Miles H. Friedlander, MD
1. Buzard KA, Ronk JF, Friedlander MH, et al. Quantitative measurement of wound spreading in radial keratotomy. Refractive & Corneal Surgery. 1992;8:217-23.
BACKGROUND: Many studies of radial keratotomy have been performed, however quantitative laboratory evaluation of the biomechanics of this procedure is still incomplete. Furthermore, most measurements of strain in the past have utilized strip testing, thus destroying the normal physiological structure and water balance of the cornea. METHODS: We report on a membrane inflation method of wound spreading in intact human corneas using the Baribeau Micronscope. RESULTS: We measured a secant elastic modulus of 7.58 x 10(6) N/m2 between 25 and 100 mm Hg. The spreading of radial keratotomy incisions as a function of intraocular pressure showed a maximum spreading of approximately 50 mu at 25 mm Hg at a radius of 3.50 mm from the optical center. A slight increase in spreading was observed in proceeding from a single to four radial incisions. CONCLUSIONS: Quantitative measurement of wound spreading is an important parameter of radial keratotomy and can provide important information regarding opposing theories of the biomechanics of this operation.
2. Couvillion JT, Sabates MA, Remus LE, Friedlander MH, Buzard KA. Radial and astigmatic keratotomy experience by residents and fellows at a teaching institution. Journal of Cataract & Refractive Surgery. 1997;23:59-64.
PURPOSE: To retrospectively study 30 cases of radial and astigmatic keratotomy performed by third-year ophthalmology residents and cornea fellows. SETTING: Tulane University Medical Center, New Orleans, Louisiana. METHODS: Patients were selected based on correction for stable myopia without or with astigmatism. Four or eight radial incisions were made using the Russian (uphill) method. The astigmatic cuts were straight transverse. RESULTS: Uncorrected visual acuity postoperatively was 20/40 or better in 28 eyes (93%). Two patients(visual acuity 20/50 and 20/70) were scheduled for secondary procedures but were lost to follow-up. Complications included three microperforations without sequelae. CONCLUSION: Radial and astigmatic keratotomy to correct myopia or myopia with astigmatism can be safe and effective in the hands of a beginning surgeon.
3. Friedlander MH. External transscleral posterior chamber lens fixation [letter; comment]. Archives of Ophthalmology. 1992;110:1681.
4. Friedlander MH. Radial keratotomy predictability [letter; comment]. Ophthalmology. 1994;101:411-2.
5. Friedlander MH, Evans BJ, Novick LH, Buzard KA, Granet, NS. New technique for studying incision depth in experimental radial keratotomy. Journal of Cataract & Refractive Surgery. 1996;22:294-8.
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