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Biomedical subjects

D R May

Publications and source records attributed to D R May.

At least 19 recordsLinked to original sources
PubMed1994

Surgical wound defects associated with endophthalmitis.

Twenty-five consecutive cases of culture-proven postsurgical endophthalmitis were evaluated. Patients underwent wound revision and pars plana vitrectomy with intravitreal antibiotic and steroid infusion (gentamicin 8 micrograms/cc, clindamycin 9 micrograms/cc, dexamethasone 8 micrograms/cc) and injection (gentamicin 100 micrograms plus clindamycin 200 micrograms [and amphotericin 5 micrograms in one case] and dexamethasone 800 to 1000 micrograms). Twenty cases demonstrated wound defects (eg, wound gape/malapposition, abscess/tissue necrosis, suture dehiscence, leak, vitreous wick). Culture-proven isolates included both gram negative and positive bacteria and fungi. Visual acuity improved in 18 of the 20 (90%) gram positive cases. Ten of the 17 (59%) patients in the Staphylococcus epidermidis subgroup achieved a visual acuity of 20/50 or better. Surgical wound defects are frequently associated with culture-proven endophthalmitis. When vitrectomy is included as part of the treatment regimen, we recommend meticulous inspection and closure of any defective surgical wounds associated with endophalmitis.

Cataract Extraction↗
PubMed1990

Low-intensity grids improve sensitivity of amsler grid testing in diabetic patients without background retinopathy.

We tested 22 eyes of 12 diabetic patients without retinopathy for visual loss using four types of Amsler grids. The Amsler grids, in order of decreasing intensity, were the standard white, bright red, fine red, and threshold (through cross-polarizing filters). The threshold grid detected the largest number of scotomas--16 versus 12, seven, and seven, respectively--and the largest total area of all scotomas--1594 degrees 2 of arc versus 1237, 994, and 927, respectively. In addition, metamorphopsia lessened as grid intensity decreased. These results demonstrate that the sensitivity of Amsler grid testing for visual loss in diabetics without retinopathy improves by decreasing the intensity of the grid used.

Adult↗
PubMed1989

A 20-gauge intraocular electromagnetic tip for simplified intraocular foreign-body extraction.

A modified tip for the Bronson intraocular electromagnet has been developed. The tip was machined to a 20-gauge cylinder that can be inserted readily into the eye either through an entrance wound or through a pars plana incision. Placement of the tip of the magnet inside the eye allows the foreign body to impact the tip of the magnet rather than the wall of the eye.

Electromagnetic Phenomena↗
PubMed1988

Light-induced maculopathy and cystoid macular edema.

We present two patients with paramacular burns induced by the operative light microscope. In one case there was associated cystoid macular edema. Of the 34 total reported cases of paramacular burns, there have been only two cases of cystoid macular edema. Thus, although the total number of reported cases of light-induced maculopathy is small, this disorder does not appear to predispose to cystoid macular edema. Loss of visual acuity is mainly caused by the proximity of the burn to the fovea.

Aged↗
PubMed1988

An improved approach to aqueous paracentesis.

We describe a quick and effective technique for performing safe anterior chamber paracenteses. The technique consists simply of inserting a small gauge disposable hypodermic needle without an attached syringe into the anterior chamber. The intraocular pressure and capillary action of the needle readily cause the rapid drainage of aqueous humor. This technique eliminates the cumbersome manipulations and potential complications associated with using an attached syringe for aspiration.

Anterior Chamber↗
PubMed1987

Threshold Amsler grid testing in maculopathies.

The Amsler grid is a suprathreshold target and thus may fail to detect relative scotomas. If the grid is viewed through two cross-polarizing filters creating low luminance conditions (threshold Amsler grid testing) the test is far more sensitive. Ten patients with disorders of the macula with normal standard white Amsler grid testing were studied with three other Amsler grid tests. Of the 15 involved eyes, 12 had visual field defects present with threshold Amsler grid testing. Tangent screen examination showed defects in 10 of these 12 eyes. The two red grids used were not as sensitive as the threshold grid. Three eyes had metamorphopsia with the white grid which became the site of a visual field defect with threshold testing. Threshold Amsler grid testing is a rapid and sensitive technique for the evaluation of the central 10 degrees of visual field in patients with maculopathies.

Adult↗
PubMed1986

Retinal toxicity secondary to intraocular gentamicin injection.

The authors present five cases of severe retinal ischemia associated with gentamicin injection. In three of the cases massive doses of gentamicin were erroneously injected into the eye; in two of the cases the authors presume that gentamicin toxicity occurred. The sequence of clinical findings was similar in all five cases. The prominent findings included early superficial and intraretinal hemorrhages, opaque and edematous retina, cotton-wool infarcts, arteriolar narrowing, and venous beading. Fluorescein angiography revealed severe retinal vascular nonperfusion. Chronic findings included rubeosis irides, neovascular glaucoma, retinal pigmentary degeneration, and optic atrophy. Of the documented cases of massive intraocular gentamicin injection, two patients had no light perception (NLP) vision and one had bare light perception. Of the two cases of presumed gentamicin toxicity, one had 20/400 vision and one had count fingers vision. Strict precautions are necessary to prevent the catastrophic events resulting from inadvertent gentamicin injection; such precautions should include precise labeling of all injectable solutions on the surgical field, waiting to draw up injectable antibiotics until the time they are needed, and drawing up injectable antibiotics under direct physician observation. All intravitreal injections should be performed slowly, in the anterior vitreous, with the needle bevel up.

Adult↗
PubMed1983

An exchange of ophthalmologists with the People's Republic of China.

From 1978 through 1981, three teams of ophthalmologists from the United States have traveled to the People's Republic of China under the auspices of the World Eye Foundation. The purpose of these visits has been to open an avenue of exchange between American and Chinese ophthalmologists. The US ophthalmologists delivered lectures and participated in discussion groups with the Chinese ophthalmologists. They had the opportunity to participate in surgical teaching cases, including some using acupuncture anesthesia. They also had the opportunity to develop ongoing working and research relationships with many Chinese ophthalmologists. As a result of these working relationships, some of these Chinese ophthalmologists have had the opportunity to visit and study in the United States.

China↗
PubMed1983

Vacuum-attached infusion terminal.

A vacuum-attached infusion terminal for use in vitrectomy procedures has the advantage of being rapidly positioned in the eye through a 20-gauge pars plana incision. The terminal can be used as a temporary infusion source or throughout an entire vitrectomy procedure.

Catheterization↗
PubMed1983

A 19-gauge illuminating infusion probe.

A 19-gauge illuminating infusion probe has been developed and used during the past four years. This instrument is potentially useful in many deep vitrectomy procedures in which intraocular illumination is also required.

Humans↗
PubMed1983

Results of 110 vitrectomies with a portable vitrectomy system.

We retrospectively evaluated the VITAC (vitreous-tissue aspiration cutter), a portable vitrectomy system with an end-cutting vitrectomy probe with a self-sharpening oscillating blade and a monoblock design, in 110 vitrectomy procedures, 34 performed at the University of California Davis Medical Center and 76 performed at the Eye and ENT Hospital in Shanghai, China. The indications for vitrectomy included penetrating injuries (22 eyes), intraocular foreign bodies (28 eyes), vitreous hemorrhages (18 eyes), cataracts (17 eyes), endophthalmitis (seven eyes), pupillary-block glaucoma (five eyes), bullous keratopathy (five eyes), aphakic penetrating keratoplasty (three eyes), pupillary membranes (two eyes), massive preretinal proliferation (one eye), and cystoid macular edema (one eye). Vitrectomy resulted in visual improvement in 19 of 34 eyes in the California series (56%) and in 60 of the 76 eyes in the Shanghai series (79%). This difference was attributable to the higher percentages of cases involving the posterior segment and vitreous hemorrhage in the California series. When results from both institutions were combined, surgery with the VITAC produced visual improvement in 79 of 110 cases (72%), comparable to the results obtained with other vitrectomy systems.

Eye Diseases↗
PubMed1983

Effect of hypothermic perfusion on corneal endothelial morphology.

The effect of moderate in-vivo hypothermic perfusion on corneal endothelial integrity was studied in the cat. Eleven cats underwent in-vivo anterior chamber perfusion for 30 minutes with either normothermic (23 degrees C) or hypothermic (5 degrees C) perfusate. Corneas were then evaluated clinically (biomicroscopy), functionally (vital staining), and morphologically (scanning electron microscopy) for changes attributable to hypothermic perfusion. All 3 modes of evaluation suggested no difference in corneal endothelial integrity under the 2 experimental perfusion conditions. At the clinical and scanning electron microscope levels hypothermic perfusion does not show any effects on the corneal endothelium. Regional hypothermia is of theoretical and potential utility in procedures involving prolonged intraocular perfusion.

Animals↗