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R W Enzenauer

Publications and source records attributed to R W Enzenauer.

62 records · Page 4Linked to original sources
PubMedDate not supplied

Abortive cryptophthalmos: a case report and a review of cryptophthalmos.

Cryptophthalmos is a rare, probably autosomal recessive condition in which the lid folds fail to separate in the embryo resulting in a continuous sheet of skin from the forehead to the cheeks covering the eyes. Cryptophthalmos has many variants and is usually associated with multiple other congenital anomalies. This article reports on an isolated case of "abortive cryptophthalmos" with multiple systemic anomalies. The surgical treatment is described and the general features of the cryptophthalmos syndrome and its variants are reviewed.

Coloboma↗
PubMedDate not supplied

Stability of the postoperative alignment in adjustable-suture strabismus surgery.

We reviewed the postoperative alignment drift in 201 patients between the ages of 14 and 75 years who underwent rectus muscle surgery with adjustable sutures from 1984 to 1989. We analyzed results for 42 primary esotropia (ET) surgeries and 37 reoperations (groups IA and IB, respectively), 34 exotropia (XT) primary surgeries and 66 reoperations (groups IIA and IIB, respectively), and 22 hypertropia (HT) surgeries (group III). Forty percent of patients required postoperative muscle adjustment. All patients underwent a minimum of 8-weeks follow up; 66% underwent 6-months follow up or longer. The postoperative drifts in alignment for primary surgeries versus reoperations were not significantly different for either ET or XT patients. The mean postoperative drift in prism diopters from the alignment immediately after the adjustment, or after the surgery if no adjustment was needed, for each group as measured during the most recent follow up was 1.3 eso-shift for group IA, 1.2 exo-shift for group IB, 4.8 exo-shift for group IIA, 4.1 exo-shift for group IIB, and 1.5 hyper-shift for group III. Only for groups IIA and IIB were these drifts found to differ significantly from zero. Based on these drift patterns, we align ET patients to orthotropia, XT patients to 5 to 7 delta esotropic, and HT patients to 1 to 2 delta hypotropic positions.

Adolescent↗
PubMedDate not supplied

Unilateral surgery for exotropia with convergence weakness.

We prospectively studied 14 patients whom we treated surgically for exotropia (XT) with convergence weakness measuring at least 8 delta for distance (6 m) that increased at least 8 delta at near (1/3 m). Surgery involved lateral rectus recessions and medial rectus strengthenings (advancements or resections) to eliminate distance and near deviations and simultaneously collapse near-distance differences. The medial rectus was strengthened more than the lateral rectus was recessed; amounts were based on the near deviation. Minimum follow-up was 6 months after surgery. Preoperatively, the mean XT at distance was 18.3 delta (range, 8 to 35 delta) and at near 30.1 delta (range, 16 to 50 delta). At latest follow-up evaluations the mean distance deviation was 0.1 delta XT and at near 1.8 delta XT. The near-distance differences were reduced by a mean of 10.2 delta; the mean postoperative difference was 1.7 delta. Unilateral surgery for XT with convergence weakness biased to medial rectus strengthening and geared to near deviation can successfully collapse the near-distance differences while satisfactorily aligning both distance and near fixation. This surgery has low risk of creating long-term postoperative esodeviations at distance.

Adolescent↗
PubMedDate not supplied

5-Fluorouracil reduces scarring after strabismus surgery.

PURPOSE: To examine the effect of topically administered 5-fluorouracil during strabismus surgery on post-operative scarring and the strength of the tendon-muscle union. METHODS: Bilateral superior and inferior rectus muscle recessions were performed on 10 Stauffland white rabbits. The operated muscles in one eye received a 5-min topical application of 50 mg/mL solution of 5-fluorouracil (5-FU). The fellow eye received placebo treatment with a 5-min application of balanced sterile saline. Both eyes were enucleated 29 days postoperatively and examined for evidence of scarring. The tensile strength of both treated and untreated muscles was measured. Two additional rabbits received no surgery but had their eyes enucleated to serve as controls for tensile strength measurements. RESULTS: A significant reduction (P = 0.0001) in the amount of scarring was noted in eyes treated with 5-FU. A reduction in the tensile strength of both operated groups compared with the unoperated groups (P = 2.72 x 10(-12)) was noted, with a small but significant difference between the two operated groups (P = 0.0423). CONCLUSION: This study suggests that 5-FU may be a useful adjunctive therapy in strabismus surgery, especially when extensive postoperative scarring is expected.

Administration, Topical↗
PubMedDate not supplied

Nocardia asteroides keratitis: a case associated with soft contact lens wear.

Ocular nocardiosis is rare. Most cases of nocardial keratitis have resulted from corneal trauma by objects contaminated with the organism. We describe the first case of Nocardia asteroides keratitis associated with an extended wear soft contact lens. We also describe its successful treatment with topical trimethoprim-sulfamethoxazole in combination sulfacetamide.

Adolescent↗
PubMedDate not supplied

Wound strength comparison of a 5.1-millimeter no-stitch with a 7.0-millimeter sutured incision in human cadaver globes.

We compared the wound strength of 5.1-millimeter no-stitch incisions with that of 7.0-millimeter sutured incisions in cadaver eyes. Each incision was performed on seven cadaver eyes. Wound integrity was evaluated by subjecting each globe to increasing intraocular pressure (IOP), increasing external pressure, and sudden external pressure. Wound leaks occurred in the 7.0-millimeter-incision globes at consistently lower IOPs and with less external pressure than they did in the 5.1-millimeter-incision globes. We conclude that the 5.1-millimeter no-stitch flap incision has greater wound integrity than the 7.0-millimeter sutured incision when subjected to either internal or external pressures.

Cadaver↗