bluuebunny/crossref_metadata_2025 huggingface dataset:
First Results With Wavefront-guided Photorefractive Keratectomy for Hyperopia
Authors: Nagy Zoltán Z , Palágyi-Deák Ilona , Kovács Andrea , Kelemen Edit , Förster Werner
Published: April 2021

ABSTRACT

PURPOSE: To compare the results of traditional laser photoablation and wavefront-supported customized ablation (WASCA) in hyperopic photorefractive keratectomy (H-PRK).

METHODS: This was a prospective study, comparing two treatment groups, each comprising 40 eyes of 20 patients. Wavefront aberrations were examined using a Shack-Hartmann aberrometer. Preoperative refraction was similar in the two groups; in the traditional H-PRK group (Group 1) it was +3.10 ± 0.85 D, and in the WASCA-guided group (Group 2) it was +2.90 ± 0.80 D. H-PRK was performed with the Asclepion-Meditec MEL 70 flying-spot excimer laser. The follow-up time was 6 months.

RESULTS: In Group 1, mean postoperative refraction was +0.14 ± 0.24 D, and in Group 2, -0.10 ± 0.25 D; mean uncorrected visual acuity was 0.92 ± 0.16 in Group 1 and 0.95 ± 0.18 in Group 2. Mean best spectacle-corrected visual acuity was 0.96 ± 0.04 in Group 1 and 1.06 ± 0.13 in Group 2. In Group 1, 67.5% (27 of 40 eyes), and in Group 2, 85% (34 of 40 eyes) were within ±0.50 D of target refraction. Regarding change of spectacle-corrected visual acuity in Group 1, 5% (2 of 40 eyes), and in Group 2, 20% (8 of 40 eyes) gained one Snellen line compared to the preoperative; in Group 1, 10% (4 of 40 eyes), and in Group 2, 12.5% (5 of 40 eyes) lost two Snellen lines. In Group 2, the root mean square value for the higher order aberration increased from the initial 0.134 to 0.257 µ?? at 6 months after surgery.

CONCLUSIONS: WASCA-guided hyperopic-PRK treatment was found to be safe and predictable. The results were better than those achieved with traditional PRK performed using the same flyingspot type excimer laser. [J Refract Surg 2002;18:S620-S623]
Measuring Corneal Thickness With a Rotary Scanning System
Authors: Franco Sandra , Almeida José B , Parafita Manuel
Published: April 2021

ABSTRACT

PURPOSE: Recently the authors presented a technique that allows measurement of the corneal thickness along a vertical meridian from optical sections obtained using a slit-lamp microscope. We present a new system that allows rotary scanning of the cornea and consequent measurement of the corneal thickness along any meridian.

METHOD: The corneal thickness along two perpendicular meridians was measured from optical sections obtained with a new rotary scanning system. To obtain the optical sections, the cornea is illuminated with a light beam that is previously expanded in a fan by a small cylindrical lens rotated on a plane-containing axis to explore the cornea. The light diffused by both corneal surfaces is collected by two video cameras placed at an angle with the light beam. The axes of the two cameras define, with the visual axis, two planes normal to each other. After image acquisition, a processing algorithm is applied in order to compute the corneal thickness along the two meridians.

RESULTS: Some preliminary results for the vertical and the horizontal meridians of one eye are shown, as well as all the intermediate computations.

CONCLUSIONS: With this system, we expect to be able to measure corneal topography and thickness along an arbitrary meridian. The rotary scanning of the cornea is mechanically simple and will eventually allow automated scanning. [J Refract Surg 2002;18:S630-S633]
Self-Curing Methyl Methacrylate: Is It Safe?
Authors: Anderson Richard L , Stasior Orkan George
Published: April 2021

ABSTRACT

Self-curing methyl methacrylate has been recently abandoned by some ophthalmic surgeons because of more than 20 deaths associated with its use in orthopedic surgery. The mechanism of cardiovascular collapse noted in orthopedic cases appears to relate to the surgical procedure as well as a direct vasodilation caused by free monomer. There are no reported cardiovascular complications with the facial uses of self-curing methyl methacrylate. Toxicities to this substance are noted. Ophthalmologists should be aware of these problems and their management Careful preoperative cardiovascular evaluation, intraoperative patient monitoring, and a well-ventilated operating room are recommended with its use. The review finds no evidence to condemn the ophthalmic uses of self-curing methyl methacrylate because of cardiovascular complications. The search for more inert synthetic compounds should continue.
Anterior Segment Ischemia and Sector Iris Atrophy: After Strabismus Surgery In A Patient With Chronic Lymphocytic Leukemia
Authors: Jacobs Donald S , Vastine David W , Urist Martin J
Published: April 2021

SYNOPSIS-ABSTRACT

A 69-year-old woman with chronic lymphocytic leukemia developed segmental iris atrophy and iridocyclitis after routine surgery for exotropia. Both the clinical picture and fluorescein angiogram indicated anterior segment ischemia. It is postulated that this was related to hyperviscosity of the blood caused by a high white blood cell count (114,000/cu mm).

The possibility of anterior segment ischemia should be kept in mind when contemplating strabismus or retinal detachment surgery in the presence of hematologic disorders likely to increase blood viscosity. I ? these cases a minimal amount of surgery should be done with proper supportive therapy. Strabismus surgery should be done in stages allowing for hemodynamic compensation between procedures.
Glaucoma Surgery in Nigerian Eyes: A Five-Year Study
Authors: Kietzman Benjamin
Published: April 2021

SUMMARY

A five-year study of 419 sclerectomies and 612 trabeculectomies has been reported. Early and late postoperative complications have been discussed and the relative effectiveness of the operations in controlling intraocular pressure in chronic simple and chronic angle closure glaucoma compared.
Iridectomy in Rubeosis Iridis
Authors: Hersh Stanley B , Kass Michael A
Published: April 2021

SUMMARY

Creating an iridectomy in the face of rubeosis iridis carries a significant risk of hyphema. A technique is described utilizing a bipolar micro-cautery to cauterize iris vessels under direct observation before cutting iris tissue. This allows the iridectomy to be performed with less risk of intraocular bleeding.
Intravitreous Air Injection and the Custodis Procedure
Authors: O'Connor Patrick A
Published: April 2021

SUMMARY

Occasional failure follows any form of retinal detachment surgery. Most of these persistent detachments are due to inadequate closure of a known retinal tear by scleral buckling. Avoidance of major reconstructive surgery may be accomplished by the judicious application of an intravitreous air injection under local anesthesia at bedside. Although technically precise, this singular maneuver was found safe and reliable. Its use is suggested as an alternative to classical reoperative procedures.
Surgical Treatment of Choroidal Detachment
Authors: Allen James C
Published: April 2021

SUMMARY

A method of surgical correction of choroidal detachment following intracapsular cataract extraction which will prevent later pupillary block is outlined.
The Management of Early Lacrimal Tube Complications
Authors: White J Henry
Published: April 2021

SUMMARY

The introduction of a closed loop of suture material through the Jones lacrimal tube, the DOR opening, and the nose at the time of surgery, facilitates the management of early postoperative complications in conj u nctivo-dacrocystorhi nostomy.
The Prognosis of Penetrating Keratoplasty: Based Upon Corneal Morphology
Authors: Paton David
Published: April 2021

SUMMARY

In this paper, the author has attempted to express the prognosis for successful penetrating keratoplasty based upon a morphological classification of corneal disease. Four groups have been designated with their basic prognosis ranging from excellent to poor. The importance of appraising the diseased cornea in the area of its optimal recipient zone has been stressed. Ancillary factors adversely affecting the estimated final prognosis of keratoplasty have been considered, with emphasis upon the importance of glaucoma, lid function, tear film, ocular inflammation and patient compliance.

Not only is it important for the surgeon to appraise the chance of successful surgery, but it is essential for the patient to be informed in advance regarding the probability for successful surgery and the need to comply with sometimes demanding requirements of postoperative care.
Phacoanaphylactic Endophthalmitis: Echographic Diagnosis of Phacoanaphylactic Endophthalmitis
Authors: Hodes Barton L , Stern George
Published: April 2021

SUMMARY

A sixty-year-old black diabetic female developed a severe postoperative endophthalmitis eight days after unplanned extracapsular cataract surgery. Gram stain of a diagnostic vitreous aspirate showed no organisms, and culture of the aspirate was negative for bacteria and fungi. A- and B-scan ultrasonography showed the presence of intra-vitreal lens fragments; the diagnosis of phacoanaphylactic endophthalmitis was made and intensive steroid therapy was instituted early in the course of the disease. Resorption of the lens fragments in association with gradual diminution of the inflammatory process was documented by serial echograms of the eye. The vitreous ultimately cleared and the patient regained useful vision. Ultrasonography is recommended as an essential part of the diagnostic evaluation of any patient with postoperative endophthalmitis especially with a history of extracapsular surgery.
Wide-Angle Cutter Vitrophage
Authors: Peyman Gholam A
Published: April 2021

SUMMARY

A wide-angle cutter vitrophage facilitates removal of semi-solid or thick retropupillary membranes. The cutting orifice permits engagement of inflexible material which is then cut and removed via the instrument The wide-angle cutter has successfully removed thick secondary membranes and expedites pars plana removal of cataracts with 2+ nuclear sclerosis.
Anterior Chamber Depth After Intrascleral Filtering Surgery
Authors: Mackool Richard J , Buxton Jorge N
Published: April 2021

SUMMARY

Intrascleral filtering surgery was performed i ? 58 eyes and the anterior chamber (AC) depth was estimated postoperatively by recording the equivalent number of corneal thicknesses (CT) of central AC depth (lens-cornea distance). Lens-cornea touch occurred in 3 of 28 eyes with chronic simple glaucoma and was highly correlated with cataract formation. Lens-cornea touch did not develop in any of 11 eyes with other types of phakic glaucoma. Lens-cornea touch did not occur in any eye if the postoperative AC depth was ever 2 CT or greater and all three instances of lens-cornea touch occurred on or by the fifth postoperative day. Nineteen aphakic eyes were operated and all had normal AC depth from the first postoperative day. The data do not support the common belief that filtering procedures done beneath a scleral flap result in faster AC depth reformation than filtering procedures not done beneath a scleral flap.
A Fiber-Optics Pig-Tail Probe
Authors: Cohen Samuel W , Banko William , Cohen Harold H
Published: April 2021

SUMMARY

A pig-tail probe with a fiber-optics bundle incorporated within its thickness is described. The instrument is used as is commonly done at present with the standard pig-tail probe. In addition, the fiber-optics bundle delivers cold light to the tip of the probe which has been found very useful for locating the torn ends of a canaliculus, as well as delineating the anatomy of the lacrimal sac.
Marginal Tarsorrhaphy: A Technique to Minimize Premature Eyelid Separation
Authors: Grove Arthur S
Published: April 2021

SUMMARY

By using a continuous intermarginal monofilament suture, a partial tarsorrhaphy can be performed which has a minimal tendency to separate prematurely. This technique is especially useful where recovery from facial paralysis is anticipated. Surgical division of the tarsorrhaphy can be performed easily with little, if any, defect of the eyelids.
Blindness Following Blowout Orbital Fractures
Authors: Cullen Gerald C R , Luce Cyril M , Shannon Gerard M
Published: April 2021

SUMMARY

Blindness following blowout fractures is an unfortunate complication. The ophthalmologist must be aware of the events and sites of injury to the optic nerve which lead to visual problems.

Preventive measures include immediate recognition of the signs of impending optic nerve compression and execution of treatment without delay.

The importance of monitoring vision cannot be overstressed. Judicious surgery involves a post-injury delay in cases that are improving daily. The avoidance of additional surgical trauma with implant insertion during that period may help prevent postoperative blowout blindness.
Cicatricial Entropion
Authors: Bercovici Edwin , Hornblass Albert , Smith Byron
Published: April 2021

SUMMARY

One hundred thirty-five cases of cicatricial entropion operated by the OculoPlastic Service of the Manhattan Eye, Ear & Throat Hospital were reviewed. Results of 114 of these were available for study. There was an overall success rate in primary surgery of 57 percent Of those cases reoperated, only nine percent had a subsequent successful result The most common procedure done was the transverse blepharotomy and marginal rotation. There was no statistical correlation between the success rate and the age or sex of the patient Results on the fellow eye correlated well with results of the first eye in bilateral cases.
Normal Lid Margin After Eyelid Reconstruction
Authors: Cies William A , Baylis Henry I
Published: April 2021

SUMMARY

To prevent corneal damage, the central lid margin must have a normal skinconjunctiva interface following the lid reconstruction. A two-step procedure may be employed: In the lower lid an initial Hughes reconstruction should be tried. If this is unacceptable, a subsequent block excision of the segment is performed. The important step in both phases is a thorough lateral cantholysis. In the upper lid, the central defect is immediately reconstructed by sliding the lateral lid remnant to the medial remnant The resulting lateral defect is reconstructed with a Hughes procedure. In both cases, a physiologic lid margin is insured, because normal lid is sutured to normal lid.
Extracapsular Surgery and Lens Implantation
Authors: Worst Jan G F
Published: April 2021

SUMMARY

Extracapsular surgery is an ideal type of cataract surgery in combination with lens implantation insofar as stability and fixation of the lens is greatly enhanced.

However, a number of complications can be expected. The main problem of extracapsular surgery is posterior capsule opacification. This is due to regeneration of germinal lens fibers.

To prevent this a complete removal of cortical lens matter is advisable, even in lens implantation. This however requires special lenses, which have additional iris fixation.
Lens Implantation Surgery in the Second Eye
Authors: Clayman Henry M , Jaffe Norman S , Light David S , Eichenbaum Daniel M
Published: April 2021

SUMMARY

In a series of 730 patients who underwent lens implant surgery, 44 (6%) had bilateral implants. Eighty-eight percent of these patients had at least one year's interval between operations and 50% more than two years. Surgery on the first eye resulted in vision of 20/40 or better in 86% of patients. Eighty-three percent of patients were 20/40 or better in the second eye following surgery. The principal cause of vision less than 20/40 was senile macular degeneration. Follow-up observation ranged from 4-96 months.

Conservative criteria are advised for bilateral implant surgery, with an appropriate interval between operations considering the increased complexity of the implant procedure.
Iris Plane Pseudophakoi (Copeland Lens): Prevention of Synechiae Formation
Authors: Blumenthal Michael , Rothkoff Leonard , Shoham Akiva , Monos Tova
Published: April 2021

SUMMARY

The iris plane Copeland lens was inserted in 56 cases. A high incidence of synechiae and retrolental membrane formation was noted. This could be prevented or reduced in severity by the controlled use of pupil dilatation in the postoperative period.
Intraocular Lens in Laboratory Animals
Authors: Eifrig David E , Doughman Donald J
Published: April 2021

SUMMARY

This report summarized the findings in 40 rabbit eyes undergoing extracapsular cataract extraction, 20 of which underwent intraocular lens implantation.

The parameters of postoperative evaluation are shown to be limited by the susceptability of the rabbit cornea to corneal edema in the early postoperative phases. The only apparent parameter of statistical importance in this series, however, was the day at which the intraocular lens implanted eye returned to normal compared to the day that the non-implanted eye returned to normal. The fact that there is a 13-day difference in these eyes and the fact that this difference is statistically significant may be important.

Pathologic examination of lens implanted eyes has shown that the surgical objectives of intracapsular loop fixation are quite feasible. Microscopic study also showed that there is minimal tissue response to the materials placed in the anterior chamber in this type of surgery.
Preoperative Topical Antibiotics and Lash Trimming in Cataract Surgery
Authors: Perry L Douglas , Skaggs Carson
Published: April 2021

SUMMARY

Fifty patients admitted for cataract extraction had their lids and conjunctivae cultured two days preoperatively, on the morning of surgery, and on each of the first four postoperative mornings. Multiple topical preoperative antibiotics given for forty-eight hours before surgery produced a marked reduction in the periocular bacterial flora, an effect which persisted throughout the postoperative period. Lash trimming prior to surgery did not alter the periocular bacterial flora present on the morning of surgery or at any time during the first four postoperative days. While multiple preoperative topical antibiotics may reduce the incidence of postoperative endophthalmitis through suppression of periocular bacterial flora, no such role can be postulated for lash trimming.
Management of a Patient with Orbital Varices, Visual Loss, and Ipsilateral Glaucoma
Authors: Kollarits Carol R , Gaasterland Douglas , Di Chiro Giovanni , Christiansen John , Yee Robert D
Published: April 2021

SUMMARY

A man with congenital left orbital varices developed progressive ipsilateral visual loss beginning at age 62. Work-up demonstrated elevated intraocular pressure, decreased outflow facility, and mildly elevated episcleral venous pressure in the affected eye.

Initiation of adequate glaucoma treatment was associated with interruption of declining visual acuity and with expansion of the constricted visual field. Medical control of coexisting glaucoma should be attempted prior to consideration of surgical intervention in any patient with visual loss and an ipsilateral orbital varix.
Surgical Correction of the Lateral Canthal Deformity Associated With Anophthalmic "Enophthalmos"
Authors: Walter William L
Published: April 2021

SUMMARY

In order to correct the lateral canthal and lower eyelid deformities associated with anophthalmic "enophthalmos," this paper proposes that a surgical modification of the bead implant operation be used in order to reposition the lateral canthal tendon to a higher level than its preoperative location. The surgical technique is described, and its usefulness in correcting similar lateral canthal deformities associated with fracture dislocations of the zygoma is mentioned.
Periosteal Graft in Scleromalacia
Authors: Rao Gullapalli N , Aquavella James V , Palumbo Anthony J
Published: April 2021

SUMMARY

A case of scleromalacia perforans in a 60-year-old white male without any associated systemic disease is reported. The patient had central retinal artery occlusion and Mooren's type of peripheral corneal degeneration in this eye preceding the development of scleromalacia.

Various modalities of treatment, both medical and surgical, have been described in the literature and among surgical procedures various tissues were used as graft material in the areas of scleral thinning. We chose periosteum as the graft material on the basis of our experience with it in cases of "through-and-through" keratoprosthesis and the result has been very encouraging. Though our experience is limited to only one case, we feel that periosteum as graft material has a place in cases of scleromalacia.
Cataract Aspiration with the O'Gawa Double-Bore Cannula
Authors: Nisbet R Michael , Guyton Jack S
Published: April 2021

SUMMARY

Sixty-eight soft cataracts were removed utilizing the O'Gawa double-bore aspiratingirrigating cannula. The postoperative visual acuity was found to be 20/100 or better in 83% and 20/40 or better in 59% of the 64 cases in which visual acuity was obtainable. In congenital cataracts, associated ocular defects such as strabismus or nystagmus reduced the visual prognosis. All cases of traumatic cataract had associated defects, usually a corneal laceration, however, visual improvement was noted in 81% of the cases. Significant postoperative corneal edema was not seen. Complications attributable to the operation included: rupture of the posterior capsule, insufficient removal of lens cortex, and pupillary block glaucoma. Discission of the posterior capsule was necessary in 26% of the eyes with an intact capsule. Retinal detachment followed the operation in three instances.

The O'Gawa double-bore cannula is recommended for the removal of soft cataracts.
Orbital Recurrence of Malignant Melanoma of the Choroid 24 Years After Enucleation
Authors: Saunders David H , Rodrigues Merlyn M , Shannon Gerard M
Published: April 2021

SUMMARY

An orbital recurrence of a choroidal malignant melanoma 24 years after enucleation has been described. This diagnosis should be considered in any patient presenting with a malfitting prosthesis following an enucleation for a choroidal malignant melanoma.
Trabeculectomy in Blacks: A Two-Year Follow-Up
Authors: Ferguson James G , Macdonald Roderick
Published: April 2021

SUMMARY

Fifty trabeculectomies were performed in 46 black patients for control of intraocular pressure in chronic open angle glaucoma. Forty-two eyes (84%) were controlled at the end of a two-year follow-up period. Thirty-eight (76%) required no medication for control while four eyes (8%) required antiglaucomatous medication for adequate control of intraocular pressure.
Echothiophate Iodide for Flat Anterior Chamber Following Cataract Extraction
Authors: Rothkoff L , Biedner B , Blumenthal M
Published: April 2021

SUMMARY

Three cases are presented of late flat anterior chambers which were cured by echothiophate iodide treatment. Two of the cases required repeated instillations to achieve permanent restoration of normal chamber depth. We now recommend that echothiophate treatment be considered in cases of late flat anterior chamber unresponsive to standard medical treatment.
The Management of Meibomian Gland Carcinoma
Authors: Harvey John T , Anderson Richard L
Published: April 2021

SUMMARY

We present nine cases of sebaceous adenocarcinoma seen on the Oculoplastic Service at the University of Iowa over the past five years. It is essential to make the biopsy-proven diagnosis of meibomian gland adenocarcinoma promptly, using multiple full thickness eyelid biopsies. We recommend the Mohs' fresh-frozen technique in patients with surgically resectable lesions, exenteration in those with orbital extension, and radical neck dissection for cases with nodal involvement. Radiotherapy may be indicated in patients with extensive tumors who cannot tolerate or refuse surgery or as an adjunct to surgery in others.
Worsening of Myopia Following A Circular Keratotomy
Authors: Perry L Douglas , Taylor Lawrence C
Published: April 2021

SUMMARY

Radial keratotomy is a relatively new procedure performed to flatten the cornea and thus reduce or eliminate myopia. We are reporting a case of a patient who underwent a circular keratotomy instead of the radial keratotomy for which permission had been given. Myopic astigmatism worsened following the procedure.
Lock Suture for Strabismus Surgery
Authors: Shen Ivy L
Published: April 2021

SUMMARY

Two alternative ways of locking the suture in strabismus surgery are presented. One way provides a far superior lock than the other. It will be worthwhile to remember that this can be achieved by GTTS which stands for "Go Through Toward Second."
Management of Subluxed Posterior-Chamber Intraocular Lenses
Authors: Stark Walter J , Bruner William E , Martin Neil F
Published: April 2021

SUMMARY

Subluxation of a posterior-chamber lens (IOL) (sunset syndrome) can be a difficult problem to manage. We describe a modification of the McCannel iris fixation suture technique for the management of subluxed posterior-chamber IOLs.
Surgical Management of Pseudophakic Corneal Edema: Complications and Visual Results Following Penetrating Keratoplasty
Authors: Arentsen Juan J , Laibson Peter R
Published: April 2021

SUMMARY

Of 45 eyes with pseudophakic bullous keratopathy, 40 underwent a penetrating corneal transplant. Thirty-six were followed for over six-months post surgically. Preoperative increased intraocular pressure and endothelial dystrophy in the contralateral eye were common findings. The most important factors limiting visual acuity postoperatively were increased intraocular pressure and cystord macular edema.

Although most grafts remained clear, this does not correlate with the final visual outcome in these patients.

Eyes in which the IOL was retained had statistically better visual results than eyes in which the IOL was removed because of associated complicating factors.
Pressure Profile of Ophthalmic Surgical Procedures: An Experimental Study on the Rabbit Eye
Authors: Honda Yoshihito , Kawano Shin-ichiro , Negi Akira , Koizumi Kyoko
Published: April 2021

SUMMARY

A balloon sensor was implanted in the posterior wall of the rabbit eye, and pressure fluctuation during several surgical procedures was monitored. Temporary IOP increase during digital massage sometimes reached near 100 mm Hg. Pressure increase during incision on the cornea was quite high, while corneal suturing, lens extraction, iridectomy, and open-sky vitrectomy induced minor fluctuating pressure on the posterior wall. Diathermy coagulation and scleral incision during simulated retinal detachment surgery increased IOP, exceeding 50 mm Hg and sometimes reaching 100 mm Hg.
Iris Retractor for Cryoextraction of Lens Under the Microscope
Authors: Inoue Takashi
Published: April 2021

SUMMARY

We developed the new iris retractor for the cryolens extraction under the microscope.
"In The Bag": Shearing Intraocular Lens Implantation in a Patient with Multiple Severe Coagulopathies
Authors: Eifrig David E , Blatt Philip M
Published: April 2021

SUMMARY

In patients with coagulation defects, the use of a posterior chamber lens implanted within the capsular bag after extracapsular cataract extraction appears to be well suited for the avoidance of long-term hemorrhagic complications. Bleeding tendencies during and following surgery can be managed medically with careful collaboration of a hematologist or coagulationist. This patient's multifaceted coagulopathy was easily manageable by treating each component as a separate entity. It is our present view that the vast majority of patients with severe coagulopathy can safely undergo cataract surgery and can be considered for intraocular lens implantation.
Salicylate-Induced Bleeding Problem in Ophthalmic Plastic Surgery
Authors: Paris George L , Waltuch George F
Published: April 2021

SUMMARY

A 54-year-old woman with clinically asymptomatic PCV underwent eyelid surgery. Twenty-four hours after an uncomplicated procedure she had a severe bleeding diathesis following the ingestion of a small amount of aspirin. Treatment of her bleeding disorder and a review of the effects of salicylates on platelet function are discussed.
Local Injection of Steroids for Juvenile Hemangiomas Which Disturb the Visual Axis
Authors: Brown Bernice Z , Huffaker Gary
Published: April 2021

SUMMARY

Steroids have been used since 1967 for the treatment of hemangiomas1 and for orbital hemangiomas since 1970.2 These were systemically administered which caused concern because of the possible systemic side effects.

In 1979, Kushner3 described local injection of steroids in the eyelid of infants where an hemangioma obstructed the visual axis or refractive error was induced by pressure from the lesion.

Five cases of lid hemangioma were treated using this method with varying degrees of success (possibly depending on percentage of mix of the tumor, capillary vs. cavernous). There were no measurable deleterious effects from the injections after a two-year follow-up.
Pupillary Block Glaucoma Following Intraocular Lens Implantation
Authors: Kielar Richard A , Stambaugh James L
Published: April 2021

SUMMARY

Seven cases of pupillary block glaucoma occurred in a series of 665 consecutive cases of cataract extraction with insertion of an iris supported intraocular lens, an overall incidence of 1%. The incidence with an iris plane lens was 1.7%, and for all other styles used the incidence was 0.3%. Common factors noted were iris plane intraocular lens and early postoperative complications predisposing to pupillary block. In four of the seven cases, there was a period of normal intraocular pressure followed by elevated intraocular tension with a deep central anterior chamber two weeks to fifteen months following cataract extraction, with subsequent development of corneal edema and typical shallowing of the anterior chamber with iris bombe. Five of seven cases ultimately regained control of intraocular pressure although extensive peripheral anterior synechia were present. No patient ultimately had a visual acuity better than 20/50.
Moxalactam (Moxam) in the Treatment of Experimental Staphylococcal Endophthalmitis
Authors: Leeds Norman H , Peyman Gholam A , House Barbara
Published: April 2021

SUMMARY

We investigated the intraocular penetration, retinal toxicity, clearance from the vitreous, and antibacterial activity of moxalactam (Moxam), a new third-generation cephalosporin with activity against aerobic and anaerobic gram positive organisms and many gram negative organisms. Seventy-four albino rabbits were used. Subconjunctival injection yielded therapeutic aqueous and vitreous levels for all hours studied. Intraocular penetration following single dose intravenous and intramuscular administration was poor. Two mg injected into the vitreous produced rare focal retinal toxicity.

Eleven of the 1 1 eyes receiving intravitreal injections of 2 mg moxalactam eight hours after inoculation with S. aureus were sterile and free of morphologic changes. Moxalactam appears to be a potent broad spectrum antibiotic with a low degree of toxicity to rabbit retinal tissue.
Maintenance of Mydriasis with Epinephrine During Cataract Surgery
Authors: Duffin R Michael , Pettit Thomas H , Straatsma Bradley R
Published: April 2021

SUMMARY

The pupillary response to various doses of intraocular epinephrine (0.1 ml of 1:16,000, 1:32,000, 1:64,000, 1:80,000, or 1:96,000) was studied in 55 consecutive patients during extracapsular cataract surgery. The 1:16,000 epinephrine concentration provided a mean 0.74 mm increase in pupil diameter (range 0.0 to 1.7 mm) when administered to re-dilate the pupil after nucleus expression. The mean increase in pupil area with 1:16,000 epinephrine was 27% which greatly facilitated removal of lens cortex in most cases. However, 25% of all pupils failed to dilate with epinephrine 1:16,000. The other concentrations provided essentially the same mydriasis as the 1:16,000 concentration. Pupils smaller than 6 mm dilated more easily than pupils larger than 6 mm. Iris color, age, or sex had no significant effect on the mydriatic response. It is concluded that an extremely dilute concentration of epinephrine (i.e., 1:96,000 or less) may be effective in maintaining mydriasis during cataract surgery.
Proliferation of Fibroblast-like Cells on Failing Intraocular Lenses
Authors: Wolter J Reimer , Felt Douglas P
Published: April 2021

SUMMARY

The process of reactivation and multifocal proliferation of fibroblast-like cells near giant cells on the surface of a well-developed cellular membrane covering a Choyce anterior chamber lens implant is described histologically in an eye that had a good surgical result at first and later developed bullous keratopathy, corneal ulceration, and final rupture three years following surgery. This is compared with another eye with a late stage of scarformation surrounding a Choyce implant two and a half years after implantation with severe complications. Details of lens implant cytology are demonstrated and discussed.
A Mask Strip to Prevent Fogging of Glasses at Surgery
Authors: Nevyas Herbert J
Published: April 2021

SUMMARY

A device to prevent the surgeon's eyeglasses and instrument eyepieces from fogging is described. It consists of a double adhesive-faced tape strip that is placed along the upper border of the surgical mask so that it adheres to the mask and to the face, preventing the upward passage of moist air.
Granular Cell Tumor of the Orbit: Case Report and Review of the Literature
Authors: Karcioglu Zeynel A , Hemphill Gregory L , Wool Brandon M
Published: April 2021

SUMMARY

This is a case report of orbital granular cell tumor in a 65-year-old female who came to our attention with progressive medial displacement of her right eye for the past two years. Clinical, radiologic, histologic, and ultrastructural features of the tumor are described and a review of 18 previously reported cases is given.
Foreign Body Reaction to Firm Nuclear Lens Substance
Authors: Wolter J Reimer
Published: April 2021

SUMMARY

Epithelioid and giant cells were covering the surface of a free-floating brunescent nucleus of a lens that was left in the posterior chamber for two years after extracapsular cataract surgery. This is used asan example to show that the anterior eye has the ability to react to free-floating material in its fluids with a simple foreign body reaction.
Macular Edema in Branch Retinal Vein Occlusion: Types and Treatment
Authors: Jalkh Alex E , Trempe Clement L
Published: April 2021

ABSTRACT

In this study of branch retinal vein occlusion, we distinguished between cystoid macular edema caused by increased capillary pressure and noncystoid edema due to hard exudates in the macula caused by chronic leakage from vascular abnormalities in the posterior pole or midperiphery. We performed laser photocoagulation in 51 eyes with cystoid macular edema to achieve focal narrowing of the retinal arterioles perfusing the macular area affected by the cystoid edema; good anatomic and functional results were achieved in 40 of these eyes (78%). In 25 of the five eyes, the treated segment of the retinal arteriole was outside the area of macular edema; results were successful in 19 of these eyes (76%). In 14 eyes with noncystoid exudative macular edema, we performed laser photocoagulation to the vascular abnormalities; good anatomic and functional results were obtained in 12 of these (86%).
Newton Rings on the Surface of Implanted Intraocular Lenses
Authors: Okada Kiyoshi , Sagawa Hiroaki
Published: April 2021

ABSTRACT

Using clinical specular microscopy, we studied a postoperative cellular reaction on the anterior surface of implanted artificial intraocular lenses in living human eyes. An amorphous coating filled the spaces between fibroblast-like cells, histiocytes, and foreign body giant cells in 29 of 118 eyes. In most cases the coating was observed as interference fringes (Newton rings). We observed the rings from seven to 63 days after surgery. Clinically, the patients did not show any visual disturbance at the time of these observations. With time, fibroblast-like cells decreased in number. By two months after surgery, most of the cells on the implants had already disappeared.
Branch Retinal Vein Occlusion Associated With Optic Nerve Drusen: A Case Report
Authors: Richmond Preston P , Orth David H
Published: April 2021

ABSTRACT

Proliferative retinopathy secondary to a branch vein occlusion developed in an otherwise healthy 24-year-old woman who also had optic nerve drusen. Since the patient sustained a preretinal hemorrhage, quadrantic photocoagulation was applied to the nonperfused quadrant of the retina involved in the occlusion. This case illustrates that compression of a branch retinal vein is another potential complication of optic nerve drusen.
Quantification of Progressive Diabetic Macular Nonperfusion
Authors: Goldberg Richard E , Varma Rohit , Spaeth George L , Magargal Larry E , Callen Deanna
Published: April 2021

ABSTRACT

We used the IS-2000 Image Analyzer to estimate the extent of progressive diabetic macular nonperf usion in a patient by means of an automatic clustering algorithm applied to digitized fluorescein angiograms of the patient's macula taken over time. This method may provide an objective and reproducible quantification of progressive macular nonperfusion.
Distention of the Lacrimal Sac in Neonates
Authors: Boynton James R , Drucker David N
Published: April 2021

ABSTRACT

We present seven cases of neonatal lacrimal sac distention, ranging from sterile dacryocystocele, subacute dacryocystitis, and acute dacryocystitis. Three patients were cured by probing, one by digital pressure decompression, and two by silicone tube intubation.
Therapeutic Ultrasound For Refractory Glaucoma: A Three-Center Study
Authors: Maskin Steven L , Mandell Alan I , Smith Jess A , Wood Robert C , Terry Stuart A
Published: April 2021

ABSTRACT

We present the results of therapeutic ultrasound for refractory glaucoma in a three-center study over 1 year. One hundred fifty-eight eyes were treated, with a mean follow-up of 8.0 months. The mean fall in intraocular pressure was 38.4%. Life table analysis for three success criteria are presented. Success varied between 66% and 72% at the mean follow-up time. Complications occurred in 11.4%, including phthisis bulbi in 0.6% and persistent hypotony in 2.5%. There was a mean loss of less than one line of visual acuity. Therapeutic ultrasound appears to be safe and effective for treatment of refractory glaucoma.
Gore-Tex™ Soft Tissue Bands as Scleral Explants in Rabbits: A Preliminary Histologic Study
Authors: Tawakol Magdy E , Peyman Gholam A , Liu Kwan-Rong , Kaufman Herbert E
Published: April 2021

ABSTRACT

Gore-Tex™ (polytetrafluoroethylene) grafts have been used in a variety of surgical procedures, particularly vascular, plastic, and reconstructive surgery. As suggested by previous animal studies, Gore-Tex™ soft tissue patches (expanded polytetrafluoroethylene) may have application in ocular surgery for scleral buckling and support procedures. We buckled the scleras of 14 rabbit eyes using strips of polytetrafluoroethylene soft tissue patches and monitored ocular tissue reaction and histologic changes in response to this material.
Posterior Synechiae in Intercapsular Cataract Surgery
Authors: Raines M F , Corridan P , O'Neill E C
Published: April 2021

ABSTRACT

Sixty-eight patients (76 eyes) who had undergone standard intercapsular cataract extraction and posterior chamber lens implantation were reviewed for the presence of posterior synechiae between the anterior capsule remnants and the iris. Thirty-five eyes (46%) had such synechiae, the characteristics of which are described. Risk factors for the development of posterior synechiae in this type of surgery include intraoperative trauma, postoperative inflammation, and the size of the anterior capsulectomy.
The Importance of Intraocular Lens Inspection Prior to Implantation
Authors: Cameron J Douglas , Lane Stephen S , Lindstrom Richard L
Published: April 2021

ABSTRACT

Open-loop, posterior chamber intraocular lenses were obtained from existing inventories of regional hospitals and surveyed for functional (optical) and structural defects. The majority of lenses (90%) were acceptable by industry optical grade standards. Most of the lenses (90%) varied by at least 0.5 diopter from the power stated on the packaging. Two lenses did not meet optical resolution standards. Most of the lenses (80%) had some surface or loop surface abnormality as judged by scanning electron microscopy. Four of the lenses had surface protrusions or burrs, either at the tip of the loop or at the lens-optic junction. These more serious defects could be seen easily at magnifications of the operating microscope. The lenses with serious structural defects tended to be the same as those lenses with functional (optical) defects. This study demonstrates the usefulness of careful intraoperative examination using the operating microscope prior to intraocular lens implantation to detect manufacturing defects which continue to exist in currently manufactured lenses. Lens inspection should be directed to the ends of the loops, the loop-optic junction, and the internal surface of the positioning holes.
Intractable Orbicularis Myokymia: Treatment Alternatives
Authors: Jordan David R , L Anderson Richard , Thiese Steven M
Published: April 2021

ABSTRACT

Orbicularis myokymia frequently occurs in young, otherwise healthy individuals. The intermittent muscle fasciculations are transient and generally disappear with time. If the myokymia is persistent or progressive, neurologic assessment and investigation may be necessary. Muscle relaxants, botulinum-A toxin, and surgical myectomy are methods of treatment that only occasionally need to be considered. We present limited orbicularis myectomy and botulinum-A toxin injections as efficacious treatments in five selected intractable cases of orbicularis myokymia.
The Gass Hook as an Aid in Inferior Oblique Recession
Authors: Parker Anne V , Nelson Leonard B
Published: April 2021

ABSTRACT

We describe how use of the Gass hook allows safer placement of the lateral rectus stay suture for inferior rectus recession through an inf erotemporal cul-de-sac incision.
Photocoagulation of Chorioretinal Anastomoses in Far-Advanced Age-Related Macular Degeneration
Authors: Cialdini Arnaldo P , Jalkh Alex E , Trempe Clement L , Weiter John J , Nasrallah Fadi P , Roodhooft Jan M
Published: April 2021

ABSTRACT

In age-related macular degeneration, communication between the retinal and choroidal circulations occurs spontaneously or following unsuccessful laser photocoagulation of subretinal new vessels. The resulting chorioretinal anastomotic complex, which includes the subretinal new vessels and their feeder retinal vessels, usually shows marked exudation and produces an extensive serous detachment of the neurosensory retina in the posterior pole, often associated with hard exudates. Eleven eyes with chorioretinal anastomotic complexes were treated using the monochromatic green argon laser Adequate closure of the chorioretinal anastomotic complexes by photocoagulation resulted in retinal flattening in the posterior pole with resolution of the hard exudates and improvement of vision in eight of the 11 treated eyes.
Low-Dose 5-Fluorouracil and Glaucoma Filtration Surgery
Authors: Rabowsky Jeffrey H , Ruderman Jon M
Published: April 2021

ABSTRACT

We show that a 40-mg total dose of subconjunctival 5-fluorouracil after glaucoma filtering surgery can provide a success rate comparable to that demonstrated in prior studies employing a higher dose. Sixty-four eyes with poor prognoses underwent filtering surgery with postoperative subconjunctival injections of 5 mg of 5-fluorouracil daily for seven days followed by one injection 1 week later. In 75% percent of the eyes intraocular pressure stabilized at 21 mm Hg or less regardless of medications used. The majority of failures occurred within 6 months of treatment. Postoperative corneal epithelial defects occurred in 30% of the cases, conjunctival wound leaks in 6.3%. A 40-mg dose of subconjunctival 5-fluorouracil appears to be effective and may be associated with a lower incidence of postoperative complications than higher doses.
Needlestick Injuries in Ophthalmology
Authors: Mansour Ahmad M
Published: April 2021

ABSTRACT

Because serious nosocomial diseases can be transmitted by needlestick injuries, a retrospective review of needlestick injuries was conducted for a period of 2.5 years at a major university teaching hospital. The objective was to determine the needlestick injury rate among employees of the Department of Ophthalmology versus the other departments. Ophthalmologists had the highest incidence per person of needle injuries among physicians. Retina and strabismus surgeons were at higher risk than anterior segment surgeons.
Use of Neodymium: YAG Laser to Open an Occluded Molteno Tube
Authors: Fiore Philip M , Melamed Shlomo
Published: April 2021

ABSTRACT

A patient with refractory glaucoma secondary to trauma and repeat penetrating keratoplasty had Molteno implant surgery to control elevated intraocular pressure. Six weeks after surgery intraocular pressure rose abruptly, and a fibrinous membrane was seen covering and occluding the tip of the Molteno tube. The Q-switched neodymium (Nd): YAG laser was used successfully to open the membrane, with subsequent renewal of aqueous flow and control of intraocular pressure. Bevel-up cutting of the tube tip facilitates Nd: YAG laser opening of such an obstruction. We describe this use of the Nd: YAG laser and recommend bevel-up trimming of implant tubes in aqueous implant surgery.
Deep Sclerectomy With Trabeculotomy Ab Externo: One-Stage Procedure (DS 1)
Authors: Hara Tsutomu , Hara Takako
Published: April 2021

ABSTRACT

Our new full-thickness filtering procedure was performed on 20 eyes with narrow-angle glaucomas (15 patients, mean age 69±12 years) with high intraocular pressure (K)P) despite initial peripheral iridectomy. This procedure was intended to maintain anterior chamber depth completely during intraoperative and postoperative periods. Under conjunctival and thin scleral flaps, the deep (4x1.5 mm) scleral block containing the outer wall of Schlemm's canal was removed. After closing the scleral flap with eight interrupted sutures and the conjunctival flap with a running suture, a 1-mm spatula was inserted beneath the scleral flap, and the trabeculum was punctured. The mean preoperative and final postoperative IOPs were 34.8±17.2 mm Hg and 14.9±4.9 mm Hg, respectively. Follow-up time was at least 12 months. Final postoperative IOP was less than 21 mm Hg without oral medication in 16 eyes (80.0%). The only complication was slight bleeding from the punctured trabeculum. This bleeding was completely absorbed within a week.
Communicating Intravitreal Cysticercosis
Authors: Kumar Atul , Verma Lalit , Khosla P K , Tewari H K , Jha S N
Published: April 2021

ABSTRACT

A viable intravitreal Cysticercus cellulosae communicating with subretinal space was identified in a 45year-old man. The cyst was removed in toto via the direct scleral approach without incident. To our knowledge this is the first report of intravitreal Cysticercus with subretinal extension removed successfully by the direct route. The role of careful ultrasonic scanning in cases of intravitreal cysticercosis is emphasized.
Improved Resolution of Specular Micrographs
Authors: Merin Lawrence M , Koch Douglas D
Published: April 2021

ABSTRACT

The purpose of specular photomicrography of the corneal endothelium is to depict fine cellular morphology and to determine total cell density. The use of silver-based photographic films to record the cells and generate enlarged paper prints yields the highest resolution currently possible. Previously, the quality of these prints was diminished when the highly resolved cell image was combined with the standardized grid used for quantification, since the sub-optimal quality of the grid's plastic substrate caused optical aberrations. We present a prototype device and a modified technique that enables the full resolution of the microscope to be represented on photographic prints and allows highly detailed views of the endothelial mosaic to be depicted with or without the standardized grid.