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Biomedical subjects

M Edward Wilson

Publications and source records attributed to M Edward Wilson.

24 records · Page 2Linked to original sources

Pediatric cataract surgery and intraocular lens implantation: practice styles and preferences of the 2001 ASCRS and AAPOS memberships.

A survey of pediatric cataract surgery and intraocular lens (IOL) implantation practice patterns of adult and pediatric cataract surgeons was performed in October 2001. Questionnaires were distributed to the American Society of Cataract and Refractive Surgery and the American Association for Pediatric Ophthalmology and Strabismus. The overall return rate was 12.6% and 41.0%, respectively. Results show that pediatric cataract surgery with IOL implantation is being performed at a younger age than 8 years ago. Also, pediatric cataract surgery practice patterns are evolving in step with advances in adult surgery but with notable differences.

Cataract Extraction↗

Single-piece acrylic intraocular lens implantation in children.

PURPOSE: To assess the short-term outcomes of single-piece acrylic intraocular lens (IOL) implantation in children by determining the incidence of postoperative visual axis opacification and the need for a second procedure to clear the axis, cell deposits on the IOL optic, posterior synechias, and IOL decentration. SETTING: Miles Center for Pediatric Ophthalmology, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA. METHODS: This retrospective case review comprised 43 consecutive implantations (33 patients) of a single-piece hydrophobic acrylic IOL (AcrySof SA30AL or SA60AT, Alcon). An analysis of 42 eyes with posterior capsulectomy and vitrectomy was performed. Eyes with traumatic cataract and secondary IOLs were excluded. RESULTS: Single-piece acrylic IOLs were implanted in 42 eyes. The mean age was 33.5 months +/- 28.9 (SD) (range 0.5 to 110 months) and the mean follow-up, 12.0 +/- 8.2 months (range 1.0 to 27.5 months). Postoperative opacification of the visual axis occurred in 7 eyes (16.7%). Secondary surgical procedures were required in 5 eyes (11.9%). Lens deposits were observed in 8 eyes (19.0%) and synechias, in 5 eyes (11.9%). All IOLs were well centered postoperatively. CONCLUSION: The short-term data suggest implantation of the AcrySof single-piece hydrophobic acrylic IOL is safe in the pediatric eye.

Cataract↗

The management of strabismus in adults--I. Clinical characteristics and treatment.

INTRODUCTION: This is the first in a series of articles intended to evaluate the management of strabismus in adults, including clinical outcomes and the quality, cost, and value of treatment from the perspectives of patients and health care providers. Here we present clinical characteristics, complexity of surgery, treatment success, and resolved complaints in a group of adult patients who underwent strabismus surgery. METHODS: This is a multicenter retrospective study analyzing the type and amount of ocular misalignment before and after surgery in adult patients with strabismus onset before (BVM, or age < 9 years) or after (AVM, or age >/= 9 years) visual maturation. Success was evaluated in terms of alignment, motility, and the presence of diplopia; subjective success was measured in terms of resolved complaints. The complexity of surgery was determined using the Intensity/Complexity Index and compared with success rates. RESULTS: Data are reported on 299 patients (90 BVM and 145 AVM) whose eyes were successfully aligned in 63% of the BVM cases and 81% of the AVM cases. Subjective complaints resolved at similar rates in the BVM and AVM subgroups. Successful alignment was not correlated with complexity of surgery, but motility and sensory success rates were correlated with complexity of surgery. CONCLUSION: Within each of the BVM and AVM subgroups, this study of adult strabismus showed similar surgical success rates compared with published data. This qualifies these patient groups as clinically typical of adults undergoing strabismus surgery. Additional studies will expand on health value analyses.

Adolescent↗

Clinical outcomes of pars plana capsulotomy with anterior vitrectomy in pediatric cataract surgery.

PURPOSE: The management of the posterior capsule in pediatric cataract surgery remains challenging. The purpose of our study was to evaluate the role and clinical outcomes of primary pars plana capsulotomy and pars plana anterior vitrectomy during pediatric cataract surgery with intraocular lens (IOL) implantation. METHODS: Consecutive cases of pars plana capsulotomy and anterior vitrectomy during pediatric cataract surgery were retrospectively reviewed. The surgical technique was the same in all patients and involved pars plana capsulotomy with anterior vitrectomy after the IOL was implanted in the capsular bag. RESULTS: Seventy-six pediatric cataract cases in 61 patients performed from 1994 through 1999 used the pars plana posterior capsulotomy technique and were included in this analysis. A posterior chamber IOL was implanted in all cases. There were no intraoperative complications associated with the surgery. Median age at the time of surgery was 21 months. All patients had at least 1 year of follow-up and mean follow-up was 29.4 months. Among patients old enough to read Snellen's letters (53 eyes), final best-corrected visual acuity was 20/40 or better in 32 eyes (60%) and 20/50 to 20/200 in 21 eyes (40%). Poor final visual acuity was associated with deprivation amblyopia or optic nerve dysplasia or hypoplasia. There were no postoperative retinal complications or cases of IOL dislocation during the follow-up period. Seven eyes (9.2%) of five patients with a median age of 2.5 months developed reopacification of the visual axis at a mean of 4.1 months postoperatively. This event occurred in 6 of 28 eyes with an age of 6 months or less (21.4%), versus only 1 of 48 eyes with an age greater than 6 months (2.0%) (P =.006, Fisher exact test). The visual axis was restored by pars plana membranectomy in 6 eyes and 1 eye of one patient underwent neodymium:YAG laser membrane discission. CONCLUSIONS: Pars plana capsulotomy with pars plana anterior vitrectomy is a safe, effective method of managing the posterior capsule in pediatric cataract surgery with IOL implantation. Visual axis reopacification is associated with a very young age at the time of surgery. Continued follow-up of these patients is important to assess the long-term outcomes of this surgical approach.

Acrylic Resins↗