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C Schnyder

Publications and source records attributed to C Schnyder.

26 records · Page 2Linked to original sources
PubMed1994

[Re-evaluation of the role of argon laser trabeculoplasty in therapy of glaucoma].

BACKGROUND: The pressure lowering effect of Argon laser trabeculoplasty (ALT) has been well demonstrated in the past. Today some clinicians tend to avoid ALT perhaps because it has been used in erroneous indications. The aim of this study was to re-evaluate the usefulness of ALT and to define its indication in the treatment of glaucoma. PATIENTS AND METHODS: A collective of 81 patients treated by ALT entered in a data bank between 1989 and 1991 were analysed retrospectively, focussing on: the percentage of patients requiring trabeculectomy (TE) after ALT, the mean time from ALT to TE, the stage of disease progression at which the decision for ALT was taken and the post-ALT evolution of ocular pressure (IOP), visual field and optic disc. RESULTS: After a mean follow-up of 28 +/- 10.5 months a TE was performed in 25% of cases. It was found that in our clinical practice the decision for ALT tended to be taken at a rather late stage of disease. For the patients that did not need a TE, the mean decrease of IOP at the end of follow-up was 5.4 mm Hg and the analysis of glaucoma parameters showed that there was no significant worsening of disease. The disease progression in the group of patients that were operated was already significantly worse than the total collective before ATL was performed. CONCLUSIONS: ALT is useful in the treatment of glaucoma, as long as it is not considered as an alternative to TE and as long as the patients benefit from a strict follow-up. Advanced cases should however be operated without delay.

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PubMed1993

Anti-inflammatory effect of diclofenac drops after argon laser trabeculoplasty.

Using a laser flare-cell meter, the anti-inflammatory effect of diclofenac sodium drops was evaluated after argon laser trabeculoplasty in a double-masked placebo-controlled study. Fifty-three eyes with pseudoexfoliative (43 eyes) or pigmentary glaucoma (10 eyes) were randomly assigned to treatment (n = 27) or placebo (n = 26) groups. Diclofenac (0.1%) or placebo drops were administered once before and after trabeculoplasty and then four times daily for a total of 4 days. Visual acuity, intraocular pressure, and anterior chamber flare, measured with the laser flare-cell meter, were evaluated before trabeculoplasty, 3 and 6 hours after trabeculoplasty, and 1, 2, 4, 7, and 14 days after trabeculoplasty. Flare increase after argon laser trabeculoplasty was completely blocked by 0.1% topical diclofenac and the mean of maximal flare increases was reduced significantly in the diclofenac group. Therefore, 0.1% diclofenac drops represent a very efficient anti-inflammatory therapy after argon laser trabeculoplasty.

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PubMed1992

[Anti-inflammatory effect of topical diclofenac sodium (Voltarène Ophta) after argon laser trabeculoplasty: preliminary results of a prospective double-blind method].

Using the laser flare-cell meter (LFMC), we have previously determined the intensity and pattern of post-ALT ocular inflammation. Inflammation peak occurs 48 hours after ALT and clinically relevant inflammation is seen in 100% of pigmentary glaucomas (PIG), 75% of pseudoexfoliative glaucomas (PEXG) but only in 25% of primary open angle glaucomas (POAG). We also showed that topical diclofenac reduced inflammation in all 17 treated patients. Prostaglandins are thought to play a major role in ALT-inflammation and it is therefore logical to assume that NSAID are effective in that situation and will probably advantageously replace corticosteroids. In order to assess the anti-inflammatory effect of diclofenac drops (Voltaren Ophtha) we included a total of 37 PIG or PEXG (19 in the diclofenac and 18 in the placebo group) scheduled for ALT in prospective randomized placebo-controlled study. Visual acuity, tonometry, and LFCM flare measure were performed before, 3, 6 hours, 1, 2, 4, 7, 14 days after ALT. Topical diclofenac or placebo was given before and after ALT and then QID for a total of 4 days. Mean maximal flare increase was significantly less in the diclofenac group than in the placebo group (4.6 +/- 3.8 ph/msec v. 17.4 +/- 19 ph/msec; p less than 0.01). Flare increase compared to pre-ALT values was significant at 1 and 2 days after ALT in the placebo group only (p less than 0.02; p less than 0.05); no significant flare increase occurred in the diclofenac group.(ABSTRACT TRUNCATED AT 250 WORDS)

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PubMed1985

[The use of low-dose amitriptyline in psychogeriatrics. A clinical, pharmacokinetic and pharmacogenetic study].

Two groups of six depressive psychogeriatric patients (age 69-93) have been treated for three weeks with either 25 mg or 50 mg of amitriptyline (AT) per day. Before the beginning of the treatment and after 8, 15 and 22 days of medication, the patients (7 outpatients and 5 hospitalized patients) underwent various psychopathological tests (Hamilton, Crichton) and biochemical investigations, i.e. clinical chemistry and hematology, analyses of AT and nortriptyline (NT), in the plasma. In some subjects the hydroxylated metabolites and the binding of these substances to plasma proteins were also measured. Except one patient, all responded favourably to the treatment. No difference between the two doses has been observed as regards their clinical efficacy and incidence of side effects. The plasma levels of AT and NT were below those generally recommended in the literature. The monitoring served to identify some cases of noncompliance and, in one patient, a deficiency of hydroxylation of AT, confirmed by the debrisoquine test. These results suggest that the "therapeutic window" needs redefinition and that low-dose medication with antidepressants is indicated in a psychogeriatric population.

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