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Biomedical subjects

M Lazar

Publications and source records attributed to M Lazar.

At least 235 records · Page 13Linked to original sources

Pupil size in Jewish theological seminary students.

PURPOSE: To investigate the authors' clinical impression that pupil size among myopic Jewish theological seminary students is different from pupil size of similar secular subjects. METHODS: This cross-sectional study was conducted on 28 male Jewish theological seminary students and 28 secular students or workers who were matched for age and refraction. All participants were consecutively enrolled. Scotopic and photopic pupil size was measured by means of a Colvard pupillometer. Comparisons of various parameters between the groups were performed using the two-sample t-test, Fisher exact test, a paired-sample t-test, a two-way analysis of variance, and Pearson correlation coefficients as appropriate. RESULTS: The two groups were statistically matched for age, refraction, and visual acuity. The seminary students were undercorrected by an average of 2.35 diopters (D), while the secular subjects were undercorrected by only 0.65 D (p<0.01). The average pupil size was larger in the religious group under both scotopic and photopic luminance. This difference was maintained when the two groups were compared according to iris color under both conditions, reaching a level of statistical significance (p<0.0001). There was a significant difference in photopic pupil size between dark and light irises (p=0.049), but this difference was not maintained under scotopic conditions. CONCLUSIONS: The average pupil size of young ultraorthodox seminary students was significantly larger than that of matched secular subjects. Whether this is the result of intensive close-up work or of apparently characteristic undercorrection of the myopia is undetermined.

Adult↗

Spontaneous thrombosis of a traumatic cavernous sinus fistula.

Post-traumatic thrombosis of cavernous sinus and orbital veins has been reported in conjunction with carotid-cavernous sinus fistula (CCSF). CCSF are abnormal communications between the carotid artery and the cavernous sinus. Spontaneous thrombosis of a CCSF is a rare event mainly seen in the indirect (dural) type of fistula. We report on a patient with a possible post-traumatic CSSF which underwent partial spontaneous thrombosis and presented with an extreme degree of proptosis.

Adult↗

Pitfall of acquired ocular torticollis.

Following a posttraumatic concussion syndrome, a 24-year-old female presented at left clavicular fracture and dislocation with a compensatory head posture thought to be due to her sternocleidomastoid muscle involvement. Further investigation disclosed the existence of a concomitant superior oblique muscle palsy seemingly also of traumatic origin. The clinical course and the constellation of her symptoms are described.

Clavicle↗

Benign palsy of superior oblique muscle.

Thirteen patients with nontraumatic superior oblique muscle palsy were examined during a four to seven year follow-up period. Extensive investigations disclosed no underlying systemic or neurologic diseases. In all patients a quick improvement and recovery of the motility imbalance occurred spontaneously in about 10 weeks, suggesting a benign prognosis in the condition.

Adult↗

Atropine cycloplegia: how many instillations does one need?

Atropine is accepted generally as the most efficient cycloplegic agent. Although it is considered a relatively safe drug, toxic local and systemic side effects do occur. The recommended regimen for atropine cycloplegia has been 7 to 10 applications within 3 to 4 days. We compared the cycloplegic effect of four instillations of atropine drops to the effect of eight instillations. The results showed that the cycloplegia obtained after eight instillations was not greater than after four instillations.

Accommodation, Ocular↗

The effect of spherical photorefractive keratectomy on myopic astigmatism.

The aim of this report is to present the effects of spherical photorefractive keratectomy (PRK) by excimer laser on myopic astigmatism. Spherical PRK was performed in 96 eyes with myopia associated with astigmatism of between 0.75 and 2.00 diopters (D) using the Summit excimer laser. The reduction both in sphere and in cylinder was found to be highly statistically significant (P < 0.0001 for both). The mean reduction of cylinder was 46%. Astigmatic error of less than 2.00 D can be corrected significantly by spherical PRK.

Adult↗

Symmetry of outcome after photorefractive keratectomy for myopia.

The aim of this study was to find out whether the outcome of excimer laser photorefractive keratectomy (PRK) in the second eye can be predicted from the results of the first, and to determine whether we should modify our therapeutic approach to the second eye according to the results of the first. Bilateral PRK was performed in 73 patients using the Summit Technology excimer laser. All patients included in this study had a follow-up of at least 12 months in both eyes. The change of refraction and the haze of the two eyes were compared. Sixty percent of patients had a difference in refraction between the two eyes smaller than 0.50 diopters (D), and 75% had a difference smaller than 1.00 D. The degree of symmetry in response to treatment was greater in patients with a preoperative spherical equivalent refraction of less than -6.00 D. Most patients had a similar degree of haze in both eyes. The results of our study demonstrate that a considerable degree of symmetry in the outcome of surgery exists between the two eyes of the same patient undergoing PRK, especially in low to moderate myopia.

Adolescent↗

Influence of patient age on photorefractive keratectomy for myopia.

BACKGROUND: To determine whether the outcomes of photorefractive keratectomy (PRK) for myopia are age-dependent. METHODS: The influence of age on PRK outcomes was analyzed for one eye of each of 72 patients divided into two groups: 39 patients (18 to 26 years) and 33 patients (35 to 54 years). The influence of the amount of preoperative myopia (low myopia less than -4.00 diopters (D); moderate to high myopia -4.00 or more D) was also evaluated. All patients were followed for at least 1 year, and all underwent cycloplegic refractions. RESULTS: One year after PRK, the average refraction was -0.15 D in the younger group and +0.38 D in the older group. The achieved refraction was higher than the attempted by +1.00 D or more only in eyes with moderate to high myopia (-4.00 to -10.00 D); 11.54% (3 eyes) of the younger group and in 34.78% (8 eyes) of the older group. CONCLUSIONS: After PRK for myopia, patients between the ages of 35 and 54, with moderate to high myopia, obtained more refractive change with the same intended dioptric correction compared to younger patients with moderate to high myopia. Attempted correction should be adjusted according to age and amount of myopia.

Accommodation, Ocular↗

Patient satisfaction after 5.0-mm photorefractive keratectomy for myopia.

PURPOSE: To examine patient satisfaction following photorefractive keratectomy (PRK) in a large number of subjects. METHODS: We used a questionnaire to examine overall patient satisfaction in 173 patients (173 first-operated eyes) at least 1 year after they had undergone PRK. Mean preoperative spherical equivalent refraction was -7.05 +/- 3.73 D (range, -1.50 to -15.00 D). Fifty-one patients had unilateral surgery and 122 had bilateral surgery, 60 of whom had follow-up of 1 year for both eyes. Visual and refractive results, the use of corrective lenses, and subjective side effects were also studied. RESULTS: Eighty percent of 173 patients reported they were satisfied or very satisfied with the surgical outcome, while 19.7% reported they were dissatisfied. The average satisfaction score was 7.92 +/- 2.22 out of a possible 10. After PRK, 77.5% reported improvement or great improvement in their general quality of life; 16.8% were very disturbed by subjective visual symptoms. Of the 51 bilateral patients, 85% required no corrective lenses after surgery. Patients who had bilateral operations were more satisfied than those who had unilateral ones. Statistically significant associations were found between patient satisfaction and initial refraction: as preoperative refraction increased, percentage of satisfied or very satisfied patients decreased. CONCLUSION: Patient satisfaction after PRK was generally high, but subjective visual symptoms remain a problem.

Adult↗

Comparison of photorefractive keratectomy on one eye and laser in situ keratomileusis on the other eye of the same patient.

OBJECTIVE: The aim of this study was to compare the results of excimer laser photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) in the same patient. METHODS: All consecutive patients who underwent PRK in one eye and LASIK in the second eye using the same excimer laser (Nidek EC-5000) and had at least 12 months of follow-up were included in this retrospective study (N = 23). Uncorrected and spectacle-corrected visual acuity, final spherical equivalent refraction, and degree of haze were compared. RESULTS: Mean postoperative spherical equivalent refraction in the group of eyes that underwent PRK was +0.73 D (range, -5.50 to +3.50 D). Mean postoperative spherical equivalent refraction in the group of eyes that underwent LASIK was +0.07 D (range, -1.25 to +3.50 D) (P = .046). CONCLUSION: In our study, eyes treated with LASIK had better results than eyes treated with PRK.

Adult↗

Bilateral comparison of photorefractive keratectomy for myopia using two excimer lasers.

PURPOSE: The aim of this study was to compare the results of excimer laser photorefractive keratectomy (PRK) in patients who underwent PRK using the Summit Apex (Omnimed) excimer laser in one eye and the Nidek EC-5000 excimer laser in the other. METHODS: All consecutive patients who underwent PRK with the Summit Apex laser (Omnimed) in one eye and the Nidek laser (EC-5000) in the second and had at least 12 months of follow-up were included in this retrospective study (n=30). Uncorrected and spectacle-corrected visual acuity, final spherical equivalent refraction, and grade of subepithelial haze were compared. The average preoperative spherical equivalent refraction of eyes treated with the Summit laser was -6.00 D (range, -2.50 to -8.75 D), and for Nidek-treated eyes it was -5.57 D (range, -2.50 to -8.80 D). RESULTS: Forty-seven percent of Summit-treated eyes and 53% of Nidek-treated eyes had uncorrected visual acuity of 6/6 or better; 61% of Summit-treated eyes and 63% of Nidek-treated eyes had uncorrected visual acuity of 6/7.5 or better; 95% of Summit-treated eyes and 95% of Nidek-treated eyes had uncorrected visual acuity of 6/12 or better (difference not statistically significant). Seventy-three percent of eyes treated with the Summit laser and 80% of eyes treated with the Nidek laser had a postoperative refraction within +/-0.50 D of emmetropia; 97% of Summit-treated eyes and 87% of Nidek-treated eyes had a postoperative spherical equivalent refraction within +/-1.00 D of emmetropia; the difference between the two lasers was not statistically significant. However, the percent of eyes with persistent hyperopia was smaller in the Nidek group after 3 months (P=.0062) and after 6 months (P=.07) than in the Summit group. Videokeratography was not done. CONCLUSION: Both lasers were effective with relatively low side effects. No significant difference was found between the two lasers in postoperative uncorrected visual acuity or refractive outcome. Eyes operated with the Nidek laser had less persistent hyperopia and stabilized earlier.

Adult↗

White matter reorganization after surgical resection of brain tumors and vascular malformations.

BACKGROUND AND PURPOSE: Diffusion tensor imaging (DTI) and white matter tractography (WMT) are promising techniques for estimating the course, extent, and connectivity patterns of the white matter (WM) structures in the human brain. In this study, DTI and WMT were used to evaluate WM tract reorganization after the surgical resection of brain tumors and vascular malformations. METHODS: Pre- and postoperative DTI data were obtained in 6 patients undergoing surgical resection of brain lesions. WMT using a tensor deflection algorithm was used to reconstruct WM tracts adjacent to the lesions. Reconstructed tracts included corticospinal tracts, the corona radiata, superior longitudinal and inferior fronto-occipital fasciculi, cingulum bundles, and the corpus callosum. RESULTS: WMT revealed a series of tract alteration patterns including deviation, deformation, infiltration, and apparent tract interruption. In general, the organization of WM tracts appeared more similar to normal anatomy after resection, with either disappearance or reduction of the deviation, deformation, or infiltration present preoperatively. In patients whose lesions were associated with corticospinal tract involvement, the WMT reconstructions showed that the tract was preserved during surgery and improved in position and appearance, and this finding correlated with improvement or preservation of motor function as determined by clinical assessment. CONCLUSION: WMT is useful for appreciating the complex relationships between specific WM structures and the anatomic distortions created by brain lesions. Further studies with intraoperative correlation are necessary to confirm these initial findings and to determine WMT utility for presurgical planning and evaluation of surgical treatments.

Adolescent↗