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Biomedical subjects

S L Forstot

Publications and source records attributed to S L Forstot.

43 records · Page 3Linked to original sources

Morphologic characteristics of posterior polymorphous dystrophy. A study of nine corneas and review of the literature.

Based on their own study of nine corneas with clinically documented posterior polymorphous dystrophy and a review of the literature, the authors describe the morphologic features of this entity. Study by phase contrast light microscopy and transmission and scanning electron microscopy found that changes were primarily in the endothelium and consisted of endothelial cell degeneration and loss with focal fibroblastic and epithelial-like cell transformation. Secondary alterations of Descemet's membrane were seen; they consisted of abnormal lamination with deposition of abnormal collagen material, particularly in the posterior collagen layer, and formation of guttate excrescences and pits.

Adult↗

Bilateral corneal leukomas.

We present this case to suggest that xerophthalmia should be considered in the differential diagnosis of children from less developed countries with corneal leukomas, particularly when it is not clear if the opacities are congenital. With more children from less developed countries being referred for adoption in America, and with continuing refugee groups coming to America, other unsuspected cases of xerophthalmia may be seen.

Child, Preschool↗

Unilateral pseudo-synophthalmos.

A 4 1/2-year-old girl had an unusual congenital defect of her left eye which we have elected to call a unilateral pseudo-synophthalmos. We have found no other such case reported. We review the case history and findings, discuss the embryology, and explore the possible embryologic explanations for such an anomaly.

Abnormalities, Multiple↗

Purse-string sutures for hyperopia following radial keratotomy.

BACKGROUND: Five years ago, we presented 19 procedures employing two intrastromal purse-string sutures to treat hyperopic shift following radial keratotomy. Thirty-four additional procedures and longer follow-up are now presented detailing the task of rehabilitating these eyes. METHODS: Fifty-three eyes of 53 radial keratotomy patients who were unhappy with their uncorrected vision and who were dissatisfied with contact lens or spectacle correction underwent double corneal intrastromal purse-string suturing and were subsequently followed for at least 1 year. There were seven eyes with primary overcorrection and 46 eyes with progressive hyperopic shift. Spherical equivalent refraction before purse-string sutures ranged from +0.50 to +6.25 D (mean, +2.60 D, SD +/- 1.26 D). Prior to purse-string suturing, uncorrected visual acuity ranged from 20/30 to 20/400 with 21 eyes (45.3%) 20/100 or worse. RESULTS: The follow-up after suturing averaged 3.6 years (range, 1 to 10 yr). All patients had follow-up of at least 1 year. The steepening in average keratometric power was 2.94 +/- 1.72 D (range, 1.06 to 6.68 D). The sherical equivalent refraction after suturing averaged -0.15 +/- 1.17 D (range, +3.75 to -2.50 D). Uncorrected visual acuity after suturing was 20/40 or better in 38 eyes (72%) and 20/50 to 20/100 in 15 eyes (28%). The number of eyes with a spherical equivalent refraction of +/- 0.50 D with 0.50 D or less refractive astigmatism was 15 (26% of eyes). There were 34 eyes (66%) with +/- 1.00 D with 1.00 D or less of refractive astigmatism, and 42 eyes (78%) with +/- 2.00 D with 2.00 D or less refractive astigmatism. Most of the spread was on the myopic side, as intended. There were no significant intraoperative or postoperative complications. Fifteen eyes gained two or more lines of best spectacle-corrected visual acuity and no eyes lost one line. CONCLUSION: Double intrastromal purse-string suturing produces steepening of the central cornea and reduces hyperopia after radial keratotomy.

Adult↗

Surgical correction of hyperopia following radial keratotomy.

BACKGROUND: No effective treatment for hyperopia following radial keratotomy has been described. A new surgical technique of two purse-string intrastromal sutures was investigated for correction of this hyperopia. METHODS: Eighteen radial keratotomy patients who were unhappy with uncorrected vision and who were unsatisfied with contact lens or spectacle correction, after informed consent, underwent corneal suturing. The 19 hyperopic eyes included 5 original overcorrections, 5 overcorrections after reoperation, and 9 progressive hyperopes. The refractive error ranged from +1.25 to +5.75 diopters spherical equivalent (mean +3.47 D). Presuturing uncorrected visual acuity ranged from 20/50 to 20/400 with 11 eyes (58%) 20/100 or worse. RESULTS: The follow up after double purse-string suturing averaged 24 months (range, 12 to 47 months). All patients had follow up of at least 1 year; 14 patients (74%) had follow up of 2 years or more. The change in refractive spherical equivalent following surgery averaged -3.30 D (range, -1.00 to -7.50 D). The steepening in average keratometry was 4.10 D (range, 1.00 to 8.00 D). The refraction after suturing averaged -1.12 D (range, +2.50 to -3.50 D). Uncorrected visual acuity after suturing was 20/40 or better in 14 eyes (74%), and 20/50 to 20/80 in 5 eyes (36%). There were no significant intraoperative, early or late postoperative complications. Seventeen eyes were either the same or gained 1 line of acuity; 2 eyes gained 2 lines of acuity; no eyes lost any lines of refractive Snellen acuity. CONCLUSIONS: The placement of two purse-string intrastromal sutures appears to provide significant steepening of the central cornea following excessive flattening after radial keratotomy. The steepening effect appears to remain stable with greater than 1-year follow up. This surgical technique offers an alternative to symptomatic hyperopic postradial keratotomy patients who cannot be corrected with spectacles or contact lenses.

Adult↗