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J J Alpar

Publications and source records attributed to J J Alpar.

At least 37 records · Page 2Linked to original sources
PubMed1986

Long-term results of keratoplasty in eyes with intraocular lenses.

We present a retrospective study of our patients who had penetrating keratoplasty in eyes which had intraocular lenses in situ. Our results show that although the short-term result was good with any kind of intraocular lenses, the long-term (more than five years) graft survival was better if intraocular lenses with pre-iridial optics were removed and/or replaced at the time of the grafting with posterior chamber lenses.

Cataract Extraction↗
PubMed1986

Endothelial cell loss in different non-automated extracapsular nuclear evacuation techniques and the role of sodium hyaluronate.

In this study the effect of seven different non-automated nuclear evacuation techniques and the role of sodium hyaluronate (Healon) were evaluated. Thirty-five cats (seven groups) and 140 human patients (seven groups) were included in the study. Each experimental animal and human group was operated using one of the seven non-automated techniques. In each animal, one eye was operated with sodium hyaluronate and the other with Balanced Saline Solution (BSS). In each human group of 20 patients during cataract extraction and IOL implantation, sodium hyaluronate was used in half of the patients and BSS was used in the remaining ten. Eyes treated with sodium hyaluronate lost approximately 50% fewer endothelial cells and had approximately 50% less increase in corneal thickness than their counterparts treated with BSS. Based on the results of the endothelial cell loss and the corneal thickness, it is concluded that the most traumatic used technique was no. 2, followed by that of no. 5. The technique no. 7 may be considered as the most atraumatic of the tested procedures. Sodium hyaluronate effectively protected the endothelium, and its routine use in cataract surgery is recommended.

Aged↗
PubMed1986

Sodium hyaluronate (Healon) in glaucoma filtering procedures.

Healon (sodium hyaluronate) has been used in a prospective study designed to investigate its possible usefulness in promoting effective bleb formation and preventing cleft closure in trabeculectomy for glaucoma. One hundred fourteen patients with open-angle glaucoma were randomly assigned to one of two groups. In one group (55 patients), filtering surgery was performed without the use of Healon. In the remaining 59 patients, Healon was used to separate the iris from the cleft, the sclera from the sclera and the conjunctiva from the sclera. The surgical procedure used was the Stallard-Worst triangular modification of Cairns' method, combined with removal of the Tenon's capsule. The patients whose operations were performed with the aid of Healon had a higher success rate, as manifested by better and more permanent bleb formation and maintenance, more open clefts, less scarring, less peripheral anterior synechiae formation, and significantly lower long-term intraocular pressure. Moreover, the number of patients requiring supplemental postoperative timolol therapy was significantly smaller in the Healon group (5/59 patients: 8.5%) than in the control group (33/55 patients: 60%). There was a transient delay in the reduction of intraocular pressure following trabeculectomy in the Healon patients which was not observed in control patients. Apart from this, no adverse effects were associated with the use of Healon.

Aged↗
PubMed1986

Experiences with the Neodymium: YAG laser: interruption of anterior hyaloid membrane of the vitreous and cystoid macular edema.

Patients who needed posterior capsulectomy at different times following cataract surgery were treated with: The Meditec OPL3 mode-locked Nd:YAG laser; The LASAG Microruptor 2 Q-switched Nd:YAG laser. Random selection determined which instrument should be used for which patient. Further random selection determined the use of placebo with topical steroids vs. topical Indomethacin and topical steroid treatment. The results showed that there is a connection between the time the posterior capsulectomy is performed after cataract surgery, the number of applications used to interrupt the membrane, and the integrity of the anterior hyaloid membrane.

Cataract Extraction↗
PubMed1985

Posterior capsulotomy in sulcus-fixated versus bag-fixated intraocular lenses in diabetic patients.

Forty-one diabetic patients who had modified J-loop lenses with ten-degree angulation implanted in the ciliary sulcus and 58 diabetic patients who had the same style lenses implanted in the capsular bag had posterior capsulotomy performed on the table or later at predetermined intervals. The operation was performed with a cystotome needle or with the Nd:YAG laser on the first postoperative day or later. The study indicates that the development of new or the worsening of old diabetic iris and retinal changes, as well as cystoid macular edema, were much less if the intraocular lens was implanted in the capsular bag, at least nine months elapsed between cataract surgery and capsule interruption, and topical indomethacin and topical steroid treatment was given preoperatively and postoperatively. There was little difference in diabetic progression between cystotome needle and YAG laser posterior capsulotomy.

Aged↗
PubMed1985

The use of Healon in McCannel suturing procedures.

McCannel sutures were applied to cat eyes with different surgical techniques. The cats' right eyes were operated without Healon, the left eyes with Healon. With every technique, Healon offered significant protection to the cornea, as was manifested in much smaller increases of the pachometry reading and much smaller decreases of the endothelial cell count when Healon was used, as compared to the eyes in which Healon was not used. The McCannel suture can be a dangerous procedure, but, although its use has declined recently with improvements in lens design, it is still an important procedure. Routine use of Healon (1 per cent sodium hyaluronate) is recommended, whatever technique is chosen.

Animals↗
PubMed1985

Use of the Ethicon 1713 suture for McCannel suturing.

The double-arm, straight-needle Ethicon 1713 suture with its STC6 micropoint spatula needle offers advantages over previously available needles for fixing intraocular lenses. Under certain circumstances, such as securing posterior chamber haptics to the iris, the advantage is significant. However, I recommend a shorter needle than the one presently available. Intracameral injection of sodium hyaluronate (Healon) increases the safety of this procedure.

Humans↗
PubMed1985

Comparison of Healon and Amvisc.

Twenty-two patients were randomly assigned to either Healon or Amvisc treatment during extracapsular cataract extraction and intraocular lens implantation surgery in order to compare the safety and efficacy of the two preparations of sodium hyaluronate. Amvisc was found to be a significantly more inflammatory preparation than Healon and caused intraocular pressure elevation shortly after surgery in a considerable number of patients. Healon maintained the anterior chamber better than Amvisc and facilitated the surgical procedure.

Cataract Extraction↗
PubMed1984

Cataract extraction and diabetic retinopathy.

A prospective study of the effect of cataract extraction and intraocular lens implantation on insulin-dependent diabetics is presented. Cataract extraction was performed on 138 patients with diabetic retinopathy. The patients were randomly selected for intracapsular or extracapsular extraction and for the administration of topical indomethacin or placebo. In a second group, 103 diabetic patients received intraocular lens implants, which were anterior-chamber-angle fixated, iris supported, iridociliary sulcus supported, or placed in the capsular bag. Random selection determined who among the extracapsular cases would have on-the-table capsulotomy or six-month-postoperative capsulotomy. The study indicated that a greater progression of diabetic changes occurred in both the posterior and the anterior segment of the eye after intracapsular extraction than after extracapsular extraction, especially if the capsulotomy was performed six months postoperatively. Furthermore, the study indicated that in-the-bag implantation without on-the-table capsulotomy was a safe procedure; anterior-chamber-angle-fixated lenses exhibited a higher incidence of diabetic changes in the anterior and posterior segments than the other lenses.

Aged↗
PubMed1984

The use of Healon in corneal transplant surgery with and without intraocular lenses.

Healon was used in penetrating keratoplasty in order to assess the effect on donor cornea. Forty patients were divided into four groups. In Group 1, there were 20 patients who underwent intracapsular cataract extraction, intraocular lens implantation, and penetrating keratoplasty. In Group 2, there were 10 patients who underwent intracapsular cataract extraction and corneal graft surgery. In Group 3, there were four patients with corneal dystrophy who underwent penetrating keratoplasty; and in Group 4, there were six patients with decompensated corneas who had intraocular lenses in situ and who underwent corneal replacement surgery. In each group, half of the patients randomly selected were treated with Healon, while the remaining patients served as controls and were treated with air/BSS. Healon treated recipients lost fewer endothelial cells and had thinner corneas than their control group counterparts. The intraocular pressure was slightly higher in the Healon group, but was easily controlled by proper medication. Healon was found to be beneficial to the patient and a safe adjunct in penetrating keratoplasty surgery.

Aged↗
PubMed1981

Keratoplasty with primary and secondary lens implantation.

Twenty-eight patients who had cataract and corneal scarring were operated on with combined penetrating graft, cataract extraction, and lens implantation (group A); 20 patients who had aphakic corneal dystrophy or dystrophy caused by intraocular lens received simultaneous penetrating graft, vitrectomy, and lens implantation or revision of the intraocular lens (group B). Group B had more severe disorders and more complicated surgery, and therefore poorer visual results than group A.

Adult↗
PubMed1980

Wound healing.

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Aged↗