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Biomedical subjects

S Levartovsky

Publications and source records attributed to S Levartovsky.

At least 19 recordsLinked to original sources
PubMed2005

Long term effect on IOP of a stainless steel glaucoma drainage implant (Ex-PRESS) in combined surgery with phacoemulsification.

AIM: To evaluate the efficacy and safety of a stainless steel miniature glaucoma drainage device (Ex-PRESS R50) for the surgical treatment of primary open angle glaucoma (POAG) and cataract when combined with phacoemulsification. METHODS: Clinical, prospective, multicentre, single treatment arm, non-randomised, non-masked study. The Ex-PRESS device was implanted at the limbus under a conjunctival flap. Phacoemulsification cataract extraction and in the bag IOL implantation were performed through clear cornea temporally. PRIMARY OUTCOME: IOP change; secondary outcomes: side effects and VA changes. RESULTS: 26 eyes of 25 patients were implanted with the device. The mean (SD) follow up was 23.9 (10.4) months and the mean age was 75.1 (7.1) years. 17/26 eyes have more than 3 years of follow up. One case was discontinued because of device removal, one because of death, and three were lost to follow up. EFFICACY: preoperative IOP was 21 (4) mm Hg; at 1, 2, and 3 years IOP was 15.3 (3.1) mm Hg (35% reduction), 16.6 (2.7) mm Hg (29% reduction), and 16 (2.6) mm Hg (22% reduction) respectively. Kaplan-Meyer determined overall success rate (IOP < or = 21 mm Hg at the last visit with or without medications) as 76.9%. The number of antiglaucoma medications was reduced by 95% at year 1. Only six patients (23%) were taking IOP lowering treatment at their last visit, five with one medication and one with two medications. Side effects: early postoperative complications were clinically mild and included six cases of hypotony (IOP <5 mm Hg), three cases of hyphaema (<2 mm) with no clinically significant further effects. Long term complications were two cases (7.7%) of device rotation (one treated by reposition) and three cases (11.5%) of conjunctival erosion at 2 and 3 years. CONCLUSIONS: The Ex-PRESS implant, combined with phacoemulsification cataract extraction, is clinically safe and effective, maintaining in the long term a large reduction in IOP and in the number of antiglaucoma medications.

Aged↗
PubMed2001

Bacterial keratitis after [correction of following] laser in situ keratomileusis.

PURPOSE: The development of bacterial keratitis after laser in situ keratomileusis (LASIK) has been described in only a few isolated cases. We report the development of bacterial keratitis as a postoperative complication of LASIK in three subjects. DESIGN: A retrospective interventional small case series. PARTICIPANTS: Three patients who underwent LASIK for correction of myopia during July and August 1998 and had bacterial keratitis develop after surgery. METHODS: Bacterial keratitis was encountered in the operated eyes between 1 and 22 days after surgery. Topical antibiotic therapy was administered. In one eye, which had significant opacification and irregularity of the flap was developed, lamellar keratoplasty was performed. MAIN OUTCOME MEASURES: Postoperative inflammation was followed clinically and photographically until it resolved. Visual acuity was measured at intervals throughout the follow-up period. RESULTS: Keratitis resolved within 3 to 16 days of starting antibiotic therapy. The final best-corrected visual acuities were 20/30, 20/15, and 20/25. CONCLUSIONS: Although infectious keratitis after LASIK is an infrequently reported event, it should be discussed preoperatively with patients as a possible complication.

Adult↗
PubMed2001

Long-term follow-up of occlusion therapy in amblyopia.

OBJECTIVE: To determine whether the results of occlusion therapy for amblyopia are maintained into adulthood. DESIGN: Prospective, observational case series. PARTICIPANTS: Fifty-four patients, who were successfully treated in childhood for unilateral amblyopia by occlusion, were followed up to the age of 9 years, were evaluated in 1984 for long-term results 6.4 years on average after cessation of treatment, and accepted our invitation for reevaluation in 1999. METHODS: All patients were given a complete eye examination. The visual acuity (VA) was measured. RESULTS: The average period of follow-up was 21.5 years (range, 17.2-25.1 years). The mean age at the most recent examination was 29.0 +/- 2.1 years (range, 25.1-34). At this examination, a best-corrected visual acuity (BCVA) of 20/40 or better was achieved by 72.3% of the patients. The mean BCVA was 20/35 (20/25-20/70) at the end of occlusion therapy, 20/45 (20/20-20/300) in 1984, and 20/34 (20/15-20/100) at the present examination. Relative to the results at the end of therapy, BCVA at the present examination was maintained or improved in 66.7% of the patients. Relative to 1984, the BCVA in 1999 was maintained or improved in 87% of the patients. MAIN OUTCOME MEASURE: Visual acuity. CONCLUSION: Comparative evaluation of BCVA at a long-term follow-up examination, performed 21.5 years on average after cessation of occlusion therapy, showed that VA was maintained or improved in two thirds of patients who had been successfully treated by occlusion for unilateral amblyopia in childhood.

Adult↗
PubMed1998

[Toxic optic neuropathy caused by methanol poisoning].

A 40-year-old woman attempted suicide by drinking methanol. Her visual acuity began to deteriorate 36 hours later and was found to be 6/60 in her right eye with no light perception in the left. No systemic manifestations other than the eye symptoms were found. In the following months visual acuity improved without specific therapy. 2 months following the methanol, visual acuity was 6/6 in the right eye and finger-counting at 1 meter in the left eye. There was pronounced optic atrophy in the left eye, as well as a central defect in the left visual field due to the methanol toxicity.

Adult↗
PubMed1998

Long-term effect of hypermetropic anisometropia on the visual acuity of treated amblyopic eyes.

AIM: To evaluate the effect of the extent of hypermetropic anisometropia on the long term visual acuity results in amblyopic eyes following their treatment by occlusion. METHODS: The visual acuity of 86 patients, who had been treated for unilateral amblyopia by occlusion of the fellow eye and followed up at least to the age of 9 years, was examined 6.4 years, on average, after cessation of treatment. Patients were divided into two groups--those with a small amount of hypermetropic anisometropia, where the spherical equivalent difference between the eyes ranged between 0 and +1.50 dioptres, and those with a large amount of hypermetropic anisometropia, where the difference was +1.75 dioptres or greater. RESULTS: Deterioration of visual acuity after cessation of occlusion treatment occurred in 51% of the patients in the group with a small amount of anisometropia and in 75% of the patients in the group with a large amount. At cessation of treatment, the average visual acuity in both groups was 20/40+. At the long term follow up examination, however, the average visual acuity was 20/40- and 20/70, respectively. This difference was statistically significant. CONCLUSIONS: Hypermetropic anisometropia greater than 1.50 dioptres appears to be a risk factor for deterioration of visual acuity in the long term, following treatment of amblyopic eyes by occlusion of the fellow eye.

Adolescent↗
PubMed1996

Shear bond strength of several new core materials.

This study compared the shear bond strengths of three core materials: a light activated glass-ionomer cement (VariGlass VLC), a fluoride-release dual cure composite resin (Fluoro Core), and a conventional silver-reinforced glass-ionomer cement (Miracle Mix) when cured to dentin. Fifty-four noncarious molar teeth were extracted, cleaned, mounted in acrylic resin, and sectioned horizontally to expose the dentin surface. Each material was mixed according to manufacturer's instructions, applied in a premade mold to the exposed dentin, and then cured. The specimens were randomized into three group (six teeth from each material) and stored (37 degrees C, 100% humidity) for 15 minutes, 24 hours, and 24 hours and were then thermocycled (5 degrees to 55 degrees C) for 125 cycles. The specimens were tested for shear bond strength with the Instron universal testing machine. The differences among time groups were not statistically significant except for Miracle Mix and VariGlass VLC cements, which showed a greater improvement with thermocycling. This study indicated that the FluoroCore resin exhibited the greatest shear bond strength of the core materials and that VariGlass VLC cement had greater bond strength than Miracle Mix cement except after thermocycling, when VariGlass VLC cement and FluoroCore resin were not significantly different.

Acrylic Resins↗
PubMed1995

Factors affecting long term results of successfully treated amblyopia: initial visual acuity and type of amblyopia.

AIMS: The study aimed to assess the effect of initial visual acuity and type of amblyopia on the long term results of successfully treated amblyopia. METHODS: The visual acuity of 94 patients, who had been successfully treated for unilateral amblyopia by occlusion of the good eye and followed up to the age of 9 years, was examined 6.4 years, on average, after cessation of treatment. Patients were divided into two groups according to the depth of amblyopia before occlusion therapy was started: those with visual acuity between 20/60 and 20/100 and those with visual acuity of 20/100 or worse. RESULTS: Deterioration of visual acuity was observed in 42% of patients in the first group and in 63% of patients in the second group. Their average deterioration, as measured by the Snellen chart, was 0.58 and 1.54 lines, respectively. The results were also assessed by the division of patients into three groups according to the type of amblyopia: strabismic, strabismic anisometropic, and anisometropic. Deterioration of visual acuity occurred in 46%, 79%, and 36% of patients in these three groups, with an average deterioration on the Snellen chart of 0.70, 2.04, and 0.64 lines, respectively. CONCLUSION: It is concluded that low initial visual acuity and strabismic anisometropic amblyopia are risk factors for deterioration of visual acuity in the long term, following the successful earlier treatment of eyes with amblyopia.

Adolescent↗
PubMed1995

Results of treatment with topical mitomycin C 0.02% following excision of primary pterygium.

AIMS: The effectiveness of instillation of mitomycin C eyedrops on the recurrence rate of pterygium was assessed in patients undergoing primary pterygium surgery. Any side effects were also noted. METHODS: Primary pterygia in 38 consecutive patients were surgically excised during July to December 1992. After surgery, mitomycin C 0.02% eyedrops twice daily for 5 days as well as dexamethasone 0.1% four times tapered for the next 6 weeks were instilled. Postoperative follow up ranged from 6 to 11 months. RESULTS: In one patient the pterygium recurred after 3 months (recurrence rate 2.6%). The side effects encountered were: avascularised sclera in 13 cases between 1-10 months postoperatively; ocular discomfort and lacrimation in five cases; superficial punctate keratitis during the first month in three cases; pyogenic granuloma in two cases. In one patient steroid induced increased intraocular pressure was found 4 weeks after surgery. The adverse side effects were all mild, self limiting, and easily treated. CONCLUSION: This study suggests that postoperative instillation of mitomycin C 0.02% eyedrops twice daily for 5 days following excision of primary pterygium is an effective and safe treatment to obviate pterygium recurrence.

Administration, Topical↗
PubMed1994

A comparison of the diametral tensile strength, the flexural strength, and the compressive strength of two new core materials to a silver alloy-reinforced glass-ionomer material.

This study compared three mechanical properties of two recently introduced core materials, a light-activated glass ionomer cement (VariGlass VLC) and a fluoride-release dual cure composite resin (FluoroCore), with those of a conventional silver-reinforced glass-ionomer cement (Miracle Mix). Seventy-two samples (eight per product for each property) were prepared for testing diametral tensile strength, flexural strength, and compressive strength. The specimens were cured, stored for 24 hours at 37 degrees C in 100% humidity, and tested with the use of an Instron universal testing machine. The results of this study indicate that the diametral tensile strength, flexural strength, and compressive strength of the FluoroCore and VariGlass VLC materials were significantly higher than those of the conventional Miracle Mix. The values obtained with FluoroCore material were consistently higher than those obtained with VariGlass VLC material.

Acrylic Resins↗
PubMed1993

An unusual presentation of adenoid cystic carcinoma of the lacrimal gland.

Adenoid cystic carcinoma of the lacrimal gland is a highly malignant tumor usually characterized by symptoms of less than 1 year's duration. Computed tomographic (CT) findings of adjacent bony erosion or focal tumor sclerosis are also suggestive. We present a 57-year-old female patient who manifested symptoms of an enlarging mass in the right lacrimal fossa for almost 3 years prior to the establishment of the diagnosis of adenoid cystic carcinoma. CT findings during those years were not supportive for malignancy. The treatment included en bloc resection of the mass and adjacent bone and radiotherapy.

Carcinoma, Adenoid Cystic↗
PubMed1990

Management of lower-lid retraction with hard-palate mucosa grafting.

Lower eyelid retraction is frequently managed by recession of the lower-lid retractors and interposition of a "spacer graft." We have used hard-palate mucosa as our spacer material in 25 eyelids of 18 patients. A graft twice the height of the measured amount of lid retraction was used and resulted in predictable, satisfactory results. The hard-palate mucosa was easily obtained and the donor site healed well in all patients, with minimal care.

Adult↗