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S A Updegraff

Publications and source records attributed to S A Updegraff.

7 recordsLinked to original sources
PubMed2000

Laser in situ keratomileusis technique.

The collective surgical experience of laser in situ keratomileusis continues to grow. It is apparent that surgical technique can greatly improve visual outcomes, prevent complications, and aid in the management of intraoperative surgical complications. The authors provide a review of their surgical technique that has been successfully used in over 20,000 eyes. This "wet technique" prevents interface debris and irregular astigmatism and markedly reduces flap adherence time. In the authors' experience, this technique is very efficient and helpful in treating intraoperative complications such as buttonhole keratectomy or epithelial sloughing. The goal of any laser in situ keratomileusis surgery should be to achieve a crystal-clear interface with a quick and stable visual recovery.

Cornea↗
PubMed1994

Pupillary block during cataract surgery.

Sudden phakic pupillary block occurred immediately upon cortical cleaving hydrodissection during cataract surgery in two patients. We believe this unique complication is related to the recent introduction of viscoelastics with properties that enhance the maintenance of the anterior chamber during capsulorhexis. We postulate that the cause of the block was a combination of O-ring capsulocortical and iridocapsular seals that tamponade hydrodissection fluid posteriorly. Additional precipitating factors were diabetes, poorly dilating pupils, and increased vitreous pressure, which may have contributed to the sudden and irreversible nature of this block. If this complication is not recognized, an aqueous misdirection syndrome may ensue, requiring pars plana vitrectomy. Immediate mechanical breakage of the pupillary and capsular block, resulting in an immediate decrease in intraocular pressure from greater than 70 mm Hg, may cause severe retinal vascular damage. These cases stress the importance of mechanical pupil dilation to prevent this serious complication of cataract surgery.

Aged↗
PubMed1993

Delayed sustained increase in intraocular pressure secondary to the use of polyacrylamide gel (Orcolon) in the anterior chamber.

Orcolon, a new viscoelastic substance, was withdrawn from the market in the United States by the manufacturer (Optical Radiation Corporation [ORC], Azusa, Calif) because of reports of delayed sustained increases in intraocular pressure (IOP) observed in patients who had undergone anterior segment surgery involving the use of this product. We examined the charts of 118 cases of anterior segment surgery involving Orcolon at our institution and found delayed IOP spikes in 20 of the 116 cases that had at least 3 months of follow up. Procedures included cataract extraction, penetrating keratoplasty, secondary intraocular lens implantation, and glaucoma surgery. Response to maximal medical therapy was poor; 11 patients underwent procedures for IOP control, an additional 4 required new or increased medications, and 3 developed persistent iritis, which required steroids. Four patients lost two or more lines of Snellen line chart visual acuity, and one went from counts fingers to light perception. The cause may be related to the presence of small particles of viscoelastic, which could lead to decreased aqueous outflow, particularly in eyes with an already compromised trabecular meshwork.

Acrylic Resins↗
PubMed1989

Collagen corneal shields enhance penetration of topical prednisolone acetate.

We used an animal model to compare the corneal and aqueous penetration of topical prednisolone acetate 1% with and without the presence of a commercially available collagen corneal shield. A significant (P less than .02) increase in penetration into cornea and aqueous humor at 30 minutes and 120 minutes was found in eyes with a collagen corneal shield in place. Increased concentrations were achieved by soaking the shield in prednisolone acetate for 15 minutes prior to application.

Administration, Topical↗