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Biomedical subjects

F W Price

Publications and source records attributed to F W Price.

At least 37 records · Page 2Linked to original sources
PubMed1993

Management of concurrent corneal diseases and cataract.

Cataract surgery is the most common surgical procedure in the United States, and the likelihood of encountering complications from concurrent corneal disease and cataract surgery is great. The rise of pseudophakic bullous keratopathy as an indication for corneal transplantation reflects the current trend toward increasing corneal pathology arising from cataract surgery and intraocular lens complications. Attitudes regarding astigmatism have changed drastically. Cataract surgery, coupled with astigmatic procedures, is becoming the procedure of choice for visual rehabilitation. Congenital corneal conditions and systemic disease processes are also considered in this review.

Astigmatism↗
PubMed1993

Molteno implants in patients with previous cyclocryotherapy.

We report four cases in which cyclocryotherapy proceded Molteno implantation for refractory glaucoma. Three of the four cases were complicated by chronic postoperative hypotony, apparently resulting from overfiltration by the seton, even though a single-plate implant, with a limited filtration area, was used. Religation of the filtering tube or removal of the implant should be considered in these cases.

Aged↗
PubMed1992

Changing trends in explanted intraocular lenses: a single center study.

Over a nine-year period, our practice removed 1,091 intraocular lenses. The most common type of lens requiring explantation was the closed-loop anterior chamber lens (58.6%). The Stableflex lens represented the largest percentage of all removed lens types (28.8%). The number of closed-loop anterior chamber lenses requiring removal peaked in 1988 and then gradually declined. All other lens styles have shown gradually increasing removal rates. Older style iris-fixated lenses and rigid anterior chamber lenses, which have not been implanted for several years, have increasing removal rates. Late breakage of fixational polypropylene sutures with pupil-supported iris-fixated lenses have occurred in five cases; the average time from implantation to suture breakage was 112 months.

Anterior Chamber↗
PubMed1992

Explantation of posterior chamber lenses.

A consecutive series of 119 explanted posterior chamber lenses is reviewed. Seventy (58.8%) were removed because of dislocation or improper fixation, 15 (12.6%) because of anisometropia, and 18 (15.1%) because of chronic inflammation. Sixty-two (52.1%) of these explantations probably occurred for reasons that can be avoided by changes in preoperative, operative, or postoperative techniques. The rate of posterior chamber lens explantations is quite low considering the large number of lenses implanted; with changing surgical techniques, we anticipate that the number of lenses requiring removal will decrease.

Aged↗
PubMed1991

Immunohistochemistry of Terrien's and Mooren's corneal degeneration.

Lamellar keratoplasty specimens from a patient with Terrien's marginal degeneration and a patient with Mooren's ulcer were compared using routine histopathologic and immunohistochemical staining with an avidin-biotin-peroxidase complex. Less than 25% of the resident cells in the Terrien's marginal degeneration specimen expressed major histocompatibility class II antigens compared with 75% to 100% of the resident cells in the Mooren's ulcer specimen. The ratio of CD4 cells (T-helper/inducer) to CD8 cells (T-suppressor/cytotoxic cells) in the Terrien's marginal degeneration specimen was almost 1:1 compared with 24:1 in the Mooren's ulcer specimen. In addition, less than 5% of the infiltrating cells from the Terrien's marginal degeneration specimen stained positive for CD22 (B cells), compared with 25% to 50% from the Mooren's ulcer specimen. These data may help explain why Terrien's marginal degeneration runs a more benign course than does Mooren's ulcer and provides a rationale for the use of immunosuppressive drugs to treat Mooren's ulcer.

Adult↗
PubMed1991

Progression of visual acuity after penetrating keratoplasty.

A consecutive series of 721 eyes was followed for visual acuity changes after keratoplasty in four groups: keratoconus, Fuchs' dystrophy, pseudophakic bullous keratopathy with retained intraocular lenses, and aphakic/pseudophakic bullous keratopathy with secondary implants during keratoplasty. Follow-up ranged from 12 to 84 months. Keratoconus eyes showed the quickest recovery of visual acuity: by 12 months, 91% attained a best-corrected vision of 20/40, and the mean lines of visual acuity for the group plateaued thereafter. The other three groups showed continuing improvement in vision through 24 months. From 3 months through 3 years after keratoplasty, the keratoconus and Fuchs' groups consistently showed better visual acuity levels than either the retained or the secondary implant groups (P less than 0.0001). Reporting changes in visual acuity over time offers multiple advantages compared with providing best-attained or last-recorded visual acuities after keratoplasty.

Adolescent↗
PubMed1991

Graft survival in four common groups of patients undergoing penetrating keratoplasty.

Graft survival rates and causes of graft failure were evaluated for 1046 consecutive keratoplasties in four groups: keratoconus, Fuchs' dystrophy, pseudophakic bullous keratopathy with retained intraocular lenses (IOLs), and pseudophakic/aphakic bullous keratopathy with secondary lens implants. Patient follow-up averaged 23 months (range, 1-84 months). There was a significant difference in graft survival among the four groups, P less than 0.0001. The keratoconus and Fuchs' groups had the highest survival rates and pseudophakic bullous keratopathy with retained IOLs the lowest rate. Problems with the external surface of the graft caused the largest number of graft failures. Grafts for pseudophakic bullous keratopathy with retained posterior chamber lenses had a significantly higher failure rate from rejection and endothelial decompensation, 5.1%, compared with less than 1.0% in keratoconus, Fuchs' dystrophy, or bullous keratopathy with secondary implants (P less than 0.0005).

Adolescent↗
PubMed1990

Natural history of cystoid macular edema in pseudophakic bullous keratopathy.

A retrospective review of 25 consecutive patients having penetrating keratoplasty (PKP) with the preoperative diagnoses of pseudophakic bullous keratopathy (PBK) and cystoid macular edema (CME) was undertaken to analyze the natural history of preoperative CME following keratoplasty. Follow-up ranged from 13 to 54 months with a mean of 27 months. All patients had intraocular lens exchanges with 24 receiving posterior chamber lenses; 23 had lenses sutured to the posterior iris. Sixteen patients (64%) recovered a visual acuity of 20/40 or better. The average time for visual recovery to 20/40 was nine months with a range of two to 45 months. Eighteen (72%) had resolution of angiographic CME. Three patients previously diagnosed as having chronic CME recovered visual acuity of 20/40 or better. Cases of PBK with CME may have an excellent visual prognosis if the IOL is managed properly at the time of PKP.

Aged↗
PubMed1990

Spectrum of Nd:YAG laser-induced intraocular lens damage in explanted lenses.

A series of explanted intraocular lenses (IOLs) and autopsy globes containing IOLs that had previously had Nd:YAG laser posterior capsulotomy were analyzed at the Intermountain Ocular Research Center. A broad spectrum of laser-induced IOL damage was found. In the majority of instances, the damage was classified as mild and consisted of tiny pits on the IOLs' posterior surface. These pits would not be expected to produce any visually significant consequences. Moderate damage consisted of larger, more extensive pitting, craters, and small cracks. The most severely damaged IOLs showed extensive cracking and focal fracturing of the optic. Extensive damage may result in unacceptable visual blurring, distortion, and glare which in extreme cases may warrant IOL explantation, as presented in a case report.

Aged↗
PubMed1990

Suprachoroidal hemorrhage after placement of a scleral-fixated lens.

Six days after suture-fixation of a posterior chamber lens to the sclera, a suprachoroidal hemorrhage occurred causing pain and intraocular lens dislocation. Placing the sutures at the 3 o'clock and 9 o'clock positions and having the needles exit 2 mm posterior to the limbus may have inadvertently increased the possibility of the hemorrhage. Suprachoroidal hemorrhage after suture-fixating lenses to the sclera and ciliary body area is a potential complication that patients should be advised of preoperatively.

Choroid Hemorrhage↗
PubMed1989

Sutured retropupillary posterior chamber intraocular lenses for exchange or secondary implantation. The 12th annual Binkhorst lecture, 1988.

The histopathologic findings of four eyes obtained postmortem with iris-sutured posterior chamber intraocular lenses (PC IOLs) are described. These IOLs were implanted as exchange procedures. In most instances, the loops were not situated in the ciliary sulcus but rather were suspended behind the iris and ciliary body. Therefore, the primary mechanism of fixation of iris-sutured PC IOLs appears to be the sutures themselves rather than adherence to the ciliary tissues. This report of four eyes is preliminary, but the pathologic analysis, showing few significant lesions attributable to the IOL, provides a reason for optimism for using this technique. A long-term clinical study comparing the results of sutured PC IOLs with those of anterior chamber IOLs (AC IOLs) used in secondary or exchange implantation, as well as collection and analysis of more pathologic specimens, should provide a more definitive answer as to the preferred procedure.

Aged↗
PubMed1989

Visual results of suture-fixated posterior chamber lenses during penetrating keratoplasty.

Between August 12, 1982, and June 30, 1987, 233 consecutive eyes had posterior chamber intraocular lenses (PC IOLs) suture-fixated to the posterior aspect of the iris during penetrating keratoplasty (PKP). In all cases, insufficient capsular material was present to provide adequate fixation for the implant. Lenses were placed in 72 aphakic eyes as a secondary implant, and 159 lenses were placed after removal of another implant. Follow-up ranged from 1 year to 68 months with 59.5% of patients achieving visual acuity of 20/40 or better, and 74% of 20/80 or better. Suture-fixating a PC IOL to the iris offers multiple advantages over placement of an anterior chamber lens during PKP. The complication rate appears low, and long-term problems with glaucoma and recurrent corneal decompensation should be reduced.

Aged↗
PubMed1989

Polypropylene ligatures as a means of controlling intraocular pressure with Molteno implants.

A technique for controlling intraocular pressure in the immediate postoperative period with Molteno implants is described. Filtration tubes were closed with polypropylene sutures in 13 patients. Filtration tubes closed with 7-0 sutures provided the most satisfactory partial to complete lumen closure. The ligatures in six patients later were opened by argon laser.

Adolescent↗
PubMed1988

Factors contributing to corneal decompensation with the Stableflex lens.

A retrospective review was conducted on 38 eyes with Stableflex intraocular lenses in which the lenses were removed or the eye had penetrating keratoplasty. Preoperative axial length measurements were significantly lower in eyes with Stableflex lenses than in control eyes. Based on these data, axial length measurements may be valuable in predicting which eyes will develop corneal problems with small-diameter, closed-loop anterior chamber lenses. Axial lengths may also be beneficial in deciding preoperatively which eyes may need smaller-size anterior chamber lenses of other designs. This is believed to be the first report linking short axial lengths to problems with anterior chamber lenses and recommending the use of axial length measurements for preoperative sizing of anterior chamber lenses.

Analysis of Variance↗