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Biomedical subjects

C E Mein

Publications and source records attributed to C E Mein.

8 recordsLinked to original sources
PubMed1998

Endogenous Aspergillus endophthalmitis. Clinical features and treatment outcomes.

OBJECTIVE: This study evaluated the clinical features and treatment outcomes in patients with endogenous Aspergillus endophthalmitis. DESIGN: The study design was a multicenter retrospective chart review. PARTICIPANTS: Ten patients (12 eyes) with culture-proven endogenous Aspergillus endophthalmitis treated by 1 of the authors were studied. INTERVENTION: Intravitreous amphotericin B injection, pars plana vitrectomy, systemic amphotericin B therapy, and oral anti-fungal therapy were performed. MAIN OUTCOME MEASURES: Elimination of endogenous Aspergillus endophthalmitis and Snellen visual acuity, best corrected, were measured. RESULTS: All patients had a 1- to 3-day history of pain and marked loss of visual acuity in the involved eyes. Varying degrees of vitritis was present in all 12 eyes. In 8 of 12 eyes, a central macular chorioretinal inflammatory lesion was present. Four patients (six eyes) had associated pulmonary diseases and were receiving concurrent steroid therapy. One of these patients with chronic asthma also was abusing intravenous drugs. Overall, six patients (six eyes) had a history of intravenous drug abuse, whereas a seventh patient (one eye) was suspected of abusing intravenous drugs. Blood cultures and echocardiograms were negative for systemic aspergillosis. Management consisted of a pars plana vitrectomy in 10 of 12 eyes. Intravitreous amphotericin B was administered in 11 of 12 eyes. Systemic amphotericin B therapy was used in eight patients. One patient was treated with oral antifungal agents. In three eyes without central macular involvement, final visual acuities were 20/25 to 20/200. In eight eyes with initial central macular involvement, final visual acuities were 20/400 in three eyes and 5/200 or less in four eyes. Two painful eyes with marked inflammation, hypotony, and retinal detachment were enucleated. CONCLUSIONS: Endogenous Aspergillus endophthalmitis usually has an acute onset of intraocular inflammation and often has a characteristic chorioretinal lesion located in the macula. Although treatment with pars plana vitrectomy and intravitreous amphotericin B is capable of eliminating the ocular infection, the visual outcome generally is poor, especially when there is direct macular involvement.

Adult↗
PubMed1991

Recognition and removal of the posterior cortical vitreous during vitreoretinal surgery for impending macular hole.

Vitreoretinal surgery for impending macular hole includes recognition and removal of the posterior cortical vitreous. Previously described surgical techniques for removal of cortical vitreous used either rigid instruments (a tapered extrusion needle or a barbed microvitreoretinal blade) or a short fenestrated soft-tipped suction needle. We used a technique with the cannulated extrusion needle that detects the presence of the posterior cortical vitreous and facilitates safe removal of this layer from the retina. Although this technique is most useful when performing vitrectomy for impending macular hole, it may also be used during vitrectomy for other conditions with uncertain detachment of the posterior cortical vitreous.

Aged↗
PubMed1991

Preoperative antibiotic and povidone-iodine preparation of the eye.

We compared gentamicin 0.3% one drop every three hours the night before and the morning of surgery ("half-day regimen") with the same drug one drop qid for three days ("three-day regimen") in 15 eyes undergoing intraocular surgery. Conjunctival cultures of both groups taken before povidone-iodine preparation showed mean colony counts of 3.67 +/- 0.82 in the half-day regimen versus 1.0 +/- 0.43 in the three-day regimen. Conjunctival cultures taken after the administration of a povidone-iodine 5% preparation showed 7.17 +/- 3.52 and 2.75 +/- 0.88, respectively, in the two groups. Although there was a statistical difference in colony counts, topical gentamicin 0.3% given the night before and day of surgery had comparable low colony counts with the three-day course. The 5% povidone-iodine solution was not effective in reducing bacterial flora although it did eliminate all fungal colonies.

Bacteria↗
PubMed1990

Shaken baby syndrome.

Violent shaking causes severe injury in infants, but the diagnosis of shaken baby syndrome is often difficult to make because of the lack of obvious external signs. Consultations by other specialists may not be helpful, since the findings of most organ systems, taken in isolation, are usually nonspecific. Shaken baby syndrome should be considered in infants presenting with seizures, failure to thrive, vomiting associated with lethargy or drowsiness, hypothermia, bradycardia, hypertension or hypotension, respiratory irregularities, coma or death. Shaken babies are usually less than one year old, and most are under six months of age. Head injury (notably subdural hemorrhage) and retinal hemorrhages are the hallmarks of the syndrome.

Brain Concussion↗
PubMed1990

Ocular anesthesia for cataract surgery: a direct sub-Tenon's approach.

We describe a new technique in which ocular anesthesia is obtained by dissection of the superior quadrants, as in strabismus or retinal surgery, followed by direct infusion of the retrobulbar space with local anesthetic agent, using a blunt 19-gauge cannula. In 112 cases of cataract surgery in which we used this direct sub-Tenon's approach, we found it to be a safe, simple, and effective method of achieving rapid ocular anesthesia.

Adult↗
PubMed1990

Local anesthesia for vitreoretinal surgery.

A new technique for retrobulbar anesthesia for use during vitreoretinal surgery is described. A blunt 19-gauge cannula is used to directly inject the anesthetic agent into the retrobulbar space via a sub-Tenon's approach. The method reported herein virtually eliminates the possibility of complications from the administration of a standard retrobulbar block and allows prolonged vitreoretinal surgery to be performed under local anesthesia. We report the results of our first fifty-eight cases of vitreoretinal surgery performed using this technique.

Adolescent↗
PubMed1989

Augmentation of local anesthesia during retinal detachment surgery.

Because the effect of local anesthesia from a retrobulbar injection diminishes with time, local anesthesia during prolonged retinal surgery may be difficult. A simple, safe, and effective technique for administration of supplemental intraoperative local anesthesia during retinal detachment surgery is described. After a limbal peritomy is performed and the quadrants are dissected bluntly, a 19-guage irrigating cannula is passed posterior to the globe to irrigate the recti muscles and the retrobulbar space with 4% lidocaine hydrochloride. Using this technique, even prolonged vitreoretinal surgery can be performed using local anesthesia with minimal patient discomfort.

Anesthesia, Local↗