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Biomedical subjects

M Goggin

Publications and source records attributed to M Goggin.

At least 19 recordsLinked to original sources
PubMed2004

Late onset post-keratoplasty astigmatism in patients with keratoconus.

AIM: 10 eyes of 10 patients are reported where progression of keratoconus in the host cornea occurred more than 10 years after penetrating keratoplasty with resultant increase in astigmatism. The technique and results of graft refractive surgery in seven eyes are presented. METHODS: The clinical features and management of these patients were retrospectively analysed. Graft refractive surgery involved an incision at the graft-host junction adjacent to the host thinning with compressive resuturing. Astigmatic changes were calculated using vector analysis. RESULTS: There were seven men and three women with a mean age of 41.2 years. The average age when undergoing penetrating keratoplasty in the affected eye was 28.4 years and the average time after penetrating keratoplasty until keratoconus appeared in the host cornea defined by host thinning was 13.5 years. The mean cylinder power before host thinning was noted was 5.07 D (SD 2.19) and the mean after host thinning was 11.0 D (2.53). The mean vector calculated disease induced astigmatism magnitude was 7.59 D (3.09). Graft refractive surgery was performed in seven eyes. The mean cylinder power before and after graft refractive surgery was 11.28 D (2.15) and 7.09 D (5.53) respectively. The surgically induced astigmatism vector magnitude was 7.36 D (4.88). CONCLUSION: Progression of keratoconus in the host cornea late after penetrating keratoplasty is characterised by a large astigmatic change where the flat axis of astigmatism passes through an area of host thinning visible on slit lamp examination. Compressive resuturing performed in the area of host thinning resulted in satisfactory reduction of astigmatism.

Adult↗
PubMed2000

Management of irregular astigmatism.

Using a liberal definition of corneal irregularity, modern videokeratoscopy may define approximately 40% of normal corneas with a toric refractive error as possessing primary irregular astigmatism. The causes of secondary forms of irregular astigmatism include corneal surgery, trauma, dystrophies, and infections. Internal refractive surface and media irregularity or noncorneal astigmatism (ocular residual astigmatism) contribute to irregular astigmatism of the entire refractive path of which crystaline lenticular astigmatism is usually the principal contributing component. Treatment options have increased in recent years, particularly, though not exclusively, through the advent of tailored corneal excimer laser ablations. However, discussion continues concerning the systematic approach necessary to enable treatment to achieve an optimal optical surface for the eye. Discussion also continues as to what constitutes the optimal corneal shape. Some refractive procedures may increase higher order aberrations in the attempt to neutralize refractive astigmatism. The way to further refinement of the commonly performed refractive techniques will ultimately lie in the integrated inclusion of a trio of technologies: topographic analysis of the corneal surface, wavefront analysis of ocular refractive aberrations, and vector planning to enable the appropriate balance in emphasis between these two diagnostic modalities. For the uncommon, irregularly roughened corneas, the ablatable polymer techniques show some promise.

Animals↗
PubMed1997

Surgical management of macular holes: results using gas tamponade alone, or in combination with autologous platelet concentrate, or transforming growth factor beta 2.

BACKGROUND: Vitrectomy and gas tamponade has become a recognised technique for the treatment of macular holes. In an attempt to improve the anatomic and visual success of the procedure, various adjunctive therapies--cytokines, serum, and platelets--have been employed. A consecutive series of 85 eyes which underwent macular hole surgery using gas tamponade alone, or gas tamponade with either the cytokine transforming growth factor beta 2 (TGF-beta 2) or autologous platelet concentrate is reported. METHODS: Twenty eyes had vitrectomy and 20% SF6 gas tamponade; 15 had vitrectomy, 20% SF6 gas, and TGF-beta 2; 50 had vitrectomy, 16% C3F8 gas tamponade, and 0.1 ml of autologous platelet concentrate prepared during the procedure. RESULTS: Anatomic success occurred in 86% of eyes, with 96% of the platelet treated group achieving closure of the macular hole. Visual acuity improved by two lines or more in 65% of the SF6 only group, 33% of those treated with TGF-beta 2 and in 74% of the platelet treated group. In the platelet treated group 40% achieved 6/12 or better and 62% achieved 6/18 or better. The best visual results were obtained in stage 2 holes. CONCLUSION: Vitrectomy for macular holes is often of benefit and patients may recover good visual acuity, especially early in the disease process. The procedure has a number of serious complications, and the postoperative posturing requirement is difficult. Patients need to be informed of such concerns before surgery.

Adult↗
PubMed1997

Holmium laser thermokeratoplasty for the reversal of hyperopia after myopic photorefractive keratectomy.

BACKGROUND: Overcorrection following myopic photorefractive keratectomy, with a target of emmetropia, leaving a spherical equivalent of more than 1.0 D of hyperopia is of the order of 1%. This study analyses the efficacy, safety, and 1 year stability of outcome of laser thermokeratoplasty (LTK) carried out on eyes with persistent symptomatic hyperopia following photorefractive keratectomy (PRK) for myopia. METHOD: 11 consecutive eyes in 11 patients underwent LTK using the Technomed Holmium 25, contact holmium:YAG laser system. The mean spherical equivalent before LTK was +2.06 D (SD 1.02 D, range +1.00 D to +4.75 D) based on a non-cycloplegic refraction. Between four and 16 burns were used per eye, depending on the error to be corrected. RESULTS: The mean spherical equivalent was +0.511 D (SD 0.551) at 1 year. Ten of the 11 eyes were seeing 6/12 or greater, unaided (91%) and nine were within 1.0 D of the target sphere equivalent (82%). Recovery of unaided acuity occurred during the first week in four cases and the first month in the rest. One eye lost greater than one line of best corrected vision (9%), going from 6/5 to 6/7.5 and one gained a line (9%), 6/12 to 6/7.5. No complications occurred during the follow up period. CONCLUSIONS: In this study of a small number of eyes with hyperopia induced by PRK, LTK appears safe, predictable, and stable for low errors followed for 1 year.

Adult↗
PubMed1996

Regression after photorefractive keratectomy for myopia.

OBJECTIVE: To evaluate the effect of topical steroid treatment in eyes that showed refractive regression after photorefractive keratectomy (PRK) to correct myopia. SETTING: Mater Private Hospital, Dublin, Republic of Ireland. METHODS: In this prospective study with a minimum of 6 months follow-up, 289 eyes were treated over 2 1/2 years. Of these eyes, 23 had myopic regression of 0.75 diopters (D) or more. Topical steroid treatment was given to reverse the regression. Refraction and uncorrected visual acuity before and after treatment were measured. RESULTS: Twelve eyes in the regression group had at least 18 months of follow-up. At the final examination, eight of these eyes had an uncorrected visual acuity of 20/40 or better; six were within 1.00 D of intended refraction. CONCLUSION: Refractive regression after PRK for myopia was permanently reversed in some eyes; final stable refraction was close to the intended value in about half.

Administration, Topical↗
PubMed1995

Diode laser photocoagulation to the vascular retina for progressively advancing retinopathy of prematurity.

AIMS: To estimate the effectiveness of diode laser photocoagulation of the retina posterior to the ridge in eyes with retinopathy of prematurity (ROP). METHODS: Diode laser photocoagulation was applied posterior to the fibrovascular ridge in stage 4a ROP in six eyes of four infants and in advancing stage 3+ in two eyes of one infant. Seven eyes had previously been unsuccessfully treated with diode laser photocoagulation anterior to the ridge. RESULTS: Six eyes of four children had total regression, two eyes of two children had flat maculae with residual peripheral tractional detachment and maintained vision. CONCLUSION: These preliminary results indicate that diode laser photocoagulation posterior to the ridge may be a useful treatment in late stage 3 and stage 4A ROP following failed laser treatment to the avascular retina in threshold stage 3 disease.

Disease Progression↗
PubMed1995

Retinopathy of prematurity in a south Australian neonatal intensive care unit.

PURPOSE: To establish the incidence and severity of retinopathy of prematurity (ROP) in an Australian population of premature infants, and define risk factors for this population. METHODS: A survey of neonates born weighing less than 1501 g and/or with gestational age below 33 weeks, was undertaken at a neonatal intensive care unit in South Australia. RESULTS: ROP was diagnosed in 16.0% of the 94 neonates who were screened until retinal vascularisation was complete. Threshold disease occurred in 4.2%. Logistic regression identified three significant risk factors for the development of ROP: days of mechanical ventilation, multiple birth and female sex. CONCLUSIONS: The incidence of ROP was relatively low when compared with figures recently published for two large populations studied in the United States and England. This difference was due to a lower incidence of mild forms of the disease. Days of mechanical ventilation, multiple birth and female sex were independently predictive of the occurrence of ROP. As small numbers of infants with ROP are managed at individual Australian centres each year, a national ROP register is recommended to facilitate the study of the disease in this country.

Female↗
PubMed1994

Refractive outcome following diode laser versus cryotherapy for eyes with retinopathy of prematurity.

The refractive error in 15 eyes with threshold retinopathy of prematurity treated with diode laser photocoagulation was compared with 25 eyes with the same disease severity treated by cryotherapy. Myopia was present in 40% (six eyes) of the first group ranging from -1.50 to -3.50 dioptres; while 92% (23 eyes) showed myopia which ranged from -0.50 to -8.00 dioptres in the cryotherapy group. Sixty per cent (nine eyes) were hypermetropic at less than +3.0 dioptres in the laser group, while only 8% (two eyes) of the cryotherapy group showed hypermetropia. There was no significant difference in astigmatism between the two groups. Eyes with threshold disease treated with diode laser photocoagulation developed significantly less myopia than those treated with cryotherapy (p = 0.0006, two tailed value).

Cryosurgery↗
PubMed1993

Casemix--what is it and what does it mean to ophthalmology?

The Australian government is committed to the establishment of a prospective payment system based on casemix information for acute hospital care in the near future, because these systems are demonstrably socially equitable and more efficient than present 'historical' systems. Since ophthalmology is an outpatient-based specialty, the establishment of a good ambulatory casemix system is essential to this specialty. Considerable input from clinicians will be required to establish a satisfactory system, and to maintain it in years to come.

Ambulatory Care↗
PubMed1993

Two cases of coloboma associated with unbalanced translocations.

Two cases of coloboma are recorded, both secondary to previously unreported unbalanced translocations. These cases underline the association of chromosomal abnormalities and coloboma, particularly when accompanied by systemic abnormalities. They also highlight the importance of a full systemic assessment of coloboma patients and adequate genetic counselling for both patients and their families.

Chromosome Aberrations↗
PubMed1993

Diode laser for retinopathy of prematurity--early outcome.

Diode laser treatment for retinopathy of prematurity was successful in 81% of 21 eyes with 'threshold' (zone 2, stage 3+) disease. This compares favourably with cryotherapy and argon laser photocoagulation. The retinal outcome and technique are discussed.

Female↗
PubMed1993

Erythrocyte docosahexaenoic acid correlates with the visual response of healthy, term infants.

Recent studies have reported that formula-fed preterm infants score lower on visual and developmental tests relative to breast-fed preterm infants. This phenomenon has been associated with the presence of docosahexaenoic acid (DHA), an omega-3 fatty acid, in breast milk and its absence from infant formula. To investigate the possibility that DHA status of healthy, term infants is also related to neuronal function of the visual pathway, we studied the erythrocyte fatty acid profiles of 16 infants at 22.3 +/- 3.9 wk of age and related these to maturity of the visual pathway as assessed by visual-evoked potentials. Healthy, term infants fed breast milk had better visual-evoked potential acuity (p < 0.05) and higher DHA levels (p < 0.001) than infants who received infant formula as their major energy source. There was a positive correlation between erythrocyte DHA and visual-evoked potential acuity (p < 0.01). The data are preliminary and the long-term effects as yet unknown. However, our results suggest that there is an urgent need to evaluate the dietary fatty acid supply of formula-fed term infants.

Breast Feeding↗