface of the iris. A poor clinical response to conventional glaucoma therapy, including trabeculotomy, goniotomy, trabeculectomy and medical therapy, supports the belief that the marked hypoplasia of Schlemm's canal was a mejor factor contributing to the elevated intraocular pressure. Furthermore, the multiplicity of abnormalities of anterior chamber angle structures suggests that some cases of congenital glaucoma may result from an early and extensive disorder in the formation of anterior segment tissues.
The Spectrum in the Morphology of the So-Called "Morning Glory Disc Anomaly"
Authors: Traboulsi Elias I , O'Neill John F
Published: April 2021

ABSTRACT

Eight cases illustrating the different configurations of the morning glory disc anomaly are presented. The spectrum of the appearance is due to variability in excavation of the disc, amount of glial tissue and hyaloid system remnants in the center of the disc, and degree of peripapillary pigmentary changes. There is no correlation between optic disc configuration and visual acuity. This anomaly should be suspected in infants presenting with unilateral retinal detachment.
Leukemic Iris Infiltration
Authors: Schachat Andrew P , Jobs Douglas A , Graham Michael L , Ambinder Richard F , Green W Richard , Saral Rein
Published: April 2021

ABSTRACT

Three patients with acute lymphoblastic leukemia and leukemic infiltration of the iris are presented. The clinical features, diagnostic techniques, and treatment of this condition are described.
Accommodation Deficiency in Healthy Young Individuals
Authors: Chrousos Georgia Antonakou , O'Neill John F , Lueth Brian D , Parks Marshall M
Published: April 2021

ABSTRACT

Ten patients, ages 10 to 19, with accommodation insufficiency are reported. All patients were in good health and asymptomatic, except for asthenopia during near visual activities. Each patient's amplitude of accommodation was measured and found to be considerably below the minimal normal for their respective ages (an average of 6 diopters). Only three patients had associated convergence insufficiency. No etiology for the diminished accommodation was suggested fay history or could be identified by careful examination. All patients were successfully managed optically with bifocals or reading glasses, although three required the addition of base-in prisms for the near exodeviation. Near vision testing and determination of the near point of accommodation should be part of the pediatrie ophthalmologic examination in all patients with complaints referable to their reading and visual performance at near.
Wave Form Characteristics of Vertical Oscillations in Longstanding Vision Loss
Authors: Pritchard Cindy , Flynn John T , Smith J Lawton
Published: April 2021

ABSTRACT

Eye movement recordings were collected on ten patients who had monocular vertical oscillations of their eye with longstanding vision loss. Amplitude of the oscillations ranged from 3° to 50°. Frequencies ranged from .12 to 5 cycles/second and were inversely correlated with amplitudes. Three subjects appeared to have two wave forms superposed on one another. Depending on which of these wave forms we use In analysis, there may be a correlation between oscillation amplitude and duration of vision loss. Presence of the two wave forms is discussed in terms of their possible etiologic relationship with the vertical drift phenomenon.
Unusual Ocular Findings in Identical Twins
Authors: Shippman Sara , Schudel Susanne , Millman Arthur , Weseley Alan C
Published: April 2021

ABSTRACT

We report an unusual case of dissimilar strabismus in monozygotic twins and describe the anatomical features which caused it.
Monocanalicular Lacrimonasal Intubation
Authors: Vila-Coro Antonio Aguirre , Arnoult Jeffrey B , Mazow Malcolm L
Published: April 2021

ABSTRACT

A new technique to obtain patency of the lacrimal drainage system was used in three children with bilateral congenital obstruction of the lacrimonasal duct (six cases) and upper canalicular abnormalities (five cases). The upper canalicular abnormalities prevented bicanaliculonasal intubation.

A silicone tube was passed through the lower canaliculus, traversing the lacrimal drainage system and into the nasal fossa. The proximal end of the tube was placed subconjunctival^ in the inferior fornix and secured. The distal end of the tube was passed through the subcartilaginous nasal septum to the contralateral nasal fossa and tied to a tube similarly passed through the opposite lacrimal system.

The procedure was successful in all six cases, with all tubes remaining in place the desired length of time. Postoperative identification and removal of the tubes offered no difficulties and was followed by permanent patency of the lacrimal drainage system in all six cases.
LONG TERM CARE
Authors: Anonymous
Published: April 2021

EMPLOYMENT FUTURE
UPDATE YOUR KNOWLEDGE OF KLINEFELTER SYNDROME
Authors: Cohen Felissa L , Durham Jerry D
Published: April 2021

EARLY STUDIES IMPLIED THAT MALES WITH KLINEFELTER SYNDROME WERE AT HIGH RISK FOR MENTAL ILLNESS AND CRIMINAL TENDENCIES, BUT RECENT PROSPECTIVE STUDIES OF AFFECTED NEWBORNS DISPUTE MUCH OF WHAT WAS FORMERLY BELIEVED.
CONSUMER GROUP
Authors: Anonymous
Published: April 2021

SENIOR CITIZENS
BOOK AVAILABLE
Authors: Anonymous
Published: April 2021

PETS & PROFESSIONALS
Drug Abuse and the Elderly
Authors: Caroselli-Karinja Marie
Published: April 2021

As the incidence of misuse and abuse of drugs increases among a significant segment of the elderly population, nurses must become more aware of the problem and of what they can do to help.
Self-Help Therapy in PARENTS
Authors: Hunka Carol Davis , O'Toole Anita W , O'Toole Richard
Published: April 2021

The senior author became a quasimember of two Parents Anonymous groups in order to observe how group processes functioned to bring about individual change.
The Power of the Dissociative State
Authors: Peplau Hildegard E
Published: April 2021

Hildegard E. Peplau, RN, EdD, FAAN, Describes Her First-Hand Experience With Empathie Transmission of Anxiety
Ethical Decision Making Patterns
Authors: Garritson Susan Hunn
Published: April 2021

Nurses' decisions are strongly influenced by concerns for clients' limitations and professional responsibility to maintain social safety.
McKinney Act brings emergency relief for homeless
Authors: Anonymous
Published: April 2021

Federal assistance targets chronic mentally ill and substance abusers
LEGACY OF VIETNAM
Authors: Berkseth Janet Kempf
Published: April 2021

The unresolved anger and despair felt by the bereaved family members of over 50,000 soldiers who lost their lives in the tragedy of the Vietnam War still reverberates in American society today and presents an unvoiced yet persistent need to health care professionals.
Evolution of Psychiatric Community Care
Authors: Moffett Myrna J
Published: April 2021

What obligations does the 20th century nursing profession have to the mentally ill?
Somatoform Disorders: How to Reduce Overutilization of Health Care Services
Authors: Corbin Lucetta Jo , Hanson Richard W , Hopp Susan A , Whitley Anne-Claire
Published: April 2021

Instead of dismissing client complaints as hypochondriasis, primary care providers must look to the individual's psychosocial needs, which may be masked by imaginary problems.
Future Directions in Psychiatric Nursing From the Perspective of History
Authors: Peplau Hildegard E
Published: April 2021

Hildegard E. Peplau's long and distinguished career as a pioneer in psychiatric nursing continues. Her influence over the thinking in the field can be measured by the great volume of footnote citations and frequent quotes of her work in the new literature. Her sustained mentoring of scores of psychiatric nurse leaders is remarkable as an exercise in dedication and commitment to the profession and to psychiatric clients.

In this issue are featured an historical overview by Or. Peplau and two new articles that reflect the impact of her work.

Dr. Peplau's article was prepared for the 175th Anniversary celebration of McLean Hospital and was delivered on April 26, 1986, as the first Distinguished Scholars in Nursing Lecture. This article is an edited version of that presentation.

Following Peplau's article, "Establishing a Nurse-Client Relationship," discusses Peplau's theory regarding the nurse-client relationship as the crux of the nursing process and its consequent developmental phases.

"Peplau's Theory and Case Management," combines Peplau's interpersonal theory of nursing with a case management model to facilitate a higher level of functioning and quality of life for the psychiatric client.
Dying, God, & Anger
Authors: Henderson Kathryn J
Published: April 2021

Comforting Through Spiritual Care
CUTTING VOICES
Authors: Machoian Lisa
Published: April 2021

Self-Injury in Three Adolescent Girls
My Worst Nightmare
Authors: O'Rourke Edwina M
Published: April 2021

A Nurse's Personal Account of Assault and Recovery
Effect of Radial Keratotomy Incision Direction on Wound Depth
Authors: Melles Gerrit R J , Binder Perry S
Published: April 2021

ABSTRACT: The majority of ophthalmic surgeons who perform radial keratotomy make incisions from the optical clear zone to the limbus (downhill; centrifugal), instead of from the limbus to the optical clear zone (uphill; centripetal). To compare the efficacy of these techniques, one surgeon performed keratotomy incisions in 10 eyes of 5 monkeys using the same double-edged diamond blade set to 80% of central pachometry. Four or eight centrifugal (downhill) and centripetal (uphill) incisions were made in each eye. Achieved incision depth was measured by light microscopy 2.5 to 8 months postoperative. Downhill incision depth averaged 46% (range 38% to 61%), whereas uphill incision depth averaged 74% (range 53% to 87%) (P<.0005). In both groups, incision deviation from the perpendicular (lateral tilt error) was greatest adjacent to the optical clear zone (P<.01). These differences may be explained by tilt error (forward or backward) or by the perpendicular front cutting action of a vertical blade being more effective than the angled blade. [Refractive and Corneal Surgery 1990;6:394-403.]
Relaxing Incisions With Compression Sutures to Reduce Astigmatism After Epikeratoplasty
Authors: Fronterre Aldo , Portesani Gian Paolo
Published: April 2021

ABSTRACT: Relaxing Incisions with compression sutures were performed in seven eyes with high astigmatism following epikeratoplasty for keratoconus and in one case of posttraumatic aphakia. Mean preoperative keratometric astigmatism was 7.64 ± 2.51 diopters (range 5.50 D to 13.00 D) in the epikeratopiasties for keratoconus and about 10.00 D in the hyperopic epikeratoplasty. The surgical procedure consisted of a free-hand dissection perpendicular to the steeper meridian along the scar between the edge of the epikeratoplasty lenticule and the recipient cornea, with an additional incision into the recipient stroma to an approximate depth of 80%. Following the incisions, compression sutures were added 90° away in the flatter meridian. After surgery, the net decrease in keratometric astigmatism was 6.50 D ± 2.90 D (range 5.00 to 13.00 D) in the eyes with epikeratoplasty for keratoconus and 6.50 D in the eye with hyperopic epikeratoplasty. Uncorrected visual acuity improved in six eyes and remained unchanged in two eyes. Spectaclecorrected visual acuity improved in every eye and contact-lens-corrected visual acuity improved in seven eyes and was unchanged in one eye. This procedure, already employed for astigmatism correction after penetrating keratoplasty, was effective in decreasing astigmatism after epikeratoplasty. [Refractive and Corneal Surgery 1990;6:413-417.]
Ocular Damage After Implantation of Oversized Minus Power Anterior Chamber Intraocular Lenses in Myopic Phakic Eyes: Case Reports
Authors: Saragoussi Jean-Jacques , Othenin-Girard Philippe , Pouliquen Yves J M
Published: April 2021

ABSTRACT

BACKGROUND: Positioning in the iridocorneal angle is one of the factors determining long-term tolerance of anterior chamber intraocular lenses (IOLs). This problem has again become topical with the use of myopic IOLs with angular supports.

METHODS: The authors describe three eyes illustrating the possible complications resulting from the insertion of oversized minus power anterior chamber implants in myopic phakic eyes.

RESULTS: The complications developed early or late after surgery. They consisted mainly of inflammatory reactions, stable or progressive pupillary deformation, and adherence of the iris to the implant.

CONCLUSIONS: In myopic phakic eyes, the insertion of incorrectly sized IOLs with angular supports may cause complications which have already been reported for anterior chamber implants in aphakic eyes. Haptic flexibility does not always make up for incorrect sizing due to imprecise preoperative evaluation of iridocorneal angle diameter. Refract Corneal Surg. 1993;9:105-109.)

RESUME

INTRODUCTION: Le positionnement dans I'anglo irido-cornéen est un des factures conditionnant la qualité de la tolérance à long terme d'un implant de chambre antérieur. Ce problème est de nouveau d'actualité avec l'utilisation des implants myopiques à support.

METHODES: Les auteurs présentent trois observations illustrant les complications pouvant résulter de la mise en place d'implants de chambre antérieure de puissance négative surdimensionnés dans les yeux phakes myopes.

RÉSULTATS: Les complications observées sont apparues précocemment ou de façon retardée par rapport à l'aete chirrical. Elles ont été essentiellement représentées par des réactions inflammatoires, des déformations pupillaires stables ou évolutives, des adhérences iris-implant.

CONCLUSIONS mise en place d'implants myopiques à supports angulaires surdimensionnés peut entraîner des complications déjà rapportées pour les imlants de chambre antérieure dans les yeux aphakes. La flexibilité des haptiques ne permet pas toujours de compenser les erreurs de taille liées à l'imprécision de l'évaluation peropératoire du diamètre de l'angle irido-cornéen. (Translated by Jean-Jacques Saragoussi, MD, Paris, France.)

SOMMARIO

PREMESSA: Il posizionamento a livello dell'angolo sclero corneale e' uno dei fattori determinanti la tolleranza a lungo termine delle lenti intraoculari impiantate in camera anteriore. Questo problema e' stato riconsiderato con l'utilizzo di lenti intraoculari miopiche a supporto angolare.

METODI: Gli authori illustrano le possibili complicanze derivanti dall'impianto di lenti a basso potere di dimensioni piu'grandi del previsto, in camera anterior in tre occhi miopi fachici.
Lamellar Keratoplasty With Lyophilized Tissue for Treatment of Corneal Scarring
Authors: Tayyib Mohammed , Sandford-Smith John H , Sheard Christine E , Rostron Chad K
Published: April 2021

ABSTRACT

BACKGROUND: A pilot study was carried out in Pakistan to assess the feasibility of the use of lathed freeze-dried corneal tissue in the treatment of corneal scarring.

METHOD: Six eyes underwent lamellar keratoplasty and were followed up for 18 months.

RESULTS: Visual improvement was obtained in every eye. In one eye, the procedure was complicated by delayed epithelialization of the graft, but in the remaining five patients, the grafts epithelialized rapidly.

CONCLUSIONS: The use of freeze-dried donor tissue simplifies storage and distribution of corneas and may offer the best hope of treatment in developing countries for patients with corneal scarring. [Refract Corneal Surg 1993;9:140-142.)
Photorefractive Keratectomy for Myopia: Preliminary Results in 147 Eyes
Authors: Machat Jeffery J , Tayfour Fouad
Published: April 2021

ABSTRACT

Excimer photorefractive keratectomy (PRK) was performed on 100 consecutive patients (147 eyes) for the correction of myopia. The follow up period ranged from 3 to 16 months (mean, B). Preoperative myopia ranged from - 1.75 to - 8.75 D (mean -3.90 D).

Patients were divided into three groups for analysis based upon their degree of preoperative myopia: mild (≤-2.90 D)1 moderate (-3.00 to -5.90 D), and severe (≥-6.00 D). Uncorrected visual acuity was 20/40 or better in 88.4% (130/ 147) overall; 97% of mild, 91% of moderate, and 68% of severely myopic patients. Preoperative astigmatism remained the primary cause of reduced uncorrected visual acuity. Postoperatively, 68% of patients overall had a spherical equivalent refraction within ± 1.00 D. The majority of treated corneas had trace (53%) to mild (29%) subepithelial haze. One patient with severe myopia developed significant subepithelial opacification postoperatively with partial regression and loss of one line of best spectacle corrected visual acuity. (Refract Corneal Surg (suppl) 1993;9:S16-S19.)
Effect of Corticosteroids in Postoperative Care Following Photorefractive Keratectomies
Authors: Tengroth B , Fagerholm P , Söderberg P , Hamberg-Nyström H , Epstein D
Published: April 2021

ABSTRACT

Since the start of photorefractive keratectomy (PRK) Seiler has recommended the use of topical corticosteroids during the first 3 months after surgery.1 The rationale for this treatment was to diminish the inflammatory reaction as well as to control the keratocytes from producing collagen and creating scars. Our knowledge of corneal wound healing in general, and after PRK in particular, is very limited and the action of corticosteroids is still unclear. Corticosteroids, when given in comparatively large topical doses, create problems. Between 15 and 30% of patients are corticosteroid responders with increased intraocular pressure. This is a threat to the eye, and also a burden for the doctor as intraocular pressure has to be checked during the treatment. The risk for cataract formation after longer periods of topically administered corticosteroids also has been discussed.

In order to decrease the rise in intraocular pressure, FML has been used in place of dexamethasone. During the 4 years follow up after PRK it has been reported that a number of patients do not regress or get a scar formation if they have not used corticosteroids in the postoperative period. The reasons to avoid topical corticosteroids in some patients are a misunderstanding of their instructions, or those who have had a history of herpes infection or glaucoma.

A double-masked study of the effects of corticosteroids after PRK was performed by Gartry, et al in a small group of patients. After 6 months, the results revealed that there were no differences between the corticosteroid and the non-corticosteroid group. However, the standard deviation was high.

As a result of these findings, our group stopped the use of dexamethasone in the postoperative care of PRK patients. The result of this was very dramatic. Within a month's time, a myopic regression started in a majority of the patients. This regression was greater than that seen in earlier experience. At 3 months, the regression increased and it was impossible to avoid corticosteroids in these patients. As a consquence of these results we did two retrospective studies. (Refract Corneal Surg (suppl) 1993;9:S61-S64.)
Double-Blind Corticosteroid Trial in Identical Twins Following Photorefractive Keratectomy
Authors: Machat Jeffery J
Published: April 2021

ABSTRACT

The use of topical corticosteroids following excimer laser photorefractive keratectomy (PRK) is widespread, but the role of corticosteroids remains poorly defined. The purpose of this study was to evaluate the use of different corticosteroid postoperative regimens following 193-nanometer excimer PRK in identical twins.

Preoperatively, cycloplegic refraction of the left eye of each twin measured -3.00 D sphere. The full correction was treated utilizing the identical technique within the same 30 minute period. The study was conducted in a double-blind fashion and the refraction, corneal clarity, uncorrected and best spectacle corrected visual acuity, and kerafometry were assessed over the 6-month study period. Both twins were placed on an identical regimen, tapering their drops over a 3-month period.

Corneal clarity was remarkably well preserved with essentially clear corneas observed in both twins. Similarly, both twins achieved 20/15 vision with a cycloplegic refraction of +0.75 D at 6 months. The only difference in the healing pattern was the slightly more rapid visual recovery in twin A. The code was revealled upon the cessation of corticosteroid regimen. Twin A had received fluoromethalone 0.1% and Twin B received dexamethasone 0.1%. Keratometry demonstrated identical flattening. There were no corticosteroid induced intraocular pressure rise or other complications noted.

Identical twins presented a unique opportunity to better understand wound healing following laser keratectomy. The results of this limited study indicated that for at least lower degrees of myopia the need for full strength topical corticosteroids remains questionable. (Refract Corneal Surg (suppl) 1993;9:S105-S107)
The Erodible Mask in Photorefractive Keratectomy for Myopia and Astigmatism
Authors: Brancato Rosario , Carones Francesco , Trabucchi Giuseppe , Scialdone Antonio , Tavola Alessandra
Published: April 2021

ABSTRACT

This paper reports a new approach for performing photorefractive keratectomy (PRK) that uses an erodible mask to control shape transfer processes. The advantages of this technique, when compared to conventional PRK performed with mechanical diaphragm, are 1) the possibility of transferring almost any shape onto corneal surface; 2) a smoother corneal surface following photoablation; 3) easier eye fixation; and 4) a controlled humidified environment over ablation zone.

We report our experimental study on scanning electron microscopy of polymethylmethacrylate (PMMA) plates ablated using conventional technique versus erodible mask technique; the results showed a smoother surface in the PMMA plate ablated using the erodible mask. We also report our preliminary clinical results of four eyes treated for the correction of myopia combined with astigmatism. Myopia ranged from -2.00 to - 10.00 D, and astigmatism ranged from - 1.50 to -2.50 D. Three months after surgery, all four eyes were within ± 1 .00 D of myopic attempted correction, but astigmatism was completely corrected only in one eye. No complications or scarring have been reported.

We believe the erodible mask could be effective in the correction of myopia and myopic astigmatism, but further improvements are necessary to allow easier alignment of the mask over the eye.

All commonly available excimer laser devices produce photorefractive keratectomy as a concentric ablation of the corneal stroma, deeper in the center than in the peripheral part;1-3 this is produced by means of an iris or diaphragm which, depending on the type of laser, progressively opens or closes, allowing a greater laser beam delivery in the center.4,5 In all cases, the movement of the diaphragm is not progressive and linear but occurs in steps. This results in ablation in micrometrie "steps" that are not perfectly smooth.6 In addition, the concentric aperture (or closure) of the diaphragm produces only circular ablations, able to correct myopia, but not astigmatism or hyperopia. (Refract Corneal Surg (suppl) 1993;9:S125-S130)
Keratomileusis for Myopia With the Excimer Laser (Buratto Technique): Short-Term Results
Authors: Buratto L , Ferrari M , Genisi C
Published: April 2021

ABSTRACT

We present a prospective clinical study based on the results of 150 consecutive cases of myopic intrastromal keratomileusis cases using the ExciMed UV200 193 nm excimer laser 193-nanometer (Summit Technology, Inc, Waltham, Mass) to reduce high myopia. The mean and standard deviation of the follow up considered was 3.13 ± 1.12. The mean preoperative spheroequivalent was -18.96 ±3.70 D and -2.32 ±2.36 D postoperatively. One hundred twenty-eight eyes (85.3%) were within ± 1.00 D from the intended correction. In a majority of cases the best spectacle corrected visual acuity was unchanged or improved.

No cases of intraoperative complications were observed; postoperative complications are reported. The Buratto technique to correct or reduce high myopia is efficient and safe, while the predictability is satisfactory. (Refract Corneal Surg (suppl) 1993;9:S130-S133.)
Corneal Iron Line Associated with Steep Central Islands after Photorefractive Keratectomy
Authors: Krueger Ronald R , Tersi Ira , Seiler Theo
Published: April 2021

ABSTRACT

PURPOSE: To report a new corneal iron deposit after excimer laser photorefractive keratectomy (PRK).

METHODS: Two patients with symptomatic persistent steep central islands were noted to have a corneal iron ring at 6 months to 1 year after surgery. This is different from the centred iron spot noted in most patients at 1 year.

RESULTS: One patient had repeated PRK with improvement of his symptoms and resolution of the iron ring.

CONCLUSIONS: A corneal iron ring after excimer laser PRK suggests the presence of a persistent steep central island of stromal origin. Since corneal iron deposition signifies chronicity, symptomatic patients should be retreated as resolution of the steep central island is not likely to occur. [J Refract Surg 1997;13:401-403]
Laser in situ Keratomileusis for Myopia of -2 to -25 Diopters
Authors: Tsai Ray Jui-Fank
Published: April 2021

ABSTRACT

PURPOSE: To evaluate excimer laser in situ keratomileusis in the treatment of low, high, and excessively myopic eyes in Taiwan, 77 patients (104 eyes) were treated with Nidek EC-5000 excimer laser and divided into four groups.

METHODS: In situ keratomileusis was performed with a Chiron or SCMD microkeratome. The Nidek EC-5000 excimer laser was used, with multiple passes and a multiple zone ablation technique was performed for myopia higher than -10.00 D.

RESULTS: In eyes with a preoperative spherical power equal to or less than -7.00 D (29 eyes of 18 patients), the preoperative cycloplegic mean spherical equivalent refraction was -5.44 ± 1.36 D. The mean postoperative subjective spherical equivalent refraction was 0.25 ± 0.64 D at 1 month, 0.056 ± 0.55 D at 3 months, -0.069 ± 0.415 D at 6 months, and 0.022 ± 0.496 D at 9 months. The predictability of postoperative 9 month results demonstrated that 86.21% of eyes were within ±0.50 D, 96.55% were within ±1.00 D, and 100% were within ±2.00 D of emmetropia.

In eyes with a preoperative spherical power equal to or less than -10.00 D and higher than -7.00 D, 26 eyes of 17 patients had a preoperative cycloplegic mean spherical equivalent refraction of -8.41 ± 0.84 D. The mean postoperative subjective spherical equivalent refraction was -0.043 ± 1.15 D at 1 month, -0.12 ± 0.92 D at 3 months, -0.21 ± 1.05 D at 6 months, and -0.37 ± 1.04 D at 9 months. The predictability of postoperative 9 month results demonstrated that 76.92% of eyes were within ±0.50 D, 80.77% were within ±1.00 D, and 96.5% were within ±2.00 D of emmetropia.

In eyes with a preoperative spherical power equal to or less than -15,00 D and more than than -10.00 D, 40 eyes of 27 patients had a preoperative cycloplegic mean spherical equivalent refraction of -12.65 ± 1.51 D. The mean postoperative subjective spherical equivalent refraction was 0.275 ± 1.72 D at 1 month, -0.30 ± 1.34 D at 3 months, -0.47 ± 1.23 D at 6 months, and -0.62 ± 1.23 D at 9 months. The predictability of postoperative 9 month results demonstrated that 62.5% of eyes were within ±0.50 D, 75% were within ±1.00 D, and 87.5% were within ±2.00 D of emmetropia.

For 19 eyes of 15 patients with a preoperative spherical power greater than -15.00 D, the preoperative cycloplegic mean spherical equivalent refraction was -19.53 ± 2.61 D. The mean postoperative subjective spherical equivalent refraction was -0.40 ± 1.22 D at 1 month, -0.69 ± 1.34 D at 3 months, -0.83 ± 1.40 D at 6 months, and -0.65 ± 2.99 D at 9 months. The predictability of postoperative 9 month results demonstrated that 31.5% of eyes were within ±0.50 D, 52.63% were within ±1.00 D, and 63.16% were within ±2.00 D.

CONCLUSION: LASDX is a safe and effective technique for the treatment of low, high, and excessive myopia. [J Refract Surg 1997;13(suppl):S427-S429]
Patient Satisfaction after Photorefractive Keratectomy for Low Myopia Using the Visual Analogue Scale
Authors: Rushood Abel A , Nassim Hala M , Azeemuddin T
Published: April 2021

ABSTRACT

OBJECTIVE: To subjectively assess patient satisfaction after photorefractive keratectomy (PRK) for low myopia using the visual analogue scale.

METHODS: We evaluated the satisfaction of 28 patients (53 eyes) who underwent PRK. Their baseline myopia ranged from -0.50 to -5.00 diopters (D) with a refractive cylinder ranging between piano to -2.00 D. They were all treated using the Nidek EC5000 scanning excimer laser with an ablation zone diameter of 5.5 mm and a transition zone diameter of 7.0 nun. Mean follow-up time was 11 months.

RESULTS: Mean satisfaction in this group of patients was 90.95 + 8.9%. We found that age, baseline astigmatism, postoperative refraction, and postoperative haze influenced the satisfaction outcome.

CONCLUSION: Satisfaction assessment after PRK in patients with low myopia using the visual analogue scale is simple, subjective, reproducible, quick, and probably reliable. [J Refract Surg 1997;13(suppl):S438-S440]
Excimer Laser Photorefractive Keratectomy for Hyperopia
Authors: Pietilä Juhani , Mäkinen Petri , Pajari Seppo , Uusitalo Hannu
Published: April 2021

ABSTRACT

OBJECTIVE: Excimer laser photorefractive keratectomy (PRK) has been shown to be an effective method in the treatment of refractive errors, especially myopia. We evaluated prospectively the efficacy, predictability, stability, and safety of excimer laser PRK in the treatment of hyperopia.

METHODS: Thirty-four hyperopic eyes were treated with an Aesculap-Meditec (MEL 60) excimer laser. The patients were divided into two groups. In the low-moderate hyperopia group, baseline spherical equivalent refraction was between +1.50 and +6.00 diopters (D) (mean, +4.20 ± 1.30 D) and in the high hyperopia group between +6.25 and +9.75 D (mean, +7.70 ± 1.30 D). Follow-up visits occurred 1, 3, 6, and 12 months after surgery.

RESULTS: One-year results were available for a total 27 eyes (79%): 15 eyes with low to moderate hyperopia and 12 eyes with high hyperopia. One year after PRK in the low-moderate group, six eyes (40%) had a refractive error within ±1.00 D of emmetropia, but in the high hyperopia group only two eyes (17%) were within ±1.00 D of emmetropia; three eyes (20%) and one eye (8%) were within ±0.50 D, respectively. The stability of the refractive change was better in the low to moderate hyperopia group; in the high hyperopia group there was still some regression after 6 months. At 12 months, 10 eyes (67%) in the low-moderate and one eye (8%) in the high hyperopia group had postoperative uncorrected visual acuity of 20/40 or better. One eye in the low-moderate hyperopia group saw 20/20 without correction. Only one eye lost two lines of spectacle-corrected visual acuity. Haze was more intense in the high hyperopia group, but it did not reduce visual acuity. No vision-threatening complications were observed.

CONCLUSIONS: When low to moderate hyperopia up to +6.00 D is treated, excimer laser PRK with the Aesculap Méditée MEL60 laser is safe and moderately effective, and refraction stabilizes after 3 months in most eyes . However, PRK is not sufficient to treat high hyperopia in an effective and predictable way. [J Refract Surg 1997;13:504-510]