bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Two Microkeratome Systems
Authors: Binder Perry S , Moore Max , Lambert Robert W , Seagrist Debra McCoy
Published: April 2021

ABSTRACT

BACKGROUND: Microkeratomes are currently used for keratomiluesis in situ (automated lamellar keratoplasty) for myopia and hyperopia and for laser in situ keratomileusis (LASIK). Visual and refractive complications have been reported with these refractive surgical procedures. We compared two microkeratomes in their ability to resect corneal lamellae to gain insight into possible mechanism(s) of refractive and visual complications following lamellar refractive procedures.

METHODS: Using an eyebank eye model, we performed automated lamellar keratoplasty to theoretically correct 10.00 diopters (D) of myopia using the Automated Corneal Shaper, manufactured by Chiron, Inc. and the MicroPrecision microkeratome, manufactured by Eye Technology, Inc. Diameters before (wet) and after fixation, thicknesses of excised tissue, and scanning electron microscopy were measured in a masked evaluation to compare instruments. Ultrasonic corneal pachymetry and a mechanical tissue compression gauge were also used to assess thickness of excised tissue.

RESULTS: The Chiron automated corneal shaper created blade chatter marks at the edges of all excisions, smaller than anticipated excision diameters, and a wide range of tissue thicknesses. In contrast, the MicroPrecision microkeratome created smoother resections of all tissues without creating blade marks; tissue diameters and thicknesses were closer to the intended dimensions compared to the Chiron automated corneal shaper.

CONCLUSION: Different microkeratomes create different morphologic features as they excise corneal tissue. Differences in instrument design, mechanics of the tissue excision and blade oscillation, and instrument traverse combined with surgical skill influence the configuration of lamellar keratotomies. [J Refract Surg 1997;13:142-153]
Effect of Diclofenac on Prostaglandin Liberation in the Rabbit after Photorefractive Keratectomy
Authors: Tomas-Barberan S , Törngren L , Lundberg K , Fagerholm P , Rolfsen W
Published: April 2021

ABSTRACT

BACKGROUND: An analyses of the concentration of arachidonic acid metabolites and the infiltration of leukocytes in the aqueous humour of rabbits after excimer laser keratectomy was performed. The ability of topical diclofenac to block prostaglandin E
2
liberation into the aqueous humour was also investigated.

METHODS: Photorefractive keratectomy was performed on both eyes of 60 New Zealand rabbits. Prostaglandin E
2
, 6-keto prostaglandin F^sub 1α^ and thromboxane B2 were detected by radioimmunoassay and leukocytes were counted in the aqueous humour for 120 hours postoperatively. Topical diclofenac was instilled (1 drop/4h) in six animals and prostaglandin E
2
was analyzed in the aqueous humour 16 hours postoperatively.

RESULTS: The prostaglandin E
2
concentration in the aqueous humour increased from 13 in control animals, to 251 pg/100µl at 16 hours after treatment (p<0.05). A statistically significant elevation in the aqueous concentration of 6-keto prostaglandin F^sub 1α^ could not be demonstrated. Thromboxane B2 and leukocytes could not be detected at any time point. Topical diclofenac (1 drop/4h) reduced the levels of prostaglandin E
2
in the aqueous humour below 10 pg/100µl, 16 hours postoperatively.

CONCLUSION: Topical diclofenac (1 drop/4h) inhibited prostaglandin E
2
release into the aqueous humour. [J Refract Surg 1997;13:154-157]
Excimer Laser Photorefractive Keratectomy for Hyperopia
Authors: Danjoux Jean-Pierre , Kalski Richard S , Cohen Peter , Lawless Michael A , Rogers Christopher
Published: April 2021

ABSTRACT

OBJECTIVE: To prospectively study excimer laser correction of hyperopia, with a 1-year followup.

METHODS: Eleven consecutive hyperopic eyes (10 phakic and 1 aphakic) underwent correction of hyperopia using the Summit Technology SVS Apex Plus excimer laser. Data collection included cycloplegic refraction, spectacle-corrected visual acuity, contrast sensitivity, corneal haze, manual keratometry, and videokeratography. Prior to treatment the mean hyperopic spherical equivalent refraction (corneal plane) was +5.80 diopters (D)(SD 2.10). The mean attempted correction was +3.09 D at the corneal plane.

RESULTS: Refractive data for the group showed a mean overcorrection at 1 month of +3.18 D. This regressed slightly before stabilizing at 3 months, with a mean overcorrection of +1.88 D. Thereafter there was no statistically significant fluctuation in refraction ip = 0.67). The amount of overcorrection and regression was greater in eyes that received higher corrections. Changes in manual keratometry and videokeratography mirrored the attempted correction more closely than refraction, although stabilization did not occur until 6 months.

CONCLUSIONS: Because the hyperopic correction achieved when measured by refraction was greater than expected, algorithms should be adjusted. The hyperopic erodible disc and Axicon lens system is capable of treating low to moderate amounts of hyperopia. [J Refract Surg 1997; 13:349355]
Effect of Topical Tranilast and Corticosteroids on Subepithelial Haze after Photorefractive Keratectomy in Rabbits
Authors: Furukawa Hiroyuki , Nakayasu Kiyoo , Gotoh Toshiko , Watanabe Yasuo , Takano Toshiyuki , Ishikawa Takashi , Kanai Atsushi
Published: April 2021

ABSTRACT

BACKGROUND: Tranilast (trade name Rizaben), an anti-allergic drug with anti-inflammatory effects, is thought to inhibit synthesis of extracellular matrix of fibroblasts through the suppression of TGF-ß. We evaluated the effect of topical tranilast on the subepithelial haze that developed after excimer laser keratectomy and its effect was compared with that of betamethasone eye drops

METHODS: Excimer laser keratectomy (phototherapeutic keratectomy mode) was performed with the Nidek EC-5000 excimer laser on 16 rabbit corneas (eight rabbits). From the second postoperative day, topical 2% tranilast was instilled in the right eye and the control solution in the left eye, four times daily. Until the fourth week after the operation, we measured the densitometric values of scattered light intensity of the subepithelial haze with an anterior ocular analyzer, EAS-1000 (Nidek). At the fifth postoperative week, light and electron microscopy and immunohistochemistry with an antibody to TGF-ß were also performed.

RESULTS: Densitometric values of the subepithelial haze in the corneas treated with 2% tranilast were slightly less than those of the subepithelial haze in the control corneas. However, the values of the subepithelial haze in the betamethasonetreated corneas were significantly less than those in control corneas. Histochemical examinations revealed that topical tranilast had a small effect on the subepithelial haze after excimer laser keratectomy in rabbits.

CONCLUSION: Topical 0.1% betamethasone can limit the amount of subepithelial haze and tranilast may inhibit development of subepithelial haze by the suppression of TGF-ß. [J Refract Surg 1997; 13(suppl):S457-S458]
Corneal Asphericity in Eye Bank Eyes Implanted with the Intrastromal Corneal Ring
Authors: Burris Terry E , Holmes-Higgin Debby K , Silvestrini Thomas A , Scholl John A , Proudfoot Robert A , Baker Phillip C
Published: April 2021

ABSTRACT

OBJECTIVE: To evaluate the effects of the intrastromal corneal ring, a device developed to reduce myopia, on corneal asphericity in a large set of eye bank eyes.

METHODS: Forty-one deturgesced eye bank eyes were implanted with intrastromal corneal rings of five different thicknesses, ranging from 0.25 mm to 0.45 mm. Corneal asphericity, before and after implantation, was examined using two different metrologies. Corneal asphericity profiles were produced from dioptric power data collected from videokeratography. To statistically assess the corneal asphericity differences between exam times for each intrastromal corneal ring thickness, dependent sample confidence intervals (95%) were calculated for the mean differences between preoperative and postoperative measures for each topographic diameter zone. Laser holographic interferometry was used to inspect corneal asphericity in one eye bank eye case study for four intrastromal corneal ring sizes. Wave unit map and geometric zonal spot ray tracing analyses derived from laser holographic interferometry topography were surveyed.

RESULTS: Videokeratographic analysis suggested that preoperative corneal shape was prolate, ie, flattened from central to paracentral cornea. Corneal shape became more prolate with intrastromal corneal ring implantation for all intrastromal corneal ring thicknesses. Laser holographic interferometry demonstrated that prolate asphericity was preserved with the intrastromal corneal ring sizes tested and that optical collection efficiency of the cornea was not diminished.

CONCLUSION: Using two different measurement techniques, this eye bank eye study demonstrated that intrastromal corneal rings maintain prolate corneal asphericity. [J Refract Surg 1997;13:556-567]
Dichlorotriazinyl Aminofluorescein Inhibits Human Keratocyte Proliferation in Vitro
Authors: Rofougaran Roya , Pakkar Alireza , Wee Won Ryang , McDonnell Peter J
Published: April 2021

ABSTRACT

PURPOSE: Dichlorotriazinyl aminofluorescein (DTAF) has been used to stain corneal stromal collagen as part of in vivo experimentation. Toxicity of this drug, if present, might alter the observed wound healing. To determine if this drug has any deleterious effect on keratocytes, we evaluated it in vitro.

METHODS: Human keratocytes in 96 well plates were exposed to different concentrations of DTAF (10e-7, 10e-6, 10e-5, 10e-4, 10e-3, 10e-2, and 1Oe-I mg/ml of media). Exposure times of 1 and 24 hours at each concentration of DTAF were evaluated. The cell number was measured 1 and 3 days after exposure to the drug using a coulter-counter and a hemocytometer.

RESULTS: The proliferation of keratocytes after 24 hours of exposure to the drug was inhibited in a dose dependent manner by DTAF, but 1 hour exposure of keratocytes to the drug did not inhibit keratocyte proliferation.

CONCLUSION: These results suggest that DTAF has inhibitory effects on human keratocyte proliferation after 24 hours of exposure, while exposure limited to 1 hour does not induce such a change. [J Refract Surg 1997;13:568-570]
Photorefractive Keratectomy For Hyperopia and Aphakia with a Scanning Spot Excimer Laser
Authors: Sener Bozkurt , Özdamar Akif , Aras Cengiz , Yanyali Ates
Published: April 2021

ABSTRACT

OBJECTIVE: To study the safety, efficacy, predictability, and stability of photorefractive keratectomy (PRK) for hyperopia and aphakia.

METHODS: Fifteen eyes of 15 patients (mean age, 33 ± 5.95 yrs) were enrolled in the study and divided into three groups. The first group was comprised of six eyes that had hyperopia ranging from +1.75 to +4.75 D; the second group had seven hyperopic eyes ranging from +5.00 to +9.75 D; the third group included two eyes of two aphakic patients. All eyes had PRK with a 193 nm argon fluoride excimer laser (Chiron-Technolas, Keracor 116) with a 10 Hz repetition rate and a fluence of 120 mJ/cm2. The total follow-up time in all eyes was 12 months.

RESULTS: In the lower hyperopia group, 0% eyes were within ±0.50 D and 66% (N=4) of eyes were within ±1.00 D of emmetropia with the other two eyes between +1.00 and +2.00 D at 1 year after PRK In the higher hyperopia group, all eyes had at least +3.00 D of hyperopia at 1 year. In the aphakic group, both eyes achieved less than 50% of the target correction of +10.00 D at 1 year. Final uncorrected visual acuity ranged from 20/20 to 20/30 in the lower hyperopia group, 20/30 to 20/50 in the higher hyperopia group, and count fingers in the aphakic group.

CONCLUSIONS: PRK is a relatively safe, stable, and effective procedure with reasonably good predictability for eyes with less than +5.00 D of baseline hyperopia, and poor predictability for eyes with more than +5.00 D of baseline hyperopia. PRK is ineffective in the correction of aphakia. [J Refract Surg 1997;13:620-6231
Endotoxin Levels in Steam and Reservoirs of Table-top Steam Sterilizers
Authors: Whitby James L , Hitchins Victoria M
Published: April 2021

ABSTRACT

PURPOSE: To document endotoxin levels in "Statim" cassette sterilizer reservoirs and in steam delivered to the cassette in the unwrapped instrument cycle. To document endotoxin levels in sterilizer reservoir water using different management protocols.

METHODS: Endotoxin levels were determined using the Limulus Amebocyte Lysate test. Endotoxin preparations were from Escherichia coli and Ralstonia pickettii. All samples were collected in depyrogenated glassware and stored at -20°C until assayed.

RESULTS: The majority of water samples contained <1.0 Endotoxin Unit (EU)/mL The highest level found in sterilizers in clinical use was 5.3 EU/ml. Endotoxin was not detected in steam condensate within the limits of the assay. When the endotoxin level in the reservoir water was experimentally enhanced to 200 EU/ml, cassette steam condensate endotoxin levels were from 0.5% to 5% of the reservoir level. Daily and weekly emptying of the cassette reservoir consistently yielded low endotoxin levels as did monthly emptying, but with the latter there was a trend toward higher levels that favors weekly emptying as a precautionary measure.

CONCLUSIONS: Endotoxin levels in the reservoirs of 23 sterilizers involving 240 samplings were never high enough to yield detectable endotoxin levels in steam in the sterilizer cassette. Regular weekly emptying of sterilizer reservoirs would eliminate the risk of endotoxin transfer during steam sterilization. [J Refract Surg 2002;18:51-57]
Comparison of Placido-based, Rasterstereography, and Slit-scan Corneal Topography Systems
Authors: Guarnieri Fabio A , Guarnieri José C
Published: April 2021

ABSTRACT

PURPOSE: Elevation-based topography systems have received growing recognition. We compared a Placido-based (EyeSys), a rasterstereography (PAR), and a slit-scan system (Orbscan) for human subjects.

METHODS: Measurements were obtained from 221 eyes of 119 human subjects. We made statistical comparisons central curvature, keratometric curvatures, and meridians between the three systems. We also compared the optical pachymetry of the slit-scan system with an ultrasonic device. We analyzed cases of subclinical keratoconus, central island, photorefractive keratectomy for myopia, and hyperopia correction with arcuate keratotomy.

RESULTS: The statistical comparison showed better correlation between the Placido-based and the rasterstereography systems in measurement of central curvature (R=0.95). The slit-scan system showed better correlation with the Placido system in the preoperative and postoperative radial keratotomy group (R=0.73) than in the group that included postoperative PRK eyes (R=0.69). Similar results were obtained for keratometric curvatures and meridians. The Orbscan pachymetry correlation with ultrasonic was R=0.69 and increased when the postoperative PRK eyes were excluded (R=0.95).

CONCLUSIONS: Slit-projection topography and pachymetry seemed to be affected by hydration in the postoperative PRK group. The pachymetric map was useful in predicting the final outcome of refractive surgery and in the diagnosis of keratoconus. [J Refract Surg 2002;18:169-176]
Anterior Corneal Surface After Nidek EC-5000 Multipass and Multizone Photorefractive Keratectomy for Myopia
Authors: Rosa Nicola , Lanza Michele , De Rosa Giuseppe , Romano Antonio
Published: April 2021

ABSTRACT

PURPOSE: To evaluate the correlation between the presence of irregularities in corneal ablation and the number of ablation zones with multipass and multizone photorefractive keratectomy (PRK).

METHODS: The differential maps obtained from corneal topography performed before and 1 month after PRK in 62 eyes that had undergone PRK with the Nidek EC-5000 excimer laser were assessed for irregularities. PRK treatment ranged from -1.00 to -16.00 D (mean -5.25 ? 2.72 D), and the number of zones ranged from one to five.

RESULTS: Of 62 differential maps, 27 had an irregular pattern according to the Hersh classification, with a non-significant correlation with the number of treatment zones (chi2 = 5.09, P>.1).

CONCLUSION: Our results suggest that corneal topography irregularities arising from multizone PRK were not related to the amount of treatment or to the number of ablation zones. [J Refract Surg 2002;18:460-4621
Enlargement of the Temporal Clear Corneal Cataract Incision to Treat Pre-existing Astigmatism
Authors: Rao Sanjay N , Konowal Alexandra , Murchison Allison E , Epstein Randy J
Published: April 2021

ABSTRACT

PURPOSE: To evaluate the effect of enlarging the temporal clear corneal cataract incision on preexisting against-the-rule astigmatism.

METHODS: We performed a prospective study of 21 eyes of 21 consecutive patients with astigmatism greater 3*1.75 D, who underwent temporal clear corneal cataract surgery by phacoemulsification. Patients were divided into two groups. The first group, with medium astigmatism, consisted of 14 patients (14 eyes) with 1.75 to 2.74 D of againstthe-rule astigmatism, and had an incision enlarged to 4.5 mm. The second group, with higher astigmatism, consisted of seven patients (seven eyes) with 2.75 to 3.75 D of against-the-rule astigmatism and had an incision enlarged to 5.5 mm. Corneal topography was performed preoperatively and 24 months postoperatively on all eyes. Surgically induced cylinder changes were compared by examining preoperative and postoperative keratometric power using vector analysis.

RESULTS: Mean preoperative cylinder in the medium against-the-rule astigmatism group was 2.10 ± 0.23 D and mean postoperative cylinder at 3 months was 1.17 ± 0.29 D. Using vector analysis, mean change in cylinder in the medium group was 0.93 ± 0.42 D (P<001). In the higher against-the-rule astigmatism group, mean preoperative cylinder was 2.85 ± 0.10 D and mean postoperative cylinder at 3 months was 1.63 ± 0.38 D. Mean change in cylinder in the higher astigmatism group was 1.34 ± 0.58 D (P<001). For both groups, Student's f-test showed that the postoperative decrease in cylinder was statistically significant (P=.005).

CONCLUSION: By enlarging the size of the standard (2.8 to 3.5 mm) temporal clear corneal cataract incision, pre-existing against-the-rule astigmatism was reduced. [J Refract Surg 2002;18:463-467]
Artisan Phakic Iris Claw Intraocular Lens for High Primary and Secondary Hyperopia
Authors: Alió Jorge L , Mulet M Emilia , Shalaby Ahmad M M
Published: April 2021

ABSTRACT

PURPOSE: To evaluate the efficacy, predictability, and safety of the Artisan iris claw phakic intraocular lens for the correction of high primary and secondary hyperopia.

METHODS: Fifty-seven eyes were divided into two groups: 29 eyes had primary hyperopia (mean refraction 6.06 ± 1.26 D, and 28 eyes had secondary hyperopia, (mean refraction 5.88 ± 1.88 D) induced or residual following a previous corneal refractive procedure. Consecutive implantation of the Artisan iris claw phakic intraocular lens was performed. Main outcome measures recorded were BSCVA, UCVA, refraction, and astigmatic change, intraocular inflammation, and endothelial cell loss.

RESULTS: Primary hyperopic group: Preoperatively, mean UCVA was 0.4 ± 0.7 and mean BSCVA was 0.2 ± 0.6. After implantation, mean UCVA was 0.3 ± 0.6 and BSCVA was 0.1 ± 0.6. Mean cycloplegic residual spherieal refractive error after surgery was 0.10 ± 0.57 D (range -1 to +2 D). Mean surgically induced astigmatism was 1.48 ± 0.89 D. Safety index was 1.11. Efficacy index was 0.83. Secondary hyperopic group: Preoperatively, mean UCVA was 0.5 ± 0.7 and mean BSCVA was 0.2 ± 0.6. Postoperatively, mean UCVA was 0.4 ± 0.7 and mean BSCVA was 0.2 ± 0.6. Mean cycloplegic residual spherical refractive error was 0.55 ± 1.49 D. Mean surgically induced astigmatism was 1.85 ± 1.19 D. Safety index was 1.05. Efficacy index was 0.7. Postoperative iridocyclitis was observed in one eye (3.4%) in the primary group and in three eyes (10.7%) in the secondary group. Overall corneal endothelial cell loss at 1 year of follow-up was 9.4%.

CONCLUSION: The Artisan iris claw phakic intraocular lens was reasonably safe and predictable for correcting high hyperopia. [J Refract Surg 2002;18:697-707]
Diffuse Lamellar Keratitis and Flap Margin Epithelial Healing After Laser in situ Keratomileusis
Authors: Asano-Kato Naoko , Toda Ikuko , Tsuruya Tomoko , Takano Yoji , Tsubota Kazuo
Published: April 2021

ABSTRACT

PURPOSE: To evaluate whether wound healing of the corneal epithelium at the flap margin influences development of diffuse lamellar keratitis (DLK) after laser in situ keratomileusis (LASIK).

METHODS: We examined prospectively 1928 eyes of 994 patients after LASIK. Condition of wound healing at the flap margin 1 day after LASIK was graded as gutter score from 0 to 3, according to the extent of fluorescein staining. Existence of DLK, gutter score, and the location of DLK and gutter were evaluated.

RESULTS: Sixty-eight eyes (3.5%) developed DLK. The average gutter score was significantly higher in patients with DLK compared to those without DLK (P<.001). The location of DLK was identical to the location of gutter in 44 eyes (77.2%).

CONCLUSION: Disruption of integrity of the epithelial barrier function at the flap margin was associcated with diffuse lamellar keratitis after laser in situ keratomileusis. [J Refract Surg 2003; 19:30-33]
Equation for Corneal Asphericity After Corneal Refractive Surgery
Authors: Jiménez José R , Anera Rosario G , del Barco Luis Jiménez
Published: April 2021

ABSTRACT

PURPOSE: To determine the exact theoretical asphericity after refractive surgery when the parabolic approximation of the Munnerlyn formula is utilized.

METHOD: From a least-square analysis and considering the conicoid model for anterior cornea, we calculated the final asphericity (p '-factor) from the preoperative asphericity and the radii before and after surgery.

RESULTS: The final p-factor is given by p'=p(R'3/R3); R is the final radius of curvature; R is the preoperative radius; and p is the preoperative p'-factor.

CONCLUSIONS: This equation for postoperative asphericity may be useful in studying the influence on asphericity of different surgical variables. It allows comparisons of real asphericity with the asphericity that should theoretically result. It also explains the increased spherical aberration after refractive surgery and the deterioration of retinal image quality that some authors have found experimentally. [J Refract Surg 2003;19:65-69]
Efficacy of Phototherapeutic Keratectomy in Various Superficial Corneal Pathologies
Authors: Moniz Noel , Fernandez S Tony
Published: April 2021

ABSTRACT

PURPOSE: To study the use of phototherapeutic keratectomy in the treatment of various corneal pathologies.

METHODS: We performed a nonrandomized consecutive study of patients who presented with superficial corneal diseases and poor vision. After slit-lamp microscopy, 31 eyes were included: corneal dystrophies, 20 eyes; pterygium, 1 eye; recurrent erosions, 3 eyes; superficial corneal opacities, 6 eyes; band-shaped keratopathy, 1 eye. All patients were treated with the Nidek EC-5000 excimer laser following manual epithelial debridement. A central 6.0 to 7.5-mm zone was treated with a surrounding 1-mm blend zone. Ablation zone diameter was determined by surgeon preference, presence of pannus, and overall corneal diameter. Follow-up ranged from 6 to 24 months, with a mean of 1 year.

RESULTS: Epithelial healing occurred between 3 and 8 days in most eyes. Patients were followed for a minimum of 1 year. More than 50% of patients gained more than 2 Snellen lines; 12% for whom PTK was done for recurrent corneal erosions were symptomatically better. No eye was retreated. One patient with band keratopathy did not improve. Delayed epithelial healing occurred in three eyes. A trace to mild reticular subepithelial stromal haze was present in most eyes. Most patients showed a tendency to shift toward hyperopia.

CONCLUSION: Phototherapeutic keratectomy may facilitate better visual acuity and reduced photophobia in eyes with various corneal pathology. Proper case selection is crucial. [J Refract Surg 2003;19(suppl):S243-S246]
Two-stage Laser in situ Keratomileusis to Correct Refractive Errors After Penetrating Keratoplasty
Authors: Busin Massimo , Zambianchi Luca , Garzione Federico , Maucione Vincenzo , Rossi Scipione
Published: April 2021

ABSTRACT

PURPOSE: To evaluate the effect of a two-stage laser in situ keratomileusis (LASIK) procedure on eyes with high astigmatism and/or anisometropia after penetrating keratoplasty.

METHODS: Eleven postoperative penetrating keratoplasty eyes were included in a prospective, non-controlled study. All patients had at least 4.00 D of astigmatism and/or at least 3.00 D of anisometropia and were spectacle and contact lens intolerant. Two-stage LASIK was performed; in the first stage a hinged corneal flap 160 µm in thickness and 9 mm in diameter was created. After stabilization of corneal shape (1 to 3 months after keratotomy), the corneal flap was lifted and laser refractive treatment (second stage) was performed.

RESULTS: After the first stage, a statistically significant reduction in refractive astigmatism (P<.01) was recorded. In all eyes but one, best spectacle-corrected visual acuity was maintained or improved after the procedure. Three months after the second stage, refractive astigmatism in 8 of 11 eyes (73%) was within ±1.00 D, and spherical equivalent refraction in 9 of 11 eyes (82%) was within ±1.00 D of intended correction. Preoperative irregular astigmatism persisted in three patients (3 eyes) who could not be corrected within ±1.00 D of refractive astigmatism and/or ±1.00 D of intended spherical equivalent refraction. In one eye, an interface infiltrate developed shortly after creation of the flap, and resulted in limited melting.

CONCLUSIONS: A two-stage LASIK procedure improved visual acuity and refraction in postoperative penetrating keratoplasty eyes with high astigmatism and/or anisometropia. Complications were uncommon but can lead to loss of vision. [J Refract Surg 2003;19:301-308]
Mesopic Contrast Sensitivity Function After Laser in situ Keratomileusis
Authors: Montés-Micó Robert , España Enrique , Menezo Jose L
Published: April 2021

ABSTRACT

PURPOSE: To evaluate contrast sensitivity under mesopic conditions in patients who have undergone uncomplicated bilateral laser in situ keratomileusis (LASIK) for myopia.

METHODS: Best-corrected monocular contrast sensitivity was measured with the Stereo Optical F.A.C.T. chart at 1.5, 3, 6, 12, and 18 c/deg in 20 patients (20 left eyes) before and after bilateral LASIK (with the Nidek EC-5000 excimer laser and the Automated Corneal Shaper). Mean preoperative refractive error was -6.40 ± 1.28 D (range -4.00 to -8.00 D) and postoperative mean refractive error was -0.41 ± 0.45 D (range -0.75 to +0.50 D). Contrast sensitivity function was measured before and 6 months after surgery using four different chart luminances: 85, 5, 2.5, and 0.1 cd/m
p 2
, the first being a photopic level and the rest mesopic. Log contrast sensitivity values at each spatial frequency were used for statistical analysis and normalized values for graphical representation.

RESULTS: Contrast sensitivity of postoperative LASIK eyes did not differ from preoperative values at a photopic level (85 cd/m
p 2
). However, under mesopic conditions (5 cd/m
p 2
or less) a statistically significant reduction (P<.01) in contrast sensitivity was found at high spatial frequencies (12 and 18 c/deg), although no significant contrast sensitivity differences were observed at low and middle spatial frequencies (P>.01 for 1.5, 3 and 6 c/deg).

CONCLUSIONS: LASIK induced significant reductions in contrast sensitivity under mesopic conditions only at high spatial frequencies, even though the photopic contrast sensitivity function was normal. [J Refract Surg 2003;19:353-356]
Nausea and Vomiting After Local Anesthesia for Cataract Extraction in Elderly Female Patients - Effect of Droperidol Premedication
Authors: Karhunen Ulla , Orko Riitta
Published: April 2021

SUMMARY

One hundred fifty elderly female patients undergoing cataract extraction were divided into three groups. Fifty patients were premedicated with droperidol, pethidine and atropine; another group of 50 patients with pethidine and atropine. They were operated on under local anesthesia. The control group consisted of 50 patients premedicated with pethidine and atropine, and they were given general anesthesia. Postoperative nausea and vomiting were registered until noon the next day. Comparison of different groups showed that droperidol decreases the occurrence of postoperative sickness.
Modern Eye Banking
Authors: Aquavella James V
Published: April 2021

SUMMARY

Ophthalmology has accepted the primary responsibility for supervision and control of the medical aspect of eye banking. Operating within the framework of the American Academy of Ophthalmology and the Eye Bank Association of America, Medical Standards have been promulgated which recognize the need for standardization and quality control throughout the eye banking procedures.1 The role of the Medical Director and the Medical Standards Committee has been strengthened. Challenges to be met include increasing the supply of donor tissue, the development of a statistical data base, research to expand endothelial viability, the incorporation of new technology, and the necessity to develop resources to combat an increasingly hostile financial and political environment in our nation's hospitals.
Blepharospasm: A Surgical Procedure for Therapy
Authors: Battista Arthur F
Published: April 2021

SUMMARY

Seventeen patients with intractable blepharospasm underwent bilateral percutaneous fractional thermolytic destruction of branches of the facial nerve. Thirteen were women and four men; their ages ranged from 46 to 76 years with an average of 62 years. Since local and intravenous analgesia were used, the patients were awake and cooperative, resulting in minimal complications. In this series, patients had an average improvement of 69%. Minimal scarring results from the percutaneous route and these patients may undergo staged procedures for further relief of their symptoms.
Congenital Rotary Nystagmus Associated with Head Turning - Successful Surgical Management
Authors: Estes Robert L , Sandall Gary S , Martonyi Jean
Published: April 2021

SUMMARY

Congenital nystagmus is a rhythmic ocular oscillation usually in the horizontal plane which may be associated with a significant head turn, tilt, or tip to achieve maximal damping of eye movements and improved vision. Purely rotary congenital nystagmus associated with head turn is unusual. This report outlines findings in a case of congenital rotary nystagmus with a functionally significant 30-degree head turn and describes successful surgical management. Current management of patients with congenital nystagmus is discussed.
Use of Sodium Hyaluronate in Reformation and Reconstruction of the Persistent Flat Anterior Chamber in the Presence of Severe Hypotony
Authors: Fisher Yale L , Turtz Arnold I , Gold Melanie , Cohen Ben Z , Uram Martin
Published: April 2021

SUMMARY

Sodium hyaluronate (Healon)is a n aid in the surgical management of anterior chamber reformation and lysis of irodocorneal, vitreocorneal adhesions. Patients with aphakic persistent flat chambers, iris and vitreocorneal adherence associated with severe hypotony, and large choroidal separations are more easily treated with this new viscoelastic material.
A Practical Approach to the Management of Lacrimal Gland Lesions
Authors: Hurwitz J J
Published: April 2021

SUMMARY

The differentiation of lacrimal gland tumors into two distinctive groups by history, physical examination, and radiological investigations separates those patients who should be treated by total excision and those who should be biopsied. This allows for rational subsequent management in an attempt to prolong survival and decrease morbidity.
Acute Cataract and Glaucoma - A Complication of Retinal Detachment Surgery
Authors: Yoshizumi Marc O , Nobe Janis R
Published: April 2021

SUMMARY

A case of a rapidly developing intumescent catara et o us lens after scierai buckling surgery for a rhegmatogenous retinal detachment, resulted in pupillary block and acute, secondary angle closure glaucoma in a hyperopic eye. The rapid sequence of events following retinal detachment surgery, the unusual mechanism for the development of glaucoma after retinal detachment surgery, and the therapeutic and surgical procedures performed to restore the patient's vision make this a unique clinical report.
Dacryocystorhinostomy: A Review of 119 Cases
Authors: Zolli Christine L , Shannon Gerard M
Published: April 2021

SUMMARY

One hundred nineteen dacryocystorhinostomies were reviewed and were found to be most commonly performed on females in their seventh decade, with silent epiphora being the most common presenting symptom. Trauma was the single most frequent cause of surgery in males and required complex reconstruction in mosteases. Three of the seven dacryocystorhinostomy failures occurred in these traumatic dacryostenosis cases. An unusually high percentage of dacryocystorhinostomy surgery was performed on women who had had previous hysterectomies or serious gynecologic pathology.
Lacrimal Sac Papilloma: Presentation of an Unusual Case
Authors: Nunziata B Richard , Horbeek Johannes H , Gombos George M
Published: April 2021

SUMMARY

This is a case report of an unusual presentation for a transitional cell papilloma of the lacrimal sac. Our patient had epiphora and a nodular lesion in the upper lid with tissue extending through the punctum. There was no swelling over the lacrimal sac, Biopsy and dacryocystography confirmed the origin of the lesion to be the lacrimal sac.
The Chamber Maintainer System (CMS)
Authors: Lewicky Andrew O , Lopez Osvaldo I , Petkus Raymond W , Stillerman Manuel L
Published: April 2021

SUMMARY

An instrument is presented that allows the surgeon constant control over the anterior chamber depth from the beginning of ECCE/IOL surgery until the end, thereby facilitating all steps of the procedure.
A Combined Surgical Approach to Bilateral Superior Oblique Palsy
Authors: Pinchoff Barry S , Bergstrom Terry J , Sandall Gary S
Published: April 2021

SUMMARY

In two cases of bilateral superior oblique palsy the vertical component of the deviation was more prominent in one eye and the excyclotorsion more prominent in the fellow eye. A tuck of the superior oblique was performed on one eye and an adjustable Harada-lto procedure on the fellow eye. This combined approach was used to reduce both the torsional and vertical components in these patients with complicated bilateral superior oblique palsies while effecting a more exact resolution of the torsional component.
Open-Sky Irrigation and Aspiration of Cataract During Triple Procedure
Authors: Raju V K , Weinstein George W
Published: April 2021

SUMMARY

A method of irrigation and aspiration of cataract during the triple procedure is described. This method involves an open-sky technique rather than a closed system of irrigation -aspiration.
Argon Laser Debridement of the Posterior Capsule: A Potential Treatment for Posterior Capsule Opacification After Extracapsular Cataract Surgery
Authors: McDonnell Peter J , Fagadau Warren R , Green W Richard , Patz Arnall , Stark Walter J , Yeo Julia H
Published: April 2021

ABSTRACT

We treated an opacified membrane on the anterior surfaces of the posterior capsule of two cynomologous monkeys that had undergone extracapsular cataract extraction and intraocular lens insertion. After development of opacification of the posterior capsule, argon laser energy was employed in an attempt to debride the capsules while maintaining structural integrity of the capsule. With this technique, small areas of destruction of the membrane on the anterior surface of the posterior capsule were created with preservation of the capsule.
Proteinaceous Film Without Macrophages Covering Lens Implant in Acute Panophthalmitis
Authors: Wolter J Reimer
Published: April 2021

ABSTRACT

A very well-preserved capsule-like proteinaceous film continuously covering a Copeland lens implant in a late stage of alpha streptococcus panophthalmitis exhibits neutrophils and fibrin as well as massive pus on its outer surface. But no macrophages, fibroblastlike cells, or giant cells are found. The proteinaceous film has resisted the proteolytic actions of the massive pus present on and around the implant.
Effect of Ocular Compression on Intraocular Pressure
Authors: Bolling James P , Kurrle Robert W , O'Day Denis M
Published: April 2021

ABSTRACT

A prospective double-blind controlled study was undertaken to determine the effects of different compression times applied to soften the eye on normal subjects. Application of the Honan intraocular pressure reducer (HIPR) produced a significantly (p<0.02) greater decrease in intraocular pressure when applied for 40 minutes (14.3 mmHg SD= 1.7) when compared to a five-minute application (8.8 mmHg SD =1.7). No untoward effects were noted in these patients. Physiologic effects of external ocular compression are discussed.
Fire Hazard During Ophthalmic Surgery
Authors: Lederman Ira R
Published: April 2021

ABSTRACT

A plastic surgical drape was ignited by a disposable cautery during cataract surgery performed under local anesthesia. The flame was quickly extinguished, and the procedure was completed without complications. The patient did well postoperatively and attained a corrected visual acuity of 20/25. Precautions should be taken to minimize the possibility of fire occurring during ophthalmic surgery.
Oversize Donor Buttons in Corneal Transplantation Surgery for Keratoconus
Authors: Perry Henry D , Foulks Gary N
Published: April 2021

ABSTRACT

The authors report preliminary findings in 34 patients treated with oversize donor buttons for keratoconus. Seventeen patients received oversize donor grafts and 17 received same-size material. A significant increase in myopia was observed in the oversize group when compared with the same-size group, which indicates a trend toward increased corneal curvature in oversized corneal grafts. Oversize material therefore is contraindicated in treating keratoconus.
Relative Afferent Pupillary Defect in Eyes With Retinal Detachment
Authors: Folk James C , Thompson H Stanley , Farmer Samuel G , O'Gorman Thomas W , Dreyer Richard F
Published: April 2021

ABSTRACT

Relative afferent pupillary defects were measured before and after surgery in 38 patients with unilateral rhegmatogenous retinal detachment. All 38 patients were measured preoperatively and the mean (± SD) pupillary defect was 1.4 ± 0.7 log units. The afferent pupillary defect decreased in 36 of the 38 patients after successful scleral buckling operations (postoperative mean = 0.4 ± 0.3 log units). Twenty patients had defects postoperatively of 0.3 log units or less, and seven of these had no measurable defects at all.

A prediction model, using the variables of total number of peripheral quadrants detached and whether the macula was detached, yielded the following prediction equation: Relative afferent pupillary defect (log units) = 0.35 × (total quadrants) + 0.68 × macula detachment. This means that the detachment of each peripheral quadrant of retina caused about 0.35 log units of defect, whereas detachment of the macula caused 0.68 log units. The standard error of this estimate was rather large (± .65 log units); therefore, the size of the afferent pupillary defect can only roughly predict the extent of the retinal detachment and vice versa.
Respiratory Depression Following Retrobulbar Bupivacaine: Three Case Reports and Literature Review
Authors: Rodman David J , Notaro Saralyn , Peer Gerald L
Published: April 2021

ABSTRACT

Retrobulbar bupivacaine (0.75%) administration has been implicated as a causative factor in respiratory distress, cardiovascular dysfunction, and various central nervous system disturbances. The three cases here demonstrate two separate occurrences of respiratory and central nervous system (CNS) complications following retrobulbar bupivacaine (Marcaine) injection. It is thought that the immediate and delayed occurrences result from inadvertent injection at either of two sites: intravascularly or directly into the membranous sheath surrounding the optic nerve.
Biochemical Abnormalities in the Aqueous in Chronic Open-Angle Glaucoma
Authors: Herschler Jonathan , Litin Bradley S
Published: April 2021

ABSTRACT

We studied gel electrophoretic patterns of proteins in the aqueous humor of patients undergoing cataract or glaucoma surgery. Of special interest was a protein doublet present in the range of 130,000 to 135,000 dal tons. Analysis of the relative concentration of these two proteins in a given sample revealed statistically significant differences in aqueous humor obtained from patients with chronic open-angle glaucoma compared with that obtained from patients with non-chronic open-angle glaucoma or those with cataract. These differences could not be accounted for by other factors, such as preoperative medicines or age. It is possible that the outflow obstruction in chronic open-angle glaucoma somehow may be related to abnormalities in the protein distribution in the aqueous humor of susceptible individuals.
Surgical Management of the Secondary Glaucomas: Part I
Authors: Katz L Jay , Spaeth George L
Published: April 2021

ABSTRACT

Surgical approaches to the secondary glaucomas vary depending on the pathogenesis and stage of the disease. In this first part, neovascular glaucoma management is reviewed. Panretinal ablation by laser or cryopexy and goniophotocoagulation used to reverse neovascularization are helpful, but not permanently curative. Filtering surgery is not as successful for neovascular glaucoma as it is for the primary adult glaucomas. Therefore, modifications using 5-fluorouracil, carbon dioxide lasers, and alloplastic implants have been investigated. Although ciliary body ablation using cryotherapy or photocoagulation may reduce intraocular pressure, vision may still deteriorate.
Public Health Ophthalmology: A Comprehensive Model for the Prevention of Blindness in Developing Nations
Authors: Heldt Jean-Paul
Published: April 2021

ABSTRACT

In recent years, blindness In developing nations has been increasingly recognized as a public health problem requiring new approaches. To better prepare eye care professionals to assume their multidisciplinary responsibilities as epidemiologists, health planners, administrators, and educators, a new conceptual model is presented. This eye care plan and delivery scheme for developing nations attempts to integrate three essential disciplines of blindness prevention (epidemiology, administration, and education) with six major causes of blindness (cataract, trachoma, glaucoma, xerophthalmia, onchocerciasis, and leprosy) at three levels of intervention (community, primary, and secondary). The result can be conceptualized as a three-dimensional geometric model. This spatial construct has many practical applications and should serve as a useful frame of reference for eye care professionals and organizations active in international ophthalmology and blindness prevention in developing countries.
Simplified Diagnostic Coding Sheet For Computerized Data Storage and Analysis in Ophthalmology
Authors: Tauber Joseph , Lahav Moshe
Published: April 2021

ABSTRACT

A review of currently-available diagnostic coding systems revealed that most are either too abbreviated or too detailed. We have compiled a simplified diagnostic coding sheet based on the International Coding and Diagnosis (ICD-9), which is both complete and easy to use in a general practice. The information is transferred to a computer, which uses the relevant (ICD-9) diagnoses as database and can be retrieved later for display of patients' problems or analysis of clinical data.
Reduction of Inflammation Following Cataract Surgery by the Nonsteroidal Anti-Inflammatory Drug, Flurbiprofen
Authors: Sabiston David , Tessler Howard , Sumers Karen , Osterle Carolyn , Cheetham Janet K , Duzman Efraim , DeGryse Ronald
Published: April 2021

ABSTRACT

In this double-masked clinical trial, 72 patients undergoing cataract extraction surgery received a topical loading dose of 0.03% flurbiprofen or vehicle before surgery and one drop four times daily for 2 weeks after surgery. The severity of conjunctival hyperemia, aqueous humor cells, and aqueous humor flare was lower in the flurbiprofen-treated group than in the vehicle-treated group at all follow-up visits; the differences were significant on day 14. Four patients treated with flurbiprofen and two treated with vehicle exhibited postoperative hyphemas. Treatment with flurbiprofen appeared to decrease the severity of inflammation following cataract extraction surgery.
A New Technique of Treating Rhegmatogenous Retinal Detachment Using the Q-Switched Nd:YAG Laser
Authors: Berglin Lennart , Stenkula Staffan , Crafoord Sven , Öhrström Arne
Published: April 2021

ABSTRACT

In eyes with retinal detachment and a horseshoe break, vitreous traction on the retina has been relieved by severing the flap of the break with the aid of the Q-switched Nd:YAG laser. The retina often flattens in eyes with shallow retinal detachment after this treatment; the breaks then can be sealed off with argon laser. In cases of retinal detachment treated with expanding gas, fewer recurrences were observed when vitreous traction had been relieved by Nd:YAG laser treatment.
Strengthening the Weak Superior Oblique Muscle
Authors: Bartley George B , Dyer John A
Published: April 2021

ABSTRACT

Tucking of the superior oblique tendon is an effective strengthening procedure, but it invariably results in at least transient postoperative Brown's syndrome. This complication may be avoided by using a modification of the Harada-Ito procedure, in which the entire superior oblique tendon is advanced anterolaterally without disinsertion or resection. The operation is easy to perform and may be used with adjustable sutures if desired.
Back-Flush Bipolar Diathermy Needle
Authors: Zivojnovic Relja , Vijfvinkel Ger
Published: April 2021

ABSTRACT

We have developed a back-flush needle with a built-in capability for endodiathermy. This new instrument can both aspirate blood and coagulate the bleeding vessel.
Intraocular Gas Injection in the Treatment of Cornea-Lens Touch and Choroidal Effusion Following Fistulizing Surgery
Authors: Franks W A , Hitchings R A
Published: April 2021

ABSTRACT

Five eyes with large choroidal detachments and flat anterior chambers following fistulizing surgery were treated with injection of perfluoropropane into the anterior chamber. In all cases the choroidal detachments resolved within 4 days, without the need for drainage. Three phakic eyes developed anterior capsular opacification in the area of contact between the gas bubble and the anterior capsule. Injection of perfluoropropane is recommended as a simple and effective approach to the management of choroidal detachments with flat anterior chamber in Pseudophakic eyes and in cataractous phakic eyes.
Intraocular Pressure Profile During General Anesthesia
Authors: Varghese C , Chopra S K , Daniel R , Kaur B
Published: April 2021

ABSTRACT

The effect of some anesthetic drugs on intraocular pressure (IOP) was studied in 120 normal healthy patients undergoing non-ophthalmic surgical procedures. IOP rose significantly following the injection of succinylcholine (SCh) alone, or when such injection had been preceded by a pretreatment with a "self-taming" dose of SCh or d-tubocurarine (d-Tc). Though the rise in IOP after diazepam pretreatment was significant, the magnitude was lower than that observed in the groups pretreated with the other two agents. Halothane brought the IOP down faster and lower than ether.

SCh is unsafe for intubation for the administration of general anesthesia in cases involving penetrating ocular injuries. It can, however, be used safely for routine ophthalmic surgery, providing that 8 minutes are allowed to elapse between injection and corneal or scleral incision. Halothene is preferred to ether, since the former lowers IOP faster and in a greater amount than the latter.