[Effectiveness, tolerance and acceptance of polyvidon preparations].
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Adolescent↗
Biomedical subjects
H Höh
Publications and source records attributed to H Höh.
Using LIPCOF (lid-parallel conjunctival fold) for assessing the degree of dry eye, it is essential to observe the exact position of that specific fold.
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Conjunctiva↗
[Early trans-sphenoid decompression in indirect traumatic optic neuropathy].
BACKGROUND: Indirect traumatic optic neuropathy represents a severe, potential vision-threatening disease process that requires close interdisciplinary cooperation for treatment. In general, any therapy has been discussed controversially in the literature. Based upon experiences with spinal cord trauma, high-dose steroid therapy is recommended initially to minimize secondary consequences following orbital trauma. The usefulness of surgical decompression of the optic nerve has been confirmed in several studies but is still not recommended in principle. PATIENTS AND METHOD: In nine consecutive patients with known indirect traumatic optic neuropathy and marked losses of vision, transsphenoidal optic decompressions were carried out with simultaneous systemic megadose steroid therapy. RESULTS: A postoperative increase in visual acuity from 1/35 to 10/20 occurred in five patients, while no improvement in visual acuity could be achieved in the other four patients. DISCUSSION AND CONCLUSION: Previous reports have indicated that some authors will not recommend surgical decompressions if a loss of sight or no light perception occurs directly after an accident. This situation was seen in seven of our patients. The visual acuity of four patients remained no light perception in spite of surgical treatment. In three other patients, an increase in visual acuity from amaurosis improved to 1/35, 4/20 and 8/20, respectively, following early decompression combined with steroids. This experience together with the positive results of other studies supports carrying out decompressions of the optic nerve, even when an amaurosis occurs directly after trauma.
Adolescent↗
[Antiproliferative therapy with 5-fluorouracil in erbium:YAG laser sclerostomy ab externo].
BACKGROUND: Erbium laser sclerostomy (ELS) ab externo is a minimally invasive addition to conventional fistulating glaucoma surgery. To date, the success rate of this method is lower than that of trabeculectomy or goniotrepanation. The chief cause of therapy failure is postoperative episcleral scarring of the bleb. It was the aim of the present study to decrease the occlusion rate of this complication. PATIENTS AND METHODS: 41 eyes were treated with subconjunctival injections of 5-fluorouracil perioperatively to an intended total dose of 40 mg to prevent episcleral scarring. At the same time, bigger probe diameters were used (550 microns and 700 microns instead of 300 microns). RESULTS: After 3 months, the proportion of patients with regulated intraocular pressure after using bigger probe diameters combined with anti-proliferative therapy was significantly higher (550 microns fiber +5-FU: 73%; 700 microns fiber +5-FU: 71%) than for a 300 microns fiber without 5-FU (38%). Average intraocular pressure in successful cases was 11.6 +/- 4.2 mmHg in the 550 microns fiber +5-FU group and 12.3 +/- 4.0 mmHg in the 700 microns fiber +5-FU group. CONCLUSION: The short-term results of erbium laser sclerostomy as a minimally invasive technique can be improved by using increasing laser fiber diameters and by perioperative injections of 5-FU to prevent episcleral fibrosis.
Antimetabolites↗
[Selective percutaneous transluminal thrombolytic therapy with rt-PA in central retinal artery occlusion].
UNLABELLED: In central retinal arterial occlusion systemic fibrinolytic therapy can involve a variety of serious complications. The local application of a fibrinolytic agent close to the embolus by means of a femoral catheter should reduce the rate of complications. We therefore present the results of a preliminary study of nine consecutive patients treated with rt-PA via transcutaneous femoral catheter. PATIENTS: From October 1993 to January 1994, nine patients ranging in age from 50 to 83 years who had central retinal occlusion were treated with rt-PA. The latency from the onset of the symptoms to the beginning of the therapy was 10-37 h. A catheter was placed via the femoral artery, the tip being located either at the common carotid artery or at the internal carotid artery or at the internal carotid artery. A continuous infusion containing 10 micrograms (ACTILYSE (rt-PA) was given over 2 h. Thereafter, each patient received 7000 IU heparin sulfate 4 times daily for 3 days and 1200 micrograms pentoxifylline i.v. daily for 10 days. On discharge, permanent therapy with salicylic acid (100 micrograms) was prescribed. The patients have been followed up for up to 18 months so far. RESULTS: In five of eight patients an improvement of central visual acuity was observed. It changed from perception of hand movement only to 12/20 in three patients. In two of these patients visual acuity had continued to improve after 6-9 months, to 16/20 and 20/20. In one patient visual acuity fell to 6/20 because of progression of ischemic ophthalmopathy. In our patients visual acuity could still be improved even 27 h after arterial occlusion. CONCLUSION: A low incidence of complications and the good effect on thrombolysis support the local rt-PA therapy. Good interdisciplinary cooperation is required. Patients must be referred for this therapy as early as possible.
Aged↗
[Prospective study of surgical therapy of pterygium: bare sclera technique vs. free conjunctiva-limbus transplant].
Many techniques of pterygium surgery with various rates of recurrence are described in the literature. We report on the outcome after pterygium excision with bare-sclera technique compared with free transplantation of limbal conjunctiva. We used the bare-sclera technique in 21 eyes and performed free transplantation of conjunctiva in 34 eyes. The duration of follow-up was 14 months. In patients operated with the bare-sclera technique there were significantly more recurrences (eight vs four, P < 0.025) and cases of development of pyogenic granuloma (four eyes vs no eyes, P < 0.01). In patients with primary surgery and free limbal transplant we found no case of recurrence, but the bare-sclera technique was associated with a recurrence rate of 35.5% (P < 0.01). We recommend free limbal conjunctival transplantation even in patients with primary surgery of a pterygium.
Aged↗
Results of occlusion therapy in anisomyopic amblyopia with myelinated nerve fibers.
The combination of anisomyopia and myelinated nerve fibers in the highly myopic eye is often correlated with severe and therapy-resistant amblyopia. There are very few reports on successful amblyopia therapy in patients with this constellation of symptoms. We report on six patients aged 6, 7, 9 (two cases), and 28 years (two cases) who presented with anisomyopia, myelinated nerve fibers, and severe amblyopia in the highly myopic eye. The four younger patients took part in a therapeutic trial with contact lens correction and occlusion. The six patients suffered from varying degrees of anisomyopia, which ranged between -3.5 and -18.5 D. Four patients underwent strict occlusion therapy. The best visual improvement was from 1/25 to 0.2 (factor of 5) and the best final visual acuity was 0.4. Two patients had microstrabismus, three displayed exotropia, and one patient showed no strabismus. The combination of unilateral high-grade myopia and myelinated nerve fibers represents a special conjunction that is usually correlated with severe amblyopia. The amblyopia is practically resistant to therapy, even under strict treatment regimen with contact lenses and forced occlusion. The goal must be to diagnose this constellation in the first 2 years of life. As case reports show in the literature, consistent therapy at this age can lead to good visual acuity.
Adult↗
[Eye injuries caused by opening or explosion of beverage bottles].
Exploding beverage bottles can cause serious ocular injuries. The mechanisms of injury and the consequences were studied retrospectively in 21 patients admitted to the hospital between 1982 and 1992. Most of the patients (76%) were injured by propulsion of the bottle cap. Bottle explosions following dropping on the floor were the most frequent cause of perforating ocular injuries by glass fragments from a beverage bottle. Among our patients, 12 (57%) had severe globe contusions and 9 (43%) had lamellar or penetrating globe injuries. In 83% of the contusions, 100% of the lamellar injuries and 62% of the penetrating eye injuries almost complete visual rehabilitation (vision 0.5-1.0) was achieved. Vision was saved in all the injured eyes. About 2% of all eye injuries admitted to hospital are caused by bottle explosions. The consumer can reduce the danger of bottle explosions by storing bottles in a cool place and taking care not to shake then before use. Manufacturing industry is called upon to develop and to use stopper systems connected to the bottles to prevent propulsion of bottle caps.
Adolescent↗
[Dapiprazol antagonizes tropicamide- and phenylephrine-induced mydriasis in the elderly].
Dapiprazole eye drops were applied 1 h after topical tropicamide or phenylephrine instillation in 30 elderly subjects. Pupil diameter normalized much earlier than in controls receiving placebo. Dapiprazole constricted the tropicamide-dilated pupil by 1 mm after 1 h and normalized the pupil diameter of the phenylephrine-dilated pupil within 1 h, whereas the pupils of the patients receiving placebo remained dilated. Intraocular pressure did not change; no major side effects were seen.
Adrenergic alpha-Antagonists↗
[Lid-parallel conjunctival folds are a sure diagnostic sign of dry eye].
Dry eye syndromes are becoming more important for the ophthalmologist. Various circumstances lead to a significant impairment of the three layered precorneal film, whose disturbed equilibrium causes diverse pathological changes in the ocular surface. Apart from symptoms and clinical signs, various clinical tests and laboratory procedures can be used to confirm the diagnosis. We looked at the utility of the lid-parallel conjunctival fold (LIPCOF) with regard to the diagnosis "dry eye". In this publication we describe and classify LIPCOF, stage 0 to stage 3, and investigate its relationship to the severity of dry eye. Dryness is determined by the "sicca score", a scale between 0 and 12 based on a wide-ranging spectrum of tests, including the Schirmer I-test, tear-film break-up time, rose bengal and and fluorescein staining, the lysozyme test and impression cytology. In this prospective study we examined one eye in each of 267 patients, assigning them to one of two groups based on the absence or presence of LIPCOF. These two groups are comparable in gender and age (group-matching). For the diagnosis of dry eye, using LIPCOF, statistical analysis of the data showed a negative predictive value of 75.95% and a positive predictive value of 93.09%. The correlation pattern of LIPCOF with the patient's medical history and slit-lamp. They are a dependable diagnostic sigh of dry eye. Consideration and classification of LIPCOF enlarges and facilitates diagnosis of dry eye syndromes by the ophthalmologist.
Adolescent↗
[New developments in 1991 in the field of the eyelids].
The publications of the year 1991 dealing with new developments in the field of lids have been reviewed. New methods of reconstruction of the upper and lower eye lid are presented. Chondroplast is a substitute for the tarsal plate which is preserved in a new way and is available in an unlimited amount. A four snip procedure for the correction of lower lid entropion is presented. A new technique of ectropion correction which allows great flexibility in the extent of the approximation of the lower lid to the globe is available. New simplified variations of the surgical treatment of Graves' disease provide a predictable height and contour of the eye lid as well as improved cosmetic results. Alternatively to Botulinum toxin Doxorubicin was injected as a treatment for benign essential blepharospasm and hemifacial spasm in an experimental study.
Eyelid Diseases↗
[Astigmatism against the rule after small incision cataract surgery. A multifactorial, multivariate study].
BACKGROUND: Small-incision cataract surgery has been further developed by the introduction of the sutureless technique. This procedure has reduced operation time and the surgically induced astigmatism compared to closure technique. PATIENTS AND METHODS: We evaluated 426 patients operated by the same surgeon using the same intraoperative approach. Patients were monitored for postoperative induced astigmatism and postoperative complications. RESULTS: Our results demonstrated small induced astigmatism after one week and one month. The no-stitch technique showed the smallest postoperative astigmatism with the least variation. With multivariate methods we also analysed several factors influencing the axis of the induced astigmatism. CONCLUSION: The most important factor for a postoperative astigmatism against the rule is using the no-stitch-technique and the existence of a preoperative astigmatism against the rule.
Astigmatism↗
[Fresh submacular hemorrhage--results of surgical removal by pars plana approach].
BACKGROUND: The natural course of prominent central subretinal hemorrhages may lead to central scotomas with loss of central visual function due to toxic and mechanic damage to the photoreceptor cells. We report results after operative removal of acute submacular hemorrhages in five patients. MATERIALS AND METHODS: In five patients with central subretinal hemorrhage we removed the subretinal bloodclot by means of endosurgery through pars plana and retinotomy. As internal tamponade we used SF6 gas/air mixture (4 patients) and silikon oil (1 patient). The cause of the subretinal hemorrhage was disciform senile maculadegeneration in 4 patients and rupture of an arterial macroaneurysm in one patient. The postoperative course was free of complications in four patients. One patient developed retinal detachment, the retina could be reattached by episcleral buckling procedure. RESULTS: Out of the four patients with disciform maculadegeneration three had an improvement of visual acuity of more than two lines postoperatively. In one patient the visual acuity showed only a minimal improvement. There was no decrease of visual acuity in any patient. There was a marked improvement of vision in the patient without preexisting maculadegeneration, whose bleeding was caused by a ruptured arterial macroaneurysm. Two out of five patients developed in due course a proliferative vitreoretinopathy. Visual acuity was not decreased by proliferative vitreo-retinopathy and until now there has been no indication for surgical intervention. CONCLUSIONS: Indications for surgical removal of central subretinal bleedings are in our opinion that the hemorrhage must be prominent and include the macula, that the hemorrhage is not older than one week and that visual acuity was better before hemorrhage. After careful consideration the surgical extraction of central subretinal bleeding via pars plana and retinotomy can be recommended and may be useful in some patients.
Aged↗
[Recent progress in therapy of the lacrimal ducts 1991].
We went through papers on lacrimal duct disorders published in 1991 seeking new information which could be directly applied. Practical clinical information was given priority over academic results. 1. New strategies were adopted in particular in the surgical treatment of lacrimal duct obstructions. The most important progress in this context was in the use of various types of laser in combination with improved video endoscopes, e.g. in laser dacryocystorhinostomy or laser conjunctivodacryocystorhinostomy. 2. A special instrument, the "Reiss punctal punch", was developed for treatment of punctal stenosis. It enhances and facilitates punctoplasty. 3. With regard to the lacrimal gland and tear secretion, it was shown that epidermal growth factor (EGF) is a natural component of human tears and is formed in the lacrimal gland. It is not yet known whether corneal wound healing can be influenced by administering drugs which alter EGF production.
Adolescent↗
[1991 new developments regarding the conjunctiva].
Publications on the subject of conjunctiva in 1991 have been reviewed. Clinical relevant topics have been stressed. In the field of conjunctival affections caused by microorganisms a spectrum of bilateral squamous conjunctival tumors associated with human papillomavirus type 16 were first documented. Chlamydial antibodies cause proliferation of lymphocytes. The peripheral lymphocyte proliferative response to whole chlamydial elementary bodies seems to have a strong correlation between the responses to the Chlamydia trachomatis serotypes B and L1. In the field of impression cytology of the conjunctiva the topographical distribution of ocular surface cells was described. In patients with glaucoma using long-term topical medication, there seem to be significant degrees of conjunctival metaplasia associated with the number of glaucoma medications. These changes in the conjunctival surface may be related to the preservatives in the preparations (benzalkonium compounds). An ultrastructural defect in conjunctiva in recessive dystrophic epidermolysis bullosa may increase the susceptibility of the conjunctiva to minor mechanical trauma. Thus resulting in the bullous and cicatrical changes seen clinically.
Adrenergic beta-Antagonists↗
Preliminary results following implantation of iris-suture-fixated posterior-chamber lenses.
Iris-suture-fixated posterior-chamber lenses with a 7-mm optic zone and modified C-loops with 2 holes were implanted in 30 patients (8 men and 22 women), of whom 13 received simultaneous corneal transplantations. The mean follow-up period was 13.3 months. The iris was penetrated from behind and the intraocular lens was sutured with two double-armed 9-0 prolene sutures, the knot being positioned on the anterior surface of the iris. Most patients showed an increase in visual acuity except for two who had pre-existing retinopathy and one who developed a seclusio pupillae. The complications seen were: mild distortion of the pupil (7), iris capture (1), posterior synechiae (1) and ablatio chorioideae (1). This new technique yields good results in cases of intraoperative rupture of the capsule. In patients undergoing simultaneous corneal transplantation, a longer follow-up period is needed.
Adult↗
Central subretinal hemorrhage from a retinal arterial macroaneurysm--two-step treatment with laser and vitreoretinal surgery.
Central subretinal hemorrhage can be a complication of arterial retinal macroaneurysm. Subretinal bleeding may lead to mechanical and toxic damage of photoreceptors, causing persisting central scotomas. Prophylactically, we perform a two-step therapy using an argon laser and vitreoretinal surgery to achieve coagulation of the bleeding source and drainage of subretinal blood.
Adult↗
[Local anesthetic effect and subjective tolerance of a single dose of 0.25% bupranolol in probands with healthy eyes. Randomized parallel double-blind study].
.25% Bupranolol in an oily solution decreases corneal sensitivity statistically significant from the 3. to the 15. minute after the application. The maximum of decrease is found between the 6. and the 15. minute in contrast to beta-blockers in aqueous solution (1.-3. minute). The topical subjective compatibility of 0.25% Bupranolol equals that of preserved 0.5% Timolol.
Adult↗