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R C Drews

Publications and source records attributed to R C Drews.

At least 19 recordsLinked to original sources

YAG laser demonstration of the anatomy of the lens nucleus.

I used YAG laser energy to demonstrate the position and surface of the core of the lens nucleus and to prove the existence of the radial structure of the lens nucleus. Not only does hydrodissection of the epinuclear layers from the nuclear core demonstrate the existence of an anatomical substrate, but also radial fracturing of the nucleus both in phacoemulsification and planned extracapsular surgery can make use of these anatomical features to achieve smaller incisions and thereby smaller wounds.

Anterior Chamber

The management of patients with intraocular lenses. Guidelines for those who do not perform this operation.

The management of patients with intraocular lenses can be done quite well by any knowledgeable ophthalmologist. Every examination must include the measurement of intraocular pressure and a thorough slit-lamp examination, specifically noting: Corneal edema, local or diffuse; Increasing corneal guttata; Touch of lens or iris suture to the cornea; Aqueous ray or cells, KP, LP (lens precipitates); Lens displacement; Iris suture problems; Pupil margin erosion; Secondary cataract; Vitreous face: loss or thickening; Retrolenticular membrane formation; Vitreous cells. Ophthalmoscopy should include examination of the peripheral retina for detachment, but visual fields should be done whenever detachment is suspected. Contact lens--slit-lamp examination of the macula for cystoid edema should be supplemented by Flourescein angioscopy when needed. Lens removal should be done only after careful consideration. The damage induced by such surgery must be weighed against the problems of leaving the lens in place. Consultation is mandatory. When in doubt, refer.

Edema

Endothelial cell loss in intraocular lens placement.

Endothelial cell counts were done on eyes selected to fall into four categories: unoperated, intracapsular cataract extraction without implantation, and intracapsular cataract extraction with easy or difficult insertion of an intraocular implant. Uncomplicated cataract extraction resulted in less than 9% cell loss. Implantation in "easy" eyes resulted in 12% cell loss (p greater than 0.3). Eyes in which implantation was difficult suffered an average loss of 65% of the endothelial cells (p less than .001). The reasons for cell loss are discussed and some improvements in techniques are mentioned with examples of the value of analysis of motion picture records of the surgery. The obvious lesson to be learned is that everything possible must be done to optimize routinely the conditions for lens implantation. The surgeon who finds conditions unfavorable for lens implantation must consider that persistence will mean sacrificing, on the average, two-thirds of the corneal endothelial cells.

Cataract Extraction

Polypropylene.

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Evaluation Studies as Topic