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K D Epley

Publications and source records attributed to K D Epley.

6 recordsLinked to original sources
PubMed1999

Lacrimal sac diverticula associated with a patent lacrimal system.

PURPOSE: To describe the clinical features of lacrimal sac diverticula. METHODS: Orbital masses were evaluated in 3 patients. One patient had a large tumor extending from the medial orbit associated with upward globe displacement, one had a mass inferior to the medial canthus, and one had an inflamed mass in the right lower lid. Two of the patients had no history of chronic epiphora, sinus disease, or nasal trauma. In all patients, irrigation demonstrated lacrimal drainage system patency. RESULTS: Surgical exploration confirmed the diagnosis of lacrimal sac diverticulum in all patients. Two diverticula were associated with a dacryolith. Each patient was successfully managed with excision of the diverticulum and dacryocystorhinostomy. CONCLUSIONS: Lacrimal sac diverticula should be considered in the diagnosis of medial orbital tumors, and computed tomography is useful in the diagnosis of lacrimal sac diverticula.

Adult↗
PubMed1999

A simplified technique for stable transscleral suture fixation of posterior chamber intraocular lenses.

We describe a technique for implanting ciliary sulcus posterior chamber intraocular lenses (PCIOLs). This technique uses radial keratotomy (RK) markers to facilitate PCIOL centration, 2-point scleral suture fixation for each haptic to prevent PCIOL tilt, and partial thickness sclerotomies to prevent suture erosion. Postoperative results of 20 eyes with PCIOLs sutured to the ciliary sulcus were reviewed. Suture placement was determined using a Mendez degree gauge with Bores axis marker (Katena USA, Denville, NJ). Two-point scleral suture fixation without a scleral flap was used for each haptic. Average follow-up was 17.1 months. Postoperative best corrected visual acuity was 20/40 or better in 95% of eyes. Average best-corrected post-operative visual acuity was 20/29. One patient with a previous retinal disease lost 3 lines of visual acuity. This technique results in excellent postoperative visual acuity without PCIOL decentration, tilt, or suture erosion.

Aphakia, Postcataract↗
PubMed1998

Osteosarcoma of the orbit associated with Paget disease.

Osteosarcoma is a common primary bone malignancy most often involving the long bones and occurring in the second decade of life. Orbital involvement in this disease process is rare and is usually due to extension of the tumor from an adjacent sinus cavity. Orbital osteosarcoma arising from preexisting Paget disease is exceedingly rare. We report the case of a 78-year-old female patient with Paget disease of the forehead who presented with rapidly increasing bilateral proptosis and visual loss for several months. Examination showed bilateral aphakia, decreased motility, proptosis with resistance to retropulsion, and tumorous infiltration of the eyelids and periorbital soft tissue. Fundus examination showed marked bilateral scleral indentation without overlying serous retinal detachment. A computed tomographic (CT) evaluation of the orbits demonstrated extensive soft tissue involvement of the paranasal sinuses, nasal cavity, periorbital soft tissue, and orbits, with compression of the optic nerve and globe bilaterally. Biopsy of the periorbital soft tissue demonstrated osteosarcoma. Radiation therapy failed to stem the progression of the disease process, and the patient died approximately 4 months later. Although osteosarcoma of the orbit associated with Paget disease is unusual, it should be considered in the differential diagnosis of older patients with a rapidly progressive orbital mass.

Aged↗
PubMed1998

Platinum spatula versus Mini-tip Culturette in culturing bacterial keratitis.

PURPOSE: To compare the traditional method of culturing bacterial keratitis (platinum spatula) with the use of a commercially available Mini-tip Culturette (Becton-Dickinson, Cockeysville, MD, U.S.A.). METHODS: An experimental model of bacterial keratitis was created in rabbit corneas by intrastromal injection of bacteria. Cultures were taken of rabbit corneas with both the Mini-tip Culturette and the platinum spatula. Culture results were compared with corneal colony counts. Humans with community-acquired presumed bacterial keratitis were cultured with both the Mini-tip Culturette and the platinum spatula. The sensitivity and specificity of the Mini-tip Culturette method was determined and compared with the platinum-spatula technique. RESULTS: Rabbit keratitis model: 100% of corneas had established infections by colony count. Each ulcer was culture positive with platinum spatula, moist Mini-tip Culturette, and dry Mini-tip Culturette. Human keratitis: Seven patients had culture-negative keratitis with both the Mini-tip Culturette and the platinum spatula. Five patients were culture positive with both the Mini-tip Culturette and the platinum spatula. One of the positive cultures had growth of multiple organisms by using the platinum spatula but not with the Mini-tip Culturette. The sensitivity of the Mini-tip Culturette was 83.3%. The specificity of the Mini-tip Culturette was 100%. Detected organisms included group A beta-hemolytic Streptococcus, S. aureus, coagulase-negative Staphylococcus, Serratia marcescens, and Pseudomonas aeruginosa. CONCLUSION: The Mini-tip Culturette is a highly specific and moderately sensitive method for culturing bacterial keratitis.

Animals↗
PubMed1997

Household objects as a cause of self-inflicted orbital apex syndrome.

This report describes two cases of self-inflicted penetrating nonprojectile orbitointracranial injury. Suicide attempts caused by these types of injuries are very rare. An understanding of the orbital and intracranial anatomy and the avoidance head turn help to predict potential injury sites. Computed tomography and cerebral angiography were helpful in the treatment of these two cases.

Adult↗