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Biomedical subjects

D Uthoff

Publications and source records attributed to D Uthoff.

At least 19 recordsLinked to original sources
PubMed1998

Secondary implantation of scleral-fixated intraocular lenses.

PURPOSE: To evaluate the results of a large series of secondary implantations using scleral-fixated posterior chamber intraocular lenses (IOLs). SETTING: Bellevue Eye Hospital, Kiel, Germany. METHODS: This retrospective review comprised 624 consecutive patients who had secondary implantation of a posterior chamber IOL with scleral fixation between 1988 and 1995. All patients had been aphakic for at least 1 year. An ab interno or ab externo suture technique through the ciliary sulcus was used. Visual outcome and complications 1 year after surgery were determined. RESULTS: Best corrected visual acuity improved or remained unchanged in 92.0% of eyes; 8.0% lost one or two lines. Intraocular lens decentration of more than 1.5 mm occurred in 1.9% of eyes. Suture erosion was observed in 17.9%, cystoid macular edema in 5.8%, retinal detachment in 1.4%, and vitreous hemorrhage in 1.0%. Severe uveitis occurred in 0.5%. CONCLUSION: Secondary IOL implantation with scleral fixation was a safe procedure. Although there was a small risk of significant complications, more than 90% of patients regained or improved their preoperative visual acuity.

Aphakia, Postcataract↗
PubMed1994

Retrobulbar (intraconal) anesthesia with a curved needle: technique and results.

We report the results of two prospective studies of retrobulbar anesthesia using curved 25 mm and 28 mm needles. These studies were prompted by our experience with the 25 mm needle in more than 13,000 cases of intraconal anesthesia in which one case of postoperative ischemic neuropathy was the only complication. The technique involves the transcutaneous introduction of the curved needle at the middle of the lower lid, following a curved track close to the inferior orbital wall, around the globe, parallel to the plane of the medial orbital wall (i.e., in a strictly sagittal plane lateral to the optical axis in primary gaze). No complications were noted in the prospective studies. Side effects were chemosis in 30% of cases, subconjunctival hemorrhage in 5%, and lid hemorrhage in 2%. Since these comparative studies, we have used the 28 mm needle without significant complications in more than 8,000 cases. This method of retrobulbar anesthesia is superior to peribulbar anesthesia, and because of its safety and reliability, is preferable.

Aged↗
PubMed1994

[Fine structure of conjunctival lymphatic vessel valves].

BACKGROUND: Lymphatic valves are due to ensure a zentripetal flow of lymph. The majority of the authors regard these valves as bicuspid structures with joint insertion points of the downstream localized free valvular edges. Because of that valvular structure a retrograde flow of lymph is impossible. Observations of our own however demonstrated retrograde flow of fluid under physiological conditions. In the following paper the structure of conjunctival lymphatic valves should be investigated or rather those structures, which were regarded as valves hitherto. Are there segmental connections, which allow retrograde flow of lymph? Is a regulation of lymph flow possible without self-acting valves? MATERIALS AND METHODS: In the conjunctiva of bovine post-mortem eyes (n = 100) segmental connections of lymphatic vessels with a diameter of less than 1 mm were opened specifically under control of slit lamp microscope after having undertaken an interstitial double contrast lymphography (solution of Berliner Blue/air). Some of these preparations (n = 20) could be investigated further on with the scanning electron microscope. That procedure allowed to make the patterns of flow and vessels structures in the beginnings of the lymphatic system observed with the slit lamp microscope congruent with those structures shown by the scanning electron microscope. RESULTS: The following segmental connections could be demonstrated: 1. Lymphatic vessels, which flow like a pipe into the wall of another segment. 2. Laterally arranged oval connections with valve resembling an aperture. 3. Segments of lymphatic vessels arranged in a line, which flow into one another between two hump-shaped protrusions with bicuspid valvular structures. Also the existence of different connecting structures ("valves") in one segment ("gear segment") were observed. In bulbus-like segmental connections arranged one behind the other with two valvular leaflets it could be demonstrated by scanning electron microscopy, that the two leaflets were attached apart at the vessel wall. That divergence to the previous models of lymphatic valves means, that these valvular leaflets cannot work as self-acting valves and prevent retrograde flow. CONCLUSIONS: However according to the valveless model of Libau a directed regulation of flow is possible. Perhaps the valvular structures described above play an important part by the interaction between the endothelium of lymphatic vessels and the substances transported in the lymph. The variety of segmental connections, the network of vessels with different diameters, which seem to be connected by feed-back, demand a new way of looking at the initial lymph flow.

Animals↗
PubMed1994

Cicatricial ectropion in ichthyosis: a novel approach to treatment.

Four kinds of ichthyosiform dermatoses have been described. Only lamellar ichthyosis or ichthyosis congenita is associated with the development of ectropion and subsequent eye symptoms. Conservative treatments have been tried but surgical correction of the ectropion was ultimately required for symptomatic relief. Autografts have been used successfully, provided an available donor site can be found. Grafts taken from the arm, eyelids, postauricular skin, and groin have been used with success. An uncircumcised youth with total body involvement from ichthyosis developed bilateral upper and lower ectropion. The penile foreskin was the only possible suitable donor site because it seemed unaffected by the disease. A circumcision was performed and the foreskin divided into four separate full-thickness skin graft triangles to treat the four-lid ectropion. There was successful resolution of the eye symptoms and a watertight closure. To our knowledge, this is a unique case in which penile foreskin has been used to correct cicatricial ectropion.

Adolescent↗
PubMed1990

[Saccular initial segments of the lymphatic vessel system].

It is commonly said that the lymphatic system begins "blindly" as saccular outpocketings. In order to examine these saccular outpocketings, 120 injections into the conjunctival lymphatics of 60 bovine postmortem eyes were carried out, measuring the level of injection pressure and simultaneously documenting the various filling stages photographically. 20 trials were selected for further analysis. We recorded low initial pressures when the tip of the needle was situated close to a larger lymphatic vessel and the coloured solution (1% aqueous Berliner Blue) as possibly applied intravascularly. Higher initial pressures were seen on positioning inside fine networks of vessels. Extremely high initial pressures without any visible filling of vessels but in the presence of simultaneously increasing depots of dye were probably caused by absent or insufficient connection between the tip of the needle and a vessel. During lymphography numerous coarser and finer, tube-like projections (saccular outpocketings) filled, from which further progression of the coloured solution could only be observed when higher injection pressures were applied. We were able to prove that such segments had connections to neighbouring vessels as well as forming plexus of their own. Based on our findings we have reason to doubt the existence of tube-like initial segments in the lymphatic system. Rather in the conjunctiva of the bovine eye this system has the structure of a fine network where tube-like segments can be demonstrated as temporary filling stages.

Animals↗
PubMed1987

[Endocapsular cataract surgery and endocapsular artificial lens implantation].

This paper describes a simple procedure for endocapsular cataract extraction followed by implantation of an artificial lens with endocapsular fixation. The special instruments required, as well as a new endocapsular artificial lens, are also described. The advantages of this safe and gentle procedure are pointed out and the author's experience in 4700 cases is communicated.

Cataract Extraction↗
PubMed1986

[Preoperative preparation for cataract operation in artificial lens implantation].

A method of producing ocular hypotony, a decrease in motility, sufficient akinesia of the facial nerve as well as deep analgesia is described. This procedure seems to be more comfortable for the patient and preferable for the surgeon because it is safe. It consists of a single retrobulbar injection using a high-capacity syringe and oculopression at a higher pressure with a special instrument over a period of 20 minutes. The advantage of this method, some theoretical information, and the author's experience with it are communicated.

Anesthesia, Conduction↗
PubMed1986

[Klippel-Feil syndrome and status dysraphicus].

Apart from the obligatory symptoms of Klippel-Feil syndrome (short neck, low hairline on nape, limited rotation of the head) many other so-called facultative dysraphic impairments may be found. The most common is spina bifida, which is the prototype of the "dysraphia syndrome". Therefore, Klippel-Feil syndrome belongs to a heredo-degenerative constitution type of "status dysraphicus".

Humans↗
PubMed1986

[Behçet syndrome].

Behçet's syndrome is described on the basis of historical facts taken exclusively from original papers, and considering especially those symptoms which are usually neglected. The differentiation of certain symptom-oriented subforms such as angio-Behçet, arthro-Behçet, entero-Behçet, neuro-Behçet, pneumo-Behçet, and uro-Behçet gives a better understanding of this syndrome and also stresses the fact that many fields of medical activity are concerned with it. The historical facts show that ophthalmology and dermatology share the credit for having identified this syndrome.

Behcet Syndrome↗
PubMed1985

[Clinical findings following a 32-year wearing time of a Ridley artificial lens].

Clinical pathological findings 32 years after implantation of an artificial lens by Ridley himself are described. Changes were found in the cornea, anterior chamber, chamber angle, iris, retropupillary space, posterior segment and vitreous. The possible reasons for these complications are discussed and the clinical course is described.

Aged↗
PubMed1985

[Kaposi's sarcoma and AIDS].

Kaposi's sarcoma occurs as a complication in numerous cases of AIDS, the much-discussed acquired immune deficiency syndrome. Considering the latter's near-epidemic incidence, the clinical and histological features of Kaposi's sarcoma are recalled to mind. Hitherto only sporadically recorded in non-African countries, the disease is now more frequently observed also in the USA and Central Europe. In textbooks of ophthalmology Kaposi's sarcoma has so far been grossly neglected. Therefore, on the basis of historical facts taken exclusively from original papers, Kaposi's sarcoma is reconsidered with special reference to ophthalmological aspects.

Acquired Immunodeficiency Syndrome↗