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Biomedical subjects

R J Cooling

Publications and source records attributed to R J Cooling.

54 records · Page 3Linked to original sources
PubMed1988

Neodymium: YAG laser iridotomies--short-term comparison with capsulotomies and long-term follow-up.

This study addresses three aspects of anterior segment Nd:YAG laser treatment--acute endothelial damage, as assessed by endothelial specular photomicrography (ESP), acute and long-term intraocular pressure (IOP) changes, and long-term iridotomy patency. The acute ESP and IOP changes in 26 eyes (21 patients) after Nd:YAG laser iridotomies were compared to 39 eyes (37 patients) after Nd:YAG laser capsulotomy. Similar endothelial damage occurred in both groups, although less damage was noted in the group of 9 eyes in which capsulotomies were undertaken in the presence of an intraocular lens. In a parallel study 53 eyes (44 patients) were followed for a mean of 83 weeks (19 months) from the time of Nd:YAG iridotomy. There were no late closures and no late rises in IOP. The level of acute IOP rise after treatment did not predict long-term IOP. We conclude that Nd:YAG iridotomy is an effective procedure in the long-term, and that both iridotomy and capsulotomy are accompanied by noteworthy acute endothelial changes and intraocular pressure rises.

Cornea↗
PubMed1988

Toxocariasis: a practical approach to management of ocular disease.

The diagnosis of ocular toxocariasis is difficult to make with certainty. New methods of antigen detection are helpful. Surgical intervention may play a role in improving the prognosis, but the place of specific chemotherapy remains undefined. We discuss three case histories to illustrate these points. We suggest that the visual prognosis need not be so poor as commonly believed, and outline a suggested plan of management.

Adolescent↗
PubMed1988

Fluorescein angiography of anterior uveal melanocytic tumours.

A retrospective analysis of 32 cases of anterior uveal melanocytic tumours included 14 cases in which the tumours could be categorised histologically as malignant, of intermediate cytology with equivocal features of malignancy, or as benign progressive naevi. An additional eight cases without a histological diagnosis were included as benign naevi, because there had been no change in their clinical characteristics after a minimum follow-up of four years. Clinical features and iris fluorescein angiographic (IFA) findings were analysed with respect to these groups in an attempt to identify features predictive of malignant or locally invasive behaviour. Very small tumours were more likely to be benign (p = 0.029). Glaucoma and episcleral vascular dilatation occurred in ciliary body tumours only. Tumours involving the anterior chamber angle proved more likely to be malignant (p = 0.019). IFA showed a disorganised vasculature and gross late leakage in 4/7 (56%) malignant melanomas as well as in 2/6 (33%) tumours with intermediate cytology. No benign tumours showed these features. Four out of nine (44%) benign tumours, but no tumours with malignant or intermediate cytology, showed complete masking of fluorescence. Early leakage of dye from tumour vessels and a geometric tumour vasculature were not specific features of any tumour category. IFA correlated with the cytology and behaviour of anterior uveal melanocytic tumours in 11/22 (50%) of our cases.

Adult↗
PubMed1987

Retinal detachment following Nd:YAG posterior capsulotomy.

Five hundred and eighty-two patients who underwent Nd:YAG laser posterior capsulotomy at Moorfields Eye Hospital were reviewed retrospectively. Twelve patients (2 per cent), nine of whom were previously myopic, subsequently developed rhegmatogenous retinal detachment. Comparison with other studies suggests there is no greater risk of retinal detachment associated with Nd:YAG laser capsulotomy than with surgical discission. The relevance of the damage mechanisms of Nd:YAG lasers are discussed.

Eye Diseases↗
PubMed1987

Intraocular argon laser photocoagulation.

Intraoperative photocoagulation using an endolaser delivery system is an important recent development in the field of vitreous microsurgery. Endolaser photocoagulation is indicated in a wide variety of vitreoretinal disorders and offers important advantages over previous techniques of endophotocoagulation using xenon energy. We review our experiences of argon laser endophotocoagulation to identify the role of this technique, the potential hazards and stringent precautions required for theatre personnel.

Animals↗
PubMed1987

Ocular injuries associated with the use of airguns.

Sixty patients with eye injuries resulting from the use of airguns were admitted to a large eye hospital over an 11-year period. The typical patient was a young male teenager; 70 per cent of patients were under the age of 17, the age at which it is legally permissible to own an air weapon. In 4 cases the missile lodged in the ocular adnexae, in 18 cases there was a penetrating eye injury and in 38 patients blunt nonpenetrating eye injury. The prognosis for visual recovery was poor especially following penetration of the globe; visual acuity was reduced to 6/60 or less in 40 per cent of all eyes and in 18 per cent the injured eye was excised.

Adolescent↗
PubMed1987

Retinal relieving incisions.

Retinal relieving incisions were undertaken during closed microsurgery for the treatment of retinal detachment complicated by retinal shortening as a result of incarceration or irresectable epiretinal membranes. In 16 of 20 eyes the retina remained attached after a minimum follow up of six months. Visual acuity of 2/60 or better was achieved in eleven of the 20 eyes and seven eyes had an acuity of 6/60 or better. Retinal relieving incisions are required in a minority of retinal re-attachment procedures and are compatible with useful visual function.

Adult↗
PubMed1986

The role of vitrectomy following accidental intraocular injection of deposteroid preparations.

Four cases of accidental intraocular injection of deposteroid preparation treated by early vitrectomy are reported. Previous reports indicate that with conservative management loss of vision is due to retinal detachment or optic neuropathy. Early vitrectomy is advocated to allow identification and treatment of retinal breaks to prevent retinal detachment and the removal of potentially retino-toxic preservatives and carriers contained in the steroid preparations. Immediate paracentesis may prevent ischaemic optic neuropathy.

Adult↗
PubMed1986

Traumatic retinal detachment--mechanisms and management.

Experience has shown that the overwhelming majority of traumatic retinal detachments are rhegmatogenous in origin. Retinal breaks are predominantly located within the vitreous base region but may occur at sites of focal scleral impact or from posterior vitreous avulsion. Although the use of scleral buckling techniques alone may be sufficient, closed microsurgery may be required to relieve trans-gel or surface retinal traction and to facilitate the identification and permanent closure of retinal breaks. Prophylactic measures including the use of closed microsurgery play a vital role in the management of traumatic retinal breaks and prevention of complex retinal detachment.

Cryosurgery↗
PubMed1984

Vitrectomy and fluid/silicone-oil exchange for giant retinal tears: results at six months.

The results of vitrectomy combined with fluid/silicone-oil exchange in 73 eyes with giant retinal tears are reported at six months after surgery. Initial anatomical success was achieved in 71 out of 73 eyes (97%) and, prior to removal of silicone-oil, in 66 out of 73 eyes (90%). In 63 eyes (86%) the retina remained attached six months after surgery. Of these visual acuity was 6/60 or better in 44 (70%). The high proportion of eyes with macular detachment before surgery and the frequency of macular abnormalities are thought to account for reduced vision in many of the anatomically successful cases.

Adolescent↗
PubMed1983

Management of retinal detachment following congenital cataract surgery.

Retinal detachment complicating previous congenital cataract surgery poses problems in management, especially related to difficulties in ophthalmoscopic visualization of breaks. The recent introduction of closed microsurgical techniques has significantly improved the prognosis in such cases.

Adolescent↗
PubMed1982

Management of complex retinal detachments by vitrectomy and fluid/silicone exchange.

The combined procedure of pars plana vitrectomy and liquid silicone exchange has been developed for the management of complex retinal detachment. Complete re-attachment was achieved in 88 per cent of eyes with giant retinal breaks and visual improvement occurred in 71 per cent. Macular re-attachment was obtained in 68 per cent of eyes with massive periretinal proliferation (MPP) and visual improvement occurred in 53 per cent. In contrast, in thirteen cases of severe diabetic traction detachment, only four remained attached with visual improvement in one. In seven eyes with severe perforating trauma and retinal detachment, retinal re-attachment was achieved in four and visual improvement in three. We conclude that this technique is indicated in giant retinal breaks, is encouraging in MPP, has a very limited role in the management of diabetic traction detachment, and requires further evaluation in the management of traumatic detachment.

Diabetic Retinopathy↗
PubMed1982

The injured eye.

Explore the source record for details and available documents.

Burns, Chemical↗
PubMed1981

Closed microsurgery in the management of intraocular foreign bodies.

The instrumentation and techniques of closed intraocular microsurgery offer a valuable approach to the management of selected intraocular foreign bodies. These methods facilitate the removal of retained material and the surgical repair of intraocular damage resulting from penetration. Although guidelines have been proposed, the precise indications and appropriate timing of surgery have not been established. We present the results of closed microsurgery in a consecutive series of patients with posterior segment intraocular foreign bodies or their sequelae. Factors which appear to limit visual recovery are discussed in relation to the timing of surgery.

Adolescent↗
PubMed1980

Retinal detachment in congenital glaucoma.

This paper reports the occurrence of retinal detachment in 18 patients suffering from congenital glaucoma. Difficulty in establishing control of the glaucoma and the presence of high myopia were common findings. The poor results of detachment surgery were related to opacites in the media preventing evaluation of the renal details and the development of massive preretinal retraction.

Adolescent↗
PubMed1979

Arachnoid hyperplasia in optic nerve glioma: confusion with orbital meningioma.

A case is reported of an optic nerve glioma with a marked degree of arachnoid hyperplasia which was initially diagnosed as an optic nerve meningioma. Hyperplasia of the arachnoid was also the underlying cause for expansion of the optic canal. The relationship between arachnoid hyperplasia in optic nerve glioma and meningioma of the optic nerve sheath in childhood is discussed.

Arachnoid↗