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Biomedical subjects

B C Joondeph

Publications and source records attributed to B C Joondeph.

At least 19 recordsLinked to original sources
PubMed1992

Comparison of three permanent intraocular magnets.

A comparison was performed of three small-gauge, permanent, rare-earth, intraocular magnets to assist the posterior segment surgeon with the decision as to which magnet to purchase or to use in different clinical situations. The magnetic force was measured at varying distances from the instrument tip using a 1/8-inch steel ball as the test object. There were small differences in magnetic strength between the three instruments that may have clinical significance in certain situations. Two of the instruments had a retractable magnet within an outer sleeve, allowing for controlled attraction and release of a magnetic foreign body by the surgeon.

Eye Foreign Bodies↗
PubMed1991

Delayed-onset pseudophakic endophthalmitis.

We reviewed 19 cases of delayed-onset pseudophakic endophthalmitis in which diagnostic cultures were performed at one month or more after cataract extraction with posterior chamber intraocular lens implantation. We isolated four different organisms in these 19 cases: 12 Propionibacterium species (63%), three Candida parapsilosis (16%), three Staphylococcus epidermidis (16%), and one Corynebacterium species (5%). Because of the unusual delayed-onset features of these cases and the retrospective nature of this study, a variety of treatment regimens were used. Twelve patients had recurrence of marked inflammation despite an apparent initial cure, and ten of these patients had positive culture results on repeat examination of intraocular fluids. Nine patients continued to be treated with topical corticosteroids postoperatively to suppress low-grade inflammation. Of the 19 patients, 16 had final visual acuity of 20/400 or better. Delayed-onset pseudophakic endophthalmitis had a more favorable visual prognosis, compared to acute-onset endophthalmitis.

Adrenal Cortex Hormones↗
PubMed1991

Penetrating ocular injury from contaminated eating utensils.

Although the rate of infectious endophthalmitis following penetrating ocular injury is generally less than 10%, certain settings may carry a greater risk of infection. One such setting is penetrating injury resulting from eating utensils contaminated with oral flora. We reviewed six of these injuries. Culture-positive bacterial endophthalmitis developed in four of the six eyes; only one of the eyes retained reading visual acuity (greater than 20/50) and two eyes lost light perception. The potential for infection and limited visual outcome in this series warrants aggressive prophylaxis and treatment. The unexpected isolation of Haemophilus influenzae in two of the four infections suggests that broad-spectrum antibiotic treatment should be considered in all such injuries since less common organisms may be encountered.

Adult↗
PubMed1991

Cilioretinal artery occlusion in young adults with central retinal vein occlusion.

Ten patients, all younger than 50 years of age, had a temporal cilioretinal artery occlusion associated with a nonischemic central retinal vein occlusion. On fluorescein angiography, the cilioretinal artery eventually filled in all but one eye. The cilioretinal artery showed pulsations on fluorescein angiography in five eyes. The central retinal vein occlusion eventually resolved and the fundus assumed a normal appearance in all nine of the followed cases. Eight of nine eyes that underwent follow-up examination had final visual acuity of 20/30 or better. The occlusion of the central retinal vein produces an elevation of intraluminal capillary pressure because the central retinal artery continues to pump blood into the retina. Because the perfusion pressure of the cilioretinal artery is lower than the central retinal artery, it becomes relatively occluded. The prognosis for these patients is generally good unless the entire parafoveal capillary net is affected by the cilioretinal artery that is occluded.

Adult↗
PubMed1991

Clinical course of multifocal choroiditis: photographic and angiographic evidence of disease recurrence.

Multifocal choroiditis is a syndrome that simulates the presumed ocular histoplasmosis syndrome but, in addition, includes vitritis and anterior uveitis. Because of its relatively recent acceptance as a distinct clinical entity, there is little information available on the long-term natural history of this condition. We managed three cases of multifocal choroiditis with recurrent active inflammation. Two patients had new peripheral chorioretinal lesions in previously normal retina, and the other had both peripheral chorioretinal scars and new swelling of the disc.

Adult↗
PubMed1990

Management of subretinal foreign bodies with a cannulated extrusion needle.

We treated two patients who had nonmagnetic subretinal foreign bodies (metallic pellet and lens nucleus fragment) in the presence of a retinal detachment and a distant retinal break. After the pars plana vitrectomy, the soft, flexible tip of the cannulated extrusion needle was used to push the foreign object gently away from the posterior pole toward the retinal break where it was grasped and removed from the eye. This technique for subretinal foreign body removal is preferable to creating a large posterior retinotomy overlying the foreign body because of the potential risks of further macular trauma, hemorrhage, or proliferation of periretinal membranes from the retinotomy site.

Adolescent↗
PubMed1990

Observations concerning patients with suspected impending macular holes.

Between September 1987 and April 1989, 18 patients (21 eyes) with suspected impending Stage 1 macular holes were referred to the Bascom Palmer Eye Institute. Only one patient had a Stage 1 hole. The others had an aborted stage of macular hole formation (eight eyes), Stage 2 holes (four eyes), a Stage 3 hole (one eye), or other lesions unrelated to hole formation. We believed that most of the apparently incorrect referring diagnoses were the product of incorrect interpretation of the biomicroscopic and fluorescein angiographic findings, and were not caused by changes occurring before our examination.

Fluorescein Angiography↗
PubMed1990

Macroaneurysm.

Explore the source record for details and available documents.

Aneurysm↗
PubMed1990

Transscleral contact retinal photocoagulation with an 810-nm semiconductor diode laser.

Since the 810-nm wavelength has marked transmissibility through the sclera and absorption by melanin, it would be ideal for transscleral photocoagulation. We performed experiments to determine if consistent transscleral chorioretinal lesions could be produced in Dutch belted pigmented rabbits using the 810-nm laser, and if this modality caused less blood-retinal barrier disruption than retinal cryopexy of clinically equivalent treatment areas. The laser applications produced whitish to grayish-white retinal lesions when the surgeon, under direct visualization, used low powers and long durations (5 to 10 seconds), and controlled the treatment duration. Histopathologic evaluation of a lesion demonstrated an intact sclera overlying the chorioretinal lesion. Vitreous protein concentration, which was measured to assess blood-retinal barrier disruption, was significantly less in eyes treated with transscleral photocoagulation than in eyes treated with cryopexy of clinically equivalent treatment areas. We conclude that transscleral 810-nm laser treatment may be a viable clinical alternative to retinal cryopexy.

Animals↗
PubMed1989

The surgical management of giant retinal tears with the cannulated extrusion needle.

In 18 eyes of 17 patients, we treated retinal detachment caused by a giant retinal tear by unfolding and repositioning the retina with a cannulated extrusion needle. After pars plana vitrectomy, a fluid-gas exchange was performed with the patient in the supine position. Using the cannulated extrusion needle to drain subretinal fluid posterior to the giant retinal tear, the retinal flap was manipulated into the correct anatomic position. With this technique, 18 of 18 eyes with retinal detachment caused by a giant retinal tear were successfully reattached intraoperatively. Although eight of these eyes subsequently redetached and required additional surgical procedures, 16 of 18 eyes remain attached with a mean follow-up of 11 months.

Adult↗
PubMed1989

A new culture method for infectious endophthalmitis.

We studied the use of blood culture bottles for culturing vitreous specimens obtained during vitrectomy for infectious endophthalmitis. In a retrospective review of 83 cases, blood culture bottles yielded a 91% incidence of positive cultures. A laboratory comparison of direct media inoculation, a membrane filter system, and three blood culture systems was undertaken using inocula of nine organisms in three different concentrations. The blood culture bottle systems became positive at the same time as, or within 24 hours of, the membrane filter system for nearly every organism tested. A prospective clinical comparison was also performed in 14 cases of endophthalmitis, confirming our laboratory findings. The direct inoculation of blood culture bottles may be an acceptable adjunct or alternative to more sophisticated laboratory techniques for vitreous cultures in infectious endophthalmitis.

Adolescent↗
PubMed1989

Hemostatic effects of air versus fluid in diabetic vitrectomy.

The potential hemostatic effect of an intravitreal air bubble after diabetic vitrectomy was studied in an animal model and in a randomized clinical trial. One day after vitrectomy with induced intraoperative hemorrhage, vitreous cavity hemorrhage was present in 60% of air-filled rabbit eyes compared with 27% of fluid-filled eyes. The prevalence and extent of hemorrhage was equal in the two groups on postoperative days 3 and 7. In a clinical trial of 51 eyes undergoing diabetic vitrectomy, 70% of eyes randomized to air-filled vitreous cavity after vitrectomy had vitreous cavity hemorrhage on postoperative day 1 compared with 50% of fluid-filled eyes. At 1 week, the incidence of hemorrhage was 78% for air and 61% for fluid. The 6-month visual and anatomic results were similar in both groups. These findings suggest that an intravitreal air bubble neither improves hemostasis nor reduces the visual outcome after diabetic vitrectomy.

Adult↗