bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmaceutical Production and Intraocular Lens Implantation: Technology Appropriate to the Third World
Authors: Brian Garry R , Hollows Fred C
Published: April 2021

ABSTRACT

Eritrea, in the Horn of Africa, suffers the serious hearth problems and obstacles to the provision of adequate health care that typify Third World countries. Yet, despite the compounding effect of war, the Eritreans' pharmaceutical facility meets 40% of their capsule and tablet requirements, and all their intravenous fluid demands. If intravenous fluid production is possible in this environment, as it is, then the authors contend that routine microscopic intraocular surgery (including intraocular lens implantation) should be as well. The establishment of an Eritrean facility capable of such surgery is recorded. The authors believe this type of surgery should be seriously considered in any attempt to deal with the problem of Third World cataract blindness.
Heat Retention in Varieties of Warm Compresses: A Comparison Between Warm Soaks, Hard-Boiled Eggs and the Re-Heater
Authors: Freedman Howard L , Preston Karen L
Published: April 2021

ABSTRACT

Warm compresses are the most common form of treatment for chalazia and other inflammatory conditions of the eyelids. We compared the heat retention characteristics of warm washcloths, hard-boiled eggs, and a heat-generating product called the Re-Heater when used for delivering heat to the eyelids. Skin temperature was measured during 20-minute applications of each "device." The Re-Heater had the best total heat delivery, followed closely by the hard-boiled egg. Both of these methods are reusable, easy, and cause no discomfort. We recommend that physicians instruct their patients in the use of either of these techniques when heat application to the eyelids is desired.
Can Chronic Bulbar Hypotony Be Responsible for Uveal Effusion? Report of Two Cases
Authors: Daniele Salvatore , Schepens Charles L
Published: April 2021

ABSTRACT

We describe two patients with a unilateral uveal effusion syndrome characterized by spontaneous ciliochoroidal and retinal detachment, shallow anterior chamber, poorly reactive pupil, and bulbar hypotony. A space-occupying substance of high molecular weight (sodium hyaluronate), injected into the anterior chamber, raised the intraocular pressure of these patients to 24 mm Hg. Within 24 to 72 hours the uvea flattened, and later the retina settled completely. Satisfactory clinical stability has continued in the followup period. Because a rheologic study of the aqueous humor revealed hyposecretion and hypotony in the apparently unaffected fellow eye, it is suggested that a primary bulbar hypotony can trigger a uveal effusion syndrome in an otherwise normal-sized eye with no structural abnormality.
Conjunctivochalasis: A Surgical Technique
Authors: Serrano Federico , Mora Luz Matilde
Published: April 2021

ABSTRACT

Conjunctivochalasis can be surgically corrected when it gives an appearance of a moist eye, produces tearing by mechanical obstruction of the lower punctum, or if it impedes the normal outflow of the lacrimal film. We present a surgical technique that provides a satisfactory anatomical reconstruction, does not leave a deformity, and will not lead to a retraction that could produce a cicatriciel ectropion. We stress the importance of a complete ophthalmologic examination to rule out more common causes of tearing.
A Comparison of Motility: Autogenous Dermis-Fat vs Synthetic Spherical Implants
Authors: Bosniak Stephen L , Nesi Frank , Smith Byron C , Schechter Burton , Cote Robert
Published: April 2021

ABSTRACT

The socket and prosthesis motility and the forniceal depths in a group of 47 patients who had undergone enucleation and implantation of synthetic spherical implants were compared with those in a group of 34 patients who had undergone enucleation and implantation of autogenous dermis-fat orbital implants. The primary autogenous dermis-fat orbital implants provided greater socket movement and deeper fornices than the synthetic spherical implants. Prosthesis motility, however, was the same in the two groups.
Merest Sclera Technique for Primary Pterygium Surgery
Authors: Anduze Alfred L
Published: April 2021

ABSTRACT

Over a 5-year period, 800 patients with primary pterygium underwent "merest sclera" surgery, a procedure in which the injured limbo-conjunctival area is covered completely with superior and inferior conjunctiva) flaps so that the tear film can be reestablished. After a 1-year follow-up, 17 recurrences were found (2.1%). All these resulted from premature wound dehiscence and/or postoperative infection.
Outcome of White Pump Shunt Surgery for Neovascular Glaucoma in Asians
Authors: Chihara Etsuo , Kubota Hidenori , Takanashi Taiji , Nao-i Nobuhisa
Published: April 2021

ABSTRACT

We compared the effect of seton (White pump shunt) surgery (16 eyes) with that of trabeculectomy and 5-fluorouracil (31 eyes) in treating 38 Asian patients with medically uncontrollable neovascular glaucoma. We found the probability of long-term success (intraocular pressure « 26 5= 5 mm Hg) of seton surgery (53.0% at 3 years) to be similar to that obtained following trabeculectomy with adjunctive 5fluorouracil (45.4% at 3 years). However, 3 years postoperatively, the probability of the preservation of visual acuity was significantly greater following trabeculectomy than seton surgery (67.1% vs 23.1%; P < .05). In addition, the prevalence of postoperative complications was higher with the seton procedure (P < .001). The loss of endothelial cells 6 months postoperatively was more marked with seton surgery than with trabeculectomy, whether the shunt device touched the cornea (P < .000001) or not (P < .0005). In conclusion. White's pump shunt was effective in lowering the IOP of eyes with neovascular glaucoma. However, care must be taken to prevent postoperative complications, the incidence of which exceeded those observed following trabeculectomy with adjunctive 5-fluorouracil.
Healon® Yellow as a Surgical Tool in Maneuvering Intraocular Tissues
Authors: Stenkula Staffan , Ivert Lena , Berglin Lennart , Crafoord Sven
Published: April 2021

ABSTRACT

Tinted sodium hyaluronate (Healon® Yellow) was used during posterior segment surgery mainly for the dissection of epiretinal membranes in cases of proliferative diabetic retinopathy and macular pucker. The yellow color facilitated injecting the viscoelastic substance under the membranes and simplified its removal at the end of surgery.
Glaucoma Associated With Epithelial Downgrowth Controlled With Molteno Tube Shunts
Authors: Costa Vital P , Katz L Jay , Cohen Elisabeth J , Raber Irving M
Published: April 2021

ABSTRACT

We report two histopathologically proven cases of epithelial downgrowth in which the secondary glaucoma was controlled by a double-plate Molteno tube shunt and useful vision restored with a penetrating keratoplasty. The combination of a tube shunt and penetrating keratoplasty may be indicated to maintain useful vision in advanced cases of epithelial downgrowth associated with secondary glaucoma.
Anterior Chamber Tube Shunt to an Encircling Band (Schocket Procedure) in the Treatment of Refractory Glaucoma
Authors: Spiegel Detlev , Shrader Robb R , Wilson Richard P
Published: April 2021

ABSTRACT

We reviewed a series of 42 eyes in patients with refractory glaucoma who had undergone a Schocket procedure. The mean follow up was 17.5 months; the minimal follow up, 8 months. The success rate was 81%, with "success" defined as either (1) an intraocular pressure less than 21 and greater than 5 mm Hg, with a pressure reduction of at least 10%, and less or no medication; or (2) a pressure reduction of at least 30%, with no change of medication. When eyes with a loss of more then one Snellen line of visual acuity were interpreted as failures, the success rate dropped to 61%. Forty percent of all cases required revision. In four cases, the shunt had to be removed (three cases due to hypotony and one secondary to conjunctival erosion). These results are in the range of those obtained by other investigators using this technique or other tube-shunt procedures.
YAG Laser Demonstration of the Anatomy of the Lens Nucleus
Authors: Drews Robert C
Published: April 2021

ABSTRACT

I used YAG laser energy to demonstrate the position and surface of the core of the lens nucleus and to prove the existence of the radial structure of the lens nucleus. Not only does hydrodissection of the epinuclear layers from the nuclear core demonstrate the existence of an anatomical substrate, but also radial fracturing of the nucleus both in phacoemulsification and planned extracapsular surgery can make use of these anatomical features to achieve smaller incisions and thereby smaller wounds.
Cyclodialysis Cleft Following Holmium Laser Sclerostomy, Treated by Argon Laser Photocoagulation
Authors: Terry Stuart A
Published: April 2021

ABSTRACT

I report, to my knowledge for the first time, a case of inadvertent cyclodialysis cleft formation as a complication of holmium laser sclerostomy. Argon laser photocoagulation was used successfully to repair the cleft.
Ohmmeter-Guided Nasolacrimal Intubation
Authors: Bargum Ralph
Published: April 2021

ABSTRACT

Retrieval of steel probes via the inferior meatus of the nose in monocanalicular and bicanalicular nasolacrimal intubation can be a tricky maneuver, possibly complicated by bleeding from lacerated soft tissue around the inferior turbinate. Using a low-voltage device (essentially, an ohmmeter) to assure contact between the retrieval hook and the distal end of the steel probe greatly facilitates the procedure.
Lack of Toxicity of Intravitreally Administered Interferon Alpha-2a
Authors: Karaçorlu Murat A , Peyman Gholam A , Cruz Sergio , Soike Kenneth F
Published: April 2021

ABSTRACT

We investigated the toxicity of single doses of intravitreally administered interferon alpha-2a in albino rabbits. Following injection of interferon in doses of 40 000, 80 000, 160 000, 320 000, and 640 000 IU/0.1 mL, no significant histologic changes were detected by light and electron microscopy. Photopic and scotopic electroretinography showed no alteration of retinal function.
A Superior and Inferior Orbital Rim-Based Exophthalmometer (Orbitometer)
Authors: Naugle Thomas C , Couvillion John T
Published: April 2021

ABSTRACT

In exophthalmometry when the lateral orbital rim is used as the instrument's fixation base, any alteration in the rim will render serial measurements inaccurate. The exophthalmometer we describe (technically, an "orbitometer") uses the superior and inferior orbital rim areas as a base of reference, making it particularly useful in lateral orbitotomy procedures. This instrument can be aligned at the midpupil horizontally and vertically with a vertical fixation bar. In addition, a vertical bar grathent scale allows measurement of hypoophthalmos and hyperophthalmos.
Effect of Subconjunctival Daunorubicin on Glaucoma Surgery in Rabbits
Authors: Xu Yan , Yang Guo Hua , Gin Wei Min , Chen Ke Qin , Song Xiao Hong
Published: April 2021

ABSTRACT

Daunorubicin (DNR), an antibiotic-antimetabolite, was used as an adjunct to standardized partialthickness filtration surgery in 21 rabbits to determine its effects on that surgery. Postoperatively, one of the eyes of each rabbit received subconjunctival injections of DNR 25 µg or 50 µg, while the fellow eyes received only diluent, daily for 2 to 14 days. Bleb survival, fistula patency, the thickness of the subconjunctival connective tissue, and postoperative complications were investigated. The filtration blebs lasted significantly longer (P < .005), the rate of fistula closure was significantly lower (P < .005), and the subepithelial connective tissue was much looser and thicker in the experimental eyes than in the control eyes. Corneal toxicity occurred more frequently in the eyes treated with the higher-dose DNR than in those treated with the lower dose and in the control eyes.
Molteno Implants in Patients With Previous Cyclocryotherapy
Authors: Wellemeyer Mark L , Price Francis W
Published: April 2021

ABSTRACT

We report four cases in which cyclocryotherapy preceded Molteno implantation for refractory glaucoma. Three of the four cases were complicated by chronic postoperative hypotony, apparently resulting from overfittration by the seton, even though a single-plate implant, with a limited filtration area, was used. Religation of the filtering tube or removal of the implant should be considered in these cases.
Closed-System Phacoemulsification and Posterior Chamber Implant Combined With Penetrating Keratoplasty
Authors: Malbran E S , Malbran E , Buonsanti J , Adrogué E
Published: April 2021

ABSTRACT

The main intraoperative difficulties of performing a procedure combining open-sky extracapsular cataract extraction, implantation of posterior chamber intraocular lens (PC-IOL), and penetrating keratoplasty ("triple procedure"), most frequently caused by the uncompensated posterior pressure created when the cornea is open, include incomplete capsulorhexis, incomplete aspiration-irrigation of the cortex, uncertain placing of the IOL, posterior capsule rupture, choroidal effusion, and even expulsive hemorrhage. We recommend a two-step procedure that eliminates these problems. The first step begins with removal of epithelium, half-thickness trephining of the cornea, and capsulorhexis; proceeds through phacoemulsification and aspiration-irrigation; and ends with implantation of the PC-IOL, using a pressurized system. The second step is penetrating keratoplasty.

In the six cases undergoing this procedure, none of these complications developed or even tended to develop. Although the follow up in these six cases is very short (from 1 to 6 months), the advantage of the technique is that it effectively precludes the above mentioned intraoperative complications, which could affect late results.
Indirect Micro-Ophthalmoscopy: Intraoperative Binocular Indirect Ophthalmoscopy With the Operating Microscope
Authors: Rao K Rama Mohan , Wessels Izak F
Published: April 2021

ABSTRACT

A hand-held indirect lens and an operating microscope can provide a view of the fundus similar to that provided by the usual binocular indirect ophthalmoscope headpiece. The only modification required is that the working distance must be increased to allow the microscope to be focused on the aerial image created by the hand-held lens. This technique provides a cost-effective means of retinal examination in preparation for intraocular lens implantation. Also, the view of the fundus it provides when complications such as choroidal hemorrhage or lens nucleus dislocation occur, facilitates appropriate management, ft also can be used during posterior segment procedures such as foreign body removal, posterior vitrectomy, and retinal detachment repair. The advantages of this method include the possibility of using the microscope's zoom capability to provide greater magnification, and beam splitters for video or still-camera documentation of the findings during examination under anesthesia.
Vasovagal Heart Block Following Cataract Surgery Under Local Anesthesia
Authors: Hampl Karl F , Marsch Stephan C , Schneider Markus , Flammer Josef
Published: April 2021

ABSTRACT

Hemodynamic alterations during eye surgery usually consist of sinus bradycardia and hypotension provoked by the oculocardiac reflex. We report a case in which severe sinus bradycardia occurring immediately after the end of surgery was complicated by second-degree atrioventricular block, hypotension, and symptomatic myocardial ischemia.
Delayed Sustained Increase in Intraocular Pressure Secondary to the Use of Polyacrylamide Gel (Orcolon) in the Anterior Chamber
Authors: Herrington Ronald G , Ball Stuart F , Updegraff Stephen A
Published: April 2021

ABSTRACT

Orcolon, a new viscoelastic substance, was withdrawn from the market in the United States by the manufacturer (Optical Radiation Corporation [ORC], Azusa, Calif) because of reports of delayed sustained increases in intraocular pressure (IOP) observed in patients who had undergone anterior segment surgery involving the use of this product. We examined the charts of 118 cases of anterior segment surgery involving Orcolon at our institution and found delayed IOP spikes in 20 of the 116 cases that had at least 3 months of follow up. Procedures included cataract extraction, penetrating keratoplasty, secondary intraocular lens implantation, and glaucoma surgery. Response to maximal medical therapy was poor; 11 patients underwent procedures for IOP control, an additional 4 required new or increased medications, and 3 developed persistent iritis, which required steroids. Four patients lost two or more lines of Snellen line chart visual acuity, and one went from counts fingers to light perception. The cause may be related to the presence of small particles of viscoelastic, which could lead to decreased aqueous outflow, particularly in eyes with an already compromised trabecular meshwork.
The "Lock-and-Valve" Incision: Truce in the "Suture Wars
Authors: Berger Roland R , Coller Beulah Van
Published: April 2021

ABSTRACT

We describe a variation of the "classical" cataract incision that uses midsize incisions and standard instrumentation. Perpendicular entrance and oblique cut create an acute angle with the iris plane, generating an intracorneal valve. This results in better apposition of the wound's lips and less responsiveness to variations in intraocular pressure; thus, fewer stitches are required. We have achieved favorable results in 16 patients using this type of incision.
Failed Dacryocystorhinostomy: The Sump Syndrome
Authors: Jordan D R , McDonald H
Published: April 2021

ABSTRACT

A dacryocystorhinostomy may fail due to a problem along the canaliculus, at the ostomy site of nasolacrimal sac to nose, due to an intranasal problem or related to the stent. The "sump syndrome" occurs when a residual nasolacrimal sac forms, collects fluids, and leads to tearing. This entity, although uncommon, has a characteristic clinical history and radiologic appearance.
A Refined Technique of Transscleral Suture Fixation of Posterior Chamber Lenses Developed for Cases of Complicated Cataract Surgery With Vitreous Loss
Authors: Mittelviefhaus Hans , Wiek Jutta
Published: April 2021

ABSTRACT

Described is a new technique of transscleral suture fixation of posterior chamber intraocular lenses (PCIOLs) designed to simplify the procedure in cases of complicated cataract surgery with vitreous loss. Sling-sutures are hooked to both haptics of the PC-IOL and the transscleral sutures are buried in scierai tissue without scierai flaps. This scleral-slit technique, which has been successfully used in 20 patients, provides a useful alternative, even in destabilized eyes, to techniques that require preparation of scierai flaps.
Management of Silicone-Induced Cataract in AIDS Patients Treated for Viral Retinitis-Associated Retinal Detachment
Authors: Korobelnik Jean-François , Hannouche Daniele , Cochereau Isabelle , Demers Pierre , Hoang-Xuan Thanh
Published: April 2021

* BACKGROUND AND OBJECTIVE: To evaluate the outcome of cataract surgery for patients with acquired immunodeficiency syndrome (AIDS) who underwent vitrectomy and silicone tamponade for viral retinitis-associated retinal detachment.

* PATIENTS AND METHODS: The authors retrospectively reviewed the data of five AIDS patients (five eyes) who had cataract within a mean period of 4 months following vitrectomy and silicone oil tamponade for viral retinitis-associated retinal detachment. Phacoemulsification and implantation of a polymethylmethacrylate posterior chamber intraocular lens were performed. The mean postoperative followup was 3 months.

* RESULTS: Neither silicone oil loss nor retinal redetachment were reported postoperatively. Visual acuity improved in two eyes and remained unchanged in one eye. Total blindness occurred in two eyes.

* CONCLUSION: Although cataract surgery in these eyes is a relative easy procedure and does not interfere with the retinal status, visual outcome remains poor because of possible postoperative optic atrophy.

[Ophthalmic Surg Lasers 1997;28:828-831.]
Suture-Supported Posterior Chamber Intraocular Lens Implantation
Authors: Ayoub Adham M
Published: April 2021

Abstract. This article describes a new technique for secondary implantation of posterior chamber intraocular lenses in the absence of capsular support. In this technique, the intraocular lens is supported by a simple net, consisting of two mattress sutures that pass across the eye at the most anterior area of the pars plana ciliaris, 3 mm from the limbus. Both sutures have limbs 3 to 4 mm apart that intersect at 90° angles in the pupillary area. The main advantage of this technique is that the sutures are placed prior to the opening of the globe, thereby reducing the time that the eye must be open for the insertion of the intraocular lens. Because the exposure time and the intraocular manipulations are decreased, the consequent vitreous disturbances and the risk of infection, cystoid macular edema, and retinal detachment are likewise reduced. Another advantage of this technique is the additional support for the intraocular lens, which reduces the incidence of decentration and tilt. Moreover, because the sutures are placed in the most anterior part of the pars plana ciliaris, which is avascular, the incidence of bleeding is decreased. [Ophthalmic Surg Lasers 1997;28:869-873.]
A Comparison of Postoperative Complications From Pressure-Ridge Molteno Implants Versus Molteno Implants With Suture Ligation
Authors: Gerber Steve L , Cantor Louis B , Sponsel William E
Published: April 2021

* BACKGROUND AND OBJECTIVES: The pressure-ridge Molteno implant incorporates a ridge on the proximal episcleral plate to limit aqueous outflow during the immediate postoperative period. This modification is intended to decrease the high incidence of postoperative hypotony and flat anterior chambers following Molteno tube implantation, while avoiding the pressure spikes that can occur with suture ligation of the Molteno tube. This study was devised to compare postoperative intraocular pressure control and complications associated with pressureridge Molteno implantation versus a standard Molteno implantation with suture ligation of the tube.

* PATIENTS AND METHODS: Thirty eyes were prospectively randomized to receive either a pressureridge, double-plate Molteno implant or a standard, double-plate Molteno implant with suture ligation of the tube.

* RESULTS: Postoperative intraocular pressure was significantly higher at day 1 and week 2 in the sutureligation implant group, although the final pressure at 12 weeks was not different between the two groups. Six of 1 5 eyes from the pressure-ridge implant group experienced shallow or flat anterior chambers with hypotony, whereas 5 of 15 eyes from the sutureligation implant group had significant postoperative pressure spikes.

* CONCLUSION: Because the ridge effect is unpredictable, further modifications are necessary to prevent postoperative hypotony.

[Ophthalmic Surg Lasers 1997;28:905-910.]
Midterm Reversible Failure in Trabeculectomies With Adjunctive Mitomycin-C
Authors: Kasahara Niro , Smith Thomas J , Sibayan Santiago A , Montenegro Martha H , Simmons Ruthanne B , Simmons Richard J
Published: April 2021

* BACKGROUND AND OBJECTIVES: Trabec ulectomies usually fail early (< 21 days) or late (> 6 months) when no antifibrotic agent is used. Failure is uncommon during the midterm period, between 3 weeks and 6 months. The purpose of this study is to verify the incidence of failure of trabeculectomies with mitomycin-C (MMC) during the midterm period and to evaluate the safety and efficacy of laser suture lysis (LSL) for reversing it.

* PATIENTS AND METHODS: The authors reviewed the records of 130 consecutive patients who underwent trabeculectomy with adjunctive MMC.

* RESULTS: Fourteen patients (15 eyes) had increased intraocular pressure (IOP), between 21 and 185 days (median 41 days). LSL was effective in decreasing the IOP to acceptable levels in 10 (66.6%) of the 15 eyes. No complications related to LSL were noticed.

* CONCLUSION: The reversibility of midterm failure seems to be a unique feature of trabeculectomies with MMC.

[Ophthalmic Surg Lasers 1997;28:986-991.]
Postoperative Miotics for Patients With Infantile Esotropia
Authors: Spierer Abraham , Zeeli Tal
Published: April 2021

* BACKGROUND AND OBJECTIVES: To examine the postoperative effect of echothiophate iodide in children who underwent surgery for congenital esotropia, and to find out whether it significantly reduced the residual esotropia.

* PATIENTS AND METHODS: Forty-one children who underwent surgery to correct congenital esotropia were randomly divided into a study group and a control group. The children in the treatment group received echothiophate iodide eyedrops once daily for 4 months, and all the children received dexamethasone eyedrops for 1 week after surgery. The strabismus angle was measured at 6 days, 6 months, and 12 months postoperatively for every patient. The measurements were compared in both groups using the paired Student's t test.

* RESULTS: The surgical procedure reduced the mean angle of esotropia by 32.4 prism diopters (PD) in the treatment group, and 38.8 PD in the control group. Six months after surgery, a mean decrease in the esotropia of 1 .0 PD was observed in the treatment group, and a mean increase of 0.2 PD was observed in the control group. Twelve months postoperatively, the esotropia increased, by an average of 1.4 and 2.8 PD in the treatment and control groups, respectively. These differences were not statistically different (P > .05).

* CONCLUSION: Echothiophate iodide, given postoperatively for congenital esotropia, does not improve the surgical results during the first postoperative year.

[Ophtlialmic Surg Lasers 1997;28:1002-1005.]
The Long-term Effects of an Accidental Injection of Depot Corticosteroids in an Infant Eye
Authors: Zwaan Johan
Published: April 2021

Abstract. A 4-month-old infant received an accidental intraocular injection of methylprednisolone while undergoing penetrating keratoplasty for congenital, hereditary endothelial dystrophy. This was not discovered until 4 months later, at which time the intraocular pressure (IOP) was increasing and an early cataract was forming. A lensectomy and vitrectomy were performed when the child was 12 months old. The IOP remained higher than that of the fellow eye, but the recovery was otherwise uneventful. This indicates that intraocular depot steroid may be tolerated, except when there is the occurrence of known pharmacologic side effects. [Ophthalmic Surg Lasers 1997;28:1017-1019.]
A Simple Method for Accurate Centering of the Hessburg-Barron Suction Trephine During Penetrating Keratoplasty
Authors: Van Rensburg Piet D J , Raber Irving M , Orlin Stephen E
Published: April 2021

Abstract. The Hessburg-Barron suction trephine has become one of the most commonly used trephination systems. The authors present a simple method for accurate, reproducible centration of the trephine during penetrating keratoplasty surgery. [Ophthalmic Surg Lasers 1997;28:1025-1026.]
Comparison of Low-Dose Intraoperative Mitomycin-C vs 5-Fluorouracil in Primary Glaucoma Surgery: A Pilot Study
Authors: Vijaya Lingam , Mukhesh Bickol N , Shantha Belekuduru , Ramalingam Sriram , Devi Alaghatta V Sathi
Published: April 2021

* BACKGROUND AND OBJECTIVE: This study was undertaken to compare the efficacy and safety of low-dose intraoperative application of mitomycin-C (MMC) with that of 5-fluorouracil (5-FU) in primary trabeculectomy.

* PATIENTS AND METHODS: A non-randomized prospective study was performed between August 1994 and November 1995. Thirty-two eyes of 16 consecutive patients who underwent trabeculectomy for uncontrolled glaucoma of various causes form the study group. The mean age was 46.8 ± 9.9 years. The first eye received MMC (0.2, 0.4 mg/ml), fellow eye received 5-FU (50 mg/ml), for 1 minute intraoperatively. Bleb characteristics and intraocular pressure (IOP) control were analyzed. Success of surgery based on IOP control was measured by 3 different criteria: IOP less than 21 mm Hg; IOP less than 21 mm Hg with more than 30% reduction; and IOP less than 16 mm Hg with more than 30% reduction.

* RESULTS: Mean preoperative IOP was 31.4 ± 12.7 mm Hg in MMC group and 27.8±8.8 mm Hg in 5-FU group. Mean follow-up in MMC group was 16.12 ± 8.17 months; in 5-FU group 13.37 ± 8.19-months. At last follow-up all 5-FU blebs were nonischemic, while 4 eyes in the MMC group showed non-ischemic blebs, and 12 eyes had ischemic blebs. There was no statistically significant difference between MMC group and 5-FU group success rates with all 3 criteria. Success rates were: IOP less than 21 mm Hg; 100% in both groups; IOP less than 21 mm Hg with more than 30% reduction; MMC group 93.8%, 5-FU group 75%; less than 16 mm Hg with more than 30% reduction; MMC group 87.5%, 5-FU group 68.8%.

CONCLUSIONS: Low-dose intraoperative MMC and 5-FU can provide control of IOP in primary trabeculectomy, 5-FU group showed more non-ischemic blebs.

[Ophthalmic Surg Lasers 2000;31:24-30.]
Photodynamic Therapy for Corneal Neovascularization Using Topically Administered ATX-S10(Na)
Authors: Gohto Yuko , Obana Akira , Kanai Masakazu , Nagata Satoshi , Miki Tokuhiko , Nakajima Susumu
Published: April 2021

* BACKGROUND AND OBJECTIVE: We investigated the effect of photodynamic therapy (PDT) using topically administered ATX-S10(Na) on corneal neovascularization (CoNV).

* MATERIAL AND METHODS: Rabbit eyes with induced CoNV were treated with ATX-S10(Na) eye drops (10 mg/mL) every 5 minutes, 5 to 25 times. Five to ninety minutes after topical administration, the CoNV were irradiated with a diode laser using a wavelength of 670 nm.

* RESULTS: The CoNV were occluded fluorescein angiographically in 7 of 16 treated eyes. The eyes having occluded, CoNV were irradiated using fluence of 510-1019 J/cm
p 2
within 20 minutes of eye-drop administration. However, the effect was more variable than what we found using systemic administration in our previous investigation.

* CONCLUSIONS: Experimental CoNV was occluded by photodynamic therapy using topically administered ATX-S10(Na), suggesting this modality as a possible treatment for CoNV avoids the side effects found with systemic administration of the dye. Further efforts to improve the eye drops in terms of pH and osmotic pressure are needed to achieve increased dye accumulation.

[Ophthalmic Surg Lasers 2000;31:55-60.]
Limbal Papilloma with Massive Corneal Extension
Authors: Chaudhuri Zia , Chandra Jaya , Arora Ritu , Bansal Raj Lakshmi , Bhomaj Sharad
Published: April 2021

Abstract. The authors report a case of limbal papilloma wirh extensive corneal involvement. The limbal lesion was excised completely, leaving a clear corneal bed. Histopathologically, the lesion was found to be a limbal papilloma. Massive superficial involvement of the cornea by papilloma is rare. Simple excision is effective in treating the condition with restoration of vision and cosmesis. [Ophthalmic Surg Lasers 2000; 31:73-75.]
Pneumatic Retinopexy: A Survey of Current Practice Patterns Among the Vitreous Society Members
Authors: Wild Michael R , Ruby Alan J , Rosenshein Joseph
Published: April 2021

Abstract. It was our purpose to assess the current practice patterns of vitreoretinal surgeons in the continental United States regarding the use of pneumatic retinopexy for the repair of rhegmatogenous retinal detachments. Preferences of vitreoretinal surgeons regarding the repair of rhegmatogenous retinal detachments were obtained via mail survey of all active members of the Vitreous Society residing in the continental United States as of December 1995. Forty-eight percent of those surveyed responded to the questionnaire. Sclera! buckle was preferred over pneumatic retinopexy by more than 2 to 1 for repair of multiple superior tears within 3 clock hours, moderate myopia, small vitreous hemorrhage, detached macula, age greater than 65 years old, visually significant cataract, mild proliferative vitreoretinopathy, pseudophakia, and patient membership in an HMO. Pneumatic retinopexy was preferred in patients who were uninsured and in cases in which an operating room was not immediately available. Although the initial success rate of pneumatic retinopexy was felt to be lower than scleral buckling, the majority felt that there was no difference in the ultimate visual outcome. Among responding members of the Vitreous Society, scierai buckling continues to be the procedure of choice for the repair of the majority of primary retinal detachments. [Ophthalmic Surg Lasers 200031:76-81.]
Optical Coherence Tomography Findings in Diabetic Macular Edema Before and After Vitrectomy
Authors: Giovannini Alfonso , Amato Giampaolo , Mariotti Cesare , Scassellati-Sforzolini Baldo
Published: April 2021

* BACKGROUND AND OBJECTIVE: To assess the role of optical coherence tomography (OCT) in the evaluation and follow-up after vitrectomy for diabetic macular edema.

* MATERIALS AND METHODS: The 18 eyes of 12 patients affected by presumed diabetic vitreousinduced macular edema underwent biomicroscopy with a Goldmann contact lens, fluorescein angiography, and OCT.

* RESULTS: OCT revealed two patterns of edema. The first group (15 eyes) was characterized by widespread thickening of the neurosensory retina with an increased nonhomogeneous reflectivity of the inner retinal layers; cystoid-like spaces of absent or reduced reflectivity in the neurosensory retina were also present. In the second group (3 eyes), a cystoid macular edema with a dome-shaped foveal profile because of a markedly increased retinal thickness in the foveal region was observed. The disappearance of the physiologic foveal profile was always seen. Biomicroscopy revealed an increased reflex of the inner limiting membrane in the first group and minimal alterations in the second one. Four patients (7 eyes) underwent vitrectomy with posterior hyaloid removal. In 5 eyes, the patients experienced a visual improvement greater than two Snellen lines. The restoration of the normal foveal profile and the reduction of the retinal thickness on the OCT were evident in all cases one month after surgery.

* CONCLUSION: OCT appears to be a useful tool in the diagnosis and management of diabetic macular edema and in the monitoring of the morphological changes after vitrectomy.

[Ophthalmic Surg Lasers 2000;31:187-191]
Confirmation of Persistent Closure of Surgically Repaired Macular Hole in Subsequent Retinal Detachment by Optical Coherence Tomography
Authors: Herring Joel H , Chen Ching J , Chen Lin L
Published: April 2021

Abstract. Idiopathic macular holes have shown response to surgical intervention with vitrectomy, presumably because of glial cell proliferation in the reapproximated tissue.1'2 We describe a patient with postoperative closure of a macular hole who subsequently developed a retinal detachment involving the macular area. Despite the detachment, the macular hole remained closed as evidenced by biomicroscopy and optical coherence tomography (OCT). OCT provides accurate documentation and assessment of pre- and postoperative conditions in macular hole surgery. [Ophthalmic Surg Lasers 2000:31:243-244]
Postoperative Refractive Error After Simultaneous Vitrectomy and Cataract Surgery
Authors: Suzuki Yukihiko , Sakuraba Tomoki , Mizutani Hideyuki , Matsuhashi Hideaki , Nakazawa Mitsuru
Published: April 2021

* PURPOSE: To evaluate the effect of vitrectomy on postoperative refraction after simultaneous vitrectomy and cataract surgery.

* METHODS: We compared the spread between predicted and actual refractions in 206 eyes after a simultaneous vitrectomy, phacoemulsification, aspiration and acrylic lens insertion (combined surgery group), and in 67 eyes after cataract surgery only (cataract surgery group) as control. A vitrectomy was performed for diabetic retinopathy in 127 eyes, macular hole in 32 eyes, rhegmatogenous retinal detachment in 16 eyes, branch retinal vein occlusion in 15 eyes, and other conditions in 26 eyes. In the combined surgery group, 79 eyes had a gas tamponade after insertion of the intraocular lens.

* RESULTS: The spread between predicted and actual refractions was -0.05 - 1.18 diopters (average ± SD) in the combined surgery group and +0.55 ± 1.32 D in the cataract surgery group. The actual refractive errors in the combined surgery group were found to shift toward myopia when compared with the controls. Among the combined surgery group, 127 eyes without a gas tamponade showed a postoperative refractive error of +0. 14 ± 1.11 D, while 79 eyes with a gas tamponade demonstrated an error of -0.36 ± 1.22 D.

* CONCLUSIONS: Use of a gas tamponade in the combined surgery group increased the myopic change and was thought to have pressed the intraocular lens forward.

[Ophthalmic Surg Lasers 2000;31:271-275]
Disintegration of the Inferior Rectus Muscle During Strabismus Surgery for Restrictive Hypotropia
Authors: Paysse Evelyn A , Coats David K
Published: April 2021

Abstract. We describe a case of disintegration of the inferior rectus muscle during routine strabismus surgery for restrictive hypotropia after cataract surgery. We used this surgical approach to repair the complete infraduction deficit incurred from the injury. [Ophthalmic Surg Lasers 2000;31:328-330]
Characterizing Progression to Neovascular AMD in Fellow Eyes of Patients Treated With Intravitreal Anti-VEGF Injections
Authors: Starr Matthew R. , Xu David , Boucher Nicholas , Saroj Namrata , Patel Luv G. , Ammar Michael , Pandit Ravi R. , Jenkins Thomas L. , Ho Allen C.
Published: April 2021

BACKGROUND AND OBJECTIVE:

The purpose of this study was to assess the real-world incidence of conversion to bilateral neovascular age-related macular degeneration (nAMD) following treatment initiation of nAMD in the initial eye.

PATIENTS AND METHODS:

This was a retrospective cohort of electronic health records from retinal centers across the United States (Vestrum Database) of all patients with unilateral nAMD treated with anti-vascular endothelial growth factor therapy.

RESULTS:

A total of 22,553 patients with unilateral nAMD were included. Fellow eyes of 8,522 patients (38%) converted to nAMD. Among these, 2,639 (12%), 2,030 (9%), and 1,802 (8%) patients converted in Years 1, 2, and 3, respectively, after diagnosis in the first eye. Fellow eyes had better vision at conversion and 1 year following conversion.

CONCLUSIONS:

The fellow eye should be monitored at regular intervals to detect signs of neovascularization. Fellow eyes presented with significantly better vision at diagnosis than the initial eye and maintained better visual acuity with less injections.

[
Ophthalmic Surg Lasers Imaging Retina.
2021;52:123–128.]
Differentiation of Features of Inflammatory Neovascular Membrane Versus Active Posterior Uveitis by SS-OCTA
Authors: Arias Juan D. , Parra M. Margarita , Arango Francisco J. , Hoyos Andrea T. , Rangel Carlos M. , Sánchez-Ávila Ronald M.
Published: April 2021

BACKGROUND AND OBJECTIVE:

Neovascularization is a sight-threatening, uncommon complication of posterior uveitis that often goes undetected until persistent clinical findings appear, or in light of treatment failure. This could be attributed to the relative similarity of activity signs in inflammatory neovascular membranes (NVM) and active posterior uveitis. The purpose of the present study is to recognize imaging features that distinguish uveitic neovascularization from active uveitis using swept-source optical coherence tomography angiography (SS-OCTA).

PATIENTS AND METHODS:

Cross-sectional study. Patients with posterior uveitis with visual acuity (VA) decrease and at least one of the following findings were assessed by SS-OCTA: retinal thickening, subretinal or intraretinal fluid, and retinal hyperreflective areas. The change of VA and imaging features after treatment with anti-vascular endothelial growth factor (VEGF) therapy were analyzed in cases with inflammatory NVM.

RESULTS:

Forty-five eyes of 40 patients were evaluated. Twenty-four eyes (53.3%) showed signs of activity, of which eight (33.3%) presented inflammatory NVM. Imaging features that differentiate inflammatory neovascularization from active posterior uveitis included: vitreous cellularity (
P
= .003), outer retinal infiltration (
P
= .08), choroidal thickness (
P
= .003), posterior shadowing (
P
= .013), subretinal fluid (
P
= .04), and neovascular network (
P
≤ .001). According to NVM characteristics by OCTA, multiple anastomoses and peripheral arcades were visualized at baseline in 85.7% of cases. Mean pre-operative best-corrected VA of inflammatory NVM was 20/150 (logMAR: 0.88 ± 0.60) with significant improvement to 20/40 (logMAR: 0.32 ± 0.22) after anti-VEGF treatment (
P
= .027).

CONCLUSIONS:

SS-OCTA achieves the distinction of inflammatory NVM from active posterior uveitis through specific imaging features. Inflammatory neovascularization presents a suitable response after anti-VEGF therapy.

[
Ophthalmic Surg Lasers Imaging Retina
. 2021;52:129–137.]
Scleral Buckle Removal: Indications, Timing, Complications, and Long-Term Outcomes
Authors: Eshraghi Hamoon , Prenner Jonathan L. , Zhang Rui , Roth Daniel B. , Wheatley H. Matthew , Fine Howard F. , Mantopoulos Dimosthenis
Published: April 2021

BACKGROUND AND OBJECTIVE:

To report indications, timing, complications, and outcomes of scleral buckle (SB) removal surgery.

PATIENTS AND METHODS:

Retrospective observational case series. Eyes that underwent SB removal between 2010 and 2016 with greater than 1 year of follow-up were included. Main outcome measures were post-SB removal complications and best-corrected visual acuity (BCVA).

RESULTS:

Fifty eyes that underwent SB removal met the inclusion criteria. Indications include exposed SB (54%), infection (26%), diplopia (16%), and recurrent retinal detachment (4%). Mean and median intervals between SB placement and removal were 65 months and 30 months. Complications include recurrent retinal detachment (12%), transient ocular hypertension (6%), and persistent diplopia (4%). There was no significant change in mean BCVA after SB removal (
P
= .979).

CONCLUSIONS:

Exposed SB, infection, and diplopia are the most common indications for SB removal. The single-surgery success rate is high and the risk for complications is relatively low.

[
Ophthalmic Surg Lasers Imaging Retina.
2021;52:138–144.]
Directional Reflectivity of the Ellipsoid Zone in Dry Age-Related Macular Degeneration
Authors: Griffin Shane M. , Jia Yali , Johnson Alicia J. , Antony Bhavna J. , McDonald H. Richard , Johnson Robert N. , Lujan Brandon J.
Published: April 2021

BACKGROUND AND OBJECTIVE:

Ellipsoid zone (EZ) reflectivity on optical coherence tomography (OCT) is affected by the orientation of the scanning beam. The authors sought to determine how directional reflectivity changes in dry age-related macular degeneration (AMD).

PATIENTS AND METHODS:

Retrospective image analysis included 17 control and 20 dry AMD subjects. Directional OCT (D-OCT) was performed using multiple displaced pupil entrance positions. EZ pixel values and apparent incidence angles were measured.

RESULTS:

EZ reflectivity decreased in off-axis scans in controls (
P
< .001), AMD areas between drusen (
P
< .001), and AMD areas overlying drusen (
P
< .001). The magnitude of decrement in EZ reflectivity was significantly higher when incidence angles exceeded 10° in controls than in AMD areas between drusen (
P
= .024).

CONCLUSION:

EZ reflectivity in dry AMD may vary by incident angle of light less than in controls, possibly indicating alteration of photoreceptor orientation or integrity.

[
Ophthalmic Surg Lasers Imaging Retina.
2021;52:145–152.]
Refining the Removal of Perfluorocarbon Liquid Remnants Through Negative Staining With Vital Dyes
Authors: Coppola Michele , Marchese Alessandro , Bandello Francesco
Published: April 2021

The complete removal of perfluorocarbon liquid (PFCL) after complex vitreoretinal surgery can be a challenging task. However, it remains a crucial step to avoid several ocular complications associated with retained PFCL. In this report, the authors describe a simple and effective technique to highlight the presence of retained PFCL bubbles in the epiretinal space through negative staining with vital dyes.

[
Ophthalmic Surg Lasers Imaging Retina
. 2021;52:153–154.]
Optimization of inventory system with defects, rework failure and two types of errors under crisp and fuzzy approach
Authors: Taheri Javad , Mirzazadeh Abolfazl
Published: April 2021

In this paper, a new approach was applied to a single-item single-source (\begin{document}$ SISS $\end{document}) system at the "\begin{document}$ EOQ-type $\end{document}" mode considering imperfect items and uncertainty environment. The mentioned method was intended to produce an optimum order/production quantity as well as taking care of imperfect processes. The imperfect proportion of the received lot size was described by an imperfect inspection process. That is, two-way inspection errors may be committed by the inspector as separate items. Thus, this survey was aimed to maximize the benefit in the traditional inventory systems. The incorporation of both defects and defective classifications (Type-\begin{document}$ I\&II $\end{document} errors) was illustrated, in a way that the defects were returned by the consumers. Moreover, this inventory model had an extra step in the scope of inspection; which occurred after the rework process with no inspection error. To get closer to the practical circumstances and to consider the uncertainty, the model was formulated in the fuzzy environment. The demand, rework, and inspection rates of the inventory system were considered as the triangular fuzzy numbers where the output factors of the inventory system were obtained via nonlinear parametric programming and Zadeh's extension principle. Finally, this scenario was illustrated through a mathematical model. The concavity of the objective function was also calculated and the total profit function was presented to clarify the solution procedure by numerical examples.
A Proposed Learner’s Data Model: Integrating Informal Learning and Enhancing Personalization and Interoperability
Authors: Nehiri Nissrin , Aknin Noura
Published: April 2021

A learner profile is key to personalize learning content. Nowadays learners use different applications and tools to learn (Formal and informal types). Indeed, the diversity of profiles, their content, their structure, their operation, and the actors concerned, limits possible interoperability. Hence, the need for a rich and an interoperable learner profile that describes all previous learning achievements or experiences. In this work, after a brief analysis of available standards in this area, an approach is proposed to build an interoperable learner model based on xAPI statements that combine the formal and informal experiences to enhance learning analytic and personalization. Then, we present a tool to transform collected data into our XML model proposed based on the IMS-LIP standard, and in the end, we explore his utility.
Psychological Motivations of Students for Book Borrowing in Libraries of Higher Vocational Colleges from the Perspective of “Three Comprehensive Education”
Authors: Yan Rong
Published: April 2021

The innovative “three comprehensive education” model can mobilize the initiatives of students in higher vocational colleges, whose book borrowing behaviors are affected by “three comprehensive education”. This paper mainly studies the psychological motivations of students for book borrowing in libraries of higher vocational colleges from the perspective of “three comprehensive education”. Firstly, the psychological motivations for book borrowing were analyzed in details under the mechanism of “three comprehensive education”. Then, a dataset was created from the mass data on book borrowing and students. The relevant features were compressed as model inputs, aiming to improve model performance and reduce storage cost. Finally, a perception model was constructed to analyze the psychological motivations of students for book borrowing, and used to solve the five-class classification problem based on the directed acyclic graph. Experimental results prove the scientific of the psychological pattern analysis and the effectiveness of the proposed model. The research results provide a theoretical and practical reference for the effect analysis of “three comprehensive education”.