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Biomedical subjects

I Boniuk

Publications and source records attributed to I Boniuk.

10 recordsLinked to original sources
PubMed1991

Vitrectomy for premacular fibroplasia. Prognostic factors, long-term follow-up, and time course of visual improvement.

Two hundred seventy eyes with premacular fibroplasia consecutively treated by pars plana vitrectomy and membrane peeling were reviewed. This study is among the largest series with long-term follow-up reported to date. Visual improvement of two or more lines was achieved in 43% of eyes at 6 to 12 months, in 54% at 1 to 2 years, in 60% at 2 to 3 years, and in 58% at 3 to 5 years. Overall, complications occurred in 34 eyes (13%). Cataract progression after vitrectomy was noted in 106 (57%) of phakic eyes at 3 to 5 years, and 43 of these eyes underwent subsequent cataract extraction. Mean time to best visual acuity after vitrectomy was slightly less than 1 year for all eyes unless they had cataract worsening with subsequent cataract extraction (1.9 years). Significant factors affecting visual outcome were: preoperative lens status, visual acuity before vitrectomy, duration of preoperative symptoms of distortion and/or blurred vision, and the occurrence of intraoperative complications.

Adolescent↗
PubMed1991

External argon laser drainage of subretinal fluid using the endolaser probe.

The results of 200 consecutive scleral buckling procedures in which the argon endolaser probe was used to create a choroidotomy for drainage of subretinal fluid are reported. This technique was used in any case requiring drainage and was specifically employed in cases in which needle drainage was contraindicated because the detachment was shallow. The argon laser was set at 0.2 seconds, 1.25 watts, and was used with the endolaser probe held adjacent to, but not touching, the choroid. Drainage was successfully accomplished in 98% of cases. Rates of subretinal hemorrhage, retinal incarceration, and perforation related to laser drainage were 5.5%, 2.5%, and 1%, respectively. No large or submacular subretinal hemorrhages occurred. This technique appears to be particularly promising for drainage of shallow retinal detachments.

Choroid↗
PubMed1979

Bupivacaine anesthesia in retinal detachment surgery.

Retinal detachment surgery and other long-duration ocular procedures can be performed safely with local anesthesia, but a long-acting anesthetic is required. A randomized and masked prospective series of 126 scleral buckling procedures was undertaken to test a mixture of bupivacaine (Marcaine), lidocaine (Xylocaine), and epinephrine against lidocaine and epinephrine. The data collected show a conclusive superiority of the bupivacaine mixture in longevity of action and overall performance. Also, there was significantly less variability in the quality of anesthesia with the mixture than with lidocaine (p = .0015).

Anesthesia, Local↗
PubMed1978

Grand mal seizures after retrobulbar block.

Convulsions developed in two patients after retrobulbar block. The amount of local anesthetic agent that was used was considerably less than the intravenous toxic dose in both cases. No retrobulbar hemorrhage resulted. The probable cause of seizures was inadvertent injection of local anesthetic directly to the CNS via the ophthalmic artery or its sheath.

Aged↗
PubMed1977

Pseudophakic retinal detachment.

Our experiences with a small group of patients who had intraocular lens implants performed at the time of cataract extraction, and who subsequently developed retinal detachment are reviewed. The technical problems related to retinal detachment surgery in the presence of intraocular lenses and the results of this surgery are summarized.

Adult↗
PubMed1975

Early photocoagulation treatment of active histoplasmic maculopathy.

Photocoagulation has proved to be an effective means of treating active presumed histoplasmic maculopathy. Xenon arc and argon laser light sources have proved equally effective when moderately intense, confluent burns are produced, and both are ineffective when mild lesions are produced. The membrane must be destroyed for the treatment to be effective; and, of course, the fovea must be preserved. In treating neovascular nets that are very close to the fovea, the argon laser offers the advantage of being capable of producing a sharper zone of delineation than the xenon arc (Fig. 6). When moderate amounts of subretinal fluid or hemoglobin overlie the neovascular membrane, it is very difficult to achieve the required degree of coagulation. Under these circumstances, it is best first to try to reduce the height of the sensory retinal detachment by means of systemic steroid treatment. If this is not successful, xenon photocoagulation has produced better coagulation effects than the argon laser. Analysis of our data indicates that resultant visual acuity can be correlated with pretreatment visual acuity (Fig. 5), with best results achieved before visual acuity deteriorates beyond the 20/40 level. The closer the edge of the neovascular membrane is to the fovea, the more risky it is to treat. However, these lesions are also those most apt to destroy central vision if left alone. It is encouraging to note that in only 3 of the 16 lesions in which the foveal edge was within 1 degree of the fovea did the visual acuity deteriorate to the 20/200 level, compared to 50 percent deterioration reported in the natural history of this disease [3].

Argon↗
PubMed1975

Drainage of subretinal fluid: why, when, where and how.

The release of subretinal fluid is only required in certain complicated types of retinal detachment and should be avoided when possible. An important consideration in releasing subretinal fluid is the timing of this step in relation to the application of diathermy or cryotherapy as the primary treatment modality. Drainage should precede application of cryotherapy but follow the use of diathermy. The most satisfactory site for drainage is either immediately above or below the medial or lateral long ciliary nerve, just posterior to the equator of the globe. A technique for drainage of subretinal fluid has been developed and evaluated. An 'L'-shaped scleral flap is dissected to produce a relatively staphylomatous zone and the choroid is perforated near its center.

Choroid↗