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Biomedical subjects

R S Wagner

Publications and source records attributed to R S Wagner.

At least 37 records · Page 2Linked to original sources
PubMed1988

Infantile exotropia in healthy children.

Constant exotropia is uncommon during the first year of life. We retrospectively identified 13 patients with large, constant exotropia during the first year of life which required surgery. Bilateral lateral rectus muscle recessions were done in all 13 cases. Only two patients have required reoperation. The clinical characteristics and management of this unusual condition are similar to those of infantile esotropia.

Exotropia↗
PubMed1988

Trabeculectomy with cyclocryotherapy for infantile glaucoma in the Sturge-Weber syndrome.

Various mechanisms have been proposed to explain the pathogenesis of infantile glaucoma in the Sturge-Weber syndrome. We report the results of treating six patients with combined trabeculectomy and cyclocryotherapy. Successful control of the intraocular pressure occurred in all patients. Two patients required a second procedure at another site. We feel that the success of this procedure provides evidence that the glaucoma is secondary to elevated episcleral venous pressure in this condition.

Acetazolamide↗
PubMed1987

Congenital unilateral adduction deficit with simultaneous abduction. A variant of Duane's retraction syndrome.

Congenital adduction deficit not associated with other signs of oculomotor nerve weakness occurs infrequently. Type 2 Duane's retraction syndrome accounts for some of these cases. The authors identified three children with unilateral adduction deficits and simultaneous abduction of the eyes on attempted lateral gaze into the field of action of the apparently paretic medial rectus muscle. This is the first report of a series of patients with this condition previously termed simultaneous or synergistic divergence. All patients had a large exotropia, and two had a horizontal face turn away from the involved eye. A large (14 mm) lateral rectus muscle recession done on one of these children reduced the face turn but did not eliminate the simultaneous abduction. Clinical, intraoperative, and electromyographic data suggest that this condition is an unusual variant of type 2 Duane's syndrome.

Child↗
PubMed1986

Spasmus nutans. A benign clinical entity?

Spasmus nutans occurs in early childhood and consists of a triad of symptoms as follows: small-amplitude, rapid, horizontal nystagmus in one or both eyes asymmetrically; head nodding; and anomalous head position. Once thought to be a benign clinical entity, there are an increasing number of reports linking spasmus nutans to optic nerve and chiasmal gliomas. We describe 14 patients with spasmus nutans, none of whom were found to have a tumor with computed tomographic scanning. One patient, however, had an arachnoid cyst and an empty sella and another patient had a porencephalic cyst. The diagnosis of spasmus nutans, its implications, and its management are discussed.

Brain↗
PubMed1986

Treatment of congenital ptosis by maximal levator resection.

The treatment of severe congenital ptosis may include frontalis suspension or maximal levator resection. A previous study of 145 consecutive frontalis suspensions for congenital ptosis showed a fairly high recurrence rate, frequent granuloma formation, and significant brow scars. In 28 patients undergoing 32 maximal levator resections utilizing our technique, 28 patients had excellent results. Two required reoperations and two additional patients had undercorrections that did not warrant reoperation. There were no significant complications. We believe that maximal levator resection is a better surgical alternative than frontalis suspension in the treatment of severe congenital ptosis whether unilateral or bilateral. In our experience, maximal levator resection provides a better cosmetic result and the recurrence rate is probably less than with frontalis suspension.

Adolescent↗
PubMed1986

Dacryocystitis following Kawasaki's disease.

A 6 1/2-year-old white male child had developed bilateral dacryocystitis 1 year earlier, approximately 6 months after resolution of the acute phase of Kawasaki's disease. The patient had had no previous history of dacryostenosis or epiphora. After he failed to respond to appropriate antibiotic therapy, probing was partially successful on the right side, but complete obstruction persisted on the left side. At age 7 1/2 years, dacryocystorhinostomy was performed successfully on the left side. To our knowledge, dacryocystitis has not been reported previously following Kawasaki's disease. Other reported ocular complications of Kawasaki's disease, with the exception of a case of bilateral conjunctival scarring, have occurred in the acute phase of the disease.

Child↗
PubMed1986

Neodymium: YAG laser surgery: the treatment of pediatric cataract disease.

Cataract extraction in children has undergone dramatic changes during the past 20 years, largely as a result of technologic advances. The neodymium: yttrium aluminum garnet (Nd:YAG) laser has indirectly brought the surgical technique full circle. The posterior capsule may be preserved at surgery and treated successfully with the Nd:YAG when necessary. In 16 such cases reported here, 11 patients with congenital and five with acquired cataracts all had improved vision after treatment with the Nd:YAG laser. The youngest patient was aged four years. The safety of Nd:YAG laser therapy is supported by this study.

Adolescent↗
PubMed1985

High hyperopia in Leber's congenital amaurosis.

Few studies comment on the type of refractive errors found in patients with Leber's congenital amaurosis. The association of an uncomplicated infantile form of this condition with high hyperopia but without systemic complications has been suggested. In a retrospective study, we identified 11 patients who satisfied the criteria for the diagnosis of this subtype of Leber's congenital amaurosis. All of our cases were found to have at least +6.00 diopters of hyperopia on cycloplegic refraction. No systemic abnormalities were found in any of these children. We suggest that high hyperopia be included in the diagnostic criteria of this specific form of Leber's congenital amaurosis.

Blindness↗
PubMed1985

Neodymium:YAG laser capsulotomy of secondary membranes in the pediatric population.

Posterior capsulotomy is occasionally performed at the conclusion of extracapsular cataract extraction because of the high incidence of secondary membrane formation. Using a Nd:YAG laser we successfully performed posterior capsulotomies on 16 children who developed secondary membranes following extracapsular cataract extraction in which the posterior capsule was left intact. Eleven patients had congenital cataracts and five had acquired cataracts. The youngest patient was four years. All had improvement in visual acuity. Preserving most of the posterior capsule provides additional support to the eye and has been associated with a decreased incidence of cystoid macular edema. It also allows secondary implantation of a posterior chamber intraocular lens in the future.

Adolescent↗
PubMed1985

Aicardi syndrome in one dizygotic twin.

The Aicardi syndrome consists of infantile spasms, defects of the corpus callosum, dorsal vertebral anomalies, and chorioretinal lacunar defects. The etiology is, as yet, unknown. The most likely cause, however, is an X-linked mutational event that is lethal in males. The first case of the Aicardi syndrome known to occur in one twin is reported. The patient was female and her unaffected sibling was male. This provides strong evidence to support the theory of an X-linked mutational event as the cause of this condition. The typical chorioretinal defects, often difficult to document because these children die at an early age, are clearly illustrated in this report.

Agenesis of Corpus Callosum↗
PubMed1984

Treatment of congenital ptosis with frontalis suspension: a comparison of suspensory materials.

One hundred forty-five consecutive frontalis suspension procedures performed during the years 1976 to 1982 at the Wills Eye Hospital for the repair of congenital ptosis were reviewed. Results with nylon polyfilament cable-type suture ( Supramid Extra) as the suspensory material were compared to results with allogenic fascia lata. Forty-nine of the 121 polyfilament cable-type suture procedures (40.5%) were considered failures either because of ptosis recurrence (28.1%) or granuloma formation (12.4%). Only two of 24 (8.3%) of the fascia lata cases failed. No granuloma was associated with the use of fascia lata. The clinical and pathologic characteristics of ptosis recurrence and suture-rejection granuloma formation are discussed. Available preparations of allogenic fascia lata are reviewed and suggested as alternatives to the use of nylon polyfilament cable-type sutures for the repair of congenital ptosis.

Blepharoptosis↗
PubMed1984

Developmental aspects in the assessment of visual function in young children.

The developmental aspects in the assessment of visual acuity in the preverbal child have been reviewed. Several investigative techniques indicate that visual acuity of infants increases significantly between birth and age 6 months. Transient oculomotor deviation in infancy must be differentiated from pathologic ocular conditions. Changes in refraction of the developing eye that occur normally and as a result of an ocular disorder must be recognized and managed early in the infant's life.

Age Factors↗