bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors Associated With Late Infection of Filtering Blebs and Endophthalmitis
Authors: Ashkenazi Isaac , Melamed Shlomo , Avni Isaac , Bartov Elisha , Blumenthal Michael 
Published: April 2021

ABSTRACT
Late infection of filtering blebs and endophthalmitis are hazardous complications of glaucoma filtering surgery frequently associated with bleb failure and loss of functional vision. To determine possible risk factors for the development of these complications, characteristics of nine eyes of nine patients after filtering surgery in whom tate endophthalmitis developed were compared with those in patients who had received a comparable operation at the same time in whom endophthatmitis did not develop. An average of 7.7 ± 6.2 years (range, 6 months to 18 years) elapsed between the time of the filtering procedure and the initial appearance of endophthalmitis. Factors associated with increased risk were: increased axial length, thin and leaky bleb, conjunctivitis, upper respiratory infection, and the winter season.
A New Technique of Iridotomy in Extracapsular Cataract Extraction and Implantation
Authors: Alpar John J 
Published: April 2021

ABSTRACT
In 1346 consecutive patients undergoing cataract surgery and intraocular lens implantation, we prospectively studied the complications associated with iris iridectomies or iridotomies as compared with those occurring when iris openings were made. We found that the transfixion of the iris with the discission knife is easy, relatively harmless, and prevents a number of complications seen when no iridectomy was performed or if a large iris opening had been made with scissors.
A Biomechanical Evaluation of Rabbit Corneas in M-K and Dexsol
Authors: Barron Brent C , Smolek Michael K , McCarey Bernard E 
Published: April 2021

ABSTRACT
We compared the average force required to separate normal corneas at a 50% stromal depth, with the force required to separate corneas stored for 2, 5, 7, 10, and 14 days in either McCarey-Kaufman or Dexsol corneal storage medium. The required interlamellar separation force was calculated by standardizing the width of the test strips. The average required force for 35 fresh rabbit corneas (no storage) was 9.1 ±1.5 g/mm. There was no significant change in the required separation force after storage in either medium for up to 14 days.
Allograft Rejection After Penetrating Keratoplasty for Keratoconus
Authors: Girard Louis J , Esnaola Nestor , Rao Rosemary , Barnett Laura , El Maghraby Akef , Canizales Ruben 
Published: April 2021

ABSTRACT
We retrospectively studied 91 penetrating keratoplasties in 65 patients to evaluate the overall incidence of allograft rejection and the incidence in unilateral as compared with bilateral cases following penetrating keratoplasty for keratoconus. All surgeries were performed by the senior author following a standardized technique. The average age of the patients was 35 years; the average follow up, 6.5 years. Nine of the 91 grafts (9.9%) were rejected. The time of rejection varied from 6 months to 13 years after surgery. Eight of the nine rejections (88.9%) were reversible with steroid treatment and have survived up to 10 years. One graft failure requiring repeat penetrating keratoplasty (1.1%) occurred 13.25 years after surgery. The unrejected clear grafts have survived up to 21.5 years. The results of this study support the excellent prognosis of penetrating keratoplasty for keratoconus.
Nd:YLF Laser Sclerostomy
Authors: Park Steve B , Kim Jae Chan , Aquavella James V 
Published: April 2021

ABSTRACT
We used a Q-switched Nd:YLF picosecond laser, operating at the 1053-nanometer wavelength with a spot separation of 10 urn and a crossing width of 1000 x 10 µm in a rectangular pattern, to create ab externo sclerostomies in 12 New Zealand white rabbits. The mean energy used was 30 J (range, 24 to 65 J). Filtering blebs were observed for 1 week, with a concurrent drop in intraocular pressure. Histology performed at days 3, 10, and 30 revealed clean-cut sclerostomies, with minimal thermal and mechanical damage.
Retrobulbar Blockade of Somatic, Motor, and Visual Nerves by Local Anesthetics
Authors: Schimek Franz , Steuhl K Peter , Fahle Manfred 
Published: April 2021

ABSTRACTSomatosensory, motor, and visual sensory blockade were investigated after retrobulbar injection of 3 m L 2% lidocaine, prilocaine, or mepivacaine plus hyaluronidase (15 U/mL) and naphazoline nitrate (1:20 000) in 90 cataract patients (n = 30 per group). Before injection as well as 20 and 90 minutes after injection, and then every 30 minutes, the quality of the retrobulbar blockade was evaluated in terms of the following factors until full recovery of function: (1) cornea! sensitivity at the three extraincisional quadrants as determined with an esthesiometer; (2) horizontal and vertical motility, and elevation of the lid; (3) visual acuity on an arbitrary score scale ranging from 0 (no light perception) to 6 (visual acuity > 0.05); and (4) the time required for recovery from retrobulbar anesthesia. The data were analyzed by one- (anesthetic) and two-factor (anesthetic and time) analysis of variance.Full somatic recovery of corneal sensitivity occurred within 247 ± 10.2 minutes after lidocaine, within 221 ± 9.2 minutes after prilocaine, and within 280 ± 8.5 minutes after mepivacaine (F = 10.1; P < .0001). Full motor recovery (all muscles) occurred within 290 ± 5.8 minutes after lidocaine, within 258 ± 5.7 minutes after prilocaine, and within 295 ± 4.8 minutes after mepivacaine (F = 13.3, P < .0001) On the average, visual acuity decreased most after mepivacaine and least after lidocaine administration, although the differences between the three anesthetics in this regard were not significant. One patient temporarily lost vision after mepivacaine administration.Overall, the somatosensory and motor blockade were most pronounced after mepivacaine.
Drainage Tube Implants in the Treatment of Glaucoma Following Penetrating Keratoplasty
Authors: Sherwood Mark B , Smith M Fran , Driebe William T , Stern George A , Beneke John A , Zam Z Suzanne 
Published: April 2021

ABSTRACT
A retrospective review was undertaken to compare outcomes in 26 eyes that underwent penetrating keratoplasty (PKP) and drainage tube surgery (Morteno double-plate implant or Schocket procedure). Drainage tube surgery was performed either before PKP (10 eyes), after PKP (7 eyes), or at the same time as PKP (9 eyes). Mean follow up was 22 months. The average preoperative intraocular pressure (IOP) for all of the eyes was 31 mm Hg; 96% of them achieved a final IOP of less than 18 mm Hg (average, 14 mm Hg on a mean of 0.8 medications). Graft failure occurred in 11/26 (42%). Eight of these eyes were regrafted, and six of these eight have remained clear at a mean follow up of 22 months after grafting. The overall PKP success rate, including the eyes that underwent repeat PKP, was 81%. Visual acuity remained stable or improved in 70% of the eyes.
The Glaucoma Laser Trial (GLT): 5. Subgroup Differences at Enrollment
Authors: Anonymous  
Published: April 2021

Glaucoma Laser Trial Research Group*
ABSTRACT
Data collected at enrollment on the 271 patients (542 eyes) who participated in the Glaucoma Laser Trial IGLT) were analyzed for subgroup differences. The subgrouping variables included four patient characteristics (race, sex, age, and history of a vascular disease) and one ocular characteristic (myopia). The strongest differences observed were between blacks and whites. As compared with the eyes of the white patients, those of the black patients had lower mean decibels per test location in the visual field (P < .001), greater mean defect (P < .001), number of abnormal test locations (P < .001), and corrected loss variance (P = .009), as well as greater cup depth (P < .001 ), and larger mean horizontal (P = .002) and vertical (P < .001) cup/disc ratios.
Scleral Flap Sutures and the Development of Shallow or Flat Anterior Chamber After Trabeculectomy
Authors: Blok Michiel D W , Greve Erik L , Dunnebier Erwin A , Muradin Farley , Kijlstra Aize 
Published: April 2021

ABSTRACT
To determine whether closing the scierai flap with extra sutures can reduce the risk of overfiltration after trabeculectomy, we divided 339 trabeculectomies into three groups based on the number of scierai flap sutures used in the procedure, and studied the postoperative complications and results. The incidence of shallow or flat anterior chamber was significantly less in eyes that had received seven to nine sutures than in those that had received from two to six. Also, the incidence of cornea-lens touch was significantly less in the eyes with seven to nine sutures (P = .02, Fisher Exact Test). This study suggests that extra scierai flap sutures (in combination with laser suture lysis) is a safe and effective method of significantly reducing the risk of overfiltration after trabeculectomy.
Intraocular Dexamethasone Penetration via Subconjunctival or Retrobulbar Injections in Rabbits
Authors: Bodker Fred S , Ticho Benjamin H , Feist Richard M , Lam Tim T 
Published: April 2021

ABSTRACT
Using high-performance liquid chromatography, we compared tissue levels of dexamethasone in the aqueous, vitreous, retina, and choroid of rabbits, 1 and 4 hours following subconjunctival or retrobulbar injection. One hour following injection, dexamethasone levels in all of these tissues were similar in both the subconjunctival and retrobulbar groups. Four hours following injection, the concentrations in the two groups also were similar, except in the choroid, in which the subconjunctival injection yielded significantly lower dexamethasone levels than the retrobulbar injection. Tissue steroid levels were comparable ipsilateral and contralateral to the injected eyes in both treatment groups after 4 hours, except in the retina, in which the levels were lower in the contralateral eye after subconjunctival injection. These data suggest that dexamethasone absorption and delivery is predominantly hematogenous following both subconjunctival and retrobulbar injection, especially in highly vascular tissues, such as the choroid. Hematogenous delivery of dexamethasone appears to peak earlier in the choroid and presumably in other intraocular tissues following subconjunctival injections, while retrobulbar injections provide more steady, long-term delivery.
Merkel Cell Carcinoma of the Eyelid
Authors: Hamilton Jenny , Levine Mark R , Lash Richard , Koenigsberg Adam 
Published: April 2021

ABSTRACT
The Merkel cell is part of the dendritic cell population of the epidermis, and studies suggest it has a role as a slowly adapting mechanoreceptor involved with mediating the sense of touch. Merkel cells can give rise to malignant neoplasms, one tenth of which occur in the eyelid and periocular area, and manifest as painless erythematous nodules, with overlying telangiectatic blood vessels. Merkel cell carcinoma can mimic other malignant lesions, and the diagnosis can be difficult. One third of the tumors recur, and there is a high rate of metastasis. The estimated 5-year survival rate is 38%.
Initial treatment should be aggressive, including surgical resection, with consideration of postoperative radiation. Merkel cell carcinoma responds to chemotherapy, but routinely recurs on cessation of treatment. Two cases are presented to illustrate the typical presentation of Merkel cell carcinoma and the importance of electron microscopy and immunohistochemical studies.
Intraoperative Stress Experienced by Surgeons and Assistants
Authors: Yamamoto Akira , Hara Tsutomu , Kikuchi Keiko , Hara Takako , Fujiwara Takaaki 
Published: April 2021

* BACKGROUND AND OBJECTIVE: To determine the intraoperative stress on surgeons and assistants during cataract surgery, 12 surgeons and 3 assisting nurses were assessed based on their level of professional experience.
* METHODS: Surgeons were classified as inexperienced, intermediate, or experienced. Nurse assistants were classified as inexperienced or experienced. The intraoperative heart rates and urine adrenaline levels of each participant were measured.
* RESULTS: Inexperienced surgeons and nurse assistants had the highest heart rates at the beginning of surgery, and the rates tended to decrease toward the end of surgery. All values were higher than the other two groups throughout surgery. In surgeons with intermediate experience, the heart rates were not as high as in the inexperienced personnel; however, the heart rates were high throughout the surgery. The heart rate in one intermediate surgeon was markedly increased when a surgery was simultaneously broadcast on closed-circuit television. In experienced surgeons and a nurse assistant, the measurements increased slightly.
* CONCLUSIONS: The variations in heart rates and urine adrenaline levels showed characteristic patterns based on the experience of the surgical personnel.
[Ophthalmic Surg Lasers 1999; 30: 27-30.]
Extrusion and Granuloma Formation with Mersilene Mesh Brow Suspension
Authors: Mutlu F Mehmet , Tuncer Kemal , Can Cevat 
Published: April 2021

BACKGROUND AND OBJECTIVE: A variety of biologic or synthetic materials have been used in brow suspension ptosis surgery. We describe extrusion and granuloma formation in 5 cases of congenital ptosis operated with Mersilene mesh sling.
PATIENTS AND METHODS: Case reports with review of literature.
RESULTS: Two cases of extrusion and 3 cases of granuloma formation were encountered in 79 eye lids of 52 (6.3%) patients performed for the treatment of congenital ptosis. Mersilene mesh fibers in the cut surface and a foreign body reaction were found by microscopic evaluation of tissue harvested at the time of surgical removal of the sling.
CONCLUSION: Despite the operative precautions, the probability of extrusion and granuloma formation should be in mind in cases of congenital ptosis operated with Mersilene mesh sling, a synthetic material.
[Ophthalmic Surg Lasers 1999; 30: 47-51.]
Apraclonidine 0.5% Versus Brimonidine 0.2% for the Control of Intraocular Pressure Elevation Following Anterior Segment Laser Procedures
Authors: Chevrier Robert L , Assalian Alfred , Duperré Jean , Lesk Mark R 
Published: April 2021

* BACKGROUND AND OBJECTIVE: Both apraclonidine hydrochloride 0.5% and brimonidine tartrate O. 5% are potent alpha-2 agonists, effective in controlling the intraocular pressure (IOP) rise following argon laser trabeculoplasty (ALT). Brimonidine has recently become available commercially as a 0.2% solution. Our goal in this study was to compare the efficacy and side effect profile of 0.2% brimonidine to that of 0.5% apraclonidine in the prevention of IOP spikes following anterior segment laser procedures.
* PATIENTS AND METHODS: Patients undergoing argon laser trabeculoplasty, Nd:Yag peripheral iridectomy or posterior capsulotomy were prospecrively randomized to receive either apraclonidine 0.5% or brimonidine 0.2%, approximately 10 minutes prior to laser surgery. Intraocular pressure was measured by a masked observer, using Goldmann applanation tonometry, before and 1 hour after the treatment.
* RESULTS: 51 ALTs, 21 peripheral iridectomies, and 13 posterior capsulotomies were performed. The incidence of an IOP rise greater than 5 mmHg was 3/43 (7.0%) in the brimonidine group and 0/42 (0%) in the apraclonidine group (P=0.08, chi-squared). There were no IOP elevations greater than 8 mmHg. All IOP rises of greater than 5 mmHg occurred in the ALT sub-group, and within this sub-group, the mean change in IOP from pre- to post-op was -4.00 ± 5.87 in the brimonidine group versus -4.29 ± 3.86 in the apraclonidine group (.P=O. 84). There was a statistically significant decrease in IOP from baseline in both drug groups (P<.0001).
* CONCLUSIONS: Both drugs are highly effective in controlling IOP spikes following anterior segment laser procedures. There is a tendency toward higher risk of IOP rise following argon laser trabeculoplasty with 0.2% brimonidine as compared to 0.5% apraclonidine, however, this was not statistically significant.
[Ophtalmie Surg Lasers 1999;30:199-204.]
Intravitreal Tissue Plasminogen Activator for Acute Central Retinal Vein Occlusion
Authors: Lahey J Michael , Fong Donald S , Kearney John 
Published: April 2021

* OBJECTIVES: We investigated the efficacy of intravitreal tissue plasminogen activator (tPA) for the treatment of acute central retinal vein occlusion.
* DESIGN: Twenty-six eyes with central retinal vein occlusion (CRVO, n=23) and hemi-retinal vein occlusion (n=3) with recent onset of visual symptoms (^ 21 days) were identified and given an intravitreal injection of 65 -1 10 µg of tPA.
* RESULTS: Among eyes with CRVO, visual acuity improved to 2* 20/40 in 7 of 23 patients (30.4%) at 6 weeks, and 8 of 23 patients (34.8%) at 6 months. Visual acuity improved or stabilized in 69.6% (16 of 23 patients) at the 6 week visit and persisted with longer follow-up. Four patients developed doubling of the visual angle. No patients developed rhegmatogenous retinal detachment, infection or neovascular glaucoma. One patient developed a small vitreous hemorrhage and 2 developed an increase in the size of pre-existing macular hemorrhage.
* CONCLUSION: Intravitreal tPA administered early in the course of central retinal vein occlusion did not lead to catastrophic hemorrhagic events. Intravitreal tPA may cause worsening of vision in some patients. While some eyes appear to have benefited from the therapy, no conclusions can be reached because there was not a concurrent control group. A randomized clinical trial is necessary to determine its efficacy.
* SUMMARY STATEMENT: Intravitreal tPA administered early in the course of central retinal vein occlusion did not lead to catastrophic hemorrhagic events. A randomized clinical trial is necessary to determine its efficacy.
[Ophthalmic Surg Lasers 1999;30:427-434.]
Corneal Endothelial Cell Loss After Multiple Vitreoretinal Procedures and the Use of Silicone Oil
Authors: Friberg Thomas R , Guibord Nathalie M 
Published: April 2021

* BACKGROUND AND OBJECTIVE: Corneal decompensation and complications are a frequent cause of visual loss after vitreoretinal surgery. This paper presents data regarding endothelial cell loss in aphakic and Pseudophakie silicone oil filled eyes when oil was retained for many months. This study updates our previous investigation on the subject.
* PATIENTS AND METHODS: The corneal endothelial cell count of 10 eyes of 10 consecutive patients who had undergone vitreoretinal surgery, including fluid-gas exchange and ultimately silicone oil placement, were obtained. The patients underwent an average of 2.7 ± 0.9 vitreoretinal procedures before the final procedure which induced the placement of silicone oil in the vitreous cavity. All had inferior iridectomies. The endothelial cell density measurements were obtained an average of 1 year after silicone oil placement. In all eyes, the oil was felt necessary for long term tamponade and therefore was not removed. The cell density of the operated eye was compared to the fellow eye, none of which had undergone silicone oil placement.
* RESULTS: Both gas and retained silicone oil contribute to the loss of corneal endothelial cell density. The average endothelial cell loss in the 10 eyes with oil retained for an average of 10 ± 12 months was 68.8 ± 31.4%, as compared to the fellow eye. The average cell loss was higher in the three eyes with silicone oil in the anterior chamber (range 44 to >95%). Pseudophakie eyes fared better, on average, than aphakic eyes (51.66 ± 28% vs. 66.63 ± 26.3%) with respect to cell loss. Five aphakic eyes and 1 Pseudophakie eye developed corneal edema.
* CONCLUSIONS: Endothelial cell loss occurs after vitreoretinal surgery and is exacerbated by long term silicone oil retention. The corneal endothelial cell damage is probably cumulative from procedure to procedure. Endothelial cell loss may be pronounced in eyes without a physical barrier between the anterior segment and the vitreous cavity, and in eyes where oil migrates into anterior chamber.
[Ophthalmic Surg Lasers 1999;30:528-534]
Surgical Chorioretinal Venous Anastomosis for Ischemic Central Retinal Vein Occlusion
Authors: Peyman Gholam A , Kishore Kamal , Conway Mandi D 
Published: April 2021

* BACKGROUND AND PURPOSE: To report results of a pilot study to create chorioretinal venous anastomosis (CRVA) in eyes with ischemie central retinal vein occlusion (CRVO) via a pars plana approach.
* PATIENTS AND METHODS: Five eyes of 5 patients with ischemic CRVO underwent surgical CRVA. Following pars plana vitrectomy, the posterior hyaloid face was removed, and slit-like incisions were made with a microvitreoretinal blade adjacent to a major retinal vein in each quadrant. Small pieces of 5-0 Mersilene sutures (Ethicon, Somerville, NJ) were positioned over the vein and inserted into these incisions to promote vascularization. Panretinal photocoagulation was applied.
* RESULTS: A functional CRVA site was noted at 10 of 16 attempted sites (4 sites in 1 patient could not be evaluated because of cataract). Minor fibrous proliferation was noted at CRVA sites in all eyes. Optic atrophy developed in 3 eyes. Visual acuity improved in 3 eyes, remained unchanged in 1, and deteriorated in 1 eye after a mean follow up of 13.4 months (range 8-20 months).
* CONCLUSION: Surgically induced CRVA may improve the prognosis in some eyes with ischemic CRVO.
[Ophthalmic Surg Lasers 1999;30:605-614.]
Primary Trabeculectomy in Young Adults: Long-term Clinical Results and Factors Influencing the Outcome
Authors: Jacobi Philipp C , Dietlein Thomas S , Krieglstein Günter K 
Published: April 2021

* OBJECTIVE: To assess the long-term clinical outcome of primary trabeculectomy in young adults, and evaluate potential risk factors contributing to failure of filtering surgery.
* MATERIAL AND METHODS: A retrospective review was carried out of the charts of all glaucomatous patients between the age of 15 to 45 years. These patients had no history of previous extra- or intraocular surgery and had undergone primary trabeculectomy without the use of antimetabolites from January 1988 to January 1995 at the University Eye Hospital of Cologne. A total of 51 eyes of 45 patients fulfilled the inclusion criteria. There were no drop-outs from follow-up. Mean follow-up was 5.2 years (range, 2.5 to 9.5 years). Outcome was defined as a success when postoperative intraocular pressure (IOP) was 21 mm Hg or lower. If further glaucoma medication was required the outcome was described as a qualified success, and when the patient was free of medication the outcome was considered a complete success.
* RESULTS: Using the Kaplan-Meier survival curve, cumulative life-table success rates were 88% at 1 year (n = 51), 82% at 3 years (n = 47), 76% at 5 years (n = 26), and 70% at 7 years (n = 22). At final visit 71% (n = 36) were classified as successes, with 54% (n=30) being successful without adjunct medication. Seventeen percent (n = 6) required additional topical medication. Previous laser trabeculoplasty and an IOP greater than 40 mm Hg during the course of the disease was found to adversely affect the outcome. Eyes with iridocorneal epitheliaiopathy (ICE) syndrome, Riegers anomaly, and uveitic glaucoma failed more frequently than those with juvenile, pigmentary, and primary open-angle glaucoma (POAG). Younger age (< 30 years) was not associated with a lower success rate after controlling for glaucoma category.
* CONCLUSION: The success rate of the uncomplicated group compares favorably with the 75% to 90% success rates of trabeculectomy commonly cited for primary glaucomas in older adults. Primary trabeculectomy in young patients may have a favorable outcome even without antimetabolite therapy.
[Ophthalmic Surg Lasers 1999;30:637-646.]