bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantitative CW Nd:YAG Pars Plana Transscleral Photocoagulation in Postmortem Eyes
Authors: Schubert Hermann D , Agarwala Atul 
Published: April 2021

ABSTRACT
The effect of different types of burns and numbers of lesions on, and the role of initial pressure head in, the rate of aqueous outflow was studied in enucleated human and porcine eyes. Noncontact and contact CW Nd:YAG laser applied to human eyes 3 mm posterior to the limbus produced a 34% and 51% increase, respectively, in outflow as compared with controls (P= .01). In porcine eyes, outflow increased directly with the number of noncontact bums as well as with the amount of perfusion pressure.
Our results suggest that intraocular pressure and outflow are functions of both the intensity of irradiation and the surface area treated, and that each individual pressure head may require an optimal pars plana area of treatment of therapeutic degree to lower pressure and yet prevent overfiltration and phthisis. Our results also suggest that there may be a passive transneuroepithelial and transscleral outflow component in clinical laser cycloablation and, therefore, a need to grade laser treatments in order to prevent visual loss through unnecessary injury.
Iontophoresis for Eyelid Anesthesia
Authors: Meyer Dale R , Linberg John V , Vasquez Roberto J 
Published: April 2021

ABSTRACT
Local anesthesia is appropriate for eyelid surgery, but patients fear the pain of injections. We evaluated iontophoresis of lidocaine for eyelid skin anesthesia to pinprick pain sensation in normal subjects, and prior to regional infiltration of the anesthetic agent in patients undergoing eyelid surgery. After iontophoresis of lidocaine hydrochloride 4% solution to one randomly chosen eyelid, pinprick skin sensation was tested in a double-masked manner. Subjective pain scores of 10 subjects were significantly less [P < .008} on the iontophoresis treated eyelids (0.25) than on the untreated eyelids (2.55). Nine patients undergoing bilateral upper eyelid surgery had iontophoresis applied to one randomly chosen eyelid prior to the usual anesthetic injections. In this doublemasked evaluation, patients reported significantly less pain (P <.02) on the treated eyelids (1.4) than on the untreated eyelids (4.7). We conclude that iontophoresis is effective for achieving short-term, superficial anesthesia of eyelid skin.
Silastic Foam Dressing for Healing Exenteration Cavities
Authors: Benson Mark T , GiImour Hilary , Nelson Michael E , Rennie Ian G 
Published: April 2021

ABSTRACT
Dressing the exenterated orbital cavity is difficult and time consuming for staff, traumatic to the healing wound, and painful for the patient, particularly when the wound is being left to granulate. We report the use of a silastic foam dressing which offers a number of advantages in this clinical situation.
Hemorrhagic Choroidal Detachment With Anterior Vitreoretinal Adhesions
Authors: Freeman William R , Schneiderman Todd E , Weinreb Robert N , Baerveldt George 
Published: April 2021

ABSTRACT
We present three cases of large intraoperative or postoperative hemorrhagic choroidal detachment with subsequent adherence of the retina to anterior segment structures. Surgical management involved bimanual vitrectomy through anterior sclerotomy sites and dissection within the anterior segment. Successful retinal reattachment was achieved in two of these cases (18-months' follow up). In the third case, the retina remained attached for 4 months but then redetached.
Paralimbal Compression Suture for Molteno Implants
Authors: Allinson Richard W 
Published: April 2021

ABSTRACT
When a Molteno implant is being inserted, the silicone tube occasionally can be misdirected anteriorly, bringing the end of the tube dangerously close to the corneal endothelium. A paralimbal compression suture of 8-0 nylon may redirect the tube more posteriorly, preventing such contact.
Scleral Fixation of Posterior Chamber Intraocular Lens Implants Combined With Vitrectomy
Authors: Friedberg Mark A , Berler David K 
Published: April 2021

ABSTRACT
Selected patients undergoing pars plana vitrectomy and lensectomy may be ideal candidates for scleralfixated lenses. We present our current technique for implanting such lenses, a technique designed to avoid the problems of suture exposure, lens rotation, and infection.
Trabeculodialysis for Inflammatory Glaucoma: A Review of 25 Cases
Authors: Williams Ruth D , Hoskins H Dunbar , Shaffer Robert N 
Published: April 2021

ABSTRACT
We reviewed the results following trabeculodialysis in 25 eyes of 22 patients with secondary glaucoma due to chronic anterior uveitis. After 1 year, intraocular pressure (IOP) was uncontrolled (>21 mm Hg) in 11 eyes (44%). Trabeculodialysis controlled IOP (<21 mm Hg) in 14 eyes (56%), with an average follow up of 52 months (range, 12 to 151 months). Sixteen eyes (64%) were aphakic, but did no worse than the phakic eyes. One eye developed a subchoroidal hemorrhage 3 days postoperatively which required drainage. No other serious complications were encountered. Trabeculodialysis is a safe procedure which can achieve pressure control in these difficult eyes.
Capsulorhexis, Phacoemulsification, and Posterior Chamber Lens Placement Following Iridocyclectomy
Authors: Lindquist Thomas D 
Published: April 2021

ABSTRACT
Two patients developed cataract following iridocyclectomy for iris melanoma invading the angle. Although several clock hours of zonular fibers had been surgically resected, the use of a continuous, circular capsulorhexis followed by phacoemulsification maintained the integrity of the anterior capsular margin and allowed for stable "in-the-bag" placement of a posterior chamber intraocular lens (PC-IOL). Continuous, circular capsulorhexis is the optimal anterior capsulectomy procedure, minimizing the incidence of radial tears and the risk of subsequent PC-IOL decentration.
Computerized Analysis of Corneal Topography as an Aid in Fitting Contact Lenses After Radial Keratotomy
Authors: McDonnell Peter J , Garbus Jenny J , Caroline Patrick , Yoshinaga Patrick D 
Published: April 2021

ABSTRACT
To select an appropriate base curve to use in fitting a contact lens in 16 eyes of 10 patients following radial keratotomy, we used a videokeratoscope that generates a 32-ring image, covering the entire cornea, to measure the midperipheral corneal curvature. We then based contact-lens selection on the curvature 3.5 mm superior to the visual axis. Photographic documentation of fluorescein patterns and subjective reports of the patients indicated a successful fitting in all cases.
A New Cannula for Removal of 12 O'Clock Cortex Through a Sideport Corneal Incision
Authors: Hagan John C 
Published: April 2021

ABSTRACT
A new cannula for aspiration of 12 o'clock cortex through a corneal sideport incision is now commercially available. The primary difference between this cannula and previously available ones is that the hub has a male adaptor, allowing direct connection to an automated irrigation/aspiration device.
Surgically-Induced Astigmatism in Combined ECCE With Filtering Procedures Compared to ECCE Alone
Authors: Choplin Neil T , Monroe John F 
Published: April 2021

ABSTRACT
Extracapsular cataract extraction with implantation of a posterior chamber lens combined with filtering surgery (glaucoma triple procedure) is frequently employed in the comanagement of cataract and glaucoma. Nineteen triple procedures with a minimum of six months follow up were compared to 19 cases of extracapsular cataract extraction with lens implant matched for age, sex, and surgeon with regard to surgically induced astigmatism as determined by vector analysis. Follow up averaged 10 months for the triple group and 14 months for the controls. There was no statistically significant difference in preoperative astigmatism between the two groups nor in the mean number of sutures cut.
Postoperatively, the keratometric cylinder averaged 2.55 ± 1.54 diopters for the cases and 1.20 ± 1.11 D for the controls; the difference of 1.36 D was statistically significant (P = .004). The postoperative refractive cylinder was 2.34 ± 1.54 D for the cases and 1.29 ± 1.07 D for the controls; the difference of 1.05 D was statistically significant (P = .017). With regard to surgically-induced astigmatism, vector analysis showed that the cases averaged 2.18 ± 1.25 D and the controls 1.23 ± 0.81 D; the difference of 0.95 D was statistically significant (P = .006). With regard to surgically-induced astigmatism, vector analysis showed that the cases averaged 2.18 ± 1.25 D and the controls 1.23 ± 0.81 D; the difference of 0.95 D was statistically significant (P = .006). When analyzed for change along the vertical meridian, the cases averaged 1.12 ± 1.57 D surgically-induced against-the-rule astigmatism, as compared with 0.30 ± 1.16 D for the controls (difference, 0.83 D; P = .062). The glaucoma triple procedures induced approximately 1.00 D more cylinder than the controls.
Visual Correction Following Penetrating Keratoplasty
Authors: Smiddy William E , Hamburg Tracey R , Kracher Gregory P , Stark Walter J 
Published: April 2021

ABSTRACT
Postoperative visual correction following penetrating keratoplasty usually includes spectacles, but for some patients optimal vision may be obtained using contact lenses. We studied 126 eyes of 101 patients undergoing penetrating keratoplasty to determine the frequency of postoperative contact-lens use, its clinical associations, its effect on the risk of corneal graft rejection, and its potential effects on topical medications. A total of 20 patients (16%) wore contact lenses postoperatively for maximal optical correction. Among eyes with good macular potential, 17 of 63 (27%) wore contact lenses. Contact-lens wear did not preclude the use of chronic postoperative topical medications, nor did it increase the risk of corneal graft rejection. We conclude that contact lenses may be useful for optimizing vision after penetrating keratoplasty, especially when macular potential is good.
Idiopathic Preretinal Fibrosis A Review of 237 Cases
Authors: Pilkerton A Raymond , Gilbert William S , Perraut L Edward , Perraut L Edward , Garfinkel Richard A 
Published: April 2021

ABSTRACT
We reviewed the charts of 223 patients 236 eyes) with idiopathic preretinal fibrosis, dividing them into two groups: those who only had been observed, and those who, after an observation period, had the membranes surgically removed. All of the patients had been followed from 6 to 120 months (mean, 29 months). Vision in the nonsurgical group slowly deteriorated and was accompanied by metamorphopsia. More rapid visual deterioration occurred in 60 eyes (25%), of which 37 (16%) required surgery. Vision in 78% of the surgical group improved, with the greatest subjective benefit considered to be subsidence of metamorphopsia. Vision spontaneously improved in 2.5% of the cases.
Penetrating Keratoplasty for Corneal Perforation in an Obtunded Patient
Authors: Van Meter Woodford S , Conklin John 
Published: April 2021

ABSTRACT
A ventilator-dependent patient obtunded from severe head trauma suffered a spontaneous corneal perforation with lens extrusion secondary to nosocomial Pseudomonas keratitis. Despite the patient's guarded condition, a successful tectonic penetrating keratoplasty with lens removal was performed for restoration of the globe. Upon recovery, the patient's only useful vision was in her operated eye. Preventative measures against prolonged corneal exposure in an obtunded patient include copious artificial tears and lubricants, use of scleral lenses, moisture chambers, bandage contact lenses, or tarsorrhaphies.
Anterior Lens Capsulotomy Using the Holmium YAG Laser in Pig Cadaver Eyes
Authors: Miyake Kensaku 
Published: April 2021

ABSTRACT
Anterior lens capsulotomy was performed on pig cadaver eyes using the evaporation and coagulation functions of the holmium YAG laser. Laser energy ranging from 50 to 80 mJ was delivered to the lens-capsule surface by a 26-gauge fiber-optic quartz needle probe. In eight of 10 eyes, a tear-free, 4.0-millimeter-diameter circular capsulotomy was achieved, through which endocapsular phacoemulsification and aspiration were performed and a posterior chamber intraocular lens with a 6.5-millimeter-diameter optic was placed inside the lens capsule. Throughout the procedure, capsular integrity was maintained in all eight eyes, with no tearing at the capsular margin.
Bipolar Cautery and Internal Thermal Sclerostomy in a Rabbit Model
Authors: Au Yue-Kong , Reynolds Mark D , Chadalavada Ravi , Misra Raghunath P 
Published: April 2021

ABSTRACT
Internal thermal sclerostomy (ITS) was performed unilaterally in 35 adult New Zealand rabbits using a pinpoint bipolar cautery probe and radio-frequency power supply, with the nonoperated eyes serving as controls. Standard trabeculectomy using a limbal-based flap was also performed on 10 additional rabbits, and served as a second bench mark for comparison with the ITS technique. Intraocular pressure (IOP) was measured in all eyes preoperatively and on postoperative days 2, 4, 6, and 8. A significant (P = .005) difference between the reduction in IOP in the ITS eyes and in the control eyes was found up to postoperative day 8; on that day the reduction in IOP was 5.2 mm Hg. IOP in the eyes undergoing standard trabeculectomy was significantly (P = .05) reduced up to postoperative day 2, and gradually decreased, to 2.5 mm Hg, on postoperative day 8. The greatest reduction in IOP (2.9 mm Hg) for these eyes also occurred on postoperative day 2. Complications of ITS included iris burn (23%), peripheral corneal edema (17%), and iritis (9%). No ruptured blebs, flat anterior chambers, hyphemas, or lens damage occurred. The potential advantages of the ITS procedure using the bipolar cautery probe include a decreased risk of cataract formation because of the curved probe design. The procedure is also technically simple to perform and requires only inexpensive and readily-available equipment.
The Protective Effect of Early Intraoperative Injection of Viscoelastic Material in Trabeculectomy
Authors: Barak Adiel , Alhalel Amir , Kotas Ronit , Melamed Shlomo 
Published: April 2021

ABSTRACT
In a prospective study, we evaluated the effect of intracameral injection of sodium hyaluronate (HA) in trabeculectomy on short- and long-term results, including the effect on the corneal endothelium. Twenty-two patients were randomly assigned into two groups: group A, consisting of 11 patients, underwent standard trabeculectomy; in group B (11 patients), additionally, HA was injected into the anterior chamber immediately following paracentesis in an attempt to minimize shallowing of the chamber after the subsequent trabeculectomy. Both groups had comparable age distributions, preoperative intraocular pressures (IOPs), preoperative endothelial cell counts, postoperative IOPs after 3 months, and glaucoma medication indices. The reduction in the number of endothelial cells after 1 month was significantly greater in group A than in group B (16.1% vs 6.7%). Also, significantly more shallow anterior chambers occurred in group A (three eyes vs one eye). However, 1 day postoperatively, the average IOP was 16.4 mm Hg in group A, as compared with 25 mm Hg in group B. Thus, although HA, injected early in trabeculectomy, appeared to protect against corneal endothelial loss and flat anterior chamber, it also seemed to be associated with early IOP spikes.
Patterns of Tissue Damage Produced by Repeated Use of a Corneal Trephine: A Scanning Electron Microscopic Study
Authors: Jaais Fathilah , Dutton Gordon N 
Published: April 2021

ABSTRACT
We studied by scanning electron microscopy the effects of the repeated use of a newly-designed, disposable, suction trephine (Microsurgical, Ltd, Bedfordshire, England) on the nature of the cut of successive corneal buttons from sheep eyes. After the trephine was used more than nine times, the cut edge became more irregular as successive buttons were produced. Also, progressively greater degrees of endothelial cells adjacent to the cut edge were lost. Although the corneal buttons initially were circular, those produced after the 20th cut became more oval. These results suggest that a disposable corneal trephine should be reused no more than nine times.
Intravitreal Antibiotics: Accuracy of Dilution by Pharmacists, Ophthalmologists, and Ophthalmic Assistants, Using Three Protocols
Authors: Narvaez Julio , Wessels Izak F , Mattheis Jay K , Beierle Floyd 
Published: April 2021

ABSTRACT
We compared the accuracy with which general ophthalmologists, pharmacy personnel, and ophthalmic assistants diluted intravitreal antibiotics, using a method of their own devising, a new protocol using an insulin syringe, and Duane's protocol. The insulin syringe method proved less accurate and more complex than Duane's protocol, but was better than not using a standardized protocol at all. With all methods, the pharmacy personnel produced the most accurate dilutions, with the least variability. The ophthalmologists' dilutions were much more variable both without a protocol and with the insulin syringe method, but they were acceptable with the Duane's protocol. The ophthalmic assistants produced unacceptable results with all methods. Since the decision to inject antibiotics is usually made under emergency conditions, when errors of dilution are more likely, whenever possible, pharmacy personnel should be entrusted with providing the dosage of medications to be injected intraocularly. If pharmacists are unavailable, ophthalmologists may reconstitute medications using a reliable and simple protocol such as Duane's.
A Possible Role of Free Radicals in the Transplantation of Retinal Pigment Epithelial Cells
Authors: Ophir Avinoam , Chevion Mordechai 
Published: April 2021

ABSTRACT
Oxygen-derived free radicals have been implicated in tissue injury following ischemia and reperfusion (reoxygenation). It has been hypothesized that the radicals are produced during the early reperfusion stage. Recently, submacular implantation of retinal pigment epithelium cells has been reported. It is probable that during the procedure, the transplant and the 180-degree folded outer retina underwent a period of ischemia, followed by reoxygenation. We, therefore, infer that free radicals were produced during the reoxygenation stage of the procedure, injuring both tissues. We suggest that these hypotheses be investigated with the aim of improving the surgical outcome in eyes with age-related macular degeneration.
Failure of Collagen Plugs to Predict Epiphora After Permanent Punctal Occlusion
Authors: Glatt Herbert J 
Published: April 2021

ABSTRACT
In two patients with keratoconjunctivitis sicca, epiphora did not occur after temporary canalicular occlusion with collagen implants, but did occur after subsequent permanent punctal occlusion. This suggests that collagen implants may not always produce total occlusion. Patients should be warned of this possibility.
Bilateral Congenital Posterior-Capsular Defects: A Case Report
Authors: Vajpayee Rasik B , Sandramouli S 
Published: April 2021

ABSTRACT
We report a rare case of bilateral congenital posteriorcapsular defects and its successful management by the dry-aspiration technique. To our knowledge, this is the first documented case of a posterior-capsular rupture with no demonstrable cause.
Ten-Year Follow Up Comparing Anterior and Posterior Chamber Intraocular Lens Implants
Authors: Downing John E 
Published: April 2021

ABSTRACT
Results achieved in eyes following a single surgeon's first 200 procedures consisting of intracapsular cataract extraction and implantation of a Choyce-Tennant anterior chamber lens (AC-IOL) (1977 to 1980) are compared with those achieved following the same surgeon's first 200 procedures consisting of extracapsular cataract extraction and implantation of a posterior chamber intraocular lens (PC-IOL) (1980 to 1982). For the AC-IOL eyes, follow up ranged from 11.1 to 14.2 years (mean, 12.0 years); for the PC-IOL eyes, from 9.5 to 10.8 years (mean, 10.0 years).
The AC-IOL eyes had many early problems: pupillary block (7%), iritis (15%), and secondary glaucoma (8%). Four percent developed corneal edema, 1.5% vitritis, and 2% localized iris holes under the lens. Ectropion uveae appeared in 8.5%, indicating some ongoing inflammation. One and one-half percent of these lenses were removed or exchanged. Seventy-nine and one-half percent of these eyes had 20/40 or better vision at 10 years; 4% had visual loss along with corneal edema or vitritis, apparently related to the AC-IOLs.
The PC-IOL eyes had comparatively few lens-related complications: 1% corneal edema, 1.5% iritis, 1% vitritis, and 2% secondary glaucoma. Some localized trapping of the pupil occurred in 8%. One percent of the PC-IOLs were removed, and 1% decentered, requiring McCannell sutures. Final visual acuity at 10 years was 20/40 or better in 77.5%. None of the PC-IOL eyes had decreased vision related to the lens implant.
An Epidemiologic and Pathologic Study of Globes Enucleated Following Trauma
Authors: Freitag Suzanne K , Eagle Ralph C , Jaeger Edward A , Dunn Eric S , Jeffers John B 
Published: April 2021

ABSTRACT
This retrospective study examined demographic, clinical, and histopathologic factors in 24 traumatically ruptured globes that were enucleated at Wills Eye Hospital during a 2-year period. The majority of these injuries occurred in a violent assault setting with a blunt mechanism, during the evening and early morning hours, and in the fall and winter months. Most patients were black males, and 67% were substance abusers. Clinically, the initial visual acuity in 96% of the eyes was light perception or worse. Five of the eyes were enucleated primarily. Gross examination of the globes revealed that 92% of the wounds involved the sclera, 83% of the eyes had hyphema, and 71% of the lacerations were longer than 10 mm. Histopathologic examination demonstrated that the majority of eyes had fragmented or missing lenses, disrupted ciliary bodies, and detached choroids. Ninety-six percent of the retinas were detached. There was one case of acute endophthalmitis.
The Tarsal Pillar Technique for Narrowing and Maintenance of the Interpalpebral Fissure
Authors: Tanenbaum Myron , Lett Dewayne , Gossman M Douglas , Haines Peter , Bergin Donald J , McCord Clinton D , Friedman Harold I 
Published: April 2021

ABSTRACT
We describe a tarsorrhaphy technique whereby an ipsilateral upper-eyelid tarsal pillar is sutured to a corresponding lower-eyelid recipient site. This technique allows maintenance of a narrowed interpalpebral fissure indefinitely, yet is easy to reverse without incurring lid-margin damage. Additionally, the procedure can be adjusted postoperatively to either narrow or widen the initial surgical result. We report our combined surgical experience in 35 consecutive procedures using this technique to treat eyes with exposure-related keratopathy of varied etiology, including facial nerve palsies, combined facial nerve palsy and trigeminal neuropathy with an anesthetic cornea. Graves' disease, congenital craniofacial anomalies, and severe keratitis sicca syndrome. The procedure was successful in improving exposure keratopathy symptoms in all 35 cases. Complications, reflecting the authors' learning curve with this new procedure, included intermarginal pyogenic granulomas, stretching of the tarsal pillar, minor lowereyelid-margin eversion, and tarsal pillar dehiscence.