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Biomedical subjects

B E Frueh

Publications and source records attributed to B E Frueh.

At least 19 recordsLinked to original sources
PubMed2004

[First experience with amniotic membrane transplantation].

BACKGROUND: The purpose of this retrospective study was to analyze the outcome of amniotic membrane transplantation (AMT) performed at the University Eye Clinic Bern during the last 12 months. PATIENTS AND METHODS: Nine men (62.4 +/- 16.7 yrs.) and four women (78.3 +/- 22.3 yrs.) were treated with an AMT and grouped according to the ophthalmologic diagnosis: Group A, chronic corneal surface defect without limbal stem cell deficiency (n = 8); Group B, conjunctival fornix reconstruction (n = 7); Group C, filtering bleb defect (n = 2). RESULTS: 11/17 (65 %) AMT's performed in 14 eyes of 13 patients showed a favorable postoperative result after a mean follow-up time of 8.7 (+/- 2.9) months. In Group A (chronic corneal surface defect) 4/8, in Group B (conjunctival fornix defect) 7/7 and in Group C (filtering bleb defect) 0/2 showed an improvement of the basic ocular problem. 4/8 patients from Group A and 7/7 patients of Group B showed postoperatively a strong reduction of the ocular inflammation. CONCLUSIONS: In the present small study, favorable results were achieved in patients with chronic corneal surface defects without limbal stem cell deficiency and conjunctival fornix defects following AMT. In patients with fornix defects, the AMT seemed to be a valuable alternative to the more complicated transplantation of mouth- or nose mucous membrane. The two eyes with filtering defects failed.

Adult↗
PubMed2004

[Retrospective analysis of deep lamellar keratoplasties].

BACKGROUND: Purpose of this retrospective study was to analyse the outcome of deep lamellar keratoplasty. PATIENTS AND METHODS: The records of 9 patients with deep lamellar keratoplasty were reviewed. Age, sex, systemic diseases, indication for surgery, pre- and postoperative visual acuity and findings, visual acuity and findings at last follow-up and complications were noted. RESULTS: Nine eyes of 9 patients have been operated with the "big bubble" technique described by Anwar. Indications for operation were keratoconus (4), keratoglobus (1), central corneal scar after keratitis (3) and after alkali burn (1). In 3 cases the intraoperative technique had to be changed to penetrating keratoplasty. The preoperative visual acuity was 0.2 to 0.3. All 9 patients showed a postoperative improvement of visual acuity: best corrected from 0.3 to 0.8. In one eye particles in the interface were found. At last follow-up all grafts were clear. There were no postoperative complications. CONCLUSIONS: The results demonstrate that deep lamellar keratoplasty is a technically difficult procedure, in 3 out of 9 patients the operation method failed. The postoperative course after deep lamellar keratoplasty did not show any severe complications. The patients who had to be changed to penetrating keratoplasty were not disadvantaged in respect of the final result (visual acuity and findings). The postoperative visual acuities after deep lamellar keratoplasty and after penetrating keratoplasty were comparable. Despite the small number of patients and the relatively short observation period, we noticed that after deep lamellar keratoplasty the sutures could tendentially be removed earlier and thus the duration of topic steroids therapy was shorter compared to penetrating keratoplasty.

Adult↗
PubMed2001

[Surgical correction of refractive errors].

This article reviews operation techniques and indications for the surgical correction of ametropia. The author also explains and lists the anomalies of refraction. The limitations of the methods as well as open questions for the future are discussed.

Humans↗
PubMed2000

Prospective, randomized clinical evaluation of Optisol vs organ culture corneal storage media.

OBJECTIVE: To compare the outcome of penetrating keratoplasty with the use of corneas stored either in Optisol (Chiron Ophthalmics, Irvine, Calif) or in organ culture. METHODS: Penetrating keratoplasty was performed on 12 pairs of patients matched by age and diagnosis. Each pair of procedures was done on the same day by the same surgeon using the same technique. Twelve pairs of corneas were used. One cornea of each pair had been stored in organ culture at 36 degrees C and one in Optisol at 4 degrees C. Mean (+/-SD) storage time was 6+/-3 days. Mean endothelial cell density before storage was 2617/mm(2) for the corneas in organ culture and 2624/mm(2) for the corneas in Optisol. Examinations were performed at 1, 4, 12, and 24 months. RESULTS: One reversible rejection occurred in the Optisol group. At 1 month the mean endothelial cell density was 2327+/-341/mm(2) for the organ culture group and 2240+/-504/mm(2) for the Optisol group. At 12 months the difference was more pronounced (2225+/-410 and 2103+/-466/mm(2), respectively), although statistically not significant. Corneal thickness also did not show any statistically significant difference. CONCLUSION: Penetrating keratoplasty performed with corneas stored for a maximum of 11 days in either Optisol or organ culture show similar outcomes in the first 2 postoperative years. Arch Ophthalmol. 2000;118:757-760

Adult↗
PubMed2000

Treatment of postkeratitis fusarium endophthalmitis with amphotericin B lipid complex.

PURPOSE: The authors report the first case of Fusarium solani keratitis that progressed to fungal endophthalmitis and was successfully treated with amphotericin B lipid complex (ABLC). METHOD: The case of a 34-year-old immunocompetent woman who developed a contact lens-related F. solani keratitis requiring emergency penetrating keratoplasty (PKP) was analyzed. The immunocompetent patient developed fungal endophthalmitis (anterior chamber tap positive for F. solani three months after PKP) and was eventually treated with ABLC. RESULTS: Systemic amphotericin B (total, 0.42 g) and ketoconazole in addition to topical natamycin and amphotericin did not prove to be effective in eradicating the mycosis in the anterior chamber. Under ABLC treatment (total, 8.79 g), the anterior chamber inflammation resolved completely. No recurrence was observed during an 11-month follow-up after treatment was discontinued. CONCLUSION: ABLC proved to be effective in treating F. solani endophthalmitis. It is an important addition to the ophthalmic armamentarium, and appeared to be a better therapeutic agent than standard amphotericin B in this patient.

Adult↗
PubMed1999

Eyelid, conjunctival, and corneal findings in sleep apnea syndrome.

OBJECTIVE: To determine the prevalence of eyelid, conjunctival, and corneal findings in patients with sleep apnea syndrome (SAS). DESIGN: Case series. PARTICIPANTS: Seventy-two white patients referred for evaluation of suspected SAS. INTERVENTION: Complete examination of eyelids, conjunctiva, and cornea, including videokeratography. MAIN OUTCOME MEASURES: Spearman rank correlations were determined between the respiratory disturbance index (RDI) during night sleep, a value used to diagnose and grade SAS, and tear film break-up time, eyelid distraction distance, presence or absence of ocular irritation symptoms, blepharoptosis, floppy eyelids, lacrimal gland prolapse, keratoconus, and endothelial dystrophy. Each correlation was controlled for age and body mass index. RESULTS: According to the RDI, 44 (61 %) of the 72 patients had SAS. The RDI correlated positively with the eyelid distraction distance (P = 0.05), presence or absence of floppy eyelids (P = 0.01), and lacrimal gland prolapse (P = 0.01), and correlated negatively with tear film break-up time (P = 0.02). None of our patients with floppy eyelids had corneal abnormalities. One patient with SAS had bilateral keratoconus; another had bilateral Fuch endothelial dystrophy. CONCLUSIONS: Sleep apnea syndrome was significantly associated with reduced tear film break-up time, floppy eyelids, and lacrimal gland prolapse. However, ocular irritation symptoms and corneal involvement were rare among patients with SAS. These findings do not confirm previous studies that reported a high prevalence of corneal involvement in floppy eyelid syndrome.

Adult↗
PubMed1999

Oversized grafts.

Explore the source record for details and available documents.

Child, Preschool↗
PubMed1999

[Central corneal diseases].

BACKGROUND: Central corneal pathologies can lead to an irreversible decrease of best corrected visual acuity if not diagnosed and treated appropriately. This article reviews the differential diagnosis of central corneal opacities in the newborn, of central infectious corneal ulcers, and the therapy of sterile, central keratolysis. MATERIAL AND METHODS: Authors' personal experience and review of the literature. RESULTS: Flow charts for diagnosis and treatment strategy have been elaborated. CONCLUSIONS: Corneal opacities in newborns create an emergency situation. In order to treat successfully and avoid or diminish amblyopia, it is imperative to rule out congenital glaucoma. The aetiology of central corneal ulcers should always be confirmed by positive cultures to be able to treat specifically. When the standard topic therapy fails, one has to consider rare bacteria, parasites, virus, or patients' compliance. The treatment of central sterile keratolysis in rheumatoid arthritis must be intensive and immunosuppression has to be performed early enough in the course of prevent the formation of a descemetocoele or spontaneous corneal perforation.

Arthritis, Rheumatoid↗
PubMed1999

In vivo confocal microscopy of fleck dystrophy.

PURPOSE: To use in vivo confocal microscopy to evaluate corneas with fleck dystrophy. METHODS: Both eyes of three patients with corneal fleck dystrophy were examined with a scanning slit confocal microscope. Corneal epithelium, stroma, and endothelium were evaluated, as well as the basal epithelial and stromal nerves. RESULTS: The epithelium did not show any anomalies, but the basal nerves showed hyperreflective inclusions. Throughout the entire stroma, hyperreflective dots of various shapes were seen. These consisted mostly of spherical matter with a diameter of 3-5 microm and were sometimes enclosed in cyst-like structures. The majority of the stromal cells and stromal nerves appeared normal. The endothelial cell layer was unaffected. CONCLUSION: In vivo confocal microscopy demonstrates previously unreported inclusions in the basal nerves of fleck dystrophy corneas. In addition to this new finding, the study confirms earlier histopathologic reports, demonstrating accumulation of pathologic material in the stromal cells.

Adult↗
PubMed1999

Eye injuries caused by cow horns.

PURPOSE: To assess ocular injuries caused by cow horns; to investigate clinical findings, treatment, and visual outcome in a population of dairy farmers; and to propose possible preventive measures. METHODS: A retrospective review was conducted to identify patients seen over a 45-month period with cow horn-inflicted eye injuries. Eleven patients were identified and their charts reviewed for demographics, mechanism of injury, initial and final visual acuity, surgeries performed, and anatomic outcome. RESULTS: The mean age of the patients was 64 years. Seven patients had open-globe injuries with vitreous hemorrhage. In five cases, pars plana vitrectomy was performed. Final best-corrected visual acuity was < or = hand motion in five patients, between 20/160 and 20/80 in three patients, and better than 20/32 in three patients. CONCLUSION: The majority of the cow horn injuries studied caused severe permanent impairment of vision. Owing to the blunt nature of the horns, a significant amount of energy is imparted into the eye. To prevent these injuries, coagulation of the horns should be performed 2 weeks after a calf's birth or farmers should be advised to wear safety glasses.

Accidents, Occupational↗
PubMed1998

In vivo confocal microscopy after photorefractive keratectomy in humans. A prospective, long-term study.

OBJECTIVE: To assess corneal morphological characteristics in vivo after photorefractive keratectomy (PRK) in humans. METHODS: Eighteen eyes were examined before and after PRK by means of in vivo confocal microscopy. Epithelial, stromal, and endothelial morphological characteristics were recorded. Minimum follow-up was 12 months. RESULTS: Immediately after PRK, the anterior stroma showed marked intercellular edema. At 1 month, fine linear structures were noted in the anterior stroma and midstroma, and a thin hyperreflective scar was present. The linear structures and the scar tissue were more marked at 4 months but were still present up to 26 months. Anterior stromal keratocyte density increased significantly 1 and 4 months after PRK, whereas midstromal and posterior keratocytes and endothelial cell densities did not change. Basal epithelial nerves were recognizable as early as 1 month after PRK. Contact lens-related microdots in the stroma remained unaffected. CONCLUSIONS: The stromal linear structures represent a finding that is detectable only by confocal microscopy at high magnification, is not related to previous contact lens wear, and is still visible 26 months after PRK. The extension of these structures as far as the midstroma indicates that the permanent corneal changes caused by PRK affect deeper stromal layers than the immediate subepithelial region.

Adult↗
PubMed1997

Transplantation of congenitally opaque corneas.

AIMS: To assess retrospectively the prognosis and complications of corneal grafting for congenital opacities. METHODS: Fifty eight eyes of infants and young children with congenital corneal opacities were studied retrospectively. Preoperative diagnoses included sclerocornea (27 eyes), Peters' anomaly (17 eyes), partial sclerocornea (12 eyes), and congenital glaucoma (two eyes). Penetrating keratoplasty was performed between 5 days and 65 months of age with a mean follow up of 40 (SD 29) months. RESULTS: The overall success (including regrafts) was 70% in eyes with sclerocornea, 83% for partial sclerocornea, and 100% for Peters' anomaly. However, 23 eyes had to be regrafted between 2 weeks and 110 months postoperatively. The probability of maintaining a clear graft, calculated by survival analysis, was 75% (SE 6%) at 1 year and 58% (7%) at 2 years for the entire group. Complications included cataract development (12 eyes), secondary glaucoma (14 eyes), epithelial defects (six eyes), band keratopathy (five eyes), retinal detachment (three eyes), wound leakage (two eyes), retrocorneal membrane (one eye), and microbial keratitis (two eyes). CONCLUSIONS: It is concluded that corneal grafting for congenital opacities in infants has an excellent potential for long term survival and should be performed as early as possible for unilateral as well as bilateral involvement. The postoperative course is complex and often requires regrafting.

Child, Preschool↗
PubMed1995

[Confocal microscopy of the cornea in patients with diabetes].

PURPOSE: To investigate with confocal microscopy the cornea of diabetics type I and II. MATERIAL AND METHODS: Thirty eyes of 10 patients with diabetes mellitus type I, 10 with d.m. type II, and 10 of controls were entered in the study. Eyes with corneal or anterior segments pathologies were excluded. In-vivo corneal morphology was studied using a confocal microscope. RESULTS: Cell density of basal epithelial cells, anterior stromal keratocytes, and endothelial cells did not differ significantly between the groups. In the diabetic groups polymorphy of both epithelial and endothelial cells was noted. Abnormal stromal nerves were also noted in 2 cases. DISCUSSION: Our findings support previous studies on corneal epithelial and endothelial morphology in diabetic patients. The corneal stroma appears to be affected only in its nerves, although in few cases.

Adult↗