Contribution to Binkhorst's membrane deprivation and Worst's decompartmentalization of the eye syndromes.
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Biomedical subjects
Publications and source records attributed to J J Alpar.
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The Fink-Weinstein syringe which is combined with the Kelman irrigation-aspiration handpiece, using a special adaptor to accommodate the short Venotube, is presented for the removal of soft cataract and of cortical materials in a closed system using filtered balanced salt solution.
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A case has been presented where uncomplicated intracapsular cataract extraction and smooth implantation of a Copeland lens was followed by CME, later by CED. The process was stopped by performing a penetrating corneal graft and replacing the offending lens with a Medallion two-loop Medical Workshop lens. The case seems to support Binkhorst's theory of Membrane Deprivation Syndrome and Worst's findings of Decompartmentalization of the Eye.
Twenty-eight combined grafting and lens implantation operations were performed for patients with corneal disease plus cataract, or aphakia. Eighteen of these cases had cataract extraction at the time of surgery and ten had grafting, vitrectomy and secondary lens implantation in already aphakic eyes. The longest follow-up was forty-seven months; the shortest, six months with an average of 21 months. Complications included cystoid macular edema (five), transient rise in intraocular pressure, hemorrhage. One lens had to be removed, and one graft will have to be replaced with possible removal of the lens. Cystoid macular edema occurred in two cases of the 18 graft-cataract-implant cases (11%) and in three of the 10 cases of graft-vitrectomy-implant patients (30%), a total of 17.9%. Hemorrhage occurred in two cases (7%), and transient elevation of the intraocular pressure also in two cases (7%).
Presented is a new simplified and safe suturing technique to prevent Binkhorst and Fyodorov II lenses from dislocating. To data, 74 lenses have been implanted by this technique. There have been no complications. Follow-up time is from three weeks to 14 months.
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Tarsorrhaphy was effective in correcting a case of bilateral total eversion of the upper eyelids in a newborn infant.
An unusual complication of repair of orbital floor blow-out fracture is reported. The supramid plate eroded partially through the orbital floor into the maxillary sinus creating a springboard-like mechanism. When the pressure in the maxillary sinus increased, the posterior portion of the supramid plate was pushed upward. This motion of the plate displaced the eye forward and somewhat outward as well as upward. Following the resection of the portion of the plate protruding into the orbit, the symptoms disappeared.
The histopathologic findings in two cases of senile macular degeneration were correlated with the premortem clinical studies, from the onset in both cases and through the disciform stage in one case. In case 2, the postmortem eyes were obtained only one month after ophthalmoscopic, fluorescein angiographic, and fundus photographic studies were performed, all on the same day. Our report not only adds to the few clinicopathologic correlations of the lesions in senile macular degeneration reported in the literature, but also presents the first reconstruction to scale of subretinal pigment epithelial (sub-RPE) neovascularization. Our results confirm the diagnosis of sub-RPE neovascularization and serous detachment of the retinal pigment epithelium. Drusen were correlated as to number and general location but not individually. Serous detachment of the neurosensory retina was found histopathologically but not clinically.
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