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Biomedical subjects

K B Mellin

Publications and source records attributed to K B Mellin.

At least 19 recordsLinked to original sources
PubMed1996

[Treatment with tissue plasminogen activator (tPA) in risk patients with fibrin reactions after cataract operations].

The postoperative course after cataract surgery can be complicated by the formation of severe fibrinous membranes, especially in cases with previous goniotrepanation, after syn echiolysis, iridotomy or iris suturing, and in patients with diabetes or uveitis. This study retrospectively analyzes the efficacy of intraocular tissue plasminogen activator (tPA) for fibrinolysis in these conditions commonly considered as contraindications to tPA therapy. When antiinflammatory therapy was unsuccessful in lysing fibrinous membranes, 10 micrograms of tPA (Actilyse) was injected into the anterior chamber following the first postoperative day (n = 15). In addition, topical corticosteroids and cycloplegics were given postoperatively. Lysis of the fibrinous membranes was achieved in all patients. However, in three cases lysis was incomplete or recurred. Complications of intraocular tPA therapy consisted of mild hyphema (n = 1) and transient dysfunction of the corneal endothelial cells (n = 2). In conclusion, the results suggest intraocular low-dose tPA as an effective approach for the treatment of severe fibrinous membranes after cataract surgery even in high-risk patients.

Adolescent↗
PubMed1994

[Argon laser trabeculoplasty in chronic simple glaucoma with visual field defects and papillary damage].

It has been recently demonstrated that the intraocular pressure (IOP) after argon laser trabeculoplasty (ALT) in primary open-angle glaucoma rises in the long term. The present study analysed the effect of the postoperative rise in IOP in 36 patients (group A) with glaucomatous optic nerve damage or visual field defects. The results were compared with those in 37 patients without such glaucomatous damage (group B). The IOP, the cup-disk ratios and the visual fields (Goldmann) were retrospectively studied. All patients were under topical glaucoma medication. At the end of the follow-up (group A 20.2 +/- 3.39 months, group B 17.4 +/- 3.59 months), the IOP was uncontrolled in both study groups, and visual fields and disc cupping had worsened in both groups. The results indicate that ALT should not be considered in patients with optic disc damage or glaucomatous visual field defects.

Aged↗
PubMed1993

[Results of goniotrepanation in chronic simple glaucoma after drug therapy and argon laser trabeculoplasty].

In a retrospective study the effects of goniotrephination following antiglaucoma medication and argon laser trabeculoplasty (ALT) were examined. The study addressed the first treated eye in each of 61 patients. In all patients tropial antiglaucoma medication was continued after ALT. In the period between ALT and goniotrepanation the cup-disc ratio (CDR) progressed significantly (P < 0.01), with worsening of visual field defects. The long-term antiglaucoma medication and the ALT had no effect on the wound healing following the filtering procedure. ALT is contraindicated in preexisting pathologic CDR and visual field defects. In such cases intraocular pressure must be reduced to below 20 mmHg: filtration surgery is effective in lowering the intraocular pressure sufficiently.

Adrenergic beta-Antagonists↗
PubMed1992

[Corneal transplantation].

In contrast to organ transplantations corneal grafts are tissue transplantations with the advantage of a minority of immune stimulating cells. The incidence of allograft rejections is greater in penetrating grafts than in lamellar grafts because of endothelial immune reactions. The decompensation of the graft is caused by the damage of the endothelial layer. The influence of HLA-A, -B and -DR matching is proven in case of vascularised cornea or of repeated perforating keratoplasty. The introduction of the immunosuppressive therapy with Ciclosporin A was successful in maintaining a clear graft.

Corneal Diseases↗
PubMed1992

[The pterygium, Autologous conjunctiva-limbus transplantation as treatment].

Based on a new concept of the limbus as a junctional zone for separating the vascularized conjunctiva from the avascular cornea, this study presents conjunctival/limbal autograft transplantation for 22 cases of pterygium. The pterygia were primary in 17 eyes, cicatricial in 1 and recurrent in 4. In all cases a free transplant of the superotemperal limbus with an adjacent piece of thin conjunctiva was placed in the excision area. Postoperative follow-up ranged from 1 1/2 to 17 months, with a mean of 8.7 months. Only two pterygia recurred. In all other cases ideal anatomic reconstruction was achieved without any side effects. The authors believe that conjunctival/limbal transplantation is an encouraging technique for treating a pterygium surgically.

Conjunctiva↗
PubMed1991

[Value of Doppler carotid artery sonography in ophthalmologic diagnosis].

We report the clinical and Doppler sonographic findings on the internal carotid artery in 230 patients with various purely ocular vascular symptoms. For evaluation, the patients were subdivided into four groups: group I (107): central retinal artery obstruction (CRAO) (13), branch retinal artery obstruction (BRAO) (31), amaurosis fugax (AF) (13), anterior ischemic optic neuropathy (AION) (50); group II: retinal vein occlusion (25); group III: "low-tension glaucoma" (55); group IV: chronic open-angle glaucoma with a possible vascular co-factor (43). In group I with signs of arterial ocular mal-perfusion; 29.5% of cases with CRAO and BRAO revealed significant stenosis or complete obstruction of the ipsilateral internal carotid artery. Only 4 of 50 cases (8.0%) with AION showed positive findings. A remarkable result of this evaluation is the coincidence that nearly all high-grade obliterations and obstructions of the internal carotid arteries diagnosed in this study were exclusively confined to eyes with very severe ischemic changes in both anterior and posterior segments. In no other case was localization or extent of the obstructive process in the internal carotid artery predictive. Venous retinal obstructions with only 16% positive findings did not show any correlation with arterial occlusive disease of extracranial vessels based on demographic aspects and clinicopathological studies. Also no etiological correlation could be detected in either of the glaucoma groups (III and IV).

Blood Flow Velocity↗
PubMed1990

[Initial experience with autologous conjunctiva/limbus transplantation in pterygium].

The present paper reports on the technique and results of conjunctiva/limbus transplantation in 13 eyes with primary or cicatricial pterygium (12 cases and 1 case, respectively). In all cases the pterygia were located nasally. The operation was performed by bare sclera excision, covered with a free graft from the superotemporal conjunctiva and limbus. After a mean follow-up time of 5 months there was only one recurrence. On the basis of a new understanding of limbal diseases the authors believe that conjunctiva/limbus transplantation is an encouraging and appropriate technique for ideal anatomic reconstruction and low recurrence rates in pterygia.

Adult↗
PubMed1990

[Surgical iridectomy following acute angle-closure glaucoma. A retrospective study of 107 patients].

In 69 of 107 patients with primary angle-closure glaucoma, it was possible to control intraocular pressure and visual fields by means of peripheral surgical iridectomy; in 17 of these patients topical glaucoma medication was required in addition. In 11 cases a second surgical operation other than iridectomy was necessary: 6 lensectomies for malignant glaucoma in 2 cases and lens subluxation or phacomorphic glaucoma in 4 and 5 filtering procedures. Among the 85 treated fellow eyes 68 were controlled by iridectomy alone and 17 eyes needed additional topical glaucoma medication. One case of persisting wound leakage from the corneo/scleral wound was the only complication observed in this study. The advantages and disadvantages of peripheral surgical iridectomy are compared with those of argon and neodymium: YAG iridotomies. Owing to the low rate of complications the authors apply the surgical approach as the routine technique for primary angleclosure glaucoma.

Follow-Up Studies↗
PubMed1990

[Functional results after surgery of congenital cataract].

In this retrospective study, the functional results of a total of 14 children with congenital cataract have been analyzed. Four had unilateral and 10 cases bilateral cataract. All children were operated on before the age of 4 months and received a silicone permanent-wear contact lens a few days after the operation. At the time of surgery in all children with unilateral cataract we found additional pathology of the eye, such as microcornea or strabismus. The children with bilateral cataract had secondary eye disorders such as nystagmus and strabismus. After an average follow-up time of 4.5 years, the children with unilateral aphakia reached a visual acuity of 10/200 in the cases with bilateral aphakias an average visual acuity of 60/200 was obtained. In the future, improvement of the functional results can only be achieved when the diagnosis and therapy take place before secondary eye disorders develop such as nystagmus and strabismus.

Cataract↗
PubMed1989

[Management of conjunctival wounds with suture or fibrin glue following intraocular lens implantation--a comparative study].

A randomized prospective study was done to analyze conjunctival wound closure after extracapsular cataract extraction in 100 patients. When the conjunctival wound was closed with stitches 36.7% of the patients reported the sensation of a foreign body in the eye; the same sensation was reported by 7.8% after fibrin sealant. On postoperative day 7, 11.8% of the patients had conjunctival wound dehiscence after the wound had been adapted with fibrin sealant and in 32.6% after using stitches to close the conjunctival wound. Using a fibrin sealant for conjunctival wound closure significantly reduces the postoperative foreign body sensation and wound dehiscence of the conjunctiva. The main problem with fibrin sealant was handling the glue during the operation.

Aged↗
PubMed1987

[Argon laser trabeculoplasty in special forms of open-angle glaucoma].

Argon laser trabeculoplasty was performed in 71 eyes with complicated forms of open-angle glaucoma and insufficiently regulated intraocular pressure. The follow-up time was 18 +/- 6 months. The success rate was 35% in the group with secondary forms of glaucoma (37 treated eyes). Depending on the special indication a great difference in the subgroups was noted: the ALT failed in 4 cases of glaucoma after trauma, but was successful in 45% of all cases of aphakic glaucoma. Thirty-four eyes were treated by ALT after trabeculectomy had failed. The success rate in this group was 71%.

Glaucoma↗
PubMed1986

Ultrastructure of the rabbit corneal stroma after experimental keratomileusis.

Experimental keratomileusis operations were performed on 13 rabbit eyes. The corneas of the rabbits, in particular the stroma, were investigated up to 24 months after the operation by light and electron microscopy. The most striking features of the corneal ultrastructure following experimental keratomileusis were the presence of abnormal collagen fibrils and electron-translucent vacuoles in the interface.

Animals↗
PubMed1986

[Therapy of acute keratoconus].

The incidence of acute keratoconus has increased in recent years. A defect of the endothelium and Descemet's membrane allows the aqueous to flow into the stroma. The therapy of choice is penetrating keratoplasty. The discussion concerning the best time for the operation is still going on. The present authors have performed penetrating keratoplasties on 9 patients at the acute stage during the last 2 years. The results show that early surgery can prevent progression of the symptoms, with corneal edema and pannus, and subsequent complications.

Combined Modality Therapy↗