bluuebunny/crossref_metadata_2025 huggingface dataset:
Current perspectives for the treatment of chronic myeloid leukemia
Authors: KARAKULAK ELİFCAN ALADAĞ , HAZNEDAROĞLU İBRAHİM CELALETTİN
Published: January 2019

Background: With an annual incidence of 1-2 in a million, Ph*(+) chronic myeloid leukemia (CML) is a clonal hematopoietic stem cell disease that makes myeloid neoplastic cells breed out of control. This BCR-ABL (+) myeloproliferative disease makes up about 15-20% of all leukemia cases in adults. CML is seen more in males than females, with a rate of three to two. However, it does not show difference in prevalence in terms of age. CML consists of three clinical phases. The first one is the chronic phase, defined by rising white blood cell levels and also by myeloid proliferation and bone marrow maturation. While this phase does not exhibit complications, in diagnosis, it composes most of the patients. The second phase is the accelerated phase, which the disease progresses onto if it is not treated or does not respond to treatment. This time usually takes about three years. The third phase is the blastic phase. The chronic phase can still progress onto the next two phases within the first 2 years, with a rate of 10%. In the following years, the possibility increases by a 15-20% each year. Tyrosine kinase inhibitors (TKI) are the revolutionary drugs for the management of disease course in CML.
Methods: The aim of this review is to assess current approaches to CML patient’s follow-up and treatment with TKI. The CML and TKI literature search was made in PubMed, Web of Science, Scopus with particular focus on the randomized clinical trials, recommendations, guidelines and expert opinions.
Results: In managing CML, various treatment methods have been utilized for many decades. Prior to the development of tyrosine kinase inhibitors (TKI), interferon alpha was the primary tool, which was then complemented by allogeneic hematopoietic stem cell transplantation (HSCT). HSCT was actually successful in slowing the disease down in the long term and curing up to a 50% of the patients. Then the coming of imatinib era opened up different treatment perspectives. For the patients resistant or intolerant to the imatinib, second and third generation TKIs are successfully used in distinct CML disease states.
Conclusion: The survival benefits of TKI including imatinib, nilotinib, dasatinib, bosutinib, and ponatinib for the CML patients are outstanding. TKI-related adverse events could impact on the clinical course especially in long-term drug administrations. Current aim for the CML disease management in TKI era is to provide age- and sex-matched normal life duration to the CML patients.

Keywords: Chronic, myeloid, leukemia, tyrosine, kinase, inhibitors
Lorsque l’autisme se dessine
Authors: Gay-Corajoud Valérie
Published: January 2019

Théo est autiste. Le dessin n’est pas son point fort. À l’inverse même, dessiner est compliqué, tenir un crayon est douloureux. Et puis, dessiner quoi ? puisque son imaginaire est bridé. Pourtant, au fil des années, il parvient à maîtriser le trait suffisamment pour traduire la complexité de son monde intérieur et surtout pour le cadrer afin que personne ne puisse le modifier. Le dessin devient sa version de la réalité et cela n’est pas discutable puisque, dorénavant, c’est là, posé sur le papier. Les dessins deviennent, donc, des boucliers, des plans, des passerelles et c’est ce qui le motive pour progresser, jusqu’à faire de certains dessins, découpés et plastifiés, ses objets transitionnels.
La musique comme voie thérapeutique pour les personnes autistes
Authors: Gepner Bruno , Scotto di Rinaldi Stéphane
Published: January 2019

La littérature sur la musicothérapie pour les enfants autistes souligne les nombreux bénéfices qu’ils peuvent en retirer, notamment pour leurs communications et interactions sociales. Mais il n’existe que très peu de données sur la musicothérapie pour les adultes autistes. Après une recension de cette littérature, nous présenterons d’une part les objectifs et les modalités de fonctionnement d’un atelier thérapeutique à médiation musicale pour un groupe d’adultes autistes Asperger musiciens, et d’autre part la méthodologie (pré-test – 12 mois de séances de musicothérapie – post-test) destinée à évaluer les effets de ces séances sur leur vie en général, et plus particulièrement leur humeur, leur communication et leurs interactions socio-émotionnelles, leur sensorialité et leurs fonctions exécutives. Enfin, nous présentons quelques données du pré-test, et quelques observations qualitatives encourageantes quant au bien-fondé de cette voie thérapeutique pour des adultes autistes musiciens.
Modifications des représentations sociales de l’autisme et introduction du concept « autism-friendly »
Authors: Chamak Brigitte
Published: January 2019

Depuis les années 1990, les représentations sociales de l’autisme ont subi de profondes transformations, même si la diversité des représentations culturelles demeure. La définition de l’autisme, les hypothèses étiologiques et les traitements ont changé. L’élargissement des critères diagnostiques est à l’origine de l’introduction dans la catégorie de personnes avec langage aux capacités cognitives importantes. Ces personnes ont commencé à s’exprimer et redéfinir l’autisme comme une différence et non comme une maladie ou un handicap. Un nouveau mouvement social célèbre la « neurodiversité », participe à une dé-stigmatisation de l’autisme et à l’apparition du concept « autism-friendly » . Cependant, ces représentations positives et la médiatisation accrue des personnes présentant un syndrome d’Asperger ont pour conséquence un désintérêt pour ceux qui n’ont pas leurs compétences.
Carole, un bébé à haut risque
Authors: Laznik Marie-Christine
Published: January 2019

La prise en charge précocissime d’un bébé dit à haut risque d’autisme a permis la non-installation du tableau autistique, dans une famille où la composante génétique est évidente. Ceci vient confirmer l’espoir que plusieurs auteurs mettent dans les prises en charge extrêmement précoces des fratries d’enfants autistes
Risque d’autisme : une architecture complexe
Authors: Chaste Pauline
Published: January 2019

L’autisme a été défini en tant que trouble à part entière par Leo Kanner en 1943, comme une incapacité innée à créer le contact émotionnel habituel, biologiquement déterminé, avec autrui. Malgré des évolutions, et des désaccords, quant à la définition du trouble et des limites avec les autres catégories diagnostiques, l’altération du fonctionnement social et la présence de comportements répétitifs ont toujours été considérées comme les caractéristiques fondamentales du trouble. La dernière décennie a vu apparaître de nouvelles méthodologies en génétique, permettant des études à l’échelle du génome et non plus d’un gène en particulier. Leur application dans l’autisme a permis l’identification des premières mutations rares de l’autisme non syndromique, mais aussi des progrès remarquables dans la compréhension de l’architecture génétique du risque d’autisme. Ce qui se dessine est complexe, et finalement s’approche fort du risque polygénique envisagé initialement. En parallèle, certains facteurs de risque épigénétiques commencent à être dévoilés.
La prise en compte en psychothérapie des vécus sensoriels des enfants autistes
Authors: Lheureux-Davidse Chantal
Published: January 2019

Cet article explore les troubles sensoriels souvent méconnus des enfants autistes. Quand le thérapeute s’y intéresse et prend en compte leurs intérêts sensoriels, ces enfants se sentent plus concernés, mieux compris et les rencontres sont facilitées. Entre hypersensibilité et hyposensibilité, ils atteignent parfois des états de saturation sensorielle qui leur font éviter le lien aux autres qui est particulièrement complexe et imprévisible. Ils peuvent tenter de décharger une intensité trop forte ou un excès d’informations sensorielles qu’ils ne peuvent ni filtrer ni traiter. Des installations en clivage leur permettent de s’apaiser au prix d’une dispersion psychique et d’une difficulté à coordonner différentes sensations. Un suivi thérapeutique offre une régulation relationnelle qui fait diminuer les modes de régulation autistiques au bénéfice d’un intérêt spontané pour le lien aux autres, d’une meilleure coordination dans le vécu corporel et dans l’espace. L’enfant s’ouvre à de nouvelles explorations avec son environnement.
Les effets des écrans sur les tout-petits : syndrome ou symptôme ? Hypothèses sociétales et psychomotrice
Authors: Balland Morgane , Bizeul Delphine , Guilliet Carole , Bossière Marie-Claude
Published: January 2019

Quatre professionnelles en cmp enfant (psychomotriciennes et pédopsychiatre) constatent l’arrivée, de plus en plus fréquente, d’enfants présentant des troubles relationnels (évitement, stéréotypies sensorielles et retard de langage) en lien avec une exposition massive et précoce aux écrans. Elles observent la diminution des troubles au début des soins et avec l’arrêt de cette surexposition. Parallèlement à la question de la place des écrans dans le monde des adultes, elles développent dans cet article leur travail clinique auprès de deux enfants qui semblaient se vivre comme enfermés, en deux dimensions dans les écrans, ne pouvant accéder à la tridimensionnalité (enveloppe, verticalité et relation). Elles tentent de comprendre comment la mise en place de stimulations adaptées et d’appuis relationnels sécurisants permet de se présenter et d’être au monde pleinement, en trois dimensions.
Exploring Perceptions of Health Care Providers' Use of Electronic Advance Directive Forms in Electronic Health Records
Authors: Folarinde Bunmi , Alexander Gregory Lynn , Galambos Colleen , Wakefield Bonnie J. , Vogelsmeier Amy , Madsen Richard W.
Published: January 2019

The current study explored the perceptions of health care providers' use of electronic advance directive (AD) forms in the electronic health record (EHR). The Technology Acceptance Model (TAM) was used to guide the study. Of 165 surveys distributed, 151 participants (92%) responded. A moderately strong positive correlation was noted between perceived usefulness and actual system usage (
r
= 0.70,
p
< 0.0001). Perceived ease of use and actual system usage also had a moderately strong positive correlation (
r
= 0.70,
p
< 0.0001). In contrast, the strength of the relationship between behavioral intention to use and actual system usage was more modest (
r
= 0.22,
p
< 0.004). There was a statistically significant difference in actual system usage of electronic ADs across six departments (χ
2
[5] = 79.325,
p
< 0.001). The relationships among primary TAM constructs found in this research are largely consistent with previous TAM studies, with the exception of behavioral intention to use, which is slightly lower. These data suggest that health care providers' perceptions have great influence on the use of electronic ADs. [
Journal of Gerontological Nursing, 45
(1), 17–21.]
Burden and Coping Ability of Individuals Caring for Chronically Ill Older Adults in Nigeria: A Mixed Methods Study
Authors: Faronbi Joel Olayiwola , Butcher Howard K. , Olaogun Adenike Ayobola
Published: January 2019

Family members play key roles in the care of older adults with chronic illness. However, little is known about the negative consequences of caregiving in Sub-Sahara Africa. The current study examined the influence of caregivers' burden and coping ability on the health-related quality of life of caregivers of older adults with chronic illness. An exploratory sequential mixed methods study was conducted among 16 family members. Findings showed that caregivers experienced severe burden, coped moderately with the burden, and had poor quality of life. Furthermore, directed content analysis of the in-depth interviews uncovered six major themes: (a)
Being Pulled in Opposite Directions
, (b)
Experiencing Poor Health,
(c)
Receiving Support From Family and Friends,
(d)
Turning to God for Help
, (e)
Seeking Relief for Aching Bodies
, and (f)
Seeking Remedies for Sleeplessness
. The current findings may have implications for designing programs that aim to improve the well-being of caregivers. [
Journal of Gerontological Nursing, 45
(1), 39–46.]
Management Outcome in Prethreshold Retinopathy of Prematurity
Authors: Azad Raj Vardhan , Sethi Anita , Kumar Harsh
Published: January 2019

ABSTRACT

Purpose: To evaluate the success of and timing for intervention in retinopathy of prematurity (ROP).

Patients and Methods: Eighty-two eyes of 50 children with stage 3 ROP were divided into two groups based on severity. Cryotherapy or laser therapy was performed soon after the detection of threshold stage in the first group of 40 eyes and at a prethreshold stage in the second group of 42 eyes. The patients were observed from 4 months to 2 years and regression or progression was noted. Unfavorable outcomes including macular and disc drag ano the progression of ROP to stages 4 and 5 were correlated with birth weight, gestational age, age at threshold, and age at intervention.

Results: Regression of ROP occurred in 75 (91.46%) of the eyes. An overall unfavorable outcome occurred in 14 (17.07%) of the eyes, 11 of which reached threshold during the critical period of 37 to 39 postconceptional weeks of age. Of the cases (n = 14) with an unfavorable outcome, 9 eyes (22.5%) were in the group treated in the threshold stage (n = 40) and 5 eyes (11.9%) were in the group treated at a prethreshold stage (n = 42). The mean birth weight, gestational age, age at threshold, and age at intervention in the favorable and unfavorable outcome groups were 953.2 ± 2.19 g and 1,059.57 ± 2.62 g, 28.63 ± 2.03 weeks and 28.36 ± 1.98 weeks, 38.04 ± 2.13 weeks and 37.71 ± 1.13 weeks, and 38.32 ± 2.34 weeks and 38.25 ± 1.05 weeks, respectively.

Conclusion: Early intervention at a prethreshold stage of ROP or at a younger postconceptional age (ie, younger than 37 weeks) may decrease the incidence of an unfavorable outcome.

J Pediatr Ophthalmol Strabismus 2003;40:330-334.
Topical Mydriatic and Cycloplegic Spray for Chinese Children
Authors: Wong Chun-yu , Fan Dorothy S P , Yu Christopher B O , Lam Dennis S C
Published: January 2019

ABSTRACT

Purpose: To assess the efficacy and tolerance of mydriatic and cycloplegic spray versus drops for Chinese children.

Methods: The effects of the spray (cyclopentolate 0.25%, phenylephrine 0.625%, and tropicamióe 0.5%) and the drops (cyclopentolate 1%, phenylephrine 0.5%, and tropicamide 0.5%) were evaluated in 29 children (58 eyes) in two separate sessions. There was a 1-week period between the applications of the spray and the drops. Dilated pupil size and refraction after cycloplegia were the primary outcome variables used to assess the efficacy. A subjective discomfort score was used to assess acceptance of the spray and the drops.

Results: The mean age of the study population was 4.33 ± 1 .39 years (range, 3 to 8 years). The mean pupil size was 6.9 mm for the spray and 6.6 mm for the drops. The spray appeared to be slightly more effective than the drops, with a mean difference of 0.3 mm that was statistically significant (P = .001, two-tailed f test). No statistically significant difference in cycloplegic response was found between the spray and the drops (P = .535, two-tailed ü test). Administration of the spray caused less discomfort than did administration of the drops (P < .001, Wilcoxon signed-rank test).

Conclusions: The spray system appears to be clinically equivalent to the drops for achieving effective pupil dilation and cycloplegia, even in a population with dark irides such as ours. Tolerability and acceptance improved because the spray was applied to the closed eyelids.

J Pediatr Ophthalmol Strabismus 2003;40:349-352.
Ophthalmic Surgery, Lasers & Imaging
Authors: Schuman Joel S , Greenfield David S
Published: January 2019

The Official Journal of the International Society for Imaging in the Eye
Subthreshold Infrared Footprinting With Indocyanine Green for Localizing LowIntensity Infrared Photocoagulation
Authors: Salvetti Paola , Rosen Jonathan M , Reichel Elias
Published: January 2019

Abstract. A novel technique for localizing subthreshold infrared (810 nm) laser treatment and its use in three patients is described. Two patients were treated for choroidal neovascularization with transpupillary thermotherapy or focal subthreshold photocoagulation, and the third patient was treated with grid laser photocoagulation for diabetic macular edema using the 810-nm laser after undergoing indocyanine green angiography for diagnostic purposes. Postoperative indocyanine green images, obtained without reinjection of indocyanine green, revealed areas of hypofluorescence that corresponded to the laser treatment spots. This technique, named subthreshold infrared footprinting, can precisely localize subthreshold infrared laser photocoagulation sites and is potentially useful for evaluating treatment postoperatively and planning additional therapy if necessary. [Ophthalmic Surg Lasers Imaging 2003;34:44-48]
Optical Coherence Tomography of a Traumatic Neodymium:YAG Laser-Induced Macular Hole
Authors: Hagemann Luiz , Costa Rogerio A , Ferreira Henrique M , Farah Michel E
Published: January 2019

Abstract A 34-year-old electronics technician with a macular hole caused by a Neodymium (Nd):YAG laser injury underwent follow up with optical coherence tomography for 1 year. Optical coherence tomography showed a defect in all retinal layers at the macula center, with rectified and perpendicularly orientated borders to the retinal pigment epithelium. One year postinjury, the hole dimensions increased, and optical coherence tomography disclosed less evident rectified borders. After 1 year of follow up, the optical coherence tomography characteristics of a traumatic Nd:YAG laser macular hole can change, looking similar to a senile idiopathic hole. [Ophthalmic Surg Lasers Imaging 2003:34:57-59]
Surgical Peculiarities in Type II Diabetic Cataracts During Phacoemulsification
Authors: Khokhar Sudarshan , Pangtey Mayank S , Soni
Published: January 2019

* BACKGROUND AND OBJECTIVE: To record the surgical peculiarities during phacoemulsification in patients with type II diabetes.

* PATIENTS AND METHODS: A retrospective, noncomparative analysis. Data from 58 eyes of 43 patients having significant cataract with type II diabetes of more than 5 years' duration who underwent phacoemulsification were considered. Intraoperative difficulties and complications were noted and analyzed.

* RESULTS: In 24.13% (n = 14) of the cases, the nucleus could not be divided after initial trenching. The management of the nucleus and the cortex required modifications in the surgical technique.

* CONCLUSIONS: Type II diabetic cataracts were sticky and leathery in approximately one-quarter of the cases.

[Ophthalmic Surg Lasers Imaging 2003;34:100-103.]
Laser and Surgical Management of Hyperplastic Persistent Pupillary Membrane
Authors: Gupta Rajeev , Kumar Suresh , Sonika  , Sood Sunandan
Published: January 2019

Abstract. Two patients (50 and 14 years old) presented with extensive hyperplastic pupillary membranes and significant reduction of visual acuity. The patients were treated by surgical excision and sectioning of the membrane using a Q-switched Nd:YAG laser. Although both of the modalities achieved good surgical and functional results, laser treatment should be preferred over surgery because of potential complications associated with the latter. [Ophthalmic Surg Users Imaging 2003;34:136-139.]
A Newborn With Lipemia Retinalis
Authors: Ozdemir Murat , Bay Ali , Yasar Tekin , Cinal Adnan
Published: January 2019

Abstract. Lipemia retinalis is a rare ocular manifestation of certain types of hyperlipidemia. A case of a newborn with lipemia retinalis evaluated by laboratory and clinical findings is described. A creamy white appearance of all retinal blood vessels was demonstrated by color fundus photographs. The patient had elevated levels of triglycerides (29,000 mg/dL) and cholesterol (1,470 mg/dL). Lipid electrophoresis indicated hyperprebetalipoproteinemia. Type IY primary hyperlipoproteinemia was diagnosed. [Ophthalmic Surg Laser Imaging 2003;34:221-222.]
Trypan Blue Staining of the Anterior Capsule Under an Air Bubble With a Modified Cannula
Authors: Toprak Ahmet Baris , Erkin Esin Fatma , Guler Cenap
Published: January 2019

Abstract. To attain good visibility of the anterior capsule in the advanced or white cataract, trypan blue 0.1% is used to stain the anterior capsule. The dye is usually injected under an air bubble. However, it is difficult to inject the dye properly due to capillary forces. An ordinary anterior chamber cannula was modified and its coverage area increased to facilitate the staining of the anterior capsule under an air bubble. The anterior capsule was stained properly by using the modified cannula in all of the cases. [Ophthalmic Surg Lasers Imaging 2003;34:236-238.]
Scanning Laser Doppler Flowmetry of Nonperfused Regions of the Optic Nerve Head in Patients With Glaucoma
Authors: Simon Guy J Ben , Moroz Iriz , Goldenfeld Mordechai , Melamed Shlomo
Published: January 2019

* BACKGROUND AND OBJECTIVE: To examine the reliability of scanning laser Doppler flowmetry in measuring capillary flow in regions of the optic nerve head, which are manifested differently by confocal tomographic angiography.

* PATIENTS AND METHODS: Capillary blood flow of the optic nerve head was measured in 16 eyes of 13 patients who had glaucoma with moderate to severe visual field defects. Blood flow measurements were taken by the scanning laser Doppler flowmeter and analyzed using the automatic full-field perfusion image analyzer (AFFPIA). Flow values were compared between perfused and nonperfused halves of the optic nerve head. Vascular anatomy of the optic nerve head was evaluated by confocal laser tomography with indocyanine green injection, and visual field tests by a standard visual field analyzer.

* RESULTS: Analysis of laser capillary flow parameters by the AFFPIA disclosed a mean lower flow value in nonperfused compared with perfused discs (426 ± 310 vs 547 ± 306; P = .006). There was also a positive correlation between visual field defect and capillary angiography of the optic nerve head.

* CONCLUSIONS: Flow measurements of the optic nerve head by scanning laser Doppler flowmetry using the AFFPIA revealed a mean lower flow value in nonperfused discs of patients who had glaucoma with severe visual field defect. Capillary angiography demonstrated by Heidelberg retina angiography has a good correlation with the pattern of visual field defect.

[Ophthalmic Surg Lasers Imaging 2003,34:245-250.]
Indocyanine Green Dye-Enhanced Transpupillary Thermotherapy of Classic Subfoveal Choroidal Neovascularization
Authors: Sharma Tarun , Shah Nitant , Gopal Lingam , Shanmugam Mahesh P , Bhende Pramod , Bhende Muna , Shetty Nitin S , Sukumar B
Published: January 2019

* BACKGROUND AND OBJECTIVE: To evaluate the efficacy of indocyanine green dye-enhanced transpupillary thermotherapy for the treatment of classic subfoveal choroidal neovascular membrane (CNVM) with differing etiologies.

* PATIENTS AND METHODS: Nine eyes of 9 patients with classic subfoveal CNVM with different etiologies that was treated with indocyanine green dye-enhanced transpupillary thermotherapy were prospectively studied. All patients underwent pretreatment fluorescein angiography. Three minutes after dye injection (25 mg of indocyanine green), transpupillary thermotherapy was delivered using a modified diode laser at 810 nm, with a variable spot size of 0.8 to 2 mm depending on the size of the CNVM. A power range between 100 and 800 mW was used and treatment was initiated in one spot for 60 seconds; the end point was a barely detectable light gray appearance of the lesion. The outcome measures were assessed by Snellen visual acuity chart and obliteration of the CNVM by fluorescein angiography. Mean follow-up was 16 months.

* RESULTS: Obliteration of the CNVM was seen in all patients during the last visit. Visual acuity improved in one eye and remained stable (±2 line change on Snellen chart) in three eyes. Three eyes revealed a moderate visual loss of 3 to 4 lines and two eyes had a severe decline (> 5 lines) in vision. None of the eyes exhibited recurrence of the CNVM during follow-up.

* CONCLUSIONS: Indocyanine green dye-enhanced transpupillary thermotherapy was highly effective in closing classic CNVM in all cases without any recurrence. Visual acuity was either stabilized or improved in 4 of 9 eyes (44.5%).

[Ophthalmic Surg Lasers Imaging 2004;35:197-206.]
Predictors of Success in Macular Hole Surgery With Emphasis on the Internal Limiting Membrane (ILM) and ILM Peeling
Authors: Oz Ozay , Fudemberg Scott J , Cakir Banu , Jones Michael P , Akduman Levent
Published: January 2019

* BACKGROUND AND OBJECTIVE: To study the predictors of success in macular hole surgery.

* PATIENTS AND METHODS: Twenty-two eyes of 2 1 patients underwent macular hole surgery. The hole closure rate and the visual improvement were studied based on the preoperative visual acuity, stage and duration of the macular hole, the type of intravitreal tamponade used, and internal limiting membrane peeling. The internal limiting membrane was peeled only when it was clinically prominent.

* RESULTS: Macular holes were closed in 19 of the 22 eyes and visual improvement of 2 lines or more was achieved in 17 eyes. Preoperative visual acuity, duration of the macular hole, type of intraocular tamponade used, and internal limiting membrane peeling did not affect the outcome. A final visual acuity of 20/70 or better was more common after surgery for stage 2 holes (P =.01 9).

* CONCLUSION: The best predictor of outcome was the stage of the hole, with best results obtained in stage 2 holes.

[Ophthalmic Surg Lasers Imaging 2004;35:207214.]
Visual Results and Complications of Posterior Chamber Intraocular Lens Implantation After Capsular Tear During Phacoemulsification
Authors: Onal Sumru , Gozum Nilufer , Gucukoglu Ahmet
Published: January 2019

* BACKGROUND AND OBJECTIVE: To determine the visual outcome and complications of posterior chamber intraocular lens implantation after capsular tear in patients undergoing phacoemulsification at Istanbul University, Istanbul Faculty of Medicine, Department of Ophthalmology, Istanbul, Turkey.

* PATIENTS AND METHODS: The medical records of patients who underwent phacoemulsification surgery for senile cataract from January 1, 1996, to December 31, 1998, were reviewed. Patient inclusion criteria were implantation of a posterior chamber intraocular lens after phacoemulsification, being operated on by one of two surgeons, and a follow-up of at least 1 year. There were 58 eyes in the group with capsular tear and 1 59 eyes in the group with intact capsule.

* RESULTS: A final visual acuity of 0.8 or more was more common in eyes with uncomplicated phacoemulsification surgery (chi-square = 16.25, P= .03). Refraction stabilized most commonly at 2 to 6 months postoperatively in patients with capsular tear and 1 to 21 days postoperatively in patients with uncomplicated phacoemulsification (chi-square = 22.61, P< .001). Complications such as retinal detachment (odds ratio = 11.70, P< .05), cystoid macular edema (odds ratio = 26.33, P< .01), increased intraocular pressure (odds ratio = 14.54, P < .05), and decentration of the intraocular lens (odds ratio = 32.79, P = .00 1 ) were more frequendy observed in eyes with capsular tear.

* CONCLUSIONS: It takes longer for the refraction to stabilize in eyes with posterior chamber intraocular lens implantation after capsular tear during phacoemulsification. Complications such as retinal detachment, cystoid macular edema, increased intraocular pressure, and decentration of the intraocular lens are more common in these patients, and therefore they should be observed for a longer period of time.

[Ophthalmic Surg Lasers Imaging 2004;35:219-224.]
Walker-Warburg Syndrome: Congenital Neurodysplasia and Bilateral Retinal Folds
Authors: Berrocal Audina M , Scott Ingrid U , Flynn Harry W
Published: January 2019

Abstract. A 2-month-old girl with a history of congenital hydrocephalus presented due to "wandering eyes." Initial eye examination at age 2 months showed response to light and a prominent retinal fold that extended through the macula and made contact with the posterior and inferior temporal lens capsule in each eye. Combined with the patients neurologic findings, the results of the ocular examination led to the diagnosis of Walker-Warburg syndrome. During 5 years of follow-up, the patient developed progressive cataracts in both eyes but maintained ambulatory vision in the left eye. Walker-Warburg syndrome should be included in the differential diagnosis for pediatric patients with a history of prominent retinal folds. [Ophthalmic Surg Lasers Imaging 2004;35:256-258.]
A Curved Vitrectomy Probe
Authors: Chalam K V , Shah Vinay A , Tripathi Ramesh C
Published: January 2019

Abstract. A curved vitrectomy probe for better accessibility of the peripheral retina in phakic eyes is described. The specially designed curved vitrectomy probe has a 20-gauge pneumatic cutter. The radius of curvature at the shaft is 19.4 mm and it is 25 mm long. The ora serrata is accessed through a 3.0- or 4.0mm sclerotomy in phakic eyes without touching the crystalline lens. Use of this instrument avoids inadvertent trauma to the clear lens in phakic eyes requiring vitreous base excision. This curved vitrectomy instrument complements wide-angle viewing systems and endoscopes for safe surgical treatment of peripheral retinal pathology in phakic eyes. [Ophthalmic Surg Lasers Imaging 2004;35:259-260.]
A Conjunctival Retractor for Glaucoma Filtering Surgery
Authors: Ritch Robert , Shihadeh Wisam A , Liebmann Jeffrey M
Published: January 2019

Abstract. A new conjunctival retractor provides the desired exposure of the scleral bed during filtering surgery. It elevates the conjunctiva without causing crush injury and allows excellent exposure of the scleral bed with a smaller incision than is required when non-toothed forceps or Week cell sponges are used. The surgeon or assistant holding the retractor can move it in various directions to provide a good view of any particular site for which exposure is needed. [Ophthalmic Surg Lasers Imaging 2004;35:261-262.]
Effective Treatment of Diffuse Diabetic Macular Edema by Temporal Grid Pattern Photocoagulation
Authors: Shimum Masahiko , Yasuda Kanako , Nakazawa Toru , Ota Satsuki , Tamai Makoto
Published: January 2019

* BACKGROUND AND OBJECTIVE: To determine the effectiveness of laser grid pattern photocoagulation to the macula but not the papillomacular bundle for the treatment of diffuse diabetic macular edema.

* PATIENTS AND METHODS: Thirty-five eyes of 23 patients with diffuse diabetic macular edema underwent laser grid photocoagulation excluding the papillomacular bundle area. Best-corrected visual acuity by Snellen chart, foveal thickness using a retinal mapping program by optical coherence tomography (OCT), and mean deviation sensitivity by Humphrey automated central perimetry were investigated before and 1, 3, and 6 months after the treatment.

* RESULTS: Six months after treatment, the visual acuity was improved by 2 or more lines in 16 eyes (43%) and the foveal thickness decreased in 32 eyes (91%). The mean deviation worsened in 34 eyes (97%). There was a significant correlation between the improvement of visual acuity and the initial mean deviation, suggesting that a better visual acuity would be expected with a preoperative mean deviation of approximately -20 dB.

* CONCLUSION: Grid pattern photocoagulation without treatment to the papillomacular bundle area was effective in treating diffuse diabetic macular edema, especially in eyes with an initial mean deviation showing moderate dysfunction.

[Ophthalmic Surg Lasers Imaging 2004;35:270-280.]
Age-Related Differences in Normal Corneal Topography
Authors: Topuz Habibe , Ozdemir Murat , Cinal Adnan , Gumusalan Yakup
Published: January 2019

* BACKGROUND AND OBJECTIVE: The aim of this study was to compare age-related differences in the corneal topography of a normal population using a computerized corneal topography system.

* PATIENTS AND METHODS: The randomized comparative study included 240 eyes of 120 subjects with normal corneas. Subjects were divided into six age groups: 5 to 10 years (group 1), 11 to 20 years (group 2), 21 to 30 years (group 3), 31 to 40 years (group 4), 41 to 50 years (group 5), and 51 years or older (group 6). Average corneal power and corneal astigmatism were examined. An average corneal topography map was constructed and the astigmatism pattern was determined in each age group.

* RESULTS: Average corneal power values were 41.64 ± 0.85 diopters (D), 42.35 ± 0.90 D, 42.63 ± 0.99 D, 42.94 ± 0.93 D, 43.38 ± 0.77 D, and 43.53 ± 0.88 D in groups 1 to 6, respectively (P < .001). Mean astigmatism values were similar in all age groups (P = .225). Younger subjects had with-the-rule astigmatism, but older subjects showed a shift to oblique or against-the-rule astigmatism. The averaged maps of groups 1 to 3 showed a vertical bow-tie pattern, but the central steep area gradually extended horizontally and it became a round configuration in groups 4 to 6.

* CONCLUSION: This study suggests that the normal cornea becomes steeper in the horizontal line and superior vertical quadrant and shifts from with-the-rule to against-the-rule astigmatism, but the amount of physiological corneal astigmatism does not change with age.

[Ophthalmic Surg Lasers Imaging 2004;35:298-303.]
A New and Improved Vitreoretinal Erbium:YAG Laser Scalpel: Long-Term Morphologic Characteristics of Retinal-Choroidal Injury
Authors: Joseph Daniel P , Allen Peter , Negus Dan , Hobart Jim
Published: January 2019

* BACKGROUND AND OBJECTIVE: To report a modified erbium:YAG laser scalpel designed to incise tissue more efficiently and safely than other systems reported to date.

* MATERIALS AND METHODS: An erbium:YAG laser delivery system was built to deliver laser energy in bursts of micropulses with a repetition rate of 1,000 Hz. The laser was coupled to handpieces with tip designs equipped with shields, backstops, and beveled, straight, and flexible fibers. In vivo studies in the rabbit eye were performed to determine damage threshold, optimal pulse energy, and burst frequency required to make incisions in the retina and choroid. The safety profile and directional control provided by the handpieces were tested for consistency. Partial- and full-thickness retinal-choroidal incisions were examined clinically and histologically at various time intervals.

* RESULTS: The best incisions were obtained at a fluence of 3.5 J/cm
p 2
or greater, a burst repetition rate of 10 to 40 Hz, and 6 micropulses per burst. Retinal damage occurred when incising laser energy was used 500 µm or closer to the retinal surface. Depth of penetration of laser energy did not depend on burst repetition rate. The use of laser endoprobes equipped with shields and backstops provides absolute protection from stray laser energy in aqueous media. The use of flexible beveled fiber tips provides reliable, accurate directional control. Retinal-choroidal incisions and damage resulted in local retinal-choroidal degeneration and adhesion formation.

* CONCLUSION: The modifications to the erbium:YAG laser scalpel provide a more efficient, versatile, and safe application to vitreoretinal surgery than any system reported to date.

[Ophthalmic Surg Lasers Imaging 2004;35:304-315.]
Wavelength Independence and Interdevice Variability of Optical Coherence Tomography
Authors: Schuman Stefanie G , Hertzmark Ellen , Fujimoto James G , Schuman Joel S
Published: January 2019

* BACKGROUND AND OBJECTIVE: Comparison of nerve fiber layer (NFL) thickness and macular retinal thickness measurements in two different commercial optical coherence tomography (OCT) machines with the same and different super luminescent diode lasers (SLDs).

* PATIENTS AND METHODS: Thirty eyes of 30 subjects were studied, with each eye scanned on two different OCT machines on the same day. Three 3.4-mm diameter circumpapillary NFL scans and six 6mm radial scans centered on the fovea were obtained. Macular volumes were calculated from the central 3.45 mm of the 6 radial scans.

* RESULTS: The first study (identical SLDs of 850 nm) included 10 eyes of 10 subjects for mean NFL thickness and 6 eyes of 6 subjects for macular volume. There was no systematic difference between the measurements on the two machines for NFL (difference = 5.6 µm, standard error [SE] = 3.8, P= .18) or macular volume (difference = -0.003 mm3, SE = 0.064, P = .96). The second study (SLDs of 850 and 820 nm) included 20 eyes of 20 subjects. There was no significant difference between the two machines for mean NFL (difference = 3.4 µm, SE = 2.9, P= 0.26) or macular volume (difference = -.017 mm3, SE = 0.017, P = .33). For the smaller areas of the macular scan, several (including the outer ring) showed a significant systematic difference between measurements at the two wavelengths, but even these had at most 12% of the total variance attributable to the different wavelengths.

* CONCLUSION: Our study indicates that OCT measurements of NFL thickness do not differ much when the device or the wavelength of the SLD is changed. Some measurements of the macular thickness in specific areas may differ systematically for different wavelengths, but in most cases the difference is small.

[Ophthalmic Surg Lasers Imaging 2004;35:316-320.]
Analysis of Optic Disc Change Using the Heidelberg Retina Tomograph in an Acquired Pit of the Optic Nerve
Authors: Oh Joo Youn , Park Ki Ho
Published: January 2019

Abstract. A 51 -year-old woman diagnosed as having normal-tension glaucoma developed an acquired pit of the optic nerve. The optic disc was viewed by the Heidelberg Retina Tomograph (HRT; Heidelberg Engineering, Heidelberg, Germany) before and after development of an acquired pit of the optic nerve. HRT parameters and cross-sectional images of the optic disc were compared. Maximum cup depth at the site of the acquired pit of the optic nerve increased after development of the acquired pit of the optic nerve (from 1.200 to 2.432 mm). The neuroretinal rim area and volume in the lnferotemporal octant were reduced (rim area from 0.070 to 0.010 mm
p 2
, rim volume from 0.009 to 0.001 mm
p 3
). The morphologic changes in the optic disc were also detected topographically and reflectively. [Ophthalmic Surg Lasers Imaging 2004;35:325-327.]
The Smooth Surface Tunnel Porous Polyethylene Enucleation Implant
Authors: Woog John J , Dresner Steven C , Lee Tae Soo , Kim Yoon-Duck , Hartstein Morris E , Shore John W , Neuhaus Russell W , Kaltreider Sara A , Migliori Michael E , Mandeville John T H , Roh Joo Heon , Amatto Malena M
Published: January 2019

* BACKGROUND AND OBJECTIVE: To describe early clinical results with the porous polyethylene smooth surface tunnel (SST) enucleation implant.

* PATIENTS AND METHODS: Uncontrolled, prospective interventional case series of patients undergoing enucleation with placement of the SST implant. This implant consists of a porous polyethylene sphere with a smooth anterior surface containing pre-drilled tunnels to facilitate direct suturing of the rectus muscles to the implant without use of an implant wrap. Postoperatively, socket healing was assessed, and prosthesis and socket motility were evaluated by the surgeon using an ordinal scale (0 = no motility to 4 = excellent motility).

* RESULTS: Thirty patients received the SST implant, with a mean follow-up of more than 23 months. Two cases of exposure occurred and were managed surgically without the need for explantation. Mean socket motility was 3.1 on a 0 to 4 ordinal scale, with mean prosthesis motility of 2.8.

* CONCLUSION: The SST implant provides satisfactory socket motility and is generally well tolerated in the anophthalmic socket without the need for wrapping material.

[Ophthalmic Surg Lasers Imaging 2004;35:358-362.]
Comparison of the Thermal Effect on Clear Corneal Incisions During Phacoemulsification With Different Generation Machines
Authors: Kaushik Sushmita , Ram Jagat , Brar Gagandeep Singh , Bandyopadhyay Supratik
Published: January 2019

* BACKGROUND AND OBJECTIVE: Older generation phacoemulsification units are widely employed where economics do not permit frequent upgrades. Thermal effects on the cornea while performing phacoemulsification with different generation machines were evaluated.

* PATIENTS AND METHODS: The thermal effect on the clear corneal incision during uncomplicated phacoemulsification performed by the Series 10,000 (Alcon Laboratories, Fort Worth, TX) and the Diplomax (Allergan, Irvine, CA) machines was clinically evaluated and correlated with the effective phacoemulsification time required. The clinical outcome was analyzed with respect to wound closure and surgically induced corneal astigmatism.

* RESULTS: The average effective phacoemulsification time required to emulsify a grade IV cataract was 88.33 ± 15.81 seconds with the Series 10,000 machine and 61.67 ± 21.79 seconds with the Diplomax machine. A grade 2 or more thermal effect was seen in 19.33% of patients operated on with the Series 10,000 machine and 3.22% of patients operated on with the Diplomax machine. The resultant tissue retraction affected wound closure and mean surgically induced corneal astigmatism (1.71 ± 1-05 D with the Diplomax machine and 2.21 ± 1.32 D with the Series 10,000 machine).

* CONCLUSIONS: Newer generation machines require less phacoemulsification power to emulsify hard cataracts, and the clinical outcomes are more favorable. Incision burns must be kept in mind when working with older generation phacoemulsification machines.

[Ophthalmic Surg Lasers Imaging 2004;35:364-370.]
Management of Magnetic Intravitreal Foreign Bodies in 71 Eyes
Authors: Soheilian Masoud , Abolhasani Abbas , Ahmadieh Hamid , Azarmina Mohsen , Dehgan Mohammad H , Mashavekhi Arman , Siadat Farshid , Moshfeghi Andrew A , Peyman Gholam A
Published: January 2019

* BACKGROUND AND OBJECTIVE: To evaluate the management of a series of eyes with magnetic intravitreal foreign bodies.

* PATIENTS AND METHODS: This retrospective review examined consecutive cases of ocular injury associated with intraocular foreign bodies; 71 eyes included had a single metallic intraocular foreign body (< 5 mm) located in the vitreous cavity removed by external magnet or intraocular forceps. Variables included preoperative and postoperative visual acuity, retinal break formation, retinal detachment, presence of an afferent pupillary defect, intraocular pressure, entrance site, foreign body size, method of extraction, and time between occurrence and surgical extraction.

* RESULTS: Factors predictive of good visual outcome (visual acuity > 20/200) were: shortest interval between trauma and foreign body extraction, preoperative visual acuity of 20/200 or better, and absence of afferent pupillary defect.

* CONCLUSIONS: In this nonrandomized study, good visual results could be obtained in eyes undergoing prompt foreign body removal, especially those with good preoperative visual acuity and no afferent pupillary defect.

[Ophthalmic Surg Lasers Imaging 2004;35:372378.]
Blood Flow Studies and Serological Testing in the Diagnostic Evaluation of Glaucoma: A Pilot Study
Authors: Greenfield David S , Bagga Harmohina
Published: January 2019

* BACKGROUND AND OBJECTIVE: To evalu ate the prevalence of hemodynamically significant carotid artery stenosis, peripapillary blood flow, and serologie abnormalities in a pilot study among patients with glaucoma.

* PATIENTS AND METHODS: All subjects underwent complete eye examination, standard automated perimetry, carotid Doppler ultrasonography, serum laboratory testing, and scanning laser Doppler flowmetry (SLDF). Subjects were subdivided into two groups based on glaucoma subtype (normal-tension vs primary open-angle glaucoma) and severity (mild vs moderate-advanced) .

* RESULTS: Twenty eyes of 20 patients with associated glaucomatous visual field loss were enrolled. No significant differences in age, gender, intraocular pressure, systemic comorbidity, number of antiglaucoma medications, and prior filtration surgery were observed between the groups based on the type and severity of glaucoma. The prevalence of clinically significant (> 70%) carotid stenosis, mean peripapillary blood flow assessed by SLDF, mean erythrocyte sedimentation rate, mean hematocrit, mean hemoglobin, and positive FTA-ABS was similar in both groups. Severity of glaucomatous damage as determined by visual field mean defect did not correlate with the degree of carotid anery stenosis (R2 < 0.0001, P= .99) or peripapillary blood flow derived from mean SLDF (R
p 2
= 0.0005, P =.92).

* CONCLUSION: Data from this pilot study demonstrate that the prevalence of hemodynamically significant carotid stenosis, peripapillary blood flow, and serologie abnormalities are similar in patients with normal-tension and primary open-angle glaucoma, and do not correlate with glaucoma severity.

[Ophthalmic Surg Lasers Imaging 2004;35:406-4l4.]
Management of Porous Polyethylene Implant Exposure in Patients With Retinoblastoma Following Enucleation
Authors: Kim Jong-Hyun , Khwarg Sang-In , Choung Ho Kyung , Yu Young Suk
Published: January 2019

* BACKGROUND AND OBJECTIVE: To report the features and the management of porous polyethylene implant exposure in patients with retinoblastoma following enucleation.

* PATIENTS AND METHODS: The medical records of 33 patients (33 sockets) following enucleation and porous polyethylene implantation for retinoblastoma were reviewed.

* RESULTS: The mean age at enucleation was 24 months (range, 2 to 85 months). The exposure rate was 33% (11 cases), and the mean time from enucleation to exposure was 15 months (range, 7 to 29 months). One case was resolved only by supportive management, and the remaining 10 were successfully treated with a scleral patch graft and maintained well during a mean follow-up of 15 months after surgical repair. There was no statistical evidence that age, gender, implant size, or chemotherapy had an effect on implant exposure.

* CONCLUSIONS: Porous polyethylene implant exposure does not seem to be resolved by conservative management. We recommend early surgical management, such as scleral patch graft, as opposed to supportive management.

[Ophthalmic Surg Lasers Imaging 2004;35:446452.]
Small-Incision Manual Extracapsular Cataract Extraction Using Deep-Topical, Nerve-Block Anesthesia
Authors: Kaderli Berkant , Avci Remzi
Published: January 2019

* BACKGROUND AND OBJECTIVE: To determine whether deep-topical anesthesia is suitable for small-incision manual extracapsular cataract extraction (ECCE).

* PATIENTS AND METHODS: Three hundred twenty-six eyes of 253 patients had small-incision manual ECCE under topical anesthesia with a 4% lidocaine-soaked sponge. The severity of the pain, eye movements, blepharospasm, and intraoperative complications were recorded. Patient and surgeon satisfaction levels were assessed.

* RESULTS: Operations on 323 eyes (99%) were completed with topical anesthesia. Intraoperatively, topical anesthesia was converted to peribulbar anesthesia in 3 eyes (0.9%) because of excessive eye movements. The cauterization of the scleral vessels and conjunctiva and the subconjunctival injection were the stages causing severe pain. The most frequent intraoperative complication was posterior capsule rupture in 6 eyes (1.8%). The satisfaction level was 95% for the patients and 90% for the surgeon.

* CONCLUSION: Deep-topical, nerve-block anesthesia provides anesthesia with sufficient quality for small-incision manual ECCE.

[Ophthalmic Surg Lasers Imaging 2004;35:460-464.]