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Biomedical subjects

Andrew J Morrell

Publications and source records attributed to Andrew J Morrell.

4 recordsLinked to original sources
PubMed2004

Blindness and rectus muscle damage following spinal surgery.

PURPOSE: To report a rare case of blindness and rectus muscle damage from ocular compression after spinal surgery. DESIGN: Observational case report. METHODS: A 16-year-old girl underwent scoliosis surgery in the prone position. After surgery, she complained of visual loss in the right eye. Examination showed no perception of light, periorbital bruising, corneal haze, fixed dilated pupil, and loss of adduction beyond the midline. RESULTS: Orbital computed tomography scan showed a swollen medial rectus with no other orbital pathology. The muscle swelling can be explained by ischemia from compression of the globe against the medial wall of the orbit. Ocular compression also caused retinal and optic nerve ischemia, resulting in loss of vision. Medial rectus function recovered with time, but the patient continues to have no light perception. CONCLUSIONS: Blindness after spinal surgery is a rare but devastating complication, and all precautions to avoid ocular compression must be taken.

Adolescent↗
PubMed2002

Randomized controlled clinical trial of beta irradiation as an adjunct to trabeculectomy in open-angle glaucoma.

OBJECTIVE: To assess the effect of a single intraoperative application of 750 cGy of beta irradiation on the outcome of trabeculectomy for uncontrolled open-angle glaucoma. DESIGN: A prospective, randomized, double-blind, placebo-controlled clinical trial. PARTICIPANTS: Sixty-one eyes of 61 Caucasian patients at low risk of filtering surgery failure, with poorly controlled primary or secondary open-angle glaucoma undergoing routine trabeculectomy. METHOD: Patients were randomly assigned to control or beta irradiation groups. All patients underwent standard trabeculectomy with fornix-based conjunctival incision. Eyes assigned to beta irradiation received 750 cGy of beta irradiation directly over the sclerostomy site on completion of conjunctival suturing. An identical but inactive applicator was applied to control eyes, delivering no radiation. Both operator and patient remained masked to the assignment for the 12-month follow-up period. MAIN OUTCOME MEASURES: The main outcome measure was intraocular pressure (IOP) control. Complete success of IOP control was defined as an IOP less than 21 mmHg at 12 months without need for additional medication. Qualified success was defined as an IOP less than 21 mmHg at 12 months where additional medication was required. RESULTS: Complete success of IOP control was achieved in 19 (86%) control eyes and 35 (90%) irradiated eyes (P = 1.0). Qualified success of IOP control was achieved in 21 (95%) control eyes and 39 (100%) irradiated eyes at 12 months follow-up (P = 1.0) CONCLUSIONS: We experienced a very high success rate of filtration surgery in this select population without adjunctive irradiation. Our sample size was too small to show any improvement in success with use of beta irradiation in this group. Other studies would have to be done to determine whether it may have measurable benefit in cases with a high risk of filtration failure.

Aged↗