bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trabeculectomy with and without Mitomycin-C in a Black African Population
Authors: Mwanza J.-C.K. , Kabasele P.M. 
Published: January 2018

Purpose To evaluate the beneficial effects of intraoperative application of mitomycin-C during trabeculectomy in a black African population in Congo-Kinshasa. Methods A prospective randomized study in 22 eyes (11 patients) with open-angle glaucoma. All patients underwent trabeculectomy with application of mitomycin-C (0.4 mg/ml for 2.5 min) under the scleral flap in the right eye and trabeculectomy alone in the left eye. Assessment of the clinical outcome included intraocular pressure, visual acuity, visual field and complications. The follow-up was 20 months. Success of the filtering surgery was defined as a final IOP of 21 mmHg or lower without antiglaucoma medications and no further glaucoma surgery necessary. Results The success rate of trabeculectomy was 81.8% in eyes treated with mitomycin-C compared with 63.6% in eyes not receiving this drug. Rates of intraocular pressure reduction were 57.9% and 42.9% respectively. Complications occured in 36.3% of the eyes managed with mitomycin-C against 9% in the control eyes. Conclusions Mitomycin-C, as adjunctive treatment during trabeculectomy in black Africans, offers great benefit in lowering IOP, but with a substantial high risk of complications. These data need to be confirmed by further studies in this population.
Differences in the Composition of Inflammatory Cell Infiltrate in Lens-Induced Uveitis under Therapy with Allopurinol or Steroids
Authors: Sekundo W. , Augustin A.J. 
Published: January 2018

Purpose The aim of this study was to compare the qualitative changes in the composition of inflammatory cell infiltrate in lens-induced uveitis (LIU) under treatment with allopurinol (Allo), methylprednisolone (Pred) or the two drugs combined (Allo/Pred). Methods Twenty male Wistar rats were sensitized with lens proteins for eight weeks. Intravenous (IV) therapy was started after anterior capsule disruption in one eye of each animal. Five rats were randomly assigned to each of the four groups: controls, Allo (50 mg/kg bw), Pred (7.5 mg/kg bw) and Allo/Pred (50 mg/7.5 mg per kg bw). Eyes were enucleated 24 hours later and fixed in paraformaldehyde/glutaraldehyde. Sections at three levels were stained with Giemsa and examined using a 0 to 4+ score for each type of inflammatory cell. Granulocytes were seen as neutrophils and eosinophils. Neutrophils were divided into polymorphs and “others”, and graded with lymphocytes. Results In all therapy groups there was a significant reduction of polymorphs (p<0.05) in comparison to the control group. There was also a significant reduction in lymphocytes (p<0.05) in the Pred and Allo/Pred groups as compared to the control group and the Allo group. Conclusions Single-dose IV allopurinol significantly reduced the overall number of polymorphonuclear leucocytes in LIU. Unlike methylprednisolone, allopurinol did not have any significant impact on lymphocytes.
Grading Choroidal Neovascular Membrane Regression after Strontium Plaque Radiotherapy; Masked Subjective Evaluation vs Planimetry
Authors: Jaakkola A. , Tommila P. , Laatikainen L. , Immonen I. 
Published: January 2018

Purpose To analyze angiographic changes in choroidal neovascular membranes (CNVM) after strontium-plaque (90Sr) irradiation for exudative age-related macular degeneration (AMD) using masked measurement of the CNVM areas and a masked subjective comparison of CNVM size and leakage. Methods We studied the baseline, 3, 6, and 12-month angiograms of 19 eyes treated with 90Sr-plaque irradiation for exudative AMD. The area of CNVM-related hyperfluorescence was measured quantitatively, and the angiograms were subjectively evaluated by a masked grader. Results In 7 of the 19 eyes the CNVM-related hyperfluorescence was too scattered to be analyzed by planimetry but masked subjective grading correlated with the clinical response to irradiation. In the remaining 12 eyes, the CNVM decreased in size in 67% of the eyes and showed leakage in 67%. Planimetry and subjective assessment of the size and leakage of the CNVMs similarly reflected the regression after irradiation. Conclusions CNVM size and leakage frequently diminish after 90Sr-plaque irradiation. Quantitative measurement of the CNVM areas, or a grading system based on masked subjective assessment, give similar results for evaluating these changes. Masked subjective grading can be used even in cases where the CNVM is too scattered to be outlined for planimetry.
Effect of Hormone Replacement Therapy on Ocular Hemodynamics in Postmenopausal Women
Authors: Atílla H. , Arslanpençe A. , Batioğlu F. , Eryilmaz T. , Aytaç S. , Özcan H. , Kurtay G. 
Published: January 2018

Purpose To evaluate the effect of hormone replacement therapy on ocular hemodynamics in postmenopausal women. Methods Ocular Doppler ultrasonography was performed in 20 postmenopausal women on hormone replacement therapy (HRT) and in 20 women without treatment, as the control group. Central retinal artery (CRA), posterior ciliary artery (PCA) and ophthalmic artery (OA) flow velocities and vascular resistances were measured prospectively by a radiologist blinded to the therapy. There were no associated systemic or ocular diseases or any medication history. Results The mean age of the patients on HRT was 50.05 ± 4.5 yrs (range 44 - 62). The mean age of the control group was 52.8 ± 4.09 yrs (range 46 - 65). The mean duration of HRT was 1.6 ± 1.4 yrs (range 3 months - 5 years). There were no differences between the groups in terms of flow velocities, vascular resistivities or pulsatility indices of OA, CRA and PCA (p>0.05). Conclusions HRT is essential in postmenopausal women for relief of vasomotor symptoms, cardioprotection and prevention of osteoporosis. Even though vaso-occlusive complications of hormone preparations have been reported, we did not observe any changes in ocular hemodynamics detectable with Doppler ultrasonography.
Photodisruptive Nd:YAG Laser in the Management of Premacular Subhyaloid Hemorrhage
Authors: Çelebi S. , Kükner A.S. 
Published: January 2018

Purpose Premacular subhyaloid hemorrhage is usually a benign condition that generally improves spontaneously and rarely causes visual loss. However, because the hemorrhage may cause permanent macular changes before it resolves, Nd:YAG laser posterior hyaloidotomy may be indicated in selected cases. This study investigated the effects of drainage of premacular subhyaloid hemorrhage into the vitreous with Nd:YAG laser treatment. Methods This study was conducted between February 1996 and March 1999. Six patients had a circumscribed premacular hemorrhage in one eye and were treated with the Nd:YAG laser to drain the blood into the vitreous cavity. The hemorrhage originated from Valsalva retinopathy (2 cases), proliferative diabetic retinopathy (2 cases), central retinal vein occlusion (1 case), and blunt ocular trauma (1 case). The size of the hemorrhage is expressed in disc diameters. Results The mean pretreatment hemorrhage measured 5.7 disc diameters (range 3.5–8.0). Visual acuity in all cases before laser treatment was hand movement. After laser treatment, the hemorrhage instantly drained into the vitreous cavity, resulting in rapid improvement of vision. Drainage was complete within one week and visual acuity improved dramatically. The mean follow-up was 26.3 months (range 7–42 months). No retinal damage or rebleeding occurred due to the laser treatment, and vitrectomy was not required in any eye. Conclusions Nd:YAG laser posterior hyaloidotomy may be useful for draining a premacular hemorrhage into the vitreous cavity in selected cases. To establish this as a routine procedure, a randomized prospective study is needed to compare observation, primary vitrectomy, and Nd:YAG laser treatment.
Surgical Removal of Subfoveal Choroidal Neovascularization: Visual Outcome and Prognostic Value of Fluorescein Angiography and Optical Coherence Tomography
Authors: Brindeau C. , Glacet-Bernard A. , Coscas F. , Mimoun G. , Boukhli L. , Coscas G. , Soubrane G. 
Published: January 2018

Purpose To study the functional results of macular surgery and determine pre-operative features associated with better final visual outcome. Methods Forty-two consecutive patients underwent surgical removal of subfoveal choroidal neovascularization (CNV), related to age-related macular degeneration (AMD) in 8 eyes, degenerative myopia in 14 eyes, multifocal choroiditis (MFC) in 10 eyes, idiopathic CNV in 6 eyes and other etiologies in 4 eyes. Mean age was 49 years. Pre-operative visual acuity (VA) was 20/200 or less in 30 eyes (71.4%) and never better than 20/40. Fluorescein angiography was analyzed before and after surgery. Pre-operative optical coherence tomographs (OCT) were studied in a masked fashion. Mean follow-up was 12 months (range 4–48 months). Results Final VA was 20/200 or less in 25 eyes (60%). According to the CNV etiology, the percentage were 87.5%, 80%, 57.1% and 20% respectively in eyes with AMD, MFC, high myopia, and idiopathic or other diseases. Post-operative VA improved in 21 eyes (50%) but subsequently declined in 7% by the final examination. Patients younger than 50 years had better functional results (p=0.006). Lack of retinal pigment epithelium (RPE) changes on pre-operative angiography was correlated with good visual outcome (p<0.001). The OCT study confirmed some features already described and showed some different CNV patterns: above and usually separated from the RPE, below and not separated from the RPE, and ungradable. Eyes with the first OCT pattern had the best visual outcome. Main complications included 4 (10%) retinal detachments and 9 (21%) recurrences. OCT was also useful to confirm CNV recurrences post-operatively. Conclusions CNV surgical excision results vary depending on the underlying disease, the RPE and choriocapillaris function, and the features observed on pre-operative OCT images.
Ultrastructural Study of Primary Lacrimal Adenocarcinoma
Authors: Gong H. , Hayashida H. , Kitaoka T. , Amemiya T. 
Published: January 2018

Purpose Primary adenocarcinoma of the lacrimal gland is a rare malignant tumor of the orbit. Up to now, there has been no presentation of its ultrastructural features. The histopathological findings and fine structures of one case of adenocarcinoma of the lacrimal gland are described in the present work. Methods The patient was a 59-year-old Japanese man with proptosis that had persisted for one month. A tumor was extirpated, and the tissues were prepared for light and electron microscopic examination. Results Electron microscopic examination demonstrated that the tumor cells had well-developed microvilli and lumens. These ultrastructure features are similar to those seen in adenocarcinomas at other sites. Conclusions These observations suggest that the accurate diagnosis of rare malignant adenocarcinoma depends not only on routine techniques such as light microscopy of hematoxylin-eosin and PAS-diastase stained slides, but also on electron microscopic findings.
Intraocular Invasion by Malignant Orbital Fibrous Histiocytoma: A Case Report
Authors: Marback E.F. , Marback P.M.F. , Sento SÉ D.C. , Marback R.L. 
Published: January 2018

Purpose To present a case of intraocular invasion by an orbital malignant fibrous histiocytoma. Methods Case report. Case Report An 84-year-old man was exenterated due to a malignant fibrous histiocytoma of the right orbit. On image investigation and histologic sections, the tumor entirely filled the right eye and orbit. The patient died of intracranial spread of the lesion. Conclusions Fibrous histiocytoma of the orbit can invade the eye.
Primary Total Hip Arthroplasty Using a Grit-Blasted, Press-Fit Femoral Prosthesis. Long-Term Results with Survivorship Analysis
Authors: Grappiolo G. , Blaha J.D. , Gruen T.A. , Burastero G. , Spotorno L. 
Published: January 2018

Background This report presents the initial experience with the use of a grit-blasted, press-fit femoral prosthesis. Methods The first 300 consecutive primary total hip arthroplasty procedures using a collarless, three-dimensional tapered, straight, titanium alloy stem with a grit-blasted surface (performed in 299 patients) were evaluated with independent clinical and radiographic follow-up examinations up to sixteen years. Eight different types of acetabular components, including a cementless all-polyethylene socket in 80 percent of the cases, were used. Radiographic evaluation, performed by an independent observer using a zonal analysis method, included assessment of component migration, Engh's implant-bone femoral fixation score, implant-bone demarcations, and periprosthetic osteolysis. The average duration of long-term radiographic follow-up was 12.6 years (range; 10 to 16 years). Results At last examination only five hips were lost to follow-up and 69 patients were deceased. The overall mechanical failure rate (i.e. unstable with or without revision) of the femoral component was 2 percent. The femoral revision rate was 7 percent (two hips for aseptic loosening, five hips for septic loosening, and twelve hips with osseointegrated stems for severe progressive femoral osteolysis) and the acetabular revision rate was 27 percent (revised for either socket migration or progressive peri-acetabular osteolysis or both). Survivorship, based on any revision (femoral or acetabular) was 89 percent at ten years and 62 percent at fourteen years; survivorship of the femoral component was 95 percent at ten years and 90 percent at fourteen years. The incidence of femoral periprosthetic osteolysis, by radiographic examination at ten years or more was 47 percent, including 12 hips (5 percent) with distal endosteal osteolysis. Femoral implant-bone fixation was stable, bone-ongrowth in 97 percent; stable, fibrous-fixation in 1 percent, and unstable, fibrous-fixation in 2 percent of the cases. Conclusions The grit-blasted, press-fit, collarless, tapered femoral component continued to perform well clinically and radiographically up to sixteen years of follow-up despite the challenging environment of periprosthetic osteolysis associated with the acetabular component design. The high incidence of failure among the cementless all-polyethylene sockets was not unexpected and the use of this acetabular implant was discontinued in 1985. While considered a “first-generation” cementless stem, this implant is still in use virtually without design modifications. This study demonstrates the durability of the results of the grit-blasted femoral component and indicates that such an implant offers a viable alternative for fixation without bone cement.
Arthroplasty in High Grade Congenital Hip Dislocation: Personal Experience and Review of the Literature
Authors: Randelli F. , Randelli P. , Visentin O. , Monteleone M. , Brianza G. , Randelli G. 
Published: January 2018

Total hip arthroplasty (THA) in congenital high grade hip dislocation often represents a problematic issue. Reviewing their selected cases and literature data, authors focus on some key points for this demanding surgery. Most important steps are acetabular positioning and surgical approach (exposure and release). We used two different cups, the Zweymuller and the Wagner cup, with good primary stability. A Conus stem (Wagner) or an Alloclassic stem (in less displastic femoral shape) were used. We always performed this surgery as a one step procedure. In the same cases a shortening femoral osteotomy was performed to allow refractory reduction. Possible complications are discussed.
Bipolar versus Total Hip Arthroplasty in the Treatment of Avascular Necrosis of the Femoral Head in Young Patients
Authors: Scheerlinck T. , Dezillie M. , Monsaert A. , Opdecam P. 
Published: January 2018

The authors evaluate medium-term results of bipolar and total hip arthroplasty as a treatment for avascular necrosis of the femoral head. Between 1990 and 2000, 57 hips (45 patients) were treated with a bipolar (BHA: 37 hips) or total hip arthroplasty (THA: 20 hips) depending on the radiographic and macroscopic aspect of the acetabulum. At surgery, all patients were under 65 years of age (average: 45.09 years). All had the same cementless hydroxylapatite coated femoral stem inserted through an anterolateral approach. The BHA were followed during a mean of 4.49 years. One BHA was lost to follow-up. Seven out of 36 hips (19.44%) were considered failures: three due to a poor functional result (Harris Hip Score (HHS) <70) and four which needed conversion to THA for groin pain. Two hips were revised for periprosthetic fracture. Twenty BHA (55.56%) had a good or excellent result (HHS 80). The THA were followed for a mean of 4.32 years. One THA was lost to follow-up. Four out of 19 hips (21.05%) were considered as failures. Three due to a poor functional result (HHS<70) and one which needed cup revision for recurrent dislocation. Fifteen THA (78.95%) had a good or excellent functional result (HHS80). BHA as a treatment of avascular necrosis of the femoral head in young patients preserves bone stock for later revisions and can lead to excellent results. But the outcome seems less predictable than after THA. Groin pain associated to BHA can be treated successfully with conversion to THA if necessary.
Long-Term Survival of Stanmore Total Hip Replacements Inserted with Radiolucent Bone Cement
Authors: Wimhurst J.A. , Hobby J.L. , Roberts C.P. , Gibbs A.N. , Deliss L.J. , Rushton N. 
Published: January 2018

Radio-opacifiers in bone cements are an accepted part of every-day practice. They have, however, been shown to be a potential cause of an increase in third body wear and to excite bone resorption in in vitro and in vivo studies. We reviewed the results of 228 consecutive Stanmore total hip replacements performed between 1981 and 1985 in 211 patients. All were inserted with radiolucent bone cement. Information regarding whether the prosthesis had been revised was available for all patients. Seventy-three patients (83 hips) were still alive and 41 patients (44 hips) were sufficiently healthy to attend clinic. Information regarding pain level was obtained from the remaining 32 patients. When revision of the implant was taken as the end-point, there was 95% ten-year survival, 91% fifteen-year survival and 75% eighteen-year survival. These long-term results of Stanmore THRs, performed in a district general hospital, with radiolucent bone cement, compare favourably with the other published series for this implant. We did not find the inability to see the bone cement a particular disadvantage when reviewing radiographs for signs of loosening.
Uncemented Custom-Made Femoral Components
Authors: Mohan B. , Nixon J.R. , Doran E. 
Published: January 2018

We present our experience of total hip replacement (THR) in younger patients using a custom-made smooth titanium alloy femoral prosthesis. Measurements made from pre-operative marker radiographs allowed creation of templates and subsequent computer analysis to mill the stem prior to surgery. Fifty-one such cementless implants were carried out in 43 patients between January 1993 and June 1996 with follow-up to an average of 47 months. Sixteen hips have required revision to date; 13 of these operations were for aseptic loosening. Two more were awaiting revision, giving an overall failure rate of 35.3 %. The average duration from primary operation to revision was 47 months. Thus, even though the concept of an uncemented custom-made femoral component is attractive, the failure rate was found to be unacceptably high. This device may achieve “fit and fill”, but adequate bone on- or in-growth was not achieved. On the basis of these data we have discontinued the use of this implant since 1996.
Failure of an Uncemented Press-Fit Acetabular Cup in Primary Total Hip Arthroplasty
Authors: Mohan N. Rama , Grigoris P. , Hamblen D.L. 
Published: January 2018

We reviewed fifteen primary total hip replacements performed using the uncemented, non-porous coated press-fit AcSys Shearer Cup. A modular titanium straight femoral stem with a 32mm head was used in all cases. The mean age of the group containing five males and 10 females was 66 years. Eight cups have been revised for aseptic loosening at a mean of seven years and the remaining four cups are radiologically loose. At revision surgery none of the cups showed any evidence of bony ingrowth. Our 10-year results with this cup indicate an unacceptably high failure rate of 80%. Absence of bony ingrowth and the lack of a secure locking mechanism between the polyethylene liner and the metal shell are the most important causes of failure. The use of a 32mm diameter head and implantation of the cup in an open position contributed to this failure. Even though this cup is no longer manufactured, our experience suggests that all non-porous coated cups should be closely followed up.
Giant Synovial Cyst Causing Femoral Occlusion following a Hip Replacement
Authors: Farrington W.J. , Lewis P. , MacEachern A.G. 
Published: January 2018

Long-term follow-up of total hip replacements (THR) is essential for accurate recording of complications associated with this procedure, in particular the occurrence of wear and aseptic loosening which may warrant revision surgery. A significant proportion of patients with aseptic loosening are asymptomatic and radiological signs may be subtle and easily missed. Occasionally a synovial cyst can develop as a result of polyethylene wear debris and aseptic loosening. These cysts are usually small but can expand and become symptomatic. We describe a case where a large cyst caused sufficient extrinsic compression of the femoral vein as to occlude it. This was a potentially life-threatening complication. We emphasize the importance of clinical examination for leg swelling and groin mass in routine surveillance of total hip replacement.
Mid-Term Results with the Porous-Coated Anatomic Hip Prosthesis with 28mm Head. An Eight to Twelve Year Follow-up of 39 Hips
Authors: Laursen J.O. , Mossing N. B. , Myrthue G. 
Published: January 2018

In the 1980s, uncemented prostheses were considered advantageous in younger patients. One of the prostheses used in Denmark was the Porous Coated Anatomic (PCA) prosthesis. Follow-up results from Aarhus University Hospital (AaUH) showed progressive osteolysis along the stem at five to seven years, and use of the prosthesis was no longer recommended. We used the PCA prosthesis with a modular 28mm head, and so far our results with patients operated on between 1989 and 1993 do not confirm the negative results published. Thirty-nine consecutive cases were followed prospectively with clinical and radiographic assessment. At the 8–12 year follow-up four patients had undergone revision. Three revisions were for aseptic loosening of the cup at 5, 10 and 12 years, and one was because of thigh pain without radiological signs of loosening at revision. The cumulative survival rate was 95% at five years, 92% at ten years and 85% at twelve years. If we include radiologically loose components, five cups were re-operated or radiographically loose (12.8%) and 4 stems were re-operated or radiographically loose (10.2%). Thus the survival rate at 12 years was 85% and 90% for cup and stem respectively. So far we have not experienced progressive radiographic changes. The difference in results may stem from the fact that we used 28mm heads (versus 32mm heads in the Aarhus series), which allows a more adequate polyethylene thickness and thereby lesser creep of the polyethylene and less polyethylene debris production.