Search PubMed⌕ Search

Biomedical subjects

J Kwartz

Publications and source records attributed to J Kwartz.

16 recordsLinked to original sources
PubMed1997

Preoperative ultrasound biomicroscopy to assess ease of haptic removal before penetrating keratoplasty combined with lens exchange.

PURPOSE: To evaluate a method of assessing anterior chamber intraocular lens (IOL) haptics before combined penetrating keratoplasty and IOL exchange in eyes with poor corneal clarity resulting from pseudophakic bullous keratopathy (PBK). SETTING: Department of Ophthalmology, Toronto Hospital, Ontario, Canada. METHODS: Twelve eyes (25 haptics) with PBK were studied using ultrasound biomicroscopy (UBM). The degree of haptic encasement was graded. The result was compared with the degree of difficulty and the complications encountered in removing the IOL at the time of surgery. The surgeons were masked as to the UBM results. RESULTS: All haptics were easily visualized with UBM, with 23 in the angle and 2 passing through a peripheral iridectomy. On UBM, 9 haptics were noted to lie free in the angle, and 16 were encased by fibrotic tissue. Eight were covered by less than 100 microns and 8 by more than 100 microns of tissue. Calculations using Kappa statistics found a strong predictive value for the UBM in identifying the presence or absence of fibrotic encasement and degree of difficulty in removing the anterior chamber IOL haptics. Ultrasound biomicroscopy also allowed assessment of the adjacent angle for synechias. CONCLUSION: Ultrasound biomicroscopy provides an alternative method for evaluating anterior chamber IOL haptics when gonioscopy is not possible because of corneal opacity. This method allows the surgeon to predict preoperatively the degree of difficulty that will be encountered in explanting the IOL.

Anterior Chamber↗
PubMed1995

Penetrating keratoplasty for pseudophakic corneal oedema.

AIMS: The study was designed to investigate the results of penetrating keratoplasty (PK) for pseudophakic corneal oedema (PCO). METHODS: Retrospective analysis of 80 consecutive patients (82 eyes) who underwent PK for PCO between the years 1980-1992 with a minimum follow up of 12 months. RESULTS: PKs for PCO have accounted for as many as 20% of all grafts performed in the hospital in recent years. The interval between cataract extraction and PK ranged from 6 to 161 months (mean 51 months). The intraocular lens was removed in 45 (55%), left in situ in 30 (37%), and exchanged in seven (8%) of cases respectively. Of the intraocular lenses involved 62% were iris supported, 31% angle supported, and 7% were posterior chamber lenses. Actuarial analysis shows graft survival to be 91% at 1 year and 86% at 2 years after surgery. The likelihood of graft survival was significantly enhanced by removal of the intraocular lens (p < 0.01). A corrected Snellen visual acuity worse than 6/60 was present in 36% of patients with a clear corneal graft. Ocular comfort was achieved in all patients with a clear corneal graft. CONCLUSION: PK for PCO resulted in a disappointing visual result in a large proportion of patients. PK was, however, successful in relieving pain and corneal ulceration when present.

Corneal Edema↗
PubMed1995

Disposable soft contact lens ulcers: a study of 43 cases seen at Manchester Royal Eye Hospital.

We report an outbreak of 43 episodes of presumed microbial keratitis in 42 disposable soft contact lens wearers seen in the Accident Room of Manchester Royal Eye Hospital during a period of 20 months, and compare this with the general incidence of contact lens-related corneal infection found in a retrospective survey of 6 months' Accident Room attendances during the same period. Thirty-seven patients had worn Acuvue lenses, three had worn Nuvue, and there was no record in two cases. Corneal scrapes were taken for microbiological examination in 27 patients, and 6 of these were culture positive. Conjunctival swabs were taken from eight eyes and one was culture positive. The contact lenses of 11 patients were sent for culture and all grew pathogenic organisms. Pseudomonas spp. were the most common organisms grown, having been found in three of six corneal scrapes and six of 11 contact lens cultures. All affected eyes responded promptly to cessation of contact lens wear and topical antibiotic therapy, with none sustaining severe or permanent visual loss. Reasons for the associated high risk of microbial keratitis are discussed. Thirty-three of the 42 patients responded to a questionnaire regarding lens wear and care and their responses are reported. In consequence, we consider disposable soft contact lenses to be relatively high-risk devices for the cosmetic management of simple myopia, and their continued use must be called into question.

Adolescent↗
PubMed1994

The 'baseball' orbital implant: a prospective study.

The 'baseball' orbital implant was described by Frueh and Felker in 1976. Although this implant was originally described for use as a secondary implant, it has also been widely used as a primary implant at the time of enucleation. This prospective study evaluated the effectiveness of this implant used both primarily and secondarily. Forty-four patients were implanted between April 1990 and May 1991, 19 of the implants being primary and 25 secondary. A standardised operative and post-operative protocol was followed. The mean follow-up time was 31 months (range 24-36 months). The patients were evaluated for the degree of volume replacement, implant and associated prosthesis motility, secondary eyelid and socket problems, patient satisfaction, the need for further surgery and post-operative complications. The overall results achieved by primary implantation were superior to those of secondary implantation. Our results suggest that this implant provides a satisfactory functional and cosmetic rehabilitation of the anophthalmic patient with few complications.

Adolescent↗
PubMed1991

Ocular prostheses.

Explore the source record for details and available documents.

Blepharoptosis↗
PubMed1991

Three wall orbital decompression for Graves' ophthalmopathy via a coronal approach.

Ten patients with dysthyroid eye disease who underwent a three wall orbital decompression procedure performed via a coronal approach were reviewed. The indications, results, complications and surgical techniques involved in this surgery are discussed. We believe that this approach offers a number of advantages over other techniques and has a role in the management of carefully selected patients with dysthyroid eye disease who have severe unilateral or bilateral proptosis, with or without dysthyroid optic neuropathy.

Adult↗
PubMed1990

General practitioner referrals to an eye hospital: a standard referral form.

To assess general practitioner (GP) referrals to an eye hospital, 500 consecutive referral letters were analysed for content, diagnosis, ocular examination, and medical and drug history. Inadequate information was provided. Visual acuity was measured by general practitioners in only 3.7% of referrals. The standard of ocular examination compared unfavourably with that of ophthalmic opticians. A standard ophthalmic referral form is proposed, and referral protocols are desirable. Undergraduate education in ophthalmology is inadequate and requires more curricular time.

Correspondence as Topic↗
PubMedDate not supplied

Microphthalmos with cyst in monozygous twins.

We present two cases of microphthalmos with cyst affecting monozygotic twins. The etiology and pathogenesis of this developmental anomaly are discussed. The diagnostic evaluation, differential diagnoses, and management options of this unique disorder are also considered.

Cysts↗