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Biomedical subjects

Steven Gayer

Publications and source records attributed to Steven Gayer.

9 recordsLinked to original sources
PubMed2006

Ocular decompression devices: liquid mercury balloon vs the tungsten powder balloon.

PURPOSE: To determine if an intraocular pressure (IOP)-reducing device containing tungsten powder decreases pressure comparably to the traditional mercury-containing apparatus. DESIGN: Prospective randomized, single-blind, controlled, phase I equivalence study. METHOD: At a tertiary care center, both eyes of 24 volunteers with normal IOP were treated with an ocular compression device containing either liquid mercury or tungsten powder. The IOP was measured at baseline and after 10 minutes of ocular compression. RESULTS: The mean reduction in IOP was 3.6 mm Hg +/- 2.0 with the mercury-containing device and 4.4 mm Hg +/- 2.1 with the tungsten-filled apparatus. An equivalence study analysis using a paired t-test and a sequential analysis protocol did not demonstrate a statistically significant difference between the IOP-lowering effects of the two devices. CONCLUSIONS: The IOP-lowering effect produced by a tungsten powder-filled balloon ocular decompression device compared with a traditional mercury-containing device was not statistically different.

Bandages↗
PubMed2006

Anesthesia for pediatric ocular surgery.

Ophthalmic pathology in infants and children undergoing eye surgery ranges from the rare and atypical to the commonplace. These pathologies include nasolacrimal duct obstruction, strabismus, congenital or traumatically induced cataracts, penetrating eye injuries, glaucoma, retinopathy of prematurity, intraorbital tumors, and more. Nasolacrimal duct stenosis, cataracts, and traumatic eye injuries often occur in otherwise healthy pediatric patients; however, many ophthalmopathies can be associated with other congenital disorders that may have important anesthesia implications. In this article, we will review pertinent anesthesia issues within the context of various ophthalmic diseases.

Anesthesia↗
PubMed2002

Local anesthesia with intravenous sedation for surgical repair of selected open globe injuries.

PURPOSE: To report factors associated with the use of local anesthesia with intravenous sedation (local anesthesia/sedation) rather than general anesthesia for surgery for open globe injuries in adult reparable eyes. DESIGN: Retrospective, nonrandomized, comparative case series. METHODS: Medical records were reviewed of all patients with open globe injuries repaired at Bascom Palmer Eye Institute between 1995 and 1999. "Adult reparable eyes" (eyes in patients >/=18 years of age, not treated with primary enucleation or evisceration, followed up >/=2 months) were included. RESULTS: In all, 220 eyes of 218 patients met inclusion criteria. General anesthesia was employed in 80 of 200 (36%) and local anesthesia/sedation in 140 of 220 (64%). Patients who had local anesthesia/sedation were significantly more likely to have an intraocular foreign body (31% vs 14%; P =.010, chi-square test), better presenting visual acuity (1.8 logMAR [logarithm of the minimum angle of resolution] units vs 2.5 logMAR units; P <.001, t test), more anterior wound location (75% corneal/limbal vs 65%; P =.003, chi-square), shorter wound length (6.3mm vs 10.8mm; P <.001, t test), and dehiscence of previous surgical wound (26% vs 12%; P =.021, chi-square) and were significantly less likely to have an afferent pupillary defect (22% vs 51%; P <.001, chi-square). There was no anesthesia-related complication in either group. The local anesthesia/sedation group had a shorter mean operating time than did the general anesthesia group (78 minutes vs 117 minutes; P <.001, t test). The general anesthesia group had a longer mean follow-up than the local anesthesia/sedation group (20.2 months vs 13.9 months, respectively; P =.002, t test). Change in visual acuity between the presenting and final examinations was similar for open globe injuries repaired with general anesthesia compared with local anesthesia/sedation (0.94 vs 0.72 logMAR units of visual acuity, respectively; P =.16, t test). CONCLUSIONS: Local anesthesia/sedation is a reasonable alternative to general anesthesia for selected patients with open globe injuries.

Adolescent↗
PubMedDate not supplied

Regional anesthesia with monitored anesthesia care for surgical repair of selected open globe injuries.

BACKGROUND AND OBJECTIVE: To investigate clinical features and visual acuity outcomes associated with the use of regional anesthesia with monitored anesthesia care (RA/MAC) versus general anesthesia for open globe injuries in adult reparable eyes. PATIENTS AND METHODS: Retrospective, consecutive case series including all adults with open globe injuries repaired at Bascom Palmer Eye Institute between 2000 and 2003. RESULTS: The study included 238 eyes of 238 patients with a median age of 41 years. RA/MAC was employed in 141 (59%) eyes and general anesthesia in 97 (41%) eyes. Patients who had RA/MAC were significantly (P< .001) more likely to have anterior wound location (64% corneal/limbal vs 50%), shorter wound length (6.5 vs 12 mm), and formed anterior chamber (82% vs 56%), and were significantly less likely to have an afferent pupillary defect (12% vs 43%). The improvement from presenting visual acuity to each postoperative follow-up interval was similar for the two groups. CONCLUSIONS: RA/MAC is a reasonable alternative to general anesthesia for selected patients with open globe injuries.

Adolescent↗