Network


Latest external collaboration on country level. Dive into details by clicking on the dots.

Hotspot


Dive into the research topics where James I. McNeill is active.

Publication


Featured researches published by James I. McNeill.


Journal of Refractive Surgery | 1989

Adjustment of Single Continuous Suture to Control Astigmatism After Penetrating Keratoplasty

James I. McNeill; Izak F. Wessels

The presence of high amounts of regular and irregular astigmatism after penetrating keratoplasty has been a major challenge for corneal surgeons. We have devised a technique of suture adjustment which redistributes the tension in a single continuous 10-0 nylon suture according to keratometric findings and overcomes some of the limitations of other published methods for reducing penetrating keratoplasty astigmatism. Suture adjustment is performed at the slit-lamp microscope using topical anesthesia, from as early as the first postoperative day. The effects are controllable, reversible, stable, and can achieve relaxation or tightening of any meridian. Of 330 consecutive eyes undergoing penetrating keratoplasty, 205 required and underwent one or more suture adjustments. The mean keratometric astigmatism after suture adjustment was 2.87 D (SD = 1.87), compared to a preceding consecutive series of 136 eyes without suture adjustment with 4.80 D (SD = 3.13) mean astigmatism (P less than 0.0001). This effect persisted even when the suture had to be removed (P less than 0.0001). Infection did not occur. Only five eyes (2.4%) experienced a broken suture, which was readily spliced. We recommend adjustment of a single continuous suture, when moderate to severe astigmatism is present after a penetrating keratoplasty.


Current Eye Research | 1991

Detection of herpes simplex virus DNA sequences in corneal transplant recipients by polymerase chain reaction assays

Edouard M. Cantin; Jian Chen; James I. McNeill; Dru E. Willey; Harry Openshaw

Polymerase chain reaction (PCR) assays were used to amplify herpes simplex virus type 1 (HSV-1) thymidine kinase (TK) sequences in DNA extracted from formalin-fixed, paraffin embedded corneas of patients undergoing corneal transplantation. PCR reamplification with an internal (nested) set of primers was required for detection in 10 of the 12 positive corneas indicating very low abundance of viral sequences. Three of the positive corneal samples were from failed corneal grafts. Overall, TK sequences were detected in 8 of 11 corneas from subjects with a past history of herpes keratitis and in 4 of 11 corneas from subjects with no past history of herpetic eye disease.


Ophthalmology | 1990

An Adjustable Single Running Suture Technique to Reduce Postkeratoplasty Astigmatism: A Preliminary Report

David T.C. Lin; Steven E. Wilson; James J. Reidy; Stephen D. Klyce; Marguerite B. McDonald; Herbert E. Kaufman; James I. McNeill

The authors compared postkeratoplasty astigmatism over a 4-month period after surgery in a randomized, prospective study of two groups of patients (total N = 18) who received two different suture techniques. The test group N = 8) had a single running suture with postoperative suture adjustment; on the basis of computer-assisted topographic analysis, the suture was tightened in the flatter meridian and loosened in the steeper meridian in the first month after surgery. The control group (N = 10) had a standard double running suture procedure with no postoperative adjustment; the single running 10-0 nylon suture was removed 3 months after surgery. Four months after penetrating keratoplasty, mean (+/- standard deviation) astigmatism in the test group was 1.7 +/- 0.7 diopters (D), and all patients had less than 2.6 D of astigmatism. In the control group, mean astigmatism was significantly higher (5.4 +/- 2.4 D; range, 0.7-9.0 D; P less than 0.01). The results suggest that postkeratoplasty astigmatism can be reduced with the single running suture technique accompanied by postoperative suture adjustment.


Ophthalmic Surgery and Lasers | 1977

A double running suture technique for keratoplasty: earlier visual rehabilitation.

James I. McNeill; Herbert E. Kaufman

The technique of using two continuous sutures of different caliber and relative tightness, running in the same direction, is described for penetrating keratoplasties. The primary purpose of the technique is to allow visual correction earlier in the postoperative period. In addition, graft slippage with override and posterior wound gape, both occurring at suture removal with resultant functional loss, have been eliminated.


Ophthalmology | 1990

Posterior Infectious Crystalline Keratopathy with Staphylococcus epidermidis

Anthony J. Lubniewski; Kenneth W. Houchin; Edward J. Holland; Douglas A. Weeks; Izak F. Wessels; James I. McNeill; J. Douglas Cameron

Two cases of infectious crystalline keratopathy located in the posterior stroma after penetrating keratoplasty are presented. Topical steroids and suture removal were risk factors in both cases. In the first case, a moderate anterior chamber reaction was present. Crystalline infiltrates persisted on topical and systemic steroid therapy. In the second case, deep corneal ulceration, hypopyon, and vitreitis were noted. A vitreous aspirate showed rare gram-positive cocci in pairs. The corneal ulceration and crystalline keratopathy persisted despite intravitreal and topical antibiotics. Therapeutic penetrating keratoplasty was performed in both cases. Staphylococcus epidermidis sensitive to vancomycin was isolated from corneal tissue. Light microscopy documented aggregates of gram-positive bacteria anterior to Descemets membrane, with an overlying keratitis. Electron microscopy in the second case showed all bacteria within stromal keratocytes. No clinical recurrence was seen using topical vancomycin. As demonstrated in the cases presented, infectious crystalline keratopathy can occur exclusively in the deeper layers of the cornea. Isolation of S. epidermidis, associated inflammation, and intraocular spread of organisms are rare findings.


Ophthalmology | 1991

An Improved Palpebral Spring for the Management of Paralytic Lagophthalmos

James I. McNeill; Younghyun Oh

Facial nerve paralysis with orbicularis muscle palsy can result in serious corneal complications, such as exposure, ulceration, and perforation. Eyelid springs have been used for patients with orbicularis muscle palsy to provide corneal protection while maintaining vision by restoring some kinetic eyelid function. The authors report on 24 patients with facial nerve paralysis who underwent implantation of an eyelid spring over a period of 8 years. The most common cause of orbicularis muscle paralysis was acoustic neuroma, followed by squamous cell carcinoma. Eighty-three percent of the cases successfully regained and maintained their eyelid function during the follow-up period, averaging 3.0 years. We have modified the spring to allow permanent attachment to the orbital rim by wiring. This modification of the surgical technique has minimized the most common postoperative complication: loosening of the spring from its periosteal attachment with subsequent loss of function and extrusion. In addition, transcutaneous adjustments of the spring now can be made without an incision using clasp-adjusting dental pliers. In selected patients, the placement of an eyelid spring prevents the corneal complications associated with paralytic lagophthalmos while maintaining visual function.


Journal of Cataract and Refractive Surgery | 2001

Flared phacoemulsification tips to decrease ultrasound time and energy in cataract surgery.

James I. McNeill

Purpose: To determine the effect on ultrasound (US) time and energy of using flared phacoemulsification tips in cataract surgery. Setting: Private referral practice of Pacific Cataract & Laser Institute, Chehalis, Washington, USA. Methods: One surgeon using the Allergan Medical Optics Diplomate phacoemulsification machine performed cataract surgery by a single divide‐and‐conquer technique. A prospective nonmasked consecutive study group (n = 262) was selected from patients operated on with phaco tips flared by 25%. A consecutive control group (n = 440) was selected from patients having surgery using the same technique except for the use of straight phaco tips. The study group had cataract surgery over a 5 week period and the control group, over an earlier 10 week period. Two weeks separated the groups. Cases complicated by vitreous loss were eliminated. The 2 groups were compared by age, sex, total phaco time (TPT, the total time ultrasound energy was applied), and equivalent phaco time (EPT, the product of the phaco time elapsed and the phaco energy). Results: One patient in each group was eliminated for vitreous loss during surgery. There were no significant differences in age, sex, or eye between the 2 groups. The study group had a mean TPT of 29.2 seconds ± 11.7 (SD) (range 0 to 88 seconds) and a mean EPT of 16.4 ± 8.6 seconds (range 0 to 67 seconds). The control group had a mean TPT of 34.4 ± 16.1 seconds (range 0 to 130 seconds) (P < .001) and a mean EPT of 20.0 ± 12.8 seconds (range 0 to 107 seconds) (P < .001). Conclusion: Flared ultrasonic phacoemulsification tips significantly reduced the US time and energy used in cataract surgery.


Journal of Cataract and Refractive Surgery | 1993

Corneal incision dehiscence during penetrating keratoplasty nine years after radial keratotomy

James I. McNeill

ABSTRACT As the use of radial keratotomy (RK) to correct myopia increases, more patients are having penetrating keratoplasty (PK). Radial keratotomy incisions are known to show incomplete wound healing. When the radial corneal RK incisions are cut by the corneal trephine, the peripheral part of each incision may open, even years after surgery. In this case, a 56‐year‐old man had visual distortion and diplopia in one eye nine years after RK. Contact lenses did not correct the problem, and the patient could not tolerate the contact lenses. Penetrating keratoplasty was performed. During surgery about one‐third of the peripheral RK incisions spontaneously opened, making suturing difficult. Although the final visual result was 20/20 corrected acuity, this case shows that RK incisions may remain incompletely healed and easily open during PK surgery as long as nine years after the RK surgery.


Journal of Refractive Surgery | 1991

A Purse-String Suture for Penetrating Keratoplasty Following Radial Keratotomy

James I. McNeill; David L Wilkins

As the prevalence of radial keratotomy for myopia increases, more cases are undergoing penetrating keratoplasty. Radial keratotomy incisions are known to show incomplete wound healing. When the radial corneal radial keratotomy incisions are cut by the corneal trephine, the peripheral part of each incision frequently opens, even years after the radial keratotomy surgery. A case is presented that describes the use of a simple purse-string suture to hold the peripheral radial keratotomy incisions closed and stable during penetrating keratoplasty suturing and postoperative healing. The purse-string suture simplifies the corneal transplant surgery, allowing greater precision in suture placement by stabilizing the peripheral cornea.


Ophthalmology | 1978

The McNeill-Goldman Ring: A Combined Scleral Ring and Blepharostat

Kenneth N. Goldman; James I. McNeill

Reprint requests to Montefiore Hospital and Medi· cal Center, 111 E 210th St, Bronx, NY 10467. (Dr Goldmanl. veloped at the University of Florida, not only supports the globe but also obviates the need for any additional means of eyelid separation. This eliminates the problem of excessive speculum bulk or weight which sometimes leads to cum bersome maneuvering or increased pressure on the globe. The ring is a modification of the Legrand double ring and includes extra struts between the anterior and posterior rings to insure no lid-to-globe contact, and the lid wings or stops, which provide lid separation with attendant excellent surgical field exposure (Fig 2). The small angle of the wings from the horizontal insures that any eyelid pressure or

Collaboration


Dive into the James I. McNeill's collaboration.

Top Co-Authors

Avatar
Top Co-Authors

Avatar
Top Co-Authors

Avatar

Edouard M. Cantin

City of Hope National Medical Center

View shared research outputs
Top Co-Authors

Avatar

Harry Openshaw

City of Hope National Medical Center

View shared research outputs
Top Co-Authors

Avatar

James J. Reidy

Louisiana State University

View shared research outputs
Top Co-Authors

Avatar

Kenneth N. Goldman

Albert Einstein College of Medicine

View shared research outputs
Top Co-Authors

Avatar
Top Co-Authors

Avatar

Stephen D. Klyce

Louisiana State University

View shared research outputs
Top Co-Authors

Avatar

Steven E. Wilson

Louisiana State University

View shared research outputs
Top Co-Authors

Avatar

Anthony J. Lubniewski

Washington University in St. Louis

View shared research outputs
Researchain Logo
Decentralizing Knowledge