Search PubMed⌕ Search

Biomedical subjects

J J Rowsey

Publications and source records attributed to J J Rowsey.

At least 73 records · Page 4Linked to original sources
PubMed1982

Radial keratotomy: preliminary report of complications.

We have observed the following complications with radial keratotomy which require further evaluation: missing the visual axis while marking the central cornea, regression of myopic flattening, epithelial defects, recurrent erosions, stromal overgrowth, Cogan's map-dot fingerprint corneal dystrophy with Moncreiff iron lines, blood in the incisions, vascular ingrowth, perforation of the anterior chamber, induction of astigmatic errors, epithelial ingrowth, glare complaints and decreased night vision, pain, fluctuating vision from morning to evening, overcorrection and unpredictable results, contact lens refitting difficulties, endothelial cell loss, and corneal scarring. We feel these complications require extensive further study before the relative safety and long-term efficacy of this experimental procedure may be determined.

Anterior Chamber↗
PubMed1981

Corneal topography. Corneascope.

We present an introduction to a clinical quantitative corneascope for measurement of corneal topography in detail. This instrument provides contour keratometry in all corneal meridians. We review the normal myopic and hyperopic eye contours, keratoconus, pellucid marginal degeneration, and wound gape and compression related to cataract surgery. We present a modified Placido disk for office use that incorporates the unique incident light image of the corneascope for rapid review of irregular corneal contours. Corneal topography irregularities frequently contribute to devastating refractive states of the eye and should be examined carefully when keratorefractive surgery is considered.

Cornea↗
PubMed1981

Preliminary report of Los Alamos Keratoplasty Techniques.

We have found that intrastromal diathermy heat to the cornea spares the epithelium and endothelium, while preferentially allowing contraction of the midstromal corneal collagen. Extensive animal studies have demonstrated a potentially useful dosage range for primate corneal diathermy. We have initiated cautious preliminary human studies utilizing the Los Alamos Keratoplasty unit in the last 12 months to reshape the corneas of keratoconus patients who were referred for penetrating keratoplasty. The steepest area of the cone may be flattened from 4 to 57 diopters, thereby allowing a return to contact lens use. We recommend the technique of Los Alamos Keratoplasty as an alternative to penetrating keratoplasty in patients who have been successful in contact lens wear, but whose cone progression precludes continued satisfactory fitting. The procedure appears effective in this preliminary study. The eventual safety and long-them efficacy of this experimental keratorefractive surgical technique requires extensive further study.

Adult↗
PubMed1980

Closed vitrectomy for the vitreous touch syndrome.

We used closed vitrectomy techniques to remove formed vitreous from the anterior chamber in a consecutive series of 38 eyes with the vitreous touch syndrome. The visual results in these cases were related to the severity of corneal edema and the visual acuity recorded preoperatively. Most patients with preoperative visual acuities of 6/15 (20/50) or better demonstrated a clearing of corneal edema and an improvement in vision. Of eyes achieving visual acuities of 6/12 (20/40) or better within six weeks of vitreous surgery, 14 (74%) maintained this level during follow-up. No eyes with preoperative visual acuities of 6/90 (20/300) or worse achieved good results. The incidence of complications of vitreous surgery was acceptable, although cystoid macular edema developed postoperatively in at least 10%. Closed virectomy techniques provide a safe and effective means of treating the vitreous touch syndrome when corneal edema is localized.

Corneal Diseases↗
PubMed1980

Intraocular lens disasters: peripheral anterior synechia.

Peripheral anterior synechia formation appears to complicate intraocular lens use by producing (1) progressive endothelial cell loss, (2) fibrous metaplasia of the endothelium, and (3) angle cicatrization with glaucoma. We present 13 patients with these complications and the anterior segment reconstruction techniques that are necessary to alleviate these relatively late intraocular lens complications.

Adult↗
PubMed1979

Fusarium oxysporum endophthalmitis.

A 27-year-old man sustained a thorn injury to his left eye and a culture-proven Fusarium oxysporum endophthalmitis developed. This was successfully treated with a vitrectomy, intravitreal and intravenous amphotericin B, and oral flucytosine. The patient maintains 20/20 vision at this time in his left eye. We recommend combined therapy for this filamentous fungal infection.

Adult↗
PubMed1978

Helminthosporium corneal ulcers.

We studied four cases of Helminthosporium corneal ulcers from four different institutions. One case occurred in an immune-deficient infant, another in a patient three months after removal of a foreign body; the third case occurred in a patient with a corneal dystrophy who was wearing soft contact lenses and using topical corticosteroids; and the fourth occurred in a patient with a history of multiple foreign bodies. Antifungal sensitivities were performed in three cases and showed relatively good sensitivity to available antifungal medications; even though all four patients improved, there was poor correlation between in vitro sensitivities and clinical response.

Adult↗
PubMedDate not supplied

Refraction problems after refractive surgery.

While refractive surgery such as radial keratotomy, epikeratophakia, and corneal relaxing incisions offer many potential benefits to patients, they can also generate optical problems such as overcorrection or undercorrection of the prior refractive error and variable vision. The authors offer suggestions for avoiding problems through proper patient selection; candid preoperative communication with the patient about possible difficulties and limitations; understanding of the physiological changes that may occur; and optical techniques for alleviating postoperative vision problems.

Contact Lenses↗
PubMedDate not supplied

Surgical correction of moderate myopia: which method should you choose? I. Radial keratotomy will always have a place.

This set of "Viewpoints" articles examines the relative merits of radial keratotomy (RK), photorefractive keratectomy (PRK), and laser assisted in-situ keratomileusis (LASIK). Drs. Rowsey and Morley review advances in RK techniques, long-term results, and complications, and explain why RK will remain a viable method for correction of moderate myopia, notably its minimal cost. Drs. Steinert and Bafna review both PRK and LASIK, discussing techniques and results and comparing their advantages and disadvantages with each other and with RK. Dr. Dutton, as "Viewpoints" section editor, summarizes clinical, technologic, and economic aspects of all three techniques, concluding that all will find a place among refractive surgeons for some time to come.

Cornea↗
PubMedDate not supplied

Suturing in lamellar surgery: the BRA-technique.

BACKGROUND: The principle of refractive corneal lamellar surgery rests on the modification of corneal shape after the removal of a superficial disk with a microkeratome. The 150-microns-thick disk is easily torn, rotated or decentered by the traditional eight-bite running suture, producing irregular astigmatism which is the major cause of visual deficit after these procedures. METHODS: We propose a new suture technique, designated the BRA suture, which we have used in more than 300 cases of various types of refractive corneal lamellar procedures. Based on the overlay concept, the suture is anchored in four points of the nonoperated corneal periphery. RESULTS: With this technique, the iatrogenic irregular astigmatism induced by the suture has been eliminated and corneal scars significantly reduced. This suture also decreases surgical time, accelerates visual recovery, and increases patient comfort due to its early removal. CONCLUSIONS: We consider this the ideal suture for refractive corneal lamellar surgery due to its effectiveness, simplicity, and safety.

Astigmatism↗
PubMedDate not supplied

Use of keratoscopy, slit-lamp biomicroscopy, and retinoscopy in the management of astigmatism after penetrating keratoplasty.

Selective suture removal following corneal transplant surgery can facilitate the reduction of astigmatism. We present concepts concerning astigmatism analysis after keratoplasty related to suture compression by reviewing keratoscopy, slit-lamp biomicroscopy, and retinoscopy findings. Keratoscopy observations indicating tight sutures include peripheral indentation of the keratoscope rings, individual keratoscope ring images between tight sutures, and decentration of the corneal apex away from a tight suture. The utilization of the Van Loenen keratoscope at the slit-lamp in "dynamic keratoscopy" allows the surgeon to readily recognize these findings and also proves useful intraoperatively. Slit-lamp biomicroscope observations indicative of tight sutures include a doughnut of tissue compression, Kaye's epithelial white dots, and epithelial or endothelial stress lines. Retinoscopy observations demonstrate that tight sutures induce astigmatism with the narrowest side of the retinoscopy beam pointing directly toward the tightest suture. Astigmatism management plays a major role in the future success of ophthalmology and needs to be increasingly integrated into the practice of the general ophthalmologist.

Aged↗
PubMedDate not supplied

Ab interno radial keratotomy.

We describe a modified approach to perform radial keratotomy which was tested in human donor eyes. Using a Beaver blade #5910, the sclera was entered tangentially 1 mm from the limbus up to the edge of the optical zone while staying in the deep stroma. The shaft was rotated 90 degrees, allowing the cutting edge to dissect from the deep stroma to the epithelium in a radial fashion. The procedure was repeated resulting in eight radial incisions. An average of 8.20 diopters (standard deviation SD = 2.40 D) of flattening was obtained in 20 human donor eyes. Histopathologic study of the radial incisions in another group of 10 donor eyes revealed a mean depth of 58.9% of corneal thickness. (SD = 12.4%). The present technique allows radial keratotomy to be performed without the sophisticated instrumentation necessary for the "external" approach.

Cornea↗
PubMedDate not supplied

Three year results of the Prospective Evaluation of Radial Keratotomy (PERK) study.

The Prospective Evaluation of Radial Keratotomy (PERK) study is a nine-center clinical trial of a standardized technique of radial keratotomy in 435 patients who had simple myopia with a preoperative refractive error between -2.00 and -8.00 diopters (D). We report results for one eye of each patient. The surgical technique consisted of eight incisions using a diamond micrometer knife with the blade length determined by intraoperative ultrasonic pachymetry and the diameter of the central clear zone determined by the preoperative refractive error. At three years after surgery, 58% of eyes had refractive error within one diopter of emmetropia; 26% were undercorrected, and 16% were overcorrected by more than one diopter. Uncorrected visual acuity was 20/40 or better in 76% of eyes. The operation was more effective in eyes with a preoperative refractive error between -2.00 and -4.37 diopters. Between one and three years after surgery, the refractive error changed by 1.00 diopter or more in 12% of eyes, indicating a lack of stability in some eyes.

Astigmatism↗
PubMedDate not supplied

Model of epithelial downgrowth: III. Scanning and transmission electron microscopy of iris epithelialization.

Epithelialization of uveal structures is frequently difficult to diagnose clinically and may require scanning and/or transmission electron microscopy to detect histologically. Since the scanning and transmission electron microscopic findings of progressive iris epithelialization have not previously been described, we examined a cat model of epithelial downgrowth for iris findings from 23 days through 4 months post-implantations of epithelium. Features associated with iris epithelialization included direct contact of iris with implanted epithelium, allowing initially rapid epithelialization of anterior iris structures, and slower epithelialization of posterior iris pigmented epithelium. The morphology of the migrating epithelium progressed from spindle shaped cells with small numbers of pseudopodia and microvillae to confluence of up to five layers of stratified epithelium with numerous surface microvilli. Anterior iris epithelial morphology consisted of cuboidal shaped cells with "looser" cell junctional interdigitations, versus a more squamous appearance of posterior iris epithelialization. A monolayer of lead cells or thin sheets of epithelium may be present well before a clinically apparent multicellular sheet of epithelium is seen.

Animals↗