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J Worst

Publications and source records attributed to J Worst.

10 recordsLinked to original sources
PubMed1992

Retinal detachment surgery following implantation of a keratoprosthesis. A case report.

Retinal detachment is an eye with a keratoprosthesis usually has an extreme poor prognosis. We describe the successful repair of a total retinal detachment following implantation of a new type Worst-keratoprosthesis in the only eye of a 70-year-old patient. A vitrectomy, epiretinal peeling, 180 degrees superior retinotomy, subretinal membrane peeling and an injection of perfluorooctane were performed to flatten the retina. After the endophotocoagulation a perfluorooctane-silicone oil exchange was performed. An additional intervention was necessary to treat a redetachment. After 3 months follow-up the retina has remained attached and the patient regained ambulatory vision.

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PubMed1978

Extracapsular surgery in lens implantation (Binkhorst lecture). Part iv. Some anatomical and pathophysiological implications.

Extracapsular surgery is an ideal type of cataract surgery in combination with lens implantation in that stability and fixation of the lens is greatly enhanced. However, a number of complications can be expected. The main problem of extracapsular surgery is posterior capsule opacification. This is due to regeneration of germinal lens fibres. To prevent this a complete removal of cortical lens matter is advisable, even in lens implantation. This however requires special lenses which have additional iris fixation. The author's technique for extracapsular surgery is described. The clinically protective effect of extracapsular surgery for the macula has led to the discovery of a new antomical structure in front of the macula, the bursa premacularis. The bursa premacularis is a well-defined fluid-filled space inside the vitreous body in front of the macula. It is postulated to have a protective function for the macula in a hydrodynamic and biochemical sense. A number of pathological conditions could be explained as primarily determined by toxic substances in the premacular bursa or defective detachment of the premacular bursa in the course of posterior vitreous detachment. If this latter condition exists, intracapsular surgery will cause cystoid macular edema, as aqueous can enter the perimacular retina. Cystoid macular edema therefore is postulated to be anatomically predetermined.

Cataract Extraction↗
PubMedDate not supplied

[Hemorrhage in the premacular bursa treated with the Q-switched Nd-YAG laser].

Hemorrhages in the premacular bursa may cause an important loss of the visual acuity due to their localization. Several treatments, going from a conservative attitude to prompt vitrectomy, have been proposed. Three cases of premacular hemorrhage, treated by Nd-YAG laser puncture, are reported. One or two impacts are sufficient to empty the blood collection into another vitreous compartment. The blood is dispersed through the vitreous on the second day after treatment and is resorbed within the ten to fifteen following days. With the help of ultrasound, the blood volume was estimated to be equal to or less than 10 microliters in the three cases. In all cases the YAG laser puncture allows a faster recovery of the visual acuity as compared to the conservatively treated cases. In no instance a recurrence, macular degeneration or preretinal proliferation was observed. The new concepts of vitreo-macular relations and vitreous anatomy are well illustrated by this therapeutic indication. Although the precise localization of a blood collection in the premacular area remains controversial, we consider it of no consequence to the outcome of the treatment.

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