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Biomedical subjects

G R Kirkby

Publications and source records attributed to G R Kirkby.

36 records · Page 2Linked to original sources
PubMed1996

Ocular perforation during peribulbar anaesthesia.

Six cases of ocular perforation after peribulbar anaesthesia are reported. They were referred to our vitreoretinal unit from other hospitals over a 6 week period. Some recent reports of ocular perforation with peribulbar anaesthesia suggest a good prognosis. In this series all six required surgical intervention and most cases associated with a retinal detachment had a poor outcome. This study highlights the dangers of ocular perforation and emphasises the need for supervised training of peribulbar anaesthesia and early referral should ocular perforation occur.

Aged↗
PubMed1996

A survey of ocular perforation during ophthalmic local anaesthesia in the United Kingdom.

A survey of local anaesthetic related ocular perforation in the United Kingdom is reported. A total of 531 consultant ophthalmologists were sent a postal questionnaire and there was a 71% response rate. Thirty respondents reported 39 perforations occurring under their care during the previous year. Details of the cases are presented. The rate of local anaesthetic related ocular perforation is higher than in previous reported series. Efforts to reduce the incidence will require consideration of alternative techniques, audit, and training.

Anesthesia, Local↗
PubMed1996

Bilateral endogenous Escherichia coli endophthalmitis: a devastating complication in an insulin-dependent diabetic.

We report a case of bilateral endogenous Escherichia coli endophthalmitis in an insulin-dependent diabetic. This condition appears to occur almost exclusively in diabetics, and is invariably related to a urinary tract infection. Treatment of any infection in diabetics should be aggressive, and any deterioration in vision should be addressed promptly.

Diabetes Mellitus, Type 1↗
PubMed1995

Ocular protection in squash clubs: time for a change?

All squash clubs in the West Midlands were surveyed by postal questionnaire to determine their level of awareness to the risk of ocular injury. Of the 100 clubs surveyed, 51 questionnaires were returned. None of the clubs responding had any information warning of the potential hazards of ocular injury. Thirteen of the clubs had sporting goods shops; of these, three sold protective eye-wear. Significantly, all three stocked the open or lenseless type of eye-guard and only one had the guards with impact-resistant plastic lenses. The majority of clubs (96%) expressed a desire for further information. It is concluded that: (1) players are not warned of the hazards of playing without appropriate eye protection, (2) hazardous eye-guards (open type) continue to be sold, and (3) there is a desire to improve the safety of the sport.

Eye Injuries↗
PubMed1994

Previously undiagnosed lymphoma presenting as recurrent dacryocystitis.

Lymphoma occurring in the lacrimal sac is uncommon and usually occurs in patients with known systemic disease. We report the case of an 82-year-old woman who presented with recurrent right dacryocystitis and a mass in the left lower eyelid. The results of the biopsy of the eyelid and fine-needle aspiration of the swelling arising from the lacrimal fossa demonstrated low-grade B-cell non-Hodgkin's lymphoma. This unusual presentation and the histopathological features are described.

Aged↗
PubMed1992

Effect of heparin surface modification of polymethylmethacrylate intraocular lenses on signs of postoperative inflammation after extracapsular cataract extraction. One-year results of a double-masked multicenter study.

PURPOSE: A heparin surface modified posterior chamber intraocular lens (IOL) was compared with a conventional polymethylmethacrylate (PMMA) IOL regarding postoperative complications caused by inflammation. METHODS: Five hundred twenty-four patients from 10 different centers were included in a parallel group, double-masked, multicenter study. RESULTS: The cumulative number of patients with inflammatory cellular deposits on their IOLs during the first postoperative year differed significantly in favor of the heparin surface modified group, with 29.8% of the patients having cellular deposits compared with 48.8% of patients in the control group. Cellular deposits were observed most frequently at 3 months after surgery, and the difference between the groups was most pronounced and statistically significant at this time. The same results were seen at 1 year, but the difference was not significant. The number of cellular deposits per patient, however, was significantly lower in the heparin surface modified group at 1 year. Cumulatively, there were significantly more patients with posterior synechiae in the PMMA group than in the heparin surface modified group during the 1-year follow-up. Complications were few and comparable between the groups. CONCLUSION: The results of this study indicate that heparin surface modification reduces the inflammatory response to PMMA IOLs.

Adult↗
PubMed1991

Ofloxacin compared with chloramphenicol in the management of external ocular infection.

The safety and efficacy of 0.3% ofloxacin in treating bacterial ocular infections was compared with that of 0.5% chloramphenicol in a parallel-group, randomised clinical trial at five sites. Clinical and microbiological improvement rates were studied in 84 culture-positive patients. Patients with suspected bacterial ocular infections were evaluated for clinical improvement and were included in drug safety and comfort analyses. Clinical improvement did not differ significantly between drug treatments. All patients completing the study (79 assigned ofloxacin, and 74 chloramphenicol) showed clinical improvement. Clinical improvement in the culture-positive groups was 100% (41/41) after ofloxacin treatment, and 95% (41/43) after chloramphenicol treatment. Microbiological improvement rates were similar for the two drugs: 85% (33/39) improved with ofloxacin, and 88% (38/43) improved with chloramphenicol. Both drugs were well tolerated. Adverse reactions possibly due to the study medication occurred in 1% (1/89) of those who received ofloxacin, and in 4% (4/93) of those who received chloramphenicol.

Adult↗
PubMed1989

Is padding necessary after cataract extraction?

The results of a prospective study to assess the value of padding eyes following cataract surgery are reported. A group of eyes dressed with a petroleum jelly mesh, gauze pad, and cartella shield were compared with a group dressed only with a cartella shield. Study of the eyes and lids before and after operation, including the taking of lid margin and fornix swabs for culture, suggested that there was no significant difference in the bacterial presence between the two groups. The eyes dressed with a cartella shield alone appeared less prone to discharge. The relative merits of different types of dressing are discussed.

Bandages↗
PubMed1987

The removal of silicone oil from the anterior chamber in phakic eyes.

The appearance of large silicone oil globules in the anterior chamber of phakic eyes leads to serious intraoperative and postoperative problems. Using hyaluronate sodium, the silicone can be safely removed from the anterior chamber, the crystalline lens may be saved, and the posterior segment procedure can be completed.

Anterior Chamber↗
PubMed1987

Hereditary sensory neuropathy with neurotrophic keratitis. Description of an autosomal recessive disorder with a selective reduction of small myelinated nerve fibres and a discussion of the classification of the hereditary sensory neuropathies.

A Kashmiri family with 3 members affected by a congenital sensory and autonomic neuropathy and corneal opacification is described. The 3 affected cases were offspring of consanguinous marriages in two generations; autosomal recessive inheritance is therefore probable. Pain and temperature sensation was lost in the limbs with a resulting mutilating acropathy. Sudomotor function was also impaired. Motor function, tendon reflexes, kinaesthetic sensation and sensory nerve action potentials were normal. Sural nerve biopsy showed a selectively reduced small myelinated nerve fibre population. Corneal histology revealed neurotrophic keratitis. The classification of the hereditary sensory and autonomic neuropathies is discussed. This family represents a previously unrecognized variant.

Adult↗
PubMed1985

Shifting subretinal fluid in rhegmatogenous retinal detachment.

In a consecutive series of 470 cases of rhegmatogenous retinal detachment 25 (5%) were found to have shifting subretinal fluid (SRF) at the preoperative examination. The study showed that the association between SRF and rhegmatogenous retinal detachment is unusual but not rare. Shifting SRF was most often associated with aphakic and longstanding retinal detachment, and found in cases in which the retinal holes were small.

Aphakia↗
PubMed1983

Ocular hypertension and posture.

Thirty-seven patients with ocular hypertension (OH) and 29 age matched controls were studied. Intraocular pressure (IOP) measurements were made in the sitting position and, immediately after changing posture, in the lying position. Sixty-three (85%) of the OH eyes and all the control eyes showed either stable IOP readings on changing posture of small elevations up to 3 mmHg. Eleven (15%) of the OH eyes showed larger elevations of IOP, between 5 and 9 mmHg when the patients changed to the lying position. We suggest that an IOP measurement in the lying position should be included in the routine evaluation of the patient with ocular hypertension.

Female↗