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Biomedical subjects

O R Kline

Publications and source records attributed to O R Kline.

18 recordsLinked to original sources
PubMed1989

Comparison of the unwanted optical images produced by 6 mm and 7 mm intraocular lenses.

Unwanted optical images are noticed by a surprisingly large number of patients following cataract extraction with implantation of posterior chamber intraocular lenses (IOLs). These images are caused by the positioning holes, lens edge, or laser ridge. We studied 550 eyes in which one of seven different IOLs was inserted. The IOLs varied in optic diameter, the presence or absence of positioning holes or a laser ridge, the use of partial depth holes or placement of positioning holes in tabs outside the optical zone. We determined that unwanted optical images could practically be eliminated by using a 7 mm optic without positioning holes. This study also demonstrated that partial depth holes offer no advantage over full thickness holes for reducing unwanted optical images and that positioning holes, even on a 7 mm optic, produce a significant number of complaints.

Equipment Design↗
PubMed1986

Contralateral amaurosis after retrobulbar injection.

Contralateral amaurosis after retrobulbar injection of local anesthetic agents occurred in two patients, a 64-year-old woman and a 57-year-old man. The amaurosis resulted from migration of the anesthetic agents to the optic chiasm and contralateral optic nerve via the subarachnoid space. In both cases visual acuity returned to preoperative levels within 90 minutes. A modified technique in which patients look straight ahead or slightly downward and outward during retrobulbar injection, as opposed to the traditional upward and inward positioning of the globe, avoids inadvertent piercing of the sheaths of the optic nerve and injection of substances into the subarachnoid space.

Akathisia, Drug-Induced↗
PubMed1986

Pseudophakic phacoanaphylactic endophthalmitis.

Two cases of pseudophakic phacoanaphylactic endophthalmitis are reported. Both responded favorably to a total posterior capsulectomy performed in addition to removal of the intraocular lens and remaining cortical material. Current theories on phacoanaphylactic endophthalmitis are discussed. Excision of the entire posterior capsule with anterior capsular flaps and entrapped cortex is emphasized as an integral part of the treatment of this condition.

Aged↗
PubMed1986

Effectivity of laser ridge intraocular lenses.

Two hundred fifty intraocular lenses with varying sizes of laser ridges were implanted following extracapsular cataract surgery to determine the effectivity of the laser ridge in creating a space between the intraocular lens and the posterior capsule. Six weeks post-operatively, the distance between the intraocular lens and the posterior capsule was judged as adequate in 92% of cases with a .35 mm ridge, 88% cases with a .25 mm ridge, and 80% of those with a .15 mm ridge. A group of non-angulated, non-ridged lenses placed out of the capsular bag had an adequate space in 82% of cases, and a group of non-angulated, non-ridged lenses placed in the capsular bag had only 44% adequate spaces. Intraocular lenses with laser ridges should be used to enhance the space between the intraocular lens and the posterior capsule, thus increasing the safety of postoperative Nd:YAG laser posterior capsulotomy.

Evaluation Studies as Topic↗
PubMed1985

Intraocular lenses and anticoagulation and antiplatelet therapy.

Questionnaires were sent to 200 members of the American Intra-Ocular Implant Society to assess the preoperative, intraoperative, and postoperative management trends with intraocular lens implant patients on warfarin sodium and aspirin therapy. Responses were received from 135 members. A sizable majority of practitioners (75%) withhold warfarin sodium both prior to and following surgery. In many cases, the medicine is withheld for longer than is necessary, increasing the risk of medical complications. Respondents slightly favored (53%) discontinuing aspirin, which is perceived to be less harmful than warfarin sodium, preoperatively. Although management decisions must be individualized, according to both the surgeon's technique and the particular patient, certain general guidelines are applicable.

Anticoagulants↗
PubMed1984

Aborted posterior chamber intraocular lens insertions: a "second Choyce".

We reviewed 1,200 patients who had had extracapsular cataract extraction prior to implantation of a posterior chamber lens. Intraoperative contraindication to posterior chamber lens insertion arose in one hundred seven cases. These patients received anterior chamber lenses and their results were generally the same as similar complicated cases that have been reported.

Aged↗
PubMed1983

Scanning electron microscopy of removed intraocular lenses.

During a six-year period, 27 intraocular lenses (2%) were removed from a population of 1,794 implanted eyes. The frequency of and reasons for removal of the lenses, as well as patient information, dates of insertion and removal, types of surgery, and lens manufacturers, were recorded. Twelve of 15 lenses obtained for study were examined by scanning electron microscopy. These revealed poor finish quality, molding defects, and loop degradation. In the first four years the incidence of lens removal was approximately 3.8%. During the following three years, there was a dramatic reduction in the number of lenses removed, suggesting that increased experience and better lens design led to fewer lens removals.

Adult↗
PubMed1982

Corneal melting with intraocular lenses.

Five patients with collagen vascular disease and keratoconjunctivitis sicca underwent cataract surgery and implantation of intraocular lenses. Postoperative development of corneal melting may have been potentiated by the use of topical 0.1% dexamethasone sodium phosphate alcohol and neomycin sulfate. Permanent visual loss occurred in two patients. Implant removal was necessary in two eyes. Medical management consisted of discontinuance of administration of steroids and antibiotics, as well as the addition of tear substitutes, cycloplegics, and pressure patching.

Aged↗
PubMed1982

Wills eye hospital residents' intraocular lens experience.

Intraocular lens (IOL) operations performed by Wills Eye Hospital residents over a three-year period were reviewed retrospectively. The growing numbers of implants performed, the trends in methods of cataract extraction, the trends in types of intraocular lenses, and the relative safety of the procedure were examined. The estimate for the total number of intraocular lenses implanted by Wills Eye Hospital residents this past year was 600, or 60 per senior resident, and the percent of patients seeing 6/12 or better was 93.2%. There has been a great increase in the number of intraocular lenses implanted by residents at Wills Eye Hospital, with planned extracapsular cataract extractions and posterior chamber lenses currently favored. This analysis documents a very high visual success rate and acceptably low complication rate in closely supervised residents' surgery.

Cataract Extraction↗
PubMed1981

Specular microscopy with intraocular lens implantations.

Specular microscopy performed six months postoperatively on 122 lens implant patients showed that endothelial cell loss rates varied according to method of cataract extraction and type of lens implant. Phacoemulsification with implantation of a Platina-style lens was associated with the highest cell loss; planned extracapsular cataract extraction with implantation of a Choyce-style or J-loop lens was associated with the lowest cell loss. The presence of marked striate keratopathy on the first postoperative day was directly related to endothelial cell loss.

Aged↗
PubMed1978

Visual results and complications of 500 intraocular lens implantations.

These statistics reported for the visual results and complications of 500 intraocular lenses suggest that better visual results are obtained following extracapsular surgery. After all nonoperative causes for vision less than 6/12 were eliminated, 85.2% of the intracapsular cataract extractions had 6/12 or better vision. A similar group of planned extracapsular cataract extractions and phacoemulsifications yielded vision of 6/12 or better in 95% and 91.2% respectively.

Adult↗
PubMed1977

Phacoemulsification visual results and complications: report of 800 cases.

The visual results and complications of 700 Kelman-Phacoemulsification operations have been presented. Early in this series, corneal opacification and vitreous loss were a major concern. Complications decreased with experience and at the present time visual results are at least as good as they were with routine intracapsular cataract extractions. Kelman has stated that the phacoemulsification operation is not an easy operation to learn. It is, to say the least, not a watch-one, do-one, teach-one procedure. If one is an average surgeon, however, he can with persistance and perseverance master the technique. The procedure, however, I feel is not for the occasional operator. The phacoemulsification operation has essentially been under trial these past few years. Its advocates, however, have continued to grow in number and as the statistics come in, it appears that at least for the present, the Kelman-Phacoemulsification operation in one form or another is going to take a very active part in the treatment of the patient with cataract formation.

Adult↗