BACKGROUND: Excimer laser phototherapeutic keratectomy has generated considerable interest in treating superficial corneal and scleral pathology. The excimer laser is also used to treat recurrent corneal epithelial erosions. METHODS: With the MEL 50 Aesculap-Meditec 193-nanometer argon-fluoride excimer laser, we treated 74 eyes of 73 individuals, who suffered from posttraumatic, therapy-resistant, recurrent corneal epithelial erosions. We used the excimer laser in spot-mode under manual guidance. Only in those eyes where the erosion was covered with loose bullous epithelium did we remove the epithelium mechanically prior to surgery. The postoperative follow-up period ranged from 6 months to 4 years. RESULTS: Of the 74 eyes, 55 (74.43%) eyes were recurrence-free. One eye developed superficial haze in the treated area. No other complications occurred. CONCLUSION: Phototherapeutic keratectomy in recurrent epithelial erosions is a promising treatment, especially in recalcitrant cases with the erosion over the entrance pupil. Photoablation allows a fast reepithelialization of the affected area and quick relief for painful symptoms.

Adult↗

PubMedDate not supplied

Cigarette smoking and lens opacities: the Beaver Dam Eye Study.

We evaluated the relationship between cigarette smoking behavior and lens opacities in cross-sectional data on 4,926 adults in Beaver Dam, Wisconsin. The frequencies of more severe levels of nuclear sclerosis increased with packyears of cigarette smoking in women and men. For women, the odds ratio (OR) associated with 10 packyears was 1.09 (confidence interval [CI] = 1.04, 1.16) and for men it was 1.09 (CI = 1.05, 1.14) after controlling for age. The frequencies of posterior subcapsular opacities also increased in both sexes with increased packyears. The OR associated with 10 packyears of cigarette smoking was 1.06 (CI = 0.98, 1.14) for women and 1.05 (CI = 1.00, 1.11) for men after controlling for age. There was no significant effect on cortical opacities. Smoking was associated with past cataract surgery. The significant relationships of smoking with lens opacities suggest an etiologic effect. If confirmed prospectively, our results would indicate another benefit of smoking cessation.

Adult↗

PubMedDate not supplied

Excimer laser photorefractive keratectomy for hyperopia.

BACKGROUND: Excimer laser photorefractive keratectomy has generated considerable interest as a technique for correcting myopia. In this study, the excimer laser was used to correct hyperopia. METHODS: A prospective clinical study based on the results of photorefractive keratectomy in 23 consecutive hyperopic eyes (one eye per patient) is presented. The excimer laser used in this study was a MEL 60 (Aesculap-Meditec); this laser emits 193-nanometer laser light. A 1-year follow-up study of two groups of eyes was performed. All patients were followed for 12 months. The first group comprised 15 hyperopic eyes with preoperative refraction between +2.0 and +7.5 diopters (mean spherical equivalent +4.7 +/- 1.6 D). The second group comprised eight aphakic eyes with preoperative refraction between +11.0 and +16.0 D (mean spherical equivalent +13.1 +/- 2.0 D). RESULTS: In group 1, 12 eyes (80%) were within +/- 1.0 D of the intended correction (baseline, +2.0 to +7.5 D) after 1 year. In group II, only three of the eight aphakic eyes (37%) were within +/- 1.0 D of the intended final refraction (baseline, +11.0 to +16.0 D). The stability of refraction in group I was better than in group II. At 12 months, best corrected visual acuity was unchanged in 14 eyes of group I. One eye had lost two lines. In group II, best corrected visual acuity was unchanged in six eyes after 12 months. In two eyes, best spectacle-corrected visual acuity was lower than the preoperative value, because of decentration of the ablation zone. After 1 year, 80% of the eyes in group I and 25% of those in group II had a visual acuity of 20/40 or better. CONCLUSION: Photorefractive keratectomy is an efficient and relatively safe procedure for correcting hyperopia up to +7.5 D. The predictability is good. Results of photorefractive keratectomy to correct highly hyperopic (aphakic) eyes are not as encouraging. Three patients in this study lost one to three lines of best spectacle-corrected visual acuity due to decentration of the clear zone. Two of the patients belonged to group II. Therefore, we do not recommend photorefractive keratectomy in highly hyperopic eyes, especially if they are aphakic, because even slight decentration may lead to loss of best corrected visual acuity. As in other refractive surgical procedures, great care must be taken to improve the centration of the clear zone.

Adult↗

PubMedDate not supplied

Treatment and control of hypercholesterolemia and hypertension in persons with and without diabetes.

Our object was to examine whether the frequency of medical treatment for hypercholesterolemia or hypertension and the frequency of control of these conditions were different in persons with and without known diabetes. Subjects 43-86 years of age with (n = 376) and without (n = 4,420) known diabetes participated in the Beaver Dam Eye Study. Hypercholesterolemia was defined as a serum cholesterol of > or = 6.2 mmol/L or use of lipid-lowering agents, and hypertension was defined as a systolic blood pressure > or = 140 mm Hg or diastolic blood pressure > or = 90 mm Hg or use of antihypertensive medications. Those subjects with diabetes had a similar frequency of hypercholesterolemia (42.8% versus 43.3%, P = .22) and a significantly higher frequency of hypertension (73.1% versus 48.3%, P < .0001) than those without diabetes. In those who were hypercholesterolemic, subjects with diabetes were slightly more likely to use lipid-lowering agents than those without diabetes (14.6% versus 9.8%, P = .05). In those who were hypertensive, subjects with diabetes were more likely to be on antihypertensive medications than those without diabetes (77.4% versus 57.0%, P < .0001). After adjusting for sociodemographic and cardiovascular disease risk factors, the odds of a participant with hypercholesterolemia receiving treatment with lipid-lowering agents was 1.61 (95% confidence intervals [CI] = 0.98, 2.65) and the odds of a participant with hypertension receiving treatment with antihypertensive medications was 2.32 (95% CI = 1.68, 3.20) for those with diabetes versus those without.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

[Serotonin antibodies in fibromyalgia syndrome--expression of a neuroendocrinologic autoimmune disease?].

Explore the source record for details and available documents.

Arthritis, Rheumatoid↗

PubMedDate not supplied

Opportunity knocks ... will nurses answer?

Explore the source record for details and available documents.

Health Care Reform↗