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Biomedical subjects

T P Stratford

Publications and source records attributed to T P Stratford.

7 recordsLinked to original sources

Krypton laser-induced lens opacity as a complication of retinal photocoagulation.

Lens opacification is a well-documented complication of argon laser photocoagulation, particularly in eyes with preexisting cataracts. In eyes with media opacity, the krypton laser is frequently used for its superior penetrating qualities. To date, lens opacification from krypton application has not been documented. We report such a case in a cataractous eye with a vitreous hemorrhage undergoing panretinal photocoagulation. Factors previously implicated in the etiology of laser-induced lens damage were not present. The opacities were similar to those produced by the argon laser. We present a mechanism for understanding laser-induced lens damage and speculate on the difference between the interaction of argon versus krypton laser energy with lens constituents.

Cataract↗

Anterior segment ischemia: a complication of retinal detachment repair in a patient with sickle cell trait.

Anterior segment ischemia (ASI) is a dreaded complication of retinal detachment surgery particularly in patients with predisposing factors such as sickle cell disease. We report a case of ASI after scleral buckling in an otherwise healthy black patient with sickle cell trait. Conditions of relative hypoxia intraoperatively from either anesthesia or surgical manipulation may precipitate vasoocclusive phenomena in these normally asymptomatic patients. Since the incidence of sickle cell trait in the black population in the United States is 8.5%, we recommend these patients have a preoperative sickle test followed by hemoglobin electrophoresis with quantification if positive. The presence of sickle cell trait should alert the surgeon to the risk of ASI, and factors predisposing to hypoxia should be minimized when possible.

Anterior Eye Segment↗

Normal intraocular pressure during enucleation for choroidal melanoma.

A simple surgical technique for maintaining normal intraocular pressure during enucleation of eyes with a malignant melanoma of the choroid consists of making an incision into the anterior chamber through clear cornea with a microvitreo-retinal blade, followed by the introduction of a No. 21-gauge scalp vein needle or a No. 23-gauge sidewall-holed needle attached to a closed system filled with balanced salt solution. Measurements of pressure fluctuations during five enucleations are given. Such a system maintains the anterior chamber and keeps fluctuations in IOP to a minimum. This may be important in preventing hematogenous dissemination of tumor cells, resulting in metastatic disease.

Adult↗

Retinal angiomatous mass. A complication of retinal detachment surgery.

Retinal angiomatous masses were observed as a very late complication in four patients following scleral buckling procedures with drainage of subretinal fluid. The lesions manifested 5-19 years after the original surgical procedure, and the presenting complaint was decreased vision secondary to vitreous clouding. In three patients a vascularized retinal mass greater than 3 disc diameters in size was observed at the site of choroidal perforation for drainage of subretinal fluid. A fourth patient demonstrated a similar lesion in the location of a suture used to anchor the encircling element, possibly the point of accidental choroidal perforation. Three of the four patients were treated by photocoagulation or cryocoagulation with cicatrization of the angiomatous mass and obliteration of the vascular net. This resulted in clearing of vitreous opacities and subretinal exudates, with restoration of vision to a level prior to the onset of symptoms.

Adult↗