Search PubMed⌕ Search

Biomedical subjects

H D Hoskins

Publications and source records attributed to H D Hoskins.

At least 19 recordsLinked to original sources
PubMed1992

Holmium laser sclerostomy in glaucoma management: a new tool for an old procedure.

A THC: YAG laser (thulium, holmium, chromium doped YAG crystal) was used to create thermal sclerostomies in 49 glaucomatous eyes of 46 patients. The laser is a long-pulsed (300 microseconds), compact, self contained, solid state laser operating in the near infrared (2.1 mu). A 1 mm conjunctival stab incision was made 12 mm away from the sclerostomy site to allow entry of a specially designed 22-gauge (712 mu) optic probe that delivers energy at a right angle to the long axis of the fiber. Probe insertion produced minimal disturbance of the conjunctiva. Pulse energies of 80 mJ tot 120 mJ were used with a repetition rate of 5 pulses/sec. Total energy levels to produce full-thickness sclerostomies ranged from 1.4 to 7.2 J. Subconjunctival 5-fluorouracil injections were administered in 46 eyes. Estimated probability of success was 74% at 6 months and 67% at 12 months. Mean intraocular pressure of successful cases was 13.3 mmHg at both both 6 months & 12 months. Twelve cases failed within the initial 6 months, and two additional cases failed by 12 months.

Follow-Up Studies↗
PubMed1992

Filtering seton implant for glaucoma: initial animal trial.

A newly developed silicone filtering seton device was implanted in each of five eyes of four rhesus monkeys after they had undergone extensive argon-laser trabeculoplasty to raise their intraocular pressure (IOP). One animal (one implant eye) was killed at 6 weeks. The other three animals (four implant eyes) were observed for 17 to 24 months following implantation surgery. Mild to moderate postoperative inflammation subsided during the first postoperative week. The eyes remained quiet throughout the remainder of follow up. The postoperative IOPs varied between 18% and 70% of the IOPs at the time of implant surgery. In the three monkeys that had unilateral surgery, the IOP at the final follow-up measurement was equal to or lower than the IOP in the unoperated fellow eye. In the monkey that had bilateral surgery, both of the final IOPs were lower than the preoperative ones.

Animals↗
PubMed1992

Trabeculodialysis for inflammatory glaucoma: a review of 25 cases.

We reviewed the results following trabeculodialysis in 25 eyes of 22 patients with secondary glaucoma due to chronic anterior uveitis. After 1 year, intraocular pressure (IOP) was uncontrolled (greater than 21 mm Hg) in 11 eyes (44%). Trabeculodialysis controlled IOP (less than 21 mm Hg) in 14 eyes (56%), with an average follow up of 52 months (range, 12 to 151 months). Sixteen eyes (64%) were aphakic, but did no worse than the phakic eyes. One eye developed a subchoroidal hemorrhage 3 days postoperatively which required drainage. No other serious complications were encountered. Trabeculodialysis is a safe procedure which can achieve pressure control in these difficult eyes.

Aphakia↗
PubMed1991

A 3-month comparison of 1% and 2% carteolol and 0.5% timolol in open-angle glaucoma.

Carteolol, a nonselective beta-adrenergic antagonist with intrinsic sympathomimetic activity, was compared in 1% and 2% topical solutions with 0.5% timolol in 105 patients with primary open-angle glaucoma. In this double-masked, randomized 3-month trial, all three preparations significantly lowered intraocular pressure throughout the study, with no significant differences being observed. There were also no significant differences among the three preparations with regard to ocular or systemic adverse reactions, including heart rate and blood pressure.

Administration, Topical↗
PubMed1991

Subconjunctival THC:YAG laser thermal sclerostomy.

A THC:YAG laser (thulium, holmium, chromium-doped YAG crystal) was used to create thermal sclerostomies in 21 glaucomatous eyes of 19 patients. The laser is a long-pulsed (300 microsec), compact, self-contained, solid state laser operating in the near infrared (2.1 mu). A 1-mm conjunctival stab incision was made 12 mm away from the sclerostomy site to allow entry of a specially designed 22-gauge (712 mu) optic probe that delivers energy at a right angle to the long axis of the fiber. Probe insertion produced minimal disturbance of the conjunctiva. Pulse energies of 80 mJ to 120 mJ were used with a repetition rate of 5 pulses/second. Total energy levels to produce full-thickness sclerostomies ranged from 1.4 to 4.8 J. Subconjunctival 5-fluorouracil injections were administered in 15 eyes. At 3 months the mean intraocular pressure of successful cases (16) was 14 mmHg (range, 9 to 22 mmHg). Of successful cases, the mean intraocular pressure at 6 months was 13 mmHg (range, 2 to 22 mmHg). Five cases failed within the initial 3 months, and 3 additional cases failed by 6 months. The authors conclude that this full-thickness sclerostomy technique may simplify filtering surgery without anterior chamber instrumentation and with minimal conjunctival trauma.

Adult↗
PubMed1991

The effect of a glaucoma medication reminder cap on patient compliance and intraocular pressure.

A multi-site, open-labeled clinical trial was conducted to evaluate the ease of use and acceptance of a newly developed medication cap with a memory aid (C Cap Compliance Cap, Allergan, Inc.) and its effect on patient compliance and intraocular pressure. One-hundred-twenty-two patients with glaucoma or ocular hypertension received their prescribed eye drops in bottles with the compliance cap. Overall, 83% of the patients found the compliance cap very easy to use. By the end of the study, significantly more patients (67%) claimed 100% compliance than prior to using the compliance cap (41%). An overall drop in intraocular pressure of 0.8 mm Hg was seen. However, in a subset of patients who reported an increase in compliance, mean intraocular pressure decreased from baseline by 1.7 mm Hg. The results of this study suggest that the compliance cap helps patients with glaucoma or ocular hypertension remember to take their medication as prescribed.

Adolescent↗
PubMed1991

A new contact neodymium:YAG laser for cyclophotocoagulation.

A newly developed compact (40 kg), self-contained contact Neodymium:YAG laser produces high-peak, high-energy (800 mJ/pulse), short (1.0 millisecond) pulses with 1 to 3 pulses/exposure. Energy is delivered via a 320-microns cleaved quartz fiber optic probe. Cyclophotocoagulation was performed in five eyes of three medium-sized Dutch-pigmented rabbits. The eyes received exposures of 1 to 3 pulses/exposure. Energy delivered ranged from 100 to 800 mJ/pulse. Histopathology revealed ciliary body disruption and hemorrhage with no damage to overlying sclera. When used for transscleral cyclodiathermy in the rabbit, the laser created significant ciliary body disruption with minimal scleral injury.

Animals↗
PubMed1990

Analysis of surgical and medical management of glaucoma in Sturge-Weber syndrome.

Management of glaucoma associated with Sturge-Weber syndrome (SWS) is difficult. The authors reviewed 36 eyes of 30 SWS patients with either early or late-onset glaucoma with a mean follow-up of 122 months (range, 24-253 months). Intervals between required surgical or medical interventions were analyzed. Intervention was attributed to elevated intraocular pressure (IOP) in 55% of cases and disc change in 45%. Median stable postoperative interval with goniotomy was 12 months; with trabeculotomy, 21 months; with trabeculectomy, 34 months; with argon laser trabeculoplasty, 25 months; and with medications, 57 months. Survival analysis shows statistically significant differences between goniotomy and medications. Intraoperative choroidal expansions developed in 24% of cases receiving a trabeculectomy, and none developed with either goniotomy or trabeculotomy.

Adolescent↗
PubMed1990

Subconjunctival THC: YAG laser limbal sclerostomy Ab externo in the rabbit.

A chromium-sensitized, and thulium and holmium-doped YAG laser (THC:YAG laser) was used to create bilateral limbal sclerostomies in six Dutch pigmented rabbits. The laser is a long-pulsed (300 microseconds) [corrected], compact, self-contained, solid-state laser operating in the near infrared (2.1 microns). A 1-mm conjunctival stab incision was made 12 mm away from the sclerostomy site to allow entry of a specially designed 26-gauge (480 microns) optic probe that delivers energy at right angles to the long axis of the fiber. Probe insertion minimally disturbed the conjunctiva. Pulse energies of 60 to 150 mJ were used with a repetition rate of 5 pulses/s. Energy levels ranging from 1.35 to 6.6 J produced full-thickness sclerostomies. Histopathology showed a sharply defined perforating limbal wound at all energy levels. The overlying conjunctiva was intact, with swelling of the adjacent cornea. A peripheral iridectomy was intentionally created with the laser through the peripheral limbus, resulting in a sharply defined perforating tract through the iris/ciliary body. This technique may simplify filtering sclerostomy surgery, without anterior chamber instrumentation and with minimal conjunctival trauma.

Animals↗
PubMed1989

[Argon laser treatment of filtering bleb insufficiency].

The present paper reports on experience with a new contact lens which enables monophilic fixation sutures of the scleral flap to be severed transconjunctivally using highly focussed argon laser beams. The procedure is used in the early postoperative period on patients with failing filtering blebs. Indications and the procedures itself are described in detail.

Contact Lenses↗
PubMed1988

Confidence intervals for change in automated visual fields.

Three successive fields of 136 eyes (86 patients) were extracted from our data base containing over 3000 visual fields performed on the Humphrey visual field analyser with program 30-2. Series of fields in which the second field was depressed relative to the first were selected for analysis to determine how much change between the first two fields was required to predict a downward trend as confirmed by the third field in the series. The data were stratified with respect to initial field damage. Seven regions of the visual field were analysed including the upper and lower temporal and nasal quadrants, the superior and inferior Bjerrum regions, and the whole field. Minimally damaged regions required between 4.7 and 5.6 dB change in mean sensitivity, whereas more damaged regions required between 5.5 and 7.2 dB change in mean sensitivity to have 95% confidence that the negative trend would be confirmed by the third field. The superior Bjerrum region was the most sensitive for the detection of change, and the lower temporal region was the least sensitive. We conclude from this series of data that large changes between two successive fields are required to be sure that the changes are due to disease rather than chance fluctuation. Where any doubt exists, the field should be repeated to confirm the reality of change.

Aged↗
PubMed1985

Clinical experience with timolol in childhood glaucoma.

We studied 67 patients (100 eyes) with childhood glaucoma who were treated with timolol maleate. Thirty of these patients (40 eyes) did not require additional surgery or medications after being treated with timolol (follow-up, from six to 60 months). Thirty-one eyes (78%) in this group had a pressure drop; 18 eyes (45%) had a pressure drop of greater than 10 mm Hg. We conclude that timolol is effective in the treatment of pediatric glaucoma, although there is a need to be aware of its potential complications.

Adolescent↗
PubMed1984

Anatomical classification of the developmental glaucomas.

With the use of observations in 250 cases of childhood glaucoma, defects were classified anatomically according to the three major anterior chamber structures affected: the trabecular meshwork, the iris, and the cornea. The classification should do much to facilitate communication in the area of the developmental glaucomas and provide standardization of terminology to allow collaborative study of these rare diseases.

Adolescent↗
PubMed1984

Laser iridectomy--a technique for blue irises.

A two-step technique for laser iridectomy in light blue irises is described, which simplifies penetration of these irises and allows success rates approaching 100%. Step one utilizes a high energy, long duration, predominantly thermal laser burn that destroys overlying iris stroma. In step two, the laser energy is reduced and exposure time is shortened to facilitate removal of remaining pigment epithelium.

Argon↗
PubMed1984

Management of failing filtering blebs with the Argon laser.

Using the Argon laser and a special lens, the authors have developed a technique for cutting trabeculectomy flap sutures through the overlying conjunctiva. The technique is described and three case reports are presented. The availability of this technique permits suturing the scleral flap tightly, thus minimizing postoperative flat chambers. If filtration is inadequate in such cases, suture cutting with the laser can open the flap and permit more successful filtration.

Adult↗
PubMed1983

Information from data. Computer assisted techniques.

This paper discusses developments in computer systems which can facilitate medical research and medical care. System limitations and the importance of careful design are covered. Considerations in the selection of data for entry and in the type of data entered are also described. Included is a step-by-step analysis of the conversion of data into useful information.

Computers↗
PubMed1983

Complications of laser trabeculoplasty.

Laser trabeculoplasty (LTP) is a relatively new procedure requiring evaluation for long-term effectiveness and associated complications. The authors review some 300 LTPs and identify complications. Among the most serious are transient or persistent rise in intraocular pressure, iritis, and progression of visual field loss. The authors recommend LTP as an alternative to glaucoma surgery in selected patients not controlled by medications.

Glaucoma↗