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Biomedical subjects

B D Fouraker

Publications and source records attributed to B D Fouraker.

10 recordsLinked to original sources
PubMed1998

Recurrent endophthalmitis after cataract surgery with a scleral-tunnel incision.

PURPOSE: To present a case of recurrent postoperative endophthalmitis with a scleral-tunnel abscess and adjacent microbial keratitis. METHODS: A 76-year-old woman with microbial keratitis and recurrent endophthalmitis after cataract surgery was referred to a tertiary care center for further management. The medical chart of the patient was reviewed. RESULTS: The patient was seen on the eighth postoperative day with endophthalmitis that responded to medical treatment. Initial vitreous cultures were negative. The endophthalmitis recurred after the medical treatment was discontinued. She subsequently developed microbial keratitis at 1 o'clock adjacent to the limbus. Cultures from the site of corneal abscess and vitreous grew coagulase-negative Staphylococcus. Gonioscopy revealed the presence of a scleral abscess, which responded to subconjunctival injection of vancomycin and an intense and prolonged course of topical antibiotics. CONCLUSION: A scleral abscess should be suspected in a patient with endophthalmitis or microbial keratitis or both after a scleral-tunnel incision for cataract surgery.

Administration, Topical↗
PubMed1996

Use of a mirror needle holder with transsclerally sutured posterior chamber intraocular lenses.

A mirror needle holder has been designed to facilitate the passage of a needle through the ciliary sulcus during transscleral fixation of posterior chamber (PC) intraocular lens (IOLs). Two human postmortem eyes were used to demonstrate the efficacy of this mirror used as the needle holder. This method was compared with the current method of passing sutures without view of the ciliary sulcus. The mirror needle holder demonstrated precise passage of the needle into the ciliary sulcus by direct visualization of the ciliary processes and sulcus. This method may avoid the complications associated with transsclerally sutured PC IOLs during penetrating keratoplasty and secondary IOL placement.

Ciliary Body↗
PubMed1995

One-year results of the intrastromal corneal ring in nonfunctional human eyes. Intrastromal Corneal Ring Study Group.

OBJECTIVE: The intrastromal corneal ring (ICR), a new keratorefractive device designed to correct myopia, was evaluated for safety and efficacy as part of a phase I Food and Drug Administration clinical trial. PATIENTS AND METHODS: Ten patients, each with one nonfunctional eye, underwent surgical implantation of the ICR, which is a split ring composed of polymethyl methacrylate. The eyes were followed up during a 1-year period and were evaluated for wound healing, implant-related inflammation, intraocular pressure, corneal thickness, endothelial cell count, and refractive effects. RESULTS: Wound healing was uncomplicated in all of the patients. No patient experienced implant-associated inflammation or extrusion. Intraocular pressure, corneal thickness, and endothelial cell counts were unaffected by the ICR. Non-sight-threatening intraoperative events included ring decentration and inadequate attachment of a vacuum-centering guide. The ICR reduced keratometrically determined spherical equivalence by an average of -2.5 +/- 1.1 diopters (mean +/- SD). Spherical equivalence, as determined by retinoscopy, was reduced by an average of -2.4 +/- 1.0 D. Results of corneoscopy and computerized videokeratography further confirmed this reduction of myopia. CONCLUSIONS: The ICR may be a safe and efficacious device that offers predictable results with few side effects, and it may be a feasible alternative to current keratore-fractive procedures.

Adult↗
PubMed1992

Efficacy of tobramycin-soaked collagen shields vs tobramycin eyedrop loading dose for sustained treatment of experimental Pseudomonas aeruginosa-induced keratitis in rabbits.

We compared the efficacy of a fortified tobramycin-soaked collagen shield to the efficacy of a single loading dose (four 50-microliters drops) of fortified tobramycin eyedrops in the treatment of New Zealand White rabbits with Pseudomonas aeruginosa-induced keratitis. Eyedrop loading-dose efficacy was evaluated with and without lateral tarsorrhaphy. Six hours after a single treatment, significantly fewer Pseudomonas colonies were present in the corneas of all three drug-treated groups as compared to the number of colonies in the corneas of balanced salt solution-treated control rabbits (P less than .006). Although no significant difference was observed between any of the drug-treated groups, lateral tarsorrhaphy was associated with a greater than tenfold decrease in the number of colony-forming units (P = .073). We found no significant difference in efficacy between a collagen shield presoaked in tobramycin, and a single loading dose of tobramycin eyedrops, in the treatment of rabbits with P. aeruginosa-induced keratitis.

Administration, Topical↗
PubMed1991

Intraocular safety of ciprofloxacin.

Retinal toxicity resulting from the treatment of exogenous bacterial endophthalmitis with multiple antibiotics has increased the importance of evaluating the efficacy of new potent antibiotics for monotherapy. The retinal and corneal toxicity of ciprofloxacin hydrochloride, which is rapidly bactericidal against gram-positive and gram-negative bacteria, was evaluated in the rabbit eye. Retinal toxicity was dose-dependent in phakic and aphakic rabbit eyes as determined with electroretinography, light microscopy, and transmission electron microscopy. An intravitreal dose of greater than 100 micrograms also resulted in dose-dependent acute corneal toxicity in aphakic vitrectomized rabbit eyes. Results of instillation of ciprofloxacin directly into the anterior chamber of phakic rabbit eyes confirmed dose-dependent corneal toxicity. No retinal or corneal damage was observed in aphakic or phakic rabbit eyes after administration of an intravitreal dose of 100 micrograms. Results of electroretinography and light microscopy alone are insufficient to evaluate the retinal toxicity of antibiotics. Ultrasonic pachymetry is the best method of detecting probable associated corneal toxicity.

Animals↗
PubMed1991

Recurrent corneal erosion: pathology of corneal puncture.

Recurrent corneal erosion is a difficult disorder to treat. Despite conventional therapy, some patients continue to have episodes of erosion. Recent literature suggests the efficacy of corneal puncture, which is thought to induce adherence of the epithelium and basement membrane to the anterior stroma. We performed multiple corneal punctures with 23-, 25-, 27-, and 30-gauge needles on one patient who underwent penetrating keratoplasty 7 weeks later. We found that an insertion depth of 0.1 mm was sufficient to cause the production of new basement membrane and fibrocytic reaction in the anterior stroma. Analysis of the pathologic specimen supports the use of the larger 23- and 25-gauge needles, and cautions against the use of small gauge needles, especially 30-gauge, for this procedure.

Basement Membrane↗
PubMed1990

A comparison of en face and tangential wide-area excimer surface ablation in the rabbit.

We used an argon fluoride excimer laser (193 nm) to perform anterior corneal surface ablation in New Zealand white rabbits (25 eyes) using both en face and tangential methods. We followed up the animals for 90 days using slit-lamp photography and pachymetry at predetermined intervals. We also examined selected tissues with scanning electron microscopy and transmission electron microscopy. Immediate and subsequent examinations revealed significant differences in clarity between the two groups. When viewed through slit-lamp microscopy, the rabbits undergoing the en face method exhibited hazy corneas and irregular surfaces, whereas the corneas that underwent tangential keratectomy demonstrated less haze and fewer surface irregularities. Through histologic study and electron microscopy, we corroborated this finding. At 30 days, there was a statistically significant difference in clarity between en face--treated corneas and those treated tangentially.

Animals↗
PubMedDate not supplied

Update on epikeratoplasty.

Epikeratoplasty is a surgical procedure which modifies the surface topography of the cornea by the addition of a tissue lens. This procedure has been applied to patients with keratoconus, myopia, and aphakia. Several large studies of epikeratoplasty have been conducted which suggest that the procedure be limited to keratoconus and aphakic patients who are contact and spectacle lens intolerant.

Aphakia↗