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Biomedical subjects

J Barraquer

Publications and source records attributed to J Barraquer.

At least 19 recordsLinked to original sources
PubMed1999

Precrystalline posterior chamber intraocular lens for surgical correction of severe myopia.

PURPOSE: To report early experience with a posterior chamber precrystalline intraocular lens designed for correction of severe myopia from -10 to -30 diopters. This intraocular lens respects the transparent crystalline lens and does not interfere with accommodation. METHOD: The concave-convex methylmethacrylate lens, with flexible haptics that are supported in the sulcus, is placed behind the iris, in front of the lens, and centered with the pupil. RESULTS: From July 1995 to November 1998, 149 precrystalline lenses have been inserted with few, generally reversible complications, which are now largely prevented by adequate modification of the intraocular lens. Correction has been satisfactory and stable. CONCLUSION: Although follow-up is relatively short, precrystalline lens placement may be considered an important contribution to the surgical management of severe myopia to improve the patient's vision and, consequently, quality of life.

Adult↗
PubMed1997

Storage, surgery, outcome, complications, and new developments in corneal and conjunctival grafts.

This review covers last year's literature on corneal, limbal, and conjunctival transplantation including tissue storage and eye banking. In this area, the main themes were related to a better evaluation of tissue viability and the exclusion of disease transmission. An analysis of the changing indications for penetrating keratoplasty shows the differences between American and European series. Most efforts in relation to surgical techniques are oriented toward obtaining better refractive results, whereas the study of large series sheds new light on the risk factors for graft failure and other complications. Limbal transplants have acquired the status of a new field in the surgical treatment of ocular surface disease, particularly in relation to corneal stem cell deficiencies.

Conjunctiva↗
PubMed1997

Extrusion of abnormal endothelium into the posterior corneal stroma in a patient with posterior polymorphous dystrophy.

PURPOSE: To report the presence of abnormal endothelium that extruded into the posterior corneal stroma in a patient with posterior polymorphous dystrophy. METHODS: The corneal button of a man who underwent penetrating keratoplasty for posterior polymorphous dystrophy was examined by light and electron microscopy. Immunoperoxidase staining for cytokeratins, vimentin, and the endothelial antigen recognized by monoclonal antibody 2B4.14.1 antigen was performed. Two-color immunofluorescence staining for simultaneous detection of cytokeratins and 2B4.14.1 antigen was also done. RESULTS: Much of the endothelium had characteristic features of epithelium-like cells, and abnormalities in Descemet's membrane were present. Curious oval and slit-like spaces in the posterior stroma were lined by epithelium-like endothelial cells and were continuous with the anterior chamber through defects in Descemet's membrane. CONCLUSION: These abnormalities in the posterior stroma have not previously been described in histopathologic reports of posterior polymorphous corneal dystrophy and are likely an unusual variation in the spectrum of this hereditary disorder.

Adolescent↗
PubMed1996

Forceps and vacuum injuries to the cornea: histopathologic features of twelve cases and review of the literature.

Histopathologic and ultrastructural features were examined from 11 cases of corneal injury from obstetrical forceps and one case from vacuum extraction. Four major types of histopathologic features were observed. Type I (n = 4) included large tears of Descemet's membrane with a fragment of Descemet's membrane extending into the anterior chamber at one end of the tear and scroll formation at the other end. Type II (n = 6) consisted of scrolls of Descemet's membrane at each margin of the original break. Type III (n = 2) included those with small breaks in Descemet's membrane and healing by fibrosis at and posterior to the original tear. Type IV (n = 1) contained a small break in Descemet's membrane with minimal fibrosis. Transmission electron microscopy revealed Descemet's scrolls and retrocorneal fibrous tissue. Scanning electron microscopy revealed folds in Descemet's membrane and attenuation or absence of endothelium. Spindle- and stellate-shaped cells and pigment granules were present in the area of the tear in most cases. A review of the literature is presented.

Adult↗
PubMed1995

Reevaluation of corneal dystrophies of Bowman's layer and the anterior stroma (Reis-Bücklers and Thiel-Behnke types): a light and electron microscopic study of eight corneas and a review of the literature.

To clarify whether Reis-Bücklers' and Thiel-Behnke's corneal dystrophies are one entity or whether two distinct corneal dystrophies of Bowman's layer and the superficial stroma (CDB) exist, 28 corneal specimens with clinically suspected diagnosis of CDB were examined by light and electron microscopy, and the literature was reviewed. Eight specimens came from patients with a honeycomb-shaped pattern of opacities at the level of Bowman's layer. Study of those eight specimens disclosed destruction of Bowman's layer, a subepithelial fibrocellular tissue with an undulant configuration, absence of the epithelial basement membrane in many areas and the presence of "curly" collagen fibers with a diameter of 9-15 nm. We concluded that two distinct autosomal dominant CDB exist and propose the designations CDB type I (synonyms: geographic or "true" Reis-Bücklers' dystrophy) and CDB type II (synonyms: honeycomb-shaped or Thiel-Behnke's dystrophy). The eight corneas of our series were characterized as CDB type II. CDB I is clinically characterized by confluent geographic opacities at the level of Bowman's layer, histopathologically by bandshaped granular Masson-positive subepithelial deposits, and ultrastructurally by the presence of "rod-shaped bodies" and may be a superficial variant of granular dystrophy. Visual loss is significantly greater in CDB I, and recurrences after keratoplasty or keratectomy seem to be earlier and more extensive in CDB I. Most cases reported thus far in the literature as "Reis-Bücklers' dystrophy" are CDB II (honeycomb-shaped or Thiel-Behnke's dystrophy).

Adult↗
PubMed1994

[Lens surgery: yesterday, today and tomorrow].

Short review of the evolution of lens surgery since the beginning of our century up to the present time: from extracapsular to intracapsular extraction and back again to the modern version of extracapsular extraction. From the beginning of intraocular lens implantation to modern intraocular lenses and, finally, a focus on the future toward the possibilities of "restoration" of the lens to recuperate not only visual acuity but also accommodation.

Cataract Extraction↗
PubMed1992

Cataract surgery and IOL implantation. More than 40 years of personal experience. My present criteria and considerations.

The author refers his personal experience with different types of IOL since 1950. After an initial period of enthusiasm (1950 to 1961) the author abandoned the techniques of Ridley, Strampelli and Dannheim, because of the considerable incidence of severe complications directly related to the IOL. Over many years he emphasized the serious postoperative complications which appeared in the course of the years, even with the different new types of IOL which acquired a certain prestige. With the new posterior chamber lenses placed in the capsular bag, the results became more encouraging and the author resumed IOL implantation with this type of lenses after an adequate period of observation and experimentation. The present criteria, technique and results of the author are discussed together with some considerations on future research work to develop new techniques for substitution of the opacified lens and also to attempt to restore accommodation.

Accommodation, Ocular↗
PubMed1989

Congenital idiopathic corneal endotheliopathy.

Two unrelated boys had a history of bilateral corneal clouding at birth following uncomplicated full-term gestations and spontaneous vaginal deliveries (without forceps). Clinical examinations disclosed bilateral corneal edema, no inflammation, and normal intraocular pressures. There was no history of similarly affected family members. The patients underwent penetrating keratoplasty at ages 4 months (patient 1) and 12 years (patient 2). Light and electron microscopic studies of the corneal buttons from both patients revealed areas of degeneration of the endothelium and separation of rounded endothelial cells. The morphologic features were strikingly similar to those in two acquired forms of corneal disorders--autoimmune endotheliopathy and "acute endotheliitis." Immunocytologic and in situ hybridization studies for herpes simplex virus were not consistent with either productive or latent corneal infection. Ultrastructural changes in Descemet's membrane reflect delayed or abnormal development of the postnatal nonbanded layer in patients 1 and 2, respectively. These suggest an intrauterine insult that resulted in endothelial dysfunction. The histologic and ultrastructural features of these two congenital cases are not typical of those seen in any of the recognized causes of congenital corneal clouding. We propose that these cases represent a unique congenital corneal endotheliopathy of undetermined origin.

Child↗
PubMed1988

Corneoscleral autotransplant.

We describe the clinicopathologic features of a corneoscleral autotransplant in place for 18 years, with excellent visual results. Donor and some recipient trabecular meshwork was present in some areas. Donor trabecular meshwork was hypocellular and partially covered by an overgrowth of uveal melanocytes. A cyclodialysis cleft was present and closed only by loose connective tissue. It is likely that aqueous outflow was, in part, to the supraciliary space.

Cataract Extraction↗
PubMed1987

Terrien's marginal degeneration: clinicopathologic case reports.

We report the clinicopathologic features of seven cases of Terrien's marginal degeneration. Three specimens studied were lamellar resections and four were full-thickness corneal segments. Of the four full-thickness specimens, three were semilunar and one was an annular ("doughnut-shaped") specimen. All cases had stromal thinning, vascularization, lipid keratopathy and local absence of Bowman's membrane. Descemet's membrane was markedly thickened and the endothelium was intact. Three of the four full-thickness corneal specimens showed healed ruptures of Descemet's membrane. One specimen had four healed successive ruptures in Descemet's membrane in the same area. The corneal endothelium in that area had produced a basement membrane that totalled 35 micron in thickness. The clinical and histopathologic features of pellucid and Terrien's marginal degeneration are similar. When idiopathic peripheral corneal thinning remains clear, it is regarded as pellucid degeneration; vascularization, scarring, and lipid keratopathy are regarded as Terrien's marginal degeneration. Breaks in Descemet's membrane contribute to these latter changes.

Basement Membrane↗
PubMed1985

Immunosuppressive agents in penetrating keratoplasty.

One of the problems with corneal grafting is the occurrence of rejection. Immune reaction is considered to be an important cause of graft failure. Early recognition of such graft reaction can frequently be treated successfully with intensive topical administration of corticosteroids. Generally, I prefer to add systemic corticosteroids and immunosuppressive agents such as azathioprine. In the present study two cases are described to illustrate the use of azathioprine and demonstrate that even severe and recurrent graft reactions can be successfully treated with immunosuppressive agents.

Adrenal Cortex Hormones↗
PubMed1982

Prophylaxis of infection in keratoplasty.

The necessity for special operating rooms used exclusively for intraocular surgery, careful preparation of the patient and prevention of infection with preoperative antibiotics is emphasized. Also, the graft must be obtained and stored in aseptic and atraumatic conditions. If, in spite of these precautions postoperative endophthalmitis does occur, the graft must be replaced by a fresh donor cornea and the purulent material eliminated by irrigation, as long as the infection is still limited to the anterior segment of the eye.

Anti-Bacterial Agents↗