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Biomedical subjects

J A Katowitz

Publications and source records attributed to J A Katowitz.

At least 19 recordsLinked to original sources
PubMed1992

Congenital unilateral fibrosis, blepharoptosis, and enophthalmos syndrome.

The authors report four cases of the rarest form of the congenital fibrosis syndrome. This disorder is exhibited in infancy as unilateral blepharoptosis, strabismus, limited ductions, globe displacement (enophthalmos and blepharoptosis), and decreased vision, usually due to amblyopia. Forced ductions are positive and surgical exploration confirms anomalous muscle structure. Computed tomography and magnetic resonance imaging studies in these four patients were diagnostically beneficial, showing extraocular muscle and tendinous insertion involvement, and poorly defined intraconal and extraconal masses that had the appearance of scar or inflammatory tissue. All patients had globe displacement. The opposite eye and intracranial contents were normal in all of our patients. Results of histopathologic examination obtained at surgery in three of these patients show replacement of affected structures by fibrous tissue and included the extraocular muscles, orbital fat, Tenon's capsule, and conjunctiva.

Adult↗
PubMed1992

Ocular and adnexal findings in patients with facial microsomias.

The authors reviewed the ocular findings in 49 patients with facial microsomias not considered part of a known syndrome. Five patients had bifacial microsomia, and 44 patients had hemifacial microsomia. These patients were evaluated in the Craniofacial Clinic in the Division of Pediatric Ophthalmology at Children's Hospital of Philadelphia between the years 1979 and 1989. Ocular or adnexal abnormalities were present in 67% of patients. Visual loss was present in 8% of eyes. Amblyopia was present in 16% of patients. Significant refractive errors were present in 27% of patients, and anisometropia was documented in 8%. Strabismus was present in 22% of patients, and significant lid and adnexal abnormalities were seen in 41%. Because ocular or adnexal findings present in a significant percentage of patients with more mild forms of facial microsomias, regular examinations to uncover and treat these abnormalities are recommended.

Adolescent↗
PubMed1992

Evaluation of a collagen/hydroxylapatite implant for orbital reconstructive surgery.

A variety of autogenous and alloplastic materials have been used to correct enophthalmos. Hydroxylapatite (HA), is a calcium-phosphate-based compound that has been extensively studied as a bone replacement material. We studied the properties of a new dense particulate form of HA in a collagen matrix (PFC/HA) implanted in the subperiosteal space of ten rabbit orbits for a period of 6 months. All animals were studied with pre- and postoperative computed tomography (CT) scans, and measurements of induced proptosis and implant volume were made. The proptosis induced by the implant averaged 2.2 mm and was stable over a 6-month period. Implant volume was constant throughout the study. Three-dimensional computer-generated images of the soft tissue, skeletal, and implant surfaces confirmed the implant stability. All animals were studied histologically with fluorochrome bone markers, which revealed minimal foreign body reaction to the implant, no evidence of infection, and marked fibrovascular ingrowth. We found the PFC/HA to possess properties that make it an ideal implant material: ease of availability, ease of handling, no resorption, minimal immunogenicity, infection resistance, no observed migration, biointegration, and no risk of disease transmission. PFC/HA may make an excellent implant material to manage orbital volume.

Animals↗
PubMed1990

The ophthalmic manifestations and treatment of the amniotic band syndrome.

The amniotic band syndrome is an unusual cause of craniofacial deformities. The syndrome, which is initiated by rupture of the amnion, results in an unpredictable combination of compression deformities of the fetus, construction or amputation defects of the extremities, and craniofacial clefting deformities. The type and extent of ophthalmic abnormalities are dependent on the band location and timing. They include a combination of bony orbital clefts or hypertelorism; lid anomalies such as colobomas, ptosis, and ectropion; lacrimal outflow obstruction; and globe involvement. We review the clinical course of 14 patients diagnosed with, or suspected as having, this syndrome and describe the methods of treatment. In most instances, multiple surgical procedures were required to restore function. Satisfactory cosmesis proved more difficult to obtain.

Amniotic Band Syndrome↗
PubMed1989

Timing of Silastic tubing removal after intubation for congenital nasolacrimal duct obstruction.

One thousand five hundred twenty-one patients (2,038 eyes) with congenital nasolacrimal duct obstruction were reviewed at The Children's Hospital of Philadelphia. Of these, 174 patients with congenital dacryostenosis involving 192 eyes underwent polymeric silicone (Silastic) intubation to treat the dacryostenosis. All patients had undergone at least several months of conservative management consisting of topical antibiotics and massage. All had undergone at least one probing and irrigation. Congenital dacryostenosis as well as resolution of symptoms were confirmed by clinical examination and use of a modified dye disappearance test. In 192 eyes the overall success rate was 83.33%. When broken down into age group, progression of success rates were from 100% in the 6-13 month age group to 79.6% in the over 24-month age group. Success rates differed significantly according to how long the Silastic tubing remained in position, especially in older age groups. The data suggest that Silastic intubation is a successful means of treating congenital dacryostenosis and that one should consider leaving the silastic in place for 6 months when possible.

Age Factors↗
PubMed1987

Ocular and adnexal complications of unilateral orbital advancement for plagiocephaly.

Strabismus, ptosis, lateral canthal dystopia, nasolacrimal obstruction, and cranial nerve palsy were noted preoperatively in 32%, 21%, 14%, 12%, and 9% of 34 patients, respectively, undergoing ophthalmologic evaluation prior to unilateral orbital advancement for plagiocephaly. Thirty-two percent of the patients had normal preoperative ocular and adnexal examination results. Ptosis, strabismus, and amblyopia were frequently acquired postoperative abnormalities in 29%, 18%, and 18% of the patients, respectively. Forty-four percent of the patients had no new abnormalities following craniofacial surgery.

Child↗
PubMed1987

Timing of initial probing and irrigation in congenital nasolacrimal duct obstruction.

A series of 427 patients with congenital dacryostenosis involving 572 eyes was seen at the Children's Hospital of Philadelphia. All patients were treated conservatively with antibiotics and massage prior to decision by the parents to request probing. Congenital dacryostenosis, as well as resolution of symptoms, were confirmed by clinical examination and use of a modified dye disappearance test. In 572 eyes, the success rate of initial probing was found to be 97% under 13 months of age. Over 13 months, however, the mean success rate was found to be 54.7%. When broken down into smaller age categories, a stepwise progression was observed from 76.4% between 13 and 18 months to 33.3% for patients probed after 24 months. In addition, the number and complexity of subsequent procedures appeared to increase along with the age at which the initial probing was performed. These data suggest that initial probing should be done prior to 13 months of age depending on the severity of symptoms and parent compliance with medical management.

Child, Preschool↗
PubMed1987

Three-dimensional computed tomographic imaging.

Recent developments in imaging techniques now allow reconstruction of actual three-dimensional images from computed tomographic data. This article discusses the basic concepts involved in three-dimensional imaging and reviews its potential as a diagnostic and management tool for the clinical ophthalmologist. New computer techniques allow review of actual three-dimensional images in both static and dynamic formats. This can allow the clinician to define more accurately a normal and pathologic anatomy involving skeletal structures in particular.

Eye Diseases↗
PubMed1987

Ophthalmic considerations in cranio-orbital surgery.

Interdisciplinary management of cranio-orbital problems has allowed improved surgical results in the diagnosis and management of motility and adnexal deformities. Careful evaluation of visual function preoperatively, combined with proper timing of repair, can greatly assist the development and maintenance of optimum visual function.

Eye Diseases↗
PubMed1985

Dacryoscintigraphy in children.

Dacryoscintigraphy was performed in 34 pediatric patients aged between 13 months and 20 years. Twenty-six were 12 years of age or younger. The study is easy to perform and provides useful information regarding the function of the nasolacrimal system. The radiation dose to the lens of the eye, estimated to be 4-14m rads/100 uCi of technetium pertechnetate, is considerably less than that of a skull x-ray or dacryocystography. Of the 74 nasolacrimal systems studied, the findings were in agreement with the clinical observations and other methods of testing in 63. In nine instances, the findings altered the clinical management while the results were inconclusive or misleading in the remaining two. Dacryoscintigraphy was found to be a useful physiological test in the evaluation of children with epiphora.

Adolescent↗
PubMed1979

Frontalis suspension in congenital ptosis using a polyfilament, cable-type suture.

Fifty-five frontalis sling procedures were performed with use of 4--0 polyfilament, cable-type ophthalmic suture (Supramid Extra) as the material for suspension. Recurrences numbered 16, recorded through a follow-up period of one to ten years. Trauma accounted for five recurrences. A pattern of gradual droop of the lid operated on became most obvious between six and ten years postoperatively and accounted for six of seven recurrences during this period. These findings suggest that this suture material is a poor alternative to fascia lata for permanent frontalis suspension in patients with congenital ptosis and should be used only in unusual circumstances, or when a temporary procedure is indicated.

Adolescent↗
PubMed1979

Recurrent facial fibrous histiocytoma.

A case of fibrous histiocytoma required 4 surgical excisions over an 11-year period. The technique of frequent observation and early excision of recurrences is probably the best approach to established histiocytomas. Complete primary excision seems to offer the best chance of definitive cure.

Adult↗
PubMed1977

Lattice corneal dystrophy. Report of an unusual case.

The clinical, histochemical, light and electron microscopic evaluation of a case of lattice corneal dystrophy, appears clinically as an atypical granular dystrophy. There is structural and histochemical differentiation of the two dystrophies. Electron microscopy is often an invaluable aid in establishing a definitive diagnosis. The possible sources of the filamentous material found in lattice corneal dystrophy are discussed. It seems that not only keratocytes, but also corneal epithelial cells, occasionally may have the ability to elaborate the abnormal material that is considered to be amyloid in nature.

Corneal Dystrophies, Hereditary↗