bluuebunny/crossref_metadata_2025_split huggingface dataset:
Superior Oblique Tuck Surgery in the Management of Superior Oblique Palsies/Superior Oblique Tuck Surgery in the Management of Superior Oblique Palsies: Discussion
Authors: Morris Robert J , Scott William E , Keech Ronald V 
Published: April 2021

ABSTRACT
Three hundred and twenty-four patients with superior oblique muscle palsies required surgery over a 15-year period. Forty-four patients underwent superior oblique tuck surgery. Fifteen patients had unilateral and six bilateral tucks alone. Seventeen had unilateral tucks and three bilateral tucks in conjunction with other extraocular muscle surgery. Three had unilateral tucks with a contralateral Harada-lto procedure. The best results were obtained with isolated superior oblique tucks and tucks in conjunction with a contralateral inferior rectus muscle recession or an ipsilateral inferior oblique muscle weakening procedure. The mean vertical correction following isolated, unilateral surgery was 3.6 prism diopters (range, 0 to 11 Δ) in primary gaze and 15.3 Δ (range, 0 to 40 Δ) in the field of maximum deviation. The mean eso correction in downgaze with bilateral superior oblique tucks was 1 5.2 Δ (range, 10 to 21 Δ). There was no statistically significant correlation between the size of the tuck and the amount of deviation corrected. Some degree of postoperative Brown syndrome was seen in all patients, but became less marked with time and in no patient was it severe enough to require reversal of the tuck. In only four patients was there a significant lessening of the effect of the procedure with time. The results show that the superior oblique tuck procedure is an effective operation. In patients with unilateral muscle palsies, 64.3% with an abnormal head posture, 37.5% with diplopia, and 100% with both an abnormal head posture and diplopia achieved an excellent result. In patients with bilateral muscle palsies, 50% with an abnormal head posture and 66% with both an abnormal head posture and diplopia achieved an excellent result. The incidence of complications is lower than previously reported: only two patients had symptomatic Brown syndrome and four had a reduction of the effect of the tuck with time.
An Alternative Approach to the Surgical Management of Exotropia-The Unilateral Lateral Rectus Recession
Authors: Nelson Leonard B , Bacal Darron A , Burke Miles J 
Published: April 2021

ABSTRACT
Fifty-five patients with moderate angle exotropia of 15 to 20 prism diopters were surgically treated with a unilateral lateral rectus recession of 7.0, 7.5, or 8.0 mm. The mean age at surgery was 14.5 years. The mean preoperative deviation was 18.0 Δ. The mean lateral rectus recession was 7.6 mm. At the initial postoperative follow up, all patients were either a small-angle exotropia or esotropia, or orthophoric. Twenty-eight of the 55 patients (51%) were orthophoric at their most recent follow up. Twenty-four patients (44%) were undercorrected, with 22 of these having residual exodeviations less than 8 Δ. Three patients (5%) were overcorrected.
Results of a Prospective Randomized Trial of Botulinum Toxin Therapy in Acute Unilateral Sixth Nerve Palsy
Authors: Lee John , Harris Sharon , Cohen Janine , Cooper Karen , MacEwen Caroline , Jones Stephen 
Published: April 2021

ABSTRACT
Forty-seven patients entered a prospective randomized trial to assess the effect of early botulinum neurotoxin A treatment to the ipsi lateral antagonist medial rectus on the ultimate recovery rate of acute unilateral sixth nerve palsy. Twenty-two patients received injections and 25 acted as controls.
The overall etiologies were microvascular (72.3%), unknown (17%), multiple sclerosis (6%), and one case each of central nervous system (CNS) sarcoidosis and basilar artery ectasia.
Eighty-three percent of the patients entered the trial within 2 weeks of the onset of symptoms and 95.7% within 3 weeks.
The controls had a final recovery rate of 20/25 (80%), and the injected group had a final recovery rate of 19/22 (86%). No serious side effects were encountered.
We conclude that there is no evidence for a prophylactic effect of botulinum toxin in the group that we have studied.
Traumatically Ruptured Globes in Children
Authors: Rudd Jay C , Jaeger Edward A , Freitag Suzanne K , Jeffers John B 
Published: April 2021

ABSTRACT
This retrospective study was designed to document the etiology of tra u metical Iy ruptured globes in children and to determine the prognostic value of several clinical parameters with respect to visual outcome. Forty-six children 16 years of age and under seen in the emergency room over a 2-year period were found to have full thickness penetration of the globe.
Fifty-nine percent of injuries occurred during recreational activities, and 59% occurred outside of the home. Boys outnumbered girls by a 6:1 ratio. For children, initial visual acuity proved to be less valuable as a prognostic indicator with regard to final vision than has been reported in adults. Smaller corneal wounds offered better visual outcomes. Four eyes were enucleated. Ten ruptures (22%) were related to activity involving guns. Four of six BB gun injuries were the result of a ricocheted BB. Visual outcomes in gun-related injuries were particularly poor.
Teaching Interpersonal Skills: A Model for Facilitating Optimal Interpersonal Relations
Authors: Topf Margaret , Dambacher Betty 
Published: April 2021

ABSTRACT
This article draws upon the results of a series of studies involving observations of interviews involving psychiatric patients and their friends, and between psychiatric patients and nurses. A twodimensional structure of interpersonal behavior is described. Three principles of effective interpersonal relations are detailed, including interpersonal complementarity, interpersonal versatility, and interpersonal influence. Research results that indicate how psychiatric patients have trouble exercising these principles are reported. A three-phased assessment, intervention, and reassessment approach to facilitating interpersonal skills in patients is detailed. A counselor-teacher approach to the treatment of psychiatric patients is recommended.
Dialectical Behavior Therapy for Patients With Borderline Personality Disorder
Authors: Alper Gretchen , Peterson Sandra J 
Published: April 2021

ABSTRACT
This study examined the effectiveness of dialectical behavior therapy (DBT) in the treatment of people diagnosed with borderline personality disorder (BPD). The frequency of self-injurious behaviors of 15 women hospitalized on a DBT unit was traced over a 4-week period. Data on selfinjurious behaviors and the use of the DBT approach were collected from a review of incident reports and patients' charts. The self-injurious behaviors decreased by almost 50%.
In addition, four RNs, who were involved on the DBT unit both before and after the institution of the treatment approach, were interviewed. Semi-structured interviews were conducted to determine the nurses' perceptions of the effectiveness of DBT. Their responses were uniformly positive. The most commonly occurring phrase was "it works."
Role of the Corneal Epithelium in Refractive Changes Following Laser in situ Keratomileusis for High Myopia
Authors: Spadea Leopoldo , Fasciani Romina , Necozione Stefano , Balestrazzi Emilio 
Published: April 2021

ABSTRACT
PURPOSE: Epithelial hyperplasia is one of the factors that plays a role in myopic regression after photorefractive keratectomy (PRK). We evaluated the role of the epithelium following excimer laser in situ keratomileusis (LASIK) performed on highly myopic eyes.
METHODS: Fifty eyes of 32 patients (18 females and 14 males; mean age, 31.7 ± 6.5 years) were treated with LASIK for myopia with an attempted correction ranging between -8.50 and -12.25 D (mean, -10.48 ± 1.43 D). No sutures were placed. The thickness of the central epithelium was evaluated either with a 50-MHz ultrasonic pachymeter or an ultrasound biomicroscope. Postoperatively, topical corticosteroid drops were administered for at least 1 month.
RESULTS: Follow-up was at least 12 months. Epithelium measurements were thicker compared to preoperative measurements from the first week postoperatively (mean, +1.9 µm, +2.77%; P<.05). Epithelial thickness peaked at the third month after LASIK (mean, +6.5 /im, +9.5%; P<05) and remained stable through 12 months. A negative correlation between epithelium thickness and manifest refraction from the first month postoperatively to the end of follow-up was present.
CONCLUSION: The epithelium seemed to have a role in the regression of refractive effect after LASDX to correct high myopia. [J Refract Surg 2000;16:133-139]
Laser in situ Keratomileusis for Recurrent Hyperopia Following Laser Thermal Keratoplasty
Authors: Attia Walid , Pérez-Santonja Juan J , Alió Jorge L 
Published: April 2021

ABSTRACT
PURPOSE: Laser thermal keratoplasty (LTK) has its main indication in the correction of hyperopia. However, regression of refractive effect following LTK is a limitation. Laser in situ keratomileusis (LASDK) may provide a good alternative to correct residual refractive errors.
METHODS: Fifty hyperopic eyes with varying amounts of regression after LTK underwent LASIK. The Chiron Automated Corneal Shaper microkeratome was used to make a flap of 160 /im and laser ablation was performed with the Technolas 217 Pianoscan excimer laser. Postoperative follow-up was 6 months.
RESULTS: Mean spherical equivalent refraction improved from +2.92 ± 1.60 D to +0.36 ± 1.48 D. Mean best spectacle-corrected visual acuity changed from 0.78 ± 0.14 before LASHi to 0.76 ± 0.16 D 6 months after LASHi. Mean uncorrected visual acuity changed from 0.37 ± 0.16 to 0.66 ± 0.24. Fortytwo percent (21 eyes) were within ±0.50 D of intended correction, 60% (30 eyes) were within ±1.00 D, and 76% (38 eyes) were within ±2.00 D. After LASHi, confluent haze between previous LTK spots was observed in most eyes, as LASHi ablation took place at the sites of the LTK spots.
CONCLUSIONS: LASHi after LTK is a good alternative for hyperopic regression. Predictability and efficacy are less than with primary LASIK for hyperopia, but the procedure is equally safe. [J Refract Surg 2000;16:163-169]
Laser in situ Keratomileusis Flap Complications and Management
Authors: Gimbel Howard V , Peters N Timothy , Iskander Nader G , Penno Ellen Anderson 
Published: April 2021

ABSTRACT
PURPOSE: To provide detailed descriptions of intraoperative and postoperative flap complications independent of the microkeratome. Management of these complications is discussed.
METHODS: Complications have been assimilated and categorized based on our past experiences and those of others. Methods for managing these complications are discussed.
RESULTS: Positive results were considered to be successful resolution of the flap complication, which typically occurs in the majority of cases.
CONCLUSION: LASDX is a technically difficult surgical procedure with unique complications. Excellent flap management both intraoperatively and postoperatively is essential to maximize visual outcome. Some flap complications are easily managed and others require immediate expert surgical intervention to preserve good visual outcomes. [J Refract Surg 2000;16(suppl):S223-S225]
Customized Corneal Ablation and Super Vision
Authors: MacRae Scott M , Schwiegerling James , Snyder Robert 
Published: April 2021

ABSTRACT
PURPOSE: To review the early development of new technologies that are becoming available through customized corneal ablation techniques.
METHODS: The authors describe the early development of two diagnostic methods to perform customized corneal ablation as well as a variety of new treatment modalities in development.
RESULTS and CONCLUSION: Results using the wavefront sensors indicate that these techniques have the potential to be more sensitive than traditional refraction and keratometry. Subtle defects such as coma and spherical aberration can be detected and treated. A whole series of new technologies are being incorporated to treat patients with customized corneal ablation. [J Refract Surg 2000;16(suppl):S230-S235]
Intacs After Laser in situ Keratomileusis: A Preliminary Report
Authors: Durrie Daniel S , Vande Garde Trent L 
Published: April 2021

ABSTRACT
PURPOSE: To assess the corneal topographic and refractive results and feasibility of placing Intacs in eyes with a history of previous laser in situ keratomileusis (LASIK) surgery.
METHODS: This was a prospective study on 25 eyes with residual myopia between -0.75 and -3.00 D. Residual myopia in these patients was secondary to regression or planned undercorrection due to preoperative thin corneas.
RESULTS: Main outcome measures included uncorrected visual acuity, preservation of best spectacle-corrected visual acuity, refractive predictability, corneal topographic changes, and evaluation of surgical complications.
CONCLUSIONS: Initial Intacs procedures after previous LASIK were performed uneventfully. In addition to correcting residual myopia, these procedures may improve night vision symptoms in some patients. These cases may improve our understanding of the ideal corneal shape. [J Refract Surg 2000;1 6(suppl):S236-S238]
Visual Outcome in High Myopia After Laser in situ Keratomileusis
Authors: Moniz Noel , Fernandes Tony , Narayanan Kutty K , Sreedhar Ani 
Published: April 2021

ABSTRACT
PURPOSE: The aim of the study was to study the results of LaAIK for myopia over -12.00 D.
METHODS: Surgery was done using Hansatome microkeratome and Nidek EC-5000 excimer laser. One hundred forty-five eyes were followed for a minimum of 6 months to assess the extent of correction and the gain or loss of lines as compared of previous spectacle correction.
RESULTS: Forty percent of eyes gained at least one line, 56% remained the same, and 4% lost one line of visual acuity. Thirty-five eyes were undercorrected with the majority between 0 and -5.00 D. One hundred ten eyes achieved their preoperative best spectacle-corrected visual acuity with no correction. Complications were minimal.
CONCLUSION: LASIK with the Nidek EC-5000 excimer laser achieved good results in eyes with myopia over -12.00 D. [J Refract Surg 2000; 16(suppl):S247-S250]
Intrastromal Corneal Ring Segments In a Patient With Previous Laser in situ Keratomileusis
Authors: Fleming Joseph F , Lovisolo Carlo F 
Published: April 2021

ABSTRACT
PURPOSE: Intrastromal corneal ring segments (ICRS; Intacs) were inserted in a patient with residual myopia of -3.375 D (spherical equivalent) 10 months after laser in situ keratomileusis (LASIK).
METHODS: A standard intrastromal corneal ring segment implantation technique was used with the addition of intraoperative ultrasonic pachymetry in 4 quadrants at the 7-mm zone to insure adequate stromal thickness for segment insertion.
RESULTS: Four months after ICRS surgery and 14 months after LASIK, the patient had uncorrected visual acuity of 20/20 and a cycloplegic refraction of piano -1.00 ? 23°.
CONCLUSION: Implantation of intrastromal corneal ring segments in an eye with previous LASIK resulted in additional corneal flattening with a decrease in residual myopia and improved uncorrected visual acuity. [J Refract Surg 2000;16:365-367]
Postoperative Inflammation, Microbial Complications, and Wound Healing Following Laser in situ Keratomileusis
Authors: Alió Jorge L , Pérez-Santonja Juan J , Tervo Timo , Tabbara Khalid F , Vesaluoma Minna , Smith Ronald J , Maddox Bobby , Maloney Robert K 
Published: April 2021

ABSTRACT
Although the biology of corneal wound healing is only partly understood, healing after photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) differs in many respects, and the mechanisms appear to be differently controlled. There is less of an inflammatory and healing response after LASIK, but a longer period of sensory denervation. The cellular, molecular, and neural regulatory phenomena associated with postoperative inflammation and wound healing are likely to be involved in the adverse effects after LASIK, such as flap melt, epithelial ingrowth, and regression. Interface opacities in the early postoperative period include diffuse lamellar keratitis (DLK), microbial keratitis, epithelial cells, and interface opacities. Diffuse lamellar keratitis (sands of the Sahara syndrome) describes an apparently noninfectious diffuse interface inflammation after lamellar corneal surgery probably caused by an allergic or a toxic inflammatory reaction. Noninfectious keratitis must be distinguished from microbial keratitis to avoid aggressive management and treatment with antimicrobial drugs. Microbial keratitis is a serious complication after LASIK, but a good visual outcome can be achieved following prompt and appropriate treatment. [J Refract Surg 2000; 16: 523-5381
Visual Benefit of Correcting Higher Order Aberrations of the Eye
Authors: Williams David , Yoon Geun-Young , Porter Jason , Guirao Antonio , Hofer Heidi , Cox Ian 
Published: April 2021

ABSTRACT
There is currently considerable debate concerning the visual impact of correcting the higher order aberrations of the eye. We describe new measurements of a large population of human eyes and compute the visual benefit of correcting higher order aberrations. We also describe the increase in contrast sensitivity when higher order aberrations are corrected with an adaptive optics system. All these results suggest that many, though not all, observers with normal vision would receive worthwhile improvements in spatial vision from customized vision correction, at least over a range of viewing distances and particularly when the pupils are large. Keratoconic patients or patients suffering from spherical aberration as a result of laser refractive surgery as it is presently performed would especially benefit. These results encourage the development of methods to correct higher order aberrations. [J Refract Surg 2000;16:S554-S559]
A Quick Method for Analyzing Hartmann-Shack Patterns: Application to Refractive Surgery
Authors: Haman Habib 
Published: April 2021

ABSTRACT
A quick method to analyze the Hartmann-Shack pattern was developed. This method allows us to study the limitations of the system and to determine how to improve its capacity to measure a large range of aberration. It can treat situations presenting difficulty when analyzing a detected pattern. An application to eyes with large amounts of aberration due to corneal surgery is considered. [J Refract Surg 2000;16:S636-S642]
Determining the Accuracy of an Eye Tracking System for Laser Refractive Surgery
Authors: Taylor Natalie M , Eikelboom Robert H , van Sarloos Paul P , Reid Philip G 
Published: April 2021

ABSTRACT
PURPOSE: Patient eye and head movements during laser refractive surgery may result in errors between the surgical beam position and the desired location for optimum correction. This, in turn, may lead to reduced postoperative vision, including increased higher order aberrations of the eye. Active eye tracking systems are often incorporated into laser delivery systems, which aim to reduce the effect of patient eye movement.
METHODS: In this study, the accuracy of an eye tracking system designed for laser refractive surgery was determined. An enucleated porcine eye was attached to a scanning device and the movement measured using the eye tracking system. The recorded position is compared to the preprogrammed position of the scanning device.
RESULTS: The system demonstrated an accuracy of 0.06 m for an intact cornea and 0.1 mm for a cornea with a thin flap removed. This compares to an average decentration of ablation of 0.4 mm for patients relying on passive fixation, as measured by previous clinical trials.
CONCLUSION: implementation of this eye tracker would lead to improved alignment between the laser and eye during laser refractive surgery. [J Refract Surg 2000;16:S643-S6461
Longitudinal Evaluation of Optical Aberrations Following Laser in situ Keratomileusis Surgery
Authors: Hong Xin , Thibos Larry N 
Published: April 2021

ABSTRACT
Objective measurements of the optical aberrations of an eye were taken with a Shack-Hartmann aberrometer immediately before, immediately after, and at regular intervals over a two month recovery period following LASIK refractive surgery. Results indicate that the surgery induced large amounts of positive spherical aberration which regressed slightly during recovery. Computed point-spread functions for various pupil diameters indicate that retinal image quality was the same before and after surgery for small and medium sized pupils (<4 mm diameter) but was significantly degraded for large pupils (>4 mm). [J Refract Surg 2000;16:S647-S650]
Reference Axis Selection: Subcommittee Report of the OSA Working Group to Establish Standards for Measurement and Reporting of Optical Aberrations of the Eye
Authors: Applegate Raymond A , Thibos Larry N , Bradley Arthur , Marcos Susana , Roorda Austin , Salmon Thomas O , Atchison David A 
Published: April 2021

ABSTRACT
It is the committee's recommendation that the ophthalmic community use the line of sight as the reference axis for the purposes of calculating and measuring the ocular optical aberrations. [J Refract Surg 2000;16:S656-S658]
Immunohistochemical Study of Subepithelial Haze After Phototherapeutic Keratectomy
Authors: Lee Yuan-Chieh , Wang I-Jong , Hu Fung-Rong , Kao Winston W-Y 
Published: April 2021

ABSTRACT
PURPOSE: Subepithelial haze is a frequent complication and is often the cause of regression after photorefractive keratectomy (PRK). The lack of understanding of this undesirable complication following PRK is in part due to the limited availability of suitable tissues for pathological studies.
METHODS: We examined the expression of various extracellular components in the cornea of a 46-year-old man who underwent phototherapeutic keratectomy (PTK) to remove a central corneal scar secondary to trauma. The patient subsequently underwent penetrating keratoplasty. A scar-free region containing an area of slight subepithelial haze adjacent to normal cornea was used for immunohistochemical staining with antibodies directed against cytoskeletal proteins, ie, vimentin, desmin and smooth muscle actin, and the extracellular components, laminin, heparan sulfate, keratan sulfate, and collagen types III, IV, V, and VII.
RESULTS: Immunohistochemistry revealed that basal epithelial cells expressed components of basement membrane. The stromal fibroblasts within the haze tissue were labeled by anti-smooth muscle actin antibodies, a characteristic of myofibroblasts, which synthesized and secreted extracellular matrix components that contributed to the formation of the disorganized collagenous matrix and may account for subepithelial haze.
CONCLUSIONS: The expression patterns for the cytoskeletal proteins and extracellular components indicated that the formation of subepithelial haze is a process of tissue remodeling, involving both corneal basal epithelial cells and keratocytes during wound repair. [J Refract Surg 2001;17:334-341]
Surgery in an Attempt to Change Corneal Curvature
Authors: Szuniewicz Waclaw , Fasanella R M 
Published: April 2021

SUMMARY
An historical review up to 1952 of surgical methods intended to change the refractive power of the eye is given.
Experimental work at Yale utilizing 49 rabbits and dogs includes repeated prior studies done by others. This work incorporated:
1. Procedures on the anterior surface of the cornea,
2. Procedures on the posterior surface of the cornea, and
3. Procedures through all corneal layers (total segmented corneal resection) (SCR).
In obtaining desired refractive changes, SCR created relatively higher refractive changes, assured stability and a more accurate calibration and calculation in advance of surgical procedures. However, even though total segmented corneal resection seemed superior, it was often complicated in animals.