Archives of Ophthalmology

Wolf, Gerald L.;Lynch, Seamus;Berlin, Irving

1975 Archives of Ophthalmology

doi: 10.1001/archopht.1975.01010020335001pmid: 1147803

Abstract A specialized technique developed specifically for ophthalmic surgery has led surgeons at the Manhattan Eye, Ear and Throat Hospital to perform most private cataract extractions—more than 1,000 per year—with patients under general anesthesia. Because this practice is followed by so few ophthalmic surgeons elsewhere, an evaluation of the relative safety and benefits of local vs general anesthesia was undertaken. A retrospective study comparing 2,217 consecutive patients operated on under general anesthesia with 561 patients operated on under local analgesia leads us to believe that general anesthesia provides the surgeon with optimum operating conditions. General anesthesia has proved to be a safe procedure, with a minimum of complications. The ophthalmic surgeon is assured of absolute patient immobility, with safety equivalent to that seen with procedures performed with local analgesia, despite the advanced age and resulting physiological degeneration of the patient population. References 1. Wolf GL, Sanger C, Berlin I, et al: General anesthesia for intraocular surgery in Turtz AI (ed): Proceedings of the Centennial Symposium, Manhattan Eye, Ear and Throat Hospital, Ophthalmology . St. Louis, CV Mosby Co, 1969, vol 1, chap 29, pp 290-294. 2. Petruscak J, Smith RB, Breslin P: Mortality related to ophthalmology surgery . Arch Ophthalmol 89:106-109, 1973.Crossref 3. Schwartz H, DeRoetth A: Effect of succinylcholine on intraocular pressure in human beings . Anesthesiology 19:112-113, 1958.Crossref 4. Pantuck EJ: Ecothiopate iodide eye drops and prolonged response to suxamethonium . Br J Anaesth 38:406-407, 1966.Crossref 5. Cavallaro RJ, Krumperman LW, Kugler F: The effect of echothiophate therapy on the metabolism of succinylcholine in man . Anesth Analg 47:570-574, 1968.Crossref 6. Katz RL, Matteo RS, Papper EM: The injection of epinephrine during general anesthesia with halogenated hydrocarbons and cyclopropane in man . Anesthesiology 23:597-601, 1962.Crossref 7. Bellville JW, Bross IDJ, Howland WS: Postoperative nausea and vomiting: Antiemetic efficacy of trimethobenzamide and perphenazine . Clin Pharmacol Ther 1:590-596, 1960.

Grupposo, Salvi S.

1975 Archives of Ophthalmology

doi: 10.1001/archopht.1975.01010020339002

Abstract Among 251 eyes successfully operated on for retinal detachment, the postoperative visual acuity was better in those without preoperative macular detachment (72 eyes) than in those with macular detachment (179 eyes). In eyes with macular detachment, the level of visual acuity obtained postoperatively was not statistically correlated with the duration of detachment for up to eight weeks. After eight weeks, the prognosis for recovery of macular function was reduced significantly according to the duration of detachment. References 1. Gonin J: Guérisons opératoires de décollements rétiniens . Rev Gen Ophtalmol 37:337-340, 1923. 2. Kronfeld PC: Function of the reattached retina . Arch Ophthalmol 10:646-663, 1933.Crossref 3. Grupposo SS: Visual results after scleral buckling with silicone implant , in Schepens CL, Regan CDJ (eds): Controversial Aspects of the Management of Retinal Detachment . Boston, Little Brown & Co, 1965, pp 354-363.

Fraunfelder, Frederick T.;Hanna, Calvin;Woods, Arthur H.

1975 Archives of Ophthalmology

doi: 10.1001/archopht.1975.01010020343003pmid: 1147804

Abstract A previously unrecognized characteristic clinical entity, "pseudoentrapment of ointment in the cornea" may occur in corneal lesions that have (1) topical application of ointments to the corneal lesion, (2) application of a firm pressure dressing, and (3) stromal loss or distortion of its normal architecture that allows for ointment globules to lie below the corneal surface. The clinical picture is that of a cluster of large ointment globules lodged within the corneal defect. Experimental data suggest that the ointment globules are entrapped within the wound exudates and lodged below the plane of the corneal surface. No treatment is necessary since the globules are extruded within the next 24 to 48 hours even if the pressure dressing is continued. Pseudoentrapment of ointment in the cornea is compared with and differentiated from corneal ointment entrapment and corneal spheroidal degeneration. References 1. Fraunfelder FT, Hanna C, Parker JM: Spheroid degeneration of the cornea and conjunctiva: I. Clinical course and characteristics . Am J Ophthalmol 74:821-828, 1972. 2. Fraunfelder FT, Hanna C: Spheroid degeneration . Am J Ophthalmol 75:901-902, 1973. 3. Hanna C, Fraunfelder FT: Spheroid degeneration of the cornea and conjunctiva: 2. Pathology . Am J Ophthalmol 74:829-839, 1972. 4. Garner A: Keratinoid corneal degeneration . Br J Ophthalmol 54:769-780, 1970.Crossref 5. Roy FH, Hanna C: Spontaneous congenital iris cyst . Am J Ophthalmol 72:97-108, 1971. 6. Fraunfelder FT, Hanna C, Cable M, et al: Entrapment of ophthalmic ointment in the cornea . Am J Ophthalmol 76:475-484, 1973. 7. Swan KC, White NG: Corneal permeability: 1. Factors affecting penetration of drugs into the cornea . Am J Ophthalmol 25:1043-1058, 1942. 8. Fraunfelder FT, Hanna C: Ophthalmic ointment . Trans Am Acad Ophthalmol Otolaryngol 77:467-475, 1973.

Drews, Robert C.

1975 Archives of Ophthalmology

doi: 10.1001/archopht.1975.01010020347004pmid: 1147805

Abstract Statistically, primary malignant melanoma of the orbit in a Negro should be exceedingly rare. As far as I know, this is the only report of such a case. References 1. Benedict WL: Surgical treatment of tumors and cysts of the orbit . Am J Ophthalmol 32:763-773, 1949. 2. Rottino A, Kelly A: Primary orbital melanoma . Arch Ophthalmol 27:939-949, 1942.Crossref 3. Foster J: An encapsulated orbital melanoma . Br J Ophthalmol 28:293-296, 1944.Crossref 4. Cardia L: Su di un caso di melanoblastoma della loggia anteriore dell'orbita . Minerva Oftalmol 3:148-151, 1961. 5. Hagler WS, Brown CC: Malignant melanoma of the orbit arising in a nevus of Ota . Trans Am Acad Ophthalmol Otolaryngol 70:817-822, 1966. 6. Jay B: Malignant melanoma of the orbit in a case of oculodermal melanosis . Br J Ophthalmol 49:359-363, 1965.Crossref 7. Wolter JR, Bryson MJ, Blackhurst RT: Primary orbital melanoma . Eye Ear Nose Throat Mon 45:64-67, 1966. 8. Henderson JW, Farrow GM: Malignant melanoma primary in the orbit: Report of a case . Trans Am Acad Ophthalmol Otolaryngol 76:1487-1490, 1972. 9. Jakobiec FA, Ellsworth R, Tannenbaum M: Primary orbital melanoma . Am J Ophthalmol 78:24-39, 1974. 10. Hogan MJ, Zimmerman LE: Ophthalmic Pathology . Philadelphia, WB Saunders Co, 1962, p 413.

Perry, Henry D.;Yanoff, Myron;Scheie, Harold G.

1975 Archives of Ophthalmology

doi: 10.1001/archopht.1975.01010020349005pmid: 1170833

Abstract A patient had Fuchs heterochromic iridocyclitis of approximately 17 years' duration. Histologically, keratic precipitates, iris atrophy, rubeosis iridis, discontinuous rubeosis of the anterior chamber angle, a chronic nongranulomatous iridocyclitis, and trabeculitis were noted. The cause of the glaucoma probably is a combination of rubeosis of the anterior chamber angle and trabeculitis. References 1. Kimura SJ, Hogan MJ, Thygeson P: Fuchs' syndrome of heterochromic cyclitis . Arch Ophthalmol 54:179-186, 1955.Crossref 2. Doughman DJ: Fuchs' heterochromia . Survey of Ophthalmol 11:297-300, 1966. 3. Makely TA Jr: Heterochromic cyclitis in identical twins . Am J Ophthalmol 41:768-772, 1956. 4. Franceschetti A: Heterochromic cyclitis (Fuchs' syndrome) . Am J Ophthalmol 39:50-58, 1955. 5. Goldberg MF, et al: Cytopathologic and histopathologic aspects of Fuch's heterochromic iridocyclitis . Arch Ophthalmol 74:604-609, 1965.Crossref 6. Duke-Elder S: System of Ophthalmology: Diseases of the Uveal Tract . St. Louis, CV Mosby Co, 1966, vol 9, pp 594-602. 7. Amsler M, Verrey F: Hétérochromie de Fuchs et fragilité vasculaire . Ophthalmologica 111:177-181, 1946.Crossref 8. Loewenfeld IE, Thompson HS: Fuchs' heterochromic cyclitis: A critical review of the literature: I. Clinical characteristics of the syndrome . Survey of Ophthalmol 17:394-457, 1973. 9. Matteucci P: Considérations pathogéniques sur l' hétérochromie de Fuchs . Bull Mem Soc Fr Ophthalmol 63:220-224, 1950. 10. Georgiades MG: Le Syndrome "Hétérochromie-Cataracte" . Bull Mem Soc Fr Ophthalmol 56:470-487, 1956. 11. Lerman S, Levy C: Heterochromic iritis and secondary neovascular glaucoma . Am J Ophthalmol 57:479-480, 1964. 12. Francois J: Nouvelle contribution a l'étude de L'Hétérochromie de Fuchs . Ann D'Oculist 187:255-272, 1954. 13. Kolker AE, Hetherington J Jr: Becker-Shaffer's Diagnosis and Therapy of the Glaucomas . St. Louis, CV Mosby Co, 1970, p 227. 14. Chandler PA, Grant WM: Lectures on Glaucoma . Philadelphia, Lea & Febiger, Publishers, 1965, pp 88, 256-257.

Powell, James O.;Glaser, Joel S.

1975 Archives of Ophthalmology

doi: 10.1001/archopht.1975.01010020352006pmid: 1147806

Abstract A 16-year-old girl presented with progressive, painless proptosis of the left eye. X-ray studies revealed an extensive lesion involving the left orbit, antrum, and middle cranial fossa. A biopsy confirmed the diagnosis of aneurysmal bone cyst, and the lesion was surgically excised. There has been no evidence of recurrence after three years. In a review of the literature, we were able to find only seven other cases of aneurysmal bone cyst involving the orbit. References 1. Jaffe HL, Lichtenstein L: Solitary unicameral bone cyst: With emphasis on the roentgen picture, the pathologic appearance, and the pathogenesis . Arch Surg 44:1004-1025, 1942.Crossref 2. Lichtenstein L: Aneurysmal bone cyst: A pathological entity commonly mistaken for a giant-cell tumor and occasionally for hemangioma and osteogenic sarcoma . Cancer 3:279-289, 1950.Crossref 3. Buraczewski J, Dabska M: Pathogenesis of aneurysmal bone cyst . Cancer 28:597-604, 1971.Crossref 4. Jaffe HL: Tumors of Bone and Soft Tissues . Chicago, Year Book Medical Publishers, 1965, pp 45-48. 5. Biesecker JL, et al: Aneurysmal bone cysts: A clinicopathologic study of 66 cases . Cancer 26:615-641, 1970.Crossref 6. Thompson P: Subperiosteal giant cell tumor, ossifying sub-periosteal hematoma, aneurysmal bone cyst . J Bone Joint Surg 36:281-291, 1954. 7. Edling NPG: Is the aneurysmal bone cyst a true pathologic entity? Cancer 18:1128-1130, 1965. 8. Dabska M, Buraczewski J: Aneurysmal bone cyst . Cancer 23:371-389, 1969.Crossref 9. Tillman BP, Dahlin DC, Lipscomb PR, et al: Aneurysmal bone cyst: An analysis of ninety-five cases . Mayo Clin Proc 43:478-495, 1968. 10. Nobler MP, Higinbotham NL, Phillips RF: The cure of aneurysmal bone cyst . Radiology 90:1185-1192, 1968.Crossref 11. Lichtenstein L: Aneurysmal bone cyst: Observations on fifty cases . J Bone Joint Surg 39:873-882, 1957. 12. Bhende YM, Kothare SN: Aneurysmal bone cyst: A case report . Indian Med Gazette 85:544-546, 1950. 13. Constantini F, et al: Aneurysmal bone cyst as an intracranial space occupying lesion: A case report . J Neurosurg 25:205-207, 1966.Crossref 14. Jeremiah BS: Aneurysmal bone cyst of the temporal bone . J Int Coll Surg 43:179-183, 1963. 15. Odeku EL, Mainwarins AR: Unusual aneurysmal bone cyst: A case report . J Neurosurg 22:172-176, 1965.Crossref 16. Kubicz S, Sobieszczanska-Radoszewska L: A case of aneurysmal cyst of the ethanoid and frontal bone in an 8-year-old boy . Otolaryngol Pol 16:665-669, 1962. 17. LeJeune FE, Bordelon JP: Aneurysmal bone cyst of the maxillary antrum . Eye Ear Nose Throat Mon 49:216-217, 1970. 18. Ellis DJ, Walters PJ: Aneurysmal bone cyst of the maxilla . Oral Surg 34:26-32, 1972.Crossref 19. Bhaskar SN, Bernier JL, Godby F: Aneurysmal bone cysts and other giant cell lesions of the jaws: Report of 104 cases . J Oral Surg 17:30-41, 1959. 20. Wang SY: An aneurysmal bone cyst of the maxilla . Plast Reconstr Surg 25:62-72, 1960.Crossref 21. Vianna MR: An aneurysmal bone cyst in the maxilla: Report of a case . J Oral Surg 20:432-434, 1962. 22. Yarington CT, Abbott J, Raines D: Aneurysmal bone cyst of the maxilla: Association with giant-cell reparative granuloma . Arch Otolaryngol 80:313-317, 1964.Crossref 23. Byrd DL, et al: Aneurysmal bone cyst of the maxilla . J Oral Surg 27:296-300, 1969. 24. Fite JD, Schwartz JF, Calhoun FP: Aneurysmal bone cyst of the orbit: A clinicopathologic case report . Trans Am Acad Ophthalmol Otolaryngol 72:614-618, 1968. 25. Siedenbiedel H: Brauner tumor der orbita (Gutartiger Riesenzellentumor) . Klin Monatsbl Augenheilkd 122:86-90, 1953. 26. Offret G, et al: Kyste anéurysmal des os à localisation orbitaire . Bull Soc Ophthalmol Fr 71:1049-1054, 1971. 27. Arnould G, et al: Exophthalmie unilatérale par kyste solitaire de l'orbite . Rev Otoneuroophtalmol 33:59-61, 1961. 28. Komorn RM: Management of vascular tumors of the head and neck . South Med J 65:1106-1112, 1972.Crossref 29. Cadac MA, Malis LI, Anderson PJ: Aneurysmal parietal bone cyst . J Neurosurg 37:237-241, 1972.Crossref

Anderson, Douglas R.;Forster, Richard K.;Lewis, Mary Lou

1975 Archives of Ophthalmology

doi: 10.1001/archopht.1975.01010020355007pmid: 1170834

Abstract In six patients with aphakic pupillary block, argon laser produced full-thickness iridotomies that succeeded in restoring anterior chamber and intraocular pressure to normal. In one case, it was shown that location of iridotomy is important in determining whether or not iridotomy will succeed in relieving aphakic pupillary block. In two cases, pupillary block had resulted in shallowing of the anterior chamber without pressure elevation. Cases reported here show that ccntinuous laser energy, such as from an argon laser, can produce a full-thickness opening, in contrast to the short duration pulse of the ruby, which will destroy only pigmented structures without producing a full-thickness iris opening. This need to produce some degree of spread of damage to unpigmented tissue elements in order to achieve an iris opening is a problem in phakic patients where injury to the lens must be avoided. References 1. Shaffer RN: A suggested anatomic classification to define the pupillary block glaucomas . Invest Ophthalmol 12:540-544, 1973. 2. Gass JDM: Surgical management of pupillary block glaucoma , in Welsh RC, Welsh J (eds): The Second Report on Cataract Surgery . Miami, Fla, Miami Educational Press Inc, 1971, pp 382-385. 3. Kolker AE, Hetherington J: Becker-Shaffer's Diagnosis and Therapy of the Glaucomas . St. Louis, CV Mosby Co, 1970, pp 192-193. 4. Jaffe NS: Cataract Surgery and Its Complications . St. Louis, CV Mosby Co, 1972, p 174. 5. Perkins ES: Laser iridotomy . Br Med J 2:580-581, 1970.Crossref 6. Perkins ES: Laser iridotomy for secondary glaucoma . Trans Ophthalmol Soc UK 41:777-780, 1971. 7. Perkins ES, Brown NAP: Iridotomy with a ruby laser . Br J Ophthalmol 57:487-498, 1973.Crossref

Patti, Joseph C.;Cinotti, Alfonse A.

1975 Archives of Ophthalmology

doi: 10.1001/archopht.1975.01010020359008pmid: 1170835

Abstract Five patients who underwent uneventful cataract extraction developed flat anterior chamber (AC) secondary to pupillary block, 2 ½ to 4 weeks postoperatively. None had a wound leak. After drug therapy had failed to restore the AC, iris photocoagulation was performed. Four eyes were treated with a xenon-arc photocoagulator, and one with both a portable xenon-arc unit and an argon laser. The AC deepened immediately and permanently in all cases. No complications occurred, and visual acuity was good. Iris photocoagulation with a xenon-arc unit is a valid alternative to intraocular surgery in therapy for flat AC that is caused by aphakic pupillary block in patients in whom medicinal therapy fails and no wound leak is present. References 1. Jaffe NS: Cataract Surgery and Its Complications . St. Louis, CV Mosby Co, 1972, p 166. 2. Chandler PA, Grant WM: Lectures on Glaucoma . Philadelphia, Lea & Febiger, 1965, p 238. 3. Schepens CL: Management of complex cases , in Cockerham WD (ed): Symposium on Retina and Retinal Surgery . St. Louis, CV Mosby Co, 1969, pp 199-200. 4. Meyer-Schwickerath G: Light Coagulation . St. Louis, CV Mosby Co, 1960, pp 105-107. 5. Shea M, in discussion, Schepens CL, Regan CDJ (eds): Controversial Aspects of the Management of Retinal Detachment . Boston, Little Brown & Co, 1965, p 261.

Lang, Robert F.;Riekhof, F. Tempel;Steinmuller, David

1975 Archives of Ophthalmology

doi: 10.1001/archopht.1975.01010020361009pmid: 1096857

Abstract A technique of interlamellar keratoplasty was employed to evaluate the influence of differences in histocompatibility on the results of corneal transplantation in highly inbred rats. The degree of corneal clarity and vascularity and the incidence of rejection of relatively compatible ("weak") and incompatible ("strong") allografts were recorded blindly in recipients with normal and vascularized corneas and in recipients sensitized with donor tissue either before or after corneal grafting. In contrast to the well-known effects of histocompatibility on skin and organ allografts, there was no substantial effect whatsoever of histocompatibility on either the severity of corneal allograft reactions or the incidence of rejection. Consequently, the results of this experimental investigation suggest that tissue typing may have little or no value in clinical keratoplasty. References 1. Elliott JH: Immune studies in corneal graft rejection . Invest Ophthalmol 10:216-234, 1971. 2. Polack FM: Corneal transplantation . Invest Ophthalmol 12:85-86, 1973. 3. Ehlers N, Ahrons S: The influence of histocompatibility upon the corneal immune reaction after intralamellar allotransplantation in rabbits . Tissue Antigens 1:23-31, 1971.Crossref 4. Palm J, Black G: Interrelationships of inbred rat strains with respect to Ag-B and non-Ag-B antigens . Transplantation 11:184-189, 1971.Crossref 5. Smolin G, Stein MR: Potentiation of the corneal graft reaction by complete Freund's adjuvant . Arch Ophthalmol 87:60-66, 1972.Crossref 6. Siegel S: Nonparametric Statistics for the Behavioral Sciences . New York, McGraw-Hill Book Co, Inc, 1956, pp 116-127. 7. Finney DJ, et al: Tables For Testing Significance in a 2×2 Contingency Table . Cambridge, Cambridge University Press, 1963. 8. Billingham RE, Silvers WK (eds): Transplantation of Tissues and Cells . Philadelphia, Wistar Institute Press, 1961, pp 1-26, 90-92. 9. Hildemann WH: Components of antigenic strength . Transplant Rev 3:5-21, 1970. 10. The Tenth Report of the Human Renal Transplant Registry: Prepared by the Advisory Committee to the Renal Transplant Registry . JAMA 221:1495-1501, 1972.Crossref 11. Kornblueth W, Nelken E: A study on donor-recipient sensitization in experimental homologous partial lamellar corneal grafts . Am J Ophthalmol 45:843-847, 1958. 12. Gibbs DC, Batchelor JA, Casey TA: The Influence of HL-A Compatibility on the Fate of Corneal Grafts: CIBA Foundation Symposium-Corneal Graft Failure . New York, CIBA Foundation, 1973, pp 293-306.

Huamonte, Felipe;Refojo, Miguel F.;Banuelos, Antonio

1975 Archives of Ophthalmology

doi: 10.1001/archopht.1975.01010020366010pmid: 1147807

Abstract Experimental scleral buckling was obtained in rabbits by using expandable silicone rubber implants under scleral trap doors. Buckle heights ranged from 2.3 to 4 mm after injection of 0.05 to 0.15 ml of fluid into the implants. The rate of decrease in buckle height followed up ophthalmoscopically for five months, was found to be slow and continuous and was caused mainly by loosening of the scleral flaps rather than by the diffusion of fluid from the implants. Implants expanded with chloramphenicol solutions provided sustained release of the antibiotic in the area of the operation. This was confirmed in agar plates by inhibition of the growth of Sarcina lutea around subimplant tissues and the expanded implants that were recovered post mortem. These implants provide an opportunity to modify the buckle height easily, either during the procedure or postoperatively. References 1. Banuelos A, Refojo MF, Schepens CL: Expandable silicone implants for scleral buckling: I. Introduction of a new concept . Arch Ophthalmol 89:500-502, 1973.Crossref 2. Refojo MF, Banuelos A: Expandable silicone implants for scleral buckling: II. Experiments in vitro . Arch Ophthalmol 90:127-130, 1973.Crossref 3. Refojo MF, Thomas DA: Sustained release of antibiotics from scleral buckling materials: I. Gelatin and solid silicone rubber. Ophthalmic Res, to be published.