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Biomedical subjects

E M Perlman

Publications and source records attributed to E M Perlman.

14 recordsLinked to original sources

Effect of collagen implants in the reduction of high astigmatism induced by penetrating keratoplasty.

PURPOSE: To evaluate the insertion of EagleVision collagen plugs as spacers between corneal relaxing incisions to correct significant residual astigmatism after penetrating keratoplasty (PKP). SETTING: Ambulatory Clinic of the Department of Ophthalmology, Rhode Island Hospital, and Rhode Island Eye Institute, Providence, Rhode Island, USA. METHODS: This study comprised 8 patients meeting the following criteria: had previous PKP, had at least 5.0 diopters of residual keratometric astigmatism with all the sutures removed, were free from eye infection, and were at least 21 years old. All 8 patients had unilateral high astigmatism after PKP. Four eyes were randomly assigned to the control group of astigmatic keratectomy (AK) incisions without the collagen implants and 4 eyes to the experimental group of AK incisions with collagen implants. RESULTS: Best corrected visual acuity 1 day, 3 weeks, and 1, 2, and 6 months after AK showed decreased astigmatism in all the patients who had the relaxing incisions. The amount of astigmatism was lower in patients who received AK incisions with collagen implants (P < .28). Minimal adverse effects were noted. CONCLUSION: Implanting a biocompatible material into AK incisions to correct post-PKP astigmatism appears to be safe and may enhance astigmatic correction.

Adult

Intense photophobia caused by Arthrographis kalrae in a contact lens-wearing patient.

PURPOSE: To report a case of Arthrographis kalrae keratitis and to note that its clinical manifestation resembles Acanthamoeba corneal infection. METHODS: Case report. RESULTS: The patient's keratitis was caused by A kalrae, a very rare soil fungus. CONCLUSIONS: Arthrographis kalrae can cause a keratitis that manifests with severe photophobia and a slowly progressive corneal infiltrate whose symptoms can mimic Acanthamoeba. Our patient most likely acquired the fungus from exposure to soil and not from her contact lenses.

Administration, Oral

A form of variable astigmatism induced by pseudopterygium.

Pterygium and pseudopterygium have long been known to induce astigmatism and may do so without entering the visual axis. We present a case report of a 34-year-old man with a traumatic pseudopterygium which produced a "dynamic" astigmatism, varying in different fields of gaze. Due to the pseudopterygium's attachment to the lateral canthus, it produced a tethering effect with markedly decreased vision and wrinkling of Descemet's membrane when the eye was directed away from the anchoring point. This model may apply to other ocular diseases where perilimbal attachments and adnexal adhesions to the corneal surface may occur; such connections should be looked for in cases with unexplained low levels of visual acuity.

Adult

A mechanical three-step test.

A simple mechanical binary search device is described that can be used to perform the Parks' three-step test. Instructions to make the device from light cardboard are provided.

Humans

An analysis and interpretation of refractive errors after penetrating keratoplasty.

Despite advances in microsurgical techniques, astigmatism after penetrating keratoplasty is still a perplexing problem. In this paper, using retrospective studies, experiments, and observations, the factors that seem most significant in creating excessive postoperative astigmatism are delineated. The difficulty of creating a circular recipient hole of the same size and shape as the donor button appears to be a prime area for clinical research and technical development.

Astigmatism

Clinically unsuspected phacoanaphylaxis after ocular trauma.

Phacoanaphylaxis (lens-induced uveitis) is a potentially curable ocular inflammation secondary to lens truma. Recently we have seen three clinically undiagnosed enucleation specimens in our eye pathology laboratory with this entity. Our observations add an argument to the recent concept that early lens removal in cases of traumatic cataract with lens capsule rupture would ultimately lead to better visual results.

Adult