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Biomedical subjects

R C Troutman

Publications and source records attributed to R C Troutman.

At least 19 recordsLinked to original sources
PubMed1993

Control of astigmatism aided by intraoperative keratometry.

An evaluation of the final "sutures out" postoperative astigmatism in two groups of keratoconus patients undergoing penetrating keratoplasty is presented. Group I consists of a retrospective evaluation of keratoconus patients who underwent penetrating keratoplasty without using the Troutman Keratometer prior to suturing the button into position. Group II patients had their donor button rotated in the recipient bed until approximate sphericity was indicated by a circular reflex from the Troutman Keratometer before suturing into position. The mean final astigmatism with all sutures removed from Group I was 4.64, SD 1.89, and for Group II 2.27, SD 1.27. Selective positioning of the donor button using the Troutman Keratometer leads to a significant reduction in the final sutures out astigmatism in patients undergoing penetrating keratoplasty for keratoconus.

Astigmatism↗
PubMed1989

The role of penetrating keratoplasty and epikeratoplasty in the surgical management of keratoconus.

A series of 86 penetrating keratoplasties for keratoconus was analysed. The surgery, using an 8.2 mm donor cornea into an 8.0 mm recipient opening, was performed between January 1983 and January 1986. The donor cornea was secured by two opposing continuous sutures, placed at full corneal thickness under surgical keratometry control. Both sutures were removed on average 30 weeks after surgery. The mean postoperative sutures out astigmatism was 5.4 dioptres (range 0 to 19.0), and following astigmatism surgery in 17 eyes, the mean astigmatism was 4.3 dioptres (range 0 to 10.5). Graft reaction occurred in 11.6% but was cleared medically in all cases and no corneas were lost. One month after suture removal, with spectacle correction, 45.5% of the primary group achieved vision of 6/6, 90.7% were 6/9 or better, and 97.7% were 6/12 or better. Comparing these results with recently published data on epikeratoplasty, for the treatment of keratoconus, it is evident that penetrating keratoplasty offers the best means whereby the eye can obtain its full visual potential.

Adolescent↗
PubMed1987

Keratophakia--postoperative astigmatism.

Forty-nine cases of primary keratophakia and 13 cases of secondary keratophakia were analyzed for postoperative astigmatism. For primary cases, the surgically induced astigmatism was 1.55 D, whereas for secondary cases it was 0.19 D (insignificant). There was a tendency for both procedures to induce against-the-rule astigmatism, and both procedures were found capable of producing irregular astigmatism.

Astigmatism↗
PubMed1987

Penetrating keratoplasty for keratoconus.

A series of 86 penetrating keratoplasties for keratoconus were analyzed. The surgery, using an 8.2 mm donor cornea into an 8.0 mm recipient opening, was performed over the period January 1983 to January 1986 by one surgeon. The donor cornea was secured by two opposing continuous sutures, placed at full corneal thickness under surgical keratometry control. Both sutures were removed at an average 30 weeks after surgery. The mean postoperative sutures-out astigmatism was 5.4 diopters (range 0-19.0 diopters) and following secondary astigmatism surgery in 17 eyes, the mean group astigmatism was 4.3 diopters (range 0-10.5 diopters). Although graft reaction occurred in 11.6% of cases it was cleared medically and did not affect final vision results. One month after suture removal, with spectacle correction, 45.5% of the primary group saw 20/20, 90.7% 20/30 or better, and 97.7% 20/40 or better. Comparing these results with recently published data on epikeratophakia for the treatment of keratoconus, it is evident that penetrating keratoplasty offers these usually young patients a better chance for recovery of useful industrial acuity.

Astigmatism↗
PubMed1986

A new laser for collagen wounding in corneal and strabismus surgery: a preliminary report.

It has been shown that using a small spot size 2 to 5 mu, a dye modified excimer laser emitting at 595 nm can produce laser ablation of tissue in corneal stroma without compromising anterior and posterior limiting membranes. The surface of extraocular muscle tendon sheath has been similarly laser modified. An instrument, under prototype construction, designed for clinical application of this laser energy is described as well as clinical implications of such surgical interventions in corneal and extraocular muscle surgery.

Collagen↗
PubMed1985

The diagnostic value of a ring infiltrate in acanthamoebic keratitis.

During the past ten years it has become increasingly apparent that acanthamoebae can directly infect the cornea, usually after trauma, associated with contaminated water or soft contact lens wear. Thirteen cases of acanthamoebic keratitis have been published. In only three of these cases was the diagnosis first made by microbiologic methods, while in the others it was made only after pathologic examination of resected corneal specimens or enucleated eyes. We report three additional cases, two of which were accurately diagnosed by corneal scrape-smears and cultures before penetrating keratoplasty was performed. The reason for the accurate laboratory diagnosis in these cases was the presence of a diagnostic paracentral annular corneal infiltrate or abscess, a feature identified in over two-thirds of the earlier cases but one which has not been adequately emphasized or pursued for its early diagnostic value. We review the other clinical and epidemiological features of this entity, microbiological diagnostic techniques, the pathologic aspects, the role of topically and systemically administered medicaments, and finally point out the almost unavoidable role of penetrating keratoplasty after the temporizing effects of medical treatments have been achieved.

Adult↗
PubMed1985

New compound curved needle TG6-C PLUS.

The benefits of a compound curve needle design will be seen readily when used as suggested. The surgeon will be able to position the needle repeatedly and accurately between the wound edges from needle entry through tissue, to exit to the opposite side of the wound. Continuous or interrupted corneal wound closure can be done consecutively without varying more than a few tenths of a millimeter in the positioning of the needle from bite to bite. During retrieval the compound curve needle has yet another advantage. The flat curve of the distal needle body minimizes the tissue distortion as the needle body is pulled through. The wound remains in close apposition. In wound closure, though an important and essential attribute of a surgical needle is its "sharpness", sharpness eventually reaches a maximum. The very sharp needles such as the new EthiconTM TG PLUS needles, have such little tactile feedback that shape and needle strength as exemplified by the compound curvature design become of primary importance. These combinations provide the consistent and accurate needle passage necessary for corneal wound apposition, with all of its optical as well as anatomic consequences, in the final outcome of contemporary keratoplasty and cataract procedures.

Cornea↗
PubMed1984

Selective positioning of the donor cornea in penetrating keratoplasty for keratoconus: postoperative astigmatism.

The final "sutures-out" astigmatism in patients who had undergone penetrating keratoplasty for keratoconus was evaluated for two groups of patients. Group 1 consisted of patients operated upon using the Troutman surgical keratometer but without giving attention to the orientation of the donor button in the recipient bed. Patients in Group 2 were also operated upon utilizing the surgical keratometer, but the donor button was rotated in the recipient bed until a position of apparent sphericity was indicated by the keratometer before suturing the graft. The mean final astigmatism was 4.42 +/- 1.85 D for Group 1 and 5.13 +/- 3.17 D for Group 2. The difference was not statistically significant. The results indicate that selective positioning of the donor button in an attempt to minimize astigmatism, as determined with a qualitative surgical keratometer, does not lead to a reduction in the final astigmatic error in patients undergoing penetrating keratoplasty for keratoconus.

Adult↗