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Biomedical subjects

L Hefetz

Publications and source records attributed to L Hefetz.

13 recordsLinked to original sources
PubMed1998

Corneal thickness and curvature in normal-tension glaucoma.

PURPOSE: To determine whether normal-tension glaucoma, defined as a condition in which glaucomatous optic nerve and visual field changes exist without documentation of intraocular pressure greater than 21 mm Hg or other apparent cause for these changes, is overdiagnosed in patients with decreased central corneal thickness and curvature. METHODS: Twenty-one patients with normal-tension glaucoma were compared with 25 patients with primary open-angle glaucoma and 27 age-matched healthy subjects. Corneal thickness was determined by ultrasonic pachymetry. Corneal curvature was determined using a keratometer. Eyes with corneal pathology or previous intraocular surgery were excluded. RESULTS: Mean corneal thickness +/- SD in 21 eyes of 21 patients with normal-tension glaucoma was 0.521 +/- 0.037 mm, significantly (P = .0028) lower than in 25 eyes of 25 patients with primary open-angle glaucoma (0.556 +/- 0.035 mm) and 27 eyes of 27 healthy subjects (0.555 +/- 0.034). Mean corneal curvature in the three groups was not appreciably different: 43.90 +/- 1.81 diopters, 43.66 +/- 1.68 diopters, and 44.36 +/- 1.13 diopters in the patients with normal-tension glaucoma and primary open-angle glaucoma and the healthy subjects, respectively. CONCLUSIONS: Corneal thickness is significantly reduced in patients with normal-tension glaucoma compared with patients with primary open-angle glaucoma (P = .0028) and normal subjects (P = .0037). This may lead to underestimation of intraocular pressure and misdiagnosis in some of these patients. Corneal curvature was similar in patients with normal-tension glaucoma and primary open-angle glaucoma and in healthy subjects.

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PubMed1998

Excimer laser phototherapeutic keratectomy for recurrent corneal erosion.

PURPOSE: To evaluate the outcome of excimer laser phototherapeutic keratectomy (PTK) for recurrent corneal erosion. SETTING: Laser Institute, Assay Harofeh Medical Center, Zerifin, Israel. METHODS: Twenty-three patients with a mean age of 50.56 years +/- 13.87 (SD) were referred between 1991 and 1995 for recurrent corneal erosion that did not respond to conservative treatment. All were treated by excimer laser PTK. Patients were interviewed and examined before and after treatment. RESULTS: Disease duration ranged from 2 months to 10 years. Frequency of attacks ranged from weekly to three to four times a year. Re-epithelialization of the cornea was established within an average of 3 days after PTK treatment. Follow-up was 12 to 60 months (mean 38.43 +/- 12.08 months). Nineteen (83%) patients were free of recurrences, and 3 had one recurrence treated successfully by patching. One patient who had two recurrences had a second PTK procedure and was symptom free for 14 months. No patient reported reduced visual acuity or quality. Postoperative best corrected visual acuity was unaltered in 21 eyes and improved in 2. There was no significant difference between preoperative and postoperative manifest refractions. CONCLUSION: Excimer laser PRK appears to be a safe and effective treatment for recurrent erosions of the cornea.

Adult↗
PubMed1997

[Laser photorefractive surgery].

As photorefractive keratectomy (PRK) with excimer laser gains world-wide acceptance, more patients are able to discard their spectacles. Our study comprised 611 eyes which underwent PRK and were followed for at least a year. Those with myopia up to -6.00D had better post-operative visual acuity and refraction, than patients with higher grades of myopia. They had less corneal haze and a greater proportion were satisfied with their results. Complaints of halos and glare were similar at all degrees of myopia up to -10.00D.

Follow-Up Studies↗
PubMed1997

Normal heterophoric changes: 20 years' follow-up.

BACKGROUND: Evaluation of changes in the heterophoric condition of 100 normal individuals over a 20-year period. METHODS: A retrospective study was undertaken. Charts of 100 normal men were reviewed. Individual changes in the heterophoric status were recorded over a 20-year period. The average value of the phoria at age 18-22 years was compared with the average value at age 34-38 years. Measurements were taken for near and distance fixation. No one was heterotropic. Changes in convergence and accommodation were also calculated. RESULTS: A 0.9 +/- 1.7 prism diopter increase in esophoria for distance fixation and a 0.6 +/- 2.5 prism diopter increase in exophoria for near fixation were found. These changes were statistically significant (P < 0.001 and P < 0.02 respectively). The near point of convergence receded by 0.5 +/- 1.1 cm (P < 0.001), and a decrease in accommodation over time of 2.8 +/- 1.4 diopters was found (P < 0.001). CONCLUSION: An increase in esophoria for distance fixation and a exophoria for near fixation was found in a 20-year follow-up of 100 normal subjects.

Accommodation, Ocular↗
PubMed1997

For how long can regression continue after photorefractive keratectomy for myopia?

PURPOSE: The presence and degree of regression were assessed from 18 to 30 months after photorefractive keratectomy (PRK). METHODS: A total of 449 eyes (449 patients) were treated with an Aesculap Meditec 193-nm Arf Excimer laser. These 449 eyes were followed during the first 24 months after PRK, and 252 of these eyes were followed for 24 to 30 months. RESULTS: Thirty (6.7%) of the 449 eyes followed for up to 24 months showed good refractive results during the first year and a half but regressed thereafter and required retreatment. Late regression was confined to subjects with pretreatment myopia above -4.0 diopters (D) and was the same in low- and high-myopic eyes between 18 and 24 months post-PRK. However, between 24 and 30 months, regression was higher in low-myopic eyes, where it reached -0.55 D, than in high-myopic eyes, where it was -0.21 D. This lower frequency of regression in high-myopic eyes is attributed to the relatively high rate of retreatment in this group during the first 18 months after PRK. CONCLUSIONS: Although the findings indicate a fairly low rate of regression after 24 months, there still are insufficient data on which to predict when regression post-PRK stabilizes.

Adult↗
PubMed1997

Refractory intraocular pressure increase after photorefractive keratectomy.

A patient with developmental angle anomaly developed a corticosteroid-induced refractory increase in intraocular pressure (IOP) after photorefractive keratectomy (PRK). Trabeculectomy was required to reduce the pressure. Although rare, corticosteroid-induced refractory IOP increase is a serious complication of PRK and may necessitate trabeculectomy. More frequent monitoring of IOP in post-PRK patients and a re-evaluation of postoperative treatment are indicated.

Adult↗
PubMed1997

Influence of patient age on refraction and corneal haze after photorefractive keratectomy.

AIMS/BACKGROUND: Since wound healing processes are known to be more rapid in those who are young, it was decided to examine the effect of patient age on refractive outcome of photorefractive keratectomy (PRK). METHODS: The records of 599 eyes that had undergone PRK were studied retrospectively. The eyes were categorised by baseline myopia and patient age. Spherical equivalent and corneal haze were compared in the baseline refraction and age groups at 3, 6, and 12 months after PRK. RESULTS: There were no differences in postoperative refraction and corneal haze in the different age groups. CONCLUSION: Patient age had no statistically significant effect on refraction and corneal haze 1 year after PRK.

Adult↗
PubMed1997

Results of a repeated excimer laser photorefractive keratectomy for myopia.

BACKGROUND AND OBJECTIVE: As photorefractive keratectomy (PRK) becomes more widely used, the incidence of repeated PRK increases. The present study was conducted to evaluate results of repeated PRK in view of the meager data on this topic. PATIENTS AND METHODS: In this retrospective study, the authors reviewed the records of 1028 eyes that had undergone PRK, and analyzed the results of 66 eyes that required a second PRK for undercorrection according to baseline refraction. RESULTS: A second PRK was performed in 6.3%, 13.7%, and 10.1% of low, moderate, and high myopes, respectively. The mean refraction 1 year after repeated PRK was similar in both myopic groups: less than -1.00 D. Of the low myopes, 87.50% had residual refraction within 1 D after 1 year. Of the moderate myopes, 88.23% had residual refraction within 1 D after 1 year. All of the low myopes achieved uncorrected visual acuity (VA) of 20/25 or better 1 year after repeated PRK, compared with 58.82% of the moderate myopes. Loss of best-corrected VA never exceeded two lines. CONCLUSION: The overall results of PRK appear to be satisfactory.

Adult↗
PubMedDate not supplied

Early and late postoperative application of 5-fluorouracil following trabeculectomy in refractory glaucoma.

Intraocular pressure (IOP) control was studied retrospectively in two groups of 14 consecutive patients following trabeculectomy with adjunctive postoperative 5-fluorouracil (5-FU) treatment. In one of the groups (the early-treatment group), 5-FU injections were started 2.4 +/- 0.6 days postoperatively; in the other group (the delayed-treatment group), they were started only when clinical signs suggested impending bleb failure (12.6 +/- 5.4 days postsurgery). The patients in the two groups were age-matched and had a similar history of previous failed glaucoma operations or diabetes, both of which are considered indications for postoperative 5-FU injections. The mean number of 5-FU injections and the total dose in the two groups did not differ significantly (5.3 +/- 0.8 and 5.5 +/- 1.1 injections, respectively; 26.4 +/- 3.9 and 27.5 +/- 5.3 mg 5-FU total dose, respectively). The average follow up for the two groups was 16.7 +/- 2.5 and 16.9 +/- 2.7 months, respectively. With an IOP of 18 mm Hg or less with or without medications considered a success, 42.8% of the delayed-treatment and 71.4% of the early-treatment cases were successful. More medications were required in the early-treatment group. Postoperative transient corneal epithelial defects occurred in 71.4% and 78.4% of the eyes in the late- and early-treatment groups, respectively, an insignificant difference. Conjunctival wound leak occurred in one patient (in the delayed-treatment group).(ABSTRACT TRUNCATED AT 250 WORDS)

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