bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experimental Evaluation of Low-Viscosity Fluorosilicone Oil as a Temporary Vitreous Substitute
Authors: Liu Kwan-Rong , Peyman Gholam A , Miceli Michael V 
Published: April 2021

ABSTRACT
Fluorosilicone oil, a high specific gravity fluorinated siticene oil, has been recently reevaluated for temporary use in surgery to repair complicated retinal detachments. We evaluated the toxicfty of a low-viscosity 300 centistokes) fluorosilicone oil as a vitreous substitute in vitrectomized eyes of albino rabbits. No toxicrties could be demonstrated by histopathologic and electroretinographic examinations 6 weeks following surgery. In vitro experiments also showed no toxic effects on cultured retinoblastoma cells. When fluorosilicone oil was injected into the anterior chamber, endothelial cell damage could be seen 2 weeks following injection. Low-viscosity fluorosilicone oil appears to be a safe vitreous substitute for temporary use; it is easily injected and removed, and it maintains adequate surface tension for intraocular tamponade. Because of its relative low viscosity, 300-cst fluorosilicone oil (FS) may be a better vitreous substitute than perfluorocarbon liquids for both intraoperative manipulation of the retina and short-term intraocular tamponade for complicated retinal detachments.
Intraocular Pressure After Peripheral Retinal Cryopexy in Normotensive Human Eyes
Authors: Schubert Hermann D 
Published: April 2021

ABSTRACT
Intraocular pressure (IOP) was measured before and after peripheral retinal cryopexy given for lattice degeneration and small retinal breaks. During the period of observation the IOP of treated eyes decreased, suggesting that freezing of areas remote from the ciliary body may tower IOP through mediation and/or transscleral outflow.
A Comparative Evaluation of Three Methods of Analyzing Optic Disc Topography
Authors: Varma Rohit , Douglas Gordon R , Steinmann William C , Wijsman Kees , Mawson Dan , Spaeth George L 
Published: April 2021

ABSTRACT
Topographical evaluations of the optic discs of 17 eyes obtained using a clinical planimeter, the Rodenstock video-ophthalmograph, and the IS 2000 image analyzer were compared. The parameters studied were vertical and horizontal cup-to-disc ratios, cup volumes, rim areas, disc areas, and rim area-to-disc area ratios. There was good correlation between the measurements obtained by the three methods (correlation coefficients ranged from 0.46 to 0.88). For various parameters, the correlations between clinical planimetry and image analysis were higher than either those between image analysis and video-ophthalmography, or those between clinical planimetry and video-ophthalmography. The mean horizontal cup-todisc ratios and rim areas as measured by clinical planimetry were significantly higher than those measured by image analysis. Image analysis measured signiflcantly higher disc area and rim areas and lower cup volumes than video-ophthalmography.
Intraocular Lens Explantation With and Without Penetrating Keratoplasty
Authors: Noecker Robert J , Branner William A , Cohen Kenneth L 
Published: April 2021

ABSTRACT
We reviewed the records of 33 consecutive patients who had undergone intraocular lens (IOL) explantations for IOL-related complications. Results from 19 eyes that underwent penetrating keratoplasty at the time of explantation (pk eyes) were compared with the results from 14 eyes that underwent only IOL explantation (nk eyes). Uvettis was the most common indication for explantation in the npk eyes; frank bullous keratopathy was the most common in the pk eyes. Fifteen of the IOLs explanted from the pk eyes were anterior chamber IOLs, 13 of which were the semiflexible, closed-loop type. Ten of the npk eyes had anterior chamber IOLs explanted, six of which also were the semiflexible, closed-loop type. Visual acuities in the pk group were significantly worse than they were in the npk group, both before and after explantation. Based on this review, we conclude that if anterior chamber and iris-supported IOL complications occur and medical therapy fails, IOL explantation prior to the need for penetrating keratoplasty may improve visual acuity.
Peribulbar Anesthesia for Primary Vitreoretinal Surgery
Authors: Nicholson Anjali D , Singh Preetam , Badrinath Sengamedu S , Murugesan Radha , Sundararaj Ian , Vardarajan Srinivasan , Krishnan Madhusudan , Nagarajan Krishnaswamy , Gopal Lingam , Sharma Tarun , Challa Jagannadh K 
Published: April 2021

ABSTRACT
We prospectively studied the efficacy of peribulbar anesthesia in 76 consecutive patients who underwent vitreoretinal surgery. The mean duration of anesthesia was 124.74 ± 50.17 minutes, and the mean duration of akinesia, 151.5 ± 54.45 minutes. Adequate anesthesia and akinesia, independent of the duration of surgery, was obtained in 26 of 33 (78.8%) patients who underwent vitrectomy; 9 of 32 (28.1%) who underwent scleral buckling; and 2 of 11 (18.2%) who underwent vitrectomy combined with scleral buckling. In all, topical and systemic supplementation of drugs for inadequate anesthesia or akinesia allowed 32 of the 33 (97%) vitrectomies, 30 of the 32 (94%) scleral buckling procedures, and all 11 of the combined surgeries to be completed as planned. Three (4%) patients vomited, moved, or were restless, resulting in an operative complication or postponement of surgery. Fifty-eight (76%) said they would desire similar anesthesia if subsequent surgery was needed in the same or fellow eye. We conclude that peribulbar anesthesia should be considered primarily for patients requiring vitreous surgery alone, and as an alternative for patients requiring scleral buckling or combined surgery for whom general anesthesia is contraindicated.
Combined Cataract-Glaucoma Surgery Using the THC:YAG (Holmium) Laser Ab Interno Without Gonioscopy
Authors: Kendrick Ronald M , Kollarits Carol R 
Published: April 2021

ABSTRACT
We describe a simple method of combined cataract-glaucoma surgery, involving use of the THC:YAG (holmium) laser ab interno, without gonioscopy, in which the initial cataract incision remains small and the glaucoma filtering procedure can be completed relatively quickly, with minimal surgical manipulation of the conjunctiva. In a series of 15 eyes (13 patients) with visually significant cataracts and medically uncontrolled glaucoma, followed for an average of 14 weeks (range, 1 to 26 weeks), 13 of the 15 eyes had decreased IOR Visual acuity was improved in 9 eyes, remained the same in 4 eyes (with age-related macular degeneration), and was worse in 2 eyes (with opacification of the posterior capsule sufficient to account for the decrease in acuity).
Intraocular Lens Insertion During Vitrectomy
Authors: Smiddy William E 
Published: April 2021

ABSTRACT
Vitrectomy was performed in 10 patients in combination with posterior chamber intraocular lens (IOL) insertion. Indications for vitrectomy included traumatically dislocated cataract, choroidal hemorrhage, epiretinal membrane, lens involving intraocular foreign body, vitreous hemorrhage, and extruded anterior chamber IOL. Postoperative visual acuity improved in each case. The main advantages of simultaneous IOL insertion, in selected cases, are reduced cost and inconvenience, and more rapid visual rehabilitation.
Pupillary Capture of a Posterior Chamber Lens Following Convulsive Seizures
Authors: Forstot S Lance , Ellis Philip P 
Published: April 2021

ABSTRACT
Total pupillary capture of the optic of a posterior chamber intraocular lens (PC-IOL) occurred over 1 year after implantation, following severe, convulsive seizures. We suggest that the generalized seizures and associated extraocular muscle contractures created significantly elevated vitreous pressure, which caused anterior displacement of the IOL. To our knowledge, this is the first reported case of late pupillary capture of a PC-IOL following severe, convulsive seizures.
Topical Fluorometholone Reduces Stremal Inflammation After Photorefractive Keratectomy
Authors: Campos Mauro , Abed Hamid Moghareh , McDonnell Peter J 
Published: April 2021

ABSTRACT
To examine the effectiveness of topical steroids in decreasing corneal stremai inflammation induced by photorefractive keratectomy, four rabbits underwent uniocular corneal deepithelialization, or deepithelialization followed by photorefractive keratectomy. Topical fluorometholone acetate 0.5% was applied topically to half of the eyes after photorefractive keratectomy. Polymorphonuclear leukocytes (PMNs) were counted 24 hours after surgery· The number of PMNs in the corneal stroma was significantly higher after photorefractive keratectomy than after deepithelialization alone (P = .001) and than in normal unoperated corneas; fluorometholone treatment significantly reduced PMN accumulation (P = .001). Photorefractive keratectomy in rabbits induces an intense inflammation of the superficial stroma that can be effectively treated with topical fluorometholone. A short course of topical corticosteroide may, therefore, be appropriate after excimer laser surgery in humans.
A Technique for Knotting a Suture Around the Loops of a Dislocated Intraocular Lens, Within the Eye, for Fixation in the Ciliary Sulcus
Authors: Navia-Aray Emigdio A 
Published: April 2021

ABSTRACT
I describe a new, simpler, technique for attaching a suture to the haptic of a dislocated posterior chamber lens implant. A 10-0 polypropylene suture is used, doubly armed with straight needles. This technique has been used successfully in five cases.
Trabeculotomy Combined With Phacoemulsification and Implantation of an Intraocular Lens for the Treatment of Primary Open-Angle Glaucoma and Coexisting Cataract
Authors: Tanihara Hidenobu , Honjo Megumi , Inatani Masaru , Honda Yoshihito , Ogino Nobuchika , Ueno Satoki , Negi Akira , Ichioka Hiroshi , Mizoguchi Takanori , Matsumura Miyo , Nagata Makoto 
Published: April 2021

* BACKGROUND AND OBJECTIVE: The authors previously reported the usefulness of trabeculotomy ab externo for the treatment of primary openangle glaucoma in adult patients. In an attempt to elucidate the long-term risk-to-benefit ratio of this surgical modality in combination with cataract surgery, the authors conducted a retrospective study of the surgical effects and complications of a triple procedure: phacoemulsification, implantation (of an intraocular lens), and trabeculotomy (PIT).
* PATIENTS AND METHODS: The authors conducted a retrospective study of patients treated with PIT at multiple hospitals. Intraocular pressure (IOP) and visual function data were obtained from patients after PIT as an initial surgical treatment in cases where antiglaucoma medications failed to resolve uncontrolled IOP (higher than 21 mm Hg). Included in this study were 96 eyes of 64 patients with primary openangle glaucoma and coexisting cataract. The mean follow-up period was 22.6 ± 14.7 months (range 3-56 months).
* RESULTS: In 94 (98%) of the 96 eyes, the IOP was well controlled, having achieved a level of 21 mm Hg or lower at the final examinations. The mean preoperative IOP of the 33 eyes that underwent the triple procedure using a single flap method (PIT-I) was 24.3 ± 3.9 mm Hg, with an average of 2.1 ± 1.1 medications. At the final examinations, the mean IOP had dropped to 16.0 ±1.2 mm Hg, with an average of 1.2 ± 1.2 medications. The mean preoperative IOP of the 63 eyes that underwent the triple procedure using a double flap method (PIT-II) was 26.2 ± 6.2 mm Hg, with an average of 1.9 ± 1.2 medications. At the final examination, the mean IOP for this group was 15.6 ± 2.9 mm Hg, with an average of 1.0 ± 0.9 medications.
* CONCLUSION: The long-term results from this multicenter study showed that the triple procedure, PIT, can be useful and effective as an initial surgical treatment for open-angle glaucoma in glaucoma patients with coexisting cataract.
[Ophthalmic Surg Lasers 1997;28:810-817.]
Intraoperative Miotics and Posterior Capsular Opacification Following Phacoemulsification With Intraocular Lens Insertion
Authors: Phillips Barratt , Crandall Alan S , Mamalis Nick , Olson Randall J 
Published: April 2021

* BACKGROUND AND OBJECTIVES: Posterior capsular opacification (PCO) is a frequent complication following phacoemulsification with intraocular lens (IOL) implantation. A series of consecutive patients receiving capsular bag- fixated, silicone IOL implants were assessed for both incidence of PCO and the administration of intraoperative miotics.
* PATIENTS AND METHODS: During a 5-year period, 477 consecutive eyes were retrospectively evaluated. Surgeries were grouped according to intraoperative miotic agent: 0.01% carbachol or 1.0% acetylcholine. Patients receiving no miotic drug served as a control group. Yttrium-aluminum-garnet (YAG) laser posterior capsulotomy was performed on patients with clinically significant PCO.
Clinical Application of Er:YAG Laser for the Treatment of Pterygium
Authors: Nakammura Kunihiko , Bissen-Meyajima Hiroko , Shimmura Shigeto , Tsubota Kazuo 
Published: April 2021

* BACKGROUND AND OBJECTIVE: To evaluate the clinical application of Er: YAG laser for the treatment of pterygium.
* METHOD: Five patients (5 eyes) with pterygium, 2 primary cases and 3 retreatment cases, whose ages ranged from 44 to 68 years (mean 54.4 years), were treated with the Er: YAG laser. The optical system consisted of a fluorozirco-aluminate glass fiber and a handpiece tip made of quartz glass. The tip of the guiding probe was applied to the surface of the pterygium, where the laser beam was emitted. The radiant energy was set at 10 mj with water spray.
* RESULT: The removal of pterygium was accomplished under topical anesthesia with a laser output approximate range from 50 to 100 shots. Complications such as corneal erosion or thinning of the sclera were not observed. However, recurrence was seen in the 3 retreatment cases.
* CONCLUSION: The Er: YAG laser system may be a clinically useful tool as a laser surgical knife for ocular tissue.
[Ophthalmic Surg Lasers 2000;31:8-12.]
Photoablative Laser-Grid Trabeculectomy in Glaucoma Filtering Surgery: Histology and Outflow Facility Measurements in Porcine Cadaver Eyes
Authors: Jacobi Philipp C , Dietlein Thomas S , Colling Tom , Krieglstein Günter K 
Published: April 2021

* BACKGROUND AND OBJECTIVE: Midinfrared laser technology opens new perspectives in experimental glaucoma surgery. The aim of the study was to determine the efficacy of grid-laser trabeculectomy to reduce aqueous outflow resistance sufficiently in perfused porcine cadaver eyes.
* MATERIALS AND METHODS: Twenty-five freshly enucleated porcine cadaver eyes were randomly assigned to either laser-grid trabeculectomy (LGT), conventional trabeculectomy (CT), or control. In all surgical cases a scierai flap was prepared in a standardized manner. In order to penetrate into the anterior chamber a 1 × 2 mm sclerectomy was performed in CT, and 10 transscleral ablation craters were created in LGT. An erbium:YAG laser (2.96 µm) was used for transscleral photoablation. Radiation was delivered in a single 6 mJ-pulse of 200 µs duration by means of an articulated zirconium fluoride optical fiber and a 200 µm quartz fiber-tip. Outflow facility was measured at a constant perfusion pressure.
* RESULTS: Laser-grid trabeculectomy (LGT) yielded reproducible ablation areas varying between 210-300 µm in diameter, with 90% being full-thickness penetrations. Collateral thermal damage was less than 30 µm. Outflow facility measurements revealed a statistically significant increase (mean ± SD) from 0.255 ± 0.096 µL/min/mm Hg in control eyes (n = 9) to 0.772 ± 0.157 µL/min/mm Hg in the LGT group (n = 9), and 2.957 ± 0.602 µL/min/mm in the CT group (n = 7). Flattening of the anterior chamber, folding of Descemets membrane, and iris prolapse were only observed in the CT eyes but not in the GLT group.
* CONCLUSION: Application of the laser-grid trabeculectomy produces patent transscleral perforation with minimal collateral tissue damage and effects a significant reduction (67%) in outflow resistance without any postoperative hypotony-related complications.
[Ophthalmic Surg Lasers 2000;31:49-54.]
Clinical Results of Ahmed Glaucoma Valve Implantation in Refractory Glaucoma with Adjunctive Mitomycin C
Authors: Kook Michael S , Yoon Juntaek , Kim Jaeyong , Lee Moo-Song 
Published: April 2021

* OBJECTIVE: To study the surgical outcome and complications of Ahmed glaucoma valve (AGV) implantation with mitomydn C (MMC) in refractory glaucoma.
* PATIENTS AND METHODS: The authors retro spectively reviewed the records of 40 eyes in 37 consecutive patients who underwent combined AGV with MMC (0.4 mg/mL; 5 minutes). All patients had a minimum of 6 months of follow-up. Outcome measures were best corrected visual acuity, intraocular pressure (IOP), the number of medications, success rates, and the incidence of complications.
* RESULTS: The Kaplan-Meier life table analysis revealed that the probabilities of surgical success based on our success criteria at 1 year and 2 years postoperatively were 80% and 77%, respectively. Postoperative IOP was significantly lower at all follow-up intervals. At the final visit fewer glaucoma medications were used (2.5 vs 0.7, preoperative vs postoperative). The most frequent complication was hypotony (17%).
* CONCLUSION: In this retrospective case series with relatively short follow-ups, AGV implantation with mitomycin C in refractory glaucoma appears to be effective without increased complication rates.
[Ophthalmic Surg Lasers 2000;31: 100-106]
Human Lens Effect on In Vivo Scanning Laser Polarimetric Measurements of Retinal Nerve Fiber Layer Thickness
Authors: Collur Surekha , Carroll Alicia M , Cameron Bruce D 
Published: April 2021

* OBJECTIVE: To determine the effect of the human lens on retinal nerve fiber layer measurements by scanning laser polarimetry. This technique uses the form birefringence of the retinal nerve fiber layer to estimate its thickness. The GDx Nerve Fiber Analyzer contains an optical retarder element to compensate for the birefringence of the human cornea.
* PATIENTS AND METHODS: Fourteen nonglaucomatous pseudophakic or aphakic eyes were matched by age and race to 14 nonglaucomatous phakic eyes. Intraocular pressure, optic nerve head evaluation by slit lamp biomicroscopy and visual fields were performed to establish the absence of glaucoma. The nerve fiber layer thickness measurements by the GDx Nerve Fiber Analyzer were compared between the two groups.
* RESULTS: The average nerve fiber layer thickness in the phakic group was 67.2±11.9 urn and in the nonphakic group was 66. 1 ± 1 1 .8 µ?? (?=0.80).
* CONCLUSION: The human lens has negligible influence on in vivo nerve fiber layer thickness measured by the GDx Nerve Fiber Analyzer.
[Ophthalmic Surg Lasers 2000;31:126-130]
Threshold Power Levels for NPe6 Photodynamic Therapy
Authors: Kazi Abdul A , Peyman Gholam A , Unal Melih , Khoobehi Bahram , Yoneya Shin , Mori Keisuke , Moshfeghi Darius , Moshfeghi Andrew A 
Published: April 2021

* OBJECTIVE: To determine the threshold power levels for producing retinal and choroidal vascular occlusion using mono-L-aspartyl chlorin e6 (NPe6) photodynamic therapy; to evaluate its efficacy with longer intervals between photosensitìzer injection and laser application; to determine the elapsed time between light application and appearance of angiographie changes.
* METHODS: Pigmented and nonpigmented rabbits were injected intravenously with 2 mg/kg of NPe6 before laser irradiation of the retìna-choroid. Group 1 was treated at increasing power levels; fluorescein angiograms were obtained at each fluence. Group 2 animals were exposed to laser irradiation at 5 minutes, and 1 and 3 hours postinjection to determine (by fluorescein angiography 24 hours post-treatment) if increasing the interval affected outcome. Group 3 animals underwent fluorescein angiography at 30 minutes, 1 hour, 2 hours, and 24 hours posttreatment to document the time between laser application and subsequent vessel closure.
* RESULTS: Choroidal vessel occlusion was angiographically evident in all lesions at fluences of > 2.65 J/cm2 in pigmented rabbits and at > 0.88 J/cm2 in nonpigmented tabbits. Lesion diameter decreased as the time between injection and treatment increased. Vessel occlusion was documented at least 2 hours after treatment.
* CONCLUSION: Choroidal vessel occlusion can occur at very low fluence.
[Ophthalmic Surg Lasers 2000;31:136-142]
Optical Coherence Tomography Images of Retinitis Pigmentosa
Authors: Ogata Nahoko , Ida Hisashi , Takahashi Kanji , Fukuchi Toshic , Uyama Masanobu 
Published: April 2021

Abstract. The retinas of 3 patients with typical retinitis pigmentosa (RP) were evaluated by optical coherence tomography (OCT), fluorescein angiography (FA), and fundus photography (FP).
OCT showed that retinal thickness was decreased in the areas of the retina affected by RP, and nearly normal in the unaffected macular area. Reflectivity was partially decreased in the affected retinal areas and pigment masses were hyper- reflective. Reflectivity of the macular area was nearly normal except in the fovea, where it was decreased because of edema. Cystic spaces of the fovea were evident in Patient 1. [Ophthalmic Surg Lasers 2000:31:253-256]
Stages of Milestones Implementation: A Template Analysis of 16 Programs Across 4 Specialties
Authors: Yaghmour Nicholas A. , Poulin Lauren J. , Bernabeo Elizabeth C. , Ekpenyong Andem , Li Su-Ting T. , Eden Aimee R. , Hauer Karen E. , Tichter Aleksandr M. , Hamstra Stanley J. , Holmboe Eric S. 
Published: April 2021

ABSTRACT

Background
Since 2013, US residency programs have used the competency-based framework of the Milestones to report resident progress and to provide feedback to residents. The implementation of Milestones-based assessments, clinical competency committee (CCC) meetings, and processes for providing feedback varies among programs and warrants systematic examination across specialties.

Objective
We sought to determine how varying assessment, CCC, and feedback implementation strategies result in different outcomes in resource expenditure and stakeholder engagement, and to explore the contextual forces that moderate these outcomes.

Methods
From 2017 to 2018, interviews were conducted of program directors, CCC chairs, and residents in emergency medicine (EM), internal medicine (IM), pediatrics, and family medicine (FM), querying their experiences with Milestone processes in their respective programs. Interview transcripts were coded using template analysis, with the initial template derived from previous research. The research team conducted iterative consensus meetings to ensure that the evolving template accurately represented phenomena described by interviewees.

Results
Forty-four individuals were interviewed across 16 programs (5 EM, 4 IM, 5 pediatrics, 3 FM). We identified 3 stages of Milestone-process implementation, including a resource-intensive early stage, an increasingly efficient transition stage, and a final stage for fine-tuning.

Conclusions
Residency program leaders can use these findings to place their programs along an implementation continuum and gain an understanding of the strategies that have enabled their peers to progress to improved efficiency and increased resident and faculty engagement.