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Biomedical subjects

H D Cavanagh

Publications and source records attributed to H D Cavanagh.

At least 145 records · Page 8Linked to original sources
PubMed1984

Penetrating keratoplasty in children.

Retrospectively studied were 91 patients, 14 years of age or less, who had 152 penetrating keratoplasties in 107 eyes, with an average follow-up of 30.1 months. Survival analysis showed the probability of obtaining a clear graft at one year to be 60 +/- 8% in 45 eyes with congenital opacities, 70 +/- 8% in 31 eyes with opacities from trauma and 73 +/- 8% in 31 eyes with acquired nontraumatic opacities. Most failures occurred during the first postoperative year and were characterized by the gradual loss of graft clarity from undetermined cause. Twenty-nine percent (10) of the 34 eyes with congenital corneal opacities in which vision could be measured had a most recent visual acuity better than 6/120 (20/400). Irreversible amblyopia, glaucoma, other structural abnormalities of the anterior segment and mental retardation complicated visual rehabilitation in the congenital group. In the post-traumatic group, vision was better than 6/120 (20/400) in 45% (13) of 29 eyes, being limited by vitreoretinal pathology, fibrous ingrowth, and optic nerve damage from glaucoma. Visual acuity in the acquired, nontraumatic group was better than 6/120 (20/400) in 67% (20) of 30 eyes. The percentage of patients achieving 6/12 (20/40) or better in the congenital, post-traumatic, and nontraumatic groups were 3% (1/34), 17% (5/29), and 47% (14/30), respectively. In the congenital group, only patients with posterior polymorphous dystrophy obtained a visual acuity of 6/30 (20/100) or better. Preoperative vascularization of the cornea, persistent epithelial defects, and performance of lensectomy-vitrectomy were factors most highly correlated with poor graft survival.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Results of penetrating keratoplasty for pseudophakic corneal edema with retention of intraocular lens.

We reviewed the records of 26 consecutive patients undergoing penetrating keratoplasty for pseudophakic corneal edema in which the original intraocular lens was retained. The average interval between lens implantation and penetrating keratoplasty was 31.5 months. Follow-up after keratoplasty ranged from 11 to 59 months, with an average of 24.5 months. Six patients had anterior chamber lenses; sixteen, iris or iridocapsular lenses; and four, posterior chamber lenses. A vitrectomy was performed in 14 (54%) patients. Of the 21 patients with clear grafts (80%), 8 (38%) had vision of 20/40 or better while 7 (33%) had acuities of 20/200 or worse. Visual acuity of 20/40 or better was attained by 3 of 4 (75%) patients with posterior chamber lenses but only 3 of 16 (19%) patients with iris-supported lenses. Cystoid macular edema was the principal cause of decreased acuity in 12 of the 13 patients with clear grafts and acuity less than 20/40. Angiographic confirmation was obtained in 7 of 12 patients. Overall, the results are similar to those reported for pseudophakic keratoplasty with intraocular lens removal. No adverse effect of retaining a securely fixated intraocular lens was demonstrated.

Cataract Extraction↗
PubMed1983

Endophthalmitis following penetrating keratoplasty.

To determine the incidence of infectious endophthalmitis in the early postoperative period following penetrating keratoplasty, and the type and origin of the causative organisms, all cases of penetrating keratoplasty performed at the Emory University affiliated hospitals between January 1977 and March 1982 were reviewed. Four (0.2%) of the 1,876 cases developed infectious endophthalmitis. In all four, evidence of infection developed within 72 hours, and in three the donor rim culture grew the same organism as was obtained from the anterior chamber or vitreous. The causative organisms were Streptococcus pneumoniae, Staphylococcus aureus, group D Streptococcus-enterococcus, and Pseudomonas aeruginosa. Eyes with positive donor rim cultures had a 22-fold increased incidence of endophthalmitis.

Aged↗
PubMed1983

Results of penetrating keratoplasty in 123 eyes with pseudophakic or aphakic corneal edema.

The clinical records of 123 eyes that received a penetrating keratoplasty for aphakic or pseudophakic corneal edema with a mean follow-up time of 18 months were studied retrospectively. Thirty-five eyes from which an intraocular lens (IOL--85% iris fixated) was removed at the time of keratoplasty were compared with 88 eyes that never had an IOL. The mean interval between initial cataract surgery and penetrating keratoplasty was 28 months for the pseudophakic group from which the IOL was removed and 67 months for the aphakic group without IOL. In both groups, 97% had an anterior vitrectomy. Corneal grafts remained clear in 91% of the previously pseudophakic eyes and in 81% of the aphakic eyes (P less than or equal to 0.05). The final corrected visual acuity was worse in the pseudophakic eyes with IOL removed (16% saw 6/6 to 6/12 while 22% saw worse than 6/60) than in the aphakic eyes (34% saw 6/6 to 6/12 while 7% saw worse than 6/60). Postoperative maculopathy occurred in 43% of eyes from which IOLs were removed and in 22% of aphakic eyes.

Aged↗
PubMed1982

Cost-effectiveness in eyebanking.

The current operating budget for American eyebanks is more than $5 million per year, and an increasing portion of this expense is being paid by third-party payers. American eyebanks were surveyed to determine what a reasonable cost per transplant tissue might be and to see if recommendations could be made that would help optimize cost-effectiveness in American eyebanking. Most well-run eyebanks needed between $222 to $464 to process each donor cornea for transplantation. This cost-effective goal was most often met if the bank provided at least 150 corneas annually and if there was a full-time professional staff using modern tissue preservation techniques. An eyebank unable to meet these goals should consider obtaining its tissue from the nearest cost-effective eyebank, allowing the redirection of charitable contributions to other more cost-effective eye care-related community activities.

Computers↗
PubMed1982

Extended-wear contact lenses in patients with corneal grafts and aphakia.

Extended-wear contact lenses (EWCL) were fitted successfully on 61 aphakic eyes with penetrating corneal grafts. In two- to 32-months follow-up there were 26 eyes that had varying amounts of superficial neovascularization of the grafts and one Staphylococcus epidermidis corneal graft ulcer. There were five homograft rejections, all occurring in severely diseased eyes. Variable vision and visual acuity less than that with hard contact lenses or aphakic spectacles were the most frequent problems. Both were due to the high corneal astigmatism present in many patients. The results indicate that EWCLs may be used safely by patients with penetrating corneal grafts and aphakia, particularly if there is no host corneal edema, scarring, or vascularization, if these are no synechias to the graft wound, and if the astigmatism is less than 3.0 diopters.

Adolescent↗
PubMed1982

Cholinergic, adrenergic, and PGE1 effects on cyclic nucleotides and growth in cultured corneal epithelium.

Effects of adrenergic and cholinergic drugs and prostaglandin E1 on cyclic nucleotide accumulation and parameters of growth and basement membrane synthesis were examined in corneal epithelial cell cultures. 8-bromo-cGMP significantly (p less than 0.05) enhanced incorporation of labeled thymidine and leucine, as did acetylcholine and carbamylcholine, which elevated cGMP and decreased cAMP/cGMP ratio. Responses to acetylcholine were abolished by atropine and alpha-bungarotoxin. Precursor incorporation was inhibited by dibutyryl cAMP and adenosine 5'-monophosphate and by norepinephrine, epinephrine, prostaglandin E1, and theophylline, which significantly elevated cAMP levels and cAMP/cGMP ratio. Propranolol, but not phenoxybenzamine, blocked responses to effective concentrations of norepinephrine. Norepinephrine, PGE1, and dibutyryl cAMP also significantly elevated uptake of labeled glucosamine and incorporation of labeled proline into collagenase-sensitive protein or the hydroxyproline fraction of protein hydrolysates, while acetylcholine had no effect on parameters of basement membrane synthesis. Propranolol blocked responses to norepinephrine. Results were consistent with a cGMP-mediated stimulatory role of the cholinergic transmitter in corneal epithelial growth regulation, cAMP-mediated beta-adrenergic suppression of regrowth and increased basement membrane production after initial injury to the corneal epithelium, and potentiation of the adrenergic effect by prostaglandins.

8-Bromo Cyclic Adenosine Monophosphate↗
PubMed1982

Binding of [3H]dihydroalprenolol and [3H]quinuclidinyl benzilate to intact cells of cultured corneal epithelium.

In intact cultured rabbit corneal epithelial cells we have identified [3H]dihydroalprenolol ( [3H]DHA) and [3H]quinuclidinyl benzilate ( [3H]QNB) binding activities which meet criteria for beta-adrenergic and muscarinic cholinergic receptors. For saturable, propranolol-sensitive [3H]DHA binding, Bmax = 0.374 +/- 0.063 fmol/microgram protein; KDHA = 12.5 +/- 2.4 nM from Scatchard analysis. For saturable, atropine-sensitive [3H]QNB binding, Bmax = 0.403 +/- 0.053 fmol/microgram protein; KQNB = 15.4 +/- 0.7 nM. The order of potency of unlabeled adrenergic agonists in competition for [3H]DHA sites was isoproterenol greater than epinephrine greater than norepinephrine. For unlabeled cholinergic agonists competing for [3H]QNB sites, the order was oxotremorine greater than acetylcholine greater than or equal to carbamylcholine. Acetylcholine did not inhibit [3H]DHA binding, nor did isoproterenol or choline inhibit [3H]QNB binding. Effectiveness of drugs in stimulating cAMP or cGMP accumulation closely paralleled efficacy in competition for [3H]DHA or [3H]QNB sites. Results confirm the presence in intact cultured corneal epithelial cells of beta-adrenergic receptors (demonstrated by others in corneal membrane suspensions), identify in intact cells muscarinic cholinergic receptors (not previously detected in broken cell preparations), and supply evidence for receptor-mediated regulation of cyclic nucleotide levels in these cells, further supporting our hypothesis of bidirectional influence by cAMP-mediated beta-adrenergic and cGMP-mediated cholinergic "first messengers" on proliferation during healing of corneal epithelial defects.

Alprenolol↗
PubMed1981

Electron microscopy for the diagnosis of ocular viral infections.

Tear samples obtained from patients with suspected viral conjunctivitis were examined by virus culture and by the pseudoreplica method for electron microscopy (EM). Adenoviruses were isolated in 13 of the 34 cases (38%) clinically diagnosed as adenovirus conjunctivitis. Characteristic adenoviral particles were demonstrated by electron microscopy in seven of the culture-positive, and two of the culture-negative samples. In cases of herpes simplex virus ocular infection, tears were virus positive by culture in one-third of the patients; two-thirds of the culture positive specimens were also positive by EM. This study demonstrates the potential of electron microscopy as a rapid, specific, and relatively inexpensive method for the laboratory diagnosis of ocular viral infections.

Adenoviridae Infections↗
PubMed1980

Extended wear hydrogel lenses. Long-term effectiveness and costs.

During the period 1976-79, 1,201 of 1,552 aphakic patients were successfully fitted with third generation extended wear hydrogen lenses of thin-membrane design (CSI¿ lens) and highly hydrated polymer design (Permalens,¿Sauflon¿) without significant or permanent visula loss. Between 79% and 82% of the patients who failed did so in the first 90 days, and thereafter failure rates declined with time. Replacement rates for lenses approximated one lens per eye per year. Rates of required removal for cleaning varied. Ten to 13% of patients required cleaning at less than three-month intervals, and 5-6% at less than one month. For average patients with unilateral devices and no complication, extended wear lenses in Georgia are estimated to cost approximately three times as much as an intraocular lens over a 20-year follow-up period. General advantages ofextended wear third generation lenses include: (1) an acceptably savce and visually effective way to correct aphakia when patients are carefully selected, fitted, educated, and followed; (2) can be easily removeed, refitted or updated as technology advances; and (3) will not replace intraocular lenses, but can be used when implantation is contraindicated and should prevent the need for secondary or bilateral implantation or keratophakia in most cases.

Aged↗
PubMed1980

Microscopic features and biologic behavior of eyelid tumors.

A review of some of the more important microscopic and biologic characteristics of the most common malignant eyelid neoplasms is presented. These are: intraepithelial spread, subepithelial spread, multicentric origination, dermal or stromal involvement. Also presented are factors influencing local recurrence, local invasion, metastasis, and mortality. It is emphasized that an eyelid tumor may not be clinically defined by visual means as to its extent of invasion. The above characteristics must be identified and considered in the course of treatment of these lesions and must be brought to mind when evaluating forms of therapy for eyelid neoplasms which rely primarily on clinical means to determine the extent of tissue involvement.

Adenocarcinoma↗
PubMed1979

Primary radiation therapy for meibomian gland carcinoma.

Three patients with Meibomian gland carcinoma were treated initially with irradiation. This therapy was palliative in one case that eventually required orbital exenteration because of recurrent disease. A second patient was clinically tumor-free ten months after treatment when he died of a myocardial infarction. The third patient has shown no evidence of recurrent disease in the 25 months since treatment.

Aged↗