bluuebunny/crossref_metadata_2025 huggingface dataset:
Interaction Between Silicone Oil and Silicone Intraocular Lenses: An In Vitro Study
Authors: Senn Peter , Schmid Martin K , Schipper Isaak , Hendrickson Phillip
Published: April 2021

Abstract. The objective of this study was to examine the interaction between silicone oil and silicone intraocular lenses (IOLs) in vitro. Six types of silicone IOLs were placed in silicone oil (1000 or 5000 centistokes) for 1 minute, 7 days, and 420 days. Slit-lamp examination, target photographs, and opacity measurements were performed. Optical measurements were repeated in a balanced salt solution after removal from the oil. The IOL surface was examined through scanning electron microscopy, and surface irregularities underwent x-ray spectroscopy. No changes were observed while the IOLs were stored in silicone oil, but in the balanced salt solution, the IOLs were observed to have a layer of silicone oil droplets that reduced the optical quality. Scanning electron microscopy showed that oil-coated foreign body particles were simulating IOL surface defects. After ultrasonic cleaning with ethanol, the oil layer was broken, and no damage to the IOL surface could be detected. The length of exposure to silicone oil, the type of oil, and the type of IOL were found to have no bearing on the interaction between silicone oil and silicone IOLs. Although no surface damage is incurred by silicone IOLs from silicone oil, the reduction in optical quality and fundus view due to remnant oil droplets seems to indicate that complex cases requiring silicone oil injection may contraindicate IOLs made of silicone.

[Ophthalmic Surg Lasers 1997;28:776-779.]
Intraoperative Prediction of Intraocular Pressure for the First Postoperative Day Following Glaucoma Filtration Surgery
Authors: Lanzl Ines M , Moster Marlene R , Hodges Denise Dudley
Published: April 2021

Abstract. The goal of glaucoma filtering surgery is to achieve adequate control of intraocular pressure (IOP). This prospective study evaluates the authors' accuracy in predicting IOP for the first postoperative day (POD 1) through digital palpation of the globe and evaluation of the achieved leakage at the end of trabeculectomy. Fifty patients underwent trabeculectomy with or without the use of an antimetabolite. At the conclusion of the procedure, an IOP prediction for POD 1 was given by the surgeon. The recorded IOP readings on POD 1 were compared with this prediction. The results were evaluated by linear regression analysis. The IOP predictions were within ± 3 mm Hg of the forecasted value for 31 patients (62%), within ± 6 mm Hg for 44 patients (88%) and outside of ± 6 mm Hg for 6 patients (12%). Short-term postoperative IOP control is reasonably predictable and may be adjusted for individual care. [Ophthalmic Surg Lasers 1997;28:780-782.]
The Accuracy of Finger Tension for Estimating Intraocular Pressure After Penetrating Keratoplasty
Authors: Rubinfeld Roy S , Cohen Elisabeth J , Laibson Peter R , Arentsen Juan J , Lugo Miguel , Genvert Gail I
Published: April 2021

* BACKGROUND AND OBJECTIVE: Intraocular pressure (IOP) estimation by Goldmann tonometry is inaccurate in the immediate postoperative period after penetrating keratoplasty. For this reason, many corneal surgeons use a finger tension (FT) IOP estimation technique in the early post-keratoplasty period. The authors performed a prospective clinical study to evaluate the accuracy of this traditional technique.

* PATIENTS AND METHODS: FT estimates were performed by three experienced corneal surgeons on 68 patients on the first and second days after penetrating keratoplasty. These estimates were compared with MacKay-Marg (MM) tonometry readings for these patients.

* RESULTS: The mean confident FT from the pooled data of the three surgeons exceeded the MM reading by 5.0 mm Hg (22.6 vs. 17.6). The mean FT exceeded the MM reading by only 3.9 mm Hg for the most accurate surgeon. Some observers were significantly more accurate than others, however, lid edema and tenderness of the globe markedly diminished the FT accuracy of all of the observers at significance levels of P < .001 and P < .01, respectively. Among all of the FT estimates, in only one patient (2%) did the FT underestimate the MM reading by more than 10 mm Hg.

* CONCLUSION: The authors' results suggest that for some patients, and for some surgeons, the FT or digital method of IOP estimation remains useful for detecting elevated IOP early after corneal transplantation if the proper technique is used and substantial lid edema and patient discomfort are absent.

[Ophthalmic Surg Lasers 1998;29:213-215.]
Penetrating Keratoplasty With a Valved Glaucoma Drainage Implant for Congenital Glaucoma and Corneal Scarring Secondary to Hydrops
Authors: Zacharia Peter T , Harrison Devin A , Wheeler David T
Published: April 2021

Abstract. The simultaneous management of glaucoma and corneal opacification is sometimes required in infants with severe congenital glaucoma if timely visual rehabilitation is to be achieved. A 1-month-old female infant presented with an enlarged, protuberant, opaque cornea in each eye and elevated intraocular pressure. An intrastromal, fluid-filled cleft was noted in both corneas. It resolved over 3 weeks as corneal scarring progressed. Peripheral corneal clearing allowed a view of an essentially normal anterior chamber. Penetrating keratoplasty and Ahmed (New World Medical Inc., Rancho Cucamonga, CA) valve implant surgery with mitomycin-C were performed simultaneously in the two eyes 1 month apart. At 15 months of age, the patients grafts were clear and the intraocular pressure was well controlled in both eyes. One eye required multiple procedures for eventual glaucoma control. No postoperative overfiltration occurred. The authors conclude that the use of a valved implant should be considered in patients who require urgent simultaneous corneal and glaucoma surgery for severe congenital glaucoma. This combination may improve early postoperative control of aqueous outflow and positively affect long-term graft survival in these difficult cases. [Ophthalmic Surg Lasers 1998; 29:318-322.]
Isolated Posterior Capsule Rupture in Blunt Trauma: Pathogenesis and Management
Authors: Rao Srinivas K , Parikh Sunil , Padhmanabhan Prema
Published: April 2021

Abstract. Although blunt ocular trauma frequently damages the crystalline lens, isolated rupture of the posterior capsule is an infrequently reported occurrence. The authors describe three patients with this unusual presentation. All patients underwent cataract extraction and intraocular lens (IOL) implantation using a limbal approach. There were no intraoperative complications. All patients achieved good postoperative visual acuity with well-positioned posterior chamber IOLs (in-the-bag in two eyes, sulcus fixated in one eye). Isolated rupture of the posterior capsule in young patients can be safely managed using the limbal approach and implantation of posterior chamber IOLs, is possible. [Ophthalmic Surg Lasers 1998;29:338-342.]
Quantification of Holmium:YAG and Thulium:YAG Laser-Induced Scleral Shrinkage for Buckling Procedures
Authors: Sasoh Mikio , Parel Jean-Marie , Manns Fabrice , Nose Izuru , Comander Jason , Smiddy William E
Published: April 2021

* BACKGROUND AND OBJECTIVE: To quantify and compare holmium:YAG (2.1 µm) and thulium:YAG (2.0 pm) laser-induced scleral shrinkage for retinal buckling procedures.

* MATERIALS AND METHODS: Two overlap ping spots of either laser radiation were applied at the equatorial sclera of 50 human cadaver eyes. Scleral shrinkage was expressed as a relative change of length between two reference points on the scleral surface, and quantified as a function of energy per pulse, total energy, scleral thickness, and intraocular pressure (IOP). Tissue effects were studied histopathologically.

* RESULTS: Shrinkage was most dependent on total fluence and attained a maximum of 27% to 30% with an IOP of 4 mm Hg, regardless of scleral thickness or laser parameters, but decreased with increasing IOP. The thulium:YAG laser produced more efficient scleral shrinkage and less collagen damage than the holmium:YAG laser.

* CONCLUSION: The recommended parameters for laser-induced scleral shrinkage are the thulium:YAG laser, with 2.4 J/cm
p 2
per pulse and 12.0 to 14.4 J/cm
p 2
total fluence (5 to 6 pulses). IOP control (≤ 4 mm Hg) is crucial during laser scleral buckling.

[Ophthalmic Surg Lasers 1998;29:410-421.]
Myopia, Hypotony, and Lenticular Shift Following Strabismus Surgery
Authors: Brodsky Michael C
Published: April 2021

Abstract. A 5-year-old girl had hypotony, myopia, and anterior displacement of the lens-iris diaphragm following routine strabismus surgery. This constellation of findings suggests that surgical manipulation of the intact sclera produced a limited effusion involving the supraciliary space. Following cycloplegia, these findings resolved over several weeks, suggesting that this rare complication is self-limited and associated with a good prognosis for recovery. [Ophthalmic Surg Lasers 1998;29:426-427.]
Management of the Molteno Silicone Tube in Corneal Transplant Surgery
Authors: Freedman Jeffrey
Published: April 2021

Abstract. A method to prevent tube-corneal touch in patients with Molteno implants who require corneal transplants is presented. A double-armed 10-0 Prolene suture is passed from limbus to limbus so that within the anterior chamber the suture acts as a splint for the silicone tube of the Molteno implant, keeping it away from the cornea. This suture has been used in six patients, all aphakic or pseudophakic, requiring corneal transplants for bullous keratopathy. In all six patients, the silicone tube was successfully splinted away from the endothelium of the corneal transplant. [Ophthalmic Surg Lasers 1998;29:432-434.]
Topical Tissue Plasminogen Activator Appears Ineffective for the Clearance of Intraocular Fibrin
Authors: Zwaan Johan , Latimer W Bruce
Published: April 2021

* BACKGROUND AND OBJECTIVE: To determine the efficacy of topical tissue plasminogen activator (tPA) for the resolution of postoperative or inflammatory intraocular fibrinous exudates.

* PATIENTS AND METHODS: Each treatment consisted of drops of 1 mg/ml tPA given 9 times 5 minutes apart. Records were reviewed and the results at 24 and 48 hours were recorded. Sixty-two patients had a total of 94 treatments.

* RESULTS: Fibrin exudates following intraocular surgery in 34 patients were treated 44 times. In 6 patients there was a positive result. Fibrin associated with intraocular infection was treated in 9 patients. None showed clear improvement. Nineteen patients had a total of 34 treatments for poorly controlled intraocular pressure (IOP) after glaucoma surgery. Five patients showed adequate control of the IOP, 12 did not change, and 2 had a questionable improvement. Eleven patients had adequate IOP control after additional treatment. Seven required suture lysis, 2 ab interno bleb revision, and 2 YAG capsulotomy or iridotomy to reduce the IOP to an acceptable level.

* CONCLUSIONS: Within the limits of this retrospective study and taking into account that fibrin may resolve spontaneously, it appears that topical tPA drops are not effective for the liquefaction of intraocular fibrin after surgery or in association with intraocular inflammation. They did not improve IOP control after glaucoma surgery.

[Ophthalmic Surg Lasers 1998;29:476-483.]
Long-Term Results After Filtering Surgery With Limbal-Based and Fornix-Based Conjunctival Flaps
Authors: Auw-Haedrich C , Funk J , Boemer T G
Published: April 2021

* BACKGROUND AND OBJECTIVE: To compare the long-term results of filtering surgery using either a limbal-based or fornix-based flap.

* PATIENTS AND METHODS: From 1985 to 1988, 90 eyes of 81 glaucoma patients undergoing filtering surgery were included in a prospective randomized clinical trial. They were alternately operated on with either a limbal-based or fornix-based conjunctival flap. The authors evaluated the functional and morphologic long-term results of 34 eyes (18 fornix based, 16 limbal based) after a minimum follow-up of 6 years. Intraocular pressure (IOP), visual acuity, visual field, intensity of symptoms due to dry eyes, and corneal overlap of the filtering bleb using planimetry were reexamined.

* RESULTS: No statistically significant difference of IOP reduction, deterioration of visual acuity, deterioration of visual field, sicca score, or corneal overlap of the filtering bleb was found between the limbal-based and fornix-based groups. There was no correlation between corneal overlap of the filtering bleb and the sicca score.

* CONCLUSION: The long-term results of fornixbased and limbal-based filtering surgery did not show a statistically significant difference.

[Ophthalmic Surg Lasers 1998;29:575-580.]
Krypton Laser Suture Lysis
Authors: Aktan S Gulderen , Mandelkorn Robert M
Published: April 2021

* BACKGROUND AND OBJECTIVES: Traditionally, the argon laser has been used with suture lysis. The authors evaluate the krypton laser and define the parameters for the successful use of the laser with this procedure.

* PATIENTS AND METHODS: Five consecutive patients undergoing combined cataract and trabeculectomy surgery who were considered candidates for this procedure underwent krypton laser suture lysis. Three laser suture lysis contact lenses were used during this procedure. None of the patients underwent adjuvant chemotherapy in the form of either 5-fluorouracil or mitomycin-C.

* RESULTS: All five patients were successfully treated with the krypton laser. In all cases, the 10-0 nylon sutures were cut. No complications were observed in any patients. The only side effect observed was occasional mild pain noted by the first few patients during the procedure. As the krypton laser settings were adjusted, this problem was corrected.

* CONCLUSION: The krypton laser can be successfully used to cut 10-0 nylon sutures following trabeculectomy surgery.

[Ophthalmic Surg Lasers 1998;29:635-638.]
Changes in Anterior Chamber Depth and Intraocular Pressure After Phacoemulsification and Posterior Chamber Intraocular Lens Implantation
Authors: Cekic Osman , Batman Cosar , Totan Yüksel , Emre M Ihsan , Zilelioglu Orhan
Published: April 2021

* BACKGROUND AND OBJECTIVE: To determine anterior chamber depth (ACD) and intraocular pressure (IOP) following uncomplicated cataract extraction with phacoemulsification and posterior chamber intraocular lens (IOL) implantation.

* PATIENTS AND METHODS: The ACDs and IOPs of 56 patients were prospectively evaluated after phacoemulsification and IOL implantation. Measurements of ACD were performed using ultrasonography and measurements of IOP were performed using a Goldmann applanation tonometer preoperatively and at 1 week and 1, 3, 6, and 9 months postoperatively.

RESULTS: The mean IOP had decreased and the mean ACD had increased significantly by 1 month postoperatively (P < .03 and P < .01, respectively). Between 1 and 3 months, a significant increase in ACD (P < .05) and decrease in IOP (P < .01) was also observed. The ACD peaked (3-51 ± 0.45 mm) and the IOP reached its lowest value (10.05 ± 2.23 mm Hg) at 3 months postoperatively. The reduction in IOP and increase in ACD remained significant during the follow-up period, compared with the preoperative values.

* CONCLUSION: These results suggest that increases in ACD and decreases in IOP occur in selected patients after uncomplicated cataract extraction by phacoemulsification with IOL implantation.

[Ophthalmic Surg Lasers 1998;29:639-642.]
Effect of Scleral Indentation on Diode Laser Transscleral Retinal Photocoagulation
Authors: Loewenstein Anat , Lamborne Andrew N , Haller Julia A , de Juan Eugene
Published: April 2021

* BACKGROUND AND OBJECTIVE: To evaluate the effect of the degree of scleral indentation with a modified AlGaAs diode laser for transscleral retinopexy in the rabbit.

* MATERIALS AND METHODS: Transscleral diode laser photocoagulation was performed on the eyes of Dutch-belted rabbits using a modified AlGaAs diode laser with a wider base and various prism protrusions.

* RESULTS: The transscleral photocoagulation generally became more efficient with an increasing amount of scieral indentation. Effectiveness increased up to a prism protrusion of 1.5 mm.

* CONCLUSION: This study shows that a wide-based AlGaAs diode laser with a 1.5-mrn protrusion provides a more easily oriented probe for creating more efficient chorioretinal burns.

[Ophthalmic Surg Lasers 1998;29:658-662.]
Ocular Vascular Thrombosis Following Tin Ethyl Etiopurpurin (SnET2) Photodynamic Therapy: Time Dependencies
Authors: Moshfeghi Darius M , Peyman Gholam A , Moshfeghi Andrew A , Khoobehi Bahram , Primbs George B , Crean David H
Published: April 2021

* BACKGROUND AND OBJECTIVES: To evaluate the optimal time from the end of photosensitizer injection to the commencement of light application for creating characteristic rundus lesions and the time to vascular occlusion following photodynamic therapy (PDT) with tin ethyl etiopurpurin (SnET2).

* MATERIALS AND METHODS: Following intravenous injection of SnET2 0.5 mg/kg or lipid emulsion alone, the fundus of rabbits was irradiated at different times (5 to 240 minutes) after photosensitizer injection using 664 ± 7-nm laser light with an irradiance of 354 mW/cm
p 2
and fluence of 20 J/cm
p 2
. Ophthalmoscopy and fluorescein angiography were performed 1 day after SnET2 PDT. In separate groups of rabbits, treated areas of the fundus were imaged within 30 minutes following PDT using fluorescein vesicle and microsphere angiography with scanning laser ophthalmoscopy to document time of vascular occlusion. All animals were killed 1 day following treatment and eyes were examined by histopathotogy.

* RESULTS: Areas of hypofluorescence (indicating vascular occlusion) were seen when activating laser light was applied 5 to 20 minutes after SnET2 injection. Retinal vessels remained perfused in all cases. The time to vascular occlusion was 70 to 120 and 40 to 90 minutes in nonpigmented and pigmented rabbits, respectively. No safety issues were seen.

* CONCLUSION: PDT with SnET2 was effective in occluding the choriocapillaris. Activating light needs to be applied within a specific time frame after photosensitizer injection to achieve vascular occlusion.

[Ophthalmic Surg Lasers 1998;29:663-668.]
Microscopic Examination of Surgical Margins of Intraocular Tumors Excised En Bloc
Authors: Margo Curtis E
Published: April 2021

Abstract. Microscopic examination of the surgical margins of an en bloc resection of an intraocular tumor is difficult because of the small size of the specimen. A technique to study the surgical margins of en bloc resections is described that minimizes gross handling of the tissue in the laboratory. Step sections at 1/8-mm intervals along the anteroposterior axis of the eye provide sufficient sampling to detect involvement of the surgical margin. They also allow easy anatomic reconstruction of the tumor with glass slides. [Ophthalmic Surg Lasers 1998;29:692-694.]
Combined Phacoemulsification and Trabeculectomy Versus Trabeculectomy Alone: A Comparison Study Using Mitomycin-C
Authors: Derick Robert J , Evans John , Baker N Douglas
Published: April 2021

* BACKGROUND AND OBJECTIVE: To compare the results of combined phacoemulsification and trabeculectomy (PEM/TRAB) plus mitomycin-C with those of trabeculectomy alone (TRAB) plus mitomycin-C.

* PATIENTS AND METHODS: The authors retrospectively reviewed 42 eyes in 38 consecutive patients who underwent combined PEM/TRAB with mitomycin-C. An age-matched control group of 42 patients who underwent TRAB with mitomycin-C during the same time period was randomly selected from 248 consecutive patients. All patients had a minimum of 12 months of follow-up.

* RESULTS: Mean preoperative intraocular pressure (IOP) and number of glaucoma medications were similar for the two groups (22.8 ± 6.9 mm Hg vs 22.9 ± 6.8 mm Hg, 2.12 ± 0.8 vs 2.26 ±1.0 medications, combined PEM/TRAB vs TRAB, respectively). Postoperative IOP was significantly lower at all followup intervals. At final follow-up after a mean of 21.8 ± 6.0 months, IOP averaged 13-9 ± 5.1 mm Hg in the PEM/TRAB group and 12.3 ± 4.7 mm Hg in the TRAB group. Bleb survival was excellent in both groups, although slightly higher in the TRAB group (37 of 42 PEM/TRAB vs 41 of 42 TRAB). Both groups required significantly fewer glaucoma medications at final follow-up (0.38 ± 0.6 vs 0.5 ± 0.8, PEM/TRAB vs TRAB). Complications were similar between the two groups.

* CONCLUSION: The success rate for combined PEM/TRAB appears to approach that of TRAB alone.

[Ophthalmic Surg Lasers 1998;29:707-713.]
Episcleral Versus Combined Episcleral and Intrascleral Application of Mitomycin-C in Trabeculectomy
Authors: Vass C , Menapace R , Strenn K , Rainer G
Published: April 2021

* BACKGROUND AND OBJECTIVE: To determine whether intrascleral exposure to mitomycin-C (MMC) improves the control of intraocular pressure (IOP), increases the incidence of complications, or both.

* PATIENTS AND METHODS: The authors retrospectively evaluated 38 eyes of 29 patients following the intraoperative application of MMC (0.2 mg/ml; 5 minutes). In 21 eyes the MMC-soaked sponge was applied to the intact episclera (episcleral group). In 17 eyes, two sponges, one episcleral and the other intrascleral (sandwich group), were applied. The median follow-up times were 19.0 (episcleral group) and 24.0 (sandwich group) months. Outcome measures were the IOP, the number of medications, success rates, and the incidence of complications.

* RESULTS: The only statistically significant difference between the two groups was the 2-week postoperative IOP, which was significantly lower in the episcleral group (P= .0314).

* CONCLUSION: Because there is no additional benefit, the authors recommend that the intrascleral application of MMC be avoided. However, they did not observe increased complication rates when MMC was applied in this way.

[Ophthalmic Surg Lasers 1998;29:714-721.]
Capsule-Bending Ring for the Prevention of Capsular Opacification: A Preliminary Report
Authors: Nishi Okihiro , Nishi Kayo , Menapace Rupert
Published: April 2021

* BACKGROUND AND OBJECTIVE: To report the preliminary results of a study on the preventive effect of the capsule-bending ring on anterior and posterior capsule opacification (ACO and PCO, respectively).

* PATIENTS AND METHODS: The ring is an open, band-shaped, circular polymethylmethacrylate (PMMA) ring measuring 11 mm in diameter with pre-tension (13 mm in diameter when the ring is open), 0.2 mm in thickness, and 0.7 mm in width. To retain sharp edges, the ring is not polished. The sharp edges should create a sharp, discontinuous capsular bend in the fornix, which induces contact inhibition of migrating lens epithelial cells after cataract surgery. This capsule-bending ring is inserted into the capsular fornix following phacoemulsification, prior to the implantation of an intraocular lens (IOL). In a multicenter trial, 100 patients were scheduled to undergo phacoemulsification and IOL implantation in both eyes within 1 month. The procedure was performed with the ring in 1 eye and without the ring in the other eye of each patient.

* RESULTS: The anterior capsule was prevented from coming into contact with the IOL, and ACO was significantly ieduced in the eyes with the ring, rendering the capsular opening larger 3 months after surgery. PCO was obviously reduced on slit-lamp examination in the follow-up period up to 6 months, but needs to be evaluated during a longer period.

* CONCLUSION: This band-shaped, sharp-edged capsule-bending ring may be useful for cases that need good fundus visualization for photocoagulation or expected vitreoretinal surgery and for the prevention of PCO.

[Ophthalmic Surg Lasers 1998;29:749-753.]
Digital Palpation of Intraocular Pressure
Authors: Birnbach Charles D , Leen Martha Motuz
Published: April 2021

* BACKGROUND AND OBJECTIVE: Previous studies investigating the accuracy of digital palpation through the eyelids to estimate intraocular pressure (IOP) have shown disappointing results. In this study, the accuracy of digital assessment of IOP by palpation of the bare cornea is investigated.

* MATERIALS AND METHODS: The IOP of a cadaveric eye model was varied from 5 to 40 mm Hg in increments of 5 mm Hg. Two examiners, one experienced and one inexperienced, digitally palpated the corneas and estimated IOP. The results were compared before and after a 1-hour training session.

* RESULTS: Prior to the training session, the experienced examiner guessed correctly 46% of the time and was correct within 5 mm Hg 100% of the time. The inexperienced examiner guessed correctly 21% of the time and was within 5 mm Hg 62% of the time. After the training session, the experienced examiner's score did not significantly change, whereas the inexperienced examiner improved significantly (38% correct, 88% within 5 mm Hg, P = .05.)

* CONCLUSIONS: Digital assessment of IOP by palpation of bare cornea is accurate when performed by experienced individuals. A minimal amount of training using the eye model may improve one's accuracy.

[Ophthalmic Surg Lasers 1998;29:754-757.]
The Outcome of the Functioning Filter After Subsequent Cataract Extraction
Authors: Halikiopoulos Demetrios , Moster Marlene R , Azuara-Blanco Augusto , WiIson Richard P , Schmidt Courtland M , Spaeth George L , Katz L Jay , Augsburger James J
Published: April 2021

* OBJECTIVE: To evaluate and compare the outcome of functioning filtration surgery followed by cataract surgery with posterior intraocular lens implantation by both phacoemulsification and extracapsular cataract extraction (ECCE) techniques in glaucomatous eyes.

* PATIENTS AND METHODS: We retrospectively evaluated the clinical course of 77 eyes (68 patients) that after successful trabeculectomy, underwent cataract surgery by either phacoemulsification or ECCE techniques. We determined the frequency of partial and absolute failure following cataract surgery by either phacoemulsification or ECCE in eyes with functioning trabeculectomies. Partial failure of intraocular pressure (IOP), control after cataract extraction was defined as the need for an increased number of antiglaucoma medications or argon laser trabeculoplasty to maintain IOP <21mm Hg. Complete failure of IOP control after cataract surgery was defined as an IOP >21 mm Hg on at least two consecutive measurements one or more weeks apart or the performance of additional filtration surgery. Failure rates were calculated using the Kaplan-Meier actuarial method. Failure rates between phacoemulsification and ECCE subgroups were compared using the log rank test.

* RESULTS: The probability of partial failure by the third postoperative year after cataract surgery was 39.5% in the phacoemulsification subgroup and 37.3% in the ECCE subgroup. This small difference is not statistically significant (P= 0.48). The probability of complete failure by the fourth postoperative year after cataract surgery was 12.0% in the phacoemulsification subgroup and 12.5% in the ECCE subgroup. This difference is also not statistically significant (P = 0.77). At the 6-month follow-up visit, visual acuity of both groups improved one or more lines in 87.0% of patients, and worsened one or more lines in 3.9% of patients. Sixty-one percent achieved visual acuity of 20/40 or better. The most frequent complication was posterior capsular opacification requiring laser capsulotomy that occurred in 31.2% of patients.

* CONCLUSION: Cataract extraction by either phacoemulsification or ECCE following trabeculectomy surgery may be associated with a partial loss of the previously functioning filter and the need for more antiglaucoma medications to control IOP.

[Ophthalmic Surg Lasers 2001;32:108-117]
Hollow Bandage Contact Lens
Authors: Porges Yair , Ophir Avinoam
Published: April 2021

* OBJECTIVE: To report on the use of a new bandage contact lens (BCL) for a leaking filtering bleb.

* PATIENTS AND METHODS: A hollow BCL, with an internal central opening of 6 mm, has been applied on three eyes that had leaking blebs shortly after either trabeculectomy or combined cataract extraction and trabeculectomy, each with a fornixbased conjunctival flap.

* RESULTS: The treatment with this lens was found beneficial: the leakage subsided and the patients were comfortable with the lens. The internal hollow of the BCL enabled us to monitor the intraocular pressure throughout the entire follow-up period without transient and repeated removal of the BCL.

* CONCLUSION: The new hollow BCL was found efficacious. The study suggests that this lens may have advantages over the commonly used BCLs that are related to the elimination of the need for its frequent removal and reinsertion for tonometry. This decreases the risk of both the exposure of the lens and the filtering bleb to contamination and the interference with the continuity of the process of conjunctival epithelial closure.

[Ophthalmic Surg Lasers 2001;32:124-128]
Use of Erbium:YAG Laser in the Treatment of Palpebral Xanthelasmas
Authors: Mannino Giuseppe , Papale Antonio , De Bella Francesco , Mollo Roberto , Morgia Paolo , Gabrieli Corrado Balacco
Published: April 2021

* OBJECTIVE: In light of the research and the use of lasers in the therapy of xanthelasmas, the authors report their experience in the treatment of this pathology with Erbium: YAG laser.

* MATERIALS AND METHODS: In 30 patients» all female, 70 xanthelasmas were treated with Erbium:YAG laser, 65 (93%) of which were on the upper eyelid and 5 (7%) on the lower eyelid, varying from 1X1.5 mm to 1 1 X 20 mm in size. Spots with a diameter of 1.6 mm, energy of 300 mj, frequency of 1 -5 Hz and in a number varying were used in relation to the extent of the pathology.

* RESULTS: In all cases, the appearance and functional results were good, without leaving scars and/or dyschromia.

* CONCLUSIONS: Erbium:YAG laser, in the treatment of xanthelasmas, is a parasurgical method that is simple to perform and because of the successful aesthetic and functional results, is a valid alternative to the more traditional treatment methods.

[Ophthalmic Surg Lasers 2001;32:129-133]
GGRGDSPCA Peptide: A New Antiscarring Agent on Glaucoma Filtration Surgery
Authors: Avila Marcel , Ortiz Gabriel , Lozano Jose M , Franco Pedro , Patarroyo Manuel E
Published: April 2021

* BACKGROUND AND OBJECTIVE: GGRGDSPCA synthetic peptide competes for integrin receptor in scar formation after glaucoma filtering surgery in a rabbit model. The purpose of this study was to evaluate the use of this peptide and compare it with mitomycin on glaucoma filtering surgery.

* MATERIALS AND METHODS: Posterior sclerectomy was performed in both eyes of 17 rabbits. The right eye received GGRGDSPCA (p605) at 0, 4, 8, 12, and 16 days after. Nine left eyes received saline as a control; the remaining 8 eyes received mitomycin C at 0.5 mg/mL intraoperative. Intraocular pressures and biomicroscopy were evaluated as well as bleb function.

* RESULTS: Intraocular pressure decreased significantly in both the peptide and mitomycin treated eyes in comparison with the saline group (P = 0.0003). Pressure was similar in both groups. The blebs showed filtrating function in a functional analysis at day 21 and 41 in the mitomycin cases as well as in the peptide group. Histologic analysis performed in both peptide and mitomycin groups showed inhibitory effect in fibrocellular and collagen organization with bleb formation.

* CONCLUSIONS: The p605 peptide showed to be similar to mitomycin C in controlling and improving glaucoma filtering surgery in rabbits. This alternative may potentially be useful for similar purposes in humans for the control of glaucoma and improvement of filtering surgery.

[Ophthalmic Surg Lasers 2001;32:134-139]
Postoperative Complications Following Vitrectomy for Proliferative Diabetic Retinopathy with Sew-On and Noncontact Wide-Angle Viewing Lenses
Authors: Virata Steven R , Kylstra Jan A
Published: April 2021

* BACKGROUND AND OBJECTIVE: To compare the occurrence of vitreous hemorrhages and retinal detachments following vitrectomy surgery with sew-on lenses to a noncontact wide-angle lens system.

* PATIENTS AND METHODS: Retrospective review of 180 patients who underwent primary vitrectomy for proliferative diabetic retinopathy. The occurrence of persistent and recurrent vitreous hemorrhages as well as postoperative retinal detachments in the two groups was determined.

* RESULTS: There was no statistically significant difference in the occurrence of persistent vitreous hemorrhages between the sew-on (55%) and the wideangle (42%) lens systems (P= 0.099). Likewise, recurrent vitreous hemorrhages were similar in both the sew-on (15%) and the wide-angle (17%) lens systems (P = 0.838). However, postoperative detachments were more frequent in the sew-on group (9%) than in the wide-angle (1%) group (P= 0.046).

* CONCLUSION: In patients with proliferative diabetic retinopathy, using a wide-angle noncontact lens system significantly reduced the incidence of postoperative retinal detachments, but not persistent or recurrent vitreous hemorrhages.

[Ophthalmic Surg Lasers 2001;32:193-197]
Microbubble Retention and Failed Macular Hole Surgery
Authors: Chow David R , Hassan Tarek
Published: April 2021

Abstract. This case reports a possible new cause of failed macular hole surgery. Standard macular hole surgery with removal of epiretinal membranes, 16% C3F8, and strict postoperative prone positioning was performed on a patient with stage 4 macular hole. Macular hole surgery failed with retention of a microbubble of C
3
F
8
within the macular hole during the follow-up period. Retention of a microbubble within a macular hole may prevent closure of the hole and be a previously unrecognized cause of failed macular hole surgery. [Ophthalmic Surg Lasers 2001;32:243-244]
Scleral Tunnel for the Implantation of Glaucoma Seton Devices
Authors: Ozdamar Akif , Aras Cengiz , Ustundag Can , Tamcelik Nevbahar , Ozkan Sehirbay
Published: April 2021

Abstract. The technique described in this paper shows how to use a long scleral tunnel for the implantation of anterior tube parts of glaucoma drainage devices. It involves the creation of a scleral tunnel beginning 10 mm behind the limbus and extending to the anterior chamber. Anterior tube parts of Krupin eye valve with disk is inserted through the scleral tunnel to the anterior chamber. The disk part is secured to the episclera as used in the standard technique. We have used this technique in 6 eyes of 6 consecutive patients with refractory glaucoma. The placement of anterior tubes as part of glaucoma seton devices was done in all patients. While mean intraocular pressure (IOP) was 39.3 ± 4.9 mm Hg (ranged from 29 to 56 mm Hg) preoperatively, it was 16.6 ± 5.3 mm Hg (ranging from 1 1 to 25 mm Hg) at the end of follow up. Mean follow-up time was 7.16 ± 1.16 months (ranging from 6 to 9 months). After surgery, conjunctival erosion or displacement of the anterior tube and dellen formation were not found in any eyes. The use of a long scleral tunnel for the implantation of anterior tube parts of glaucoma seton devices offers some advantages over standard implantation techniques. [Ophthalmic Surg Lasers 2001;32:432-435]
Traumatic Wound Dehiscence After Corneal Graft
Authors: Oshry Tzafrir , Lifshitz Tova
Published: April 2021

* BACKGROUND AND OBJECTIVE: Any trau ma to a corneal transplanted eye is likely to lacerate the corneal wound because of persistent wound weakness, even years after keratoplasty. We evaluate the risks and consequences oí trauma after penetrating keratoplasty (PKP).

* METHODS: Records of 1 1 patients who had been treated in our department from 1992 to 1998 for traumatic wound dehiscence after PKP were reviewed for the type of insult, visual acuity, operative methods, and outcome.

* RESULTS: The period between corneal grafting and wound rupture ranged from two months to three years. In 9 patients, the sutures were still in place. AU the ruptures occurred at the donor-recipient interface. In 5 patients, the rupture was in the inferior half of the wound, in another 5 patients in the superior half, and in 1 patient it was nasal. In all the patients, the extent of the rupture was over 120 degrees and the lens was effected. All the patients had posterior segment involvement, the extent of which was related to the visual outcome. One eye was enucleated, another eye regrafted, and 8 of the remaining 9 grafts were restored and remained transparent.

* CONCLUSIONS: Despite severe trauma, most of the grafts' clarity can be restored, and good visual results can be achieved.

[Ophthalmic Surg Lasers 2001 ,-32:470-473]
Purtscher-Like Retinopathy After Retrobulbar Injection
Authors: Lim Boon-Ang , Ang Chong-Lye
Published: April 2021

Abstract. Purtscher-like retinopathy occurred in a 46year-old Chinese male who received 5 mL of 2% lignocaine, retrobulbar injection, and underwent pterygium excision with conjunctiva graft. The visual acuity improved spontaneously from 20/120 on the first postoperative day to 20/20 within 8 weeks. The disc swelling, veinous tortuosity, retinal whitening, and hemorrhage resolved with time. However, relative afferent papillary defect and an arcuate visual field deficit persisted. The mechanisms of this Purtscherlike retinopathy are postulated. [Ophthalmic Surg Lasers 2001;32:477-478]
Endoscopic Goniotomy With Anterior Chamber Maintainer: Surgical Technique and One-Year Results
Authors: Bayraktar Sükrü , Koseoglu Taylan
Published: April 2021

Abstract, The surgical technique of endoscopic goniotomy (EG) using the anterior chamber maintainer (ACM) for congenital glaucoma is evaluated, and oneyear follow-up data are presented. Endoscopic goniotomy was performed in 12 eyes of 7 patients. A doubleport - special goniotomy knife mounted on the endoscope's probe inserted through the first incision and ACM through the second incision - EG technique was used in 6 eyes of 3 patients, while a three-port - knife, endoscope probe, and ACM inserted through separate incisions - technique was preferred in the remaining 6 eyes of 4 patients. EG of approximately 240° could be done without major complications in all eyes. At the end of the average follow-up period of 14.2 ± 9.7 months, the mean intraocular pressure was reduced from 38.3 ± 6.9 mm Hg to 17.6 ± 2.8 mm Hg (P = 0.002), the average number of glaucoma medications from 2.1 ± 0.3 to 0.3 ± 0.5 (P= 0.001), and the mean cup/disk ratios from 0.84 ± 0.11 to 0.79 ± 0.14 (P = 0.014), while there was no statistically significant change in the average corneal diameter (P = 0.16). Therefore, endoscopic goniotomy with ACM was found to be an effective treatment modality for congenital glaucoma. [Ophthalmic Surg Lasers 2001;32:496502]
Outcomes of Bilateral Macular Hole Surgery
Authors: Tabandeh Homayoun , Smiddy William E , Mello Mozart , Flynn Harry W , Feuer William J
Published: April 2021

ACKGROUND AND OBJECTIVE: Char acteristics and outcomes in patients undergoing macular hole surgery in both eyes are studied.

MATERIALS AND METHODS: Demographic and clinical data were abstracted from patients' medical records for a retrospective study of 31 consecutive patients (62 eyes) who underwent macular hole surgery in both eyes between 1992-1998. Outcome measures included best corrected Snellen visual acuity and status of the macular hole 3 months after surgery.

RESULTS: The duration of symptoms was 5.5 months at the time of surgery in the first eye and 9.8 months in the second operated eye (P = 0.063). The macular hole was closed after surgery in both eyes (17), only in the first eye (6), only in the second eye (6), and not closed in either eye (2) (P = 0.9) (46/62, 74% eyes overall). With reoperation 55/62 (89%) were closed. In eyes with a closed macular hole, the visual acuity improved 2 or more lines in 20 (88%) first eyes and 12 (52%) of the second eyes (P = 0.02). Cataract surgery was performed in 12 (41%) first eyes and 13 (45%) second eyes within 1 year of the initial macular hole surgery. The occurrence of cataract surgery in the second eye correlated with the first eye (P= 0.017).

CONCLUSION: Macular hole surgery is usually successful in one or both eyes. Surgical results in the second eye do not appear to correlate with the results in the first eye.

[Ophthalmic Surg Lasers 2002:33:9-15]
Implantation of Second Glaucoma Drainage Devices After Failure of Primary Devices
Authors: Godfrey David G , Krishna Rohit , Greenfield David S , Budenz Donald L , Gedde Steven J , Scott Ingrid U
Published: April 2021

BACKGROUND AND OBJECTIVE: To evaluate the efficacy and safety of implantation of a second glaucoma drainage device for eyes that have failed a primary device.

PATIENTS AND METHODS: Medical records of patients receiving a primary glaucoma drainage device at Bascom Palmer Eye Institute from January 1987 to October 1998 were reviewed, of which 18 eyes of 18 patients were studied. Patients failing a primary glaucoma drainage procedure and receiving a second glaucoma drainage device were included in this study. The second eye in the same patient was excluded if a second drainage implant was required. All patients received a second device in a standardized fashion with the drainage tube inserted in the anterior chamber. Main outcome measures included: visual acuity, intraocular pressure (IOP), antiglaucomatous medication, length of follow up, and surface area of glaucoma drainage device. Success was defined as an IOP less than or equal to 2 1 mm Hg with or without medications, and at least a 20% reduction in IOP, without the need for additional glaucoma procedures.

RESULTS: The mean postoperative IOP (19.6 ± 9.4 mm Hg; range, 8-50 mm Hg) was significantly (P = 0.006) lower than the mean preoperative IOP (29.5 ± 8. 1 mm Hg; range, 20-52 mm Hg) at last follow up (mean 19.6 ± 13.6 months; range, 6-47 months). The mean number of postoperative antiglaucomatous medications (2.2 ± 1.2; range 0-4) was statistically similar (P = 0.2) to mean preoperative number of antiglaucomatous medications (2.6 ± 1.2, range 1-4). Using Kaplan-Meier estimates, successful IOP reduction was observed in 89%, 83%, 63%, and 37% of eyes at 6 months, 1, 2, and 3 years, respectively. Four patients (21%) had a decline in visual acuity.

CONCLUSIONS: Implantation of secondary glaucoma drainage devices may be useful in eyes that have failed primary devices.

[Ophthalmic Surg Lasers 2002;33:37-43]
Clinical Applications of Capsular Tension Rings in Cataract Surgery
Authors: Gimbel Howard V , Sun Ran
Published: April 2021

BACKGROUND: Although the open capsular tension ring was designed to manage zonular dialysis during cataract surgery, it also lowers the incidence of capsule contraction, stabilizes the capsular bag, and enhances IOL centration. With appendages, it provides a partial solution for those eyes with colobomata and aniridia.

MATERIALS AND TECHNIQUES: Subsequent modifications to the capsular tension ring include the Cionni ring, capsular edge ring, coloboma ring, and aniridia ring. A square-edge design may inhibit posterior capsule opacification, and the aniridia and coloboma rings with appendages create an artificial it is in traumatic or congenital colobomata.

RESULTS: Designs, functions, indications, and results of different types of capsular tension rings are reviewed, as well as applications in pediatric cases, and considerations for their routine use in adult cataract surgery.

CONCLUSIONS: The potential benefits of capsular edge ring implantation in pediatric cataract surgery cases are explored. [Ophthalmic Surg Lasers 200233:44-53]
Iris Prolapse in Small Incision Cataract Surgery
Authors: Taguri Abdel Hakim , Sanders Roshini
Published: April 2021

Abstract. Iris prolapse is a rare complication after small incision cataract surgery. We looked at the possible operative and perioperative factors that might have contributed to this complication in 2 of our patients and in another 10 patients identified through a national questionnaire survey. The details of 12 cases of iris prolapse following small incision cataract surgery are presented. Since iris prolapse may occur in small incision cataract surgery, notably in the presence of certain predisposing factors, extra diligence is required in wound construction and closure in highrisk patients. [Ophthalmic Surg Lasers 2002;33:6670]
Surgical Method and Results of Levator Aponeurosis Transposition for Graves' Eyelid Retraction
Authors: Khan Jemshed A , Garden Valerie , Faghihi Mohamed , Parvin Mahyar
Published: April 2021

Abstract. Predictability of final eyelid height and contour following surgical correction of eyelid retraction remains problematic. We describe our surgical method and results with the distal levator aponeurosis transposition procedure for eyelid retraction. The procedure consists of disinserting the distal levator aponeurosis from the tarsal plate and excising Muller's muscle. The lateral three-fifths of the distal aponeurosis is fashioned into a flap that is disinserted laterally, rotated inferiorly 90 degrees, and attached to the tarsal plate. Distal levator transposition is useful in the management of dysthyroid retraction and in the reduction of the margin reflex distance (MRD) asymmetry between upper eyelids. However, it shares with other eyelid lowering procedures, the disadvantage of poor predictability of final MRD. [Ophthalmic Surg Lasers 2002;33:79-82]
Extrusion and Fragmentation of Hydrogel Exoplant 11 Years After Scleral Buckling Surgery
Authors: Kawano Taku , Doi Motoaki , Miyamura Masataka , Esaki Koji , Sasoh Mikio , Uji Yukitaka
Published: April 2021

Abstract. MAI or MIRAgel is a hydrogel developed as a scleral buckling material. We identified upper lid masses and a limitation of supraduction in the left eye of a patient who was associated with extrusion and fragmentation of the MIRAgel episcleral exoplant 11 years after scleral buckling surgery. The material could not be removed completely because of fragmentation. Fragmentation and extrusion of MIRAgel may be rare, but periodic long-term follow-up examinations should be performed after this product has been used. [Ophthalmol Surg Lasers 2002;33:240-242]
Intranasal Endoscopic Diagnosis and Treatment in Congenital Nasolacrimal Duct Obstruction
Authors: Choi Woong C , Kim Kyu S , Park Tae K , Chung Chun Suk
Published: April 2021

* BACKGROUND AND OBJECTIVE: To identify the causes of congenital nasolacrimal duct obstruction using intranasal endoscopy.

* PATIENTS AND METHODS: Eleven children with symptoms of epiphora since birth were selected for treatment. A silicone tube was inserted after identifying the causes of prior probing failures by observing the probing tip directly with intranasal endoscopy.

* RESULTS: As confirmed through intranasal endoscopic examination, tearing was caused by mucosal obstruction, submucosal passing of the probe, pus collection, and inferior turbinate impaction. The probe passed into the submucosal space in 5 patients and, by performing probing medially instead in the usual posterolateral direction, probing succeeded in 4 patients. One case was accompanied by a bone abnormality; we bent the probe tip into the nasal cavity to form the lacrimal pathway.

* CONCLUSION: By using intranasal endoscopy, a silicone tube can be inserted under direct visualization and any causative abnormalities can be identified. This can also minimize the intranasal trauma sometimes caused by blind probing.

[Ophthalmic Surg Lasers 2002;33:288-292]