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Biomedical subjects

N Wilson-Holt

Publications and source records attributed to N Wilson-Holt.

10 recordsLinked to original sources
PubMed1992

Hypertropia following insertion of inferiorly sited double-plate Molteno tubes.

The use of double-plate Molteno tubes is well established in the management of intractable glaucoma, particularly in eyes that may have had previous surgical procedures, often involving the superior conjunctiva with subsequent subconjunctival scarring. As it is frequently the case that the area of least scarring is inferiorly, we have sited the tubes there but have found that, although this usually provides good control of intraocular pressure, successful drainage of aqueous has been associated with the development of hypertropia due to upward displacement of the globe by fluid encapsulated around the plates. We report a retrospective study of 16 eyes undergoing inferiorly sited double-plate Molteno tubes, in which 9 eyes developed significant hypertropia at a mean time after insertion of 3.5 months. Mean degree of hypertropia was 9.8 prism dioptres. The management of this complication is discussed.

Adolescent↗
PubMed1992

Migrating scleral explants.

Anterior migration of an extrascleral explant is an uncommon complication following buckling procedures. We report five patients where the explant cheesewired through the rectus muscle insertion following retinal detachment surgery. Muscles were not disinserted at the time of surgery in any case. Ocular motility problems were only seen in two patients. The probable mechanisms of this hitherto unreported complication are discussed.

Adult↗
PubMed1992

Spontaneous relieving retinotomies in diabetic silicone filled eyes.

We describe in six patients the delayed occurrence of inferior tractional retinal detachments following epiretinal reproliferation 4 to 5 months after vitrectomy and silicone oil tamponade for diabetic related retinal detachments. The epiretinal traction was spontaneously relieved by the occurrence of large inferior tension breaks which subsequently enlarged and coalesced to form retinotomies. This process appears to be relatively benign as it remains limited to the peripheral retina, and in all six patients the posterior retina has remained attached for a minimum of 12 months follow up, with improved central visual acuity.

Adult↗
PubMed1992

The chemoattractant activity of the vitreous to human scleral fibroblasts following retinal detachment and proliferative vitreoretinopathy.

The results are presented of a migration assay of scleral fibroblasts to 25% diluted vitreous samples from 27 patients with complex retinal detachments divided into three groups: group 1, no proliferative vitreoretinopathy (PVR); group 2, early PVR; and group 3, advanced PVR. There was a statistically significantly greater migration with vitreous samples from group 3 than with group 1 (p less than 0.0001) but no significant correlation for migration with the age of patients, duration of retinal detachment, or number of retinal procedures undertaken. Analysis of vitreous by gel electrophoresis showed that cellular migration was proportional to the number of peptide bands. Vitreous fibronectin levels were measured and there was a positive correlation between fibronectin in the vitreous samples and the migration of fibroblasts to the vitreous (r = 0.68, p less than 0.004).

Adult↗
PubMed1992

Advanced uncontrolled glaucoma. Nd:YAG cyclophotocoagulation or tube surgery.

Forty-five patients with advanced uncontrolled glaucoma who had had noncontact neodymium:YAG (Nd:YAG) cyclophotocoagulation were matched and compared with 45 patients who underwent tube implantation surgery. The matching was based on selected criteria, including diagnosis, number of previous operations on the index eye, number of previous glaucoma operations, aphakia, vitrectomy, and age. The drop in intraocular pressure (IOP) was statistically significant in each of the 2 groups at 1, 4, 6, and 12 months of follow-up (P less than 0.001). The tube patients needed fewer antiglaucoma medications at 1 year (P less than 0.025) and more surgical intervention for IOP control, although this was not statistically significant (P greater than 0.1). Laser treatment was repeated in 49% of cases, and age younger than 40 years was identified as a risk factor for poor response to this mode of therapy. The effect on visual acuity and the expected complications also are discussed.

Adult↗
PubMed1990

Extended criteria for vitrectomy and fluid/silicone oil exchange.

The results of vitrectomy combined with fluid/silicone oil exchange at six months after surgery in 39 eyes with complex retinal detachments without (initially) severe proliferative vitreoretinopathy, proliferative diabetic retinopathy or giant retinal tears, are reported. Eyes with detachments as a result of macular holes, large multiple or posterior breaks, and eyes which had undergone previous, unsuccessful vitreoretinal surgery are included. In 90% the retina remained reattached, with functional improvement in 72%. These findings, together with the relatively low incidence of complications observed, lead us to recommend this technique in the management of selected detachments falling outside the parameters within which its use is generally accepted.

Cataract↗
PubMed1989

Thiomersal keratoconjunctivitis, frequency, clinical spectrum and diagnosis.

Thiomersal keratoconjunctivitis is a common problem in soft contact lens wearers, accounting for thirty two (10%) of three hundred and twelve consecutive referrals for contact lens related problems to an out patient department. The clinical findings in 55 patients are described, of which 42 show the 'typical' appearance of the condition. This consists of non-specific conjunctival changes, limbal follicles, superficial punctate keratopathy and superior corneal epithelial opacity. Thirteen atypical cases are presented, demonstrating superior limbitis occurring in isolation, coarse punctate keratopathy, severe keratopathy with visual loss, pseudo-dendritic corneal lesions, acute conjunctival hyperaemia without keratopathy. Symptoms were also seen in two patients who were hard lens wearers. In such atypical cases, diagnosis may be difficult but can be aided by the use of topical challenge with thiomersal.

Adult↗
PubMedDate not supplied

Complete cryptophthalmos: case report with normal flash-VEP and ERG.

We report an infant with bilateral complete cryptophthalmos as part of Fraser Syndrome. Clinical examination and recordings of the electroretinogram and flash visual evoked potential showed a functional visual pathway at retinal and post-retinal levels. Anatomical considerations and the possible complications of surgery made reconstruction of the lids and palpebral fissures inappropriate.

Abnormalities, Multiple↗
PubMedDate not supplied

Bilateral blinding uveitis in a child after secondary intraocular lens implantation for unilateral congenital cataract.

A 3-year-old boy underwent secondary implantation of an iris supported intraocular lens following extraction of a unilateral congenital cataract. Eight months later, he developed a bilateral plastic uveitis which, in spite of intensive medical treatment, resulted in NPL (no perception of light) in the implanted eye and 2/60 vision in the fellow eye. Sympathetic ophthalmia possibly played a role in the pathogenesis of the uveitis.

Anti-Bacterial Agents↗