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Biomedical subjects

I Raivio

Publications and source records attributed to I Raivio.

11 recordsLinked to original sources
PubMed1999

Prospective evaluation of external ocular microbial growth and aqueous humor contamination during cataract surgery.

PURPOSE: To analyze the route of aqueous humor contamination leading to the development of postoperative endophthalmitis. SETTING: Department of Ophthalmology, University of Helsinki, Finland. METHODS: Forty-nine eyes of 49 patients (31 having phacoemulsification and 18 extracapsular cataract extraction [ECCE]) participated in the study. Four bacterial cultures were taken: preoperative conjunctival swab, lid margin culture, intraoperative lacrimal lake sample, and immediate postoperative anterior chamber fluid sample. RESULTS: Preoperative lid margin cultures were positive in 59.2% of eyes, conjunctival cultures in 69.4%, and lacrimal lake cultures in 24.9%. Four aqueous humor samples (8.2%) showed bacterial growth in the anterior chamber aspirate: 3 in the phacoemulsification and 1 in the ECCE group. The bacteria isolated in this study, Staphylococcus epidermidis and Propionibacterium acnes (2 positive isolates each) were sensitive to the preoperative topical antibiotics used. No aqueous humor sample or any from other locations showed gram-negative microbe growth. The most frequently recovered microbes in all samples collected from the 3 other sources were S epidermidis and other coagulase-negative staphylococcus species, followed by P acnes and other propionibacterium species. Staphylococcus aureus, and diptheroids. CONCLUSION: The ocular surface significantly contributed to the transmission of microbes into the eye during cataract surgery. These microbes could not be eradicated by topical preoperative antibiotics. However, no patient developed postoperative endophthalmitis. Natural defense mechanisms appear to fend off a minor inoculum with these microbes of relatively low pathogenicity.

Anti-Bacterial Agents↗
PubMed1991

Acute closed angle glaucoma and sunshine.

STUDY OBJECTIVE: The aim was to examine a possible association of amount of sunshine and risk for acute closed angle glaucoma. DESIGN: This was a retrospective analysis of hospital discharge registry data, linked to meteorological data for the same period. SETTING: The study was a national survey using hospital discharge data for the whole of Finland over a 10 year period. PARTICIPANTS: All subjects with the acute closed angle glaucoma diagnosis from the hospital discharge registry were collected for the years 1972 to 1982. A total of 1796 patients were found. MEASUREMENTS AND MAIN RESULTS: Meteorological data from two cities in Finland, Helsinki and Oulu, were collected for the same years from the Finnish Meteorological Institute. A peak incidence of acute closed angle glaucoma was noted whenever the number of hours without sunshine increased. A regression analysis including incidence of acute closed angle glaucoma as a dependent variable, and sex, mean temperature, mean air pressure, mean humidity, total amount of rain per month, and mean sunshine hours as independent variables, was constructed. Sex and sunshine hours best explained the variation in incidence in a covariate model. No other meteorological variate could improve the model fit. CONCLUSIONS: The result confirms that the number of hours without sunshine is positively associated with the incidence of acute closed angle glaucoma, when other meteorological variables are controlled for.

Female↗
PubMed1988

Visual results and social rehabilitation after cataract surgery. A retrospective comparison of the effect of non-IOL and IOL surgery.

This report examines the changes that occurred in the post-operative visual and social function of patients with cataract when the hospital responsible for cataract treatment (roughly 1000 cataract extractions per year) shifted from non-IOL to IOL techniques. Visual function and vision-dependent social performance were compared retrospectively in 116 patients, 53 of whom had undergone cataract extraction without IOL implantation, and 63 of whom had been treated by IOL implantation. Patients with no IOL had the possibility of using extended-wear contact lenses if unable to tolerate aphakic spectacles. Visual results and social rehabilitation were good with both techniques, and there was no significant difference in vision-dependent social performance between the groups. The quality of vision and patient satisfaction with surgery were better in IOL patients. It appears that, once vision is restored by surgery and contact lenses are available, post-operative function in patients is determined by factors other than the type of cataract surgery. However, the shift to IOL surgery brings about improved quality of vision and patient satisfaction.

Aged↗
PubMed1988

Economic evaluation of cataract surgery: a comparison between IOL and non-IOL techniques.

Using a sample of 116 patients, 53 of whom had undergone cataract extraction without IOL implantation, and 63 of whom had been treated by IOL implantation, a retrospective evaluation of differences in economic effects was performed. The use of non-IOL technique was cheaper for the hospital, but the overall costs for society were soon higher, mainly as a result of the significantly higher costs of obtaining contact lenses and spectacles in the non-IOL group. The longer we expect cataract surgery patients to live post-operatively the greater will be the difference in favour of using the IOL technique. The estimated annual savings to society for every 875 patients operated would be from FIM 5 million to FIM 26.5 million if non-IOL technique was used and from FIM 10.5 million to FIM 28.5 million with IOL surgery. Cataract surgery, and especially with IOL technique, seems to be an operation resulting in substantial savings to society.

Cataract Extraction↗
PubMed1987

Incidence of acute glaucoma in Finland from 1973 to 1982.

The incidence of acute closed-angle glaucoma was studied in 1796 patients derived from the hospital discharge registry of Finland for the years 1973-1982 (469 males and 1327 females). The average incidence was 3.8 cases/100,000 per year. The incidence showed a steep rise with age. The highest incidence was observed in both sexes in the group 80 years of age and older. The incidence was higher (Chi-square 7.81, df = 1, P less than 0.01) among women (5.3/100,000 per year) than among men (2.0/100,000 per year). The age-adjusted incidence for the whole period of 1973-1982 showed no statistically significant rise. The seasonal variation of incidence was statistically significant (P less than 0.001). In winter (December, January, February) and in autumn (September, October, November) the incidences were higher compared to spring (March, April, May) and summer (June, July, August). This association was greater (P less than 0.001) among females than among males (P less than 0.05). Mean sunshine hours showed a reverse association with the incidence of acute glaucoma. The association was statistically significant when both sexes were pooled together (P less than 0.001). There was no sex interaction with regard to the association of incidence of acute glaucoma and mean sunshine hours.

Acute Disease↗
PubMed1987

Validity of hospital discharge registry in acute glaucoma.

Validity of hospital discharge registry in Finland was evaluated in acute glaucoma. Hospital records of 172 patients with the diagnosis 370.00 (acute glaucoma) in the registry were collected from different hospitals. The typical findings in acute glaucoma were searched for in patient documents. The diagnosis of acute glaucoma was in agreement in both the registry and in the present investigation in 80.2%. Other recordings validated in patient files (% of agreement in parenthesis) were: date of birth (98.8%), social security number (92.4%), sex (99.4%), hospital code (100%), date of admission (88.4%), date of discharge (90.2%). The type of hospital did not affect the amount of false recordings. The highest percentage of false recordings was noticed in the health care centers. The most common false diagnoses were: simple glaucoma (11 cases), secondary glaucoma (8 cases) and chronic congestive glaucoma (7 cases). The validity assessment is of importance in epidemiologic studies employing discharge registries.

Acute Disease↗
PubMed1985

Incidence of choroidal malignant melanoma in Finland in the years 1973-1980.

Recent reports concerning the incidence of choroidal and ciliary body melanomas have raised a suspicion of an increase of this malignancy in the developed countries. The rapid rise in the incidence of melanoma of the skin is well known. This study covers the incidence of choroidal and ciliary body melanomas in Finland over the years 1973-1980. A total of 382 cases of intraocular malignant tumours were reported to the Finnish Cancer Registry. 285 choroidal and ciliary body melanomas were found. The age-specific incidences showed a steep rise from the age of 30 to the age of 70. The peak incidence was in the age-group 70 and over. There was only one case, a girl 12 of age, in the age-group 15 years and younger. The age adjusted incidences showed no significant increase during the study period. The age-specific incidence showed no significant difference compared to a previous study. Sex, laterality or latitude were not found to be risk factors.

Adolescent↗
PubMed1981

Eye injuries in children.

We report a retrospective study of children's eye injuries treated during 1977 at Helsinki University Eye Hospital. There were 110 cases representing 34.5% of all eye injuries and 3% of all patients treated in 1977; 81.8% were boys and 18.2% girls. Half of the injuries were caused by another child, one-third were self-inflicted, and the rest were other accidents. The risk of eye injury in girls was low and stable at all ages, but in boys the risk grew markedly at the age of 8 years. The commonest cause of injury was a thrown missile. Other important causes were shots, hits, and sports accidents. Two-thirds of the injuries were concussions. The proportion of perforation was 8.9%, which is a much lower figure than in earlier reports, suggesting that the injuries have become milder. Some kind of complication was seen in 16% of concussions. No secondary bleeding was found among them. Permanent impairment of vision was seen in 2 cases: one had a visual acuity of 0.1 because of traumatic cataract and the other 0.6 because of corneal scars. Although the number of perforations was too low for statistical analysis, the final result in this group suggests that the prognosis of perforating eye injury is still as bad as it was during the 1950s.

Adolescent↗
PubMedDate not supplied

Early rehabilitation after small incision cataract surgery.

BACKGROUND: The use of smaller cataract incision is thought to induce less astigmatism, resulting in a more stable refraction and more stable wound. METHODS: We have analyzed the early astigmatic changes and rehabilitation in 20 eyes of 16 patients operated with advanced phacoemulsification techniques. The patients operated with small-incision surgery (incision 4.0 mm) were compared to those with large-incision surgery (incision 7.5 mm). Keratometric values and visual acuity data were evaluated up to 6 months postoperatively. RESULTS: Less initial induced astigmatism was demonstrated at day 7 postoperatively with a 4.0-millimeter incision (0.1 +/- 0.53 D) compared with a 7.5-millimeter incision (1.90 +/- 1.97). Similar but not statistically significant changes were seen at days 1 and 30 postoperatively. Visual rehabilitation was also faster in the small-incision group and 70% of the eyes gave uncorrected visual acuity of 20/40 or better in this group as early as the first postoperative day. Only 11% of the eyes showed that uncorrected visual acuity after large-incision surgery at first postoperative day. CONCLUSION: The low amount of induced cylinder, rapid stabilization of the wound, and faster visual rehabilitation confirms the advantage of small-incision cataract surgery to large-incision surgery.

Aged↗