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Biomedical subjects

K D Lemmen

Publications and source records attributed to K D Lemmen.

8 recordsLinked to original sources
PubMed1992

[Postmortem endoscopic diagnosis].

The use of endoscopical methods augments the macroscopical diagnosis in autopsies. Cavities and sinuses which are hardly accessible may be inspected and photographically documented as well without damage of the anatomical context. In terms of forensic autopsies the endoscopical technique is mostly recommended for the inspection of the fundus of the eye, the external auditory meatus up to the tympanic membrane, the naso- and laryngopharynx. Pathological and traumatical changes can be valued at once in situ. Forensic evidence of postmortal endoscopical findings is exemplified.

Adolescent↗
PubMed1989

Pars plana vitrectomy and silicone oil injection in proliferative diabetic retinopathy.

A retrospective study is reported on 106 eyes with proliferative diabetic retinopathy, treated by vitrectomy and silicone oil injection. Indications were traction detachment in 91 eyes and nonclearing rebleeding in 15 eyes; 31 eyes had previously had vitrectomy. Anatomical success was obtained at the end surgery in 91 eyes, and after a minimum follow-up of 6 months in 68 eyes (64%). Functional results were as follows: satisfactory visual acuity (0.5-0.05) in 23 eyes (22%), ambulatory vision (0.03-CF) in 14 eyes (13%), HM-LP in 54 eyes (51%), and NLP in 15 eyes (14%). The functional results are limited by recurrent detachments due to characteristic reproliferations under the silicone bubble or by ischemic diabetic angiopathy in the attached retina. A positive effect of silicone oil is demonstrated in the reduction of preexisting or postoperatively new iris neovascularization and in preventing postoperative rebleeding.

Adult↗
PubMed1989

[Problems in pneumatic retinopexy].

Fifty-four phakic eyes with selected rhegmatogenous retinal detachment (one retinal tear or a circumscribed group of tears in the upper two-thirds of the fundus, no sign of PVR) were treated by pneumatic retinopexy (transconjunctival cryopexy, intraocular gas injection with appropriate postoperative head positioning). After postoperative follow-up of six months or more primary reattachment of the retina was found in 27 patients (50%). In 12 eyes (22%) there was insufficient relief of traction, so that the detachment persisted (seven eyes) or recurred (five eyes). New retinal tears developed in 12 eyes (22%) between three days and six months postoperatively. This was probably due to interaction of the gas bubble with the vitreous base, an incompletely detached posterior vitreous border, or intravitreal condensations. Three eyes (6%) developed PVR. Other complications were vitreous hemorrhage (one eye) and subretinal gas bubble (one eye). The higher rate of complications, including the development of new tears, as compared to episcleral buckling procedures is discussed. In the authors's view appropriate experience on the part of the retinal surgeon and a level of intraoperative asepsis adequate for intraocular procedures are of major importance.

Adolescent↗
PubMed1989

[Keratopathy following vitrectomy with silicone oil injection].

We present a retrospective study on keratopathy following vitrectomy and injection of SF96 silicone oil (viscosity 1000 centipoise, n = 232 eyes) and the purified OP 1000 silicone oil (viscosity 1000 centipoise, n = 129 eyes). In cases with aniridia, with closed inferior basal iridectomy (IBI) or without IBI, keratopathy was found in 74 of the 166 eyes (45%) injected with silicone SF96 and in 14 of the 30 eyes (47%) injected with silicone OP 1000. An intact IBI reduced the incidence of keratopathy to 0% (SF96, 0/45 eyes) or 6% (OP1000, 5/88 eyes) when the anterior chamber was free of silicone. When silicone oil was in contact with the corneal endothelium (due to periretinal reproliferation, hypotony, overfilling or droplet formation), there was corneal decompensation in 66% (SF96, 14/21 eyes) or 55% (OP1000, 6/11 eyes). The keratopathy presents as calcified band keratopathy or diffuse bullous corneal edema as in "endothelial decompensation." These variations in keratopathy are in agreement with the following basic diagnoses: 77% (43/56 eyes) of trauma patients (n = 130) develop calcified band keratopathy, and 47% (24/51 eyes) of patients with idiopathic proliferative vitreoretinopathy (n = 182) present with diffuse bullous corneal edema.

Cornea↗
PubMed1988

[Early vitrectomy with primary silicone oil injection in very severely injured eyes].

Performing early vitrectomy with primary silicone oil filling in 11 severely injured eyes (large or multiple intraocular foreign bodies, double perforations, ruptures - all with vitreous hemorrhage and retinal detachment), the authors succeeded in treating the posterior segment trauma with adequate hemostasis in ten cases. During postoperative follow-up of between 12 and 39 months there were no recurrences of hemorrhage. Primary retinal reattachment was achieved in seven eyes. A traction detachment due to proliferative vitreoretinopathy developed in three eyes at a relatively late stage (6-19 months postoperatively): reoperation was successful in two cases. With regard to functional results, six eyes had a visual acuity of between 1/25 and 0.6, and in four it was in the range between perception of light projection and hand movements. There were three cases with keratopathy encouraged by aniridia or hypotonia. One eye with emulsification of the silicone oil developed a secondary glaucoma which responded to topical treatment. In three cases the silicone oil was removed without complications. In one eye there was an expulsive choroidal hemorrhage which could not be managed intraoperatively and which led to phthisis and amaurosis postoperatively.

Adolescent↗