PubMed Health⌕ Search

Biomedical subjects

B R Straatsma

Publications and source records attributed to B R Straatsma.

At least 19 recordsLinked to original sources
PubMed1992

Results of inpatient and outpatient cataract surgery. A historical cohort comparison.

PURPOSE: The transition from inpatient to outpatient cataract surgery during the last decade was not accompanied by prospective investigation of its effect on visual outcomes or surgical complications. The authors performed this study to assess the impact of this transition on surgical results. METHODS: The authors reviewed 600 extracapsular cataract extractions performed by 4 experienced ophthalmic surgeons during a 36-month period; in 300 cases, patients were hospitalized after surgery (inpatient group), and, in 300 cases, patients were never hospitalized (outpatient group). The same surgical techniques were used in all cases. Visual outcome and rates for operative and postoperative complications were compared. RESULTS: There were no statistically significant differences between the inpatient and outpatient groups for visual acuity. Excluding patients with pre-existing nonlenticular ocular disease, a best-corrected visual acuity of 20/40 or better was achieved in 93.1% of inpatient cases and in 97.2% of outpatient cases 6 months after surgery. Postoperative, clinically apparent cystoid macular edema was more common in the inpatient group (P = 0.03); however, after exclusion of patients with diabetes, hypertension, age younger than 65 years, and eyes with pre-existing nonlenticular disease, there was no statistically significant difference between groups. No significant differences in rates for other operative and postoperative complications were identified, including wound dehiscence, unplanned postoperative filtering blebs, infectious endophthalmitis, retinal detachment, persistent iridocyclitis, glaucoma, and corneal edema. CONCLUSION: This study does not demonstrate that the transition to outpatient cataract extractions has had an adverse effect on surgical outcomes.

Aged↗
PubMed1991

Lens capsule and epithelium in age-related cataract.

On the basis of preoperative assessment of patient characteristics, intraoperative obtainment of a lens-capsule and epithelium specimen, histopathologic investigation of lens capsule and epithelium, and biochemical analysis of glutathione reductase in lens epithelium, age-related cataract was studied in 50 adult patients who underwent consecutive extracapsular cataract-posterior chamber lens implant surgery. Patients (25 men and 25 women; age range, 41 to 91 years; mean age, 75 years) had a wide range of systemic and ocular disease; 17 of 50 (34%) patients had a history of severe vision-impairing cataract in a first-degree relative. Anterior lens-capsule thickness ranged from 10 to 22 microns, with a mean of 17 microns. Statistical analysis of lens-epithelium ultrastructure in 41 of 50 specimens documented mixing of normal and abnormal cells, verified a gradation in the degree of abnormal ultrastructural features, and demonstrated a statistically significant decrease in epithelial cytologic activity with advancing age (P = .038). Biochemical analysis documented a severe glutathione reductase deficiency in nine of 39 (23%) lens-epithelium specimens, possibly reflecting a dietary deficiency of riboflavin.

Adult↗
PubMed1991

Tissue plasminogen activator treatment of experimental subretinal hemorrhage.

To determine if tissue plasminogen activator, a clot-specific fibrinolytic agent, could eventually be used to assist in the clearance or removal of subretinal hemorrhage, we studied the effect of subretinal injections of tissue plasminogen activator, autologous blood, balanced salt solution, and the combination of either tissue plasminogen activator or balanced salt solution after subretinal injection of autologous blood on retinal morphologic characteristics and clearance of subretinal hemorrhage in the albino rabbit. No morphologic evidence of tissue plasminogen activator toxicity was found in the rabbit retina at a dose of 25 to 50 micrograms/0.1 ml. Subretinal hemorrhage cleared faster after subretinal injection of tissue plasminogen activator when compared to balanced salt solution (P = .0005) but did not completely prevent overlying retinal degeneration. Both tissue plasminogen activator and balanced salt solution were found to decrease the toxic effects of subretinal blood on the morphologic characteristics of the rabbit retina, and this effect can be explained at least partly by dilution of the subretinal blood.

Animals↗
PubMed1990

Posterior vitreous cyst.

We observed two patients who had unilateral posterior vitreous cysts; one patient had been observed for 17 years. Both patients were young females who reported transient, infrequent obscurations of vision that were not disabling. One involved eye was emmetropic, and the other was highly myopic. No other ocular abnormalities were present. In the patient observed for 17 years, the physical characteristics of the posterior vitreous cyst remained unchanged. With this stable clinical course, posterior vitreous cyst that does not visually disable the patient may be managed by periodic observation.

Adolescent↗
PubMed1979

Donor eye program.

Explore the source record for details and available documents.

Academic Medical Centers↗
PubMed1979

Myelinated retinal nerve fibers associated with ipsilateral myopia, amblyopia, and strabismus.

Four patients had extensive unilateral myelinated nerve fibers associated with ipsilateral myopia, amblyopia, and strabismus. Their profound visual impairment, exotropia, and the early age onset of symptoms indicated that the amblyopia may have been organically caused. Prognosis is poor for even partial correction but good results have been obtained with intense therapy that includes full correction of the refractive error in each eye and extraocular muscle surgery if cosmetically necessary. In patients with axial myopia, images of a similar size will be produced by placing a lens of the correct power at the spectacle plane. In younger patients, a contact lens should not be used to correct the refractive error because it creates an undesirable anisometropia. Younger patients who have parafoveal fixation and no strabismus respond best to amblyopia therapy.

Adolescent↗
PubMed1978

Address of the President. Look around with awareness.

In conspectus, consideration is given to the first "academy" in ancient Greece, current national health goals, change affecting health and medical care in the United States, and evolution--as well as the promising future--of the American Academy of Ophthalomology and Otolaryngology. Contemplating the future, the advice of James Thurber is increasingly valid: "Look backward not with anger, nor forward with fear, but look around with awareness."

Academies and Institutes↗
PubMed1977

Experimental immunogenic rubeosis iridis.

We have developed a primate model of rubeosis iridis in monkeys systemically sensitized to crystalline beef insulin. After intravitreal insulin injection, the dose-related immunogenic inflammation includes cells, flare, fibrin, and blood in the anterior chamber. With more severe inflammation, posterior synechiae, iris bombé, and cataracts occur. Of particular importance, new blood vessels develop within the stroma and on the anterior surface of the iris. Following injection of small amounts of insulin, the anterior surface vessels may regress over time, and the iris regains its normal appearance and coloration. However, the new stromal vessels persist and are cuffed by inflammatory cells including plasma cells. After injection of large amounts of insulin, more extensive structural alterations develop as noted above in conjunction with persistent iris anterior surface and stromal neovascularization. The relationship of rubeosis iridis to clinical inflammatory syndromes and to previous laboratory studies is discussed. Stromal neovascularization was a consistent finding in this experimental model even when anterior surface vessels regressed. On the basis of these experimental data and a review of publications describing human pathology, we believe that a broadening of the classic definition of rubeosis iridis is waranted to include a recognition of the stromal component of the clinical and pathologic findings.

Animals↗