bluuebunny/crossref_metadata_2025 huggingface dataset:
Laser Pneumatic Retinopexy for Repair of Recurrent Retinal Detachment After Failed Scleral Buckle-Ten Years Experience
Authors: Friberg Thomas R , Eller Andrew W
Published: April 2021

* BACKGROUND: Although pneumatic retinopexy was introduced for the repair of primary retinal detachments, we have had excellent long-term success in employing this technique along with laser photocoagulation following failure of routine scleral buckle surgery in nonvitrectomized eyes over the last 10 years.

* PATIENTS AND METHODS: We categorized a consecutive series of 40 eyes that failed primary scleral buckling surgery and had at least six months followup. Eyes were separated into two groups: those with 1) subretinal fluid persisting or developing during the first 14 days after surgery or 2) those accumulating subretinal fluid at least 14 days after initially successful anatomic reattachment of the retina.

* RESULTS: In these groups, 36 of the 40 eyes (90%) were successfully reattached using outpatient pneumatic retinopexy alone. Complications were limited to the production of new retinal breaks in 5 patients. The 4 pneumatic retinopexy failures were all subsequently treated successfully with either scleral buckle revision or vitrectomy.

* CONCLUSION: We believe that laser pneumatic retinopexy repair of recurrent retinal detachments following scleral buckle and without significant proliferation vitreoretinopathy (PVR) should be considered ahead of conventional surgical intraoperative techniques. Laser pneumatic retinopexy may be a very successful procedure for the treatment of recurrent retinal detachments after failed scleral buckle surgery. In a consecutive series of 40 eyes with recurrent retinal detachment, we were able to repair 36 with pneumatic retinopexy alone.

[Ophthalmic Surg Lasers 2001;32:13-18]
Iris Neovascularization After Vitrectomy Combined With Phacoemulsification and Intraocular Lens Implantation for Proliferative Diabetic Retinopathy
Authors: Kadonosono Kazuaki , Matsumoto Satoru , Uchio Eiichi , Sugita Miyuki , Akura Junsuke , Ohno Shigeaki
Published: April 2021

* PURPOSE: To analyze the incidence of iris neovascularization after vitrectomy combined with phacoemulsification and intraocular lens (IOL) implantation using a small incision in the treatment of proliferative diabetic retinopathy (PDR).

* PATIENTS AND METHODS: We studied a consecutive series of 46 eyes in which vitrectomy combined with phacoemulsification and IOL implantation had been performed, and compared the surgical results with a prior series of 40 eyes in which vitrectomy alone had been performed.

* RESULTS: Postoperative iris and angle neovascularization was found in 6 eyes (15%) treated by vitrectomy alone, but in only 1 eye (2%) treated by combined vitrectomy (P<0.05). Final visual acuity improved by two or more lines in 23 eyes (57%) in the vitrectomy alone group, and in 35 eyes (76%) in the combined vitrectomy group.

* CONCLUSIONS: The incidence of postoperative rubeosis iridis was significantly lower, and the visual results were satisfactory with vitrectomy combined with phacoemulsification and IOL implantation for PDR. These findings suggest that combined vitrectomy for PDR is a useful surgical procedure.

[Ophthalmic Surg Lasers 2001;32:19-24]
Excimer Laser Photorefractive Keratectomy for Hyperopia
Authors: Pacella Elena , Abdolrahimzadeh S , Gabrieli C Balacco
Published: April 2021

* BACKGROUND AND OBJECTIVE: Photorefractive keratectomy (PRK) has been extensively evaluated for the correction of myopia. This study was undertaken to assess the safety, efficacy, and reliability of PRK in the correction of hyperopia.

* PATIENTS AND METHODS: There were 28 eyes with refractions of +1 to +7.75 D treated for hyperopia with the Chiron Technolas 217-C excimer laser. Thorough visual assessments were made before treatment and at regular follow-up to 18 months. Complications and patient satisfaction were noted.

* RESULTS: At 18 months the mean subjective refraction was +0.46 ±1.00 D with 26 eyes (92.8%) within 1 D of emmetropia. Thirteen eyes (46.4%) achieved uncorrected visual acuity (UCVA) of 20/20 or better and all patients had an UCVA of ≥ 20/32 or better. Best corrected visual acuity (BCVA) remained unchanged in 26 eyes (92.8%) and improved in 2 eyes (7.2%). On the seventh day from treatment, 17 eyes (25%) had a loss of 2 or more lines of BCVA At 15 days this was reduced to 8 eyes (14.3%) and at one month to 3 eyes (3.6%). There were no cases of loss of 2 or more lines of BCVA at 18 months of follow-up. All patients expressed a high degree of satisfaction.

* CONCLUSIONS: Photorefractive keratectomy safely and effectively reduced hyperopia in the patients studied. The technique was reliable and still offered good results at 18 months of follow-up.

[Ophthalmic Surg Lasers 2001;32:30-34]
Quantitative Analysis of Hydroxyl Radicals in the Anterior Optic Nerve of the Cat Following Transient Ischemia
Authors: Ophir Avinoam , Porges Yair
Published: April 2021

* PURPOSE: Ischemic insults in the optic nerve are relatively common ocular disorders. This study provides quantitative data on the generation of hydroxyl radicals in the anterior optic nerve of the cat during the early reperfusion phase following 90 minutes of ischemia.

* MATERIALS AND METHODS: Cats were injected intravenously with sodium salicylate that by acting as an hydroxyl radical trap, forms 2,3-dihydroxybenzoic acid (2,3-DHBA). Ischemia was achieved by intraocular pressure (IOP) elevation via cannulation of the anterior chamber. Ischemia was maintained for 60 minutes in 6 eyes and 90 minutes in 12 eyes, followed by 5 minutes of reperfusion. In an additional 6 eyes, ischemia was maintained for 90 minutes without reperfusion.

* RESULTS: After 90 minutes of ischemia and reperfusion, mean normalized levels of 2,3-DHBA (ie, ng 2,3-DHBA/µg salicylate/mg protein) that represent the levels of hydroxyl radicals were 2.47 times (at least) higher in the anterior optic nerves than in the fellow sham-operated controls (P = 0.03). These levels were 3.9 times (at least) greater than in the corresponding levels after 90 minutes of ischemia without reperfusion (P = 0.005).

* CONCLUSION: This study provides a quantitative analysis and evidence for the generation of hydroxyl radicals in the optic nerve of the cat following transient ischemia. A quantitative analysis may provide an important tool to detect even relatively small levels of free radicals in the tissues, and to evaluate the relative efficacy of various therapeutic agents in the inhibition of free radical generation following ischemia and reperfusion.

[Ophthalmic Surg Lasers 2001;32:55-62]
Three-Dimensional Analysis of Macular Diseases With a Scanning Retinal Thickness Analyzer and a Confocal Scanning Laser Ophthalmoscope
Authors: Konno Suguru , Takeda Masumi , Yanagiya Norihiko , Akiba Jun , Yoshida Akitoshi
Published: April 2021

* OBJECTIVE: To compare three-dimensional analysis of macular diseases obtained using the scanning retinal thickness analyzer (RTA) with that obtained using the confocal scanning laser ophthalmoscope, Heidelberg Retina Tomograph (HRT).

* PATIENTS AND METHODS: Both the RTA and the HRT were used to examine 50 eyes of 36 patients with diabetic macular edema, macular edema following branch retinal vein occlusion, age-related macular degeneration, and idiopathic macular holes.

* RESULTS: In most macular diseases, the retinal thickness map constructed using the RTA agreed with the image obtained with the HRT. The two maps were not consistent with each other, however, in patients with dense retinal hemorrhages and with extrafoveal fixation.

* CONCLUSIONS: Although both the RTA and the HRT give additional information to clinically evaluate macular diseases, they do have limitations. The discrepancy between these two analyses in some specific macular pathologies might be caused by the different wavelengths of the laser beam and the different methodologies used to scan the retina.

[Ophthalmic Surg Lasers 2001;32:95-99]
Diode Laser Cyclophotocoagulation in Refractory Glaucoma: Comparison Between Pediatric and Adult Glaucomas
Authors: Izgi Belgin , Demirci Hakan , Demirci F Yesim K , Turker Gulcin
Published: April 2021

* OBJECTIVE: To evaluate the outcome of contact transscleral diode laser cyclophotocoagulation (CTDC) in eyes with advanced glaucoma and to compare the efficacy in pediatric and adult patients.

* PATIENTS AND METHODS: Included in the study were 4 1 eyes (39 patients) with advanced glaucoma ( 1 5 eyes of 1 3 pediatric patients and 26 eyes of 26 adult patients). The patients were followed at least for six months or until failure of the procedure, if shorter than 6 months. The mean follow-up of all patients was 10 months (median 8 months, range 324 months); the mean pretreatment intraocular pressure (IOP) was 34.5 ±10.9 mm Hg for all cases, 36.2±12.6 mm Hg in adult cases and 31.6±6.5 mm Hg in pediatric cases

* RESULTS: At last follow-up after first treatment, there was significant decrease in IOP and the mean reduction in IOP was 12.11 ±10.5 mm Hg for all eyes. The mean reduction in IOP adult (13.6±11.8 mm Hg) and (9.9±6.8 mm Hg) patients. While the success rate after the first diode laser therapy was 59%, it increased to 75% after retreatments. The most common complications were conjunctival hyperemia and anterior chamber reaction. There was no difference in the complication rate between the pediatric and adult cases.

* CONCLUSION: CTDC is a safe and effective therapy in eyes with advanced refractory glaucoma in the short term. But multiple applications may be needed in the long term. The results in adult and pediatric patients were found to be similar in efficacy and safety.

[Ophthalmic Surg Lasers 2001;32:100-107]
Corneal Topography Changes After Vitreoretinal Surgery
Authors: Azar-Arevalo Oly , Arevalo J Fernando
Published: April 2021

Abstract. The authors report the results of a prospective study to assess corneal topography changes after vitreoretinal surgery procedures. Computer-assisted videokeratography using a Topographic Modeling System- 1 (TMS-I) were prospectively performed before and after vitreoretinal surgery (vitrectomy with or without scleral buckling) in 12 eyes (patients) with varied vitreoretinal pathology, including cytomegalovirus (CMV) retinitis, CMV-related retinal detachment, retinal detachment with and without proliferative vitreoretinopathy, trauma, acute retinal necrosis, and macular hole. Preoperative and postoperative surface regularity index (SRI), surface asymmetry index (SAI), and induced astigmatism were determined. Patients were followed for an average of 6 months (range: 2-15 months). Mean preoperative SRI was 0.52 (0.05-1.06) and postoperative SRI was 0.73 (0.25-1.36). Mean preoperative SAI was 0.43 (0.22-0.93) and postoperative SAI was 0.56 (0.21-0.99). Mean induced astigmatism was 0.7 diopters. Our study suggests that the central corneal optical quality (SRI) and the asymmetri city of the anterior corneal curvature (SAI) deteriorates after vitreoretinal surgery. [Ophthalmic Surg Lasers 2001;32:168-172]
The Superior and Inferior Components of Whitnall's Ligament
Authors: Jordan David R , Gupta Sean , Hwang Ivan
Published: April 2021

Abstract. During an orbital dissection in a 60-year-old white male, we came across a very well defined superior and inferior component of Whitnafl's ligament (Figure 1). The superior component of Whitnall's ligament is well described and well known to ophthalmologists performing eyelid surgery. The inferior component, however, is not well recognized or described. This cadaver dissection illustrates both Whitnall's components well. [Ophthalmic Surg Lasers 2001;32:173-174]
Outcomes of Temporal Clear Cornea Versus Superior Scleral Tunnel Phacoemulsification Incisions in a University Training Program
Authors: Karp Kenneth O , Albanis Chris V , Pearlman Julie B , Goins Kenneth M
Published: April 2021

* BACKGROUND AND OBJECTIVES: To eval uate the complication and visual outcomes of residents performing temporal clear cornea (TCC) compared to superior scleral tunnel (SST) phacoemulsification.

* PATIENTS AND METHODS: We conducted a retrospective analysis of complications and visual outcomes for 534 phacoemulsification procedures done by third-year residents over a five-year period (June 1992-July 1 997) at the department of ophthalmology, University of Chicago. All cases were completed using a TCC or SST incision.

* RESULTS: There was vitreous loss in 6.0% of 348 eyes with TCC incisions and in 11.8% of 186 eyes with SST incisions (P < 0.02). Posterior capsule breaks occurred in 11.5% of the TCC group versus 17.7% in the SST group (P < 0.0453). Best corrected visual acuity of 20/40 or better was achieved in 82.5% of all eyes with TCC incisions and in 75.3% of all eyes with SST incisions (P < 0.05). When 151 patients with previous ophthalmic conditions were excluded, the difference in BCVA between the two groups was not statistically significant.

* CONCLUSIONS: Most institutions train residents with the SST technique prior to advancing to TCC. This study demonstrates that with proper teaching, residents can achieve excellent outcomes using TCC incisions, and can therefore be trained in this technique concurrently with SST incisions.

Ophthalmic Surg Lasers 2001;32:228-232]
Tectonic Epikeratoplasty: A Surgical Procedure for Corneal Melting
Authors: Lifshitz Tova , Oshry Tzafrir
Published: April 2021

* BACKGROUND AND OBJECTIVE: Tectonic epikeratoplasty (TEK) is a method in which a corneal button, preserved in glycerin is used as a seal over corneal perforation. The graft is sutured to the recipient sclera, upon the sick melted cornea, with silk sutures, after 360° peritomy of the conjunctiva. The graft is left in place for a few weeks, and by that time the cornea is completely healed. We describe our experience in TEK as a method of treatment for selected cases of melted cornea or descemetocele.

* METHODS AND PATIENTS: We review 12 TEK operations done in our department over the period of 1992 to 1997, and describe the outcome in each case.

* RESULTS: The 12 TEK operations included 9 eyes of 9 patients. The patients, 7 males and 2 females, suffered from ocular surface disturbances including indifference to pain syndrome, Steven-Johnson syndrome, dry eye, relapsing herpetic keratitis, post-traumatic corneal thinning, and local anesthetic abuse. Six of the 9 eyes had leaking perforated corneal ulcer, and the remaining 3 had an imminent perforation caused by descemetocele or melting. All the grafts but one fell off the eyes between 10 and 21 days following surgery. In most of the cases the leakage ceased, and a scar sealing the perforation site was observed. One eye had gone through this procedure 3 times, and another eye had gone through it twice. In only 3 cases did the procedure fail to eliminate leakage, and another TEK or urgent penetrating keratoplasty (PKP) was done.

* CONCLUSIONS: TEK is an available method for saving the integrity of the globe when PKP is not possible. Although it increases corneal vascularity, PKP can be done later under optimal conditions.

[Ophthalmic Surg Lasers 2001;32:305-307]
Internal Limiting Membrane Removal for Traumatic Macular Holes
Authors: Kuhn Ferenc , Morris Robert , Mester Viktória , Witherspoon C Douglas
Published: April 2021

* OBJECTIVE: To evaluate a new surgical technique for traumatic macular holes and to provide epidemiological information for such holes.

* MATERIALS AND METHODS: Vitrectomy with internal limiting membrane (ILM) removal but without adjuvant use on 17 consecutive eyes.

* RESULTS: The hole closed in 100% of eyes. Vision improved ≥2 Snellen lines in 16 eyes (94%). The macula showed additional trauma-related damage in 10 eyes (59%). No permanent complication related to ILM removal was seen. Among 4440 eyes with contusion trauma in the United States Eye Injury Registry, the risk of macular hole formation is 9 times higher in eyes closed than with open globe injury (1.4% versus 0.15%).

* CONCLUSIONS: Without introducing special risks, removal of the macular ILM appears to be a highly successful surgical option in improving vision in eyes with traumatic macular holes. The majority of eyes benefit from ILM removal, even when additional traumatic macular pathology is present.

[Ophthalmic Surg Lasers 2001;32:308-315]
Valsalva Retinopathy-Like Hemorrhage Associated With Combined Trabeculotomy-Trabeculectomy in a Patient With Developmental Glaucoma
Authors: Mandal Anil K , Jalali Subhadra , Rao Vallam S , Gothwal Viyaya K , Karim Abdul
Published: April 2021

Abstract. This case describes valsalva retinopathy-like hemorrhage in a patient with developmental glaucoma who underwent primary combined trabeculotomy-trabeculectomy. A 12-year-old boy with developmental glaucoma in both eyes developed shallow anterior chamber following combined trabeculotomy-trabeculectomy in his right eye. He underwent air injection for reformation of the anterior chamber under general anesthesia. Following reformation of the anterior chamber on the 5 th postoperative day, examination of the patient revealed valsalva retinopathy-like hemorrhage. The patient was treated with betamethasone and cyclopentolate in the postoperative period, and was followed by complete absorption of the retinal hemorrhages with retention of normal visual acuity. Valsalva retinopathy-like hemorrhage may occur with valsalva maneuver during general anesthesia. [Ophthalmic Surg Lasers 2001;32:330-332]
"Luggage-Tag" Suture Fixation of Partially Dislocated Intraocular Lenses
Authors: Virata Steven R , Holekamp Nancy M , Meredith Travis A
Published: April 2021

Abstract. There are many techniques for sulcus-suturing dislocated or partially dislocated intraocular lenses. Many involve passing suture or a knot around the end of the haptic before securing the suture to the sclera. However, in some patients, the tip of the dislocated haptic cannot be visualized. We describe a suturing method using vitrectomy techniques that was used in two patients when the end of the haptic could not be visualized. The technique involves passing an untied loop of double-armed suture under the haptic so that it emerges upward between the haptic and the optic. The loop of suture is regrasped from above the haptic and externalized. The free ends are passed through the loop in a manner analogous to a luggage tag, and the knot is secured. This technique may be useful in patients where the tip of the haptic cannot be visualized, or in patients requiring minimal manipulation of the intraocular lens. [Ophthalmic Surg Lasers 2001;32:346-348].
Keratometric Results During the First Year After Keratoplasty: Adjustable Single Running Suture Technique Versus Double Running Suture Technique
Authors: Ramirez Manuel , Hodge David O , Bourne William M
Published: April 2021

* BACKGROUND AND OBJECTIVE: To compare the 3-month and 1-year postoperative keratometric results in a retrospective sequential series of corneal grafts performed with either a double running suture technique or an adjustable single running suture technique.

* MATERIALS AND METHODS: Keratometry values obtained 3 months and 1 year after penetrating keratoplasty, when sutures were still present, were compared between 31 grafts with double running sutures and 27 grafts with single running sutures, 15 of which had been adjusted postoperatively.

RESULTS: No significant difference in mean keratometry between the 2 groups was found either 3 months or 12 months after keratoplasty. Mean keratometric astigmatism was significantly less in the single running group at both 3 months (2.2 ± 1.9 vs 4.5 - 2.8, mean ± SD, P<0.001) and 12 months (3.0 ± 2.2 vs 4.2 ± 2.1, P= 0.03). Within groups, there was no significant change from 3 months to 12 months in either mean keratometry or keratometric astigmatism.

* CONCLUSION: The single running suture technique, with postoperative adjustments, produced less keratometric astigmatism during the first postoperative year, when sutures were still in place.

[Ophthalmic Surg Lasers 2001;32:370-374]
Primary Congenital Glaucoma and Erupted Teeth (Natal Teeth) in the Newborn: A Report of Two Cases
Authors: Mandal Anil K
Published: April 2021

Abstract. Primary congenital glaucoma may be associated with several ocular, adnexal, and systemic abnormalities. Presented are two cases of primary congenital glaucoma that were associated with natal teeth; ie, the teeth were present in the oral cavity at the time of birth. To the knowledge of the author, this is the first report on the association of primary congenital glaucoma and natal teeth. [Ophthalmic Surg Lasers 2001;32:419-421]
A Novel Suture Technique in Stellate Corneal Lacerations
Authors: Akkin Cezmi , Kayikcioglu Ozcan , Erakgun Tansu
Published: April 2021

Abstract. A novel suture technique for regular stellate corneal lacerations, called a star-shaped suture is described. The suturing begins from inside any of the wound lips in a clockwise direction. Suture placement proceeds in a counterclockwise direction by the adjacent wound limb, while the suture passes are all in clockwise direction. Finally, a star-shaped suture is achieved with the knot self-buried in the corneal stroma at the initial entry site. This is a continuous suture, of which tractional forces direct to the center of the wound providing good apical apposition for stellate lacerations. This suture technique can be an alternative for the reconstruction of stellate corneal lacerations. [Ophthalmic Surg Lasers 2001;32:436-437]
Closure of Chronic Macular Holes Using Passive Aspiration to the Edges of the Macular Hole
Authors: Peyman Gholam A , Cheema Rizwan A , Conway Mandi D
Published: April 2021

Abstract. Full-thickness macular holes are characterized by central dehiscence of neurosensory tissue and a reduction in visual acuity. According to Gass1 and then Johnson and Gass,2 full-thickness macular holes are caused by progressive vitreous cortex condensation, resulting in tangential traction with centrifugal displacement of photoreceptor elements at the fovea. [Ophthalmic Surg Lasers 2001;32:486-489]
Hyperbaric Oxygen Therapy for Mitomycin C-Induced Scleral Necrosis
Authors: Bayer Atilla , Mutlu Mehmet , Sobaci Gungor
Published: April 2021

Abstract. Intraoperative or postoperative use of mitomycin C is one of the treatment options to reduce the recurrence of pterygia. Scleral necrosis, a potentially blinding complication after mitomycin C use, has been among great concern in ophthalmic practice. A patient is presented in whom scleral necrosis developed 20 days after a pterygiectomy with bare sclera technique was performed, followed by the application of 0.4 mg/mL of topical mitomycin C eye drops for 3 weeks. After conjunctival flap failures the patient was treated with hyperbaric oxygen therapy. The sclera revascularized and returned to near normal thickness after 24 sessions of hyperbaric oxygen therapy. This case demonstrates that it is an effective, novel treatment. [Ophthalmic Surg Lasers 2001;32:490-493]
Aqueous Shunts for Intractable Glaucoma in Infants
Authors: Pereira Mary Lucy M , Araujo Silvana V , Wilson Richard P , Azuara-Blanco Augusto , Moster Marlene R , Schmidt Courtland M
Published: April 2021

BACKGROUND AND OBJECTIVE: To evaluate the long-term outcome of aqueous shunts in the treatment of infantile glaucoma refractory to conventional treatment.

PATIENTS AND METHODS: The records of all patients up to 3 years of age managed with aqueous shunts for uncontrolled glaucoma between November 1990 and November 1996 were retrospectively reviewed. Ten eyes of 6 patients were included in the study.

RESULTS: The mean preoperative intraocular pressure (IOP) was 29.75 ±4.15 (mm Hg; SD), with none of the eyes on antiglaucoma medication. Postoperatively, the mean IOP was 18.25 ± 5.34 (mm Hg; SD) at a mean follow up of 50 ± 25.6 (SD) months with 7 eyes on topical antiglaucoma medication. At the final follow up, 6 eyes were considered successfully controlled without reintervention, 2 more were controlled after shunt revision, and 2 were considered failures.

CONCLUSIONS: Aqueous shunts were relatively effective in this series of infants with recalcitrant glaucoma.

[Ophthalmic Surg Lasers 2002:33:19-29]
Perfluorocarbon Liquid Assists in Stripping the ILM to Treat Detached Retina Caused by Macular Hole
Authors: Nishimura Akira , Kita Katsutoshi , Segawa Yasunori , Shirao Yutaka
Published: April 2021

Abstract. Stripping the internal limiting membrane (ILM) is supposed to be beneficial in attaching the retina in retinal detachment because of macular hole. However, it is difficult to lift up and strip the ILM over extensively detached retinas because such retinas are very mobile. To evade this difficulty, we flattened the detached retina with perfluorocarbon liquid (PFCL) and peeled the ILM in the presence of PFCL. The ILM flap was easily turned up and enlarged with the posterior counter traction by PFCL. Intraoperative flattening of the retina with PFCL is useful in peeling the ILM from detached retinas. [Opthalmic Surg Lasers 2002;33:77-78]
Comparison of Trabeculectomy With Mitomycin C With or Without Phacoemulsification and Lens Implantation
Authors: Kleinmann Guy , Katz Haia , Pollack Ayala , Schechtman Edna , Rachmiel Roni , Zalish Miriam
Published: April 2021

* PURPOSE: To compare the results of combined trabeculectomy with phacoemulsification and posterior chamber intraocular lens (IOL) implantation to those of trabeculectomy alone using mitomycin C (MMC) application intraoperatively in all cases.

* PATIENTS AND METHODS: A retrospective comparative study of consecutive patients was conducted on two groups: 102 eyes of 90 patients studied in the combined procedure group, and 33 eyes of 30 patients in the trabeculectomy alone group.

* RESULTS: Both groups showed a significant decrease in IOR The combined group had a change from 21.5±5.8 mm HG preoperative to 14.73±3.44 mm HG postoperative, P=0.0001; the trabeculectomy group changed from 24.2±7.5 mm HG preoperative to 12.46±3.86 mm HG postoperative, P=0.0001. This represents a 31.5% reduction in IOP in the combined group versus a 48.5% reduction in the trabeculectomy alone group (P=0.0001). The follow-up time was longer in the trabeculectomy group (trabeculectomy group, 22.6±13.3 months; combined group, 14.2±8.0 months), P=0.00l4. There were 97 eyes in the combined group (95%) and 32 eyes (97%) in the trabeculectomy group that had an IOP of less than 20 mm HG at the end of follow up. Postoperatively, the two groups showed similar significant reductions in the number of antiglaucomatous medications used (combined group, 0.82±1.0 compared with 2. 65±0. 84 preoperatively, P=O-OOOl; trabeculectomy group, 0.76±1.2 compared with 2.7±0.95 preoperatively, P=O-OOOl). There were no cases of bleb leakage in the combined group and two cases (6%) in the trabeculectomy group.

* CONCLUSION: The reduction of IOP is significantly larger after trabeculectomy alone than after the combined procedure; however, the functional and anatomical results of the combined procedure of phacoemulsification, posterior chamber IOL implantation, and trabecutectomy with MMC application were as good as those of trabeculectomy alone with MMC.

[Ophthalmic Surg Lasers 2002; 33; 102-108]
Reproducibility of Retinal Nerve Fiber Layer Thickness Measurements Using Scanning Laser Polarimetry in Pseudophakic Eyes
Authors: Rhee Douglas J , Greenfield David S , Chen Philip P , Schiffman Joyce
Published: April 2021

* OBJECTIVE: To assess the reproducibilicy of retinal nerve fiber layer measurements in pseudophakic normal and glaucomatous eyes using scanning laser polarimetry (GDx, Laser Diagnostic Technologies, Inc., San Diego, CA).

* PATIENTS AND METHODS: Normal and glaucomatous patients with polymethylmethacrylate posterior chamber intraocular lenses that satisfied entry criteria underwent imaging by two experienced operators. Eyes with posterior capsule opacification or vision less than 20/30 were excluded. Baseline images (mean pixel SD less than 8 mm) were obtained on 3 separate days within a 7-week period. Reproducibility, defined as the pooled within eye variance of these 3 measurements and the coefficient of variation for 12 retardation parameters generated by GDx software were calculated.

* RESULTS: Eighteen eyes (11 glaucoma, 7 normal) of 1 5 patients (7 female, 8 male) were enrolled (mean age 78 ± 6 years). Among glaucomatous eyes, the average mean deviation and corrected pattern standard deviation using achromatic automated perimetry (ZeissHumphrey, Dublin, CA) was -3.8 ± 1.5 dB (range, -1.89 to -5.04 dB) and 4.9 ± 3-3 dB (range O to 11.05 dB), respectively. Coefficient of variation was 10% or less for all retardation parameters except ellipse modulation (20.2%) and neural network number (12.4%). Glaucomatous and normal eyes had similar variability for 8 of 1 2 (66.7%) retardation parameters. Inferior ratio, ellipse modulation, and superior ratio were significantly less variable in glaucomatous eyes (P = 0.007, 0.02, and 0.04 respectively) than normal eyes. Superior integral was more variable in glaucomatous eyes (P= 0.03).

* CONCLUSION: Retardation measurements may be obtained in pseudophakic eyes with acceptable reproducibiltty, Normal eyes and eyes with mild glaucomatous damage have similar variability for most retardation parameters.

[Ophthalmic Surg Lasers 2002;33:117-122]
Paramacular Von Hippel Angioma With Tractional Macular Detachment
Authors: Majji Ajit B
Published: April 2021

Abstract. A rare case of paramacular angioma with tractional macular detachment that was managed successfully with laser, followed by surgical intervention with good visual outcome, is presented. A 23-year-old female patient with paramacular Von Hippel angioma was treated with argon laser photocoagulation. Threemonths following photocoagulation, vítrectomy with epiretinal tractional membrane removal was attempted successfully. Visual acuity improved from a preoperative level of 20/200 to 20/50 at the 6 months postoperative period. No recurrence of epiretinal membrane or exudation was observed during the follow-up period. Photocoagulation, followed by surgical intervention for removal of epiretinal traction membranes, resulted in relieving the tractional macular detachment and recovering useful visual acuity in paramacular Von Hippel angioma. [Ophthalmic Surg Lasers 2002;33: 145-147]
Corneal Graft Rejection and Recurrent Anterior Uveitis Associated With Intraocular Cilium
Authors: Orhan Mehmet , Tatlipinar Sinan , Irkec Murat
Published: April 2021

Abstract. A 60-year-old male patient with Pseudophakie bullous keratopathy in his right eye underwent corneal transplantation. Graft rejection occurred and the patient was regrafted 1 year later. The postoperative course was complicated with recurrent anterior uveitis attacks. In his right eye, he had a cilium in the posterior chamber at the five o'clock position between the intraocular lens and iris. The cilium was removed and the patient was free of any anterior uveitis or corneal rejection for 18 months. Eyes harboring corneal transplants and suffering frequent rejection, or chronic recurrent anterior uveitis should be examined carefully for the possible presence of foreign bodies. [Ophthalmic Surg Lasers 200233:231-232]
Pterygium Surgery: Conjunctival Rotation Autograft Versus Conjunctival Autograft
Authors: Dadeya Subhash , Malik K P S , Gulliani B P
Published: April 2021

* BACKGROUND AND OBJECTIVES: To compare the safety and efficacy of conjunctival rotation autograft to conjunctival autograft in primary pterygium surgery.

* PATIENTS AND METHODS: A prospective randomized study was performed of 39 eyes in 31 patients who had undergone pterygium surgery. Nineteen eyes were treated by conjunctival rotation autograft (Group A). Twenty eyes were treated by conjunctival autograft (Group B). Follow up ranged from 8 to 12 months (mean 11 months). Recurrence was defined as postoperative regrowth of 2 mm fibrovascular tissue onto clear cornea in the area of previous pterygium excision.

* RESULTS: Recurrence was observed in 5.88% (1/17) in Group A and in 5.55% (1/18) in Group B.

Four eyes were excluded from the study. Delayed wound healing occurred in 11.76% of eyes, and 5.88% of eyes had persistent congestion in Group A. A loose graft was present in 5.55% of eyes, and 5.55% of eyes had dellen formation in Group B.

* CONCLUSION: We conclude that conjunctival rotation autograft and conjunctival autograft are both equally effective methods to reduce the recurrence rate after pterygium surgery. Conjunctival rotation autograft can be tried as an alternative attractive procedure for pterygium surgery to reduce the chances of recurrence. However, a larger, randomized, prospective double masked study with more patients and a longer follow up will eventually demonstrate the superiority of one procedure over the other.

[Ophthalmic Surg Lasers 2002;33:269-274]
Epiblepharon of the Lower Eyelid: Technique of Surgical Repair and Quantification of Excision According to the Skin Fold Height
Authors: Khwarg Sang In , Choung Ho-Kyung
Published: April 2021

* BACKGROUND AND OBJECTIVE: To describe our excisional technique for lower eyelid epiblepharon to reduce a medial undercorrection and to provide a guide for the excision amount using a classification system of epiblepharon according to the skin fold height.

* PATIENTS AND METHODS: After classification, an elliptical excision of skin and orbicularis muscle, including that below the lower canaliculus after tarsal suturing of the upper edge of the incised skin, was consecutively performed for 111 eyelids of 58 patients. The widest width of the excisional ellipse was measured.

* RESULTS: The results were successful in 108 eyelids. The mean widest width of the excisional ellipse was 1.1, 1.7, 2.5, and 3.0 mm in Class I, II, III, and IV epiblepharons, respectively.

* CONCLUSION: This surgical technique is effective for the correction of epiblepharon, and it is easy to determine the amount of excision. Using this technique, a 1 mm to 3 mm width of excision is sufficient.

[Ophthalmic Surg Lasers 2002;33:280-287]
Simultaneous Choroidal and Brain Metastasis as Initial Manifestations of Lung Cancer
Authors: Shields Jerry A , Perez Noel , Shields Carol L , Foxman Scott , Foxman Brett
Published: April 2021

Abstract. A previously healthy 75-year-old woman developed blurred vision in her left eye and was found to have an amelanotic choroidal metastasis. Cranial magnetic resonance imaging disclosed 2 brain lesions compatible with metastasis. Subsequent evaluation revealed a primary cancer in the lung. Simultaneous metastasis to the choroid and the brain from an occult primary lung cancer is rare. This case underscores the need for a detailed systemic evaluation in a patient with an amelanotic choroidal mass in which a metastasis is a diagnostic consideration. [Ophthalmic Surg Lasers 2002;33:323-325]
Local Methotrexate and Dexamethasone Phosphate for the Treatment of Recurrent Primary Intraocular Lymphoma
Authors: Velez Gisela , Boldt H Culver , Whitcup Scott M , Nussenblatt Robert B , Robinson Michael R
Published: April 2021

Abstract. A 70-year-old patient with recurrent bilateral primary intraocular lymphoma (PIOL) was treated with local injections of methotrexate and periocular dexamethasone phosphate to both eyes over the course of 5 months. Local therapy consisted of a cycle to each eye of 3 intravitreal injections of methotrexate (200 µg in a total volume of 0.1 cc) administered on days 1, 5, and 8, followed by a subtenon injection of dexamethasone phosphate (7.5 mg in a total volume of 0.3 cc) on day 9. This treatment cycle was administered 4 times for the right eye and 3 times for the left eye, at 4 to 6 week intervals. Electroretinography was used to assess retinal function prior to and during each treatment regimen.

Complete regression of the lymphomatous infiltrates and resolution of the vitritis was observed with preservation of visual acuity and no changes on electroretinography. The effect was sustained for 24 months after termination of treatment in the absence of systemic chemotherapy, radiation treatments, or maintenance intravitreal injections.

Local combined chemotherapy can be used to treat recurrent PIOL, and can serve as successful palliative therapy in patients for whom further treatment with systemic chemotherapy or radiation is contraindicated. [Ophthalmic Surg Lasers; 33:329-333]
A Simple, Safe Bimanual Technique for Subincisional Cortex Aspiration
Authors: Sakamoto Takashi , Shiraki Kunihiko , Inoue Kohji , Yanagihara Nobuyo , Ataka Shinsuke , Kurita Kaori
Published: April 2021

Abstract. We developed a bimanual manipulation technique to facilitate the removal of the subincisional lens cortex in small-incision phacoemulsification cataract surgery. A separate aspiration handpiece, not connected to an aspiration tube, is passed into the anterior chamber through a side-port corneal incision. Under irrigation with a standard infusion/aspiration (I/A) handpiece through a tunnel incision, the cortex is stripped off with the separate handpiece and removed with the I/A handpiece. In 227 eyes, subincisional cortex removal and subsequent capsule polishing was performed safely with the separate handpiece. Rupture of the posterior lens capsule occurred in 3 high-risk eyes. [Ophthalmic Surg Lasers 2002;33:337-339]
Uveitic Angle Closure Glaucoma in a Patient With Inactive Cytomegalovirus Retinitis and Immune Recovery Uveitis
Authors: Goldberg Daniel E , Freeman William R
Published: April 2021

Abstract, We report a case of uveitic acute angle closure glaucoma in a patient with acquired immunodeficiency syndrome (AIDS) associated with inactive cytomegalovirus retinitis and immune recovery vitritis. We conducted a long-term, follow-up examination of a 47-year-old male with AIDS and inactive cytomegalovirus retinitis caused by immune recovery on highly active antiretroviral therapy (HAART). We found vitritis and ultimate development of uveitic glaucoma in the postoperative periods following repair of retinal detachment and extracapsular cataract extraction with intraocular lens implant. An episode of acute angle closure secondary to posterior synechiae and iris bombé subsequendy developed, requiring peripheral laser iridotomy. Immune recovery in the setting of inactive cytomegalovirus retinitis can result in intraocular inflammation severe enough to cause angle closure glaucoma and profound ocular morbidity.

[Ophthalmic Surg Lasers 2002;33:421-425]
Intravitreal Removal of Large, Fibrotic Choroidal Neovascular Membrane Complexes in Submacular Surgery
Authors: Haivala Darin R , Nanda Sumit K
Published: April 2021

Abstract, Submacular surgery is a current alternative technique for the treatment of subfoveal choroidal neovascular membranes (CNVM). One of the difficulties often encountered with this technique is the actual removal of the neovascular membrane complex from the eye. It is often too large and fibrotic to be removed directly through a sclerotomy site without risking significant sclerotomy site complications. The vitreous cutter can be used, but despite high aspiration settings, the large, fibrotic neovascular membrane complex may still not be able to be completely removed safely and expeditiously. We describe an alternative technique using the phacofragmentation handpiece to remove large fibrotic neovascular membranes from the vitreous cavity thereby reducing sclerotomy site complications and surgical time.

[Ophthalmic Surg Lasers 2002;33:436-437]
Patient Comfort with Combined Anterior Sub-Tenon's, Topical, and Intracameral Anesthesia Versus Retrobulbar Anesthesia in Trabeculectomy, Phacotrabeculectomy, and Aqueous Shunt Surgery
Authors: Kansal Sukesh , Moster Marlene R , Gomes Marcia C , Schmidt Courtland M , Wilson Richard P
Published: April 2021

* PURPOSE: To assess patient comfort using combined anterior sub-Tenon's, topical, and intracameral ("Blitz") anesthesia versus retrobulbar anesthesia in glaucoma surgery.

* PATIENTS AND METHODS: In this study, 139 consecutive patients who received retrobulbar anesthesia and 139 consecutive patients who received Blitz anesthesia during glaucoma surgery were evaluated in a prospective fashion. The retrobulbar group included 49 trabeculectomies, 36 aqueous shunts, and 54 phacotrabeculectomies. The Blitz group included 49 trabeculectomies, 30 aqueous shunts, and 60 phacotrabeculectomies. Patients were asked to assess their level of ocular pain operatively and postoperatively on a 10point visual analog scale. The operative and postoperative pain scores and postoperative sedation of patients receiving retrobulbar anesthesia were compared with those of patients receiving Blitz anesthesia during trabeculectomy, phacotrabeculectomy, and aqueous shunt surgery, separately.

* RESULTS: No statistically significant difference was found in the mean operative or postoperative pain scores between the two groups during trabeculectomy, phacotrabeculectomy, or aqueous shunt surgery.

* CONCLUSIONS: Blitz anesthesia offers a reasonable alternative to retrobulbar anesthesia for trabeculectomy, phacotrabeculectomy, and aqueous shunt surgery.

[Ophthalmic Surg Lasers 2002;33:456-462]
Role for Rapid Surgical Intervention in Uveal Effusion Syndrome With Associated Optic Neuropathy
Authors: Bhullar Shaminder S. , Gray Matthew J. , Kay Christine N.
Published: April 2021

Uveal effusion syndrome (UES) can be associated with nanophthalmos and rarely can present with concomitant optic neuropathy. This case report describes nanophthalmic UES and optic neuropathy treated with early sclerectomies. One month postoperatively, the patient experienced significant improvement in choroidal effusions and optic neuropathy, with increases in visual acuity and visual fields. Early scleral windows surgery for UES with associated optic neuropathy can provide prompt improvement of choroidal swelling, optic nerve edema, and vision, although the relapsing course of this disease presents a challenge to long-term visual prognosis.

[
Ophthalmic Surg Lasers Imaging Retina.
2014;45:e11–e13.]
A Strategy for Teaching Health Literacy to Physician Assistant Students
Authors: Ruggeri Barbara , Vega Amy , Liveris Marissa , St. George Thomas E. , Hopp Jane
Published: April 2021

This brief report presents a model that incorporates an analogous “see-one,” “do-one,” “teach-one” pedagogical strategy and experiential learning for mastery of health literacy principles by first-year Master of Science in Physician Assistant Studies students. Students completed a series of health literacy activities including classroom-based lecture (see-one), hands-on application of health literacy activities (do-one), and application and peer-instruction of health literacy best practices with other health science students (teach-one) as part of a two-semester hands-on learning experience. A health literacy knowledge examination, qualitative student feedback, and faculty review of content application were used to assess for effectiveness. Students demonstrated a significant and sustained positive change in knowledge examination scores complemented by positive faculty poster review. Physician Assistant student health literacy knowledge is increased and sustained after application of see-one, do-one, teach-one strategy with students demonstrating health literacy considerations in real-client application during experiential learning. Education programs seeking to meet the call for health professionals prepared to address gaps in health literacy should consider a see-one, do-one, teach-one and experiential learning approach over multiple semesters.

[
HLRP: Health Literacy Research and Practice.
2021;5(1):e70–e77.]
Decentralization estimators for instrumental variable quantile regression models
Authors: Kaido Hiroaki , Wüthrich Kaspar
Published: April 2021

The instrumental variable quantile regression (IVQR) model (Chernozhukov and Hansen (2005)) is a popular tool for estimating causal quantile effects with endogenous covariates. However, estimation is complicated by the nonsmoothness and nonconvexity of the IVQR GMM objective function. This paper shows that the IVQR estimation problem can be decomposed into a set of conventional quantile regression subproblems which are convex and can be solved efficiently. This reformulation leads to new identification results and to fast, easy to implement, and tuning‐free estimators that do not require the availability of high‐level “black box” optimization routines.
Soundscape of protected and unprotected tropical Atlantic coastal coral reefs
Authors: Borie Alfredo , Magalhães Rezende Sergio , Padovani Ferreira Beatrice , Maida Mauro , Radford Craig , Travassos Paulo
Published: April 2021

Behavioural patterns and distributions of crustaceans, fish and mammals can be inferred from acoustic recordings of the extremely noisy marine acoustic environment. In this study, we determined the soundscape of protected and non-protected marine areas between January and April 2016. Sonobuoy (a device for sound monitoring) recordings began at sunset and lasted approximately 12 hours per day. The results show a complex soundscape dominated by biological sounds produced by crustaceans and fish. Six fish chorus-dominant frequencies between 200 and 1000 Hz occurred at a similar time each day, except for chorus I. The choruses consisted of high-energy callings after the last reef line within the protected area. However, fish choruses showed low energy levels in unprotected areas. The results show the importance of protected areas for fish populations and the usefulness of passive acoustics to monitor biodiversity of sounds of commercial fish in Brazilian tropical costal reefs.
Information Privacy, Cultural Values, and Regulatory Preferences
Authors: Benamati John H. , Ozdemir Zafer D. , Smith H. Jeff
Published: April 2021

The global nature of e-commerce is complicating privacy issues because perceptions of privacy, trust, risk, and fair information practices vary across cultures, and differences in national regulation create challenges for global information management strategies. Despite the spike in international regulatory attention devoted to privacy issues and the tensions associated with them, there has been very little research on the relationship between information privacy concerns and consumers' regulatory preferences, and even rarer is research that incorporates cultural values into a framework that includes privacy concerns and regulation. This study examines privacy concerns, a full complement of cultural values, trust, risk, and regulation at the individual level in a cohesive manner. Relying on a dataset of consumers gathered in the United States and India, the authors test a model that incorporates these constructs as well as trust and risk beliefs. The model explains 48% of the variance in consumers' regulatory preferences, and all but one of the hypotheses find statistical support.