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H Michael Lambert

Publications and source records attributed to H Michael Lambert.

2 recordsLinked to original sources

Dynamic intraocular pressure measurements during vitrectomy.

OBJECTIVES: To directly measure dynamic intraocular pressure (IOP) during vitrectomy and to determine whether disposable pressure transducers placed in the infusion line can indirectly measure with accuracy the dynamic IOP during vitrectomy. METHODS: Experimental clinical study of 10 patients undergoing vitrectomy. Dynamic IOP was sampled via an extra pars plana incision with a catheter transducer equipped to measure direct IOP during vitrectomy by attaching a metal flange near the pressure-sensing tip. Disposable blood pressure transducers were placed in the infusion tubing fluid path to determine the IOP by indirect means. During various maneuvers of vitrectomy including air-fluid exchange and gas-forced infusion, pressure measurements were taken simultaneously from the indwelling pressure transducer and the disposable blood pressure sensors in the infusion line. RESULTS: The directly measured IOP varied between 0 and 120 mm Hg during vitrectomy. During fluid flow, the indirectly measured IOP, calculated from the infusion line pressures, accurately corresponded with the directly measured IOP. CONCLUSIONS: Closed vitrectomy causes wide fluctuations in IOP. The IOP can be accurately measured during fluid flow with inline sensors.

Adolescent↗

Visual outcomes of silicone oil versus gas tamponade for macular hole surgery.

PURPOSE: To determine the effectiveness of silicone oil versus gas tamponade to treat macular holes. METHODS: A retrospective review of patients who underwent macular hole repair with either silicone oil or gas tamponade. RESULTS: Data collected from 66 eyes from a retina only practice (Retina and Vitreous of Texas) were reviewed to assess visual outcomes of surgery with silicone oil versus 14% C3F8 gas tamponade. 21 eyes were non-randomized to silicone oil tamponade and 45 eyes underwent gas tamponade. The average overall follow-up time was 11.8 months. Stage 2 holes constituted 9% of the holes; stage 3 and 4 made up 75%; recurrent holes were 11%; and 5% were traumatic holes. Of the macular holes not treated previously, 81.3% (13 of 16) were sealed successfully with silicone oil tamponade while 83.7% (36 of 43) of the gas-treated eyes were sealed. The overall primary closure rate was 83.1% (49 of 59). The pre-operative decimal visual acuity was 0.104 (20/192) for the silicone oil group and 0.193 (20/104) for the gas-treated group. The post-operative decimal visual acuity at 1 year was 0.208 (20/96) for the silicone oil group and 0.453 (20/44) for the gas-treated group. The reopening rate for the silicone oil group was 14% (3 of 21) and 9% (4 of 45) for the gas-treated group. The need for cataract surgery post macular hole repair was 36% (4 of 11 phakic patients) for the silicone oil group and 61% (17 of 28 phakic patients) for the gas-treated group. CONCLUSIONS: With short-term follow-up silicone oil tamponade and gas tamponade are both successful in anatomic closure of macular holes. In eyes with macular holes surgically repaired with gas tamponade significant improvements in visual acuity are seen more frequently than eyes treated with silicone oil tamponade. Toxicity of silicone oil to the retinal pigment epithelium and/or photoreceptors may play a role in these results.

Aged↗