Cogan-Reese syndrome. Progressive growth of endothelium over iris.
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Corneal Diseases↗
Biomedical subjects
N Mamalis
Publications and source records attributed to N Mamalis.
Cutaneous malignant melanoma and oculodermal melanocytosis (nevus of Ota): report of a case and review of the literature.
A 29-year-old white man, with oculodermal melanocytosis, had a rapidly enlarging, erythematous, painful nodule over his left brow, within the nevus. The lesion was excised and diagnosed as a malignant melanoma. Systemic evaluation showed no evidence of distant disease. This is the tenth case reported of a cutaneous melanoma developing in a nevus of Ota. Melanoma arising in the choroid, brain, orbit, iris, ciliary body, or optic nerve in association with a nevus of Ota is well documented. Careful observation is necessary in patients with a nevus of Ota, particularly in white patients, in whom malignant degeneration seems to occur with a disproportionate frequency.
Adult↗
In vitro analysis of AcrySof intraocular lens glistenings in AcryPak and Wagon Wheel packaging.
PURPOSE: To compare the formation of "glistenings" in acrylic intraocular lenses (IOLs) packaged in Wagon Wheel and AcryPak packaging systems. SETTING: John Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. METHODS: Acrylic IOLs in Wagon Wheel (WW) and AcryPak (AP) packaging were analyzed in vitro. The lenses were placed in a test chamber with a controlled temperature and evaluated every 48 hours for 336 hours. The presence of glistenings within the lens optic was assessed using slitlamp evaluation and a quantitative microscopic evaluation with an image analysis system. RESULTS: When maintained at a constant temperature, the WW-packaged IOLs showed no glistening formation and the AP-packaged IOLs, significant glistening formation. Glistenings were noted in the WW-packaged IOLs only under fluctuating temperature conditions. Quantitative image analysis confirmed the presence of glistenings only in AP-packaged IOLs maintained at a constant temperature. CONCLUSION: The glistenings in AcrySof IOLs were temperature dependent and confined to IOLs packaged in AcryPak folders and maintained at constant (body) temperatures. These findings are believed to be consistent with fluid formation within the acrylic optic, somehow related to the AcryPak packaging system.
Acrylates↗
Ocular transmucosal absorption and toxicity of sufentanil in dogs.
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Absorption↗
Conjunctival epithelial inclusion cyst.
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Aged↗
Intraoperative miotics and posterior capsular opacification following phacoemulsification with intraocular lens insertion.
BACKGROUND AND OBJECTIVES: Posterior capsular opacification (PCO) is a frequent complication following phacoemulsification with intraocular lens (IOL) implantation. A series of consecutive patients receiving capsular bag-fixated, silicone IOL implants were assessed for both incidence of PCO and the administration of intraoperative miotics. PATIENTS AND METHODS: During a 5-year period, 477 consecutive eyes were retrospectively evaluated. Surgeries were grouped according to intraoperative miotic agent: 0.01% carbachol or 1.0% acetylcholine. Patients receiving no miotic drug served as a control group. Yttrium-aluminum-garnet (YAG) laser posterior capsulotomy was performed on patients with clinically significant PCO. RESULTS: The percentage of eyes requiring YAG laser capsulotomy was similar for the three groups: 21.6% (25 of 91) for the carbachol group, 18.4% (14 of 62) for the acetylcholine group, and 18.6% (53 of 232) for the control group. A chi-squared analysis indicated that the difference among the groups was not statistically significant. The three groups also had similar average follow-up times between surgery and YAG capsulotomy (carbachol group = 52.2 weeks, acetylcholine group = 47.5 weeks, and control group = 48.3 weeks). CONCLUSION: Intraocular miotics do not increase the incidence of PCO.
Acetylcholine↗
Scanning electron microscopic characteristics of small-incision intraocular lenses.
PURPOSE: To evaluate the surface characteristics of commonly used, small-incision, intraocular lenses (IOLs). METHODS: Representative samples of five groups of foldable IOLs (4 silicone and 1 acrylic) underwent surface and edge-finish examination using a slit lamp. The IOLs were folded using a folding block and forceps. All the IOLs then were examined using a scanning electron microscope. A one-piece polymethylmethacrylate IOL was used for comparing surface-finish characteristics. The IOLs were examined for optic surface quality, edge finish, haptic, haptic/optic junction, and possible post-folding modifications. RESULTS: Slit-lamp evaluation of the surface quality of all of the silicone lenses demonstrated a smooth finish of the optic surface, edge, and haptics. Scanning electron microscopic analysis of the IOLs demonstrated adequately finished haptics or footplates and optics. Excess molding flash was seen on the edges of the some of the silicone IOLs, and no molding flash was observed on others. The acrylic IOL had a somewhat sharper optic edge. Irregular finish of the haptic/optic junctions of some of the IOLs (both silicone and acrylic) was noted. CONCLUSIONS: Currently available foldable IOLs have demonstrated adequate lens finish. However, irregularities of the haptic/optic junctions and molding flash are present on most IOLs evaluated, indicating room for improvement in the finish of foldable IOLs. Phacoemulsification with capsular bag IOL placement may decrease the clinical significance of these relatively subtle lens finish irregularities.
Acrylamide↗
Visual significance of glistenings seen in the AcrySof intraocular lens.
PURPOSE: To investigate the visual significance of "glistenings" in acrylic intraocular lenses (IOLS). SETTING: John Moran Eye Center, University of Utah, Salt Lake City. METHODS: Seventeen patients who had phacoemulsification with implantation of the AcrySof acrylic IOL were evaluated by slitlamp examination and visual acuity, contrast sensitivity, and glare testing. Ten patients had a silicone posterior chamber IOL in the opposite eye and had testing with similar visual parameters for comparison. Glistenings noted in the acrylic IOLs were graded at the slitlamp. Laboratory analysis of five acrylic IOLs was also done to reproduce the glistenings noted clinically. RESULTS: All 17 patients with the acrylic IOLs had some lenticular glistenings, ranging from trace to 2+. Statistical analysis of visual acuity, contrast sensitivity, and glare testing revealed a statistically significant difference between the acrylic and the silicone IOLs only in contrast sensitivity. Laboratory analysis of the acrylic IOLs showed similar glistenings from 48 to 72 hours after they were placed in balanced salt solution. CONCLUSIONS: A patients who received AcrySof IOLs that came in the AcryPak had some degree of glistenings. There was also a significant decrease in contrast sensitivity compared with that of fellow eyes with silicone IOLs. The glistenings are likely caused by water vacuoles that form within the lens after hydration within the eyes. Further studies are necessary to assess the exact cause of these glistenings.
Acrylates↗
Combined phacoemulsification, intraocular lens implantation, and trabeculectomy.
PURPOSE: To analyze the results of phacoemulsification and posterior chamber intraocular lens (IOL) implantation combined with trabeculectomy. SETTING: John Moran Eye Center, University of Utah, Salt Lake City. METHODS: Two hundred twelve eyes of 174 patients with glaucoma and cataracts were analyzed retrospectively after cataract removal by phacoemulsification with posterior chamber IOL implantation combined with trabeculectomy. RESULTS: With an average follow-up of 26 months, patients had a significant improvement in visual acuity. The preoperative mean intraocular pressure (IOP) of 23.1 mm Hg decreased postoperatively to 15.9 mm Hg. Mean number of glaucoma medications decreased from 1.85 preoperatively to 0.41 postoperatively. Twenty-one patients (10% had a postoperative IOP of greater than 21 mm Hg, and seven required trabeculectomy revisions. CONCLUSION: Combined phacoemulsification, posterior chamber IOL implantation, and trabeculectomy yielded excellent results in the treatment of patients with both cataract and glaucoma.
Adult↗
Comparison of two plate-haptic intraocular lenses in a rabbit model.
PURPOSE: To compare the presence of fibrosis through footplate positioning holes in two different silicone intraocular lenses (IOLs) following phacoemulsification with IOL implantation. SETTING: Moran Eye Center, University of Utah, Salt Lake City. METHODS: Twelve New Zealand white rabbits had phacoemulsification with placement of a control silicone IOL in one eye and a study IOL with a larger positioning hole in the opposite eye. The amount of force required to remove the IOLs from the capsular bag was analyzed at 3 and 6 weeks postoperatively. RESULTS: The force necessary to remove the study lens with the larger positioning holes was statistically significantly greater at both 3 and 6 weeks than that necessary to remove the control lenses. Capsular fibrosis with proliferative lens cortical material through the larger positioning holes was also documented grossly using the Miyake technique. CONCLUSION: The larger footplate positioning holes in the study silicone IOL significantly increased capsular bag fixation in the rabbit model following phacoemulsification and IOL implantation.
Animals↗
Neodymium: YAG capsulotomy rates after phacoemulsification with silicone posterior chamber intraocular lenses.
PURPOSE: To retrospectively evaluate the incidence of neodymium: YAG (Nd:YAG) laser capsulotomies for posterior capsule opacification (PCO) in eyes receiving one of two types of capsular-bag-fixated silicone posterior chamber intraocular lenses (IOLs) over 7 years. SETTING: John Moran Eye Center, University of Utah, Salt Lake City. METHODS: Four hundred eighty-eight eyes that had cataract extraction with a continuous curvilinear capsulorhexis and implantation of one of two kinds of silicone posterior chamber IOLs were evaluated to assess the incidence of PCO. One hundred thirty-nine received a one-piece, plate-type IOL (Staar) and 349, a three-piece, modified C-loop IOL (AMO). RESULTS: With an average follow-up of 84.3 weeks in the Staar IOL group and 93.5 weeks in the AMO IOL group, the incidence of posterior Nd:YAG laser capsulotomy for PCO was 30.2% and 39.1%, respectively. CONCLUSION: The incidence of Nd:YAG laser capsulotomy after phacoemulsification with implantation of a silicone posterior chamber IOL was still relatively high with long-term follow-up. Although the proportion of patients with a one-piece silicone IOL requiring Nd:YAG capsulotomy was less than that in the three-piece silicone IOL group, the difference was not statistically significant.
Aged↗
Thelazia californiensis conjunctival infestation.
There are few reports of Thelazia californiensis infestation in humans in the literature. The authors report the clinical and histopathologic features of two patients who presented with symptoms of a mild unilateral chronic conjunctivitis from infestation by this parasite. In each case, the symptoms resolved immediately after removal of the worms. These are the first two patients from the Rocky Mountain area to be described with an infection from this particular worm. T. californiensis should be included in the differential diagnosis of patients with chronic conjunctivitis following hiking or camping in the mountains or back-country.
Adult↗
Effect of intraocular lens size on posterior capsule opacification after phacoemulsification.
Posterior capsule opacification (PCO) is one of the most common complications of phacoemulsification with intraocular lens (IOL) implantation. This retrospective study evaluated the incidence of neodymium: YAG (Nd:YAG) laser capsulotomies for PCO in two groups of patients with different sizes of poly(methyl methacrylate) (PMMA), capsular bag-fixated IOLs. We evaluated 437 eyes that had phacoemulsification with continuous curvilinear capsulorhexis over a four-year period. Patients were placed in one of two groups, based on IOL size: large IOL (lens length 13.5 mm or greater) and small IOL (lens length less than 13.5 mm). In the large IOL group, 106 of 280 patients (38%) required YAG laser posterior capsulotomy; in the small IOL group, 25 of 157 patients (16%) did. This difference was statistically significant even though the average follow-up was 84.1 weeks in the large IOL group and 54.1 weeks in the small IOL group.
Cataract↗
Complications and results of phacoemulsification performed by residents.
The use of phacoemulsification by ophthalmic surgeons has increased markedly over the past five years. Previous studies have reported relatively high rates of vitreous loss by residents learning phacoemulsification. We retrospectively analyzed the complications and results in 300 cases of phacoemulsification with intraocular lens implantation performed by residents. The first 40 cases done by four residents in their second year of training were compared with approximately the last 40 cases done by each resident at the end of the third year. The overall rate of surgical complications was 6.3%, and the total rate of vitreous loss was 3.3%. The rate of surgical complications during the initial surgeries in the second year of residency was 9.3%; it was 3.3% by the end of the third year. The rate of vitreous loss was 5.3% in the second year and 1.3% during the third year. Postoperatively, 90.6% of all eyes had a final best corrected visual acuity of 20/40 or better (95% excluding patients with pre-existing ocular disease). With proper training and supervision, the rate of surgical complications for residents learning phacoemulsification is acceptably low when compared with the rate of extracapsular cataract extraction.
Clinical Competence↗
Crystallization on intraocular lens surfaces associated with the use of Healon GV.
OBJECTIVE: To describe a series of patients who had visually significant crystalline deposits on their intraocular lenses during cataract surgery with the use of Healon GV (a high concentration and high molecular-weight hyaluronate sodium). METHODS: Patients were examined for crystalline deposits on their intraocular lenses. These deposits were compared with intraocular lens type, viscoelastic solutions, any other intraocular substance used, type of surgery, and perioperative medications. RESULTS: In the 11 patients with documented changes (six photographically), the only consistent finding was the use of Healon GV. Furthermore, since we discontinued the use of Healon GV, we have not seen a recurrence of these deposits in more than 500 consecutive patients. The deposits could last a long time (at least 6 months) if sequestered by the posterior capsule, and they are believed to be visually significant at times (Snellen visual acuity of 20/40 or worse). CONCLUSION: Healon GV use is associated with a new clinical finding of crystalline deposits on intraocular lenses. These deposits can be clinically significant.
Aged↗
Perforated bacterial corneal ulcer in a radial keratotomy incision secondary to minor trauma.
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Cornea↗
Primary adenoid cystic carcinoma of the lacrimal sac: report of a case.
A 41-year-old white woman presented with a 1-month history of epiphora and a painless medial canthal mass on the left that was unresponsive to antibiotic treatment. Computerized tomography (CT) and magnetic resonance imaging (MRI) scans delineated a soft tissue mass with bony destruction originating in the area of the left lacrimal sac with extension into the maxillary and ethmoid sinuses and inferomedial orbit. Open biopsy of the mass revealed adenoid cystic carcinoma (ACC). On surgical exploration, the tumor was found to originate from the lacrimal sac wall. Radical surgery with wide excision of surrounding bone and periorbital tissue was performed in light of the histological diagnosis and tumor extension. Orbital exenteration was not performed in order to preserve the patient's left eye. A 6-week course of adjunctive radiotherapy was applied without complication. The patient was clinically and radiologically free of tumor at 1-year follow-up. This case represents only the third time that primary ACC arising from the lacrimal sac has been reported.
Adult↗
Embryonal rhabdomyosarcoma of the orbit in a 35-year-old man.
A 35-year-old man had rapidly progressive proptosis of the right eye with associated chemosis over a period of several weeks. Computed tomography demonstrated a solid extraconal mass in the inferior anterior right orbit. Pathologic examination revealed the lesion to be an embryonal rhabdomyosarcoma. Consistent with the diagnosis, immunohistochemical assays demonstrated positive staining with myoglobin, desmin, and muscle-specific actin. The lesion grew rapidly and was further surgically excised. Subsequently, treatment with radiation and chemotherapy was initiated. Primary embryonal rhabdomyosarcoma of the orbit is an extremely rare tumor in adults, and, to our knowledge, this patient represents the oldest individual reported to have developed such a tumor, as documented by immunohistochemical analysis.
Adult↗