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Biomedical subjects

P N Arnold

Publications and source records attributed to P N Arnold.

9 recordsLinked to original sources
PubMed1996

No-stitch phacotrabeculectomy.

PURPOSE: To describe and evaluate no-stitch trabeculectomy combined with phacoemulsification and intraocular lens implantation. SETTING: Arnold Cataract Center, Springfield, Missouri. METHODS: Results of two groups that had combined phacoemulsification/trabeculectomy were compared. One group had a standard, "two-stitch" phacotrabeculectomy in which the scleral tunnel incision was secured with sutures. In the no-stitch group, no scleral "flap" was created. The scleral tunnel (pocket) was left intact over the trabeculectomy, and no sutures were used to close the scleral incision. One episcleral suture was used to secure the conjunctiva at the limbus. RESULTS: Mean intraocular pressure (IOP) reduction in the no-stitch group (n = 66) was 9.7 mm Hg; 88% of eyes required no glaucoma medication after a mean of 13.2 months. At the last examination, 95% had an IOP of 21 mm Hg or less and 73%, 16 mm Hg or less. A detectable bleb was present in 92%. These results, comparable to those of the two-stitch group, were consistent in eyes followed over 2 years. CONCLUSION: No-stitch phacotrabeculectomy is a simple, safe, effective way to combine phacoemulsification and trabeculectomy that might lead to better filtration without the risks of other techniques (e.g. releasable sutures, suturelysis, antimetabolite therapy.

Aged↗
PubMed1994

Photic phenomena after phacoemulsification and posterior chamber lens implantation of various optic sizes.

Anecdotal reports and in vitro and clinical studies indicate that 5.0 mm x 6.0 mm ovoid posterior chamber lenses may have a higher incidence of photic phenomena, perhaps caused when the thicker truncated lens edge presents within the pupillary aperture. To evaluate these subjective phenomena, we gave a questionnaire to a random sample of patients who received one of three different poly(methyl methacrylate) (PMMA) posterior chamber lens optic styles (5.0 x 6.0 mm ovoid, 7.0 mm round, 5.5 mm round) placed in the bag. About 20% of all IOL groups reported photic phenomena, with symptoms similar between groups. The percentage reporting persistent phenomena was also comparable. We concluded that eyes in which any IOL optic is covered by the anterior capsular edge do not have a higher incidence of photic phenomena, which may instead result from the PMMA or vitreoretinal traction after cataract extraction.

Cataract Extraction↗
PubMed1992

Study of acute intraoperative suprachoroidal hemorrhage.

Acute intraoperative suprachoroidal hemorrhage or effusion (AISH) was studied in a prospective manner over the past three years. In a general cataract surgery population of 2,523 patient eyes, 15 (0.6%) experienced an AISH. Results of a specific surgical management technique are presented. Surgical control of the AISH consisted of immediate closure of the incision and application of pressure directly to the eye. This tamponades the effusion or hemorrhage, which allows coagulation and completion of the case. There was no attempt to drain the suprachoroidal space. All cases were completed the same day, usually within an hour. The postoperative visual acuities were quite good--20/40 or better in 93% of cases. Factors contributing to AISH were 4+ brunescent nuclear sclerosis, the large incision used with nucleus expression extracapsular cataract extraction, and the combination of anticoagulation and systemic vascular disease.

Acute Disease↗
PubMed1992

Prospective study of a single-injection peribulbar technique.

The single-injection peribulbar technique is an effective method of obtaining anesthesia and akinesia prior to anterior segment eye surgery. I conducted a prospective study of 2,684 consecutive cases of a particular peribulbar block that I performed for more than three years. The incidence of sight-threatening complications was 0.6%. None of the cases was canceled because of peribulbar hemorrhage. Only 1.2% of the cases required a supplemental injection of anesthesia.

Anesthesia, Local↗