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Biomedical subjects

E Mehdorn

Publications and source records attributed to E Mehdorn.

At least 19 recordsLinked to original sources
PubMed1995

[No-stitch tunnel incision vs. corneoscleral incision. A prospective, randomized study].

An important factor in early visual recovery after cataract surgery is surgically induced astigmatism. In a randomized clinical trial we compared the development of astigmatism and visual acuity after three different types of incision and suture techniques. Sixty-seven patients were randomized into three groups: (a) scleral tunnel incision (5 mm) without suture (no stitch) (n = 23) (b) scleral tunnel incision (5 mm) with suture (single stitch) (n = 23) (c) corneoscleral incision (5 mm) with suture (CS suture) (n = 21). Implants: 5 mm optic size; follow-up period: 6 months. There was no statistically significant difference among the 3 groups concerning age distribution and preoperative astigmatism. Postoperative follow-up at day 1, weeks 1, 2, months 1, 4 and 6 showed astigmatic values ranging from 0.84 to 1.41 D (means values, vector analysis; differences not significant: P > 0.10). The surgically induced astigmatism ranged from 1.13-1.74 D (differences not significant P > 0.16). At all follow-up dates the mean uncorrected distance acuity did not differ significantly among the three groups (P > 0.35). No quantitative statistically significant differences could be detected among the three incision and suture techniques.

Aged↗
PubMed1994

[Night driving capacity of pseudophakic patients].

One hundred pseudophakic patients (aged 62.1 +/- 10.8 years) were examined for glare sensitivity and contrast vision, using the Mesoptometer II, 15.8 +/- 9.8 months after implantation of monofocal intraocular lenses. The patients were tested in order to determine whether they met the requirements of the German Ophthalmological Society (DOG) for the granting of a driver's license. The patients were divided into three groups: (1) pseudophakic bilaterally (n = 50), (2) pseudophakic in one eye with phakic contralateral eye (n = 25), and (3) pseudophakic in one eye with cataract in contralateral eye (n = 25). There were no differences between the groups in corrected distance acuity (ANOVA, P = 0.17). Fifty-two percent of the patients did not fulfill the requirements of the DOG (group 1 50%, group 2 24%, group 3 84%). In groups 1 and 2 the binocular results for glare sensitivity and contrast vision were significantly better than the monocular results (P < 0.001). In group 3, however, there was no difference between binocular and monocular results (P > 0.3). In 20% of patients in this group the binocular results were worse than the monocular results. Results for both contrast vision and glare sensitivity were significantly related to age. Overall, this population of pseudophakic patients were 40-50% less suited to night driving than were healthy volunteers with normal eyes.

Aged↗
PubMed1993

Depth of focus and functional results in patients with multifocal intraocular lenses: a long-term follow-up.

We did a follow-up study of 35 patients who had phacoemulsification with implantation of diffractive, multifocal intraocular lenses (IOLs) 2.5 years ago. The patients had an average age of 58.2 +/- 9.6 years. Fifty multifocal IOLs were implanted (3M 815LE, n = 45; 3M 825X, n = 5). Refractive values, visual acuity, depth of focus, and the dependence on corrective glasses were evaluated. Eighty percent of the spherical equivalents ranged from -1 to +1 D (mean 0.25 +/- 0.71). In 76% the cylindric power was not higher than 1 D (mean 0.87 +/- 0.64). With distance correction, 100% of the patients achieved a visual acuity of 20/40 or better. Without correction, 86% achieved 20/40 or better. Near acuity of 20/40 or better with only distance correction was achieved in 98% of patients. Ninety-four percent had a near acuity of 20/40 or better without any correction. The depth of focus was significantly better in the multifocal group than in a control group of patients with monofocal IOLs (P < .01). Although 90% of the patients had good uncorrected visual acuity results of 20/40 or better for near and distance, 58% preferred glasses for distance and/or near.

Accommodation, Ocular↗
PubMed1993

[Pseudo-accommodation of diffractive multifocal lenses and monofocal lenses].

35 patients were examined for their pseudoaccommodation 6 to 18 months after cataract extraction and implantation of a diffractive multifocal intraocular lens (MIOL). While in 15 patients a MIOL had been implanted in both eyes 20 patients had a MIOL in one eye only. 45 type 3M 815 LE and 5 3M 825 XE lenses were implanted. The mean age was 58.2 years +/- 9.6 years (33 to 76). Only patients without any pathology except cataract and preoperative refractive errors < +/- 5 diopters of spherical and +/- 1 diopter of astigmatic refraction were eligible for implantation of MIOLs. After estimation of the objective and subjective refraction the patients' pseudoaccommodation was measured by testing their visual acuity, adding lenses of +/- 1, 2, 3, 4, 5 diopters to their best distance correction. All patients with MIOLs reached a visual acuity of 0.4 or better with a maximum peak at 0 and -3 diopters. The visual acuity of the MIOL patients was significantly better in the range of -1 to -4 diopters compared to the results of a control group of patients with monofocal IOLs. This suggests a wider range of pseudoaccommodation in patients with MIOLs.

Accommodation, Ocular↗
PubMed1993

[What is new in neuro-ophthalmology? Diagnosis, therapy and patient education in optic nerve neuritis].

The diagnosis of optic neuritis is based on clinical signs and symptoms. Ancillary testing is of little medical value, but helpful to evaluate the risk of developing multiple sclerosis and for proper counseling of the patient. The visual field defects caused by optic neuritis are less often central, but most often altitudinal or sectorial, and thus of little help to differentiate between papillitis and anterior ischemic optic neuropathy. In contrast to common belief, the usual therapy with oral prednisone at an initial dose of 100 mg/day may be harmful. This therapy does not accelerate recovery of visual function and does not lead to a better final result but increases the risk of new episodes of neuritis and may favour the development of multiple sclerosis. In the case of severe visual loss (visual acuity < or = 0.1) a megadose-therapy with 1000 mg methylprednisolone/day accelerates the recovery of visual function. Side effects of the megadose therapy are infrequent and not severe. In the case of moderate visual loss (visual acuity > or = 0.5) no therapy is advocated.

Clinical Trials as Topic↗
PubMed1993

[Long-term results of contrast perception and glare sensitivity in patients with diffraction multifocal lenses].

OBJECTIVE: To test the longterm findings for glare and contrast sensitivity in patients with diffractive multifocal intraocular lenses. STUDY DESIGN: Measurements were done using the Mesoptometer II under standardized contrast level and brightness illumination settings (0.032 and 0.1 cd/m2 brightness illumination for testing contrast sensitivity (0.1 cd/m2 brightness illumination and glare of 0.35 Lux for glare testing). Furthermore the patients were tested on their ability to fulfill the requirements of the German Ophthalmological Society (DOG) for mesopic vision to obtain a driver's license. PATIENTS: 40 patients with multifocal intraocular lenses (MIOL), aged 59.3 +/- 9.1 years, were examined 2 years after lens implantation (3M 815 LE and 3M 825 XE) and compared to results of a control-group of 40 patients with monofocal IOL's. RESULTS: There were no significant differences testing contrast sensitivity. Patients with monofocals, however, reached significant better results than patients with multifocals (p < 0.01) when tested for visual acuity under low contrast conditions and glare sensitivity. CONCLUSIONS: Seventy percent of MIOL-patients and 56% of Monofocal-patients failed to meet the minimum requirements for driver's license. Both patient groups showed decreased values for glare and contrast sensitivity when tested 2 years after cataract surgery.

Adaptation, Ocular↗
PubMed1993

Carotid artery disease in vascular ocular syndromes.

We prospectively investigated 83 consecutive patients with vascular ocular syndromes: 19 suffered from amaurosis fugax attacks, 23 had occlusions of the central retinal artery or a branch retinal artery occlusion, 26 had a central retinal vein occlusion or a branch retinal vein occlusion, and another 15 exhibited an anterior ischemic optic neuropathy. In 5 patients bilateral symptoms occurred; thus a total of 88 eyes were affected. All patients underwent a neurological examination and ultrasound investigations of the carotid arteries, including continuous wave (cw)-Doppler-sonography and duplex ultrasound. Stenosis of more than 50% diameter reduction and occlusion of the internal carotid artery ipsilateral to the symptomatic eye were significantly more frequent in amaurosis fugax attacks and central or branch retinal artery occlusion than in central or branch retinal vein occlusion or anterior ischemic optic neuropathy (p < .025). Additionally, the analysis of plaque surface and echogenicity of the plaques on the affected side with a high-resolution duplex scan uncovered that ulcerated plaque surfaces and plaques with a heterogeneous echogenicity were found significantly more frequent in the internal carotid arteries of patients with amaurosis fugax attacks and central or branch retinal artery occlusions than in patients with anterior ischemic optic neuropathy (p < .04) or central and branch retinal vein occlusion (p < .025). We conclude that amaurosis fugax attacks and central retinal artery or branch retinal artery occlusions are due to arterio-arterial embolization from ulcerated and heterogeneous carotid artery plaques.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

Low-tension glaucoma: a comparative study with retinal ischemic syndromes and anterior ischemic optic neuropathy.

In low-tension glaucoma (LTG), nerve-fiber-bundle defects are assumed to result from ischemia of the choroidal branches of the posterior ciliary arteries, due either to local vascular changes or, presumably, hemodynamically occlusive carotid artery disease. To study the possible hemodynamical origin of LTG, we examined and compared, clinically and by ultrasound (continuous-wave Doppler and duplex-scanning), the extracranial carotid arteries of (1) 21 patients (34 eyes) with LTG, (2) 48 patients (49 eyes) with retinal ischemic syndromes (RIS), and (3) 15 patients (17 eyes) with anterior ischemic optic neuropathy (AION). High-grade stenoses and occlusions of the internal carotid arteries ipsilateral to the affected eyes were significantly more frequent in the RIS patients (17 of 49) than in the LTG patients (2 of 34; P < .01) and the AION patients (0 of 17; P < .01). Among our relatively small group of LTG patients, we found no striking evidence supporting a hemodynamic origin of LTG.

Aged↗
PubMed1990

[Megadose steroid therapy in papillitis with progressive visual loss].

A megadose steroid therapy with 1000 mg methylprednisolone i.v. per day given for several days was tried in two patients with papillitis, in whom a progressive visual loss had been observed for two weeks. In both cases a prompt and extensive recovery occurred. In two additional patients with progressive visual loss caused by papillitis megadose steroid therapy could not be given because of oto-rhinological and dental contraindications. Based on the assumption that the rapid recovery observed after the megadose steroid therapy of neuritis may have resulted essentially from an antiedematous effect, a purely antiedematous treatment with infusions of mannitol was given. In both patients visual acuity returned as promptly as in the patients treated with megadose steroids. These four observations together with reports of the literature indicate that the megadose steroid therapy, and perhaps a purely antiedematous therapy, are of potential benefit in selected cases of papillitis with progressive and severe loss of vision.

Dose-Response Relationship, Drug↗
PubMed1990

[Circulatory disorders of the retina and optic nerve].

Amaurosis fugax and retinal artery occlusion are mainly caused by emboli originating from the carotid arteries and the heart. Ischemic ophthalmopathy is the result of severe carotid or ophthalmic artery stenosis. Retinal vein occlusions probably develop if the venous outflow is hampered or if blood viscosity is increased. Optic nerve infarction is now regarded as a localized disease of the small vessels. In all circulatory disorders of the retina and the optic nerve a careful medical and neurologic-angiologic work-up is mandatory. For arterial occlusions of the retina or the optic nerve, no therapy is available so far that has unequivocally proven effective. In retinal vein occlusion it has been definitely shown that photocoagulation can prevent ocular complications. The hemodilution therapy for arterial or venous circulatory disorders is as yet not generally accepted since studies are lacking that fulfill the hard criteria of modern therapeutic trials. New data about the risk of cerebral ischemia and survival of patients with ocular circulatory disorders, as well as a critical analysis of the risk and benefit of vascular surgery, have led to a considerable decrease in surgery and favor the medical prevention of stroke.

Humans↗
PubMed1990

[Drusen papilla with vision disorder and pathologic visual evoked potentials].

Six cases of optic nerve head drusen ophthalmoscopically are reported. Five of these had pathological latencies of the P 100 potentials on VEP examination. Only three of the patients had subjective visual complaints; all six, however, had variable visual field defects. Optic nerve head drusen are an important differential diagnosis, which can be readily established especially in those younger patients who need neurological and ophthalmological examination because of visual disturbances and pathological VEP responses.

Adult↗
PubMed1989

Suppression scotomas in primary microstrabismus--a perimetric artefact.

Static perimetry with stereoscopic targets, "stereo-perimetry", was performed on eight patients with primary microstrabismus to find out how strabismic subjects see under natural conditions, i.e. how they ordinarily make use of their squinting eye. In all cases, suppression scotomas were detectable using dissociating perimetric techniques. By means of stereoperimetry, however, the scotomas were not detectable. On the contrary, stereo-acuity was always best in the center of the suppression scotomas. This result indicates that suppression scotomas of the microstrabismic subjects examined here represented perimetric artefacts. In microstrabismic patients, the cooperation of the deviated eye in the central visual field is probably much better than has previously been thought.

Adolescent↗
PubMed1989

[Trans-scleral ciliary body coagulation with the neodymium:YAG-cw-laser in secondary glaucoma].

Transscleral coagulation of the ciliary body was performed by means of the continuous wave Neodymium: YAG laser in 39 eyes with various types of secondary glaucoma that was not controlled by medical therapy. Three days later, the mean intraocular pressure measured 54% of the pre-laser pressure; 3 months later it was 52%, 6 months later 47%, and 12 months later 58%. In 11 of 14 eyes (78.6%) treated in an attempt to preserve the remaining visual function, the pressure proved to be under control (less than or equal to 20 mmHg) 6 months after treatment. Major complications, such as hyphema or bleeding into the vitreous, were rare (7/39) and occurred only in the eyes with neovascular glaucoma.

Ciliary Body↗