Biomedical subjects

C A Swinger

Publications and source records attributed to C A Swinger.

24 records · Page 2Linked to original sources

PubMed1981

Keratophakia and keratomileusis--clinical results.

A random, retrospective study was performed on 158 patients. who underwent keratophakia and keratomileusis for the correction of refractive errors. The primary indication for surgery was high anisometropia. Data on corneal curvature modification, refraction, accuracy, stability, and complications are reported. Both keratophakia and hypermetropic keratomileusis are capable of fully correcting aphakic hyperopia. Myopic keratomileusis corrected up to 16 diopters of myopia in this series. Lamellar refractive keratoplasty appears to have no significant detrimental effect on visual acuity. The majority of myopic patients had an improved best-corrected visual acuity postoperatively. High or irregular astigmatism was not noted following this surgery. The stability of the postoperative curvature appeared to be good with both keratophakia and myopic keratomileusis. Complications in this series were minimal, and one resulted in decreased vision postoperatively. Inaccuracy in achieving the desired refractive result appeared to be the major disadvantage of these techniques.

Adolescent↗

PubMed1981

Refractive surgery for the correction of myopia.

Interest in the surgical correction of myopia is increasing. At the present time, two procedures are clinically employed: radial keratotomy and myopic keratomileusis. The two techniques are described, and a detailed clinical comparison is presented.

Cornea↗

PubMed1979

Keratophakia: a preliminary evaluation.

The results of 18 cases of combined cataract extraction and keratophakia are presented. Initial results indicate that these procedures may replace the use of alloplastic materials for the correction of aphakic ametropia either as a primary or a secondary procedure.

Aged↗

PubMedDate not supplied

Postoperative astigmatism.

With the numerous significant advances in surgical methodology--e.g., microinstrumentation, the operating microscope, the surgical keratometer, and intraocular lenses--that have been developed over the past two decades, both surgeons and patients have become increasingly aware of the final optic result of any surgical intervention. This is especially so since the development of refractive surgery, where good uncorrected vision is frequently the final arbiter of success. We have progressed to the stage where the optic manipulation of the cornea, whether intentional or otherwise, can be understood in terms of a number of variables. These include the preparation and closure of the surgical wound, the choice of suture material, and both intraoperative and postoperative manipulations. Where these have failed and postoperative astigmatism still occurs, a number of surgical procedures are available to reduce the astigmatic error to an acceptable level.

Astigmatism↗

PubMedDate not supplied

Freezing increment in keratophakia.

In homoplastic keratomileusis, keratophakia, and epikeratophakia, the corneal tissue that provides the final refractive lenticule undergoes a conformational change when frozen. Because corneal tissue is composed primarily of water, an assumed value of 9.08% (approximate volumic percentage expansion of water when frozen) is frequently used for the increase in thickness, or freezing increment, rather than measuring it directly. We evaluated 32 cases of clinical keratophakia and found the increase in thickness to average 37 +/- 21%. In this series of 32 cases, the percentage of patients with a greater than 4 D residual refractive error was 16%. If an assumed freezing increment of 9.08% had been used, the percentage would have been 28%, with two-thirds of these 28% manifesting a marked undercorrection. Because of a lack of studies documenting the behavior of corneal tissue following cryoprotection and freezing, it is suggested that measurements be taken during homoplastic surgery to minimize the potential for significant inaccuracy in obtaining the desired optic result.

Corneal Transplantation↗

PubMedDate not supplied

Excimer laser photorefractive keratectomy after radial keratotomy.

BACKGROUND: Correction of residual myopia after radial keratotomy may be attempted with repeated keratotomy surgery, but predictability can be less than satisfactory. Excimer laser photorefractive keratectomy (PRK) provides an alternative approach to improving the refractive result in these patients. METHODS: Twenty-five eyes of 20 patients at five clinical locations underwent PRK for residual myopia after radial keratotomy. The number of incisions ranged from 4 to more than 16. Clear zones ranged from 3 mm to 4 mm. Best corrected visual acuity was 20/20 or better in 16 of the 25 eyes, with a range from 20/12 to 20/80. Uncorrected visual acuity was 20/200 or worse in 15 of the 25 eyes, with a range from 20/25 to finger counting. The interval between radial keratotomy and PRK averaged 33.5 months, with a range from 5 to 96 months. Nineteen eyes had 6 months or more of follow up; 15 had 12 months or more. RESULTS: Corneal haze was maximal 1 month after surgery (mean +/- SE, 0.65 +/- 0.09), and declined to 0.35 +/- 0.16 at 12 months. Twelve months after PRK, mean keratometric readings were 40.19 +/- 0.81 diopters (D) and mean spherical equivalent refraction was -1.42 +/- 0.47 D. Nine (60%) of the 15 eyes with 12 months follow up were within 1 D of emmetropia and 12 (80%) were within 2 D. Eight (53%) of the 15 eyes had uncorrected visual acuities of 20/40 or better. Spectacle-corrected visual acuity in the eyes with 12 months follow up improved in 4, did not change in 4, and worsened in 6. CONCLUSIONS: The results of PRK are less predictable in eyes that have previously undergone radial keratotomy, and these eyes respond with more haze after PRK than normal eyes.

Adult↗