An improved contact-lens holder for vitreous surgery.
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Biomedical subjects
Publications and source records attributed to D Hickingbotham.
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Intraocular cyclophotocoagulation with endoscopic visualization, following lensectomy and anterior vitrectomy, was performed on 14 eyes of eight rhesus monkeys. Two eyes received lensectomy and vitrectomy without laser treatment. One eye of each animal was studied one to eight months postoperatively, while the contralateral eyes were enucleated for study immediately after surgery. Histopathologic changes in the treated ciliary processes immediately after therapy included variable degrees of disruption in the epithelial layers and bleeding, while the late changes ranged from partial disruption of the epithelium and intrastromal pigment clumping to replacement of the processes by a fibrotic mass. The degree of these structural changes correlated reasonably well with the level of laser energy used and especially with the immediate, visible tissue alteration. These data may be useful in the development of clinical protocol for intraocular cyclophotocoagulation.
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Carcinoma metastatic to the choroid was diagnosed in three patients by cytopathologic examination of subretinal fluid. The specimen was obtained using a scleral depressor modified to allow controlled aspiration of subretinal fluid through a sharp, angled, 30-gauge needle. This new method provides a useful tool for accurate diagnosis of carcinoma metastatic to the choroid in cases where the diagnosis is in question.
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A new instrument, the membrane peeler cutter (MPC), has a solenoid-activated right-angled microscissors (diameter, 0.9 mm) that can be used as a hooked needle as well. It has been successfully used in more than 50 vitrectomy procedures that were complicated by intraocular membrane formation at the preretinal level. It has also been helpful in the cutting of pupillary membranes.
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We have developed a series of temporary keratoprostheses that permit closed pars plana vitrectomy in eyes with abnormal corneas. These devices are placed into a trephined opening in the cornea, and provide a clear, stable view of the intraocular contents. Immediately after vitrectomy, the keratoprosthesis is replaced with a corneal graft. We have used this technique successfully in four eyes with opaque or severely traumatized corneas.
A new foreign-body forceps with diamond-coated jaws can grasp and hold intraocular foreign bodies of any shape and composition. A self-closing mechanism holds the material once grasped.
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A metallic tube is attached to the operating table or wrist rest, acts as a support for the assistant's hand, and provides free air flow during vitreous surgery while the patient is under local anesthesia.
A portable system for external photography combines a focusing lamp and movable flash unit with a wide focusing range. The system is arranged to operate from a single two-position trigger and may be hand-held or mounted on a slitlamp stand. It is designed for use in general ophthalmology in a multilaned office practice or bedside use in a hospital situation.
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