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Biomedical subjects

S Masket

Publications and source records attributed to S Masket.

At least 19 recordsLinked to original sources
PubMed2001

Truth and consequences.

Explore the source record for details and available documents.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2000

Phacoemulsification and lens implantation after scleral buckling surgery.

PURPOSE: To determine the intraoperative and postoperative complications and best-corrected visual acuity outcomes of eyes undergoing phacoemulsification and intraocular lens implantation after retinal detachment repair by the scleral buckling technique. METHODS: The charts of all patients who underwent phacoemulsification and intraocular lens implantation between July 1991 and May 1998 in two surgical practices were reviewed to identify eyes with a history of retinal detachment repaired by the scleral buckling technique. Eyes with a history of pars plana vitrectomy were excluded. Demographic and surgical data, preoperative and postoperative best-corrected visual acuity, and intraoperative and postoperative complications were recorded. RESULTS: We identified 34 eyes of 32 patients. The mean interval from retinal detachment repair to phacoemulsification was 12.4 years. The mean interval from phacoemulsification to final examination was 20 months. Risk factors for retinal detachment included isolated myopia (82%), myopia with lattice retinal degeneration (5.9%), and myopia with trauma (8.8%). One eye (2.9%) had no identifiable risk factors. Final best-corrected visual acuity of 20/40 or better was attained in 29 (85%) of 34 eyes and 20/20 or better in 18 (53%) of the eyes. Of the five eyes with the lowest best-corrected visual acuity, three had a macula-off retinal detachment; one had a posterior capsule opacity, epiretinal membrane, and corneal edema secondary to ocular ischemia; and one had advanced glaucoma. All five eyes still experienced an improvement in best-corrected visual acuity. With regard to complications, one eye had a posterior capsular tear with vitreous loss and another developed a postoperative retinal tear. Posterior capsule opacification requiring laser capsulotomy developed in 13 eyes (38%). No eye developed a retinal redetachment. CONCLUSION: Phacoemulsification and intraocular lens implantation can be performed safely after scleral buckling surgery and excellent best-corrected visual acuity results can be attained in most eyes. No modification of surgical technique is necessary. No retinal redetachment occurred in this series.

Adult↗
PubMed2000

Truncated edge design, dysphotopsia, and inhibition of posterior capsule opacification.

A 73-year-old woman had implantation of a silicone intraocular lens (IOL) with a truncated edge design. Like some other patients with acrylic IOLs, she experienced long-term undesirable reflections and halos. However, the posterior capsule remained clear. The fellow eye had a different style silicone IOL, which induced no visual side effects but was associated with early posterior capsule opacification.

Aged↗
PubMed1998

Phacoemulsification and lens implantation after pars plana vitrectomy.

OBJECTIVE: This study aimed to describe the intraoperative and postoperative complications and visual acuity outcomes of patients undergoing Kelman phacoemulsification (KPE) and intraocular lens (IOL) implantation after pars plana vitrectomy (PPV). DESIGN: The study design was a retrospective review of a consecutive surgical series. PARTICIPANTS: Forty-four eyes of 43 patients who underwent surgery at the Jules Stein Eye Institute, Los Angeles, California, or Advanced Vision Care, West Hills, California, were studied. INTERVENTION: Office records, referring retina specialists' records, and operative reports were reviewed for demographic information, indications for PPV, preoperative cataract severity, unplanned intraoperative events and complications, early and late postoperative complications, and postoperative visual acuities. MAIN OUTCOME MEASURES: Complications and postoperative visual acuities were measured. RESULTS: The mean interval from PPV to KPE was 20 months. The mean interval from KPE to final examination was 19 months. Primary indications for PPV included development of a macular epiretinal membrane, macular hole, proliferative diabetic retinopathy, retinal detachment, vitreous abscess, and vitreous hemorrhage. The degree of nuclear sclerosis in postvitrectomy eyes was greater than that in typical cataract eyes (P = 0.00002). The most common intraoperative problem was the discovery of a posterior capsule plaque. In a few cases, surgery was made difficult by unusual fluctuations in anterior chamber depth and lens zonule instability. The most common early postoperative complication was corneal edema; the most common late complication was the need for neodymium:YAG (Nd:YAG) laser posterior capsulotomy. An IOL was implanted in every eye. There were no retinal detachments. Median visual acuity improved from 20/125 before cataract surgery to 20/40 6 weeks after surgery to 20/30 on final examination. Visual acuity of 20/40 or better was achieved by 63.6% of eyes at 6 weeks and by 72.7% of eyes by final examination. CONCLUSIONS: Kelman phacoemulsification and IOL implantation can be performed safely after PPV. Intraoperative and postoperative complications are uncommon. Pre-existing posterior segment pathology limits the ultimate improvement in visual acuity, but substantial gains in visual acuity are realized by most patients.

Adult↗
PubMed1998

Efficacy and safety of intracameral lidocaine as a supplement to topical anesthesia.

PURPOSE: To establish the benefit of nonpreserved intracameral lidocaine 1% as an adjunctive anesthetic agent to topical anesthesia for small incision cataract surgery and to determine the agent's safety with respect to corneal toxicity. SETTING: Advanced Vision Care, West Hills, California, USA. METHODS: A retrospective chart review of cataract surgery performed between January 1995 and March 1997 was done. The efficacy of intracameral lidocaine was determined by comparing the number of topical anesthesia cases (Group 1) and of combined topical and intracameral anesthesia cases (Group 2) that required conversion to a more profound level of local anesthesia, determined by patient discomfort, surgeon discomfort, or both. To determine the presence and bias of a surgical learning curve, Group 1 was subdivided chronologically into two subgroups. Corneal toxicity was assayed by the degree of clinical corneal edema noted by slitlamp examination on the first postoperative day. RESULTS: Six hundred thirty-one charts satisfied the criteria for inclusion; 352 cases (Group 1) had topical anesthesia alone and 279 subsequent cases (Group 2), combined topical and intracameral anesthesia. In Group 1, 42.6% of cases required conversion to some form of additional local anesthesia, whereas in Group 2, less than 1.0% required conversion. In the earlier subgroup, 45.8% of cases required conversion and in the latter, 34.3%. On the first day after surgery, 88.2% of Group 2 cases and 76.7% of Group 1 cases were free from corneal edema. The difference was statistically significant but probably resulted from a change in phacoemulsification technique from sculpting to chopping in the latter cases, which were performed under combined topical and intracameral anesthesia. CONCLUSIONS: Intracameral nonpreserved lidocaine 1% appears to be both efficacious and nontoxic as an anesthetic adjunct in small incision cataract surgery.

Anesthesia, Local↗
PubMed1998

Piggyback intraocular lens implantation.

Piggyback intraocular lenses (IOLs), used in eyes requiring high IOL powers, are generally implanted in the capsular bag. Proper position of the IOL loops is, however, an unresolved issue. In this case of piggyback implantation in both eyes of a patient, the loops of the second IOL were positioned at an axis between 45 and 60 degrees away from those of the first IOL. Six weeks after surgery, the loops in both eyes had rotated into a parallel position.

Aged↗
PubMed1996

Short-and long-term effect of clear corneal incisions on intraocular pressure.

PURPOSE: To evaluate short- and long-term intraocular pressure (IOP) after cataract surgery using clear corneal incision to assess whether there is a statistically significant postoperative IOP decrease. SETTING: Advanced Vision Care, West Hills, California. METHODS: We retrospectively 135 eyes of 89 randomly selected patients who had scleral tunnel or clear corneal cataract surgery with a follow-up of at least 6 months. Patients with pre-existing glaucoma were excluded. RESULTS: In the clear corneal group (n = 84), mean IOP was statistically significantly lower (P = .019) 12 months after surgery than preoperatively (13.65 versus 15.57 mm Hg). Although there was a trend toward decreased IOP in the scleral tunnel incision group (n = 51), the difference was not statistically significant (P = .178). CONCLUSION: We found a trend toward lower IOP that, if permanent, raises serious implications about the necessity of combined procedures in patients with both glaucoma and cataract.

Aged↗
PubMed1996

Astigmatic stabilization of 3.0 mm temporal clear corneal cataract incisions.

PURPOSE: To determine the time needed for corneal shape changes to stabilize after a laterally oriented, 3.0 mm, unsutured, single-hinge clear corneal tunnel cataract incision combined with implantation of a foldable acrylic 5.5 mm intraocular lens. SETTING: Advanced Vision Care, West Hills, California. METHODS: The study comprised 45 patients who had a similar phacoemulsification technique and lens implantation through an unenlarged 3.0 x 2.5 mm self-sealing temporal clear corneal tunnel incision. Changes in corneal curvature were determined by computerized videokeratography (corneal topography) prior to surgery and at 1, 2, and 6 weeks after surgery. Simulated keratometry was ascertained from topography and analyzed with the Lens-Stat software program. RESULTS: Preoperative corneal cylinder, cylinder axis, and central corneal curvature did not change markedly after surgery. By vector analysis, approximately 0.50 diopter (D) of induced cylinder was noted, whereas less than 0.25 D of cylinder change was observed in the surgical meridian. Although statistically similar, there were slight differences between the data at 1 and 2 weeks postoperatively. However, the 2 and 6 week data were indistinguishable, indicating that the incision method used in the study was fully stable within 2 weeks of surgery. CONCLUSIONS: The surgical method resulted in stable corneal curvature by 2 weeks after surgery at which time the patient is ready for final spectacle prescription and can be discharged from acute postoperative ophthalmologic care in the absence of complicating factors. The shortened recovery time is beneficial for the patient and has significant potential effects on the global costs of cataract rehabilitation and the reimbursement schemes for postoperative management.

Acrylates↗
PubMed1996

Avoiding complications associated with iris retractor use in small pupil cataract extraction.

While there are several options for managing the small pupil during cataract surgery, adjustable iris retractors are beneficial when there is a risk of cutting or tearing the iris, such as with rubeosis. Appropriate use of this new surgical tool includes proper placement of the parcenteses and a gradual and limited enlargement of the pupil, perhaps to no more than 5.0 mm.

Cataract Extraction↗
PubMed1993

Undesired light images associated with ovoid intraocular lenses.

Ovoid intraocular lenses (IOLs) accounted for approximately 35% of the lenses implanted in 1991. Despite their popularity among surgeons, patient observations and complaints suggest that ovoid lenses are associated with undesired optical images postoperatively. A pilot clinical study was carried out to test that hypothesis. A multicentered investigation of 289 cases with well-centered IOLs determined that 45% of 168 patients with ovoid lenses observed unwanted optical phenomena at some time after surgery, whereas 17% of 121 patients with round IOLs had similar complaints. Based upon the preliminary clinical study a laboratory investigation was designed to assess optical performance differences between ovoid and round IOLs. One testing system used scatterometry and a second, ray tracing analysis. Both methods determined that the truncated, thickened edge of ovoid lenses was associated with significant light scattering, possibly accounting for the extraneous light images observed by some patients. The results of the clinical and laboratory investigations suggest that undesired optical images produced by ovoid IOLs are due to lens shape rather than to the reduced dimension of the optic.

Cataract Extraction↗