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Biomedical subjects

H Lincoff

Publications and source records attributed to H Lincoff.

At least 55 records · Page 3Linked to original sources
PubMed1985

Results of 100 aphakic detachments treated with a temporary balloon buckle: a case against routine encircling operations.

One hundred patients with aphakic detachment were treated with temporary balloon buckles. The balloons were deflated and withdrawn after seven to 10 days. Permanent attachment depended on cryo- or laser-induced adhesions round the break. The procedure was initially successful in 79 patients. Ten retinas became detached again after the balloon was withdrawn and required a more permanent buckle. Sixty-nine retinas remained attached. The final results after additional operations were equivalent to those obtained by traditional methods, but significantly fewer complications occurred. The balloon procedure tests the validity of routinely encircling aphakic detachment.

Aphakia, Postcataract↗
PubMed1984

Perfluoropropane gas in the management of proliferative vitreoretinopathy.

Perfluoropropane (C3F8), an expanding fluorinated hydrocarbon gas, was used as an adjunct to vitreous surgery in the management of 18 patients with retinal detachment complicated by proliferative vitreoretinopathy. Ten patients had reattached retinas six months after disappearance of the gas. The average intraocular longevity of the gas in successful cases was 92 days; that in failed cases was 62.7 days. This difference was not statistically significant. However, internal retinal tamponade by longer-lasting gases appears to increase the rate of retinal reattachment in the surgical management of proliferative vitreoretinopathy.

Eye Diseases↗
PubMed1984

Intravitreal disappearance rates of four perfluorocarbon gases.

The disappearance rates of bubbles from the vitreous of rabbits were measured for four perfluorocarbon gases. The decay rate for each was found to be exponential and thus independent of the volume injected. Clinical observations indicated that the disappearance of the perfluorocarbon gases in patients also follows exponential decay, but that the half-lives are three to five times longer than in rabbits.

Animals↗
PubMed1983

Perfluoro-n-butane. A gas for a maximum duration retinal tamponade.

The behavior of the gas perfluoro-n-butane (C4F10) in the rabbit vitreous suggests that the gas might be useful as a long-term intravitreal tamponade in retinal detachment surgery. Perfluoro-n-butane was found to expand more and remain in the eye longer than any gas previously reported. A 0.3-mL bubble expanded five times and displaced the entire rabbit vitreous in three days. The volume of the bubble began to shrink after one week, but still filled more than half the eye at three weeks. The time for total disappearance was more than three months.

Animals↗
PubMed1983

Use of an intraocular gas tamponade to find retinal breaks.

We used the receding meniscus of an intraocular bubble being absorbed or the advancing meniscus of an expanding bubble to find the levels of retinal breaks in five patients with retinal detachments in which the breaks could not be found by the usual examination techniques. When we used a receding meniscus, the subretinal fluid was drained and the volume replaced by a perfluorocarbon gas calculated to fill the eye below the probable level of the retinal break. The bubble closed the break and maintained reattachment until the gas was absorbed. The level of the meniscus when redetachment first occurred indicated the level of the break. When we used an advancing meniscus, small amounts of perfluorocarbons were injected without drainage of subretinal fluid. As the gas bubble expanded it reattached the retina from above downward. When the bubble covered the retinal break, it tamponaded it and the remaining fluid absorbed within hours. The level of the meniscus when the retina became reattached marked the level of the retinal break.

Adult↗
PubMed1983

The perfluorocarbon gases in the treatment of retinal detachment.

Four straight chain perfluorocarbon gases that had been studied in animals were tried in 30 patients. The larger volumes injected into patients made for extended disappearance times. Two milliliters of CF4 diminished to half volume in six days and had a total disappearance time of 16 days; 0.8 ml of C2F6 diminished to half volume in 10 days and had a disappearance time of 40 days; 1 ml of C3F8 diminished to half volume in 35 days and disappeared in 70 days; 0.6 ml of C4F10 diminished to half volume in 45 days and disappeared in 120 days. The expansion potential was estimated to be the same as measured in the animal model.

Animals↗
PubMed1982

Selection of xenon gas for rapidly disappearing retinal tamponade.

A gas that rapidly disappears from the vitreous may be of value in the treatment of retinal detachment. Xenon, argon, helium, carbon dioxide, and nitrous oxide were injected into the eyes of animal models to measure their disappearance times. Both Ar and He behaved much like air. The rapid disappearance of Co2 and N2O caused a profound hypotension. The gas with the most promising characteristics was Xe: 88% disappeared in three hours. The gas was replaced by aqueous as rapidly as it went into solution, so that the hypotensive effect was small.

Absorption↗
PubMed1982

Application of xenon gas to clinical retinal detachment.

Xenon gas was used as an intravitreal tamponade in four cases of retinal detachment. The rapid disappearance of the gas could be predicted by experiments with an animal model, and there was no notable hypotensive phase. The brief presence of the gas was sufficient to press out retinal folds and effect reattachment. The uveal response was less than with air or with the longer-lasting gases. The time the patient had to be in a prone or bent position was reduced to a few hours.

Aged↗
PubMed1982

Expanding gas bubbles for the repair of tears in the posterior pole.

Expanding, long-lived intraocular perfluorocarbon gas bubbles can make possible the repair of retinal detachments with holes or tears in the posterior pole. Vitrectomy is not necessary for injecting the gas. The patient should be prone in order to bring the gas bubble to the top of the visual axis. Four perfluorocarbon gases have the appropriate coefficient of expansion to provide adequate intraocular gas volumes by displacing the fluid vitreous. Volumes of 1 to 2 cc are sufficient. Intraocular space for these amounts can be obtained either by draining subretinal fluid or by injecting 0.6 cc of C2F6 (which expands 3.3x) without draining. If the patient cannot tolerate being prone, most of the fluid vitreous can be displaced with an intraocular injection of 0.9 cc of C4F10 (which expands 5x).

Fluorocarbons↗
PubMed1982

A scleral marker with additional uses.

We use a scleral marking pen to indicate the position of a retinal break. Although its primary purpose is to mark the localizing impression of the cryosurgical probe, the pen can be modified to serve as a localizer, as a measuring device, and as a buckle simulator.

Cryosurgery↗
PubMed1982

[A modified gas bubble technique for treating an overhanging flap of a giant tear (author's transl)].

An overhanging flap of a giant tear was successfully unfolded with a small gas bubble after attempts with a large bubble had failed. Biomicroscopy revealed that in a primary case the posterior hyaloid membrane is not attached to the posterior flap of a giant tear. The small intraocular gas bubble has the shape of a planoconvex lens, while this is not so with a larger bubble. Due to its tapered edge the small bubble can slide under the overhanging flap and reattach it. The small gas bubble, however, is too small to tamponade the entire tear. Therefore, a second intraocular injection is required to enlarge the bubble. This gas bubble technique in two steps can be reduced to a single gas injection by using one of the new perfluoro-carbon gases described, which have a much greater expansion potential.

Gases↗
PubMed1981

Posterior lip traction caused by intravitreal gas.

Traction on the posterior edge of a large tear may be an irreparable consequence of an intraocular gas tamponade used in the first instance to treat the tear. In two of three patients treated with octofluorocyclobutane (C4F8) and perfluoromethane (CF4), redetachment of a retinal tear occurred as a result of traction on the posterior edge of the tear when, prior to the operation, the posterior edge seemed to be free of any traction. With redetachment, a membrane became visible between the anterior and posterior lips of the tear. The membrane was probably posterior hyaloid augmented by cellular proliferation. The gas bubble, which had been intended to press the retina against the pigment epithelium, probably brought the detached posterior hyaloid into contact with the retina as well, and an adhesion between the hyaloid and retina formed.

Adult↗
PubMed1981

Remodeling of the cryosurgical adhesion.

A cryosurgical adhesion was considered mature and complete at two weeks. A reexamination of the lesion showed that the adhesion, at two weeks, was mediated by depolarized cells and was not stable. In subsequent months, the cells repolarized, and a remodeling of the adhesion took place. The desmosomal connections between the blunt surfaces of pigment epithelium and Müller's cells were displaced by villous processes that developed from the apical surfaces of repolarizing pigment epithelium. The villi interdigitated with short processes that were elaborated by Müller's cells from a redifferentiated outer limiting membrane.

Animals↗
PubMed1981

Results with a temporary balloon buckle for the repair of retinal detachment.

We created temporary scleral buckles in 100 patients who had retinal detachments by inserting a balloon into the parabulbar space for one week. Cryopexy- or laser-induced adhesions were needed to make the attachments permanent. In 90 patients the balloon closed the retinal break and reattached the retina. In six instances the break reopened because of traction or poor adhesion and required a scleral sponge operation to reattach the retina permanently. The low complication rate may compensate for the increased risk of redetachment.

Adult↗
PubMed1981

Parabulbar balloon to augment a failing scleral buckle.

We used an unsecured parabulbar balloon to augment failing scleral buckles in 12 patients with retinal detachments. The balloon was inserted into Tenon's space and expanded over the existing buckle, raising and broadening the buckling effect. In ten patients the leaking breaks closed and the retinas reattached without drainage of subretinal fluid. The balloon was withdrawn after seven days. The attachments were made permanent with adhesions induced by laser applications to the edges of the breaks.

Adult↗