bluuebunny/crossref_metadata_2025 huggingface dataset:
Topical Cyclosporine as a Possible New Antimetabolite in Trabeculectomy
Authors: Turaçli M Erol , Gündüz Kaan , Aktan Gülderen , Sencer Huriye
Published: April 2021

* BACKGROUND AND OBJECTIVE: The authors conducted a randomized, prospective, and controlled clinical and transmission electron microscopic study to investigate the possible role of cyclosporine in trabeculectomy as an antimetabolite agent.

* PATIENTS AND METHODS: Twelve patients underwent trabeculectomy with topical cyclosporine and another 12 patients had trabeculectomy without cyclosporine.

* RESULTS: There was a statistically significant decrease in the postoperative intraocular pressure (P < .05) and in the number of medications needed postoperatively (P < .01) in the cyclosporine group. There were no significant complications in either group. Transmission electron microscopic examinations of the excised trabecular scierai tissue showed that cyclosporine caused inhibition of fibroblasts and led to a disruption in collagen organization at the level of the surgical dissection. Middle scierai layers were generally not affected except in some cyclosporinetreated eyes, which showed only a mild cytopathic effect.

* CONCLUSION: This study showed that topical cyclosporine was safe and effective for use as an antimetabolite in trabeculectomy. Further studies are needed to substantiate the adjuvant role of cyclosporine in glaucoma filtering operations.

[Ophthalmic Surg Lasers 1996;27:438-444.]
A Fluorescent Vesicle System for the Measurement of Blood Velocity in the Choroidal Vessels
Authors: Peyman Gholam A , Khoobehi Bahram , Shaibani Sanan , Shamsnia Saeed , Ribeiro Ismael
Published: April 2021

* BACKGROUND AND OBJECTIVE: Evaluation of the pathophysiologic mechanisms involved in the choroidal circulation is difficult because of the presence of the retinal pigment epithelium. The authors have developed a technique for measuring blood velocity in individual choroidal vessels using the scanning laser ophthalmoscope and intravenously injected indocyanine green encapsulated in multilamellar vesicles. In this report, the authors describe their attempts to measure choroidaJ blood velocity in three different regions of the choroid of the primate eye.

* MATERIALS AND METHODS: A video-to-digital processor was used to digitize the video images of the choroid of a monkey at a sample rate of 1/30 of a second. The blood velocity in the selected choroidal vessel segments was calculated by measuring the distance the liposome traveled in a given time.

* RESULTS: The average blood velocities were 5-16 mm/s under the macula, 4.04 mm/s in the vortex vein system, and 2.03 mm/s in the choroidal circulation nasal to the optic nerve.

* CONCLUSION: This technique is an effective method of measuring blood velocity in a primate model and has several important advantages compared with the dye dilution technique.

[Ophthalmic Surg Lasers 1996;27:459-466.]
Iontophoresis of Indocyanine Green and Monastral Blue B for Gonioscopic Diode Laser Sclerectomy
Authors: Wang Yujen , Cohen Robyn E , Schuman Joel S
Published: April 2021

Abstract. Ab interno gonioscopic diode laser sclerectomy should allow the creation of a filtration fistula in glaucoma treatment using light energy in the near infrared range. Diode laser sclerectomy can be facilitated by dying the sclera to optimize laser energy absorption at the appropriate wavelength. Indocyanine green (ICG) and Monastral Blue B (MBB) are two dyes that have their peak absorptions in the near infrared region. This study determined the feasibility of ICG and MBB iontophoresis in human cadaver sclera and transconjunctivally in rabbits in vivo. MBB was unable to achieve full-thickness scierai staining in either model. ICG was able to penetrate 400 (¿m in human cadaver sclera and approximately 500 µ?? transconjunctivally in rabbit sclera in vivo. [Ophthalmic Surg Lasers 1996;27:484-487.]
Treatment of Presumed Fungal Endophthalmitis With Oral Fluconazole
Authors: Zarbin Marco A , Becker Eleanor , Witcher Jack , Yamani Amir , Irvine Alexander R
Published: April 2021

Abstract. Amphotericin B is the usual treatment for fungal endophthalmitis, but its toxicity and lack of oral bioavailability may limit its use in some patients. The authors report the successful management of two cases of presumed metastatic fungal endophthalmitis with oral fluconazole, a bis-triazole compound with a broad anrifungal spectrum. [Ophthalmic Surg Lasers 1996;27:628-631.]
Retinal Irradiation From an Operating Microscope During Vitrectomy: Observation by Endoscopy
Authors: Ogura Yuichiro
Published: April 2021

Abstract. Phototoxic retinopathy due to light from the operating microscope has been reported during cataract surgery, as well as during vitreous surgery. A neutral density filter for the coaxial light or coverage of the cornea with various materials has been advocated to prevent retinal complications. However, it is difficult to actually monitor the fundus during surgery with usual methods. The author used an endoscope to demonstrate how intensively the light from the operating microscope is focused on the retinal surface during vitreous surgery. [Ophthalmic Surg Lasers 1996; 27:636-637.]
Orbitotomy Facilitated by a Mechanical Retraction System
Authors: Putterman Allen
Published: April 2021

Abstract. A series of arms and retractors that attach to the operating table to aid the surgeon during orbitotomy and dacryocystorhinostomy is described. This enables the surgeon to consistently retract and expose orbital structures without assistance. [Ophthalmic Surg Lasers 1996;27:638-639.]
Intraocular Pressure Increments After Cataract Extraction in Glaucomatous Eyes With Functioning Filtering Blebs
Authors: Wygnanski-Jaffe Tamara , Barak Adiel , Melamed Shlomo , Glovinsky Yoseph
Published: April 2021

* BACKGROUND AND OBJECTIVE: The effects of cataract extraction on intraocular pressure (IOP) were studied in glaucoma patients who had previously undergone trabeculectomy.

* PATIENTS AND METHODS: The files of 22 patients with 25 glaucomatous eyes with functioning filtering blebs who underwent cataract extraction were retrospectively reviewed. All patients had undergone pretrabeculectomy examination and had at least 18 months of follow-up after cataract surgery. Visual acuity, IOP, status of the filtering bleb, and the number of medications applied were recorded.

* RESULTS: The mean increase in IOP was 3.63 mm Hg, 3.84 mm Hg, 5.4 mm Hg, and 2.8 mm Hg at 3, 6, 12, and 18 months after cataract extraction, respectively. This elevation was statistically significant 3 months postoperatively (P < .001) and remained relatively constant thereafter. The postoperative IOP was still significantly lower than the pretrabeculectomy IOP (P <. 001).

* CONCLUSIONS: Cataract extraction through corneal incisions in patients with functioning filtering blebs is followed by an increase in IOP Cataract surgery in these patients does not neutralize the pressure-lowering effect achieved by the trabeculectomy, but it tends to elevate the post-trabeculectomy baseline pressure.

[Ophthalmic Surg Lasers 1997;28:657-661.]
Argon Laser Photocoagulation in the Treatment of the Palpebral Lobe Cysts of the Lacrimal Gland (Dacryops)
Authors: Pantaleoni F Bozzoni , Spagnolo S , Martini A , Pupparo S , Rosati C , Pescosolido N
Published: April 2021

Abstract. Dacryops is a closed cyst that develops on the palpebral lobe of the lacrimal gland, manifesting in the region of the external canthus. Its slow and insidious growth causes mechanical and aesthetic problems that do not regress spontaneously. Treatment involves excision of the cyst while sparing the adjacent glandular tissues. In cases associated with hypolacrimation, marsupialization of the cyst is indicated. To obtain a reduction of the cyst to an aesthetically acceptable level in cases of simple dacryops, the authors suggest argon laser therapy, which avoids the risks related to surgery and general anesthesia and eliminates the need for hospitalization. Two patients with simple dacryops were treated with blue-green argon laser under local anesthesia. At the end of follow-up, the cysts had been clinically reduced in volume and were not visible by external examination. In cases of simple dacryops, laser therapy is suitable for the reduction of the cyst. Photocoagulation treatment is not advisable in cases that are complicated by fistulas or where the clinical presentation is atypical. [Ophthalmic Surg Lasers 1997;28:690-692.]
Macular Hole Surgery Without Using Adjunctive Additives
Authors: Smiddy William E , Pimentel Sergio , Williams George A
Published: April 2021

* BACKGROUND AND OBJECTIVE: To evaluate the efficacy of performing surgical techniques for macular holes without using adjunctive additives.

* PATIENTS AND METHODS: A prospective study was completed of consecutive eyes treated for macular holes of 1 year or less duration that had not had previous vitreous surgery. The best-corrected visual acuity and hole flattening were determined.

* RESULTS: Postoperative flattening of the hole was achieved in 39 (91%) of 43 eyes, with at least a 50% reduction of the minimum resolvable visual angle (3-line visual increase) in 65% of the eyes and a final vision of 20/40 or better in 40% of the eyes during the follow-up interval (mean 10.6 months).

* CONCLUSIONS: The success rate of current macular hole surgical techniques suggests that adjunctive additives may not be necessary for most cases. Thus, new treatment modalities need to be evaluated with carefully controlled studies.

[Ophthalmic Surg Lasers 1997;28:713-717.]
Combined Penetrating Keratoplasty and Limbal Allograft Transplantation for Severe Corneal Burns
Authors: Theng Julian T S , Tan Donald T H
Published: April 2021

Abstract. The management of ocular surface disease presents a significant challenge to ophthalmologists. Recent advances in the etiology and pathophysiology of ocular surface diseases, such as chemical and thermal burns or Stevens-Johnson syndrome, include the concept of the limbal stem cell. Limbal stem cell theory suggests that the corneal limbus contains epithelial stem cells that are responsible for a continuous supply of corneal epithelial cells, which not only migrate from the deep to superficial epithelial layers, but also progress in a centripetal direction, inward from the limbus. Support for this concept is provided indirectly by the relatively poor prognosis for penetrating keratoplasty for these types of ocular surface diseases. In such cases, it is suggested that limbal damage and depletion is present and is a significant factor in loss of integrity of the ocular surface; therefore, conventional penetrating keratoplasty, which does not include limbal tissue, does not have a high success rate. [Ophthalmic Surg Lasers 1997;28:765-768.]
Phacoemulsification and Intraocular Lens Implantation in a Patient With Mooren's Ulcer
Authors: Akova Yonca A , Aslan Bekir S , Duman Sunay
Published: April 2021

Abstract. A 61-year-old man with progressive, bilateral Mooren's ulcer had subjective symptoms of pain, discomfort, and blurred vision. Biomicroscopic examination showed 360° of peripheral ulceration of the cornea. There were 1+ cells in the anterior chamber, and nuclear sclerosis of the lens was present. He was treated with topical and systemic steroids, perilimbal conjunctival resection, and systemic cyclophosphamide therapy. After the complete control of inflammation, the patient remained in remission for 14 months. When a cataract developed in the right eye, reducing the visual acuity to light perception, the authors performed a scleral tunnel incision and phacoemulsification with intraocular lens implantation. After 18 months of postoperative follow-up, the vision improved to 20/30, and the eye was stable. Phacoemulsification and scleral tunnel incision with intraocular lens implantation can be successfully performed after the complete control of inflammation with medical therapy. [Ophthalmic Surg Lasers 1997;28:769-771.]
A "Clothesline" Suture Technique for the Repair of a Conjunctival Tear During Trabeculectomy
Authors: Furgason Thomas G , Perkins Todd W
Published: April 2021

Abstract. This report describes a new technique for the intraoperative repair of a conjunctival tear during trabeculectomy. A single suture was used in a "clothesline" fashion to wall off the conjunctival defect from the aqueous flow, allowing the defect to scar closed. This technique will allow the surgeon to salvage a functioning bleb, thereby avoiding more radical surgical options. [Ophthalmic Surg Lasers 1997;28:772-773.]
Phacoemulsification and Posterior Chamber Intraocular Lens Implantation After Scleral Buckling, Vitrectomy, or Both
Authors: Kang Yong Hong , Lee Jin Hak
Published: April 2021

* BACKGROUND AND OBJECTIVE: Previous studies have documented the risk of complications for eyes with prior vitreoretinal surgery that later undergo intracapsular or extracapsular cataract extraction. The authors reviewed the records of patients with a history of vitreoretinal surgery and subsequent phacoemulsification to assess the visual outcome in the relatively early postoperative period and to determine die risk of postoperative complications.

* PATIENTS AND METHODS: The authors identified 21 eyes of 21 patients with a history of scleral buckling, vitrectomy, or both, who subsequently underwent phacoemulsification. Data recorded before, during, and after surgery were reviewed.

* RESULTS: The best-corrected visual acuity improved in 20 (95%) of 21 eyes, and the final bestcorrected visual acuity was 20/40 or better in 12 (57%) of 21 eyes. The intraoperative complications included iridodialysis, zonular dialysis, and posterior capsular rupture. The immediate postoperative complications were microcorneal edema, anterior chamber hyphema, vitreous hemorrhage, and fibrinous pupillary membrane. No retinal detachments occurred during the postoperative follow-up period, which ranged from 3 to 10 months. Late complications included isolated cases of posterior capsular opacity, herpetic corneal ulcer, and iris posterior synechia; however, the final visual acuities were not limited, except in one eye with a corneal ulcer.

* CONCLUSION: Although some postoperative complications did occur, they did not limit final vision, and useful vision was achieved.

[Ophthalmic Surg Lasers 1998;29:23-27.]
Visual Outcome and Ocular Survival in Patients With Retinal Detachments Secondary to Openor Closed-Globe Injuries
Authors: Matthews G Philip , Das Arup , Brown Sally
Published: April 2021

* BACKGROUND AND OBJECTIVE: A retrospective study was undertaken to establish predictive clinical features for final visual outcome and ocular survival for patients who have sustained traumatic retinal detachments (RDs).

* PATIENTS AND METHODS: The authors reviewed 191 cases of RD following open- or closedglobe trauma. The clinical features that were analyzed included the initial visual acuity, the location of the wound, the mechanism of injury (blunt, sharp, or projectile), and the number of quadrants of RD.

* RESULTS: The significant predictive factors for good visual outcome (1/200 or better) included an initial visual acuity of hand motions or better, wounds located anterior to the equator, closed-globe injuries, sharp injury in open globes, and three or fewer quadrants of RD. The factors that predicted enucleation included an initial visual acuity of light perception or no light perception, wounds located posterior to the equator, and four quadrants of RD.

* CONCLUSION: The significant predictive factors for final visual outcome in patients witli traumatic RD were the initial visual acuity, the location of the wound, the mechanism of injury, and the number of quadrants of RD.

[Ophthalmic Surg Lasers 1998;29:48-54.]
The Role of Preoperative Ultrasonography for Patients With Dense Cataract: A Retrospective Study of 509 Cases
Authors: Anteby Irene I , Blumenthal Eytan Z , Zamir Ehud , Waindim Paul
Published: April 2021

* BACKGROUND AND OBJECTIVE: Ocular ultrasonography is widely used for the evaluation of eyes with opaque ocular media. Although preoperative ultrasonography of the globe has been recommended for patients with dense cataracts, the value of such an examination is currently unknown. The purpose of this study was to evaluate the prevalence and nature of intraocular pathologies detected by preoperative ultrasound examination in patients with dense cataract.

* PATIENTS AND METHODS: The authors retrospectively studied 509 patients referred for routine ultrasound examination of the globe due to dense cataract. Exclusion criteria included known posterior segment pathology, previous ocular surgery or penetrating trauma, and age of younger than 18 years. All the patients underwent ultrasound examination by B-scan and standardized A-scan.

RESULTS: In 19.6% of the patients, a posterior segment pathology was revealed by the ultrasound examination. The most frequently disclosed abnormalities were posterior staphyloma (7.2%), retinal detachment (4.5%), and vitreous hemorrhage (2.5%). One patient with a large choroidal malignant melanoma was identified. The prevalence of posterior segment pathologies was slightly higher in patients with a history of ocular trauma, compared with the nontraumatic cataract group (29.6% versus 19.0%, respectively; P = .1). The prevalence of retinal detachment was increased in the traumatic cataract subgroup (14.8% compared with 3.9%), but this difference did not reach statistical significance.

* CONCLUSION: Preoperative ultrasound examination for patients with dense cataract can be used to detect pathologies that may influence the surgical strategy and the postoperative visual prognosis.

[Ophthalmic Surg Lasers 1998;29:114-118.]
The Inhibition of Lens Epithelial Cell Migration by a Discontinuous Capsular Bend Created by a Band-Shaped Circular Loop or a Capsule-Bending Ring
Authors: Nischi Okihiro , Nishi Kayo , Mano Chizuko , Ichihara Masuji , Honda Tomoaki
Published: April 2021

* BACKGROUND AND OBJECTIVE: This study investigated the inhibitory effect of a discontinuous capsular bend created by an intraocular lens (IOL) with a band-shaped loop or a capsule tension ring on migrating lens epithelial cells (LECs).

* MATERIALS AND METHODS: To create a sharp bend in the capsule, the round form (shown on cross section) of the open-circular loop of a polymethylmethacrylate IOL was changed to a band-like shape, 1.0 mm wide and 0.2 mm thick. A capsule tension ring of the same shape (on cross section) with a 14-mm diameter was also made. After cataract surgery, this IOL or ring was implanted into the capsular bag in 5 rabbit eyes. The same IOL with an unmodified haptic or conventional capsule tension ring was implanted in the contralateral eye as a control. After 8 weeks, Miyake view and histopathologic examinations were performed.

* RESULTS: LECs accumulated at the equatorial corner outside the haptic or ring, showing the inhibition of LEC migration. In the control eyes, LECs accumulated inside the haptic or ring, forming a Soemmering's ring cataract, thus showing markedly less inhibition of LEC migration on macroscopic and microscopic observations.

* CONCLUSIONS: A discontinuous bend in the capsule significantly inhibited LEC migration in rabbit eyes. The creation of a capsular bend through the appropriate design of the IOL-haptic or capsule tension ring might significantly decrease the incidence of posterior capsule opacification for humans.

[Ophthalmic Surg Lasers 1998;29:119-125.]
The "Deroofing" of Schlemm's Canal in Patients With Open-Angle Glaucoma Through Placement of a Collagen Drainage Device
Authors: Welsh N H , DeLange J , Wasserman P , Ziémba S L
Published: April 2021

* BACKGROUND AND OBJECTIVES: A preliminary study was conducted to examine a new surgical approach for the management of patients with open-angle glaucoma in which Schlemm's canal is opened to restore drainage in a nonpenetrating fashion. The authors compared the results of the surgical procedure including the new glaucoma drainage device with the results of standard trabeculectomy.

* PATIENTS AND METHODS: The authors performed a new type of surgical procedure on 58 consecutive patients with open-angle glaucoma. The procedure entails "deroofing" Schlemm's canal to facilitate the drainage of aqueous without penetrating the eye. This is done by exposing the canal after a partial-thickness sclerectomy and keratectomy along a 5-mm arc. After the canal was deroofed, a new type of collagen glaucoma drainage device was placed in the surgical site to maintain drainage postoperatively. Patient data, including intraocular pressure (IOP), complications, and the number of medications required to maintain adequate pressures, were analyzed for 1 year postoperatively.

* RESULTS: Within 1 to 2 months postoperatively, 80.9% of the patients achieved an IOP lower than 21 mm Hg. This improved to 88.9% at 3 to 6 months postoperatively and 87.5% at 6 to 12 months postoperatively. The only major complications were microperforations (8.6%) related to surgical technique and a few cases of high IOP that required repeat operations (10.3%).

* CONCLUSIONS: The nonpenetrating technique for deroofing the canal effectively allows the drainage of aqueous to acceptable levels (in the range of 15 to 17 mm Hg) without the complications associated with penetrating trabeculectomy. Complications are rare, and the collagen drainage device appears to be effective for allowing the drainage site to remain patent after its dissolution.

[Ophthalmic Surg Lasers 1998;29:216-226.]
Early Intraocular Pressure After Phacoemulsification Combined With Trabeculectomy
Authors: Hopkins J Jill , Apel Andrew , Trope Graham E , Rootman David S
Published: April 2021

* BACKGROUND AND OBJECTIVE: To determine the efficacy of combined phacoemulsification-trabeculectomy in preventing early postoperative increases in intraocular pressure (IOP).

* PATIENTS AND METHODS: Eighty patients were enrolled in a prospective cohort study. Thirty-six patients with cataracts and uncontrolled glaucoma underwent combined phacoemulsification-trabeculectomy, and 44 patients with cataracts underwent phacoemulsification alone. The operations were performed in a standardized manner by one surgeon. IOP was measured at 4 hours, 1 day, and 7 days after surgery. The need for intervention (digital massage, medications) and the presence of complications were documented.

* RESULTS: Four hours after surgery, 5.5% of patients undergoing the combined procedure had IOPs greater than 30 mm Hg, compared with 22.7% of phacoemulsification patients P < .05). No significant difference in IOP was found between the groups at postoperative day 1 or day 7.

* CONCLUSION: These results suggest that combined phacoemulsification-trabeculectomy protects against early postoperative elevations in IOP. This finding may influence the surgical management of cataracts in patients with poorly controlled glaucoma and significant compromise of visual field or optic nerve.

[Ophthalmic Surg Lasers 1998;29:273-279.]
Reproducibility of Retinal Thickness Measurements in Normal Eyes Using Optical Coherence Tomography
Authors: Baumann Matthias , Gentile Ronald C , Liebmann Jeffrey M , Ritch Robert
Published: April 2021

* BACKGROUND AND OBJECTIVE: To determine the reproducibility of retinal thickness measurements in normal eyes using optical coherence tomography (OCT).

* PATIENTS AND METHODS: Multiple 3.20mm vertical cross-sectional images through the center of fixation of consecutive patients with normal results on ocular examinations were obtained. Each image was divided into seven 320-pm segments. Regional retinal thicknesses for each section were measured using both the manually assisted (requiring observer localization of reflectivity peaks) and the automated modes (observer-independent measurement) of the computer software.

* RESULTS: Eighteen right eyes were studied. The mean coefficient of variation was less than 10% for all locations using the manually assisted method (average standard deviation less than 17 pm [range 9 to 16 pm]). The automated method was less reliable, with a coefficient of variation greater than 10% for locations within 500 pm of fixation. Automated measurements at fixation were the least reproducible because of poor internal limiting membrane reflectivity.

* CONCLUSION: OCT is capable of reproducible measurement of retinal thickness in normal eyes. Computer-driven, automated measurement of retinal thickness within 500 pm of fixation needs to be refined and its reproducibility reassessed in this region.

[Ophthalmic Surg Lasers 1998;29:280-285.]
Pars Plana Vitrectomy, Lensectomy, or Extraction in Transscleral Intraocular Lens Fixation for the Management of Dislocated Lenses in a Family With Marfan's Syndrome
Authors: Omulecki Wojciech , Nawrocki Jerzy , Palenga-Pydyn Dorota , Sempinska-Szewczyk Joanna
Published: April 2021

* BACKGROUND AND OBJECTIVES: Congenital lens subluxation may be a difficult therapeutic problem. Surgical treatment options include iris manipulation or lens discission, aspiration, intracapsular or extracapsular extraction, and lensectomy through the pars plana. It is not established which kind of aphakic correction is the most appropriate in these cases.

* PATIENTS AND METHODS: A father and his two sons with Marfans syndrome were operatively treated for lens dislocation in both eyes. Pars plana vitrectomy was done in all eyes. Dislocated lenses were removed by lensectomy in three eyes and with an intracapsular method in three eyes. The outside-in scleral fixation technique was used for primary posterior chamber intraocular lens (PC IOL) implantation in all cases.

* RESULTS: All eyes achieved good visual acuity (20/20-20/25). Time of observation ranged between 8 and 20 months. There were no intraoperative or postoperative complications.

* CONCLUSION: Pars plana vitrectomy and primary scleral-fixated IOL implantation is a safe procedure and gives good visual rehabilitation in adult patients with Marfan's syndrome.

[Ophthalmic Surg Lasers 1998;29:375-379.]
Trabeculectomy With the Use of Amniotic Membrane for Uncontrollable Glaucoma
Authors: Fujishima Hiroshi , Shimazaki Jun , Shinozaki Naoshi , Tsubota Kazuo
Published: April 2021

Abstract. Although trabeculectomy is an established surgical technique for glaucoma, in some cases it does not achieve a good filtering effect despite the use of mitomycin-C (MMC). The authors have developed a new surgical technique for uncontrollable glaucoma that uses amniotic membrane to prevent postoperative adhesion of conjunctiva and sclera. They performed trabeculectomy with a limbal-based conjunctival flap using 0.4 mg/ml of MMC for 2 minutes. Amniotic membrane was then placed under the scleral flap and sutured using 10-0 nylon. Among 14 eyes of 13 patients who underwent this procedure, intraocular pressure was controlled to less than 20 mm Hg after surgery in 13 eyes, including 3 eyes that underwent a second surgery with the same technique and 2 eyes that underwent laser trabeculoplasty. The authors' results suggest that this technique is efficacious for the reduction of intraocular pressure in high-risk glaucoma patients. [Ophthalmic Surg Lasers 1998;29:428-431.]
Transcanalicular Laser-Assisted Revision of Failed Dacryocystorhinostomy
Authors: Woo Kyung In , Moon Seong Neon , Kim Yoon-Duck
Published: April 2021

* BACKGROUND AND OBJECTIVE: Despite the high success rate of external dacryocystorhinostomy (DCR), recurrent tearing after DCR can be troublesome. The authors performed transcanalicular revision in 6 patients with failed DCR.

* PATIENTS AND METHODS: With the use of a continuous wave Nd:YAG laser with a sclerostomy probe, the internal ostium was reopened by a transcanalicular approach. The authors applied 0.4 mg/ml of mitomycin-C around the opening for 5 minutes intranasally and inserted a silicone tube as a stent.

* RESULTS: A total of 7 operations were performed in 6 patients. The operation was successful after the first revision in 5 of the 6 patients, but 1 of the patients required a second procedure.

* CONCLUSIONS: The transcanalicular laserassisted revision has several advantages. It is simple and fast, skin incision is avoided, there is good hemostasis, it is less traumatic, and there is less postoperative morbidity.

[Ophthalmic Surg Lasers 1998;29:451-455.]
Transscleral Fixation of a Dislocated Silicone Plate Haptic Intraocular Lens via the Pars Plana
Authors: Akduman Levent
Published: April 2021

Abstract. A method for transscleral fixation of silicone plate haptic posterior chamber intraocular lenses (PC IOLs) via the pars plana is described. One 10-0 polypropylene transscleral suture passed through the sclera and the PC IOL hole and a similar suture passed through the sclera only were withdrawn outside the eye through the the pars plana and tied together. Pulling up the scleral end of one suture placed the PC IOL haptic in the sulcus and the knot was pulled outside the eye. Perfluorocarbon liquid was used during the procedure to safely manipulate the PC IOL. The PC IOL was well centered at 3 months of follow-up. Posteriorly dislocated silicone plate haptic PC IOLs can be safely sutured to the sclera via the pars plana by this method. [Ophthalmic Surg Lasers 1998;29:519-521.]
Three-Year Follow-up of Trabeculectomies Performed With Different Concentrations of Mitomycin-C
Authors: Mietz Holger , Krieglstein Günter K
Published: April 2021

* BACKGROUND AND OBJECTIVE: Mitomycin-C is effective for improving success rates of trabeculectomies. The authors sought to determine long-term success rates and complications by studying two widely used concentrations.

* PATIENTS AND METHODS: Trabeculectomies were performed with mitomycin-C (MMC) in concentrations of 0.5 mg/ml (group 1) and 0.2 mg/ml (group 2) in a prospective, nonrandomized fashion. Patients were observed for at least 3 years, and all follow-up data were analyzed in addition to the preoperative and postoperative conditions and complications.

* RESULTS: A total of 51 and 40 eyes (groups 1 and 2, respectively) were observed for 3 years. The majority of the eyes had repeat trabeculectomy. Complete surgical success was reached in 76% and 63%, respectively. The mean intraocular pressure (IOP) in the two groups decreased significantly, and the decrease was larger in the MMC 0.5 mg/ml group (P < .015). The mean visual acuity did decrease in the two groups, but this was not significant. Complications included short-term and long-term hypotony, conjunctival dehiscence, choroidal detachments, and endophthalmitis. Trabeculectomies failed both within the first 3 months (n = 4; 4%) and later (n = 11; 12%).

* CONCLUSION: Three-year results of trabeculectomies performed with MMC are promising. A doseresponse effect of the concentration of MMC and IOP levels is present, suggesting that the higher concentration leads to lower IOP values. Despite the antimetabolic effect of MMC, trabeculectomies fail in both the short-term and the long-term.

[Ophthalmic Surg Lasers 1998;29:628-634.]
Outcomes of Extracapsular Cataract Extraction and Phacoemulsification Performed in a University Training Program
Authors: Albanis Chris V , Dwyer Maureen A , Ernest J Terry
Published: April 2021

* BACKGROUND AND OBJECTIVES: As the number of older Americans increases, more patients will need cataract extraction surgery. Outcome studies will be necessary to assess and improve the quality of care. This study documents the outcomes of extracapsular cataract extraction (ECCE) performed at Oak Forest County Hospital (OFH) and phacoemulsification (PE) performed at the University of Chicago Hospitals (UCH) by residents who were training at the University of Chicago.

* PATIENTS AND METHODS: Residents train using ECCE during their second year at OFH, and learn PE at the UCH during their third year. The authors performed a chart review of all patients who had undergone ECCE at OFH (N = 52) and all patients who had undergone PE at the UCH (N = 343) from 1995 through 1997. Complete preoperative, intraoperative, and postoperative clinical data were recorded on the American Society of Cataract and Refractive Surgery database.

* RESULTS: There were no intraoperative complications at OFH, and 23 of 52 (44%) of the eyes had a final best-corrected visual acuity (BCVA) of 20/40 or better. At the UCH, vitreous loss occurred in 16 of 343 (5%) of the PE patients. A final BCVA of 20/40 or better was achieved in 300 of 343 (87%) of the PE eyes.

* CONCLUSIONS: The visual outcomes of patients who undergo ECCE at a county hospital are poor, but the surgical complications are minimal. The visual outcomes of patients who undergo PE at a university hospital are good, but the complication rates are slightly higher.

[Ophthalmic Surg Lasers 1998;29:643-648.]
Tangential Vitreous Traction Observed in Optic Disc Pit Maculopathy Without Apparent Serous Detachment
Authors: Joko Takeshi , Kusaka Shunji
Published: April 2021

Abstract. The authors describe a rare case of a patient with an optic pit that was accompanied by a cyst-like change in the macula without serous retinal detachment. A 38-year-old woman with a 10-year history of visual impairment in her right eye was referred to the authors' clinic. The best-corrected visual acuity was 20/200 in the right eye, and ophthalmoscopy showed a cyst-like change in the macula with tangential traction by the surrounding vitreous. The patient was treated with vitrectomy and the posterior vitreous was separated from the retina during the procedure. After the surgery, the cyst-like region disappeared and the corrected visual acuity improved to 20/40. The authors suggest that tangential vitreous traction played an important role in the pathogenesis of the optic pit maculopathy. [Ophthalmic Surg Lasers 1998;29:677-679.]
Cavernous Hemangiomas of the Orbital Apex With Intracranial Extension
Authors: Mawn Louise A , Jordan David R , Gilberg Steven M
Published: April 2021

Abstract. Cavernous hemangiomas are benign vascular tumors that usually present as unilateral, intraconal mass lesions in middle-aged women. They may on occasion extend to the orbital apex or have intracranial extension. The authors present three patients with deep apical hemangiomas, two of whom had intracranial extension to the cavernous sinus area. [Ophthalmic Surg Lasers 1998;29:680-684.]
Corneal Refractive and Endothelial Changes Following THC:YAG (Holmium) Laser Sclerostomy
Authors: Trible John R , Olander Kenneth W , Koenig Steven B
Published: April 2021

* BACKGROUND AND OBJECTIVE: To determine the effect of THC:YAG (holmium) laser sclerostomy on corneal curvature and endothelial cell counts.

* PATIENTS AND METHODS: One hundred twenty-five cases were reviewed for high postoperative corneal astigmatism (> 5 D) or preoperative and postoperative endothelial cell count measurements in eyes without preoperative evidence of corneal endothelial compromise.

* RESULTS: Nine patients had keratometry readings at 2 to 3 months with documented corneal astigmatic changes of 5-62 to 12 D (mean 7.27 ±2.16 D). Sixteen eyes of 14 patients studied with specular microscopy had central mean endothelial cell count reductions of 6.5% following THC:YAG laser sclerostomy. The total energy applied correlated with the percentage reduction in endothelial cell counts (r = .507, P = .045, n = 16, Spearman correlation).

* CONCLUSION: Higher laser energy levels can result in high corneal astigmatism, which in some cases may be persistent, and a reduction in endothelial cell count.

[Ophthalmic Surg Lasers 1998;29:733-737.]
A Traumatic Macular Hole Secondary to a High-Energy Nd:YAG Laser
Authors: Chuang Lan-Hsin , Lai Chi-Chun , Yang Ko-Jen , Chen Tun-Lu , Ku Wan-Chen
Published: April 2021

Abstract. A case is reported of a traumatic macular hole caused by a high-energy Nd:YAG laser. The initial ocular examination revealed an explosive, cratershaped, full-thickness macular hole surrounded by local edema and detachment. By the 12th day after the injury, the hole had shrunk progressively and was covered by a thin fibrin-like membrane. A thick epiretinal membrane covered the injured area 1 month after the injury. Nine months after the injury, the macular hole closed spontaneously with a partially detached epiretinal membrane. This case demonstrates one of the natural healing processes of a traumatic macular hole. Although the hole finally closed, the patient did not regain his vision because of the severe damage to the photoreceptors, retinal pigment epithelium, and choroid. [Ophthalmic Surg Lasers 2001;32:73-76]
Long-Term Results of Various Anterior Capsulotomies and Radial Tears on Intraocular Lens Centration
Authors: Oner F Hakan , Durak Ismet , Soylev Meltem , Ergin Mehmet
Published: April 2021

* BACKGROUND AND OBJECTIVE: To evaluate the long-term effects of various anterior capsulotomies and radial tears on intraocular lens (IOL) centration.

* MATERIALS AND METHODS: Ninety-five eyes of 87 senile cataract patients operated with extracapsular technique were evaluated in IOL tilt and decentration with a new method of measurement. According to the type of anterior capsulotomy and number of radial tears, five groups were constituted as, can opener, envelope, continous curvilinear capsulorrhexis (CCC), CCC with one radial tear (relaxing incision at quadrant 12), and CCC with two relaxing incisions (relaxing incisions at quadrants 6 and 12), respectively.

* RESULTS: Early decentration and tilt in groups CCC and CCC with one radial tear were significantly lower than the other groups (P < 0.05). Late decentration and tilt in the CCC group were significandy lower than the other groups (P < 0.01). Highest values of tilt and decentration were determined in envelope capsulotomy. Additional symmetric relaxing incision at quadrant 6 revealed no effect on the prevention of decentration and tilt compared to one relaxing incision.

* CONCLUSION: CCC with one radial tear is not ideal but sufficient for IOL centration. All other anterior capsulotomy techniques, other than intact CCC, do not guarantee the IOL centration.

[Ophthalmic Surg Lasers 2001;32:118-123]
Open-Angle Glaucoma Secondary to Blood Clot in the Schlemm's Canal Following Scleral Buckle Surgery and Its Treatment with tPA
Authors: Ayyala Ramesh S , Tran Can N , Bellows A Robert , Hutchinson B Thomas
Published: April 2021

Abstract, Obstruction of the episceral venous system can present with glaucoma.1 We present two patients who were referred to us for management of acute glaucoma with presumed episceral venous compression. The first patient had open-angle glaucoma with probable elevated episcleral venous pressure and blood in the Schlemm's canal, following a 360° scleral buckle surgery. The second patient had open-angle glaucoma from delayed peribulbar hemorrhage following uncomplicated cataract surgery with blood in the Schlemm's canal. Both patients were successfully treated with intracameral injection with tissue plasminogen activator (tPA). [Ophthalmic Surg Lasers 2001;32:145-148]
Chorioretinitis Sclopetaria from BB Ex Memoria
Authors: Otto Clifton S , Nixon Karen L , Mazzoli Robert A , Raymond William R , Ainbinder Darryl J , Hansen Elizabeth A , Krolicki Thaddeus J
Published: April 2021

Abstract. Chorioretinitis sclopetaria presents a characteristic pattern of choroidal and retinal changes caused by a high velocity projectile passing into the orbit, in close proximity to the globe. While it is unlikely that a patient should completely forget the trauma causing such damage, preserved or compensated visual function may blur the patient's memory of these events over time. Characteristic physical findings help to clarify the antecedent history. Despite the lack of an acknowledged history of ocular trauma or surgery, in our case, the characteristic ocular findings discovered at presentation allowed for recognition of the underlying etiology. Because of good visual function, the patient had completely forgotten about the trauma that occurred 12 years earlier. Strabismus surgery was performed for treatment of the presenting symptomatic diplopia. The pathognomonic findings in chorioretinitis sclopetaria are invaluable in correctly diagnosing this condition, especially when a history of ocular trauma is unavailable.

[Ophthalmic Surg Lasers 2001;32:152-155]
Persistent Indocyanine Green Angiographic Findings in Multiple Evanescent White Dot Syndrome
Authors: Yen Michael T , Rosenfeld Philip J
Published: April 2021

Abstract. This report describes unique findings of persistent peripapillary and posterior pole hypofluorescence on indocyanine green angiography (ICGA) in multiple evanescent white dot syndrome (MEWDS). A 38-year-old woman experienced a sudden decrease of visual acuity in the left eye. Multiple white lesions were seen on fundus examination. Fluorescein angiography, indocyanine green angiography, and automated perimetry were performed. Fundus appearance and fluorescein angiography were consistent with the diagnosis of MEWDS. Automated perimetry revealed an enlarged blind spot. ICGA revealed a zone of hypofluorescence surrounding the optic disc and throughout the posterior pole. The enlarged blind spot resolved after seven weeks along with the signs and symptoms of MEWDS. Nine months after initial presentation, ICGA revealed persistent peripapillary and posterior pole hypofluorescence. Resolution of the enlarged blind spot and return of vision does not completely correlate with the disappearance of hypofluorescent areas on ICGA. These findings suggest that MEWDS may result in persistent abnormalities in choroidal circulation even after clinical symptoms resolve.

[Ophthalmic Surg Lasers 2001;32:156-158]
Using the Eye Fixation Speculum as an Adjunct to Pterygium Surgery
Authors: Mulhern Mark G , Sher Neal , O'Connor Gerard
Published: April 2021

Abstract. A technique is described that overcomes the two biggest problems facing the surgeon when dissecting a pterygium from the cornea - bleeding and eye movement. Our technique however, requires only minimal anesthesia (topical and subconjunctival) and the use of a disposable speculum and suction ring. An added advantage is this particular speculum gives good exposure of the superior bulbar conjunctiva; this facilitates harvesting a conjunctival autograft. [Ophthalmic Surg Lasers 2001;32:162-165]
Adjuvant Methods in Macular Hole Surgery: Intraoperative Plasma-Thrombin Mixture and Postoperative Fluid-Gas Exchange
Authors: Blumenkranz Mark S , Ohana Esther , Shaikh Saad , Chang Stanley , Coll Gustavo , Morse Lawrence S , De Bustros Serge
Published: April 2021

* BACKGROUND AND OBJECTIVE: The opti mal method for surgical management of idiopathic macular holes remains unknown. Adjuvant methods including intraoperative cytokines and postoperative fluid-gas exchange with and without laser have been described. We report on the safety and final results of routine intraoperative autologous plasma-thrombin mixture and postoperative fluid-gas exchange when necessary as an adjunct to the surgical therapy of this disease.

* PATIENTS AND METHODS: A consecutive series of 1 14 patients (mean age 66.9 years) with primary idiopathic full thickness Stage II, III, and IV macular holes were primarily treated by vitrectomy, fluid/perfluorocarbon gas exchange, and application of autologous plasma-thrombin mixture to the macular hole. Visible epiretinal membranes were peeled but the normal appearing internal limiting membrane was not routinely stripped. Outcome measures included final Snellen visual acuity, rate of macular hole closure, complications, and number of supplemental procedures performed.

* RESULTS: Closed at one month, were 110 of 121 (91%) macular holes, including two that underwent repeat fluid/gas exchange and laser within the first two weeks after surgery. At the time of final follow-up (mean: 10.9 months), 110 of 121 (91%) macular holes were closed. This included 8 of 9 eyes that had reopening of the macular hole between one and 2 1 months successfully treated by repeat fluid-gas exchange and 2 eyes that underwent a second successful pars plana vitrectomy, membrane peeling, and repeat fluid-gas exchange. Overall, 98 of 121 eyes overall (81%) were successfully treated by a single surgery; 94 of 121 (78%) achieved two lines or greater of visual improvement; 83 of 121 (69%) achieved 20/70 or better vision; and 47 eyes (39%) achieved 20/40 or better vision. Complications in this series included infectious endophthalmitis (1 eye), intraoperative retinal break (2 eyes), late retinal detachment (5 eyes), transient mild intraocular pressure elevation (46 eyes), inflammatory response (six eyes), epiretinal membrane (6 eyes), intraretinal hemorrhages (1 eye), and cataract (33 of 99 phakic eyes underwent cataract extraction during the follow-up).

* CONCLUSION: A combination of intravitreal perfluorocarbon gas and autologous plasma-thrombin mixture (tissue glue) was well tolerated in most patients and did not result in any specific long-term complications. The use of supplemental fluid-gas exchange when necessary improved the final success rate. Further well-controlled and randomized studies will be required to determine the efficacy of this as an adjunct or alternative to other methods of treatment for macular holes.

[Ophthalmic Surg Lasers 2001;32:198-207]
Anatomic and Histopathologic Findings Following A Failed Ahmed Glaucoma Valve Device
Authors: Ayyala Ramesh S , Layden William E , Slonim Charles B , Margo Curtis E
Published: April 2021

Abstract Ahmed glaucoma valve implant (AGV) is one of the more commonly used implants in difficult glaucomas. The histology of a functioning bleb following AGV implantation and its anatomic relationship to the optic nerve when placed in the superionasal quadrant has been described. We report the histology of a failed bleb and the anatomic relationship between the optic nerve and the AGV end-plate when placed 9 mm from the limbus in a patient with neovascular glaucoma. [Ophthalmic Surg Lasers 2001;32:248-249]
Laser Therapy in the Management of Choroidal Breast Tumor Metastases
Authors: Levinger Samuel , Merin Saul , Seigal Ruth , Pe'er Jac
Published: April 2021

* PURPOSE: To evaluate the potential of laser photocoagulation as a method of treating small metastatic lesions of breast carcinoma in the choroid.

* METHODS: The 10 eyes of 7 patients were treated by Krypton red or argon green laser applications for small choroidal breast carcinoma metastasis with serous detachment of the retina. Before treatment 5 eyes had visual acuity of finger counting and 5 eyes had visual acuity of 6/15 or better. The treatment was repeated once in all eyes, except 1 eye in which it was repeated 3 times.

RESULTS: In all eyes, one to two weeks after the treatment the tumor shrunk, the subretinal serous detachment absorbed, the retina flattened, and the visual acuity improved to 6/6-6/21. No reduction in vision was seen after the second treatment until the end of the follow-up period. In 1 eye, new tumors located elsewhere were again twice successfiilly treated. Patients reported a significant improvement of their quality of vision, as judged subjectively.

* CONCLUSIONS: Laser treatment is a feasible, easy, rapid, and effective therapy for small choroidal breast carcinoma.

[Ophthalmic Surg Lasers 2001;32:294-299]
Severe Penetrating Ocular Injury From Ninja Stars in Two Children
Authors: Jeng Bennie H , Steinemann Thomas L , Henry Paul , Brodsky Michael C
Published: April 2021

Abstract. The authors describe two cases of penetrating ocular trauma in children resulting from ninja stars. In the first case, despite a scleral laceration, loss of iris tissue, and a vitreous hemorrhage, the child had a good result with a final best corrected visual acuity of 20/20. Unfortunately, the child in the second case did not fare as well. In this case, the child suffered a large corneal laceration and traumatic cataract. He ultimately required a penetrating keratoplasty, and he is currently being treated for amblyopia, strabismus, and elevated intraocular pressures. His best corrected visual acuity is 20/70. [Ophthalmic Surg Lasers 2001;32:336-337]