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Biomedical subjects

R H Langston

Publications and source records attributed to R H Langston.

At least 19 recordsLinked to original sources
PubMed1996

Coagulase-negative Staphylococcus endophthalmitis after cataract surgery with intraocular vancomycin.

PURPOSE: We studied a case of postoperative coagulase-negative Staphylococcus endophthalmitis in a 79-year-old man who had undergone cataract extraction in which vancomycin had been used intraoperatively in the infusion fluid. METHODS: The medical records were reviewed for the clinical history, ocular findings, and the vitreous and anterior chamber culture results. RESULTS: Acute, postoperative coagulase-negative Staphylococcus endophthalmitis developed in the patient in whom vancomycin had been used intraoperatively in the infusion fluid. CONCLUSIONS: Restraint is urged in the prophylactic use of vancomycin in the infusion fluids.

Acute Disease↗
PubMed1988

Corneal edema related to accidental Hibiclens exposure.

Five patients developed corneal edema presumably caused by accidental preoperative ocular exposure to Hibiclens. In all cases, the patients complained of ocular pain after surgery. Conjunctival inflammation and corneal epithelial defects were found in all patients. Between two and ten weeks after exposure, stromal and epithelial edema, with a predilection for the inferior cornea initially, developed in all patients. The corneal edema resolved in three patients in approximately six months, leaving mild stromal scarring and reduced endothelial cell counts. The corneal edema in the other two patients progressed to diffuse bullous keratopathy, which eventually required penetrating keratoplasty. We recommend that Hibiclens be avoided in preoperative preparation of the facial skin to prevent accidental ocular exposure.

Accidents↗
PubMed1988

Ophthalmic irrigants: a current review and update.

The search for an ideal intraocular irrigating solution is of paramount importance to te ophthalmic surgeon. An intraocular irrigating solution, as well as surgical technique, can have deleterious effects on ocular tissues. Since an intraocular irrigating solution comes in contact with the cornea, lens, trabecular meshwork, uvea, vitreous, and retina, and ideal irrigant would be ome that ensures biological function for all of these tissues. In a practical sense, the best irrigant is one that causes the least possible damage to the structural integrity and function of the intraocular environment. This paper summarizes the development, uses, and efficacy of intraocular irrigating solutions as currently used during intraocular surgery.

Animals↗
PubMed1986

Susceptibility of Acanthamoeba to cryotherapeutic method.

Acanthamoeba keratitis is becoming an increasingly well-known clinical entity. The Acanthamoeba species in their encysted state are resistant to antimicrobial agents, resulting in corneal infections that are refractory to medical therapy. Corneal cryotherapy has been used to treat Acanthamoeba keratitis with varying and equivocal success. We subjected trophozoites and cysts of two species of Acanthamoeba recovered from corneal infections to trials of in vitro freeze-thaw-refreeze cryotherapeutic methods. The trophozoites of both species were killed in all trials. However, the cysts of both species survived all trials. Cryotherapy may not be an effective means to eliminate Acanthamoeba cysts from the cornea.

Amebiasis↗
PubMed1986

Susceptibility of Acanthamoeba to soft contact lens disinfection systems.

Members of the genus Acanthamoeba are increasingly recognized as agents of indolent, chronic, infectious keratitis. Recently, Acanthamoeba corneal infection has been reported in some persons who wear soft contact lenses. In this study, three "heat" and three "cold" soft contact lens disinfection systems were tested according to the manufacturers' instructions against Acanthamoeba castellanii and Acanthamoeba polyphaga in separate trials, and with appropriate controls. Suspensions of Acanthamoeba cysts or trophozoites of each species were tested individually. Each of the three heat disinfection units killed all acanthamoebae in one cycle in all trials. A chlorhexidine 0.005%/thimerosal 0.001% solution killed A. castellanii trophozoites and cysts, but those of A. polyphaga survived. Trophozoites and cysts of both species survived an alkyl triethanol ammonium chloride 0.013%/thimerosal 0.002% solution and a hydrogen peroxide 3% preparation. Heat disinfection overall appears to be more effective in killing Acanthamoeba trophozoites and cysts as compared to cold disinfection methods.

Amoeba↗
PubMed1984

Infectious crystalline keratopathy.

In three patients (three men, 44, 67, and 83 years old) an unusual keratopathy characterized by white, branching, crystalline stromal opacities produced lesions that were insidious, that increased in size slowly, and that were clinically and histopathologically associated with little corneal inflammation. Intraocular inflammation eventually became evident in two of the patients. The keratopathy developed while the patients were using topical corticosteroids. In two cases, histopathologic studies disclosed accumulations of gram-positive cocci in the corneal stroma; a viridans streptococcus agent was isolated on culture. In one case, the viridans streptococcus was determined to be a dextran producer, which may have contributed to the pathogenesis of the keratopathy. Despite aggressive treatment with a variety of drugs, epithelial healing, and resolution of the corneal infiltrate, residual scarring persisted in two cases and neovascularization and graft edema in one case each.

Adrenal Cortex Hormones↗
PubMed1984

Antiviral medications and corneal wound healing.

Masked controlled rabbit studies were done to determine the toxic effects on corneal wound healing of the antiviral ointments 0.5% idoxuridine, 3% Ara A, and 3% acyclovir, and the antiviral drops 0.1% idoxuridine, 3% Ara AMP, and 1% trifluridine. Ara A, acyclovir, trifluridine and idoxuridine drops had no significant effects on the rate of closure of epithelial wounds. Idoxuridine ointment given 5 times a day significantly retarded the rate of epithelial wound closure, but not when given 4 times a day. Only Ara AMP caused a retardation of epithelial healing and an actual increase in the defect after 4 days of treatment. Histopathologically all drugs, except acyclovir, showed a toxic effect on the regenerating epithelium. All drugs, except acyclovir, showed retarded stromal wound healing with reduced bursting strength and collagen content. Ara AMP had increased bursting strength and collagen content possibly because of greater inflammation. Acyclovir, in comparison to all the other medications studied, appeared to have minimal to no toxic effects on experimental epithelial and stromal wound healing, and on this basis is the agent of choice for use in herpes simplex stromal keratitis with ulceration and as a prophylactic agent for long-term use after penetrating keratoplasty.

Animals↗
PubMed1982

Prevention and management of corneal decompensation.

While the chances of corneal decompensation following lens implantation are low, they are greater than in nonimplant cataract surgery and increase with the passage of time postoperatively. All the factors leading to corneal decompensation are not known, but available evidence suggests the most significant is trauma at the time of surgery. The likelihood of corneal decompensation can be limited by careful patient selection and surgical techniques and by appropriate management of postoperative complications. In the event of irreversible corneal decompensation, penetrating keratoplasty, with or without removal of the implant lens, offers a substantial chance of visual rehabilitation.

Age Factors↗
PubMed1982

Scleral grafting in the management of ligneous conjunctivitis.

Ligneous conjunctivitis is a rare, usually bilateral, chronic membranous conjunctivitis, which begins acutely in childhood and persists for many years. In view of the poor results obtained with other forms of therapy in the past, the resection of the involved conjunctiva and tarsus with the grafting of donor sclera is offered as another alternative in the management of this distressing condition.

Adult↗
PubMed1981

Comparison of endothelial evaluation techniques.

Comparative evaluation of the corneal endothelium with the Heyer-Schulte specular photomicroscope, the McIntyre CEB reticle affixed to a slitlamp, and a slitlamp alone found the reticle-slitlamp combination to give results within a 10% average of endothelial cell counts determined with the specular microscope. The reticle also compared favorably in time and cost savings. All three methods of corneal evaluation were effective for observation of polymegathism. Because of its lower magnification, the slitlamp without the reticle was best suited for evaluation of cornea guttata.

Cornea↗
PubMed1978

Intraocular lens implantation: a review.

Intraocular lens implantation has been developing over the past 15 years in Europe and is now becoming popular in the United States. Lens materials and designs as well as surgical techniques are still being evaluated. The overall results are excellent, with a small increase in complications being the price paid for a dramatic increase in visual rehabilitation.

Cataract Extraction↗