Lawrence Ho

To report two patients with endogenous endophthalmitis complicated by choroidal neovascularization managed with intravitreal bevacizumab (Avastin, Genentech, Inc., South San Francisco, CA) or ranibizumab (Lucentis, Genentech, Inc., South San Francisco, CA) and their respective outcomes. Retrospective chart review of 2 patients, one a 54-year-old diabetic woman on chemotherapy for pemphigus vulgaris and the other a 77-year-old diabetic male with cellulitis, who were treated for endogenous endophthalmitis complicated by choroidal neovascularization. The patients were managed with off-label intravitreal anti-vascular endothelial growth factor injections. The first patient received one dose of intravitreal bevacizumab (Avastin) with improvement in vision and anatomy. The second patient received four doses of intravitreal ranibizumab (Lucentis) with improvement in vision and structural appearance. Choroidal neovascularization secondary to endogenous endophthalmitis responds to anti-vascular endothelial growth factor therapy with bevacizumab or ranibizumab.

To determine if a difference in intraocular pressure (IOP) exists after small-gauge pars plana vitrectomy randomized to fluid versus 80% sterile air fill. Ninety-two eyes undergoing 23-gauge and 25-gauge transconjunctival pars plana vitrectomy were randomized to fluid versus air fill, and IOP was measured at 5 different time points. There is no difference in the mean IOP for eyes undergoing small-gauge pars plana vitrectomy randomized to fluid versus air fill after vitrectomy. Using 23-gauge instrumentation, the mean immediate and 2-hour postoperative IOPs were statistically lower than the mean preoperative IOP. The mean Postoperative Day 1 and Week 1 IOPs were statistically higher than the mean immediate postoperative IOP. Using 25-gauge instrumentation, the mean IOP was not statistically different at any time points in the 2 groups. When comparing 23-gauge with 25-gauge instrumentation, the immediate postoperative IOP was statistically lower and the rate of suture closure for sclerotomies was higher for 23-gauge vitrectomy. When performing 23-gauge or 25-gauge pars plana vitrectomy, there was no difference in mean IOP for fluid- versus air-filled eyes. However, the mean IOP in the immediate postoperative period was statistically lower, and there was a higher rate of suture closure for 23-gauge compared with 25-gauge instrumentation.

To report a newly identified syndrome of bilateral microcornea, posterior megalolenticonus, persistent fetal vasculature, and chorioretinal coloboma (MPPC). Noncomparative case series. Eight patients with MPPC syndrome. Clinical data collected retrospectively included visual acuity, findings on office examination as well as examination under anesthesia, and, in some cases, fluorescein angiography. Intraoperative findings and postoperative visual acuity and clinical findings were recorded when surgical intervention was performed. Clinical description, intraoperative findings, and surgical outcomes. All patients were found to have microcornea with corneal diameters of less than 8 mm. In all cases, the crystalline lens was found to be retrodisplaced with massive enlargement and a dramatic posterior lenticonus (posterior megalolenticonus), and the ciliary processes frequently were drawn to the lens capsule. A stalk of persistent fetal vascular tissue extended from the posterior pole of the lens to the optic disc. Posterior chorioretinal coloboma was present in all cases. Some cases also exhibited grossly dysplastic retina. Presentation frequently was asymmetric. Eight eyes of 6 patients underwent lensectomy, vitrectomy, membrane peeling, and fluid-Healon exchange (Healon OVD [sodium hyaluronate]; Advanced Medical Optics, Santa Ana, CA) with functional vision in at least 4 of the 5 patients with postsurgical follow-up. Bilateral microcornea, posterior megalolenticonus, persistent fetal vasculature, and chorioretinal coloboma syndrome is a distinct syndrome previously unreported, to the authors' knowledge, and appropriate surgical intervention may result in significantly improved visual function.

NVOLUNTARY tremor hinders and even makes certain handheld micromanipulation tasks impossible. This physiological tremor is a complex phenomenon that has traditionally been thought to be roughly sinusoidal with a bandwidth between 8-12 Hz [1]. However, it has become ...

The economic impact of musculoskeletal conditions in the United States represents $126 billion. Bone fracture repairs are among the most commonly performed orthopedic procedures; about 6.8 million come to medical attention each year in the United States ...

— This paper demonstrates tremor compensation for human subjects using an active handheld micromanipulator. This instrument uses optical and inertial sensing to detect its own motion, estimates tremor using linear filtering, and a flexure-based manipulator to actuate the tip. Compensation results while tracing a line with the tool are presented for both novice users and a trained surgeon. Learning effects from repetition of the trials over a ten-day period are described. I I.