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Biomedical subjects

A Scharrer

Publications and source records attributed to A Scharrer.

14 recordsLinked to original sources

[Complications of foldable intraocular lenses requiring explantation. Results of the 2000 and 2001 survey in Germany].

PURPOSE: A survey was sent to all members of the German Society of Ophthalmic Surgeons to evaluate complications that required explantation of foldable intraocular lenses (IOLs). METHODS: Data on preoperative visual acuity, foldable IOL design and material, and the reason for explantation were obtained and analysed. We received 185 surveys for 2000 and 2001. RESULTS: In 2000 and 2001, the most common reasons for IOL explantation were: incorrect lens power (31%) and dislocation (19%) in three-piece acrylic IOLs, incorrect power (31%) and decentration (17%) in monofocal silicone IOLs, and opacification (46%) in hydrophilic IOLs. The most common reasons for the exchange of monofocal IOLs were lens opacification in 2000 and incorrect IOL power in 2001. CONCLUSION: Besides the most frequent complications of decentration and incorrect power observed in rigid IOLs,new complications associated with foldable IOLs occurred (e.g., optic opacification and calcification). Accurate calculation of IOL power and further improvements in material and design are still necessary to minimize the rate of explantations.

Acrylates↗

[Complications with foldable intraocular lenses with subsequent explantation in 1998 and 1999. Results of a questionnaire evaluation].

PURPOSE: A questionnaire was sent to all members of the German Society of Ophthalmic Surgeons to evaluate complications of foldable intraocular lenses (IOLs) that required explanation. METHODS: Information on preoperative visual acuity, foldable IOL design and material as well as the reason for IOL explantation was obtained and analysed. We received 167 completed questionnaires for 1998 and 1999. RESULTS: In 1998 and 1999 the most common reasons for IOL explantation were as follows: incorrect lens power for 56% of the 3-piece hydrophobic acrylic IOLs, 16% because of glare or other photic phenomena, 40% of the 1-piece hydrophilic acrylic IOLs were explanted because of incorrect lens power and 30% for IOL damage. For the 3-piece monofocal silicone IOLs, 41% were explanted because of incorrect IOL power and 32% because of IOL decentration. For the 1-piece Hydrogel IOL, 76% were explanted because of opacification of the optic and 14% because of incorrect lens power. Most multifocal IOLs were explanted because of photic phenomena. CONCLUSION: In addition to the most common complications such as decentration and incorrect IOL power observed in rigid IOLs, new complications associated with foldable IOLs occurred such as optic opacification, glare and photic phenomena. Some complications seemed to appear in particular IOL types (opacification: SC-60BOUV, MDR), while others were observed in all types of foldable lenses. Accurate calculation of the IOL power and further improvement of the IOL material and design seem to be necessary to minimise the rate of explantations.

Device Removal↗

[Guanethidine/dipivefrin and pilocarpine in the treatment of increased intraocular pressure].

Thirty patients with ocular hypertension or open-angle glaucoma were tested to see if, and to what extent, guanethidine/dipivefrin and pilocarpine produced a supplementary reduction in intraocular pressure. An equally marked additional lowering of pressure was achieved when patients who had been given guanethidine/dipivefrin over an extended period of time were additionally treated with one dose of pilocarpine 2%. The reduction in intraocular pressure was much more pronounced in patients who had been treated with pilocarpine 2% alone over an extended period of time, followed by a single dose of guanethidine/dipivefrin, than in those who had been treated first with guanethidine/dipivefrin and subsequently with pilocarpine.

Drug Therapy, Combination↗

[Metipranolol 0.1% and pilocarpine 2% as a fixed combination compared to each substance alone in the treatment of glaucoma. A controlled, randomized clinical study comparing the intraindividual effects and tolerance].

A fixed combination of pilocarpine 2% and metipranolol 0.1% was found to have a better pressure-lowering effect than pilocarpine 2% alone or metipranolol 0.1% alone, as well as being tolerated well, both subjectively and objectively. In many cases only the fixed combination was successful in lowering intraocular pressure to tolerable values.

Clinical Trials as Topic↗

[Local subjective tolerance of levobunolol and metipranolol in a double-blind comparative study in patients with increased intraocular pressure].

We evaluated the ocular comfort of 0.5% levobunolol hydrochloride and 0.6% metipranolol hydrochloride ophthalmic solutions in a randomized, double-masked, paired-comparison clinical trial. The drugs were given twice daily for 7 days to 16 patients with open-angle glaucoma or ocular hypertension. Patients rated comfort in terms of the severity of burning and/or stinging. For both drugs, the severity rating of ocular discomfort was low, averaging between 1 and 2 on a scale of 0-10. At initial and follow-up visits, the mean severity rating of burning or stinging with metipranolol was 2, slightly greater than the mean score of 1 with levobunolol. At 55% (26 of 47) of the patient visits, the patients rated levobunolol as more comfortable than metipranolol. Metipranolol (Betamann; Mann) was rated as more comfortable than levobunolol at only 9% (4 of 47) of the patient visits. The duration of burning and stinging was also rated as longer lasting with metipranolol treatment than with levobunolol (Vistagan; Pharma-Allergan) treatment. Although little ocular discomfort was reported for either drug, the majority of the patients tested rated levobunolol the more comfortable of the two drugs.

Clinical Trials as Topic↗

Long-term ocular hypotensive effect of levobunolol: results of a one-year study.

Data for the first 12 months are reported for an ongoing, multicentre, clinical study comparing the long-term, ocular hypotensive efficacy and safety of topical levobunolol (0.5% and 1%) and timolol (0.5%). This study was a double-masked trial testing 88 patients with chronic open angle glaucoma or ocular hypertension. During the 12-month period drops were instilled twice daily into both eyes after a washout of prestudy ocular hypotensive medication. The effect of the three treatments in reducing intraocular pressure (IOP) was similar. Mean IOP reductions over the 12 months averaged 7.2 mmHg for the 0.5% levobunolol group, 6.2 mmHg for the 1% levobunolol group, and 6.0 mmHg for the timolol group. Decreases in mean heart rate of up to 5 beats per minute were observed in the 0.5% levobunolol group, up to 8 beats per minute in the 1% levobunolol group, and up to 4 beats per minute in the timolol group. Several patients were removed from the study owing to side effects possibly related to levobunolol treatment.

Adult↗

A clinical evaluation of the effects of topically applied levobunolol and timolol on increased intraocular pressure.

Data from two short-term double-masked studies using 24 and 16 subjects suggest that topically applied levobunolol safely and effectively treats open-angle glaucoma and ocular hypertension. The onset of effect of a single drop of 0.5% levobunolol occurred within the first hour, producing a maximal hypotensive effect of more than 8 mm Hg after two hours. An intraocular pressure deceased of greater than or equal to 2 mm Hg was still observed after 24 hours for both concentrations of levobunolol tested (0.5% and 1%). Intraocular pressure decreases of more than 9 mm Hg persisted during a one-month trial in which patients were treated twice daily, confirming the results obtained in the 24-hour study. Systemic effects of both timolol (0.5%) and levobunolol (0.5% and 1%) included a consensual intraocular pressure-decreasing effect in the untreated eye and clinically significant reductions in heart rate. Diastolic blood pressure was decreased at two and four hours after administration of 0.5% levobunolol.

Administration, Topical↗

[Changes in intraocular pressure during prostaglandin-induced abortion (author's transl)].

Experimental animal studies have shown that local or systemic application of prostaglandin produces an acute increase in intraocular pressure. Investigations were carried out in 17 women undergoing prostaglandin-induced abortions to determine whether any changes in IOP occurred. In 16 of the patients there was no evidence of any effect; in the other one there was a transient moderate pressure elevation.

Abortion, Induced↗

[Anthocyanosides in the treatment of retinopathies (author's transl)].

Thirty-one patients with various types of retinopathy were investigated with regard to the effect of anthocyanosides on the retinal vessels. Especially in patients with diabetic retinopathy, a positive influence on the permeability and tendency to hemorrhage was observed. The importance of internal treatment of the primary disease is pointed out.

Adult↗

[Beta-blocking treatment (author's transl)].

Twenty-six patients with open-angle glaucoma were investigated to see if and to what extent topical treatment with timolol 0.5% produced systemic effects. All of the patient had contraindications to the systemic use of beta-blockers such as bradycardia, cardiac insufficiency and chronic obstructive pulmonary disease. In some patients the treatment had marked cardiovascular or pulmonary effects, especially in the group with chronic obstructive pulmonary disease.

Administration, Topical↗

[The effect of timolol and dipivalyl-epinephrine in the treatment of the elevated intraocular pressure (author's transl)].

Twenty-seven patients with ocular hypertension or open angle glaucoma were tested to see if, and to what extent, timolol and dipivalyl-epinephrine produced a supplementary reduction of intraocular pressure. In a shortterm study, 14 patients were tested with timolol (0.1%) and dipivalyl-epinephrine (0.25%). Simultaneous application of both substances produced a statistically more significant reduction of intraocular pressure than either timolol (0.1%) or dipivalyl-epinephrine (0.25%) alone. In 13 patients a comparison was made between patients who received both timolol (0.25%) and dipivalyl-epinephrine (0.1%) bis x and patients who received only timolol (0.25%) bis x over a period of 6, 9 and 12 weeks. Both substances used in combination produced a statistically more significant reduction in intraocular pressure than timolol (0.25%) bis x alone. The simultaneous application of an alpha and beta-adrenergic agonist and beta-adrenergic antagonist is not contradictory. The results are discussed on the basis of the mode of action of the applied substances.

Drug Therapy, Combination↗

[The effect of timolol and parasympathicomimetica in the treatment of the elevated intraocular pressure (author's transl)].

45 patients with ocular hypertension or open-angle glaucoma were tested to see if, and to what extent timolol and three other different parasympathicomimetics (pilocarpine 2%, carbachol 1.5%, aceclydine 2%) produced an supplementary reduction of the intraocular pressure. An equally marked, additional drop in eye pressure was achieved when patients who had been given timolol over an extended period of time, were additionally treated with one dose of pilocarpine 2% or carbachol 1.5%. Aceclydine 2% produced no statistically significant additional effect. Patients who had only been treated with pilocarpine 2% over an extended period of time and then were given one dose of timolol 0.25% produced a drop in eye presure more than double that of those patients who had been primarily treated with timolol and then received pilocarpine or carbachol. These results will be discussed on the basis of the mode of action of the applied medications.

Carbachol↗

[Timolol and acetazolamide in the treatment of increased intraocular pressure (author's transl)].

Twenty-four patients with open-angle glaucoma were tested to see if, and to what extent, timolol and acetazolamide produced a supplementary reduction of intraocular pressure. Twelve patients were treated with timolol eye drops, 0.5% b.d over a period of one week and then received one dose i.v. acetazolamide 250 mg which produced a statistically significant drop in intraocular pressure. Twelve patients with open-angle glaucoma who had been treated with acetazolamide 500 mg t.d.s. orally over a period of one week, received one drop of timolol 0.25% which produced a statistically significant additional effect. These results are discussed on the basis of the mode of action of the applied medications.

Acetazolamide↗