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Biomedical subjects

R J Olson

Publications and source records attributed to R J Olson.

At least 19 recordsLinked to original sources

Changing trends in the indications for penetrating keratoplasty.

The indications for penetrating keratoplasty have changed over the past several years. Nine hundred ninety-nine penetrating keratoplasty specimens from 1981 through 1990 were analyzed. Overall, keratoconus was the most common indication for penetrating keratoplasty (24.2%). This was followed by pseudophakic bullous keratopathy (23.0%), regraft (13.1%), scarring (8.2%), and Fuchs' endothelial dystrophy (5.8%). Pseudophakic bullous keratopathy was the most common indication for penetrating keratoplasty in each year from 1984 through 1989 with a peak in 1987 (33%). Since 1987, the number of pseudophakic bullous keratopathy cases has decreased; and in 1990, keratoconus (33.1%) surpassed pseudophakic bullous keratopathy (24.1%) as the most common indication for penetrating keratoplasty. This decreasing incidence of pseudophakic bullous keratopathy may reflect the discontinued use of closed-looped anterior chamber and iris-plane intraocular lenses most commonly associated with this complication.

Cataract Extraction

Quantitative microdialysis of dopamine in the striatum: effect of circadian variation.

Two quantitative microdialysis methods were used to determine the concentration of extracellular dopamine in the anterior striatum of the rat. In the first method, the slow perfusion flow rate method, perfusion was at 57 nl/min and dialysate samples were collected every 90 min for 18 h and assayed for dopamine (DA), DOPAC (3,4-dihydroxy-phenylacetic acid), homovanillic acid (HVA) and 5-hydroxy-indoleacetic acid (5-HIAA). There was a significant increase in the concentration of dopamine during the dark cycle compared with the light cycle (14.7 +/- 1 nM vs. 9.3 +/- 0.7 nM; mean +/- SEM; P less than 0.0001), indicating possible circadian variations in the extracellular concentration of DA. There was a steady decrease in the level of DOPAC and HVA, and no change in the level of 5-HIAA. For the point of no-net-flux method, animals were perfused with 4 concentrations of DA or DOPAC, bracketing the extracellular concentrations. The extracellular concentrations of DA and DOPAC using this method were 10.2 +/- 1.7 nM and 17.4 +/- 2.6 microM, respectively. The in vivo recoveries for DA and DOPAC as derived from the slope of the linear regression curves were 72 +/- 3% and 43 +/- 5%. These values were shown to be significantly different (P less than 0.001). Both methods gave similar results for the level of DA in the striatum.

3,4-Dihydroxyphenylacetic Acid

Toxic anterior segment inflammation following cataract surgery.

Cataract extraction with posterior chamber intraocular lens implantation is rarely complicated by an acute, sterile, anterior segment inflammation. We report three unrelated cases of acute intraocular inflammation following uncomplicated cataract extraction and posterior chamber intraocular lens placement. A constellation of clinical features were found in these cases. The hallmark of this entity was an acute toxic inflammatory reaction occurring in the anterior segment on the first postoperative day. Typically, widespread corneal edema with diffuse corneal endothelial damage occurred, accompanied by a fixed, dilated pupil with significant iris atrophy and sometimes a severe secondary glaucoma. Since all cultures were negative, the resulting inflammatory processes were not a result of endophthalmitis. We believe that a toxic insult introduced into the anterior chamber at the time of surgery precipitated the acute inflammatory processes seen in these cases.

Aged

Hyperopia, anisometropia, and irregular astigmatism in a patient following revisional radial keratotomy.

We present a patient who underwent bilateral radial keratotomy (RK) followed by a bilateral revisional RK for undercorrection. After the second procedure, the patient had a severely flattened left cornea, with marked hyperopia and irregular astigmatism. The right eye, however, remained myopic, causing extreme anisometropia. We hypothesize that the different results in these two eyes may have been due to a critical number of damaged left corneal stromal fibers. Patients undergoing revisional RK or requiring additional incisions may be at increased risk for such a complication.

Anisometropia

Penetrating keratoplasty 1981-1988: clinical indications and pathologic findings.

We analyzed 740 penetrating keratoplasty specimens received at the Intermountain Ocular Research Center from 1981 through 1988. These corneal specimens were categorized by clinical indications for removal and pathologic confirmation of the clinical findings. Keratoconus was the most common indication for a penetrating keratoplasty (22.8%). This was closely followed by pseudophakie bullous keratopathy (21.8%), regraft (13.2%), scarring (8.9%), aphakic bullous keratopathy (6.4%), and Fuchs' endothelial dystrophy (5.8%). Since 1984, pseudophakic bullous keratopathy has surpassed keratoconus as the most common indication for penetrating keratoplasty (27.3% vs. 20.2%). Pseudophakic bullous keratopathy was found more commonly than keratoconus in each of the last four years of this study. The most common type of intraocular lens associated with pseudophakic bullous keratopathy was an anterior chamber lens (52.8%), with iris-fixated (26.7%) and posterior chamber (17.4%) lenses seen less frequently.

Adolescent

Noninvasive repositioning of a posterior chamber intraocular lens following pupillary capture.

A case of pupillary capture of a posterior chamber intraocular lens (IOL) is presented. A nonsurgical approach that may help reposition an IOL optic entrapped in a pupillary capture when chemical mydriasis fails is described. Suggestions for a logical progression of nonsurgical procedures to help release optic capture are presented. Possible causes and preventative measures to decrease the incidence of pupillary capture of a posterior chamber IOL are discussed.

Adult

Protective effects of Healon and Occucoat against air bubble endothelial damage during ultrasonic agitation of the anterior chamber.

An important aspect of any new viscoelastic substance is the corneal endothelial protection. We compared the protective effects of sodium hyaluronate (Healon) and hydroxypropylmethylcellulose (Occucoat) by introducing a controlled volume of air bubbles into the anterior chamber of human eye bank eyes during ultrasonic agitation of the anterior chamber. Eight eyes received Healon and 11 eyes received Occucoat. Damage to endothelial cells in the central cornea was quantified by vital staining. Endothelial damage averaged 4.5% in eyes in which no viscoelastic was used (positive control); damage was 0.4% in eyes in which a viscoelastic was injected but no air bubbles were introduced (negative control). We found that endothelial damage averaged 4.25% in specimens that received air plus Healon and 1.4% in specimens that received air plus Occucoat. Occucoat appeared to have somewhat better protective effects than Healon against air bubble damage to the corneal endothelium during ultrasonic agitation of the anterior chamber.

Air

A comparison of rust-ring removal methods in a rabbit model: small-gauge hypodermic needle versus electric drill.

Corneal rust rings are common findings after removal of a metallic foreign body. These rings should be removed to prevent inflammation and scarring. We compared the corneal damage in rabbit eyes caused by rust-ring removal using two different methods: a small-gauge hypodermic needle and a hand-held electric ophthalmic drill. No significant difference was found in the amount of corneal scarring as graded by a masked observer. However, there was a trend toward deeper stromal damage in the drill-treated subjects (207 +/- 73 microns) than in the needle-treated subjects (172 +/- 61 microns). In light of this finding, we suggest caution in removing central rust rings with an electric drill since an avoidable, permanent scar may result.

Animals

A new look at postoperative instructions following cataract extraction.

We sought to determine whether, given the decreasing rate of complications associated with cataract surgery and IOL implantation, postoperative restrictions placed on patients undergoing these procedures could be significantly and safely relaxed. We reviewed the charts of 216 patients who had undergone capsulorhexis or "can-opener" capsulotomy, phacoemulsification, and insertion of an oval IOL over a 3-year period, noting any operative or postoperative complications. All of these patients had been examined the day after surgery and, if no complications were noted, had been instructed only to refrain from activities that produced pain. No shield was required, and no instructions were given to restrict showering, hair washing, or any other normal physical activity. We found no complications related to any postoperative activity. These results suggest that current postoperative instructions typically restricting such patients' activities should be reevaluated.

Aged

Phacoemulsification combined with pars plana vitrectomy.

Phacoemulsification combined with pars plana vitrectomy was performed on seven patients with both cataracts and vitreoretinal disease. Six of the seven had a posterior chamber intraocular lens (PC-IOL) placed in the capsular bag following cataract extraction. Visual acuities ranging from light perception to hand movement preoperatively, postoperatively ranged from hand movement to 20/25. There were no perioperative complications. During an average follow-up of more than 6 months, neovascular glaucoma developed in one patient, and a conjunctival cyst in another. The PC-IOLs were well tolerated. The small limbal incision used in phacoemulsification allows better control during the vitrectomy procedure and ensures a water-tight wound. In addition, with the limbal approach, the posterior lens capsule is maintained, with all the attendant advantages.

Adult

Air bubble endothelial damage during phacoemulsification in human eye bank eyes: the protective effects of Healon and Viscoat.

Following insertion of either Healon (sodium hyaluronate) or Viscoat (sodium chondroitin sulfate-sodium hyaluronate) into the anterior chamber of human eye bank eyes, a controlled amount of small air bubbles was introduced into the anterior chamber during phacoemulsification. After vital staining, damage to endothelial cells in the central cornea was quantified. Endothelial damage averaged 4.5% in eyes in which no viscoelastic was used (positive control), whereas damage was only 0.4% (P less than .001) in eyes in which a viscoelastic was inserted but no air bubbles were introduced (negative control). Endothelial damage in test specimens using air plus Healon averaged 4.9%. Damage in test specimens using air plus Viscoat averaged 0.3% (P less than .02). As demonstrated by scanning electron microscopy, many areas in the positive controls and in the Healon test specimens were damaged too extensively to quantitate accurately by the method we used. Thus, Viscoat may prevent or lessen damage to the corneal endothelium by small air bubbles during phacoemulsification.

Air

Corneal-scleral melt in association with cataract surgery and intraocular lenses: a report of four cases.

Four patients with rheumatoid arthritis had cataract extraction with implantation of an intraocular lens (IOL). Postoperatively three patients developed progressive scleromalacia perforans. All three cases required patch grafting of the sclera and two of them developed progressive melting of the sclera and graft. The fourth case involved progressive corneal melting with extrusion of the IOL despite treatment with penetrating keratoplasties. All four cases developed retinal detachments with loss of vision and three of the eyes were subsequently enucleated. We describe each case and discuss the clinicopathologic correlations of this condition. The need for careful evaluation of rheumatoid arthritis patients with cataract surgery and IOL implantation is emphasized.

Aged

Combination of 16S rRNA-targeted oligonucleotide probes with flow cytometry for analyzing mixed microbial populations.

Fluorescent oligonucleotide hybridization probes were used to label bacterial cells for analysis by flow cytometry. The probes, complementary to short sequence elements within the 16S rRNA common to phylogenetically coherent assemblages of microorganisms, were labeled with tetramethylrhodamine and hybridized to suspensions of fixed cells. Flow cytometry was used to resolve individual target and nontarget bacteria (1 to 5 microns) via probe-conferred fluorescence. Target cells were quantified in an excess of nontarget cells. The intensity of fluorescence was increased additively by the combined use of two or three fluorescent probes complementary to different regions of the same 16S rRNA.

Base Sequence