bluuebunny/crossref_metadata_2025 huggingface dataset:
A Method of Monocanalicular Silicone Intubation
Authors: Long John A
Published: April 2021

ABSTRACT

A method for silicone intubation of a single canaliculus is described. A lacrimal stent has been crafted from a short segment of silicone tubing and a punctal plug. The distal end of the stent is fixed in the punctum with a punctal plug. The silicone stent, which is attached to the punctal plug, bridges the canalicular laceration. Because the punctal plug remains fixed in the punctum, no sutures are needed to fixate the stent to the eyelid.
A Simplified Scleral Graft Technique for Covering an Exposed Orbital Implant
Authors: Goldberg Morton F
Published: April 2021

ABSTRACT

A simplified method of covering an exposed orbital implant is presented. Donor sclera is placed between Tenon's capsule and the spherical implant without dissecting any tissue planes between the conjunctiva and Tenon's capsule. Technical manipulations and bleeding are thereby minimized. Preplaced absorbable sutures in the periphery of the graft are externalized and tied to the anterior surface of the conjunctiva.
Liposome-Encapsulated 5-Fluorouracil in the Treatment of Proliferative Vitreoretinopathy
Authors: Joondeph Brian C , Peyman Gholam A , Khoobehi Bahram , Yue Beatrice Y
Published: April 2021

ABSTRACT

Liposomes, small bilayer vesicles composed of phospholipids, can entrap and thus slow the release of drugs. We investigated the use of liposome-encapsulated 5-fluorouracil (5-FU), an antiproliferative agent, in the treatment of proliferative vitreoretinopathy (PVR) in an animal model. Doses of up to 1.6 mg administered intravitreally in rabbits demonstrated no retinal toxicity by histologic or electroretinographic criteria. In an experimental animal model of PVR, intravitreal injection of homologous rabbit cor· neal fibroblasts caused tractional retinal detachments in 90% of eyes after 4 weeks. The addition of 1.6 mg of liposome-encapsulated 5-FU decreased the rate of detachment to 32%, compared with 55% for 1 mg of free 5- FU. Thus, liposomal encapsulation of an antiproliferative agent such as 5-FU may be a valuable adjunct to conventional vitreous surgery in managing PVR.
The Effect of Scleral Cautery on Corneal Astigmatism in Cadaver Eyes
Authors: Bergmann Mark T , Koch Douglas D , Zeiter John H
Published: April 2021

ABSTRACT

We studied the effect of scleral cautery on corneal astigmatism in 20 cadaver eyes using the Zeiss wetfield bipolar cautery either at or 2 mm posterior to the corneoscleral limbus. The chord of cauterized area was set at either 5.5 or 11 mm. Cautery induced net corneal steepening along the meridian of the cauterized area, and induced the greatest astigmatism when applied at the limbus. At each location the 11-mm cautery application induced less astigmatism. The majority of the astigmatic change occurred within the first 5 to 10 seconds of application. We found that scleral cautery at or 2 mm posterior to the limbus can induce extensive corneal astigmatism.
Treatment of Periorbital Molluscum contagiosum by Incision and Curettage
Authors: Gonnering Russell S , Kronish Jan W
Published: April 2021

ABSTRACT

Molluscum contagiosum, caused by a doublestranded DNA virus, is found world-wide, affecting humans as well as other primates and marsupials. In humans, a biphasic incidence occurs with peak infection rates among young children and young adults. In children, infection is spread by direct contact or through fomites, with lesions predominating on the trunk, extremities, and face. In young adults, this disease is spread primarily through sexual contact. Periocular infection can cause secondary chronic follicular conjunctivitis, superficial keratitis, and punctal occlusion. Although many modes of therapy are effective in destruction of the virus, some may have significant side effects when used in the periocular area. We describe treatment by incision and curettage, which we recommend as a simple, effective method of managing this problem.
Trabeculectomy With Resection of Ciliary Processes in Glaucoma Following Scleral Buckling
Authors: Melamed Shlomo , Frenkel Ronald , Krug Joseph H , Allingham R Rand
Published: April 2021

ABSTRACT

We report a case of glaucoma following scierai buckling that required filtering trabeculectomy. Despite anterior entry to the anterior chamber, swollen ciliary processes were incarcerated In the sclerostomy site, blocking aqueous How. Resection of the occluding ciliary processes resulted in restoration of aqueous flow through the sclerostomy. This case demonstrates that anterior rotation of the ciliary body and processes plays an important role in the pathogenesis of glaucoma following scierai buckling operation.
An Alternative Method of Canalicular Stent Tube Placement in Lacrimal Drainage Surgery
Authors: Archer Kathleen F , Hurwitz J J
Published: April 2021

ABSTRACT

Certain situations in lacrimal drainage surgery require stent tubing: in a dacryocystorhinostomy (DCR) when flap anastomosis or clearance of the common internal punctum is problematic; when a common canalicular obstruction indicates a DCR and common internal punctoplasty; when a lateral common canalicular or individual canalicular obstruction indicates a canaliculodacryocystorhinostomy (CDCR); in cases involving a totally obliterated canalículos and when intubating the patent canaliculus in conjunction with a DCR or CDCR.

We describe a simple and effective technique of tube placement, using silastic tubing which involves placing a silastic sleeve under direct visualization for precise tube fixation. This method has been employed successfully in 379 cases from a 5-year series of over 1,000 lacrimal drainage operations.
Implantation of a Disc Lens in the Capsular Bag
Authors: Watts Mark T , Pearce John L
Published: April 2021

ABSTRACT

We report a series of 65 cataract extractions with implantation of a rigid, posteriorly vaulted, disc-shaped lens in the capsular bag. Eighty-nine percent achieved 20/40 vision or better, and 54% achieved 20/20 vision or better. The lens remained well centered in all cases.

The method is described, and the practical and theoretical advantages of implantation of a lens approaching a natural shape are discussed.
Reproducibility of Determining Vitamin A Status by Impression Cytology
Authors: Wittpenn John R , Natadisastra Gantira , Mele Lisa , Sommer Alfred
Published: April 2021

ABSTRACT

Impression cytology is a simple technique for detecting vitamin A deficiency. Methods of specimen collection, fixation, and staining are amenable to use in developing countries. Routine use of the technique requires good interobserver agreement. We compared the impression cytology results of 206 patient examinations analyzed by an experienced observer with those obtained by a newly trained observer. Percent agreement measured 96% (197/206) with a kappa of 0.90, indicating excellent agreement. Further improvement in interobserver agreement may be obtainable by simplification of the staining process to highlight the presence or absence of goblet cells, and by simplification of the staging criteria.
Diagnosis and Treatment of Chronic Postoperative Bacterial Endophthalmitis
Authors: Brady Steven E , Cohen Elisabeth J , Fischer David H
Published: April 2021

ABSTRACT

Chronic postoperative bacterial endophthalmitis has recently assumed a prominent role in the differential diagnosis of inflammation following extracapsular cataract extraction with posterior chamber intraocular lens implantation. The optimal diagnostic and therapeutic approach to this entity has not yet been clearly defined. We present a case of chronic postoperative Propionibacterium acnes endophthalmitis in which the diagnosis was made by anterior chamber paracentesis, and topical, periocular, and systemic antibiotic therapy resolved the inflammation. Anterior chamber paracentesis for aerobic and anaerobic cultures may be an appropriate initial diagnostic step in suspected cases. While successful treatment may require surgical intervention in some cases, others may respond to antibiotic therapy alone.
Results of a Graded Relaxing Incision Technique for Post Keratoplasty Astigmatism
Authors: Arffa Robert C
Published: April 2021

ABSTRACT

A technique of graded relaxing incisions and compression sutures was performed for correction of post keratoplasty astigmatism in six patients who were spectacle and contact lens intolerant. Correction was achieved in all six patients after surgery, five with spectacles and one with a contact lens. Keratometric astigmatism decreased from an average of 9.63 diopters preoperative^ to 2.17 D postoperatively, a reduction of 7.46 D, or 77%. Up to 13.50 D of correction was obtained. In general, the effect of surgery progressed from 1 week to 3 months postoperatively, and regressed from 3 to 6 months. Complications included perforation in two patients, one requiring suturing and application of tissue adhesive, and graft reaction in two patients. Although the number of patients is small, it appears that this technique can successfully reduce post keratoplasty astigmatism, even in excess of 10 D.
A New Suturing Technique for Ciliary Sulcus Fixation in the Absence of Posterior Capsule
Authors: Pannu Jaswant Singh
Published: April 2021

ABSTRACT

A new method of suturing for managing various complications is described.
Morbidity Following Prolonged Postoperative Hypotony After Trabeculectomy
Authors: Migdal Clive , Hitchings Roger
Published: April 2021

ABSTRACT

The postoperative course of a series of 54 patients that had undergone primary trabeculectomy for openangle glaucoma is reviewed. Almost one third of the eyes had prolonged postoperative hypotony with an intraocular pressure <8mm Hg for more than 2 weeks. The possible significance of prolonged hypotony and choroidal effusions is discussed in relation to the final intraocular pressure and the effect on visual acuity.
Factors Associated with Conjunctival Intraepithelial Neoplasia: A Case Control Study
Authors: Napora Casimir , Cohen Elisabeth J , Genvert Gail I , Presson Angela C , Arentsen Juan J , Eagle Ralph C , Laibson Peter R
Published: April 2021

ABSTRACT

Familial and environmental factors may play a role in the development of conjunctiva! intraepithelial neoplasia (ClN). Nineteen patients with biopsy-proven CIN completed a questionnaire to evaluate possible predisposing factors. Nineteen age-matched and sexmatched controls completed questionnaires and received slit-lamp examinations. Factors associated with a relatively increased risk of developing CIN included exposure to petroleum products, heavy cigarette smoking, light hair and ocular pigmentation, and family origin in the British Isles, Austria or Switzerland. Non-office and nonprofessional workers were more likely to develop conjunctiva! intraepithelial neoplasia (p = .05), as were those who were not college graduates (p=.07.)
Blindness Following Blepharoplasty: Two Case Reports, and a Discussion of Management
Authors: Goldberg Robert A , Marmor Michael F , Shorr Norman , Christenbury Jonathan D
Published: April 2021

ABSTRACT

We present two cases of unilateral permanent visual loss following four-eyelid blepharoplasty. Clinical and radiographic evidence suggested orbital hemorrhage was the cause of visual loss in both cases. In particular, electrophysiologic tests indicated that optic nerve dysfunction, and not retinal ischemia, was responsible for loss of vision. Timely orbital decompression is the cornerstone of managing these dramatic cases.
Temporary Conduction Block of Optic Nerve After Retrobulbar Anesthesia
Authors: Verma Lalit , Arora Ritu , Kumar Atul
Published: April 2021

ABSTRACT

Three patients who experienced temporary visual loss after retrobulbar anesthesia with 2% lidocaine (Xylocaine) are described. Visual evoked potentials (VEPs) consistently increased in latency and decreased in amplitude. Abnormal VEPs such as these recorded for humans after retrobulbar anesthesia are, to our knowledge, reported here for the first time.
Neovascular Glaucoma Following Pars Plana Vitrectomy for Complications of Diabetic Retinopathy
Authors: Wand Martin , Madigan John C , Gaudio Alexander R , Sorokanich Stephen
Published: April 2021

Our study shows that a completely attached retina and aggressive panretinal photocoagulation are of paramount importance in decreasing the risk of neovascular glaucoma following vitrectomy for complications of proliferative diabetic retinopathy.
Malignant Glaucoma Induced by an Intraocular Lens
Authors: Reed Janis E , Thomas John V , Lytle Robert A , Simmons Richard J
Published: April 2021

ABSTRACT

A case of malignant (ciliary block) glaucoma apparently induced by a large posterior chamber intraocular lens (PC-IOL) is presented. The involved eye was small, with an axial length of 21.7 mm and a preoperative refractive error of +8.25 D. An uncomplicated extracapsular cataract extraction with implantation of a PC-IOL with a 7 mm optic was performed. Within 1 week postoperatively, malignant glaucoma developed, for which surgical intervention was required. We recommend avoiding implantation of PC-IOLs with large optics in certain small eyes, since these implants may be more likely than lenses with smaller optics to induce malignant glaucoma in such eyes.
Klebsiella Metastatic Endophthalmitis - A Complication of Shock Wave Lithotripsy
Authors: Kremer I , Gaton D D , Baniel J , Servadio C
Published: April 2021

ABSTRACT

A 70-year-old man suffering from nephrolithiasis developed acute pyelonephritis following extracorporeal shock wave lithotripsy of renal stones. After 10 days, urosepsis complicated by meningitis was diagnosed, and 72 hours later he developed right panophthalmitis with perforation of the globe, which was treated by enucleation. A week later, while on cefotaxime and cefuroxime, a focal infectious process developed in the retina of the left eye's posterior pole, spreading into the vitreous and causing retinal detachment. The patient was treated by vitrectomy and retinal detachment surgery, with good anatomical results. The functional result, however, was poor. Endophthalmitis is a possible complication, though rare, of urosepsis in patients undergoing shock wave lithotripsy.
A New Universal Laser Apparatus for Intra and Extraocular Irradiation Tasks in the Eye
Authors: Fankhauser Franz , Kwasniewska Sylvia
Published: April 2021

ABSTRACT

We describe a universal laser apparatus for multipurpose clinical tasks. The main unit consists essentially of a Haag-Streit slit lamp combined with a rigidly mounted Q-switched laser. The apparatus is designed basically for performing ph otodisruptive tasks. Radiation emitted by either a pseudocontinuous cw Nd: YAG laser (with a dynamic range of 10 W) or by an air-cooled 4-W argon ion laser energy source either may be transmitted via fiber optics into the main unit or, when detached from the main unit, may be used independently. Energy emitted by the modules and transported by specialized light cables and delivery systems can be used to perform transsclera I Nd: YAG laser irradiation of the ciliary body or the choroid and retina. Probes are available for endocoagulation of the latter two by either cw Nd: YAG or argon laser light. Other probes are being developed for chorioretinotomy, internal sclerostomy, dissection of the sclera, or for other extra bul bar work. All functions are monitored and displayed by a central processor.
Long-Term Follow Up of Clear Cornea Trabeculectomy
Authors: Fahmy Iman A , Ali Moones A , Spaeth George L
Published: April 2021

ABSTRACT

We evaluated the long-term results of Cairns' clear cornea "trabeculectomy" performed on the Glaucoma Service of the Wills Eye Hospital in six patients with serious glaucoma. Although postoperative pressures initially were lower in all six, these lower pressures were not maintained. Pressure in three of the patients finally was controlled only after instituting medical treatment, including carbonic anhydrase inhibitors in two. The operation failed in the other three, two of whom underwent further surgeries. We conclude that Cairns' clear cornea trabeculectomy, in itself, is not adequate to control intraocular pressure in cases of serious glaucoma.
Apraxia of Lid Opening in Blepharospasm
Authors: Jordan David R , Anderson Richard L , Digre Kathleen B
Published: April 2021

ABSTRACT

Apraxia of lid opening is a nonparalytic motor abnormality characterized by difficulty in initiating the act of lid elevation. It has been reported with extrapyramidal disorders, including Parkinson's disease, Huntington's chorea, progressive supranuclear palsy, and Shy-Drager syndrome. We found seven cases (7%) of functionally disabling apraxia of lid opening in 100 consecutive blepharospasm patients studied. It is important for physicians treating blepharospasm to be aware of the association between these two visually debilitating disorders.
Thermal Side Reactions During In Vitro Contact Cyclophotocoagulation With the Continuous Wave Nd: YAG Laser
Authors: Stolzenburg Silvia , Kresse Steffen , Müller-Stolzenburg Norbert W
Published: April 2021

ABSTRACT

We compared the effects of continuous wave Nd: YAG laser irradiation on the ciliary body and sclera of enucleated porcine eyes produced by two means of transmission: contact coagulations via a quartz fiber (core 600 µm), and noncontact coagulations via a focussing handpiece. Application times ranged from 10 ms to 1.5 seconds. During contact coagulations using plane fiber tips the temperature at the fiber tip, due to deposits of carbonized tissue, sometimes increased markedly, increasing the risk of perforation. Clinical application of the contact method using plain fiber tips is not recommended.
Unsuspected Paperboard-Endophthalmitis in Ruptured Eye
Authors: Wolter J Reimer , Pavilack Mark A
Published: April 2021

ABSTRACT

The eye of a 3-year-old boy was directly exposed to the explosion of an M-80 firecracker which he had been holding in his hand. The cornea and lens were ruptured. Although not evident on an initial CT scan, pathologic examination revealed a paperboard foreign body lodged in the vitreous. This paperboard, rather than the burnt powder, was likely the central focus of the subacute endophthalmitis that developed.
Anterior Eyewall Perforation During Subconjunctival Cataract Block
Authors: Yanoff Myron , Redovan Edward G
Published: April 2021

ABSTRACT

A patient was given a new type of subconjunctival block in preparation for cataract surgery. During the insertion of the needle subconjunctival^, the anterior eyewall was inadvertently perforated, resulting in a tiny retinal tear and focal retinal detachment. The cataract surgery, including intraocular lens implantation, was carried out without further problems. The retinal tear and tiny detachment were repaired the next day by argon laser photocoagulation. The visual result was excellent. To our knowledge, this is the first report of anterior eyewall perforation occurring with the use of this new subconjunctival anesthetic block.
Enhancing Filtration in the Early Postoperative Trabeculectomy Refractory to Digital Massage
Authors: Parrow Kyle A , Shin Dong H
Published: April 2021

ABSTRACT

Digital massage often can be used to lower intraocular pressure (IOP) after trabeculectomy or trabeculectomy combined with extracapsular cataract extraction and intraocular lens implantation. However, occasionally filtration, and thus IOP reduction, is refractory to massage. We present a pressurelowering technique in which focal pressure is applied adjacent to the trabeculectomy flap firmly enough to indent the sclera and induce bleb formation.
Keratoconus After Penetrating Keratoplasty
Authors: Rubinfeld Roy S , Traboulsi Elias I , Arentsen Juan J , Eagle Ralph C
Published: April 2021

ABSTRACT

Signs of keratoconus, including Munson's sign, apical thinning, and Vogt's striae, developed in a 41-year-old woman 6 years after successful penetrating keratoplasty. Screening donor corneas for ectatic diseases may prevent such occurrences.
Suture Patterns and Corneal Graft Rotation in the Cadaver Eye
Authors: Au Yue-Kong , Mahjoub Salah B , Hart John C
Published: April 2021

ABSTRACT

Torque and antitorque running sutures as described by Eisner are commonly used in penetrating keratoplasty. We tested the rotational effect of three different 16-bite running suture patterns on eight cadaver eyes, with the following results: (1) the torque pattern rotates the corneal graft counterclockwise by 0.7 ±0.1 mm at the wound or 11°; (2) the antitorque pattern rotates the corneal graft clockwise by 0.7 ±0.1 mm at the wound or 11°; /3) an intermediate "no torque" pattern, the bites of which form an isosceles triangle, produces no rotational effect. We recommend the use of a "no torque" pattern to minimize corneal graft rotation.
Scanning Electron Microscopy of Corneal Incisions Using Steel, Diamond, and Sapphire Blades
Authors: Van Meter Woodford S , Breen Charles , Hainsworth Dean P , Geissler Richard
Published: April 2021

ABSTRACT

In order to compare the wound morphology they produce, we used steel (Myocure), diamond (CILCO DK 121), and sapphire (Katena K2-6500) blades, to make parallel linear incisions, 500 µm deep, in 12 fresh enucleated porcine eyes. There was no discernible difference among the blades in terms of either the morphology of the collagen lamellae of the sides or the depth of the incisions produced. The major differences in the cuts produced were attributable primarily to the differences in the footplates.
Argon Laser Pretreatment in Nd: YAG Iridotomy
Authors: Goins Kenneth , Schmeisser Elmar , Smith Thomas
Published: April 2021

ABSTRACT

Argon laser pretreatment prior to Nd: YAG laser iridotomy may decrease the incidence of operative hemorrhage. In a prospective, randomized clinical trial involving 12 patients (24 eyes), one eye was randomly assigned treatment with the Nd: YAG laser alone, while the other eye was pretreated with argon laser photocoagulation immediately prior to Nd:YAG laser. Eight of the 12 eyes (67%) treated with Nd: YAG laser alone had operative hemorrhages; only 2 of the 12 (17%) pretreated eyes did. Thus, argon laser pretreatment significantly reduced the incidence of hemorrhage during Nd: YAG iridotomy (P= .012).
Artificial Orbit System for Experimental Surgery With Enucleated Globes
Authors: Lowery MS Joseph A , Parel Jean-Marie , Roussel Thomas J , Simon Gabriel , Lee William , Nose Izuru
Published: April 2021

ABSTRACT

A portable system for holding, accurately positioning, and restoring the physiologic integrity of enucleated globes during experimental anterior segment procedures and pars plana vitrectomy is described. A 0 to 500-mm Hg vacuum fixation ring and positioning apparatus mechanically locks globes into known spatial position while they are supported in a 2 to 6-mm Hg pressurized, pliable socket designed to match the size and pressure of a natural orbit. A gravity infusion system and an implantable piezoelectric pressure sensor in conjunction with a syringe and stopcock assembly allow for controlled inflation of globes to intraocular pressure OOP) levels from 0 to 70 mm Hg, and to over 300 mm Hg. The fixation vacuum level, and intraocular and extraocular pressures are simultaneously monitored on 3-digit LED displays, and permanent records of each can be generated by routing data to storage devices. The anterior segment remains accessible at all times for surgical procedures and diagnostic measurements. The entire system is portable, allowing globes to be transported to multiple experimental stations, while all pressure settings and the position of the globe are maintained.

To demonstrate applications of the artificial orbit system, we describe experiments using it to calibrate applanation tonometers, and to study the relationship between IOP and corneal curvature as well as the effect of trephination procedures and limbal vacuum fixation on IOP.
Central Retinal Vein Obstruction and Axial Length
Authors: Brown Melissa M , Brown Gary C , Menduke Hyman
Published: April 2021

ABSTRACT

The axial lengths of 24 consecutive adult eyes with unilateral central retinal vein obstruction (CRVO) were compared with those of contralateral unaffected eyes and those of a control population. The lengths of the two eyes of persons with a unilateral CRVO were not significantly different. By contrast, eyes of persons with CRVO averaged 0.67 mm (approximately 2 diopters) shorter than their control counterparts (P - .03). This anatomic difference may be a factor in the development of CRVO.
A New Ophthalmic Microtrephine
Authors: Sisler Hampson A , Allarakhia Liaquat
Published: April 2021

ABSTRACT

We present a new instrument designed to facilitate the microtrephination of tissues required in various ophthalmic procedures. This microtrephine is a 21-gauge stainless steel tube, 0.81 mm in diameter and 16 mm long, with a sharpened cutting end and a plastic finger-grip area to facilitate micro-rotation. A standard plastic luer hub allows the trephine to be used with a syringe, either a standard type or one with a spring-assisted plunger. Scar tissue, biopsy specimens, or abnormal inflammatory fluids can be suctioned into the syringe for subsequent pathologic examination.
Keratoscopy Through the Slit Lamp
Authors: Durán Juan A , Labella Fernando
Published: April 2021

ABSTRACT

We present a keratoscope we have found to be reliable, easy to use, and time-saving.
Normal Eyelid Crease Position in Children
Authors: Zamora Rene L , Becker William L , Custer Philip L
Published: April 2021

ABSTRACT

Proportions of the upper lid were determined based on the following measurements in 33 children: lashline-lid crease (LC), lashline-lower brow (LB), vertical fissure, and horizontal fissure. Age-matched mean measurements (mean LC/LB ratio = 0.33) for 26 white vs 7 black children, and for 16 males vs 17 females were not significantly different. However, the mean ratio in 15 preschool and school-age children was significantly greater than that in 18 infants and toddlers (less than 4 years old) (P < .01 ). We conclude that the normal eyelid crease position in children is one third up the lashline to the lower brow. However, the normal eyelid crease position in infants and toddlers is slightly less than, and, in older preschool and school-age children, slightly greater than this distance up the lashline. Thus, age may determine the surgical placement of the eyelid crease in children with indistinct creases.
A Modification of Cryosurgery for the Management of Elevated Bleb
Authors: Susanna Remo
Published: April 2021

ABSTRACT

Elevated blebs may be very troublesome to patients, especially those with only one eye. I describe a technique that can be used to reduce the size of the bleb without diminishing its function, and, as in the case presented, resolve cornea) dellen.
Prophylaxis of Endophthalmitis
Authors: Peyman Gholam A , Daun Michael
Published: April 2021

ABSTRACT

Prophylactic antibiotics can be administered by various routes to prevent endophthalmitis. Topical application is simple and minimally invasive, but it provides relatively poor penetration into the vitreous. Collagen shields are effective in delivering therapeutic levels of antibiotics to the cornea and aqueous but not to the vitreous cavity. Systemic administration for prophylaxis is questionable because of the poor ocular penetration of most drugs (however, some antibiotics, such as imipenem, pefloxacin, and ciprofloxacin, may provide therapeutic levels to the vitreous). Subconjunctival injection may provide significant drug levels in the aqueous for 4 to 6 hours. However, we found subconjunctival gentamicin ineffective in experimentally induced Pseudomonas aeruginosa endophthalmitis in postoperative aphakic eyes.

We recommend the use of antibiotics in infusion fluid. In cases of trauma, we inject 48 ^g gentamicin and 54 ^g clindamycin intracamerally or intravitreally.
Wound Strength Comparison of a 5.1-Millimeter No-Stitch With a 7.0-Millimeter Sutured Incision in Human Cadaver Globes
Authors: Heier Jeffrey S , Walton William T , Enzenauer Robert W , Rice William , Tuman David
Published: April 2021

ABSTRACT

We compared the wound strength of 5.1 -millimeter no-stitch incisions with that of 7. 0-millimeter sutured incisions in cadaver eyes. Each incision was performed on seven cadaver eyes. Wound integrity was evaluated by subjecting each globe to increasing intraocular pressure HOP), increasing external pressure, and sudden external pressure. Wound leaks occurred in the 7. 0-mill i meter-incision globes at consistently lower IOPs and with less external pressure than they did in the 5.1 -millimeter-incision globes. We conclude that the 5.1-millimeter no-stitch flap incision has greater wound integrity than the 7.0millimeter sutured incision when subjected to either internal or external pressures.
Early and Late Postoperative Application of 5-Fluorouracil Following Trabeculectomy in Refractory Glaucoma
Authors: Hefetz Limor , Keren Tamar , Naveh Nava
Published: April 2021

ABSTRACT

Intraocular pressure HOP) control was studied retrospectively in two groups of 14 consecutive patients following trabeculectomy with adjunct i ve postoperative 5-fluorouracil (5-FU) treatment. In one of the groups (the early-treatment group), 5-FU injections were started 2.4 ± 0.6 days postoperatively; in the other group (the delayed-treatment group), they were started only when clinical signs suggested impending bleb failure (12.6 ± 5.4 days postsurgery). The patients in the two groups were age-matched and had a similar history of previous failed glaucoma operations or diabetes, both of which are considered indications for postoperative S-FU injections. The mean number of 5-FU injections and the total dose in the two groups did not differ significantly (5.3 ± 0.8 and 5.5 ±1.1 injections, respectively; 26.4 ± 3.9 and 27.5 ± 5.3 mg 5-FU total dose, respectively). The average follow up for the two groups was 16.7 ± 2.5 and 16.9 ± 2.7 months, respectively.

With an IOP of 18 mm Hg or less with or without medications considered a success, 42.8% of the delayed-treatment and 71.4% of the early-treatment cases were successful. More medications were required in the early-treatment group. Postoperative transient corneal epithelial defects occurred in 71.4% and 78.4% of the eyes in the late- and early-treatment groups, respectively, an insignificant difference. Conjunctiva! wound leak occurred in one patient (in the delayed-treatment group).

These results suggest that application of 5-FU at a relatively late postoperative point (more than 10 days after surgery), based on clinical evidence of impending bleb failure, can still effectively control IOP, although to a lesser degree than application at an earlier point postoperatively. Thus, in cases with impending bleb failure, 5-FU application may be advisable even at a relatively late point after surgery.
Open-Sky Phacoemulsification During Corneal Transplantation
Authors: Lindquist Thomas D
Published: April 2021

ABSTRACT

A continuous, circular capsulorhexis maintains the integrity of the anterior capsule. During corneal transplantation, a capsulorhexis may be combined with phacoemulsification, allowing the cataractous lens to be delivered in small fragments, thereby maintaining the integrity of the anterior capsular margin. This approach allows stable "in-the-bag" placement of a posterior chamber intraocular lens (PC-IOL) during combined cataract extraction and corneal transplantation. The technique also minimizes the risk of radial anterior capsular tears and subsequent decentration of the PC-IOL.
Prevalence of Posterior Vitreous Detachment in Retinitis Pigmentosa
Authors: Hikichi Taiichi , Akiba Jun , Trempe Clement L
Published: April 2021

ABSTRACT

To investigate the prevalence of posterior vitreous detachment (PVD) and PVD with collapse in relation to age in eyes with retinitis pigmentosa (RP), we retrospectively studied the vitreous condition in 218 eyes of 109 patients with RR Two hundred thirty healthy eyes of 115 subjects served as controls. The prevalence of both PVD and PVD with collapse, respectively, in the first through the sixth decades of life, and in the second through the seventh decades was significantly higher in the RP eyes than in the controls (P < .01). Our findings demonstrated the early onset and progression of PVD with age in the eyes with RP as compared with the control eyes.
Microplate Fixation of Prefabricated Subperiosteal Orbital Floor Implants
Authors: Jordan David R
Published: April 2021

ABSTRACT

Microplating and miniplating systems are widely available for repairing fractures involving the orbit, face, cranium, and mandible. These plates are superior to traditional wiring techniques because the fractured bones are held in position immediately after the plates have been screwed into position (rigid fixation). Recently, we have found the T-shaped microplate quite helpful in securing the prefabricated subperiosteal orbital floor implants commonly used to augment orbital volume in anophthalmic sockets.
Posterior Lens Dislocation During Attempted Phacoemulsification
Authors: Chern Sandra , Yung Chi-Wah
Published: April 2021

ABSTRACT

Mechanisms of posterior lens dislocation during phacoemulsification have been suggested, but the actual mechanism involved has not been demonstrated. Chart reviews of cataract surgeries performed at Indiana University from 1991 until the present identified nine cases of posterior lens dislocation that occurred during phacoemulsification. In four, the procedure was converted early to a can-opener capsulotomy. Cadaver eye studies showed the role of an imperfect capsulorhexis in extending tears while a "trap door" was being formed for posterior nuclear dislocation during phacoemulsification.
Improvement of Visual Field Indices After Surgical Reduction of Intraocular Pressure
Authors: Gandolfi Stefano A
Published: April 2021

ABSTRACT

In a prospective case series (consecutive patients) of 30 eyes from 30 subjects with medically uncontrolled glaucoma being treated at a hospital-based, referral glaucoma service, we sought to ascertain if a surgically obtained reduction of intraocular pressure (IOP) in human glaucomatous eyes is paralleled by an improvement of the visual field. Uncomplicated limbus-based trabeculectomy was performed in 13 men and 17 women familiar with computerized perimetry testing, with a pupil diameter of at least 4 mm (measured at the Goldmann perimeter bowl), a best-corrected visual acuity of 20/20 in both eyes, and a Mean Sensitivity (MS) index greater than 10 dB. The main outcomes measured were: visual field data (Octopus, program Gl) and IOP (mean of the two highest values during the diurnal curve) obtained 3 days before and 3 months after surgery in both the operated and the fellow eyes.

In the operated eyes, an increase of MS (from 17.2 ± 2.4 to 18.9 ± 2.8, P < .00000T, paired samples two-tailed t test) was observed. Meanwhile, the Corrected Loss Variance (CLV) remained substantially the same (46.8 ± 12.2 before, vs 47.3 ± 13.4 after; P = .87, paired samples two-tailed ttest). The increase in MS was positively correlated with the amount of IOP reduction (linear regression: r = 0.901, P < .00001). No statistically significant change of either MS or CLV values occurred in the fellow eyes.

The correlation between the amount of IOP reduction and the increased MS suggests that, in the short term, reducing the IOP may improve visual function to some extent. The apparent lack of correlation between the amount of IOP reduction and the CLV may indicate that the depth of the preexistent glaucomatous scotomas remains unchanged.
Caruncular Malignant Melanoma in a Black Patient
Authors: Kalski Richard S , Lomeo Mark D , Kirchgraber Paul R N , Levine Mark R
Published: April 2021

ABSTRACT

An 84-year-old black woman had a right caruncular lesion that had progressively enlarged over the past 3 months. Surgical excision and cryotherapy were performed. A biopsy confirmed the diagnosis of caruncular malignant melanoma, a rare lesion which, to our knowledge, has not been previously reported in a black patient.
The Ocular Effects of Intralenticular Iron Foreign Bodies in Rabbits
Authors: Virata Steven R , Kylstra Jan A , Peiffer Robert L
Published: April 2021

ABSTRACT

Optimal treatment of intralenticular metallic foreignbody injuries remains controversial, especially in patients with clear lenses and good vision. Using 20 rabbit eyes, we examined the cataractogenic potential of intralenticular iron and its effects on the retina. Iron wire implanted into the lenses of 12 rabbit eyes caused cataracts in every eye within 4 weeks. However, after 4 ½ weeks, none of these eyes showed evidence of retinal siderosis. No cataracts developed in five eyes with intralenticular glass, while three with intravitreal iron showed marked retinal toxicity. These results suggest that as long as the lenses remain clear, conservative management of these injuries carries minimal risk of permanent retinal damage.
The "Lost Lens": A New Surgical Technique Using the Machemer Lens
Authors: Weinstein George W , Charlton Judie F , Esmer Ertan
Published: April 2021

ABSTRACT

We describe a method of removing a posteriorly dislocated lens involving the use of a Machemer lens to visualize displaced lens remnants. Following core vitrectomy, the lens remnants are brought anteriorly and then removed by phacoemulsification. Lens implantation may then be performed with sulcus fixation. Eight of 10 patients in which this technique was used achieved 20/40 or better visual acuity.
Ocular Motility Defects in Patients With the Krupin Valve Implant
Authors: Frank Jacqueline W , Perkins Todd W , Kushner Burton J
Published: April 2021

ABSTRACT

To determine the prevalence of ocular motility defects following placement of a Krupin valve with disk and adjunctive mitomycin-C in glaucoma patients, a retrospective case series of all patients receiving a Krupin valve with disk and intraoperative mitomycin-C in a university-based referral practice was conducted. Each of the seven consecutive patients undergoing placement of a Krupin valve with disk in one eye because of uncontrolled glaucoma, developed significant primary position heterotropia or limitation of ocular rotations. One patient had significant postoperative diplopia. We conclude that the Krupin valve with disk used with intraoperative mitomycin-C can be associated with the development of ocular motility defects. The limitation of rotations appears to relate to the combined mechanisms of implant and cyst bulk and the displacement of the oculorotary muscles by the encapsulating cyst.
Cataract Formation in Peter's Anomaly After Trabeculotomy
Authors: Mullaney Paul , Al-Awad Abdulaziz
Published: April 2021

ABSTRACT

Trabeculotomy is a well-documented procedure for reducing intraocular pressure in primary infantile glaucoma with cloudy corneas. However, the efficacy of the procedure is reduced in glaucoma associated with other ocular disorders. We report a child with lens-corneal adhesions in whom trabeculotomy produced a secondary cataract.
Alveolar Soft-Part Sarcoma of the Orbit
Authors: Jordan David R , MacDonald Hector , Noel Leon , Carpenter Blair , Brownstein Seymour , Munro Shane
Published: April 2021

ABSTRACT

Alveolar soft-part sarcoma is a malignant soft tissue neoplasm that involves mainly the deep soft tissues of the extremities, particularly the thighs and the buttock. Involvement of the orbit is uncommon. We describe a young child with such a tumor and illustrate the characteristic features.
Oncocytic Adenocarcinoma of the Lacrimal Sac: Report of a Case With Paranasal Sinus and Orbital Extension
Authors: Perlman Jay I , Specht Charles S , McLean Ian W , Wolfe S Anthony
Published: April 2021

ABSTRACT

A 92-year-old man has had multiple recurrent oncocytic tumors involving the right paranasal sinuses and orbit. A benign oncocytoma that arose from the right lacrimal sac was initially diagnosed at age 80 years. The tumor recurred at 3 and 7 years after initial resection. There was greater histologie atypia in the first recurrent tumor, which extended into the right paranasal sinuses. The second recurrence had zones of oncocytic adenocarcinoma exhibiting prominent nuclear atypia and mitotic activity; this tumor massively invaded the right paranasal sinuses and orbit. We describe the clinical and pathologic features of this rare case.
Effect of Brimonidine 0.5% on Intraocular Pressure Spikes Following 360° Argon Laser Trabeculoplasty
Authors: Anonymous
Published: April 2021

* BACKGROUND AND OBJECTIVE: Brimonidine tartrate 0.5%, a topical alpha2-adrenergic agonist, was administered before and after argon laser trabeculoplasty (ALT) to evaluate its efficacy against postoperative intraocular pressure (IOP) spikes.

* PATIENTS AND METHODS: Two randomized, double-masked, vehicle-controlled investigations evaluated four treatment regimens in 471 patients undergoing ALT for glaucoma or ocular hypertension. The combined results are presented.

* RESULTS: IOP elevations ≥10 mm Hg occurred in 1% (1/122) of the patients who received brimonidine before and after ALT; in 2% (2/119) of those receiving brimonidine before and vehicle after; in 1% (1/114) of those receiving vehicle before and brimonidine after; and in 23% (27/116) of those receiving vehicle before and after (P<.001).

* CONCLUSION: The brimonidine regimens were generally effective and well-tolerated ocularly and systemically.

[Ophthalmic Surg Lasers 1995;26:404-409.]
Ultrasound Biomicroscopy and Corneal Endothelium in Nd:YAG-Laser Iridotomy
Authors: Marraffa Michele , Marchini Giorgio , Pagliarusco Andrea , Perfetti Sergio , Toscano Andrea , Brunelli Chiara , Tosi Roberto , Bonomi Luciano
Published: April 2021

* BACKGROUND AND OBJECTIVE: Thirty eyes affected by angle-closure glaucoma that had undergone YAG-laser iridotomy were studied to evaluate variations of central anterior chamber depth, width of the angle, and loss of endothelial cells after laser treatment.

* PATIENTS AND METHODS: These parameters were determined before and after iridotomy: endothelial cell count using a "non-contact" specular biomicroscope, and anterior chamber depth and angle width using ultrasound biomicroscopy (UBM). The width of the iridotomy and the distance of the iridotomy from the scleral spur and from the corneal endothelium were also measured by UBM, after laser treatment.

* RESULTS: Results confirmed that, after iridotomy, there is not a significant variation in the central depth of the anterior chamber: it goes from 2.02 mm pre-laser to 2.07 ± 0.38 mm post-laser. There is, however, a statistically significant increase in the angle (P < .001), which goes from 10.69 ± 8.88° (0.109 ± 0.07 mm) to 21.03 ± 11.28° (0.183 ± 0.09 mm). The mean dimension of the iridotomies was 0.46 ± 0.13 mm. The mean endothelial cell count was 55.8 ± 4.08 cells per linear millimeter before laser treatment and 47.01 ± 5.39 cells per linear millimeter afterward (P < .001).

* CONCLUSION: This study confirms that YAG-laser iridotomy leads to a reduction in the average endothelial cell density. The loss of these cells is inversely proportional to the distance of the iridotomy from the endothelium and the scleral spur.

[Ophthalmic Surg Lasers 1995;26:519-523.]
Simultaneous Surgery for Bilateral Pediatric Cataracts
Authors: Zwaan Johan
Published: April 2021

* BACKGROUND AND OBJECTIVES: To perform a review of the literature comparing the safety of bilateral simultaneous lensectomies in children versus the risk of more than one general anesthesia within a short time frame, and to study the results of bilateral surgery in a small group of patients.

* PATIENTS AND METHODS: Bilateral simultaneous lensectomies were performed in 9 children (18 eyes), in whom increased anesthetic risks warranted this approach.

* RESULTS: There were no postoperative complications for at least 6 months.

* CONCLUSION: Data in the current literature on endophthalmitis after cataract surgery and on the risks of repetitive anesthesia are inadequate to weigh the risk of bilateral endophthalmitis against the reduced risk of one anesthesia versus two and the advantages of simultaneous early visual rehabilitation. Until such information becomes available, simultaneous removal of bilateral infantile cataracts should probably be reserved for selected cases where the anesthetic risk is higher than average.

[Ophthalmic Surg Lasers 1996;27:15-20.]
Hinge Keratoplasty
Authors: Weiss Jayne S
Published: April 2021

Abstract. A simple trephination technique is described that allows the surgeon to be prepared to handle an expulsive hemorrhage before it occurs. After trephination is performed, the host button is excised except for a 1 clock hour width of tissue. This hinge allows the attached button to fold over the corneal rim away from the surgical field. There is no interference with subsequent intraocular procedures. Should expulsive hemorrhage develop, the attached button can be immediately flipped into place and the wound quickly sewn closed. [Ophthalmic Surg Lasers 1996;27:156-157.]
Removal of Silicone Oil and Epimacular Proliferation From Eyes Following Vitrectomy
Authors: Sharma Tarun , Bhende Pramod Sadashiorao , Parikh Sunil , Gopal Lingam , Biswas Jyotirmay , Badrinath Sengamedu Srinivasa
Published: April 2021

* BACKGROUND AND OBJECTIVES: Epimacular proliferation (EMP) represents a localized form of reproliferation at the macula. The significance of EMP in eyes that have undergone vitrectomy is still not clear. This study investigated the redetachment rate following silicone oil removal when combined with removal of EMP.

* PATIENTS AND METHODS: Twenty-two consecutive eyes underwent removal of silicone oil and EME These eyes had attached retinas following silicone oil injection used as an adjunct to complex vitreoretinal surgery.

* RESULTS: The retina remained attached in 19 (86.4%) of the eyes, with functional improvement in vision in 81.8% of the eyes. Visual acuity of 6/60 (20/200) or better was obtained in 12 (54.5%) of the eyes. The mean follow-up time was 6.3 months.

* CONCLUSION: These results suggest that removal of EMP and silicone oil does not increase the risk of redetachment.

[Ophthalmic Surg Lasers 1996;27:192-196.]
Corneal Topographic Changes and Induced Astigmatism Resulting From Superior and Temporal Scleral Pocket Incisions
Authors: Kohnen Thomas , Mann Paul M , Husain Syed E , Abarca Adrian , Koch Douglas D
Published: April 2021

* BACKGROUND AND OBJECTIVE: To determine the corneal topographic changes that are induced by superior and temporal 5-mm sclera! pocket incisions.

* PATIENTS AND METHODS: The authors retrospectively reviewed the records of 43 patients who underwent phacoemulsification with posterior chamber lens implantation through unsutured 5-mm scierai pocket incisions, 24 superiorly and 19 temporally. Corneal curvature was measured using computerized videokeratography, and the induced astigmatism was calculated with the Holladay- Cravy- Koch formula.

* RESULTS: At 4 to 6 weeks postoperatively, there was mild flattening along the meridian of the incision in both groups. The change was greater with the superior incisions, but the differences between the groups were not statistically significant. Surgically induced astigmatism was 0.7 D (± 0.1 D) in the eyes that received superior incisions, and 0.3 D (± 0.1 D) in the eyes that received temporal incisions; this difference was statistically significant (P < .03).

* CONCLUSIONS: At 4 to 6 weeks postoperativeIy, temporal 5.0-mm sclera! pocket incisions provide more stable postoperative topography than do superior sclera! pocket incisions.

[Ophthalmic Surg Lasers 1996;27:263-269.]
Monocular Diplopia Following Excimer Laser Photorefractive Keratectomy After Radial Keratotomy
Authors: Hersh Peter S , Shah Shetal I , Durrie Daniel
Published: April 2021

Abstract. A 48-year-old man had symptoms of monocular diplopia following photorefractive keratectomy (PRK) for residual myopia after radial keratotomy. The cornea was characterized by a ring of subepithelial haze. A new type of corneal topography analysis that depicts areas of focal optical micro irregularity was used to diagnose the etiology of the optical symptoms. [Ophthalmic Surg Lasers 1996;27:315-317.]