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Biomedical subjects

R Bowell

Publications and source records attributed to R Bowell.

At least 19 recordsLinked to original sources
PubMed1999

Intraocular lenses in children: changes in axial length, corneal curvature, and refraction.

AIM: To assess changes in axial length, corneal curvature, and refraction in paediatric pseudophakia. METHODS: 35 eyes of 24 patients with congenital or developmental lens opacities underwent extracapsular cataract extraction and posterior chamber intraocular lens implantation. Serial measurements were made of axial length, corneal curvature, objective refraction, and visual acuity. RESULTS: For patients with congenital cataracts (onset < 1 year age) the mean age at surgery was 24 weeks. Over the mean follow up period of 2.7 years, the mean increase in axial length of 3.41 mm was not significantly different from the value of an expected mean growth of 3.44 mm (paired t test, p = 0.97) after correction for gestational age. In the developmental cataract group (onset > 1 year of age) the mean age at surgery was 6.4 years with a mean follow up of 2.86 years. This group showed a mean growth in axial length of 0.36 mm that was not significantly different from an expected value of 0.47 mm (paired t test, p = 0.63). The mean preoperative keratometry was 47.78 D in the congenital group and 44.35 D in the developmental group. At final follow up the mean keratometry in the congenital group was 46.15 D and in the developmental group it was 43.63 D. In eyes followed for at least 2 years, there was an observed myopic shift by 24 months postoperatively of 3.26 D in the congenital cases (n = 10) and 0.96 D in the developmental cases (n = 18). CONCLUSION: The pattern of axial elongation and corneal flattening was similar in the congenital and developmental groups to that observed in normal eyes. No significant retardation or acceleration of axial growth was found in the eyes implanted with IOLs compared with normal eyes. A myopic shift was seen particularly in eyes operated on at 4-8 weeks of age and it is recommended that these eyes are made 6 D hypermetropic initially with the residual refractive error being corrected with spectacles.

Cataract↗
PubMed1998

Congenital ptosis: longterm results using stored fascia lata.

PURPOSE: Frontalis brow suspension, using stored donor fascia lata, allows early correction of severe congenital ptosis. We report longterm results of 18 patients, (29 ptotic eyelids). METHODS: Patient records were retrospectively reviewed. Lid position at the first and subsequent post-operative visits was recorded, as was the time when ptosis recurred. RESULTS: The mean follow-up period was 42.9 months (range 7 to 84 months). All patients achieved a Good initial result. Partial ptosis recurrence was noted in 7 patients (10 eyelids), within 18 months of surgery. One of these patients required reoperation. Lid position did not change after the first 18 months. No late failures were encountered. CONCLUSION: Longterm lid position is remarkably stable after early surgical correction of severe congenital ptosis using stored fascia lata.

Blepharoptosis↗
PubMed1996

Advanced cicatricial retinopathy of prematurity--outcome and complications.

AIMS: To assess the outcome and complications of patients with advanced retinopathy of prematurity (ROP). METHODS: All patients with eyes achieving stage 4 or 5 retinopathy of prematurity were reviewed. Twenty one eyes were diagnosed during ROP screening in maternity hospitals and 10 eyes were of infants transferred for treatment. RESULTS: Thirty one eyes of 17 patients were included. Thirteen eyes were treated for acute disease but progressed to stage 4 or 5; seven had cryotherapy and six diode laser photocoagulation. Cataract was found in 17 eyes (54.8%), glaucoma in seven eyes (22.6%), microphthalmos in 15 (48.4%), and corneal opacification in four eyes (12.9%). Fifteen eyes had surgical procedures; two (6.5%) had trabeculectomy, four (12.9%) had lensectomy, and nine (29%) retinal detachment repair. Transferred infants had their initial eye examination later than infants in hospitals screened by the authors and 80% of them had progressed beyond threshold ROP by the time they were transferred for treatment. Twenty nine eyes (93.6%) had visual acuities of 3/60 or less and only two eyes (6.5%) achieved 6/18 or less. CONCLUSION: The visual outcome of the eyes undergoing retinal re-attachment surgery was disappointing. Cataract, microphthalmos, and glaucoma were the most frequent complications, and surgical intervention was often required. The need for children who are blind as a result of ROP to have long term follow up is shown.

Cataract↗
PubMed1996

Long-term follow up of primary trabeculectomy for infantile glaucoma.

BACKGROUND: The treatment for infantile glaucoma is surgical. Treatment options include goniotomy, trabeculotomy, combined trabeculotomy-trabeculectomy, and trabeculectomy. METHODS: Patients who had a follow up of 5 years or longer after primary trabeculectomy were examined to determine the long term stability in infantile glaucoma. RESULTS: In eyes with primary infantile glaucoma 92.3% achieved control of their glaucoma with a single trabeculectomy; 100% achieved control with two trabeculectomies; 85.7% of eyes with secondary infantile glaucoma achieved control with a single trabeculectomy. There were no serious complications experienced in either group. CONCLUSION: Primary trabeculectomy is a safe and successful operation for infantile glaucoma.

Case-Control Studies↗
PubMed1994

Management of congenital dacryocele.

Congenital dacryocele is a distension of the naso-lacrimal sac usually present at birth or in the first three months of life. It occurs commonly in females and may present with dacryocystitis. Treatment includes probing and antibiotics if infection is present.

Female↗
PubMed1993

Ophthalmic findings in classical galactosaemia--prospective study.

Thirty three children with classical galactosaemia diagnosed through newborn screening are considered. It is concluded that cataract formation has a direct relationship with poor dietary control. Erythrocyte galactose-1-phosphate (Gal-1-P) levels do not correspond to cataract formation unless many times higher than normal. The value of crystalline lens biomicroscopy is confirmed as a useful method for monitoring the dietary and biochemical control in classical galactosaemia.

Cataract↗
PubMed1991

Optic nerve hypoplasia, encephalopathy, and neurodevelopmental handicap.

Abnormalities of the central nervous system are frequently described in optic nerve hypoplasia. In a longitudinal study of 46 consecutive children (32 term, 14 preterm) with bilateral optic nerve hypoplasia 32 (69.5%) had associated neurodevelopmental handicap. Of these, 90% had structural central nervous system abnormalities on computed tomographic brain scans. Neurodevelopmental handicap occurred in 62.5% of the term and 86% of the preterm infants respectively. Term infants had a greater incidence of ventral developmental midline defects and proportionately fewer maternal and/or neonatal complications throughout pregnancy, while encephaloclastic lesions were commoner among the premature infants. An association of optic nerve hypoplasia with the twin transfusion syndrome and prenatal vascular encephalopathies is described.

Abnormalities, Multiple↗
PubMed1991

Ocular manifestations in fetal alcohol syndrome.

Eight children with the fetal alcohol syndrome are described with ocular anomalies. They all had a strong history of maternal alcohol abuse throughout pregnancy, especially in the first trimester. All the children had eye abnormalities. These included external eye lesions, Peters' anomaly, lens opacification, ocular motility disorders, and optic nerve hypoplasia.

Child↗
PubMed1991

Ophthalmic findings in maple syrup urine disease.

Maple Syrup Urine Disease is an autosomal recessive disorder of branched chain amino acid metabolism with an incidence in Ireland of one in 140,154 births. Ocular complications in untreated or late diagnosed patients includes optic atrophy, grey optic papilla, nystagmus, ophthalmoplegia, strabismus and cortical blindness. Seven patients with maple syrup urine disease were studied. All were diagnosed with the aid of newborn screening and commenced on early dietary treatment (mean age at diet introduction = 5 days). All remain physically well, with average intellectual performance, three having minor neurological defects and one strabismus. Early diagnosis, proper therapy and subsequent vigilant management may reduce substantially the risks of ophthalmic complications in this rare disease.

Child↗
PubMed1990

Childhood blindness.

Eighty five visually handicapped children who attended the eye department were assessed. The children had a mean age of 3.6 years--range 0.3-14.7 years. The aetiological factors for severe visual handicap (visual acuity less than 3/60) were evaluated into prenatal factors; factors operating at birth and the immediate perinatal period; or factors operating in childhood. Genetic counselling and improvements in the management of pre-term infants is recommended in the reduction of childhood blindness. A national computerised childhood blind register should be established.

Adolescent↗
PubMed1989

Primary trabeculectomy in congenital glaucoma.

The reported success rates in the treatment of congenital glaucoma with goniotomy, trabeculotomy, and trabeculectomy suggest that trabeculectomy should be performed if the other procedures fail. We propose that the decision to perform primary trabeculectomy in primary and secondary congenital glaucoma reduces the effect which the many variable findings in surgical anatomy may have on the outcome of other procedures. This is a retrospective study of the results of primary trabeculectomy in 21 consecutive eyes of 15 patients with congenital glaucoma. Eighteen of 13 patients' eyes were controlled after a single trabeculectomy and remained controlled after a mean follow-up of 3.9 years (range 1.5 to 6.7 years). The role of primary trabeculectomy in congenital glaucoma merits further consideration.

Child↗
PubMed1989

Ocular complications in homocystinuria--early and late treated.

Homocystinuria due to cystathionine-beta-synthetase deficiency is an autosomal recessive disorder of methionine metabolism with an incidence in Ireland of 1 in 52,544 births. Ocular complications in untreated patients include ectopia lentis, secondary glaucoma, optic atrophy, and retinal detachment. There are no characteristic signs or symptoms in infancy, and early detection relies on screening of newborn babies. Nineteen patients with homocystinuria were studied; 14 received dietary treatment and vitamin supplementation starting in the newborn period. Of these, none developed ectopia lentis after a mean follow-up of 8.2 years, compared with a 70% dislocation rate in untreated patients with a similar follow-up period. Ectopia lentis developed and progressed in five patients diagnosed later in life, despite tight biochemical control. The risk of ocular complications in homocystinuria can be substantially reduced in patients started on treatment within six weeks of birth.

Adolescent↗
PubMed1984

Cataract surgery.

Explore the source record for details and available documents.

Cataract Extraction↗
PubMed1981

Current concepts of Behçet's disease.

Seven patients, who satisfied the criteria laid down by Mason and Barnes (1969) for inclusion under the heading Behçet's disease, were assessed clinically and investigated with particular reference to immune status and blood fibrinolytic activity. In one patient in whom it was possible to obtain an eye for examination, there was evidence, on microscopic examination, of an immune vasculitis as well as clot formation, particularly in the veins. All the patients were treated with fibrinolytic agents and the favourable results obtained with this treatment suggest that it should be considered as the first line of therapy in what is otherwise a very difficult condition to manage.

Adult↗