Pluronic polyol possesses a negative temperature coefficient of gelation; it is liquid at low temperatures and gelatinous at high temperatures. Pluronic F108 was evaluated as a potential material for alloplastic keratorefractive surgery: 0.3 ml of the material in a liquid state was injected into a surgically prepared axial 7 mm mid-stromal corneal bed in 17 rabbits; fellow eyes in the rabbits were sham-operated but not injected. Postoperatively, rabbits were clinically evaluated with biomicroscopy, keratometry, and pachymetry at regular intervals up to three months following surgery. Animals were periodically sacrificed and corneas were studied by light and electron microscopy. The material appeared to be well tolerated by the cornea. Both control and pluronic eyes showed an initial increase in corneal thickness peaking at one week postoperatively, with return to near normal levels by the end of the third week. Refractive flattening of approximately three diopters was noted in the experimental group, while no change was seen in the control group.
Charts of all infantile esotropes who received their primary surgical procedure at the North Carolina Memorial Hospital, between February 1978 and June 1984 were reviewed. Neurologic problems (general and ocular) were identified in 29 of the 47 patients (61.7%) followed a minimum three months (x = 25.0 ± 2.9 mos). Frequent general neurologic problems were prematurity, hydrocephalus, mental retardation, cerebral palsy, meningomyelocele, intraventricular hemorrhage, and seizures (neonatal and/or postnatal). Abducens nerve palsy was the most common ocular neurologic impairment. Neurologic impaired esotropes were older (x = 31.9 ± 3.8 mos) than the "normal" group (x = 17.0 ± 3.3 mos) at the time of surgery. Recession/resection procedures were performed on 13 (44.8%) of the neurologically impaired and nine (50.0%) of the normal esotropes. Bimedial recessions were employed on 12 (41.4%) of the patients with neurologic problems and seven (38.8%) of the normal esotropes. Unilateral medial recessions and/or inferior oblique recessions were performed on six patients. At last follow-up, orthophoria (± 10Δ) was present in 16 (55.2%) neurologically impaired patients and 15 (83.3%) normal esotropes (p<0.05 by the normal deviate (z) test). Seven (24.1%) neurologically impaired patients had residual esotropia, while consecutive exotropia was present in six (20.7%) patients. Among normal esotropes, residual esotropia was found in one patient and consecutive exotropia in two (11.1%) patients. DVD's occurred in nine patients while four subjects developed a postoperative accommodative component.
To standardize circumferential keratotomy as a clinically useful ke rato refractive procedure to alter astigmatism, this study investigated the corneal topographic response of 20 eye bank eyes to circumferential keratotomies. Five eyes received 30°, 60°, and 90° symmetrical keratotomies around each of four optic zones. Systematic corneal topographic change was evident in patterns which were repeated for all optic zones and keratotomy lengths, Clinical results can be evaluated against this model.
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