Search PubMed⌕ Search

Biomedical subjects

S I Brown

Publications and source records attributed to S I Brown.

At least 19 recordsLinked to original sources
PubMed1998

The psychosocial impact of macular degeneration.

BACKGROUND: Age-related macular degeneration (AMD), the leading cause of irreversible blindness and low vision among the elderly, has not been well studied with regard to its impact on daily life. This study was designed to demonstrate the impact of AMD on quality of life, emotional distress, and functional level. PARTICIPANTS: The study sample consisted of 86 elderly adults (average age, 79 years) with AMD who were legally blind in at least 1 eye. Participants completed a battery of measures that included the Quality of Well-being Scale, the Instrumental Activities of Daily Living index, self-rated general health status, and the Profile of Mood States. RESULTS: Persons with AMD experienced significant reductions in key aspects of daily life. Their ratings for quality of life (average Quality of Well-being Scale score=0.581) and emotional distress (average Profile of Mood States total score=65.36) were significantly worse than those for similarly aged community adults and were comparable with those reported by people with chronic illnesses (eg, arthritis, chronic obstructive pulmonary disease, acquired immunodeficiency syndrome, and bone marrow transplants). Patients with AMD were also more likely than a national sample of elderly individuals to need help with daily activities. Visual acuity was related to ability to carry out daily activities (Instrumental Activities of Daily Living, r=0.28, P=.008). Quality of life ratings were significantly related to the ability to carry out daily activities (r=-0.38, P=.001), self-rated general health status (r=-0.21, P=.05), and emotional distress (Profile of Mood States total score, r=-0.25, P=.02). Individuals with a shorter period of perceived vision loss were more likely to report high levels of emotional distress (r=-0.24, P=.03) than those with a longer period of perceived vision loss. Further, those who were blind in 1 eye were even more significantly distressed than those who were blind in both eyes. CONCLUSIONS: Elderly persons with AMD causing legal blindness in 1 or both eyes have significant emotional distress and profoundly reduced quality of life and need help with key daily activities.

Activities of Daily Living↗
PubMed1997

The use of capsaicin in herpes zoster ophthalmicus neuralgia.

The treatment of neuralgia which occurs during and following herpes zoster ophthalmicus is often unsatisfactory. Capsaicin (trans-8-methyl-N-vanillyl-6-nonenamide) is a drug which depletes substance P and may be effective in inhibiting pain. We utilized topical capsaicin to the affected dermatome five times daily for 4 weeks in 6 patients with acute and post herpetic neuralgia. In four cases pain was markedly relieved and narcotic medications were either discontinued or significantly reduced. In two cases, pain was not reduced. Four patients had side effects including burning sensation at the site of the drug administration (4 cases), dermatitis as a result of overuse of the drug (2 cases) and hyperesthesia (1 case). Our results suggest that capsaicin may be a useful therapy for the alleviation of pain in some individuals with herpes zoster ophthalmicus. However, controlled studies are needed to establish these results.

Administration, Topical↗
PubMed1997

Transplantation of congenitally opaque corneas.

AIMS: To assess retrospectively the prognosis and complications of corneal grafting for congenital opacities. METHODS: Fifty eight eyes of infants and young children with congenital corneal opacities were studied retrospectively. Preoperative diagnoses included sclerocornea (27 eyes), Peters' anomaly (17 eyes), partial sclerocornea (12 eyes), and congenital glaucoma (two eyes). Penetrating keratoplasty was performed between 5 days and 65 months of age with a mean follow up of 40 (SD 29) months. RESULTS: The overall success (including regrafts) was 70% in eyes with sclerocornea, 83% for partial sclerocornea, and 100% for Peters' anomaly. However, 23 eyes had to be regrafted between 2 weeks and 110 months postoperatively. The probability of maintaining a clear graft, calculated by survival analysis, was 75% (SE 6%) at 1 year and 58% (7%) at 2 years for the entire group. Complications included cataract development (12 eyes), secondary glaucoma (14 eyes), epithelial defects (six eyes), band keratopathy (five eyes), retinal detachment (three eyes), wound leakage (two eyes), retrocorneal membrane (one eye), and microbial keratitis (two eyes). CONCLUSIONS: It is concluded that corneal grafting for congenital opacities in infants has an excellent potential for long term survival and should be performed as early as possible for unilateral as well as bilateral involvement. The postoperative course is complex and often requires regrafting.

Child, Preschool↗
PubMed1992

11-0 mersilene as running suture for penetrating keratoplasty.

We evaluated astigmatic results and complications of the combined suturing technique in penetrating keratoplasty by using 11-0 Mersilene as a running suture. Twenty-seven grafts were studied for a follow-up that ranged between ten and 46 months (mean, 27.2 months). During the study, complications included three graft failures, one instance of inadvertent breakage of the running suture, one instance of one suture bite cutting through the recipient cornea, and suture microabscesses in two eyes. Keratometric astigmatism was 2.5 +/- 2.1 diopters at six months, was 2.4 +/- 2.3 diopters at 12 months, and was 2.5 +/- 2.0 diopters at 24 months. Our data indicate that 11-0 Mersilene is suitable for the running suture in corneal transplants in the combined technique. Spontaneous suture dissolution did not occur throughout the follow-up period. The use of a less biodegradable suture enables the maintenance of low levels of astigmatism for longer periods when compared with a previous study that used 11-0 nylon suture.

Adult↗
PubMed1992

Running nylon suture dissolution after penetrating keratoplasty.

We attempted to evaluate whether the low degrees of astigmatism achieved early in the postkeratoplasty period with the combined interrupted/running suturing technique were maintained for long periods of time. For 13 to 70 months (mean, 30.2 months), we monitored a group of patients (25 eyes) who had previously undergone the combined interrupted/running suturing technique (12 interrupted 10-0 nylon sutures and one running 11-0 nylon suture). Nine running sutures broke spontaneously, causing a significant increase of the keratometric astigmatism of the entire population from 1.7 +/- 1.6 to 3.4 +/- 2.6 diopters (mean +/- standard deviation). The mean vector-corrected change in astigmatism after suture breakage was 4.9 +/- 2.6 diopters. Surgical procedures to reduce astigmatism were required in many of the eyes in which the 11-0 running nylon suture broke. Our results suggested that 11-0 nylon is not an ideal material for the running suture because its high rate of spontaneous disruption leads to undesired, statistically significant increases in postkeratoplasty astigmatism. Further, our results indicated that the selective suture technique can maintain low degrees of astigmatism only if the sutures remain intact. Studies of the effect of keratoplasty suturing techniques on astigmatism should probably include a follow-up that is sufficiently long to indicate its long-term value to the patient.

Adult↗
PubMed1992

Fibrin-enmeshed tobramycin liposomes: single application topical therapy of Pseudomonas keratitis.

Treatment of bacterial keratitis requires frequent application of topical antibiotics. We studied the efficacy of a single topical administration of tobramycin incorporated in large multivesicular liposomes and enmeshed in a fibrin sealant on rabbit corneas infected with Pseudomonas aeruginosa. One cornea each of 25 New Zealand albino rabbits was infected with P. aeruginosa. Twenty-four hours later, the animals were randomly divided into five groups of five. Group A received single hourly drops (50 microliters) of fortified tobramycin (14.5 mg/ml, total of 17.4 mg). Group B received a single topical application of 3.5 mg tobramycin, in 0.1 ml multivesicular liposomes, enmeshed in a fibrin sealant with an overlaying bandage contact lens. Group C was treated in the same manner as group B without the addition of fibrin sealant. Groups D and E served as nondrug-treated controls, with group D receiving topical fibrin-enmeshed liposomes devoid of tobramycin and group E receiving hourly topical balanced salt solution (BSS) drops. All animals were killed 24 h after initiation of therapy. Significantly fewer colonies of Pseudomonas were present in corneas of all three treated groups, as compared with the two nondrug-treated control groups (p less than 0.02). There were significantly fewer colonies of Pseudomonas in groups A and B as compared with group C (p less than 0.02). No significant difference was noted between a single administration of topical fibrinen-meshed tobramycin-encapsulated liposomes (group B) and 24 doses of hourly fortified topical tobramycin (group A, p greater than 0.05). Tobramycin-encapsulated megaliposomes may serve as a useful adjunct in treatment of Pseudomonas keratitis.

Administration, Topical↗
PubMed1990

Experimental radial thermokeratoplasty in rabbits.

Radial thermokeratoplasty is a new technique designed to reduce hyperopia. We evaluated the histopathological effect at 2, 4, and 30 days following radial thermokeratoplasty in rabbit corneas. Surgical complications included variable-sized coagulations and microperforations in two eyes. Light microscopy disclosed that the burns were 90% in depth and healing occurred by epithelial ingrowth. The stroma surrounding the coagulation was acellular early but keratocyte repopulation was apparent by 30 days. A retrocorneal membrane four to five cells thick was noted at the early time points; however, by 30 days only a double layer of spindle-shaped cells remained. By electron microscopy, damage to surrounding endothelial cells was estimated to be 300 microns (from the center of the coagulation). Our results suggest that radial thermokeratoplasty, which utilizes a temperature of 600 degrees C placed within the cornea to a depth of 90%, will cause significant damage to the corneal endothelium beneath and surrounding the coagulation site.

Animals↗
PubMed1989

The effect of increased intraocular pressure on visual acuity and corneal curvature after radial keratotomy.

To detect the effect of increased intraocular pressure on visual acuity and corneal curvature after radial keratotomy, we measured these variables in the sitting and inverted positions in 18 patients who underwent radial keratotomy (Group 1) and compared their results with those from the unoperated on eyes of seven patients (Group 2). We also compared the results before and after inversion within each group. Intraocular pressure increased to approximately two times normal in each group. Significant improvement in visual acuity and reduction in central keratometry were noted only in Group 1. By multiple regression analysis, visual improvement correlated with the number of incisions but not the time since surgery. Our study provides evidence that increased intraocular pressure may account for transient changes in vision and corneal curvature after radial keratotomy.

Adult↗
PubMed1987

Corneal transplantation in microphthalmic eyes.

We performed corneal transplantation in nine microphthalmic eyes of five patients, who ranged in age from 1 to 63 months. The anteroposterior diameter of the eyes ranged from 12.5 to 16 mm. Complications from the surgery included superficial epithelial erosions in three eyes, leading to superficial scarring in one eye, glaucoma, and suture microabscesses. Despite these complications, seven of nine grafts have remained clear and vision developed in all eyes.

Abscess↗
PubMed1987

Immunological study of proteins and mucosubstance in saline soluble human ocular mucus.

Proteins and mucosubstance of the saline extract of human ocular mucus were studied by immunological analysis. A minor study was made with human tears for comparison. Immunoelectrophoresis of proteins from these two sources consistently revealed similar characteristic gel patterns. Proteins were found as the major constituents of both samples. However, more mucosubstance was present in the saline extract of human ocular mucus than in tears. Seventeen proteins were identified in the mucus extract. Albumin, IgA, and lactoferrin appeared to be the three major proteins, while lysozyme, lactoferrin, tear prealbumin, and ocular mucoisolate were tear and ocular mucus specific. Although saline soluble mucoisolate is complex in structure, it seemed to resist electrical dissociation, producing only one major precipitation line along with a line of IgA during immunoelectrophoresis. The ocular mucoisolate accounted for about 12% of the saline extractable proteins of human ocular mucus.

Eye↗
PubMed1987

Treatment of superior limbic keratoconjunctivitis with topical cromolyn sodium.

Eight patients with superior limbic keratoconjunctivitis (SLKC) were treated with topical cromolyn sodium. All standard modes of therapy had failed. Six patients manifested marked improvement or complete resolution of their condition. The administration of cromolyn sodium appears to be a safe and effective alternative in the treatment of SLKC.

Administration, Topical↗
PubMed1985

Bacterial endophthalmitis associated with exposed monofilament sutures following corneal transplantation.

Three cases of bacterial endophthalmitis following corneal transplantation resulted from suture abscesses that were initiated by loose or broken exposed sutures. Histopathologic examination clearly demonstrated that the infection gained access to the anterior chamber by following a deeply placed suture that traversed the posterior wound gap at the donor-host interface. We believe that exposed sutures may lead to significant postoperative complications and must be carefully observed.

Abscess↗
PubMed1984

Therapy of Mooren's ulcer.

In 37 eyes of 23 patients with Mooren's ulcer initial treatment with topical corticosteroids healed 12 ulcers. Conjunctival excision, used if the corticosteroids failed, healed eight ulcers. Patients failing to respond to topical corticosteroids and conjunctival excision were treated with immunosuppression. This resulted in healing of four of 13 ulcers. Overall, 24 of 37 ulcers (65%) were healed. Eight of nine unilateral ulcers and six of six bilateral nonsimultaneous ulcers (ulcer began in one eye after healing in the other) healed after treatment with topical corticosteroids and conjunctival excision. However, only ten of 22 bilateral simultaneous ulcers responded to topical corticosteroids, conjunctival excision, and immunosuppression. Bilateral, simultaneously active Mooren's ulcer is a severe, relentlessly destructive condition for which no completely satisfactory treatment exists.

Administration, Topical↗