Biomedical subjects
Publications and source records attributed to G F Hilton.
An 81-year-old woman with good vision was followed up with the diagnosis of a minimally active melanoma. This tumour was eventually found to be a diffuse melanoma with extraocular extension. Diffuse melanomas of the uvea are difficult to diagnose, have frequent and early extrascleral extension, and have a poorer prognosis than most melanomas of the uveal tract.
A patient with X-linked juvenile retinoschisis was followed from age 5 years. At age 15 he developed rubeosis iridis and neovascular glaucoma in one eye, resulting in no light perception. A review of the literature revealed this case to be the first reported association of X-linked juvenile retinoschisis and neovascular glaucoma.
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In a series of 629 consecutive retinal detachments, 20 (3%) eyes had preoperative subretinal fibrosis without preretinal fibrosis. The incidence varied in a linear fashion with the duration of the detachment, varying from 0.8% in cases less than one month old to 22% in cases estimated to be more than two years old. Nineteen of the 20 detachments were anatomically cured by scleral buckling.
We devised an adjustable length infusion needle for Ocutome vitrectomy. Visualization of the tip of the infusion terminal is not necessary and the risk of infusion into the uvea is eliminated.
Six hundred consecutive retinal detachments were operated on with silicone scleral buckles. Twenty-three implants, or 3.8%, were removed. There was one solid silicone implant and 22 silicone sponges. Removal was required because of infection (seven eyes), foreign-body sensation without infection (seven eyes), recurrent subconjunctival hemorrhages (four eyes), impingement on the optic nerve (one eye), and distortion of the macula (four eyes). The postoperative infection rate was 1.8% for silicone sponges, and there were no infections in eyes buckled with solid silicone. Only one retina redetached after buckle removal, yielding a recurrence rate of 4%. The one recurrence was successfully managed by a second scleral buckle.
Our modification of the limbal peritomy technique in retinal detachment surgery involved recession of the confunctiva 3 mm posterior to the corneoscleral limbus as the conjunctiva was closed. This recession offered some advantages over the standard nonrecessed method: fewer sutures were required; postoperative ophthalmoscopy was not impaired by conjunctiva swelling over the cornea; the eye was comfortable and quiet in appearance because there was no suture material or inflamed conjunctiva adjacent to the corneoscleral limbus. We have not encountered any disadvantages in several hundred cases.
To maintain corneal clarity during scleral buckling operations, the surgeon firmly rolls a dry cotton applicator across the edematous corneal surface, and the epithelial edema fluid is pressed out and absorbed by the applicator. This technique, which may be repeated a number of times, reduces the number of cases that require removal of the epithelium.
In a prospective study of 415 consecutive eyes operated on for retinal detachment, there were no apparent retinal breaks in 41 eyes. Examination of the most likely site for breaks during, or shortly after, cryotherapy was helpful in detecting tiny breaks in several cases. All detachments without apparent breaks were operated on with a three-step operation: we applied two rows of confluent cryotherapy to all retinal breaks, drained subretinal fluid, and used buckles just anterior to the equator. Surgical cure, defined as reattachment for at least six months, was achieved in 93% of eyes with apparent breaks, and in 85% of eyes without apparent breaks. The latter figure increased to 91% when the seven patients with preoperative massive preretinal retraction were excluded.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.