PubMed Health⌕ Search

Biomedical subjects

Ian C Francis

Publications and source records attributed to Ian C Francis.

At least 19 recordsLinked to original sources
PubMed2006

Prospective controlled study of vapor pressure tear osmolality and tear meniscus height in nasolacrimal duct obstruction.

PURPOSE: To determine tear osmolality (TO) and tear meniscus height (TMH) in patients with functional (FNLDO) and primary acquired (PANDO) nasolacrimal duct obstruction. Additionally, to determine the effect of successful dacryocystorhinostomy surgery on these tear parameters. DESIGN: Prospective case-controlled interventional case series. METHODS: Up to 20 microl of basal tears were collected from 20 age- and gender-matched control subjects, 33 patients with FNLDO, 28 patients with PANDO, and 31 patients after successful dacryocystorhinostomy. TMH was measured with videoreflective dacryomeniscometry, and TO was measured with vapor pressure osmometry. RESULTS: Thirty-nine percent of the patients with FNLDO (13/33) elected to undergo dacryocystorhinostomy surgery, compared with 64% of the patients with PANDO (18/28; P = .09). TMH was significantly higher in the disease groups (FNLDO median, 630 +/- 187 microm; PANDO median, 620 +/- 210 microm) compared with the control subjects (median 262 +/- 50 microm; P < .01). In those patients who underwent surgery, TMH was slightly higher in FNLDO than PANDO (P = .08), and TMH reduced significantly after surgery (P < .05). Mean TO in the control subjects was 313 +/- 17 mmol/kg, in FNLDO was 309 +/- 19 mmol/kg, and in PANDO was 315 +/- 24 mmol/kg (P > .05). TO was similar in those patients who progressed to surgery compared with the total group and was unaffected by surgery. CONCLUSION: TO was similar in normal control subjects and in the watery eye group and was unchanged after dacryocystorhinostomy surgery. Despite the slightly higher TMH in patients with FNLDO, a higher proportion of patients PANDO elected to have surgery. Relative to FNLDO, patients with PANDO who progressed to surgery had lower TMH and normal TO, which suggests that a complete lacrimal drainage obstruction induces negative feedback that results in no reduction in TO.

Aged↗
PubMed2005

Videoreflective dacryomeniscometry in normal adults and in patients with functional or primary acquired nasolacrimal duct obstruction.

PURPOSE: Videoreflective dacryomeniscometry (VRD) for evaluation of marginal tear film has not been performed in patients with watery eye or in a controlled study. We used VRD to evaluate the height of the central marginal lower lid tear film in normal adults and compared it with two watery-eye groups and a postoperative dacryocystorhinostomy (DCR) group. DESIGN: Case-controlled interventional case series. METHODS: We evaluated with VRD 20 subjects with normal lacrimal drainage function, 21 patients with primary acquired nasolacrimal duct obstruction (PANDO), 28 patients with functional nasolacrimal duct obstruction (FNLDO), and a postoperative group of 14 patients derived from the previous two pathologic groups. Comparison between the four groups was performed to determine statistically significant differences between tear film height. RESULTS: PANDO and FNLDO groups were shown to have significantly greater median tear meniscus heights ([TMH] PANDO: 620 microm, interquartile range [IQR] 453 microm; FNLDO: 731 microm, IQR 529 microm) than normal subjects (296 microm, IQR 214 microm; P < .001) and postoperative PANDO patients (265 microm, IQR 159 microm). There was no significant difference in TMH between PANDO and FNLDO groups preoperatively (P = .275). There was a reduction in median TMH postoperatively of 355 microm (P = .008) in PANDO and 360 microm (P = .068) in FNLDO. CONCLUSIONS: PANDO and FNLDO patients have similar preoperative TMH. In both these groups, TMH is significantly greater than in normal control subjects. Lacrimal drainage surgery substantially reduces TMH as measured using VRD in PANDO.

Aged↗
PubMed2005

Spectrum of clear corneal incision cataract wound infection.

PURPOSE: To describe the presentation, management, and outcome of 5 patients who presented with main-port or side-port wound infection after uneventful clear corneal cataract surgery. SETTING: Ophthalmic Surgery Centre, Chatswood, and Department of Ophthalmology, Prince of Wales Hospital, Randwick, Australia, and Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom. METHODS: This retrospective case series comprised 5 patients who had uneventful clear corneal phacoemulsification surgery and developed either a main-port or side-port wound infection. The clinical features, microbiologic studies, management, and results are reported. RESULTS: The median age of the patients was 79 years. Infection of the main-port incision occurred in 3 cases and of the side port in 2 cases. The patients presented from a few days to several weeks after uneventful phacoemulsification. In 2 cases, the bacteria Pseudomonas aeruginosa and Staphylococcus aureus were isolated. In 1 case, the fungus Aspergillus was isolated and required extensive medical and surgical treatment. In the other 2 cases; empiric antimicrobial therapy was given because no organism was isolated in 1 case, and in the other milder case, microbiological investigations were not performed. Final visual acuity was 6/4 in 2 cases and 6/5, 6/12, and 6/18 in 1 case each. CONCLUSIONS: Bacterial or fungal wound infection can present within days or even several weeks following clear corneal cataract surgery. Patients with ocular discomfort or blurred vision after such surgery should be advised to report promptly. Rapid identification and appropriate management of patients with clear corneal wound infection can result in good visual outcomes.

Aged↗
PubMed2005

Intraoperative management of iris prolapse using iris hooks.

Iris prolapse has become an unusual and generally benign event in routine cataract surgery using endocapsular phacoemulsification techniques. We operated on the second eye of a patient with hyperopia whose first eye surgery in our care had been uneventful. In the second eye, as soon as the phaco incision was made and hydrodissection begun through the primary incision, the iris repeatedly prolapsed through the incision. This was managed definitively by applying iris hooks, 1 at each side of the primary incision, to the pupillary border so the prolapsing iris was held peripherally in the anterior chamber and under modest tension.

Aged↗
PubMed2005

A rapidly fatal case of T-cell lymphoma presenting as idiopathic orbital inflammation.

A 41-year-old Caucasian woman presented with a painful, red right eye with minimal systemic symptomatology, and was initially diagnosed with right idiopathic orbital inflammation. Ten days later, she developed abdominal and respiratory symptoms; this led to her demise within a further week. Post-mortem examination demonstrated widespread extranodal NK/T- cell lymphoma (nasal type), involving the right posterior orbit, lungs, uterus, left adrenal gland, pericardium and meninges. Thorough physical examination with early orbital biopsy should be considered to exclude underlying treatable pathology in managing patients with presumed idiopathic orbital inflammation.

Adult↗
PubMed2005

Centripetal lens epithelial cell migration: a prospective study of the Alcon SA60AT intraocular lens.

PURPOSE: To evaluate prospectively the incidence and severity of centripetal lens epithelial cell migration (CLECM) onto the anterior surface of the Alcon SA60AT intraocular lens (IOL). METHODS: One hundred and four consecutive cases of SA60AT IOL implantations were prospectively evaluated. At the 1-month postoperative visit, best corrected visual acuity (BCVA) was obtained. Following maximal pupillary dilatation, the extent of CLECM was assessed using a simplified grading scale (0-4). The centrality of the lens within the capsular bag was recorded. Patients with the highest grade of CLECM were recalled for reassessment at a minimum of 3 months. RESULTS: Centripetal lens epithelial cell migration data were obtained on 99 patients. Of these, 94% demonstrated CLECM of varying severity at 1 month postoperatively. The severity was low grade in 54% of patients (29% grade 1, 24% grade 2), and high grade in 40% of patients (16% grade 3, 24% grade 4). BCVA results were good (91.9% 6/6 or better) and did not correlate with CLECM grade. Operative capsulorhexis size did not correlate with the severity of CLECM. The lens was well-centred in 91 of 92 patients in whom lens position was assessed. Twenty-three patients with grade 4 CLECM at 1 month were brought back for reassessment (3.5-13 months postoperatively) and 18 of these demonstrated complete regression of CLECM (to grade 0). CONCLUSIONS: There is a high incidence and severity of CLECM 1 month postoperatively using the Alcon SA60AT IOL. There was no significant correlation between CLECM grade and either BCVA at 1 month, capsulorhexis size or lens centration. CLECM appears to be a frequent, benign and transient event with this lens.

Acrylic Resins↗
PubMed2005

A tribute to Dr Medduma B. Kappagoda.

Dr Medduma B. Kappagoda ('Kappa') was a dynamic, unique ophthalmologist. His knowledge and comprehension of ophthalmology were outstanding. He is best remembered for his love of and care for people of all backgrounds, his teaching and his sense of humour.

Australia↗