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Biomedical subjects

P R O'Connor

Publications and source records attributed to P R O'Connor.

18 recordsLinked to original sources
PubMed1976

External buckling without drainage for selected detachments in aphakic eyes.

Of 325 patients with retinal detachments, 110 patients (34%) had aphakic eyes. These detachments were subdivided into three types based on their clinical appearance during indirect ophthalmoscopy and slit-lamp biomicroscopy. Fifty-two patients (47%) had aphakic detachments (Type 3), categorized by small tears due to traction along a prominent posterior or vitreous base and the absence of visible retinal degeneration. Fifty of the 52 patients in this group were operated on by using a modification of the nondrainage procedure developed by Custodis, and employing cryosurgical coagulation and an external encircling buckle using a 3-mm silicone sponge. The sponge was secured beneath the retinal tear, and its length was shortened to produce a moderately elevated buckle. Although 50% of retinal tears were open at the end of the operation, 60% of all eyes operated on without drainage reattached in 16 hours, 90% in one week, and the remainder in two weeks. Visual acuity of 70% of these patients was 6/15 (20/50) or better when tested six months after surgery. The operation did not wall away peripheral fluid, but closed retinal tears completely, reduced circumferential vitreous traction, and avoided drainage of subretinal fluid.

Aged↗
PubMed1976

External buckling without drainage.

Scleral buckling without drainage of subretinal fluid is a technique suitable to a broad range of detachment problems including aphakia, vitreous traction, multiple tears, high myopia, and large breaks, as well as old or extensive detachment. Retinal detachments operated on by modification to the Custodis procedure reattach in a spontaneous and predictable manner determined by the patient's age, the duration of the detachment, and its extent. Ninety percent of cases are completely reattached four days following surgery. Clues to successful surgery when subretinal fluid persists are retinal tear closure, documented daily fluid loss, macular reattachment, and dependent shifting of subretinal fluid. When uncertainty still exists, the final objective evaluation is the observation that fluid fails to accumulate beneath the retina when the patient is unpatched and mobilized. The operation is extraocular and avoids the problems of drainage-choroidal hemorrhage, retinal incarceration, vitreous loss, and restoration of hypotony. The technique offers the modern surgeon a simple, direct, and rational approach applicable to 75 percent of retinal detachments, and it also assures a smooth, uncomplicated recovery.

Drainage↗
PubMed1976

Intravitreous air injection and the Custodis procedure.

Occasional failure follows any form of retinal detachment surgery. Most of these persistent detachments are due to inadequate closure of a known retinal tear by scleral buckling. Avoidance of major reconstructive surgery may be accomplished by the judicious application of an intravitreous air injection under local anesthesia at bedside. Although technically precise, this singular maneuver was found safe and reliable. Its use is suggested as an alternative to classical reoperative procedures.

Air↗
PubMed1975

Prognostic criteria in macular histoplasmic choroiditis.

1. Fifty percent of 22 patients "desensitized" to histoplasmin developed subsequent activity, as compared to 44% of 23 patients without "desensitization." 2. Prednisone-induced remission of subclinical activity in patients monitoring their own central fields appears to be the most rewarding therapy for these desperate patients.

Argon↗
PubMed1975

Multifocal serous choroidopathy.

Six percent of young and middle-age adults with idiopathic central serous choroidopathy were found to have bilateral multifocal areas of pigment epithelial detachments and transmissional defects during fluorescein angiography. The usual features of this chronic and recurring disease warrant its classification as a specific syndrome. The maculopathy is generally unresponsive to steroid therapy and may require photocoagulation to effect a cure.

Adult↗