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L Apt

Publications and source records attributed to L Apt.

At least 37 records · Page 2Linked to original sources
PubMed1991

Electrooculography and discriminant analysis in Duane's syndrome and sixth-cranial-nerve palsy.

Eye-movement recordings may be helpful in the differentiation of Duane's syndrome from sixth-cranial-nerve palsy. Voluntary horizontal saccades were recorded and quantitated by electrooculography in 18 patients with unilateral type I Duane's syndrome and in 25 patients with sixth-nerve palsy. When ranges of abduction were matched, the peak velocities of abducting saccades in affected eyes were decreased equally in both groups. However, the peak velocities of adducting saccades in sound eyes were slowed in patients with Duane's syndrome. Because the standard deviations in saccadic velocities are large, computer-based, stepwise discriminant analyses were performed to identify the variables that proved to be useful in differentiating the two disorders. By entering these variables into the discriminant functions that were created, we could distinguish Duane's syndrome from sixth-nerve palsy in a statistically significant manner.

Abducens Nerve↗
PubMed1990

Overnight admission of outpatient strabismus patients.

The trend to outpatient strabismus surgery prompted us to determine the frequency of, and the reasons for, postoperative overnight hospital admission following such surgery. In one year, 303 outpatient strabotomies were performed at the Jules Stein Eye Institute on patients over 15 months old. Twenty-four (7.9%) were admitted overnight postoperatively. Compared with controls, those admitted were older (37 vs 20.5 years), and had a longer duration of anesthesia (145 vs 116 minutes) and surgery (104 vs 75 minutes) (P less than .01 for each). The time that surgery commenced and the use of perioperative medications were not significant factors. The most frequent reasons for overnight admission were nausea (38%) despite prophylaxis and the use of bilateral patches (16%). To minimize postoperative admissions, better strategies should be developed to decrease the frequency of significant postoperative nausea, the duration of surgery and anesthesia, and, if possible, the use of bilateral patches.

Adolescent↗
PubMed1989

Outpatient topical use of povidone-iodine in preparing the eye for surgery.

Povidone-iodine 5% solution placed on the eye immediately before ophthalmic surgery within the preoperative preparation significantly reduces the conjunctival bacterial flora. In 40 patients undergoing ophthalmic surgery, the authors compared the outpatient use of povidone-iodine for 3 days before surgery with a 3-day course of a combination antibiotic ophthalmic solution (Neosporin) placed on the other eye. All patients also received topical povidone-iodine on the operating table directly preceding surgery. Cultures taken just before preparation of the operative field showed a similar reduction of bacteria by each regimen. Cultures taken after preparation but before commencement of surgery showed a further reduction for both regimens, but more for eyes previously treated with the antibiotic (P less than 0.02). To minimize the conjunctival bacterial flora before surgery, the authors continue to recommend instillation of a broad-spectrum antibiotic for 3 days before surgery, followed by application of povidone-iodine solution to the eye immediately before surgery within the preoperative preparation.

Ambulatory Care↗
PubMed1988

Source of the conjunctival bacterial flora at birth and implications for ophthalmia neonatorum prophylaxis.

To understand better the source of conjunctival bacteria in neonates, we studied 106 infants immediately after birth before any eyedrops were applied. The 50 infants delivered by cesarean section had significantly fewer species (0.50 +/- 0.85 vs 1.84 +/- 1.33) and colony forming units (272 +/- 1,019 vs 1,790 +/- 3,779) cultured per subject than the 56 infants delivered vaginally. In infants delivered by cesarean section within three hours of membrane rupture, 24 of 30 (80%) of the conjunctival cultures were sterile, while the rest bore a few cutaneous bacteria (0.23 +/- 0.50 species and 2 +/- 9 colony forming units per subject). The conjunctivae of infants delivered vaginally bore significantly more bacteria characteristic of vaginal flora: microaerophilic as Lactobacillus or truly anaerobic as Bifidobacterium. Neonates delivered by cesarean section more than three hours after membrane rupture showed a bacteriologic flora mixture quantitatively and qualitatively midway between those two groups. Infants delivered by cesarean section within three hours of membrane rupture may not need prophylactic eyedrops because of the type and scarcity of conjunctival bacteria.

Bacteria↗
PubMed1988

Conjunctival anaerobic and aerobic bacterial flora in paediatric versus adult subjects.

Although the bacterial flora of the conjunctiva in children and adults has been studied, there has been no previous comparison between these two age groups of anaerobic as well as aerobic bacteria. Conjunctival cultures from 229 eyes of 144 uninfected subjects were analysed for aerobic, microaerophilic, and anaerobic bacteria. Adults showed a greater number of species per eye than did younger subjects (1.47 versus 1.13; p less than 0.05). Anaerobic species, predominantly Propionibacterium, were obtained from 27.1% of all eyes, but from a significantly greater percentage (30.2% versus 12.8%) of adults' than children's eyes (p less than 0.04). Streptococcus spp. were cultured from 14.9% of the children's eyes as opposed to only 2.2% from adults (p less than 0.005). Understanding the differences in conjunctival flora between normal adults and children aids the interpretation of culture results and leads to properly defining and treating potential pathogens.

Adolescent↗
PubMed1987

Herpetic canalicular obstruction.

The viruses of primary herpes simplex, herpes zoster, chicken pox, and vaccinia may produce inflammatory changes in the epithelial lining of the lacrimal canaliculi, resulting in varying degrees of obstruction. Five cases are described and compared with previously reported cases. A review of the literature suggests that the association of ocular viral infections and canalicular complications may be more prevalent than previously suspected. The possible important role of antiviral agents is considered. Early recognition and intubation can often prevent permanent canalicular obstruction, but late cases may require the Jones tube procedure, conjunctivodacryocystorhinostomy.

Child↗
PubMed1985

Chemical preparation of the eye in ophthalmic surgery. IV. Comparison of povidone-iodine on the conjunctiva with a prophylactic antibiotic.

We previously found that half-strength (5%) povidone-iodine solution significantly reduced the bacterial flora of the conjunctiva. To compare the antibacterial effect of a topical combination antibiotic (Neosporin ophthalmic solution) given three times daily for three days preoperatively with that of half-strength povidone-iodine solution given as part of the preoperative preparation, conjunctival cultures were studied from 35 patients undergoing ocular surgery. When used individually, the antibiotic and povidone-iodine solutions caused a similar and substantial decrease in the number of colonies and species of bacteria cultured. When both drugs were used together, the decrease was even more striking, making 83% of the conjunctivae sterile. To minimize bacterial flora before ocular surgery, we recommend that a broad-spectrum topical antibiotic be given for three days preoperatively and that half-strength povidone-iodine solution be used as part of the preoperative preparation.

Anti-Bacterial Agents↗
PubMed1985

Antimicrobial preparation of the eye for surgery.

An important source of postoperative eye infection is the indigenous flora in and around the eye. Therefore, proper preparation of the operative field is crucial. Through an international survey we determined that ophthalmic surgeons used widely varying techniques in the pre-operative antimicrobial preparation of the eye. On the basis of these survey responses we have studied to date the effect on the bacterial flora of the conjunctiva of three regimens. Irrigation of the conjunctiva with saline tended to increase the ocular flora; instillation of silver protein solution had no significant effect. Povidone-iodine drops (5%) significantly reduced both colony and species counts.

Anti-Infective Agents, Local↗
PubMed1984

Chemical preparation of the eye in ophthalmic surgery. III. Effect of povidone-iodine on the conjunctiva.

A half-strength povidone-iodine (Betadine) solution was used topically as part of the preoperative chemical preparation of the eye. Aerobic and anaerobic bacterial cultures of the conjunctiva were taken before and after the chemical preparation in 30 consecutive patients; the second eye served as a control. In the control eyes, no significant change in the number of colonies or species of bacteria was found. In the povidone-iodine-treated eyes, the numbers of colonies decreased 91% and the number of species decreased 50% (statistically significant). We therefore recommend that a half-strength povidone-iodine solution be used as part of the chemical preparation of the eye for surgery.

Administration, Topical↗
PubMed1984

Absent meibomian glands in the ectrodactyly, ectodermal dysplasia, cleft lip-palate syndrome.

A 27-year-old woman with the syndrome characterized by ectrodactyly, ectodermal dysplasia, and cleft lip-palate had an absent lacrimal punctum in each eye, with signs and symptoms of nasolacrimal obstruction during childhood. Examination disclosed bilateral corneal vascularization and opacification, with diffuse superficial punctate staining of the ocular surface epithelium by fluorescein, an instantaneous tear film break-up time, and normal Schirmer tear measurements. A full-thickness biopsy specimen of the eyelid confirmed the absence of meibomian glands that had been suspected because of absent meibomian gland orifices and secretions. The total absence of meibomian gland secretions in this patient may be a primary feature of this case and may contribute to a lipid-deficient and unstable tear film with resultant desiccation and destruction of the ocular surface epithelium. Breakdown of the corneal epithelium in association with obstruction and infection of the nasolacrimal system may be a particularly disastrous combination for the cornea that resulted in the recurrent, severe bacterial corneal ulcers found in our patient.

Adult↗
PubMed1983

Chemical preparation of the eye in ophthalmic surgery. I. Effect of conjunctival irrigation.

We investigated the effect on bacterial flora of conjunctival irrigation as part of the chemical preparation of the eye before surgery. Forty consecutive patients underwent conjunctival irrigation with a saline solution in one randomly selected eye. Aerobic and anaerobic bacterial conjunctival cultures were taken in masked fashion before and after the preparation. In nonirrigated eyes, the colony counts before and after the preparation were virtually identical; the species count increased 23%. In irrigated eyes, the colony count increased 18% and the species count increased 46%. The increase in the species count was significant. Our findings suggest irrigation with a saline solution does not reduce the bacterial flora of the conjunctiva.

Conjunctiva↗
PubMed1983

Chemical preparation of the eye in ophthalmic surgery. II. Effectiveness of mild silver protein solution.

Although a mild silver protein solution (Argyrol) has been used for a number of years and is still used by many ophthalmic surgeons, its efficiency as an antibacterial agent on the conjunctiva has not been scientifically evaluated as part of the preoperative chemical preparation of the eye. We studied the effectiveness of a mild silver protein solution on the conjunctival flora of 32 patients in a masked fashion. By bacteriologic analysis, the mild silver protein solution was found to be no more effective in reducing the number of species and colonies in the treated eye than in the untreated eye. While the mild silver protein solution does stain mucus and other debris on the eye to facilitate irrigation, this study did not demonstrate a significant bactericidal effect.

Conjunctiva↗
PubMed1982

An anatomical reevaluation of rectus muscle insertions.

Certain strabismus operations require a thorough knowledge of the anatomy of rectus muscle insertions. Earlier anatomical studies were based on a small sample size and did not use precise microscopic techniques for measurements. To obtain accurate measurements of rectus muscle insertion relationships, 100 consecutive normal adult autopsy eyes were examined with a Vernier caliper and a dissecting microscope for high magnification. Statistical analysis of these data provided a set of normal values for (1) distances from anterior and posterior limbus to rectus muscle insertions, (2) distances between anterior and posterior limbus, (3) length of line ("width") of rectus muscle insertions, and (4) distances between rectus muscle insertions. Although most of the determinations were somewhat similar to older previous studies, statistically they were significantly different. The ophthalmologist can make use of the revised set of figures for rectus muscle insertion relationships in operations such as transposition procedures for A-V patterns and cranial nerve palsies, large recessions, and advancements in reoperations after recessions.

Adult↗
PubMed1982

Chemical preparation of skin and eye in ophthalmic surgery: an international survey.

We surveyed 214 ophthalmologists worldwide to learn their methods of preoperative chemical preparation of eye and skin. A 96.8% return rate was achieved. While a wide diversity of agents was reported, povidone-iodine was the most popular agent applied to the skin. The conjunctiva usually was either ignored or rinsed with a saline solution by the respondents. Almost a quarter used mild silver protein (Argyrol) on the conjunctiva. Most of the preparation is performed by the physician rather than the nurse. Review of the advantages and pitfalls of the agents reported should cause the ophthalmologist to reconsider these agents for their effectiveness, spectrum, and duration of action.

Anti-Infective Agents, Local↗