bluuebunny/crossref_metadata_2025 huggingface dataset:
Monomanual Pupil Stretcher
Authors: Barboni Piero , Zanini Maurizio , Rossi Annalisa , Savini Giacomo
Published: April 2021

Abstract. The monomanual pupil stretcher is a new instrument that allows the authors to easily, quickly, and safely stretch the pupil. The specific features of the hooks allow pupil stretching to be performed in a single maneuver and in a more effective manner. [Ophthlamic Surg Lasers 1998;29:772-773.]
Hook and Loop Fastener on Loose Prisms Assists in Measuring Ocular Deviation
Authors: Wessels Izak F , Thomas Steve , Wessels Delia A
Published: April 2021

Abstract. It is difficult to hold a pair of loose prisms in one hand. Doing so can lead to inaccuracy, which worsens with large-angle exotropia or vertical deviations. The authors applied a self-adhesive hooked Velcro (Velcro Sticky Back Tape, Velcro USA Inc., Manchester, NH) strip to the base and the top of loose prisms. They applied the complementary looped Velcro to a wooden bar. As a result, a pair of prisms could be suspended horizontally and/or vertically while being held in one hand. Forty consecutive patients undergoing strabismus surgery without adjustable sutures were retrospectively studied to evaluate the accuracy of this method. Clinical use confirmed its ease and convenience. Of 19 patients with exotropia and 15 patients with esotropia (mean ages 41.9 and 15.7 years, respectively; mean deviations 44.7 and 49.8 D, respectively), 4 patients with abducens paralysis, and 2 patients with trochlear palsies, 1 surgery achieved less than 10 D of residual deviation in all but 2 (5.9%). This simple, inexpensive system can assist with the clinical evaluation of ocular deviation. [Ophthalmic Surg Lasers 1998;29:774-777.]
The Treatment of Lacrimal Apparatus Obstruction With the Use of an Inner Canthal Jones Tube Insertion via a Transcaruncular Route
Authors: Lee Jong Soo , Jung Geun , Lee Ji Eun , Oum Boo Sup , Lee Sang Hyup , Rho Hwan Jung
Published: April 2021

* BACKGROUND AND OBJECTIVE: To evaluate the clinical utility of the lacrimal bypass surgery using Bowman's probe in treatment of obstruction of the lacrimal apparatus.

* PATIENTS AND METHODS: This study evaluated 124 cases of obstruction of the lacrimal passage systems with mean epiphora of 2.7 years. An incision was made on the side of the caruncle, and the lacrimal bone was penetrated between the lacrimal sac and the nasal mucosa by Bowman #0. Insertion of a Jones tube was made at the new lacrimal pathway, a puctum dilator or scissors was introduced through the caruncle and dilated across the lacrimal bone into the nasal cavity. The Jones tube was introduced over the probe into the nasal cavity, and fixed at the caruncle with nonabsorbable suture material.

* RESULTS: Complete resolution of epiphora was accomplished in 120 (96.8%) of 124 eyes; only 4 (3.2%) eyes failed during a mean of 17.1 months of follow-up.

* CONCLUSION: This procedure is simple and safe with no facial scarring, short operation time, high success rate, and can be performed under local anesthesia. Therefore, the clinical utility of this procedure seems to be of value in treatment of complicated obstruction of the lacrimal apparatus.

[Ophthalmic Surg Lasers 2001;32:48-54]
Progressive Outer Retinal Necrosis in a Patient with Nephrotic Syndrome
Authors: Shinoda Kei , Inoue Makoto , Ishida Susumu , Kawashima Shinichi , Wakabayashi Toshiko , Suzuki Saburosuke , Katsura Hiroshi
Published: April 2021

Abstract. Progressive outer retinal necrosis syndrome (PORN) is a variant of necrotizing herpetic retinopathy and the majority of the described cases were related to acquired immunodeficiency syndrome. We present a patient who is HIV negative with nephrotic syndrome and prednisolone use for 4 months who showed clinical features of PORN. Low CD4 counts and lymphocytopenia suggested immunosuppression. In the left eye, tractional retinal detachment at the posterior pole followed by incomplete posterior vitreous detachment developed. In addition to intravenous administration of acyclovir, vitreous surgeries including stripping of the posterior hyaloid and silicone-oil tamponade were successfully performed to repair the retinal detachment in the left eye and to prevent it in the right eye. [Ophthalmic Surg Lasers 2001;32:67-72]
Sclerotomy Using Needle Puncture and Subconjunctival Injection of Mitomycin C
Authors: Wygnanski-Jaffe Tamara , Belkin Michael , Rosner Mordechi , Yoseph Glovinsky
Published: April 2021

* OBJECTIVE: To explore the possibilty of creating a temporary sclerotomy using a 26-gauge needle and sustaining its patency by injectiong 0.1 mL of 0.1 mg/mL of mitomycin C (MMC)

* ANIMALS AND METHODS: Twenty-four New Zealand white rabbits were randomized into 3 groups. In the test group, puncture was performed using 26gauge needle penetrating the anterior chamber at the limbus, and 0.1 mg/mL MMC were injected subconjunctivally. In the control group, a puncture was performed in the same fashion and in the MMC group, MMC only was injected subconjunctivally. Intraocular pressure (IOP) was measured prior to surgery and at days 1, 3, 7, 10, 14, 21, and 28.

* RESULTS: The mean intraocular pressure in eyes that underwent puncture with application of MMC was significantly lower than the IOP in the eye at all measurements up to and including day 21. In the puncture group, pressure was significantly lower than in the fellow eye only at day 3. No significant pressure reduction was observed at any measurement interval in eyes treated with MMC only.

* CONCLUSION: This simple technique of subconjunctival puncture of the limbus combined with application of MMC was effective in lowering IOP in rabbits. This may serve to attain a temporary filter in patients who need strict short-term pressure control.

[Ophthalmic Surg Lasers 2001;32:140-144]
The Association of Unilateral Congenital Glaucoma and Congenital Lower Lid Entropion: Causal or Casual?
Authors: Mandal Anil K , Honavar Santosh G , Gothwal Vijaya K
Published: April 2021

Abstract. This case documents unilateral congenital glaucoma associated with congenital lower lid entropion. A 2-year-old female infant was referred for evaluation and treatment of right-side buphthalmos caused by congenital glaucoma associated with bilateral congenital lower lid entropion that was prominent on the right side and present at birth. Examination disclosed a lower eyelid entropion of the right side that was treated surgically by reinserting the disinserted retractor aponeurosis to anterior inferior tarsal border. After three weeks, the patient was successfully treated with primary combined trabeculotomy-trabeculectomy for congenital glaucoma. The entropion of the left lower lid was asymptomatic and did not require any surgery. Buphthalmos caused by congenital glaucoma may be associated with congenital lower lid entropion and the association may be causal or coincidental.

[Ophthalmic Surg Lasers 2001;32:149-151]
Retrocorneal Membrane After Penetrating Keratoplasty
Authors: Lifshitz Tova , Oshry Tzafrir , Rosenthal Gideon
Published: April 2021

Abstract. Retrocorneal membranes after penetrating keratoplasty (PKP) is a well known complications, resulting from unintentional retention of the host Descemet's membrane (DM), or donor DM detachment. We describe for the first time the formation of a retrocorneal inflammatory membrane that mimics donor DM detachment or retained recipient DM, and discuss the differential diagnosis of a retrocorneal membrane after PKP. Two patients who underwent PKP and subsequently developed a retrocorneal membrane are described. In both patients' eyes a retrocorneal membrane was observed immediately following penetrating keratoplasty. While the first patient's membrane persisted for 33 months in the presence of a clear graft, the second patient's membrane disintegrated and dissolved within two weeks following treatment with topical steroids. The first case describes a patient with retained Descemet's membrane, while in the second case, it turned out that the retrocorneal membrane was actually an inflammatory membrane.

[Opthalmic Surg Lasers 2001;32:159-161]
Risk Factors in Endophthalmitis Leading to Evisceration or Enucleation
Authors: Tsai Yi-Yu , Tseng Sung-Huei
Published: April 2021

* BACKGROUND AND OBJECTIVE: This study aimed to evaluate the risk factors associated with evisceration or enucleation in endophthalmitis cases.

* PATIENTS AND METHODS: A retrospective analysis was conducted of all cases of endophthalmitis in a single unit over a 10-year period. The cases were divided into two groups. The group 1 consisted of patients with endophthalmitis who underwent evisceration or enucleation. The group 2 included patients with endophthalmitis who recovered with intravitreal injection or vitrectomy.

* RESULTS: During the 10-year study period, 86 patients with endophthalmitis were admitted for treatment. Evisceration or enucleation was undergone by 20 patients (23.2%) (Group 1); Group 2 consisted of 66 patients. Older age (P= 0.03), no light perception at presentation (P < 0.0001), endophthalmitis associated with corneal ulcer (P < 0.0001), and endogenous endophthalmitis (P = 0.048) were statistically significant factors associated with the need for evisceration or enucleation.

[Ophthalmic Surg Lasers 2001;32:208-212]
Postoperative Complications and Visual Results in Uniocular Pediatric Traumatic Cataract
Authors: Brar Gagandeep S , Ram Jagat , Pandav Suriner S , Reddy Ganjikunta S , Singh Usha , Gupta Amod
Published: April 2021

* BACKGROUND AND OBJECTIVES: This study was prospectively carried out to evaluate the postoperative complications and visual results following posterior chamber intraocular lens (PCIOL) implantation in children with unilateral traumatic cataract.

* PATIENTS AND METHODS: We prospectively evaluated 40 children, 12 years or younger, with traumatic cataract (blunt trauma, n = 22 eyes, repaired penetrating eye injury, n = 18 eyes) undergoing PCIOL implantation with a minimum follow-up period of one year. Children with posterior segment ocular injury were excluded.

* RESULTS: The postoperative complications were significantly higher in the penetrating eye injury group as compared to blunt trauma group (ie, pupillary capture 44.44% vs 9.09%, posterior capsulotomy rate 83.33% vs 40.90% and IOL decentration 27.77% vs 4.54%). The final visual acuity was 6/12 or better in 38.8% and 86.36% of eyes with penetrating eye injury and blunt trauma, respectively.

* CONCLUSION: Extracapsular cataract extraction (ECCE) with PCIOL implantation in traumatic cataract following blunt trauma results in better visual outcome and fewer complications compared to penetrating eye injury if the posterior segment is not involved.

[Ophthalmic Surg Lasers 2001;32:233-238]
Histopathology of Polytetrafluoroethylene (Gore-tex) as a Scleral Buckle in Humans
Authors: Sheu Shwu-Jiuan , Chou Li-Chen , Lee Inn-Yang , Wang Chen-Chiang
Published: April 2021

Abstract. Several materials have been used for scleral buckling implants in retinal detachment surgery. Of these, polytetrafluoroethylene (PTFE, Gore-tex) has the relative advantage of decreasing infection and extrusion when it is used as a scleral buckle material. In this report, we present the clinical and histopathologic finding of a case where Gore-tex was used as an encircling buckle material for retinal detachment operation. [Ophthalmic Surg Lasers 2001;32:245-247]
Structural Changes of the Retina in Retinal Vein Occlusion-Imaging and Quantification With Optical Coherence Tomography
Authors: Lerche Ralf-Christian , Schaudig Ulrich , Scholz Frank , Walter Andreas , Richard Gisbert
Published: April 2021

* BACKGROUND AND OBJECTIVE: To evaluate the potential oí optical coherence tomography (OCT) for imaging and quantifying structural changes in the retinal architecture following venous occlusive disease.

* PATIENTS AND METHODS: We studied 20 patients with retinal venous occlusive disease: 5 patients suffered from branch retinal vein occlusion (BRVO), and 15 from central retinal vein occlusion (CRVO). Patients with CRVO were studied within 72 hours after the first onset of symptoms. Patients were examined by OCT after a complete ophthalmologic examination including fluorescein angiography. A standard set of linear scans through the center of fixation and individual scans over areas of special interest were performed. Scans were qualitatively evaluated and quantitative measurements were performed on single A-scans at 5 locations of linear scans. Measurements were taken in the center of fixation, at the foveal rim, and at the edge of the scan. We measured total retinal thickness, thickness of cystoid spaces, and thickness of the highly reflective outer band.

* RESULTS: OCT produced detailed images of retinal thickening, intra- and subretinal hemorrhage, intra- and subretinal fluid accumulation, and formation of intraretinal cystoid spaces. Quantitative evaluation revealed a mean central retinal thickness of 274 ±181 urn (72-760 urn) in patients with central retinal vein occlusion. Visual acuity did not correlate with central or extrafoveal retinal thickness.

* CONCLUSION: Optical coherence tomography is a useful imaging technique for studying changes of retinal architecture following venous occlusive disease. Even minor changes like localized subretinal fluid accumulation or beginning epiretinal membrane formation can be visualized in detail. In contrast to other diseases like diabetic maculopathy, quantitative assessment of macular thickness does not correlate to visual acuity. Nevertheless, because of detailed imaging, OCT might become a useful tool in the follow-up and treatment of individual patients.

[Ophthalmic Surg Lasers 2001;32:272-280]
Acute Bilateral Postoperative Endophthalmitis in a HLA-DQ5-Positive Patient: Possible Susceptibility to Infections
Authors: Nicoli Carlos L , Wainsztein Ricardo D
Published: April 2021

Abstract. An unusual case of bilateral acute endophthalmitis in association with the HLA-DQ5 histocompatibility antigen is reported. A 35-year-old woman with high myopia and cataracts in both eyes underwent phacoemulsification procedures performed in separate sessions using different viscoelastic substances and following the same strict prophylactic measures. After each surgical procedure, she developed S epidermidis acute endophthalmitis in the right eye and Propionibacterium acnes acute endophthalmitis in the left eye; both were successfully treated with capsular bag irrigation and intracameral vancomycin (1 mg/0.1 mL). She tested positive for the HLA-DQ5 (DQ1), DQ2 antigen. The question is raised as to whether the HLA-DQ5 histocompatibility antigen may be a predisposing factor for both staphylococcal and P Acnes acute endophthalmitis. A multicenter prospective study is proposed to identify this HLA antigen in all patients scheduled for cataract surgery who have a history of postoperative endophthalmitis in the fellow eye. [Ophthalmic Surg Lasers 2001;32:322-324]
Cataract Surgery With Primary Posterior Chamber Intraocular Lens Implantation in Nanophthalmos
Authors: Mandal Anil K
Published: April 2021

Abstract. A 56-year-old Asian woman with nanophthalmos and cataract in the right eye underwent extracapsular cataract extraction with primary posterior chamber intraocular lens implantation of +31.0 D. Intraoperatively, there was severe vitreous upthrust; however, there was no vitreous loss and the lens could be placed in the posterior chamber. The patient's post-operative course was uneventful except for a moderate degree of coagulum over the lens. Her best-corrected visual acuity was 20/80. The patient required YAG capsulotomy one year later. Her intraocular pressure was under control without any medication. With appropriate precautionary measures, primary posterior chamber intraocular lens implantation can be performed in nanophthalmic eyes with a favorable visual outcome. [Ophthalmic Surg Lasers 2001;32:333-335]
Suramin to Enhance Glaucoma Filtering Procedures: A Clinical Comparison With Mitomycin
Authors: Mietz Holger , Krieglstein Günter K
Published: April 2021

* BACKGROUND AND OBJECTIVE: Trabeculectomies performed with mitomycin are more likely to be successful, but have an increased rate of complications. We performed a novel approach to enhance the outcome of trabeculectomies using suramin, a substance that inhibits the action of growth factors.

* MATERIALS AND METHODS: Trabeculectomies were performed in 10 eyes of 10 patients with advanced stages of complicated glaucoma and/or poor visual prognosis in a prospective, consecutive study. For comparison, an equal number of matched controls were selected from surgical cases using mitomycin and another 20 cases without mitomycin. Pre- and post-operative data were evaluated as well as complications and the need for further surgeries.

* RESULTS: The follow up was 18 months for the eyes in all groups. Average IOP values decreased from 32.7 mm Hg and 29.5 mm Hg to 19.7 mm Hg and 19.3 mm Hg in the suramin and mitomycin groups. The average number of medications decreased from 2.6 and 2.5 (P <0.86, t-test) to 1.3 and 0.4 (P <0.027) in the suramin- and mitomycin-treated eyes at the last visit. Hypotony following trabeculectomy occurred in 2/10 cases in suramin-treated eyes and 5/10 cases in mitomycin-treated eyes (P <0.18). Hypotony lasting for more than three months occurred in 0/10 suramin-treated eyes and 5/10 mitomycin-treated eyes. Conjunctival dehiscence (2/10), choroidal detachment (4/10), hypotony maculopathy (1/10), and endophthalmitis (1/10) were only noted in mitomycin-treated eyes. Without mitomycin 60% of surgeries performed failed.

* CONCLUSIONS: In this first study using suramin to inhibit fibrosis following trabeculectomy for complicated cases of glaucoma, it appears that the use of suramin is associated with fewer cases of severe hypotony, choroidal detachment, and severe visual loss as compared to mitomycin, while the success rates seem to be similar.

[Ophthalmic Surg Lasers 2001;32:358-369]
Gold Implant Treatment for Discomfort Induced by a Filtering Bleb
Authors: Crichton Andrew C S , Ashenhurst Michael , Kirker Andrew W
Published: April 2021

Abstract. We present a post-trabeculectomy patient suffering from blurred vision and foreign body sensation that was not alleviated by conventional treatments. Our treatment involved placing a gold weight implant onto the anterior surface of the tarsal plate to gravity-assist closure and increase coverage of the filtering bleb. [Ophthalmic Surg Lasers 2001;32:425-427]
Aureobasidium pullulans Scleritis Following Keratoplasty: A Case Report
Authors: Gupta Viney , Chawla Rohan , Sen Seema
Published: April 2021

Abstract. Fungal scleritis is a rare entity. A 50-year-old patient with culture proven Aureobasidium pullulans corneal ulcer underwent therapeutic keratoplasty. He developed scleritis 5 days following surgery. Although the patient had symptomatic improvement after antifungal therapy, surgical debridement, and cryotherapy, visual improvement was only marginal. Aureobasidium pullukns should be looked for as a cause for keratomycosis and scleromycosis, especially in tropical countries. [Ophthalmic Surg Lasers 2001;32:481-482]
Morphology of the Trabecular Meshwork Three Years After Erbium: YAG Laser Trabecular Ablation
Authors: Dietlein Thomas S , Jacobi Philipp C , Mietz Holger , Krieglstein Gunter K
Published: April 2021

Abstract. Laser trabecular ablation (LTA) is an abinterno approach with the purpose to improve outflow facility by removing trabecular tissue and open Schlemm's canal. In a blind eye with secondary glaucoma following silicone oil surgery, Erbium:YAG LTA had been performed applying 12 neighboring single laser pulses (5-7 mj pulse energy, 200 ps pulse duration) to the trabecular meshwork. Enucleation was performed three years after the procedure that did not achieve pressure control. Light-microscopy revealed neither marked scarring nor endothelial proliferation in the treated trabecular meshwork. However, most of the recognizable ablation craters failed to open Schlemm's canal. Although limited scar formation within the trabecular meshwork after LTA is a promising aspea, the present technique of Er: YAG LTA still needs technical and surgical improvements to guarantee reliable and reproducible openings of Schlemm's canal. [Ophthalmic Surg Lasers 2001;32:483-485]
A Comparative Study of Small Incision Trabeculectomy Avoiding Tenon's Capsule With Conventional Trabeculectomy
Authors: Das J C , Sharma Pankaj , Chaudhuri Zia , Bhomaj Sharad
Published: April 2021

BACKGROUND AND OBJECTIVE: The purpose of this study was to compare the results of small incision trabeculectomy (SIT) avoiding Tenon's capsule vis-à-vis conventional trabeculectomy, and find a safe, effective alternative to conventional trabeculectomy with or without pharmacological wound modulation.

PATIENTS AND METHODS: A controlled prospective study was conducted on 80 consecutive openangle glaucoma patients requiring glaucoma filtration surgery. They were divided into two groups: Group I (n = 40): patients undergoing conventional trabeculectomy; and Group II (n = 40): patients undergoing limbal approach SIT. Patients were followed up serially for a minimum of 12 months and their intraocular pressure was monitored. Success of the procedure was defined as an intraocular pressure (IOP) <22 mm Hg with no additional antiglaucoma médication or surgery, and achieving at least a 30% reduction from the initial IOP at which optic disc cupping and/or visual field changes occurred.

RESULTS: A significant fall (P <0.0001) in the final mean IOP was present in both groups at all time intervals in comparison to their preoperative values. The final mean intraocular pressure achieved with conventional trabeculectomy was 18.90 ± 4.86 mm Hg versus 16.60 ± 5.93 mm Hg with SIT. The final success rate of 90% was obtained with SIT vs 80% with conventional trabeculectomy. No major complications were encountered with either procedure although complications such as shallow anterior chamber and progression of cataractogenesis were seen more often in patients undergoing conventional trabeculectomy.

CONCLUSION: Small incision trabeculectomy avoiding Tenons capsule is a low-cost and safe alternative to conventional trabeculectomy that effectively reduces IOP in 90% of cases. The use of a small 2.5 mm limbal incision, which obviates the dissection of Tenons capsule and absence of any major complication, suggests that this procedure be used more often in glaucomatous eyes needing filtering surgery.

[Ophthalmic Surg Lasers 2002;33:30-36]
Acquired Anterior Ocular Melanocytosis Following Cataract Extraction
Authors: Kiratli Hayyam , Irkeç Murat
Published: April 2021

Abstract. The right eye of a 59-year-old man was the subject of extracapsular cataract extraction and posterior chamber lens implantation. He gradually developed superior sectoral scleral and diffuse iris hyperpigmentation within 7 years postoperatively. The iris was also uniformly thickened. He sustained 20/20 visual acuity in the Pseudophakie eye. Despite marked pigmentation of the angle, his right intraocular pressure remained within normal limits. We use the term acquired anterior ocular melanocytosis because the pigmentary changes were confined to the anterior segment and the choroid was not involved. We conclude that surgical injury in the form of cataract extraction can induce episcleral/scleral hyperpigmentation and iris hyperchromia. [Ophthalmic Surg Lasers 2002; 33:71-73]
Ophthalmoscopy and Vitreoretinal Surgery in Patients With an ARRAY Refractive Multifocal Intraocular Lens Implant
Authors: Mainster Martin A , Reichel Elias , Warren Keith A , Harrington Peter G
Published: April 2021

Abstract. We developed a clinical strategy for dealing with situations in which ophthalmoscopic examination and vitreoretinal surgery are difficult in patients with an ARRAY® refractive multifocal intraocular lens (IOL) implant. The ARRAY zonal-progressive IOL has a central 2. 1 -mm distance-vision zone for optically-unobstructed posterior pole observation. A concentric near-vision zone (+3.5-diopter add) surrounds this central zone. Optical ray-tracing is used to determine how a 2.1-mm pupil limitation restricts monocular and binocular retinal image size in head-mounted, slitlamp, and operating microscope ophthalmoscopy. A 2.1-mm pupil decreases the retinal field of view of high magnification, narrow field lenses much more than that of wider-field, lower magnification lenses. This "worst-case" analysis suggests an ophthalmoscopic strategy, but is not strictly valid for the ARRAY lens because the near-vision zone surrounding its 2.1-mm central zone is not opaque. The near-vision zone contributes defocused information to the ophthalmoscopic image, diminishing its resolution and depth information. Wide-field, low magnification lenses are potentially less problematic than higher magnification lenses for examining and treating patients with an ARRAY IOL implant. This strategy is useful for panretinal photocoagulation or photodynamic therapy, but not for procedures requiring high magnification stereoscopic vision such as macular vitreoretinal surgery. [Opthalmic Surg Lasers 2002;33:74-76]
Treating Cytomegalovirus Retinitis-Related Retinal Detachment By Combining Silicone Oil Tamponade and Ganciclovir Implant
Authors: Martidis Adam , Danis Ronald P , Ciulla Thomas A
Published: April 2021

* BACKGROUND AND OBJECTIVE: With the efficacy of pars plana vitrectomy and silicone oil infusion in treating cytomegalovirus (CMV) retinitis-related retinal detachment and the success of the ganciclovir implant in controlling CMV retinitis, we sought to evaluate the possible benefits of combining these two procedures in one surgical operation.

* PATIENTS AND METHODS: A retrospective review of 10 patients was conducted. Each patient was diagnosed with a CMV retinitis-related retinal detachment and treated with pars plana vitrectomy and silicone oil infusion, with simultaneous placement of a ganciclovit implant. Parameters evaluated included location of retinal detachment, reattachment rate, preand post-operative Snellen visual acuity, pre- and postoperative CMV retinitis activity and location, and complications of the combined procedure.

* RESULTS: Overall anatomic reattachment was achieved in all 10 patients. Four patients presented with macular involvement of their retinal detachments. Three of these patients experienced significant postoperative improvement in visual acuity. Surgery preserved visual acuity in the 6 patients who presented with macula attached. Best postoperative acuity was better than or equal to 20/100 in 7 (70%) patients. All 3 CMV retinitis patients with inactive retinitis preoperatively remained free of retinitis for the duration of follow up. At last follow up, 8/10 (80%) showed no active CMV retinitis and no patients experienced progression of their retinitis.

* CONCLUSIONS: Results of this series indicate that patients benefit from excellent anatomic reattachment rates, preservation or improvement of visual acuity in most cases, and extended control of their CMV retinitis. Combining the two procedures appears viable. Further study is warranted to assess definitive anatomic and functional outcomes resulting from this new technique.

[Ophthalmic Surg Lasers 2002;33:135-139.]
Electrical Cataract: A Case Study
Authors: Chaudhuri Zia , Pandey Pramod K , Bhatia Amit
Published: April 2021

Abstract. A case of bilateral cataract sustained after electrical trauma was seen in a referral practice. We examined a young patient with dense anterior and posterior subcapsular cataract in his right eye and pseudophakia in his left eye who gave a history of gradually progressive painless loss of vision after sustaining injury from a high voltage electric current. Extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (PCIOL) implantation was performed in his right eye. Visual rehabilitation in both eyes after ECCE with PCIOL implantation was good with the patient attaining uncorrected visual acuity of 20/30 in both eyes postoperatively. It appears that the surgical results and visual rehabilitation after ECCE with PCIOL implantation in patients with electrical cataract without any other ocular damage is excellent.

[Ophthalmic Surg Lasers 2002:33;166-168]
Hyperbaric Oxygen Therapy Reduces Visual Field Defect After Macular Hole Surgery
Authors: Kuroki Akiko Mera , Kitaoka Takashi , Taniguchi Hiroyasu , Amemiya Tsugio
Published: April 2021

* BACKGROUND AND OBJECTIVE: One of the serious complications that may arise after macular hole (MH) surgery is a temporal visual fields (TVF) defect. We hypothesized that hyperbaric oxygen (HBO) therapy improves the visual field (VF) in these patients.

* MATERIALS AND METHODS: Vitrectomy for MH was performed on 73 eyes from 1994 to 1997. TVF defect was detected in 19 eyes and, ofthat 19, 12 patients were followed. Seven patients were treated with HBO therapy and 5 were controls. HBO was performed for approximately 110 minutes a day with 100% oxygen inhalation and a maximum of 2.8 atmospheric pressure. This continued for 20 days. The preoperative VF determined by kinetic perimetry was considered to be 100%, and the VF following HBO therapy was compared with that standard.

* RESULTS: We detected VF defect (postoperative VF area average 7 1.9 ± 12.8% of the preoperative VF). In all 5 patients who had no HBO therapy, TVF defects remained, while the TVF recovered remarkably in all patients treated with HBO therapy. The VF recovered to 81 .7- 16.7% of the preoperative VF after 3 days of HBO, and to 9 1.6 ±15.8% months after HBO therapy.

* CONCLUSION: We speculated that the cause of TVT defect is likely to be chorioretinal circulation disturbance during surgery, and that HBO activates the retinal cells and improves VF. We conclude that HBO is useful in the treatment of TVF defect after macular hole surgery.

[Ophthalmic Surg Lasers 2002;33:200-206]
Ultrasound Biomicroscopy of Corneal Hydrops in Terrien's Marginal Degeneration
Authors: Berrocal Audina M , Chen Paul C , Soukiasian Sarkis H
Published: April 2021

Abstract. Terrien's marginal degeneration (TMD) is a rare form of corneal ectasia. Few case reports have documented hydrops of the cornea in patients with TMD. We present the first case known to us of corneal hydrops in TMD where there is stromal edema in addition to the aqueous cystic cavities, and the first case demonstrating ultrastructural anatomy of this entity by ultrasound biomicroscopy. [Ophthalmic Surg Lasers 2002;33:228-230]
Perifoveal Traction Retinal Detachment Following Successful Optic Disc Pit Surgery
Authors: Gotzaridis Eustratios V
Published: April 2021

Abstract. A 25-year-old male presented 8 years after a successful vitreoretinal operation for a left optic disc pit (ODP). On presentation his visual acuity had reduced from 6/5 (20/15) to 6/12 (20/40) in his operated eye. On examination an annular serous retinal detachment possibly secondary to tangential traction by either the internal limiting membrane (ILM) or residual lamellar vitreous cortex or both around the peripheral macular area was seen. The central fovea was flat. Following an uncomplicated vitrectomy and ILM peel, visual acuity improved to 616 (20/20) postoperatively. The author suggests that traction forces are responsible for the development of the serous detachment in eyes with ODP. Epiretinal membranes together with the ILM should be removed in all patients undergoing therapy for a retinal detachment associated with ODP in an effort to initially achieve a further relief of all forces and to try to avoid the late retinal detachment associated with epiretinal membrane or ILM contraction. [Ophthalmic Surg Lasers 2002;33:243-245]
Transient Multifocal Electroretinogram Dysfunction in Multiple Evanescent White Dot Syndrome
Authors: Chen David , Martidis Adam , Baumal Caroline R
Published: April 2021

Abstract. A 22-year-old female patient with acute monocular scotomata after an upper respiratory infection and the fluorescein angiographic findings consistent with the diagnosis of multiple evanescent white dot syndrome (MEWDS) is described. Unlike fullfield ERG, which shows a generalized depressed signal in MEWDS, the authors showed areas of depressions corresponding to the scotomata using multifocal electroretinogram (MFERG). The MFERG abnormalities seen at presentation resolved with the resolution of clinical symptoms after 6 weeks, in contrast to a previous report. The MFERG may be a useful tool to further characterize MEWDS and other blind-spot enlarging syndromes. [Ophthalmic Surg Lasers 2002; 33:246-249]
Late Postoperative Opacification of Hydrophilic Acrylic Intraocular Lenses
Authors: Oner Hakan F , Durak Ismet , Saatci Osman A
Published: April 2021

* BACKGROUND AND OBJECTIVE: To evaluate the incidence of postoperative opacification of hydrophilic acrylic intraocular lenses (IOLs) and discuss the surgical management.

* PATIENTS AND METHODS: Seventy-two eyes of 72 consecutive patients who received the same type of hydrophilic acrylic IOL (Intraocular Optical International, I.O.I., California, USA) after uneventful phacoemulsification were evaluated retrospectively. Systemic status, follow-up time, recognition time of IOL opacification, time lapse between implantation and explantation, and surgical technique during explantation were reported.

* RESULTS: IOL opacification was noted in 3 patients (4.1%). Time lapse between implantation and first recognition of opacification was 6.3 ± 1.5 months (range: 5-8 months). Two of the patients had insulin-dependent diabetes mellitus and both were on renal dialysis for diabetic nephropathy, whereas one had no systemic disease. Opacified hydrophilic acrylic IOLs were exchanged with Acrysof® IOL, and no further opacification occurred after lens exchange.

* CONCLUSION: Use caution on implantation of hydrophilic IOLs because late opacification is a serious complication requiring further surgery.

[Ophthalmic Surg Lasers 2002;33:304-308]
Pars Plana Modified Baerveldt Implant Versus Neodymium:YAG Cyclophotocoagulation in the Management of Neovascular Glaucoma
Authors: Chalam Kakarla V , Gandham Sai , Gupta Shailesh , Tripathi Brenda J , Tripathi Ramesh C
Published: April 2021

* OBJECTIVE: To determine the relative effectiveness of neodymium:YAG cyclophotocoagulation (NCYC) and pars plana modified Baerveldt implant (PPBI) surgery on intraocular pressure (IOP) control in eyes with neovascular glaucoma (NVG).

* PARTICIPANTS: In this retrospective comparative group study, 30 patients with NVG treated with contact NCYC were compared with 18 patients who underwent PPBI. Patients groups were not statistically dissimilar with respect to the underlying disordercausing angle and iris neovascularization, intraocular pressure, and patients age.

* RESULTS: During a follow up of 6 months, an IOP control of ^6 and <21 mm Hg was achieved in 23 eyes (76.6%) treated with NCYC compared with 17 eyes (94.4%) receiving PPBI (P=O. 13). Among eyes that had unsuccessful outcome in both groups, the proportions with persistently high IOP or hypotony were greater in the NCYC group than in the PPBI group. Based on our criteria, the cumulative proportion of failure in the NCYC group was 23.3% at 6 months as compared to 5.6% in the PPBI group. Seven eyes (23.3%) in the NCYC group lost fight perception versus 1 eye (5.6%) in the PPBI group. The incidence of postoperative choroidal effusion (36%) was higher in the PPBI group.

* CONCLUSIONS: This study suggests that in the management of NVG, PPBI surgery more frequently controls IOP in a medically acceptable range with less hypotony and greater preservation of visual acuity than NCYC.

[Ophthalmic Surg Lasers 2002;33:383-393]
Epibulbar Osseous Choristoma: Case Report and Review of the Literature
Authors: Gayre Gregg Samuel , Proia Alan D , Dutton Jonathan J
Published: April 2021

Abstract. Epibulbar osseous choristoma is a choristomatous lesion of the conjunctiva containing bone. Originally called epibulbar osteoma, this lesion was first described by von Graefe in 1863. We discuss a case of a 4-year-old patient who presented with an epibulbar lesion consistent histopathologicaliy with an epibulbar osseous choristoma, and report a review of the literature. The differential diagnosis of osseous choristoma should include classical limbal dermoids, epithelial inclusion cysts, prolapsed orbital fat, papillomas, dermolipomas, and complex choristomas. Although the rarest of epibulbar choristomas, 51 epibulbar osteomas have now been reported in the medical literature. Most commonly, this variety of choristoma presents as an isolated epibulbar lesion within the supratemporal quadrant but may occur in other locations on the surface of the globe and possibly in conjunction with other choristomatous tissue as much as 10% of the time. Frequendy, they may involve the muscle or have dense attachments to the underlying sclera. Osseous choristomas most likely represent congenital lesions with a potential for slow growth but may occur in association with trauma. Options for management include observation or surgical excision. When surgery is contemplated, preoperative radiographic imaging may be helpful for assessing adhesion to the sclera or extraocular muscles.

[Ophthalmic Surg Lasers 2002;33:410-415]
Corneal Burn: A Rare Complication of Radiofrequency Diathermy Capsulotomy
Authors: Tsai Chieh-Chih , Kau Hui-Chuan , Kao Shu-Ching , Hsu Wen-Ming
Published: April 2021

Abstract. We present 2 patients with accidental corneal burns inflicted during clear cornea cataract surgery using radiofrequency diathermy for anterior capsulotomy. During the capsulotomy procedure, the anterior capsule was not opened and only a small air bubble appeared when the energy was turned on. Meanwhile the area of the corneal tunnel that contacted the shoulder of the diathermy tip became opaque and shrank with a small defect in the anterior corneal lip. Postoperatively, focal corneal shrinkage with iris incarceration into the defect of the corneal tunnel and resultant peaking pupil were noted in the 2 patients. The corneal burns resulted in temporary irregular astigmatism with mild visual acuity impairment. To our knowledge, this is the first report of a corneal burn as a complication of radiofrequency diathermy for anterior capsulotomy in clear cornea cataract surgery. [Ophthalmic Surg Lasers 2002;33:430-432]
Scleral Fixation of Posterior Chamber Intraocular Lenses Using Fascia Lata to Cover the Knots
Authors: Bashshur Ziad , Ma'luf Riad , Najjar Dany , Noureddin Baha'a
Published: April 2021

* BACKGROUND AND OBJECTIVE: To describe the use of fascia lata to cover the polypropylene knots of scleral fixated posterior chamber intraocular lenses (PCIOL).

* PATIENTS AND METHODS: Fascia lata was used to cover the knots of scleral fixated PCIOL in 5 eyes with significant scleral thinning. Four of the 5 eyes had the PCIOL insertion and the fascia lata patching in the same setting. The fifth eye previously had scleral fixated PCIOL with late suture erosion through a partial thickness scleral flap.

* RESULTS: There was no suture exposure or graft thinning throughout a follow-up period of 8 to 16 months. The eyes tolerated the fascia lata well with no early or late postoperative complications.

* CONCLUSION: Fascia lata provides an effective means to cover the knots of scleral fixated PCIOL, especially in aphakic patients with significant scleral thinning.

[Ophthalmic Surg Lasers 2002;33:445-449]
Socket Reconstruction With Combined Mucous Membrane and Hard Palate Mucosal Grafts
Authors: Lee Alexander C , Fedorovich Irene , Heinz Grant W , Kikkawa Don O
Published: April 2021

* OBJECTIVE: To evaluate the use of combined mucous membrane and hard palate mucosal grafts in the reconstruction of contracted eye socket.

* PATIENTS AND METHODS: Thirteen eyes of 13 patients with contracted sockets underwent socket reconstructive surgery with combined mucosal membrane and hard palate mucosal grafts.

* RESULTS: The average follow-up period was 33 months. Five of 13 patients required additional surgery after initial socket reconstruction. However, all patients who underwent socket reconstruction with hard palate mucosal grafts were able to wear a cosmetically acceptable ocular prosthesis postoperatively.

* CONCLUSION: Combined mucosal membrane and hard palate mucosal grafts can be effectively used in the reconstruction of contrated sockets.

[Ophthalmic Surg Lasers 2002;33:463-468]
Neodymium:YAG Laser Surgery in the Hospital District of Southwestern Finland During the Years 1987 to 1998
Authors: Saari K Matti , Tornblom Riikka-Maija , Paasio Pekka , Tuominen Juhani
Published: April 2021

* BACKGROUND AND OBJECTIVE: To investigate the annual incidence rates of Neodymium:YAG laser procedures in the treatment of eye diseases.

* PATIENTS AND METHODS: In this population-based retrospective study, we evaluated 6,040 patients treated with a Nd: YAG laser in the hospital district of southwestern Finland during the years 1987 to 1998. The corresponding annual incidence rates of different Nd: YAG laser procedures were calculated using the corrected population statistics of the hospital district.

* RESULTS: The annual incidence rates of all NdYAG laser procedures rose significandy (/*<0.0001) from 32.1 per 100,000 patients in 1987 to 169.0 per 100,000 people in 1998. A great majority of Nd: YAG patients were females with a higher median age than the males in the study (P<0.0001).

* CONCLUSION: The rise of the annual population-based incidence rates of cataract surgery with a 7% to 29% need of Nd: YAG laser capsulotomies explained the increase of all Nd: YAG laser procedures.

[Ophthalmic Surg Lasers 2002;33:475-479]
Müller's Muscle-Conjunctival Resection for Blepharoptosis With Poor Levator Function
Authors: Cohen Adam J , Weinberg David A
Published: April 2021

Abstract. We describe a patient with blepharoptosis, poor levator function, and a positive phenylephrine test who responded favorably to Müller's muscle-conjunctival resection, alleviating the need for a frontalis suspension ptosis repair in the presence of very deep superior sulci. [Ophthalmic Surg Lasers 2002;33: 491-492]
Vitreous Surgery for Bilateral Bullous Retinal Detachment in Vogt-Koyanagi-Harada Syndrome
Authors: Gaun Satoko , Kurimoto Yasuo , Komurasaki Yusuke , Yoshimura Nagahisa
Published: April 2021

Abstract. A successful surgical treatment (vitrectomy) for bilateral bullous retinal detachment in a patient with Vogt-Koyanagi-Harada (VKH) disease is reported. A 78-year-old woman had severe reduction of visual acuity in both eyes because of an extremely bullous nonrhegmatogenous retinal detachment accompanied by VKH disease. We performed lens extraction and vitrectomy on both eyes combined with systemic and topical corticosteroid therapy. The retina was reattached immediately after the surgery and her visual acuity promptly improved in both eyes. She had no recurrence of retinal detachment even after tapering the dose of corticosteroid. We suggest that vitrectomy may be an effective therapeutic option in the treatment for severe bullous retinal detachment associated with VKH disease. [Ophthalmic Surg Lasers 2002; 33:508-510]
Management of IRVAN Syndrome With Observation
Authors: Basha Madhi , Brown Gary C. , Palombaro Geremie , Shields Carol L. , Shields Jerry A.
Published: April 2021

A 7-year-old girl with IRVAN (idiopathic retinal vasculitis, aneurysms, and neuroretinitis) syndrome was monitored for 9 years. The patient had symmetric multiple aneurysmal dilations, retinal vasculitis, and severe hard exudation in the macula bilaterally. Long-term visual acuity in her untreated right eye was 20/25. In the left eye, treated with laser panretinal photocoagulation and intravitreal vascular endothelial growth factor inhibitor therapy, visual acuity decreased to 20/200 from macular hard exudates and central fibrovascular tissue. Observation is a consideration in IRVAN syndrome if the vision remains good with hard exudation.

[
Ophthalmic Surg Lasers Imaging Retina
. 2014;45:e18–e22.]
Interview Administration of PROMIS Depression and Anxiety Short Forms
Authors: Taple Bayley J. , Griffith James W. , Wolf Michael S.
Published: April 2021

Background:

Health literacy reflects a person's reading and numeracy abilities applied to understanding health-related information. These skills may influence how patients report symptoms, leading to underestimates or overestimates of symptom severity. No prior studies have examined health literacy measurement bias.

Objective:

The purpose of the current study was to determine whether PROMIS (Patient-Reported Outcomes Measurement Information System) anxiety and depression short forms, administered by interview, capture symptoms equally across health literacy groups. We examined the psychometric properties of PROMIS anxiety and depression short forms using differential item functioning (DIF) analysis by level of health literacy.

Methods:

The sample analyzed included 888 adults, age 55 to 74 years, in Chicago, IL. Health literacy was measured using the Test of Functional Health Literacy in Adults. PROMIS short forms assessed anxiety and depression.

Key Results:

DIF was present in 3 of 8 depression items, and 3 of 7 anxiety items. All items flagged for DIF had lower item-slopes for people with limited health literacy.

Conclusions:

Items with DIF were less strongly related to anxiety and depression, and thus less precise. Overall, impact of DIF on PROMIS scores was negligible, likely mitigated by interview administration. Although overall test impact of health literacy was minimal, DIF analyses flagged items that were potentially too complex for people with limited health literacy. Design and validation of patient-reported surveys should incorporate respondents with a range of health literacy and methods to identify and reduce measurement bias.

[
HLRP: Health Literacy Research and Practice
. 2019;3(3):e196–e204.]

Plain Language Summary:

This study suggests that people with limited health literacy may respond differently to questions about depression and anxiety than people with adequate health literacy. Therefore, it is important to be aware of differences in literacy ability when creating and using questionnaires.
Identification of counterfactuals in dynamic discrete choice models
Authors: Kalouptsidi Myrto , Scott Paul T. , Souza-Rodrigues Eduardo
Published: April 2021

Dynamic discrete choice (DDC) models are not identified nonparametrically, but the non‐identification of models does not necessarily imply the nonidentification of counterfactuals. We derive novel results for the identification of counterfactuals in DDC models, such as non‐additive changes in payoffs or changes to agents' choice sets. In doing so, we propose a general framework that allows the investigation of the identification of a broad class of counterfactuals (covering virtually any counterfactual encountered in applied work). To illustrate the results, we consider a firm entry/exit problem numerically, as well as an empirical model of agricultural land use. In each case, we provide examples of both identified and nonidentified counterfactuals of interest.
Where did it go wrong? Marriage and divorce in Malawi
Authors: Cherchye Laurens , De Rock Bram , Vermeulen Frederic , Walther Selma
Published: April 2021

Do individuals marry and divorce for economic reasons? Can we measure the economic attractiveness of a person's marriage market? We answer these questions using a structural model of consumer‐producer households that is applied to rich data from Malawi. Using revealed preference conditions for a stable marriage market, we define the economic attractiveness of a potential match as the difference between the potential value of consumption and leisure with the new partner and the value of consumption and leisure in the current marriage. We estimate this marital instability measure for every possible pair in geographically defined marriage markets in 2010. We find that the marital instability measure is predictive of future divorces, particularly for women. We further show that this estimated effect on divorce is mitigated by the woman's age, and by a lack of men, relative to women, in the marriage market, showing that these factors interact with the economic attractiveness of the remarriage market. These findings provide out‐of‐sample validation of our model and evidence that the economic value of the marriage market matters for divorce decisions.