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Biomedical subjects

A E Maumenee

Publications and source records attributed to A E Maumenee.

At least 37 records · Page 2Linked to original sources
PubMed1987

Drg-39.

The development of extracapsular cataract extraction with insertion of an intraocular lens has undoubtedly been one of medical science's greatest advances in the rehabilitation of vision. It has also lead to vigorous debates within and without the profession about the efficacy of the procedure and its cost-benefit ratio. Criticism directed toward cataract surgery, both by those in the medical profession and those in governmental agencies, must be addressed if ophthalmologists are going to continue to be able to meet the needs of their patients.

Cataract Extraction↗
PubMed1987

Treatment of Mooren's and Mooren's-like ulcer by lamellar keratectomy: report of six eyes and literature review.

Three cases of Mooren's ulcer (four eyes) and one case of marginal corneal ulcer associated with relapsing polychondritis (two eyes) are presented with decrease in ocular inflammation following extensive lamellar keratectomy or lamellar keratoplasty. Tissue adhesive was needed in two cases to maintain ocular integrity. The procedure may work by the removal of a corneal antigenic stimulus to a self-perpetrating auto-immune phenomenon that causes corneal melting. More cases are needed to evaluate the therapeutic efficacy of lamellar keratectomy for Mooren's and Mooren's-like corneal ulcers.

Aged↗
PubMed1987

Continuing corneal endothelial loss in intracapsular surgery with and without Binkhorst four-loop lenses: a long-term specular microscopy study.

We analyzed pre- and postoperative corneal endothelial photographs of 17 intracapsular cataract extractions (ICCE) with Binkhorst four-loop intraocular lens (IOL) eyes and found 11.6% mean cell loss at 2 months (previously reported by Hirst et al) increasing to 42.4% after 5 years (p less than 0.05) and 51.8% at 7 years. Eleven ICCE eyes without IOLs similarly examined showed a 15.6% mean cell loss at 2 months (previously reported by Hirst et al), increasing to 33.4% at 5 years (p less than 0.005, paired t-test). Our results appear to indicate long-term continuing cell loss after ICCE, both with and without Binkhorst four-loop iris clip IOLs, and statistically significant greater cell loss (p less than .001, unpaired t-test) with IOLs than without.

Aged↗
PubMed1986

Clinicopathologic studies of keratoplasty eyes obtained post mortem.

Thirty eyes of 25 patients who had undergone penetrating keratoplasties were examined post mortem. Available corneal buttons and donor rims were evaluated for irregularities of the trephine margins. Of 26 eyes with clear grafts, visual acuity had been 20/80 or better in 13, worse than 20/100 in six, and was unknown in seven. In four eyes with cloudy grafts, visual acuity had been 20/400 or worse. Twenty-three eyes had had one keratoplasty and seven eyes had had two or three transplants. Microscopic examination disclosed frequent overriding wound edges with Bowman's layer incarceration in the wound in 11 eyes and Descemet's membrane incarceration in 22 eyes. Wound abnormalities were correlated with the presence and degree of astigmatism. A retrocorneal fibrous tissue layer was localized at the wound in 16 eyes, extended peripherally in 11, and extended centrally in one. Iris and vitreous incarceration in the wound occurred in 14 and eight eyes, respectively. Histopathologic features contributing to visual loss included cystoid macular edema (three eyes), senile macular degeneration (four eyes), and preretinal membranes (four eyes).

Aged↗
PubMed1986

Extracapsular cataract extraction and posterior chamber lens implantation in eyes with preexisting glaucoma.

Fifty eyes of 40 patients with glaucoma underwent extracapsular cataract extraction with posterior chamber lens implantation. Their visual results and early postoperative complications were compared with those of eyes in an age-matched group of patients without glaucoma after the same procedure. Substantial increases in early postoperative intraocular pressure (IOP) occurred in 62% of the glaucomatous eyes and in only 10% of the normal eyes. The level of best visual acuity was slightly worse (20/40) on average in the glaucomatous eyes than in the nonglaucomatous eyes (20/25). At six months after surgery, 82.5% of the nonfiltered glaucomatous eyes needed the same number of or additional glaucoma medications to maintain an IOP of less than 20 mm Hg. Ten of the glaucomatous eyes underwent trabeculectomy along with cataract surgery due to inadequate IOP control while the patient was receiving maximum medical therapy. Control was substantially improved, with 100% of these patients receiving the same number of or fewer medications at six months. By one year, only 30% of these patients required the same number of medications postoperatively as preoperatively, but all had IOP control.

Adrenergic beta-Antagonists↗
PubMed1986

Potential acuity meter for predicting visual acuity after Nd:YAG posterior capsulotomy.

We studied 30 patients with opacifications of the posterior capsule to determine if the potential acuity meter (PAM) could accurately predict final visual outcome after Nd:YAG discussion. The final visual acuity was within one line of the PAM prediction in 22 of 30 patients (73%), better by two or more lines in seven patients (23%), and worse in one patient (4%) by two lines. Although in thicker capsules the final acuity was occasionally better than the PAM prediction, the rates of false negative and false positive predictions were very low. Mild cystoid macular edema (3 patients), age-related macular degeneration (3 patients), intraocular lens status, and level of initial acuity did not diminish PAM accuracy. The PAM effectively predicts final visual acuity after YAG posterior capsulotomy, when used in a patient, unhurried manner.

Adult↗
PubMed1986

Biosynthesis of macrophage activation factor.

Splenic lymphocytes from BCG-immunized mice were cultured with PPD for 72 hrs. The proteins secreted by these cells activate peritoneal macrophages to kill TU-5 mouse kidney cells. The fraction whose molecular weight falls between 67K and 50K exhibits most of the macrophage stimulating activity. However, lymphokine protein isolated from cultures of splenic lymphocytes harvested from iron-deficient mice showed decreased macrophage stimulating activity. These results further demonstrate the requirement for iron in lymphokine-dependent macrophage cytotoxic activity. Evidence is presented to suggest that the lymphokine fraction which induces tumoricidal activity binds first to a specific site on the surface of the macrophage membrane and then induces protein synthesis. In addition, the lymphokine proteins isolated from iron deficient or unstimulated spleen cultures neither bind to nor induce tumoricidal activity in macrophages. The binding of lymphokine to macrophages seems to be specific since no significant binding occurred to several other cell lines. The binding is saturable and reversible since the bound protein can be displaced by unlabelled lymphokines or xylose at concentration of 0.1M. The SDS gel analysis of macrophage membrane proteins newly synthesized in response to lymphokine showed several proteins with the different mol. wt. but major protein peaks approximately at 55K. The significance of induction of protein synthesis in macrophages by lymphokine is discussed.

Animals↗
PubMed1986

Clinical and immunological results of corneal allograft rejection.

Of 111 episodes of graft rejection in 66 patients, 62 responded to therapy with graft clearing (responders); 49 did not (non-responders). Both groups were of similar age, sex, and etiology; both had a similar rate of glaucoma and a similar rate of previous grafting. In responders the graft reaction was shorter in duration (2.2 vs. 5.6 wks. p less than 0.005), and it was necessary to increase the number of glaucoma medications more often in non-responders compared to responders (41% vs. 19%, p less than 0.02). The interval from surgery to reaction was similar in responders and non-responders (18.2 vs. 13.3 mos., p greater than 0.1). An epithelial rejection line was present in 11% of responders, but was not present in non-responders (p less than 0.05). Lymphocytotoxic antibody development correlated with rejection in 16 of 64 episodes. Patients who responded to treatment were more frequently asymptomatic (p less than 0.05) or were treated earlier following the onset of symptoms compared to non-responders (p less than 0.0001).

Adult↗
PubMed1985

Diffuse drusen and associated complications.

An eye of a patient with an unusual form of diffuse drusen was studied by light and electron microscopy. Examination disclosed marked diffuse and nodular thickening of the inner portion of Bruch's membrane by vesicular and curvilinear membranous profiles and basement membrane-like material that was apparently derived from the retinal pigment epithelium. Deposition of this abnormal material suggests a diffuse abnormality of the retinal pigment epithelium and predisposes to serous detachment of the retinal pigment epithelium, choroidal neovascularization, hemorrhagic detachment of the retinal pigment epithelium, and disciform scarring. The features of this case are similar to previously reported cases of diffuse drusen, but differ in the early age of onset, intensity of changes, and, in part, by the nature of the abnormal material observed.

Basement Membrane↗
PubMed1985

Acute intraoperative choroidal effusion.

We studied five cases of acute choroidal effusion that occurred during intraocular surgery and one case of a localized choroidal hemorrhage. Acute intraoperative choroidal effusion is a poorly recognized surgical complication and may precede expulsive hemorrhage in many cases. The treatment is immediate closure of the wound, after which the intraocular pressure may rise to 80 mm Hg or more. However, the pressure will return to normal after 15 to 30 minutes and the area of effusion will remain localized. Scleral puncture to drain fluid is not indicated if the wound can be closed before there is a prolapse of the iris or other intraocular tissues.

Acute Disease↗
PubMed1985

The Honan intraocular pressure reducer. An experimental study.

Although use of the Honan intraocular pressure reducer is believed to be clinically safe and effective in reducing IOP and the risk of vitreous loss, the IOPs achieved during application of the device have not been directly measured. Intraocular pressure dynamics in ten eyes of five patients were measured shortly after death, using a pressure transducer within the anterior chamber as the Honan device was applied. Pressures were measured again after enucleation. The peak IOPs produced in eyes in situ were much lower than in the same eyes after enucleation. The peak IOP increased as the initial IOP was raised. The Honan device would appear to be safe for eyes undergoing routine anterior segment surgery, but the pressures that may be generated in hypertensive eyes (IOP greater than or equal to 35 mm Hg) might put these eyes at risk for vascular occlusion.

Adult↗
PubMed1985

Topical retinoid treatment for various dry-eye disorders.

We evaluated the clinical efficacy of treating various dry-eye disorders using 0.01% and 0.1% (weight/weight) topical all-trans retinoic acid ointment. Twenty-two patients were selected and classified into four major groups: keratoconjunctivitis sicca (6 patients; 11 eyes), Stevens-Johnson syndrome (9 patients; 17 eyes), ocular pemphigoid or drug-induced pseudopemphigoid (3 patients; 6 eyes), and surgery or radiation-induced dry eye (4 patients; 4 eyes), based on the criterion that they remained symptomatic even under maximum tolerable conventional medical and/or surgical therapies. The results indicated that squamous metaplasia with mucin deficiency secondary to goblet cell loss and keratinization may be the basis for the development of clinical symptoms and morbidities, as these epithelial abnormalities were invariably present before treatment. After treatment, all patients demonstrated clinical improvements in symptoms, visual acuity, rose Bengal staining, or Schirmer test. Most importantly, this topical vitamin A treatment caused the reversal of squamous metaplasia as evidenced by impression cytology. Therefore, this treatment may represent the first nonsurgical attempt to treat these disorders by reversing diseased ocular surface epithelium.

Administration, Topical↗