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Biomedical subjects

M C Kincaid

Publications and source records attributed to M C Kincaid.

At least 37 records · Page 2Linked to original sources
PubMed1991

Recurrent corneal erosion: pathology of corneal puncture.

Recurrent corneal erosion is a difficult disorder to treat. Despite conventional therapy, some patients continue to have episodes of erosion. Recent literature suggests the efficacy of corneal puncture, which is thought to induce adherence of the epithelium and basement membrane to the anterior stroma. We performed multiple corneal punctures with 23-, 25-, 27-, and 30-gauge needles on one patient who underwent penetrating keratoplasty 7 weeks later. We found that an insertion depth of 0.1 mm was sufficient to cause the production of new basement membrane and fibrocytic reaction in the anterior stroma. Analysis of the pathologic specimen supports the use of the larger 23- and 25-gauge needles, and cautions against the use of small gauge needles, especially 30-gauge, for this procedure.

Basement Membrane↗
PubMed1991

The effects of glaucoma medications on Tenon's capsule and conjunctiva in the rabbit.

Glaucoma filtering surgery fails most frequently due to fibrosis at the episcleral-conjunctival/Tenon's capsule interface. Sherwood et al have suggested that chronic topical antiglaucoma medications increase conjunctival inflammatory cells, which could increase the likelihood of fibrosis and subsequent bleb failure. In a pilot study in a rabbit model, we placed timolol, pilocarpine, and epinephrine, or a combination of all three, in one eye of 24 animals twice daily for 7 months. The fellow eye received distilled water. Microscopic examination revealed no statistically significant change in the number of acute or chronic inflammatory cells, fibroblasts, or goblet cells in the treated as compared with the control eyes. A longer duration of drug administration, or drug administration followed by surgical intervention, may be required to produce an effect on the conjunctiva and Tenon's capsule, if such an effect exists.

Administration, Topical↗
PubMed1990

The ocular effects of intracarotid bromodeoxyuridine and radiation therapy in the treatment of malignant glioma.

Since July 1985, 23 patients have been entered into a phase I/II clinical trial using intraarterial 5-bromodeoxyuridine (BUdR) (400-600 mg/m2 daily for 8.5 weeks) and focal external beam radiotherapy (59.4 Gy at 1.8 Gy daily in 6.5 weeks) in the treatment of malignant gliomas (Kernohan grades 3 and 4). The side effects in all patients have included varying degrees of anorexia, fatigue, ipsilateral forehead dermatitis, blepharitis, and conjunctivitis. Mucopurulent conjunctivitis and exposure keratitis developed in several patients and spontaneous corneal perforation developed in one. Eyes from two individuals examined at autopsy showed significant changes. Animal studies that predated clinical trials using rhesus monkeys did not predict the ophthalmologic complications seen in human subjects.

Adult↗
PubMed1989

Malignant melanoma of the iris in xeroderma pigmentosum.

Xeroderma pigmentosum is an autosomal recessive, precancerous dermatosis caused by defective repair of ultraviolet-damaged DNA. Characterized clinically by progressive cutaneous pigmentary alterations and tumorigenesis, it serves as a model for ultraviolet carcinogenesis. We describe the clinical and histopathologic findings in a 31-year-old woman with xeroderma pigmentosum and a massive iris melanoma of the left eye. Histologic examination following enucleation revealed diffuse iris replacement by spindle and epithelioid cells with extension into the trabecular meshwork. Evidence of direct extraocular extension was absent, and a metastatic evaluation showed no abnormalities. To our knowledge, this is the first reported case of xeroderma pigmentosum complicated by melanoma of the iris. It provides further evidence suggesting a role for sunlight exposure in the pathogenesis of uveal melanoma.

Adult↗
PubMed1989

Ab interno sclerostomy with a high-powered argon endolaser. Clinicopathologic correlation.

A high-powered argon blue-green laser coupled to a 300-microns quartz fiberoptic probe was used to create an ab interno sclerostomy in a patient undergoing enucleation for a blind painful eye. Despite the presence of diffuse rubeosis, 360 degrees peripheral anterior synechiae, and superior conjunctival scarring, it was possible to create a full-thickness defect from the anterior chamber angle to the subconjunctival space without operative complications. Six laser applications were required using 8 W of power per pulse and 0.1-second pulse duration. The eye was enucleated immediately after the laser procedure, prepared for light microscopy, and sectioned serially. Histologic analysis demonstrated a patent fistula approximately 300 microns in diameter with sharp wound margins. Tissue damage was localized to within 150 microns of the sclerostomy. The overlying conjunctiva was intact.

Adult↗
PubMed1989

Adenoid cystic carcinoma of the lacrimal sac.

Adenoid cystic carcinoma is the most common epithelial malignancy of the lacrimal gland and minor salivary glands. Its occurrence in the lacrimal drainage system is extremely rare. A 57-year-old woman presented with epiphora and a mass in the lacrimal sac, which proved to be an adenoid cystic carcinoma. Histologically, it appeared to arise from the wall of the lacrimal sac, and both the lacrimal gland and maxillary antrum were uninvolved by tumor. Despite aggressive surgical intervention, recurrence and metastasis developed. Adenoid cystic carcinoma must be considered in the differential diagnosis of epiphora.

Biopsy↗
PubMed1989

The ora serrata and the spiral of Tillaux. Anatomic relationship and clinical correlation.

Conventional teaching states that the spiral of Tillaux marks the location of the ora serrata. On literature review, no source for this was found. This study explores this anatomic relationship. In 20 cadaver eyes, narrow-gauge needles were placed penetrating the center of each rectus muscle insertion, and distance to the ora was measured. Insertions ranged from 2.25 mm posterior to 2.25 mm anterior to the ora, with 90% within 1 mm of it. In ten eyes, distance from the edge of insertion also was measured. Results indicate that the centers of rectus insertions, especially the lateral rectus, approximately overlie the ora, with the edges of the insertions more posterior and variable.

Eye↗
PubMed1988

Recombinant tissue plasminogen activator to lyse experimentally induced retinal arterial thrombi.

We evaluated the efficacy of intravenously administered recombinant tissue plasminogen activator to lyse laser-induced arterial thrombi in the stroke-prone, spontaneously hypertensive rat model. The arterial thrombi were confirmed histologically, and assessed by color photographs and fluorescein angiography before and after intravenous tissue plasminogen activator or saline therapy. Experimental animals received tissue plasminogen activator (1 mg/kg of body weight) given intravenously over one hour, and control animals received similar volumes of normal saline. Tissue plasminogen activator was effective in lysing experimental retinal arterial thrombi.

Animals↗
PubMed1988

Angiolymphoid hyperplasia with eosinophilia (Kimura's disease) of the orbit.

A 54-year-old man underwent enucleation of the right eye in 1975 for a malignant melanoma of the choroid, with placement of an Iowa orbital implant. He presented in 1985, with the clinical appearance of a late orbital recurrence of the choroidal malignant melanoma. However, histologic examination revealed the orbital mass to be angiolymphoid hyperplasia with eosinophilia (Kimura's disease). Only six cases of orbital involvement, proved by pathologic studies, have been published in the ophthalmic English literature. This case represented an unusual presentation of a rare disorder that involved the orbit and was probably related to the orbital implant.

Angiolymphoid Hyperplasia with Eosinophilia↗
PubMed1988

Complications after proton beam therapy for uveal malignant melanoma. A clinical and histopathologic study of five cases.

Proton beam therapy for uveal malignant melanoma has been advocated as effective therapy because of documented reduction in tumor size and few clinical complications. However, some eyes have been removed because of adverse effects. The authors report the clinical courses and pathologic findings of five eyes enucleated after proton beam irradiation. Neovascular glaucoma had developed in three eyes, two eyes had vitreous hemorrhage, and two had extraocular extension. The tumors in the radiation treatment field showed continued postirradiation growth clinically in four of the five eyes, and mitotic activity histologically in all five cases. Two and one half years after irradiation, and nearly 2 years after subsequent enucleation, one of those two patients had biopsy-proven liver metastases, and later died. Despite the considerable success rate of proton beam irradiation, the potential for clinical complications and subsequent tumor growth remains.

Adult↗
PubMed1988

Effect of cataract surgery and intraocular lenses on diabetic retinopathy.

We reviewed a series of 137 cataract extractions with intraocular lenses (IOLs) in patients with diabetes, mellitus between 1977 and 1983. All patients were followed for an average of 36 months to determine if they subsequently showed progression of diabetic retinopathy. Divided into groups according to the type of procedure and IOL received, they were compared for age, sex, duration of diabetes, treatment required for the diabetes, intraoperative complications, and follow-up period. Patients who had intracapsular cataract extractions with anterior chamber IOLs were three times as likely to show proliferative retinopathy as those who had extracapsular cataract extractions with posterior chamber IOLs. Insulin-dependent patients were three to four times more likely to show progression to proliferation than noninsulin dependent patients. We conclude that, while some procedures are riskier for the diabetic eye, extracapsular lens extraction with implantation of a posterior chamber lens does not imply an increased risk of development of proliferative retinopathy.

Aged↗
PubMed1988

Choroidal malignant melanoma with early vitreous seeding.

Primary choroidal malignant melanoma with extension through the overlying retina is a rarely reported entity, and to our knowledge actual seeding of the vitreous has never been reported. The pathologic findings in a 41-year-old woman who presented with a large amelanotic subretinal mass near the optic disc of the right eye are discussed. Fundus examination preoperatively revealed a concentration of discrete, fleshy, oval to round, vitreous bodies of varying size, limited to the area overlying the mass. Histopathology of this tumor revealed a spindle cell posterior choroidal melanoma with marked atrophy of the overlying retina. At the apex, the retina was discontinuous and melanoma cells extended into the overlying vitreous. Some of the cells surrounded asteroid bodies overlying the tumor, altering their clinical appearance. This behavior, while only involving a small fraction of the tumor cells, may imply a more aggressive tumor.

Adult↗