bluuebunny/crossref_metadata_2025 huggingface dataset:
Frosted-Iris Intraocular Lens for Traumatic Aniridia With Cataract
Authors: Vajpayee Rasik B , Majji Ajit B , Taherian Kasra , Honavar Santosh G
Published: April 2021

ABSTRACT

We describe an eye with traumatic cataract and aniridia in which we implanted a frosted-iris intraocular lens following endocapsular cataract extraction. The lens was well tolerated and the cosmetic result acceptable.
A New Knife Handle With a Safe Blade-Release Design for Surgical and Laboratory Use
Authors: Wafapoor Hussein , Peyman Gholam A
Published: April 2021

ABSTRACT

This new knife handle is designed for all Bard-Parker blades, ft safely releases the blade through a mechanism that is intended to reduce the risk of injury and subsequent infection by blood-borne pathogens.
Comparison of Three Corneal Trephines for Use in Therapeutic Penetrating Keratoplasties for Large Corneal Perforations
Authors: Ng John D , Nekola Mark , Parmley Vernon C , Richardson Margaret , Mader Thomas
Published: April 2021

ABSTRACT

Corneas with large perforations complicate penetrating keratoplasty due to the increased risk of anterior chamber collapse they pose. We hypothesize that suction trephines should produce more uniform cornea) openings than non-suction trephines. Penetrating keratoplasties using Franceschetti-type freeblades, and Hanna and Hessberg-Barron suction trephines were performed on human eye bank eyes with large corneal perforations. The trephined corneas' histologie appearance was graded according to depth, sharpness, and perpendicularity of cut. Suction trephines were easier to use, resulted in less anterior chamber collapse, caused less corneal distortion, and created a sharper, deeper and more perpendicular incision. The Hessberg-Barron and Hanna trephines performed better than the freeblades in this study.
Compliance in Patients Prescribed Eyedrops for Glaucoma
Authors: Patel Santosh C , Spaeth George L
Published: April 2021

ABSTRACT

We studied the rate of failure to use eyedrops as prescribed for glaucoma and some of the factors possibly associated with that noncompliance by interviewing 100 patients being followed in a setting emphasizing correct usage. Fifty-nine reported they had not used their eyedrops precisely as prescribed. Factors significantly influencing compliance included daily dose frequency, forgetfulness, inconvenience, and unaffordability. Gender and race were marginally significant factors, with men and blacks reporting somewhat higher rates of missed doses than women and whites. Side effects and age were not significant causes of noncompliance.
A Simple Punching Device for Use in Penetrating Keratoplasty
Authors: Urrets-Zavalía A
Published: April 2021

ABSTRACT

A method of supporting donor cornea for trephination is described. On a base of heated and then cooled paraffin, a series of small indentations are made with a sterile acrylic ball, 15 mm in diameter, about one third of its volume deep. The donor cornea is then placed in one of the indentations for trephination.
Visual Outcome of Eyes With Malignant Melanoma of the Uvea After Ruthenium Plaque Radiotherapy
Authors: Summa Paula , Immonen Ilkka , Kivelä Tero , Tommila Petri , Heikkonen Jorma , Tarkkaanen Ahti
Published: April 2021

* BACKGROUND AND OBJECTIVE: To analyze the overall visual outcome in 100 consecutive eyes with malignant uveal melanoma irradiated with ruthenium-106 plaques between 1981 and 1991.

* PATIENTS AND METHODS: The follow-up ranged from 4 months to 10.1 years (median 3-0 years). Scattergrams of equal follow-up periods, lifetable survival analysis, and Cox's proportional hazards analysis were used to analyze visual outcome.

* RESULTS: VA increased for some time in 14 eyes. By 3 years, VA of at least 20/70, 20/200, counting fingers, and light perception were retained in 27%, 41%, 67% and 82% of eyes, respectively. Macular pathology cause loss of reading vision; neovascular glaucoma or enucleation caused loss of light perception. In univariate analysis, large tumor size (height >5 mm or TNM class T3) predicted visual loss of all VA levels. For the loss of light perception, the tumor s largest basal diameter > 15 mm reached significance. In Cox's multivariate analysis tumor height >5 mm was the only significant independent risk indicator for loss of VA levels 20/70 and 20/200. For the level CF, largest basal tumor diameter also reached significance, but location of the tumor within 1 disc diameter of the optic disc, either alone or in addition to the fovea, had the greatest risk ratio (6.3, 95% CI 4.1-9.8). For losing light perception, large TNM size (T3) was the strongest risk indicator (risk ratio 10.0; 95% CI 4.5-22.5), followed by proximity of the tumor to the optic disc (risk ratio 4.3, 95% CI 2.4-7.8).

* CONCLUSION: Ruthenium brachytherapy may retain vision in an eye with a malignant melanoma of the uvea for a considerable period of rime. The data presented are useful in patient counseling and allow comparison to subsequent series.

[Ophthalmic Surg Lasers 1995;26:449-460.]
Effects of Wound Architecture and Suture Technique on Postoperative Astigmatism
Authors: Gimbel Howard V , Sun Ran , DeBroff Brian M
Published: April 2021

* BACKGROUND AND OBJECTIVE: A prospective randomized investigation was performed to evaluate the effects of wound architecture and suture techniques on postoperative astigmatism after phacoemulsification and intraocular lens implantation.

* PATIENTS AND METHODS: Two hundred eyes with preexisting with-the-rule astigmatism were randomized into four groups: (1) sutureless scleral tunnel frown incision, (2) scleral tunnel frown incision with a horizontal suture, (3) scleral tunnel frown incision with both a horizontal and a running suture, and (4) posterior limbal acute beveled cataract incision with a running suture. All the incisions were placed in the vertical steep meridian.

* RESULTS: Data were analyzed from 128 cases with 1-year follow-up. The results revealed that at the 2-month postoperative visit, preexisting astigmatism was significantly reduced in group 1 (P = .029) and significantly increased in groups 3 (P = .020) and 4 (P = .005). There was no significant change in group 2 (P = .06). By the 1-year postoperative visit, there was no significant difference in astigmatism from preoperative levels for all four groups. Vector analysis revealed no significant difference in the mean surgically induced cylinder at 1 year in all four groups. The number of eyes with induced against-the-rule astigmatism, however, was significantly higher than the number of eyes with induced with-the-rule astigmatism in all four groups (P < .01).

* CONCLUSION: The authors found that sutured wounds placed in the vertical steep meridian may initially increase with-the-rule astigmatism, whereas nonsutured wounds placed in the vertical steep meridian may initially reduce with-the-rule astigmatism. By 1 year, however, a mean flattening of the vertical steep meridian was observed in the three groups with sutures as well as in the group without sutures.

[Ophthalmic Surg Lasers 1995;26:524-528.]
Clinical Management of Posterior Chamber Intraocular Lens Implants Dislocated in the Vitreous Cavity
Authors: Shakin Eric P , Carty James B
Published: April 2021

* BACKGROUND AND OBJECTIVE: To discuss the options for management and review the authors' experience with dislocated posterior chamber intraocular lens implants.

* PATIENTS AND METHODS: A retrospective review was performed over a 3-year period of 12 consecutive patients with posterior chamber intraocular lens (PC IOL) implants dislocated into the vitreous cavity. The patients were managed wich pars plana vitrectomy, repositioning or exchange, and transscleral suture fixation of the PC IOL.

* RESULTS: The visual acuity was 20/50 or better in 9 patients and the transscleral suture fixated PC IOL was in good position in 12 patients at the most recent follow-up. Perioperative complications included corneal edema, cystoid macular edema, retinal breaks and detachments, and suture erosion.

* CONCLUSION: Visual and anatomic outcomes were favorable.

[Ophthalmic Surg Lasers 1995;26:529-534.]
Role of Dacryocystectomy in the Management of Failed Dacryocystorhinostomy Associated With Chronic Dacryocystitis
Authors: Boynton James R , Anawis Monique A
Published: April 2021

Abstract. Three patients had recurrent chronic dacryocystitis but no epiphora associated with failed dacryocystorhinostomies. Dacryocystectomy was performed on all three patients. These patients were cured of dacryocystitis following dacryocystectomy and none had epiphora postoperatively. There may be a group of patients with dry eyes and chronic dacryocystitis in whom dacryocystorhinostomy is likely to fail. Such patients may respond favorably to dacryocystectomy. [Ophthalmic Surg Lasers 1996;27: 133-136.]
Cluster Headache Presenting With Orbital Inflammation
Authors: Rubin Peter A D , Chen Valentina N , Acquadro Martin A
Published: April 2021

Abstract. Acute, noninfectious orbital inflammations often defy a specific diagnosis despite a thorough medical evaluation and are grouped in the nonspecific diagnostic category of idiopathic inflammation of the orbit (pseudotumor). An atypical case of cluster headache presenting with intermittent migratory facial swelling and orbital inflammation, and 3 mm of exophthalmos simulating idiopathic orbital inflammation is presented. Although periorbital pain is a frequent finding in patients suffering from cluster headaches, to the authors' knowledge this is the first reported case of orbital inflammation with cluster headache. After unsuccessful treatment directed at potential infectious and inflammatory causes, the patient responded well to methysergide, an established treatment for cluster headaches. A review of the known mechanisms for this disorder, peripheral and central nervous system mechanisms of pain, and migratory angioedema reveals overlapping pathophysiology, clinical findings, and associated symptoms. [Ophthalmic Surg Lasers 1996;27:143-146.]
Relaxing Retinotomy Under Perfluorocarbon Liquid
Authors: Grove Mark D J , Peyman Gholam A , Millsap C Mark
Published: April 2021

Abstract. A technique of performing a relaxing retinotomy under the perfluorocarbon liquid perfluoroperhydrophenanthrene (Vitreon, Vitrophage, Inc., Lyons, IL) is described. This procedure allows perfluorocarbon liquid to be used to maintain the retina in the desired position and to dissect proliferative membranes prior to the retinotomy without having to remove the Vitreon to perform the retinotomy. [Ophthalmic Surg Lasers 1996;27:154-155.]
Retrobulbar Anesthesia With a Flexible Catheter
Authors: Dantas Paulo Elias Correa , Nishiwaki-Dantas Maria Cristina , Henriques Marta Junqueira , de Almeida Geraldo Vicente
Published: April 2021

* BACKGROUND ANDOBJECTIVES: The authors describe a method that seeks to improve the administration of local anesthesia for intraocular surgery, avoiding the risk of potential complications associated with retrobulbar and peribulbar techniques and eliminating the inconveniences of the new methods such as subconjunctival and limbal infiltration.

* PATIENTS AND METHODS: The authors demonstrate the safety and effectiveness of this technique in 50 consecutive cases. This technique consists of a small, blunt dissection of the conjunctiva, Tenons capsule, and intermuscular septum in the inferior nasal quadrant, followed by the insertion of a flexible catheter that is guided to the retrobulbar space, where 3.0 ml of anesthetic solution is injected.

* RESULTS: AU of the patients (100%) felt that this procedure was comfortable and painless. No complications were observed. Ultrasonography demonstrated the exact catheter position in the retrobulbar space; therefore, the authors could be sure that this anesthetic infiltration was done in the appropriate and safe place.

* CONCLUSIONS: This is a direct sub-Tenons technique that is simple, effective, and safe and that avoids introducing a sharp or metallic instrument into the orbit.

[Ophthalmic Surg Lasers 1996;27:275-278.]
Surgery for Esotropia With a High Accommodative Convergence/Accommodation Ratio: Effects on Accommodative Vergence and Binocularity
Authors: Arnoldi Kyle A , Tychsen Lawrence
Published: April 2021

* BACKGROUND AND OBJECTIVE: To determine the effectiveness of strabismus surgery as an alternative treatment for high accommodative convergence/accommodation (AC/A) ratio (nonrefractive accommodative) esotropia.

* PATIENTS AND METHODS: Twenty-three consecutive children with an AC/A ratio of 5: 1 or greater and a distance-near disparity of 10 prism diopters (PD) or more were studied in a prospective design. Each patient was treated by recession of both medial rectus muscles for the full amount of esotropìa measured at near fixation through the fiill distance hyperopic correction. The magnitude of eso deviation, the AC/A ratio, and the grade of binocularity were measured before and a minimum of 4 months after strabismus surgery.

* RESULTS: Surgery reduced the mean preoperative eso deviation at near fixation by a factor of 4 (from a mean of 37 PD to a mean of 9 PD). Surgery eliminated the need for bifocals in 96% of the patients. The grade of binocular fusion or stereopsis improved in 70% of the patients, remained unchanged in 26%, and was degraded in 4%. Three (13%) of the children became exophoric; none of the children were exotropic.

* CONCLUSION: These results demonstrate that strabismus surgery is an effective alternative to the long-term use of bifocals in the treatment of high AC/A ratio esotropia. Surgery may be more effective than bifocals in restoring normal stereopsis and binocular fusion.

[Ophthalmic Surg Lasers 1996;27:342-348.]
Corneal Incision Phacoemulsification and Internal Bleb Revision
Authors: Kasahara Niro , Sibayan Santiago A , Montenegro Martha H , Simmons Ruthanne B , Smith Thomas J
Published: April 2021

* BACKGROUND AND OBJECTIVE: Cataract extraction in filtered eyes often leads to decreased outflow and, eventually, to bleb failure. The authors describe a surgical technique that promotes preservation of the filtering bleb.

* PATIENTS AND METHODS: The authors retrospectively reviewed 19 eyes of 19 consecutive patients who underwent corneal incision phacoemulsification and simultaneous internal revision of the previous filtering bleb.

* RESULTS: The mean follow-up time was 13.6 ± 7.6 months. Visual acuity improved in all patients (89.4% achieved 20/40 or better). No significant difference was noted between preoperative and postoperative intraocular pressures and astigmatism. The bleb was preserved in 89.4% of the eyes at the time of the last follow-up.

* CONCLUSIONS: This surgical technique proved to be safe and yielded good results.

[Ophthalmic Surg Lasers 1996;27:361-366.]
Outcome of Functioning Filtering Blebs After Pars Plana Vitrectomy
Authors: Thompson W Scott , Smiddy William E , Flynn Harry W , Rubsamen Patrick E
Published: April 2021

* BACKGROUND AND OBJECTIVE: To determine the status of filtering bleb function following pars plana vitrectomy.

* PATIENTS AND METHODS: The authors retrospectively reviewed patients with functioning filtering blebs undergoing pars plana vitrectomy.

* RESULTS: Twenty-three eyes with functioning filtering blebs underwent pars plana vitrectomy. Postoperatively, 7/23 (30%) of the eyes had moderate (5 to 20 mm Hg) intraocular pressure (IOP), 8/23 of the eyes had IOP persistently greater than 20 mm Hg, and 7/23 of the eyes had IOP of less than 5 mm Hg. One of 7 eyes that underwent vitrectomy within 6 weeks after trabeculectomy maintained bleb function, whereas 6 of 16 eyes that underwent trabeculectomy 6 weeks or later maintained bleb function. Loss of bleb function occurred in the early postoperative period in the majority of the patients. Prior antimetabolite therapy was not associated with preservation of bleb function.

* CONCLUSION: There is a substantial risk of bleb failure following vitrectomy, which is in part related to the often severe nature of the diseases requiring vitreoretinal surgery.

[Ophthalmic Surg Lasers 1996;27:367-373.]
Phacoemulsification With and Without Trabeculectomy in Patients With Glaucoma
Authors: Yalvac Ilgaz , Airaksinen P Juhani , Tuulonen Anja
Published: April 2021

BACKGROUND AND OBJECTIVE: This retrospective study was performed to determine the postoperative intraocular pressure (IOP) control in patients with glaucoma who underwent phacoemulsification with and without trabeculectomy.

PATIENTS AND METHODS: Thirty-five eyes underwent phacoemulsification, and 21 eyes underwent combined surgery. The minimum postoperative follow-up for both groups was 6 months.

RESULTS: The average IOP decreased from 19.7 ± 4.6 mm Hg preoperatively to 16.3 ±3.1 mm Hg in the phacoemulsification group, and from 21.2 ± 5.9 mm Hg to 14.4 ± 3.3 mm Hg in the combined group at 6 months (statistically not significant). There was no statistically significant difference between the groups in terms of visual acuity improvement or the number of glaucoma medications.

CONCLUSION: Cataract surgery, with phacoemulsification alone and combined with trabeculectomy, induces a statistically and clinically significant reduction of IOP in patients with glaucoma.

[Ophthalmic Surg Lasers 1997;28:469-475.]
A Safety Suture for Implantation of Posterior Chamber Intraocular Lenses in Complicated Cases
Authors: Assia Ehud I
Published: April 2021

Abstract. Implantation of a posterior chamber intraocular lens can be difficult and risky in complicated cases such as a large tear in the posterior capsule, a cloudy cornea, or a small pupil. The author describes a technique for performing a safe implantation. The intraocular lens is supported by a suspension suture, which is threaded through a positioning hole or tied to the lens haptic. The suture is removed once a stable fixation is achieved. [Ophthalmic Surg Lasers 1997;28:609-610.]
Perforating BB Gun Injuries of the Globe
Authors: Pulido Jose S , Gupta Sunil , Folk James C , Ossoinig Karl C
Published: April 2021

* BACKGROUND AND OBJECTIVE: To determine the visual and anatomic outcomes of eyes with perforating BB gun injuries.

* PATIENTS AND METHODS: The authors reviewed the surgical management and final visual outcome of seven patients with BB gun- related perforating injuries of the globe seen by them between 1980 and 1995. Six patients underwent surgery, and one patient refused intervention and was lost to follow-up. Scleral buckles, lensectomies, and vitrectomies were performed in these six cases.

* RESULTS: Five patients had a final visual acuity of 5/200 or better, with four patients achieving 20/200 or better and two of them having 20/70 or better. A posterior perforation involving the macula or an area temporal to the macula was associated with poor visual outcome. The visual acuity and the relative afferent pupillary defect at presentation or after the initial repair did not correlate with the final visual outcome. In addition, the presence of subretinal blood did not necessarily portend a poor prognosis in these young patients.

* CONCLUSIONS: At least some eyes with perforating injuries can retain good visual acuity with aggressive surgical management using modern vitrectomy techniques. Visual acuity should not necessarily be used as the only exclusion criterion for intervention or enucleation.

[Ophthalmic Surg Lasers 1997;28:625-632.]
Ketorolac Tromethamine in the Maintenance of Intraoperative Mydriasis
Authors: Gupta Ved P , Dhaliwal Upreet , Prasad Nagendra
Published: April 2021

* BACKGROUND AND OBJECTIVE: Mydriatics and antiprostaglandins are routinely applied preoperatively to facilitate the aspiration of cortical material during extracapsular cataract surgery and to prevent intraoperative miosis. Unfortunately, the ideal antiprostaglandin has yet to be introduced. This study represents the first prospective, case-controlled, randomized, masked, clinical trial comparing the efficacy of oral ketorolac tromethamine (KT) with the efficacy of topical flurbiprofen sodium (FS) and a placebo (normal saline) in maintaining intraoperative mydriasis without adrenaline in the irrigation solution.

* PATIENTS AND METHODS: Sixty-three patients, undergoing extracapsular cataract extraction with posterior chamber intraocular lens implantation, were randomly divided into three equal groups. Group 1 received 20 mg of oral KT 2 hours prior to surgery, group 2 received 0.03% FS topical solution at the recommended dosage, and group 3 received topical normal saline in a regimen identical to that of group 2. Identical mydriatics were used in both groups. The patients' pupils were measured at five stages of surgery.

* RESULTS: The mean pupillary diameters at each surgical stage were greater in group 1 than in group 2; however, the difference was not statistically significant. The pupils in group 3 were significantly smaller than those of group 1 or group 2 (P < .05). No systemic toxicity to KT was observed. Moreover, the need for additional postoperative analgesics was significantly greater in groups 2 and 3.

* CONCLUSIONS: Oral KT is safe, convenient, and as effective as topical FS, and has the added advantage of reducing postoperative pain.

[Ophthalmic Surg Lasers 1997;28:731-738.]
Medial Rectus Re-recession for Unacceptable Head-Turn and Esotropia in Duane's Retraction Syndrome
Authors: Biedner Ben Zion
Published: April 2021

Abstract. Duane's syndrome is a condition in which the eye exhibits palsy during abduction, with retraction of the globe and narrowing of the palpebral fissure of the affected side during adduction. Two patients with this condition underwent re-recession of the medial rectus muscle, to a position of 13.5 mm from the limbus, to treat a cosmetically unacceptable head-turn and esotropia in the primary position. Postoperatively, improvement of the head-turn with good binocular single vision in the primary position was achieved in both cases. [Ophthalmic Surg Lasers 1997;28:762-764.]
Holmium Laser Sclerostomy in Glaucomatous Eyes With Prior Surgery: 24-Month Results
Authors: Friedman David S , Katz Jay , Lean Martha
Published: April 2021

* BACKGROUND AND OBJECTIVE: To evaluate the effectiveness of holmium laser sclerostomy in glaucoma patients who have had prior intraocular surgery.

* PATIENTS AND METHODS: The authors conducted a retrospective analysis of outcomes for 25 patients who underwent holmium laser sclerostomy from 1991 to 1993.

* RESULTS: Postoperative success (defined as a drop in intraocular pressure of 30% and a final intraocular pressure of less than 22 mm Hg) at 24 months ranged from 36% to 52%, depending on criteria chosen for success. There were no major complications from the procedure.

* CONCLUSIONS: Holmium laser sclerostomy can be successful in a highly select group of patients undergoing filtration procedures who have had prior intraocular surgery.

[Ophthalmic Surg Lasers 1998;29:17-22.]
Pneumatic Retinopexy for Late-Onset Recurrent Retinal Detachment
Authors: Weinberger Dov , Stiebel-Kalish Hadas , Crystal Ornit , Axer-Siegel Ruth , Mosseive Y , Yassur Yuval
Published: April 2021

* BACKGROUND AND OBJECTIVE: Pneumatic retinopexy is used as a primary procedure for the repair of retinal detachments caused by visible retinal tears. Its application for late-onset recurrent retinal detachments following previous pneumatic retinopexy or scleral buckling procedure has not been reported to date.

* PATIENTS AND METHODS: Pneumatic retinopexy was performed in 12 patients with recurrent retinal detachments due to new retinal tears who presented 6 months to 10 years after pneumatic retinopexy (8 patients) or scleral buckling surgery (4 patients). Follow-up ranged from 6 to 24 months.

* RESULTS: All the retinas reattached within the first few postoperative days and remained attached throughout follow-up. No intraoperative or postoperative complications were observed. Visual acuity either remained unchanged (if good before) or improved.

* CONCLUSION: Pneumatic retinopexy may be a feasible option for recurrent late-onset retinal detachment under the proper clinical conditions.

[Ophthalmic Surg Lasers 1998;29:43-47.]
Conjunctival Necrosis Following the Administration of Subconjunctival Corticosteroid
Authors: Kim Terry , Rapuano Christopher J , Rodman Richard C , Vander James F , Cohen Elisabeth J
Published: April 2021

Abstract. This report describes an unusual reaction to injected subconjunctival corticosteroid. The authors examined a patient with large areas of conjunctival necrosis at the site of a previous subconjunctival corticosteroid injection. A Gram's stain and culture of the affected conjunctival area and the bottled corticosteroid suspension were negative. Necrosis of the conjunctiva is a heretofore unreported adverse reaction to a subconjunctival corticosteroid injection. These lesions probably represent a localized toxic reaction rather than a sequela of infection. [Ophthalmic Surg Lasers 1998;29:79-80.]
The Use of Scanning Laser Ophthalmoscope Microperimetry to Detect Visual Impairment Caused by Macular Photocoagulation
Authors: Ishiko Satoshi , Ogasawara Hironobu , Yoshida Akitoshi , Hanada Kazuomi
Published: April 2021

* BACKGROUND AND OBJECTIVE: To demonstrate the effectiveness of scanning laser ophthalmoscope (SLO) microperimetry in detecting retinal sensitivity and in describing areas of unstable fixation following photocoagulation therapy.

* PATIENTS AND METHODS: Two patients with iatrogenic vision loss resulting from photocoagulation therapy underwent a fundus examination, SLO microperimetry, and fluorescein angiography. One patient also underwent indocyanine green angiography.

* RESULTS: Two types of visual acuity decrease - sudden-onset and late-onset - were demonstrated following macular photocoagulation, the former resulting from incorrect identification of the fixation point, and the latter from enlarging photocoagulation scars placed in close proximity to the fovea. In one case, SLO microperimetry detected dense scotoma corresponding to the patients symptoms and an unstable fixation point. In the other case, different retinal sensitivities were found in the photocoagulation scars. No differences were found with fluorescein angiography or indocyanine green angiography.

* CONCLUSION: SLO microperimetry might be effective for quantitative assessment of retinal sensitivity in photocoagulation scars and for detecting fixation points and determining their stability.

[Ophthalmic Surg Lasers 1998;29:95-98.]
A Simple, Cost-Effective Method for Practicing Phacoemulsification in the Cadaveric Eye
Authors: Castellano David , Spraul Joseph , Whitaker Todd E
Published: April 2021

Abstract. The authors describe an inexpensive, reliable method for practicing intraocular surgery using a rigid contact lens as a temporary keratoprosthesis. This method allows clear visualization of the anterior chamber and lenticular structures for practicing modern cataract surgery, including capsulorhexis, hydrodissection, phacoemulsification, cortical aspiration, and intraocular lens insertion. [Ophthalmic Surg Lasers 1998;29:253-256.]
Time-Kill Profiles of Enterococcus to Antibiotics Used for Intravitreal Therapy
Authors: Kowalski Regis P , Karenchak Lisa M , Warren Brent B , Eller Andrew W
Published: April 2021

* BACKGROUND AND OBJECTIVE: To determine and then compare the time-kill profiles of Enterococcus to antibiotics used for intravitreal therapy.

* PATIENTS AND METHODS: The time-kill profiles of four endophthalmitis isolates of Enterococcus faecalis, one vancomycin-resistant E. faecalis isolate, and three vancomycin-resistant isolates of E. faecium were determined against vancomycin, amikacin, cefazolin, gentamicin, ampicillin, ciprofloxacin, ceftazidime, clindamycin, and the combinations of vancomycin and amikacin, vancomycin and ceftazidime, vancomycin and gentamicin, vancomycin and ampicillin, cefazolin and gentamicin, and ampicillin and gentamicin.

* RESULTS: No single antibiotic or combination was bactericidal (defined as a 99.9% kill) to all isolates of Enterococcus. Gentamicin was bactericidal to all E. faecalis isolates. None of the tested antibiotics were bactericidal to vancomycin-resistant E. faecium.

* CONCLUSIONS: The time-kill profiles demonstrated that vancomycin and ceftazidime did not produce a 99.9% kill for E. faecalis in this small study. Gentamicin combined with either cefazolin or ampicillin had somewhat better bactericidal activity and should be considered as an alternative therapy. Novel therapy may be necessary to treat endophthalmitis because of vancomycin-resistant Enterococcus, depending on the susceptibility patterns of the individual isolate and the response to initial therapy.

[Ophthalmic Surg Lasers 1998;29:295-299.]
Presumed Choroidal Granuloma With Vitreous Hemorrhage Resembling Choroidal Melanoma
Authors: Gündüz Kaan , Shields Carol L , Shields Jerry A , Schubert Hermann
Published: April 2021

Abstract. This report describes a presumed choroidal granuloma with vitreous hemorrhage resembling choroidal melanoma. A healthy 31-year-old man, who had progressive vision loss in the right eye during 1 month, was found to have a yellow-white juxtapapillary choroidal mass. Fluorescein angiography demonstrated a choroidal neovascular membrane over the lesion. There was focal persistent hypofluorescence in the late phase of fluorescein angiography. The thickness of the lesion increased from 3.0 mm to 7.1 mm during 1 month. Subretinal and vitreous hemorrhage developed. The patient was suspected to have a choroidal granuloma and choroidal neovascular membrane, and was treated with oral steroids. Ten months later, the vitreous blood cleared completely with an attached retina. Control of inflammation may have a role in the treatment of idiopathic choroidal granulomas and some choroidal neovascular membranes secondary to ocular inflammation. [Ophthalmic Surg Lasers 1998;29:422-425.]
Intraocular Pressure in Nonglaucomatous Eyes With Pseudoexfoliation Syndrome After Cataract Surgery
Authors: Wirbelauer Christopher , Anders Norbert , Pham Duy T , Wollensak Josef , Laqua Horst
Published: April 2021

* BACKGROUND AND OBJECTIVE: To investigate the course of the intraocular pressure (IOP) in nonglaucomatous patients with Pseudoexfoliation (PSX) syndrome after cataract surgery.

* PATIENTS AND METHODS: In a prospective age-matched controlled clinical study, 23 consecutive patients with PSX were studied and compared with a control group of 23 patients. The IOP was measured by applanation tonometry preoperatively, and postoperatively on day 1, after 4 weeks, and after 6 months. All patients were operated on with a self-sealing 7-mm scleral tunnel incision, phacoemulsification, and posterior chamber intraocular lens (IOL) implantation.

* RESULTS: Preoperatively the IOP was similar between both groups (P = .962). At the first postoperative day the IOP was below 22 mm Hg in all cases. After 4 weeks and 6 months a mean decrease of 3.88 mm Hg (P = .001) in the control group and of 3.15 mm Hg (P = .002) in the PSX group was observed; this difference was not statistically significant (P =.543).

* CONCLUSIONS: At 1 day postoperatively no pressure increase was observed in the eyes with PSX after scleral tunnel incision and phacoemulsification. Six months after cataract extraction with IOL implantation, the tension level decreased in the presence of PSX similarly as in normal eyes.

[Ophthalmic Surg Lasers 1998;29:466-471.]
Lack of Effect of Prophylactic Gentamicin Treatment on Intraocular and Extraocular Fluid Cultures After Pars Plana Vitrectomy
Authors: Gelfand Yuval A , Mezer Eedy , Linn Shai , Miller Benjamin
Published: April 2021

* BACKGROUND AND OBJECTIVE: To analyze the effect of preoperative prophylactic 0.3% gentamicin sulfate eye-drops on intraocular and extraocular fluid cultures after pars plana vitrectomy.

* PATIENTS AND METHODS: Forty consecutive patients undergoing pars plana vitrectomy were randomly assigned to receive either 0.3% gentamicin eyedrops or placebo preoperatively. Fluids from the vitreous cavity and from the conjunctival sac were collected for bacteriologic studies.

* RESULTS: Positive cultures from extraocular fluids were obtained in 30.4% of the gentamicin group and 35.3% of the placebo group (P = .75). Furthermore, 1 (3%) of 40 cultures of intraocular fluid and 13 (33%) of 40 cultures of extraocular fluid were positive. Culture growth positivity was not influenced by the patients' age, by diabetes, or by the duration of the operation.

* CONCLUSIONS: Prophylactic gentamicin treatment by the method applied in this study is not effective on reducing growth positivity. Contaminated extraocular fluid may play an important role in the pathogenesis of bacterial endophthalmitis following pars plana vitrectomy.

[Ophthalmic Surg Lasers 1998;29:497-501.]
Factors Affecting Image Acquisition During Scanning Laser Polarimetry
Authors: Hoh Sek Tien , Greenfield David S , Liebmann Jeffrey M , Maw Richard , Ishikawa Hiroshi , Chew Sek Jin , Ritch Rubert
Published: April 2021

* BACKGROUND AND OBJECTIVE: To illustrate artifacts that may be encountered during measurement of the peripapillary retinal nerve fiber layer (RNFL) using scanning laser polarimetry (SLP).

* PATIENTS AND METHODS: A total of 426 patients with a variety of ocular diagnoses underwent RNFL measurements using SLP from June 1996 to April 1997. Scanning was performed by two operators whose reproducibility of measurements had been previously validated. Images were selected to illustrate clinical features that adversely affected measurement of the thickness of the RNFL.

* RESULTS: Image acquisition was difficult in eyes with corneal grafts or edema, keratic precipitates, anterior uveitis, posterior subcapsular cataract, vitreous opacity, peripapillary atrophy, posterior staphyloma, and high axial myopia. These scans resulted in poor clinical correlation with visual field tests and optic nerve examination, poor reproducibility of images, and unreadable images.

* CONCLUSION: Anterior and posterior segment pathologies, particularly those localized to the cornea and lens, may produce spurious RNFL measurements and should be carefully considered prior to clinical decision making.

[Ophthalmic Surg Lasers 1998;29:545-551.]
An Improved Surgical Technique for Pterygium Excision With Intraoperative Application of Mitomycin-C
Authors: Potério Marisa B , Alves Milton R , Cardillo José A , José Newton K
Published: April 2021

Abstract. A surgical technique was designed to improve safety after pterygium excision with intraoperative application of mitomycin-C (MMC). A limbic incision was performed in 40 eyes. The body of the pterygium was dissected from the episclera to allow its excision. Care was taken to avoid excessive delamination and cauterization of tissues. A 0.02% MMC solution was then applied. Only at the end of the surgery was the head of the pterygium dissected from the cornea. The 8-0 absorbable sutures were used to place both edges of the conjunctiva together to completely cover the area of bare sclera. After a mean follow-up time of 12 months, a recurrence rate of 5% was observed. No complications of therapy were observed. This is a logical alternative to other surgical techniques. However, randomized studies with more patients and longer follow-up are necessary to determine the potential of this procedure in improving the safety of pterygium excision with intraoperative MMC. [Ophthalmic Surg Lasers 1998;29: 685-687.]
Diode Laser Cyclophotocoagulation: Histopathology in Two Cases of Clinical Failure
Authors: Walland Mark J , McKelvie Penelope A
Published: April 2021

Abstract. Diode laser photocoagulation is an alternative technique to Nd:YAG laser or cryotherapy in cycloablation. It may be more titratable with fewer local side effects. The effect is not, however, always maintained in the long term. The authors wished to establish histologic correlates with in vivo clinical outcomes of failure. Histologic findings in two cases of clinical failure of a single treatment with contact diode laser cyclophotocoagulation are presented. A recurrence of uncontrolled intraocular pressure (IOP) finally led to enucleation of the eyes 5 and 6 months after laser treatment. Histologic examination demonstrated preservation in both specimens of some ciliary processes outside the treatment zone, which was evidently over the pars plana in a case with a relatively low axial length. Persisting damage of treated ciliary processes was seen. Some efforts at ciliary epithelial regeneration were made in these, but in a disorganized and presumably nonfunctional fashion, so that a histologic explanation for the gradual postoperative rise in IOP was not evident. Diode laser cyclophotocoagulation may lower IOP by mechanisms other than destruction of ciliary epithelium. Reversal of a laserinduced increase in uveoscleral outflow may explain the gradual rise in IOP seen postoperatively in these two cases, given the ineffectual secretory epithelial regeneration in one case and the treatment over the pars plana in the other. Methods to enhance probe placement, such as ultrasound biomicroscopy, transillumination, or axial length measurement, may be useful to ensure that treatment is directed to the pars plicata. [Ophthalmic Surg Lasers 1998;29:852-856.]
Intraocular Pressure Control and Visual Outcome in Patients With Phacolytic Glaucoma Managed by Extracapsular Cataract Extraction With or Without Posterior Chamber Intraocular Lens Implantation
Authors: Mandal Anil K , Gothwal Vijaya K
Published: April 2021

* BACKGROUND AND OBJECTIVE: To evaluate long-term intraocular pressure (1OP) control and visual outcome of patients with phacolytic glaucoma.

* PATIENTS AND METHODS: Forty-five consecutive eyes of 45 patients with phacolytic glaucoma operated on between January 1990 and December 1995 and who had completed at least 1 year of followup were included in the study. Of the 45 eyes, 17 eyes underwent extracapsular cataract extraction (ECCE) with primary posterior chamber intraocular lens (PC IOL) implantation (group 1). The rest of the eyes (n = 28) underwent only ECCE (group 2) in view of satisfactory aphakic vision in the contralateral eye. Preoperative IOP, visual acuity, and anterior segment appearance were compared with postoperative data.

* RESULTS: IOP was controlled (IOP < 21 mm Hg) in all of the patients without any antiglaucoma medication, with a mean follow-up of 29.11 ± 16.25 months (range 12 to 60) and 43.2 ± 21.5 (12 to 78) months in groups 1 and 2, respectively. The IOP remained controlled without antiglaucoma medication even in the patients where the desired visual recovery was not obtained due to glaucomatous disc damage because of delayed presentation (2 to 3 weeks or more). A visual acuity of 20/40 or better was achieved in 76.5% and 60.7% in groups 1 and 2, respectively. Eighteen of the 45 patients initially presented with light perception without projection. Eight of these 1 8 patients (44%) regained a visual acuity of 20/40 or better. There was no significant intraoperative and postoperative complication in any patient.

* CONCLUSIONS: ECCE with or without primary PC IOL implantation is safe and curative in patients with phacolytic glaucoma. The addition of trabeculectomy to cataract extraction seems to be superfluous in the control of IOP in patients with phacolytic glaucoma operated on within 2 to 3 weeks of the onset of symptoms. Light perception without projection is not a contraindication for cataract surgery in phacolytic glaucoma.

[Ophthalmic Surg Lasers 1998;29:880-889.]
CO
2
-Laser in the Removal of a Plexiform Neurofibroma from the Eyelid
Authors: Lapid-Gortzak Ruth , Lapid Oren , Monos Tova , Lifshitz Tova
Published: April 2021

Abstract. We present a child with neurofibromatosis type I (NF-I) who underwent excision of a large upper lid neurofibroma using a CO
2
-laser. Plexiform neurofibromas are notorious for their bleeding tendency and the inability to achieve complete surgical excision. The CO
2
-laser is an adjunct to achieving better hemostasis and delineation of the tissue in the absence of natural tissue planes caused by the tumors diffuse mode of growth. Using the CO
2
-laser achieves better cosmesis, while reducing operation time and limiting complications. [Ophthalmic Surg Lasers 2000;31:432-434]
Fat-Conserving Aesthetic Lower Blepharoplasty
Authors: Fante Robert G , Baker Shan R
Published: April 2021

* OBJECTIVE: To evaluate a variation on lower eyelid fat-conserving blepharoplasty as a treatment for several facets of periorbital aging, especially eyelid fat protrusion and skeletonization of the inferior orbital rim.

* PATIENTS AND METHODS: Retrospective review of 14 consecutive patients at an academic center who underwent fat-conserving lower blepharoplasty over an 8-month period. Independent evaluation of surgical success was performed by two experienced surgeons.

* RESULTS: Fat-conserving blepharoplasty corrected skeletonization of the inferior orbital rim in 13 of 14 cases, and was moderately effective at correction of lower eyelid fat protrusion and wrinkles. There were no complications.

* CONCLUSION: Fat-conserving lower blepharoplasty is a safe and effective surgical technique for reduction of visibility of the bony orbital rim and can complement other procedures used to improve signs of aging in the periorbital region.

[Ophthalmic Surg Lasers 2001;32:41-47]
Diode Laser Photocoagulation for Retinopathy of Prematurity: A Histopathologic Study
Authors: Park Paul , Eagle Ralph C , Tasman William S
Published: April 2021

Abstract. Laser photocoagulation has largely supplanted cryotherapy as an effective treatment for retinopathy of prematurity. This case describes the ocular histopathologic findings of a pair of eyes in a severely premature male infant treated with diode laser photocoagulation for bilateral stage 3 retinopathy of prematurity (ROP) for 360° in zone 1 with severe plus disease. The right eye responded to treatment; the left eye developed persistent vitreous hemorrhage and total retinal detachment. The histopathologic examination of laser burns in the right eye disclosed segmental areas of chorioretinal scarring with retinal atrophy and gliosis, loss of RPE and extensive atrophy of the choroid and its vasculature, which involved both the choriocapillaris and larger vessels. The left eye had iris neovascularization, a chronic organized vitreous hemorrhage and a totally detached retina. The histopathologic findings in an eye of a premature infant with threshold ROP treated with diode laser photocoagulation resembled those reported after transsceral cryotherapy. Diode laser photocoagulation may produce less severe chorioretinal damage. [Ophthalmic Surg Lasers 2001;32:63-66].
A Novel Approach for the Fixation of Enucleated Eyes During Microsurgical Procedures Using Common Household Plumbing Accessories
Authors: Yip Chee-Chew , Heng Wee-Jin , Eong Kah-Guan Au , Yong Victor Shee-Heung
Published: April 2021

Abstract. The authors describe a novel approach for the fixation of enucleated eyes during microsurgical procedures using common household plumbing accessories. The device consists of a ring adaptor with 4 roundended screws placed horizontally at its sides and a plastic hose connector. The enucleated globe is secured in the center of the ring adaptor by gently tightening the screws. The hose connector supports the posterior pole of the globe and is secured onto a styrofoam board that provides a platform for resting the surgeons hands. The device proved very satisfactory to residents during the teaching of cataract surgery and trabeculectomy on porcine eyes. Our globe fixation device is simple, inexpensive, effective, and readily available. It may be especially useful in developing countries. [Ophthalmic Surg Lasers 2001;32:166-167]
Intravitreal Clindamycin and Dexamethasone for Toxoplasmic Retinochoroiditis
Authors: Kishore Kamal , Conway Mandi D , Peyman Gholam A
Published: April 2021

* BACKGROUND AND OBJECTIVE: To pre sent a new method for the management of toxoplasmic retinochoroiditis (TRC).

* METHODS: The patients were females ranging in age from 10 to 61 years (average 26.5). Four eyes of 4 patients were treated with intravitreal injections of 1 .0 mg clindamycin in 0.1 mL and 1.0 mg of dexamethasone in 0.1 mL. The injections were given under general or peribulbar anesthesia. Three patients continued one systemic drug. Follow-up ranged from 11 to 26 months (mean 17.5).

* RESULTS: A favorable response was noted in each eye within two weeks after the intravitreal injections. All patients required 2 to 4 intravitreal injections in the affected eye for the control of TRC. Visual acuity improved in each eye. The disc and macula were preserved in all eyes. Recurrence was noted in one case, which responded to a repeated intravitreal injection of clindamycin and dexamethasone.

* CONCLUSIONS: Intravitreal injections of clindamycin and dexamethasone are well tolerated and may offer an additional strategy to treat TRC in patients who are unable to afford or tolerate systemic therapy, or whose disease progresses despite systemic therapy.

[Ophthalmic Surg Lasers 2001;32:183-192]
Hydrodissection of Conjunctival Flap During Trabeculectomy in Eyes With Conjunctival Scarring Caused By Trachoma
Authors: Mitra Sandip , Ganesh Anuradha
Published: April 2021

* BACKGROUND AND OBJECTIVE: Conjunctival scarring caused by trachoma represents a substantial challenge even to the most experienced cataract/glaucoma surgeon. We describe a simple technique of hydrodissection of conjunctival flap during combined trabeculectomy and phacoemulsification in eyes with conjunctival scarring caused by trachoma, and discuss its impact on surgical outcome.

* PATIENTS AND METHODS: A prospective study was conducted in 10 Omani patients, aged 48 to 83 who underwent combined trabeculectomy and phacoemulsification with intraocular lens (IOL) implantation. The conjunctival flap was prepared after hydrodissection using a mixture of 1 mL of balanced salt solution (BSS) and 1 mL of lignocaine 2% with 1:200 000 adrenaline. Outcome measures that were evaluated were visual function, intraocular pressure (IOP) and bleb characteristics. Patients were followedup postoperatively for a minimum period of 6 months.

* RESULTS: The mean age of patients was 60.4 years (48-83) and a functioning bleb after 6 months was seen in 8 (80%) cases. IOP < 20 mm of Hg (applanation tonometry) without antiglaucoma medications was found in 8 cases; 1 case required one antiglaucoma medication and 1 case required more than one antiglaucoma medication for control of IOP. The latter was reoperated for control of IOP. Nonprogression of visual field was found in 8 (80%) cases.

* CONCLUSION: Preparation of conjunctival flap by hydrodissection was found to be a simple modification of the conventional technique during combined trabeculectomy and phacoemulsification in trachomatous eyes. It reduced conjunctival dissection, use of cautery and possibility of button-holing of the conjunctiva during dissection in scarred eyes. The minimal tissue dissection involved in this procedure reduced wound healing and thereby increased chances of a functioning bleb, control of IOP and nonprogression of visual field compared to combined surgery employing a conventional method (nonhydrodissection method) of conjunctival flap dissection.

[Ophthalmic Surg Lasers 2001;32:213-219]