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Biomedical subjects

I H Fine

Publications and source records attributed to I H Fine.

9 recordsLinked to original sources
PubMed1992

A prospective, randomized, double-masked comparison of a zonal-progressive multifocal intraocular lens and a monofocal intraocular lens.

INTRODUCTION: Multifocal intraocular lenses (IOLs) have been designed to provide improved near visual acuity without spectacles compared with monofocal IOLs. Early studies have reported variables amounts of decreased visual acuity and contrast sensitivity with multifocal IOLs, and some patients have experienced halos and glare. METHODS: The authors performed a prospective, double-masked, multicenter evaluation of 62 patients randomized between a new zonal-progressive optic multifocal IOL and a monofocal IOL. RESULTS: Mean postoperative spherical equivalent, astigmatism, and uncorrected and best-corrected distance visual acuity were similar between the two groups. Patients with a multifocal IOL achieved significantly better uncorrected near visual acuity than patients with monofocal IOLs (J3+ versus J7; P less than 0.0001). With distance correction only, mean near visual acuity was J2 versus J5- (P = 0.0001). Best-corrected near visual acuity was J1 for both groups, with 1.36 diopters (D) for the multifocal group versus 2.37 D for the monofocal group (P less than 0.0001). Regan contrast sensitivity was lower for the multifocal patients at all contrast levels, and achieved statistical significance at very low contrast (11% contrast; P = 0.0024). Fifty-two percent of patients with a multifocal IOL reported that they did not need spectacles at all or used them only for their fellow eye, compared with 25% of the patients with monofocal IOLs. CONCLUSION: Both monofocal and multifocal implant patients were very satisfied with the results of their cataract extraction and IOL implant surgery. A small loss of contrast sensitivity with the multifocal IOL was demonstrated, consistent with theoretical predictions. The functional significance of the loss of contrast sensitivity appears to be small and counterbalanced by the advantage of improved uncorrected near visual acuity.

Aged↗
PubMed1992

Cortical cleaving hydrodissection.

In this technique, I/A of cortex as a separate step can be omitted, thereby eliminating that portion of the surgical procedure in which posterior capsular disruption most frequently occurs. Residual cortical cleanup is accomplished in the presence of a posterior chamber IOL which protects the poserior capsule by holding it remote from the aspiration port.

Cataract Extraction↗
PubMed1992

Initial experience with the HydroSonics instrument to soften cataracts before phacoemulsification.

An ultrasonically driven needle placed into the body of the nucleus, with subsequent injection of balanced salt solution (BSS), can be used to fragment the nucleus into sections or lamellae that can potentially be emulsified with greater ease and less ultrasound energy delivered to the eye. This separation of the nucleus has been designated hydrodelineation. The six surgeons participating in this study subjectively reported that the use of hydrodelineation facilitated phacoemulsification, on average, in 91% of their cases. Review of study data indicated that significantly less ultrasound time and cumulative displayed energy were noted in phacoemulsification of grade 2+ and 3+ cataracts after hydrodelineation than in cases in which hydrodelineation was not performed. The results in cases performed with and without hydrodelineation were statistically equivalent in complications and postoperative patient outcomes.

Cataract↗
PubMed1991

The chip and flip phacoemulsification technique.

The "chip and flip" phacoemulsification technique increases safety and control within the capsular bag. The surgical maneuvers use a two-handed technique through a small curvilinear capsulorhexis.

Cataract Extraction↗
PubMed1991

The first assistant's role in the management of complications during phacoemulsification.

1. Every surgeon who performs phacoemulsification will encounter complications. Successful management of complications is enhanced by a combination of surgical skill, good judgment, and a well-trained, highly motivated first assistant. 2. The first assistant must have already mastered the names and uses of all instruments and equipment, and will have practiced the eye/hand coordination necessary to work comfortably with microscopes and loupes. A positive attitude and total concentration on the procedure and the surgeon is imperative. 3. A complete understanding of the management of the most common complications will enable the assistant to begin setting the stage to manage a complication during the anticipatory phase.

Cataract Extraction↗
PubMed1991

Astigmatism after small incision cataract surgery. A prospective, randomized, multicenter comparison of 4- and 6.5-mm incisions.

Four surgeons evaluated induced astigmatism and postoperative wound stability in a randomized prospective study of 130 patients undergoing cataract extraction. After phacoemulsification through a scleral pocket, patients received either a 6.5-mm diameter silicone optic posterior chamber intraocular lens (PC IOL) folded for insertion through a 4-mm small incision or a 6.0-mm diameter polymethylmethacrylate (PMMA) optic PC IOL placed through an approximately 6.5-mm conventional incision. Vector analysis calculations of prism diopters (D) of mean postoperative-induced keratometric astigmatism for the small incision versus conventional incision groups were, at day 1, 1.54 D versus 3.07 D (P less than 0.0001); at weeks 1 to 2, 1.00 D versus 2.43 D (P less than 0.0001); at 1 month, 0.98 D versus 1.44 D (P = 0.004); and at 3 months, 0.82 D versus 1.03 D (P = 0.089). Subgroup analysis of the suturing technique for the 6.5-mm incision showed that the technique of wound closure, as well as the wound size, influenced the induced astigmatism. For all four surgeons using three methods of suturing the 6.5-mm wound, however, the variability in the amount of induced cylinder was least with the 4.0-mm wound closed with a horizontal mattress suture. Complications in the two groups were comparable.

Aged↗
PubMedDate not supplied

The first assistant's role in managing phacoemulsification complications.

Every surgeon who performs phacoemulsification will encounter complications. Successful management of complications is enhanced by a combination of surgical skill, good judgment, and a well-trained, highly motivated first assistant. The first assistant must have already mastered the names and uses of all instruments and equipment, and will have practiced the eye/hand coordination necessary to work comfortably with microscopes and loupes. A positive attitude and total concentration on the procedure and the surgeon is imperative. A complete understanding of the management of the most common complications will enable the assistant to begin setting the stage to manage a complication during the anticipatory phase.

Cataract Extraction↗