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Biomedical subjects

D R Hardten

Publications and source records attributed to D R Hardten.

42 records · Page 3Linked to original sources
PubMed1992

Early postkeratoplasty astigmatism following placement of anterior chamber lenses and transsclerally sutured posterior chamber lenses.

Intraocular pseudophakic correction during penetrating keratoplasty (PK) for aphakic or pseudophakic bullous keratopathy may be achieved either with anterior or posterior chamber lenses. Posterior chamber lenses can be fixed to the iris or sclera in eyes lacking adequate posterior capsular support. Post-PK astigmatism can delay early visual rehabilitation of the patient. We reviewed the last 15 patients at our institution who had undergone PK and anterior chamber lens placement for bullous keratopathy. These were compared to the last 15 patients who had undergone PK and transsclerally sutured posterior chamber lens placement. Patients who had placement of a flexible anterior chamber lens at time of PK had a mean astigmatism of 6.73 D at the last visit before any sutures were removed. There was no predominant axis of astigmatism or relationship of the axis of astigmatism to the meridian of lens placement. Patients with placement of a transsclerally sutured posterior chamber lens at time of PK had a mean astigmatism of 5.18 D at the last visit before any sutures were removed. Mean astigmatism was not significantly different (P greater than 0.05) from that seen with anterior chamber lens placement. In the majority of patients the axis of post-PK astigmatism was oriented perpendicular to the meridian of the transsclerally sutured posterior chamber lens.

Aged↗
PubMedDate not supplied

Phacoemulsification and modern cataract surgery.

The techniques and results of cataract surgery have changed dramatically during the past three decades. In the USA, we have moved from intracapsular cataract extraction as the preferred technique to almost exclusively extracapsular techniques. Smaller incisions have become the standard, with phacoemulsification now being the method of choice for most surgeons. Along with these advances have come improved intraocular lens materials and designs, especially well suited for use with smaller incisions. Phacoemulsification as a method to remove the cataractous lens was first proposed more than 20 years ago. Advances in techniques and equipment have led to a dramatic increase in the popularity of phacoemulsification with increased safety and efficiency. Viscoelastic agents have been developed synchronously with modern phacoemulsification techniques, playing an integral role in the success of this new technology. Improved surgical techniques for removing the anterior lens capsule have decreased the incidence of both intraoperative and postoperative capsular complications. Nucleus removal, formerly performed primarily in the anterior chamber, is now performed in the posterior chamber, decreasing damage to the corneal endothelium. Improved wound construction allows many wounds to be left unsutured, and smaller wounds allow shorter recovery time and greater intraoperative control and safety. Intraocular lenses can have smaller optic sizes and still maintain accurate centration. Foldable intraocular lenses can take advantage of the smaller incision, even further shortening the time to visual recovery. Continual evolution of this technology promises to further improve patient outcomes after cataract surgery.

Anesthesia, Local↗
PubMedDate not supplied

Effect of refractive surgery experience on outcomes after photorefractive keratectomy.

BACKGROUND: Excimer laser photorefractive keratectomy is effective in the treatment of myopia. It is unclear whether the refractive and ocular surgical experience of the surgeon influences outcome. METHODS: Photorefractive keratectomy was performed on 131 consecutive myopic eyes by one experienced refractive surgeon and on 428 consecutive myopic eyes by six other less experienced surgeons. Outcome data were compared between groups. RESULTS: The mean preoperative spherical equivalent was -5.76 +/- 2.43 diopters (D) in the single surgeon group and -5.36 +/- 2.34 D in the multiple surgeon group. Follow-up of 6 months was available on 109 eyes (83%) in the single surgeon group and 289 eyes (68%) in the multiple surgeon group. At 6 months, the average residual refractive error was +/- 0.15 +/- 1.13 D in the single-surgeon group and +0.21 +/- 1.15 D in the multiple surgeon group. This difference was not statistically significant (p = 0.68). Correction within 1 D of attempted correction was obtained in 76 eyes (70%) in the single surgeon group and in 223 eyes (77%) in the multiple surgeon group. Uncorrected visual acuity of 20/40 or better was achieved in 89 eyes (82%) in the single surgeon group and 253 eyes (88%) in the multiple surgeon group. CONCLUSION: Refractive and visual acuity outcomes after photorefractive keratectomy are influenced minimally by the refractive surgical experience of the surgeon.

Adolescent↗