bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transscleral Diode Laser Cyclophotocoagulation for Refractory Pediatric Glaucomas
Authors: Bock Charles J , Freedman Sharon F , Buckley Edward G , Shields M Bruce 
Published: April 2021

ABSTRACT
Purpose: To evaluate the success of contact transscleral cyclophotocoagulation (TDC) in patients with refractory pediatric glaucomas.
Methods: Twenty-six eyes of 20 patients with therapyresistant pediatric glaucomas were included in this retrospective study. Subgroup analysis was performed for patients 10 or younger and patients older than 10 at time of first TDC procedure. Diode laser cyclophotocoagulation was applied using a fiber optic G-probe. Follow up until time of failure or for a minimum of 6 months was obtained for all procedures in all eyes. Failure was defined as intraocular pressure (IOP) greater than 21 mm Hg, repeat of TDC due to clinically inadequate IOP control, progression to another procedure, or serious complication.
Results: Baseline mean pretreatment IOP was 34.2 ± 10.4 mm Hg (range, 15 to 62 mm Hg). Ten of 26 eyes (38%) were successful 6 months after initial TDC. A mean decrease in IOP of 10.3 ± 14.7 mm Hg was noted after the first procedure (F<0.05). Eighteen eyes (70%) were retreated at least once. The mean decrease in IOP for all patients after all procedures was 12.9 ± 13.4 mm Hg (P<0.001). This represents a mean percent decrease in IOP of 33.2 ± 6.9%. The overall success rate was 50%, including retreated patients. The younger and older subgroups did not differ with regard to overall success, time to failure, or retreatment rate. One patient suffered a retinal detachment. Visual loss was noted in 4 of 22 eyes with reliable visual acuity measurements.
Conclusion: TDC is an effective means of decreasing IOP in some patients with refractory pediatric glaucomas. Although the retreatment rate is high, the procedure generally is well tolerated with few complications.
Effects of Strabismus Surgery on Corneal Topography
Authors: Nardi Marco , Rizzo Stanislao , Pellegrini Guglielmo , Lepri Antonio 
Published: April 2021

ABSTRACT
Background: Changes in refraction follow surgery on the extraocular muscles. We examined corneal topography before and after medial or lateral rectus muscle recession using a computer-assisted topographic analysis system.
Methods: A total of 36 patients (52 eyes) were examined. Measurements were taken 1 day before surgery and 1, 15, and 30 days after surgery.
Results: A significant change in astigmatic power was detected 1 day after surgery in the meridian of the recessed muscle, evidencing a localized flattening of the cornea. Induced astigmatism decreased over time. At 30 days following surgery, 6% of patients evidenced a residual change higher than 1 diopter (D); 12% evidenced a residual change higher than 0.5 D.
Conclusion: The increase of astigmatic power recorded 1 day after surgery is higher for medial rectus muscle recession than for lateral rectus muscle recession. Corneal topography changes, located mainly in the meridian of the recessed muscle and the optical zone, are greatly reduced or gone within 1 month of surgery.
Infantile Lensectomy and Intraocular Lens Implantation With Long-term Follow up in a Monkey Model
Authors: Lambert Scott R , Aiyer Akhila , Grossniklaus Hans 
Published: April 2021

ABSTRACT
Purpose: To report the long-term clinical and histopathologic findings in infant monkeys following a lensectomy and intraocular lens (1OL) implantation using two different surgical techniques.
Methods: A lensectomy and IOL implantation was performed on the right eye of 10 infant monkeys. A posterior capsulotomy was performed using a limbal approach in 5 monkeys (Group 1), and a pars plana approach in 5 other monkeys (Croup 2). The residual refractive error in the pseudophakic eye was then corrected with a contact lens and the fellow eye was occluded for 70% of the daylight hours. The monkeys were then examined at regular intervals for 2 to 4 years. Visual acuity was assessed using opérant testing and sweep visual evoked potentials (VEPs). At the end of the study, the pseudophakic eyes were studied histopathologically.
Results: The only complications that required reoperation were diaphanous fibrin membranes on the lens optic (n=10) and lens reproliferation into the pupillary space (n=5). The visual outcome was similar in Groups 1 and 2, with better acuities in the phakic eyes compared with the pseudophakic eyes. A higher percentage of both haptics were found in the capsular bag for the monkeys in Group 2 (n=3) than in Group ? (n=1 ).
Conclusions: Although haptic placement was superior using a pars plana approach to perform the primary posterior capsulotomy, no clinically discernable difference was noted in IOL centration between the monkeys undergoing a limbal versus a pars plana posterior capsulotomy and no difference was noted in the visual outcome.
Journal of Pediatrie Ophthalmology and Strabismus 1999;36:271-278.
Congenital Nasolacrimal Duct Obstruction: Therapeutic Management
Authors: Chiesi Carlo , Guerra Roberto , Longanesi Lora , Fornaciari Mirella , Morano Riccardo Pignatti 
Published: April 2021

ABSTRACT
Purpose: Congenital nasolacrimal duct obstruction is a common condition, and its diagnosis must be based more on regular in-time epiphora than mattering. The purpose of this study is to better define the diagnostic criteria and therapeutic strategy.
Methods: We have retrospectively evaluated 1563 subjects treated from 1990-1997 at the Pediatrie Ophthalmological Service of Modena University Eye Clinic. The mean age at first examination was 5.7 months. According to symptoms and age, patients were treated with antibiotic therapy, office probing, or general anesthesia probing. Recovery was confirmed only after a 3month symptom-free period.
Results: More than 29% of patients recovered spontaneously or with topical antibiotic therapy. Office probing reduced the number of patients who needed a general anesthesia probing (from 62.97% from 1990-1993 to 33.61% from 19941997). In the period from 1994-1997, we changed the technique and especially the age of patients, obtaining a clearing of the obstruction in about 86% of cases compared with a 39% rate in the earlier period. Since 1994, in cases of general anesthesia probing, we have used a midazolam and ketamine anesthesiologic technique that has reduced risks and increased parental satisfaction and cost-effectiveness. Also, our data show that age at first attempt highly influenced probing failure rate.
Conclusion: If the first ophthalmologic examination is precocious and correctly timed, the possibility of curing the patient using the simplest method is increased. Better results can be obtained with cooperation among pediatricians, ophthalmologists, and anesthesiologists.
Journal of Pediatrie Ophthalmology and Strabismus 1 999;36:326-330.
Teaching Interpersonal Management for Effective Professional Nursing Practice
Authors: Wyatt Margaret A , Withersty David J 
Published: April 2021

ABSTRACT
It isn't enough for us to do what we can do: The patient and his environment, and external conditions have to contribute to achieve the cure.
Hippocrates
The treatment environment is an important component of patient care. In order to provide more effective patient care one would want to be able to manipulate the environment, particularly the emotional environment. This is difficult to do and even more difficult to teach. The authors describe a teaching module in a baccalaureate program in nursing in which didactic sessions and behavioral rehearsal analysis techniques are combined. The goal is to teach interpersonal manipulation for more effective management of professional nursing practice. The results have been promising.
Childhood Cancer Is A Family Crisis: A Review
Authors: Fife Betsy L 
Published: April 2021

ABSTRACT
A diagnosis of childhood cancer has serious implications for the mental health of each family member because families are organized as interdependent units. The impact of the illness is clearly documented by this review of the literature from 1955 to the present, and specific problems relating to the patient, the parents, and the siblings are discussed. A review of studies designed to help families cope with their distress more effectively is also included, and it demonstrates the need for further experimental research in this area if the increased life span of these children is to be worthwhile.
Group Therapy for Male Batterers: Comparison of Cognitive-Behavioral & Object Relations Approaches
Authors: Diefenbeck Cynthia A 
Published: April 2021

ABSTRACT
Domestic violence is the silent epidemic in America's households, and batterers' recidivism rates are staggering, despite court-mandated treatment found in every state. This article compares and explores cognitive-behavioral and object relations theories, beginning with an overview of the conceptualization of intimate rage from each approach. In addition, the espoused treatment approaches for each theory are examined.
Surgical Correction of Hyperopia Following Radial Keratotomy
Authors: Damiano Richard E , Forstot S Lance , Dukes Debra K 
Published: April 2021

ABSTRACT
Background: No effective treatment for hyperopia following radial keratotomy has been described. A new surgical technique of two purse-string intrastromal sutures was investigated for correction of this hyperopia.
Methods: Eighteen radial keratotomy patients who were unhappy with uncorrected vision and who were unsatisfied with contact lens or spectacle correction, after informed consent, underwent corneal suturing. The 19 hyperopic eyes included 5 original overcorrections, 5 overcorrections after reoperation, and 9 progressive hyperopes. The refractive error ranged from +1.25 to +5.75 diopters spherical equivalent (mean +3.47 D). Presuturing uncorrected visual acuity ranged from 20/50 to 20/400 with 11 eyes (58%) 20/100 or worse.
Results: The follow up after double purse-string suturing averaged 24 months (range, 12 to 47 months). All patients had follow up of at least 1 year; 14 patients (74%) had follow up of 2 years or more. The change in refractive spherical equivalent following surgery averaged -3.30 D (range, -1.00 to -7.50 D). The steepening in average keratometry was 4.10 D (range, 1.00 to 8.00 D). The refraction after suturing averaged -1.12 D (range, +2.50 to -3.50 D). Uncorrected visual acuity after suturing was 20/40 or better in 14 eyes (74%), and 20/50 to 20/80 in 5 eyes (36%). There were no significant intraoperative, early or late postoperative complications. Seventeen eyes were either the same or gained 1 line of acuity; 2 eyes gained 2 lines of acuity; no eyes lost any lines of refractive Snellen acuity.
Conclusions: The placement of two purse-string intrastromal sutures appears to provide significant steepening of the central cornea following excessive flattening after radial keratotomy. The steepening effect appears to remain stable with greater than 1-year follow up. This surgical technique offers an alternative to symptomatic hyperopic postradial keratotomy patients who cannot be corrected with spectacles or contact lenses. (Refract Corneal Surg 1992;8:75-79.)
Suturing in Lamellar Surgery: The BRA-Technique
Authors: Guimaräes Ricardo Q , Rowsey J James , Guimaräes Márcia F Reis , Reis Pedro P Leite , Castro Raul Damásio R , Tirado Breno R 
Published: April 2021

ABSTRACT
Background: The principle of refractive corneal lamellar surgery rests on the modification of corneal shape after the removal of a superficial disk with a microkeratome. The 150-µm-thick disk is easily torn, rotated or decentered by the traditional eight-bite running suture, producing irregular astigmatism which is the major cause of visual deficit after these procedures.
Methods: We propose a new suture technique, designated the BRA suture, which we have used in more than 300 cases of various types of refractive corneal lamellar procedures. Based on the overlay concept, the suture is anchored in four points of the nonoperated corneal periphery.
Results: With this technique, the iatrogenic irregular astigmatism induced by the suture has been eliminated and corneal scars significantly reduced. This suture also decreases surgical time, accelerates visual recovery, and increases patient comfort due to its early removal.
Conclusions: We consider this the ideal suture for refractive corneal lamellar surgery due to its effectiveness, simplicity, and safety. (Refract Corneal Surg 1992;8:84-87.)
The PAR Technology Corneal Topography System
Authors: Belin Michael W , Litoff David , Strods Salvins J , Winn Steven S , Smith Richard S 
Published: April 2021

ABSTRACT
Background: Computer-assisted videokeratography has emerged as a useful clinical and research tool. All of the currently available commercial units utilize a modified placido disk image and require a smooth reflective surface. The PAR Technology Corneal Topography System (PAR CTS) is a prototype of a new computer-assisted corneal imaging device. The system produces a true topographic map (elevation map) by analyzing a projected grid on the corneal surface, as opposed to a placido disk reflection, and utilizes the technique of raster photogrammetry to define elevation points on the corneal surface. Because the system defines elevation points, not curvature, mathematical modeling is easily accomplished. Current software displays include a true topographic map, a spherical subtraction map in both relative and absolute scales, and a meridian analysis that is adapted to display refractive photoablative surgery.
Methods: We evaluated the accuracy of this device by analyzing three calibrated test spheres (55.76, 42.21, and 33.55 diopters). The test spheres were steel balls coated with a thin white silicone polyester coating that was necessary for grid projection. The test spheres were measured by a Taylor-Hobson contact profilometer possessing submicron accuracy. To determine the reproducibility of the system, three investigators measured three noncalibrated balls (20 mm, 18 mm, and 12 mm). The optical system was purposely decentered and refocused after each reading.
Results: Utilizing the CTS custom optics, system accuracy at the 8-millimeter test area was 0.03 (SD 0.03), 0.00, (SD 0.02), and 0.07 (SD 0.01) D respectively. Smaller diameter test areas resulted in a predicted loss of accuracy. Maximum intraobserver variability was 0.09, 0.06, and 0.11 D respectively, and maximum interobserver variability measured 0.18, 0.12, and 0.16 D.
Conclusions: These data demonstrate that the PAR CTS is both highly accurate and reproducible in determining topography of spheres that approximate the curvature of the human cornea. (Refract Corneal Surg 1992;8:88-96.)
Introduction to Biomechanics of the Cornea
Authors: Buzard Kurt A 
Published: April 2021

ABSTRACT
Background: As refractive procedures involving the cornea have proliferated, concerns over the long-term stability and predictability of these procedures have occupied a more prominent role.
Methods: Procedures and principles of mechanical engineering to mathematically model the cornea can provide valuable insight into the biomechanics of the cornea, and this approach can be used to predict corneal behavior. In order to utilize these advanced methods, some basic knowledge concerning limitations, assumptions, and techniques regarding the finite element method is needed. The principles of mechanical measurement of deformable bodies are discussed, as are the quantities stress, strain, Poisson's ratio, and creep as they are measured and used in the modeling of biologic systems. The finite element modeling procedure is discussed in a simplified geometric system.
Conclusions: While work remains to be done in this area, it is seen that useful and predictive models can be created which significantly improve our understanding and predictability of corneal procedures. (Refract Corneal Surg 1992;8:127-138.)
Computer Simulation of Arcuate Keratotomy for Astigmatism
Authors: Hanna Khalil D , Jouve Francois E , Waring George O , Ciarlet Philippe G 
Published: April 2021

ABSTRACT
Background: The development of refractive corneal surgery involves numerous attempts to isolate the effect of individual factors on surgical outcome. Computer simulation of refractive keratotomy allows the surgeon to alter variables of the technique and to isolate the effect of specific factors independent of other factors, something that cannot easily be done in any of the currently available experimental models.
Methods: We used the finite element numerical method to construct a mathematical model of the eye. The model analyzed stress-strain relationships in the normal corneoscleral shell and after astigmatic surgery. The model made the following assumptions: an axisymmetric eye, an idealized aspheric anterior corneal surface, transversal isotropy of the cornea, nonlinear strain tensor for large displacements, and near incompressibility of the corneoscleral shell. The eye was assumed to be fixed at the level of the optic nerve. The model described the acute elastic response of the eye to corneal surgery.
Results: We analyzed the effect of paired transverse arcuate corneal incisions for the correction of astigmatism. We evaluated the following incision variables and their effect on change in curvature of the incised and unincised meridians: length (longer, more steepening of unincised meridian), distance from the center of the cornea (farther, less flattening of incised meridian), depth (deeper, more effect), and the initial amount of astigmatism (small effect).
Conclusions: Our finite element computer model gives reasonably accurate information about the relative effects of different surgical variables, and demonstrates the feasibility of using nonlinear, anisotropic assumptions in the construction of such a computer model. Comparison of these computer-generated results to clinically achieved results may help refine the computer model. (Refract Corneal Surg 1992;8:152-163.)
Combined Transverse and Interrupted Radial Keratotomy for Compound Myopic Astigmatism
Authors: Lipshitz Isaac , Mayron Yoram , Loewenstein Anat 
Published: April 2021

ABSTRACT
BACKGROUND: A variety of patterns of keratotomy are used to correct naturally occurring astigmatism. We evaluated straight transverse incisions with interrupted radial incisions (jump radiais).
METHODS: In 32 human eyes with naturally occurring astigmatism, we used straight transverse incisions with interrupted radial incisions, with or without additional radial keratotomy, to correct compound myopic astigmatism. The range of preoperative refractive astigmatism was 1.00 to 3.50 D.
RESULTS: The mean follow-up time was 15 months (range, 12 to 16 months). The average surgically corrected astigmatism was 1 .55 ± 0.29 D. Eightyseven percent of the eyes achieved less than 1 .00 D of astigmatism, and the remaining four eyes retained 1 .00 to 1 .25 D of astigmatism.
CONCLUSION: Combined transverse and interrupted radial incisions are effective in correcting naturally occurring astigmatism. [Refract Corneal Surg 1992;8:280-285.)
RÉSUMÉ
INTRODUCTION. Différentes variétés de kératotomie ont été utilisées dans le traitement de l'astigmatisme myopique congénital. Nous avons évalué l'effet des incisions transverses associées à des incisions radiaires discontinues.
METHODES. Nous avons réalisé des incisions transverses droites associées à des incisions radiaires discontinues dan le traitement de l'astigmatisme congenital de 32 yeux. Des incisions radiaires transverses ont été réalisées si nécessaire pour traiter l'élément myopique de l'astigmatisme.
RESULTATS. Le recul moyen était de 15 mois (12 à 18 mois). La correction chirurgicale de l'astigmatisme était de 1.55 ± 0.29 D. 87% des yeux étaient corrigés à moins de 1 .00 D, seuls 4 yeux étaient entre 1.00 et 1.25 D.
CONCLUSION. L'association incision radiaire discontinue et transverse est efficace dans la correction de l'astigmatisme congénital. (Translated by Jean Marc Legeais, MD, Paris, France.)
SOMMARIO
PREMESSA. Una varietà di modelli di cheratotomia sono usati per correggere l'astigmatismo congenito (primario); noi abbiamo valutato le incisioni rette trasverse con incisioni radiali interrotte (radiali a salto).
METODI. In 32 occhi con astigmatismo congenito abbiamo usato le incisioni rette trasverse con incisioni radiali interrotte con o senza tagli radiali addizionali per correggere astigmatismo miopico composto. L'estensione dell'astigmatismo preoperatorio era fra 1 .00 a 3.50 diotric.
RESULTATI. Il follow up medio era di 15 mesi (da un minimo di 12 ad un massimo di 18 mesi). L'astigmatismo medio corretto chirurgicamente era 1 .55 ± 0.29 D. L'87% degli occhi ha ottenuto meno di 1 .00 D di astigmatism ed il rimanente 4 occhi ha mantenuto da 1 .00 a 1 .23 D di astigmatismo.
CONCLUSIONI. Le incisioni trasverse combinate alle radiali interrotte sono efficaci nel correggere l'astigmatismo congenito. (Translated by Lucio Buratto, MD, Milan, Italy.)
A Granny-Style Slip Knot for Use in Eye Surgery
Authors: Harris David J , Waring George O 
Published: April 2021

ABSTRACT
An adjustable knot for use in ocular surgery is described herein. The first part of the knot is a granny knot, which allows tension to be adjusted. The advantages of this knot are: 1 ) ease of tying; 2) adjustability; and 3) small size of the knot. [Refract Corneal Surg 1992;8:396-398.)
Intrastromal Photorefractive Keratectomy With a New Optically Coupled Laser Probe
Authors: Taboada J , Poirier Robert H , Yee R W , Tio F O 
Published: April 2021

ABSTRACT
BACKGROUND: Intrastromal photorefractive keratectomy is a new procedure in which compact linear or area regions of the corneal stroma can be vacuolized, yielding changes in corneal curvature.
METHODS: Diffraction-limited 1064- nanometer light pulses from a high rep rate Q-switched NdYAG laser were coupled through novel means into a probe with index-matched optical contact with the cornea. The resulting extremely reduced focal region initiated a plasma point that was free of shock front effects where tissue was reduced to liquid. This probe process was applied to the corneas of eye-bank eyes, and to living rabbit and primate eyes. The refractive effects were evaluated with slit-lamp microscopy, keratoscopy, light and electron microscopy.
RESULTS: Refractive effects similar to refractive keratotomy were observed immediately after treatment. Intrastromal highly localized vacuolized regions were observed at the depth of focus with variability of only 20 µm. The plasma point vacuoles were about 100 pm in diameter. Stromal material that occupied the vacuole space appeared completely reduced to liquid. The transition region between vacuole and normal tissue was less than 0.5 µm. The treatment vacuoles disappeared to the unaided eye 24 to 48 hours after treatment.
CONCLUSIONS: Corneal refractive power can be achieved with intrastromal keratectomy. (Refract Corneal Surg 1992;8:399-402.)