bluuebunny/crossref_metadata_2025_split huggingface dataset:
Small-Incision Techniques in Ophthalmic Plastic Surgery
Authors: Dortzbach Richard , Woog John J 
Published: April 2021

ABSTRACT
A stepped surgical incision, in which an initial small cutaneous incision is followed by progressively longer incisions in the subcutaneous tissues, limits postoperative scar formation in the skin. Placement of incisions parallel to relaxed skin-tension lines further reduces the size of the scar. We describe how these principles may be applied to ophthalmic plastic surgical procedures to improve cosmesis. Autogenous fascia lata can be harvested with scissors through a 15-mm incision parallel to relaxed skintension lines, placed over the middle of the iliotibial tract. Lacrimal bypass operations can be performed well and with good cosmesis through a 12 to 15-mm skin wound if the above principles are followed.
The Chamber-Retaining Suture Revisited
Authors: Wilson Richard P , Moster Marlene R 
Published: April 2021

ABSTRACT
In 1977, C. William Simcoe developed the anterior chamber-retaining suture as a means of preventing intraocular lens-cornea touch during intraocular lens manipulation, penetrating keratoplasty, and following filtration surgery.1-2 Though seldom remembered today, Simcoe's innovation safely and effectively insures corneal well-being following increasingly complex modern filtration and shunt procedures. The use of a combination of double-armed 9-0 nylon suture and anterior chamber-bridging straight needles simplifies placement.
Techniques of Adjustable Suture Strabismus Surgery
Authors: Kraft Stephen P , Jacobson Mark E 
Published: April 2021

ABSTRACT
Adjustable sutures allow eye muscle positions to be changed following strabismus surgery, when the patient is awake and able to cooperate in muscle balance testing. Bow-tie-knot and sliding-handle sutures can be adjusted within 24 hours after surgery. Scleral traction sutures, which can be used to fix the globe to periorbital tissues during postoperative healing, can be adjusted for up to 14 days after surgery. We describe these techniques as well as an adjustable loop suture for conjunctival closure.
Treatment of Experimental Suprachoroidal Hemorrhage With Subconjunctival Injection of Tissue Plasminogen Activator: A Negative Report
Authors: Liu James C , Peyman Gholam A , Oncel Murat 
Published: April 2021

ABSTRACT
Suprachoroidal hemorrhage was created in 10 albino rabbit eyes. Five eyes were treated with subconjunctival injections of 40 000 IU of tissue plasminogen activator (tPA) daily for 6 days; five eyes served as controls. It took approximately the same amount of time for the suprachoroidal hemorrhages to clear in both the control and treatment eyes. We conclude that subconjunctival injection of tPA does not accelerate the clearance of suprachoroidal hemorrhage.
Changing Indications for Cataract Surgery: 1974 to 1988
Authors: Moorman Consuela , Sommer Alfred , Stark Walter , Enger Cheryl , Payne John , Maumenee A Edward 
Published: April 2021

ABSTRACT
To examine changes in indications for cataract surgery which have contributed to the increasing rate of cataract extractions, we compared preoperative characteristics of 265 patients who had undergone surgery in 1988 with a similar number who had undergone surgery by the same four ophthalmologists in 1974 and 1982. Between 1974 and 1988 the number of extractions performed annually by two high-referral hospital-based surgeons rose by 68%. Over 90% of these procedures in 1974 were intracapsular extractions; in 1988, 90% were extracapsular extractions with intraocular lenses. In 1988, preoperative visual acuity was better in both the study eyes and the fellow eyes, the proportion of those with acuities better than 20/60 having risen from 10% to 21%, and from 49% to 67%, respectively. The proportion of patients waiting more than 2 years for surgery on the second eye doubled between 1974 and 1988. These changes, already evident by 1982 for the hospitalbased surgeons, became characteristic of the community-based surgeons' practices as well between 1982 and 1988.
A Method for Performing Full-Thickness, Orthotopic, Penetrating Keratoplasty in the Mouse
Authors: She Si-Chun , Steahly Lance P , Moticka Edward J 
Published: April 2021

ABSTRACT
In an attempt to overcome the lack of well characterized, inbred, and congenie strains, as well as a paucity of immunological reagents, in rabbit and rat models, we have developed a procedure for performing full-thickness, penetrating keratoplasty in the mouse. One hundred percent of isografts (BALB/c onto BALB/ c) were successful, while 83.3% of allografts (C3H onto BALB/c) failed. The use of a mouse model to study corneal graft failure will allow a critical evaluation of the role of a variety of immunological mediators in causing graft failure.
Cryotherapy for Retinopathy of Prematurity: A Histopathologic Comparison of a Treated and Untreated Eye
Authors: Vrabec Tamara R , McNamara J Arch , Eagle Ralph C , Tasman William 
Published: April 2021

ABSTRACT
A female infant born at 28 weeks gestational age, weighing 570 g, developed retinopathy of prematurity (ROP) which progressed to threshold disease in one eye. Transsclera I cryotherapy of the avascular peripheral retina resulted in complete clinical regression of the active ROP in that eye. The fellow eye continued to manifest subthreshold ROR Histopathologic findings included a striking reduction of the cryotreated retina to a thin glial scar, with associated retinal pigment epithelium atrophy, denudation of Bruch's membrane, and extensive atrophy of the underlying choroidal vasculature, predominantly the choriocapillaris.
Effects of Postoperative Mitomycin C on Glaucoma Filtration Surgery in Rabbits Treated Preoperatively With Antiglaucoma Medications
Authors: Hyung Sung-Min , Kim Dong Myung , Hong Chul , Lee Jaeheung , Youn Dong Ho 
Published: April 2021

ABSTRACT
In a rabbit model, we evaluated the effects of topically applied postoperative mitomycin C (MMC) on the success rate of glaucoma filtration surgery in animals treated preoperatively with pilocarpine hydroch ??ride 4% and levobunolol hydrochloride (Betagan) for 16 weeks. Full-thickness filtration surgery was performed with a single 5-minute intraoperative exposure to a sponge soaked with 0.4 mg/mL MMC of one eye in nine rabbits in one group (group A) and to both eyes in 13 rabbits in a second group (group B). In addition, one eye of each rabbit in group B received a daily drop of 0.4 mg/mL MMC for 13 days after the operation. All of the eyes were then followed for 80 days.
The intraoperatively applied MMC enhanced the success rate of the filtration surgery in the group A eyes. However, the eyes that also received postoperative drops of MMC (group B) had longer periods of reduced intraocular pressure (IOP) (P [chi-squared = 5.94] < .025), fewer bleb failures (P [chi-squared - 8.09] < .005), and more complications than the eyes that received only intraoperative MMC.
The "Anchor" Anterior Capsulectomy
Authors: Berger Roland R , Kenyeres Agnes M 
Published: April 2021

ABSTRACT
In recent years, continuous circular capsulorhexis (CCC) has become the preferred anterior capsulectomy in many ophthalmic centers. Yet, many ocular surgeons are still uncomfortable with it, especially when tearing the capsule on its lower semicircle, since this often results in cornea) endothelial injury, and, thus, postoperative lower corneal edema. We present a modified anterior capsulectomy, which consists of a crescent capsulorhexis and a perpendicular discission, followed by circular tearing of the resulting capsular flaps. This "anchor" anterior capsulectomy (AAC) was used in 14 cases of elective extracapsular cataract extraction, followed by intraocular lens (IOL) implantation. The capsulectomy was successful in 12, and IOL implantation was successful in 12. The procedure was relatively easy to perform and resulted in good "in-the-bag" implantation, regardless of the lOL's overall length and the optic's size. AAC can serve as an intermediate step in learning CCC as well as a reliable alternative anterior capsulectomy.
Applications for a Corneal Mattress Suture in Anterior Limbal Wound Repairs
Authors: Palmer Richard M , Burgoyne Claude F 
Published: April 2021

ABSTRACT
We describe the use of a corneal mattress suture to manage two complications of trabeculectomy: first, to repair an anterior conjunctiva! tear/disinsertion in a limbus-based conjunctiva! flap; and, second, to restore wound integrity by reinforcing a focal section of scleromalacia or to close a perforation remaining from a previous cataract wound encountered during complicated trabeculectomy. In each setting, a single, double-armed 10-0 nylon cornea) mattress suture is used as an anchor to establish a watertight limbalwound closure. Additionally, for repairing an area of a scleromalacia/perforation, the corneal mattress suture can be used to incorporate a graft of Tenon's fascia into the wound.
Repair of Retinal Detachment Associated with Congenital Excavated Defects of the Optic Disc
Authors: Brown Gary C , Brown Melissa M 
Published: April 2021

ABSTRACT
Excavated defects of the optic disc have been associated with retinal detachment in the macula and beyond. Included among these defects are congenital pits of the optic disc, optic nerve coiobomas, and the morning glory syndrome.
We report eight consecutive patients with congenital, excavated defects of the optic disc and associated retinal detachment managed with pars plana vitrectomy, laser photocoagulation, and intravitreal gas injection.
Autoscleral Flap Grafting: A Technique of Scleral Repair
Authors: Gopal Lingam , Badrinath Sengamedu S 
Published: April 2021

ABSTRACT
We describe using the technique of autoscleral flap grafting in 1 eye with scleral staphyloma, in 2 eyes with scleral ectasia, and in 1 eye with scleral deficiency following excision of a limbal tumor. In three cases, follow up was over 6 months; in the remaining case, 2 months. In one patient, the scleral ectasia recurred, since the scleral flap that could be dissected was thin. The recurrence was managed successfully by a periosteal autograft.
In Vitro Sensitivity of Human Tenon's Capsule Fibroblasts to Mitomycin C and Its Correlation With Outcome of Glaucoma Filtration Surgery
Authors: Madhavan Hajib N , Rao Sridhar B , Vijaya Lingam , Neelakantan Arvind 
Published: April 2021

ABSTRACT
Dose-inhibition studies of proliferating fibroblasts grown from Tenon's capsule biopsy specimens obtained during trabeculectomy from 17 glaucoma patients were performed using varying concentrations of mitomycin C (MMC), with exposure of cells to the drug for either 5 days or 5 minutes. Surgical outcomes were determined 3 months postoperatively. Based on in vitro results, fibroblasts were classified as either MMC-"resistant" or MMC"sensitive." Thirteen surgically successful cases were associated with 10 "sensitive" and three "resistant" fibroblasts; four surgical failures with one "sensitive" and three "resistant" fibroblasts. The in vitro studies were positively correlated with the clinical outcomes, the former correctly predicting the latter in 76.5% of the surgeries.
Use of the Giant-Pulse Nd:YAG Laser for Ab-Externo Sclerostomy in Rabbits and Humans
Authors: Barak Adiel , Rosner Mordechai , Solomon Arieh , Karni Ziv , Melamed Shiomo 
Published: April 2021

ABSTRACT
The giant-pulse Neodymium:YAG laser, a recently developed laser source, delivers up to 200 W of peak power at pulse widths of 20 or 40 msec. The instrument can create a sclerostomy with minimal surrounding damage and, consequently, relatively little postsurgical inflammation and scarring. We tested its efficacy in performing ab-externo sclerostomy in 10 adult pigmented rabbits and in five patients with end-stage glaucoma. All of the animal eyes were hypotonus immediately after the procedure. However, the intraocular pressure increased gradually, and by the third day, returned to presurgical levels in all of the eyes. All five of the glaucoma patients treated had patent sclerostomies following the procedure. They all had early hypotony, but after 3 months, four of the five sclerostomies apparently failed. The giant-pulse Nd:YAG laser appears useful for performing sclerostomy, but modifications are needed to solve the problems of early hypotony and late closure of the fistulula.
Nd: YAG Laser Treatment of Retained Descemets Membrane After Penetrating Keratoplasty
Authors: Steinemann Thomas L , Henry Katherine , Brown Michael F 
Published: April 2021

ABSTRACT
Retention of the host's Descemets membrane is an unusual complication of penetrating keratoplasty. The membrane may opacify and even threaten the health of the transplant. Following creation of a central opening with the Nd:YAG laser in such a case, visual acuity improved from counts fingers at 5 ft to 20/100.
Scheimpflug Photography and Postcataract Surgery Posterior Capsule Opacification
Authors: Lasa Maria Susan M , Datiles Manuel B , Magno Benjamin V , Mahurkar Anup 
Published: April 2021

ABSTRACT
We describe a method to objectively document postcataract surgery posterior capsule opacification using Zeiss Scheimpflug photography and computerized image analysis. We examined 42 eyes with clear capsules (group A) and 27 with posterior capsule opacities (group B). The group A eyes had significantly better visual acuity (P < .05), lower mean capsular densitometry readings (0.03 ± 0.03 optical density units versus 0.15 ± 0.11 optical density units; P < .0001), and thinner capsules (0.03 ± 0.4 mm versus 0.10 ± 0.05 mm) than the group B eyes. This new objective method of documenting postoperative capsular haze may be useful for clinical studies such as clinical trials of drugs or surgical techniques being developed to prevent or minimize capsule opacification.
Gonioscopic Ab Interno Nd:YLF Laser Sclerostomy in Human Cadaver Eyes
Authors: Oram Osman , Gross Ronald L , Severin Todd D , Orengo-Nania Silvia , Feldman Robert M 
Published: April 2021

ABSTRACT
We explored the potential of the picosecond Nd:YLF laser to perform gonioscopic ab interno sclerostomy in human cadaver eyes. Full-thickness sclerostomies were created in 12 such eyes and confirmed by external scleral and histopathologic examination. Optimum parameters for successful completion of a sclerostomy were: a rectangular pattern of 0.3 mm by 0.3 mm, a repetition rate of 1000 pulses per second, an energy-per-pulse of 400 mJ, and a spot separation between 10 and 50 µm, with no focal offset. The Nd:YLF laser reliably created successful gonioscopic sclerostomies with minimal adjacent thermal damage in human cadaver eyes.
Therapeutic Penetrating Keratoplasty in Nonhealing Corneal Ulcer
Authors: Panda Anita , Khokhar Sudarshan , Rao Venkateshwar , Das Gopal Krushna , Sharma Namrata 
Published: April 2021

ABSTRACT
Results of penetrating keratoplasty in 443 eyes of 439 patients of active infective corneal ulcers, from a period of 10 years, were analyzed. All these eyes were proven refractory to maximal medical therapy for extended periods of time, in some cases more than 6 weeks. As the surgery was performed during the active stage, the outcome was not favorable functionally. Clinical cure was obtained, however, by therapeutic penetrating keratoplasty in all but 27 of these eyes. Of unsuccessful cases, 16 could be saved with additional medical therapy, two led to phthisis bulbi, and nine required repeat therapeutic penetrating keratoplasty. Complications encountered included disturbances in intraocular dynamics such as extrusion of the lens and vitreous during surgery, secondary rise of intraocular pressure leading to damage of the optic nerve, loss of the eye due to above factors, and reinfection. The anatomical success achieved was 97% with graft clarity of 2+ or more in 39% of eyes. Useful vision, ie, better than or equal to 6/60, was possible in 33% of eyes. Thus, therapeutic keratoplasty in refractory corneal ulcer still has scope in a Third-World country.
Amblyopia in Congenital Ptosis
Authors: Hornblass Albert , Kass Lawrence G , Ziffer Anne J 
Published: April 2021

ABSTRACT
This study evaluates the association between congenital ptosis and amblyopia. Amblyopia was detected in 7 of 36 (19%) patients with congenital ptosis. Two patients (6%) with amblyopia had no contributing factors other than the presence of congenital ptosis. A statistically significant correlation between severe nonocclusive ptosis (greater than or equal to 4 mm) and the development of amblyopia was identified. No new cases of amblyopia developed after surgical repair of the ptosis, suggesting early surgery for severe nonocclusive congenital ptosis may decrease the incidence of amblyopia.
Holmium Laser Sclerostomy via Corneal Approach With Transconjunctival Mitomycin-C in Rabbits
Authors: Chi Thomas S K , Berríos Ramon R , Netland Peter A 
Published: April 2021

ABSTRACT
We studied the use of the holmium laser for sclerostomy through a small lamellar corneal incision and the effects of transconjunctival mitomycin-C on the outcome of filtration surgery without conjunctiva! incision. The holmium laser, equipped with a straightfiring probe, was used to create sclerostomies in seven New Zealand white rabbits through a corneal lamellar incision. One eye in each rabbit was treated with transconjunctival mitomycin-C (0.4 µg/mL for 5 minutes), and the fellow eye underwent sclerostomy without pretreatment with mitomycin-C as a control. The reduction in intraocular pressure was greater and persisted significantly longer in the eyes pretreated with mitomycin-C than in the controls. All control eyes had flat blebs by day 7 to 12, while the treated eyes maintained a bleb throughout the study. Microscopic examination showed that sclerostomies created by the straight-firing probe induced significantly less thermal damage than those created by the stationary side-firing probe. These results demonstrate that successful transcorneal sclerostomy without conjunctiva! incision can be created using the straight-firing holmium laser probe, with enhancement of filtration by pretreatment with transconjunctival mitomycin-C.
Keratoprosthesis as an Aid to Learning Surgical Techniques on Cadaver Eyes
Authors: Eckardt Ute , Eckardt Claus 
Published: April 2021

ABSTRACT
Practice on cadaver eyes can be an essential aid for residents and inexperienced surgeons in learning operative techniques. Cadaver eyes, however, have been of only limited utility for teaching highly complicated procedures because of the obscuring of intraocular structures caused by the rapid post mortem onset of cornea) swelling. We have overcome this problem by the use of a silicone keratoprosthesis that provides an excellent view of all intraocular tissues. Our model allows the use of donor eyes unsuitable for transplantation and facilitates the learning of even complicated cataract surgery, and vitrectomy techniques on the human eye. It thus can reduce the rate of complications in operations on patients.
The Use of a Silicone Strip Over the Sclerotomy in Vitreous Surgery
Authors: Zauberman Hanan , Hemo Itzhak 
Published: April 2021

ABSTRACT
We have developed a technique to prevent enlargement and distortion of the sclerotomy wound during vitreoretinal surgery. The technique involves the use of a silicone strip temporarily attached to the sclera. The strip and the sclera are pierced with a lance-tipped blade and surgery is done by entering through the silicone strip and then through the resulting scleral opening. Such a procedure prevents undesirable enlargement of the sclerotomy induced by trauma to the wound caused by instruments that can occur in cases of previously damaged sclera or in thin sclera associated with high myopia, it also prevents leaks through the wound as instruments are withdrawn.
Delayed Tarsal Eversion Following Periorbital Trauma
Authors: Rice Charles D , Brodsky Michael C , Hembree Kathryn 
Published: April 2021

ABSTRACT
Delayed onset of upper lid edema with exuberant chemosis developed in a 3-year-old girl following blunt periorbital trauma. Examination under anesthesia demonstrated a tightly everted upper tarsus that focally compressed the underlying conjunctiva at the superior tarsal border. Injection of subconjunctival hyaluronidase followed by local compression and temporary tarsorrhaphy resulted in rapid resolution of the chemosis and restoration of the normal lid position.
Treatment of Hypotony Maculopathy After Trabeculectomy
Authors: Cohen Steven M , Flynn Harry W , Palmberg Paul F , Gass Donald M , Grajewski Alana L , Parrish Richard K 
Published: April 2021

* BACKGROUND AND OBJECTIVE: To determine if resuturing of the scleral flap to increase IOP in the post-trabeculectomy eye is an effective treatment of hypotony maculopathy.
* PATIENTS AND METHODS: The medical records of nine consecutive patients who developed visual acuity loss after trabeculectomy related to hypotony maculopathy were reviewed to determine factors that contribute to successful restoration of visual acuity.
The average age of the patients was 50 years and average refractive error was -4.25 diopters (D). Mean Snellen visual acuity dropped from 20/25 to 20/200 after the onset of hypotony.
* RESULTS: Six of nine eyes recovered visual acuity to within one line of initial level after treatment of the hypotony. Four of these six eyes underwent resuturing of the scleral flap to reverse the excess filtration within 6 months of the onset of hypotony maculopathy. Five of these six patients had final vision of 20/30 or better. The mean phakic preoperative refractive error in these six eyes was -2.25 D, compared with a mean refractive error of -8.50 D in the three eyes with persistent visual loss (P = 0.002). After reversal of the hypotony, the average peak intraocular pressure in the six eyes with visual recovery was 33 mm Hg, compared with an average peak IOP of 7 mm Hg in the three eyes with persistent visual loss. (P = 0.015)
* CONCLUSION: Although reversal of the hypotony maculopathy in six eyes was associated with a few weeks of higher than normal IOP, the final IOP was acceptably low. Five of six filtering blebs remained functional with a mean follow-up of 3 years. The final average IOP in the six eyes that were successfully treated was 12.7 mm Hg. In this series of patients, visual acuity was restored to eyes with hypotony maculopathy by increasing the IOP to higher than normal levels.
[Ophthalmic Surg Lasers 1995;26:435-441.]
Mass Spectrometry Analysis of the By-products of Intrastromal Photorefractive Keratectomy
Authors: Habib Maged S , Speaker Mark G , Schnatter Wayne F K 
Published: April 2021

* BACKGROUND AND OBJECTIVE: To determine the nature and chemical composition of the cavitation bubbles generated by intrastromal photorefractive keratectomy (IPRK) with the Neodymium: Yttrium Lithium Fluoride (Nd:YLF) picosecond laser.
* MATERIALS AND METHODS: IPRK was performed on the corneas of three fresh human cadaver eyes with the Nd:YLF picosecond laser. High energy levels of 200 mJ/pulse to 300 mJ/pulse were used to produce the maximum amount of gas within the corneal stroma. The cavitation bubbles produced in the stroma were aspirated using a gas-tight syringe connected to a valve, and the specimens were analyzed with a mass spectrometer.
* RESULTS: The experiment was performed on three different occasions using one cadaver eye in each experiment. The analysis consistently revealed a mixture of carbon dioxide, carbon monoxide, water vapor, oxygen, and nitrogen. Atmospheric control samples also revealed oxygen and nitrogen. No other components were detected.
* CONCLUSION: The gaseous by-products of IPRK with the picosecond laser result from the simple breakdown of stromal tissue and contain no toxic or unexpected components. We found that these gaseous products are capable of rapid elimination by absorption or diffusion out of che intact cornea.
[Ophthalmic Surg Lasers 1995;26:481-483.]