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Biomedical subjects

A Spierer

Publications and source records attributed to A Spierer.

At least 37 records · Page 2Linked to original sources

Anterior chamber hemorrhage during cataract surgery in Lowe syndrome.

This article reports a spontaneous intracameral bleeding at the end of cataract surgery in both eyes of two patients with Lowe syndrome. Extracapsular cataract extraction with anterior vitrectomy and posterior capsulotomy, using the anterior chamber maintainer (ACM), was performed in both eyes of two patients. At the conclusion of the surgery, when the ACM was removed, spontaneous bleeding occurred into the anterior chamber and spread into the vitreous cavity. The hemorrhage resolved spontaneously over varying periods of time. We propose that bleeding occurred from damage to iris vessels in the abnormal angle in our patients with Lowe syndrome when the ACM was removed with a concomitant decrease in intraocular pressure.

Anterior Chamber↗

The paralimbal approach with deferred conjunctival closure for adjustable strabismus surgery.

Interest in the adjustable suture technique was renewed in the mid-1970s. The authors report a new modification of the fornix and limbal conjunctival approaches that combines the advantages of both. A paralimbal conjunctival incision is placed halfway between the limbus and the muscle insertion and directed parallel to the muscle insertion. This approach permits easy access to the rectus muscle. After the adjustable suture is temporarily secured with a bow-tie knot, the conjunctiva is partially closed using a loop suture over the muscle suture. An optional modification is the use of a "sweep suture" to break early adhesions at the time of adjustment. The adjustment procedure is performed at least 6 hours after the surgery. The conjunctiva is retracted as necessary for access to the muscle suture. If a sweep suture is used, this is first withdrawn before attempting any adjustment. After adjustment, the conjunctival loop suture is closed, covering the muscle suture. The sweep suture serves as a safeguard for what may otherwise be a difficult adjustment. This approach increases patient comfort after the surgery.

Conjunctiva↗

Normal heterophoric changes: 20 years' follow-up.

BACKGROUND: Evaluation of changes in the heterophoric condition of 100 normal individuals over a 20-year period. METHODS: A retrospective study was undertaken. Charts of 100 normal men were reviewed. Individual changes in the heterophoric status were recorded over a 20-year period. The average value of the phoria at age 18-22 years was compared with the average value at age 34-38 years. Measurements were taken for near and distance fixation. No one was heterotropic. Changes in convergence and accommodation were also calculated. RESULTS: A 0.9 +/- 1.7 prism diopter increase in esophoria for distance fixation and a 0.6 +/- 2.5 prism diopter increase in exophoria for near fixation were found. These changes were statistically significant (P < 0.001 and P < 0.02 respectively). The near point of convergence receded by 0.5 +/- 1.1 cm (P < 0.001), and a decrease in accommodation over time of 2.8 +/- 1.4 diopters was found (P < 0.001). CONCLUSION: An increase in esophoria for distance fixation and a exophoria for near fixation was found in a 20-year follow-up of 100 normal subjects.

Accommodation, Ocular↗

Reattachment of extraocular muscles using fibrin glue in a rabbit model.

PURPOSE: Reattaching extraocular muscles by the conventional suturing method may be complicated by scleral perforation. The attachment of extraocular muscles, using fibrin sealants, avoids such risk. The authors evaluated the use of fibrin sealant in a laboratory rabbit model. METHODS: Fifty-eight eyes of 29 rabbits were used in the study. In both eyes of each rabbit, the superior rectus muscle was disinserted, recessed, and either sutured or reattached to the globe by fibrin sealant. Two groups of eyes were compared. In one group (42 eyes), the recessed muscle was reattached using fibrin sealant. In the second group (16 eyes), sutures were used to reattach the recessed muscle to the globe. The insertion of the superior rectus muscle was examined 14 days after surgery, and histopathologic evaluation was performed 6 weeks after the surgery. RESULTS: Although in the sutured muscle group no slippage from the original placement was found, it was found in the group in which fibrin glue was used. The muscle slippage was greater at the small muscle recessions and smaller at the large muscle recessions. For muscle recession of 6 mm or more, the average muscle slippage was 0.12 +/- 0.28 mm, which was not statistically different from the suture group (P = 0.0828). CONCLUSIONS: Fibrin sealant was found to be effective for extraocular muscle reattachment only in large muscle recessions. However, in small muscle recessions the glue was not strong enough to overcome the contractive strength of the muscle.

Animals↗

Measurement of head-turn in ocular torticollis.

There is a need for a simple and accurate method to measure head-turn in patients who suffer from torticollis secondary to ocular disease. In the technique described here, a fixation object is moved from a point in front of the patient to a point at which the patient's face is straight. The distance that the object is moved is proportional to the amount of head-turn the patient has. With a simple mathematical calculation, the angle of head-turn can be determined, even during a routine clinical evaluation.

Head Movements↗

Postoperative miotics for patients with infantile esotropia.

BACKGROUND AND OBJECTIVES: To examine the postoperative effect of echothiophate iodide in children who underwent surgery to congenital esotropia, and to find out whether it significantly reduced the residual esotropia. PATIENTS AND METHODS: Forty-one children who underwent surgery to correct congenital esotropia were randomly divided into a study group and a control group. The children in the treatment group received echothiophate iodide eyedrops once daily for 4 months, and all the children received dexamethasone eyedrops for 1 week after surgery. The strabismus angle was measured at 6 days, 6 months, and 12 months postoperatively for every patient. The measurements were compared in both groups using the paired Student's t test. RESULTS: The surgical procedure reduced the mean angle of esotropia by 32.4 prism diopters (PD) in the treatment group, and 38.8 PD in the control group. Six months after surgery, a mean decrease in the esotropia of 1.0 PD was observed in the treatment group, and a mean increase of 0.2 PD was observed in the control group. Twelve months postoperatively, the esotropia increased, by an average of 1.4 and 2.8 PD in the treatment and control groups, respectively. These differences were not statistically different (P > .05). CONCLUSION: Echothiophate iodide, given postoperatively for congenital esotropia, does not improve the surgical results during the first postoperative year.

Administration, Topical↗

Measurement of cyclotorsion.

PURPOSE: To measure accurately the amount of cyclotorsion. METHODS: A horizontal light beam of the slit lamp is projected on the retina, crossing the fovea. The slit light will normally cross between the middle and lower thirds of the disk. Cyclotorsion of the eye will cause the horizontal slit-light beam to be projected onto a different part of the disk. The slit light is then tilted by the scale mark on the slit lamp in such a way that the slit light is crossing the fovea and the physiologic area on the disk. RESULTS: The amount of slit-lamp tilt needed is obtained from the scale mark on the slit lamp. This test correlated well with other tests used for the appreciation of cyclotorsion: the Maddox double rod test and indirect ophthalmoscopy. CONCLUSION: A simple method for measuring ocular cyclotorsion is described.

Humans↗

Position-effect variegation in Drosophila depends on dose of the gene encoding the E2F transcriptional activator and cell cycle regulator.

A dominant mutation due to the insertion of a P-element at 93E on the third chromosome of Drosophila melanogaster enhances position-effect variegation. The corresponding gene was cloned by transposon tagging and the sequence of the transcript revealed that it corresponds to the gene encoding the transcriptional activator and cell cycle regulator dE2F. The transposon-tagged allele is homozygous viable, and the insertion of the transposon in an intron correlates with a strong reduction in the amount of transcript. A homozygous lethal null allele was found to behave as a strong enhancer when heterozygous. Overexpression of the gene in transgenic flies has the opposite effect of suppressing variegation. A link is established here, and discussed, between the dose of a transcriptional activator, which controls the cell cycle, and epigenetic silencing of chromosomal domains in Drosophila.

Amino Acid Sequence↗

Anterior segment pathology associated with hypermetropia.

Eight children presented who suffered from pathological changes of the anterior chamber as part of Axenfeld-Rieger syndrome. All of them had associated hypermetropia. Hypermetropia in these cases may have resulted from disturbed development of the anterior segment of the eyes during fetal life.

Anterior Eye Segment↗

Convergence insufficiency secondary to subdural hematoma.

PURPOSE/METHODS: Symptomatic convergence insufficiency developed in a 56-year-old man after he sustained head trauma and developed subdural hematoma. RESULTS/CONCLUSION: All symptoms resolved after surgical evacuation of the subdural hematoma. Convergence insufficiency developing after head trauma could be the result of a subdural hematoma.

Brain Injuries↗

[Secondary glaucoma after congenital cataract surgery].

In a retrospective study, the incidence of secondary glaucoma after congenital cataract extraction was evaluated. Causes of this type of secondary glaucoma include peripheral anterior adhesions which obstruct the anterior chamber angle and prevent normal outflow of aqueous humor, pupillary block, intraocular hemorrhage, and chronic uveitis, among others. During the past 12 years 41 children (57 eyes) were operated for congenital cataract. Secondary glaucoma was found in a 1-month-old boy and a 1-month-old girl (5.3%; 3 eyes). Follow-up in most patients was less than 5 years. A similar incidence of secondary glaucoma has been reported by others. In spite of the low incidence of this complication, secondary glaucoma should be excluded during routine follow-up of these children.

Cataract↗

Adenovirus type 8 conjunctivitis outbreak in a neonatal intensive care unit.

An outbreak of adenovirus type 8 conjunctivitis occurred in seven premature infants who had undergone ophthalmological examination four to seven days previously. Three of the affected infants, treated with steroids because of bronchopulmonary dysplasia, showed systemic manifestations and deterioration of their respiratory disease. Second and third waves affected nine staff and 12 family members.

Adenovirus Infections, Human↗

Corneal changes in chondrodysplasia punctata syndrome.

A child with chondrodysplasia punctata syndrome is presented. In addition to the bilateral congenital cataracts that have been described previously in this syndrome, this child had bilateral corneal punctate erosions. These corneal abnormalities, which to the best of our knowledge have not been described in this syndrome before, persisted for at least three years.

Abnormalities, Multiple↗

Secondary cataract in infants after extracapsular cataract extraction and anterior vitrectomy.

Two infants developed secondary cataract after undergoing extracapsular cataract extraction (ECCE), posterior chamber intraocular lens (IOL) implantation, posterior capsulectomy, and anterior vitrectomy. A similar complication developed in a third child, who had undergone ECCE and posterior capsulotomy. The secondary cataracts developed in these patients from 3 to 12 weeks after the primary operation. In infants, unlike adults, posterior capsulectomy and anterior vitrectomy after ECCE do not seem always to prevent secondary cataracts. In infants, the complication may be related to IOL implantation.

Anterior Eye Segment↗