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Biomedical subjects

S Masket

Publications and source records attributed to S Masket.

At least 37 records · Page 2Linked to original sources
PubMed1993

Postoperative complications of capsulorhexis.

Capsulorhexis has become the preferred method of anterior capsulotomy, and untoward effects have not been frequently noted. Nevertheless, distinct complications of continuous tear anterior capsulotomy are now recognized. These include capsular bag hyperdistention, shrinkage of the anterior capsule opening with visual loss and/or intraocular lens decentration, and lens epithelial cell hyperproliferation on the posterior lens capsule. The latter has not been reported and may be associated wit reduction or closure of laser posterior capsulotomies in the form of a "string of pearls" around the capsule opening. Current styles of capsular surgery and intraocular lens implantation in which the anterior capsule edge overlaps the lens may be responsible for these phenomena. Although altering the surgical methods may obscure these complications, eliminating the anterior subcapsular and equatorial lens epithelial cells is necessary to prevent capsule contraction and lens epithelial cell hyperproliferation.

Cataract Extraction↗
PubMed1993

One year postoperative astigmatic comparison of sutured and unsutured 4.0 mm scleral pocket incisions.

The postoperative astigmatic course of unsutured and sutured 4.0 mm scleral pocket incisions was followed for one year in a small pilot study. Initially, with-the-rule changes were noted only in the sutured group; eventually both groups demonstrated a small against-the-rule change that did not differ clinically or statistically. At one year after surgery the group without suture closure developed a -0.45 diopter (D) shift while a -0.34 D change was noted in the group closed with the anchor suture method. The unsutured group of eyes demonstrated physical stability as did those eyes with suture closure; no cases developed wound leaks, hypotony, or filtration blebs. Mean intraocular pressure was statistically unchanged from preoperative levels at one day after surgery for both groups. No case demonstrated postoperative endophthalmitis. Properly performed no-stitch corneal valve incisions provide physical and astigmatic stability that is indistinguishable from sutured incisions.

Astigmatism↗
PubMed1992

A prospective, randomized, double-masked comparison of a zonal-progressive multifocal intraocular lens and a monofocal intraocular lens.

INTRODUCTION: Multifocal intraocular lenses (IOLs) have been designed to provide improved near visual acuity without spectacles compared with monofocal IOLs. Early studies have reported variables amounts of decreased visual acuity and contrast sensitivity with multifocal IOLs, and some patients have experienced halos and glare. METHODS: The authors performed a prospective, double-masked, multicenter evaluation of 62 patients randomized between a new zonal-progressive optic multifocal IOL and a monofocal IOL. RESULTS: Mean postoperative spherical equivalent, astigmatism, and uncorrected and best-corrected distance visual acuity were similar between the two groups. Patients with a multifocal IOL achieved significantly better uncorrected near visual acuity than patients with monofocal IOLs (J3+ versus J7; P less than 0.0001). With distance correction only, mean near visual acuity was J2 versus J5- (P = 0.0001). Best-corrected near visual acuity was J1 for both groups, with 1.36 diopters (D) for the multifocal group versus 2.37 D for the monofocal group (P less than 0.0001). Regan contrast sensitivity was lower for the multifocal patients at all contrast levels, and achieved statistical significance at very low contrast (11% contrast; P = 0.0024). Fifty-two percent of patients with a multifocal IOL reported that they did not need spectacles at all or used them only for their fellow eye, compared with 25% of the patients with monofocal IOLs. CONCLUSION: Both monofocal and multifocal implant patients were very satisfied with the results of their cataract extraction and IOL implant surgery. A small loss of contrast sensitivity with the multifocal IOL was demonstrated, consistent with theoretical predictions. The functional significance of the loss of contrast sensitivity appears to be small and counterbalanced by the advantage of improved uncorrected near visual acuity.

Aged↗
PubMed1992

Relationship between postoperative pupil size and disability glare.

A group of 40 postoperative cataract patients had Miller-Nadler glare testing performed before and after midpupillary pharmacologic dilation. The results indicated that pupillary enlargement is associated with increased glare disability. For that reason it is essential to maintain normal pupil shape and function after cataract surgery, a difficult task in cases with miotic pupils.

Cataract Extraction↗
PubMed1992

Preplaced inferior iris suture method for small pupil phacoemulsification.

A surgical method for managing poorly dilating pupils preoperatively is presented. A fine polypropylene suture is preplaced through the inferior iris sphincter prior to an inferior radial iridotomy in preparation for nucleus fracture endolenticular phacoemulsification. Placing the suture prior to the iridotomy assures proper aesthetic and functional alignment of the incised iris pillars, while enlarging the pupil inferiorly accommodates in-the-bag nucleus emulsification. This new surgical method maintains pupillary appearance and function postoperatively.

Cataract Extraction↗
PubMed1991

Horizontal anchor suture closure method for small incision cataract surgery.

A modified circumferential suture closure system (horizontal anchor suture) was used with scleral pocket incisions between 4.0 mm and 7.0 mm in length, phacoemulsification, and foldable or rigid posterior chamber intraocular lenses in 120 eyes. The cases were divided into three incision size groups: 4.0 mm, 5.0 mm, and 6.0 mm or greater. An additional group of patients received foldable lenses through a 4.0 mm incision that was not sutured. The postoperative results and astigmatic analyses revealed that the suture method created physically stable, watertight incisions, with minimal transient with-the-rule induced astigmatism for all groups. The longer the incision, the greater the eventual against-the-rule iatrogenic change from presurgical astigmatism. The group without suture closure also obtained a physically stable incision; however, no transient with-the-rule postoperative astigmatism was observed. Instead, a progressive but small against-the-rule astigmatic change was noted. This suggests that unsutured incisions longer than 4.0 mm may create significant postsurgical against-the-rule changes from presurgical astigmatism. Unless surgery is performed in the steepest corneal meridian, undesired changes in astigmatism will likely accompany surgery in cases without sutures when incisions greater than 4.0 mm are used.

Astigmatism↗
PubMed1990

Noncicatricial oval deformation of the pupil induced by sulcus-fixated one-piece posterior chamber lenses.

A retrospective analysis of 40 cases of sulcus-fixated one-piece poly(methyl methacrylate) posterior chamber lenses revealed ten cases (25%) that demonstrated oval deformation of the pupil, similar to the condition associated with anterior chamber lenses. This complication was not noted until several weeks after surgery, appears to be progressive, and might be the cause of glare symptoms. Possible mechanisms of the pupillary deformation include mechanical stretching of the iris by oversized lenses and fibroproliferation on the posterior iris surface. Prevention rests upon firm capsular bag fixation aided by capsulorhexis and reduction of the overall lens loop diameter.

Humans↗
PubMed1990

Comparison of the effect of topical corticosteroids and nonsteroidals on postoperative corneal astigmatism.

A controlled study compared the effects of a topical steroid (1% prednisolone acetate) and a topical nonsteroidal anti-inflammatory agent (0.03% flurbiprofen) on postoperative changes in corneal astigmatism in a series of patients having phacoemulsification and posterior chamber lens implantation through a 6.5 mm scleral pocket incision. The incisions were closed with a continuous running 10-0 monofilament nylon suture under tonometric and keratometric control. The results of the study showed that both agents demonstrated similar postsurgical astigmatic decay curves; however, the group receiving the nonsteroidal agent had an earlier decay of iatrogenically induced astigmatism. Approximately 80% of cases receiving the nonsteroidal agent completed the postoperative course without the use of topical steroids, indicating that in some cases steroids may be avoided after cataract removal.

Administration, Topical↗
PubMed1989

Reversal of glare disability after cataract surgery.

Awareness of the limitations of Snellen vision testing and the favorable risk-to-benefit ratio for cataract surgery have changed the indications for cataract rehabilitation. Interest in functional vision analysis generated the present study, which was designed to identify cataract-specific disabling glare and its reversal with best-case cataract surgical techniques. Thirty eyes with symptomatic cataracts and no other ocular diseases were evaluated by Miller-Nadler glare testing prior to and six weeks after surgery. All surgical cases were uncomplicated and were free of macular disease. They had well-centered posterior chamber intraocular lenses, clean posterior capsules, and were returned to 20/20 Snellen acuity. Careful patient selection assured that presurgical glare disability was due to cataract formation. Presurgical Miller-Nadler scores were markedly elevated and correlated well with symptomatic glare, whereas postoperative scores were indistinguishable from normals, suggesting that cataract-induced symptomatic glare is discernible, remediable, and warrants surgical intervention, but requires best-case surgery to assure glare reversal.

Adult↗
PubMed1989

Keratorefractive aspects of the scleral pocket incision and closure method for cataract surgery.

All current cataract incisions induce transient and permanent changes in corneal astigmatism. Typically, a two-phase astigmatic response is observed; an initial with-the-rule change is followed by an eventual and permanent against-the-rule shift from preoperative astigmatism. The earlier literature suggests that the magnitude of the net astigmatic swing approximates 6.0 diopters for large limbal wounds closed with interrupted sutures. However, applying the tenets of keratorefractive surgery to the cataract incision and its closure allows the surgeon to limit postoperative iatrogenic astigmatic swings. The reduced phacoemulsification incision size in combination with a scleral pocket closed with a continuous single knotted 10-0 monofilament nylon suture under tonometric and keratometric control significantly dampens the changes in corneal astigmatism during the early and late postoperative periods. My published reports, as evaluated in the present study, reveal that the net astigmatic swing may be reduced to less than 1.5 diopters, thereby affording rapid and stable optical results.

Astigmatism↗
PubMed1989

The successful removal of a subretinal cysticercus by pars plana vitrectomy.

A 39-year-old woman from Belize presented with recent vision loss in her left eye due to a subretinal cysticercus located near the macula. We are reporting the use of standard vitrectomy instrumentation and techniques to successfully remove the subretinal cysticercus by a transretinal approach. Pars plana vitrectomy with transretinal removal of the cysticercus is a useful alternative to the traditional external sclerotomy.

Adult↗
PubMed1988

Comparison of suture materials for closure of the scleral pocket incision.

Eighty-five eyes had similar phacoemulsification with posterior chamber lens implantation through a scleral pocket incision. In all cases, wound closure was accomplished with a running suture closed under control of surgical keratometry with operative intraocular pressure established at 15 mm Hg. Three groups were established to determine the influence of various suture materials on the course of postoperative astigmatism; 35 eyes were closed with 10-0 nylon, 25 eyes with 9-0 nylon, and 25 eyes with 10-0 polyester. The results demonstrated a reduced iatrogenic with-the-rule astigmatic shift early after surgery in the group closed with 10-0 nylon compared to the groups closed with the other suture materials. The results for all three groups in the late postoperative period were indistinguishable. A tendency for giant papillary conjunctivitis was noted in the eyes closed with 10-0 polyester.

Astigmatism↗
PubMed1988

Correlation between intraoperative and early postoperative keratometry.

A study to determine the correlation between intraoperative quantitative keratometry and one day postoperative office keratometry was performed. Prior reports have failed to demonstrate a positive statistical relationship between surgical and postoperative keratometry, weakening the value of quantitative intraoperative keratometry. Careful control of variables at surgery, however, can allow for positive keratometric correlation. The data of the present study revealed no statistical difference between intraoperative and one day postoperative corneal astigmatism when intraocular pressure was established at a standard physiologic level prior to final suture closure of the scleral pocket wound. When intraocular pressure was not controlled at the time of wound closure, intraoperative and postoperative corneal cylinder were statistically dissimilar. Operative quantitative keratometry, performed with tight control of variables, appears to play a vital role in reducing iatrogenic cylinder in the early postoperative phase of cataract rehabilitation.

Cataract Extraction↗
PubMed1987

Gull-wing haptic design for posterior chamber intraocular lens.

The current trend toward implantation of posterior chamber lenses within the capsular bag rather than the ciliary sulcus seems logical in light of the increasing evidence of uveal damage from sulcus fixated posterior chamber lenses. However, long-term, successful capsular bag fixation has not been demonstrated with current popular looped lenses of either flat or angulated styles. This report evaluated a new gull-wing loop design that seems to have advantages of both planar and angulated loop styles for support of posterior chamber lenses.

Humans↗
PubMed1987

Deep versus appositional suturing of the scleral pocket incision for astigmatic control in cataract surgery.

A study was performed to determine whether alternative suturing techniques of a standard wound play a significant role in the immediate and long-term postoperative course of corneal astigmatism. Two groups of patients had phacoemulsification and posterior chamber lens implantation through a scleral pocket incision closed with a continuous suture. In one group, the sutures were apposed to the posterior edge of the scleral incision; in the second group, deep suture placement designed to incorporate the internal layer of the scleral pocket was used. The deep suture group demonstrated significantly reduced transient iatrogenic astigmatism but the eventual healed astigmatic results were similar for the two groups. The deep suture group developed no filtration blebs; these did occur in three of 50 cases sutured with the appositional technique.

Astigmatism↗
PubMed1986

Pseudophakic posterior iris chafing syndrome.

Posterior iris chafing by the loop or the optic portion of sulcusfixated posterior chamber lens implants may cause a spectrum of disorders that include iris-pigment epithelial "window defects," pigment dispersion with or without elevation of intraocular pressure, intermittent microhyphemas with transient visual obscurations, and the UGH syndrome. It appears that secondary pigmentary glaucoma is more likely with planar loop design than with angulated loops. Optic and loop materials may play a role in the development of the disorder. Implantation of both supporting loops of the implant within the capsular bag is suggested to prevent posterior iris chafing.

Aged↗
PubMed1986

Temporal incision for astigmatic control in secondary implantation.

A small group of aphakic patients having secondary lens implantation had keratometry performed before and at four months after surgery. A temporally oriented scleral pocket incision and closure technique was used to place the incision in fresh tissue and in the steepest corneal meridian. The results demonstrated an overall reduction of corneal cylinder from modest flattening of the surgical axis. Placement of the scleral pocket incision in fresh temporal tissue for secondary lens implantation affords a watertight stable wound with astigmatic control.

Astigmatism↗