bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Scleral tunnel incision”‐trabeculectomy with one releasable suture
Authors: Vuori Marja‐Liisa , Viitanen Tommi 
Published: March 2003

ABSTRACT. Purpose: To describe a modified surgical technique, a scleral tunnel incision‐ trabeculectomy (STIT) and evaluate its safety and efficacy in lowering IOP in glaucoma patients.Methods: One hundred and three patients were included in a retrospective, nonrandomized clinical study. Fifty‐three patients were operated conventionally and 40 patients underwent STIT. In the modified technique the sides of the scleral flap are opened only half‐way to the limbus and the flap is closed with a single releasable “slipknot”‐suture.Results: The mean IOP on the first postoperative day was 4.5±6.8 mmHg in the conventional group and 7.4±7.1 mmHg in the tunnel incision group (p=0.012). On the second postoperative day the mean IOP was 4.5±7.3 mmHg and 6.3±6.5 mmHg in the conventional group and tunnel incision group, respectively (p=0.065). There was no statistically significant difference in the mean postoperative IOP between the groups at one month and at 6–12 months. Shallow anterior chamber and iridocorneal touch occurred statistically significantly less in the tunnel incision group than in the conventional group.Conclusion: STIT appears to be equivalent to conventional trabeculectomy (CT) in lowering IOP during the first 6–12 months postoperatively. It is also relatively safe and has fewer early complications related to excessive aqueous outflow than CT.
Long‐term visual results following primary trabeculectomy for infantile glaucoma
Authors: O'Reilly James , Lanigan Bernadette , O'Keefe Michael 
Published: March 2003

ABSTRACT.Purpose: To report the long‐term visual outcome of eyes that underwent primary trabeculectomy for infantile glaucoma and to evaluate factors that affect visual prognosis.Methods: Thirty‐five eyes of 22 consecutive patients presenting between 1980 and 1995 were included. Visual acuity, visual fields and refractive status were assessed and patient records reviewed.Results: Nineteen of 22 patients (86.3%) achieved 6/12 or better, (21 of 35 eyes; 60%). Reasons for decreased vision included amblyopia (5 eyes), field loss (4 eyes), corneal opacification (2 eyes), and uncontrolled IOP (1 eye). Primary glaucoma had a better outcome than secondary glaucoma. Vision was frequently unequal despite controlled pressure, clear media and full fields in both eyes. This was associated with myopic anisometropia and apparent amblyopia. Ten patients responded to patching. Eyes with field defects were unresponsive to patching.Conclusions: Field defects, corneal scarring, marked anisometropia and severe astigmatism result in poor vision. Anisometropic amblyopia is frequently present and responds well to patching. Visual outcome is dependent on early and sustained control of intraocular pressure and aggressive treatment of amblyopia.
Experimental transplantation of autologous iris pigment epithelial cells to the subretinal space
Authors: Crafoord Sven , Geng Lijun , Seregard Stefan , Algvere Peep V. 
Published: March 2003

ABSTRACT.Purpose: To investigate the cellular morphology in the subretinal space following transplantation of iris pigment epithelial (IPE) cells from the same eye.Methods: Following an iridectomy, fresh IPE cells were prepared and no culturing performed. After pars plana vitrectomy, a suspension of autologous IPE cells was injected into the subretinal space in 37 rabbits. The grafts were monitored by ophthalmoscopy and colour fundus photography. Rabbits were sacrificed at 1, 2, 3 and 6 months, respectively, and the eyes examined with light and electron microscopy.Results: The grafted area retained the same configuration over 6 months but then appeared less pigmented. At 1–3 months, the IPE formed one or more contiguous layers on top of native RPE. At 6 months, cells compatible with grafted IPE were present in the subretinal space, often forming monolayer‐like chains integrating with the native RPE. Depigmented cells of presumed IPE origin were seen and frequently in association with abundant melanin granules located in the apical portion of adjacent RPE cells. In such areas, large macrophage‐like cells were observed.Conclusion: Transplanted IPE cells survived for up to 6 months in the subretinal space. Our observations suggest a scenario of remodelling of the cellular layers in the subretinal space over time where grafted IPE cells formed a compound layer with the native RPE. Transplantation of autologous IPE cells may have a potential as a treatment modality in selected cases of age‐related macular degeneration.
Planned two‐step vitrectomy for extremely large and thick subretinal hematoma
Authors: Matsuo Toshihiko , Shiraga Fumio , Takasu Ippei 
Published: March 2003

ABSTRACT.Purpose: To describe a new surgical strategy, planned two‐step vitrectomy, for a large and thick subretinal hematoma involving 3 or more quadrants of the fundus.Surgical Methods: In a first‐step vitrectomy, a retinotomy was made in the posterior pole, after any vitreous hemorrhage had been removed. Following fluid‐gas exchange with no laser photocoagulation around the retinotomy, patients took a face‐down position for a few days to a week to facilitate subretinal hemorrhage movement to the vitreous cavity and anterior chamber. In a second‐step surgery, the hemorrhage in the vitreous cavity and anterior chamber was washed out. The remaining subretinal hemorrhage was aspirated, and the retina was reattached with fluid‐gas exchange and laser photocoagulation around the retinotomy.Results: The planned two‐step vitrectomy was performed in 4 consecutive patients with large and thick subretinal hematomas involving 3 or more quadrants seen during a 3‐year period. By a face‐down position after the first‐step vitrectomy, subretinal hemorrhage moved to the vitreous cavity and anterior chamber. The remaining subretinal hemorrhage in a smaller quantity could be easily removed, leading to retinal reattachment in the second‐step surgery.Conclusions: The planned two‐step vitrectomy is a safer and more effective procedure for removing a large quantity of subretinal hemorrhage in a shorter period of surgical time, compared with hemorrhage removal in a single vitrectomy.
Thyroid associated ophthalmopathy: botulinum toxin A in the treatment of upper eyelid retraction – a pilot study
Authors: Träisk Frank , Tallstedt Leif 
Published: March 2003

ABSTRACT.Purpose: Eyelid retraction in patients with thyroid associated ophthalmopathy is a common cause of eye discomfort and a disfigured facial appearance. The aim of this pilot study was to evaluate the effects and safety of inducing a temporary partial ptosis of the eyelid through injection of botulinum toxin A into the levator palpebrae superioris muscle.Methods: Nine patients were treated. They were followed up with ophthalmologic examinations and self‐assessment questionnaires until the point at which they either required renewed treatment or had no residual effect of the first injection. Maximum follow‐up time was twenty weeks.Results: In all eyes but one there was a lowering of the eyelid position one week after treatment and all these patients reported an improvement of eye appearance and symptoms. There was variability in the degree of lowering of the eyelid with the same dose of injected botulinum toxin A. It was also difficult to predict the time interval needed for re‐treatment. Ptosis impairing visual acuity was not a consequence of the treatment in any of the patients. One week after treatment two patients experienced increased diplopia but only one showed transient change in Lees screen measurement of eye motility.Conclusion: Botulinum toxin A injection may be used to lower the upper eyelid position in patients awaiting eyelid surgery. The treatment safely relieved symptoms and improved eye appearance. However, treatment was short term and difficult to predict. There is also an inherent risk of transient diplopia.
Evaluation of the new Ocuton S tonometer
Authors: Marchini Giorgio , Babighian Silvia , Specchia Luca , Perfetti Sergio 
Published: March 2003

ABSTRACT.Purpose:  To evaluate the intra‐ and interobserver variability of the Ocuton S tonometer, its correlation with Goldmann tonometry, the reliability of self‐tonometry and the safety of the instrument.Methods:  Thirty‐five healthy subjects and 45 patients with primary open‐angle glaucoma (POAG), aged from 38 to 80 years (mean age: 64.6 ± 12.2 years), underwent tonometry with the Ocuton S tonometer in one eye chosen at random. The intra‐ and interobserver variability between two operators (kappa coefficient), the Ocuton S/Goldmann correlation and the reliability of self‐tonometry were evaluated by performing two tonometries on each patient in subgroups. Each tonometry was considered as the mean of three consecutive measurements. Central ultrasonic pachymetry, keratometry and corneal biomicroscopy were also evaluated.Results:  The intra‐ and interobserver variability ranged from 0.38 to 0.66. The difference between the means of intraocular pressure (IOP) with the Ocuton S (24.4 ± 4.7 mmHg) and the Goldmann tonometer (18.1 ± 4.7 mmHg) was statistically significant (p < 0.0001). Linear regression analysis revealed a good Ocuton S/Goldmann correspondence (r = 0.88, p = 0.0001). However, IOP values detected with the Ocuton were consistently overestimated, compared to those detected with the Goldmann tonometer. The correlation between corneal thickness and IOP was statistically significant both for the Goldmann (r = 0.510, p = 0.021) and for the Ocuton S tonometer (r = 0.520, p = 0.019). No correlation was found between keratometry and IOP. The mean measurement obtained by self‐tonometry (21.9 ± 3.6 mmHg) showed no statistically significant difference when compared to the mean measurement obtained by an expert operator (21.3 ± 3.4 mmHg).Conclusion:  The Ocuton S tonometer is a safe instrument that can be used easily by the patient. However, in comparison to the Goldmann tonometer , it overestimates IOP and requires further technical and methodological refinements in order to ensure greater reliability.
The Swedish National Cataract Register: A 9‐year review
Authors: Lundström Mats , Stenevi Ulf , Thorburn William 
Published: March 2003

ABSTRACT.The Swedish National Cataract Register (NCR) has been collecting data on cataract extractions in Sweden since 1992. This unique national database now contains data pertaining to more than 400 000 operations, representing 93.4% of all operations performed nationwide during 1992–2000. Clinic participation in the NCR is voluntary. Tests have shown NCR data to be extremely reliable, while the participation of nearly all providers of cataract surgery in Sweden makes the data highly representative of cataract surgery throughout the country.The NCR collects pre‐ and per‐operative data for every cataract extraction performed at participating clinics. Surgical outcome data and data about patients' self‐assessed visual function is collected in approximately 10% of cases. Since 1998, all cases of suspected postoperative endophthalmitis have also been reported to the NCR.The rate of surgery has increased from 4.47 to 7.26 per 1000 inhabitants during the period. Female subjects have constituted about 66% of all operated subjects each year and the mean age of patients has slowly increased from 75.2 to 76.1 years. Average pre‐operative visual acuity has improved each year. Second eye surgery has increased from 28.5% to 36.8% of all surgeries. Phacoemulsification has reached 98% as type of surgery (in 2000) and 92.7% of all intraocular lenses are foldable. Surgical outcome has improved by achieving a final refraction closer to the target refraction and less surgically induced astigmatism. The positive impact of cataract surgery in very elderly people has been demonstrated, as has the positive effect of second eye surgery, especially in young subjects.The NCR has served to enhance knowledge about trends and results of cataract surgery in Sweden. This review article describes some of the activities carried out and their results.
Electroretinographic oscillatory potentials in insulin‐dependent diabetes patients: A long‐term follow‐up
Authors: Vadalà Maria , Anastasi Mario , Lodato Gaetano , Cillino Salvatore 
Published: March 2003

ABSTRACT.Purpose: The aim of this research was to study the relevance of long‐term follow‐up of electroretinographic oscillatory potentials (OPs) in predicting the onset of minimal non‐proliferative diabetic retinopathy in insulin‐dependent diabetes patients.Methods:  A total of 80 insulin‐dependent diabetics, with normal fundi and normal OPs at first examination, were followed prospectively for 10 years. Oscillatory potentials were measured and fundus examinations performed once or twice per year.Results:  During follow‐up, 35% of patients developed diabetic retinopathy after a mean disease duration of 12 ± 2 years. A decrease in OP amplitudes was seen in 46% of this group, but reductions were also seen in the 25% of patients whose fundi remained normal. Statistical analysis of best‐fit survival curves shows a significant difference (p < 0.001) in the point of Kaplan‐Meiers' curve maximal linearity (TmaxS).Conclusions:  It appears that eyes with reduced OP amplitude have a greater probability of developing diabetic retinopathy. Subnormal OP amplitudes are not proof of real concomitant visible vascular damage, but may reflect a predisposition to functional neurosensorial disorder.
Outcome after treatment of congenital unilateral cataract
Authors: Lundvall Anna , Kugelberg Ulla 
Published: March 2003

ABSTRACT.Purpose:  To evaluate long‐term functional outcome after treatment of congenital unilateral cataract.Methods:  The records of 30 consecutive children operated on before the age of 12 months at St. Erik's Eye Hospital over a 5‐year period (1991–96) were reviewed retrospectively. The patients were followed until 4–9.5 years of age. Linear Snellen visual acuity (VA), occlusion therapy compliance, and the presence of nystagmus, strabismus and other complications are reported.Results:  Six children achieved VA of 0.1 or better. They were all operated on before 3 months of age. Of the 12 infants operated on before 6 weeks of age, four have VA between 0.3 and 0.4 and eight have VA of finger counting or less. Four developed severe secondary glaucoma within 6 months of cataract extraction. Two of these had persistent fetal vasculature. Three eyes developing glaucoma became amaurotic. Occlusion therapy was abandoned before the age of 2.5 years in 21 children.Conclusion:  Good levels of VA were achieved only in children who underwent cataract surgery before 3 months of age and who adhered to the occlusion therapy schedule. Severe secondary glaucoma developed in four out of 12 children operated on within 6 weeks. Full compliance with the occlusion therapy programme was uncommon.
Outcome after treatment of congenital bilateral cataract
Authors: Lundvall Anna , Kugelberg Ulla 
Published: March 2003

ABSTRACT.Purpose:  To evaluate long‐term functional outcome after treatment of dense congenital bilateral cataract.Methods:  The records of 22 consecutive children operated on before the age of 12 months at St. Erik's Eye Hospital over a 5‐year period (1991–96) were reviewed retrospectively. Linear Snellen visual acuity (VA) at last check, presence of stereoacuity, nystagmus, strabismus and other complications are accounted for. Subject age at last check ranged from 4 to 9 years.Results:  Visual acuity could be estimated in 19 children: the median VA of the better eye was 0.4 (range: counting fingers − 0.8) and of the fellow eye 0.15 (range: amaurosis − 0.8). In nine otherwise healthy children who were operated on early (by 1 month of age), VA varied from 0.4 to 0.8 in the better eye. Four of these children achieved stereopsis. Pupillary block glaucoma developed in five eyes (in three children). Chronic glaucoma developed in eight eyes (in five children). Glaucoma occurred predominantly in children who underwent cataract extraction during the first week of life. Two of the latter had marked microphthalmos.Conclusion:  Good postoperative VA was achieved in most healthy children with dense bilateral congenital cataract when surgery was performed early (before 6–8 weeks of age). Chronic glaucoma developed predominantly when cataract extraction was performed during the first week of life.
A longitudinal study of visual acuity and visual rehabilitation needs in an urban Swedish population followed from the ages of 70 to 97 years of age
Authors: Bergman Birgitta , Sjöstrand Johan 
Published: March 2003

ABSTRACT.Purpose:  To investigate the longitudinal change in visual acuity (VA) in the oldest members of the elderly population, to estimate future numbers of people with visual impairments, and to estimate needs for and the effects of visual rehabilitation.Methods:  In the Gerontological and Geriatric Population Studies in Gothenburg, Sweden (H 70), subjects underwent repeated eye examinations at the ages of 70, 82, 88, 95 and 97 years. Logistic regression analysis was used to estimate the probability of independent living as a function of distance VA at different ages.Results:  Rates of normal VA (≥ 0.8) declined from 86% of the study group at age 70 to 7% of the study group at age 95 (0% at age 97). The incidence of VA ≤ 0.1 increased from 1.4% at age 70 to 27% (all women) at age 97. The deterioration was faster at higher ages. No statistically significant difference in best‐corrected distance VA between genders was found. A substantial improvement was achieved by correcting refractive errors. There was a statistically significant correlation between distance VA and the probability of independent living at all ages except age 97. At ages 95 and 97, about 50% of the study group were able to read newspaper print with best‐corrected glasses.Conclusions:  The number of old people with impaired vision will increase. People aged 80 years and older should have regular eye‐screening in order to preserve vision and present conditions of living. Cataract surgery and low vision rehabilitation should be offered when the subject can still benefit from it, preferably during their 80s at the latest.
Detection of herpes simplex virus in pseudoexfoliation syndrome and exfoliation glaucoma
Authors: Detorakis E. T. , Kozobolis V. P. , Pallikaris I. G. , Spandidos D. A. 
Published: March 2003

ABSTRACT.Purpose: The pathogenesis of pseudoexfoliation syndrome (PEX) remains unknown. An infection, possibly viral, is one of the proposed pathogenetic mechanisms. This study examines the presence of herpes simplex virus (HSV) and varicella‐zoster virus (VZV) in iris and anterior capsule specimens of PEX and non‐PEX patients.Methods: Iris and anterior capsule specimens were obtained from 64 patients with PEX (study group, SG) and 61 patients without PEX (control group, CG). The presence of HSV and VZV DNA was evaluated with a polymerase chain reaction (PCR).Results: Herpes simplex virus type I was detected significantly more often in iris specimens from the SG (13.79%), compared to those from the CG (1.75%). Varicella‐zoster virus DNA was not detected in any of the examined specimens.Conclusion: Results imply a possible relationship between HSV type I and PEX, although no aetiological role of HSV infection in PEX pathogenesis can be established. Results also advocate against any association between VZV and PEX.
Evaluation of VEP perimetry in normal subjects and glaucoma patients
Authors: Bengtsson Boel 
Published: March 2003

ABSTRACT.Purpose:  To estimate sensitivity to glaucomatous visual field loss using multifocal visual evoked potential (VEP) perimetry, to compare these findings to those of conventional achromatic perimetry and to determine specificity of VEP perimetry in normal subjects.Methods:  A total of 33 glaucoma patients with known visual field defects in at least one eye on standard computerized perimetry and 33 healthy subjects were tested with VEP perimetry. The glaucoma patients were also tested with standard computerized perimetry using the 30–2 SITA Fast program of the Humphrey Field Analyzer (HFA). Visual evoked potential perimetry classification and VEP probability maps were used to determine the sensitivity and specificity of the technique.Results:  Visual evoked potential perimetry classified 68% of all eyes in the glaucoma group (45/66) as pathological; sensitivity increased to 81% (38/47) when considering only those eyes with HFA field defects. It also identified more test locations with significant loss at the p < 5% level in both groups (48% and 37%, respectively) than did HFA, while HFA identified more loss at the higher significance levels p < 2%, and p < 1%. Visual evoked potential perimetry showed more significant loss in eyes with almost normal or slightly damaged standard fields, while HFA identified more significant field loss in eyes with severe conventional field damage. The mean VEP amplitude of the 66 glaucoma eyes was 1.461e−7 V; it was 1.676e−7 V for the 66 control eyes. This difference was significant (p = 0.0033), but the overlap between groups was large. Visual evoked potential perimetry classified 42% of the control eyes as ‘outside normal limits’, and VEP probability maps showed 30.0% of test segments as significantly depressed at the p < 5% level, 10.8% of sites at p < 2%, and 4.6% at the p < 1% level.Conclusion:  Mean VEP amplitude differed significantly between normal and glaucoma eyes, but the overlap was considerable. Visual evoked potential perimetry falsely classified a large number of normal eyes as pathological and showed many more significantly depressed test locations than expected. Agreement between VEP and standard perimetry was relatively poor for the glaucoma group. Further refinements are needed before VEP perimetry can be regarded as a reliable clinical method of mapping glaucomatous visual fields.
Terson's syndrome presenting as an ophthalmic emergency
Authors: Murthy Shashidhar , Salas David , Hirekataur Srinivas , Ram Raghu 
Published: March 2003

ABSTRACT.Purpose:  To report an unusual case of Terson's syndrome caused by a ruptured intracranial aneurysm presenting as an ophthalmic emergency with visual loss, without any neurological features at the time of presentation.Methods:  Case report. A 38‐year‐old man was referred to the eye emergency department with sudden loss of vision in both eyes. Vitreous haemorrhage was noted in both eyes. There was no history of loss of consciousness or headaches and no signs of meningeal irritation at presentation. The patient subsequently developed progressive neck stiffness and headache.Results:  Neuro‐imaging studies revealed a subarachnoid haemorrhage resulting from a ruptured carotid‐ophthalmic artery aneurysm.Conclusions:  It is important to consider Terson's syndrome, a potentially life‐threatening condition, in any patient presenting with bilateral vitreous haemorrhage. Some patients may not show any headache, neurological deficits or signs of meningeal irritation at presentation but may develop them later on.