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At least 1,405 records · Page 78Linked to original sources

PubMed2005

Deep lamellar keratoplasty (DLKP) in keratoconus patients using viscoadaptive viscoelastics.

PURPOSE: To demonstrate the effectiveness and safety of using viscoadaptive viscoelastics in deep lamellar keratoplasty (DLKP) for keratoconus. METHODS: A nonrandomized, comparative, interventional case series was performed on 12 eyes of 10 consecutive keratoconus patients without a history of acute hydrops. Patients were treated with DLKP using ophthalmic viscosurgical devices (OVDs) to dissociate Descemet membrane (DM) from the stroma before suturing of the donor cornea. Eight eyes were operated using Viscoat (dispersive), and 4 eyes were operated using Healon V (viscoadaptive). RESULTS: Six out of 8 eyes in the Viscoat group were successfully treated, and 2 eyes were converted to PKP because of tears in the DM. Another 3 eyes had double chambers as a result of perforations or tears in DM, which were treated by injecting air into the anterior chamber. All 4 eyes in the Healon V group were successfully operated, with 1 case with microperforation of DM during suturing. Healon V offered better control of the area to be dissociated and served as a pseudostroma that protects the exposed DM while the overlying stroma is maneuvered. CONCLUSION: Healon V is a valuable tool for performing DLKP in difficult cases such as keratoconus.

Adult↗

PubMed1992

[Occupational hygiene and health status in welders of laser devices].

Welders-assemblers of the Quant-type laser devices are exposed to bright light flashes of plasma and laser exceeding in certain measurements the maximal allowed level. Such hazards induce disorders in eyes, autonomic nervous, circulatory and immune systems of workers. Impaired humoral immunity can lead to increased incidence of acute respiratory tract diseases. Prophylactic measures, including laser and flash shielding screens and drug therapy were suggested.

Adult↗

PubMed1997

Angles of entry of ultraviolet radiation into welding helmets.

To investigate the angles of entry of ultraviolet (UV) radiation into welding helmets, a UV detector was placed in the eye socket of a head form that was then fitted with a range of welding helmets. The head form was exposed to a collimated beam of UV radiation from various orientations, and the amount of infiltration was measured. Radiation was found to be reflected from the filter plate and into the detector (eye) after entering through (1) an opening between the edge of the shield and the side of the face, and (2) an opening between the top edge of the shield and the top of the head. These results have significance for UV exposure when welding is performed in highly reflective and enclosed situations, and for the design of welding helmets.

Environmental Monitoring↗

PubMed2007

Caged substrates applied to high content screening: an introduction with an eye to the future.

The use of photoremovable protecting groups in biology affords the end user high temporal, spatial, and concentration control of reagents and substrates. High content screening and other large-scale biology applications would benefit greatly from these advantages. Herein, we report progress in this field by highlighting the recent development of controllable siRNA (csiRNA), which is a dormant siRNA that can be activated using 365 nm light. Two different experimental designs are described to highlight the temporal and concentration variables that can be controlled. First, the RNAi process is activated at two timepoints, 24- and 48-h post-transfection, to demonstrate that the action of csiRNA does not begin until activated. Second, increasing light dosage exposure to cells transfected with csiRNA that controls the concentration of active siRNA molecules. All experiments are conducted in a 96-well format with light delivered through the UCOM device.

Actins↗

PubMed2004

A head-mounted visual stimulator for neurotological examination.

OBJECTIVES: Presently, the neurotological tests, using visual stimulation, such as optokinetic nystagmus test (OKN), eye-tracking test (ETT) is being widely used for the diagnosis of vertigo or disequilibrium. The problems of these tests are the large size of the visual stimulator and therefore a wide space requirement. Even if a small apparatus is developed, the apparatus itself would be very expensive. In this study, we developed a small visual stimulation test system comprising the virtual visor, which receives an image for visual stimulation from an on-line computer. METHODS: Using smooth pursuit and optokinetic stimulation onto a virtual visor we assessed the ENG recording in 20 normal subjects. RESULT: We found the 30 degrees /s OKN, horizontal eye tracking were adequately stimulated by this technique with reliable results. CONCLUSION: This new method of smooth pursuit and optokinetic stimulating by a virtual visor is capable of producing reliable results and may be used in the clinical laboratory of vertigo. However, this stimulator also has some limitations, mainly because of the visual angle of the virtual visor stimulator.

Adolescent↗

PubMed2000

Does the endovascular repair of aortoiliac aneurysms pose a radiation safety hazard to vascular surgeons?

OBJECTIVES: Endovascular aortoiliac aneurysm (EAIA) repair uses substantial fluoroscopic guidance that requires considerable radiation exposure. Doses were determined for a team of three vascular surgeons performing 47 consecutive EAIA repairs over a 1-year period to determine whether this exposure constitutes a radiation hazard. METHODS: Twenty-nine surgeon-made aortounifemoral devices and 18 bifurcated devices were used. Three surgeons wore dosimeters (1) on the waist, under a lead apron; (2) on the waist, outside a lead apron; (3) on the collar; and (4) on the left ring finger. Dosimeters were also placed around the operating table and room to evaluate the patient, other personnel, and ambient doses. Exposures were compared with standards of the International Commission on Radiological Protection (ICRP). RESULTS: Total fluoroscopy time was 30.9 hours (1852 minutes; mean, 39.4 minutes per case). Yearly total effective body doses for all surgeons (under lead) were below the 20 mSv/y occupational exposure limit of the ICRP. Outside lead doses for two surgeons approximated recommended limits. Lead aprons attenuated 85% to 91% of the dose. Ring doses and calculated eye doses were within the ICRP exposure limits. Patient skin doses averaged 360 mSv per case (range, 120-860 mSv). The ambient (> 3 m from the source) operating room dose was 1.06 mSv/y. CONCLUSIONS: Although the total effective body doses under lead fell within established ICRP occupational exposure limits, they are not negligible. Because radiation exposure is cumulative and endovascular procedures are becoming more common, individuals performing these procedures must carefully monitor their exposure. Our results indicate that a team of surgeons can perform 386 hours of fluoroscopy per year or 587 EAIA repairs per year and remain within occupational exposure limits. Individuals who perform these procedures should actively monitor their effective doses and educate personnel in methods for reducing exposure.

Aortic Aneurysm↗

PubMed2005

Free radical development in phacoemulsification cataract surgery.

Phacoemulsification and aspiration (PEA) has become the most popular cataract surgery, due to the establishment of safe surgical techniques and development of associated instruments. However, corneal endothelial damage still represents a serious complication, as excessive damage can lead to irreversible bullous keratopathy. In addition to causes such as mechanical or heat injuries, free radical formation due to ultrasound has been posited as another cause of corneal endothelium damage in PEA. Ultrasound in aqueous solution induces cavitation, directly causing water molecule disintegration and resulting in the formation of hydroxylradicals, the most potent of the reactive oxygen species. Considering the oxidative insult to endothelial cells caused by free radicals, their presence in the anterior chamber may represent one of the most harmful factors during these procedures. Indeed, some researchers have recently started to evaluate PEA from the perspective of oxidative stress. Conversely, the major ingredient in ophthalmic viscosurgical devices (OVDs), which are indispensable for maintaining the anterior chamber in PEA surgery, is sodium hyaluronate, a known free radical scavenger. OVDs can thus be expected to provide some anti-free radical effect during PEA procedures. In addition, since commercially available OVDs display different properties regarding retention in the anterior chamber during PEA, the anti-free radical effect of OVDs is likely to depend on behavior during irrigation and aspiration. The present study followed standard PEA procedures in an eye model and measured hydroxylradicals in the anterior chamber using electron spin resonance. The kinetics of free radical intensity and effects of several OVDs during clinical PEA were also demonstrated. These studies may be of significance in re-evaluating OVDs as a chemical protectant for corneal endothelium, since the OVD has thus far only been regarded as a physical barrier. In addition, many reports about corneal endothelium damage during PEA have been published, but objective evaluation of various damaging factors has been difficult. The present assay of free radicals in a simulation of clinical PEA offers the first method to quantitatively assess stress on the corneal endothelium.

Anterior Chamber↗

PubMed2004

Efficacy of the soft-shell technique using Viscoat and Hyal-2000.

PURPOSE: To evaluate whether the soft-shell technique using Viscoat (sodium hyaluronate 3%-chondroitin sulfate 4%) and Hyal-2000 (sodium hyaluronate 1%) reduces corneal endothelial cell damage during cataract surgery. SETTING: Department of Ophthalmology, Kangnam St. Mary's Hospital, Seoul, Korea. METHODS: The nuclear opacity in 252 eyes of 230 cataract patients was classified as grade 1, 2, 3, or > or =4 using the Lens Opacities Classification System III. In each classification, the patients were divided into 4 groups before phacoemulsification based on the type of ophthalmic viscosurgical device (OVD) used during surgery: Viscoat and Hyal-2000 (soft-shell technique), Viscoat alone, Hyal-2000 alone, or Provisc (sodium hyaluronate 1%) alone. All patients were operated on using the same technique except for the OVD. The visual acuity, corneal endothelial cell density, corneal thickness, and intraocular pressure (IOP) were evaluated postoperatively. RESULTS: The rate of endothelial cell loss 2 months after surgery in eyes with a nuclear opacity grade of > or =4 was significantly different between the 4 OVD groups. The rate in eyes with a nuclear opacity grade of < or =3 was not significantly different between the groups. There were no statistically significant differences between the 4 groups in visual acuity, corneal thickness, or IOP throughout the follow-up period. CONCLUSION: The soft-shell technique using Viscoat and Hyal-2000 protected corneal endothelial cells during cataract surgery in patients with a nuclear opacity grade of > or =4.

Aged↗

PubMed2006

Scleral fixation using suture retrieval through a scleral tunnel.

Scleral fixation of intraocular lenses (IOLs) can be performed under the protection of a scleral flap. A variation of this technique uses a scleral tunnel for suture fixation to the eye. Passage of a double-armed suture through the roof of the scleral tunnel with subsequent retrieval of the suture ends through the external incision for tying facilitates scleral fixation. This modification offers several advantages: A scleral tunnel is easier to construct than a triangular flap and does not require suture closure. It affords a greater surface area for suture placement through an ab externo or ab interno approach. Tying each suture allows the suture knot to pass under the roof of the tunnel, eliminating the need for suture knot rotation. Suture retrieval and scleral fixation through a scleral tunnel incision offers a simplified and elegant method for fixation of IOLs and other intraocular adjunctive devices.

Humans↗

PubMed1993

Evaluation of a new laser-resistant operating room drape, eye shield, and anesthesia circuit protector.

To determine whether Dermacare's laser eye shield, anesthesia circuit protector, and barrier drape were laser resistant, the three products were tested with CO 2 and Nd:YAG lasers set to 70 to 60 W, respectively. Five separate areas on each product were unaffected by 1 min of continuous laser fire with each type of laser. It is concluded that the Dermacare draping products offer good laser safety under the conditions of this experiment.

Equipment Safety↗

PubMed2007

Head, face, and eye injuries in scholastic and collegiate lacrosse: a 4-year prospective study.

BACKGROUND: Risks and mechanisms of head, face, and eye injuries in high school and college lacrosse are not well documented. PURPOSE: To identify (1) primary mechanisms of head, face, and eye injuries in lacrosse and (2) differences in injury risk between the men's and women's game and between high school and collegiate levels. STUDY DESIGN: Descriptive epidemiological study. METHODS: The authors gathered data on 507,000 girls' and boys' high school and 649,573 women's and men's college lacrosse athletic exposures using sport-specific injury surveillance systems over 4 seasons. They identified the most common scenarios for head, face, and eye injuries. RESULTS: The high school girls' head, face, and eye injury rate (0.54 per 1000 athletic exposures) was significantly higher (incident rate ratio, 1.42; 95% confidence interval, 1.09-1.86) than that for boys (0.38 per 1000 athletic exposures); college women (0.77 per 1000 athletic exposures) sustained a higher rate of injuries (incident rate ratio, 1.76; 95% confidence interval, 1.42-2.19) than did men (0.44 per 1000 athletic exposures). Concussions constituted a higher percentage of injuries among boys (73%) and men (85%) than among girls (40%) and women (41%). Men sustained few facial injuries, whereas a substantial proportion of women's injuries involved the face and orbital area. CONCLUSION: Although permitting only incidental contact, women's lacrosse had higher rates of head, face, and eye injuries at both the high school and collegiate levels. Concussion was the most common injury. For men, the primary injury mechanism was player-to-player contact; women's injuries primarily resulted from stick or ball contact. High school injury rates were lower than were college rates, but the nature of injuries, body parts affected, and mechanisms were similar.

Adolescent↗

PubMed2002

Position Statement. Violence and injury in ice hockey.

Ice hockey is a sport enjoyed by many men and women at the spectator and participant level. It is played with high intensity and often involves body contact. Although the women's games is far from injury free, it is the men's game that has drawn criticism for excessive violence. Much attention has been drawn to the serious injuries that have occurred in ice hockey, specifically spinal injuries, concussions, and eye injuries. Many such injuries are the result of illegal and violent acts such as checking from behind or a deliberate high stick. Because of this, some medical organizations have called for changes in the sport, such as minimum age requirements for body-checking. As a practical matter such changes are unlikely to be accepted by hockey governing boards. Many of those involved in the sport consider body-checking a fundamental component of the game. Furthermore, a distinction needs to be made between any kind of injury and a serious, catastrophic injury. For example, although a recent study found that body-checking accounted for up to 38% of ice hockey injuries, none were of the catastrophic type. With respect to catastrophic injuries such as spinal cord trauma or a blinded eye, legal body-checking accounts for significantly less than illegal body-checking (e.g., checking from behind) or violent stick work. To reduce serious injury in ice hockey, we offer 10 recommendations, key among them automatic game suspensions for certain rules violations, and recognition of the coach as the most important figure in promoting a clean, safe game.

Head Protective Devices↗

PubMed2002

Management of the small pupil for clear corneal cataract surgery.

PURPOSE: To evaluate the benefits of using the Perfect Pupil expansion device (Becton Dickinson Ophthalmic Surgical) for cataract surgery. SETTING: Eye Laser Center, Tucson, Arizona, USA. METHODS: Thirty patients whose pupils failed to dilate beyond 4.0 mm were selected to have the Perfect Pupil used during their cataract surgery. The Perfect Pupil was inserted through an unenlarged 2.8 mm clear corneal incision into the pupillary aperture. The capsulorhexis, hydrodissection, phacoemulsification, and injection of the intraocular lens were performed through the expanded pupil with the device in place. The pupil size before, during, and after surgery was measured. RESULTS: The mean pupil size was 3.2 mm preoperatively, 7.8 mm after insertion of the device, and 4.3 mm after its removal. There were no cases of iris sphincter tear, bleeding, ruptured capsule, or irregular pupil postoperatively. CONCLUSION: The Perfect Pupil was beneficial during small-incision cataract surgery in cases in which the pupil failed to dilate adequately. The device was easy to insert and remove, expanded the pupil to approximately 8.0 mm, protected the iris sphincter during surgery, and allowed the pupil to return to its normal size, shape, and function postoperatively.

Capsulorhexis↗

PubMed2006

Occupational exposure in the electrophysiology laboratory: quantifying and minimizing radiation burden.

Fluoroscopically guided procedures in the electrophysiology room, such as radiofrequency catheter ablation and implantation of cardiac resynchronization devices, may result in high radiation exposure of electrophysiologists and assisting staff. Our aim was to provide accurate and applicable data on occupational doses to the electrophysiology laboratory personnel. We exposed fluoroscopically an anthropomorphic phantom at three projections common in electrophysiology studies. For each exposure, scattered radiation was measured at 182 sites of the cardiology room at four body levels. Effective dose values, eye lens, skin and gonadal doses to the laboratory staff were calculated. Our study has shown that a procedure requiring 40 min of fluoroscopy yields a maximum effective dose of 129 microSv and a maximum value of gonadal dose of 56.8 microSv to staff using a 0.35 mm lead-equivalent apron. A conservative estimate of the electrophysiologist's annual maximum permissible workload is 155 procedures. Staff effective dose values vary by a factor of 40 due to positioning during fluoroscopy and by a factor of 11 due to radiation protection equipment. Undercouch protective shields may reduce gonadal doses up to 98% and effective dose up to 25%. Consequently, radiation levels in the electrophysiology room are not negligible. Mitigation of occupational exposure is feasible through good fluoroscopy and working practices.

Electrophysiology↗

PubMed1991

Prevention of craniofacial injuries in ice hockey.

Prior to 1975, craniofacial injuries were the most frequent of all ice hockey injuries. Through the cooperative efforts of hockey administrators, health professionals, sports standards organizations, and the introduction of mandatory protective equipment playing rules craniofacial injuries in youth, high school, and college hockey players in the United States have been almost eliminated. Blind eye injuries, once a major problem, no longer occur in players wearing certified full face protectors. The saving in health care costs for treating eye injuries alone is estimated to be upwards of $10 million annually. Despite the phenomenal success of amateur hockey organizations in eliminating most craniofacial injuries, such injuries continue to occur in recreational, "Old Timers," major junior, and professional hockey players because of failure to use the most effective types of protective equipment. The system established in the United States for preventing craniofacial injuries in the sports of ice hockey that involves youth, high school, and college hockey associations along with standards setting and certification procedures can serve as a model for all amateur sports throughout the world.

Adolescent↗

PubMed1976

A biodifferential system of face-bow mechanics.

A review of the literature, both scientific and commercial, did not demonstrate the separation of the inner and outer bows into a biodifferential interchangeable system. The prime design idea, to separate the inner and outer bows, increased versatility and yielded a multiple appliance with a greater range of use and safety. The joint couple systems could be adapted to fulfill the criteria cited in the literature during preliminary treatment (deciduous dentition), partial treatment, full-banded treatment, and retention. The biodifferential design was compatible with most mechanical orthodontic appliances and systems currently used. The three joint designs presented and the three inner bow lock devices fulfilled the parameters expected from the normal use of the present face-bow in necessary strength, stability, and use. Further, the use of a joint couple between the inner and outer bows expanded the versatility of the face-bow into a biodifferential system and allowed for an easily manageable and orderly change of forces, vectors, sizes, and shapes requiring little chair time and minimum instruction to the patient. The inner bow could be used as an intraoral appliance for bumpers, shields, and oral screens. These easily made, preformed, interlocking parts could be marked or color coded as to type and size and keyed, grooved, and designed to prevent inverted interlocking of parts. The inner bow could be tied in, as an aid in patient cooperation, or the inner and outer bows could be pinned or ligated together to prevent separation. One of the most important factors of the biodifferential system is protection of the patient from severe trauma to the eyes, face, and mouth due to misuse or accident, as has occurred in the one-piece face-bow. The biodifferential system fulfills the five criteria of the investigation: (1) a system of interchangeable, interlocking joint parts, (2) safety and dependability, (3) easy changes in force, vectors, and moments, (4) enhanced patient cooperation, and (5) oral hygiene.

Biomechanical Phenomena↗

PubMed1989

How could canal-pluggings result in intensive direction changing type of positional nystagmus?

The objectives of this study in Rhesus monkeys is to observe the sequences which appear in the oculo-spinal-motor system after selected semicircular canals had been plugged. The left anterior and the right posterior canals in a monkey "LARP", the left anterior and posterior canals in "LALP", and the left lateral canal in "LL" were plugged under intubation general anesthesia. Three-dimensional eye recordings were performed, using two scleral coils. Behavior, posture, and vestibulo-ocular reflex were studied. Compensation was established in the light within 2 days. In darkness, no spontaneous nystagmus was recorded in the sitting position. The monkey "LALP" developed marked positional nystagmus. When the head position was changed up to 360 degrees in 15 degrees steps, horizontal, vertical and torsional eye movements showed remarkable changes. Spontaneous direction changing nystagmus in darkness was also recorded in "LALP". To conclude, direction changing positional nystagmus, which was seen for several months after the canal plugging, was difficult to explain by the damage to the adjacent ampullary and/or otolithic endorgans, but may be explained by the limited otolithic compensation in the earth parallel plane for the defective dynamic canal inputs. These observations and conclusions were from experiments using three monkeys only and should still be confirmed in more extended experiments.

Animals↗

PubMed1999

Fluorescence 125I eye applicator.

A new approach to optimize curative eye plaque brachytherapy is presented. The application of ophthalmic plaques is a common therapy modality for small and medium sized intraocular tumors. At Essen University Hospital eye applicators with photon emitting 125I seeds are used for the treatment of tumors with a thickness from 5 to 10 mm. Our clinical experiences indicate that the dose distributions of these applicators-used so far worldwide-are not optimal. A steeper dose falloff would meet the radiobiological requirements better, to provide the eradication of all tumor cells as well as sufficient occlusion of tumor supplying blood vessels. Our investigations for eye plaque optimization are based both on measurements and Monte Carlo simulation. For fast dosimetric measurements we have built a computer controlled device which allows reading out, directly and simultaneously, 16 1 mm3 scintillators. For the numerical simulations of the dose distribution of 125I eye plaques we have adapted a Monte Carlo program originally developed to calculate the synchrotron radiation in particle physics. We have investigated the influence of geometrical as well as physical eye plaque parameters on the dose distribution: Shielding of the primary radiation, penumbra modification, and energy conversion by exploiting fluorescence x-radiation have been considered. New types of fluorescence eye applicators have been designed which are more suitable for the prevention of radiopathic effects on structures at risk.

Brachytherapy↗