Search PubMed⌕ Search

Biomedical subjects

D D Shepard

Publications and source records attributed to D D Shepard.

10 recordsLinked to original sources
PubMed1987

Radial keratotomy: analysis of efficacy and predictability in 1,058 consecutive cases. Part II: Predictability.

Effectiveness and predictability of anterior radial keratotomy to correct myopia and/or astigmatism were evaluated in 1,058 consecutive surgeries. The surgical technique, results, and comparison to other series are detailed in Part I. In this paper, a retrospective study for predicting the change in refraction of eyes having radial keratotomy with and without astigmatism incisions, statistically derived predictors accounted for 72.9% of the variations in outcome.

Adult↗
PubMed1986

Radial keratotomy: analysis of efficacy and predictability in 1,058 consecutive cases. Part I: Efficacy.

Effectiveness and predictability of anterior radial keratotomy to correct myopia and astigmatism or astigmatism alone were evaluated in 1,058 consecutive surgeries. The surgical technique consisted of retrobulbar anesthetic injection, topical anesthetic, from four to 32 radial incisions with a diamond blade, cutting from the optic zone to the limbus, optical clear zone diameter from 2.75 mm to 5.00 mm, longitudinal or tangential incisions, if necessary, to correct astigmatism, and bilateral surgery at the same sitting in 72% of cases. There were 816 of 1,018 subjects (80.2%) between +/- 1 diopter (D) of emmetropia following surgery; 86.1% of 1,003 eyes were 20/40 or better uncorrected postoperatively; mean astigmatism was reduced from 0.97 D preoperatively to 0.66 D postoperatively. Sixty-seven eyes (6.3%) had microperforations; seven (0.7%) had macroperforations requiring a suture. The mean change in refraction for patients with and without perforations was 5.43 D and 4.20 D, respectively.

Astigmatism↗
PubMed1980

Consultation section.

Explore the source record for details and available documents.

Activities of Daily Living↗
PubMed1979

The fate of eyes from which intraocular lenses have been removed.

The author removed 26 intraocular lenses in a series of 800 implantations (3.25%). The factors leading to lens removal and the clinical and visual end-results are analyzed and presented in tabular form. The most common factors leading to lens removal were: corneal edema, cystoid macular edema, uveitis, vitreitis, iris erosion/laceration, recurrent dislocation, updrawn pupil, glaucoma and blunt injury. Post-removal complications were: poor wound healing, high astigmatism, amblyopia, cystoid macular edema, retinal vascular occlusion, optic atrophy and phthisis bulbi. The average length of time between lens implantation and removal was 18 months. The vitreous loss rate was 35% during lens removal. On the average, an eye gained two Snellen lines of vision following removal of the offending lens; 69% had the same or better vision post-removal, and 64% of eyes with corneal edema/dystrophy improved.

Eye Diseases↗
PubMed1978

Retinal detachment with intraocular lenses.

Of 740 patients undergoing intracapsular cataract extraction with intraocular lens implantation by the same surgeon, 18 (2.43) experienced retinal detachment. Analysis of the data of these 18 patients reveals:--the series covered 6.25 years (75 months).--there were 13 males and 5 females (72% males).--their average age at the time of cataract surgery was 63.--the median duration between cataract surgery and retinal detachment was 11 months. The shortest interval was 5 weeks, the longest was 39 months.--a predisposing fall was documented in 17%.--33% suffered vitreous loss at the time of cataract extraction.--of the 18 patients, 15 (83%) underwent retinopexy; of the remaining 3, one eye (6%) was not repairable and 2 patients (11%) refused detachment surgery.--only 6 (33%) of the 18 achieved useful post-detachment vision.

Aged↗
PubMed1977

The dangers of metal-loop intraocular lenses.

The author implanted 500 intraocular lenses (IOLs) during intracapsular surgery. Data from the 60 lenses with metal posterior loops showed a markedly high incidence of complication compared to plastic loops: twice as many overall complications, three times the cystoid mascular edema, three times the rate for subsequent corrective surgical procedures, and 30 times more IOLs had to be removed. IOL manufacturers are advised to abandon metal loops for intracapsular implantation. Polypropylene is suggested as the apparent ideal loop material.

Alloys↗
PubMed1977

Indications for intraocular lens removal.

1. The indications for removing an intraocular lens (IOL) are: A. Chronic uveitis B. Endothelial corneal dystrophy C. Uncontrollalbe glaucoma D. Metal loop cutting pupillary sphincter E. Gross decentration of IOL (fibrous bands) F. Extraocular dislocation of IOL G. Recurrent severe hyphema H. Development of rubeosis iridis I. Removal of iris (1) Iris tumor (2) Epithelial downgrowth J. Endophthalmitis K. Unilateral IOL in pending bilateral aphakia 2. The following may be indications for removing and/or replacing and/or replacing an IOL: A. Wrong dioptric power B. Foreign body attached to IOL C. IOL covered with pigment D. Repair retinal detachment after extracapsular cataract extraction E. Choyce lens too short F. Dannheim IOL with absorbed supramid loop tips G. Dislocated Ridley IOL H. Sclero-conjunctival erosion of Strampelli's "external-fixation" IOL loop. The preceding analysis of problem areas is meant to specifically define when and why to remove or replace an IOL, or institute alternative forms of treatment. One is advised to obtain consultation or a second opinion before embarking on lens-removal surgery.

Eye Diseases↗
PubMed1977

Intraocular lens implantation -- analysis of 500 consecutive cases.

The author analyzed 500 consecutive cases of intraocular lens (IOL) implantation performed in the past five years: the patients were unselected; 0.2% required enucleation (one case of epithelial downgrowth); 2% needed IOL removal; 3.6% suffered retinal detachment; males were three times as prone to retinal detachment and "vitreitis" as females; 7.5% experiences IOL subluxation; 10% required subsequent surgery for a variety of complications; 15% demonstrated clinical cystoid macular edema (CME); the lowest incidence of CME occurred with Copeland lenses (3.9%); the highest incidence of CME was seen with IOL's with metal loops (33%); 21% had CME following secondary implantation; 61% had no complications during surgery or the entire follow-up period. 79% had industrially-useful vision (20/40 or better); 95% had intracapsular extraction; there were no cases of endophthalmitis.

Adolescent↗