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Biomedical subjects

L S Poliner

Publications and source records attributed to L S Poliner.

11 recordsLinked to original sources
PubMed1992

Retinal pigment epitheliopathy after macular hole surgery.

BACKGROUND: Full-thickness idiopathic macular holes were previously considered untreatable, but surgical intervention has been proposed to collapse the hole and improve vision. This study evaluates the fluorescein angiographic changes that occur after macular hole surgery. METHODS: Sixteen patients with stage III idiopathic macular holes underwent pars plana vitrectomy, removal of the posterior hyaloid, peeling of fine epiretinal sheets along the edges of the holes, and fluid-gas exchange. Preoperative fluorescein angiograms were performed, and best-corrected preoperative visual acuity was 20/200 or less in all eyes. RESULTS: Postoperatively, the macular hole disappeared in 12 eyes (75%). In all 12 eyes, retinal pigment epithelial swelling was present, with a unique fluorescein angiographic appearance. This pattern slowly resolved over months, with gradual visual improvement but residual retinal pigment epithelial mottling. Systemic and periocular steroids had no significant impact on the process. CONCLUSION: The combination of prolonged intraocular gas contact and light exposure exceeding threshold for an already compromised macula appears to be responsible for this pigmentary pattern. Depending on the severity of the pigment epithelial alteration, this unique pattern may portend a guarded visual prognosis in affected patients undergoing successful macular hole repair.

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PubMed1992

Scatter macular photocoagulation for subfoveal neovascular membranes in age-related macular degeneration. A pilot study.

Forty eyes with age-related macular degeneration and a choroidal neovascular membrane involving the entire foveal avascular zone were enrolled in a pilot study to evaluate an unconventional photocoagulation technique that was postulated to stimulate inhibitors of neovascularization. Eighteen (45%) eyes were treated with extrafoveal scatter macular photocoagulation, and 22 (55%) eyes were treated with this type of photocoagulation and focal extrafoveal ablation of the choroidal neovascular membrane. The eyes were followed for at least 1 year and up to 4 years (average, 2.4 years). One to 7 months after treatment, approximately 45% of the membranes treated with each technique did not leak fluorescein during angiography. The absence of leakage was associated with better visual acuity, but this difference was not statistically significant. At the beginning of the study, the visual acuity was 20/200 or better in 32 eyes (80%) and 20/80 or better in 11 (28%). At the conclusion of the study, the visual acuity was 20/200 or better in 21 eyes (53%) and 20/80 or better in 7 (18%). After treatment, 24 eyes (60%) had the same or better (plus or minus two lines) visual acuities. Compared with eyes in natural history studies, those treated with scatter macular photocoagulation had less visual loss from baseline but did not recover acuity of 20/100 or better more frequently. There was no difference in results between these two methods of treatment.

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PubMed1990

Transparency overlay. A rapid method to assess retinal pathologic changes.

Many ocular disorders are managed with the aid of serial photography to detect, document, and measure change. The authors developed a method of field mapping that is a clinically useful, rapid, and inexpensive way to assess changes in retinal anatomy using recently released Polaroid 691 transparency film. This transparency film allows the pretreatment fluorescein angiogram and the posttreatment black-and-white or color transparency images to be enlarged and compared without the use of additional photographic enlargers or projectors.

Humans↗
PubMed1988

Surgical management of premacular fibroplasia.

The results of pars plana vitrectomy and membrane peeling for premacular fibroplasia (PMF) were reviewed retrospectively for 88 eyes of 86 patients. Premacular fibroplasia was idiopathic in 61 eyes (69%) and postdetachment in 27 eyes (31%). All patients had a minimum follow-up of 12 months. Visual symptoms of blurring and metamorphopsia were reduced in 75 (85%) study eyes at the end of the follow-up period. Poor visual outcome was significantly related to preoperative cystoid macular edema and prolonged duration of visual blurring. Posterior retinal breaks occurred in three eyes (5%) with idiopathic PMF and five eyes (19%) with postdetachment PMF. Cataract progression was demonstrated in 35 eyes (48%) at 12 months of follow-up and 49 eyes (68%) at 24 months of follow-up, reflecting an incidence of cataract formation that has not been previously reported (to our knowledge) after limited vitrectomy and membrane peeling for PMF.

Adult↗
PubMed1987

Intraocular pressure assessment in gas-filled eyes following vitrectomy.

The accuracy and precision of tonometric methods in measuring intraocular pressure (IOP) was assessed in 24 eye-bank eyes subjected to pars plana lensectomy/vitrectomy and air-fluid exchange. Intraocular pressure was measured in masked fashion with a Perkins' applanation tonometer, pneumatic applanation tonometer; a mercury manometer served as a reference standard. Pneumatic tonometry underestimated actual IOP by as much as 25%, and Schiotz' indentation tonometry underestimated actual IOP by as much as 79%. Perkins' applanation tonometry was significantly more accurate in estimating actual IOP in gas-filled eyes than pneumatic tonometry or Schiotz' indentation tonometry.

Humans↗
PubMed1987

Modified vitreoretinal forceps for membrane peeling.

We have designed a modified vitreoretinal forceps specifically for peeling delicate epiretinal membranes in cases of premacular fibroplasia. Improved features of the forceps include a positive-action closure, barrel design, and lightly serrated surfaces. Rotational movements are made easier by this modified forceps design. Over the past three years, 96 cases of premacular fibroplasia have been successfully managed with the modified forceps. Delicate membranes have been removed without tearing or shredding.

Humans↗
PubMed1987

New retinal detachment after pneumatic retinopexy.

Thirteen cases of rhegmatogenous retinal detachment repaired by pneumatic retinopexy were reviewed retrospectively. All patients were followed for a minimum of 6 months after surgery. At the end of follow-up, retinal detachment repair by pneumatic retinopexy succeeded in nine cases (70%) and failed in four (30%). Within 2 days of pneumatic retinopexy, vitreous condensation and traction with new retinal tears and associated detachments in previously uninvolved quadrants developed in two patients. The occurrence of new retinal detachments in the early postoperative period after pneumatic retinopexy has not been previously observed.

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PubMed1986

Natural history of retinal pigment epithelial detachments in age-related macular degeneration.

The natural history of 100 eyes of 93 patients with retinal pigment epithelial detachment (PED) and bilateral age-related macular degeneration (AMD) was retrospectively studied for a minimum of 12 months in the offices of Retina Consultants, Ltd. Detachment was defined as serous in 46 eyes, turbid in 12 eyes, hemorrhagic without evident neovascular membrane (NVM) in 20 eyes, and hemorrhagic with angiographically proven NVM in 17 eyes. Final visual results demonstrated visual acuity of 20/200 or worse in 33% of serous PED, 83% of turbid PED, and 89% of hemorrhagic PED. Despite strict inclusion criteria, 26% of serous PED developed NVM by one year and 49% of serous PED developed NVM by three years. Variables associated with NVM development in serous PED include older patient age, larger detachment size, presence of subretinal fluid at initial examination, and disciform scar in the fellow eye at presentation.

Age Factors↗
PubMed1985

Neovascular glaucoma after intracapsular and extracapsular cataract extraction in diabetic patients.

A retrospective study of the rate of development of neovascular glaucoma after cataract extraction in 242 eyes of 186 diabetic patients identified neovascular glaucoma in 13 of 146 eyes (8.9%) after intracapsular extraction, in two of 17 eyes (11.8%) after extracapsular extraction with primary capsulotomy, and in zero of 53 eyes after extracapsular extraction without capsulotomy. The incidence of neovascular glaucoma was significantly lower in patients who underwent extracapsular extraction with preservation of an intact posterior capsule than in those undergoing intracapsular cataract extraction (P less than .01) or extracapsular cataract extraction with primary capsulotomy (P less than .05).

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