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Biomedical subjects

W L Hutton

Publications and source records attributed to W L Hutton.

34 records · Page 2Linked to original sources

Retinal detachment and pseudophakia.

A consecutive series of pseudophakic retinal detachments was statistically compared with a matched group of aphakic retinal detachments. Distribution of breaks, anatomic results, and final visual acuities were tabulated. Success in reattachment was equal in the two groups, but final visual acuities were better in the aphakic group. Emphasis was placed on the intraoperative ophthalmoscopic examination of pseudophakic eyes with compromised peripheral fundus visibility.

Aphakia, Postcataract↗

Focal parafoveal retinal telangiectasis.

We describe four patients, two of whom are sisters, with an unusual form of retinal telangiectasis. The vascular abnormality is localized to the temporal parafoveal retina and is virtually identical in appearance in every patient. Other characteristics include: both men and women are involved, both eyes are generally affected, and symptoms develop in middle life. Laser photocoagulation succeeds in improving the visual acuity in the treated eyes. The consistency of the appearance and location, and the familial tendency indicates these cases probably form a subgroup of retinal telangiectasis.

Adult↗

Management of surgically dislocated intravitreal lens fragments by pars plana vitrectomy.

We examined 26 eyes (19 of them following phacoemulsification) with surgically dislocated intravitreal lens fragments; 24 eyes were subsequently operated on using pars plana vitrectomy for removal of lens fragments. From this select group of patients we found moderate to severe uveitis, glaucoma, and vitreous opacification present in virtually all cases. Less common complications were retinal detachments (six cases) and bullous keratopathy; the latter problem was found most commonly in eyes subjected to anterior segment maneuvers such as the use of lens loops or vitreous irrigation for removal of the lens material. Pars plana vitrectomy proved an excellent method for removal of lens fragments. A simultaneous two-instrument technique using the Wilson foreign-body forceps and the vitrectomy machine facilitated removal of the denser sclerotic lens fragments. This procedure resulted in resolution of the uveitis and glaucoma with improvement in visual acuity in 20 of the 24 eyes. However, only 10 of the 24 patients operated on obtained 20/40 or better visual acuity. A relatively prompt pars plana vitrectomy in eyes subjected to a minimum of surgical trauma yielded the best visual results.

Aged↗

Pars plana vitrectomy for removal of intravitreous Cysticercus.

Pars plana was used for the removal of an intravitreous cysticercus, with minimal postoperative inflammation and an excellent visual result. This approach avoids lens removal and the visualization provided by the operating microscope allows removal of all vitreous humor particles and debris. The aspirated specimens allowed identification of the Taenia solium cysticercus.

Adult↗

Vitrectomy in the treatment of ocular perforating injuries.

Using pars plana (closed) vitrectomy with related procedures we achieved improved vision in certain catagories of perforating ocular injuries. These procedures were particularly useful in removing retained nonmagnetic foreign bodies and correcting retinal detachments associated with traction bands and opaque vitreous. Limited success was obtained with longstanding injuries, double perforations from shotgun injuries, and large corneoscleral lacerations. Early vitreous surgery produced the best results.

Adolescent↗

The late stage of serpiginous (geographic) choroiditis.

Serpiginous and geographic choroiditis, one and the same disease, is characterized by episodic involvement of the pigment epithelium and choroid. Each new lesion passes through an acute phase into an atrophic and scarring one. We observed 20 patients, some with long-term follow-up; some had eventual widespread involvement of both posterior poles. There was no basis for the disease, and treatment did not affect its course. In the patients with long-term disease there was widespread atrophy of the choroid and pigment epithelium and variable amounts of pigment clumping and subretinal fibrous tissue deposition. In nine patients discrete peripheral patches of atrophy were also found. In some eyes the atrophy at the posterior pole had become so confluent that the condition could have been mistaken superficially for a primary choroidal dystrophy. The uninvolved areas appeared to be normal. The electroretinogram and electrooculogram were only affected when extensive disease was present.

Adrenal Cortex Hormones↗

Retinal hemorrhage associated with thrombasthenia.

A healthy 20-year-old man presented with a spontaneous unilateral retinal hemorrhage. Because of a history of easy bruisability, we obtained hematologic studies and diagnosed thrombasthenia, a hereditary hemorrhagic disorder. The association of retinal hemorrhage and thrombasthenia is rare. Thrombasthenia and other platelet functional disorders are becoming better defined as tests for these abnormalities become more reliable and available. Patients with apparent spontaneous retinal hemorrhages of unknown origin should be questioned about hemorrhagic tendencies, and the various tests for hemorrhagic disorders should be obtained. The hematologic survey should include the more sophisticated tests of platelet function. Patients with thrombasthenia should avoid aspirin intake.

Adenosine Diphosphate↗

Surgical removal of nonmagnetic foreign bodies.

A microsurgical technique for the removal of nonmagnetic foreign bodies in eyes with opaque media incorporated the simultaneous use of the foreign body forcepts with a vitrectomy machine equipped with fiberoptics. The superb viewing system provided by the operating microscope combined with the excellent illumination from intraocular fiberoptics offered precise surgical control. Nonencapsulated nonmagnetic foreign bodies in eyes with clear vitreous cavities were removed by using the operating microscope, corneal contact lens, and foreign body forceps introduced through a pars plana location. Vitrectomy was not performed. The surgical techniques allowed early removal of the foreign body and, in a preliminary series of cases, improved visual results in what is usually a devastating ocular injury.

Eye Foreign Bodies↗

A coaxial electrode for intraocular diathermy.

A bipolar electrode was used in intraocular coagulation of vessels. This device was a useful adjunct for the coagulation of vessels in diabetic eyes undergoing vitrectomy. No surgical complications due to the diathermy occurred in the first six patients on whom the device was used.

Diabetic Retinopathy↗

Laser iridectomy.

The argon laser and the ruby laser have been used to open the pigment layer in three cases of surgically incomplete peripheral iridectomy. The technique, its advantages and complications, were discussed. On two additional eyes, full-thickness argon laser iridectomy was unsuccessful.

Aged↗

Pars plana vitrectomy. The role of vitrectomy in penetrating ocular injuries.

Pars plana vitrectomy and related procedures occupy an important role in the management of perforating injuries. Vitreous surgery is particularly important in rendering retinal detachments observable and operable. The frequent postvitrectomy complication of delayed retinal detachment appears to be reduced with prophylactic encircling scleral buckle procedures. Although certain categories of injuries continue to carry a poor prognosis, earlier surgical intervention promises improved results.

Eye Injuries↗