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Biomedical subjects

M Blumenthal

Publications and source records attributed to M Blumenthal.

At least 91 records · Page 5Linked to original sources
PubMed1991

Effect of a resutured iridotomy on glare disability in glaucoma patients having cataract surgery.

Twenty-two glaucoma patients with fixed miotic pupils prior to cataract surgery were retrospectively divided into two groups: Group A in which the sector iridotomy was resutured after intraocular lens insertion; Group B in which the sector iridotomy was not resutured. The two groups were matched for average age, sex, average disease duration, glaucoma type, operation type, mean follow-up, and average intraocular pressure and cup/disc ratio. Glare disability was measured with the Miller-Nadler tester. A similar reduction in visual acuity under glare was found in the two groups: 0.55 + 1.2 and 0.45 + 0.9 Snellen lines for Groups A and B, respectively. These findings are explained by two additional observations: Reduction in visual acuity under glare was positively correlated to the degree of posterior capsule opacity (r=0.4) and not to the functional pupillary area (r=0.13). Functional pupillary area (upper lid in normal position) was 42% larger in the nonresutured group compared to 85% difference in the total pupillary area.

Aged↗
PubMed1991

Nd-YAG laser hyaloidotomy for malignant glaucoma following one-piece 7 mm intraocular lens implantation.

Three cases of malignant glaucoma following extracapsular cataract extraction with 7 mm one-piece posterior chamber intraocular lens implantation are presented. Nd-YAG laser hyaloidotomy was successfully performed in all eyes, but was difficult and required several sessions in two eyes. In the third eye, which had a sector iridectomy, laser hyaloidotomy applied over the edge of the lens optic through the iridectomy resulted in brisk deepening of the anterior chamber and reduction of intraocular pressure. We propose that the one-piece 7 mm optic posterior chamber intraocular lens may constitute an obstacle to successful hyaloidotomy, mainly owing to its large size, as it may block aqueous percolation from the vitreous into the anterior chamber. Eyes prone to develop malignant glaucoma after surgery should have a sector or large peripheral iridectomy to facilitate postoperative Nd-YAG laser hyaloidotomy if required.

Aged↗
PubMed1991

Vogt-Koyanagi-Harada syndrome in two siblings.

Two cases of a brother and a sister with characteristic manifestations of Vogt-Koyanagi-Harada syndrome are presented. To the best of our knowledge, this is the first report of a typical appearance of Vogt-Koyanagi-Harada syndrome in two siblings.

Adult↗
PubMed1991

Maintaining nearly physiologic intraocular pressure levels prior to tying the sutures during cataract surgery reduces surgically-induced astigmatism.

We sought to determine whether maintaining nearly physiologic levels of intraocular pressure (IOP) before the final tying of sutures in cataract surgery can help minimize postoperative-induced astigmatism. We compared the postoperative astigmatic decay curves of two similar groups of 18 patients who had undergone cataract surgery, in one of which IOP had been maintained at 17 mm Hg prior to the final tying of sutures, and in the other of which the eyes were hypotonus (3 mm Hg) at this point. Initial with-the-rule cylinder change was significantly less and astigmatic decay occurred earlier in the former group.

Aged↗
PubMed1991

Anterior capsule adherence to iris leading to pseudophakic pupillary block.

We present a rare case of anterior capsule adherence to the iris following extracapsular cataract extraction with posterior chamber intraocular lens implantation and leading to pseudophakic pupillary block. There were no synechiae at the pupillary margins associated with the capsule/iris adherence, but aqueous was entrapped behind the iris and intraocular pressure rose. Laser iridotomy was temporarily beneficial, but it had to be repeated several times.

Aged↗
PubMed1991

Risk factors associated with late infection of filtering blebs and endophthalmitis.

Late infection of filtering blebs and endophthalmitis are hazardous complications of glaucoma filtering surgery frequently associated with bleb failure and loss of functional vision. To determine possible risk factors for the development of these complications, characteristics of nine eyes of nine patients after filtering surgery in whom late endophthalmitis developed were compared with those in patients who had received a comparable operation at the same time in whom endophthalmitis did not develop. An average of 7.7 +/- 6.2 years (range, 6 months to 18 years) elapsed between the time of the filtering procedure and the initial appearance of endophthalmitis. Factors associated with increased risk were: increased axial length, thin and leaky bleb, conjunctivitis, upper respiratory infection, and the winter season.

Adolescent↗
PubMed1990

Tight scleral flap trabeculectomy with postoperative laser suture lysis.

Thirty eyes of 30 patients underwent tight scleral flap trabeculectomy. Of these eyes, 22 underwent laser lysis of the scleral flap sutures, whereas eight eyes did not require such treatment because of low intraocular pressure and active filtering blebs. In the 22 eyes treated, preoperative intraocular pressure was 32.6 +/- 8.3 mm Hg, whereas postoperative and pre-laser intraocular pressure was 29.3 +/- 7.4 mm Hg. Immediately after laser suture lysis, intraocular pressure dropped by 22.7 +/- 9.4 mm Hg (P less than .01) to 6.6 +/- 7.0 mm Hg, with elevation of the conjunctival bleb in all eyes treated. After a mean follow-up of 14.4 months, intraocular pressure was controlled (less than or equal to 18 mm Hg) in 20 of the 22 eyes treated (91%). The only major complication was a single case of anterior chamber flattening with intraocular lens touching the corneal endothelium. Combination of tight scleral flap trabeculectomy with subsequent postoperative laser suture lysis is a safe and effective method for low-level intraocular pressure control. This technique seems to combine the advantages of full-thickness filtration and trabeculectomy by achieving relatively low intraocular pressures while minimizing complications caused by excessive aqueous runoff.

Evaluation Studies as Topic↗
PubMed1990

[Aqueous drainage implants in glaucoma].

The use of implants to drain aqueous from the anterior chamber to a posterior collecting reservoir is an important additional option in the treatment of advanced refractory glaucoma. In the past decade, many problems and complications associated with drainage implants have been solved by modifications in implant design and surgical technique. These include: entry of the tube into an equatorial collecting device, increased surface area of the collecting reservoir, use of a needle track to insert the tube into the anterior chamber, suturing a donor scleral patch to cover the tube, intracameral injection of hyaluronic acid (Healon), ligation of the tube with a temporary suture, and antifibrotic medical therapy. The adoption of some or all of these modifications in recent years has clearly resulted in fewer complications and better long-term control of intraocular pressure.

Anterior Chamber↗
PubMed1990

The long-term effect on intraocular pressure of a procedure combining trabeculectomy and cataract surgery, as compared with trabeculectomy alone.

The long-term reduction of intraocular pressure (IOP) resulting from a procedure combining extracapsular cataract extraction and posterior chamber lens implantation with trabeculectomy was compared retrospectively with the IOP-lowering effect of trabeculectomy alone. Forty patients who underwent the combined procedure and 38 who underwent trabeculectomy alone had been followed for an average of 22 +/- 7 months. Both these surgical procedures significantly reduced IOP, but after a year or more, pressure levels were significantly lower in the trabeculectomy group than they were in the combined group: 12.8 +/- 4.2 mm Hg, and 16.5 +/- 5.6 mm Hg, respectively, at 18 months. Also, the mean postoperative fall in IOP was greater in the "filtered" eyes than it was in the combined group (9.8 +/- 4.6 mm Hg and 12.1 +/- 5.2 mm Hg, respectively, at 18 months). Finally, the number of medications required to maintain controlled IOP in the combined group was greater (and resumed preoperative values at 2 years) than it was in the trabeculectomy group (62.5% of the filtered eyes remained controlled unaided).

Aged↗
PubMed1989

[Posterior penetrating ocular injury].

The management of posterior penetrating ocular trauma includes thorough preoperative evaluation and exploration and careful debridement with excision or repositioning of the uvea. Vitreous incarceration should be avoided and the sclera and cornea should be reapproximated. Preventive antibiotic and steroid therapy are indicated. Vitreoretinal evaluation includes CT scan, ultrasonography and electroretinography. Vitrectomy should be performed within 5-10 days after injury when there is retinal detachment, an opaque vitreous, extensive vitreous hemorrhage, double perforating injuries, or a reactive foreign body. When there is endophthalmitis or chalcosis, vitrectomy should be performed earlier. A 22-year-old man with severe penetrating trauma of the eye is presented.

Adolescent↗
PubMed1989

[Epikeratophakia surgery for refractive errors and keratoconus].

Epikeratophakia surgery is a relatively new surgical technique which involves suturing of prelathed corneal tissue on top of the recipient's cornea. The epikeratophakia lens is lathed according to the recipient's refractive needs and therefore can correct myopia and hyperopia; a plano lenticle can be used to correct keratoconus. In the past 3 years we operated on 25 patients (27 eyes). There were 11 cases of myopia, 7 of aphakia and 7 of keratoconus. The aphakic (hyperopic) group included patients with aphakia and traumatic aphakia in whom secondary implantation of an intraocular lens was contraindicated or who were contact-lens intolerant. In the myopic group, the average correction of 18.3 diopters improved to -1.9 diopters after surgery, and in the hyperopic-aphakic group from +10.9 diopters to +1.1 diopters. In the keratoconus group there was also marked improvement after surgery. There was no major complication during or after surgery. Epikeratophakia surgery is a reversible, extraocular procedure, which is fairly simple technically, does not cause immunological rejection, and gives fairly good results in certain refractive errors and in keratoconus.

Aphakia↗
PubMed1989

Epikeratophakia after ocular trauma.

Five patients with long-standing monocular traumatic aphakia and contact lens intolerance underwent epikeratophakia. This procedure was chosen to rehabilitate the visual function in those eyes that exhibited distorted anterior segment anatomy after trauma. Three of the patients had corneal scars associated with their old perforation wounds, and all of them had undergone an intracapsular cataract extraction soon after their original injuries. Best-corrected visual acuity was 20/50 or better in all cases before surgery. Postoperative best-corrected visual acuity improved to within two lines of the best-corrected preoperative visual acuity, after a minimum follow-up period of six months. No intraoperative complications were noted. One cornea developed late-onset partial scarring of the interface in the area of the original scar, but the process arrested spontaneously.

Adult↗