bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of Orbital and Periorbital Arteriovenous Malformations
Authors: Hayes Bartlett H , Shore John W , Westfall Christopher T , Harris Gerald J 
Published: April 2021

ABSTRACT
Arteriovenous malformations (AVMs) of the orbit are progressively enlarging communications between arteries and veins that bypass normal capillary beds. In contrast to arteriovenous fistulas (AVFs), AVMs are congenital lesions with multiple large feeding arteries, a central nidus, and numerous dilated draining veins. Management of AVMs of the orbit may be difficult due to the threat of hemorrhage, vascular occlusion during treatment, and collateral damage to surrounding organs.
We managed AVM of the orbit and periorbital tissues in four patients. Neuroimaging studies, clinical decision making, operative experience, and long-term postoperative results were retrospectively reviewed. Four cases of AVM of the orbit and periorbital tissues were successfully treated with preoperative embolization and subsequent excision of the central nidus of the AVM. There was no evidence of recurrence in any of the cases over follow up ranging from 2 to 5 years.
We conclude that identification of all arterial from both internal and external carotid systems, is critical in developing a therapeutic plan. AVMs may be treated by surgical excision alone, or embolization alone. However, in the hands of an experienced interventional neuroradiologist and an appropriately chosen surgical team, most AVMs can and should be treated by a combined approach of preoperative embolization followed by surgical excision of the vascular mass. The goal of therapy is closure of the low-resistance shunt.
Simple Approach to Secondary Posterior Chamber Intraocular Lens Implantation in Patients Without a Complete Posterior Lens Capsule Support
Authors: Tomikawa Setsuko , Hara Akira 
Published: April 2021

ABSTRACT
We describe a simple new method of implanting secondary posterior chamber intraocular lenses (PC-IOLs) with ciliary sulcus fixation in patients with complete posterior lens capsule support. Two pairs of PC-9 needles (Alcon Surgical, Fort Worth, Tex) are involved, each pair connected by the Girth Hitch method, with a guiding needle on one end and a tying needle on the other. This ab externo technique overcomes many of the disadvantages noted in previous reports on secondary PC-IOL implantation.
Combined Topical and Subconjunctival Anesthesia in Cataract Surgery
Authors: Anderson Charles Joseph 
Published: April 2021

ABSTRACT
A combined technique of topical anesthesia (TA) and subconjunctival anesthesia (SCA) was used in 73 consecutive patients undergoing scierai tunnel phacoemulsffication cataract surgery. Medical records were evaluated preoperatively, intraoperative, and postoperatively. A patient questionnaire was used to obtain subjective intraoperative and postoperative information. Preoperative and intraoperative sedation of varying degrees was necessary. Ninety-five percent of the patients reported no pain. No patients required additional retrobulbar or peribulbar anesthesia. The most frequent postoperative problems were pain, a need for patching, and headache. The combined TA and SCA technique appeared safe, medically acceptable, and cost-effective.
Optimum Timing of Postoperative Adjustment in a Rabbit Model of Adjustable Suture Strabismus Surgery
Authors: Holmes Jonathan M , Townshend Alice M 
Published: April 2021

ABSTRACT
Strabismus surgeons disagree on the optimum timing of the postoperative adjustment in adjustable suture surgery. We compared the peak force necessary for adjustment at various postoperative times using a rabbit model. Twenty-four eyes of 12 rabbits underwent a superior rectus recession of 5 mm using a standard adjustable suture technique. The eyes were randomized to adjustment at 15 minutes, and at 6, 24, and 48 hours postoperatively. The peak force required to advance the muscle 3 mm was measured using a strain gauge. During each adjustment, the peak force was noted to be that required for initial disinsertion of muscle from sclera. The mean peak force required was 14 ± 5 g at 15 minutes, 37 ± 10 g at 6 hours, 60 ± 40 g at 24 hours, and 103 ± 52 g at 48 hours. There was a significant relationship between the time of adjustment and the peak force required for adjustment (F=7.8, P=0.001). Post-hoc analysis showed that the peak force required at 48 hours was greater than that required at 24 hours (P=0.04), 6 hours (P=0.003), and at 15 minutes (P=0.0002). The force required for adjustment at 24 hours and beyond was greater than the maximal force generated by an extraocular muscle. We therefore suggest that the postoperative adjustment should be performed within the first 24 hours.
Transection of the Superior Rectus Muscle During Intended Superior Oblique Tenotomy: A Report of Three Cases
Authors: Raymond William R , Parks Marshall M 
Published: April 2021

ABSTRACT
Reported complications of superior oblique surgery include postoperative vertical or torsional deviation. Brown's syndrome, head tilt, blepharoptosis, and conversion of an A-pattern to a V-pattern. McNeer reported three cases of postoperative vertical deviation, one of which was attributed to severing of the superior rectus tendon. We report three additional cases of inadvertent unrecognized transection of the superior rectus during intended superior oblique tenotomy to emphasize the importance of direct visualization of these tendons during surgery.
An Ultrasound Biomicroscopic Dark-Room Provocative Test
Authors: Pavlin Charles J , Harasiewicz Kasia , Foster F Stuart 
Published: April 2021

ABSTRACT
Ultrasound biomicroscopy can image the relationship of angle structures under any lighting conditions. Eight patients with narrow angles were examined in the light and in the dark. All of the eyes showed iris thickening and shortening, increased anterior convexity of the iris, and varying degrees of angle narrowing in the dark. In one eye, the angle was completely closed. Iridotomy in this patient flattened the iris profile and opened the angle. The degree of angle opening observed after the iridotomy did not change depending on the lighting conditions. Ultrasound biomicroscopy allows imaging of dynamic changes in anterior ocular structures as they occur and provides information regarding angle occludability in the dark.
Corneal Endothelial Polymerization of Histoacryl Adhesive: A Report of a New Intraocular Complication
Authors: Markowitz Gary D , Orlin Stephen E , Frayer William C , Andrews Anthony P , Prince Richard B 
Published: April 2021

ABSTRACT
Tissue adhesives are commonly used in ophthalmology to seal small corneal perforations. We report a case of inadvertent instillation of cyanoacrylate adhesive (Histoacryl) in the anterior chamber resulting in polymerization of the glue on the corneal endothelial surface, with iridocorneal and iridolenticular adhesion.
Ptosis Repair and Blepharoplasty in the Adult
Authors: Older J Justin 
Published: April 2021

ABSTRACT
When contemplating upper lid ptosis and blepharoplasty surgery, preoperative evaluation is essential so that the patient and the surgeon have similar expectations as to the final result of the surgery. Blepharoplasty and ptosis repair can be performed as a combined procedure in the adult. The procedure involves excising excess skin and underlying orbicularis muscle, and in some cases, orbital fat. The levator aponeurosis is advanced onto the tarsus and the excess levator excised. An eyelid crease is formed during closure by passing a suture through the advanced aponeurosis.
Long-Term Surgical Results of Combined Trabeculotomy Ab Externo and Cataract Extraction
Authors: Tanihara Hidenobu , Negi Akira , Akimoto Masayuki , Nagata Makoto 
Published: April 2021

ABSTRACT
Trabeculotomy ab externo has been demonstrated to be effective in controlling intraocular pressure (IOP) in adult patients with either primary open-angle glaucoma or pseudoexfoliation syndrome. We evaluated the surgical outcome of 60 eyes with either primary open-angle glaucoma or pseudoexfoliation syndrome that underwent combined trabeculotomy ab externo and cataract extraction. All patients were at least 40 years old, and were followed for at least 1 year. At the final examination, IOP was well controlled (21 mm Hg or less) in 54 (90%) of the 60 eyes, with or without medication. Also, "overall success" (ie, stabilization of IOP, visual field, and optic nerve status) was achieved in 49 (81.7%). Complications included fibrin exudation (22%), transient IOP elevation (17%), early perforation of the probe into the anterior chamber (10%), and detachment of Descemet's membrane (5%).
We recommend combined trabeculotomy ab externo and cataract extraction in selected cases of glaucoma with coexisting cataract. For cases in which the target IOP level is in the low teens, or for patients who may not tolerate postoperative fluctuations in IOP, we do not recommend trabeculotomy ab externo. Also, in eyes that have normal-tension glaucoma, or that have already sustained severe damage to the optic nerve, visual dysfunction caused by glaucomatous changes may progress even after successful combined trabeculotomy ab externo and cataract extraction.
Direction and Location of Retinotomy for Removal of Subretinal Neovascular Membranes
Authors: Greve Mark D J , Peyman Gholam A , Millsap C Mark 
Published: April 2021

ABSTRACT
We describe two cases in which a new retinotomy technique is used to remove subretinal neovascular membranes. The direction and location of the retinotomy are of ultimate importance in prevention of damage to retinal nerve fibers and the corresponding visual field loss. The retinotomy is made with an angled 20-gauge needle in nondiathermized retina. The direction of the retinotomy is parallel to the nerve fiber layer and located over the subretinal neovascular membrane. No laser retinopexy was necessary after removal of the subretinal neovascular membrane.
Follow-up of Argon Laser Trabeculoplasty: Is a Day-One Postoperative IOP Check Necessary?
Authors: Mittra Robert A , Allingham R Rand , Shields M Bruce 
Published: April 2021

* BACKGROUND AND OBJECTIVES: To evaluate the benefit of measuring the intraocular pressure (IOP) on the first postoperative day after argon laser trabeculoplasty (ALT).
* PATIENTS AND METHODS: We retrospectively reviewed 407 ALT procedures with perioperative apraclonidine performed on 226 patients between January 1991 and December 1993. Data analyzed included type of glaucoma, extent of treatment, whether the procedure was initial or repeat, laser parameters, and IOP preoperatively and at 1 hour, 1 day, and 1 month postoperatively.
* RESULTS: The percentage of patients with an IOP rise of greater than 3 mm Hg at 1 hour, 1 day, and 1 month following ALT was 11.3%, 4.2%, and 5.2% respectively. The incidence of IOP elevations greater than 10 mm Hg was 2.2%, 1.0%, and 1.5% at 1 hour, 1 day and 1 month, respectively. Of 17 cases with an IOP elevation greater than 3 mm Hg at 1 day, four eventually required a trabeculectomy. However, there were no consistent factors that distinguished which cases with elevated IOP at 1 day ultimately needed further therapy, nor did the 1-day postoperative examination predict which patients would have IOP elevation at 1 month.
* CONCLUSION: IOP 1 day after ALT is rarely elevated and does not correlate with IOP elevation at 1 month. Therefore, an IOP check at 1 day is not felt to be necessary for most patients.
[Ophthalmic Surg Lasers 1995;26:410-413.]
Comparison of Combined Cataract and Glaucoma Surgery Using Planned Extracapsular and Phacoemulsification Techniques
Authors: Shingleton Bradford J , Jacobson Lawrence M , Kuperwaser Mark C 
Published: April 2021

* BACKGROUND AND OBJECTIVE: The surgical management of coexisting cataract and glaucoma is a common problem for the ophthalmologist.
* PATIENTS AND METHODS: We evaluated intraocular pressure (IOP) reduction and bleb formation in combined cataract and filtration surgery, comparing planned extracapsular cataract extraction (ECCE) and phacoemulsification approaches coupled with similar trabeculectomy techniques. Seventy-two eyes with primary open-angle or pseudoexfoliation glaucoma underwent combined cataract and filtration surgery. Thirty-five eyes underwent planned ECCE, intraocular lens (IOL) implantation, and trabeculectomy, and 37 eyes underwent phacoemulsification, IOL implantation and trabeculectomy. Minimum follow-up for both groups was 1 year with a mean of 16 months.
* RESULTS: The mean IOP reduction for phacoemulsification/trabeculectomy eyes (5.0 ± 4,3 mm Hg) was significantly lower than the mean IOP reduction for ECCE/trabeculectomy eyes (2.9 ±4.1 mm Hg; P< 0.03). There was no significant difference between the groups in terms of visual acuity improvement or glaucoma medication reduction.
* CONCLUSION: Combined cataract and filtration surgery using phacoemulsification is associated with greater IOP reduction than combined surgery using ECCE.
[Ophthalmic Surg Lasers 1995;26:4l4-419.]
Combined Pars Plana Vitrectomy, Phacoemulsification, and Intraocular Lens Implantation in the Capsular Bag: A Comparison to Vitrectomy and Subsequent Cataract Surgery as a Two-Step Procedure
Authors: Senn Peter , Schipper Isaak , Perren Barbara 
Published: April 2021

* BACKGROUND AND OBJECTIVE: To evaluate the effectiveness and safety of combined surgery.
* PATIENTS AND METHODS: Combined surgery (CS) consisting of pars plana vitrectomy (PPV), phacoemulsification, and implantation of a posterior chamber intraocular lens (PC IOL) in the capsular bag was performed on 26 patients. Another 26 had phacoemulsification with PC IOL insertion one to 84 months (mean 17.3) after PPV (sequential surgery, SS). Mean follow-up was 21.9 months after CS and 19.5 months after the cataract surgery in the SS group. The data were analyzed in a prospective, nonrandomized fashion.
* RESULTS: Visual acuity and refraction, astigmatism, accuracy of biometry, intraocular pressure, intraoperative, postoperative and long-term complications, and medical treatment were comparable in the two groups. Among the four uveitis patients in each group, transient fibrin formation was more frequent with CS (100%) than with SS (25%). The advantages of CS are that only one operation is needed, intraoperative working conditions are good, macular recovery is not masked by postvitrectomy cataract formation, and ideal lens centration is achievable. Potential disadvantages of CS include a longer operative time and increased technical demand, shrinkage of the anterior capsular opening, which may interfere with fundus view, and increased inflammation may be seen in patients with preexisting uveitis.
* CONCLUSION: Combined surgery in selected patients is a safe and effective approach, and outcomes are comparable to sequential surgery.
[Ophthalmic Surg Lasers 1995;26:420-428.]
Ocular Perforation During Retrobulbar and Peribulbar Injections
Authors: Berglin Lennart , Stenkula Staffan , Algvere Peep V 
Published: April 2021

* BACKGROUND AND OBJECTIVE: To determine the ocular perforations during retrobulbar and peribulbar injections.
* PATIENTS AND METHODS: Twenty-five ocular perforations between 1976 and 1993 occurred after 13 retrobulbar and 12 peribulbar injections. Eighteen patients (72%) were women. Eighteen eyes were myopic (72%). Risk factors included high myopia in 11 cases (44%), use of Atkinson gaze in 21 cases (84%) and a sharp injection needle.
* RESULTS: Deep position of the posterior pole was common. Perforation signs comprised vitreous hemorrhage in 25 eyes (100%), subretinal hemorrhage in 19 eyes (76%), retinal breaks along the inferior vascular arcade in 19 eyes (76%), and retinal detachment in 14 eyes (56%). Proliferative vitreoretinopathy developed in 11 eyes (44%).
* CONCLUSION: Retinal detachment strongly correlated to poor visual outcome.
[Ophthalmic Surg Lasers 1995;26:429-434.]
Contact Versus Noncontact Diode Laser Transscleral Cyclophotocoagulation in Cadaver Eyes
Authors: Stroman Gesa A , Stewart William C , Hamzavi Sirus , Powers Timothy P , Blessing Walter D 
Published: April 2021

* BACKGROUND AND OBJECTIVE: The optimal placement and laser energy levels of a new contact probe with a variable focus used for transscleral diode cyclophotocoagulation were compared with the diode laser noncontact technique.
* MATERIALS AND METHODS: Fresh cadaver eyes were evaluated by a modified posterior Miyake view using videotape, light microscopy, and scanning electron microscopy.
* RESULTS: The noncontact diode technique at maximum energy (1.2 J) and contact diode applications at similar energy levels failed to produce obvious gross tissue ciliary body change and mild alterations by histology. Consistent gross, histologic, and scanning electron microscopic damage was noted at 3.0 J or more with the contact probe placed at the surgical limbus and defocused 0.5 to 1.5 mm posteriorly.
* CONCLUSIONS: This study indicates that the Multilase contact diode laser causes transscleral ciliary body destruction in a cadaver eye model and may have potential clinical usefulness.
[Ophthalmic Surg Lasers 1996;27:60-65.]
Accommodation and Iridotomy in the Pigment Dispersion Syndrome
Authors: Pavlin Charles J , Macken Peter , Trope Graham E , Harasiewicz Kasia , Foster F Stuart 
Published: April 2021

* BACKGROUND AND OBJECTIVE: Iris concavity has been noted in pigment dispersion syndrome, and could have a role in producing iris-zonule contact. Iris concavity is most likely caused by a relative increase in anterior chamber pressure. The method by which this occurs remains speculative. The authors used ultrasound biomicroscopy to examine the role of accommodation in producing iris concavity and to document changes that occur following iridotomy.
* PATIENTS AND METHODS: Thirteen patients with clinically diagnosed pigmentary dispersion and pigmentary glaucoma underwent accommodation studies while being continuously imaged with ultrasound biomicroscopy. Anterior chamber depths were measured and iris configuration noted on distance and near fixation. These studies were repeated in 6 patients following laser iridotomy.
* RESULTS: All patients showed a decrease in anterior chamber depth with accommodation. Ten patients had a planar iris configuration on distance fixation and 3 concave. Eleven of 13 patients showed increased concavity of the iris on near fixation as compared with distance fixation. Following iridotomy in 6 patients, the iris showed a planar configuration that remained unchanged on near fixation.
* CONCLUSION: Accommodation increases iris concavity in some patients with pigment dispersion syndrome. The most likely explanation is an accommodation-induced relative increase in anterior chamber pressure secondary to anterior movement of the lens surface. Iridotomy prevents change in the iris profile with accommodation.
[Ophthalmic Surg Lasers 1996;27:113-120.]
Foveal Color and Luminance Sensitivity Losses in Glaucoma
Authors: Kelly John P , Fourman Stuart M , Jindra Lawrence F 
Published: April 2021

* BACKGROUND AND OBJECTIVE: Losses in color vision sensitivity are noted in patients with glaucoma and these losses can occur before the onset of visual field defects in ocular hypertensive patients. The authors incorporate a technique that measures foveal luminance and isoluminant-color thresholds.
* PATIENTS AND METHODS: This study included 31 patients with glaucoma, 1 0 patients suspected of having glaucoma, and 67 control subjects. The testing conditions measured thresholds under identical spatial and temporal conditions. Individual differences in luminosity between colors were controlled by presenting 16 different ratios of the three phosphors on a color monitor.
* RESULTS: Relative to the control subjects, the patients with glaucoma showed a nonselective defect in both color and luminance sensitivity for red-green stimuli (P < .05), but a selective color defect for yellow-blue stimuli (P < .01). There were no statistically significant differences between patients suspected of having glaucoma and control subjects (P > .3).
* CONCLUSION: If the isoluminant-color stimuli are detected by foveal P-ganglion cells, then these results suggest that glaucoma leads to a generalized decrease in P-ganglion cell sensitivity that is more pronounced for cells with an input from cones sensitive to short wavelengths.
[Ophthalmic Surg Lasers 1996;27:179-187.]
Penetrating Keratoplasty With Donor and Recipient Corneas of the Same Diameter
Authors: Spadea Leopoldo , Bianco Guido , Mastrofini Maria Caterina , Balestrazzi Emilio 
Published: April 2021

* BACKGROUND AND OBJECTIVE: A retrospective study was conducted to investigate the effect of penetrating keratoplasty (PK) with donor and recipient corneas of equal diameter on astigmatism, corneal curvature, and spherical equivalent.
* PATIENTS AND METHODS: A total of 89 eyes of 86 consecutive patients who underwent PK with donor and recipient corneas of equal diameter were studied. The surgical techniques were performed using the Hanna suction punch block (endothelial cut) with the trephine system, and a single running 16-bÍte 10-0 nylon suture. Sixteen eyes underwent a triple procedure (PK, extracapsular cataract extraction, and intraocular lens [IOL] insertion) and 14 eyes underwent PK with sulcus fixation of a posterior chamber IOL. Follow-up ranged from 12 to 30 months (mean ± SD 17.5 ± 4.7). The sutures were removed at approximately 1 2 months postoperatively.
* RESULTS: The postoperative astigmatism ranged from 0.4 to 10.8 D (mean ± SD 4.5 ± 2.8), as evaluated by a computer-assisted videokeratograph topography unit. Twenty-seven eyes (30.3%) achieved a refractive error (spherical equivalent) within ±1.5 D of emmetropia. The mean postoperative refractive error (spherical equivalent) was -0.1 ± 3.5 D (range -6.75 to +7.25). No wound dehiscences or glaucoma was noted during the follow-up.
* CONCLUSION: The Hanna suction system creates a sharp, deep, and perpendicular cut on both button cornea and host cornea, making it possible to use donor and recipient corneas of the same diameter in PK with good clinical and refractive results, particularly for myopic (keratoconus) patients.
[Ophthalmic Surg Lasers 1996;27:425-430.]
Topical Cyclosporine and Glaucoma Drainage Implant Surgery in Rabbits
Authors: Park Ki Ho , Kim Dong Myung , Youn Dong Ho 
Published: April 2021

* BACKGROUND AND OBJECTIVE: To assess the effect of topical cyclosporine on the function of filtering blebs and fibroblast proliferation after glaucoma drainage implant surgery in rabbits.
* MATERIALS AND METHODS: Intraocular pressure, flow resistance through the implant capsule, and fibroblast density in the capsule were compared between 12 eyes that received implant surgery only (group A) and 1 1 eyes treated with topical 2% cyclosporine twice a day for 2 weeks after implant surgery (group B).
* RESULTS: There were significantly larger decreases in intraocular pressure at 1, 2, 4, and 8 weeks postoperatively in group B than in group A (n = 12, P < .05). Flow resistance was significantly lower in group B than in group A (n = 5, P < .05) at 8 weeks postoperatively. Fibroblast density was not significantly different between the two groups (n = 3, P> .05).
* CONCLUSION: These results suggest that topical 2% cyclosporine may enhance the effectiveness of glaucoma drainage implant surgery.
[Ophthalmic Surg Lasers 1996;27:452-458.]