bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recurrent Hyphema Associated With IOL Loop Displacement Treated With Argon Laser Photocoagulation
Authors: Assia Ehud I , Blumenthal Michael 
Published: April 2021

ABSTRACT
Recurrent late hyphema following cataract surgery and implantation of a posterior chamber intraocular lens (PC-IOL) is a rare complication, since there is usually no contact between the IOL and the anterior iris. If treatment with miotics or mydriatics fails, surgical removal of the IOL is often necessary. We report a patient with recurrent hyphema in his only myopic eye who had undergone two retinal detachment operations. A loop of the PC-IOL dislocated anteriorly through a peripheral iridectomy and caused localized pressure and recurrent bleeding. Conservative treatment with argon laser photocoagulation obviated more complex surgery in a high-risk patient.
Repair of a Disinserted Scleral Flap in Trabeculectomy
Authors: Riley Shawn F , Smith Thomas J , Simmons Richard J 
Published: April 2021

ABSTRACT
We report a surgical technique for repair of a disinserted scierai flap involving the use of two 10-0 nylon sutures, which are placed through the base of the scierai flap, and through and out of the peripheral cornea. These two sutures create a water-tight flap at the repaired hinged area. The procedure may thus continue as a trabeculectomy, permitting postoperative staged argon-laser suture lysis as well.
Reformation of the Anterior Chamber Following Trabeculectomy
Authors: Austin M W , Wishart P K 
Published: April 2021

ABSTRACT
Sixteen eyes requiring surgical reformation of the anterior chamber (AC) in our Unit from December 1987 to August 1991 were studied retrospectively to determine the incidence of the problem in our hospital and to evaluate the operative measures used to restore the AC. The mean preoperative AC depth of these 16 eyes was 1.92 mm (range, 1.50 to 2.50 mm). Nine had a history of angle-closure glaucoma. Poor surgical technique was a contributing factor in the development of a flat AC in 3. Of the remaining 13 eyes, 11 had a trabeculectomy with a fornix-based, and 2 with a limbus-based, conjunctival flap. Wound leaks occurred in 10 eyes with fornix-based flaps, but in none of the eyes with limbus-based flaps. Factors associated significantly with the development of flat AC following trabeculectomy were: a preoperative shallow AC, a history of angle-closure glaucoma, and the use of a fornix-based conjunctival flap. Avoiding wound leakage when performing trabeculectomy in eyes with a shallow AC or a history of angle-closure glaucoma by using a limbus-based flap may help prevent postoperative flat AC.
Eye Growth After Cataract Extraction and Intraocular Lens Implantation in Children
Authors: Kora Yukiko , Shimizu Kiyoshi , Inatomi Makoto , Fukado Yoshinao , Ozawa Tetuma 
Published: April 2021

ABSTRACT
We studied the effect of cataract extraction and intraocular lens (IOL) implantation (14 unilateral and 2 bilateral cases) on eye growth in 16 children. Visual acuity, refractive power, axial length, corneal curvature, and anterior chamber depth in both the operated and unoperated eyes were measured before and after surgery. The operated eyes tended to become myopic (maximum, -11.00 diopters). However, though the axial length of two eyes increased significantly after surgery, there was no significant difference between the postoperative increase in axial length in the operated and in the unoperated eyes. The anterior chambers of the unoperated eyes tended to be deeper. We suggest that the tendency to become myopic in the operated eyes occurred because, as axial length increases with growth, the proportion occupied by the vitreous body, ie, the part posterior to the IOL, also increases.
Use of a Silicone Sheet for Delayed Adjustable Strabismus Surgery
Authors: Shokida Maria Felisa 
Published: April 2021

ABSTRACT
Adjustable strabismus surgery sometimes fails because of changes in the angle of deviation developing a few days after surgery. A thin silicone sheet placed between the muscle and sclera prevents postoperative adhesions between these tissues, allowing adjustment to be delayed for up to 1 1 days after surgery. Once the final adjustment is made, the silicone sheet is removed.
Pars Plana Vitrectomy for Complications of Retinal Arterial Macroaneurysms-A Case Series
Authors: Brent B David , Gonce Mark , Diamond James G 
Published: April 2021

ABSTRACT
Retinal arterial macroaneurysms are distinct vascular lesions with a typically benign course. Laser treatment to these vascular lesions is controversial, and has been limited to cases of persistent macular edema. Devastating vision loss can occur, however, through vitreous or subretinal hemorrhage. We describe eight cases of retinal arterial macroaneurysms associated with subretinal or vitreous hemorrhage requiring pars plana vitrectomy. Final visual acuities ranged from 20/20 to 20/400 at most recent follow up. Until reliable indicators of rupture are identified, we suggest consideration of laser photocoagulation to clinically active, identifiable retinal arterial macroaneurysms within the macula.
Deep Venous Thrombosis Following Immobilization After Retinal Detachment Surgery
Authors: Chu Thomas G , Pince Keith J 
Published: April 2021

ABSTRACT
Although deep venous thrombosis (DVT) and pulmonary embolism are potentially fatal complications of numerous surgical procedures, DVT associated with ophthalmic surgery has rarely been reported in the current literature. We report the development of a DVT in a patient following complicated vitreoretinal surgery.
Prilocaine: An Old Anesthetic Agent and a New Ophthalmic Procedure
Authors: Coelho Etelvino T , Gomes Edigezir B , Martins Heraldo S , de Sousa Byron 
Published: April 2021

ABSTRACT
We present a new local anesthetic technique for ophthalmic surgery that reduces the risks associated with retrobulbar and peribulbar anesthesia. This method uses topical proparacaine plus 1.5 mL of prilocaine (3%) with felypressin injected into the subconjunctival (sub-Tenon's) space. Of 5210 consecutive adult patients in whom the technique was used, all demonstrated adequate analgesia. Sixty-three (1.2%) of the eyes required supplemental analgesia, provided by a single injection of prilocaine (0.5 mL). Ecchymosis and subconjunctival hemorrhage developed in 63 (1.2%) of the eyes. There were no instances of ptosis.
The Effect of Apraclonidine on the Intraocular Pressure of Glaucoma Patients Following Nd:YAG Laser Posterior Capsulotomy
Authors: Cullom R Douglas , Schwartz Louis W 
Published: April 2021

ABSTRACT
We retrospectively compared the incidence and level of postoperative intraocular pressure (IOP) spikes in 53 consecutive glaucoma patients undergoing Nd:YAG posterior capsulotomy (YPC) who received apraclonidine immediately postoperatively, with those occurring in 22 consecutive similar patients who did not receive apraclonidine. Postoperative IOP elevations of 5 mm Hg or more occurred in 13% of the apraclonidine recipients and in 59% of the nonrecipients; elevations of 10 mm Hg or more occurred in 4% of the former and in 27% of the latter. Our results suggest that apraclonidine can be a useful adjunct in preventing IOP elevations following YPC in glaucoma patients.
Pars Planitis Presenting With Vitreous Hemorrhage
Authors: Phillips William B , Bergren Robert L , McNamara J Arch 
Published: April 2021

ABSTRACT
A 31-year-old woman complained of a sudden, painless decrease in vision of the right eye. Ophthalmic examination demonstrated a vitreous hemorrhage in the right eye secondary to peripheral neovascularization. The left eye demonstrated findings consistent with pars planitis. Before this episode, vision was good in both eyes. Although rare, vitreous hemorrhage can occur in the setting of pars planitis and may be a presenting symptom. Pars planitis should be considered in the differential diagnosis of young patients with vitreous hemorrhage.
Prediction of Postoperative Visual Acuity in Patients With Total Glaucomatous Cupping Using the Potential Acuity Meter and Automated Perimetry
Authors: Stewart William C , Connor Amy B , Hunt Hurshell H 
Published: April 2021

ABSTRACT
We evaluated the effectiveness of using the Potential Acuity Meter (PAM) and automated perimetry to predict postoperative vision in 30 advanced glaucoma patients following combined cataract extraction and trabeculectomy. Using the binomial distribution at α = 0.05, PAM and automated perimetry individually were significantly useful in predicting postoperative vision of 20/40 or better. Automated perimetry, but not PAM, was useful in predicting worse than 20/40 vision. Used together, automated perimetry and PAM testing were significantly useful in predicting vision worse or better than 20/40.
A Temporary Dissecting Seton for Trabeculectomy: Delayed Re-Creation of the Glaucoma Filtering Sclerostomy and Bleb
Authors: Gross Peter G 
Published: April 2021

ABSTRACT
Presented is a new surgical technique to re-create the entire filtering pathway 2 weeks following trabeculectomy. The dissecting seton is a suture loop of 9-0 nylon, silk, or polypropylene placed in the potential outflow space of the sclerostomy and bleb area during trabeculectomy. The seton is pulled out at the slit lamp, under topical anesthesia, 1 to 3 weeks after the initial surgery in order to re-create the filtration pathway. By pulling on the seton, a cheesewiring dissection severs newly formed fibrovascular tissue that may have occluded or constricted the previously created aqueous outflow tract at any point(s). Because of the significant time delay, the reopened filtration pathway is, for the first time, filled with flowing aqueous of nearly normal composition under a well-healed conjunctiva as a result of a nearly normally functioning ciliary body in a nearly quiet eye. Delayed postoperative re-creation of the bleb with the dissecting seton may be combined with other management techniques such as 5-fluorouracil subconjunctival injections, suture cuttings, bleb massage, etc.
This technique has been used in nine cases with follow up ranging from a few weeks to 1 year. All were trabeculectomies with phacoemulsification and intraocular lens implantation. Both initial placement and subsequent handling of the dissecting seton appear to be safe, quick, easy, and inexpensive. Complications or failures have all been minor and easily managed.
Combined Cataract Extraction and Trabeculectomy: Phacoemulsification Compared With Extracapsular Technique
Authors: Wishart Peter K , Austin Michael W 
Published: April 2021

ABSTRACT
Thirty-four eyes undergoing phacoemulsification and trabeculectomy (PHACO + TRAB) were followed prospectively for 1 year postoperatively. The results of surgery were compared with those, obtained retrospectively, of the previous 34 extracapsular cataract extractions with trabeculectomy (ECCE + TRAB) performed by the same surgical team. All eyes received posterior chamber intraocular lens implants.
Preoperatively, the two groups did not differ significantly in terms of age, gender distribution, or degree and duration of glaucoma and cataract. Mean postoperative follow up for the ECCE + TRAB group was 13.6 months; for the PHACO + TRAB group, 12.6 months (P = .1). As compared with the ECCE + TRAB group, the PHACO + TRAB group had earlier visual rehabilitation, less postoperative astigmatism (P < .001), and improved long-term intraocular pressure control (P = .04). Early postoperative pressure spikes occurred in 32% of the ECCE + TRAB eyes and in 23.5% of the PHACO + TRAB eyes (P = .2). Other postoperative complications occurred more commonly in the ECCE + TRAB group: hyphema (P < .001), fibrinous iritis (P < .01), choroidal detachment (P < .05), and hypotony (P < .05). Posterior capsular opacification was significantly more common in the ECCE + TRAB group (P < .02).
These major differences probably are attributable primarily to the small incision used in phacoemulsification, which is associated with sustained IOP control during the operation, a small stable wound with low postoperative astigmatism, and early stabilization of refraction.
Peribulbar and Retrobulbar Anesthesia With Prilocaine: A Comparison of Two Methods of Local Ocular Anesthesia
Authors: Saunders D C , Sturgess D A , Pemberton C J , Morgan L H , Bourne A 
Published: April 2021

ABSTRACT
Prilocaine (Citanest) has been shown to be a satisfactory alternative to lignocaine, with certain important advantages, including superior diffusion. The latter may be especially important in peribulbar anesthesia, where the level of diffusion is a critical factor in providing a timely, high-quality block. In a prospective randomized study, we compared the effectiveness of peribulbar vs retrobulbar administration of prilocaine.
Eighty-seven patients undergoing elective intraocular surgery were randomized to receive either retrobulbar or peribulbar anesthesia with prilocaine 3% with felypressin and hyaluronidase. Pain of injection, akinesia, and anesthesia were evaluated at predetermined intervals after injection. Except for the fact that lid akinesia occurred earlier in the peribulbar group, there was no difference in the quality or rate of onset of overall akinesia in the two groups. Nor were there any differences in the pain associated with injection. Both groups had excellent operative anesthesia and akinesia.
Biomicroscopic Findings of Posterior Vitreoschisis
Authors: Kakehashi Akihiro , Schepens Charles L , de Sousa-Neto Alipio , Jalkh Alex E , Trempe Clement L 
Published: April 2021

ABSTRACT
The clinical entity of posterior vitreoschisis, splitting of the posterior cortical vitreous, is not well known. We confirmed its presence biomicroscopically in cases with posterior vitreous detachment and found it mostly associated with retinal vascular diseases, usually manifesting as two dense vitreous membranes with defects. When posterior vitreoschisis develops in an otherwise normal eye, it may not manifest as two membranes, but can form a crescent-shaped, optically empty space in the posterior vitreous cavity. Because its management is different, posterior vitreoschisis should be differentiated from other, apparently similar, conditions, especially posterior vitreous detachment.
Intracameral Tissue Plasminogen Activator to Treat Blocked Glaucoma Implants
Authors: Richards David W 
Published: April 2021

ABSTRACT
I report the use of tissue plasminogen activator to open blocked silicone tubes of Baerveldt glaucoma implants in two cases. A dose of 25 µg was used in both cases; lysis of fibrin clots occurrsd within 15 to 45 minutes.
Modeling of Erbium: YAG Laser-Mediated Explosive Photovaporization: Implications for Vitreoretinal Surgery
Authors: Berger Jeffrey W , D'Amico Donald J 
Published: April 2021

* BACKGROUND AND OBJECTIVE: Motivated by the potential for highly precise tissue removal, investigators are exploring fiberoptic microsurgical maneuvers with the erbium:YAG (Er:YAG) laser. Tissue is disrupted and removed by direct ablation and the acousto-mechanical sequelae of explosive vaporization of the tissue water. The authors investigated the scaling laws for photoablative and photodisruptive interactions and interpreted these results to optimize energy delivery for vitreoretinal surgical maneuvers.
* MATERIALS AND METHODS: A model for laser-generated-bubble expansion is presented based on energy principles and adiabatic gas expansion. Comparisons are made with the authors' previous studies of ablation rate and thermometry.

* RESULTS: The authors' modeling studies generated predictions similar to experimental data. The maximum bubble diameter increases as the cube root of the pulse energy. At constant radiant exposure, the maximum bubble diameter increases as the probe tip diameter raised to the two-thirds power. The authors demonstrated that tissue ablation depends on radiant exposure (J/cm
p 2
), whereas temperature increases, bubble size, and peak pressure depend on total pulse energy.

* CONCLUSIONS: Mechanical injury should be minimized and efficient ablation preserved by delivering low-pulse energy through small-diameter probe tips at high repetition rates.
[Ophthalmic Surg Lasers 1997;28:133-139.]
Role of the Vitreous and Macular Edema in Branch Retinal Vein Occlusion
Authors: Takihashi Masatoshi K , Hikichi Taiichi , Akiba Jun , Yoshida Akitoshi , Trempe Clement L 
Published: April 2021

* BACKGROUND AND OBJECTIVE: To deter mine the relationship between macular edema associated with branch retinal vein occlusion (BRVO) and the condition of the vitreous.
* PATIENTS AND METHODS: The authors retrospectively studied 58 patients (58 eyes) who underwent vitreous examination. The eyes were classified as having vitreomacular attachment (VMA) or vitreomacular separation (VMS), and were divided into two groups based on the mean age of the patients.
* RESULTS: Macular edema was found in 39 (67%) of the eyes. The prevalence of VMA was 8 1 % (22 of 27 eyes) in group 1 (patients who were 64 years old or younger) and 45% (14 of 31 eyes) in group 2 (patients who were older than 64 years). Although no significant relationship was found, 77% (17 of 22) of the eyes with VMA in group 1 had macular edema. The incidence of macular edema was significantly higher in eyes with VMA (93%, 13 of 14) than in eyes with VMS (41%, 7 of 17, P= .009) in group 2.
* CONCLUSION: The authors findings suggest that VMA may influence the presence of macular edema associated with BRVO.
[Ophthalmic Surg Lasers 1997;28:294-299.]
Laser Trabeculoplasty: How Little Is Enough?
Authors: Frenkel Ronald E P , Shin Dong H , Epstein David L , Hertzmark Ellen , Bohn Jeffrey L , Hong Young J 
Published: April 2021

* BACKGROUND AND OBJECTIVE: The opti mal number of laser applications for argon laser trabeculoplasty in patients with primary open-angle glaucoma has not been established. The purpose of this study was to determine the fewest number of burns necessary for clinically effective intraocular pressure reduction for these patients.
* PATIENTS AND METHODS: Using a prospective, randomized, collaborative study, the authors examined the relationship between the number of laser trabeculoplasty burns and intraocular pressure for patients with primary open-angle glaucoma. A total of 122 patients received either 50 burns to half of the trabecular meshwork (group 1) or 35 burns to one third of the trabecular meshwork (group 2) .
* RESULTS: The mean baseline intraocular pressures were similar between group 1 (22.3 ±4.1 mm Hg [mean ± SD]) and group 2 (22.8 ± 5.0 mm Hg) (P = .58). Intraocular pressure reduction at 9 to 12 months, although significant in both groups (group 1 : 4.4 ± 3.0 mm Hg, P < .0001; group 2: 3.9 ± 5.1 mm Hg, P < .0001), did not differ significantly between the two groups (P = .63).
* CONCLUSION: This study demonstrated that 35 burns may be as clinically effective as 50 burns in reducing the intraocular pressure in primary openangle glaucoma patients.
[Ophthalmic Surg Lasers 1997;28:900-904.]
Clinical Use of a New Axial Chondro-mucosal Flap in Wide Full-thickness Eyelid Reconstructions
Authors: Scuderi Nicoló , Rubino Corrado , Bertozzi Ettore 
Published: April 2021

* BACKGROUND AND OBJECTIVE: Full thickness reconstruction of more than half of an eyelid, mainly of the upper one, is a challenge for the surgeon. In 1992, for the first time, the authors reported the use of an axial chondro-mucosal flap from the nose for reconstruction of the tarsoconjunctival plane of a full thickness defect of an eyelid. This article reports and discusses the results of the follow-up of 1 8 patients operated on using the above technique during the period June 1991-March 1997.
* PATIENTS AND METHODS: Apart from the oncological evaluation, the following parameters were assessed: position, closure, the presence of epiphora, length of the palpebrai rim, rim opening, levator function, an aesthetic balance of the eyelids, and donor site morbidity. The follow-up ranged from 6 to 40 months.
* RESULTS: The axial chondro-mucosal flap was clinically viable in all patients. One patient showed a 2 mm lagophthalmos. Static parameters were within normal ranges. In upper eyelid reconstruction, an 8 to 18 mm. levator function (mean 13 mm) was shown.
* CONCLUSION: The authors discuss their complications and results and feel that this flap, associated with full thickness skin grafts, may be considered a first choice technique, in expert hands, in complex full thickness upper eyelid reconstruction, and a possible alternative in lower eyelid reconstruction, for wide defects when the use of other flaps is compromised.
[Ophthalmic Surg Lasers 1999;30:91-97.]
Optic Nerve Sheath Decompression for Progressive Central Retinal Vein Occlusion
Authors: Dev Sundeep , Buckley Edward G 
Published: April 2021

* OBJECTIVE: To review our results with optic nerve sheath decompression (ONSD) for progressive central retinal vein occlusions (CRVO).
* METHODS: Patients selected all had evidence of progressively worsening CRVO, a component of optic nerve swelling, and most were already monocular from prior disease in the contralateral eye. ONSD was performed using a nasal approach under retrobulbar anesthesia.
* RESULTS: Eight eyes from 8 patients with a mean follow-up of 12 months were analyzed. Six patients improved, 2 worsened. Mean preoperative visual acuity was 20/160, and mean final postoperative visual acuity was 20/70. No complications occurred. Nonischemic CRVOs, patients <65 years old, and those undergoing ONSD within 3 months of presentation seemed to do better.
* CONCLUSION: ONSD may improve vision or stabilize visual loss in patients with progressive CRVO.
[Ophthalmic Surg Lasers 1999;30:181-184.]
Intraocular Pressure Fluctuations During Strabismus Operations and the Postoperative Period
Authors: Snir Moshe , Axer-Siegel Ruth , Chalimi J , Shalev B , Yassur Yuval 
Published: April 2021

* PURPOSE: To evaluate the intraocular pressure (IOP) variations which occur during and after strabismus surgery.
* METHOD: We measured the IOP in 34 eyes of 20 pediatrie patients undergoing primary strabismus surgery under general anesthesia. Measurements were performed by the Tono-Pen (Mentor O&Q Inc. Norwell, MA) prior to surgery, immediately after suturing of the conjunctive, and 1 week and 4 weeks after surgery. All patients received the same local antibiotics and steroid solutions postoperatively.
* RESULTS: IOP decreased from baseline to the end of surgery by a mean of 8.26 ±1.8 mmHg and increased from baseline to 4 weeks after surgery by a mean of 3.6 ± 1.8 mmHg. Thirty-eight percent of the eyes had an IOP of 21 mmHg or more during the postoperative period.
* CONCLUSION: IOP variations are prevalent during and after strabismus surgery. Careful postoperative measurements are recommended in order to identify individuals who may be prone to iatrogenically increased IOP.
[Ophthalmic Surg and Lasers 1999;30:212-215.]