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Biomedical subjects

H D Perry

Publications and source records attributed to H D Perry.

At least 19 recordsLinked to original sources
PubMed1992

A new, band-shaped and whorled microcystic dystrophy of the corneal epithelium.

Five family members and three unrelated patients (four women, four men, 23 to 71 years old) had a dystrophy of the corneal epithelium. Direct slit-lamp examination showed bilateral or unilateral, gray, band-shaped, and feathery opacities that sometimes appeared in whorled patterns. Retroillumination showed intraepithelial, densely crowded, clear microcysts. Light and electron microscopy disclosed diffuse vacuolization of the cytoplasm of epithelial cells in the affected area. Visual acuity was so reduced in three patients that abrasion of the corneal epithelium was performed. The corneal abnormalities recurred within months, with the same reduction in visual acuity as before. The corneal opacities were progressive in two patients but diminished noticeably in another after he began using a hard contact lens. We found no other ophthalmic irregularities or associated systemic abnormalities and no indication of drug-induced keratopathy.

Adult↗
PubMed1992

Glued-on, rigid gas-permeable contact lens for severe radiation-induced keratitis.

A 68-year-old woman with severe radiation-induced keratoconjunctivitis sicca became progressively unresponsive to conventional medical treatment. Her left eye deteriorated rapidly and required total tarsorrhaphy. In an attempt to stabilize the right eye and preserve some functional vision, we glued a high-Dk rigid, gas-permeable contact lens with tissue-grade cyanoacrylate adhesive to Bowman's membrane. This glued-on contact lens induced rapid and dramatic improvement of the patient's comfort and sight. Recent developments in high-permeability, rigid, contact-lens materials now make artificial replacement of the epithelium a potentially useful treatment for severe ocular surface disease when conventional treatment has failed.

Aged↗
PubMed1992

Molluscum contagiosum of the eyelids in patients with acquired immune deficiency syndrome.

BACKGROUND: Infection with molluscum contagiosum has been reported in patients with acquired immune deficiency syndrome (AIDS). Involvement of the eyelids by molluscum in patients with AIDS has rarely been mentioned. METHODS: Two patients with AIDS presented with eyelid molluscum contagiosum. Detailed examination and follow-up was performed. RESULTS: One patient had noted ocular irritation with epiphora for several weeks and showed a typical viral keratoconjunctivitis in both eyes. The other patient progressed to confluent masses involving the entire lower eyelid on one side. Removal of the lesions by surgery and cryotherapy was followed by recurrences in both patients within 6 to 7 weeks, the incubation period for this viral infection. CONCLUSION: Molluscum contagiosum can form confluent lesions on the eyelids in patients with AIDS, which may cause a keratoconjunctivitis. Local removal of molluscum eyelid nodules appears to be of limited long-term value in patients with T-cell immunodeficiency.

AIDS-Related Opportunistic Infections↗
PubMed1992

Sterile endophthalmitis after sutureless cataract surgery.

BACKGROUND: Sutureless cataract surgery has recently increased in popularity because of the rapid visual rehabilitation and the inherent reduction of surgically induced astigmatism. METHODS: This procedure is dependent on a lamellar, multiplaned incision. As with new surgical techniques, associated complications become evident with time. Recently, there have been several cases of infectious endophthalmitis after this procedure. The authors report on nine cases of sterile endophthalmitis. In all nine cases, surgery was performed with refrigerated balanced salt solution (BSS) and 100 mg of cefazolin and/or 20 mg of methylprednisolone sodium succinate, given subconjunctivally, at its completion. RESULTS: All nine cases occurred in a period of time during which 68 cases were performed using refrigerated BSS for irrigation. These nine cases came from two different surgeons using basically the same surgical technique. After the investigation of these complications, the refrigerated BSS was discontinued, and there have been no episodes of sterile endophthalmitis in the last 650 cases. CONCLUSION: It appears that refrigerated BSS should be avoided if periocular injections are going to be used. It may be that the cold BSS fails to allow sufficient tissue swelling to seal the surgical incision, allowing for subconjunctival injections to seep into the wound, and leading to a sterile endophthalmitis.

Aged↗
PubMed1992

Soemmering's ring support for posterior chamber intraocular lens implantation during penetrating keratoplasty. Changing trends in bullous keratopathy.

BACKGROUND: Changing trends in cataract extractions have resulted in a new category of bullous keratopathy: corneal decompensation after complicated extracapsular cataract extraction. These cases of bullous keratopathy are associated with rupture of the posterior capsule, vitreous loss, and significant intraocular inflammation at the time of the original complicated extracapsular cataract extraction. METHODS: The authors reviewed 14 consecutive cases of penetrating keratoplasty for bullous keratopathy in which posterior chamber intraocular lens implantation was supported by remnants of the posterior capsule and/or Soemmering's ring without suture fixation. All 14 patients had a history of complicated extracapsular cataract extraction with capsule rupture and vitreous loss. RESULTS: All 14 patients had clear, compact grafts without migration of the intraocular lens with a mean follow-up of 12.1 months. Vision improved in 93% of cases, and there was no significant worsening of glaucoma. CONCLUSIONS: Pseudophakic bullous keratopathy after traumatic extracapsular cataract extraction with an anterior chamber intraocular lens and aphakic bullous keratopathy after traumatic extracapsular cataract extraction are two relatively new clinical entities that present new intraocular lens management options. Bullous keratopathy after complicated extracapsular cataract extraction should be recognized as a distinct clinical entity. Intraocular lens implantation into the ciliary sulcus with Soemmering's ring and peripheral capsular support provide the advantages of a posterior chamber intraocular lens without the risk of iris or scleral sutures. The authors predict that bullous keratopathy associated with traumatic extracapsular cataract extraction will become one of the more common indications for penetrating keratoplasty.

Adolescent↗
PubMed1991

Air-bag keratitis.

Explore the source record for details and available documents.

Accidents, Traffic↗
PubMed1991

Contact lens-related deep stromal intracorneal hemorrhage.

Deep corneal neovascularization is a recently described complication of contact lens wear. Visual loss associated with deep corneal neovascularization has been associated with stromal lipid leakage. Deep intracorneal hemorrhage is rare and has been documented infrequently with the use of contact lenses. The authors present five cases of deep stromal hemorrhage associated with contact lens-related deep corneal neovascularization. These patients had no other discernible cause for their vascularization and subsequent hemorrhage. One patient required a penetrating keratoplasty for visual rehabilitation. Contact lenses of all types may cause neovascularization. The deep stromal neovascularization develops insidiously and may progress in the absence of acute symptoms. The presence of deep stromal neovascularization must be watched carefully and managed as a potentially vision-threatening complication of contact lens use.

Adult↗
PubMed1991

Keratoconus associated with floppy eyelid syndrome.

Floppy eyelid syndrome is a recently described entity, which characteristically involves overweight individuals. The characteristic findings are an upper lid that may be readily everted, tarsal laxity, and diffuse papillary conjunctival changes. The cause of floppy eyelid syndrome is believed to be a mechanical disorder due to the eversion of the lids while sleeping. The cause of keratoconus remains uncertain. There are strong proponents to a mechanical etiology for this disease. The authors report five cases of floppy eyelid syndrome with concomitant keratoconus. One patient with bilateral keratoconus had bilateral symmetric floppy eyelid syndrome. The other four patients had asymmetric keratoconus and floppy eyelid syndrome. In all four patients, the keratoconus was significantly worse in the eye with the more severe case of floppy eyelid syndrome. In addition, these four patients all gave a history of sleeping with their head facing predominantly on the side with the floppy eyelid syndrome and keratoconus. Two patients with keratoconus and floppy eyelid syndrome were able to undergo successful contact lens rehabilitation of their keratoconus after treatment of the floppy eyelid syndrome.

Adult↗
PubMed1991

Nutrient utilization by sheep fed forage grown on soil treated with fluidized-bed combustion residue.

A mineral balance trial was conducted with 18 wether lambs fed sun-cured hay harvested from pastures located on a reclaimed strip-mined site. The following soil applications were made during each of 3 yr: 1) none, 2) dolomitic limestone and 3) fluidized-bed combustion residue (FBCR). Because FBCR had half the buffering capacity of limestone, it was applied at twice the rate of limestone. Apparent digestibility of hemicellulose was higher (P less than .05) for limestone-amended forage than for FBCR-amended forage (70.2 vs 67.0%), and apparent digestibility of cellulose was higher (P less than .05) for amended forages (66.7%) than for the control (63.9%). Apparent absorption and retention of N were similar among treatments, when expressed as a percentage of intake. Lambs fed control forage were in negative Ca balance, lower (P less than .01) than with amended forages. Apparent absorption and retention of Mg and Fe (g/d basis) were higher (P less than .05) for lambs on the limestone treatment than for lambs on the FBCR treatment. Apparent absorption of S was higher (P less than .01) for lambs on the FBCR treatment than for those on the limestone treatment. These differences were related to differences in mineral concentrations of the forages. Serum P was lower (P less than .05) for lambs fed FBCR-treated forage than for lambs fed limestone-treated forage (10.1 vs 12.9 mg/dl). Soil amendment with FBCR did not have deleterious effects on digestibility or mineral metabolism; in fact, it may have enhanced utilization of Ca and S and improved digestibility of some fiber components by lambs.

Animal Feed↗
PubMed1991

Apparent digestibility and nutrient balance in lambs fed different levels of flatpea hay.

Apparent digestibility and nutrient utilization were studied in a digestion and balance trial with 30 wether lambs (BW 32 kg). Lambs were blocked by weight and allotted randomly to five diets with ratios of alfalfa (Medicago sativa L.) to 'Lathco' flatpea (Lathyrus sylvestris L.) hay of 100:0, 75:25, 50:50, 25:75, and 0:100. Alfalfa was harvested in the early bloom stage and flatpea was harvested in the vegetative stage. Digestibilities of DM, NDF, ADF, cellulose, hemicellulose, and energy decreased linearly (P less than .05) as the level of flatpea hay increased to values of 53.3, 32.4, 39.9, 46.0, 40.5, and 52.5%, respectively, for 100% flatpea hay. Nitrogen retention (9 to 15% of intake) was not affected by level of flatpea hay. Ruminal pH, NH3 N, and blood urea N increased linearly (P less than .001) as level of flatpea increased in the diet, apparently a reflection of dietary N level. Calcium excretion decreased linearly (P less than .01) with increased proportions of flatpea hay and was related to dietary intake of Ca. Apparent absorption and retention showed a cubic effect (P less than .05). No clinical signs of toxicity were observed in any of the lambs during the 20-d metabolism trial. Vegetative flatpea is potentially valuable as a forage for feeding ruminants.

Animal Feed↗
PubMed1991

Cyanoacrylate temporary tarsorrhaphy in the management of corneal epithelial defects.

Cyanoacrylate tarsorrhaphy is an easily administered, painless technique for the temporary management of corneal epithelial defects. We have used the technique in 17 patients to treat persistent epithelial defects and exposure keratitis, as well as following epikeratophakia, allowing the tarsorrhaphy to remain in place for 1 to 15 days (mean, 5.7 days). Eleven of the 17 patients required only one application of cyanoacrylate; five had additional cyanoacrylate applied at the time of the original tarsorrhaphy to produce more extensive lid closure; and one required additional cyanoacrylate on day 3 to produce more extensive lid apposition.

Adult↗
PubMed1979

Factors related to corneal epithelial complications after closed vitrectomy in diabetics.

In a series of 30 vitrectomy patients, postoperative corneal complications developed in 14 (47%). Thirteen (92%) of the 14 patients with complications were diabetic. Other factors that were positively correlated with the development of corneal complications included decreased corneal sensitivity, intraoperative lensectomy, and intraoperative epithelial debridement. The corneal complications involved the epithelium in 11 (78%) of the 14 complicated cases, with involvement of the endothelium (as manifested by stromal edema) in five (35%) cases. The diabetic human corneal epithelium contains considerable levels of sorbitol and fructose, which indicates the probable presence of the sorbitol pathway. As in the lens, this pathway may lead to osmotic changes that make the diabetic corneal epithelium more vulnerable to damage intraoperatively. Postoperatively, reepithelialization is delayed because of a probable failure of adhesion of cells to the underlying basement membrane.

Cornea↗
PubMed1979

Schirmer test after topical anesthesia and the tear meniscus height in normal eyes.

The height of the inferior tear meniscus was measured in 86 normal eyes. A value greater than 0.1 mm was obtained in 93% of the eyes that were studied. However, attempts to correlate meniscus height with subsequent Schirmer test results showed that these measurements varied randomly. Schirmer tests that were conducted on 265 eyes without instillation of 0.5% proparacaine hydrochloride and on 466 eyes with proparacaine showed that topical anesthesia reduced mean test values by 40%. When proparacaine was used prior to testing, no decrease in tear production with advancing age was demonstrated, nor were results significantly different in males and females. Schirmer test values, ranging from 0 to 3 mm, were obtained in 15% of the normal volunteers when the test was performed after instillation of topical anesthesia and after blotting of the tear lake from the inferior cul-de-sac.

Adult↗
PubMed1979

Iris involvement in granulocytic sarcoma.

A 6-year-old boy with a diagnosis of acute myeoblastic leukemia in remission developed iris infiltration accompanied by uveitis, hypopyon, and vitreous hemorrhage, which was initially unilateral, later becoming bilateral. Pathologically, the eyes showed leukemic infiltrates in the conjunctiva, episclera, sclera, ciliary body, trabecular meshwork, canal of Schlemm, choroid, vitreous, and the iris. Leder stain studies showed positive esterase activity, indicating granulocytic sarcoma. Granulocytic sarcoma may appear intraocularly as iris nodules. These iris nodules may be the initial manifestation of granulocytic leukemia.

Antineoplastic Agents↗