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Biomedical subjects

A M Kozarsky

Publications and source records attributed to A M Kozarsky.

6 recordsLinked to original sources
PubMed2001

Laser in situ keratomileusis for myopia up to -11 diopters with up to -5 diopters of astigmatism with the summit autonomous LADARVision excimer laser system.

OBJECTIVE: To assess the safety and effectiveness of the Summit Autonomous LADARVision active tracking narrow beam excimer laser system for laser in situ keratomileusis (LASIK) correction of myopia and astigmatism. DESIGN: A multicenter, prospective noncomparative case series. PARTICIPANTS: This cohort consisted of 177 eyes corrected for spherical myopia up to -11 diopters (D) and 170 eyes corrected for myopia up to -11 D spherical equivalent with astigmatism up to -5 D. INTERVENTION: Treatments were performed at four sites in the United States using a 6-mm optic zone for spherical myopes and a 5.5-mm optic zone with a 1-mm blend for astigmats. MAIN OUTCOME MEASURES: Visual acuity, subjective refraction, vector analysis, subject satisfaction, intraocular pressure, complications, and adverse reactions. RESULTS: Six-month follow-up was available on 157 spherical eyes and 113 astigmatic eyes. For spherical myopes, uncorrected visual acuity (UCVA) was 20/20 or better in 60.5%, 20/25 or better in 80.3%, and 20/40 or better in 93.9%. The mean spherical equivalent was -0.29 +/- 0.45 D with 75.2% +/- 0.50 D and 94.9% +/- 1.00 D of intended. A loss of two lines of best spectacle-corrected visual acuity (BSCVA) occurred in 0.6%, and no eyes lost greater than two lines of BSCVA. For astigmatic myopes, UCVA was 20/20 or better in 52.0%, 20/25 or better in 74.5%, and 20/40 or better in 94.1%. The mean spherical equivalent was -0.23 +/- 0.49 D with 75.2% +/- 0.50 D and 95.6% +/- 1.00 D of intended. A loss of two lines of BSCVA occurred in 0.9%, and no eyes lost greater than two lines of BSCVA. Vector analysis showed that 99% of the intended cylinder was corrected on average with a mean angle of error of 4.2 degrees. Refractive stability was achieved between 1 and 3 months in 97.5% of spherical eyes and 99.4% of astigmatic eyes and confirmed between 3 and 6 months in 100% of both spherical and astigmatic eyes. CONCLUSIONS: Eyes treated for myopia up to -11 D of spherical equivalent with or without astigmatism up to -5 D show early refractive stability, good UCVA outcomes, no significant loss of BSCVA, accurate correction of astigmatism, and slight undercorrection without a change from the photorefractive keratectomy algorithm and with a single treatment.

Adult↗
PubMed1987

Chronic bacterial endophthalmitis.

We studied a specific syndrome of uveitis secondary to intraocular bacterial pathogens of low virulence after extracapsular cataract extraction and intraocular lens implantation in three eyes. The onset of photophobia, visual impairment, conjunctival redness, and uveitis was delayed for four days to 12 weeks after surgery. Chronic inflammation persisted for five weeks to 16 months before a definitive diagnosis was made. Signs and symptoms were suppressed by administration of topical and systemic corticosteroids. Intraocular biopsy and antibiotic injection both established the cause as bacterial endophthalmitis and resulted in resolution of signs and symptoms. Staphylococcus epidermidis was cultured in two eyes and Achromobacter was cultured in one.

Adrenal Cortex Hormones↗
PubMed1987

Clinical results with a ceramic keratoprosthesis placed through the eyelid.

The authors placed a ceramic keratoprosthesis through the eyelids of 11 consecutive patients: six with alkali injury, four with cicatricial pemphigoid, and one with Stevens-Johnson syndrome. The surgery was technically successful in ten patients. One patient experienced an intraoperative, expulsive choroidal hemorrhage, and the keratoprosthesis was not implanted. Six patients were followed for 21 to 56 months; three, who had no postoperative potential for visual improvement were followed for 2 to 6 months; and one patient died 14 months after surgery. Six patients achieved 20/20 to 20/100 corrected visual acuity at some point after surgery. At last examination, only three eyes (27%) saw 20/200 or better. Complications included eyelid cellulitis, extrusions, aqueous leaks, retroprosthetic membranes, endophthalmitis, and progressive glaucoma. The authors think mechanical torque by movement of eyelid and globe destabilizes the keratoprosthesis, producing many of the complications.

Adult↗
PubMed1984

Penetrating keratoplasty for exogenous Paecilomyces keratitis followed by postoperative endophthalmitis.

Three patients developed Paecilomyces lilacinus keratitis while being treated with topical corticosteroids and antibiotics. The first patient, a diabetic man, suffered superficial ocular trauma while being treated for recurrent anterior uveitis related to an iris-fixated intraocular lens. The second patient developed keratitis while being treated for anterior segment inflammation associated with herpes zoster ophthalmicus. The third patient, a woman with chronic lymphoma in remission, was receiving topical antibiotics and corticosteroids for a corneal transplant performed one year previously. All three patients underwent penetrating keratoplasty after progression to perforation or failure of medical therapy. Two eyes (cases 1 and 2) eventually required enucleation. The fungal isolates demonstrated in vitro resistance to amphotericin and natamycin with greater sensitivity to imidazole derivatives. Thus, we recommend prompt and prolonged topical treatment with miconazole or other imidazole derivatives along with avoidance of penetrating keratoplasty and corticosteroids.

Aged↗
PubMed1984

Results of penetrating keratoplasty for pseudophakic corneal edema with retention of intraocular lens.

We reviewed the records of 26 consecutive patients undergoing penetrating keratoplasty for pseudophakic corneal edema in which the original intraocular lens was retained. The average interval between lens implantation and penetrating keratoplasty was 31.5 months. Follow-up after keratoplasty ranged from 11 to 59 months, with an average of 24.5 months. Six patients had anterior chamber lenses; sixteen, iris or iridocapsular lenses; and four, posterior chamber lenses. A vitrectomy was performed in 14 (54%) patients. Of the 21 patients with clear grafts (80%), 8 (38%) had vision of 20/40 or better while 7 (33%) had acuities of 20/200 or worse. Visual acuity of 20/40 or better was attained by 3 of 4 (75%) patients with posterior chamber lenses but only 3 of 16 (19%) patients with iris-supported lenses. Cystoid macular edema was the principal cause of decreased acuity in 12 of the 13 patients with clear grafts and acuity less than 20/40. Angiographic confirmation was obtained in 7 of 12 patients. Overall, the results are similar to those reported for pseudophakic keratoplasty with intraocular lens removal. No adverse effect of retaining a securely fixated intraocular lens was demonstrated.

Cataract Extraction↗