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Biomedical subjects

K H Emmerich

Publications and source records attributed to K H Emmerich.

At least 19 recordsLinked to original sources
PubMed2002

[KTP laser in lacrimal duct surgery].

PURPOSE: The use of endoscopic methods of examination and treatment has brought new possibilities for non-invasive techniques in lacrimal surgery. The possibilities of the use of a PTP (potassium-titanium-phosphate) laser system are shown. METHOD: The use of a PTP laser for external dacryocystorhinostomy (DCR) as well as for transcanicular methods when connected to an endoscope are shown. RESULTS: With a PTP laser it is possible to make a very precise hole in the bone which simplifies the preparation of the nasal mucosal flap. Endocanalicular procedures for performing laser dacryoplasty with rechanneling of the lacrimal system is possible and examples are demonstrated. DISCUSSION: The high output of a PTP laser of up to 10 W makes a precise preparation of the bone hole for DCR possible. The endoscopic connection opens the possibility of an endocanicular use but the high energy output means that increased scar tissue formation is to be expected.

Dacryocystorhinostomy↗
PubMed2000

[CO2 laser in ophthalmology].

BACKGROUND: Baker et al. used a CO2 laser for blepharoplasty for the first time. The ultra-pulse CO2 laser provides a sophisticated instrument that makes more application alternatives possible in ophthalmology. PATIENTS AND METHODS: From March 1997 to February 1998 surgical operations were performed in the eye clinics in Hagen and Darmstadt using the CO2 laser: 145 eyelid operations and 8 others (enucleation, evisceration, oral mucosa plastic surgery, secondary hydroxyapatite implantation, squint operation). In 34 patients in a total of 64 operations, after an average follow-up period of 7 (4-11) months, an examination was carried out. RESULTS: There were serious complications in only one case. Three weeks after transconjunctival fat resection and resurfacing, one patient developed an inflammatory reaction with resulting ectropion on both sides. During steroid therapy the left lower lid flattened, but on the right side a slight ectropion remained. CONCLUSION: The CO2 laser proved to be a very useful instrument for bloodless tissue-protective surgery without conspicuous scar formation.

Blepharoplasty↗
PubMed2000

[Intraocular pressure response after administration of 3 different viscoelastic agents after cataract operation].

UNLABELLED: By using three different viscoelastics [Adatocel (methylhydroxypropylcellulose), Amvisc Plus (sodium hyaluronate) and Healon (sodium hyaluronate)] a prospective randomized study was conducted to investigate whether postoperative intraocular pressure shows significant differences according to the viscoelastics used after 150 cases of cataract surgery. PATIENTS AND METHODS: The inclusion criteria for this study were: extracapsular cataract extraction via the usual small-incision techniques and endocapsular posterior-chamber lens implantation. A total of 150 eyes were operated upon. The patients were randomly assigned to three groups according to the viscoelastics, 50 cases used adatocel, 50 Amvisc Plus and 50 Healon. As far as possible, the viscoelastics were sucked out under visual control. Intraocular pressure (IOP) was measured after 6 and 24 h. RESULTS: Six hours postoperatively, no statistically significant difference between the intraocular pressure after using different viscoelastics (adatocel: 19.6 +/- 9.7 mmHg, Amvisc Plus: 20.5 +/- 9.6 mmHg und Healon: 21.8 +/- 8.8 mmHg) was seen. At 24 h IOP was statistically significant higher for Healon than for adatocel and Amvisc Plus (adatocel: 16.3 +/- 4.8 mmHg, Amvisc Plus: 16.5 +/- 4.6 mmHg and Healon: 19.7 +/- 6.6 mmHg). CONCLUSIONS: Six hours postoperatively after phacoemulsification there was no significant difference between the IOP using different viscoelastics adatocel, Amvisc Plus and Healon. Twenty-four hours postoperatively a significantly higher intraocular pressure was measured for Healon than for the other viscoelastics.

Adjuvants, Immunologic↗
PubMed2000

[Laser canaliculoplasty].

BACKGROUND: Laser canalicular plastic surgery using the erbium-YAG laser is a new method for treating canaliculus stenosis. We compared results of this method with those of conventional surgical operations on canaliculi. PATIENTS AND METHODS: Between 1996 and 1998 a total of 44 cases of symptomatic canaliculus stenosis were treated by laser. An erbium-YAG laser with a maximum power of 100 mJ was used in conjunction with a sapphire fiber 3 cm long and 325 microns in diameter. Endoscopic diagnosis of the other parts of the lacrimal passage was carried out before and after laser treatment and after tubular intubation. After an average of 12 months the results were assessed via questionnaires and follow-up examinations. RESULTS: The success rate for reducing epiphora was 67%. Overall 86% of patients reported an improvement in canaliculus communis stenosis. CONCLUSIONS: Laser canalicular plasty as minimally invasive surgical treatment is an excellent surgical method for treating point-focal, noninflammatory canalicular stenosis.

Adolescent↗
PubMed2000

Comparison of latanoprost monotherapy to dorzolamide combined with timolol in patients with glaucoma and ocular hypertension.A 3-month randomised study.

BACKGROUND: The purpose of the study was to compare the effects on intraocular pressure (IOP) of adding dorzolamide to timolol or of switching from timolol to latanoprost monotherapy in glaucoma patients inadequately controlled on timolol. METHODS: The study was designed as a 3-month randomised, open-label, multicentre study comprising 183 patients with primary open-angle glaucoma, capsular glaucoma with IOP above 22 mmHg on treatment with one or two ocular hypotensive drugs, or ocular hypertension with IOP above 27 mmHg. After a 2- to 4-week run-in period on timolol, 0.5% twice daily, the patients were randomised to treatment with either latanoprost, 0. 005% once daily, or the combination of timolol, 0.5% twice daily, and dorzolamide, 2% twice daily. The mean diurnal IOP after 3 months of treatment was compared with baseline. RESULTS: Switching from timolol to latanoprost reduced mean diurnal IOP by 4.5+/-0.2 mmHg (mean+/-SEM, ANCOVA; 20%), and adding dorzolamide to timolol reduced mean diurnal by 4.4+/-0.2 mmHg (mean+/-SEM, ANCOVA; 20%). No serious side effects were observed with either treatment. CONCLUSION: Latanoprost monotherapy can be an alternative to combined treatment with two aqueous flow suppressors in patients whose IOP is insufficiently controlled by timolol alone.

Adrenergic beta-Antagonists↗
PubMed1999

[Endoscopic laser dacryoplasty. Methodology and outcome after 3 months].

BACKGROUND: After performing endoscopy of the lacrimal passage, the endoscopic system can be connected to an erbium-YAG laser if the indications are appropriate. MATERIALS AND METHODS: In a bi-center study we performed laser dacryoplasty in 53 cases out of 261 endoscopy procedures (18 stenoses of the canaliculi, 19 stenoses of the sac, 9 stenoses of the nasolacrimal duct, 9 restenoses following DCR). In 35 cases an examination was done and in all 53 cases the results were obtained by means of a questionnaire. RESULTS: Epiphora and irrigation were improved in more than 75%. CONCLUSION: Suitable indications are small stenoses in the sac or duct membranes following DCR. Laser dacryoplasty is a promising method, but more studies still need to be conducted to obtain long-term results. The technical system must also still be improved to make it easier to handle.

Adult↗
PubMed1998

[Dacryoendoscopy--current status].

UNLABELLED: In the years from 1995 to 1997 in the eyeclinic of Darmstadt and the eyeclinic of the St. Josef Hospital Hagen 261 dacryoendoscopies were done in a bicentrical study. PATIENTS AND METHODS: A dacryoendoscopy was done in 261 patients with an average age of 46.6 years (143 women, 93 men and 25 children). In dependance of the assessment of the mucosa conditions intraoperatively in all 261 cases the planed operative strategy was checked and if needed changed. As following surgical interventions of the lacrimal system were seen 70 cases of dacryocystorhinostomia externa, 138 cases of intubation of the lacrimal drainage system and 53 cases of laserdacryoplastic. RESULTS: The dacryoendoscopy had succeeded as method for the assessment of the mucosa conditions [5, 6]. In a study of 261 dacryoendoscopies an examination of the mucosa was possible in every case. No complications were seen while dacryoendoscopy. With help of the dacryoendoscopy the planed operative strategy was determined. Therefore we had the possibility to choose a minimal invasive operation-procedure in 53 cases. CONCLUSIONS: The dacryoendoscopy is a new important diagnostic development in diagnosis of diseases of the lacrimal drainage system. With help of better developed endoscopy-systems a much better quality of the picture is attainable. The results of the dacryoendoscopy offer the possibility to check the preoperative indication and to optimate the surgical treatment. At last only with help of the dacryoendoscopy these findings could be ascertained in which case a laserdacryoplastic is senseful.

Adolescent↗
PubMed1997

[Endoscopy of the lacrimal ducts].

UNLABELLED: The available picturing methods in the diagnosis of functional and mechanical stenosis of the lacrimal drainage system do not allow direct optical evaluation of the mucosa. With the help of dacryoendoscopy, for the first time there is the possibility of receiving a direct morphological picture of the tissue of the lacrimal drainage system. PATIENTS AND METHODS: In a clinical study in the period January to June 1996, 76 dacryoendoscopies were done before an operative intervention in the lacrimal drainage system to find out what information can be obtained with dacryoendoscopy and what use this extra information is. RESULTS: In all of the dacryoendoscopies performed, direct evaluation of the mucosa was possible. Normal findings could be clearly differentiated from mucosa of acute or chronical inflammatory processes. The choice of the operative strategy changed in part of the planned operations, although in 37 cases where the preoperative diagnosis was stenosis of the lacrimal sac, only in 26 cases was dacryocystorhinostomy performed. Dacryoendoscopy provides an additional means of guaranteeing the quality of operative procedures, e.g., after intubation. CONCLUSIONS: Dacryoendoscopy provides an important additional diagnostic possibility in the diagnosis of diseases of the lacrimal drainage system. Dacryoendoscopy offers the possibility of direct evaluation of the mucosa, the choice of operative strategy is checked and, if necessary, changed, and with the connection of an erbium YAG Laser there is minimal invasive surgery with the aim of rechannelization of the lacrimal drainage system.

Adolescent↗
PubMed1997

[Dacryoendoscopy and laser dacryoplasty: technique and results].

BACKGROUND: In a bicentrical study in the eye clinic of Darmstadt and the eye clinic of the St. Josef Hospital Hagen 261 dacryoendoscopies were performed until February 1997. MATERIALS AND METHODS: In 261 dacryoendoscopies (143 women, 93 men and 25 children, the average age was 46.6 years). In dependence of the assessment of the mucosa conditions intraoperatively in all 261 cases the planed operative strategy was checked and if needed changed. After surgical interventions of the lacrimal system 70 cases of dacryocystorhinostomia externa were seen 138 cases of intubation of the lacrimal drainage system and 53 cases of laserdacryoplastic. Intubation of the lacrimal system was always performed after laserdacryoplastic and after a patency was produced (average age 58.3 years). RESULTS: Suitable indications for a laserdacryoplastic are: circumscribed stenosis of the distal saccus, point-sized stenosis of the canaliculus, membranous restenosis after dacryocystorhinostomia externa. The method shows no important rate of intraoperative complications, only in one case there was intraoperatively a protrusion bulbi and a haematoma of the eyelid, which postoperatively eased fastly away. The postoperative convalescence is in comparence to conventional surgical interventions of the lacrimal drainage system enormously shortened. The follow-up after 3 months showed a subjective improvement of epiphora in more than 75% of the patients, the success of this intervention therefore could be compared with conventional surgical methods of the lacrimal drainage system. CONCLUSION: The dacryoendoscopy is a new important diagnostic development, which shows with help of better developed endoscopy-systems compared to previous systems a much better quality of the image and is therefore a valuable diagnostic help. Due to the check of the preoperative indication it is intraoperatively possible to confirm or, if needed, to change the indication after dacryoendoscopy. The laserdacryoplastic is an important new therapeutical development of the dacryoendoscopy and shows in suitable indications a comparable success-rate of conventional surgical interventions of the lacrimal drainage system. Therefore the possibility exists to carry out minimal invasive interventions of the lacrimal drainage.

Adult↗
PubMed1995

[Endonasal implantation of a silicon mold improves the long-term outcome of revision surgery in lacrimal duct stenoses].

BACKGROUND: Uncomplicated dacryocystorhinostomy after dacryocystitis with lacrimal sac obstruction has a success rate of 85%. However therapy of restenosis poses a problem. Vast destruction of lacrimal and nasal mucosa renders the drainage system susceptible for further stenosis. This article presents a new surgical procedure for the treatment of restenosis of the nasolacrimal apparatus. The major difference from other techniques is the endonasal implantation of a silicon foil. This counters the development of synechiae and promotes the epitheliasation of wound surfaces. As a result the nasal mucosa can easier gain access to lacrimal mucosa. A complete mucosal coating of the reconstructed lacrimal drainage system is an important condition for the sufficient drainage of the tear-film. PATIENTS AND METHODS: In 30 patients with restenosis after one or multiple dacryocystorhinostomies a silicon foil was implanted endonasally as part of their surgical revision. After skin incision and removal of scar tissue the bony ostium was enlarged. The canaliculi were intubated with silastic tubing. Afterwards the endonasal synechiae were split and a 0.2-0.4 mm silicon foil was implanted endonasally und fixed. The silastic tubing was brought through a hole in the silicon foil and knotted inside the nose. Then the wound was closed. Postoperative evaluation of the surgical success ranged from 3 to 36 months (mean 16 months). RESULTS: The postoperative result was good in 24 patients. Sixteen patients were without symptoms. 8 had epiphora only on stress. The latter felt their situation to be greatly improved. The long-term results were directly proportional to the amount of reconstructable mucosa and inversely proportional to the severity of canaliculus damage. Adverse reaction to the silicon foil were not noted. CONCLUSION: Endonasal implantation of a silicon foil is a new, easy and successful technique for the treatment of endonasal synechiae and restenosis of the nasolacrimal apparatus.

Adolescent↗
PubMed1994

[Dacryocystorhinostomia externa. Technique, indications and results].

In a retrospective study on the years 1978-1989, the data we obtained on 1014 operative procedures of external dacryocystorhinostomy at the University Eye Hospital in Münster showed an age distribution of 2-93 years with a maximum in the 5th to the 7th decade (average 53.2 years) and a sex relationship of 61% females and 39% males. In the etiology of dacryostenosis, 60% of the patients had recurrent chronic dacryocystitis, 32% history of acute dacryocystitis, 7% facial trauma and less than 1% of the cases (n = 5) tumor diseases. The functional success rate was 85% in a postoperative follow-up period of 1-11 years (average 35.6 months). No serious intra- or postoperative complications were seen.

Adolescent↗
PubMed1991

[Cold dosage in retinal cryotherapy using echography].

In cases of obscured view of the fundus a precise timing of cryotherapy of the retina is not possible. In order to avoid complications from overtreatment we use the real time ultrasonography for monitoring the spreading ice in relation to the retina.

Cryosurgery↗
PubMed1991

[Induction of chromosome aberrations in human lymphocytes as a model for evaluating the mutagenic effect of excimer laser irradiation in ophthalmology].

A model for testing the mutagenicity of excimer laser radiation in ophthalmology is presented. In contrast to other studies using cell monolayers, in our study with this model human peripheral lymphocytes (heparinized whole blood) are exposed to laser irradiation at different conditions. The possible mutagenicity of secondary radiation after exposure of the cornea is also considered. The heparinized blood is either injected into the anterior chamber of an enucleated bovine eye or filled into a quartz chamber (positive control). After irradiation the lymphocytes are stimulated and fixed during metaphase, after which the metaphases are scored for chromatid and chromosome aberrations. In the positive control group, exposure to 248 nm excimer laser radiation (500 J, 277 mJ/cm2, 10 and 20 Hz) was followed by a highly significant increase in the yield of chromatid aberrations (chromatid breaks and achromatic lesions).

Animals↗
PubMed1991

[Reasons for failure after episcleral buckling operation of the retina].

In this retrospective study about failures of epiretinal buckling procedures performed over 12 years the causes of failure are analysed. The main ones are: new retinal holes, PVR, wrong localization, and inadequate buckling effect. The aim of this investigation was to find indications of the best technique, with a view to improving the success rate, currently, 80-90%, even further.

Adolescent↗