bluuebunny/crossref_metadata_2025 huggingface dataset:
Müller's Muscle in the Treatment of Upper Eyelid Retraction: A 12-Year Study
Authors: Putterman Allen M , Fett David R
Published: April 2021

ABSTRACT

Müller's muscle is a sympathetically innervated muscle that can be excised to relieve upper eyelid retraction.

A graded, controlled excision of Müller's muscle, with or without recession of the levator aponeurosis, using sensory without motor anesthesia is an excellent technique for releasing thyroid-related upper eyelid retraction. The procedure is simple, based on anatomic and physiologic principles, tailored to the individual patient intraoperatively, and yields consistently good results.

In a 12-year study of this procedure, 96% of the treated lids attained lid levels within 1.5 mm of the opposite side. Only seven of 156 treated eyelids required additional surgery.
Intraocular 9-([2-Hydroxy-1-(Hydroxymethyl) Ethoxy] Methyl) Guanine Levels After Intravitreal and Subconjunctival Administration
Authors: Schulman Joel , Peyman Gholam A , Horton Mark B , Liu John , Fiscella Richard , Pulido Jose , Barber John C , de Miranda P
Published: April 2021

ABSTRACT

Clearance studies in rabbits following intravitreal injection of 400 ug of 9-([2-Hydroxy-l-(hydroxymethyl)ethoxy]methyl) guanine demonstrated levels of the antiviral at 60 hours above the in vitro ID50 for several strains of human cytomegalovirus. Intravitreal administration of this new antiviral may have therapeutic application in the treatment of acute retinal necrosis and cytomegalovirus retinitis complicating acquired immune deficiency syndrome (AIDS).
Two Principles for Repositioning Intraocular Lenses
Authors: Eifrig David E
Published: April 2021

ABSTRACT

Single-plane posterior chamber lenses may become subluxated or dislocated. This occurs most frequently after "in-the-bag" implantations. If the capsulezonular ring remains intact, the lens may be repositloned by converting to an "in-the-sulcus" position and performing an anterior vitrectomy.
A Method for Repositioning or Extraction of Lacrimal System Silicone Tubes
Authors: Beyer Robert W , Levine Mark R , Sternberg Ido
Published: April 2021

ABSTRACT

A method of repositioning extruding silicone tubes Is described by reintubation with a second Crawford intubation set. The method and indications are described.
Eyelid Necrosis in an Anophthalmic Patient
Authors: Woog John J , Lemke Bradley N , Dortzbach Richard K
Published: April 2021

ABSTRACT

A 72-year-old woman with chronic lymphocytic leukemia developed periorbital swelling, erythema, and discharge involving her anopthalmic left socket in the course of pseudomonas aeruginosa septicemia. Histopathologic examination of debrided eyelid tissues revealed ischemìe necrosis of the eyelid margin and deeper eyelid tissues. Underlying malignancy, disseminated systemic infection, and alteration in the vascular supply to the eyelids following enucleation may have contributed to the development of ischemie eyelid necrosis in this patient.
Large Periocular Keratoacanthoma: The Case for Definitive Treatment
Authors: Boynton James R , Searl S Scott , Caldwell Elethea H
Published: April 2021

ABSTRACT

Keratoacanthoma can usually be distinguished from squamous cell carcinoma. However, some tumors share certain characteristics of both lesions. There is a large group of actinic keratoacanthomas cytologically identical to squamous cell carcinomas.

In locations other than the ocular adnexae, conservative therapy is often recommended for keratoacanthomas since these lesions tend to regress spontaneously. Two patients with large periocular keratoacanthomas illustrate some of the diagnostic and therapeutic dilemmas related to rapidly growing potentially malignant lesions about the eye. Extensive tissue destruction and possible recurrence following excision favor definitive surgical therapy in these cases.
Medial Ectropion: Association With Lower Lacrimal Obstruction and Combined Management
Authors: O'Donnell Frank E
Published: April 2021

ABSTRACT

Nine consecutive patients who presented with a medial ectropion (12 eyelids) and epiphora were prospectively evaluated and surgically managed. Medial ectropion was successfully corrected in all 12 eyelids (mean follow-up 12.2 months). A lateral tarsal strip procedure (Anderson procedure) was used to correct the horizontal lid laxity. Resecting the retractors of the lower lid subjacent to the punctal area corrected the punctal eversion. Prior to medial ectropion repair, three of the 12 eyes demonstrated evidence of complete obstruction at or below the level of the lacrimal sac. These patients required concurrent dacryocystorhinostomy (DCR) in addition to repair of the medial ectropion. DCR with silicone intubation obviated the need for anastomosis of lacrimal sac and nasal mucosal flaps, and it corrected the punctal stenosis. Histopathologic examination of the sac specimens confirmed chronic inflammation. One of six patients without complete obstruction required DCR after medial ectropion repair and punctoplasty. Medial ectropion may predispose to lower lacrimal obstruction. In turn, the epiphora may lead to aggravation of the medial ectropion as a result of wiping of tears.
A New Capsulotomy Scissors
Authors: Stern Mark D
Published: April 2021

ABSTRACT

A new scissors has been designed to perform the square-window anterior capsulotomy. Several design features make it an improvement over the previously modified Vannas scissors.
Transorbital Penetrating Injuries to the Frontal Lobe
Authors: Sebag Jerry , Shillito John , Robb Richard
Published: April 2021

ABSTRACT

Three cases of transorbital penetrating trauma to the frontal lobe are reported. These cases are remarkable in that minimal ocular trauma was incurred and excellent vision was preserved. These cases underscore the importance of suspecting the possibility of intracranial injury when evaluating penetrating orbital trauma.
Management of the Opacified Posterior Lens Capsule: An Excision Technique for Membranous Changes
Authors: Weidle Egon G , Lisch Walter , Thiel Hans-Jürgen
Published: April 2021

ABSTRACT

In 16 patients ranging from six months to 85 years a membranous-changed posterior lens capsule was partially excised during an originally extracapsularplanned lens surgery. After removing the lens contents the anterior chamber was filled with sodium hyaluronate. The opacified posterior capsule was punctiformly opened and the retrolenticular space widened with sodium hyaluronate, too. The isolated posterior capsule could be excised with microscissors without damaging the corneal endothelium or the anterior vitreous face. Integrity of the vitreous was preserved in 94% of the operated eyes. The described technique can be regarded as the method of choice for management of solid capsular opacities in infants and may be also helpful in some cases of membranous capsular changes in adults.
Argon Laser Treatment of Trichiasis
Authors: Awari Khalid J
Published: April 2021

ABSTRACT

This paper presents the application of argon laser In the treatment of trichiasis. The technique involves the destruction of the follicles of the abnormal cilia. A beam of 50- to 200-micron spot size, 0.1- to 03 second time, and 1,000 to 1,200 mW power is used under local anesthesia. This method proved safe, convenient, precise, and effective in 11 cases. The technique is most suitable when a few fine cilia are involved, but repeated treatment may be required for more and thicker eyelashes. The follow-up period In this study varied from a minimum of four months to a maximum of nine months.
Tarsorrhaphy for Corneal Disease in Patients With Rheumatoid Arthritis
Authors: Welch Cathryn , Baum Jules
Published: April 2021

ABSTRACT

We report two patients with keratoconjunctivitis sicca and rheumatoid arthritis whose corneal surfaces regained their integrity following tarsorrhaphy when conservative therapeutic measures were unsuccessful. We suggest that tarsorrhaphy be considered early in the course of the disease in such patients when other measures have failed to arrest progressive thinning of the cornea.
Double Stent Intubations in Difficult Post-Traumatic Dacryocystorhinostomy
Authors: Hurwitz J J , Archer K F , Gruss J S
Published: April 2021

ABSTRACT

Nasolacrimal obstruction following mid-facial trauma can be a difficult challenge for the lacrimal surgeon. After the initial bony repair with wires, or screws and plates, the reconstruction of the lacrimal drainage pathway can be accomplished best after at least 3 months. We describe methods of sac stent and canalicular intubation that can be used as a double stent intubation technique for severely traumatized patients.
Intravitreal Toxicity of Cotrimoxazole
Authors: Fiscella Richard , Peyman Gholam A , Kimura Alan , Small Gregg
Published: April 2021

ABSTRACT

We investigated the intravitreal toxicity of cotrimoxazole (trimethoprim 80 mg and sulfamethoxazole 400 mg/5 ml of injection fluid) in albino rabbits. Eyes injected intravitreally with 1600 µg/0.1 cc (reported in trimethoprim concentration) exhibited no histologic or abnormal electroretinographic responses after 14 days. A vitrectomy infusion solution containing 32 ug/ml (reported in trimethoprim concentration) produced no toxicity, as demonstrated either by electroretinography or histology. Cotrimoxazole appears to be well-tolerated in rabbit eyes when administered by both intravitreal injection and vitrectomy infusion solution.
Community Eye Care 10 Years After Alma Ata: Progress, Problems, and Priorities for Private Voluntary Organizations in Developing Nations
Authors: Heldt Jean-Paul , Wessels Izak F
Published: April 2021

ABSTRACT

The 1978 International Conference on Primary Health Care held in Alma Ata, USSR, made a strong appeal for recognizing that blindness is avoidable. Most blindness can be cured by medical and surgical means, or prevented by public health measures. Now, 10 years later, it is appropriate to review and evaluate a decade of primary eye care. This article describes and reviews from a managerial perspective at three levels of intervention a community eye care program for Afghan refugees established in 1982 by the League of Red Cross in Pakistan. Factors for success and problems are analyzed, and priorities for the future are suggested.
An Inexpensive Fiberoptic Light Pipe to Aid in Placement of Episcleral Radioactive Plaques
Authors: Snyder William B , Fuller Dwain G , Fish Gary Edd
Published: April 2021

ABSTRACT

Episcleral plaque placement requires accurate localization of choroidal melanomas. Available fiberoptic light pipes can be fashioned to become scleral markers and transilluminators. The equipment is available wherever posterior segment surgery is performed. Surgical technique and equipment modifications are described.
Natural History and Management of Advanced Coats' Disease
Authors: Silodor Scott W , Augsburger James J , Shields Jerry A , Tasman William
Published: April 2021

ABSTRACT

Thirteen children evaluated in the Oncology Service of Wills Eye Hospital from 1976 through 1986 were found to have advanced unilateral Coats' disease, producing a total bullous exudative retinal detachment. All 13 eyes were blind. Six children were given no treatment for their retinopathy, and four of the six eventually developed painful neo vascular glaucoma, necessitating enucleation of the affected eye. The other seven children underwent intraocular infusion, drainage of subretinal fluid, and cryotherapy on one or more occasions. None of these seven eyes has developed painful neo vascular glaucoma, and the affected eye remains cosmetically acceptable in all seven children.
Study of Prostaglandins and Intraocular Pressure in Rabbits After Nd:YAG Laser Anterior Segment Procedures
Authors: Liu Sao J , Hunter David M , Oei Thomas , Lin Tommy , Lam Kwok-Wai
Published: April 2021

ABSTRACT

Radioimmunoassay of rabbit aqueous humor one hour after Nd: YAG laser anterior capsulotomies revealed increased concentrations of 6-keto-prostaglandin F^sub 1α^ (PGF^sub 1α^), and thromboxane B2 (TBB2). Coincidental rises in intraocular pressure (IOP) and aqueous humor protein were observed. These changes correlated with the laser power used. Pretreatment with topical 1% prednisolone acetate or 1% indomethacin prior to anterior capsulotomies inhibited the post laser rise in PGF^sub 1α^ and TBB2, but did not eliminate the post laser rise in IOP. Small rises in IOP and the concentrations of aqueous PGF^sub 1α^, TBB2, and protein were observed after NdrYAG laser iridectomies. These changes were not affected by prior treatment with 1% topical prednisolone acetate. Although PGF^sub 1α^ and TBB2 are elevated after Nd:YAG laser anterior segment procedures, a causal relationship between post treatment IOP rise and PGF^sub 1α^ or TBB2 release could not be determined.
A Technique For Removal of Filariasis of the Anterior Chamber
Authors: Samples J R , Fraunfelder F T , Swan K C , Beaver P C , Rashad A L , Rosenquist R
Published: April 2021

ABSTRACT

We describe a useful technique for removing filaria from the anterior chamber. In the case described, an immature female filaria approximately 15 mm in length was removed from the anterior chamber of a 32-year-old man in western Oregon and identified as a species of Dipetalonema. Features of four cases of filarial infection in the anterior chamber from the same geographic area are described. In three out of four cases, the worms were removed alive without difficulty by means of a simple irrigation aspiration system.
Corneal Rupture Following Radial Keratotomy in Cats Subjected to BB Gun Injury
Authors: McKnight Scott J , Fitz John , Giangiacomo Joseph
Published: April 2021

ABSTRACT

We performed this investigation to determine if radial fceratotomy (RK) predisposes an eye to rupture when exposed to projectile trauma. Radial keratotomy was performed on 22 cat eyes; 17 eyes were used as controls. Incision depth was set at 90% by averaging ten corneal thickness readings by ultrasonic pachymetry of each cornea. An optical zone of 4.0 mm was used and eight incisions were made. Eight weeks after RK the cats were divided into three groups, subjected respectively to BB velocities of 148.5 ft/sec (N = 4), 190 ft/sec (N = 5), and 240 ft/sec (N = 13). In groups 1 and 2, all nine eyes had hyphemas and no eyes perforated. In group 3, four of 13 RK eyes had corneal rupture. All control eyes had hyphemas and none ruptured. The study suggests that RK can predispose to rupture eyes exposed to projectile trauma sufficient to produce hyphema.
Endophthalmitis Following Nd: YAG Laser Posterior Capsulotomy
Authors: Carlson Alan N , Koch Douglas D
Published: April 2021

ABSTRACT

We report the development of Propionibacterium acnes endophthalmitis following Nd: YAG laser posterior capsulotomy. The patient previously underwent uncomplicated extracapsular cataract extraction with intraocular lens insertion and was free of inflammation prior to laser capsulotomy. Diagnostic vitrectomy and aqueous tap were performed, and P. acnes was isolated from the aqueous in thiol broth media after nine days of incubation under anaerobic conditions. The patient was managed with topical and systemic antibiotics and steroids. Complete resolution of inflammation with return of vision to 20/25 was achieved without removal of the intraocular lens or lenticular remnants.
Choroiditis Compatible With the Histopathologic Diagnosis of Sympathetic Ophthalmia Following Cyclocryotherapy of Neovascular Glaucoma
Authors: Sabates Roland
Published: April 2021

ABSTRACT

A 44-year-old man had a blind painful right eye secondary to neovascular glaucoma. Cyclocryotherapy was performed because medical therapy was ineffective in lowering the intraocular pressure or reducing the pain. The eye became comfortable, but 5 months later vision decreased in the left eye. Examination revealed a marked posterior uveitis suggestive of sympathetic ophthalmia. Enucleation of the right eye and corticosteroid therapy were effective in eliminating inflammation in the left eye. Histopathologic examination of the exciting right eye revealed classic signs of sympathetic ophthalmia. This case is particularly unusual because there was no history or evidence of ocular perforation in the exciting eye.
Anticoagulants and Cataract Surgery
Authors: Hall Donald L , Steen William H , Drummond Jerry W , Byrd William A
Published: April 2021

ABSTRACT

A series of 49 cataract operations in 42 patients is presented in support of our contention that if anticoagulants are necessary for a patients well being, they should not be discontinued for cataract surgery.
Posterior Chamber Intraocular Lens Implantation in the Absence of Posterior Capsular Support
Authors: Stark Walter J , Goodman Gerri , Goodman Daniel , Gottsch John
Published: April 2021

ABSTRACT

Because of the high incidence and great variety of complications associated with anterior chamber intraocular lenses, we have developed a technique for the implantation of a posterior chamber intraocular lens in the absence of posterior capsular support. The posterior chamber IOL is placed in the ciliary sulcus by suturing the superior haptic to the iris and the inferior haptic to the sclera at the ciliary sulcus. We have used this technique successfully in both complicated extracapsular surgery and secondary intraocular lens implantation.
Penetrating Orbital Injury With Cavernous Sinus Involvement
Authors: Vander James F , Nelson Christine C
Published: April 2021

ABSTRACT

Penetrating orbital injuries may involve intracranial structures as well. We report an unusual case of permanent visual loss, temporary complete ophthalmoplegia, and penetration of the internal carotid artery following penetrating nail injury. CT scanning and arteriography are important diagnostic tests to consider prior to removal of an orbital foreign body. This case also demonstrates the importance of delaying repair of traumatic ptosis and ophthalmoplegia.
Water Pressure and Flow Regulation for Water-cooled Lasers
Authors: Chambers Jerre Kelly , Talansky Marvin Lawrence
Published: April 2021

ABSTRACT

We experienced laser water valve failure resulting from poor water quality, frequent laser shutdowns from low water flow rates, and unnecessary service calls shortly after installing a new laser. The water valve failure resulted from deposits and corrosion. A dirt/rust water niter was installed, and no further water valve failure has occurred. A flow meter was added to the water system to adjust flow rates. It clearly shows when laser shutdowns are caused by low flow rates and indicates the need for water filter changes. Water pressure was monitored and is most affected by use of the laser. A convenient electric water control, activated by the laser key switch, has proved to be reliable. The water control is kept open by a timer ten minutes after the laser is shut off. We determined that our laser shutdowns were related to transient drops in water flow rates and possibly to draw off of water in other parts of the hospital.
Simple Adaptor Using a Zeiss Observer Tube on a Nikon Slit Lamp
Authors: Wessels Izak F
Published: April 2021

ABSTRACT

A simple adaptor was manufactured to allow fitting of a Zeiss beam splitter and observer tube onto a Nikon slit lamp YAG laser. No noticeable optical or mechanical problems have been experienced with this costsaving device.
Nd:YAG Laser Posterior Capsulotomy Does Not Produce Elevation of Intraocular Pressure in Cynomolgus Monkeys
Authors: Camras Carl B , Rosenthal James S , Podos Steven M
Published: April 2021

ABSTRACT

The mechanism of the intraocular pressure (IOP) elevation commonly seen in patients following neodymium (Nd):YAG laser posterior capsulotomy is unclear. Substance P, a potent polypeptide that is released into the eye after trigeminal nerve stimulation, may be the cause. In rabbits, topical application of nitrogen mustard causes a rise in IOP which is blocked by capsaicin, a presumed substance P depletor.

In the present study, six eyes of three cynomolgus monkeys underwent extracapsular lensectomies. After 2 to 3 months, capsaicin was administered by retrobulbar injection on one side of each animal, and vehicle on the contralateral side. One day later, Nd:YAG laser posterior capsulotomies were performed using 31 mJ (total energy) per eye. Diurnal IOP measurements were made before and after the retrobulbar injections and the capsulotomies. Ten weeks later, laser capsulotomies were repeated using 200 mJ/eye without pretreatment with any potential blockers. None of the six eyes, each undergoing two separate capsulotomies 10 weeks apart, showed a postoperative rise in IOP.

These results demonstrate that the cynomolgus monkey is a poor model for studying IOP elevation that often occurs following Nd:YAG laser posterior capsulotomy.
Eyelid Fistula Following Wies Entropion Repair
Authors: Custer Philip L
Published: April 2021

ABSTRACT

Fistula formation following eyelid surgery is uncommon. A patient developed an eyelid fistula and tearing shortly after a Wies entropion procedure and was effectively treated by excising the involved portion of the eyelid.
Pigmentary Retinal Degeneration and Coats' Disease: A Case Study
Authors: Arrigg Paul G , Lahav Moshe , Hutchins Robert K , Welter John J
Published: April 2021

ABSTRACT

We report a 22-year-old Hispanic man with familial congenital nystagmus, iris transillumination, and pigmentary retinal anomalies with subretinal fatty exudates similar to those seen in Coats' disease. Direct treatment of the telangiectatic vessels with cryotherapy caused a subretinal hemorrhage. We therefore recommend surrounding the area of abnormal vessels (posterior to vessels and between vessels and ora serrata) with cryotherapy to reverse the formation of the vascular anomalies.
Refugee Eye Care: A Frequently Overlooked Dimension of Disaster Assistance
Authors: Heldt Jean-Paul A , Frye Barbara A , Wessels Izak F
Published: April 2021

ABSTRACT

During the 1986 Refugee Health Group Workshop held at the London School of Hygiene and Tropical Medicine, the lead author surveyed 35 refugee workers' perceptions of blindness and its prevention in refugee communities. This paper analyzes and reports the results. Those surveyed generally agreed that blindness is a community problem of public health magnitude in most, if not all, refugee communities. In addition, respondents reported inadequate eye care services and a scarcity of literature on the topic. Refugee health organizations often overlook the need for eye care, and blindness prevention agencies are often unaware of the needs of particular refugee communities. The authors make recommendations for stimulating greater interest and active involvement in the prevention of blindness among refugees.
The Early Postoperative Pressure Course in Glaucoma Patients Following Cataract Surgery
Authors: Vu Michael T , Shields M Bruce
Published: April 2021

ABSTRACT

The intraocular pressure (IOP) course during the first 2 months after cataract surgery in patients with preexisting glaucoma was evaluated in 25 consecutive cases of extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (PC-IOL) implantation and in 25 cases of intracapsular cataract extraction (ICCE) without IOL implantation. Although the former group had a slightly more favorable postoperative IOP course, approximately half of each group had a pressure rise above 21 mm Hg on the first day postoperatively, and approximately 80% had an IOP rise during the first postoperative month. These findings support the position that all glaucoma patients require close monitoring of their IOPs immediately after both ECCE and ICCE, and that patients with moderate to advanced glaucomatous damage should probably have glaucoma surgery either before or in combination with their cataract operation.
A New Surgical Technique for Dislocated Posterior Chamber Intraocular Lenses
Authors: Insler Michael S , Mani Hamid , Peyman Gholam A
Published: April 2021

ABSTRACT

We describe a new method for fixation of dislocated posterior chamber lenses. The closed eye technique involves externalizing the haptics through the pars plana and suturing the loops to the scierai wall. There were no complications in our two patients, and the implants have remained well positioned.
Aphakic Cystoid Macular Edema Secondary to Betaxolol Therapy
Authors: Hesse Richard J , Swan John L
Published: April 2021

ABSTRACT

Since the approval of timolol for the treatment of open-angle glaucoma, beta-adrenergic blocking drugs have replaced epinephrine, a pure alpha and beta agonist, as the treatment of choice for glaucoma in aphakic patients. To date, there have been no reports of cystoid macular edema secondary to timolol, a nonselective beta-adrenergic blocker that apparently has little intrinsic sympathomimetic activity. Betaxolol is a new beta-adrenergic receptor blocker that preferentially blocks beta 1 receptors. We report a case of angiographically proven cystoid macular edema secondary to betaxolol therapy that resolved after discontinuation and recurred after a monocular therapeutic trial.
Intraocular Pressure Following Intravitreal Silicone Oil Injection
Authors: Burk Linda L , Shields M Bruce , Proia Alan D , McCuen Brooks W
Published: April 2021

ABSTRACT

The clinical features of 100 consecutive cases and the histopathology of six enucleated eyes, all having undergone silicone oil injection for complicated retinal detachments, were studied with regard to the incidence and mechanisms of postoperative intraocular pressure changes. Preoperatively, five patients had glaucoma and 35 had hypotony (7 mm Hg or less). Immediately after surgery, 43 patients had glaucoma and 14 had hypotony, while seven had glaucoma and 39 had hypotony in the late postoperative period (average follow-up of 1 year). In most cases, the mechanism of intraocular pressure change did not appear to be directly related to the presence of silicone, but rather to the preoperative status of the eye and other aspects of the vitreoretinal surgery. When silicone was a factor, the resulting intraocular pressure appeared to represent a balance between mechanisms obstructing aqueous outflow (pupillary block and the reaction to silicone bubbles in the anterior chamber angle) and mechanisms reducing aqueous production (cyclitic membranes and retinal detachment).
Hexagonal Keratotomy for Corneal Steepening
Authors: Grady Frank J
Published: April 2021

ABSTRACT

Hexagonal keratotomy is evaluated for treatment of hyperopia, presbyopia, and radial keratotomy overresponse. Initial indications are that this modality appears promising. Sixteen patients were evaluated and one complication is discussed.
Cataract Extractions for Senior Surgeons
Authors: Pizzarello Louis D , Wolf Lauren
Published: April 2021

ABSTRACT

Two groups of surgeons over the age of 70 were contacted to determine their personal experience with cataract surgery. One hundred fifty-three of 250 ophthalmologists and 107 of 250 members of the American College of Surgeons responded to a questionnaire. Sixteen (10.5%) ophthalmologists and nine (8.4%) FACS members had undergone cataract surgery in at least one eye. The mean age at the time of surgery was 72.7 years for the ophthalmologists and 66.4 years for the FACS members. Results were excellent, with 24 of the 25 eyes among the ophthalmologists having vision of 20/30 or better. Rates for surgery among spouses of both groups were lower than those for the surgeons.
'Very Late Onset' Cystoid Macular Edema
Authors: Mao Lisa Kay , Holland Peter M
Published: April 2021

ABSTRACT

Cystoid macular edema typically manifests 4 to 16 weeks after ocular surgery, ft has only rarely been documented with an onset more than 2 years postoperatively We report four patients who developed clinically significant cystoid macular edema between 7 and 16 years after initially successful surgery. Two patients had undergone intracapsular cataract extraction, one extracapsular cataract extraction, and one a scleral budding procedure. Although such cases of "very late onset" cystoid macular edema are uncommon, it should be considered in patients who suffer visual loss many years after ocular surgery.
Handle for +90-Diopter Lens
Authors: Bode Donald
Published: April 2021

ABSTRACT

This plastic handle for the +90-diopter lens holds the lens with a snap fit, facilitates manipulation, and allows storage in the shirt pocket using a half-frame spectacle case.
Epithelial Downgrowth
Authors: McAllister Ian L , Meyers Sanford M , Meisler David M , Petras Robert E , McMahon James T , George Craig W
Published: April 2021

ABSTRACT

We present a surgically treated case of epithelial downgrowth with clinicopathologic correlation and special emphasis on the ultrastructural findings. Longterm follow-up revealed a salvaged eye, but with only peripheral vision due to glaucomatous optic atrophy.
Juxtapapillary Exophytic Retinal Capillary Hemangioma Treated by Yellow Krypton (568 nm) Laser Photocoagulation
Authors: Kremer I , Gilad E , Ben-Sira I
Published: April 2021

ABSTRACT

A 30-year-old man was found to have juxtapapillary exophytic capillary hemangioma complicated by circinate maculopathy and peripapillary exudative retinal detachment. The diagnosis was made from the appearance of the tumor and confirmed by fluorescein angiography. The presence of intermittent hematuria associated with a cystic kidney supported the diagnosis of von-Hippel-Lindau disease. Subsequently, an attempt to treat the vascular lesion by yellow krypton (568 nm) laser photocoagulation failed to arrest the progression of the exudative retinal detachment, which finally became total.
A Simple, Convenient Tonometer Tip Disinfection Technique
Authors: Machesney William , Salz James J
Published: April 2021

ABSTRACT

A simple tonometer tip disinfection system is described. 10% sodium hypochlorite (household bleach) in a contact lens vial is taped to the base of the Goldmann applanation tonometer. The tonometer tip is then soaked for ten minutes in this vial.
The Relationship Between Retina Surgery and Preretinal Macular Fibrosis
Authors: Kraushar Marvin F , Morse Peter H
Published: April 2021

ABSTRACT

A prospective study of 440 eyes of 220 patients following successful operations for primary rhegmatogenous retinal detachment (132 eyes) and prophylactic operations for retinal breaks (103 eyes) revealed an incidence of preretinal macular fibrosis (PRMF) of 47% after scleral buckling surgery and 42% after prophylactic laser or cryopexy. The incidence of PRMF was significantly greater in aphakic vs phakic detachments, in detachments with operculated vs horseshoe breaks, in detachments with horseshoe breaks vs lattice degeneration, in detachments involving the macula, after scleral buckling with cryotherapy vs diathermy, and after prophylactic treatment of retinal breaks of fellow eyes with retinal detachment or retinal breaks that had developed postoperative PRMF Analysis of the data suggests that PRMF is most likely a result of the retinal break, detachment, and subsequent treatment.
Intraocular Pressure Reduction Prior to Retrobulbar Injection of Anesthetic
Authors: Zabel Ralph W , Clarke William N , Shirley Samuel Y , Rock William
Published: April 2021

ABSTRACT

Following the retrobulbar injection of anesthetic, the application of a mechanical device to lower the intraocular pressure will produce a rise in intraocular pressure that may be sufficient to compromise ocular perfusion. To increase the margin of safety for ischemic damage, a mechanical means of intraocular pressure reduction (Superpinkie) was applied prior to, rather than following, the retrobulbar injection of anesthetic. The study group consisting of 20 patients receiving the compression-injection sequence had a mean preoperative pressure of 4.70 mm Hg, while a control group of 20 patients receiving the injection-compression sequence had a mean preoperative pressure of 2.25 mm Hg. The proposed compression-injection method was well tolerated by the patients and attained surgically adequate anesthesia, akinesia, and ocular opening pressures. In selective cases, the compression-injection technique for the delivery of retrobulbar anesthesia may offer a means of better maintaining ocular perfusion and thereby lessening the risk of vascular compromise.
Treatment of Congenital Unilateral Upper Eyelid Retraction With a Marginal Myotomy Procedure
Authors: Rovit Adam J , Deupree D M , Zang Ying-Fen , Biglan Albert W
Published: April 2021

ABSTRACT

Two children with congenital unilateral upper eyelid retraction were treated successfully with surgery at 2 years of age. Excellent results were obtained using a modification of Grove's marginal myotomy procedure for lengthening the levator palpebrae superiorus muscle. To our knowledge, early surgical treatment for this rare idiopathic disorder has not been reported previously.
Management of Viral Retinitis
Authors: Schulman Joel A , Peyman Gholam A
Published: April 2021

ABSTRACT

Cytomegalovirus, herpes simplex, and herpes zoster are responsible for the majority of cases of viral retinitis. Herpes zoster also has been strongly incriminated as a causal agent in acute retinal necrosis. Effective chemotherapy exists for retinitis caused by herpes simplex and herpes zoster, along with acute retinal necrosis. Conventional antiviral therapy and i mm u nomodulators are ineffective in the treatment of cytomegalovirus retinitis in patients with acquired immune deficiency disorder. Ganciclovir, a new antiviral agent, has significantly reduced visual morbidity in these patients. Recurrence of the infection is not uncommon while patients are on the drug or when the agent is discontinued, because ganciclovir is virostatic and does not stop viral replication in the retina. The inability to control this viral retinitis using presently available chemotherapy indicates a need to examine other therapeutic modalities.
Mepivacaine Plasma Levels After Retrobulbar Anesthesia
Authors: Michelson G , Kamp H D
Published: April 2021

ABSTRACT

Plasma concentrations of mepivacaine were determined after retrobulbar anesthesia. The measured maximal blood levels that can produce systemic side effects range from 1.23 to 4.88 µg/ml. We therefore recommend preoperative and intraoperative monitoring of arterial blood pressure and ECG.
Albedo Concentration in the Anterior Eye: A Phenomenon that Locates Some Solar Diseases
Authors: Coroneo Minas T
Published: April 2021

ABSTRACT

I describe concentrations of reflected solar radiation (albedo) found at the usual sites of various conditions associated with exposure to the sun - pterygium, pinguecula, climatic droplet keratopathy and cataract and eyelid malignancy. Since the degree of limbal albedo concentration appears to be related to cornea) curvature, patients at risk can be identified by a simple test and preventative measures taken.
Muller's Muscle-conjunctival Resection Procedure in the Treatment of Ptosis in Horner's Syndrome
Authors: Glatt Herbert J , Putterman Allen M , Fett David R
Published: April 2021

ABSTRACT

The predictability of the phenylephrine test and the efficacy of the Muller's muscle-conjunctival resection procedure in the management of blepharoptosis in six cases of Homer's syndrome were assessed. Before phenylephrine testing or surgery, an average of 2.3 mm of ptosis was present. Topical phenylephrine elevated upper lids an average of 2.2 mm. The amount of elevation produced by the phenylephrine guided the amount of Muller's muscle and conjunctiva resected. Postoperative upper lid levels were exactly symmetrical in five of six patients. In one patient the previously ptotic lid was 0.5 mm higher than the contralateral lid. Even though Muller's muscle is rendered nonfunctional in Horner's syndrome by denervation, the Muller's muscle-conjunctival resection procedure proved to be a very effective method of treating ptosis in this setting. Our findings imply that the mechanism by which this procedure alleviates ptosis is independent of active contraction of Muller's muscle.
Lacrimal Gland Prolapse in Craniosynostosis Syndromes and Poor Function Congenital Ptosis
Authors: Jordan David R , Germer Bruce A , Anderson Richard L , Morales Louis
Published: April 2021

ABSTRACT

Lacrimal gland prolapse is an important, though uncommon, feature found in craniofacial abnormalities as well as in cases of poor function congenital ptosis. It occurs secondary to a number of conditions, including increased posterior pressure secondary to decreased orbital volume; also, supportive structures of the gland often may be weak in conjunction with a poor function ptosis or as a result of trauma at the time of major reconstruction. Recognition of the prolapsed gland and its replacement into the lacrimal gland fossa in craniosynostosis syndromes, as well as in cases of poor function congenital ptosis in general, allows the temporal eyelid to approach a more normal position, yielding an improved functional and cosmetic result.
A Multipurpose Dye Laser Photocoagulation System
Authors: Sasamoto Kenji , Koh Teizen , Kuroda Shinichiro , Kani Kazutaka
Published: April 2021

ABSTRACT

We modified a single argon/dye laser photocoagulator by adding two optical fibers so that it could be used with a slit-lamp microscope, an operating microscope, and with an endophotocoagulation probe. One fiber is attached to a nearby slit-lamp microscope; the other extends approximately 70 m and can be connected to either an operating microscope or an endophotocoagulation probe. An electrically-operated mirror inside the machine controls which of the two fibers the laser beam passes through. Separate control boxes for each fiber permit direct regulation of the photocoagulation process in all situations.
Accommodative Intraocular Lens with Spring Action Part 1. Design and Placement in an Excised Animal Eye
Authors: Hara Tsutomu , Hara Takako , Yamada Yoshiharu
Published: April 2021

ABSTRACT

We designed an intraocular lens (IOL) with spring action, which we call the Spring IOL, with the idea of providing a slight but adequate accommodative power. The Spring IOL consists of two 6.0-mm optics, held 4.38 mm apart, and four flexible loops. The optics are made of polymethylmethacrylate (PMMA) and the loops of polyvinylidene fluoride. The lens's refractive power is provided by the anterior optic; the posterior optic acts as a footplate to restrict the anteroposterior movement of the anterior optic. By torsionally compressing the obliquely arranged loops, a 10.0-mm 3-dimensional IOL can be reduced to 6.0 mm and inserted in the capsular bag through a 3.5-mm capsular opening. Because the Spring IOL is made of the same materials as conventional IOLs, most of the problems hindering the development of a refilling material (which could also provide accommodation) are avoided. In this first report we discuss the design of the lens, the refractive theory involved, and our experience inserting it in an excised animal eye.
Use of the Carbon Dioxide Laser in the Management of Orbital Plexiform Neurofibromas
Authors: Kennerdell John S , Maroon Joseph C
Published: April 2021

ABSTRACT

We present one of three cases in which we have used the carbon dioxide laser to successfully perform subtotal surgical removal of plexiform neurofibromas of the lid and orbit.
Mucinous Adenocarcinoma of the Orbit Arising from a Stable, Benign-Appearing Eyelid Nodule
Authors: Holds John B , Haines John H , Mamalis Nick , Anderson Richard L , Wolin Mitchell J
Published: April 2021

ABSTRACT

Mucinous adenocarcinoma is a rare eyelid tumor which should be considered in the differential diagnosis of a nodular or cystic lesion of the eyelid. This lesion may be locally aggressive and requires complete excision to prevent local recurrence or regional metastases. We present what we believe is the first report of a mucinous adenocarcinoma manifesting as a stable, benign-appearing nodule that has already given rise to a much larger secondary lesion. This case underscores the importance of performing a biopsy on even benign-appearing eyelid nodules.
Combined Cataract Implant and Filtering Surgery with 5-Fluorouracil
Authors: Cohen John S
Published: April 2021

ABSTRACT

In this preliminary retrospective study, results of combined extracapsular cataract extraction, intraocular lens implantation, and filtering surgery with subconjunctival 5-fluorouracil (5-FU) injections in 22 eyes were compared with those obtained in a similar group without 5-FU injections. Five to 35 mg (mean, 17.3 mg) of 5-FU were administered to each eye in the 5-FU group. Intraocular pressure (IOP) was controlled with fewer medications postoperatively than preoperatively in both the 5-FU group and the control group. However, the 5-FU group demonstrated statistically significant greater improvement in IOP control than the control group (P = .043).
Medical Postoperative Management of Massive Conjunctival Prolapse: A Case Report
Authors: Serrano Federico G , Mora Luz Matilde P
Published: April 2021

ABSTRACT

A severe case of conjunctival prolapse secondary to a posttraumatic carotid-cavernous fistula is presented. Management with a humid chamber and topical ointments obviated surgical intervention that might have compromised the inferior cul de sac.
Perilymphatic Subcutaneous Atrophy in Adnexal Hemangioma: A Complication of Intralesional Corticosteroid Injection
Authors: Ford Marybeth Dunston , Codere Francois
Published: April 2021

ABSTRACT

We report a case of atrophy of the perilymphatic, subcutaneous tissue following local steroid injection of an eyelid capillary hemangioma. Unlike such cases that have been previously reported, the atrophy in our case occurred after a single injection of triamcinolone. It spontaneously resolved over a period of 1 year. Although many cases of atrophy following local corticosteroid injections for other lesions elsewhere in the body have been reported, the entity we describe is a rare complication in capillary hemangioma therapy.
Ciliary Sulcus Suturing of a Posterior Chamber Intraocular Lens
Authors: Nabors Glenn , Varley Michael P , Charles Steve
Published: April 2021

ABSTRACT

We describe a method for ciliary sulcus fixation of a posterior chamber intraocular lens (PC-IOL) in the absence of an intact posterior capsule. This method, which combines a lens fixation procedure with trans pars plana vitrectomy techniques to ensure safe manipulation of the lens implant in the absence of an intact anterior hyaloid face, is ideally suited for retrieval and repositioning of PC-IOLs dislocated into the vitreous. It also permits closed system repositioning and fixation of the implant, thereby avoiding the complications of vitreous loss and the need for reopening the Mmbal incision.
The Value of Strabismus Surgery
Authors: Helveston Eugene M
Published: April 2021

ABSTRACT

Strabismus surgery is indicated for a variety of conditions stemming from misalignment of the eyes, abnormal head posture, and nystagmus. Although part of the value of such surgery lies in the fact that it improves appearance, it differs from cosmetic surgery, because, unlike the latter, it is designed to restore only normal configuration for ocular alignment - straight and/or aligned with the object of regard. A wide array of diagnostic tests are used to determine the precise treatment required, the goal of which is to provide comfortable vision, normal head position, and normal human appearance. In some cases nonsurgical techniques can be used to treat strabismus, but there is no evidence that visual training is an effective means of straightening eyes in those cases where surgery is considered the treatment of choice.

For the most common strabismus, essential infantile or "congenital" esotropia, 80 + % of infants have "straight" eyes after the initial operation, and 90% after a second operation, most of these with "straight eyes" have residual deviation of 5 prism diopters of esotropia or less. More than 50% of surgically treated patients have stable, long-term satisfactory results. Considering the effort required on the part of the ophthalmologist, together with the physical and psychological benefit to the patient, the cost of strabismus surgery should be equal to that of any major ophthalmic surgical procedure. That strabismus surgery is compensated at a lower rate, than for example, cataract surgery, suggests that strabismus surgery is an excellent value.
Side Effects of the Use of Botulinum Toxin for Treatment of Benign Essential Blepharospasm and Hemifacial Spasm
Authors: Kalra Hanspreet K , Magoon Elbert H
Published: April 2021

ABSTRACT

From April 1983 to April 1988, 381 botulinum toxin injections for lid spasms were administered to 106 patients. Sixty-nine had bilateral blepharospasm and 37 had hemifacial spasm- Of the 381 injections, 308 had been given to patients who returned for followup examinations. No systemic effects were noted at any of these visits; all side effects were temporary; there were no serious complications. Ptosis, the most frequently encountered problem, occurred after 26 (8.4%) of the injections. Other complications included: corneal exposure (after eight injections, 2.59%); face droop (after 11 injections, 3.57%); diplopia (after five injections, 1.62%); and subtle visual blurring (after eight injections, 2.59%). One patient noted jaw tenseness, another mentioned tearing, one reported brow droop, and another complained of crossed eyes. Ten injections had minimal effect; in these cases a repeat injection usually was effective. Only four patients chose surgery after beginning injections. We conclude that botulinum toxin injections are a safe, effective means of treating lid spasms.
A Modified Extracapsular Cataract Extraction for Pediatric Cataracts
Authors: Caputo Anthony R , Guo Suqin , Wagner Rudolph S , Constad William H
Published: April 2021

ABSTRACT

We present a modified procedure of extracapsular cataract extraction (ECCE) with a small central posterior capsulectomy for pediatric cataracts that is designed to eliminate posterior capsule opacification and to keep open the option of later secondary implantation of a posterior chamber intraocular lens. Of 76 study eyes in which the procedure was performed only three developed posterior capsule opacification. All seven control eyes that had standard ECCE with the posterior capsule left intact developed secondary membranes shortly after surgery.
Nd:YAG Laser Photodisruption of the Vitreous Traction in Avulsed Retinal Vessel Syndrome
Authors: Tatsui Tetsuo , Ohara Kunitoshi , Shimizu Hiroyuki
Published: April 2021

ABSTRACT

We applied Nd:YAG laser photodisruption to vitreous traction in three patients with avulsed retinal vessel syndrome. In every case the vitreous traction on the avulsed vessels was relieved and the vessel that had been avulsed in the vitreous cavity returned to the retinal surface postoperatively. There were no serious intraoperative and postoperative complications, nor was there any evidence of recurrence of vitreous hemorrhage after the treatment.
Prevention of Posterior Capsular Opacification by Cryolysis and the Use of Heparinized Irrigating Solution During Extracapsular Lens Extraction in Rabbits
Authors: Zaturinsky Boris , Naveh Nava , Saks Dan , Solomon Arie S
Published: April 2021

ABSTRACT

We tried applying a specially-designed cryoprobe to the posterior capsule as well as adding heparin, an anticoagulative, anti-inflammatory compound, to the anterior chamber irrigation solution in an attempt to inhibit secondary cataract formation following a planned extracapsular lens extraction in 36 rabbits. The first group received both cryo treatment and heparin; a second group received heparin without cryo treatment; a third group received neither heparin nor cryo treatment.

Complete opacification of the lens developed 3 months after the operation in all the rabbits not treated with heparin, and in 50% of those that received heparin. The addition of cryo treatment to the heparin-treated rabbits further reduced opacification by 20%.

We conclude that in rabbits, cryo treatment, combined with intracameral administration of heparin during surgery, has a significant inhibitory effect on secondary cataract formation.