Biomedical subjects

Nicholas P Bell

Publications and source records attributed to Nicholas P Bell.

3 recordsLinked to original sources

PubMed2006

Subretinal suture misdirection during 360 degrees suture trabeculotomy.

PURPOSE: To report a new complication of 360 degrees suture trabeculotomy attributable to subretinal suture misdirection. DESIGN: Observational case report. METHODS: Retrospective chart review. RESULTS: A 5-month-old female with bilateral congenital glaucoma underwent uncomplicated 360 degrees suture trabeculotomy in the right eye. In the left eye, a scleral flap was created and dissection to Schlemm's canal was achieved. A 6-0 Prolene suture was passed into Schlemm's canal long enough for 360 degrees of treatment, did not come out the opening, and was retracted. The procedure was completed with a trabeculotome. One month later, an unusual white tract was noted subretinally in the left eye. There was no overlying retinal break or detachment. The tract presumably was caused by the misdirected Prolene suture exiting Schlemm's canal prematurely and being directed posteriorly. CONCLUSIONS: Suture misdirection subretinally during cannulation of Schlemm's canal should be considered a possible complication of 360 degrees suture trabeculotomy.

Catheterization↗

PubMed2004

Corneal thickness in children.

OBJECTIVE: To determine normal central and paracentral corneal thickness measurements in the pediatric population and to determine if these measurements are consistent across different pediatric age groups and different racial groups. DESIGN: Prospective observational case series. METHODS: Pachymetry measurements were performed on 198 eyes of 108 children. The measurements were taken centrally as well as at four paracentral sites 3 mm from the corneal center at the 3, 6, 9, and 12 o'clock positions. The two-tailed t test was used for comparison of the continuous means for values of corneal thickness. Analysis of variance (ANOVA) was performed to determine differences among age and ethnic groups RESULTS: The mean central corneal thickness (CCT) was 549 +/- 46 microm. Paracentral corneal thickness mean values, as measured 3 mm from the corneal center, were as follows: superior, 575 +/- 52 microm; nasal, 568 +/- 50 microm; inferior, 568 +/- 51 microm; and temporal, 574 +/- 47 microm. The mean CCT values were significantly thinner than at each of the mean paracentral points (P < .05 for each comparison, paired t test). Paracentral corneal thickness measurements demonstrated no significant differences between locations (P > .05, variance analysis). The mean CCT +/- SD for each age group was as follows: 6 to 23 months, 538 +/- 40 microm; 2 to 4 years, 546 +/- 41 microm; 5 to 9 years, 566 +/- 48 microm; and 10 to 18 years, 554 +/- 35 microm (ANOVA P = .012). ANOVA performed on central pachymetry values demonstrated no significant differences among racial subgroups. CONCLUSIONS: Pediatric central and paracentral corneal thicknesses increase slowly over time and reach adult thicknesses at 5 to 9 years of age.

Adolescent↗

PubMed2004

Aspirin use in advanced uncontrolled glaucoma.

PURPOSE: To evaluate if aspirin use affects progression of primary open angle glaucoma (POAG). METHODS: A retrospective review of patients with uncontrolled glaucoma was performed. Incidence of aspirin use was noted by a one-time self-reporting survey. Controls were medically stable patients diagnosed with POAG. The primary outcome measure studied was a comparison of percentages of aspirin use in patients who have and have not undergone glaucoma filtering surgery (trabeculectomy). RESULTS: Forty-one percent (26/64) of the patients in the trabeculectomy group and 23% (17/74) of controls were using aspirin. Patients undergoing trabeculectomy were twice as likely to take aspirin (O.R., 2.29; 95% C.I., 1.10-4.79). Subgroup analyses demonstrated increased aspirin use in those operative patients who are current or former smokers (O.R., 3.71; 95% C.I., 1.10-12.56), have systemic hypertension (O.R., 3.30; 95% C.I., 1.02-22.58), or have joint disease (O.R., 4.60; 95% C.I., 1.34-15.82). CONCLUSION: A higher concurrence of aspirin use was observed in patients with POAG who required surgical management compared with patients having relatively medically stable glaucoma. This may be secondary to a higher rate of glaucoma surgery performed on patients with greater systemic illnesses, more of whom use aspirin.

Aged↗