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Biomedical subjects

F B Kremer

Publications and source records attributed to F B Kremer.

11 recordsLinked to original sources
PubMed1996

Acremonium kiliense endophthalmitis that occurred after cataract extraction in an ambulatory surgical center and was traced to an environmental reservoir.

During October and November 1993, four patients contracted Acremonium kiliense endophthalmitis at one ambulatory surgical center. We hypothesized that the source was environmental and conducted a matched case-control study, environmental evaluation, and observational studies. Case and control patients were similar in clinical characteristics. However, case patients all had surgery on the first operative day of the week or had surgery significantly sooner after the operating room opened than did controls (a median of 46 vs. 150 minutes afterward; P = .03). An environmental review revealed the ventilation system was switched on 5-30 minutes before procedures began on the first operative day of the week, and air was filtered before but not after humidification. Cultures of the humidifier water in the ventilation system yielded A. kiliense phenotypically identical to isolates from case patients. Our data suggest that switching on the ventilation system each week aerosolized a reservoir of A. kiliense and caused infection of patients. We believe this is the first reported outbreak of fungal endophthalmitis traced to an environmental source, and it underscores the importance of utilizing established hospital infection control practices in the outpatient setting.

Acremonium↗
PubMed1985

Prediction of refractive correction with radial keratotomy.

Multiple regression analysis was employed to estimate the amount of preoperative correction required to achieve emmetropia in 129 spherical radial keratotomy procedures. Age, intraocular pressure, central corneal thickness, number of incisions, number of zones, and central optical zone size are variables that describe the amount of refractive correction required in order to achieve emmetropia. The surgical procedures from which these estimates are derived yield meaningful reductions in myopia. Recommendations for further research on the prediction of optimal response to radial keratotomy are included.

Adult↗
PubMed1983

Quantitated trauma following radial keratotomy in rabbits.

Radial keratotomy was performed in 33 rabbits using an eight-incision technique. At various postoperative intervals up to 90 days, these eyes were enucleated and subjected to increasing quantitated trauma until ocular rupture occurred. Control animals (13 eyes) were subjected to similar trauma. The eyes that had surgery required approximately 50% of the control energy to rupture over the 90-day period (P less than 0.001). Corneal microperforations at surgery greatly increased the trauma risk (P = 0.02). Consistent rupture patterns resulted, both grossly and microscopically.

Animals↗
PubMed1983

Radial keratotomy: prospective evaluation of safety and efficacy.

One hundred five consecutive radial keratotomy procedures were followed for one year postoperatively. There was greatest correction of myopia with less than 8 diopters of preoperative correction, and correction to a lesser degree with more than 8 diopters of preoperative correction. There were no severe complications. Size of central optical zone, number of incisions, graduation of incisional depth, central corneal thickness, patient age, intraocular pressure, and sex are of value in predicting the success of the procedure.

Cornea↗
PubMedDate not supplied

Excimer laser in situ keratomileusis.

We have been using a 193-nm excimer laser under protocol to ablate the corneal stromal bed after creating a hinged corneal flap with a microkeratome in order to reduce or eliminate refractive error. Thirty-one consecutive eyes are reviewed with a preoperative mean spherical equivalent refraction of -6.25 diopters (D) (range -3.50 to -11.75 D). Preoperative mean astigmatism was +0.87 D (range +0.25 to +2.75 D). At 6 months postoperatively, the mean spherical equivalent refraction was -0.50 D (range -3.50 to +2.00 D). Mean postoperative astigmatism was 0.64 D (range 0.25 to 3.50 D). A result within 1.00 D of attempted correction was achieved in 74.2% of eyes. Uncorrected visual acuity after a single procedure was 20/40 or better in 81% of eyes. Spectacle corrected visual acuity was unchanged in 26 (84%), decreased 1/2 line in 2 (6%), and increased 2 lines in 1 (3%). The incidence of postoperative complications was minimal. Excimer laser ablation in the stromal bed in combination with a hinged corneal flap seems to offer many advantages over excimer laser surface ablation with fewer complications.

Astigmatism↗