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K D Teichmann

Publications and source records attributed to K D Teichmann.

At least 19 recordsLinked to original sources
PubMed1998

Haptic design for continuous-loop, scleral fixation of posterior chamber lens.

We describe a haptic design for continuous-loop fixation of posterior chamber intraocular lenses (IOLs) to sclera. The haptic ends are broadened to allow two perforations on each haptic through which the sutures are guided. In this manner (satured with continuous loops), a stable four-point fixation is achieved that resists torsional forces, depending only on the mechanical strength of the haptics. Tilt during suture placement can be avoided by inserting the surgical needles and the 27 gauge disposable needles through the sclera at similar angles and distances from the limbus. When tested in a simple experimental model (as well as clinically), the new IOL behaved as predicted. The advantage of this haptic design is a stable, tilt free fixation by a continuous loop that allows the knot to be buried; the disadvantage is that a sophisticated and meticulously executed surgical technique is essential.

Humans↗
PubMed1998

Secondary implantation of scleral-fixated intraocular lenses.

PURPOSE: To evaluate the results of a large series of secondary implantations using scleral-fixated posterior chamber intraocular lenses (IOLs). SETTING: Bellevue Eye Hospital, Kiel, Germany. METHODS: This retrospective review comprised 624 consecutive patients who had secondary implantation of a posterior chamber IOL with scleral fixation between 1988 and 1995. All patients had been aphakic for at least 1 year. An ab interno or ab externo suture technique through the ciliary sulcus was used. Visual outcome and complications 1 year after surgery were determined. RESULTS: Best corrected visual acuity improved or remained unchanged in 92.0% of eyes; 8.0% lost one or two lines. Intraocular lens decentration of more than 1.5 mm occurred in 1.9% of eyes. Suture erosion was observed in 17.9%, cystoid macular edema in 5.8%, retinal detachment in 1.4%, and vitreous hemorrhage in 1.0%. Severe uveitis occurred in 0.5%. CONCLUSION: Secondary IOL implantation with scleral fixation was a safe procedure. Although there was a small risk of significant complications, more than 90% of patients regained or improved their preoperative visual acuity.

Aphakia, Postcataract↗
PubMed1998

Detachment of Descemet's membrane.

PURPOSE: To determine predisposing factors, best method of treatment, and the final outcome in cases of Descemet's membrane detachment. SETTING: A tertiary care teaching eye hospital. METHODS: All cases of Descemet's detachment from January 1986 to May 1994 were retrospectively reviewed. Twelve eyes of 11 patients with partial or total detachment of Descemet's membrane were identified. Patients with small localized detachments at the incision area were excluded. RESULTS: All but one patient had surgical repair. Ten eyes had successful reattachment after up to four attempts at repair. Methods of repair included intracameral air or sulfur hexafluoride (SF6) 20% gas, with or without corneal sutures. After a followup of 3 to 79 months, eight eyes retained clear corneas, four eyes developed corneal edema and scarring, and two required penetrating keratoplasty. No definite predisposing factor could be identified, although four eyes had preoperative diagnoses of glaucoma and recent corneal edema. CONCLUSION: Surgical repair with injection of intracameral air or SF6 20% was successful in most cases of Descemet's membrane detachment. A preoperative diagnosis of glaucoma and a recent episode of corneal edema may increase the risk of detachment.

Aged↗
PubMed1997

Treatment of macular degeneration, according to Bangerter.

Age-related macular degeneration (AMD) is a common cause of visual loss among elderly patients. Although some risk factors have been determined, the ultimate cause of the disease is not known. For a long time, therapeutic nihilism has been the rule among ophthalmologists confronted with such patients. Bangerter has not shared this attitude, especially since the time that he incidentally discovered, more than 40 years ago, the beneficial effects of radiotherapy, in discouraging the growth of new vessels at the posterior pole of the eye. A variety of approaches are combined and used by Bangerter in the treatment of the different types of AMD, including retrobulbar injections of either vasodilating medications (in the dry - or atrophic - type) or corticosteroids (in the wet - or exudative - type), general medical measures aimed at improving metabolic and vascular functions such as supplementation with trace elements, antioxidants, and vitamins; ozone therapy; advice to increase physical fitness, improve nutrition, and abstain from smoking; and protection from excessive light exposure. Being convinced of the usefulness of his type of combination treatment, he has always rejected undertaking controlled clinical trials, of only single aspects of the therapy, as unethical and invalid. For this reason, scientific journals have not proven cooperative in several attempts at publishing his results, as collected in retrospective surveys. Recently, however, some of the several approaches combined by Bangerter in treating AMD have been pronounced effective by other investigators. We present here an overview of his treatment approaches, as few people are aware of them, to clear up misconceptions and to set records straight.

Aged↗
PubMed1997

The torque and tilt gamble.

PURPOSE: To analyze possible suture configurations at the haptics of posterior chamber intraocular lenses (IOLs) and estimate the resulting tilt. SETTING: King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia. METHODS: Using a plastic cylinder with two pairs of holes drilled on opposite sides and an IOL with eyelets in the haptics, we determined possible suture configurations and analyzed them for net torque on the IOL haptics that would result in tilting of the optic. RESULTS: We identified 64 combinations of regular and countless combinations of irregular suture configurations. Among the 16 most likely combinations, only 4 were torque-free (or torque neutral), 2 caused maximum tilt, and 10 induced some tilting. Theoretically, torque could be eliminated by radial suture placement, but this is anatomically undesirable, and by positioning the eyelet perpendicular to the haptic, but this is technically difficult. Longer suture bites tended to lessen the torsion on the haptic but increased the risk of the suture looping around the free end of the haptic. CONCLUSION: Surgeons using scleral fixation of a posterior chamber IOL should be aware of the possibility of inducing tilt and should aim for symmetrical suture configurations at the two haptics.

Foreign-Body Migration↗
PubMed1997

Phacoemulsification at King Khaled Eye Specialist Hospital--the experience of the past.

OBJECTIVE: To study the outcome of phacoemulsification (PE) compared to standard extracapsular surgery before the introduction of state-of-the-art techniques (capsulorhexis, hydrodissection, nuclear cracking, nuclear chopping, sutureless incisions) and sophisticated equipment. STUDY DESIGN: Charts from 375 patients (453 eyes) undergoing PE between 1984 and 1989 were randomly selected and studied retrospectively. A minimum age of 35 years, and a minimum follow-up of three months were required. SETTING: A large eye hospital in the Kingdom of Saudi Arabia staffed with an international faculty of ophthalmic surgeons. PATIENTS: Patients over 35 years of age undergoing PE for immature, mature and traumatic cataract. MAIN OUTCOME MEASURES: Postoperative visual acuity, and rate or frequency of intraoperative complications. RESULTS: 66.5% achieved visual acuity of 20/40 or better, which compares favourably with the 36.5% of eyes reaching this level of visual acuity after mainly standard extracapsular cataract surgery in another study at our hospital. Posterior capsule ruptures occurred in 7.5% and vitreous loss in 5.5%. Other ocular disease (odds ratio 7.51 confidence interval 4.43-12.7) and intraoperative complications (odds ratio 2.97 confidence interval 1.38-6.42) were statistically significant predictors for final visual acuity of under 20/40 (p = < 0.001 and 0.005 respectively). CONCLUSION: The outcome of PE was better than that of standard extracapsular cataract extraction in the same setting. However, since PE appeared to be used selectively, no clear advantage compared to extracapsular cataract extraction is evident in the period before the introduction of modern state-of-the-art PE-techniques.

Adult↗
PubMed1996

Management of perforations during epikeratoplasty for keratoconus.

Epikeratoplasty (EKP) in keratoconus generally has few intraoperative complications. Perforations during EKP are rare but may force the surgeon to abandon the procedure. We developed a special suture technique to manage this problem. Several deep mattress sutures are placed by taking shallow bites of the central corneal rim and deep bites of the peripheral corneal rim. This leaves the peripheral corneal rim projecting forward by approximately one third the corneal thickness. Slight stretching of this peripheral corneal rim allows adaptation of the epilenticule to form a smooth tissue plane. This method was used in two patients with significant corneal scarring and led to satisfactory visual results.

Astigmatism↗
PubMed1994

Retrobulbar (intraconal) anesthesia with a curved needle: technique and results.

We report the results of two prospective studies of retrobulbar anesthesia using curved 25 mm and 28 mm needles. These studies were prompted by our experience with the 25 mm needle in more than 13,000 cases of intraconal anesthesia in which one case of postoperative ischemic neuropathy was the only complication. The technique involves the transcutaneous introduction of the curved needle at the middle of the lower lid, following a curved track close to the inferior orbital wall, around the globe, parallel to the plane of the medial orbital wall (i.e., in a strictly sagittal plane lateral to the optical axis in primary gaze). No complications were noted in the prospective studies. Side effects were chemosis in 30% of cases, subconjunctival hemorrhage in 5%, and lid hemorrhage in 2%. Since these comparative studies, we have used the 28 mm needle without significant complications in more than 8,000 cases. This method of retrobulbar anesthesia is superior to peribulbar anesthesia, and because of its safety and reliability, is preferable.

Aged↗