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Biomedical subjects

E Maselli

Publications and source records attributed to E Maselli.

12 recordsLinked to original sources

A comparison of the rate of refractive growth in pediatric aphakic and pseudophakic eyes.

OBJECTIVE: To compare the rate of refractive growth in pseudophakic children's eyes to that of aphakic eyes. DESIGN: Multicenter, retrospective observational case series. PARTICIPANTS: 83 patients with pseudophakic eyes (100 eyes) and 74 patients with aphakic eyes (106 eyes), with an age of surgery between 3 months and 10 years and a minimum follow-up time of 3 years or more, depending on the age at surgery. METHODS: A logarithmic model was used to analyze the rate of refractive growth for each eye. MAIN OUTCOME MEASURES: Age at surgery, intraocular lens power, intraocular lens A-constant, initial postoperative refraction, final refraction, and final age. RESULTS: Overall, pseudophakic eyes showed a lesser rate of refractive growth than aphakic eyes (-4.6 diopter vs. -5.7 diopter, P = 0.03). This trend was also present but less significant when the eyes were grouped into those less than 6 months of age at surgery (-3.3 diopter vs. -4.6 diopter, P = 0.09) and older patients (-5.0 diopter vs. -6.1 diopter, P = 0.07). However, the mean quantity of myopic shift was greater in pseudophakic eyes than in aphakic eyes (-5.26 diopter vs. -4.54 diopter), despite shorter follow-up times in the pseudophakic eyes. This is due to the optical effects of a constant intraocular lens power in a growing eye. CONCLUSIONS: Pediatric pseudophakic eyes have a slightly lesser rate of refractive growth than aphakic eyes. The new rate values should be used for predicting future refractions in these eyes.

Aphakia, Postcataract↗

Does primary intraocular lens implantation prevent "aphakic" glaucoma in children?

PURPOSE: Open-angle glaucoma may develop after surgery for congenital or developmental cataract with an incidence ranging from 3% to 41%. The pathogenesis of "aphakic" (open-angle) glaucoma remains unknown. Despite numerous reported clinical series (>1000 eyes), we are unaware of any reported case of open-angle glaucoma after primary intraocular lens (IOL) implantation for congenital or developmental cataract. We decided to test the hypothesis that primary posterior chamber IOL implantation might decrease the incidence of open-angle glaucoma in children. METHODS: Pseudophakic eyes were collected from surgeons who contributed data to a refractive study and who monitored intraocular pressure on a regular basis. IOL implantation was commonly performed in eyes with a corneal diameter >10 mm. Comparable primary data on aphakic eyes were included from 2 published studies on aphakic glaucoma, which included corneal diameters and the patient's age at surgery. Glaucoma-free survival estimates for each cohort were estimated. RESULTS: Only 1 case of glaucoma was found among 377 eyes with primary pseudophakia (mean age of patient, 5.1 +/- 4.7 years; mean follow-up, 3.9 +/- 2.7 years). There were 14 eyes (11.3%) with glaucoma among 124 aphakic eyes (mean age of patient, 2.7 +/- 2.6 years; mean follow-up time, 7.2 +/- 3.9 years). CONCLUSIONS: We report a decreased incidence of open-angle glaucoma among eyes rendered primarily pseudophakic compared with those that remained aphakic after cataract surgery. We propose 2 theories on the possible mechanism of reduction in the incidence of glaucoma in pseudophakic eyes.

Adolescent↗

[Hypersplenism in surgery].

We studied 86 patients suffering from hypersplenism, associated with portal hypertension (39 patients), hematologic disease (45 patients) and with Gaucher's disease (2 patients). Inclusion criteria were the presence of thrombocytopenia < 100.000 x mm3 and leucopenia < 4.000 x mm3. No meaningful differences about the improvement of hypersplenism in portal hypertension were observed between the patients submitted to shunt and splenectomy and those submitted to shunt only. On the contrary, splenectomy caused a quick normalization of the leukothrombocytopenia in the patients suffering from hematologic disease, which, moreover, allowed to perform radio- and chemotherapy in those suffering from malignancies. We reported absence of mortality and a low and aspecific morbidity.

Adolescent↗

[Surgical treatment of strabismus by sagittal cutting of the oblique muscles. Apropos of 449 cases].

The theoretical proposals and the therapeutic approach described at the beginning of the sixties by Gobin concerning the treatment of incomitant strabismus have had such positive results as to convince many surgeons to adopt this methodology. The principal merit of Gobin's technique lies in evaluation of all aspects of the strabismus (horizontal, vertical and oblique) searching for the obstacles to ocular movements which cause alteration of binocular vision and removing them. According to the above criteria, we have operated 449 cases of incomitant strabismus due to sagittalization of the oblique muscles. The validity of this technique has been demonstrated by the results obtained in a single operation (a success rate of over 50%). With a second operation the success rate was increased to 70% (orthophoria, heterophoria and esthetic angle < 7 degrees).

Adolescent↗

Diathermo-trabeculotomy ab externo: indications and long-term results.

The authors present the results of 2 years' observation of 47 eyes operated with diathermo-trabeculotomy ab externo. This technique, based on a diathermic effect in association with trabeculotomy ab externo, allows an ample opening of Schlemm's canal and of the trabecular meshwork, with normalisation of intraocular pressure and outflow facility, for a period of up to 2 years, in open-angle and congenital glaucoma.

Electrocoagulation↗