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C Erb

Publications and source records attributed to C Erb.

72 records · Page 4Linked to original sources
PubMed1996

Retrospective long-term follow-up of the triple procedure (combined keratoplasty and cataract surgery).

PURPOSE: Combined keratoplasty and cataract surgery has been performed at the University Eye Clinic in Tübingen since the nineteen-seventies. The present study was carried out to evaluate the long-term efficacy of this procedure. MATERIAL AND METHODS: Only grafts that had been followed for at least 4 years (6.5 +/- 2.3) were included. We studied the clinical outcome and final visual acuity of 19 patients (mean age 70 +/- 8.4 years) who had undergone "triple procedure surgery" on 23 eyes at the University Eye Clinic in Tübingen between 1983 and 1991. RESULTS: The keratoplasty was the first for 20 eyes and a regraft procedure in three. The mean diameter of the donor buttons was 7.31 +/- 0.4 mm, that of the host transplants 7.17 +/- 0.4 mm. Intra-operative complications included four vis a tergo reactions and one instance of bleeding in the anterior chamber. The most frequent postoperative complications were astigmatism (61%) and secondary glaucoma (4.3%). Postoperatively, six of the affected eyes required additional surgery. Preoperative visual acuity (0.06 +/- 0.08) improved postoperatively to 0.4 +/- 0.26, which was statistically significant. The postoperative retinal vision was 0.5 +/- 0.2. CONCLUSION: The results demonstrate the long-term success of the triple procedure. It can be especially recommended for patients in reduced general health who require rapid visual rehabilitation.

Aged↗
PubMed1996

[An analysis of 148 outpatient treated occupational accidents].

BACKGROUND: The most common eye injuries are non-perforating. Eye injuries in the workplace are a major cause of socioeconomical damage, morbidity and disability, despite well publicised standards for industrial eye protection. This study investigates the epidemiological and clinical aspects of 148 occupational cases. PATIENTS: At the University Eye Clinic of Tübingen, 709 non-perforating eye injuries were registered as occupational accidents between 1995 and 1996. Of these cases, 148 were analysed retrospectively per random. RESULTS: The 5 most common injuries of 148 patients (m/f = 138/10; mean age 33.4 +/- 12 years) were related to corneal foreign body injuries (35%), chemical burns (15.5%), sub-conjunctival foreign bodies (12%), thermal/ultraviolet injuries (11%) and contusions (7.4%). Of these patients, 22.3% were employed as construction workers and 16.2% as metal workers. At the time of examination the visual acuity of the traumatic eye was 0.9 +/- 0.3. The interval between the beginning of work and accident was 6.2 +/- 6.4 hours in average (0.5-13.5 h). Of all accidents, 8.5% were caused during the first hour of work; in contrast 45.5% of all accidents were caused after 6 hours of work. Another 12.4 +/- 14.5 hours (5min.-72 h; median 7 h) passed by until the patients arrived for eye examination at the Eye Clinic of Tübingen. Only 6% of all patients arrived within the first hour, and 29.7% after 12 hours. Of all cases, 30.4% received first-aid treatment in their company by the factory doctor or by the eye doctor before examination at the Eye Clinic. Only 6.8% of all patients had protective spectacles during work. Incapacity was seen in 30.4%; the average in total was 5.5 +/- 10 days. CONCLUSION: Despite the late examination at the Eye Clinic the functional loss was mostly little except after chemical burns. Nevertheless, most occupational accidents can be avoided with better protective devices in order to reduce the incidence of injuries and socioeconomical damage. Therefore an intense campaign about protective devices at the place of employment should be required. We conclude that education about safety glasses in the workplace by tradespeople and trades assistants during tasks for which goggles are recommended could considerably reduce the rate of occupational eye traumata. The data of the University Eye Clinic of Tübingen are useful to identify strategies to prevent eye injuries such as wider and better use of safety glasses and improvement in engineering controls.

Accidents, Occupational↗
PubMed1995

Sudden increase in intraocular pressure as an initial manifestation of myelodysplastic syndrome.

PURPOSE/METHODS: We studied a rare initial manifestation of myelodysplastic syndrome in an 82-year-old woman who had acute secondary glaucoma in the right eye and mature cataracts in both eyes. RESULTS/CONCLUSION: Therapy with glaucoma control medications and cataract extraction in the right eye resulted in expulsive hemorrhage and subsequent enucleation of the right eye. After cataract extraction, examination of the left eye disclosed a central serous retinal detachment and hemorrhage. Histopathologic analysis of the right eye demonstrated myelocytic and lymphocytic infiltration.

Aged↗
PubMed1995

The Tübingen Glaucoma Study. Glaucoma filtering surgery--a retrospective long-term follow-up of 254 eyes with glaucoma.

A major focus of our study was the ability to predict the long-term success of filtering surgery. The results of glaucoma filtering surgery (trabeculectomy) as performed by the staff of the University Eye Hospital of Tübingen from 1988 through 1994 on 254 eyes of 214 patients are presented, with particular emphasis being placed not only on intraocular pressure (IOP) control but also the progression of glaucomatous damage (visual field loss or disc damage) and the etiology of visual acuity losses. There was an overall success rate of 64%. Rigid criteria for success included an IOP of less than 30 mmHg, no further visual field loss or disc damage, and no glaucomatous etiology for a decrease in visual acuity. A total of 35 eyes (13.8%) showed a loss of visual acuity after 6 months amounting to 2 or more Snellen lines, caused mainly by lens opacification, hypotony maculopathy, and "wipeout" (loss of the central visual field in the absence of another explanation). We found that there is a considerable risk for sudden loss of visual acuity after operation on older patients with small residual visual fields and severe hypotony on the 1st postoperative day. There was a 13% incidence of failure of blebs. A total of 34 eyes had an early IOP rise of more than 30 mmHg after surgery. A postoperative hypotony of less than 3 mmHg was more significantly seen in patients treated with 5-fluorouracil. Moreover, the results show that in some instances, a long-term use of topically applied glaucoma medication can adversely affect the results of fistulizing surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[Keratoplasty à chaud].

Between 1980 and 1992 we performed 128 keratoplasties à chaud on 69 (54%) eyes with progressive bacterial and on 59 (46%) eyes with progressive herpetic keratitis. In 44 of the eyes the corneas were spontaneously perforated, and in 28 (22%) a descemetocele was present. Only grafts that had been followed for at least 1 year (3.2 +/- 2.4 years) were analyzed. During this time 88 (95%) of the severely threatened eyes were preserved. In the operated eyes visual acuity improved in 20 (54%) in the bacterial and in 36 (69%) in the herpetic group. The main complications were immunological allograft rejection, cataract progression and recurrence of herpes. Allograft rejection occurred in 29 (71%) of the bacterial grafts and remained irreversible in 18 (44%) cases. 30 (63%) eyes in the group with herpetic corneal lesions developed graft rejection, 19 (37%) of these rejections were irreversible. Cataract occurred in the postoperative course in 25 (61%) of the bacterial eyes and in 23 (44%) of the herpetic ones. Recurrence of herpes presented a specific problem in this group and appeared in 12 (23%) of the grafts during a follow-up of 1 month to 12 years (3.8 +/- 2.4 years). Our results demonstrate that keratoplasty à chaud is a valuable form of managing urgent pathological processes of the cornea and shortening the course of the disease. This procedure also allows satisfactory primary functional results in many cases, however, secondary re-keratoplasty and cataract surgery are necessary to achieve functional rehabilitation.

Adolescent↗
PubMed1995

Ophthalmomyiasis externa due to the sheep botfly Oestrus ovis (Diptera: Oestridae) in southwest Germany.

We present a case of ophthalmomyiasis externa in a 54-year-old man in southwest Germany (Baden-Württemberg). After the patient had been attacked by a fly, he complained of a foreign-body sensation and itching in his right eye and developed purulent conjunctivitis. Slit-lamp examination revealed the presence of translucent, rapidly moving insect larvae in the conjunctival sac and on the corneal surface. Following removal of all larvae and instillation of gentamicin, the symptoms completely resolved within 2 days. Two of the nine larvae removed were examined by light microscopy and taxonomically classified as first-instar larvae of the sheep botfly Oestrus ovis L. 1758. Although this fly is the most common causative agent of external ophthalmomyiasis in the world, infestations in central Europe have only rarely been reported. Besides the case report and a detailed description of the larvae, an overview of the literature on European cases of ophthalmomyiasis externa caused by Oestrus ovis is given.

Animals↗
PubMed1994

[Reconstruction with free jejunal graft after pharyngo-esophageal resection for cancer: functional results and survival].

57 patients with cancer of the hypopharynx underwent 59 pharyngo-esophageal reconstructions with a free jejunal graft after total removal of a tumor combined with resection of the circumferential tissues. 18 patients had been previously irradiated. Median resumption of oral intake was 16 days; 40 out of 50 patients (98%) followed for more than 2 years regained normal eating habits. The cumulative 5-year survival rate was 44%. The free jejunal graft should be advocated as a safe and reliable procedure for hypopharyngeal cancer.

Adult↗
PubMed1993

[Stromal iris cyst].

A 50-year-old female developed a cyst of the iris stroma in her right eye. Because of slight enlargement within 10 weeks sector iridectomy was performed. Histology showed that the cyst was lined by a cellular layer resembling conjunctival or corneal epithelium. The benign clinical course (normal function, normal intraocular pressure and no recurrence after 4 years) and the intrastromal rather than epistromal localization hold evidence for a spontaneous origin. Spontaneous cysts of the iris stroma especially in adults are rarely described in the literature. The question still to be answered is whether these lesions are really spontaneous in origin or whether they represent only an intraocular epithelial invasion due to an occult perforation of the eye.

Cysts↗
PubMed1993

[Psychiatric manifestations in patients with primary open-angle glaucoma].

In a comparative study, 21 in-patient and 27 out-patients with primary open-angle glaucoma and 18 cataract patients were investigated to determine whether psychiatric symptoms were more frequent in patients with primary open-angle glaucoma. In all three groups we used Beck's Depression Inventory, the Zerssen Symptom List and the Maudsley Personality Inventory. In addition, in the case of the glaucoma in patients we applied the unsteadiness Test, the Social Interview Schedule and a psychiatric interview. Two-thirds of the glaucoma inpatients showed psychiatric symptoms, had higher scores for depression and psychosomatic complaints and had reduced emotional stability. The glaucoma out-patients had statistically significantly high scores for psychosomatic complaints. The control group showed normal scores in all tests. The present tests seem to pick up psychiatric symptoms in patients with primary open-angle glaucoma. Therefore, we can recommend them as an aid to orientation in hospital and private practice.

Adaptation, Psychological↗
PubMed1989

Sodium bicarbonate cotransport in cultured pigmented ciliary epithelial cells.

Uptake of 22Na+ was studied in cultured bovine pigmented ciliary epithelial cells (PE) in HCO3-containing media. Two components of Na+-uptake were stimulated by intracellular acidification (NH4+-prepulse): One was amiloride-sensitive, the other DIDS-sensitive. The amiloride-sensitive component of Na+-uptake probably represents Na+/H+-exchange, which has previously been characterized in PE. The second, DIDS-sensitive component stimulated by intracellular acidification, was Cl- and HCO3--dependent. We conclude that a stilbene-sensitive, Cl--dependent Na+-HCO3--cotransport is present in PE. This transport could play an important role in aqueous humor formation.

4,4'-Diisothiocyanostilbene-2,2'-Disulfonic Acid↗
PubMed1989

Coupling of 22Na and 36Cl uptake in cultured pigmented ciliary epithelial cells: a proposed role for the isoenzymes of carbonic anhydrase.

Uptake studies with 22Na and 36Cl were performed in cultured bovine pigmented ciliary epithelial cells (PE) to investigate interdependence of Na+ and Cl- transport. (1) 22Na uptake into NaCl depleted cells was stimulated by Cl-. This stimulation was abolished by the simultaneous application of amiloride (1 mM) and bumetanide (0.1 mM), indicating two independent mechanism for Cl- stimulated Na+ uptake: loop diuretic sensitive Na+/Cl- symport and an indirect stimulation of Na+/H+ exchange by Cl-. The latter component of Cl- stimulated Na+ uptake was HCO3- dependent. (2) 36Cl uptake was increased by extracellular Na+. Na+-stimulated Cl- uptake also consisted of two components. One was bumetanide sensitive and the other was blockable by amiloride and partly inhibited by the carbonic anhydrase (CA) inhibitor methazolamide (0.1 mM). (3) Homogenized PE cells were tested for biochemical CA activity using an electrometric method. The cytoplasmic as well as the membrane fraction contained specific CA activity. (4) A model is presented for Na+ and Cl- transport into PE: in addition to Na+/Cl- symport, Na+/H+ and Cl-/HCO3- double exchange may operate in the ciliary epithelium. The latter mechanism provides NaCl uptake into the cell in exchange for H+ and HCO3-, which recycle as CO2 across the membrane. This recycling of CO2 and HCO3-/H+ (and hence indirectly NaCl uptake) is facilitated by the cooperation between membrane bound and cytoplasmic CA.

Amiloride↗
PubMed1989

[Carbonic anhydrase and its function in ion transport in cultivated pigmented ciliary body epithelial cells].

The effect of inhibitors of the carbonic anhydrase on aqueous humor formation suggests that carbonic anhydrase has an important role in ion transport across the ciliary epithelium. We therefore investigated the role of carbonic anhydrase in Na+ and Cl- transport in cultured bovine pigmented ciliary epithelial cells (PE) using the radioactive isotopes 22Na and 36Cl. Our findings can be summarized as follows. (1) Na+ uptake into the cell occurs via an amiloride-sensitive Na+/H+ exchanger. (2) Cl- is transported into the cell in exchange for bicarbonate ions. (3) PE cells contain biochemical carbonic anhydrase activity. (4) Na+ uptake into NaCl-depleted cells is markedly stimulated by Cl-. This stimulation is HCO3- dependent and is completely blocked by amiloride and partly inhibited by the carbonic anhydrase inhibitor methazolamide. (5) A model is introduced for transport of NaCl in the ciliary epithelium: carbonic anhydrase is responsible for coupling of Na+/H+ exchange and Cl-/HCO3- countertransport. This model could explain the effect of carbonic anhydrase inhibitors on intraocular pressure.

Animals↗
PubMed1987

Halothane and enflurane metabolite elimination during anaesthesia in man.

Ten patients received 0.75% halothane and 12 received 1.5% enflurane for 1 h in a 50:50 nitrous oxide/oxygen mixture. Plasma and end-tidal concentrations were measured by gas-liquid chromatography (GLC) using the head-space method. Fluoride ion assay was performed with a specific electrode by HPLC, trifluoroacetate and oxalate ion levels were determined after extraction, by GLC. Comparison of the evolution of the non-metabolized forms showed that enflurane was more rapidly eliminated: by the third hour after starting, enflurane plasma concentrations were 3.6 micrograms ml-1 compared with 6.3 micrograms ml-1 for halothane. Fluoride plasma levels were nearly constant in the halothane group, but a significant increase up to 14.9 microM was observed in the enflurane group. The ratio of 10:1 in peak urinary concentrations was linked to the molecular structure and the metabolic pathways.

Adult↗