Thomas A. Deutsch

Suppressive Effects of Indomethacin on Thermally Induced Neovascularization of Rabbit Corneas

In 16 rabbits with bilateral corneal burns, indomethacin was administered topically to one eye on each day after the lesion was made to determine the effect of a prostaglandin inhibitor on the corneal neovascular response to experimental thermal burns. Comparison of the two eyes showed a reduction of both hyperemia and neovascularization in indomethacin-treated eyes during the first five days after injury. Histologic observations during this period showed a reduction in polymorphonuclear cell infiltration in the treated corneas. Inhibition of prostaglandin synthesis by indomethacin apparently led to a reduction in the inflammatory response and the subsequent corneal neovascularization.

Amniotic bands as a cause of ocular anomalies

We examined nine patients with amniotic band syndrome who had systemic and ocular pathologic deformities. The most common ocular malformations were congenital corneal leukomas or acquired corneal opacities secondary to exposure and eyelid colobomas. The eyelid defects appeared to be extensions of facial clefts in these patients and were often located adjacent to the corneal opacities. Other anomalies included microphthalmos, strabismus, and hypertelorism. One patient had the typical peripheral and facial stigmata of the amniotic band syndrome in association with a coloboma of the left iris and retina.

Moraxella nonliquefaciens Endophthalmitis After Trabeculectomy

Endophthalmitis caused by Moraxella nonliquefaciens developed five years after trabeculectomy in a 67-year-old man and 15 months after trabeculectomy in a 62-year-old women. Symptoms in both cases included pain, inflammation, and decreased visual acuity. Aggressive treatment with antibiotics and corticosteroids led to resolution within a few days.

Results of resident-performed laser in situ keratomileusis

Purpose: To analyze the results of resident‐performed laser in situ keratomileusis (LASIK). Setting: Rush University Medical Center, Department of Ophthalmology, Chicago, Illinois, USA. Methods: This retrospective study comprised 44 consecutive eyes of 22 patients who had LASIK performed from August 2000 through February 2002. Based on preoperative spherical equivalent, the eyes were divided into a low myopia group (A) (−1.0 to −6.0 diopter [D]) and a higher myopia group (B) (> −6.01 D). Preoperative and postoperative spherical equivalent (SE), best corrected visual acuity (BCVA), and uncorrected visual acuity (UCVA) were measured and analyzed within each group. Patients had at least 2 follow‐up visits, with the second visit occurring between 1 and 9 months postoperatively. Results: Preoperatively, the mean SE in Group A was −3.93 D ± 1.53 (SD) and in Group B, −8.49 ± 1.70 D. At the final visit, the SE in Group A decreased to −0.29 ± 0.55 D and in Group B, −1.09 ± 0.87 D. The UCVA in Group A at the final visit was 20/20 or better in 43% of eyes and 20/40 or better in 100% of eyes. In Group B, the UCVA was 20/20 or better in 31% of eyes and 20/40 or better in 75% of eyes. In all eyes, the BCVA improved by 1 line in 16% or remained the same in 84%. No eyes lost any lines of BCVA. The SE taken at the last visit was within ±0.5 D in 69% of all eyes and within ±1.0 D in 82% of all eyes. The incidence of patients needing retreatment in resident‐performed LASIK surgery was 3 of 44 (6.8%). Conclusions: Laser in situ keratomileusis performed by residents is a safe and effective procedure for correction of refractive error. Postoperative UCVA, refractive error, retreatment rate, and loss of BCVA were consistent with published results from nonresident surgeons. These results also exceeded the U.S. Food and Drug Administration requirements for LASIK surgery.

The Effect of Neodymium:YAG Laser Shocks on the Blood-aqueous Barrier

An animal model demonstrates that the acute inflammation seen after neodymium: YAG (Nd:YAG) capsulotomy is related to the presence of disrupted tissue suspended in the aqueous, rather than to the mechanical insults by the repeated shock waves. Seven rabbits were treated in the lens cortex of one eye with 20 bursts of 4 pulses, 24 mJ each, and followed fluorophotometrically using albumin labelled with fluorescein. This allowed transmission of shock waves to the anterior segment without releasing debris in five eyes that showed no inflammation. Two eyes with inadvertent capsular rupture showed marked blood-aqueous barrier breakdown. This suggests the use of a capsulotomy technique that relies on discission rather than pulverization of the membrane and avoids the thicker portions of the membrane when possible.

Handlight Retroillumination in HOTV Visual Acuity Testing

To the Editor. —The testing of visual acuity in a young child or an illiterate patient is often a difficult task. Poor attention and comprehension of the examination may compromise the accuracy or validity of the results. The HOTV acuity testing system (Good-Lite Co, Forest Park, Ill) is a widely used method for testing visual acuity in these patients. However, the testing is complicated by difficulty in directing the patients attention to the letter of interest. We have devised a technique for handlight retroillumination of the standard HOTV visual acuity chart to simplify the examination procedure. The patient is seated in the examination chair holding the HOTVs standard letter board. The patient is instructed in the technique of recognition of matched letters for the examiners HOTV chart to the patients board. The examiner faces the patient from a distance of 10 ft and holds up the HOTV acuity chart. Using