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Biomedical subjects

M Busin

Publications and source records attributed to M Busin.

At least 37 records · Page 2Linked to original sources
PubMed1993

Long-term results of sutureless phacoemulsification with implantation of a 7-mm polymethyl methacrylate intraocular lens.

In an attempt to minimize postoperative astigmatism while retaining the advantages of implanting intraocular lenses with large optics, sutureless phacoemulsification with implantation of a 7-mm polymethyl methacrylate intraocular lens was performed through a modified scleral tunnel in 100 consecutive patients. Visual and keratometric results, as well as complications, were recorded during a follow-up period of 12 months. Average uncorrected visual acuity improved from 20/153 before surgery to 20/66 as early as 1 week after surgery. Average best corrected visual acuity improved from 20/86 before surgery to 20/39 as early as 1 week after surgery. No significant changes in visual acuity were recorded thereafter. The absolute value of keratometric astigmatism was not increased significantly at any postoperative examination time. The induced cylinder shifted from 1.26 diopters x 74.40 degrees at 1 week to 1.22 D x 1.50 degrees at 1 month after surgery, without further relevant changes thereafter. Mean (+/- SD) endothelial cell loss was 7.2% +/- 6.1% at 1 month and 12.2% +/- 5.4% at 6 months after surgery. Corneal thickness was not increased significantly at any postoperative examination time. Implantation of intraocular lenses with large optics through a scleral tunnel allows quick visual rehabilitation as well as early stability of refraction.

Adult↗
PubMed1993

Epithelial interface cysts after epikeratophakia.

BACKGROUND: Epithelial interface cysts have been occasionally observed after lamellar keratoplasty. The authors report the incidence, clinical significance, and management of this complication in epikeratophakia patients. METHODS: From August 1987 to January 1991, 108 consecutive patients undergoing epikeratophakia entered a prospective study aimed at evaluating both clinical results and changes in corneal physiologic parameters. After an average hospitalization of 6 days, all patients underwent complete ophthalmologic examinations at regular intervals after surgery. All postoperative complications, including the development of epithelial interface cysts, were recorded and photographed. RESULTS: Over a 3-year period, epithelial interface cysts were observed in 8 eyes, with an overall incidence of 7.4%. All cysts originated under the periphery of the epilens. In five patients, the cysts enlarged centripetally but eventually ceased to grow, causing no visual impairment. In two patients, after an initial increase in size the cysts slowly regressed and finally disappeared. In only one patient, a cyst migrated over the visual axis, thus necessitating surgical removal. The cyst did not recur during an observation time of 18 months after debridement, allowing full recovery of visual acuity. CONCLUSION: The incidence of epithelial interface cysts after epikeratophakia is relatively high. Because of their peripheral location and self-limited growth, the clinical significance of this complication is low. The possibility of spontaneous regression of the cysts supports a conservative approach, as long as the visual axis is not affected. Surgical removal is possible without compromising the epi-lens and is compatible with an excellent visual outcome.

Adult↗
PubMed1993

[Phacoemulsification without suture. Results of implantation of a large optic PMMA lens].

Sutureless phacoemulsification with implantation of a 7-mm PMMA intraocular lens was performed through a modified scleral tunnel in 100 consecutive patients. This was done to minimize postoperative astigmatism while retaining the advantages of implanting intraocular lenses with large optics. Visual and keratometric results and complications are reported after completion of a follow-up period of 6 months for the first 30 patients. Average uncorrected visual acuity improved from 0.13 preoperatively to 0.30 as early as 1 week postoperatively. Average best-corrected visual acuity improved from 0.23 before surgery to 0.51 as early as 1 week after surgery. No significant changes in visual acuity were recorded thereafter. The absolute value of keratometric astigmatism was not increased significantly at any postoperative examination time. The induced cylinder (Jaffe and Clayman) shifted from -1.27 D x 166 degrees at 1 week to 1.18 D x 91 degrees at 1 month postoperatively without further relevant changes thereafter. Endothelial cell loss did not differ from that reported by other authors after conventional cataract surgery. Corneal thickness was not increased significantly at any postoperative examination time. Implantation of intraocular lenses with large optics through a scleral tunnel allows quick visual rehabilitation as well as early stability of refraction.

Adult↗
PubMed1992

Physiologic analysis of corneal healing after epikeratophakia.

The evaluation of epithelial permeability, stromal transparency, and endothelial cell density is essential to determine the resumption of normal function in each corneal physiologic unit after refractive surgical procedures. The authors report the results of a prospective study conducted in 55 consecutive patients undergoing epikeratophakia using prelathed, lyophilized tissue lenses. Epithelial permeability was evaluated by means of fluorophotometry preoperatively and 1, 2, 4, 8, 12, 24, and 52 weeks after epikeratophakia. With few exceptions, Scheimpflug photography also was performed at the same examination times to assess stromal optical density. Endothelial cell counts were performed in each patient preoperatively and between 6 and 12 months postoperatively. The epithelial barrier function resumed normal values within 8 weeks after epikeratophakia. The optical density of both donor lenticule and recipient corneas was initially increased but returned to values comparable with those of unoperated corneas by 12 weeks postoperatively. Endothelial cell density was not affected by epikeratophakia. These results confirm the authors' preliminary observation that epikeratophakia allows a relatively quick recovery of normal corneal functions and should prompt investigators to demonstrate the safety of other refractive surgical procedures in a similar way.

Aged↗
PubMed1992

[The status of the prosthodontic care of poor adults in Zurich].

This study wants to give an overview of the prothetical state of treatment of low-income, above-50-year-old patients, who called for examination and treatment at the Cantonal Public Dental Clinic of Zurich. An average of 11.5 own teeth, excluding wisdom teeth, were found among the 151 test persons, whose mean age was 71 years. 30 persons (19.9%) were edentulous. Removable dentures were found significantly more often than fixed reconstructions: 72.5% of the test persons were equipped with removable dentures and 17.2% with fixed bridges. More than 50% of the examined dentures showed hard and/or soft accumulation of plaque and calculus. 43% of the anchor teeth of all partial dentures and 16.3% of all bridge pillars showed carious lesions. About two-thirds of the "denture patients" were not satisfied with their removable denture and wished an adjustment or a new one. These results point out a big need for prothetical treatment among the examined patient group.

Aged↗
PubMed1991

Leukoplakia of the cornea presenting as fingerprint epithelial lines: a case report.

Opacities in association with fingerprint patterns of the epithelium were seen in the upper half of the right cornea of a 52-year-old patient complaining of decreased vision. Removal of the corneal epithelium from the involved area resulted in visual improvement and normalization of corneal appearance. Histological examination of the removed epithelium failed to reveal the typical intraepithelial formation of basement membrane invaginations even in the areas corresponding to the fingerprint patterns. Moderate to severe degree of atypia were seen in the epithelial cells. No abnormalities were observed in 3 conjunctival specimens excised at the time of epithelial removal. The diagnosis of corneal dysplasia (leukoplakia) was made. Our report is the first description of epithelial fingerprint patterns of the cornea associated with leukoplakia.

Basement Membrane↗
PubMed1991

Is chronic intraocular inflammation after lens implantation of bacterial origin?

In an effort to better understand the cause of chronic intraocular inflammation after intraocular lens (IOL) implantation, both scanning and transmission electron microscopy were used to compare 1 anterior chamber, 1 iris-fixated, and 3 posterior chamber IOLs removed for this condition between 2 and 16 months after implantation with 8 IOLs explanted for other reasons (decentration in 4 cases, bullous keratopathy in 4 cases). Colonization with non-slime-producing, as well as slime-producing bacteria (1 case) in the presence of a thin membranous structure of cellular origin (multinucleated giant cells and macrophage-like cells) was demonstrated on all of the 5 IOLs explanted from inflamed eyes. Neither bacteria nor membranous structures could be identified on the IOLs removed because of dislocation or from eyes with bullous keratopathy. These observations indicate that bacterial colonization and the consequent host response may be characteristic features of many otherwise unexplained cases of intraocular inflammation after IOL implantation.

Aged↗
PubMed1991

Mycotic infection of the capsular bag in postoperative endophthalmitis.

A case of mycotic infection after uncomplicated extracapsular cataract extraction with implantation of a posterior chamber modified C-loop intraocular lens (IOL) is reported. Severe postoperative intraocular inflammation, diagnosed by aqueous cultures as secondary to Staphylococcus aureus endophthalmitis, did not respond to antibiotic therapy. Despite IOL and capsular bag removal and further antibiotic treatment, the inflammation persisted and phthisis followed. Retrospective electron microscopic examination of the explanted material demonstrated the presence of abundant fungal elements in the capsular bag and spores on the IOL surface. Vitreous taps performed at the time of explantation were negative for bacteria and fungi, confirming the localized nature of the mycotic infection. To our knowledge this report represents the first observation of a mycotic infection confined to the capsular bag after cataract surgery with implantation of a posterior chamber IOL.

Aged↗
PubMed1991

[Surgical therapy of keratoconus. Epikeratophakia versus penetrating keratoplasty].

Fifteen consecutive keratoconus patients undergoing epikeratophakia and 10 consecutive keratoconus patients undergoing penetrating keratoplasty were included in a prospective study aimed at comparing the visual and refractive results of the two surgical methods. All patients had a minimum postoperative follow-up time of 12 months. Although patients undergoing epikeratophakia showed a tendency for quicker visual rehabilitation, visual acuity was comparable in the two groups as early as 3 months after surgery. The refractive results did not differ significantly in the two groups 12 months postoperatively. Epikeratophakia should be recommended for all keratoconus patients who cannot benefit from conservative treatment (spectacles or contact lenses) and who do not have central corneal opacities, especially in view of the absence of postoperative immunological rejections.

Adult↗
PubMed1991

Combined relaxing incisions and epikeratophakia for the correction of aphakia and high postkeratoplasty degree astigmatism.

A combined surgical procedure consisting of corneal relaxing incisions and epikeratophakia was used to correct high-degree postkeratoplasty astigmatism and aphakia in two patients. Both patients achieved their final refractive result as soon as 1 month after suture removal (2 and 3 months after surgery, respectively). Keratometric readings showed a reduction of approximately 20.00 diopters in one case and 10.00 D in the other, while the spherical equivalent changed from +10.00 D to +0.50 D in one eye and from +7.50 D to +1.75 D in the other. Spectacle correction was prescribed for both patients. At the last follow-up visit, about 2 years after surgery, these values were unchanged. The main advantage of the combined technique over two separate procedures was that postoperative visual rehabilitation was faster. Equally important was the stability of the refractive result over a long period of time after surgery, as well as the absence of negative effects on the preexisting corneal graft. In spite of the technical complexity of a combined surgical procedure, this approach probably represents the best choice in rare cases such as the ones reported here.

Aphakia↗
PubMed1991

[The oral health status and dental care of adults with limited incomes].

The aim of the present study was to assess oral health conditions and the level of dental care of 151 patients of the Public Dental Clinic of Zurich in order to evaluate the necessity of dental treatment. The patients examined had a mean age of 70.6 years (range 50 to 94 years) and they went to the clinic either for the first time or had been treated or examined more than two years ago. 83% of the patients lived in the city of Zurich, and 17% in the state of Zurich. 20% of the patients had a general dental check-up every year while 80% only looked for dental care when particularly needed. This fact was reflected by the generally bad oral health conditions presented by the 151 patients: 26% of the remaining teeth had carious lesions. 32% of the restorations were insufficient. 80% of the probing sites showed an average probing depth greater than 3 mm. 80% of the patients had a complete natural dentition or were partially edentulous. The partially edentulous group had an average loss of 59% of the originally present natural teeth. Of the 2492 (100%) lost teeth, 17% were not replaced, 3% were replaced by fixed and 80% by removable prosthodontics. These results indicate that restorative and reconstructive dentistry still represents a major part of dental treatments performed in the Public Dental Clinic of Zurich.

Aged↗
PubMed1990

Complications of sulcus-supported intraocular lenses with iris sutures, implanted during penetrating keratoplasty after intracapsular cataract extraction.

In a retrospective study, the authors analyzed visual results and postoperative complications in a series of 14 consecutive patients who had undergone penetrating keratoplasty and implantation of a posterior chamber intraocular lens (PC IOL) in the absence of the posterior capsule. Seven patients suffered from aphakic bullous keratopathy and seven from pseudophakic bullous keratopathy. Postoperative follow-up was 7.6 months on the average. Best-corrected postoperative visual acuity was 20/60 or better in four cases and 20/200 or better in eight. Glaucoma was present before surgery in four eyes, which persisted in all cases and developed in four new cases. Results of gonioscopic examination showed the postoperative development of goniosynechiae in four eyes. Pseudophakodonesis of various extent was present in ten eyes. Preoperatively, cystoid macular edema was diagnosed angiographically in one case. It did not improve after surgery and was seen in three additional eyes postoperatively. Causes for postoperative visual acuity lower than 20/200 were cystoid macular edema in three cases, graft rejection in one case, central retinal scar in one case, and optic nerve atrophy in one case. A distortion of the pupil was seen in three eyes in miosis and in four additional eyes in mydriasis. Corneal thickness as well as anterior chamber depth were within normal limits. Fluorophotometric evaluation of the blood-aqueous barrier showed values comparable with those obtained after intracapsular cataract extraction and implantation of an iris-fixated IOL. Despite the relatively good visual results, the high postoperative incidence of cystoid macular edema and/or glaucoma may discourage the use of this technique.

Aged↗
PubMed1990

Evaluation of functional and morphologic parameters of the cornea after epikeratophakia using prelathed, lyophilized tissue.

Up to now, the attention of ophthalmic surgeons has been focused mainly on the clinical results of epikeratophakia, demonstrating its safety, relative predictability, and capability of correcting a wide range of refractive errors. However, no prospective study has ever been undertaken to evaluate the influence of epikeratophakia on various physiologic and morphologic parameters of the cornea. The authors investigated some of these parameters prospectively in eight consecutive patients undergoing epikeratophakia with prelathed, lyophilized tissue. Fluorophotometric evaluation of the epithelial barrier function, corneal densitometry by means of Scheimpflug photography, and endothelial specular microscopy were performed preoperatively and 2, 4, 8, 12, and 24 weeks after epikeratophakia. The epithelial barrier function was shown to return to normal 4 weeks after surgery. The optical density of both the epi-lenses and the host corneas increased early after surgery, but was comparable to that of unoperated corneas 6 weeks postoperatively in all cases but one. The endothelial cell density was not altered by surgery in any patient. Despite the limited number of patients, this study indicates that most functional and morphologic parameters of the cornea are normal as early as 6 weeks after epikeratophakia in most cases.

Aphakia↗
PubMed1990

[Epikeratophakia].

Since its introduction by Kaufman in 1979, epikeratophakia has been used successfully in several thousands of patients for the correction of refractive errors. With this technique the original curvature of the cornea is changed by suturing onto it a preshaped lenticule. Depending on the different types of refractive errors to be corrected, the tissue lens is a plus lens (aphakia, hyperopia), a minus lens (myopia), or a plano lens (keratoconus). Both prelated, lyophilized tissue lenses and freshly cut lenticules have been employed with good results. However, the simplicity of the surgical technique, as well as the possibility of rejection of fresh corneal tissue, has made use of the former type of epikeratophakia lenses much more common. The basic indication for epikeratophakia is the incapability of correcting refracting errors with conservative methods, such as glasses, contact lenses or, in cases of aphakia, intraocular lenses. The results obtained in a series of 71 patients who underwent epikeratophakia at our Institute compare favorably to those reported in the literature. Following are some of the factors we identified as being responsible for our improved results: (1) the performance of all surgical procedures by the same corneal surgeon; (2) a longer hospitalization period and thereby closer observation of all patients and possible detection of early complications; (3) long-term postoperative follow-up examinations of all patients by the operating surgeon. In summary, epikeratophakia has been shown to be a safe, effective and potentially reversible procedure for the correction of refractive errors.

Cornea↗
PubMed1989

Automated corneal topography: computerized analysis of photokeratoscope images.

The analysis of corneal topography has recently become popular, mainly as a consequence of the rapid development of refractive surgery techniques. To date, computer-assisted evaluation of photokeratoscope pictures has been the most popular method used to assess corneal topography. The processing system described previously by other authors requires hand-digitizing of the photokeratoscope pictures and therefore the constant presence of an operator for a considerable amount of time. We have introduced the use of a video camera to digitize the photokeratoscope images, making the processing automatic and quicker. Moreover, precision glass spheres have been used to calibrate the system in order to minimize the intrinsic errors even further. The data obtained from the computerized analysis are presented in three different ways. Besides having the numerical values in diopters, corneal maps with various shades of grey are used, together with the quantitative, three-dimensional representation of corneal astigmatism. An automated system for the analysis of corneal topography was tested for both experimental models and clinical conditions. It was easy to use and showed high precision (less than 1% error when processing photographs of precision glass spheres).

Cornea↗
PubMed1988

Sustained gentamicin release by presoaked medicated bandage contact lenses.

Current therapeutic regimens for external ocular infections require instillation of antibiotics up to every quarter of an hour in concentrations higher than those commercially available. As an alternative to topically applied gentamicin eye drops, the possibility of sustained gentamicin release by bandage contact lenses was investigated. Ten hydrogel bandage contact lenses (61.4% HEMA and 38.6% water content) were soaked overnight in a 0.5% solution of sterile, unpreserved, commercially available gentamicin, and fitted thereafter on ten eyes of healthy adult volunteers. Gentamicin concentrations in the tear film were determined 10, 30, and 60 minutes, and 4, 8, 24, 48, 72, and 96 hours after fitting, using agar diffusion bioassay. Bactericidal concentrations (greater than 1.6 micrograms/ml) were found up to 3 days after contact lens fitting in all subjects. No toxic topical or systemic effects were seen.

Adult↗
PubMed1987

Intraocular lens removal during penetrating keratoplasty for pseudophakic bullous keratopathy.

Pseudophakic bullous keratopathy is now the most common reason for penetrating keratoplasty. In previous reports, the type of intraocular lens (IOL) most frequently encountered in these eyes was the iris plane IOL. The authors reviewed 27 cases of IOL removal during penetrating keratoplasty. Lenses were removed if they were dislocated or associated with iritis, recurrent hyphema, glaucoma, or persistent cystoid macular edema. The IOL encountered most often was the anterior chamber lens (in 22 eyes); closed thin loop, semiflexible or flexible anterior chamber lenses accounted for 19 of these. Iris plane lenses were removed from five eyes. No posterior chamber lenses were removed. Clear grafts were obtained in 24 of 27 cases (89%); visual acuity improved or remained the same in 24 cases, to 20/60 in 11 cases. The most common causes of poor postoperative vision were retinal disease (6/27 cases) and glaucoma (6/27 cases). The association between anterior chamber lenses and pseudophakic bullous keratopathy is probably the result of both the increase in use of these lenses and the documented propensity of the closed loop semiflexible anterior chamber lenses to cause complications.

Corneal Diseases↗