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Biomedical subjects

R K Forster

Publications and source records attributed to R K Forster.

At least 55 records · Page 3Linked to original sources
PubMed1986

Snailtracks of the corneal endothelium.

An unusual pattern of corneal endothelial cell alterations has been observed at the slitlamp in eyes following intraocular surgery. Because of their appearance, we have called these changes "snailtracks". We have commonly seen these snailtracks following extracapsular cataract extraction. Similar changes have been noted in cadaver corneas stored in McCarey-Kaufman (M-K) medium. This study presents information which suggests that these changes represent corneal endothelial cell damage.

Cataract Extraction↗
PubMed1985

Intraocular lens calculation in combined penetrating keratoplasty, cataract extraction and intraocular lens implantation.

We retrospectively studied 53 consecutive triple procedures (combined penetrating keratoplasty, cataract extraction and intraocular lens implantation) performed at the Bascom Palmer Eye Institute from January 1980 through August 1983. Most patients had at rest six months of follow-up. The final postoperative refractive error was compared to the predicted refractive error using the preoperative axial length and the estimated keratometry readings. The deviation from the predicted refractive error was correlated with the source of preoperative keratometry readings, the degree of donor oversize, and the donor age. We found that using keratometry readings from the operated eye resulted in more accurate intraocular lens calculations than using estimated keratometry readings not obtained from either eye (P less than .05).

Adolescent↗
PubMed1985

Late onset endophthalmitis associated with filtering blebs.

Thirty-six cases of late onset endophthalmitis in patients with filtering blebs are presented. Onset of endophthalmitis ranged from 4 months to 60 years after bleb formation. Possible contributing factors could be identified only in a minority of patients. Aqueous, vitreous or both were cultured in all cases. Eighty-three percent of eyes were culture positive. Streptococci were the most frequent causative organisms, isolated from 57% of culture positive eyes. Twenty-three percent of eyes grew Hemophilus influenzae. Only two cases were caused by staphylococci. In general, the visual outcome was poor, probably primarily due to the virulence of the infecting organisms. Endophthalmitis remains a risk even many years after creation of a filtering bleb. The microbiologic spectrum in this clinical setting is considerably different from that of recent postoperative endophthalmitis. Based on the bacteriology and clinical course of the patients presented, recommendations for management are discussed.

Adolescent↗
PubMed1985

A retrospective review of endophthalmitis due to coagulase-negative staphylococci.

We retrospectively reviewed 28 cases of postoperative endophthalmitis due to coagulase-negative staphylococci. There was an average delay between surgery and the acute presentation of 7 X 2 days (SD 3 X 3). All patients were treated with intraocular antibiotics (IOAB) or therapeutic vitrectomy with IOAB. In six of the 28 cases the organisms were resistant to gentamicin as measured by the Kirby-Bauer technique; none was resistant to cephalosporins. Isolates that had been stored by lyophilisation were reconstituted and tested by serial dilution; none was resistant to gentamicin, though two were borderline. The final visual acuity was 6/18 or better in 72% of the eyes.

Anti-Bacterial Agents↗
PubMed1985

Lasiodiplodia theobromae panophthalmitis.

Lasiodiplodia theobromae is a rare ocular pathogen. We report a case of panophthalmitis caused by this fungus. The patient was a healthy 62-year-old janitor with no history of ocular trauma in whom keratitis developed. Cultures of corneal scrapings identified the fungus. Despite treatment with appropriate antimycotics the keratitis progressed to infectious scleritis and then spontaneous perforation of the globe, which necessitated enucleation. The ultrasonographic, microbiologic and histologic findings are discussed and the results of in-vitro sensitivity testing presented.

Bacteriological Techniques↗
PubMed1983

Neisseria gonorrhoeae conjunctivitis. An outbreak during an epidemic of acute hemorrhagic conjunctivitis.

Ten patients with gonococcal conjunctivitis were examined during an epidemic of acute hemorrhagic conjunctivitis (AHC). Eye cultures in all cases demonstrated Neisseria gonorrhoeae, and seven also had isolates of N gonorrhoeae in genital specimens. All patients responded well to antimicrobial therapy. The patients had used a folk remedy in which they had applied urine to their eyes to treat the symptoms of AHC.

Acute Disease↗
PubMed1983

Acute hemorrhagic conjunctivitis Investigation of a large-scale community outbreak in Dade County, Florida.

An outbreak of acute hemorrhagic conjunctivitis (AHC) due to enterovirus type 70 occurred in Dade County, Florida, from September to December 1981. Younger age groups, members of larger households, and the poor were at significantly greater risk of acquiring AHC than others in the community. Schoolchildren were most likely to introduce AHC into the household. After exclusion of all affected children from school, there was a dramatic reduction in reported cases, with attack ratesups, members of larger households, and the poor were at significantly greater risk of acquiring AHC than others in the community. Schoolchildren were most likely to introduce AHC into the household. After exclusion of all affected children from school, there was a dramatic reduction in reported cases, with attack ratesups, members of larger households, and the poor were at significantly greater risk of acquiring AHC than others in the community. Schoolchildren were most likely to introduce AHC into the household. After exclusion of all affected children from school, there was a dramatic reduction in reported cases, with attack rates declining more rapidly for school-aged children than for other age groups. Although AHC spread readily among family members, a retrospective study of 124 affected households showed an association between lower attack rates and simple hygienic measures. Should outbreaks of AHC recur, measures to reduce transmission should include exclusion of affected schoolchildren and educating the public about hygienic precautions.

Acute Disease↗
PubMed1983

Chronic conjunctivitis associated with 'floppy eyelids'.

The floppy eyelid syndrome represents a chronic conjunctivitis characterized by a triad of (1) a loose upper lid that readily everts on elevating the lid, (2) a soft rubbery tarsus that can be folded on itself, and (3) a diffuse papillary conjunctivitis. Seven cases of this condition are reported, all involving men, and four involving obese patients.

Adult↗
PubMed1983

Clinical findings and results of treatment in an outbreak of acute hemorrhagic conjunctivitis in southern Florida.

An epidemic of acute hemorrhagic conjunctivitis in Miami, Florida, involved approximately 800 documented cases and more than 2,500 suspected cases. This epidemic was caused by an enterovirus 70 infection affecting primarily young black people residing within a high-risk area. Acute hemorrhagic conjunctivitis is characterized by the rapid onset of swollen eyelids, foreign-body sensation, burning, watery discharge, and, usually, bilateral ocular involvement. Signs include distinctive bulbar conjunctival hemorrhages and a follicular conjunctival reaction with only mild and infrequent corneal involvement. This infection is short in duration, self-limited, and free of significant ocular sequelae. Symptomatic treatment appears to be as effective as various topical medical regimens for relief of symptoms. Secondary bacterial infections (occurring in individuals who used urine as an eyewash) and one case of a transient acute Bell's palsy were the only complications associated with this acute hemorrhagic conjunctivitis epidemic.

Acute Disease↗
PubMed1983

Results in the treatment of postoperative endophthalmitis.

A retrospective study of 40 cases of postoperative endophthalmitis was conducted between July 1979 and May 1981. Treatment consisted of topical, periocular, and systemic antibiotics, as well as the use of intraocular antibiotic injection in all cases. In addition, 22 cases had a diagnostic and therapeutic vitrectomy. The cases selected for vitrectomy included cases with worse presenting visual acuity, higher percentage of positive culture results, and more virulent organisms. Because of a poor clinical response to initial therapy, 13 cases had repeat intraocular cultures performed between 24 and 72 hours at the time of repeat intraocular antibiotic injection. All 13 repeat intraocular cultures were negative. Complications of the treatment included four retinal detachments (three in the vitrectomy group). In the culture-positive cases, a final visual acuity of 20/400 or better was achieved in 13 of 29 cases (45%), and complete loss of vision (NLP) resulted in 10 of the 29 cases (34%).

Administration, Topical↗
PubMed1982

Toxicity, efficacy, and clearance of intravitreally injected of cefazolin.

The intravitreal injection of cefazolin sodium was evaluated with respect to its potential toxicity, efficacy, and clearance in the treatment of bacterial endophthalmitis in the rabbit model. Toxicity evaluation included indirect ophthalmoscopy, scotopic electroretinogram, and light microscopy of histopathologic specimens. Rabbits given doses up to and including 2.25 mg of cefazolin sodium showed no evidence of toxic reaction by these criteria after two weeks of observation. When injected within 24 hours of inoculation, 2.25 mg of cefazolin sodium sterilized five of six rabbit eyes infected with Staphylococcus aureus. Following intravitreal injection of 2.25 mg of cefazolin sodium, vitreous concentrations in excess of the minimum inhibitory concentration for S aureus were maintained for five days. A 2.25-mg dose of cefazolin sodium appears to be nontoxic, effective, and biologically active against susceptible organisms during a prolonged period, when injected into the vitreous cavity of the pigmented rabbit in vivo.

Animals↗
PubMed1982

Endothelial cell loss in penetrating keratoplasty.

Quantitative specular endothelial microscopy was performed on 39 donor corneas before operation and at three and 12 months following penetrating keratoplasty. The central endothelial cell density of these corneas had decreased by 18.3% at three months after operation and by 33.6% at the end of one year. This decrease in cell density probably results both from cell death and from migration of cells toward the peripheral cornea. Postoperative cell counts were correlated closely with preoperative counts but not with donor age. Therefore, it is important to screen donor corneas before operation with the clinical specular microscope.

Adult↗
PubMed1980

Endogenous Aspergillus endophthalmitis in drug abusers.

One of two cases of endogenous Aspergillus endophthalmitis in abusers of intravenously administered drugs was treated successfully by subtotal pars plana vitrectomy; amphotericin B administered by intravitreal, periocular, and systemic routes; and flucytosine administered systemically. Aspergillus sp should be considered a possible pathogenic organism in drug abusers with endogenous endophthalmitis. An aggressive diagnostic and therapeutic approach may result in preservation of useful vision.

Adult↗
PubMed1980

Papanicolaou cytology in the diagnosis and management of external ocular tumors.

Papanicolaou smear cytology is a simple diagnostic procedure for the evaluation and management of external ocular lesions. A variety of benign and neoplastic lesions are examined for correlation of clinical, cytologic, and histologic impressions. Accurate correlation in 38 of 41 eyes substantiates the reliability of Papanicolaou smear cytology to differentiate benign from neoplastic ocular lesions. Cytology proved useful in the preoperative evaluation of squamous cell carcinoma and related tumors of the conjunctiva, and malignant melanoma of the conjunctiva. Cytology also was valuable in the detection of tumor recurrence in squamous cell carcinoma and carcinoma-in-situ of the conjunctiva, and in Meibomian gland carcinoma of the eyelid. The accessibility of ocular tumors makes them particularly well suited for cytologic examination.

Aged↗
PubMed1980

Spectrum of microbial keratitis in South Florida.

During a nine-year period ending in 1977, we scraped and cultured 663 corneal ulcers. Of these cases of keratitis, 238 were bacterial infections, 133 were fungal, and 292 were culture-negative. Pseudomonas was the predominant bacterial organism, and Fusarium was the most common fungus isolated. November was the peak month for both bacterial and fungal keratitis. Direct inoculation of multiple media, including Sabouraud's agar, blood agar, chocolate agar, thioglycollate liquid, and brain-heart infusion liquid, enhanced the recovery rate; each medium provides special nutrients for different organisms. The Gram and Giemsa stains were satisfactory, but the newer Grocott methenamine silver stain for fungi and the limulus lysate test for gram-negative bacteria proved to be clinically useful. The clinical profile of patients with fungal keratitis differed from that of patients with Pseudomonas keratitis. Thirty-three percent of the patients with Pseudomonas keratitis were wearing contact lenses at the time of their infection, and the remainder had a high incidence of predisposing ocular conditions. Fungal keratitis tended to occur in healthy male patients who had been subjected to outdoor trauma.

Bacteria↗
PubMed1980

Management of infectious endophthalmitis.

Diagnostic anterior chamber and vitreous aspiration confirmed an infectious etiology in 78 of 140 eyes (56%) with suspected endophthalmitis. In 27 eyes the vitreous aspirate was positive, while the anterior chamber aspirate was negative. Intraocular antibiotics were used in 88 eyes including 50 which underwent therapeutic vitrectomy. Vision of 20/20 to 20/400 was achieved in 57% of recently operated, culture-positive eyes treated with intraocular antibiotics, and in 59% of those treated with combined vitrectomy and intraocular antibiotics.

Anti-Bacterial Agents↗