bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Analysis of Intraocular Lens Exchange
Authors: Lyle W Andrew , Jin Jia-Chi 
Published: April 2021

ABSTRACT
We present an analysis of 101 eyes of 98 consecutive patients who underwent intraocular lens (IOL) exchange. The period of follow up ranged from 6 to 71 months (mean, 23 months). Bullous keratopathy was the leading (86.7%) indication for IOL exchange in 45 eyes that had combined penetrating keratoplasty (PKP) and IOL exchange (PKP group). Lens dislocation (36%) and incorrect power (25%) were the most frequent indications for IOL exchange without PKP (56 eyes) (NPKP group). A final visual acuity of 20/40 or better was achieved in 50.5% of the 101 eyes, with 88% having two lines of improvement or remaining within one line of the pre-exchange acuity. The geometric mean visual acuity was significantly improved, from 20/273 preoperatively to 20/125 postoperatively, in the PKP group (P < .001), and from 20/61 to 20/43 in the NPKP group (P = .001). The main reason for vision less than 20/200 in the 23 eyes in the PKP group was glaucoma (nine eyes) and bullous keratopathy (eight eyes). In the NPKP group, seven eyes (four due to cystoid macular edema, CME) had a visual acuity less than 20/200. Posterior chamber (PC) IOL implantation was associated with significantly better visual acuity than anterior chamber (AC) IOL implantation when performed at IOL exchange (P = .004). The most common complications encountered with IOL exchange were CME (17.8%), hyphema (15.8%), glaucoma (10.9%) and PC opacity (8.9%).
Peribulbar Anesthesia in Retinal Reattachment Surgery
Authors: Arora Ritu , Verma Lalit , Kumar Atul , Tewari H K , Khosla P K 
Published: April 2021

ABSTRACT
We prospectively evaluated the effectiveness of peribulbar anesthesia in retinal reattachment surgery. Of the 24 patients studied, 2 required retrobulbar supplementation during the latter part of the surgery. Our results show that peribulbar anesthesia can be effectively used for retinal reattachment surgery and probably should be the preferred form of local anesthesia for this surgery, since the eyes involved have a relatively high incidence of axial myopia and posterior staphyloma.
Nonabsorbable Suture Material in Cataract Surgery: A Comparison of Novafil and Nylon
Authors: Seeto Raymond , Ng Simon , McClellan Kathleen A , Billson Frank A 
Published: April 2021

ABSTRACT
We compared the performance of 10-0 Novafil (polybutester, Davis & Geek, American Cyanamid Company, New South Wales, Australia.) with that of 10-0 nylon (Alcon) in 60 patients undergoing extracapsular cataract extraction and implantation of a posterior chamber intraocular lens. A standard technique was used, and the incision was closed with interrupted sutures of either 10-0 Novafil or 10-0 nylon. Length of follow up ranged from 6 to 26 months (average, 15 months).
We assessed the intraoperative handling qualities of the suture materials, as well as their effect on wound healing and inflammation. We also compared the surgically-induced astigmatism in the two suture groups over the first 3 postoperative months and then in long-term follow up (average, 15 months). Sutures removed at long-term follow up were examined by scanning electron microscopy (SEM).
Both suture materials handled easily at operation and were well tolerated by all patients. There was no significantly different surgically-induced astigmatism in the two suture groups after 12 weeks (F = .962) or during longer follow up (P = .401). SEM confirmed more advanced biodegradation of nylon as compared with Novafil sutures after they had been in place an average of 18 months.
Extreme Deepening of the Anterior Chamber During Phacoemulsification
Authors: Zauberman H 
Published: April 2021

ABSTRACT
An unusual deepening of the anterior chamber during a phacoemulsification procedure was observed in 3 patients with cataracts: 1 with high myopia, 1 with a lens opacification following a vitrectomy procedure, and 1 with pseudoexfoliation syndrome. This deepening hindered emulsification of the nucleus in the posterior chamber. Early delivery of the nucleus from the capsular bag allowed phacoemulsification to proceed at the pupillary level. The "sinking" of the lens toward the vitreous cavity appears to be related to a lack of vitreous pressure due to liquefaction, or to loosening of the zonular support in the pseudoexfoliation syndrome.
Ciliated Respiratory-Like Epithelium Forming Cystic Conjunctival Lesions in a Patient With Stevens-Johnson Syndrome
Authors: Goodglick Todd A , Mertz Persila , Wolfley Darrell , Cavanagh H Dwight , Zimmerman Lorenz 
Published: April 2021

ABSTRACT
A woman with severe cicatricial conjunctival changes secondary to allopurinol-induced Stevens-Johnson syndrome developed bilateral palpebral conjunctival cysts. Pathologic examination of these lesions revealed respiratory-like pseudostratified ciliated epithelium in the walls of several cysts of one eye. To our knowledge, this is the first report of this phenomenon.
A Prospective, Randomized, Controlled Comparison of Retrobulbar and General Anesthesia for Strabismus Surgery
Authors: Cheng Kenneth P , Larson Christopher E , Biglan Albert W , D'Antonio Joyce A 
Published: April 2021

ABSTRACT
A prospective, randomized controlled study (n = 95) was conducted to compare the morbidity and length of hospital stay associated with retrobulbar neuromuscular blockade (LA) with that associated with general anesthesia (GA) for monocular strabismus surgery in adult patients. A scoring system was developed to assess postoperative nausea and vomiting, pain, level of consciousness, oral intake, and activity while in the hospital and for the first 3 postoperative days.
There was no significant difference in the postoperative nausea and vomiting associated with the two anesthetic techniques. Although patients receiving LA experienced less immediate postoperative discomfort (P < .01) and had greater levels of activity (P < .0001) while in the hospital, the discomfort and activity levels of the two groups were similar at home. The LA group was discharged from the hospital sooner (mean, 135 minutes vs 250 minutes; P < .001), allowing more efficient use of hospital resources. Both techniques provided excellent anesthesia for monocular strabismus surgery.
Indirect Ophthalmoscope Argon Laser Treatment of Retinoblastoma
Authors: Augsburger James J , Faulkner C Byron 
Published: April 2021

ABSTRACT
We describe our use of an indirect ophthalmoscope argon laser for the treatment of selected retinoblastomas. The essential aspect of the technique is the creation, using the "continuous" exposure setting, of a confluent white laser burn completely around the tumor base. This procedure results in the prompt regression of most tumors, although several sessions, 1 to 4 weeks apart, are usually necessary for all but the smallest lesions. This method of laser treatment is applicable to retinoblastoma tumors located anywhere in the ocular fund us, including ones adjacent to the ora serrata.
Fellow Eyes in Idiopathic Macular Hole Cases
Authors: Akiba Jun , Kakehashi Akihiro , Arzabe Carlos W , Trempe Clement L 
Published: April 2021

ABSTRACT
The fellow eyes in 84 cases of unilateral idiopathic macular hole were studied retrospectively to determine prognoses and risk factors for this disorder. On initial examination, 15 of 84 eyes (18%) had a macular cystic lesion group 1), 23 (27%) had a yellow spot in the fovea (group 2), and 46 (55%) had a normal macula (group 3). Of the 84 eyes, 58 (69%) had posterior vitreous attachment. During a mean follow up of 39 months, macular hole developed in 8 of 15 eyes (53%) in group 1, and in 6 of 23 eyes (26%) in group 2. However, a macular hole did not develop in eyes with posterior vitreous separation or a normal macula. Although the risk of developing a macular hole may have been overestimated in our study, posterior vitreous attachment and macular abnormalities may be important in predicting macular hole formation in the fellow eyes in idiopathic macular hole cases.
Corneal Surface After Deepithelialization Using a Sharp and a Dull Instrument
Authors: Campos Mauro , Hertzog Lars , Wang Xun Wei , Fasano Armand P , McDonnell Peter J 
Published: April 2021

ABSTRACT
Manual removal of the corneal epithelium currently precedes excimer laser photorefractive keratectomy. To assess the smoothness of the corneal surface following this procedure, six paired human eye-bank eyes (12 eyes) were manually deepithelialized using a blunt instrument (Paton spatula) on one eye and a sharp instrument (surgical blade) on the contralateral eye; all deepithelializations were done by the same surgeon. The 12 corneas were then resected and processed in an identical fashion for scanning electron microscopy. The microphotographs obtained showed that among the corneas deepithelialized with the blunt spatula, two had a smooth surface, and four had variable amounts of residual epithelial cells and basement membrane, confirmed by light microscopy. The surface of five corneas deepithelialized with the sharp instrument were slightly rougher than the former, with occasional linear scratches; one cornea retained a small amount of basement membrane. Removal of epithelium appears to be more complete when a sharp instrument is used. These findings may have clinical relevance, since residual epithelium and basement membrane after deepithelialization may influence the depth of ablation subsequently achieved with the excimer laser.
Practice Patterns of the Office-Based Ophthalmologist
Authors: Sastry Srinivas M , Chiang  , Javitt Jonathan C 
Published: April 2021

ABSTRACT
Practice patterns of office-based ophthalmologists were characterized using data collected from the National Ambulatory Medical Care Survey (NAMCS) of 1989, a national probability sample survey conducted by the National Center for Health Statistics. The sample includes office visits made between 1989 and 1990 to nonfederally-employed physicians primarily engaged in office-based practice. Over 38 million office-based patient visits documented in the NAMCS were analyzed. Fifty-two percent of patients (20.4 million) were over 65 years old; 90% (34.9 million) were white, with blacks and Asians accounting for 5% (1.9 million) and 3% (1.1 million) of visits, respectively.
The leading primary diagnoses and professional activity associated with the visits were cataract/cataract surgery 23% (8.9 million), disorders of refraction 19.5% (7.5 million), and glaucoma 13% (4.9 million). Over 40% (16.1 million) of visits were for visual dysfunction, abnormal appearance, or abnormal sensation. Nearly 33% (12.5 million) were related to either a diagnostic/screening session or some form of treatment. The duration of visits ranged from 6 to 10 minutes (22.9%), 11 to 15 minutes (29.8%), and 31 minutes or longer (6.7%); 74% (28.1 million) of the patients were asked to return for a follow-up visit at a specified time, and 13% to return if needed. The major sources of reimbursement for office visits were Medicare (41%, 15.6 million); Blue Cross/Blue Shield (13%, 5 million); and other commercial insurance (15.5%, 5.8 million).
Posterior Capsule Opacification in Extracapsular Cataract Extraction and the Triple Procedure: A Comparative Study
Authors: Dangel Matthew E , Kirkham Steven M , Phipps Michael J 
Published: April 2021

ABSTRACT
We retrospectively studied 330 consecutive cases, comparing the incidence of posterior capsule opacification after 279 extracapsular cataract extractions (ECCEs) or phacoemulsifications and posterior chamber intraocular lens (PC-IOL) insertions, with the incidence of opacification following 51 combined corneal transplantations, cataract extractions, and PC-IOL insertions (ie, triple procedures).
Opacification developed less frequently following the triple procedure than after cataract extraction alone (9.8% vs 36.2%, respectively; P < .001). Opacification also developed later following the triple procedure. The mean length of time before capsular opacification after cataract extraction alone was 24.3 months, while a mean of 45.6 months elapsed before opacification developed after the triple procedures (P < .05).
Delineation of the mechanisms contributing to these outcome differences may provide a means of reducing the incidence of or preventing posterior capsule opacification after cataract surgery.
Late Onset Endophthalmitis Associated With Filtering Blebs
Authors: Phillips William B , Wong Tien P , Bergren Robert L , Friedberg Mark A , Benson William E 
Published: April 2021

ABSTRACT
A consecutive series of 71 cases of late onset endophthalmitis (defined as onset of symptoms at least 2 weeks after surgery) were reviewed to determine the association of this entity with glaucoma surgery filtering blebs and to identify any predisposing factors. Sixteen cases were associated with filtering blebs and two with inadvertent blebs following cataract surgery. Onset of endophthalmitis ranged from 24 days to 20 years after surgery (mean, 6.9 years). Possible contributing factors included trauma, vitreous wicks, and bleb leak. Twelve cases were culture-positive, with 5 cases of Staphylococcus epidermidis; 2, Staphylococcus aureus; 4, Streptococcus; and 1, Pseudomonas. There were no cases of Hemophilus. The more virulent organisms were generally associated with a poor visual outcome. The organisms recovered in this series were similar to those found in postoperative endophthalmitis not associated with filtering blebs.
Surgical Wound Defects Associated With Endophthalmitis
Authors: Maxwell Donald P , Diamond James G , May Donald R 
Published: April 2021

ABSTRACT
Twenty-five consecutive cases of culture-proven postsurgical endophthalmitis were evaluated. Patients underwent wound revision and pars plana vitrectomy with intravitreal antibiotic and steroid infusion (gentamicin 8 µg/cc, clindamycin 9 µg/cc, dexamethasone 8 µg/cc) and injection (gentamicin 100 µg plus clindamycin 200 µg [and amphotericin 5 µg in one case] and dexamethasone 800 to 1000 µg). Twenty cases demonstrated wound defects (eg, wound gape/malapposition, abscess/tissue necrosis, suture dehiscence, leak, vitreous wick). Culture-proven isolates included both gram negative and positive bacteria and fungi. Visual acuity improved in 18 of the 20 (90%) gram positive cases. Ten of the 17 (59%) patients in the Staphylococcus epidermidis subgroup achieved a visual acuity of 20/50 or better. Surgical wound defects are frequently associated with culture-proven endophthalmitis. When vitrectomy is included as part of the treatment regimen, we recommend meticulous inspection and closure of any defective surgical wounds associated with endophthalmitis.
Vitreoretinal Toxicity of Acetazolamide Following Intravitreal Administration in the Rabbit Eye
Authors: Borhani Hesamodin , Rahimy Mohamad H , Peyman Gholam A 
Published: April 2021

ABSTRACT
Acetazolamide, a carbonic anhydrase inhibitor, has been shown effective in the treatment of cystoid macular edema; however, chronic use of the drug is limited by its serious systemic side effects. Intraocular administration can eliminate these systemic complications. We evaluated vitreoretinal toxicity after intravitreal injection of acetazolamide in the rabbit eye. The right eye of each rabbit received a single acetazolamide injection; the left eye received balanced salt solution and served as a control. The effect of the drug was evaluated by clinical observation, electroretinography, and histopathologic study. Intravitreal injection of up to 0.5 mg acetazolamide did not cause vitreoretinal toxicity. Injection of 1 mg or higher doses depressed the b-wave amplitude of electroretinograms and damaged the outer segments of the photoreceptors, as determined by light and electron microscopy.
Control of Eyelid Retraction Associated With Graves' Disease With Botulinum A Toxin
Authors: Biglan Albert W 
Published: April 2021

ABSTRACT
Two patients had satisfactory control of eyelid retraction associated with thyroid orbitopathy with repeated treatment of the levator palpebrae superioris muscle with botulinum A toxin. The effects of the toxin lasted for 3 to 4 months.
The Corneal Quilt: A Protective Device Designed to Reduce Intraoperative Retinal Phototoxicity
Authors: O'Brien Damien P B , Francis Ian C 
Published: April 2021

ABSTRACT
The corneal quilt is a simple, safe, inexpensive, and effective device designed to decrease the risk of intraoperative retinal phototoxicity from the operating microscope. Retinal injury is a well documented hazard, especially during prolonged procedures. The corneal quilt can be easily used as an adjunct to other methods designed to protect the retina from excessive incident light. In this study, we fashioned an approximately 6- × 5-millimeter semi-transparent corneal occluder from the nonadhesive portion of a 3M Steridrape. We determined spectrophotometrically that the corneal quilt reduced the transmission not only of visible light, but of ultraviolet and blue wavelengths as well, the wavelengths known to be the most phototoxic to the retina. However, no data were obtained actually demonstrating the degree to which light is scattered after transmission through the corneal quilt.
Indocyanine Green Dye-Enhanced Diode Laser Photocoagulation of Poorly Defined Subfoveal Choroidal Neovascularization
Authors: Reichel Elias , Puliafito Carmen A , Duker Jay S , Guyer David R 
Published: April 2021

ABSTRACT
Indocyanine green (ICG) is a dye with an absorption peak (795 to 810 nm) similar to the emission peak of the diode laser (805 nm). Therefore, ICG dye-enhanced diode laser photocoagulation may permit the selective ablation of ICG-retaining choroidal neovascular membranes (CNVM) with relative sparing of the neighboring neurosensory retina. Ten patients with poorly defined subfoveal CNVM were treated with ICG dye-enhanced diode laser photocoagulation and followed for an average of 15 months. One of the 10 patients experienced an immediate significant drop in visual acuity after photocoagulation. Obliteration of the CNVM at the site of laser photocoagulation was confirmed by fluorescein angiography and ICG angiography. Subfoveal chorioretinal scar formation was noted postoperatively in all 10 patients. At last follow up, 9 of these 10 patients had no more than a two-line increase or decrease in visual acuity. These preliminary results suggest that poorly defined subfoveal CNVM can be successfully treated by ICG dye-enhanced diode laser photocoagulation with minimal adverse affect on visual acuity in most cases.
Combined Peribulbar Injection and Blunt Cannula Infiltration for Vitreoretinal Surgery
Authors: Simcock Peter R , Raymond Grant L , Lavin Michael J , Whitley Christine L 
Published: April 2021

ABSTRACT
Seventy-six patients undergoing combined peribulbar and direct intraconal infiltration local anesthesia for vitreoretinal surgery were prospectively evaluated. Forty-six patients had local anesthesia with a combination of lidocaine 2% and bupivacaine 0.5%; in 30 patients, a combination of lidocaine 2% and prilocaine 1% was used. Patient evaluation of discomfort during the administration of the anesthetic and during the operation was assessed on a visual analog scale of 0 to 10. The mean pain score recorded was 2.73. There was no statistically significant difference between the mean pain scores of the two local anesthetic groups (P = .465).
Laser-Aided External Drainage of Subretinal Fluid: Prospective Randomized Comparison With Needle Drainage
Authors: Das Taraprasad P , Jalali Subhadra 
Published: April 2021

ABSTRACT
In a prospective randomized study of 50 consecutive eyes, we compared the safety and efficacy of draining subretinal fluid transchoroidally in primary scleral buckling for rhegmatogenous retinal detachment using a needle, with the safety and efficacy of the same procedure using an angulated endolaser probe set at 1 W for 0.2 seconds, using an average of 2.4 laser burns. There were no significant complications associated with the laser-aided drainage procedures (25 eyes). In the transchoroidal needle drainage procedures (25 eyes), subretinal hemorrhage occurred in three eyes and retinal incarceration in one. Thus, though our numbers are small, there appears to be some advantage of laser-assisted drainage in terms of a lower incidence of complications.
Cyclodialysis Cleft Following a Scleral Tunnel Incision
Authors: Maffett Mark J , O'Day Denis M 
Published: April 2021

ABSTRACT
We report a case of ocular hypotony secondary to a cyclodialysis cleft that developed following a phacoemulsification procedure in which a scierai tunnel incision was used. A cyclodialysis cleft should be suspected in cases of persistent postoperative hypotony.
Guidelines for Overseas Eye Surgery Expeditions Using Short-Term Volunteers
Authors: Brown Harry S , Brown Baillie R , Wessels Izak F 
Published: April 2021

ABSTRACT
Many developing countries face the overwhelming problem of addressing preventable and curable blindness. United States-based ophthalmologists can make important contributions in this regard by volunteering to teach and deliver eye care overseas. However, there are a number of potential risks and difficulties. Surgical Eye Expeditions (SEE) International has developed a logistical outline and planning checklist designed to minimize or avoid such problems. Critical components include a firm timetable, advanced planning, advance contact with a local ophthalmologist or organization, and a thorough understanding of the importance of adapting to the needs of other cultures. With a little planning, the average philanthropic ophthalmologist can make major contributions to individuals and communities in developing nations.
Nucleus Viscoexpression Compared With Other Techniques of Nucleus Removal in Extracapsular Cataract Extraction With Capsulorhexis
Authors: Bellucci Roberto , Morselli Simonetta , Pucci Vincenzo , Bonomi Luciano 
Published: April 2021

ABSTRACT
We compared three nucleus delivery procedures used during extracapsular cataract extraction (ECCE) after capsulorhexis in 142 eyes. In 25 eyes, the nucleus was expressed through a capsulorhexis 7 mm or wider. In 40 eyes, the nucleus was broken into two pieces and removed through a capsulorhexis 6 mm or less. In 77 eyes, viscoexpression was used to remove the nucleus from the capsular bag through a capsulorhexis 6 mm or less. Nucleus expression after a wide capsulorhexis was successful in 68% of the eyes in which it was attempted. Nucleus fragmentation was successful in 90%. Postoperative inflammation was high in both of these groups. Nucleus viscoexpression was successful in 93%, with low postoperative inflammation. Although it requires a 7- to 8millimeter corneoscleral incision, based on our study, viscoexpression would appear to be the best nuclear delivery technique when ECCE, rather than phacoemulsification, is being performed.
A Human Cadaver Eye Model for Anterior and Posterior Segment Laser Applications
Authors: Oram Osman , Gross Ronald L , Severin Todd D , Feldman Robert M , Orengo-Nania Silvia 
Published: April 2021

ABSTRACT
We have developed a cadaver eye model that allows anterior and posterior segment laser procedures to be performed under closely simulated in vivo conditions. The model consists of a reusable container with an artificial cornea with a refractive power and an anterior radius of curvature similar to those of the human cornea, and a fresh cadaver eye, prepared by removing the cornea and adjusting the biometrie parameters to normal values. This cadaver eye model appears to be a valuable tool for teaching and practicing anterior and posterior segment laser procedures, as well as for research on new laser systems and applications.