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Biomedical subjects

Ferenc Kuhn

Publications and source records attributed to Ferenc Kuhn.

At least 19 recordsLinked to original sources
PubMed2006

Intracranial migration of silicone oil from an eye with optic pit.

BACKGROUND: The origin of subretinal fluid in eyes with optic pit remains controversial. METHODS: Case report. RESULTS: The authors found that silicone oil, implanted into an eye that developed proliferative vitreoretinopathy after surgery for optic pit-related macular detachment, has migrated into the subarachnoid space. CONCLUSIONS: As this case shows, cerebrospinal fluid may migrate into the submacular space in eyes with optic pits.

Adolescent↗
PubMed2006

Epidemiology of blinding trauma in the United States Eye Injury Registry.

PURPOSE: To analyze the epidemiology and clinical characteristics of serious eye injuries leading to legal blindness. METHODS: Analysis of information on 11,320 eyes in the United States Eye Injury Registry (USEIR) database. Legal blindness in this study was defined as visual acuity of worse than 20/200. RESULTS: No less than 27% of eyes with serious injury had < 20/200 final vision, although the rate varied greatly with injury type. Several risk factors were found to statistically significantly increase the chance of eye trauma resulting in blindness: age over 60 years, injury by assault, sustained on street/highway, or occurring during fall or by gunshot. Trauma to the left eye carried a statistically significantly poor prognosis as did two injury types, rupture and perforating. Involvement of the posterior segment was another factor indicating poor outcome; in particular, vitreous hemorrhage, retinal detachment, choroidal rupture, and endophthalmitis were found to increase the risk of blindness. Conversely, young age, contusion and intraocular foreign body injuries, among others, signaled a better than average chance of good outcome. Overall, 60.5% of injured eyes showed visual improvement after treatment. CONCLUSIONS: This large study identified multiple risk factors whose presence significantly increases the chance of the injured eye becoming "legally blind." Continued efforts to improve treatment and develop/implement prevention measures based on risk analysis should reduce the incidence of blinding trauma.

Adult↗
PubMed2005

Glaucoma following penetrating ocular trauma: a cohort study of the United States Eye Injury Registry.

PURPOSE: To evaluate associations between baseline structural and functional ocular characteristics and the risk of developing posttraumatic glaucoma after penetrating ocular injury. DESIGN: Prospective cohort study. METHODS: Data from the United States Eye Injury Registry (USEIR) were obtained from a total of 3,627 patients who experienced penetrating ocular injury. The risk of posttraumatic glaucoma and associated structural and functional ocular risk factors was estimated. RESULTS: The risk of developing posttraumatic glaucoma was 2.67%. The development of glaucoma was independently associated with several baseline characteristics including advancing age (relative risk 1.02/yr 95% confidence interval [1.00, 1.03]), lens injury (1.56 [1.03, 2.35]), poor baseline visual acuity (2.59 [1.62, 4.14]), and inflammation (3.02 [1.52, 6.02]). CONCLUSIONS: This study provides an estimate for the risk of developing glaucoma after penetrating ocular injury in a large cohort of patients and determined several factors that are significantly associated with the development of post-traumatic glaucoma, including advancing age, lens injury, poor visual acuity, and intraocular inflammation.

Adult↗
PubMed2005

Glaucoma after ocular contusion: a cohort study of the United States Eye Injury Registry.

PURPOSE: This cohort study was designed to evaluate risk factors for the development of posttraumatic glaucoma after ocular contusion. METHODS: Data from the United States Eye Injury Registry (USEIR) were obtained from a total of 6021 patients who experienced blunt ocular contusion. Logistic regression was used to evaluate the association between these baseline structural and functional ocular characteristics and posttraumatic glaucoma. Odds ratios with 95% confidence intervals were obtained. RESULTS: The 6-month incidence of developing posttraumatic glaucoma was 3.39%. The development of glaucoma was independently associated with: advancing age (OR = 1.02; 95% CI = 1.02, 1.03), visual acuity worse than 20/200 (OR = 1.92; 95% CI = 1.19, 3.10), iris injury (OR = 1.60; 95% CI = 1.05, 2.44), lens injury (OR = 1.86; 95% CI = 1.11, 3.11), hyphema (OR = 2.23; 95% CI = 1.40, 3.54), or angle recession (OR = 1.71; 95% CI = 1.00, 2.90). CONCLUSION: This study provides an estimate for the risk of developing glaucoma after ocular contusion in a large cohort of patients and has determined several independently predictive factors that were significantly associated with the development of posttraumatic glaucoma including poor initial visual acuity, advancing age, lens injury, angle recession, and hyphema.

Adult↗
PubMed2005

Determination of significant parameters for eye injury risk from projectiles.

BACKGROUND: Eye injuries affect a large proportion of the population and are expensive to treat. This article presents a parametric analysis of experimental data to determine the most significant factors for predicting ocular injuries or tissue lesions. METHODS: Using logistic regression, statistical values were generated to determine significant projectile characteristics for predicting ocular injury in published studies. Projectiles included BBs, metal rods, and foam particles with velocities ranging from 2 m/s to 122 m/s. RESULTS: A normalized energy (energy per projected area) value was found as the best predictor for ocular injury. Using this predictor, a 50% injury risk of corneal abrasion, lens dislocation, hyphema, retinal damage, and globe rupture was found to be 1,503 kg/s(2), 19,194 kg/s(2), 20,188 kg/s(2), 30,351 kg/s(2), and 23,771 kg/s(2), respectively. CONCLUSION: Normalized energy was the most significant predictor of injury type and tissue lesion. This finding is of great value for history-taking management triaging and as a design aid to minimize the risk of ocular injury for consumer products.

Confidence Intervals↗
PubMed2004

Vitrectomy with internal limiting membrane removal for clinically significant macular oedema.

BACKGROUND: Little has been published on internal limiting membrane (ILM) removal for clinically significant macular oedema (CSME) in eyes not improving following maximal laser treatment. METHODS: Retrospective review of the charts and intraoperative video films of 30 consecutive eyes of 27 patients undergoing vitrectomy, ILM peeling, and gas tamponade by a single surgeon. RESULTS: The average patient was 52 years old; 56% were males. The oedema was caused by diabetes in 87% of the eyes, 42% of which had proliferative disease. The oedema was diffuse in 16 eyes (53%) and cystoid (CME) in 14 (47%). In 21% of eyes, spontaneous vitreous detachment was present or the eye had already undergone vitrectomy. All but one eye had at least 6 months of follow-up (mean 12 months). The oedema resolved completely in 26 eyes (90%) and partially in 3 eyes (10%). The visual acuity improved at least two Snellen lines in 19 eyes (66%) and one line in 4 eyes (14%); the average improvement was 4 lines. The acuity was unchanged in three eyes (10%) and worsened in three eyes (10%), all due to cataract. Among the 14 eyes with CME, 11 (79%) became completely dry and the visual acuity improved in 11 eyes (79%). No ILM-related complication was encountered in any eye. CONCLUSIONS: Vitrectomy with ILM peeling is a promising approach to eyes with CSME. It appears to offer visual improvement at a much higher rate than laser therapy and with a longer-lasting effect than that of intravitreal triamcinolone. A larger study is necessary to confirm these preliminary findings.

Adolescent↗
PubMed2004

Damage control surgery in ocular traumatology.

There seems to be no decrease in the incidence of serious eye injuries. Although recent developments in technology now allow salvage of eyes that would have been lost only a few years ago, certain rules must be followed to achieve optimal outcome. Damage control surgery in ocular traumatology means that the ophthalmologist understands that eye injuries must be treated only after life-threatening conditions have been properly addressed by other specialists. Focusing on the injured eye, the ophthalmologist evaluates the types and severity of the trauma, and designs a management plan. Wounds should be cleaned and closed, infections treated and prevented, the retina reattached; however, conditions that do not require immediate intervention are usually better treated following a few days of delay, during which intense corticosteroid therapy is administered. The second, reconstructive surgery is typically performed 7-10 days postinjury, when the risk of intraoperative haemorrhage is dramatically reduced and the chance of visual rehabilitation is higher.

Critical Care↗
PubMed2003

Internal limiting membrane removal for macular detachment in highly myopic eyes.

PURPOSE: To present a treatment option for highly myopic eyes developing retinal detachment over a posterior staphyloma. DESIGN: Interventional case report. METHODS: Pars plana vitrectomy with peeling of the internal limiting membrane and gas tamponade; no laser retinopexy. RESULTS: Retinal reattachment with marked visual improvement. CONCLUSIONS: It appears that the rigid internal limiting membrane is responsible for the retina's inability to conform to the posterior staphyloma. Intraoperative findings suggest that this rigidity may also play a role in subsequent macular hole development. Internal limiting membrane removal should be considered in eyes with retinal detachment over a posterior staphyloma, whether or not a macular hole is present.

Aged↗
PubMed2002

Birmingham Eye Trauma Terminology (BETT): terminology and classification of mechanical eye injuries.

Lacking a standardized terminology of eye injury types, it is impossible to fulfill a very basic requirement in medicine: that all communications be unambiguous. Accurate interpretation of published research results, which plays an absolutely crucial role in determining how an individual patient with an eye injury is treated, becomes difficult. This article presents an internationally standardized system that finally allows accurate description of eye injuries of all types.

Alabama↗
PubMed2002

Epidemiology and socioeconomics.

Ophthalmologists should be responsible for a systemic collection of standardized data on the occurrence of eye injuries. Such a database is the key for designing prophylactic measures to successfully prevent ocular trauma. The USEIR model, whether reporting takes place over the Internet [www.USEIRonline.org www.WEIRonline.org (worldwide)] or on paper, has proved to be an efficient epidemiological tool. Use of this model in different countries has allowed making unbiased comparisons between regions or countries, highlighting injury patterns that may be different in different geographical areas, and pinpointing areas where prophylaxis (through legislation and public campaigns) appears most effective. Participation of all ophthalmologists who evaluate/treat patients with serious eye trauma is strongly encouraged.

Eye Injuries↗
PubMed2002

The Ocular Trauma Score (OTS).

Only based on a standardized terminology of ocular trauma terms, and using a very large number of injuries treated by a wide variety of ophthalmologists, could a reliable method be developed so that the functional outcome of a serious eye injury can be predicted with reasonable certainty. The authors used the databases of the United States and Hungarian Eye Injury Registries and, with a grant from the National Center for Injury Prevention at the Centers for Disease Control and Prevention, designed such a system.

Eye Injuries↗
PubMed2002

Strategic thinking in eye trauma management.

Treating patients with serious eye injuries is not only a difficult, but also occasionally frustrating process. Mastering the details of the management of individual tissue lesions allows one to "see the tree" but does not provide vision of the entire forest. To develop a comprehensive understanding that leads to strategic thinking before making actual reconstruction efforts, the surgeon should follow a fairly rigorous thought process to find the best possible management option for the particular injury (Fig. 1). His or her suggestion, as well as detailed information on other options, should be discussed with the patient, and the decision regarding how to proceed is best if it meets the approval of, and is supported by, the patient. Such an approach has the highest chance of rewarding the patient and the treating physician.

Decision Making↗