PubMed Health⌕ Search

Biomedical subjects

C M Lederer

Publications and source records attributed to C M Lederer.

9 recordsLinked to original sources
PubMed1996

Slit-lamp needle revision of failed filtering blebs using mitomycin C.

PURPOSE: The purpose of the study is to determine the efficacy and safety of Mitomycin C (MMC) augmented slit-lamp needle revision of failed filtration surgery. METHODS: The authors retrospectively reviewed the charts of 62 patients (62 eyes) (age, 72 +/- 15 years) with failed filtration surgery who underwent needle revision using MMC. A mixture of 0.01 ml of MMC (0.4 mg/ml) and 0.02 ml of bupivacaine with epinephrine was injected subconjunctivally. Twenty to 30 minutes later, a 30-gauge needle was used to perforate the area of subconjunctival fibrosis and re-establish flow. RESULTS: Overall, 118 needing procedures (mean, 1.9 +/- 1.4 revisions per eye; range, 1-7) were performed on 62 eyes (mean follow-up, 9.9 +/- 3.7 months; range, 4.5-20.1 months). Thirty-six patients (58.1%) were needled once and 26 patients (41.9%) underwent more than 1 needling procedure. Intraocular pressure decreased from 24.1 +/- 6.4 mmHg (range, 18-44) before surgery to 11.5 +/- 4.8 mmHg (range, 1-26) at last follow-up (P = 5.51 x 10(-21)). Antiglaucoma medications decreased from 1.6 +/- 1.0 to 0.3 +/- 0.6 (P = 3.8 x 10(-14)). Successful single-needling procedure was highly correlated with race (white) and past conventional glaucoma filtration surgery of more than 4 years. Complications included serous choroidal detachment (10 eyes), suprachoroidal hemorrhage (1 eye), bleb leak (5 eyes), iris blocking sclerostomy (2 eyes), hyphema (2 eyes), corneal abrasion (2 eyes), and hypotony (1 eye). CONCLUSION: Mitomycin needle revision appears to be an extremely effective way to revive failed filtration surgery. The incidence of complications compares favorably to trabeculectomy with MMC.

Adult↗
PubMed1996

Combined cataract extraction with intraocular lens implant and mitomycin-augmented trabeculectomy.

PURPOSE: Cataract and glaucoma commonly coexist in elderly patients and present complex treatment options. This study investigates the results of simultaneous treatment of both conditions using phacoemulsification with posterior chamber lens implant and mitomycin-augmented trabeculectomy (combined surgery). METHODS: A retrospective analysis was performed of 56 consecutive patients who had undergone combined surgery. Fifty-one (91%) of 56 patients had fornix-based conjunctival flaps resutured at the limbus. A variety of postoperative interventional techniques (mechanical and pharmacologic) were used to encourage the achievement of successful filtering blebs. RESULTS: All patients had follow-up of at least 12 months. The mean preoperative intraocular pressure (IOP) was 20.2 mmHg (range, 14-43 mmHg) and the mean postoperative IOP was 10.7 mmHg (range, 4-17 mmHg). Fifty-three (95%) of 56 patients had IOPs of 15 mmHg or less at the completion of follow-up. All except two patients (96%) were able to discontinue all glaucoma medications. The filtering blebs that resulted from the fornix-based conjunctival flap procedures were predominantly large, diffuse, and noncystic. Best-corrected visual acuity was 20/40 or better in 47 (84%) of 56 of patients. CONCLUSION: Control of IOP and improvement of visual acuity can be achieved in a high percentage of patients with coexisting cataract and glaucoma by performing combined surgery using intraoperative mitomycin and fornix-based conjunctival flaps resutured to the limbus. The filtering blebs illustrated a distinctive morphology compared with blebs resulting from limbus-based conjunctival flap procedures.

Aged↗
PubMed1989

Posterior synechiae after laser iridectomy.

Eighty-six eyes of 46 patients were studied retrospectively to determine the incidence of posterior synechiae after laser iridectomy. All eyes were dilated and studied with a slit lamp. The incidence of permanent posterior synechiae in the eyes in this study (37%) is much higher than that previously reported. There was a strong positive correlation between the use of miotic agents postoperatively and the finding of posterior synechiae. The probable pathogenesis of this complication is discussed, and methods to decrease the incidence of this complication are given.

Cicatrix↗
PubMed1986

Drop size of commercial glaucoma medications.

We tested 145 samples of 20 different topical medications for the treatment of glaucoma to determine the average drop size of each preparation. The average drop volumes of different preparations varied between a minimum of 25.1 microliter and a maximum of 56.4 microliter, with an average drop volume of 39.0 microliter. Our findings contradict the common assumption that commercial eyedrops contain a volume of 50 to 75 microliters.

Drug Packaging↗
PubMed1986

Argon laser trabeculoplasty in a residency program.

The following article discusses the outcome of 60 eyes with various forms of glaucoma undergoing resident-performed argon laser trabeculoplasty (ALT). The majority (46/60) of eyes had primary open-angle glaucoma. Decrease in intraocular pressure (IOP) was not as great as reported in the literature. Our results suggest that initially treating 180 degrees of the angle is associated with improved overall results. ALT has proved to be a safe and effective alternative to conventional surgery for glaucoma in a residency training setting.

Adult↗
PubMed1985

Primary angle closure glaucoma in a myopic kinship.

Three related myopic individuals with primary angle closure glaucoma are reported. They had true myopia and not pseudomyopia secondary to increased lenticular index of refraction. We believe one of these individuals (-8.62 spherical equivalent) to have the most myopic case of primary angle closure glaucoma reported in the literature. Although myopia is associated with anatomical factors that offer considerable protection from primary angle closure glaucoma, its presence does not eliminate the possibility of this disease. Laser iridectomy was effective in the treatment of these patients.

Adult↗
PubMed1984

Krypton laser trabeculoplasty. A clinical report.

Krypton red (647.1 nm) or krypton yellow (568.2 nm) laser trabeculoplasty was performed in 15 phakic eyes of 14 patients. After an average follow-up of five months, these patients had an average drop of intraocular pressure of 8.9 mm Hg. In addition, in eight of these patients studied, argon laser trabeculoplasty was performed in the opposite eye. After an average follow-up of more than five months in these eight patients, the average drop of IOP was 7.2 mm Hg in the eyes with krypton laser trabeculoplasty and 6.8 mm Hg in the eyes with argon laser trabeculoplasty. This preliminary study indicates that laser trabeculoplasty may be effectively performed with krypton wavelengths.

Aged↗
PubMed1982

Ocular findings in the intravenous drug abuser.

Two patients with talc emboli of the retinal vasculature, both of them intravenous drug abusers, are described. One underwent a pars plana vitrectomy for removal of the vascularized vitreous mass that obscured the retina. The vitreous mass was presumably a result of retinal neovascularization secondary to the talc embolic. Other ocular findings that may be observed in the intravenous drug abuser are described.

Adult↗