Perception of Purkinje vessel shadows and foveal granular pattern as a measure of potential visual acuity.

Purpose: To compare perception of 2 entoptic phenomena, the Purkinje vessel shadows and the foveal granular pattern, as measures of retinal visual acuity using a transscleral illumination technique that bypasses the anterior segment.

Setting: Retinal Vascular Center and General Eye Clinic, Wilmer Ophthalmological Institute, Johns Hopkins Hospital, Baltimore, Maryland, USA.

Methods: Both eyes of 85 patients with clear ocular media, many with retinal disease, were tested for perception of these entoptic phenomena.

Worldwide legal requirements for obtaining corneas: 1990.

Cornea transplantation offers the hope of restoring useful vision to millions of individuals worldwide. Yet it is widely used only in certain countries. While a lack of the necessary economic and technical infrastructure is the primary reason in many countries, the legal and social systems pose a similar obstacle in many other more prosperous countries.

Changing indications for cataract surgery: 1974 to 1988.

To examine changes in indications for cataract surgery which have contributed to the increasing rate of cataract extractions, we compared preoperative characteristics of 265 patients who had undergone surgery in 1988 with a similar number who had undergone surgery by the same four ophthalmologists in 1974 and 1982. Between 1974 and 1988 the number of extractions performed annually by two high-referral hospital-based surgeons rose by 68%. Over 90% of these procedures in 1974 were intracapsular extractions; in 1988, 90% were extracapsular extractions with intraocular lenses.

Visual disabilities related to intraocular lens design.

Intraocular lens implantation after cataract extraction has become a common practice in the United States. However, unwanted optical images can correct an otherwise successful surgery into one that causes patient dissatisfaction. Refinements in manufacturing design and finishing have greatly improved the quality of present day intraocular lenses, but there is continued interest in simulating the optics of the human crystalline lens.

Idiopathic presenile cataract formation and galactosaemia.

Five hundred patients undergoing cataract surgery were prospectively examined, and 46 Caucasian patients were found to have strictly idiopathic cataracts severe enough to warrant surgery on or before age 55. In a masked fashion we determined the activity of galactokinase (GK) and galactose-1-phosphate uridyl transferase (GPUT) in these patients as well as on 53 age matched controls. With respect to GK no cataract patient had an enzyme level of less than 2 standard deviations below the control mean.

The efficacy and safety of combined trabeculectomy, cataract extraction, and intraocular lens implantation.

The safety and efficacy of combined trabeculectomy, extracapsular cataract extraction (ECCE), and posterior chamber intraocular lens (PC IOL) implantation were evaluated by retrospectively analyzing 108 consecutive operations. Postoperatively, 89% of eyes achieved 20/40 or better visual acuity when preoperative macular and optic nerve diseases were excluded. Mean follow-up was 16.

Cataract extraction after retinal detachment surgery.

Extracapsular cataract extraction (ECCE) was done in 31 eyes of 27 patients after previous retinal reattachment surgery with scleral buckling. A posterior chamber intraocular lens (IOL) was implanted in 21 eyes. No significant modifications in the cataract surgical technique were necessary.

Continuing corneal endothelial loss in intracapsular surgery with and without Binkhorst four-loop lenses: a long-term specular microscopy study.

We analyzed pre- and postoperative corneal endothelial photographs of 17 intracapsular cataract extractions (ICCE) with Binkhorst four-loop intraocular lens (IOL) eyes and found 11.6% mean cell loss at 2 months (previously reported by Hirst et al) increasing to 42.4% after 5 years (p less than 0.

Drg-39.

The development of extracapsular cataract extraction with insertion of an intraocular lens has undoubtedly been one of medical science's greatest advances in the rehabilitation of vision. It has also lead to vigorous debates within and without the profession about the efficacy of the procedure and its cost-benefit ratio. Criticism directed toward cataract surgery, both by those in the medical profession and those in governmental agencies, must be addressed if ophthalmologists are going to continue to be able to meet the needs of their patients.

Treatment of Mooren's and Mooren's-like ulcer by lamellar keratectomy: report of six eyes and literature review.

Three cases of Mooren's ulcer (four eyes) and one case of marginal corneal ulcer associated with relapsing polychondritis (two eyes) are presented with decrease in ocular inflammation following extensive lamellar keratectomy or lamellar keratoplasty. Tissue adhesive was needed in two cases to maintain ocular integrity. The procedure may work by the removal of a corneal antigenic stimulus to a self-perpetrating auto-immune phenomenon that causes corneal melting.

Retinal detachment after extracapsular cataract extraction with posterior chamber intraocular lens.

The authors reviewed 3065 consecutive cases of extracapsular cataract extraction with posterior chamber lens implant (ECCE-PC IOL) and found the incidence of retinal detachment to be 1.4% overall (44/3065) and 1.7% in a group of eyes followed for at least 1 year (40/2330).

Cataract extraction after vitrectomy.

Cataract extractions were performed in 25 patients who had previously undergone pars plana vitrectomy. Posterior chamber IOLs were implanted in 20 of 26 eyes. Modification of the usual surgical technique was often necessary because the zonules and/or posterior capsule were unusually mobile.

Potential acuity meter for predicting postoperative visual acuity in penetrating keratoplasty. A new method using a hard contact lens.

An irregular corneal surface degrades the optical transmission and limits the effectiveness of the potential acuity meter (PAM) in predicting post-keratoplasty visual acuity. The authors investigated the efficacy of using a temporarily placed hard contact lens to neutralize surface irregularities in conjunction with the PAM in predicting post-keratoplasty visual acuity. A prospective evaluation was performed on 40 keratoplasty patients with a mean follow-up of 10.

Current concepts in intraocular lens implantation.

PC IOLs appear to be safe and effective and there are few contraindications. Based on the available data we feel confident about implanting PC IOLs in healthy eyes of patients aged 40 or older. For younger patients, we do not recommended an IOL unless glasses or contact lens use is not feasible.

Clinical and immunological results of corneal allograft rejection.

Of 111 episodes of graft rejection in 66 patients, 62 responded to therapy with graft clearing (responders); 49 did not (non-responders). Both groups were of similar age, sex, and etiology; both had a similar rate of glaucoma and a similar rate of previous grafting. In responders the graft reaction was shorter in duration (2.

Extracapsular cataract extraction and posterior chamber lens implantation in eyes with preexisting glaucoma.

Fifty eyes of 40 patients with glaucoma underwent extracapsular cataract extraction with posterior chamber lens implantation. Their visual results and early postoperative complications were compared with those of eyes in an age-matched group of patients without glaucoma after the same procedure. Substantial increases in early postoperative intraocular pressure (IOP) occurred in 62% of the glaucomatous eyes and in only 10% of the normal eyes.

Potential acuity meter for predicting visual acuity after Nd:YAG posterior capsulotomy.

We studied 30 patients with opacifications of the posterior capsule to determine if the potential acuity meter (PAM) could accurately predict final visual outcome after Nd:YAG discussion. The final visual acuity was within one line of the PAM prediction in 22 of 30 patients (73%), better by two or more lines in seven patients (23%), and worse in one patient (4%) by two lines. Although in thicker capsules the final acuity was occasionally better than the PAM prediction, the rates of false negative and false positive predictions were very low.