bluuebunny/crossref_metadata_2025_split huggingface dataset:
Histology of Partial Thickness Double Composite Eyelid Graft
Authors: Budenz Donald L , Beyer-Machule Charles K , Albert Daniel M 
Published: April 2021

ABSTRACT
Double composite grafting is a technique used in the repair of large (>75%) eyelid defects due to tumor resection, trauma, or congenital coloboma. The procedure utilizes two partial thickness composite grafts derived from two unaffected lids. The skin defect is covered by a pedicle skin graft to provide an adequate blood supply. This is thought to be superior to revascularization occurring from the margin of the graft alone.
We examined histologically the lid margins of two such grafts 2 and 9 months postoperatively. Each demonstrated scarred tarsus and absent meibomian glands. One of the two grafts had loss of cilia. The architecture of the graft tissue otherwise was preserved.
Fourier Analysis of the Nerve Fiber Layer by Digital Imaging Techniques
Authors: Jindra Lawrence F , van Saarloos Paul P , Eikelbloom Robert H , Cooper Richard L 
Published: April 2021

ABSTRACT
We introduce a new method to examine the retinal nerve fiber layer (RNFL) that may detect early changes in its structure due to glaucoma. Viewed in the conventional manner, in a plane perpendicular to the retina, we get an estimation of the structural integrity of the RNFL Viewed from a plane parallel to the retina, the RNFL forms a contour surface of hills and valleys. In our method red free fund us slides are digitally acquired. A waveform, representing a topographic profile cut through the resulting representation of the RNFL contour surface, was analyzed using Fourier's transform. Three cycles/mm in the Fourier power spectrum was used as an arbitrary cutoff to discriminate normal from glaucomatous RNFL. The Fourier power spectrum from normal RNFL was shifted to higher spatial frequencies, while the power spectrum from glaucomatous RNFL was shifted to lower spatial frequencies. Thus, Fourier Analysis can reveal information about such a wave form which is not obvious by visual inspection or by densrtometric techniques. This method may allow for an even earlier diagnosis of injury to the optic nerve due to glaucoma.
The Use of Free Periosteal Grafts in Extensive Lower Lid Reconstruction
Authors: Hurwitz Jeffrey J , Corin Scott M , Tucker Susan M 
Published: April 2021

ABSTRACT
We describe using a scaffold of free periosteum as a posterior lamella replacement in the reconstruction of large defects involving the lower lid. Although the tarsoconjunctival flap is the treatment of choice in lower lid defects, the technique we describe is especially useful in cases in which it is best not to cover the eye for an extended period, and in cases involving defects extending beyond those of the lower lid.
Complications of Blepharopigmentation
Authors: Goldberg Robert A , Shorr Norman 
Published: April 2021

ABSTRACT
Blepharopigmentation is a commonly performed procedure with a very low rate of reported complications. We present three complications of the permanent eyeliner procedure: two cases of long lasting pigment fanning, and one case of eyelid margin necrosis with cilia loss and secondary cicatricial entropion. These complications may be related to placement of the pigment too deeply, or to overapplication with tissue maceration. Care should be taken to avoid through-and-through eyelid margin penetration, and to limit the number of needle penetrations to no more than is necessary at each application site.
Lens Subluxation as a Complication of Cyclocryotherapy
Authors: Pearson P Andrew , Baldwin Larry B , Smith Thomas J 
Published: April 2021

ABSTRACT
There are many well known complications of cyclocryotherapy. This case represents what we believe to be the first report of cyclocryotherapy leading to lens subluxation. The patient was a 14-year-old boy with a history of ocular trauma that had resulted in intractable glaucoma. Six locations were treated inferiorly using the freeze-thaw-freeze technique. Postoperatively the patients zonular attachment was disrupted inferiorly and the lens subluxated superiorly. While remote trauma may have been partly responsible, we suspect that the cyclocryotherapy precipitated the lens subluxation.
Endocapsular Phacoemulsification and Aspiration (ECPEA)-Recent Surgical Technique and Clinical Results
Authors: Hara Tsutomu , Hara Takako 
Published: April 2021

ABSTRACT
We present our most recent technique of endocapsular phacoemulsification and aspiration (ECPEA) and report the results achieved using it in 50 consecutive eyes of 47 patients. Using a bent 0.9-mm Fragmatome tip, we removed relatively hard cataracts through 1.5-mm anterior capsular openings. With an average follow-up period of 12 months, the success rate was 72%. Causes of failure were anterior capsular openings enlarged more than 2.6 mm in nine eyes, and posterior capsular rupture in five eyes. After the incisions were extended to 6 mm, 11-mm posterior chamber lenses were inserted into the capsular bags. In the successful 36 eyes, postoperative visual acuity of better than 20/20 was achieved in 20 eyes (56%), and better than 20/40 vision in 31 (86%). Average corneal endothelial cell loss was 3.7%. Ample anterior capsular transparency was retained in 26 eyes (72%).
Alternative Method for Sulcus Fixation of Posterior Chamber Lenses in the Absence of Capsular Support
Authors: Maus Marion , Sivalingam Eliyathamby 
Published: April 2021

ABSTRACT
The realization that posterior chamber intraocular lenses have many advantages over anterior chamber ones has induced many practitioners to try methods of fixating the lenses in the ciliary sulcus when there is inadequate capsular support. Most of these methods require the use of sutures to anchor the lens to the sclera or the iris. We describe a modification of these techniques which allows the surgeon to place a stiff all-polymethylmethacrylate (PMMA) lens in the sulcus in a way that makes it unnecessary to anchor the lens, although a safety suture may be placed through the scleral lip. We believe this modification makes sulcus fixation simpler to perform and possibly safer for the patient. We have used this technique in six patients with good results.
Use of a Convex Mirror in Indirect Ophthalmoscopy for Patients in a Prone Position
Authors: Hara Satoshi 
Published: April 2021

ABSTRACT
Fundus examination with the patient in a prone position sometimes requires the observer to assume an uncomfortable position. I describe using a convex rear-view mirror with an 800-mm radius of curvature in binocular indirect ophthalmoscopy to overcome this difficulty. This device is especially helpful in pneumatic retinopexy.
Central Serous Choroidopathy in Patients Over 50 Years of Age
Authors: Berger Alan R , Olk R Joseph , Burgess Dean 
Published: April 2021

ABSTRACT
Reviewing all records of patients with the of central serous choroidopathy (CSC) at Retina Consultants, Ltd since 1975, we identified 47 with CSC who were older than 50 years at initial presentation. These patients were divided into groups, based on type of management: observation; light "CSG-type" photocoagulation; and "subretinal-neovascular-membrane photocoagulation. Although most of these retained excellent central visual acuity, overall final visual acuities were poorer than those in other reported series. Heavier photocoagulation, as compared with lighter treatment, was associated with a decreased incidence of posttreatment SRNVM formation and appeared to have no adverse effect on final visual outcome. Patients with multiple irregular on fluorescein angiography had a greater tendency develop SRNVMs, with or without treatment. thalmologists diagnosing CSC in patients over age 50 should be aware that there is a greater risk of SRNVM developing in these patients.
A Modification of the Lateral Tarsal Strip Procedure With Resection of Orbicularis Muscle for Entropion Repair
Authors: Corin Scott , Veloudios Angela , Harvey John T 
Published: April 2021

ABSTRACT
The lateral tarsal strip procedure addresses lateral canthal laxity, but is inadequate in some patients with entropion who have overriding of the orbicularis muscle. We describe our technique, which incorporates resection of the hypertrophied orbicularis. We have used this modification of the lateral tarsal strip procedure in 21 eyelids 15 patients) with excellent results.
Modifications of the Molteno Implant and Implant Procedure
Authors: Susanna Remo 
Published: April 2021

ABSTRACT
I have modified the Molteno implant and standard implantation procedure as follows with the idea of achieving the benefits noted: (1) using a 5-0 nylon suture to temporarily reduce the inner diameter of the Molteno tube in order to prevent flat anterior chamber and high IOP in the immediate postoperative period, as well as to permit early perfusion of the modified Molteno plate, likely resulting in less fibrosis and better filtration; (2) placing a 4-0 steel suture guide inside the silicone tube to ensure accurate positioning, especially crucial in some cases when a pars plana approach is used to introduce the tube; 3} placing 10 holes in the platform of the implant to increase drainage; (4) placing three holes to allow conversion of a one-plate into a two-plate implant, thus reducing the risk of complications and making reoperation easier and safer.
O2 Administration by a Nasal Probe Improves Respiration in Cataract Surgery After Retrobulbar Anesthesia
Authors: Michelson Georg , Naujoks Bernd 
Published: April 2021

ABSTRACT
We measured certain respiratory conditions (respiratory rate [RR], oxygen saturation [SO2I, and endexpiratory carbon dioxide partial pressure IpCO2] ) of 31 patients undergoing planned cataract surgery using local anesthesia in order to determine the effects of administering pure oxygen 3 L/min) by a nasal probe in 10 of them. In the patients who did not receive pure oxygen, at the end of surgery the mean RR was 1 5.8 ± 4.4/min (maximum, 21; minimum, 6.4/min); the mean SO2 was 86.9% ± 6.6% (maximum, 98%; minimum. 74%; in 11/25 patients, the SO2 was lower than 90%); and the mean pCO2 was 34.9 ± 7.7 mm Hg (maximum, 46.5; minimum, 12.15; in 4/25 patients, the pCO2 was greater than 45 mm Hg). In the patients who received pure oxygen by a nasal probe, the mean SO2 increased intraoperatively from 80.6% ± 5.8% to 96.9 ± 2.9% (in no patients was SO2 lower than 90%). Therefore we recommend an intraoperative administration of pure oxygen by a nasal probe.
Sympathetic Ophthalmia After Cyclocryotherapy of Neovascular Glaucoma Without Ocular Penetration
Authors: Harrison Thomas J 
Published: April 2021

ABSTRACT
A 66-year-old man underwent cyclocryotherapy for treatment of neovascular glaucoma in a blind eye. Although neither history, clinical examination, nor histologic evaluation uncovered any ocular penetration, he subsequently developed sympathetic ophthalmia. This and other cases suggest that cyclocryotherapy could be a factor in the pathogenesis of sympathetic ophthalmia, although the mechanism is far from clear.
Collagen Plug Occlusion of Molteno Tube Shunts
Authors: Stewart Wells , Feldman Robert M , Gross Ronald L 
Published: April 2021

ABSTRACT
We report five patients in whom collagen lacrimal plugs were used to temporarily occlude the lumen of Molteno shunts to prevent early postoperative hypotony. Only one eye, with a double plate, developed hypotony and a flat anterior chamber that required reformation. However, in three patients, the collagen plugs did not dissolve and had to be removed surgically to lower the intraocular pressure. Although the semipermeability of collagen is desirable, its unpredictable degradation renders it unsuitable for temporary occlusion of tube shunts. Other biodegradable materials may be more appropriate for this purpose.
Planned Combined I-125 Plaque Irradiation and Indirect Ophthalmoscope Laser Therapy for Choroidal Malignant Melanoma
Authors: Augsburger James J , Mullen Donald , Kleineidam Markus 
Published: April 2021

ABSTRACT
We studied the short-term impact of planned sequential episcleral I-125 plaque irradiation and indirect ophthalmoscope laser therapy in a series of 25 patients with choroidal or ciliochoroidal malignant melanoma. In a case-by-case matched comparison study, we evaluated the relative local regression of tumors which did and did not receive planned supplemental laser therapy following plaque treatment. The tumors treated with supplemental laser regressed substantially faster and more completely than those treated by plaque alone. Planned sequential I-125 plaque irradiation combined with indirect ophthalmoscope laser therapy appears to be a more effective local-tumor treatment than plaque radiotherapy alone.
Secondary Dye Testing of the Lacrimal System
Authors: Becker Bruce B 
Published: April 2021

ABSTRACT
Using the Olympus PF-22 angioscope to examine the inferior meatus during secondary dye testing of the lacrimal system, I evaluated the efficacy of the secondary dye test to localize partial or functional obstruction of the upper or lower lacrimal excretory system. Secondary dye testing was positive (dye present in the nose) in 12 of 13 lacrimal systems (92%) with functional nasolacrimal duct obstruction, in 7 of 8 (89%) with involutional ectropion, and in 4 of 5 (80%) with facial nerve palsy. Secondary dye testing was negative in the 1 lacrimal system w'rth canalicular stenosis and in 5 of the 6 (83%) with punctal stenosis. Secondary dye testing is helpful in differentiating punctal or canalicular stenosis from functional nasolacrimal duct obstruction; however, it cannot help differentiate ectropion or facial nerve palsy from functional nasolacrimal duct obstruction.
Granny Knot for Interrupted 10-0 Nylon Sutures in Cataract Sections
Authors: Phillips Calbert I 
Published: April 2021

ABSTRACT
A granny knot instead of a reef (square) knot is advocated for 10-0 nylon interrupted sutures in limbal cataract sections, especially under a conjunctiva! flap. The second of the two throws is looped in the direction opposite to that in a reef knot so that the free ends lie at right angles to the plane of the suture. The second throw is used to "run down" the first to tighten the suture. To avoid postoperative erosion through conjunctiva, the ends are cut long with a blade while they lie flush with the sclera. The knot is locked when the traction required to tighten the suture is released and the thinned nylon recovers its original diameter on each side of the knot.
Bacterial Endophthalmitis Following Cataract Surgery in an Eye With a Preexisting Molteno Implant
Authors: Ellis Brian D , Varley Gary A , Kalenak Jeffrey W , Meisler David M , Huang Suber S 
Published: April 2021

ABSTRACT
We describe a patient with a preexisting, functioning Molteno implant in whom acute endophthalmitis developed following cataract extraction. The condition was treated successfully without removing the implant.
Transscleral Neodymium:YAG Cyclophotocoagulation: Comparison of 180-Degree and 360-Degree Initial Treatments
Authors: Hardten David R , Brown J David 
Published: April 2021

ABSTRACT
In order to help clarify how much Neodymium:YAG transscleral Cyclophotocoagulation (Nd:YAG CPC) treatment should be given to maximize effectiveness and minimize complications in the treatment of refractory glaucomas, we retrospectively reviewed and compared the results achieved with an initial 180-degree noncontact Nd:YAG CPC treatment with those achieved with an initial 360-degree treatment. Forty-five patients were in the ISO-degree group and 21 in the 360-degree group. Mean follow up after the first Nd: YAG CPC treatment was 10.2 ± 7.5 months.
The average pretreatment intraocular pressure (IOP) in the 180-degree group was 33.5 mm Hg. After one treatment, IOP in these patients dropped an average of 8.4 mm Hg and was controlled successfully (5 to 22 mm Hg) in 14 31%). After a mean of 2.0 treatments, IOP in these patients dropped an average of 15.3 mm Hg, and successful IOP control was ultimately achieved in 35 (78%).
The average pretreatment IOP in the 360-degree group was 41.8 mm Hg. After one treatment, IOP in these patients dropped an average of 19.4 mm Hg and was controlled successfully in 11 (52%). After a mean of 1.3 treatments, IOP in these patients dropped an average of 20.7 mm Hg, and successful IOP control was ultimately achieved in 13 (62%).
Our study suggests that repeated 180-degree treatments can be successful. However, because we found that IOP was controlled more rapidly with fewer major complications in the 360-degree group, the risk-to-benefit ratio may be better for initial 360degree treatment.
Oculoplastic Uses of Cranial Bone Grafts
Authors: Goldberg Robert A , Garbutt Mark , Shorr Norman 
Published: April 2021

ABSTRACTCranial bone grafting for craniofacial reconstruction has gained wide acceptance in recent years and is being used with increasing frequency by ophthalmic plastic surgeons. Alloplastic materials (particularly newer materials such as porous polyethylene, hydroxyapatite, and rigidly fixated metal alloys) have a dear role in orbital reconstruction, and in many oculoplastic applications are the material of choice. However, in certain applications cranial bone grafts may be superior, eg, in managing large posttraumatic or postsurgical orbital defects or orbito-sinus defects in the milieu of chronic sinusitis. We describe our current techniques for harvesting full-thickness outer-table grafts and spirt-thickness periosteallybound "fish-scale" grafts. Harvesting cranial bone grafts is not without risk and donor site morbidity, and we do not advocate the use of cranial bone grafts in those cases that might be managed as well (or better) with alloplastic material. At the same time, ophthalmic surgeons involved in orbital reconstruction should be familiar with the indications for bone grafts and comfortable with harvesting techniques so that they are not limited when circumstances warrant the use of autogenous material.
Needling Revision of Failed Filtering Blebs With Adjunctive 5-Fluorouracil
Authors: Shin Dong H , Juzych Mark S , Khatana Anup K , Swendris Ronald P , Parrow Kyle A 
Published: April 2021

ABSTRACT
We investigated the outcome of needling revision with adjunctive subconjunctival 5-fluorouracil (5-FU) performed on 30 eyes of 30 consecutive glaucoma patients with failed filtering blebs 49.0 ± 65.4 weeks after trabeculectomy. Follow up was 67.3 ± 22.8 weeks from the time of the first needling revision and 49.9 ± 26.2 weeks from the last needling procedure. Twenty-four (80%) of the eyes were treatment successes after 2.6 ± 1 .9 needling revisions, with a mean intraocular pressure (IOP) of 13.9 ± 3.7 mm Hg on 1.5 ± 1.1 medications, a significantly lower mean IOP and number of medications than before the procedure (32.5 ± 7.8 mm Hg on 1.7 ± 1.5 medications [P < .001, paired t-test]). Needling revision with adjunctive 5-FU appears to be a safe and effective means of reestablishing filtration.
Chronic Cystoid Macular Edema and Predictors of Visual Acuity
Authors: Spaide Richard F , Yannuzzi Lawrence A , Sisco Laurie J 
Published: April 2021

ABSTRACT
Of 141 patients who had clinically significant cystoid macular edema (CME) following cataract surgery, 42 had a visual acuity of 20/200 or worse. Logistic regression demonstrated that of all the systemic and ocular factors studied, the best predictors of visual acuity of 20/200 or worse were the presence of iris in the wound (odds ratio = 2.86, P = .011) and a fluorescein angiogram grade of 4 (odds ratio = 2.91, P = .0076). Entering into the logistic regression variables such as integrity of the posterior capsule, iritis, vitreous in the wound, or type of intraocular lens did not significantly improve the ability of the model to predict which patients would have poor visual acuity. This study suggests that iris incarceration in the wound may have a more important association with poor vision in patients with chronic postsurgical CME than previously thought.
Preliminary Study of a New Intraocular Method in the Diagnosis and Treatment of Propionibacterium acnes Endophthalmitis Following Cataract Extraction
Authors: Owens Sarah L , Lam Sheridan , Tessler Howard H , Deutsch Thomas A 
Published: April 2021

ABSTRACT
Late endophthalmitis, due to Propionibacterium acnes, developed in three patients following uncomplicated extracapsular cataract extraction and posterior chamber intraocular lens (PC-IOL) insertion. Cultures from the capsular bag yielded P. acnes in all three. With topical anesthesia and through an anterior chamber paracentesis, culture specimens were taken from and cfmdamycin irrigated into the capsular bag. Filtered 100% oxygen was introduced into the anterior chamber in two; the third also received an injection of gentamicin and dexamethasone into the capsular bag. After treatment, two patients received oral antibiotics; one received hyperbaric oxygen therapy. Visual acuity was improved and inflammation reduced in all three. However, after treatment, ocular toxic effects due to clindamycin were suspected in one.
This approach offers several clear advantages, including topical anesthesia, outpatient management, elimination of the need for vitrectomy, and retention of the intraocular lens (IOL).
Temporary Sutured Tube-Tarsorrhaphy: Reversible Eyelid Closure Technique
Authors: Rapoza Peter A , Harrison Devin A , Bussa John J , Prestowitz William F , Dortzbach Richard K 
Published: April 2021

ABSTRACT
Temporary closure of the eyelids is frequently recommended for ocular surface disorders in which reepithelialization of the cornea is problematic, as well as for acute Bell's palsy. We describe an easily performed technique of temporary tarsorrhaphy using plastic tubes sutured externally to the upper and lower eyelids, with eyelid closure accomplished by tightening a loop of suture passed through the two tubes. Corneal epithelial defects in 11 of 13 patients in whom we used this technique resolved satisfactorily without complications. In the remaining two, the polypropylene sutures eroded through the eyelids between 5 and 6 weeks after surgery. The sutured tubes loosened and the loosened sutures had to be replaced. In one patient, the overly long end of a suture rotated between the apposed eyelids, inducing a corneal abrasion, but no permanent damage to the eye. We conclude that the sutured tube-tarsorrhaphy provides excellent short-term closure of the eyelids, while allowing simple, painless opening for examining the globe. The risks of inflammation and infection associated with previously described techniques are minimized.
Modified Technique of Blunt Cannula Retrobulbar Anesthesia for Vitreoretinal Surgery
Authors: Wald Kenneth J , Weiter John J 
Published: April 2021

ABSTRACT
We prospectively evaluated a modified version of a previously reported technique of retrobulbar anesthesia for vitreoretinal surgery involving the use of a blunt 19-gauge cannula to directly infuse anesthetic into the retrobulbar space. Using this method, 60 consecutive patients undergoing sclera) buckling surgery had effective anesthesia and akinesia, with no complications.
Using the Oculocephalic Reflex to Assess Effective Retrobulbar Anesthesia
Authors: Wong Randall V , Craddock Mary K , Whitten Mark E 
Published: April 2021

ABSTRACT
In order to confirm effective retrobulbar anesthesia, we attempted to stimulate the oculocephalic reflex (the doll's head phenomenon) in 40 consecutive patients undergoing elective cataract extraction with intravenous sedation. Thirty-nine of these 40 patients had a positive response, exhibiting the reflex in the nonanesthetized eye but not in the anesthetized eye. Using this test in sedated patients obviates interrupting surgery to administer additional block under less than optimal, uncontrolled conditions.