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Biomedical subjects

E L Shaw

Publications and source records attributed to E L Shaw.

At least 19 recordsLinked to original sources
PubMed1992

A modified technique for conjunctival transplant.

An improved technique for the harvesting and placement of conjunctival autograft in complex, advanced and recurrent pterygia is presented. A paper template, fashioned to the approximate size of the pterygium excision site, is used to mark and subsequently transfer the conjunctival graft to the recipient bed. The template creates a strong, steady scaffold on which to orient and align the floppy conjunctival graft. This permits easier suturing and more accurate placement of the graft. We report a series of 30 eyes in which all transplants were taken from the superior or superotemporal bulbar conjunctiva of the same eye. There were no intraoperative or postoperative complications. No graft failures or graft retractions were seen. Although there have been several cases of partial recurrence, we have not had to resort to repeat surgery. We present this modification of a technique originally developed by Thoft and later refined by Vastine and Kenyon, as an effective way to correct complex, advanced, and recurrent pterygia.

Conjunctiva↗
PubMed1985

Histologic study of a pair of human corneas after anterior radial keratotomy.

Two corneas were obtained from a man who underwent anterior radial keratotomy in both eyes less than three months before his death. The corneas were obtained and fixed 16 hours after death and prepared for histologic evaluation four days later. Both corneas showed epithelial ingrowth in the surgical wounds, epithelial inclusion cysts in some areas, and ridges or protrusions of the posterior cornea beneath the incisions. The incisions ranged in depth from 48% to 63% of the full thickness of the cornea in the right eye and from 69% to 98% in the left eye, demonstrating the difficulties involved in maintaining a precise and predictable depth of incision, which may, in turn, be related to variations in visual results. Signs of endothelial stress, in the form of collagen and fibrils on the posterior Descemet's membrane, apparently predated the refractive surgery. Precautions such as specular microscopy may be needed to rule out this kind of surgery in patients with the early signs of some types of potential corneal disease.

Basement Membrane↗
PubMed1979

Automated pattern analysis of corneal endothelium.

A proper understanding of the endothelial cell morphology of the cornea is of great significance to the corneal surgeon. Specular microscopy allows direct visualization of endothelial cell morphology and a proper analysis of these data needs automated computerized type of systems. Automated pattern analysis seems to offer a good option in this direction. From our experience it appears that such systems can be used with great advantage in the analysis of endothelial cell morphology. The data obtained from such analysis help to develop some indices for various facets of endothelial cell morphology.

Cell Count↗
PubMed1979

Endothelial cell morphology and corneal deturgescence.

In a series of 46 patients accepted for cataract removal and intraocular lens implantation, 23 showed visibly obvious variation in endothelial cell size (polymegethism) according to specular microscopic examination. In this group, mean increase in postoperative corneal thickness was 52.7% on the first postoperative day, 35.4% on the third, and 18.0% after 4 weeks. Mean corneal swelling was consistently and significantly less in the 23 patients exhibiting apparently normal endothelial cell patterns (homomegethism). In homomegethous corneas, preoperative cell density was significantly correlated with age (inversely) and postoperative cell loss (directly). Preoperative cell density in polymegethous corneas showed significant, direct correlation with age, suggesting that endothelial cell density may remain relatively constant in this condition. There was no correlation with postoperative cell loss. Significant differences in endothelial functional capability identified within each morphologically-defined group indicate a structure-function continuum. Since 15 homomegethous corneas and only one polymegethous cornea returned to preoperative thickness within 4 weeks, it appears clinically valid to use morphological criteria in predicting functional capability.

Age Factors↗
PubMed1978

Morphological appearance of the healing corneal endothelium.

We studied endothelial cell patterns in both the central and the superior regions of the cornea in 43 cases of cataract extraction and intraocular lens implantation. During the early postoperative period, the central endothelial cells maintained their preoperative appearance. The endothelium within 3 to 4 mm of the superior limbus, however, demonstrated large dark areas where no cell outlines were visible, bounded by large cells. During the late postoperative period, there was an increase in the size and a reduction in the density of the central endothelial cells. In the periphery the previously acellular areas were populated with cells of varying diameter. These changes are consistent with postoperative spreading and sliding of existing cells to cover the traumatized cell-free areas. Central endothelial cell density in the early postoperative period does not accurately reflect the actual degree of cell loss.

Cataract Extraction↗
PubMed1978

The functional reserve of corneal endothelium.

With recent advances in our knowledge of corneal physiology, coupled with the development and increasing availability of the specular microscope as a clinical instrument, valid observations relating the morphologic appearance of the corneal endothelium to its functional capacity are within our reach. Manual methods of data analysis are cumbersome, time consuming, and associated with human error and investigator bias. The Omnicon pattern analysis system lends itself to objective analysis of morphologic features, offers the possibility of quantifying the data obtained and, hopefully, will lead to a better understanding of the many aspects of endothelial cell morphology which, in total, relate to the functional reserve of a given cornea.

Cell Count↗
PubMed1977

Thermokeratoplasty in the treatment of persistent corneal hydrops.

Thermokeratoplasty (TKP) was used to treat six cases of chronic corneal hydrops previously refractory to traditional therapy. In all instances TKP resulted in a clearing of the hydrops within three weeks. In four cases the resultnat comfort and clarity precluded the necessity for transplantation, while in the remaining two cases subsequent penetrating keratoplasty was successfully performed. Thermokeratoplasty is advocated in chronic hydrops refractive to standard therapy, in acute hydrops to accelerate recovery, in recurrent hydrops to assist in healing of breaks in Descemet membrane, thus preventing recurrences, in cases with extensive hydrops to deturgesce the peripheral cornea prior to transplantation, and as definitive therapy in cases where transplantation is contraindicated.

Acute Disease↗
PubMed1977

Pneumococcal endophthalmitis following grafting of corneal tissue from a (cadaver) kidney donor.

In order to stress the need for continued vigilance in maintaining the highest standards of quality control for corneal tissue used for transplantation, we are presenting 2 cases of pneumococcal endophthalmitis which occurred in tissue transplanted from a young donor who died following acute trauma. The patient had been on cardiovascular support for over 26 hours and had suffered from a febrile illness which on autopsy revealed bronchial pneumonia. Both kidney recipients from the same donor died of myocardial infarctions on the same day in separate cities, 2 days after kidney transplantation surgery. Several recommendations are made which should assist all eye banks in providing the highest quality tissue and in preventing the occurrence of infection transmitted donor tissue.

Adult↗
PubMed1977

Intraocular lens implantation combined with penetrating keratoplasty.

A restrospective analysis was conducted of 27 cases of penetrating keratoplasty associated with intraocular lens implantation. Although not statistically significant, the results indicated an 80% success rate when penetrating keratoplasty, cataract extraction and intraocular lens implantation were combined in a single operation. Secondary implantation of intraocular lenses in cases of previous keratoplasty were unsuccessful in all three cases.

Adolescent↗
PubMed1976

Alterations in corneal morphology following thermokeratoplasty.

Fifteen corneal buttons were removed at keratoplasty from patients with keratoconus who had previously undergone thermokeratoplasty (TKP). The buttons were studied with light microscopy, in an attempt to analyze the type of changes produced by TKP. The principal histologic findings in patients with retarded epithelial healing (8 of 15) included epithelial thinning, bullous keratopathy, thickening of the epithelial basement membrane, and frequent destruction of Bowman's membrane. More severely affected patients showed asceptic stromal necrosis and fibrinous iritis with hypopyon. A poor visual result in patients with normal epithelial healing (7 of 15) was caused by superficial stromal scarring or persistent inflammatory infiltrate. Vascularization was seen in only one patient.

Adult↗
PubMed1976

Pathophysiology and treatment of corneal hydrops.

The new application of thermokeratoplasty as a treatment of both acute and chronic hydrops is presented as a possible alternative to present treatment regimens. The histopathology of keratoconus and hydrops is reviewed relating to thermokeratoplasty effect. Clinical success was achieved in the elimination of pain from advanced chronic hydrops. With the closure of the breaks in Descement's membrane central corneal clearing occurred. In cases of total hydrops although complete resolution of the edema was not always found sufficient, clearing of the corneal periphery allowed for successful penetrating keratoplasty.

Corneal Diseases↗
PubMed1976

Hydrophilic bandages in penetrating keratoplasty.

A retrospective analysis was conducted of 100 consecutive cases of penetrating keratoplasty revealing that in 68% of the cases hydrophilic bandage lenses were applied at some time during the course of the operative procedure or postoperatively. In 4% of the cases, lenses were applied before the actual start of keratoplasty and in 13% the lenses were applied before the conclusion of the operative procedure. In 28%, the initial lens application occurred within the first 10 postoperative days while in 18% initial application occurred prior to the time of suture removal. In the remaining 5% of the cases, the lens was applied relatively late in the postoperative course. Primary indications for bandage lens application were prophylactic in cases of infants, chemical burns, exposure, and dry eyes. Therapeutic indications included surface drying and erosion, wound margin defects, patient discomfort, and inflammatory episodes.

Adult↗