Search PubMed⌕ Search

Biomedical subjects

G F Hilton

Publications and source records attributed to G F Hilton.

At least 37 records · Page 2Linked to original sources
PubMed1988

Expanded indications for pneumatic retinopexy.

The Collaborative Pneumatic Retinopexy Study evaluated retinal detachments (RDs) secondary to one break or group of breaks no larger than 1 clock hour located within the superior 8 clock hours of the fundus. Eyes with prominent proliferative vitreoretinopathy (PVR) were excluded. Forty eyes which exceed these criteria and were treated with pneumatic retinopexy have been retrospectively evaluated to determine what preoperative conditions limit the application of pneumatic retinopexy. Multiple breaks in multiple quadrants, large tears up to 2.5 clock hours in size, and RDs associated with a moderate degree of PVR were successfully managed with pneumatic retinopexy. The greatest number of failures were due to inferior breaks. The overall success rate for pneumatic retinopexy was 75%. New breaks occurred in 12.5% of eyes, but all of these were successfully managed.

Humans↗
PubMed1987

Pneumatic retinopexy. A collaborative report of the first 100 cases.

The preliminary experience of one surgeon, using pneumatic retinopexy for 20 consecutive cases of rhegmatogenous retinal detachment, was previously reported. The collaborative experience of six surgeons using pneumatic retinopexy for 100 cases is now reported. This series includes cases with pseudophakia, aphakia, macular detachment, macular breaks, vitreous hemorrhage, trauma, and old detachments. Initially, 91% were reattached, but seven recurrences yielded a 6-month follow-up cure rate of 84% with pneumatic retinopexy. With subsequent scleral buckling, 98% were reattached. Postoperative complications included proliferative vitreoretinopathy (3%), macular pucker (3%), and new/missed retinal breaks (7%). A review of the literature disclosed postoperative new/missed retinal breaks in nine series: 21, 3, 8, 4, 9, 7, 5, 4, and 13%. There were no cases of glaucoma, cataract, subretinal gas, endophthalmitis, or extension of the detachment into a previously attached macula. Pneumatic retinopexy offers the advantages of reduced tissue trauma, fewer complications, no hospitalization, and less expense. The major disadvantage is the need for postoperative positioning.

Cryosurgery↗
PubMed1986

Pneumatic retinopexy. A two-step outpatient operation without conjunctival incision.

1,000 consecutive patients operated for retinal detachment were studied prospectively to determine the incidence of complications. Two parts of the operation were responsible for most of the vision-threatening complications: subretinal fluid drainage and the scleral buckle. In an attempt to reduce the complications of retinal detachment surgery, we have utilized a simplified procedure of transconjunctival cryotherapy and intravitreal gas injection with postoperative positioning. This study was limited to detachments with one or more breaks within one clock hour located within the superior eight clock hours of the fundus without signs of proliferative vitreoretinopathy. In a series of 20 consecutive patients, retinal reattachment was initially achieved in all cases. There were two recurrences that were reattached with scleral buckling. The final cure rate for the single pneumatic procedure, with six months follow-up, was 90%. No major complications were observed. This preliminary report suggests that pneumatic retinopexy has the advantages of reduced tissue trauma, no hospitalization, minimal complications, and reduced expense. The major disadvantage is the need for postoperative positioning for five days.

Cryosurgery↗
PubMed1986

Extended retinal tamponade in the treatment of retinal detachment with proliferative vitreoretinopathy.

We have used intraocular sulphur hexafluoride or liquid silicone as an adjunct to vitreous surgery in the treatment of a non-randomised sequential series of 19 eyes with retinal detachment complicated by proliferative vitreoretinopathy. We have studied the surgical results and complications of these two tamponades and drawn preliminary conclusions on their use in retinal reattachment surgery. After a seven-month minimum follow-up 13 (68%) of the eyes have reattached retinas. Six (60%) of 10 eyes treated only with silicone have reattached retinas, and four (67%) of six eyes treated only with sulphur hexafluoride gas tamponade have reattached retinas. An additional three eyes treated initially with silicone oil subsequently developed retinal detachments; all were successfully reattached with sulphur hexafluoride tamponade after silicone oil removal. Intraoperative pneumatic retinal reattachment to assess relief of retinal traction combined with the production of widespread chorioretinal adhesions to wall off persistent anterior traction and detachment, as well as extended postoperative gas tamponade of the retina, appears to enhance the surgical results in retinal detachment complicated by proliferative vitreoretinopathy. Silicone oil tamponade of the retina appears to be useful in cases where retinal traction cannot be entirely relieved and in patients who are unable to tolerate the head positioning required for effective gas tamponade of the retina. A controlled clinical study recently begun will be required to define further the precise role of these methods of retinal tamponade.

Adult↗
PubMed1985

Degenerative retinoschisis with giant outer layer breaks and retinal detachment.

Five unusual cases of retinal detachment were caused by giant (more than 90 degrees) posterior breaks in the outer layer of degenerative retinoschisis. All retinas were successfully reattached by a variety of surgical techniques. The two cases managed with scleral buckling required subsequent buckle removal because of macular distortion. Treatment with cryotherapy or laser, together with intraocular air and postoperative positioning, gave better anatomic results.

Female↗
PubMed1983

Helium ion therapy for choroidal melanoma.

Eighty-two patients with choroidal melanomas were treated with helium ion charged particle irradiation. Seventy-eight of 82 patients have either remained stable or demonstrated tumor shrinkage. Forty-five of 46 patients followed for at least 1 year after therapy have demonstrated tumor regression with a mean tumor shrinkage of approximately 31%. No tumor-related mortality has been observed. The most effective method of choroidal melanoma management is unclear. Charged particle external beam irradiation may be more applicable and have less ocular morbidity than either radioactive plaques or photocoagulation.

Adult↗
PubMed1982

Scleral buckling for retinal detachments complicated by periretinal proliferation.

Scleral buckling alone used to treat retinal detachment with massive periretinal proliferation resulted in an overall cure rate of 34.7%. The success rate declined with increasing severity of massive periretinal proliferation. A detailed anatomic classification for massive periretinal proliferation was used to define the configuration of the eyes undergoing operation. We currently recommend scleral buckling alone for moderate degrees of massive periretinal proliferation; we reserve vitrectomy with preretinal membrane removal and scleral buckling for more advanced cases.

Humans↗
PubMed1981

The drainage of subretinal fluid: a randomized controlled clinical trial.

A randomized controlled clinical trial was conducted on a series of 120 consecutive cases of rhegmatogenous retinal detachment. One group of 60 eyes, randomly selected, was managed with a scleral buckling operation that included the drainage of subretinal fluid. The other group of 60 had a similar operation without drainage. A new method for evaluating complications, the "Complications Score," was devised. The score was higher (P = 0.005) for the drainage group, but this did not decrease the final anatomic or visual results. Eighty-seven percent of the drainage group was reattached with one operation, a figure not significantly different from the 83% reattached in the nondrainage group. The final cure rate after reoperations was 97% for both groups. The best corrected visual acuity, measured six months after operation, was not significantly different for the two groups. This study concludes that equally good results can be obtained with either a drainage or nondrainage operation.

Body Fluids↗
PubMed1981

The drainage of subretinal fluid: a randomized controlled clinical trial.

A randomized controlled clinical trial was conducted on a series of 120 consecutive cases of rhegmatogenous retinal detachment. One group of 60 eyes, randomly selected, was managed with a scleral buckling operation which included the drainage of subretinal fluid. The other group of 60 had a similar operation without drainage of subretinal fluid. A new method for evaluating complications, the "Complications Score," was devised. The score was significantly higher for the drainage group but this did not decrease the final anatomic or visual results. Eight-seven percent of the drainage group were reattached with one operation, a figure not significantly different from the 83% reattached in the nondrainage group. The final cure rate after reoperations was 97% for both groups. The best corrected visual acuity, measured six months postoperatively, was not significantly different for the two groups. This study concludes that equally good results can be obtained with either a drainage or nondrainage operation.

Aged↗
PubMed1980

Lesions simulating serous detachment of the pigment epithelium. Occurrence after retinal detachment surgery.

Serous detachment of the retinal pigment epithelium (RPE) has been previously described in association with disorders of the underlying choroid and Bruch's membrane but has not been reported after retinal reattachment surgery. We have observed, for at least 16 months, three cases that clinically appeared to be RPE detachments after scleral buckling. In each case the lesions exhibited the typical biomicroscopic features of focal serous detachment of the RPE. However, the failure to show the typical fluorescein pooling has prompted us to regard these lesions as focal pockets of turbid subretinal fluid that simulate RPE detachments.

Aged↗
PubMed1980

Diagnostic modalities in choroidal melanoma.

We prospectively studied 51 patients with choroidal melanomas in a masked manner to determine the accuracy of clinical, ultrasound, and fluorescein diagnosis as well as the accuracy of tumor size measurements. In patients with clear media, clinical diagnosis was the most accurate means of detecting a choroidal melanoma. There was excellent correlation between clinical, ultrasound, and pathology measurements of tumor size. In small melanomas, clinical examination was the most accurate means of measuring tumor diameter and ultrasound the most accurate method of measuring tumor height. Even with a trained ocular oncologist, there was a significant variability in tumor measurements on serial ophthalmoscopic examinations.

Choroid Neoplasms↗
PubMed1980

Helium ion charged particle therapy for choroidal melanoma.

Nine patients with choroidal melanomas were treated with helium ion charged particle irradiation. No patient demonstrated tumor enlargement, and most lesions followed for more than five months have demonstrated tumor shrinkage. The most effective method of choroidal melanoma management is unclear. Heavy charged particle irradiation may be more applicable and have less ocular morbidity associated with it in either radioactive plaques or photocoagulation.

Adult↗