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1. Refractive Surgery: Malpractice Litigation Outcomes

Author

Grant A. Justin, Benjamin L. Custer, Steven R. Ballard, Robert B. Carroll, and Scott D. Barnes

Subjects
Adult, Male, medicine.medical_specialty, Databases, Factual, Patient demographics, media_common.quotation_subject, medicine.medical_treatment, 030230 surgery, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Jury, Informed consent, Malpractice, Refractive surgery, Humans, Medicine, Eye surgery, Aged, media_common, Plaintiff, Informed Consent, Ophthalmologists, business.industry, General surgery, Liability, Legal, Middle Aged, Refractive Surgical Procedures, Ophthalmology, 030221 ophthalmology & optometry, Female, business, Allegation
Abstract

Purpose To review data on malpractice claims related to refractive surgery to identify common allegations and injuries and financial outcomes. Methods The WestlawNext database was reviewed for all malpractice lawsuits/settlements related to refractive eye surgery. Data evaluated included patient demographics, type of operation performed, plaintiff allegation, nature of injury, and litigation outcomes. Results A total of 167 cases met the inclusion criteria, of which 108 cases (64.7%) were found to be favorable and 59 cases (35.3%) unfavorable to the defendant. A total of 141 cases were tried by a jury with 108 cases (76.4%) favorable and 33 cases (23.6%) unfavorable to the defendant. Laser in situ keratomileusis was performed in 127 cases (76%). The most common allegations were negligence in treatment or surgery in 127 cases (76%) and lack of informed consent in 83 cases (49.7%). For all cases, the need for future surgery (P = 0.0001) and surgery resulting in keratoconus (P = 0.05) were more likely to favor the plaintiff. In jury verdict decisions, cases in which failure to diagnose a preoperative condition was alleged favored the defendant (P = 0.03), whereas machine malfunction (P = 0.05) favored the plaintiff. After adjustment for inflation, the overall mean award was $1,287,872. Jury verdicts and settlements led to mean awards of $1,604,801 and $826,883, respectively. Conclusions Malpractice litigation in refractive surgery tends to favor the defendant. However, large awards and settlements were given in cases that were favorable to the plaintiff. The need for future surgery and surgery leading to keratoconus increased the chance of an unfavorable outcome.

Published
2017
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2. Subconjunctival/Perilesional Recombinant Interferon α2b for Ocular Surface Squamous Neoplasia

Author

Sachin Chhabra, Anat Galor, Scott D. Barnes, Carol L. Karp, and Eduardo C. Alfonso

Subjects
medicine.medical_specialty, Future studies, Conjunctiva, Recombinant interferon, business.industry, Cancer, Retrospective cohort study, medicine.disease, Surgery, Lesion, Ophthalmology, medicine.anatomical_structure, medicine, Carcinoma, medicine.symptom, business, Ocular surface
Abstract

Purpose To evaluate the biologic effect of subconjunctival recombinant interferon α2b (IFNα2b) for the treatment of ocular surface squamous neoplasia (OSSN). Design Retrospective study. Participants Patients with primary or recurrent OSSN treated with subconjunctival injections of recombinant IFNα2b were studied retrospectively. Intervention Patients were given perilesional subconjunctival injections of 3 million international units in 0.5 ml of IFNα2b (Intron; Schering-Plough, Kenilworth, NJ) until tumor resolution. Main Outcome Measures Patients were followed up clinically and photographically for evidence of tumor resolution and were monitored for evidence of tumor recurrence. Results The authors present a series of 15 eyes (14 patients) that were treated with perilesional, subconjunctival, recombinant IFNα2b. Clinical resolution of the tumor occurred in 13 of 15 eyes. The median time to resolution was 1.4 months (range, 0.6–5.7). In the time of follow-up after lesion resolution (median, 55 months), only 1 of the 15 eyes in the study exhibited disease recurrence, and this occurred 4 months after clinical resolution. Conclusions Perilesional subconjunctival recombinant IFNα2b may be a viable medical alternative for the treatment of OSSN. Future studies will be needed to evaluate the ideal treatment regimen of IFNα2b. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Published
2010
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3. Topical interferon alpha 2b eye-drops for treatment of ocular surface squamous neoplasia: a dose comparison study

Author

Sachin Chhabra, Scott D. Barnes, Carol L. Karp, Eduardo C. Alfonso, and Anat Galor

Subjects
Adult, Male, medicine.medical_specialty, Interferon therapy, Alpha interferon, Antineoplastic Agents, Conjunctival Neoplasms, Interferon alpha-2, Gastroenterology, Young Adult, Cellular and Molecular Neuroscience, Internal medicine, Carcinoma, medicine, Humans, In patient, Aged, Retrospective Studies, Aged, 80 and over, Dose-Response Relationship, Drug, business.industry, Carcinoma in situ, Dose comparison, Interferon-alpha, Retrospective cohort study, Middle Aged, medicine.disease, Recombinant Proteins, Sensory Systems, Surgery, Ophthalmology, Treatment Outcome, Carcinoma, Squamous Cell, Female, Neoplasm Recurrence, Local, Ophthalmic Solutions, business, Ocular surface, Carcinoma in Situ
Abstract

BACKGROUND/AIMS To compare the effectiveness and side-effect profile of two doses of interferon alpha2b (IFNalpha2b) eye-drops (1 million international units (IU)/ml versus 3 million IU/ml) in the treatment of ocular surface squamous neoplasia (OSSN). METHODS Retrospective case series. RESULTS Thirty-five eyes were identified over an 11-year period (1996-2007). Twenty-one eyes (19 patients) with conjunctival intraepithelial neoplasia (CIN) were treated with 1 million IU/ml of topical IFN-alpha2b; 12 eyes (nine patients) with CIN were treated with 3 million IU/ml. Two patients with squamous cell carcinoma (SCC) were treated with topical interferon, one with 1 million IU/ml and one with 3 million IU/ml. Baseline demographic information was not statistically different between the two groups. In patients with CIN, topical therapy eliminated disease in 81% of eyes in the 1 million IU/ml group versus 92%, in the 3 million IU/ml group, p=0.41. The median time to OSSN resolution was 2.8 months in the 1 million IU/ml group and 1.9 months in the 3 million IU/ml group, p=0.55. Neither eye with SCC responded to interferon therapy. Topical therapy was well tolerated. After a median follow-up of 24 months, three recurrences were seen in eyes successfully treated with topical therapy. CONCLUSION In our study, there were no significant differences between the 1 million IU/ml group and the 3 million IU/ml group for the treatment of CIN.

Published
2009
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4. Current trends in advanced surface ablation

Author

William Trattler and Scott D Barnes

Subjects
medicine.medical_specialty, Visual acuity, genetic structures, business.industry, Ablation Techniques, medicine.medical_treatment, Keratomileusis, Laser In Situ, Visual Acuity, Keratomileusis, General Medicine, Ablation, eye diseases, Photorefractive keratectomy, Cornea, Ophthalmology, Aberrations of the eye, Radial keratotomy, Treatment Outcome, Myopia, Humans, Medicine, medicine.symptom, business, Corneal Scar
Abstract

Purpose of review Since their introduction in the mid-1990s, surface ablation techniques have continued to evolve, enabling surgeons to give patients better quality of vision with less postoperative pain. The purpose of this chapter is to discuss that evolution, the common techniques used today, and how to address potential complications. Recent findings Advanced surface ablation techniques offer advantages over laser in situ keratomileusis, including expanded potential patient profiles, reduced haze and pain postoperatively, and increased quality of vision. Haze reduction via preserved epithelial flaps, smoother stromal beds, and introduction of mitomycin-C intraoperatively have all improved safety outcomes of advanced surface ablation. Summary Experience has shown us that virtually all patients who are candidates for laser in situ keratomileusis can be candidates for surface ablation, but patients with specific ocular conditions, such as epithelial basement membrane dystrophy, superficial corneal scars, and previous radial keratotomy will have the best outcomes with surface ablation. Surface ablation and laser in situ keratomileusis are comparable in terms of safety and quality of vision. Wavefront-guided photorefractive keratectomy offers better acuity and less induction of higher order aberrations than wavefront-guided laser in situ keratomileusis.

Published
2008
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5. Fungal Colonization and Infection in Boston Keratoprosthesis

Author

Claes H. Dohlman, Marlene L. Durand, and Scott D. Barnes

Subjects
Adult, Male, medicine.medical_specialty, Prosthesis-Related Infections, Biology, Keratitis, Cornea, Prosthesis Implantation, Endophthalmitis, Fusarium, Risk Factors, medicine, Humans, Fungal keratitis, Antibiotic prophylaxis, Aged, Candida, Retrospective Studies, Incidence, Alternaria, Middle Aged, Eye infection, medicine.disease, Dermatology, eye diseases, Anti-Bacterial Agents, Vitreous Body, Contact lens, Ophthalmology, Mycoses, Immunology, Vancomycin, Drug Therapy, Combination, Female, sense organs, Boston keratoprosthesis, Eye Infections, Fungal, medicine.drug
Abstract

Purpose To determine the incidence of and risk factors for fungal keratitis and endophthalmitis in patients with a Boston keratoprosthesis (KPro) and to determine whether surveillance cultures were helpful in predicting fungal infection. Methods A retrospective chart review was performed of 182 patients (202 eyes) who received a type 1 (through cornea) or type 2 (through cornea and lid) KPro between March 1, 1990, and December 31, 2004, and who were followed for at least 1 month (range, 1 month to 13 years; mean, 2.84 years). There were 148 eyes with type 1 and 54 eyes with type 2. Beginning in late 1999, many eyes were given a prophylactic topical regimen containing vancomycin, and many eyes with type 1 KPro were given therapeutic contact lenses. Cases of fungal keratitis or endophthalmitis were analyzed. To determine the fungal colonization rate, 70 surveillance cultures of the ocular or lid surface around the KPro optic were obtained of 36 uninfected KPro eyes (35 patients) at random time-points over 1 year (August 2002 to July 2003). Results There were 4 definite and 1 probable fungal infections in 6893 patient-months of follow-up, or 0.009 fungal infections per patient-year. These included 3 cases of definite or probable Candida endophthalmitis (C. parapsilosis, C. glabrata, and C. albicans) and 2 cases of mold keratitis (Alternaria, Fusarium). The rate was higher in eyes receiving a vancomycin-containing topical prophylactic regimen than those with on a non-vancomycin regimen (5 cases/2774 person-months vs. 0 cases/4119 person-months; P = 0.011). In eyes with type 1 KPro, the rate was higher with therapeutic contact lens wear than without (4/1682 vs. 0/3115 person-months; P = 0.015). Surveillance cultures did not predict fungal infection, and none of the 6 surveillance eyes colonized with fungi (all Candida) developed a fungal infection. The prevalence of fungal colonization in KPro eyes had not changed since our 1996 surveillance study (11% vs. 10%, P > 0.05). Conclusion Fungal infections in KPro eyes have appeared since we introduced broad-spectrum antibiotic prophylaxis and therapeutic contact lenses 5 years ago, but the infection rate remains very low in our mostly New England-based patient population. Cleaning or replacing the contact lens on a regular basis and prescribing a short course of topical amphotericin at the first visible signs of fungal colonization may prevent these infections.

Published
2007
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6. Laser Subepithelial Keratomileusis: Not Just Another Way to Spell PRK

Author

Dimitri T. Azar and Scott D. Barnes

Subjects
business.industry, Corneal Stroma, medicine.medical_treatment, Keratomileusis, Laser In Situ, Epithelium, Corneal, Spell, Dentistry, Keratomileusis, Laser, Photorefractive Keratectomy, Surgical Flaps, Refractive Surgical Procedures, law.invention, Ophthalmology, law, Humans, Medicine, Optometry, Lasers, Excimer, business
Published
2004
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7. Microbial Keratitis

Author

Joelle A. Hallak, Scott D. Barnes, Deborah Pavan-Langston, and Dimitri T. Azar

Subjects
Contact lens, medicine.anatomical_structure, Stroma, business.industry, Cornea, Medicine, business, medicine.disease, Virus, Microbiology, Keratitis
Published
2015
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8. Contributors

Author

Kjersti Aagaard, Fredrick M. Abrahamian, Ban Mishu Allos, David R. Andes, Fred Y. Aoki, Michael A. Apicella, Kevin L. Ard, Cesar A. Arias, David M. Aronoff, Michael H. Augenbraun, Francisco Averhoff, Dimitri T. Azar, Larry M. Baddour, Lindsey R. Baden, Carol J. Baker, Ronald C. Ballard, Gerard R. Barber, Scott D. Barnes, Dan H. Barouch, Alan D. Barrett, Miriam Baron Barshak, Sridhar V. Basavaraju, Byron E. Batteiger, Stephen G. Baum, Arnold S. Bayer, J. David Beckham, Susan E. Beekmann, Beth P. Bell, John E. Bennett, Dennis A. Bente, Elie F. Berbari, Jonathan Berman, Joseph S. Bertino, Adarsh Bhimraj, Holly H. Birdsall, Alan L. Bisno, Brian G. Blackburn, Lucas S. Blanton, Martin J. Blaser, Thomas P. Bleck, Nicole M.A. Blijlevens, David A. Bobak, William Bonnez, John C. Boothroyd, Luciana L. Borio, Patrick J. Bosque, John Bower, Robert W. Bradsher, Itzhak Brook, Kevin E. Brown, Patricia D. Brown, Barbara A. Brown-Elliott, Roberta L. Bruhn, Amy E. Bryant, Eileen M. Burd, Jane C. Burns, Larry M. Bush, Stephen B. Calderwood, Luz Elena Cano, Charles C.J. Carpenter, Mary T. Caserta, Elio Castagnola, Richard E. Chaisson, Henry F. Chambers, Stephen J. Chapman, James D. Chappell, Lea Ann Chen, Sharon C-A Chen, Anthony W. Chow, Rebecca A. Clark, Jeffrey I. Cohen, Myron S. Cohen, Ronit Cohen-Poradosu, Susan E. Cohn, Mark Connors, Lawrence Corey, Mackenzie L. Cottrell, Timothy L. Cover, Heather L. Cox, William A. Craig, Kent B. Crossley, Clyde S. Crumpacker, James W. Curran, Bart J. Currie, Erika D'Agata, Inger K. Damon, Rabih O. Darouiche, Roberta L. DeBiasi, George S. Deepe, Carlos del Rio, Andrew S. Delemos, Frank R. DeLeo, Gregory P. DeMuri, Peter Densen, Terence S. Dermody, Robin Dewar, James H. Diaz, Carl W. Dieffenbach, Jules L. Dienstag, Yohei Doi, Raphael Dolin, J. Peter Donnelly, Michael S. Donnenberg, Gerald R. Donowitz, Philip R. Dormitzer, James M. Drake, J. Stephen Dumler, J. Stephen Dummer, Herbert L. DuPont, David T. Durack, Marlene L. Durand, Paul H. Edelstein, Michael B. Edmond, John E. Edwards, Morven S. Edwards, George M. Eliopoulos, Richard T. Ellison, Timothy P. Endy, N. Cary Engleberg, Hakan Erdem, Joel D. Ernst, Peter B. Ernst, Rick M. Fairhurst, Jessica K. Fairley, Stanley Falkow, Ann R. Falsey, Anthony S. Fauci, Thomas Fekete, Paul D. Fey, Steven M. Fine, Daniel W. Fitzgerald, Anthony R. Flores, Derek Forster, Vance G. Fowler, David O. Freedman, Arthur M. Friedlander, John N. Galgiani, John I. Gallin, Robert C. Gallo, Tejal N. Gandhi, Wendy S. Garrett, Charlotte A. Gaydos, Thomas W. Geisbert, Jeffrey A. Gelfand, Steven P. Gelone, Dale N. Gerding, Anne A. Gershon, Janet R. Gilsdorf, Ellie J.C. Goldstein, Fred M. Gordin, Paul S. Graman, M. Lindsay Grayson, Jeffrey Bruce Greene, Patricia M. Griffin, David E. Griffith, Richard L. Guerrant, H. Cem Gul, David A. Haake, David W. Haas, Charles Haines, Caroline Breese Hall, Joelle Hallak, Scott A. Halperin, Margaret R. Hammerschlag, Rashidul Haque, Jason B. Harris, Claudia Hawkins, Roderick J. Hay, Craig W. Hedberg, David K. Henderson, Donald A. Henderson, Kevin P. High, Adrian V.S. Hill, David R. Hill, Alan R. Hinman, Martin S. Hirsch, Aimee Hodowanec, Tobias M. Hohl, Steven M. Holland, Robert S. Holzman, Edward W. Hook, David C. Hooper, Thomas M. Hooton, Harold W. Horowitz, C. Robert Horsburgh, James M. Horton, Duane R. Hospenthal, Kevin Hsueh, James M. Hughes, Noreen A. Hynes, Nicole M. Iovine, Jonathan R. Iredell, Michael G. Ison, J. Michael Janda, Edward N. Janoff, Eric C. Johannsen, Angela D.M. Kashuba, Dennis L. Kasper, Donald Kaye, Keith S. Kaye, Kenneth M. Kaye, James W. Kazura, Jay S. Keystone, Rima Khabbaz, David A. Khan, Yury Khudyakov, Rose Kim, Charles H. King, Louis V. Kirchhoff, Jerome O. Klein, Michael Klompas, Bettina M. Knoll, Kirk U. Knowlton, Jane E. Koehler, Stephan A. Kohlhoff, Eija Könönen, Dimitrios P. Kontoyiannis, Igor J. Koralnik, Poonum S. Korpe, Anita A. Koshy, Joseph A. Kovacs, Phyllis Kozarsky, John Krieger, Andrew T. Kroger, Matthew J. Kuehnert, Nalin M. Kumar, Merin Elizabeth Kuruvilla, Regina C. LaRocque, James E. Leggett, Helena Legido-Quigley, Paul N. Levett, Donald P. Levine, Matthew E. Levison, Alexandra Levitt, Russell E. Lewis, W. Conrad Liles, Aldo A.M. Lima, Ajit P. Limaye, W. Ian Lipkin, Nathan Litman, Bennett Lorber, Ruth Ann Luna, Conan MacDougall, Rob Roy, Philip A. Mackowiak, Lawrence C. Madoff, Alan J. Magill, James H. Maguire, Frank Maldarelli, Lewis Markoff, Jeanne M. Marrazzo, Thomas J. Marrie, Thomas Marth, David H. Martin, Gregory J. Martin, Francisco M. Marty, Melanie Jane Maslow, Henry Masur, Alison Mawle, Kenneth H. Mayer, John T. McBride, James S. McCarthy, William M. McCormack, Catherine C. McGowan, Kenneth McIntosh, Paul S. Mead, Malgorzata Mikulska, Robert F. Miller, Samuel I. Miller, David H. Mitchell, John F. Modlin, Rajal K. Mody, Robert C. Moellering, Matthew Moffa, Susan Moir, José G. Montoya, Thomas A. Moore, Philippe Moreillon, J. Glenn Morris, Caryn Gee Morse, Robin Moseley, Robert S. Munford, Edward L. Murphy, Timothy F. Murphy, Barbara E. Murray, Clinton K. Murray, Patrick R. Murray, Daniel M. Musher, Jerod L. Nagel, Esteban C. Nannini, Anna Narezkina, Theodore E. Nash, William M. Nauseef, Jennifer L. Nayak, Marguerite A. Neill, Judith A. O'Donnell, Christopher A. Ohl, Pablo C. Okhuysen, Andrew B. Onderdonk, Steven M. Opal, Walter A. Orenstein, Douglas R. Osmon, Michael T. Osterholm, Stephen M. Ostroff, Michael N. Oxman, Slobodan Paessler, Andrea V. Page, Manjunath P. Pai, Tara N. Palmore, Raj Palraj, Peter G. Pappas, Mark S. Pasternack, Thomas F. Patterson, Deborah Pavan-Langston, David A. Pegues, Robert L. Penn, John R. Perfect, Stanley Perlman, Brett W. Petersen, Phillip K. Peterson, William A. Petri, Cathy A. Petti, Jennifer A. Philips, Julie V. Philley, Michael Phillips, Larry K. Pickering, Peter Piot, Jason M. Pogue, Aurora Pop-Vicas, Cynthia Portal-Celhay, John H. Powers, Richard N. Price, Yok-Ai Que, Justin D. Radolf, Sanjay Ram, Didier Raoult, Jonathan I. Ravdin, Stuart C. Ray, Annette C. Reboli, Marvin S. Reitz, David A. Relman, Cybèle A. Renault, Angela Restrepo, John H. Rex, Elizabeth G. Rhee, Norbert J. Roberts, José R. Romero, Alan L. Rothman, Craig R. Roy, Kathryn L. Ruoff, Mark E. Rupp, Charles E. Rupprecht, Thomas A. Russo, William A. Rutala, Edward T. Ryan, Amar Safdar, Mohammad M. Sajadi, Juan C. Salazar, Juan Carlos Sarria, Maria C. Savoia, Paul E. Sax, W. Michael Scheld, Joshua T. Schiffer, David Schlossberg, Thomas Schneider, Anne Schuchat, Jane R. Schwebke, Cynthia L. Sears, Leopoldo N. Segal, Parham Sendi, Kent A. Sepkowitz, Edward J. Septimus, Alexey Seregin, Stanford T. Shulman, George K. Siberry, Omar K. Siddiqi, Costi D. Sifri, Michael S. Simberkoff, Francesco R. Simonetti, Kamaljit Singh, Nina Singh, Upinder Singh, Scott W. Sinner, Sumathi Sivapalasingam, Leonard N. Slater, A. George Smulian, Jack D. Sobel, M. Rizwan Sohail, David E. Soper, Tania C. Sorrell, James M. Steckelberg, Allen C. Steere, Neal H. Steigbigel, James P. Steinberg, David S. Stephens, Timothy R. Sterling, David A. Stevens, Dennis L. Stevens, Jacob Strahilevitz, Charles W. Stratton, Anthony F. Suffredini, Kathryn N. Suh, Mark S. Sulkowski, Morton N. Swartz, Thomas R. Talbot, C. Sabrina Tan, Ming Tan, Chloe Lynne Thio, David L. Thomas, Lora D. Thomas, Stephen J. Thomas, Anna R. Thorner, Angela María Tobón, Edmund C. Tramont, John J. Treanor, Jason Trubiano, Athe M.N. Tsibris, Allan R. Tunkel, Ronald B. Turner, Kenneth L. Tyler, Ahmet Uluer, Diederik van de Beek, Walter J.F.M. van der Velden, Edouard G. Vannier, Trevor C. Van, James Versalovic, Claudio Viscoli, Ellen R. Wald, Matthew K. Waldor, David H. Walker, Richard J. Wallace, Edward E. Walsh, Stephen R. Walsh, Peter D. Walzer, Christine A. Wanke, Cirle A. Warren, Ronald G. Washburn, Valerie Waters, David J. Weber, Michael D. Weiden, Geoffrey A. Weinberg, Daniel J. Weisdorf, Louis M. Weiss, David F. Welch, Thomas E. Wellems, Richard P. Wenzel, Melinda Wharton, A. Clinton White, Richard J. Whitley, Walter R. Wilson, Glenn W. Wortmann, William F. Wright, Jo-Anne H. Young, Vincent B. Young, Nadezhda Yun, Werner Zimmerli, Stephen H. Zinner, and John J. Zurlo

Published
2015
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9. Microbial Conjunctivitis

Author

Dimitri T. Azar, Deborah Pavan-Langston, Nalin M. Kumar, and Scott D. Barnes

Subjects
Contact lens, Bacterial Conjunctivitis, business.industry, Tetracycline, Topical antibiotics, Ceftriaxone, Medicine, Viral Conjunctivitis, Erythromycin, business, Azithromycin, medicine.drug, Microbiology
Published
2015
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10. Reply: To PMID 23023525

Author

Brandon N, Phillips, Dal, Chun, and Scott D, Barnes

Subjects
Male, Eye Injuries, Blast Injuries, Choroid, Humans, Female, Retinal Perforations, Wounds, Nonpenetrating, Orbital Fractures, Retina
Published
2014

11. Control of intraocular pressure elevations after argon laser trabeculoplasty

Author

John A. Campagna, Erin A. Doe, Monte S. Dirks, and Scott D. Barnes

Subjects
Intraocular pressure, Trabeculoplasty, genetic structures, business.industry, medicine.medical_treatment, Eye disease, Brimonidine, Ocular hypertension, Glaucoma, medicine.disease, eye diseases, Ophthalmology, Brimonidine Tartrate, Anesthesia, medicine, sense organs, Apraclonidine, business, medicine.drug
Abstract

Objective To determine whether brimonidine 0.2% can control intraocular pressure (IOP) spikes as well as apraclonidine 1.0% can in those patients undergoing argon laser trabeculoplasty (ALT). Design Prospective, randomized, double-masked, clinical trial. Participants A total of 56 eyes of 41 patients with open-angle glaucoma or ocular hypertension were entered in the study; 46 eyes of 41 patients were eventually used for the final analysis. Intervention Patients were randomized to receive either brimonidine 0.2% or apraclonidine 1.0% before and after 360° ALT. Both patient and physician were masked as to which agent each patient received. Main outcome measures Intraocular pressure measurements were recorded before surgery and at 1, 2, and 4 hours after surgery. The difference between the preoperative IOP (baseline) and the highest recorded postoperative IOP was recorded as the maximum IOP change. The mean of the maximum IOP change for each group was analyzed using a two-sample, one-tailed t test. Results The mean of the maximum IOP change in the brimonidine 0.2% group was −2.6 ± 3.6 mmHg, and the mean for the apraclonidine 1.0% group was −2.3 ± 3.7 mmHg ( P = 0.8). No patient had a pressure spike greater than 10 mmHg. Conclusions Brimonidine 0.2% appears to be as effective as apraclonidine 1.0% in preventing IOP spikes after argon laser trabeculoplasty.

Published
1999
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14. Subconjunctival/perilesional recombinant interferon α2b for ocular surface squamous neoplasia: a 10-year review

Author

Carol L, Karp, Anat, Galor, Sachin, Chhabra, Scott D, Barnes, and Eduardo C, Alfonso

Subjects
Adult, Aged, 80 and over, Male, Interferon-alpha, Antineoplastic Agents, Conjunctival Neoplasms, Interferon alpha-2, Middle Aged, Recombinant Proteins, Injections, Treatment Outcome, Retreatment, Carcinoma, Squamous Cell, Humans, Female, Neoplasm Recurrence, Local, Conjunctiva, Carcinoma in Situ, Aged, Follow-Up Studies, Retrospective Studies
Abstract

To evaluate the biologic effect of subconjunctival recombinant interferon α2b (IFNα2b) for the treatment of ocular surface squamous neoplasia (OSSN).Retrospective study.Patients with primary or recurrent OSSN treated with subconjunctival injections of recombinant IFNα2b were studied retrospectively.Patients were given perilesional subconjunctival injections of 3 million international units in 0.5 ml of IFNα2b (Intron; Schering-Plough, Kenilworth, NJ) until tumor resolution.Patients were followed up clinically and photographically for evidence of tumor resolution and were monitored for evidence of tumor recurrence.The authors present a series of 15 eyes (14 patients) that were treated with perilesional, subconjunctival, recombinant IFNα2b. Clinical resolution of the tumor occurred in 13 of 15 eyes. The median time to resolution was 1.4 months (range, 0.6-5.7). In the time of follow-up after lesion resolution (median, 55 months), only 1 of the 15 eyes in the study exhibited disease recurrence, and this occurred 4 months after clinical resolution.Perilesional subconjunctival recombinant IFNα2b may be a viable medical alternative for the treatment of OSSN. Future studies will be needed to evaluate the ideal treatment regimen of IFNα2b.

Published
2009

16. List of Contributors

Author

Juan-Carlos Abad, Mark B Abelson, David H Abramson, Martin A Acquadro, Anthony P Adamis, Wesley H Adams, Natalie A Afshari, Everett Ai, Lloyd M Aiello, Lloyd P Aiello, Levent Akduman, Marissa L Albano, Daniel M. Albert, Terry J Alexandrou, Eduardo C Alfonso, Jorge L Alié, Hassan Alizadeh, Ibrahim A Al Jadaan, Sabah Al-Jastaneiah, Calliope E Allen, David Allen, Robert C Allen, Albert Alm, Samar Al-Swailem, Abigail K Alt, Michael M Altaweel, Russell Anderson, Christopher M Andreoli, Sofia Androudi, Leonard PK Ang, Fahd Anzaar, David J Apple, Claudia A Arrigg, Pablo Artal, Penny Asbell, George K Asdourian, Neal Atebara, Pelin Atmaca-Sonmez, Isabelle Audo, Gerd U Auffarth, Robin K Avery, Dimitri T Azar, Ann S Baker, Mark Balles, Scott D Barnes, Donald M Barnett, Neal P Barney, Fina C Barouch, George B Bartley, Jason JS Barton, Irmgard Behlau, Jose I Belda, Jeffrey L Bennett, Timothy J Bennett, Gregg J Berdy, Carlo Roberto Bernardino, Vitaliano Bernardino, Eliot L Berson, Amitabh Bharadwaj, Robert Bhisitkul, Ravinder D Bhui, Jurij Bilyk, Valérie Biousse, Alan C Bird, Norman Paul Blair, Barbara A Blodi, Mark S Blumenkranz, H Culver Boldt, Mark S Borchert, Luigi Borrillo, Gary E Borodic, S Arthur Boruchoff, Swaraj Bose, Michael E Boulton, RW Bowman, Elizabeth A Bradley, Periklis D Brazitikos, Robert Breeze, Neil M Bressler, Susan B Bressler, Alfred Brini, Donald L Budenz, Angela N Buffenn, Scott E Burk, Salim Butrus, David Callanan, J Douglas Cameron, Louis B Cantor, William A Cantore, Jorge Cantu-Dibildox, Victoria Casas, Miriam Casper, Robin J Casten, Yara P Catoira, Jerry Cavallerano, Samantha J Chai, Maria R Chalita, Sherman M Chamberlain, Audrey S Chan, Chi-Chao Chan, Paul Chan, Matthew J Chapin, Karen L Chapman, Eric Chen, Joe Chen, Julie A Chen, Teresa C Chen, Zhou Chen, Patricia Chévez-Barrios, Emily Y Chew, Mark Chiang, James Chodosh, Eva-Marie Chong, Denise Chun, Leo T Chylack, Antonio P Ciardella, Mortimer Civan, Liane Clamen, John I Clark, Glenn Cockerham, Andre Cohen, Elisabeth J Cohen, Kathryn A Colby, Anne L Coleman, Hanna R Coleman, Joseph Colin, J Michael Collier, Grant M Comer, M Ronan Conlon, Kim E Cooper, James J Corbett, Miguel C Coma, Marshall N Cyrlin, Linda R Dagi, Matthew A Dahlgren, Timothy J Daley, Andrea P Da Mata, Bertil Damato, Donald J D'Amico, Reza Dana, Aude Danan-Husson, Helen B Danesh-Meyer, Ronald P Danis, Jason K Darlington, Stefanie L Davidson, Janet L Davis, Elizabeth A Davis, Jose J de la Cruz, Adam G de la Garza, Margaret M DeAngelis, Sheri L DeMartelaere, Joseph L Demer, Avninder Dhaliwal, J Paul Dieckert, Diana V Do, Marshall G Doane, Christopher Dodds, Claes H Dohlman, Guy Donati, Eric D Donnenfeld, Arlene Drack, Thaddeus P Dryja, David Dueker, Jay S Duker, Jennifer A Dunbar, James P Dunn, William J Dupps, Marlene L Durand, Jonathan J Dutton, Chiara M Eandi, Deepak P Edward, Robert A Egan, David A Eichenbaum, Susan E Eklund, Elizabeth C Engle, Kristine Erickson, Bita Esmaeli, Aaron Fay, Leonard Feiner, Sharon Fekrat, Frederick L Ferris, Howard F Fine, Donald C Fletcher, Paul Flikier, Richard P Floyd, Harry W Flynn, Donald S Fong, Ramon L Font, Brian JR Forbes, Rod Foroozan, Bradley S Foster, C Stephen Foster, Jill A Foster, Gary N Foulks, Tamara R Fountain, Gregory M Fox, Thomas F Freddo, Sharon F Freedman, K Bailey Freund, Thomas R Friberg, Alan H Friedman, David Friedman, Deborah I Friedman, Ephraim Friedman, Arthur D Fu, Anne B Fulton, Ahmed Galal, Steven Galetta, Mark Gallardo, Brenda Gallie, Alec Garner, James A Garrity, Damien Gatinel, Steven J Gedde, Craig E Geist, Steve Gerber, Ramon C Ghanem, Jon P Gieser, Michael S Gilmore, Howard V Gimbel, Ilene K Gipson, Tyrone Glover, Robert A Goldberg, Mordechai Goldenfeld, Scott M Goldstein, Cintia F Gomi, Haiyan Gong, John A Gonzales, John Goosey, Justin L Gottlieb, Joshua Gould, Evangelos S Gragoudas, David B Granet, Michael J Greaney, Daniel G Green, Franz Grehn, Jack V Greiner, Craig M Greven, Gregory J Griepentrog, Carl Groenewald, Cynthia L Grosskreutz, Lori Latowski Grover, Vamsi K Gullapalli, Padma Gulur, Jonathan Gunther, Manish Gupta, Mayank Gupta, David R Guyer, Darin R Haivala, Julia A Haller, GM Halmagyi, Lawrence S Halperin, Islam M Hamdi, Steven R Hamilton, Kristin M Hammersmith, Dennis P Han, Ronald M Hansen, J William Harbour, Seenu M Hariprasad, Mona Harissi-Dagher, Shirin E. Hassan, Mark P Hatton, Pamela Hawley, Yasutaka Hayashida, John R Heckenlively, Thomas R Hedges, Alfred D Heggie, Katrinka L Heher, Jeffrey S Heier, J Fielding Hejtmancik, Bonnie A Henderson, Peter S Hersh, Ahmed A Hidayat, Eva Juliet Higginbotham, Tatsuo Hirose, Allen C Ho, ThucAnh T Ho, R Nick Hogan, David E Holck, Nancy M Holekamp, Peter G Hovland, Thomas C Hsu, William C Hsu, Andrew JW Huang, Mark S Hughes, Jennifer Hui, David G Hunter, Laryssa A Huryn, Deeba Husain, Robert A Hyndiuk, Michael Ip, Brian J Jacobs, Frederick A Jakobiec, Lee M Jampol, Harold G Jensen, Fei Ji, David L Johnson, Douglas H Johnson, Mark W Johnson, R Paul Johnson, Robert N Johnson, Karen M Joos, Nancy C Joyce, J Michael Jumper, Ula V. Jurkunas, Alon Kahana, Malik Y Kahook, Elliott Kanner, Kevin Kalwerisky, Henry J Kaplan, Ekaterini C Karatza, Randy Kardon, James A Katowitz, William R Katowitz, Melanie Kazlas, Kelly S Keefe, Lara Kelley, Charles J Kent, Kenneth R Kenyon, Bilal F Khan, Jemshed A Khan, Naheed W Khan, Peng Tee Khaw, Femida Kherani, Eva C Kim, Hee Joon Kim, Ivana K Kim, Jonathan W Kim, Rosa Y Kim, Stella K Kim, Tae-Im Kim, Christina M Klais, Stephen R Klapper, Barbara EK Klein, Guy Kleinmann, Thomas Klink, Dino D Klisovic, Stephen D Klyce, Tolga Kocaturk, Thomas Kohnen, Takeshi Kojima, Tobias Koller, David A Kostick, Joel A Kraut, Chandrasekharan Krishnan, Ronald R Krueger, Joseph H Krug, Sara Krupsky, Rachel W Kuchtey, Ramsay S Kurban, Paul A Kurz, JR Kuszak, Young H Kwon, Thad A Labbe, Deborah L Lam, Jeffrey C Lamkin, Kathleen A Lamping, Anne Marie Lane, Katherine A Lane, Keith J Lane, Jonathan H Lass, Mary G Lawrence, Andrew G Lee, Carol M Lee, Michael S Lee, Paul P Lee, William B Lee, Igal Leibovitch, Bradley N Lemke, Craig A Lemley, Andrea Leonardi, Simmons Lessell, Leonard A Levin, Grace A Levy-Clarke, Julie C Lew, Craig Lewis, Wei Li, Laurence S Lim, Lyndell L Lim, Wee-Kiak Lim, Grant T Liu, John I Loewenstein, McGregor N Lott, Jonathan C Lowry, David B Lyon, Robert E Lytle, Mathew MacCumber, Bonnie T Mackool, Nalini A Madiwale, Francis Mah, Martin A Mainster, Michael H Manning, Steven L Mansberger, Robert E Marc, Mellone Marchong, Dennis M Marcus, Julie A Mares, Brian P Marr, Carlos E Martinez, Robert W Massof, Yukihiro Matsumoto, Cynthia Mattox, Marlon Maus, Cathleen M McCabe, Steven A McCormick, Michael McCrakken, James P McCulley, John A McDermott, H Richard McDonald, Marguerite B McDonald, Peter J McDonnell, Robert McGillivray, Craig A McKeown, James McLaughlin, W Wynn McMullen, Shlomo Melamed, George Meligonis, Efstratios Mendrinos, Dale R Meyer, Catherine B Meyerle, William F Mieler, Michael Migliori, Martin C Mihm, Darlene Miller, David Miller, Joan W Miller, Neil R Miller, David M Mills, Monte D Mills, Tatyana Milman, Lylas Mogk, Marja Mogk, Jordi Monés, Robert Montes-Micó, Christie L Morse, Asa D Morton, Anne Moskowitz, Shizuo Mukai, A Linn Murphree, Robert P Murphy, Timothy G Murray, Philip I Murray, Karina Nagao, Jay Neitz, Maureen Neitz, Peter A Netland, Arthur H Neufeld, Nancy J Newman, Eugene WM Ng, Quan Dong Nguyen, Jerry Y Niederkorn, Robert J Noecker, Robert B Nussenblatt, Joan M O'Brien, Paul D O'Brien, Terrence P O'Brien, Denis O'Day, R Joseph Olk, Karl R Olsen, Sumru Onal, Yen Hoong Ooi, E Mitchel Opremcak, George Ousler, Randall R Ozment, Samuel Packer, Millicent L Palmer, George N Papaliodis, DJ John Park, David W Parke, Cameron F Parsa, M Andrew Parsons, Louis R Pasquale, Neha N Patel, Sayjal J Patel, Thomas D Patrianakos, James R Patrinely, Deborah Pavan-Langston, Eli Peli, Susan M Pepin, Victor L Perez, Juan J Pérez-Santonja, John R Perfect, Henry D Perry, Joram Piatigorsky, Dante Pieramici, Eric A Pierce, Roberto Pineda, Misha L Pless, Howard D Pomeranz, Constantin J Pournaras, William Power, Manvi Prakash, Anita G Prasad, Valerie Purvin, David A Quillen, Graham E Quinn, Melvin D Rabena, James L Rae, Michael B Raizman, Alessandro Randazzo, Narsing A Rao, Christopher J Rapuano, Sherman W Reeves, Carl D Regillo, Elias Reichel, Martin H Reinke, Douglas Rhee, Claudia U Richter, Joseph F Rizzo, Richard M Robb, Anja C Roden, I Rand Rodgers, Merlyn M Rodrigues, Yonina Ron, Geoffrey E Rose, Emanuel S Rosen, James T Rosenbaum, Perry Rosenthal, Strutha C Rouse, Barry W Rovner, Malgorzata Rozanowska, Michael P Rubin, Peter AD Rubin, Shimon Rumelt, Anil K Rustgi, Tina Rutar, Mark S Ruttum, Allan R Rutzen, Edward T Ryan, Alfredo A Sadun, José-Alain Sahel, Leorey Saligan, Sarwat Salim, John F Salmon, Diva R Salomão, David Sami, Michael A Sandberg, Virender S Sangwan, Maria A Saornil, Joseph W Sassani, Rony R Sayegh, Andrew P Schachat, Wiley A Schell, Amy C Schefler, Tina Scheufele, Vivian Schiedler, Gretchen Schneider, Alison Schroeder, Ronald A Schuchard, Joel S Schuman, Ivan R Schwab, Adrienne Scott, Ingrid U Scott, Marvin L Sears, Johanna M Seddon, Theo Seiler, Robert P Selkin, Richard D Semba, Irina Serbanescu, Briar Sexton, Tarek M Shaarawy, Peter Shah, Aron Shapiro, Savitri Sharma, Jean Shein, Debra J Shetlar, M Bruce Shields, Carol L Shields, Jerry A Shields, Bradford J Shingleton, John W Shore, Lesya M Shuba, Guy J Ben Simon, Richard J Simmons, Michael Simpson, Arun D Singh, Omah S Singh, Karen Sisley, Arthur J Sit, David Smerdon, William E Smiddy, Ronald E Smith, Terry J Smith, Neal G Snebold, Lucia Sobrin, John A Sorenson, Sarkis H Soukiasian, George L Spaeth, Richard F Spaide, Monika Srivastava, Sunil K Srivastava, Alexandros N Stangos, Tomy Starck, Walter J Stark, Joshua D Stein, Roger F Steinert, Leon Strauss, Barbara W Streeten, J Wayne Streilein, James D Strong, Ilene K Sugino, Eric B Suhler, Timothy J Sullivan, Jennifer K Sun, Janet S Sunness, Francis C Sutula, Nasreen A Syed, Christopher N Ta, Hidehiro Takei, Jonathan H Talamo, Richard R Tamesis, Madhura Tamhankar, Kristen J Tarbet, Michelle Tarver-Carr, Mark A Terry, Joseph M Thomas, Vance Thompson, Jennifer E Thorne, Matthew J Thurtell, David P Tingey, King W To, Faisal M Tobaigy, Michael J Tolentino, Melissa G Tong, Gail Torkildsen, Cynthia A Toth, Elias I Traboulsi, Michele Trucksis, James C Tsai, Julie H Tsai, David T Tse, Scheffer CG Tseng, Elmer Y Tu, Ira J Udell, Alejandra A Valenzuela, Russell N Van Gelder, Gregory P Van Stavern, Deborah K Vander Veen, Demetrios Vavvas, David H Verity, Paolo Vinciguerra, Paul F Vinger, Nicholas J Volpe, Werner Wackernagel, Sonal Desai Wadhwa, Michael D Wagoner, Nadia K Waheed, David S Walton, Martin Wand, Jie Jin Wang, Scott M Warden, Lennox Webb, David Weber, Daniel Wee, Corey B Westerfeld, Christopher T Westfall, Scott M Whitcup, Valerie A White, William L White, Jason Wickens, Janey L Wiggs, Jacob T Wilensky, Charles P Wilkinson, Patrick D Williams, David J Wilson, M Roy Wilson, Steven E Wilson, Jules Winokur, William J Wirostko, Gadi Wollstein, Albert Chak Ming Wong, Tien Y Wong, John J Woog, Michael Wride, Carolyn S Wu, Darrell WuDunn, Jean Yang, Lawrence A Yannuzzi, Michael J Yaremchuk, R Patrick Yeatts, Richard W Yee, Steven Yeh, Lucy HY Young, Jenny Y Yu, Beatrice YJT Yue, Charles M Zacks, Bruce M Zagelbaum, Maryam Zamani, Marco Zarbin, Leonidas Zografos, and Christopher I Zoumalan

Published
2008
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17. Severe eye injuries in the war in Iraq, 2003-2005

Author

Lilia A. Fannin, Thomas H. Mader, Sean M. Blaydon, Sheri L. DeMartelaere, Scott D. Barnes, Anthony J. Johnson, Allen B. Thach, John P. Ritchey, Robert B. Carroll, Darryl J. Ainbinder, Ava Huchun, Roger K. George, Richard D. Stutzman, and Clifton S. Slade

Subjects
Adult, Male, medicine.medical_specialty, genetic structures, medicine.medical_treatment, Eye disease, Enucleation, Poison control, Explosions, Hospitals, Military, Eye Enucleation, Eye injuries, Military medicine, Blast Injuries, Injury prevention, Medicine, Humans, Iraq War, 2003-2011, Evisceration (ophthalmology), Retrospective Studies, business.industry, Incidence, Eyelids, medicine.disease, humanities, eye diseases, Eye Injuries, Penetrating, United States, Surgery, Ophthalmology, Military Personnel, Eye Foreign Bodies, Female, sense organs, business, Orbit, Eye Evisceration
Abstract

Purpose To document the incidence and treatment of patients with severe ocular and ocular adnexal injuries during Operation Iraqi Freedom. Design Retrospective hospital-based observational analysis of injuries. Participants All coalition forces, enemy prisoners of war, and civilians with severe ocular and ocular adnexal injuries. Methods The authors retrospectively examined severe ocular and ocular adnexal injuries that were treated by United States Army ophthalmologists during the war in Iraq from March 2003 through December 2005. Main Outcome Measures Incidence, causes, and treatment of severe ocular and ocular adnexal injuries. Results During the time data were gathered, 797 severe eye injuries were treated. The most common cause of the eye injuries was explosions with fragmentation injury. Among those injured, there were 438 open globe injuries, of which 49 were bilateral. A total of 116 eyes were removed (enucleation, evisceration, or exenteration), of which 6 patients required bilateral enucleation. Injuries to other body systems were common. Conclusions Severe eye injuries represent a significant form of trauma encountered in Operation Iraqi Freedom. These injuries were most commonly caused by explosion trauma.

Published
2007

18. Nevoid basal cell carcinoma syndrome in a black child

Author

Dirk M. Elston, Kay A. Johnston, Scott D. Barnes, John P. McPhillips, and Jenifer Hall

Subjects
Male, Pathology, medicine.medical_specialty, genetic structures, Basal Cell Nevus Syndrome, Black People, Nevoid basal-cell carcinoma syndrome, Dermatology, Left posterior, Diagnosis, Differential, Maxilla, Alveolar ridge, Humans, Medicine, Keratocyst, Child, business.industry, Tooth, Impacted, medicine.disease, Molar, Odontogenic, stomatognathic diseases, medicine.anatomical_structure, Odontogenic Cysts, Exotropia, medicine.symptom, business, Orbit, Jaw Diseases, Orbit (anatomy)
Abstract

Nevoid basal cell carcinoma syndrome (NBCCS) is rare in black persons. We describe an 11-year-old black boy with NBCCS who presented with exotropia and a painful, expanding, cystic mass in the left posterior alveolar ridge. Further examination revealed odontogenic keratocysts with palmar and plantar pitting. Less than 5% of reported patients with NBCCS are black. To our knowledge, this is the first report of a black patient with NBCCS presenting with exotropia and an impacted molar displaced into the orbit by an odontogenic keratocyst.

Published
1998
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19. Infectious keratitis after photorefractive keratectomy in the United States army and navy

Author

Steven C. Schallhorn, Keith J. Wroblewski, Kraig S. Bower, Mark F. Torres, Scott D. Barnes, Joseph F. Pasternak, Cary E. Harrison, and Walter J. Hubickey

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Staphylococcus, Visual Acuity, Infectious Keratitis, Photorefractive Keratectomy, Eye Infections, Bacterial, Keratitis, Postoperative Complications, medicine, Myopia, Humans, Fungal keratitis, Corneal Ulcer, Military Medicine, Retrospective Studies, business.industry, General surgery, Incidence, Astigmatism, Retrospective cohort study, Perioperative, Eye infection, Staphylococcal Infections, medicine.disease, Antibiotic coverage, Photorefractive keratectomy, United States, Surgery, Anti-Bacterial Agents, Ophthalmology, Hyperopia, Military Personnel, Female, Lasers, Excimer, Methicillin Resistance, business
Abstract

Purpose To review the incidence, culture results, clinical course, management, and visual outcomes of infectious keratitis after photorefractive keratectomy (PRK) at 6 Army and Navy refractive surgery centers. Design Retrospective study. Participants Twelve thousand six hundred sixty-eight Navy and Army sailors and service members. Methods Army and Navy refractive surgery data banks were searched for cases of infectious keratitis. A retrospective chart review and query of the surgeons involved in the care of those patients thus identified provided data regarding preoperative preparation, perioperative medications, treatment, culture results, clinical course, and final visual acuity. Results Between January 1995 and May 2004, we performed a total of 25337 PRK procedures at the 6 institutions. Culture proven or clinically suspected infectious keratitis developed in 5 eyes of 5 patients. All patients received topical antibiotics perioperatively. All cases presented 2 to 7 days postoperatively. Cultures from 4 cases grew Staphylococcus , including 2 methicillin-resistant S. aureus (MRSA). One case of presumed infectious keratitis was culture negative. There were no reported cases of mycobacterial or fungal keratitis. In addition, we identified 26 eyes with corneal infiltrates in the first postoperative week that were felt to be sterile, and which resolved upon removal of the bandage contact lens and increasing antibiotic coverage. Conclusions Infectious keratitis is a rare but potentially vision-threatening complication after PRK. It is often caused by gram-positive organisms, including MRSA. Early diagnosis, appropriate laboratory testing, and aggressive antimicrobial therapy can result in good outcomes.

Published
2004

20. Reply

Author

Brandon N Phillips, Scott D Barnes, and Dal Chun

Subjects
World Wide Web, Ophthalmology, Text mining, business.industry, Medicine, General Medicine, business
Published
2014
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