Appropriate temperature control is essential in the operating room environment.
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Environmental Monitoring↗
Biomedical subjects
R J Schechter
Publications and source records attributed to R J Schechter.
Mixing fortified antibiotic eyedrops.
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Anti-Bacterial Agents↗
Glass-slide vitrectomy for use by the cataract surgeon.
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Cataract Extraction↗
Suture-wick endophthalmitis with sutured posterior chamber intraocular lenses.
A patient had a corneal transplant with removal of an anterior chamber lens. As part of the procedure, an exchange posterior chamber lens was inserted and sutured transsclerally into the ciliary sulcus with two subconjunctival 10-0 polypropylene (Prolene) sutures. One month later the patient experienced a sudden decrease in vision and severe eye pain. Streptococcus viridans was cultured from the vitreous tap and the eye eventually was lost from this endophthalmitis. The infecting organism appeared to gain access to the eye through one of the Prolene sutures that had eroded through the conjunctiva and become exteriorized. This report presents a case in which an eroding 10-0 Prolene suture used for transscleral posterior chamber lens fixation was the probable mechanism causing endophthalmitis. This complication represents an avoidable risk unique to this type of intraocular lens fixation.
Aged↗
Nylon suture toxicity after vitrectomy surgery.
A patient underwent an uneventful pars plana vitrectomy with superior sclerotomies closed with 8-0 nylon suture. Four months later, the patient had a suture reaction presumably related to allergy to the suture itself. The signs and symptoms resolved after removal of the suture. Although similar cases have been reported after nylon sutures in cataract wound closure, this is the first reported occurrence of this phenomenon in vitrectomy surgery to our knowledge.
Female↗
Management of anterior and posterior proliferative vitreoretinopathy XLV Edward Jackson memorial lecture.
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Eye Diseases↗
Unnecessary alarm about lovastatin and cataracts.
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Cataract↗
Pupillary peaking with exposure of an intraocular lens positioning hole corrected by Nd:YAG laser treatment.
After posterior chamber intraocular lens insertion, a patient complained of "glare" and of seeing an "extra line." The pupil was seen to be "peaked" at the 10-o'clock meridian, exposing a lens positioning hole. Following dilation, adhesions between the anterior capsule remnants and the posterior iris surface were seen. These adhesions were severed with a Nd:YAG laser, restoring the normal pupillary shape and eliminating the patient's optical aberrations.
Female↗
Perforation of the globe during injection of local anesthesia.
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Anesthesia, Local↗
Management of inadvertent intraocular injections.
A case of inadvertent intraocular injection of lidocaine is described. The needle entered the eye through the pars plana, without causing any trauma to the anterior segment or retina. The pharmacologic effects of intraocular lidocaine could be determined in this case, which had no complications attributable to concurrent physical damage to the eye. Following the injection, the visual acuity was no light perception; vision ultimately returned to 20/20. Appropriate medical and surgical management of such cases is discussed.
Adult↗
Ball-bearing keratometry.
We obtained steel test balls for keratometer calibration at nominal cost by using a selected set of steel ball bearings, readily available for nonoptical purposes. The set of keratometer tests balls each have an accuracy of greater than one part in 1,000.
Cornea↗
Ocular findings in a newborn with cri du chat syndrome.
A deletion of the short arm of chromosome No. 5 has been termed the cri du chat (cat cry) syndrome. We report the first ophthalmologic examination of a newborn infant with this syndrome. Multiple ophthalmic abnormalities were found, including hypertelorism, telecanthus, epicanthal folds, antimongoloid palpebral fissures, exotropia, optic atrophy, and tortuosity of the retinal vasculature. It is of interest that these changes are congenital and present at birth, rather than developmental. Although such individuals are usually so severely mentally retarded that no ophthalmologic intervention is indicated, there are rare exceptions, and each case must be judged individually. Ten percent to 15% of these children inherit the chromosomal abnormality from phenotypically normal parents. Chromosomes from each parent should therefore be evaluated for the purposes of genetic counseling.
Cri-du-Chat Syndrome↗
Systemic antibiotics for use in ocular infections--penicillin-resistant Staphylococcus.
An analysis is made of the usefulness of various antibiotics in the systemic treatment of bacterial endophthalmitis. The staphylococcus is a common causative organism, particularly in cases following ocular trauma. Methicillin is the drug with which ophthalmic investigators have had the most experience, and is an acceptable therapeutic choice in the treatment of gram-positive endophthalmitis. Oxacillin has not been shown to penetrate the blood-aqueous barrier, and should not be used systemically. Dicloxacillin, currently not available for parenteral administration, is the penicillinase-resistant penicillin of choice. Cephalothin penetrates the eye well, but satisfactory levels are not maintained for a sufficient length of time. Cephaloridine, with excellent intraocular penetration and gram-negative coverage, may well be the optimal drug in patients with normal renal function.
Anti-Bacterial Agents↗
Ptosis with contralateral lid retraction due to excessive innervation of the levator palpebrae superiorus.
Two patients are presented with unilateral ptosis and contralateral lid retraction. The lid retraction disappears upon manual elevation of the ptotic lid. Each patient with this phenomenon would be expected to have a frank tropia, or monofixation syndrome and prefer to fix with the ptotic eye. Extraordinary innervation is transmitted to the levator of the ptotic eye and, since we believe the levators follow Hering's law, this excessive innervation is also transmitted to the contralateral levator. This results in lid retraction in the second eye. If the ptotic lid is manually elevated, levator innervation decreases and the contralateral lid retraction disappears. This previously unreported maneuver of manually elevating the ptotic lid is superior to patching the ptotic eye for a period of days, the previous method for demonstrating this phenomenon. These considerations are important in the evaluation of lid retraction, and in determining the nature and extent of corrective surgery.
Adenoma, Chromophobe↗
Image magnification, contact lenses, and visual acuity.
The optics of image magnification are derived. Necessary criteria for contact lens dispensing are explained and well-known approximations are demonstrated, along with their inherent limitations. The image size with spectacle lenses is contrasted with that of the corresponding contact lens, and the simple relationship between the two is demonstrated. Thus, no tables of contact lens image magnification are necessary for the clinical practitioner. Visual acuity as commonly expressed is not an exact measurement, but rather indicates that the patient has visual acuity equal to or better than the line read, but poorer than the next smaller line on the chart. It is shown how contact lens/spectacle interchange may be of significant social and legal benefit to selected groups of patients.
Contact Lenses↗