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Biomedical subjects

J O Sipperley

Publications and source records attributed to J O Sipperley.

At least 19 recordsLinked to original sources
PubMed2000

Outcome of sulcus fixation of dislocated posterior chamber intraocular lenses using temporary externalization of the haptics.

OBJECTIVE: This study evaluated the visual outcome and complications of repositioning and sulcus fixation of a dislocated posterior chamber intraocular lens (PC IOL) using a technique in which the haptics of the IOL are temporarily externalized for suture placement. DESIGN: Retrospective, noncomparative case series. PARTICIPANTS: Seventy-eight patients with a dislocated PC IOL. INTERVENTION: All patients underwent surgery to fixate the PC IOL using this technique. MAIN OUTCOME MEASURES: Patients were evaluated for visual acuity, refractive error, and surgical complications associated with the procedure. RESULTS: The average visual acuity before surgery was 20/205 (range, 20/20 to light perception), with a median refractive error of -1.00 diopters (D; range, -7.25-+15.00 D). After surgery, the average visual acuity improved to 20/72 (range, 20/20 to no light perception), with a median refractive error of -0.75 D (range, -5.50-+3.50 D). Patients were observed for a median of 15.5 months (range, 6-57 months). Twenty patients had postoperative cystoid macular edema (26%), 7 patients had an epiretinal membrane (ERM) (9%), and 5 patients had a retinal detachment (6%). Eight patients (10%) experienced iris capture of the sutured IOL, and in three patients (4%) the PC IOL dislocated again after surgery. CONCLUSIONS: This technique is an effective method for securing a dislocated PC IOL.

Adult↗
PubMed1999

Macular hole surgery with internal-limiting membrane peeling and intravitreous air.

OBJECTIVE: To examine the results of macular hole surgery using pars plana vitrectomy, internal-limiting membrane peeling, and intravitreous air in a series of consecutive patients. DESIGN: A retrospective, interventional, noncomparative case series. PATIENTS: Fifty consecutive patients (58 eyes) with full-thickness macular holes. INTERVENTION: All eyes underwent a pars plana vitrectomy with internal-limiting membrane peeling and intravitreous air, and patients were asked to position face-down for only 4 days. MAIN OUTCOME MEASURES: Status of macular holes, visual acuity, and associated findings and complications. RESULTS: All patients had postsurgical follow-up of 6 months or greater. Eight eyes (14%) presented with stage-2 macular holes, 48 eyes (83%) with stage-3 macular holes, and 2 eyes (3%) with stage-4 macular holes. Only 26 eyes (45%) had a macular epiretinal membrane seen before surgery. Fifty-three (91 %) of the 58 macular holes were closed with 1 operation, and 55 (95%) had closure of the macular holes with subsequent operations. Five (9%) of 58 eyes had an initial visual acuity of 20/50 or better, and 31 eyes (53%) had a final visual acuity of 20/50 or better. Of the 45 eyes with symptoms of less than 6 months' duration, 44 (98%) had macular holes that were closed with 1 operation and 27 (60%) had a final visual acuity of 20/50 or better. Of the 13 eyes with symptoms of 6 months' duration or longer, 9 (69%) had macular holes that were closed with 1 operation and 4 (31 %) had a final visual acuity of 20/50 or better. Complications attributed to the operation included retinal tears, retinal detachments, postoperative macular puckers, and macular light toxicity. CONCLUSIONS: The anatomic and visual results in this series are good. The current technique is similar to that of conventional macular hole surgery except for the use of intravitreous air, internal-limiting membrane peeling in all eyes, and only 4 days of postoperative positioning. This study would suggest that peeling of the internal-limiting membrane is an important adjuvant for successful closure of macular holes.

Adult↗
PubMed1999

Ocular injuries from paintball pellets.

OBJECTIVE: To evaluate the ocular effects of blunt trauma due to injury from a paintball pellet. DESIGN: Noncomparative case series. PARTICIPANTS: Thirteen patients who suffered ocular injury from paintballs are described. The patients presented to six different civilian and military emergency departments in tertiary care medical centers. INTERVENTION: Patients were treated for the ocular injury. MAIN OUTCOME MEASURES: Patients were evaluated for initial and final visual acuity. The reason for persistent loss of vision was delineated. RESULTS: There were 12 males and 1 female with an average age of 21 years (range, 12-33 years). Eleven of the 13 had no ocular protection at the time of the ocular injury. On initial examination, nine patients had a hyphema, nine had a vitreous hemorrhage, six had a retinal tear or detachment, three had corneal or corneal-scleral ruptures, and one had traumatic optic neuropathy. The final visual acuity was 20/40 or better in two patients, 20/50 to 20/150 in three patients, and 20/200 or worse in eight patients. CONCLUSION: Injuries due to paintball pellets can result in severe ocular damage and significant loss of vision. Eyecare professionals should be aware of the risks of this sport and must strongly advise participants to wear adequate protection when involved in this activity.

Adolescent↗
PubMed1999

Pars plana vitrectomy without scleral buckle for pseudophakic retinal detachments.

OBJECTIVE: To report the anatomic and visual results of primary pars plana vitrectomy (PPV) without scleral buckling to repair primary rhegmatogenous retinal detachments in pseudophakic eyes. DESIGN: Nonrandomized, prospective, comparative clinical trial. PARTICIPANTS: Two hundred eighty-three consecutive patients (294 eyes) with pseudophakia, peripheral retinal tears, and new rhegmatogenous retinal detachments were treated according to the surgery protocol. INTERVENTION: Patients underwent PPV with fluid-gas exchange and endolaser to repair the retinal detachment. Two hundred sixty-four patients (275 eyes) were followed from 6 months to 6 years and 8 months with an average follow-up of 19 months. MAIN OUTCOME MEASURES: Reattachment of the retina and visual outcome were compared to previously published studies. RESULTS: Of 97 eyes with a macula-attached rhegmatogenous retinal detachment, 88 eyes (91%) were reattached with a single operation, and of the 178 eyes with a macula-detached retinal detachment, 153 (86%) eyes were reattached with a single operation. In 241 (88%) of 275 eyes, the retina was reattached with a single operation, and in 265 (96%) of 275 eyes, the retina was ultimately reattached with subsequent operations. The median initial visual acuity was 20/300, and the median final visual acuity was 20/40. The rate of reattachment with one operation was similar for eyes with an anterior chamber intraocular lens (91%) and for eyes with a posterior chamber intraocular lens (88%). Refractive error measurements obtained in 81 eyes were essentially unchanged. The mean change in refractive error was -0.15 diopter. Seventeen eyes (6%) developed macular puckers requiring surgery, 46 eyes (17%) developed cystoid macular edema, and 6 eyes (2%) developed full-thickness macular holes. CONCLUSION: Primary PPV with fluid-gas exchange and laser is a safe, effective method to repair primary pseudophakic retinal detachments. The anatomic reattachment rate and the visual acuity obtained with this technique appear to be at least as good as those reported in the literature for scleral buckling, PPV with scleral buckling, and pneumatic retinopexy.

Fluorocarbons↗
PubMed1998

Outcomes of vitreoretinal surgery in patients with X-linked retinoschisis.

BACKGROUND AND OBJECTIVE: To assess the outcomes of vitreoretinal surgery in the treatment of vision-threatening posterior segment complications of X-linked retinoschisis. PATIENTS AND METHODS: The authors performed a retrospective analysis of 16 eyes from 11 patients who underwent vitreoretinal surgery. All the patients had a documented positive family history of X-linked retinoschisis, and all patients had bilateral macular disease. RESULTS: The ages of the patients ranged from 14 months to 37 years (mean age 15.1 years; median age 11.5 years), and postoperative follow-up ranged from 3 months to 10 years (mean 2.8 years; median 1 year). The indications for surgical intervention included rhegmatogenous retinal detachment (12 eyes), vitreous hemorrhage (2 eyes), progression of the schisis cavity through the fovea (2 eyes), cataract associated with a persistent hyperplastic primary vitreous-like condition (2 eyes), and exudative maculopathy (1 eye). The primary surgical intervention included pars plana vitrectomy alone (7 eyes), pars plana vitrectomy and pars plana lensectomy (4 eyes), and a scleral buckle procedure alone (5 eyes). Surgical success (defined as reattachment of the retina, removal of media opacities, or arrest of schisis progression) was achieved in 14 of 16 eyes, after an average of 1.2 procedures per eye. The major reason for reoperations was recurrent retinal detachment due to proliferative vitreoretinopathy. Two eyes were eventually enucleated due to pain associated with neovascular glaucoma resulting from recurrent retinal detachment. Of the remaining 14 eyes, visual acuity improved in 8 eyes and remained unchanged in 6 eyes. CONCLUSION: Vitreoretinal surgery is often helpful in stabilizing or improving visual function in patients with posterior segment complications from X-linked retinoschisis.

Adolescent↗
PubMed1997

A comparison of retrobulbar versus sub-Tenon's corticosteroid therapy for cystoid macular edema refractory to topical medications.

OBJECTIVE: The objective is to compare the effectiveness of retrobulbar and posterior sub-Tenon's injection of corticosteroids for treatment of post-cataract cystoid macular edema that was refractory to topical medications. DESIGN: A retrospective study was performed. PARTICIPANTS: A total of 48 patients (49 eyes) with post-cataract cystoid macular edema refractory to topical medications was studied. INTERVENTION: Patients received either a single retrobulbar injection (18 eyes) or 3 biweekly posterior sub-Tenon's injections (31 eyes) of corticosteroids. MAIN OUTCOME MEASURES: Patients were observed for clinical resolution of the cystoid macular edema, visual acuity, and intraocular pressure. RESULTS: Both treatment methods resulted in significant improvement in visual acuity. The posterior sub-Tenon's group had a visual improvement from 20/92 pretreatment to 20/50 post-treatment (P = 0.0001) with a median follow-up of 12 months. The retrobulbar group had a visual improvement from 20/97 pretreatment to 20/58 post-treatment (P = 0.035) with a median follow-up of 10 months. The visual improvement was not significantly different between the two groups. The average intraocular pressure increased from a pretreatment level of 14.1 mmHg to a high of 17.7 mmHg (P < 0.00005) in the sub-Tenon's group. The average intraocular pressure increased from 15.1 mmHg to a high of 17.6 mmHg (P = 0.04) in the retrobulbar group. CONCLUSIONS: Cystoid macular edema that persists after treatment with topical medications may improve after retrobulbar or posterior sub-Tenon's corticosteroid injections. There was no significant difference in outcome between the two treatment groups.

Administration, Topical↗
PubMed1991

Vitreous surgery for retinal detachment associated with choroidal coloboma.

We report the results of vitreous surgery in seven eyes with retinal detachments caused by retinal breaks at the margin of, or within, a choroidal coloboma. All seven eyes (100%) were reattached; visual acuities in five (71%) of the seven eyes improved from preoperative levels. Vitrectomy was combined with air-fluid exchange and endodrainage through preexisting retinal breaks or planned retinotomies in all but one of the cases. Part or all of the rim of the choroidal coloboma in six eyes underwent endophotocoagulation. The two eyes that did not experience postoperative visual improvement underwent intraoperative endolaser treatment 360 degrees around the optic nerve. If peripapillary endophotocoagulation is performed, especially through the papillomacular bundle, nerve fiber damage may occur and prevent visual recovery, despite retinal reattachment. For eyes with retinal detachment associated with choroidal colobomas involving the optic nerve, postoperative laser treatment through the papillomacular bundle may be preferable.

Adolescent↗
PubMed1990

Vitrectomy for epiretinal membrane with Candida chorioretinitis.

Four eyes underwent vitrectomy and epiretinal membrane dissection for tractional retinal detachment (RD) or macular pucker associated with Candida chorioretinitis. The epiretinal membranes were vascularized and, in three of four eyes, were associated with full-thickness retinal scars, presumably at the site of previous active Candida chorioretinitis. The epiretinal membranes were successfully removed in all four cases. Visual results depended on the degree of macular pathology and the presence and location of a full-thickness retinal scar.

Adult↗
PubMed1987

The management of subretinal gas following attempted pneumatic retinal reattachment.

Pneumatic retinopexy is a recently described procedure for treating retinal detachments with cryotherapy and intraocular gas injection, rather than scleral buckling. Prospective studies are underway to assess its safety and efficacy. One potential complication of this technique is persistent detachment due to subretinal gas. We report seven cases of subretinal gas following attempted pneumatic retinal reattachment. In all cases, multiple fish-egg gas bubbles were present following injection; some of these bubbles gained access to the subretinal space during the early postoperative period. The subretinal gas gave the detached retina a pearly, dome-shaped, refractive sheen. Three cases were managed by positioning the patients' heads to allow the subretinal gas to pass through the retinal break back into the vitreous cavity. One case underwent successful scleral buckling that closed the retinal break despite the presence of a small subretinal gas bubble. Three cases required vitrectomy, air-fluid exchange, and cryotherapy or endolaser treatment. In five of the seven eyes the retina was eventually reattached successfully.

Adult↗
PubMed1987

Linear nevus sebaceous syndrome.

The linear nevus sebaceous syndrome is a rare disorder first described in 1962 in two cases by Feuerstein and Mims. As originally described, it consisted of the triad of the characteristic midline facial linear nevus sebaceous of Jadassohn, seizures, and mental retardation. The authors have followed a patient with this syndrome from birth to age 8 and although he does demonstrate several neurologic and ocular abnormalities, he enjoys normal intelligence and has never suffered seizures. The features of this syndrome and several new ocular findings demonstrated in this case are described. Based on our long-term follow-up of this patient and our review of the reported cases to date, the authors suggest that the triad for this disorder should be changed to include the midline facial linear nevus sebaceous of Jadassohn, neurologic abnormalities which may, but not necessarily, include seizures and mental retardation, and ophthalmologic abnormalities.

Arachnoid↗
PubMed1986

Air travel and intraocular gas.

The safety of air travel for persons with intraocular gas after ocular surgery has been in question since the mid 1970s, when the use of intraocular gases after vitrectomy became widespread. After vitrectomy, air-fluid exchange was performed on six Rhesus monkeys. During simulated air travel in an altitude chamber, intraocular pressure rose an average of 42 mmHg with intraocular air volumes as small as 0.25 cc. Hypotony was observed after return to ground level in all cases. Transient central retinal artery occlusion and pupillary block was observed. Patient safety and comfort is endangered during air travel with very small volumes of intraocular gas.

Aircraft↗
PubMed1984

A prone bed.

Explore the source record for details and available documents.

Beds↗
PubMed1983

Intraocular foreign body from a nylon line grass trimmer.

Nylon line grass trimmers are commonplace in America's lawn armamentarium. As their number has increased, so has the potential for ocular injury from objects thrown from these tools. A patient of ours was injured by an intraocular piece of nylon line thrown from one of these tools. The patient required removal of the foreign body, lensectomy, and anterior vitrectomy to rehabilitate her eye. This report again demonstrates the need for eye protection when using any type of lawn equipment. We think manufacturers of these products should label them to show that eye protection is necessary for the safe use of these tools.

Accidents, Home↗
PubMed1981

Histopathologic evaluation of adhesive properties of early lesions in diathermy and cryopexy.

We examined the histopathologic appearance of both cryopexy and diathermy lesions, ten to 60 minutes after application in the rabbit retina. Both lesions showed immediate subretinal fluid accumulation. Thus we would not substantiate the speculation that a diathermy lesion might have greater immediate adhesive strength than a cryotherapy lesion. This explains the clinical experience that retina tends to slip with either modality when trying to treat giant retinal tears.

Animals↗