bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Comparison of the Ocular Blood Flow Tonograph and the Goldmann Applanation Tonometer
Authors: Esgin H. , Alimgil M.L. , Erda S. 
Published: March 2018

Purpose To compare the IOP readings of an ocular blood flow (OBF) tonograph (OBF Labs UK Ltd) with Goldmann applanation tonometry. Methods 194 patients were studied. In group 1, the software version 8.2 of the OBF tonograph was used in 214 eyes of 107 patients and in group 2, the 11.2 version of the tonograph was used in 174 eyes of 87 patients. Results We found 63% of the OBF tonograph readings to be within ±2mm Hg of the Goldmann applanation tonometry readings in group 1 and 60% in group 2. In group 1 the correlation coefficient between the readings of the two instruments was 0.71 and 0.82 in group 2. The mean value for the paired differences in group 1 was –1.34±2.75mm Hg overall and –1.04±2.91mm Hg overall in group 2. There was a significant difference between the Goldmann applanation tonometer and OBF tonograph readings in the 8–10mm Hg interval (p<0.001) in group 1, but not in group 2 (p>0.1). Conclusions The 11.2 version of the OBF tonograph is more accurate than the 8.2 version and measures IOP in a manner that corresponds well to the Goldmann applanation tonometer in the 8–10mm Hg and 21–29mm Hg intervals. It corresponds fairly well in the 11–20mm Hg interval.
The Effect of 0.25% Apraclonidine in Preventing Intraocular Pressure Elevation after Nd: Yag Laser Posterior Capsulotomy
Authors: Simsek S. , Ertürk H. , Demirok A. , Cinal A. , Yasar T. , Karadenizli C. 
Published: March 2018

Purpose The efficacy and adverse effects of 0.25% apraclonidine on intraocular pressure (IOP) after Nd: YAG laser posterior capsulotomy were investigated, and the results were compared with placebo, 0.50% timolol maleate and 1% apraclonidine. Methods Eighty eyes were randomly assigned to four groups of 20 eyes. In a double-masked design, the groups were treated with placebo (group I), 0.50% timolol maleate (group 2), 1% apraclonidine (group 3), 0.25% apraclonidine (group 4) one hour before and five minutes after Nd:YAG laser posterior capsulotomy. IOP was measured by applanation tonometry 1 hour before (baseline IOP) and 1,3, 24 hours after capsulotomy. Results The average baseline IOP increased respectively 3.90 ± 5.35, 5.95 ± 5.32, 1.15 ± 3.20 mmHg in the first group 1, 3 and 24 hours post-treatment. There were significant differences between baseline IOP and 1 and 3 hours but not at 24 hours (p=0.004, p=0.001, p=0.13). IOP increased 0.40 ± 4.08, 0.75 ± 5.33, 0.80 ± 6.03 mmHg in the second group at the same times. The differences between the average baseline IOP and the 1, 3 and 24h measurement were not significant (p=0.83, p=0.65, p=0.93). In the third group, IOP decreased 3.70 ± 2.40, 3.30 ± 2.47, 2.65 ± 1.56 mmHg at the measurement times, with significant differences between the average baseline IOP and the 1, 3 and 24 hour measurements (p=0.001, p=0.0001, p=0.01). In the fourth group IOP increased 0.35 ± 3.32 mmHg at 1 hour, but decreased 1.25 ± 3.41, 0.90 ± 2.07 mmHg at 3 and 24 hours. The differences were not significant (p=0.94, p=0.16, p=0.08). When the 0.25% and 1% apraclonidine groups were compared, there were significant differences between the average IOP at 1 hour in both groups but not at 3 and 24 hours (p=0.01, p=0.17, p=0.21). Similarly, there were no significant differences between the average IOP at the same times when the 0.25% apraclonidine group was compared with the timolol group (p=0.30, p=0.08, p=0.16). Some systemic and local side effects were seen in the timolol and 1% apraclonidine groups, but none with 0.25% apraclonidine. Conclusions It was concluded that 0.25% apraclonidine is effective in preventing the early elevation of IOP after Nd:YAG laser posterior capsulotomy and may offer an alternative to 0.50% timolol maleate and 1% apraclonidine.
Fixed-Dose Combination of 0.1% Diclofenac plus 0.3% Tobramycin Ophthalmic Solution for Inflammation after Cataract Surgery: A Randomized, Comparative, Active Treatment-Controlled Trial
Authors: Barraquer R.I. , ÁLvarez de Toledo J.P. , Montané D. , Escoto R.M. , Torres C. Garcia , Bennani-Tazzi M. 
Published: March 2018

Purpose To assess the efficacy, tolerance, and ocular tolerability of a fixed-dose combination of 0.1% diclofenac plus 0.3% tobramycin ophthalmic solution compared with 0.1% diclofenac (Voltaren®) and 0.3% tobramycin (Tobrex®) in patients undergoing cataract extraction by either nuclear expression (extracapsular) or ultrasound-assisted aspiration (phacoemulsification) with intraocular lens implantation. Methods Eighty-eight patients undergoing cataract extraction with intraocular lens implantation participated in a randomized, parallel, observer-masked trial, in which the clinical usefulness of a fixed-dose combination of 0.1% diclofenac plus 0.3% tobramycin ophthalmic solution, two eyedrops every 6 hours (n=44) was compared with Voltaren® and Tobrex®, one drop of each every 6 hours (n=44) in a 22-day course. Efficacy was assessed from changes of the sum of anterior chamber cell count plus flare, conjunctival hyperemia and edema, and ciliary congestion, by means of slit lamp biomicroscopy on days 1, 7, 14, and 21. Tolerance and ocular tolerability were assessed by recording intraocular pressure (IOP), side effects, and the patient's and investigator's opinions. Results Anterior chamber cell count plus flare showed no differences in the two treatment groups at any evaluation point. The study treatment was associated with a significantly higher score for conjuncitval edema on day 1 (p=0.015), conjuncitval hyperemia on day 14 (p=0.009) and anterior chamber cell count on day 21 (p=0.04), but these differences had no clinical relevance. No side effects related to the study treatment were recorded. Conclusions Efficacy, tolerance, and ocular tolerability of a fixed-dose combination of 0.1% diclofenac plus 0.3% tobramycin ophthalmic solution were comparable to Voltaren® plus Tobrex® for the control of anterior chamber inflammation after cataract surgery, with the advantage that both active principles are supplied in a single container.
Clinical Consequences of the Use of Highly Purified Silicone Oil: Comparative study of highly and less purified silicone oil
Authors: Pastor J. C. , Zarco J. M. , Del Nozal M.J. , Pampliega A. , Marinero P. 
Published: March 2018

Purpose To compare the ocular toxicity caused by the use of highly purified silicone oil to less purified silicone oil in humans. Methods Fifty-six eyes received 2,000 centistokes (cs) purified silicone oil (group 1) and 42 eyes received 2,000 cs fractionated (highly purified) silicone oil (group 2) after pars plana vitrectormy. Follow-up ranged from 6 to 48 months. Results Six months after injection, the following complications were found in groups 1 and 2, respectively: ocular hypotension (<13mmHg), 39.3% and 31%, sustained ocular hypertension (>23mmHg), 19.6% and 19%; acute hypertensive peaks (>30mmHg), 23.2% and 11.9%; corneal alterations, 19.6% and 14.3%; emulsification, 1.8% and 2.4%; silicone oil cloudiness, 28.6% and 0%; preretinal reproliferation, 14.3% and 4.8% and total or partial retinal reattachment, 78.6% and 90.5%. Conclusions Highly purified silicone oil was better tolerated than the less purified oil and caused fewer complications. Poorly purified silicone oils should be avoided in clinical practice.
Indocyanine Green Angiographic Findings in a Case of Punctate Inner Choroidopathy
Authors: Akman A. , Kadayifçilar S. , Aydin P. 
Published: March 2018

Purpose To report indocyanine green angiographic findings in a case of punctate inner choroidopathy. Methods Fundoscopy, fluorescein angiography and indocyanine green angiography were carried out on a 23-year-old woman who presented with features typical of punctate inner choroidopathy. Results Fundoscopy showed multiple small yellow lesions in the retinal pigment epithelium and inner choroid in both eyes and a subfoveal choroidal neovascular membrane in the left eye. The lesions showed early hyperfluorescence with mild leakage in the late phases of the fluorescein angiogram. On indocyanine green angiography, the lesions demonstrated obvious hypofluorescence in the early, mid and late phases. Conclusions The fluorescein and indocyanine green angiographic findings indicate that punctate inner choroidopathy affects the choriocapillaris as well as the retinal pigment epithelium and photoreceptors. However, it is still not known whether the primary pathology is in the retinal pigment epithelium, the photoreceptors or the choriocapillaris.
Efficiency of Pupillary Stretching in Cataract Surgery
Authors: Bacskulin A. , Kundt G. , Guthoff R. 
Published: March 2018

Purpose To assess the efficiency of pupillary stretching with iris hooks in poorly dilatable pupils during phacoemulsification. Methods Forty eyes with maximal preoperative mydriasis less than 4.5 mm (mean 3.9 mm S.D. 1.0) received bimanual pupillary stretching according to the technique of Miller and Keener (1994). Results Small pupils were mainly caused by long-term pilocarpine therapy (n=21), posterior synechia (n=11) or diabetic iridopathy (n=7). With multidirectional stretching, the pupil could be enlarged to mean 6.6 mm (S.D. 0.66), lasting throughout phacoemulsification. The effect of stretching was significantly greater in eyes with synechias, but no significant differences in post-operative pupil motility was observed between the three subgroups. Six eyes with pronounced postoperative inflammation responded well to antiinflammatory treatment. Conclusions Done with routine surgical instruments, bimanual pupillary stretching seems to be an easy, safe and effective procedure for enlarging small pupils by an average of 2.7 mm during phacoemulsification, especially in eyes with posterior synechias.
Color Doppler Imaging of the Retrobulbar Circulation in Age-Related Macular Degeneration
Authors: Hosal B.M. , Karakoç G. , GÜrsel E. , Çamur M. 
Published: March 2018

Purpose The aim of this study was to assess hemodynamic changes in the retrobulbar circulation in patients with age-related macular degeneration (ARMD). Methods Color Doppler imaging was used to calculate blood flow velocities and vascular resistance of the central retinal artery, short posterior ciliary artery and ophthalmic artery in patients with ARMD and in control patients. Results The average peak systolic velocity was significantly lower in the central retinal artery (p < 0.001), posterior ciliary artery (p < 0.001) and ophthalmic artery (p < 0.01) of the patients with ARMD than in control. End-diastolic blood flow velocities in the retrobulbar arteries of ARMD patients were also significantly lower (p < 0.001) than controls. Gosling's pulsatility index was significantly higher in the ophthalmic artery (p<0.01) and posterior ciliary artery (p < 0.001) of eyes with ARMD. In addition, the resistivity index was significantly higher in all retrobulbar arteries (p < 0.001) of these patients. Conclusions The hemodynamic abnormalities in the retrobulbar circulation suggest that vascular impairment may play a role in the pathogenesis of ARMD.
The Effect of Pulsed Electromagnetic Field on Patients with Endocrine Ophthalmopathy
Authors: Jankauskienė J. , Paunksnis A. , Blužienė A , Saulgozis J. 
Published: March 2018

Purpose To evaluate eye signs, proptosis and ocular movements in patients with endocrine ophthalmopathy under the influence of pulsed electromagnetic field therapy. Methods We examined 14 patients (9 women, 5 men) with endocrine ophthalmopathy and evaluated eye signs, proptosis and ocular movements before and after the course of pulsed electromagnetic field therapy, and 12 controls. Their age ranged from 29 to 57 years. Visual sensitivity was investigated with a static automatic perimeter (Allergan Humphrey Field Analyzer). The score was calculated by rating the severity of involvement of soft tissue, proptosis, extraocular movements, corneal state and optic nerve function on a scale from 0 to 3. The pulsed electromagnetic field procedures were carried out with the help of electromagnetic spectacles. Results Pulsed electromagnetic field therapy reduced the score for soft tissue and proptosis in patients who suffered from endocrine ophthalmopathy. There was fall in the mean score for ocular movements, corneal and optic nerve function but it did not reach significance after treatment. Electromagnetic field therapy has no useful effect on visual signs and eye movements in two patients who had had the illness more than two years. Conclusions Localised pulsed electromagnetic field procedures can be recommended, together with other methods of conservative treatment of endocrine ophthalmopathy.
Orbital Dirofilariasis
Authors: Strianese D. , Martini A. , Molfino G. , Falabella L. , Tranfa F. 
Published: March 2018

Purpose To warn the ophthalmologist to consider orbital dirofilariasis in the differential diagnosis of inflammatory masses of the orbit. Patients Two cases with non-specific swelling and pain of the orbit who had a initial diagnosis of “inflammatory pseudotumor of the orbit”. Results These are two new cases of orbital dirofilariasis. Conclusion In the ophthalmic literature, the highest incidence of ocular dirofilariasis is reported in Italy. Since both these patients had no history of travel in endemic areas of Dirofilaria, this parasitic infection is presumably not rare in Italy and is probably underdiagnosed.
The Long Term Results of Charnley Low-Friction Arthroplasty in Patients with Juvenile Chronic Rheumatoid Arthritis
Authors: Sochart D. H. , Porter M. L. 
Published: March 2018

Eighty Charnley low-friction arthroplasties, performed on 49 patients with juvenile chronic rheumatoid arthritis, between 1966 and 1986, were followed-up for an average duration of 217 months (18.1 years; 26 to 366 months). There were 10 male patients (17 arthroplasties) and 39 females (63 arthroplasties) whose average age at time of operation was 28.5 years (18 to 35 years). A total of 14 patients (24 arthroplasties) had died, at an average of 208 months (17.3 years, 26 to 339 months) following operation. All patients had marked improvement in levels of pain, function and range of movement of the joint, with 88% (43 patients, 70 arthroplasties) being completely free of pain and all but one of the remainder experiencing only minimal discomfort. Fourteen acetabular components (18%) were revised at an average of 148 months (12.3 years: 26 to 252 months) from the time of operation. Three were revised for deep sepsis, four for excessive wear, and seven for aseptic loosening (9%). Three acetabular components are currently loose and the total aseptic loosening rate was therefore 13% (10 hips). The average acetabular wear rate was 0.11 millimeters per year for the entire series. Twelve femoral components were revised at an average of 153.8 months (12.8 years; 26 to 231 months), three for deep sepsis, five for aseptic loosening (6%) and three following fracture of the implant. One component was revised, although not actually loose, during an operation to replace a loose acetabular component. One of the surviving implants is currently loose and the total rate of mechanical failure of the femoral implant was therefore 11% (9 hips). Acetabular component survivorship was 94% (95% C.I.: 88 - 99%) at 10 years and 79% (69 - 89%) at 25 years, with the survivorship of the femoral implant being 95% (90 - 100%) and 81% (70 - 91%) respectively.
Confirmation of the Reduction and Containment of the Femoral Head with CT or MRI Scans in DDH: The Need for Repeated Scans
Authors: Case R.D. , Gargan M.F. , Grier D. , Portinaro N.M.A. 
Published: March 2018

The accuracy of reduction of the femoral head in the acetabulum after the application of plaster casts in open and closed reduction was retrospectively assessed by means of CT or MRI scan in 59 patients and 67 hips. Scanning after the first plaster application showed that the position was not maintained in the hip spica in 1 out of 37 patients (3%), who had undergone open reduction, and 8 out of 30 (27%), who had undergone closed reduction. All hips shown to be reduced and contained at the time of the first scan, and held in a spica remained reduced on subsequent scans. This study shows that the hip is vulnerable to redisplacement, especially after closed reduction, but stabilises after the first 6 to 8 weeks in plaster. This suggests therefore that repeating the scan after each plaster change was not necessary, and that resources could be conserved. This study has also shown that all the 113 CT scans clearly defined the anatomy but 6 out of the 33 MRI scans were blurred and needed repeating.
Fragmentation of the Polyethylene Cement Restrictor in Total Hip Arthroplasty
Authors: Gabbar O.A. , Williams R.W. , Spencer R.F. 
Published: March 2018

The presence of polyethylene wear particles at the bone-cement interface after joint replacement is considered a major cause of prosthetic loosening. Nevertheless, many surgeons continue to use winged Hardinge polyethylene restrictor of which fragments are frequently seen to detach during insertion into the femoral canal, and to emerge during medullary lavage. The extent to which such fragments may be retained in the femoral cement mantle is not clear, and there is obvious concern that such fragments may result in polyethylene granuloma formation. We reviewed 89 post-operative X-rays after hip replacement employing the Hardinge restrictor. The following issues were examined: 1. Dimensions and number of distal radiolucencies in the cement and their correspondence with the wing size of the restrictor, 2. method of suction used during pressurised lavage, 3. Proximal and distal canal diameter and amount of taper, 4. Gruen zone location of radiolucencies. Linear lucencies corresponding exactly to the wings of the restrictor were found on 14 X-rays (15.7%), 7 were seen out of 54 cases in which distal suction was used during lavage, and 7 were seen in 35 cases in which proximal suction only was employed. There was no statistical difference between these two methods of suction in limiting the number of retained fragments of restrictor (P= 0.156). There was no correlation between the likelihood of fragment detachment and canal taper or distal diameter. A total of (17) detached fragments were identified, distributed in the following Gruen zones; 3 (35.3%), 4 (38.2%), 5 (26.5%). We suggest that the above observations should alert surgeons who wish to use this type of restrictor to the importance of meticulous femoral preparation, preferably under direct vision, to ensure that no fragments of restrictor become detached
A Simple Method of Planning and Performing a Proximal Femoral Varus-Shortening-Derotation Osteotomy for Hip Dislocation in Cerebral Palsy Using a Blade-Plate
Authors: Brooks R.A. , Kirby K. , Theologis T.N. 
Published: March 2018

Femoral varus, derotation and shortening osteotomy is part of the surgical treatment of hip subluxation and dislocation in children with cerebral palsy. In such cases, a post-operative neck-shaft angle of 110–120° is desirable as well as 0–15° anteversion. Standard techniques of planning a femoral osteotomy require accurate knowledge of proximal femoral deformity, but in cerebral palsy this may be difficult to measure owing to excessive anteversion and difficulties with positioning for radiographs. We have developed and used a method that does not rely on preoperative radiographic measurements or the use of the femoral diaphysis for reference. Our method is focused on achieving the desired postoperative neck-shaft and anteversion angles mentioned above. The centre of the femoral neck is used as a reference and the chisel for a blade plate is applied 20–30° varus to this neutral axis. Osteotomy cuts are then made parallel to the chisel and perpendicular to the femoral shaft. The chisel is replaced with a 90° blade plate and the osteotomy is reduced, derotated and fixed to the femoral shaft. The final neck-shaft angle is therefore 90° plus 20–30°, ie the desirable 110–120°. This position is achieved without knowledge of the angle of the wedge of bone removed by the osteotomy. This technique has been performed in 16 hips in 10 patients with cerebral palsy during one year. The final neck shaft angle fell within the desired range in 12 hips (75%). We have found this technique to be a simple and reliable means of achieving correction in patients in whom accurate preoperative estimate of the femoral neck shaft angle is not possible.
Drainage versus Non-Drainage in Total Hip Arthroplasty. A Prospective Randomised Study
Authors: Ravikumar K.J. , Alwan T. , Fordyce M.J.F. , Tuson K.W.R. 
Published: March 2018

We present a prospective review of 23 patients having 25 primary total hip arthroplasties (THAs) over a two-month period. Patients were randomly allocated into two groups, one with wound drainage and the other without. There were 12 hips in the Drain group and 13 hips in the No-drain group. Demographic characteristics and risk factors were similar in the two groups. The average wound score (ASEPSIS) was found to be higher for the No-drain group and this was statistically significant. In the No-drain group, 7 out of 13 hips developed infection (5 superficial and 2 deep). In the Drain group, 1 out of 12 hips developed deep infection. The difference in the average drop in the haemoglobin between the two groups was not statistically significant. In the Drain group, the average drainage volume was 463ml. The type of anaesthetic, duration of the operation, experience of the surgeon and the surgical approach used were not found to have a statistically significant correlation with postoperative wound infection. Our small series supports the view that the use of closed suction drainage after THA results in lower incidences of drainage from the wound site and also of wound infection.
Unrecognised Post-Operative Hyponatraemia in the Elderly with Hip Fractures
Authors: Shewale S.B. , Pandit H.G. , Rana P.S. 
Published: March 2018

Inappropriate fluid therapy and surgical stress further decrease renal ability to excrete water. This results in hyponatraemia in the elderly, who tend to have a precarious homeostatic equilibrium. There is a high incidence of post-operative hyponatraemia in elderly patients undergoing surgery. We scrutinised biochemistry records, notes and fluid charts in 227 patients who had undergone treatment for hip fractures. Patients with a possible medical cause for hyponatraemia (25) were excluded. The group of 202 patients had an average age of 77.8 years. We noted an incidence of 17.8% of mild hyponatraemia and 4.4% of severe hyponatraemia. A high index of clinical suspicion and sound knowledge of fluid balance can prevent this potentially serious complication.
Atypical Infection of a Total Hip Endoprosthesis Due to Mycobacterium Fortuitum Case Report of An Infection of a Total Hip Endoprosthesis with Mycobacterium Fortuitum
Authors: Bachfischer K. , Waizenhoefer A. , Gerdesmeyer L. , Gradinger R. 
Published: March 2018

Only a few cases of infection of an endoprosthesis with mycobacterium fortuitum have been reported, each resulting in functionally unsatisfactory outcomes. We performed a stem revision cementless total hip endoprosthesis six months after primary implantation after the appearance of the typical radiological and clinical signs of aseptic loosening. Histological and molecular-biological analysis of the intra-operative specimens confirmed an infection with Mycobacterium fortuitum. Following antimicrobial therapy, the patient is painfree and fully weight-bearing seven months after replacement. If aseptic loosening of an endoprosthesis is suspected, an infection with Mycobacterium fortuitum should be considered.