Biomedical subjects
Publications and source records attributed to G A Sutton.
A prospective study was carried out to estimate the incidence and severity of ptosis following cataract extraction and trabeculectomy. A postoperative ptosis of 2 mm or more was found in 6.2% of all cases. In this series the incidence of ptosis following surgery under local anaesthesia was greater than that under general anaesthesia. The aetiology and management of this complication are discussed.
Thirteen patients who had ptosis surgery undertaken for disinsertion of the aponeurosis of the levator palpebrae superioris were reviewed. Pre-operatively all the patients had characteristic clinical signs of levator disinsertion which was confirmed at surgery and corrected by reposition of the disinserted aponeurosis. Five of these patients were initially mistakenly diagnosed as having a neurological cause for their ptosis. The diagnosis of this type of ptosis may easily be missed.
Forty-five eyes that have undergone routine extracapsular cataract extraction with insertion of a posterior chamber intraocular lens were compared with a similar group of eyes that had undergone intercapsular extraction. Capsular fixation was more predictable following intercapsular (78%) than it was following extracapsular extraction (22%). Gonioscopy revealed prominence of the lens haptic in 22% of the intercapsular group, with peripheral anterior synechiae (PAS) in 18%; haptics were prominent in 78% of the extracapsular group, with synechiae in 55%. Lens eccentricity of 2 mm or more was seen in 2 patients (4%) following intercapsular and in 10 (22%) following extracapsular extraction. Pupil irregularities were noted in three of the intercapsular group (7%) and in eight of the extracapsular group, (13%) with peripheral iris tucking alone in three. These data strongly support the view that intercapsular is superior to extracapsular cataract surgery in terms of facilitating capsular fixation of posterior chamber intraocular lenses.
The gonioscopic appearances of 45 eyes that had undergone extracapsular cataract extraction with insertion of a Pearce Lasagap posterior chamber intraocular lens (group A) were compared with those of 45 eyes that had undergone the same procedure except for insertion of a Nova Curve Kratz posterior chamber lens (group B). Prominence of one or both loops was seen in 35 eyes (78%) of group A, with peripheral anterior synechiae (PAS) in 25 (55%). Prominence of one loop was seen in 14 eyes (31%) of group B, with PAS in 8 (18%) (P less than 0.001). Final visual acuity was comparable in both groups, 98% achieving 6/12 (20/40) or better. Although not statistically significant, the incidence of pigment dispersion, uveitis, discomfort and visual aberrations was greater in group A than in group B. We suggest that the apparent superiority of the Nova Curve Kratz lens in terms of the smaller incidence of loop prominence, as well as the reduced incidence of these other complications, is due to the fact that its haptic is inserted into the optic's edge rather than into the anterior surface of the lens optic, as is the case with the Lasagap lens.
We graded the overall cosmetic outcome of 56 patients who required excision of the eye. Each patient was then subjected to a more detailed analysis of the specific abnormalities associated with excision of the eye in order to discover which are associated most consistently with a poor cosmetic result. The only factor showing a statistically significant variation with the overall cosmetic outcome was the degree of upper lid sulcus. Taken individually the other features showed no statistically significant correlation. When each finding was scored, the averaged sum of the scores was related to cosmetic outcome with statistical significance. A method of quantifying orbital volume loss is described.
A new model of the electroacoustic discriminator and localiser has been put into production, and this paper reports on the preproduction model during its trial period in the management of patients with intraocular foreign bodies. Its particular advantage in localisation at the time of surgery and the procedure for using it are described. The visual results following surgical extraction of 17 cases of magnetic foreign bodies in the posterior segment are outlined.