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Biomedical subjects

C M Kirkness

Publications and source records attributed to C M Kirkness.

72 records · Page 4Linked to original sources
PubMed1988

Botulinum toxin A-induced protective ptosis in corneal disease.

Botulinum toxin A produces a temporary, flaccid ptosis when injected into the levator palpebrae superioris muscle. The resulting protective ptosis was used to aid healing in 21 cases of indolent ulceration, and, prophylactically, in 4 cases of neuroparalytic keratitis. Of the indolent ulcers, 90% healed completely. In all but one case, the cornea was covered completely by the lid and complete ptosis was produced in 75% of cases in an average of 3.6 days, lasting for 16 days on average before recovery began. Recovery of levator function was complete in 8.5 weeks on average. Superior rectus underaction was seen in 68% of cases but this recovered completely in all cases in an average of 6 weeks. Impression cytology showed a trend toward normal conjunctival morphology as healing progressed.

Blepharoptosis↗
PubMed1988

Monitoring ocular disease by impression cytology.

The technique for obtaining and processing conjunctival impression cytology is described. The method of grading the stained samples is outlined. Our findings in various ocular conditions with particular emphasis on; alkali burns, uveitis, hypopyon ulcer and Botulinum toxin protective ptosis are shown. Cytology from severely damaged eyes is highly abnormal, improving as the ocular disease settles. In alkali burns a return to normal cytology does not correlate with return of corneal clarity. Loss of goblet cells is a common finding in the ocular diseases demonstrated, and appears to be a non-specific indicator of ocular problems.

Alkalies↗
PubMed1988

The use of silicone drainage tubing to control post-keratoplasty glaucoma.

A series of 20 patients who developed severe post-keratoplasty glaucoma unresponsive to medical therapy and trabeculecetomy were treated using silicone drainage tubing and an anterior encircling gutter. The results indicate a four year probability of maintaining vision and normal intraocular pressure (less than 21 mmHg) of 0.68. In contrast, an earlier series of 13 patients receiving cycloablation with cryotherapy did significantly worse.

Anastomosis, Surgical↗
PubMed1988

Post-keratoplasty glaucoma.

The incidence of post-keratoplasty glaucoma remains at about 30% of all grafts performed. Aphakic eyes, particularly those after intracapsular extraction, the elderly, traumatised eyes and eyes undergoing repeat corneal grafts appear to be at greatest risk. This paper also reviews the mechanisms and treatment of post keratoplasty glaucoma.

Adult↗
PubMed1988

Comparison between posterior polymorphous dystrophy and congenital hereditary endothelial dystrophy of the cornea.

Corneal discs from 10 cases of posterior polymorphous dystrophy (PPD) and 20 cases of congenital hereditary endothelial dystrophy (CHED) were compared and contrasted using light and electron microscopy. Secondary epithelial changes were similar in both diseases but spheroidal degeneration of stroma was seen more commonly in dominant CHED and not at all in PPD, when band, calcific, keratopathy was commoner. Changes at the level of Descemet's membrane showing failure to regulate growth were seen in recessive CHED whereas dominant CHED and PPD were both associated with development of a fibrillary posterior collagen layer (PCL). Grotesquely banded PCL was also seen in some cases of PPD. Endothelial changes included vacuolation, development of microvilli and desmosomes in both diseases but multilayering was more common in PPD. The viscous layer of the cornea was seen by TEM in one case of PPD.

Adult↗
PubMed1988

Emergency presentation of corneal graft patients.

One hundred and forty-two patients with corneal grafts made 205 visits to the Accident and Emergency Department of Moorfields Eye Hospital during a twelve-month period. One-third of cases showed a graft rejection episode while another third had a problem directly related to the graft. The figures emphasise the need for continuing patient education so that graft problems may be dealt with promptly.

Corneal Transplantation↗
PubMed1988

Colour discrimination in pseudophakia.

A study was undertaken to examine the colour discrimination of fifty pseudophakic patients and to compare results with fifty age matched normal observers. Using the Farnsworth-Munsell 100-Hue test and Desaturated panel D15, performance does not differ significantly from the age matched normals, although a theoretically superior colour discriminative ability might be expected in pseudophakia. A slight trend for increasing error scores with advancing age in pseudophakia lends some support to the importance of neural factors in the ageing of colour discrimination. Several other factors influencing colour vision in pseudophakia are discussed.

Aged↗
PubMed1988

Longterm prognosis for corneal grafting in herpes simplex keratitis.

A previously reported cohort of patients was reviewed after mean follow-up of 10.9 years. The overall probability of survival was 45%, but first grafts had a greater probability of survival than second (P = 0.12) or further (P = 0.19) grafts. Preoperative active keratitis adversely affected survival (P = 0.123). The major cause of failure was graft rejection. Regrafts were more likely to fail from rejection episodes (P = 0.0005). Antiviral prophylaxis improved the outcome for rejection (P = 0.005) and reduced the incidence of HSK recurrence complicating rejection. Suppurative keratitis occurred in 12.4% of grafts as a complication of epitheliopathy including HSK recurrence. The outcome in these cases was particularly poor. Loose continuous graft sutures resulted in graft failure in 10.6% of grafts which may be improved by using interrupted suturing. Our results suggest the longterm prognosis for grafting in herpes simplex keratitis are not as good as may have been predicted from previous analyses.

Cornea↗
PubMed1988

Corneal gammopathy.

The deposition of gamma-globulin within the corneas of patients with raised levels of a specific immunoglobulin fraction has been recognised, albeit rarely, for several years. Two further instances, one concerning a man with a lymphoma of low-grade malignancy and the other a woman with rheumatoid arthritis, are presented. From a study of these patients and review of other reported cases it appears that although the morphology of the deposits can vary from case to case, the common denominator of the paracrystalline deposits is banding at approximately 10-nm intervals. IgGK is the most frequently reported immuno-globulin fraction associated with intracorneal deposition.

Cornea↗
PubMed1987

Penetrating keratoplasty and cataract surgery: the advantages of an extracapsular technique combined with posterior chamber intraocular implantation.

The results of 28 consecutive triple procedures and 33 cases of combined penetrating keratoplasty and extracapsular extraction are presented. All the eyes with the triple procedure maintained a clear graft; 77 per cent achieved an acuity of 6/12 or better. The average time before a refractive correction could be dispensed was 8.2 months, while after a combined procedure the interval was 17.4 months, although in both groups the average time until the best visual acuity was reached was similar.

Adult↗
PubMed1987

Botulinum toxin A induced protective ptosis.

Botulinum Toxin A injected into the levator palpebrae superioris produces a flaccid ptosis of the upper lid and provides a safe and effective protection for the cornea to aid healing in indolent ulceration or as prophylaxis when there is fifth or seventh cranial nerve damage. Fifteen patients have received this treatment. Levator paresis, producing ptosis for a mean of 2-3 weeks and recovering in a mean of 8.1 weeks was successfully produced in all patients and complete corneal healing was produced in 80% of patients. The major side effect was weakness of the superior rectus muscle which occurred in 80% of cases and lasted a mean of 6 weeks.

Blepharoptosis↗
PubMed1987

Congenital hereditary corneal oedema of Maumenee: its clinical features, management, and pathology.

The clinical and histological features of congenital hereditary corneal oedema in 23 patients are presented. The series includes cases of both recessive and dominant inheritance. Although the condition is present at birth or in early childhood, visual development appears to be little impaired, if at all. Penetrating keratoplasty carries a relatively good surgical prognosis and can produce a substantial visual gain even when carried out late in life.

Adolescent↗
PubMed1986

Safety of lasers.

Explore the source record for details and available documents.

Accident Prevention↗
PubMed1985

Polysulfone corneal inlays. Adverse reactions: a preliminary report.

The use of polysulfone to manufacture a lens for insertion into the corneal stroma to correct large refractive errors has been described. Two patients are presented in whom the procedure has been associated with significant loss of vision due to development of secondary changes in the cornea.

Adult↗
PubMed1985

Does light pose a hazard to the macula in aphakia?

The changes produced within the retina by ultraviolet and blue-violet light are discussed in relation to the increased sensitivity of aphakic and pseudophakic eyes to actinic damage.

Aphakia, Postcataract↗