bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proper Positioning of the Plume Evacuator in the VISX Star3 Excimer Laser Minimizes Central Island Formation in Patients Undergoing Laser in situ Keratomileusis
Authors: Cua Irwin Y , Pepose Jay S 
Published: April 2021

ABSTRACT
PURPOSE: To identify risk factors in a series of patients who developed steep central islands after laser in situ keratomileusis (LASIK).
METHODS: We analyzed and compared the refractive and topographic outcome of a study group composed of 83 eyes of 44 patients who underwent LASIK using the VISX Star3 excimer laser with a refraction-matched control group of 83 eyes treated later. The vacuum aspirator of the excimer laser was abnormally positioned during the surgeries performed in the study group.
RESULTS: Mean preoperative spherical equivalent refraction in the study group was -6.75 ± 2.50 D. Four eyes with a mean preoperative spherical equivalent refraction of -9.27 ± 2.29 D developed steep central islands. Thirty-three (38%) of 83 eyes treated needed retreatment for residual myopia or myopic astigmatism. In the control group, mean preoperative spherical equivalent refraction was -6.76 ± 2.50 D. Ninety-three percent of eyes were within ±1.00 D of target refraction. Five (6.02%) of 83 eyes required retreatment and no eyes developed central islands.
CONCLUSION: The abnormally positioned vacuum aspirator coupled with the higher preoperative refractive correction were the likely causative factors for central island formation and the increased incidence of undercorrection in these patients. [J Refract Surg 2003;19:309-315]
Fungal Keratitis After Photorefractive Keratectomy: Delayed Diagnosis and Treatment in a Co-managed Setting
Authors: Periman Laura M , Harrison Devin A , Kim Jeehee 
Published: April 2021

ABSTRACT
PURPOSE: To report a ease of fungal keratitis following photorefractive keratectomy (PRK) in a co-managed setting.
METHODS: A 35-year-old man with a preoperative refraction of -13.00 +3.75 x 18° OD, and -12.50 +2.50 x 70° OS underwent bilateral simultaneous PRK. On postoperative day 16, the patient presented with complaints of decreased vision and foreign body sensation. Examination by the co-managing optometrist revealed a visual acuity of 20/200, and a central corneal ulcer. Cultures were not taken and the patient was started on topical ofloxacin and prednisolone acetate 1% every hour. The patient was instructed to follow-up with another optometrist closer to the patient's home Tobradex (tobramycin 0.3% combined with dexamethasone 0.1%) was added to the treatment regimen on postoperative day 23, but the ulcer continued to worsen. The patient was then referred to an ophthalmologist where corneal cultures were performed, but came back negative.
RESULTS: Despite treatment with fortified antibiotics, the ulcer perforated, requiring penetrating keratoplasty. Bacterial and fungal cultures were negative. Pathology examination of the specimen revealed fungal hyphae.
CONCLUSIONS: Although co-management of refractive patients may be a common practice, it is not without risks. In this case, delayed diagnosis and inappropriate treatment resulted in a poor final outcome. [J Refract Surg 2003;19:364-366]
Vasodilation and the Etiology of Diabetic Retinopathy: A New Model
Authors: Wolbarsht M L , Landers M B , Stefansson E 
Published: April 2021

SUMMARY
The evidence in support of the theory that retinal vascular stretching leads to leakage, formation of microaneurysms, and neovascularization is reviewed. The efficacy of photocoagulation and vitrectomy in controlling retinal microangiopathy accompanying diabetes is shown to depend upon reduction of the vascular dilatation. It is possible that the vascular dilatation in diabetes results from high blood glucose levels increasing oxygen consumption in the inner retina, with a resulting vascular dilatation to supply increased oxygen to the retina. This retinal vascular dilatation is the initial cause of the vascular pathology in diabetes.
Orbital Cysts Following Enucleation: The Use of Absolute Alcohol
Authors: Hornblass Albert , Bosniak Stephen 
Published: April 2021

SUMMARY
Orbital cysts are a serious, disfiguring complication of enucleation surgery. We have presented four cases of orbital cysts, summarized their management, and reviewed the literature. Two were treated by surgical excision and two with alcohol injection. All were cured; therefore, alcohol injection is an effective alternative to surgery.
Cosmetic Eye Modified to Retain Vision
Authors: Wesley Ralph E , Cotton Angela 
Published: April 2021

SUMMARY
A patient with bilateral ocular injuries with hypotony and light perception vision was fitted with scleral shells modified to allow light to pass through the central 4-mm area. This modification, allowing the patient to retain light perception with the prosthesis in place, aided in the rehabilitation of this patient by encouraging his independent ambulation, providing clues to time, place, and direction, and offering an enhanced cosmetic effect.
A System for Slit-Lamp Polaroid Photography
Authors: Miller David , Taube John , Miller Roger , Gleason William , Babyn Paul , Moon Jon , Weiss Jeffrey N 
Published: April 2021

SUMMARY
A system is described in which a SX-70, Alpha Model II, Polaroid, single lens reflex camera, and photoflash unit can be quickly and sturdily mounted to a slit lamp.
Such a system can take sharp anterior segment prints of the eye at all slit-lamp magnifications, with white light and in the flourescein mode.
The heart of the unit is the modification of an assembly initially designed to attach the camera to a light microscope. The small flash unit and power supply were designed specifically for slit lamp usage.
Examples of "instant" photos of the anterior segment at different magnifications are presented.
Vitreous Wick Syndrome Following a Corneal Relaxing Incision
Authors: Stainer Gregory A , Binder Perry S 
Published: April 2021

SUMMARY
A 55-year-old white female underwent a 7.5 mm penetrating keratoplasty for stromal scarring secondary to herpex simplex keratitis. Postoperatively, stromal vascularization and a prolonged graft rejection forced premature suture removal and a prolonged course of topical and systemic glucocorticoids. A mild anterior wound gape spontaneously closed with reduction of steroid therapy. Eighteen months after the original surgery, the patient underwent a relaxing corneal incision to correct 12 diopters of corneal astigmatism. During an inferior incision a small microperforation was noted and the procedure was terminated. Eleven days after the relaxing incision, the patient returned with a "vitreous wick" syndrome through the superior incision. The wound dehiscence and vitreous wick were repaired without incident and the astigmatism was reduced to 7 diopters. Incisions more than 3/4 depth in aphakic patients.or in patients who have required intense steroid therapy should be monitored closely for several days after surgery for microperforations or a wound dehiscence which may lead to a "vitreous wick" syndrome.
Anterior Segment Biopsy Using Vitreous Surgical Instruments
Authors: Slusher M Madison 
Published: April 2021

SUMMARY
An unusual pupillary membrane was removed using closed microsurgical techniques and vitreous instruments. The recent development of automated intraocular scissors, as an addition to vitreous surgical instruments, provided the means of membrane biopsy and the establishment of the rare diagnosis of stromalization of the anterior chamber. The introduction of this concept and technical capability into the management of this and related cases suggests a means of obtaining certain types of intraocular tissue for pathological study en bloc.
Blue Field Entoptoscopy and VER in Preoperative Cataract Evaluation
Authors: Skalka Harold W 
Published: April 2021

SUMMARY
Blue field entoptoscopy (BFE) has been described as an effective method for evaluating macular function in patients with dense cataracts. We evaluated 150 preoperative cataract patients with BFE, and found the commercially-available instrument (MIRA BFE 100) to be accurate in patients with 20/400 or better preoperative acuity. There was a high percentage of false negative BFE results in patients with dense cataracts, and light flash VER testing was found to correlate better with attainable postoperative acuity in these patients.
The Results of 1000 Intracapsular Cataract Extractions with the Suture-Fixated Medallion Lens Implant
Authors: Kaufer Gunther 
Published: April 2021

SUMMARY
One thousand intracapsular medallion implants, performed between August 1975 and July 1980, were anlayzed for complications (minimum follow-up 6 months): cystoid macular edema, 6.5%; retinal detachment, 2.8%; corneal edema, 0.9%; aphakic glaucoma, 2.5%; suture failure, 9%; implant subluxation, 3.7%; implant dislocation, 2%; and implant removal, 0.6%. Visual acuity of 20/40 or better was achieved in 93.4% of the cases, excluding non-implant related causes of low visual acuity.
Surgical Management of Black Ball Hyphema with Sodium Hyaluronate
Authors: Sholiton David B , Solomon O David 
Published: April 2021

SUMMARY
A surgical technique for removing black ball hyphema in a Pseudophakic patient is described. Three days after a total postoperative hyphema developed, a solution of sodium hyaluronate, Healon, was injected into the anterior chamber through a 160° limbal cataract incision. Healon dissected the clotted blood off the underlying iris and intraocular lens, maintained the anterior chamber, and expressed the clot in toto out of the eye. Postoperatively the patient had no further bleeding, the intraocular pressure remained normal, the pseudophakos remained clear and well positioned, and the cornea remained clear.
Near Disasters with the Operating Microscope and A Solution
Authors: Marchese Anthony L , Olijnyk Irene , Kelertas Algimantas , Daily Mark J , McDonald James E 
Published: April 2021

SUMMARY
We report the sudden separation of two different Zeiss OPMI6 operating microscopes from their attaching brackets. This was the result of the failure of the three safety features which normally provide security. We, in turn, have designed and made a safety belt which will restrain the microscope in case it falls.
The Natural and Modified Course of Post-Cataract Astigmatism
Authors: Stainer Gregory A , Binder Perry S , Parker William T , Perl Theodore 
Published: April 2021

SUMMARY
We performed sequential central keratometry on 52 cataract patients for six months. We found no statistically significant difference in the induced postoperative astigmatism between wound closure with interrupted and double shoelace running closure with 1 0-0 monofilament nylon. In 31 patients, the postoperative astigmatism was a !ways with-therule. In 21 patients who underwent wound closure with 8-0 polyglactin suture, we documented a postoperative shift in induced astigmatism from with- to against-the-rule which took place between the fourth and fifth postoperative week. Based on our present study of the natural and modified course of post-cataract astigmatism and based upon previous research, we feel the cataract surgeon now has the appropriate means to reduce and/or control post-cataract astigmatism.
Wills Eye Hospital Residents' Intraocular Lens Experience
Authors: Wong Michael Y , Kline Oram R 
Published: April 2021

SUMMARY
Intraocular lens (IOL) operations performed by Wills Eye Hospital residents over a three-year period were reviewed retrospectively. The growing numbers of implants performed, the trends in methods of cataract extraction, the trends in types of intraocular lenses, and the relative safety of the procedure were examined. The estimate for the total number of intraocular lenses implanted by Wills Eye Hospital residents this past year was 600, or 60 per senior resident, and the percent of patients seeing 6/12 or better was 93.2%.
There has been a great increase in the number of intraocular lenses implanted by residents at Wills Eye Hospital, with planned extracapsular cataract extractions and posterior chamber lenses currently favored. This analysis documents a very high visual success rate and acceptably low complication rate in closely supervised residents' surgery.
A Model for the Pathogenesis of Retrolental Fibroplasia Based on the Metabolic Control of Blood Vessel Development
Authors: Weiter John J , Zuckerman Ralph , Schepens Charles L 
Published: April 2021

SUMMARY
We postulate that the pathogenesis of retrolental fibroplasia (RLF) is related to the disruption of the normally coordinated ocular development and maturation in which there is an interplay between function, metabolism, and blood vessel development. The normal retina is avascular until the fourth month of gestation, at which time vascularization proceeds from the optic disk towards the peripheral retina. Until this time, the underlying choroidal circulation provides for full-thickness retinal oxygenation. We hypothesize that the centrifugal maturation of the retina, including the retinal photoreceptors (the major oxygen-consuming cell type of the adult retina), precedes this vascular outgrowth. The maturation of the photoreceptors and the concomitant increased oxygen consumption would make it impossible for the choroid to provide adequate full-thickness retinal oxygenation. The resulting progressive change in the inner retinal metabolism thus provides an orderly, controlled stimulus for the subsequent progression of retinal vascularization from the optic disk to the peripheral retina. Exposure of the premature neonate to abnormal oxygen levels would selectively retard inner retinal blood vessel development while the photoreceptors continue to mature and increase their oxygen consumption. Thus, when the infant is removed from abnormal oxygen, a neovascular proliferative stimulus will develop in direct relation to the mass of non-vascularized but metabolically active retina, initiating uncoordinated vessel growth in the inner retina.
Recurrent Angle Closure Glaucoma Following A Patent 75-Micron Laser Iridotomy: A Case Report
Authors: Brainard Jay O , Landers James H , Shock John P 
Published: April 2021

SUMMARY
Laser iridotomy is becoming increasingly popularasan effective alternative therapyto surgical iridectomy; however, we report a case of recurrent angle closure glaucoma following laser treatment that produced a patent iridotomy. Possible mechanisms for the failure and its implications are discussed.
Formation of Proteinaceous Capsules on Plastic Lens Implants-By Mouse Macrophages Under Tissue Culture Conditions
Authors: Wolter J Reimer , Kunkel Steven L 
Published: April 2021

SUMMARY
Formation of continuous proteinaceous capsule-like layers is demonstrated in tissue culture on plastic lens implants as part of cellular membranes created by mouse macrophages after 48, 56, and 96 hours of incubation. The capsules resemble similar formations seen on lens implants removed from human eyes and their existence is considered part of a clinically beneficial adaptation of man-made materials to the inner eye.
Cellular Membranes on Glass Lens Implants-Formed in Tissue Culture by Mouse Macrophages
Authors: Wolter J Reimer , Kunkel Steven L 
Published: April 2021

SUMMARY
Intraocular lens implants made of glass were exposed to a suspension of mouse macrophages in tissue culture for 48 and 96 hours. After 48 hours the macrophages had formed a dense cellular membrane on the glass surface and some of them had changed into fibroblast-like cells, epithelioid cells, and early stages of giant cells. After 96 hours a firm and continuous proteinaceous capsule had formed on the glass in the interspaces between the cells. The membranes on glass implants were more cellular and more firmly adherent than those seen on plastic implants under the same conditions.
Retinopathy of Prematurity: A New Look at an Old Disease
Authors: Wolbarsht M L , George G S , Shearin W A , Kylstra J A , Landers M B 
Published: April 2021

SUMMARY
The neovascular changes of the retinopathy of prematurity can occur in premature infants in three settings: (1) when high levels of supplemental oxygen are administered, neovascularization usually commences shortly after cessation of oxygen therapy; (2) when supplemental oxygen is given for long periods of time, neovascularization can develop while the infant is still receiving oxygen; and (3) neovascularization can occur without exposure to any supplemental oxygen. We propose a model which can explain the occurrence of the retinopathy of prematurity in all these settings.
Our model demonstrates that whenever the retinopathy of prematurity occurs, arterial oxygen levels are inappropriately high in relation to the stage of retinal vessel development, even in premature neonates not given supplemental oxygen. The inhibitory effect of these elevated oxygen tensions upon carbon dioxide removal is indicated as a possible cause of neovascularization by leading to tissue acidosis and vasodilatation.
Acute Glaucoma Following Nd:YAG Laser Membranotomy
Authors: Shrader C Eric , Belcher C Davis , Thomas John V , Simmons Richard J 
Published: April 2021

SUMMARY
A 65-year-old aphake with a functioning filtration bleb underwent neodymiumiYAG laser membranotomy. Shortly thereafter, he acutely developed pain, nausea, and visual blur with an intraocular pressure of 42 mm Hg. The mechanism of the acute glaucoma is believed to be occlusion of the fistula by herniated vitreous.
The Treatment of Necrotizing Scleritis with an Autogenous Periosteal Graft
Authors: Koenig Steven B , Kaufman Herbert E 
Published: April 2021

SUMMARY
We used autogenous periosteum to reinforce scierai defects in two patients with necrotizing scleritis. This technique produced good anatomical results and maintained useful vision in each case. Autogenous periosteum offers advantages over other tissues as a tectonic graft for necrotizing scleritis, since it is easy to harvest and handle, it is strong and vascular, and is not subject to immunologie rejection.
Limitations of Blue Field Entoptoscopy In Evaluating Macular Function
Authors: Murphy Gates E 
Published: April 2021

SUMMARY
Evaluation of macular function in cataract patients using blue field entoptoscopy (BFE) has been reported as useful in all cases by some authors; another found it useful only in patients with moderate visual acuity loss due to cataract.
This paper reports findings in 101 cataractous eyes evaluated consecutively with BFE. A strong correlation was found between cataract type and percentage of false negatives, but the correlation between the preoperative acuity level and percentage of false negatives was poor. BFE was also poor in detecting moderate macular dysfunction (20/60 - 20/80).
Four cases with profound visual acuity loss due to macular holes had normal perception of BFE.
Multiple Complications Following Radial Keratotomy in an Elderly Patient: A Case Report
Authors: Salz James J 
Published: April 2021

ABSTRACT
A 68-year-old female underwent a 16-incision radial keratotomy in 1980. Her post-op course was complicated by marked overcorrection (+11.00), irregular astigmatism, and endothelial cell loss of almost 50%. Radial keratotomy in the elderly should be approached with caution because of the apparent increased effect of the surgery that occurs with increasing age.
A Randomized, Controlled Comparison of Anterior and Posterior Periocular Injection of Antibiotic in the Prevention of Postoperative Endophthalmitis
Authors: Christy Norval E , Lall Pramila 
Published: April 2021

ABSTRACT
A randomized, controlled, prospective comparison of the effectiveness of anterior and posterior injections of antibiotics in the prevention of endophthalmitis following cataract extraction was carried out in a village hospital in Pakistan. The study involved 77,015 cataract operations performed mainly by two surgeons. Anterior subTenon injections ("subconjunctival") and posterior subTenon injections ("retrobulbar") were equally effective in preventing postoperative infection.
Propionibacterium Acnes Endophthalmitis Seven Months After Extracapsular Cataract Extraction and Intraocular Lens Implantation
Authors: Jaffe Glenn J , Whitcher John P , Biswell Roderick , Irvine A Rodman 
Published: April 2021

ABSTRACT
We present a case of endophthalmitis caused by Propionibacterium acnes seven months following extracapsular cataract extraction and intraocular lens implantation. The markedly delayed clinical course of endophthalmitis associated with this organism appears to be highly stereotypical. Recognition and treatment of this complication of cataract surgery allows an excellent chance at cure.
Choroidal Neovascularization in Degenerative Myopia: Role of Laser Photocoagulation
Authors: Jalkh Alex E , Weiter John J , Trempe Clement L , Pruett Ronald C , Schepens Charles L 
Published: April 2021

ABSTRACT
Laser photocoagulation of extrafoveal choroidal new vessels was performed in 19 eyes with degenerative myopia. Sixteen eyes required only one treatment. Three eyes required more than one because of incomplete closure of the new vessels after the first treatment. Choroidal new vessel formation did not recur during the post-treatment follow-up period (average 29.2 months), and a dry, atrophic photocoagulation scar was achieved in all eyes. Visual acuity improved in only two eyes (11%), stabilized in four eyes (21%), and deteriorated in 13 eyes (68%). All except two eyes showed spontaneous progressive enlargement of the atrophic photocoagulation scar, which worsened visual acuity in 13 eyes (68%).
Microsurgical Treatment of Lens Capsule Perforations Part I: Experimental Research
Authors: Buschmann W , Gehrig O M , Vogt E , Raab H , Römer M 
Published: April 2021

ABSTRACT
Although perforating injuries of the lens capsule typically lead to traumatic cataract in humans and rats, capsular healing is observed regularly in injured rabbits and dogs. This is most likely because protein exudation in rabbits and dogs is much greater than that in humans and rats. Using isolated white Wistar rat lenses, rat lenses in vivo, and isolated human lenses, we attempted both to replace lens protein as well as develop techniques for microsurgically closing the capsule by applying a fibrinogen-based tissue adhesive. This application was effective in preventing traumatic cataract. Use of a fibrinogen-glued capsule graft yielded similarly good (but not better) results.
Correction of Postoperative Eyelid Retraction With a Simplified Levator Palpebrae Superioris (LPS) Muscle Recession: Analysis of a 10-Year Experience
Authors: Karesh James W , Putterman Allen M 
Published: April 2021

ABSTRACT
A simplified levator palpebrae superioris (LPS) muscle recession was performed to correct eyelid retraction in 56 eyelids of 48 patients. Improvement of preoperative keratopathy and cosmetically acceptable results were achieved in 93% of the eyelids. Based on preoperative surgical intervention, eyelids were divided into four groups: levator resection, levator aponeurosis advancement, surgery associated with dysthyroid ophthalmopathy, and miscellaneous reconstructive eyelid procedures. For each group the mean preoperative and postoperative eyelid levels, the mean change in eyelid level following surgery, and the mean amount of surgery performed were analyzed statistically with the two-tailed student's t-test. Linear regression was used to analyze the relationship between the change in eyelid level and the amount of levator recession performed. No significant relationship was demonstrated between eyelid retraction and dysthyroid ophthalmopathy or reconstructive eyelid surgery. However, a significant relationship was demonstrated between the amount of recession and the eyelid level change for eyelids retracted following levator resection (P<.01) and levator aponeurosis surgery (P<.05). This may indicate that the change in eyelid level following a simplified LPS recession in these two groups is predictable. However, additional prospective studies are required to further assess the clinical applicability and use of this finding.