101
|
Donnenfeld ED, Schrier A, Perry HD, Aulicino T, Gombert ME, Snyder R. Penetration of topically applied ciprofloxacin, norfloxacin, and ofloxacin into the aqueous humor. Ophthalmology 1994; 101:902-5. [PMID: 8190478 DOI: 10.1016/s0161-6420(13)31248-2] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
PURPOSE To determine the intraocular penetration of topically applied fluoroquinolone antibiotics into aqueous humor. METHODS Thirty-two patients undergoing cataract extraction received either 0.3% ciprofloxacin, 0.3% norfloxacin, or 0.3% ofloxacin topical drops. The patients were given two drops 90 minutes preoperatively and two drops 30 minutes preoperatively. At the time of surgery, 0.1 ml aqueous fluid was aspirated from the anterior chamber and immediately stored at -70 degrees C. RESULTS Concentrations of ciprofloxacin, norfloxacin, and ofloxacin were determined using a broth dilution bioassay. Morganella morganii with a known minimal inhibitory concentration was used to assay ciprofloxacin and norfloxacin levels. Salmonella enteritidis with a known minimal inhibitory concentration was used to assay ofloxacin levels. Topically applied ciprofloxacin achieved a mean aqueous level of 0.072 microgram/ml (range, 0.02-0.153 microgram/ml). One sample was below the sensitivity of the bioassay. Topical norfloxacin achieved a mean aqueous level of 0.0570 microgram/ml (range, 0.046-0.10 microgram/ml). Seven samples did not reach the sensitivity of the bioassay. Topical ofloxacin achieved a mean level in the aqueous humor of 0.338 microgram/ml (range, 0.078-0.625 microgram/ml). There was no statistically significant difference in intraocular aqueous humor levels of ciprofloxacin versus norfloxacin (P > 0.05). Topical ofloxacin achieved aqueous humor levels significantly higher than either ciprofloxacin or norfloxacin (P < 0.004). CONCLUSION Of the currently available topical fluoroquinolone antibiotics, ofloxacin achieves the highest aqueous humor concentrations.
Collapse
|
102
|
|
103
|
Donnenfeld ED, Perry HD, Schrier A, Zagelbaum B, Rodgers R. Lid imbrication syndrome. Diagnosis with rose bengal staining. Ophthalmology 1994; 101:763-6. [PMID: 7512255 DOI: 10.1016/s0161-6420(94)31290-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Lid imbrication syndrome is an abnormality of lid apposition in which the upper lid overlies the lower lid. Patients often complain of irritation, tearing, and foreign body sensation. The condition may be difficult to diagnose. METHOD Twenty-one patients with suspected lid imbrication syndrome were compared with 21 age-matched controls. All patients were given 0.5% topical rose bengal. RESULTS The diagnosis of lid imbrication syndrome was confirmed by the presence of rose bengal staining of the tarsal conjunctiva of the upper lid margin. The amount of rose bengal staining correlated with the severity of lid imbrication. Eighteen of 21 patients had received a diagnosis previously of dry eye syndrome. Four patients had persistent epithelial defects. CONCLUSIONS Rose bengal staining of the superior lid margin tarsal conjunctiva offers an extremely reliable aid for diagnosing lid imbrication syndrome. The condition commonly presents as a dry eye or persistent epithelial defect. Treatment ranges from viscous tear substitutes to horizontal lid shortening of the upper lid.
Collapse
|
104
|
Abstract
BACKGROUND Schnyder's crystalline dystrophy is a central anterior bilateral corneal dystrophy characterized by the deposition of crystals composed of cholesterol and other lipids. This condition classically is described as nonprogressive after childhood, but a series of recent studies following patients over time has challenged this teaching. PATIENTS The authors present a family pedigree including a patient first reported in 1954 and followed for 25 years with dramatic progression of the corneal condition in a dense, discoid pattern of crystals. Best-corrected visual acuity decreased from 20/30 to 20/80 in both eyes. This patient now has three children, all with typical corneal involvement. RESULTS Ocular pathologic examination performed on corneal biopsies submitted for light and electron microscopy demonstrated cholesterol deposition consistent with a diagnosis of Schnyder's. CONCLUSION Schnyder's corneal dystrophy may progress significantly over time. The characterization of this condition as stationary may need to be reconsidered.
Collapse
|
105
|
Rosenwasser GO, Sucheski BM, Rosa N, Pastena B, Sebastiani A, Sassani JW, Perry HD. Phenotypic variation in combined granular-lattice (Avellino) corneal dystrophy. ARCHIVES OF OPHTHALMOLOGY (CHICAGO, ILL. : 1960) 1993; 111:1546-52. [PMID: 8240112 DOI: 10.1001/archopht.1993.01090110112035] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To describe the phenotypic variation exhibited by members of families with combined granular-lattice (Avellino) corneal dystrophy. SETTING We examined 40 patients (age range, 12 to 85 years) from six unrelated families with Avellino corneal dystrophy. This included the first individuals to ever be examined near the presumed site of origin in Italy. In addition, one family was the first to trace its origins to Germany rather than to Italy. We studied the phenotypic expression of the disease in the cornea, visual acuities, subjective complaints, complications, treatment, and histologic condition of these individuals. RESULTS The granular stromal lesions reach their mature quantity and size early in life, and appear as either gray and crumb-shaped deposits or superficial with an annular and planar distribution. The lattice component appears gradually, beginning and maturing later in life. The phenotypic variation within families was found to be substantial. Widely variable proportions of lattice and granular changes were found within single sibships. Visual acuities ranged from 20/20 to 20/400. Recurrent corneal erosions were present but infrequent. Subjective complaints included glare and decreased night vision. Penetrating keratoplasty was required in one individual to restore vision. Histopathologic examination revealed typical amyloid and granular deposits. Granular deposits were found replacing Bowman's membrane and extending to the corneal surface. These deposits probably represent the cause of recurrent erosions. CONCLUSIONS Combined granular and lattice corneal dystrophy may present with substantial phenotypic variation. The disease can be found in individuals who trace their ancestry to both Italy and Germany, a wider geographic distribution than previously proposed.
Collapse
|
106
|
Perry HD, Hodes LW, Seedor JA, Donnenfeld ED, McNamara TF, Golub LM. Effect of doxycycline hyclate on corneal epithelial wound healing in the rabbit alkali-burn model. Preliminary observations. Cornea 1993; 12:379-82. [PMID: 8306657 DOI: 10.1097/00003226-199309000-00002] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We examined the effects of doxycycline hyclate on epithelial healing in vivo in the rabbit alkali-burn model. Twelve 2-3-kg Dutch belted rabbits were divided into three groups and received standard bilateral alkali burns (1 N sodium hydroxide for 30 s in an 11-mm circular plastic well). In group 1, two rabbits (four eyes) served as untreated controls. In group 2, five rabbits (10 eyes) received doxycycline hyclate (1.5 mg/kg) orally daily for 14 days. In group 3, five rabbits (10 eyes) received doxycycline hyclate (5 mg/kg) orally daily for 14 days. The epithelial defects were drawn and photographed on alternate days, after fluorescein staining. At conclusion, extracts of the corneas were evaluated for collagenase activity. At 14 days, the mean percentage of epithelial defects results in groups 1-3 were 50.0, 50.7, and 7.1%, respectively. Using the Wilcoxon rank sum test (two tailed), the differences were found to be statistically significant (p = 0.0015). Preliminary data indicated that oral doxycycline administration also decreased the collagenase activity in corneas obtained from these animals. Our preliminary findings indicated that systematically administered doxycycline hyclate, 5 mg/kg/day, promotes corneal reepithelialization in the rabbit alkali-burn model, a result, perhaps, of the drug's ability to inhibit excessive collagenase activity.
Collapse
|
107
|
Perry HD, Donnenfeld ED, Font RL. Intraepithelial corneal immunoglobulin crystals in IgG-kappa multiple myeloma. Cornea 1993; 12:448-50. [PMID: 8306667 DOI: 10.1097/00003226-199309000-00012] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A 52-year-old man was first examined because of bilateral superficial punctate keratitis. Slit-lamp examination disclosed numerous intraepithelial minute opacities in both corneas. A corneal biopsy revealed intraepithelial rhomboidal or rectangular crystals that immunohistochemically stained only for IgG-kappa. Serum immunoelectrophoresis demonstrated an IgG-kappa monoclonal gammopathy. Over the ensuing 6 years, the clinical appearance of the crystals changed from small dot-like opacities to polychromatic crystals. At this time, bone marrow examination established the diagnosis of multiple myeloma. Ophthalmologists should be aware of this entity and carefully monitor these patients; the corneal lesions may be the initial manifestation of an asymptomatic monoclonal gammopathy preceding the development of multiple myeloma.
Collapse
|
108
|
Finger PT, Byrne SF, Moshfeghi DM, Perry HD. Retrobulbar oedema after ophthalmic plaque radiotherapy. Br J Ophthalmol 1993; 77:604-5. [PMID: 8218065 PMCID: PMC513964 DOI: 10.1136/bjo.77.9.604] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
|
109
|
Zagelbaum BM, Donnenfeld ED, Perry HD, Buxton J, Buxton D, Hersh PS. Corneal ulcer caused by combined intravenous and anesthetic abuse of cocaine. Am J Ophthalmol 1993; 116:241-2. [PMID: 8352315 DOI: 10.1016/s0002-9394(14)71296-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
|
110
|
|
111
|
Virgile R, Perry HD, Pardanani B, Szabo K, Rahn EK, Stone J, Salkin I, Dixon DM. Human infectious corneal ulcer caused by Pythium insidiosum. Cornea 1993; 12:81-3. [PMID: 8458239 DOI: 10.1097/00003226-199301000-00015] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Pythium insidiosum is a fungus-like organism known to infect a variety of animals. In humans, the few known cases involving Pythium have included arterial infections and cellulitis. We present what we believe to be the first case of P. insidiosum recovered from a human corneal ulcer. The organism is difficult to isolate, causing delays in diagnosis. It is also resistant to the usual antifungal medications, making surgical excision the treatment of choice.
Collapse
|
112
|
Robinson MR, Udell IJ, Garber PF, Perry HD, Streeten BW. Molluscum contagiosum of the eyelids in patients with acquired immune deficiency syndrome. Ophthalmology 1992; 99:1745-7. [PMID: 1454352 DOI: 10.1016/s0161-6420(92)31737-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Infection with molluscum contagiosum has been reported in patients with acquired immune deficiency syndrome (AIDS). Involvement of the eyelids by molluscum in patients with AIDS has rarely been mentioned. METHODS Two patients with AIDS presented with eyelid molluscum contagiosum. Detailed examination and follow-up was performed. RESULTS One patient had noted ocular irritation with epiphora for several weeks and showed a typical viral keratoconjunctivitis in both eyes. The other patient progressed to confluent masses involving the entire lower eyelid on one side. Removal of the lesions by surgery and cryotherapy was followed by recurrences in both patients within 6 to 7 weeks, the incubation period for this viral infection. CONCLUSION Molluscum contagiosum can form confluent lesions on the eyelids in patients with AIDS, which may cause a keratoconjunctivitis. Local removal of molluscum eyelid nodules appears to be of limited long-term value in patients with T-cell immunodeficiency.
Collapse
|
113
|
Abstract
BACKGROUND Sutureless cataract surgery has recently increased in popularity because of the rapid visual rehabilitation and the inherent reduction of surgically induced astigmatism. METHODS This procedure is dependent on a lamellar, multiplaned incision. As with new surgical techniques, associated complications become evident with time. Recently, there have been several cases of infectious endophthalmitis after this procedure. The authors report on nine cases of sterile endophthalmitis. In all nine cases, surgery was performed with refrigerated balanced salt solution (BSS) and 100 mg of cefazolin and/or 20 mg of methylprednisolone sodium succinate, given subconjunctivally, at its completion. RESULTS All nine cases occurred in a period of time during which 68 cases were performed using refrigerated BSS for irrigation. These nine cases came from two different surgeons using basically the same surgical technique. After the investigation of these complications, the refrigerated BSS was discontinued, and there have been no episodes of sterile endophthalmitis in the last 650 cases. CONCLUSION It appears that refrigerated BSS should be avoided if periocular injections are going to be used. It may be that the cold BSS fails to allow sufficient tissue swelling to seal the surgical incision, allowing for subconjunctival injections to seep into the wound, and leading to a sterile endophthalmitis.
Collapse
|
114
|
Donnenfeld ED, Ingraham HJ, Perry HD, Russell S, Foulks G. Soemmering's ring support for posterior chamber intraocular lens implantation during penetrating keratoplasty. Changing trends in bullous keratopathy. Ophthalmology 1992; 99:1229-33. [PMID: 1513575 DOI: 10.1016/s0161-6420(92)31819-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Changing trends in cataract extractions have resulted in a new category of bullous keratopathy: corneal decompensation after complicated extracapsular cataract extraction. These cases of bullous keratopathy are associated with rupture of the posterior capsule, vitreous loss, and significant intraocular inflammation at the time of the original complicated extracapsular cataract extraction. METHODS The authors reviewed 14 consecutive cases of penetrating keratoplasty for bullous keratopathy in which posterior chamber intraocular lens implantation was supported by remnants of the posterior capsule and/or Soemmering's ring without suture fixation. All 14 patients had a history of complicated extracapsular cataract extraction with capsule rupture and vitreous loss. RESULTS All 14 patients had clear, compact grafts without migration of the intraocular lens with a mean follow-up of 12.1 months. Vision improved in 93% of cases, and there was no significant worsening of glaucoma. CONCLUSIONS Pseudophakic bullous keratopathy after traumatic extracapsular cataract extraction with an anterior chamber intraocular lens and aphakic bullous keratopathy after traumatic extracapsular cataract extraction are two relatively new clinical entities that present new intraocular lens management options. Bullous keratopathy after complicated extracapsular cataract extraction should be recognized as a distinct clinical entity. Intraocular lens implantation into the ciliary sulcus with Soemmering's ring and peripheral capsular support provide the advantages of a posterior chamber intraocular lens without the risk of iris or scleral sutures. The authors predict that bullous keratopathy associated with traumatic extracapsular cataract extraction will become one of the more common indications for penetrating keratoplasty.
Collapse
|
115
|
Lisch W, Steuhl KP, Lisch C, Weidle EG, Emmig CT, Cohen KL, Perry HD. A new, band-shaped and whorled microcystic dystrophy of the corneal epithelium. Am J Ophthalmol 1992; 114:35-44. [PMID: 1621784 DOI: 10.1016/s0002-9394(14)77410-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Five family members and three unrelated patients (four women, four men, 23 to 71 years old) had a dystrophy of the corneal epithelium. Direct slit-lamp examination showed bilateral or unilateral, gray, band-shaped, and feathery opacities that sometimes appeared in whorled patterns. Retroillumination showed intraepithelial, densely crowded, clear microcysts. Light and electron microscopy disclosed diffuse vacuolization of the cytoplasm of epithelial cells in the affected area. Visual acuity was so reduced in three patients that abrasion of the corneal epithelium was performed. The corneal abnormalities recurred within months, with the same reduction in visual acuity as before. The corneal opacities were progressive in two patients but diminished noticeably in another after he began using a hard contact lens. We found no other ophthalmic irregularities or associated systemic abnormalities and no indication of drug-induced keratopathy.
Collapse
|
116
|
Ingraham HJ, Perry HD, Donnenfeld ED, Epstein AB. Glued-on, rigid gas-permeable contact lens for severe radiation-induced keratitis. Am J Ophthalmol 1992; 113:538-40. [PMID: 1575228 DOI: 10.1016/s0002-9394(14)74726-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A 68-year-old woman with severe radiation-induced keratoconjunctivitis sicca became progressively unresponsive to conventional medical treatment. Her left eye deteriorated rapidly and required total tarsorrhaphy. In an attempt to stabilize the right eye and preserve some functional vision, we glued a high-Dk rigid, gas-permeable contact lens with tissue-grade cyanoacrylate adhesive to Bowman's membrane. This glued-on contact lens induced rapid and dramatic improvement of the patient's comfort and sight. Recent developments in high-permeability, rigid, contact-lens materials now make artificial replacement of the epithelium a potentially useful treatment for severe ocular surface disease when conventional treatment has failed.
Collapse
|
117
|
|
118
|
Ingraham HJ, Donnenfeld ED, Perry HD. Keratoconus with spontaneous perforation of the cornea. ARCHIVES OF OPHTHALMOLOGY (CHICAGO, ILL. : 1960) 1991; 109:1651-2. [PMID: 1841566 DOI: 10.1001/archopht.1991.01080120033016] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
119
|
Donnenfeld ED, Ingraham H, Perry HD, Imundo M, Goldberg LP. Contact lens-related deep stromal intracorneal hemorrhage. Ophthalmology 1991; 98:1793-6. [PMID: 1775312 DOI: 10.1016/s0161-6420(91)32048-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Deep corneal neovascularization is a recently described complication of contact lens wear. Visual loss associated with deep corneal neovascularization has been associated with stromal lipid leakage. Deep intracorneal hemorrhage is rare and has been documented infrequently with the use of contact lenses. The authors present five cases of deep stromal hemorrhage associated with contact lens-related deep corneal neovascularization. These patients had no other discernible cause for their vascularization and subsequent hemorrhage. One patient required a penetrating keratoplasty for visual rehabilitation. Contact lenses of all types may cause neovascularization. The deep stromal neovascularization develops insidiously and may progress in the absence of acute symptoms. The presence of deep stromal neovascularization must be watched carefully and managed as a potentially vision-threatening complication of contact lens use.
Collapse
|
120
|
Donnenfeld ED, Perry HD, Gibralter RP, Ingraham HJ, Udell IJ. Keratoconus associated with floppy eyelid syndrome. Ophthalmology 1991; 98:1674-8. [PMID: 1800928 DOI: 10.1016/s0161-6420(91)32070-0] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Floppy eyelid syndrome is a recently described entity, which characteristically involves overweight individuals. The characteristic findings are an upper lid that may be readily everted, tarsal laxity, and diffuse papillary conjunctival changes. The cause of floppy eyelid syndrome is believed to be a mechanical disorder due to the eversion of the lids while sleeping. The cause of keratoconus remains uncertain. There are strong proponents to a mechanical etiology for this disease. The authors report five cases of floppy eyelid syndrome with concomitant keratoconus. One patient with bilateral keratoconus had bilateral symmetric floppy eyelid syndrome. The other four patients had asymmetric keratoconus and floppy eyelid syndrome. In all four patients, the keratoconus was significantly worse in the eye with the more severe case of floppy eyelid syndrome. In addition, these four patients all gave a history of sleeping with their head facing predominantly on the side with the floppy eyelid syndrome and keratoconus. Two patients with keratoconus and floppy eyelid syndrome were able to undergo successful contact lens rehabilitation of their keratoconus after treatment of the floppy eyelid syndrome.
Collapse
|
121
|
Donnenfeld ED, Perry HD, Nelson DB. Cyanoacrylate temporary tarsorrhaphy in the management of corneal epithelial defects. OPHTHALMIC SURGERY 1991; 22:591-3. [PMID: 1961616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Cyanoacrylate tarsorrhaphy is an easily administered, painless technique for the temporary management of corneal epithelial defects. We have used the technique in 17 patients to treat persistent epithelial defects and exposure keratitis, as well as following epikeratophakia, allowing the tarsorrhaphy to remain in place for 1 to 15 days (mean, 5.7 days). Eleven of the 17 patients required only one application of cyanoacrylate; five had additional cyanoacrylate applied at the time of the original tarsorrhaphy to produce more extensive lid closure; and one required additional cyanoacrylate on day 3 to produce more extensive lid apposition.
Collapse
|
122
|
Donnenfeld ED, Perry HD, Nelson DB. Cyanoacrylate Temporary Tarsorrhaphy in the Management of Corneal Epithelial Defects. Ophthalmic Surg Lasers Imaging Retina 1991. [DOI: 10.3928/1542-8877-19911001-09] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
123
|
Finger PT, Moshfeghi DM, Smith PD, Perry HD. Microwave cyclodestruction for glaucoma in a rabbit model. ARCHIVES OF OPHTHALMOLOGY (CHICAGO, ILL. : 1960) 1991; 109:1001-4. [PMID: 2064553 DOI: 10.1001/archopht.1991.01080070113047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Microwave thermotherapy was used to treat experimentally induced glaucoma. Microwave-induced cyclodestruction was successful in reducing intraocular pressure in all treated glaucomatous eyes for 4 weeks. Two additional glaucomatous eyes were left untreated to serve as controls, and were noted to have persistently elevated intraocular pressures. Six additional eyes were then subjected to an equivalent treatment (50 degrees C in five 1-minute applications), which resulted in approximately 180 degrees of heat treatment just posterior to the corneoscleral limbus. These specimens were evaluated with light microscopy at baseline, 24 hours, and 7 days after treatment. Our clinical and histopathologic evaluations suggested that microwave thermotherapy (delivered under thermometry control) allowed for chorioretinal/ciliary body destruction that resulted in reductions of intraocular pressure in glaucomatous eyes.
Collapse
|
124
|
|
125
|
Forster LA, Fontenot JP, Perry HD, Foster JG, Allen VG. Apparent digestibility and nutrient balance in lambs fed different levels of flatpea hay. J Anim Sci 1991; 69:1719-25. [PMID: 1649158 DOI: 10.2527/1991.6941719x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Apparent digestibility and nutrient utilization were studied in a digestion and balance trial with 30 wether lambs (BW 32 kg). Lambs were blocked by weight and allotted randomly to five diets with ratios of alfalfa (Medicago sativa L.) to 'Lathco' flatpea (Lathyrus sylvestris L.) hay of 100:0, 75:25, 50:50, 25:75, and 0:100. Alfalfa was harvested in the early bloom stage and flatpea was harvested in the vegetative stage. Digestibilities of DM, NDF, ADF, cellulose, hemicellulose, and energy decreased linearly (P less than .05) as the level of flatpea hay increased to values of 53.3, 32.4, 39.9, 46.0, 40.5, and 52.5%, respectively, for 100% flatpea hay. Nitrogen retention (9 to 15% of intake) was not affected by level of flatpea hay. Ruminal pH, NH3 N, and blood urea N increased linearly (P less than .001) as level of flatpea increased in the diet, apparently a reflection of dietary N level. Calcium excretion decreased linearly (P less than .01) with increased proportions of flatpea hay and was related to dietary intake of Ca. Apparent absorption and retention showed a cubic effect (P less than .05). No clinical signs of toxicity were observed in any of the lambs during the 20-d metabolism trial. Vegetative flatpea is potentially valuable as a forage for feeding ruminants.
Collapse
|