Search PubMed⌕ Search

Biomedical subjects

P R Simcock

Publications and source records attributed to P R Simcock.

At least 19 recordsLinked to original sources
PubMed2005

Visual outcomes following ICG assisted ILM peel for Macular Hole.

PURPOSE: To evaluate the anatomical and visual outcome of indocyanine green (ICG)-assisted internal limiting membrane (ILM) peeling for macular hole surgery. A literature search identified potential factors that may affect the functional success of the procedure. METHODS: Retrospective case note review of 14 consecutive patients undergoing phaco-vitrectomy, gas and ICG-assisted ILM peeling for macular hole from July 2001 to July 2002. A 0.5% ICG solution (osmolarity 270 mOsm) was left in contact with the retina for 1-3 min. The outcome measures were hole closure, change in visual acuity, and macular pigmentary changes. RESULTS: Anatomical hole closure was achieved in 13 of 14 eyes (92.8%). The mean logMAR Snellen acuities were 0.80 (range 0.60-1.30) preoperatively and 0.77 (0.48-1.30) postoperatively. Seven eyes (50%) developed retinal pigmentary changes in the macular area. CONCLUSIONS: ICG-assisted ILM peeling for macular hole surgery achieves high rates of anatomical hole closure, but functional results are less encouraging. Previous studies suggest toxicity of the ICG to the retina, at the level of the RPE or inner retina. The results may be optimized by using a lower concentration, iso-osmolar, viscous solution, and by minimizing contact time of the solution and intensity, and duration of illumination.

Aged↗
PubMed2001

Phacovitrectomy without prone posture for full thickness macular holes.

AIMS: To investigate the role of phacovitrectomy surgery without prone posture for stage 2 and 3 macular holes. METHODS: A pilot study was performed on 20 patients (20 eyes) having phacoemulsification lens removal and vitrectomy surgery with 20% C(2)F(6) tamponade. Patients were advised to avoid lying on their backs for 10 days following surgery but no other posturing instructions were given. Closure rates and improvement in visual acuity were compared with a group of historical controls in whom phacovitrectomy with gas tamponade and face down posturing was performed. RESULTS: Anatomical hole closure was noted in 18 of the 20 eyes (90%). 19 eyes (95%) showed an improvement of at least 0.3 logMAR units. This compares favourably with the postured group in which anatomical hole closure was noted in 11 of 13 eyes (85%) and nine of 13 eyes (69%) showed an improvement of at least 0.3 logMAR units. CONCLUSION: Combined surgery facilitates the use of a large gas bubble. Sufficient tamponade of the hole occurs for closure without prone posturing. Combined surgery prevents patients posturing and returning for cataract surgery.

Aged↗
PubMed2000

Phaco-vitrectomy for full-thickness macular holes.

PURPOSE: To investigate the role of combined phaco-vitrectomy surgery in the management of full-thickness macular holes. METHODS: Thirteen eyes with full-thickness macular holes had combined phacoemulsification cataract removal and vitrectomy surgery with instillation of 20% C2F6 gas. RESULTS: The mean duration of macular holes prior to surgery was 6.5 months. Eleven holes closed, 2 remained opened. All patients except one had an improvement in visual acuity. Laser treatment was performed to treat retinal breaks noted intraoperatively in 4 patients. CONCLUSION: Combined cataract and vitrectomy surgery for full-thickness macular holes enables good visibility during surgery. A large gas bubble can be obtained with excellent tamponade of the hole. Combined surgery prevents the patients having to return for cataract surgery.

Aged↗
PubMed1997

Capsulorhexis phymosis following uncomplicated phacoemulsification surgery.

PURPOSE: The aim of the study was to assess and compare the degree of capsulorhexis phymosis following uncomplicated phacoemulsification cataract surgery in polymethylmethacrylate (PMMA) and silicone lens implants. METHOD: Sixty-four patients were evaluated 1 day, 6 weeks and 6 months following phacoemulsification cataract extraction. The anterior capsular diameters were measured with the illuminated beam of the slit lamp at 45 degrees and 135 degrees and the surface area of the opening calculated. We have measured and compared the change in the capsulorhexis size for both lens types and assessed its statistical significance with a paired Student's t-test. RESULTS: A statistically significant contraction of the capsulorhexis was noted in all patients within the first 6 weeks (p < 0.001). Capsular contraction continued between 6 weeks and 6 months post-operatively but to a lesser extent (p < 0.05). The difference in the degree of phymosis between the first period (1 day to 6 weeks) and the second (6 weeks to 6 months) was statistically highly significant for all patients (p < 0.001). The capsular areas for the silicone lens implants were significantly smaller than for the PMMA implants at 6 weeks and 6 months. None of our patients had a clinically significant capsular contracture requiring Nd:YAG laser capsulotomy. CONCLUSION: Anterior capsular contraction is commonly observed following capsulorhexis in phacoemulsification surgery. This study demonstrates that the maximum rate of contraction occurs in the first 6 weeks following surgery and is more pronounced with silicone lens implants.

Aged↗
PubMed1996

Cataract formation in the Cronkhite-Canada syndrome.

A 69-year-old man with Cronkhite-Canada syndrome presented with a 6 month history of gradually blurring vision resulting from early lens opacities that 1 month later had reduced visual acuity to hand movement in both eyes. Extracapsular cataract extraction with intraocular lens implantation resulted in good visual rehabilitation.

Aged↗
PubMed1996

Investigation of microbial keratitis: an audit from 1988-1992.

An audit was performed of the investigation of 263 cases of microbial keratitis severe enough to be admitted to the Manchester Royal Eye Hospital over the 5-year period, 1988-1992. A pathogen isolation rate of 37% was noted during the first year which increased to 79% (p < 0.05) by the final year of audit. In late 1991 a new method of inoculating enrichment broths was introduced, which also contributed by increasing the yield from corneal scrapes. The audit process resulted in the development of and adherence to our investigation protocol, improved communication between Manchester Royal Eye Hospital and the microbiology laboratory, the implementation of a new investigatory method, and a significantly improved microbial isolation rate.

Adolescent↗
PubMed1994

Is surgery for proliferative vitreoretinopathy justifiable?

Surgery for proliferative vitreoretinopathy (PVR) may require prolonged procedures often with limited improvement in visual function. Forty-seven consecutive patients who had PVR surgery in one eye had a case note review to assess anatomical re-attachment rate and improvement in visual acuity. All patients had at least 3 clock-hours of grade C PVR membrane. Surgery comprised vitrectomy and membrane peel in all cases. There was a mean follow-up period of 9 months (range 3-23 months). Thirty-two eyes (68%) had an attached retina with the mean visual acuity being 0.089 (where 6/60 = 0.10). A mean of 2.15 PVR operations were performed per eye. Seventeen patients chosen at random were contacted by telephone and standardised questions were asked regarding their surgery. Eleven (65%) patients stated that, with the benefit of hindsight, they would still have had surgery and 8 (47%) patients stated that the peripheral vision gained was of benefit.

Eye Diseases↗
PubMed1994

Neuro-ophthalmic findings in botulism type B.

In June 1989, the largest recorded outbreak of food-borne botulism occurred in the United Kingdom. Twenty-seven patients were affected during the outbreak with type B botulism. A case note review of 14 patients admitted with this condition was performed and the neuro-ophthalmic findings are presented. Patients with severe disease presented with a combination of ocular and bulbar symptoms; in mild cases dysphagia was noted first and visual disturbance followed within 24 hours. Clustering of cases and bilaterality of cranial nerve signs aided in the diagnosis. Accommodative paresis and sixth cranial nerve palsy were frequent early signs. When there was respiratory paralysis and ventilatory failure, it occurred within 12 hours of the onset of a third cranial nerve palsy.

Abducens Nerve↗
PubMed1994

Combined peribulbar injection and blunt cannula infiltration for vitreoretinal surgery.

Seventy-six patients undergoing combined peribulbar and direct intraconal infiltration local anesthesia for vitreoretinal surgery were prospectively evaluated. Forty-six patients had local anesthesia with a combination of lidocaine 2% and bupivacaine 0.5%; in 30 patients, a combination of lidocaine 2% and prilocaine 1% was used. Patient evaluation of discomfort during the administration of the anesthetic and during the operation was assessed on a visual analog scale of 0 to 10. The mean pain score recorded was 2.73. There was no statistically significant difference between the mean pain scores of the two local anesthetic groups (P = .465).

Adult↗
PubMed1993

Management of the anticoagulated patient for ophthalmic surgery.

The outcome of 50 surgical procedures in 41 patients who were anticoagulated at the time of surgery were reviewed to determine whether anticoagulation was associated with an increase in ophthalmic morbidity. Twenty-seven patients were receiving warfarin and 14 patients nicoumalone. The International Normalised Ratio (INR) was determined immediately prior to surgery and ranged from 1.1 to 4.9. Thirty-nine operations were performed under local anaesthetic and 11 under general anaesthetic. Thirty-three patients had extracapsular cataract extractions with posterior chamber lens implantation. No major haemorrhagic complications were associated with the local anaesthetic or the surgical procedure. Patients on anticoagulation therapy are at risk of life-threatening complications if their anticoagulation is stopped or reduced. This study demonstrates that most ophthalmic surgical procedures can be safely performed whilst the patient is therapeutically anticoagulated.

Acenocoumarol↗