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Biomedical subjects

R L Lindstrom

Publications and source records attributed to R L Lindstrom.

At least 145 records · Page 8Linked to original sources
PubMed1983

Ghost cell glaucoma following lens implantation.

When intraocular hemorrhage occurs following cataract surgery and lens implantation, ghost cell glaucoma may develop. An intraocular lens (IOL) may be a factor in recurrent bleeding, particularly in the predisposed patient. Six patients with ghost cell glaucoma following cataract surgery and lens implantation are described. Because intraocular pressure (IOP) was uncontrolled, vitrectomy was performed to remove the reservoir of ghost cells. In each case, postoperative visual acuity improved to 20/40 or better and IOP was controlled with the use of medications.

Aged↗
PubMed1983

The use of tissue adhesive in corneal perforations.

Eighty patients with either corneal perforation or impending perforation were treated with the application of tissue adhesive that remained in place on the average of 50 days. Forty-four percent of these cases healed with the application of glue alone. Complications occurred in nine patients (11%). Two developed marked increase in intraocular pressure that was controlled with antiglaucoma medications and seven developed corneal infiltrates. Five of the infiltrates were culture-proven bacterial infections occurring on the average of 73 days after gluing. The relationships between diagnosis, duration of glue, and complications are reviewed.

Adolescent↗
PubMed1983

Rationale for and design of the National Eye Institute Prospective Evaluation of Radial Keratotomy (PERK) Study.

A five-year, multicenter, collaborative clinical trial of radial keratotomy for myopia is being carried out at nine clinical centers. The study, funded by the National Eye Institute, is recruiting approximately 500 patients aged 21 years or older with -2.00 to -8.00 diopters of physiologic myopia who also meet other clearly defined eligibility criteria. Surgeons use a diamond-bladed micrometer knife to make eight radial incisions in the anterior cornea. The diameter of the central clear zone is determined by the amount of myopia and the depth of the incisions by intraoperative ultrasonic pachymetry. Investigators other than the surgeon gather all pre- and post-operative data. Examinations include measurement of visual acuity with standardized charts, verification of refractions by a second observer, measurement of corneal curvature by keratometry and photokeratoscopy, quantitation of glare with a glare tester, and measurement of the size of individual endothelial cells from specular photomicrographs with a computerized digitizer. A formal psychometric questionnaire is used to evaluate the patients' subjective response. Physician monitors insure adherence to the protocol during site visits and members of the Data and Safety Monitoring Board oversee the progress of the study. Biostatisticians at the Coordinating Center insure complete data collection, process the data, and assist in the interpretation of results.

Academies and Institutes↗
PubMed1983

Conjunctival autograft transplantation for unilateral ocular surface diseases.

Rehabilitation of the diseased ocular surface by autologous conjunctival transplantation as first described by Thoft has expanded the possibilities for eventual visual restoration of patients with severe ocular surface disease. This paper will introduce a new surgical technique for diseased ocular surface preparation and for the acquisition, transfer, and placement of a 360 degrees ring of autologous conjunctiva in patients with unilateral surface pathology. Patients representing different unilateral surface diseases with up to 2 years follow-up are presented and discussed.

Adult↗
PubMed1982

Secondary and exchange posterior chamber lens implantation.

A retrospective chart review of 34 secondary or exchange posterior chamber lens implantations was performed. Overall 94% of the patients achieved a visual acuity of 20/40 or better at six to 12 months postoperative. Associated intraoperative procedures included lens implant removal for exchange (50%), iris suture (41%), posterior capsule polishing (24%) or discussion (24%), and anterior vitrectomy (15%). The postoperative complications included retinal detachment (6%), persistent clinical cystoid macular edema (3%), posterior capsular opacification (3%), failure to fixate requiring iris suture (3%), hyphema (3%), and pupil capture (3%). Secondary and exchange posterior chamber lens implantation can be performed with satisfactory visual acuity results but there is a real rate of complication that needs to be considered by the surgeon and patient who is contemplating the operation.

Adult↗
PubMed1982

Keratoplasty.

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Contact Lenses, Hydrophilic↗
PubMed1982

Late capsulotomy.

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Cataract Extraction↗
PubMed1981

Combined penetrating keratoplasty, extracapsular cataract extraction, and posterior chamber lens implantation.

A retrospective chart review of 18 consecutive unselected cases of combined penetrating keratoplasty, extracapsular cataract extraction, and posterior chamber lens implantation was performed. Overall, 89% of the grafts remained clear with follow-up between six and 54 months (average 21 months). Visual acuities were 20/50 or better in 61% of the cases and 20/80 or better in 83%. Postoperative complications included two graft failures, two cases of secondary glaucoma, one case of cystoid macular edema, and one case of pupil capture. No patients to date have required a secondary discission.

Aged↗
PubMed1980

Management of the posterior capsule following posterior chamber lens implantation.

A retrospective review of posterior capsule management in 595 consecutive unselected posterior chamber lens implants performed between 10/1/76 and 9/30/79 is presented. The incidence of secondary discission required increased from 0.6%, in cases with zero to six months follow-up, to 18.4%, in cases with 24 to 36 months follow-up, to 18.4%, in cases with 24 to 36 months follow-up. A plano-convex posterior chamber lens design which allows the convex surface of the implant to contact the posterior capsule reduced the incidence of posterior capsule opacification by providing a barrier to cortical cell migration. When secondary discission is needed behind a posterior chamber lens, it may be performed successfully using a pars plana approach. Our data suggest that the incidence of the major complications of this technique, i.e. cystoid macular edema and retinal detachment, may be reduced by delaying capsulotomy for 12 months after implant surgery.

Humans↗
PubMed1979

Bacterial endophthalmitis associated with vitreous wick.

A culture proven case of bacterial endophthalmitis (alpha streptococci, not Group D, and coagulase-negative staphylococci) occurred in association with a vitreous wick 26 days following uncomplicated intracapsular cataract extraction. Despite intensive antibiotic therapy, the eye was lost to infection. Immediate surgical repair of vitreous wicks which communicate with the external ocular surface is recommended.

Aged↗
PubMed1977

Organ-cultured corneal endothelium in vivo.

We used the clinical specular microscope to examine the endothelium of 14 clear penetrating corneal grafts that ranged from 4 days to 2 1/2 years posttransplantation. All the donor corneas had been preserved in organ culture at 37 C for up to five weeks before grafting. Ten of the transplants were aphakic. The graft endothelial cell density, although less than that of normal corneas of the same age, was similar to that of other transplants done by the same two surgeons using alternate methods of donor preservation. We found a significant inverse correlation between graft endothelial cell density and the age of the corneal donor.

Adolescent↗
PubMed1976

Human corneal endothelial layer repair during organ culture.

Circular freeze-thaw endothelial wounds were created on paired human corneas. Ultrastructural and physiological studies were performed after organ culture (OC) incubation at 37 C from 1 to 21 days as well as on fresh noncultured controls. As early as 24 hours after injury, OC corneas demonstrated ultrastructurally intact endothelial cells at the margin of the wound, elongating and sliding toward its center. All OC corneas were completely covered by ultrastructurally intact and physiologically functioning endothelial cells by seven days of OC. These cells were approximately twice normal size. Enlarged endothelial cells that maintained deturgescence function were seen in the wounded area after 14 and 21 days of OC. None of the fresh controls demonstrated deturgescence function and in none could ultrastructurally intact endothelial cells be found in the area of the wound. This confirms our hypothesis that during 37 C OC incubation, human corneal endothelium repairs defects in its layer by cells that are physiologically and ultrastructurally intact.

Cornea↗
PubMed1976

A metabolic and electron microscopic study of human organ-cultured cornea.

We examined the glucose metabolism and ultrastructure of human corneas stored for 11 to 37 days in organ culture using a modified Eagle's minimum essential medium. Changing the media twice weekly provided a stable pH of 7.22 to 7.28 but the glucose concentration of the media decreased from 110 mg/100 ml to 30 mg/100 ml, and lactate concentration increased from 7 mg/100 ml to 84 mg/100 ml before media replacement. The initial rate of glucose uptake and lactate release averaged 149 mug/hr and 95 mug/hr, respectively, and the rates decreased approximately 50% by day 12. The glucose uptake rate stabilized between 40 and 60% of the original rate to day 37, but the lactate release rate decreased again at day 25 from 64 to 25%. The lactate/glucose ratio averaged 65 to 82% during the first 25 days of organ culture and 33 to 53% from days 28 to 37. Electron microscopy revealed that the endothelium formed a complete monolayer of normal appearing cells covering Descemet's membrane. Intracytoplasmic deposition of glycogen granules was present in endothelial, stromal, and epithelial cells.

Cornea↗