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Biomedical subjects

G I Genvert

Publications and source records attributed to G I Genvert.

16 recordsLinked to original sources
PubMed1998

The accuracy of finger tension for estimating intraocular pressure after penetrating keratoplasty.

BACKGROUND AND OBJECTIVE: Intraocular pressure (IOP) estimation by Goldmann tonometry is inaccurate in the immediate postoperative period after penetrating keratoplasty. For this reason, many corneal surgeons use a finger tension (FT) IOP estimation technique in the early post-keratoplasty period. The authors performed a prospective clinical study to evaluate the accuracy of this traditional technique. PATIENTS AND METHODS: FT estimates were performed by three experienced corneal surgeons on 68 patients on the first and second days after penetrating keratoplasty. These estimates were compared with MacKay-Marg (MM) tonometry readings for these patients. RESULTS: The mean confident FT from the pooled data of the three surgeons exceeded the MM reading by 5.0 mm Hg (22.6 vs. 17.6). The mean FT exceeded the MM reading by only 3.9 mm Hg for the most accurate surgeon. Some observers were significantly more accurate than others, however, lid edema and tenderness of the globe markedly diminished the FT accuracy of all of the observers at significance levels of P < .001 and P < .01, respectively. Among all of the FT estimates, in only one patient (2%) did the FT underestimate the MM reading by more than 10 mm Hg. CONCLUSION: The authors' results suggest that for some patients, and for some surgeons, the FT or digital method of IOP estimation remains useful for detecting elevated IOP early after corneal transplantation if the proper technique is used and substantial lid edema and patient discomfort are absent.

Fingers↗
PubMed1991

Lid flora in blepharitis.

The microbiologic evaluations of 332 consecutive patients with the primary diagnosis of chronic blepharitis were reviewed and compared to those of 160 control patients. The most commonly isolated organisms from lids with blepharitis were Staphylococcus epidermidis (95.8%), Propronibacterium acnes (92.8%), Corynebacterium sp. (76.8%), Acinetobacter sp. (11.4%), and Staphylococcus aureus (10.5%). Compared to controls, S. epidermidis (p less than 0.01), P. acnes (p less than 0.02), and Corynebacterium sp. (p less than 0.001) were present significantly more often. S. aureus and the isolation of more than one microbial species were not more common in blepharitis patients. Quantitatively, heavy growth, by total and individual species, was significantly more common in blepharitis patients (total, p less than 0.001; S. epidermidis, p less than 0.001, P. acnes, p less than 0.001). These data demonstrate that patients with blepharitis are more likely to have normal skin bacteria on their lids and in greater quantities than nonblepharitis patients.

Bacteria↗
PubMed1990

Factors associated with conjunctival intraepithelial neoplasia: a case control study.

Familial and environmental factors may play a role in the development of conjunctival intraepithelial neoplasia (CIN). Nineteen patients with biopsy-proven CIN completed a questionnaire to evaluate possible predisposing factors. Nineteen age-matched and sex-matched controls completed questionnaires and received slit-lamp examinations. Factors associated with a relatively increased risk of developing CIN included exposure to petroleum products, heavy cigarette smoking, light hair and ocular pigmentation, and family origin in the British Isles, Austria or Switzerland. Non-office and nonprofessional workers were more likely to develop conjunctival intraepithelial neoplasia (p = .05), as were those who were not college graduates (p = .07).

Aged↗
PubMed1990

Acridine orange and Gram stains in infectious keratitis.

Two hundred thirty consecutive cases of presumed infectious keratitis were reviewed. Cultures were positive in 49.5% (114 of 230). Acridine orange stain sensitivity (81%) was significantly greater than gram stain sensitivity (65%) (p less than 0.002). Gram stain specificity was 92%, and acridine orange specificity was 89%. In keratitis with low or moderate growth, acridine orange was positive in 73% (61 of 84) as compared with Gram stain 53% (45 of 84), (p less than 0.001). In cases of heavy microbial growth, Gram stain was positive in 97% (29 of 30), acridine orange in 100% (30 of 30). This study demonstrates that both Gram stain and acridine orange stain are excellent in cases of infectious keratitis with heavy microbial growth, but that acridine orange is significantly better than Gram stain in cases with low amounts of organisms.

Acridine Orange↗
PubMed1988

Infected vs sterile corneal infiltrates in contact lens wearers.

We examined 50 patients to determine whether differences exist between the initial clinical signs and symptoms associated with infected vs sterile corneal infiltrates. A detailed history regarding contact lens use and ocular symptoms was taken, after which a careful slit-lamp examination was performed. The ocular findings were correlated with the results of corneal cultures. Increased pain (P less than .001), discharge (P less than .0001), epithelial staining (P less than .0001), and anterior chamber reaction (P less than .0001) were associated with infected ulcers. Sterile infiltrates were usually smaller; multiple or arcuate; and without significant pain, epithelial staining, or anterior chamber reaction.

Adolescent↗
PubMed1988

Penetrating keratoplasty for pseudophakic bullous keratopathy. Management of the intraocular lens.

Management of the intraocular lens (IOL) at the time of penetrating keratoplasty (PK) for pseudophakic bullous keratopathy has been based on lens-related factors and coexisting anterior segment abnormalities. The authors reviewed the results of PK for 102 cases of pseudophakic bullous keratopathy (43 anterior chamber, 50 iris-supported, and 9 posterior chamber) with respect to: (1) the type of IOL, (2) coexisting abnormalities, and (3) management of the IOL at surgery. Graft failure after 2 years of follow-up was: (1) retained iris-supported IOLs, 9%; (2) retained anterior chamber IOLs, 60%; (3) retained posterior chamber intraocular lenses (PC IOL), 0%; (4) removed IOLs, 9%; and (5) exchanged IOLs, 20%. After 5 years of follow-up, 13 of 13 PKs with retained closed-loop anterior chamber IOLs had failed. Visual results were best in eyes with retained iris-supported, rigid anterior chamber or PC IOLs and when the IOL was removed without replacement. The authors recommend that closed-loop anterior chamber lenses and unstable lenses of any type be removed or exchanged and that well-fixated PC IOLs and iris-clip IOLs be retained at the time of PK for pseudophakic bullous keratopathy.

Aged↗
PubMed1987

Medical and surgical treatment of Acanthamoeba keratitis.

We examined seven patients with Acanthamoeba keratitis. All patients had a history of soft contact lens use. Predisposing factors included use of homemade saline, hydrogen peroxide disinfection, a history of improper lens care, and swimming with contact lenses. Currently recommended medical therapy, including topical propamidine isethionate and dibromopropamidine isethionate, miconazole, Neosporin, corticosteroids, and systemic ketoconazole, was used in all patients. Five patients have undergone penetrating keratoplasty for progressive primary Acanthamoeba keratitis (four patients) or recurrent infection (one patient) after maximal medical therapy. Two patients who began medical therapy less than three weeks after the onset of symptoms have done well. Early diagnosis of Acanthamoeba keratitis appears critical for successful medical therapy. Penetrating keratoplasty continues to have a central role in the management of more advanced cases that are unresponsive, or only transiently responsive, to medical therapy.

Adult↗
PubMed1987

Seasonal variation in contact lens-associated corneal ulcers.

We undertook a retrospective analysis of 112 patients admitted to Wills Eye Hospital, Philadelphia, between 1983 and 1985 with corneal ulcers associated with the use of contact lenses to test the clinical impression that such ulcers are more common in summer. Over half of the admissions (51%) occurred between June and September. The seasonal variation of the ulcers was statistically significant (p less than 0.01). Possible factors predisposing to corneal ulcers in people who wear contact lenses in the summer include enhanced growth of bacteria at warmer temperatures and wearing the lenses while swimming.

Adolescent↗
PubMed1985

Fitting gas-permeable contact lenses after penetrating keratoplasty.

Between Sept. 1, 1981, and Jan. 31, 1984, 74 eyes (70 patients) were fitted with gas-permeable Polycon contact lenses and monitored for at least six months (range, six to 33 months; mean, 14 months). The major indications for hard contact lens fitting were astigmatism and anisometropia. Astigmatism in this series ranged from 0 to 17.50 diopters (mean, 7.7 diopters). Most patients achieved visual acuities of 20/40 or better (67 of 74, 90%) with contact lenses. Contact lenses were discontinued in 18% (13 of 74), because of graft rejection in four cases and because of contact lens intolerance in nine cases. Our results demonstrated that gas-permeable hard lenses can be fitted successfully in most patients unable to achieve optimal vision with spectacle correction after penetrating keratoplasty.

Adolescent↗
PubMed1985

Erythema multiforme after use of topical sulfacetamide.

An 8-year-old boy developed erythema multiforme major after topical administration of sodium sulfacetamide for conjunctivitis. He had received systemic treatment with trimethoprim-sulfamethoxazole four months previously without evidence of drug allergy. There was no history of recent exposure to other drugs or evidence of herpes simplex or Mycoplasma infection. After 12 days of treatment with erythromycin ointment, 1% prednisolone eyedrops, systemic prednisone, and intravenous nafcillin, the patient's condition improved dramatically. A slit-lamp examination showed only superficial punctate keratitis. Two months later his visual acuity had improved from 20/200 bilaterally to R.E.: 20/40 and L.E.: 20/30.

Child↗
PubMed1980

Evaluation of the Papanicolaou-stained cytological smear as a screening technique for asymptomatic gonorrhoea.

To assess the Papanicolaou smear as a screening test for asymptomatic gonorrhoea 311 women who had had simultaneous Papanicolaou smears and cervical cultures performed were studied. Of the 151 women who were culture-positive only 27 (18%) had a positive result by Papanicolaou smear. The presence of either endocervical or metaplastic cells did not increase the frequency with which gonococci were recognised. The eight cytotechnologists spent at least 30 minutes for each case looking for diplococci; the variability between observers was high. The possibility of using an already widely accepted diagnostic technique, such as the cytological smear, as a means of screening for gonococci is very attractive. Unfortunately in this study the excessive time taken to examine the slides, the poor correlation of observers' findings, and a low sensitivity for finding diplococci made the Papanicolaou smear an impractical method for detecting gonorrhoea in asymptomatic women.

Bacteriological Techniques↗
PubMedDate not supplied

Personality and keratoconus.

We studied personality traits of patients with keratoconus in a controlled prospective study using the Minnesota Multiphasic Personality Inventory (MMPI). Whereas four of 16 (25%) control patients with herpes simplex keratitis had scores indicative of psychological abnormality, 15 of 28 (54%) keratoconus patients had scores indicative of abnormality (P less than .05). Keratoconus patients who had undergone penetrating keratoplasty had a lower rate of abnormal scores (3 of 9; 33%) than unoperated keratoconus patients (12 of 19; 63%) (P less than .05). Patients who considered themselves moderate or severely limited by their eye condition were more likely to have abnormal scores (7 of 8; 87%) than patients who thought they were mildly affected (8 of 20; 40%) (P less than .05).

Adolescent↗