bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevention of Arthrofibrosis After Arthroscopic Screw Fixation of Tibial Spine Fracture in Children and Adolescents
Authors: Parikh Shital N. , Myer David , Eismann Emily A. 
Published: February 2014

Arthrofibrosis is a major complication of tibial spine fracture treatment in children, potentially resulting in knee pain, quadriceps weakness, altered gait, decreased function, inability to return to sports, and long-term osteoarthritis. Thus, prevention rather than treatment of arthrofibrosis is desirable. The purpose of this study was to evaluate an aggressive postoperative rehabilitation and early intervention approach to prevent permanent arthrofibrosis after tibial spine fracture treatment and to compare epiphyseal and transphyseal screws for fixation.
A consecutive series of 24 patients younger than age 18 with displaced type II and III tibial spine fractures who underwent arthroscopic reduction and screw fixation between 2006 and 2011 were retrospectively reviewed. Final range of motion was compared between patients with epiphyseal (n=12) and transphyseal (n=9) screws. One-third (4 of 12) of patients with epiphyseal screws underwent arthroscopic debridement and screw removal approximately 3 months postoperatively; 3 patients lacked 5° to 15° of extension, 1 experienced pain with extension, and 1 had radiographic evidence of screw pullout, loss of reduction, and resultant malunion. In the transphyseal screw group, 3 patients had 10° loss of extension, and all corrected after arthroscopic debridement and screw removal. The two groups did not significantly differ in time to hardware removal or return to sports or final range of motion. No growth disturbances were identified in patients after transphyseal screw removal.
An aggressive approach of postoperative rehabilitation and early intervention after arthroscopic reduction and screw fixation of tibial spine fractures in children was successful in preventing permanent arthrofibrosis.
Efficacy of Delayed Decompression of Lumbar Disk Herniation Causing Cauda Equina Syndrome
Authors: Aly Tarek A. , AboRamadan Mohamed Osama 
Published: February 2014

Cauda equina syndrome (CES) is a rare but serious neurosurgical emergency that can have devastating long-lasting neurologic consequences. Compression of the cauda equina can result in paralysis of bowel and bladder function. Such compression has been considered the only absolute indication for surgery in cases of lumbar disk disease. Therefore, it is extremely important that physicians be aware of the condition so that a surgeon is consulted before neurological damage becomes permanent. This article reports the results of delayed surgical decompression in cases of lumbar disk herniation with CES.
The study group comprised 14 patients (11 men and 3 women) with a mean age of 48 years (range, 36–57 years). Clinical presentation was chronic low back pain, sciatica, and impaired sphincter function. All patients had a fenestration at the affected level and site, and the disk fragments were excised and the disk space cleared. The surgeries were performed 1 to 3 months after onset of sphinctric disturbance. Postoperatively, all patients were relieved of back and/or leg pain and showed sensory improvement. Twelve patients regained full control of urination and defecation. Lower extremity strength improved in 9 patients.
The classical presentation of CES is not obvious. Even if surgery is performed late due to delayed presentation, significant improvement in neurologic and bladder function can still be expected.
Performance of Four New Photoscreeners on Pediatric Patients With High Risk Amblyopia
Authors: Arnold Robert W. , Armitage M. Diane 
Published: February 2014

Purpose:
A new study by the American Academy of Pediatrics touts the benefits of photoscreening, especially in preverbal children who cannot yet perform monocular acuity screening. Emerging devices have not been compared in young and developmentally challenged children.

Methods:
Consecutive patients in a pediatric eye practice had a comprehensive eye examination and four photoscreens: PlusoptiX (PlusoptiX, Nuremburg, Germany), SPOT (PediaVision, Lake Mary, FL), iScreen (iScreen, Memphis, TN), and the GoCheckKids application (Gobiquity, Aliso Viejo, CA) for the iPhone 4s (Apple, Cupertino, CA) with Delta Center Crescent interpretation. They were validated according to the 2003 American Association for Pediatric Ophthalmology and Strabismus uniform guidelines.

Results:
One hundred eight children aged 1 to 12 years participated, with 56% having amblyopia risk factors and 10% having autism. For the four devices, sensitivity, specificity, and inconclusive results were as follows: PlusoptiX (83%, 86%, 23%), SPOT (80%, 85%, 4%), iScreen (75%, 88%, 13%) and iScreen (with Delta Center Crescent) (92%, 88%, 0%), and GoCheckKids (with Delta Center Crescent) (81%, 91%, 3%).

Conclusions:
Even in high risk and young children, current instrument-based screeners can reliably screen for refractive and strabismic risk factors that lead to amblyopia. Some devices can reduce the proportion of inclusive results in challenging cases.

[J Pediatr Ophthalmol Strabismus 2014;51(1):46–52.]
Physician Use of White Coats in Pediatric Ophthalmology
Authors: DeBenedictis Caroline N. , Liu Grace T. , Nelson Leonard B. , Leiby Benjamin E. , Dai Yang , Levin Alex V. 
Published: February 2014

Purpose:
Recent literature reports that patients and parents of pediatric patients prefer their physician to wear a white coat and to address them informally. This study aims to characterize current practice patterns of pediatric ophthalmologists regarding their use of white coats and salutations during outpatient pediatric encounters.

Methods:
An eight-question survey was e-mailed to members of the American Academy of Pediatric Ophthalmology and Strabismus in 2012. The questions focused on clinical setting, use of white coats in out-patient encounters, and preferred language used to address the patient’s parents. Surveys not completed in full were excluded from data analysis.

Results:
Of approximately 1,266 members who received the survey, 606 completed the survey. Five hundred ninety-nine surveys were included in the data analysis. Sixty-three percent of attending physicians and 80% of fellows reported they did not routinely wear white coats while examining outpatient children. Forty-six percent of attending physicians and 48% of fellows addressed the patient’s parents as “mom” or “dad”. There was no significant association between wearing a white coat and type of practice setting, practice characteristics, or location in a children’s hospital for attending physicians or fellows.

Conclusions:
Contrary to preferences expressed by patients and their parents, a majority of pediatric ophthalmologists do not routinely wear white coats during pediatric outpatient examinations. Practice patterns appear to be in line with previously reported parental greeting preferences.

[J Pediatr Ophthalmol Strabismus 2014;51(1):13–16.]
Surgical Dose-Effect Relationship in Single Muscle Advancement in the Treatment of Consecutive Strabismus
Authors: Kim Bo Hyuck , Suh Soh Youn , Kim Jeong Hun , Yu Young Suk , Kim Seong-Joon 
Published: February 2014

Purpose:
To evaluate the dose-effect relationship for single muscle advancement in consecutive esotropia and consecutive exotropia.

Methods:
Medical records from 22 patients with consecutive esotropia (n = 11) or exotropia (n = 11) were retrospectively reviewed. All patients had undergone either single lateral rectus or medial rectus advancement surgery. The alterations in muscle position and the angle deviation were measured in millimeters and prism diopters (PD) and the change in deviation was determined by subtracting the postoperative angle of deviation at 1 week from the preoperative angle. To quantify the clinical effect of muscle advancement, the ratio of the change in muscle position to the change in visual angle deviation was calculated (ie, the surgical dose-effect relationship).

Results:
The mean deviation was 25.5 ± 10.4 PD preoperatively and 0 ± 6.9 PD at 1 week postoperatively. The success rate was 82% in the consecutive esotropia group and 91% in the consecutive exotropia group. The average correction ratio was 4.31 ± 0.96 PD/mm. In multiple regression analysis of total patients with consecutive strabismus and the consecutive esotropia group, the amount of muscle advancement and preoperative angle deviation were positively correlated with the correction ratio. In the consecutive exotropia group, there was no significant relationship between variables.

Conclusions:
Single muscle advancement generally provides enough correction for most consecutive strabismus cases. Surgical dose-effect relationship increases with preoperative angle deviation and amount of muscle advancement. Surgeons should consider reducing the amount of muscle advancement in patients with larger angle deviations, especially patients with consecutive esotropia.

[J Pediatr Ophthalmol Strabismus 2014;51(2):93–99.]
Treatment of Consecutive Exotropia: Unilateral Lateral Rectus Recession Combined With Medial Rectus Advancement or Resection
Authors: Mangla Deepak , Simon John W. , Mangla Neeraj , Zobal-Ratner Jitka 
Published: February 2014

Purpose:
Consecutive exotropia presents a difficult clinical problem, especially when previously recessed medial recti are to be strengthened. Surgical options include advancement, typically with a small resection, and resection alone.

Methods:
The authors retrospectively reviewed records of all patients who underwent a second two-muscle surgery on a single eye for consecutive exotropia. Patients with paralytic strabismus and those with less than 1 month of postoperative follow-up were excluded. In 2003, one of the authors began medial rectus resections without advancements in most cases, whereas a second author continued to perform advancements. Two treatment groups were thus reviewed.

Results:

Forty-two patients qualified for inclusion, including 23 for the resection group and 19 for the advancement group. Preoperative deviations were similar (
P
= .35, 95% confidence interval: −2.64 to 9.82). Postoperative deviations averaged 11.4 prism diopters (PD) in the resection group and 11.5 PD in the advancement group (
P
= .98, 95% confidence interval: −12.2 to 12.3). Forty-eight percent of the resection group and 63% of the advancement group achieved alignment within 10 PD of orthophoria (
P
= .33, 95% confidence interval: −9.0% to 39%).

Conclusions:
Surgical results were favorable following both techniques. Although both techniques appear to be adequate, resection of previously recessed medial recti may be preferable because they allow use of standard surgical tables and avoid advancement of inflamed tissue into the palpebral fissure.

[J Pediatr Ophthalmol Strabismus 2014;51(2):116–119.]
Visual Outcomes of a Trifocal Aspheric Diffractive Intraocular Lens With Microincision Cataract Surgery
Authors: Alió Jorge L. , Montalbán Raúl , Peña-García Pablo , Soria Felipe A. , Vega-Estrada Alfredo 
Published: February 2014

PURPOSE:
To evaluate the visual outcomes of patients with a new diffractive trifocal intraocular lens (IOL).

METHODS:
A trifocal diffractive Fine Vision IOL (Physiol, Liege, Belgium) was implanted after microincision cataract surgery (MICS) in 40 eyes of 20 patients with bilateral cataract. The monocular and binocular visual performance and the refractive status were assessed, as well as the defocus curve and contrast sensitivity at 1 and 6 months postoperatively.

RESULTS:

The monocular visual outcomes (logMAR) at 6 months postoperatively were uncorrected distance visual acuity 0.18 ± 0.13, uncorrected near visual acuity 0.26 ± 0.15, and uncorrected intermediate visual acuity 0.20 ± 0.11. With the best distance correction, the visual outcomes were 0.05 ± 0.06 for corrected distance visual acuity, 0.16 ± 0.13 for distance corrected near visual acuity, and 0.17 ± 0.09 for distance corrected intermediate visual acuity. Binocular defocus curve at 6 months shows a wide range of useful vision with 0.19 ± 0.08 (logMAR) at −1.50 diopter defocus. The monocular contrast sensitivity under scotopic conditions (3 cd/m
2
) was within normal range for a population older than 60 years.

CONCLUSION:
The trifocal Fine Vision IOL can restore vision at different distances after cataract surgery, specifically intermediate and near vision.

[
J Refract Surg.
2013;29(11):756–761.]
Multi-Component Adjustable Intraocular Lenses: A New Concept in Pediatric Cataract Surgery
Authors: Portaliou Dimitra M. , Kymionis George D. , Pallikaris Ioannis G. 
Published: February 2014

PURPOSE:
The multi-component intraocular lens (IOL) (IVO; SAS, Strasbourg, France) is a novel approach to the treatment of pediatric cataract. Because the refractive requirements for pediatric eyes often change over time, current IOL technology does not easily allow refractive adjustments after the primary surgical intervention. The multi-component IOL concept allows easy, surgical refractive adjustments to the initial surgical implantation at any postoperative time period. Thus, both surgical implantation and enhancement surgery have been successfully accomplished in adult patients.

METHODS:
A novel surgical approach to pediatric cataract surgery is described. At the time of the primary surgery, a two component IOL was implanted. At any postoperative time period, the front lens component, located in front of the capsular bag, could be easily surgically exchanged because the dioptric power requirements of the pediatric eye changed over time.

RESULTS:
Both primary and enhancement surgeries have been done in adult patients with good results. Implantations have occurred uneventfully in all cases with no intraoperative or postoperative complications. There was no statistically significant difference in the endothelial cell density, anterior chamber depth, and pachymetry readings preoperatively and 2 years postoperatively. There was no interlenticular fibrosis present.

CONCLUSION:
The multi-component IOL should provide a unique and greatly needed surgically adjustable approach to the treatment of pediatric cataract.

[
J Refract Surg.
2014;30(1):62–66.]
Four-Year Visual, Refractive, and Contrast Sensitivity Outcomes After Wavefront-Guided Myopic LASIK Using an Advanced Excimer Laser Platform
Authors: Shaheen Mohamed Shafik , Massoud Tamer Hamdy , Ezzeldin Hani , Khalifa Mounir Ahmed 
Published: February 2014

PURPOSE:
To evaluate the 4-year visual, refractive, and contrast sensitivity outcomes of wavefront-guided LASIK for the correction of low to moderate myopia using the VISX CustomVue technology (Abbott Medical Optics, Inc., Santa Ana, CA).

METHODS:
This was a prospective study including 255 consecutive eyes of 145 patients (age range: 19 to 55 years) with low to moderate myopia (mean spherical equivalent: −3.36 ± 1.71 diopters [D]) undergoing laser refractive surgery. Wavefront-guided LASIK was performed in all eyes using the VISX STAR S4 IR excimer laser platform and the CustomVue procedure for the ablation profile design. Visual, refractive, and contrast sensitivity changes were evaluated during a 4-year follow-up period.

RESULTS:

Postoperative logMAR uncorrected distance visual acuity was 0.1 or better (20/25 Snellen) in 98.0% and 100% of eyes at 1 and 4 years, respectively. At 4 years postoperatively, mean spherical equivalent was reduced significantly to a mean value of −0.22 ± 0.28 D (
P
< .01), with 97.3% of eyes with a spherical equivalent within ±0.50 D. The astigmatic power vector component J
0
of manifest refraction was also reduced significantly (
P
< .01). Postoperative logMAR corrected distance visual acuity was 0.0 or better (20/20 Snellen) in 96.1% and 98.8% of eyes at 1 and 4 years, respectively. Improvement in contrast sensitivity was observed in some spatial frequencies between 1 and 4 years postoperatively. No significant correlations were found between 4-year contrast sensitivity and corrected distance visual acuity (0.024 ⩽
r
⩽ −0.120,
P
⩾ .06).

CONCLUSION:
Wavefront-guided LASIK using the VISX CustomVue technology provides an effective and predictable correction of low to moderate myopia in the long term, preserving the patient’s visual acuity and quality.

[
J Refract Surg.
2013;29(12):816–822.]
Early Clinical Outcomes of Wavefront-Guided Myopic LASIK Treatments Using a New-Generation Hartmann-Shack Aberrometer
Authors: Schallhorn Steven , Brown Mitch , Venter Jan , Teenan David , Hettinger Keith , Yamamoto Hiromi 
Published: February 2014

PURPOSE:
To provide an initial retrospective evaluation of early postoperative outcomes after wavefront-guided myopic LASIK using a new-generation Hartmann-Shack wavefront sensor.

METHODS:
A noncomparative, retrospective study of 243 eyes of 126 patients that underwent primary wavefront-guided LASIK, using wavefront data obtained with a new Hartmann-Shack aberrometer (iDesign Advanced WaveScan aberrometer; Abbott Medical Optics, Inc., Santa Ana, CA). Visual acuity, refraction, and patient satisfaction were evaluated 1 month after surgery.

RESULTS:
The manifest spherical equivalent was reduced from −3.28 ± 1.79 diopters (D) (range: −9.88 to −0.38 D) before surgery to −0.03 ± 0.29 D (range: −1.00 to +1.25 D) 1 month after surgery. The manifest spherical equivalent was within 0.50 and 1.00 D of target in 93.0% and 99.6% of eyes, respectively. Manifest astigmatism preoperatively (−0.72 ± 0.67 [range: 0.0 to −5.00 D]) was reduced to −0.14 ± 0.20 (range: 0.0 to −1.00 D) at 1 month and the vector-derived correction ratio (surgically induced refractive change/intended refractive correction) was 1.02 ± 0.30. Uncorrected distance visual acuity of 20/16, 20/20, and 20/25 or better was achieved in 79.0%, 93.4%, and 96.7% of eyes, respectively. No eyes lost two or more lines of corrected distance visual acuity, whereas a gain of one or more lines was observed in 14.0%. Most patients (98.5%) reported that they were satisfied with the outcome of their procedure.

CONCLUSIONS:
Wavefront-guided LASIK using the new aberrometer in this retrospective evaluation was effective, safe, and predictable in the early postoperative time period for the correction of myopia with high patient satisfaction.

[
J Refract Surg.
2014;30(1):14–21.]
Prospective Randomized Contralateral Eye Evaluation of Subjective Quality of Vision After Wavefront-Guided or Wavefront-Optimized Photorefractive Keratectomy
Authors: He Lingmin , Manche Edward E. 
Published: February 2014

PURPOSE:
To compare the effect of wavefront-guided (WFG) and wavefront-optimized (WFO) photorefractive keratectomy (PRK) on patient perceived quality of vision.

METHODS:
Seventy-one patients (142 eyes) were enrolled in this prospective, randomized, fellow eye controlled study. One eye was randomized to undergo WFG PRK treatment by the AMO Visx CustomVue S4 IR excimer laser system (Abbott Medical Optics, Inc., Santa Clara, CA) and the fellow eye received WFO PRK treatment by the Alcon Allegretto Wave Eye-Q 400 Hz excimer laser system (Alcon Laboratories, Inc., Fort Worth, TX). Patients answered questionnaires on their visual symptoms and quality of vision preoperatively and at 1, 3, 6, and 12 months after surgery.

RESULTS:

Patients in both groups reported better vision compared to baseline from 3 months onward (mean change in score of 1.56 to 2.51 in the WFO group and 1.54 to 2.28 in the WFG group,
P
⩽ .003). Both groups experienced less nighttime glare from 6 months onward (
P
⩽ .030). Halos, double vision, and visual clarity were initially worse (
P
⩽ .025) but not significantly different after 1 month. Haze and fluctuating vision resolved after 3 months. Visual symptoms were similar between the two groups at all times (
P
⩾ .059) except at 6 months, when patients felt their WFG eyes had more excellent vision (
P
= .029). A composite of all symptoms was also similar between the groups until 12 months when patients had fewer symptoms in their WFO eye (
P
= .044).

CONCLUSIONS:
One year after surgery, patient self-reported visual symptoms were not significantly different in eyes receiving WFG or WFO PRK. However, the average of all symptoms was lower in eyes receiving wavefront-optimized treatment.

[
J Refract Surg.
2014;30(1):6–12.]
Femtosecond Laser Versus Manual Clear Corneal Incision in Cataract Surgery
Authors: Mastropasqua Leonardo , Toto Lisa , Mastropasqua Alessandra , Vecchiarino Luca , Mastropasqua Rodolfo , Pedrotti Emilio , Di Nicola Marta 
Published: February 2014

PURPOSE:
To compare functional and morphological outcomes of femtosecond laser clear corneal incision (CCI) versus manual CCI during cataract surgery.

METHODS:
Sixty eyes of 60 patients who underwent CCI during cataract surgery were randomized into two groups: femtosecond laser CCI (30 eyes) and manual CCI (30 eyes).

RESULTS:

There were no significant between-group differences in uncorrected distance visual acuity, corrected distance visual acuity, surgically induced astigmatism, and corneal aberrations. Keratometric astigmatism was significantly lower in the femtosecond laser CCI group compared to the manual CCI group at 30 and 180 days (
P
< .05). Central endothelial cell count was significantly higher in the femtosecond laser CCI group compared to the manual CCI group at 7 and 30 days postoperatively (
P
< .05). A lower increase of corneal thickness at the incision site was observed at 30 and 180 days postoperatively in the femtosecond laser CCI group compared to the manual CCI group (
P
< .05). In addition, femtosecond laser CCI showed a better morphology (lower percentage of endothelial and epithelial gaping and endothelial misalignment) compared to manual CCI at different time points. Total phacoemulsification time was significantly lower in the femtosecond laser CCI group (
P
< .05).

CONCLUSIONS:
The femtosecond laser procedure was safe, efficient, and less damaging, as evidenced by lower central endothelial cell loss, lower increase of corneal thickness at the incision site, and better tunnel morphology compared to the manual technique.

[
J Refract Surg.
2014;30(1):27–33.]
Optical Coherence Tomography Combined With Videokeratography to Differentiate Mild Keratoconus Subtypes
Authors: Rabinowitz Yaron S. , Li Xiaohui , Canedo Ana Laura Caiado , Ambrósio Renato , Bykhovskaya Yelena 
Published: February 2014

PURPOSE:
To develop parameters using a combination of optical coherence tomography (OCT) and videokeratography to detect early keratoconus.

METHODS:
Videokeratography, wavefront analysis, and measured OCT indices were performed on 180 normal eyes, 46 eyes with moderate keratoconus, 54 eyes with early keratoconus, 7 eyes with forme fruste keratoconus, and 16 eyes with keratoconus “suspect” to determine the most sensitive parameters for separating these groups.

RESULTS:

A combination of videokeratography and OCT indices (inferior-superior [I-S] value and minimum pachymetry) was statistically the most significant in separating the keratoconus groups from normal eyes (
P
< .001). Using a newly derived index, the minimum pachymetry divided by the I-S value (pachymetry/asymmetry [PA]/I-S index) with a cut-off of 100, 100% of early and forme fruste keratoconus could be identified as being abnormal with 7 normals misclassified (misclassification rate 2.7%). By adding keratoconus “suspect” to the analysis and an I-S value of 1.2 as a cut-off point, 5 “suspects” were classified as normal and 11 normals as abnormal (misclassification rate 7.8%). The PA/I-S index, with a cut-off point of 100, reduced this misclassification rate to 4.4%.

CONCLUSIONS:
These results suggest that OCT combined with videokeratography may be more useful for differentiating mild forms of keratoconus than videokeratography alone.

[
J Refract Surg.
2014;30(2):80–86.]