Biomedical subjects

D E Möller

Publications and source records attributed to D E Möller.

16 recordsLinked to original sources

PubMed2004

Application of sterilised human amnion for reconstruction of the ocular surface.

BACKGROUND: Despite improved surgical techniques and the use of new medication, healing of corneal and conjunctival defects cannot always be achieved. In this connection the clinical use of human amnion, produced by different techniques, has represented a successful alternative for the past ten years. The purpose of the present investigation was the development of a clinically secure, therapeutically efficient, and easy-to-handle (transport, storage, application) allogenic amnion transplant. PATIENTS AND METHODS: A new method for an amnion preparation, which contains a sterilisation process in peracetic acid and a drying process in a laminar flow cabinet, was developed as an alternative to previous techniques described in the literature. Amnion transplantation was used to treat 41 patients, 36 of them with corneal ulcer. Further indications for amnion transplantation were symblepharon, descemetocele, as well as dehiscence of conjunctiva after cerclage. RESULTS: Seventy-three percent of cases showed postoperative improvement evidenced by constant vision, while 15 percent showed decreased vision. CONCLUSIONS: The study confirms the observations of previous investigators who consider amnion transplantation an efficient therapeutic method for a multitude of eye diseases. The new method described in this report, guarantees patients' safety by using a validated new sterilisation process against infections that can be transmitted by human tissue. At present this method constitutes the only process available in Germany, and is approved by the Federal Institute for Drugs and Medical Products (BfArM) for the manufacture of human amnion transplants as a finished medical product.

Adult↗

PubMed2004

The influence of different preservation and sterilisation steps on the histological properties of amnion allografts--light and scanning electron microscopic studies.

Despite thorough donor screening and preparation under aseptic conditions, conventional methods of preservation do not exclude the probability of a contamination with pathogenic germs. The purpose of this study was to investigate the changes of histological parameters of amnion transplants (ATs) through different methods of sterilisation and preservation. Therefore 10 different procedures for sterilisation and preservation of ATs were described. Specimens of each group were studied using different histological procedures such as light microscopy and scanning electron microscopy. General staining (Haematoxylin-eosin stain, periodic-acid-Schiff, Domack) and immunohistochemical methods have been applied in order to gain additional information concerning the structure of the amniotic epithelium and the basement membrane but also the distribution of collagens and intermediate filaments. Furthermore, the measurement of the ATs thickness was included in order to study the influence of the manufacturing procedures to this property. As a result we found that the histological appearance of the ATs is closely related to the applied sterilisation and preservation procedures. Although the basement membrane remained intact, especially the amniotic epithelium was partially destroyed by irradiation sterilisation. Further, the dissolution of the connective tissue layers into single fibre bundles was clearly visible. Procedures with and without peracetic acid sterilisation (PAA) preserved the tissue structure. Our results showed a significant variation in the tissue's thickness after different preservation procedures. Air- and freeze-dried ATs were found to be the thinnest tissues varying from 20 to 30 microm, the thickest ATs preserved in glycerol varied from 45 to 50 microm. Because ATs showed a preserved tissue structure after PAA sterilisation it can be recommended as an alternative for methods previously described in literature. Depending on the specific use of the AT one may choose from thinner or thicker allografts.

Amnion↗

PubMed2000

[Pupil physiology after cataract surgery].

BACKGROUND: The goal of a cataract operation is to achieve an optimal outcome, which includes a round and functioning pupil. The goal of this study was to analyze the influence of cataract operations on pupils that appear to be normal on slit-lamp examination postoperatively. PATIENTS AND METHODS: A videopupillography was performed on 47 eyes of 47 patients after phacoemulsification without complications in the first eye, and on 12 eyes of 12 patients after phacoemulsification without complications in the second eye. RESULTS: After surgery, the first eyes showed a significantly more constricted pupil compared to the non-operated eye independently of the stage of irritation. After surgery of the second eye, this was only observed under near dark conditions. CONCLUSION: Even the morphologically normal pupil shows a change in motility postoperatively. We believe that the reason for this is the mechanical manipulation of the iris during cataract operation. During this, the sensitive dilator muscle of the pupil is affected, leading to temporary or permanent changes in pupillary function. The change in motility of the contralateral, non-operated eye cannot be easily explained. The pupil size is important for the visual process and alteration of its function allows an evaluation of the quality of the operation.

Humans↗

PubMed2000

[Eye complications in 458 children with rheumatoid arthritis].

BACKGROUND: Besides arthritis or other systemic manifestations, endogenous inflammation (most commonly uveitis) can be a symptom of rheumatoid arthritis in children. The uveitis of children shows certain differences compared to that in adults. This study will show these differences and their incidences. PATIENTS AND METHODS: Retrospective analysis of the histories of 458 children that were admitted to the pediatric clinic due to rheumatism related diseases. An analysis of the general and pediatric data, laboratory results and therapy were combined with the ophthalmologic data. RESULTS: 45 (9.8%) of the 458 patients suffered from uveitis at least once during the studied time period between 1992 and 1996. Most common complications of the therapy were clouding of the lens up to full cataract (in both eyes in eight out of nine patients). Seven patients underwent cataract operation. Further complications are synechiae, band shaped keratopathy, secondary glaucoma and retinal diseases. CONCLUSION: Since the pediatric uveitis usually does not take an acute course and since children rarely can articulate themselves precisely, a regular ophthalmologic examination of pediatric rheumatology patients is necessary, as well as every uveitis in children should warrant pediatric-rheumatologic diagnostics. The impact of uveitis is much more severe for children when compared to adults, since it not only endangers the vision but the whole development of the child.

Age Factors↗

PubMed1996

[Color Doppler ultrasound of the temporal arteries--a new method for diagnosing temporal arteritis].

BACKGROUND: Recently increasing attention has been paid to temporal arteritis which is not a very rare disease. Early establishment of the diagnosis and start of therapy can reduce serious visual complications. PATIENTS AND METHODS: The temporal arteries of 10 patients with temporal arteritis, 8 patients with polymyalgia rheumatica, and 23 controls were investigated with a high resolution ultrasound system, measuring size of lumen and wall as well as blood flow velocity. RESULTS: Colour doppler sonography of the superficial temporal artery showed a characteristic hypoechoic halo around the perfused lumen of an often stenosed or occluded artery. Neither patients with polymyalgia rheumatica nor controls had this hypoechoic halo. The halo disappeared 10-14 days after start of therapy with glucocorticoids. CONCLUSIONS: We think that colour doppler sonography of the temporal arteries is a simple, quick, and non-invasive method to diagnose temporal arteritis. When there will be more experience, sensitivity and specificity of the method can be defined. Perhaps sonography might replace biopsy in some cases in the future.

Aged↗

PubMed1996

Laser Scheimpflug videography.

Conventional Scheimpflug photography uses slits with a constant width of 80 microns. This parameter limits the resolution as sharp contours are imaged with a basic uncertainty. In order to reduce this basic uncertainty we developed an illumination slit with a width of 20 microns and less, using a green helium-neon laser (543 nm). With this slit, much sharper imaging of ocular contours can be achieved. Since this illumination is coupled to on-line videographic detection of the Scheimpflug image, any adjustment of the target is done under visual control at the monitor. Using this device, the slope of a densitogram of contrasted contours (for example the corneal surfaces) is steeper, which guarantees a more accurate detection of corneal thickness and curvature.

Cornea↗

PubMed1992

[Local mitomycin C therapy after excision of pterygium].

In order to prevent recurrence of pterygium after excision we treated 21 patients postoperatively with Mitomycin-C-eye drops 0.02%. In a mean follow up of 1 1/2 years, we have not seen any recurrence or side effect. We conclude, Mitomycin-C 0.02% is a safe, simple and effective treatment to prevent recurrence of pterygium and we suggest to continue for a further experience.

Combined Modality Therapy↗

PubMed1973