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Biomedical subjects

C S Atkinson

Publications and source records attributed to C S Atkinson.

7 recordsLinked to original sources
PubMed1997

Glaucoma after cataract extraction and posterior chamber lens implantation in children.

PURPOSE: To evaluate the incidence of postoperative glaucoma in children who have cataract extraction and posterior chamber intraocular lens (IOL) implantation. SETTING: Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA. METHODS: The incidence of glaucoma of all etiologies was evaluated in 45 eyes of 37 selected consecutive patients aged 1 to 18 years who had cataract extraction and posterior chamber IOL implantation from 1991 to 1994. Mean follow-up was 23 months (range 6 to 38 months). Nineteen patients had traumatic and 18 had developmental cataract. Exclusion criteria were microcornea smaller than 9.0 mm in diameter, preoperative glaucoma, or poor pupil dilation. The surgical technique comprised a continuous curvilinear anterior capsulorhexis in most cases, extracapsular aspiration by Ocutome or phacoemulsification, and retention of the posterior capsule. A peripheral iridectomy was done in 7 eyes (16%). Postoperative medications included topical atropine combined with topical, subconjunctival, and systemic corticosteroids and antibiotics. RESULTS: Three patients with traumatic cataract developed postoperative glaucoma during the follow-up. One developed pseudophakic pupillary block; however, a peripheral iridectomy prevented glaucoma. Two other patients developed late-onset glaucoma: one secondary to angle recession and the other to peripheral anterior synechias. No patient with developmental cataract developed glaucoma. CONCLUSION: Careful patient selection, atraumatic surgical technique, continuous curvilinear capsulorhexis, in-the-bag IOL placement, postoperative atropine, and topical and systemic corticosteroids significantly lower the incidence of pseudophakic pupillary block and glaucoma. Although no patient developed glaucoma, lifelong follow-up is mandatory to detect chronic open-angle and traumatic angle-recession glaucoma.

Adolescent↗
PubMed1995

Cataract surgery and intraocular lens implantation in children.

PURPOSE: To evaluate visual outcome and complications after extracapsular cataract extraction with posterior chamber intraocular lens implantation in children. METHODS: Extracapsular cataract extraction with posterior chamber intraocular lens implantation was performed on 20 eyes of 19 patients with traumatic cataract, ten eyes with unilateral congenital or developmental cataract, and 15 eyes (eight patients) with bilateral developmental cataract. Nd:YAG posterior capsulotomy was performed in the early postoperative period as indicated. RESULTS: Fourteen (70%) of 20 eyes with traumatic cataract had best-corrected pseudophakic visual acuity of 20/40 or better. When we excluded four eyes with macular injuries from analysis, 14 (87%) of 16 eyes had visual acuity of 20/40 or better. In patients with bilateral cataract in whom vision was quantified by Snellen acuity (nine eyes of five patients), nine of nine eyes had best-corrected pseudophakic visual acuity of 20/40 or better. In the remaining three patients, six of six eyes had central steady and maintained fixation. Visual outcome was poorest in patients with unilateral cataract (ten eyes); one eye had best-corrected pseudophakic visual acuity of 20/40; two eyes, 20/60; two eyes, 20/70; one eye, 20/100; and two eyes, 20/200. One additional eye had central steady maintained fixation and noncentral fixation. Five of ten eyes had four or more lines improvement in visual acuity. Postoperative complications occurred in five eyes, each of which had traumatic cataract. Three eyes developed iris capture, one eye had a postoperative intraocular hemorrhage, and another developed a dense secondary membrane. In 45 postoperative postoperative eyes, 27 (60%) received one Nd:YAG laser posterior capsulotomy. A second Nd:YAG laser posterior capsulotomy was performed in 11 (41%) of these 27 eyes. CONCLUSIONS: Extracapsular cataract extraction with posterior chamber intraocular lens implantation in children can be accomplished in selected patients, with generally favorable results. However, many of the patients in this series remain potentially amblyogenic, and long-term follow-up may temper our present visual results.

Adolescent↗
PubMed1994

Treatment of secondary posterior capsular membranes with the Nd:YAG laser in a pediatric population.

Thirty-two eyes of 28 pediatric patients were treated with the H. S. Meridian Microruptor III Nd:YAG laser for secondary posterior capsular membranes after cataract extraction either with or without posterior chamber intraocular lens implantation. This laser allows for 90-degree rotation of the laser delivery system to treat recumbent patients who may be under general endotracheal anesthesia. In all patients, at least a 5-mm axial capsulotomy was created. The energy requirements for the procedure were related to the density of the membrane, which correlated with the time lapse between cataract extraction and laser capsulotomy. A second laser capsulotomy was performed in eight eyes. Nd:YAG capsulotomy can be performed in a child of any age by using the Microruptor III. For surgeons who choose to retain the posterior capsule in pediatric cataract extraction, particularly after posterior chamber intraocular lens implantation, this technique offers the noninvasive capability to create and maintain a clear visual axis.

Adolescent↗
PubMed1989

The ferret as an animal model in cerebrovascular research.

Clinical and pathologic observations have suggested analogies between the developing nervous system of ferrets (Mustela putorius furo) and those of more traditional animal models employed in stroke research. Experimental work has demonstrated advantages of the ferret as a model of visual development. We performed in vivo cerebral angiography and postmortem neurovascular dissection of latex-injected specimens of adult ferrets. The great vessels include a cervical arterial trunk that gives rise to both carotid arteries. The anatomy of the cranial arteries is similar to that of rabbits. No carotid rete mirabile is present. There are no intracranial anastomoses between the external and internal carotid systems. We present in vivo cerebral angiograms with pathologic correlation that demonstrate that ferrets may provide the same anatomic advantages as a rabbit model for the experimental study of cerebrovascular disease, with the additional advantage of a long extracranial cervical segment of the carotid artery, affording easier access to the intracranial vasculature.

Animals↗
PubMedDate not supplied

Idiopathic tractional corectopia.

Four infants were referred for congenital unilateral corectopia. In each case, the abnormal position of the pupil was caused by a fibrous structure that tethered the iris pupillary margin to the peripheral cornea. No patients showed characteristics of intrauterine infection, Rieger anomaly, ectopia lentis et pupillae, or iris coloboma. Amblyopia was not present in any of the patients. Three children demonstrated progression of the corectopia in the first 6 months of life. Two who developed shallow anterior chambers were treated surgically, one with an Nd:YAG laser and the other with incisional surgery. The third was treated with medical mydriasis. All four children have had favorable visual outcomes to date. The origin of the tethering strands is unclear but may be related to incomplete regression of vessels from the embryologic vascular system. We recommend medical or surgical intervention for unilateral corectopia when the pupillary aperture is displaced peripheral to the central visual axis or when the position of the iris threatens angle structures. Prophylactic occlusion therapy may also be indicated.

Female↗