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Biomedical subjects

M J Groh

Publications and source records attributed to M J Groh.

At least 19 recordsLinked to original sources
PubMed2001

[Postoperative opacification of 12 hydrogel foldable lenses (Hydroview(R))].

BACKGROUND: To evaluate postoperative lens opacifications in foldable hydrophilic intraocular lenses. PATIENTS AND METHODS: 12 patients (9 female; 3 male; mean age 77.5 +/- 3 years) were referred from one ophthalmologic surgeon because of opacification of IOLs and markedly decreased visual acuity. Time between implantation and explantation varied from 8 month to 3 years. IOL explantation was performed in all 12 patients and IOL were examined by light-, transmission- and scanning electron microscopy. RESULTS: IOL-explantation was uneventful in all 12 patients. The explanted IOLs showed crystalline deposits 0.5 to 2 microm in diameter immediately beneath the surface of the lens. Eight of 12 patients had elevated serum levels for glucose (6 patients with manifest diabetes mellitus, 2 patients with pathological elevated levels for glucose). CONCLUSIONS: Postoperative opacification of hydrogel foldable lenses (Hydroview(R)) are apperantly caused by formation of crystalline deposits beneath the lens surface. These deposits may be associated with metabolic disorders, e.g. diabetes mellitus.

Adsorption↗
PubMed2001

Screening models for glaucoma.

For social and economic reasons, glaucoma screening is a useful and necessary task, with possible benefits for individuals and the health care system arising from the early diagnosis and early therapy of patients with glaucoma. Early treatment of patients with glaucoma decreases the probability that those patients will become blind and lowers the direct and indirect costs for patients with glaucoma. Most of the reported studies dealing with glaucoma screening used only one parameter (eg, intraocular pressure) to detect and to discriminate glaucoma patients from healthy subjects. Glaucoma screening devices might be combined to obtain the best specificity and sensitivity. Because the diagnosis of glaucoma is very closely associated with a morphologic change in the optic nerve head, one screening parameter should be the morphology of the papilla. To increase specificity and sensitivity, a combination of morphologic and functional testing might be useful. In this review, we report the context of glaucoma screening in terms of health economics, the testing quality of devices for functional and morphologic screening, and the results of a pilot study.

Adult↗
PubMed2000

[Development of endothelial cell number in the host corneal endothelium. Status after block excision and eccentric corneal scleroplasty].

PURPOSE: Block excision of anterior uveal tumors and cystic epithelial ingrowth to the anterior chamber is a curative treatment for morphological rehabilitation of the globe. This study quantified the course of the host corneal endothelium after this peripheral corneoscleral graft. PATIENTS AND METHODS: This retrospective cross-sectional study examined 53 specular microscopic photographs of the central host cornea in 30 patients. The diameter of the block excision was 8.5 +/- 1.9 mm (6.0-11.0 mm). Follow-up after surgery averaged 37.9 +/- 47.6 months (1-216). RESULTS: The corneal endothelial cell count decreased with the duration of follow-up after block excision. The cell count was not related to indication for surgery or to diameter of block excision. Mean visual acuity was 16/20 before block excision and 6/20 at the end of follow-up. CONCLUSION: There is a significant loss of endothelial cells of the host after block excision, requiring a second central penetrating keratoplasty in some patients. Loss of endothelial cells may be due to the surgical trauma, chronic immunological reaction against the donor endothelium, or migration of the host endothelial cells onto the corneoscleral graft.

Adult↗
PubMed2000

[Mid- and long-term results after trabeculectomy in patients with juvenile and late-juvenile open-angle glaucoma].

BACKGROUND: To determine success rate of trabeculotomy in patients with juvenile and late-juvenile glaucoma in a retrospective study. PATIENTS AND METHODS: 46 eyes of 41 juvenile glaucoma-patients (24 female, 17 male) were submitted to trabeculotomy during the period of 1980-1997. Patients age at the time of surgery was 30.2 +/- 10.5 years (11-49 years, median 21 years). Follow-up time was 35 +/- 46 months (1-155 months). RESULTS: Median preoperative visual acuity was 1.0 (range 0.002 to 1.25), postoperative visual acuity at the end of the follow up period was 0.8 (median) with a range from 0.002 to 1.2. In all patients preoperative intraocular pressure was elevated and a glaucomatous configuration of the optic disc was noticed. Preoperative intraocular pressure (IOP) ranged from 30.5 +/- 13.2 mm Hg, after surgery IOP was 16.2 +/- 5 mm Hg. Mean decrease of the IOP postoperatively was 54.4%. In 37% of the eyes IOP was lower than 23 mm Hg without additional medication, in 47% of the eyes IOP was lower than 23 mm Hg with additional medication. In 8 eyes additional antiglaucoma-surgery was necessary. After a follow-up time of 60 months 81% of the patients (n = 37 eyes) had an IOP below 23 mm Hg, after 120 months in 80% of the patients (n = 29 eyes) IOP was below 23 mm Hg. CONCLUSION: The success rate of trabeculotomy (defined as the ability to lower intraocular pressure lower than 23 mm Hg with or without antiglaucoma medication) in our patients is 84%. After second operation, success rate is 89%. Trabeculotomy for patients with juvenile open angle glaucoma is a safe procedure and avoids problems and complications of filtering procedures.

Adult↗
PubMed1999

[Changes in retinal blood flow by topical administration of 0.1% dipivefrin].

PURPOSE: Most of the antiglaucomatous drugs affect ocular blood flow. Blood flow of the anterior uvea under the effect of glaucoma medication has been described in the literature, but measurement of microcirculation at the posterior pole correlated to glaucoma medication is rarely found. We present a placebo-controlled study in which we focused on the short and long-term effects of topical dipivefrine 0.1% on the microcirculation of the retina and optic nerve head. PATIENTS AND METHODS: In a randomized, placebo-controlled double-masked study we examined 40 healthy persons (21 male and 19 female) with a mean age of 35 +/- 4.6 years. Two groups of volunteers (n = 20) were treated either with placebo or dipivefrine 0.1% for 5 days twice a day. Measurement of microcirculation was done at baseline, 30 min after the first application and on days 3 and 5. Microcirculation was evaluated by scanning-laser Doppler flowmetry (SLDF, Heidelberg Engineering; Heidelberg, Germany) [retinal and optic nerve head capillary blood flow (ONH)]. Systemic parameters were checked at all times of blood flow measurement (blood pressure, pulse); intraocular pressure (IOP) was also measured at baseline, 30 min after and on days 3 and 5. RESULTS: Systemic parameters: None of serum medications affected blood pressure or pulse. Dipivefrine 0.1% lowered the IOP significantly (P = 0.01). Microcirculation: dipivefrine 0.1% leads to a significant reduction of retinal capillary blood flow (P = 0.01). ONH blood flow was not significantly affected by dipivefrine 0.1%. CONCLUSION: Retinal capillary perfusion is affected by dipivefrine 0.1% medication. In neuroprotection, it is of interest that glaucoma medication did not alter the microcirculation in a way that leads to an increase of hypoxemia. Therefore, we consider dipivefrine 0.1% not to be useful for long-term glaucoma treatment.

Adult↗
PubMed1999

[Value of conjunctival biopsy in diagnosis of sarcoidosis].

PURPOSE: Retrospective study concerning the value of conjunctival biopsy in the diagnosis of sarcoidosis. PATIENTS AND METHODS: Between 1990 and 1996 we performed conjunctival biopsy in 11 patients (mean age 42.7 +/- 16.4 years) with suspect of sarcoidosis. RESULTS: In 8 of the 11 patients the diagnosis of sarcoidosis was established during the clinical course. In four of these eight patients conjunctival biopsy was positive. Five of the eight were under systemic steroids at the time of biopsy. Of the four patients with clinically established sarcoidosis and negative biopsy, three were under systemic steroids at the time of biopsy. In two patients diagnosis of sarcoidosis was established primarily by conjunctival biopsy. CONCLUSION: Conjunctival biopsy is a simple tool in the diagnostic of sarcoidosis. If possible, biopsy should be undertaken before systemic steroid treatment. We consider conjunctival biopsy to be useful as the first diagnostic tool before other invasive methods.

Adult↗
PubMed1999

Rhegmatogenous retinal detachment after block excision of epithelial implantation cysts and tumors of the anterior uvea.

OBJECTIVE: To report on frequency, time of occurrence, treatment, and final outcome of rhegmatogenous retinal detachment after block excision, combined with corneoscleral tectonic grafts, of intraocular epithelial implantation cysts and tumors of the anterior uvea involving the anterior chamber angle. DESIGN: Noncomparative case series. PARTICIPANTS: The study included 144 patients who had consecutively undergone scleral full-thickness block excision of tumors of the anterior uvea (n = 87) or intraocular epithelial implantation cysts (n = 57). Diameter of the block excision ranged between 5.5 and 20 mm. In 39 patients, the tumor extended posterior to the ora serrata. INTERVENTIONS: Retinal detachment surgery. MAIN OUTCOME MEASURES: Retinal detachment rate, visual acuity, risk factors. RESULTS: Retinal detachment occurred in 10 (6.9%) of 144 patients (2 of 57, or 3.5% of patients with cysts; 8 of 87 or 9.2% of patients with tumors) 3 to 12 months after block excision. Six patients underwent primary pars plana vitrectomy with temporary endotamponade by silicone oil, which was removed 3 to 9 months later. In four patients, a scleral buckling procedure only was performed. After a mean follow-up of 31 months after silicone oil removal or the buckling procedure (median, 30 months; range, 13-42 months), the retina has remained attached in all patients operated on. Visual acuity increased from 2/20 (median; range, light perception-6/20) to 8/20 (median; range, 2/20-12/20). In the eyes with retinal detachment compared to the eyes without retinal detachment, the block excision was significantly larger (13.75+/-4.86 mm vs. 9.41+/-3.02; P = 0.01) and was located significantly more posteriorly (limbus distance of posterior excision margin: 6.75+/-2.87 vs. 4.35+/-3.24 mm; P = 0.01). CONCLUSIONS: Scleral buckling procedures and primary pars plana vitrectomy with temporary ocular endotamponade can give acceptable results in eyes with rhegmatogenous retinal detachment occurring after block excision of epithelial implantation cysts or tumors of the anterior uvea. Despite intraoperative vitreous prolapse or tumor extension posterior to the ciliary body, rhegmatogenous retinal detachment occurs in fewer than 10% of patients undergoing block excision of cysts or tumors of the anterior uvea. Size and posterior location of the block excision are the main risk factors for rhegmatogenous retinal detachment, which becomes unlikely later than 12 months after surgery.

Adolescent↗
PubMed1999

[Expulsive hemorrhage in perforating keratoplasty--incidence and risk factors].

BACKGROUND: Expulsive hemorrhage is a severe complication of intraocular surgery. In a retrospective study we looked up surgical records of all penetrating keratoplasties (PK) performed in our department between 1989 and 1998. In all patients suffering from expulsive or preexpulsive choroidal hemorrhage we intended to find out possible risk factors and to report on the final outcome of these eyes. PATIENTS AND METHODS: Between January 1989 and November 1998 a total of 2421 PKs were performed. Nine preexpulsive and three expulsive hemorrhages occurred. The group of patients with preexpulsive hemorrhage consists of four females and five males (mean age 57 +/- 6.5 years). Three patients (one female, 2 males; mean age 67 +/- 8.5 years) suffered from expulsive hemorrhage. RESULTS: Incidence of expulsive hemorrhage was 0.1% (preexpulsive hemorrhage 0.4%). All twelve operations were performed under general anesthesia. Risk factors for preexpulsive hemorrhage were: previous ocular surgery (three patients), ocular trauma (2 patients) and internal diseases (five patients): arterial hypertension, coronary heart disease, diabetes. Preoperative visual acuity was light perception to 4/20, visual acuity at the last postoperative examination after a mean follow-up of 41.0 +/- 22.6 months ranged from light perception to 12/20. Risk-factors for expulsive hemorrhage were: previous ocular surgery (two patients), primary open angle glaucoma (two patients), coronary heart disease (one patient) und asthma bronchiale (one patient). One of the patients awoke from general anesthesia during the "open-sky" situation. Preoperative visual acuity was light perception to 2/400, visual acuity at the last postoperative examination (mean follow-up 14.0 +/- 1.0 months) was light perception in all eyes. CONCLUSION: The incidence of an expulsive hemorrhage was 0.1% in 2412 Pks. Risk factors are ocular and internal predispositions which can hardly be controlled, although arterial blood pressure was not significantly elevated during opening of the globe.

Adult↗
PubMed1999

[Congenital divided compound nevi of the eyelids].

BACKGROUND: Congenital divided nevi of the eyelids are a rare melanocytic lesion. Only 30 patients are reported in literature. We report on a 6-year-old boy and a 41-year-old male with this lesion and give a short overview of the literature. CASE REPORTS: Patient 1: A 6-year-old boy presented with a pigmented divided nevus of the left eye involving the upper and lower lid naselly. The lesion had increased in size in the last one year. Otherwise the results of ophthalmological examination were unremarkable. The divided nevus was completely excised. Histopathological studies revealed a melanocytic compound nevus. Patient 2: A 41-year old male presented in our department with a divided pigmented nevus on his left eye involving the upper and lower lid laterally. The lesion had gradually increased since birth. Otherwise the results of ophthalmological examination were unremarkable. A subtotoal excision and debulking procedure was performed. The defect in the lower eyelid was covered using a transposition flap from the upper eyelid. Histopathological examination revealed a melanocytic compound nevus. CONCLUSION: Divided nevi of the eyelids may be disfiguring and include the possibility of deprivation amblyopia when reaching a certain size in childhood. Malignant changes of this lesion were not observed so far. Total excision or subtotal excision and a debulking procedure may be helpful.

Adult↗
PubMed1999

[Clearing of the host cornea after penetrating keratoplasty for pseudophakic bullous keratopathy].

BACKGROUND: In this study, we have focussed on the clearing of the host cornea after successful penetrating keratoplasty (PK) for pseudophakic bullous keratopathy and the clinical factors that may influence this phenomenon. PATIENTS AND METHODS: We recruited the study group out of all keratoplasties performed in our department between 1984 and 1996 using the following criteria: (1) pseudophakic bullous keratopathy that involved the whole host cornea preoperatively, (2) no additional ocular diseases, (3) all operations performed before January 1st 1996, (4) sufficient photodocumentation, (5) complete clinical records, (6) clear graft at the end of the follow-up period. Using these criteria, 48 patients (28 females and 20 males; mean age at the time of surgery 72.7 +/- 8.8 years) were included in the study group. Donor age ranged from 34 to 86 years (mean age 65.8 +/- 12.0 years). The opacity of the host cornea was graded from 0 to 3 (0 = clear cornea; 3 = total opacity) within a circular zone of 1 mm diameter adjacent to the graft in four quadrants (I-IV). Finally, an index for the mean opacity index was calculated [TG = (I + II + III + IV)/4] and correlated with clinical parameters. RESULTS: The index for the mean opacity was 2.8 preoperatively. After a mean follow-up of 9.6 +/- 12.3 months, the index decreased significantly to 1.8 (p = 0.01). Mean visual acuity before PK was 20/400, at the end of the follow-up it was 20/50. The index of opacification was significantly correlated with patients age (p = 0.03; r = 0.2) and inversely with the follow-up period (p = 0.001; r = -0.6) and with the visual acuity at the end of the follow-up period (p = 0.05; r = -0.2). Using the 193-nm excimer laser for donor and host trephination led to a higher clearing of the host circular zone (mean opacification index 1.7) than mechanical trephination (mean 2.1) (p = 0.01). CONCLUSION: Our results indicate that expansion of donor endothelial cells onto host's Descemet's membrane is possible and successful with respect to clearing of the host cornea in pseudophakic bullous keratopathy. Nonmechanical excimer laser trephination of donor and host from the epithelial side seems to promote this phenomenon due to a better apposition of the cut surfaces.

Aged↗
PubMed1999

[Results after cyclodiathermy: report on 29 eyes].

BACKGROUND: Persisting angle-closure glaucomas with circular anterior synechia and lost anterior chamber are at the moment an unsolved therapeutical problem. Antiglaucomatous anterior cyclodiathermy is a last therapeutical option to serve the eye. PATIENTS AND METHODS: We retrospectively examined the results and the complications of 29 eyes, which were consecutively treated with anterior cyclodiathermy between 1992 and 1998. RESULTS: We found a significant decrease of the intraocular pressure (IOP) during mean follow-up of 10 month, reduction of antiglaucoma medication, no change of visual acuity and no severe complications (no phthisis bulbi, no severe intraocular hemorrhage, no sympathetic ophthalmia). CONCLUSION: Anterior cyclodiathermy is a successful treatment for selected patients with severe forms of glaucoma, if other operation techniques and antiglaucoma medication fail to decrease the IOP.

Adolescent↗
PubMed1999

[Papilledema and acute loss of vision in a patient with pseudotumor cerebri].

PATIENT: We report on a 30-year old female with bilateral visual loss within four days. She assured that she had been able to do computer-work until four days before presentation. Ophthalmoscopy and echography established the diagnosis of a bilateral papilledema. Visual acuity was 20/500 in both eyes. Perimetry revealed a small central residual visual field. Further examinations lead to the diagnosis of a primary pseudotumor cerebri. CLINICAL COURSE AND THERAPY: Conservative treatment of the elevated intracranial pressure and ventriculo-peritoneal shunting improved visual acuity and visual field and lead to a decrease of the papilledema. Follow up time was 30 months. CONCLUSION: In a small number of patients pseudotumor cerebri presents with an acute visual loss. Immediate diagnosis and therapy can lead to an improvement of vision.

Acute Disease↗
PubMed1998

[A rare cause of peracute vision loss: pseudotumor cerebri. Case report of course with recurrence after decompression of the optic nerve].

In primary pseudotumor cerebri (PTC) intracranial pressure is elevated by so far unknown mechanisms. There is a wide range of clinical courses. Therapy is controversial. We present a case of PTC with acute visual loss. After optic nerve sheath decompression a relapse occurred. A 30-year old female patient experienced visual loss within 48 h accompanied by headache and slight neck stiffness. Visual acuity was 1/50 in the right eye; in the left eye just hand movements and light were perceived. Fundoscopy revealed a 9 dptr. prominent optic disc bilaterally. After optic nerve sheath decompression (ONSD) she improved, but underwent a relapse after 3 months. Twenty-four-hour measurement of intracranial pressure revealed elevated values. As a consequence ventriculo-peritoneal shunting was performed, leading to prominent improvement. Primary PTC can cause acute visual loss. If conservative treatment fails, different surgical procedures should be considered.

Adult↗
PubMed1998

[Alagille syndrome (arteriohepatic dysplasia): stable ocular findings after 23 years of illness].

BACKGROUND: Alagille syndrome is a arteriohepatic dysplasia which is in most cases correlated with ocular disorders. The most common ocular defect is a posterior embryontoxon. PATIENT: We report on a 27-year-old patient suffering from Alagille syndrome, seen in our department for 23 years. Within these 23 years the ophthalmological status concerning visual acuity and intraocular pressure of the patients was stable. Iris-stroma-atrophy showed a small increase on both eyes. CONCLUSION: In comparison to patients with Axenfeld anomaly a development of glaucoma is not observed in these patients. Maybe the anomalies of the anterior chamber angle are less severe or different from those in Axenfeld anomaly. The disease is also correlated with hepato- or/and splenomegaly by biliary hypoplasia, cardiac disorders etc. Cooperation of paediatricians, internal specialists and ophthalmologists are necessary for the treatment of these patients.

Adult↗
PubMed1998

[Ophthalmomyiasis externa caused by Oestrus ovis in Franconia].

BACKGROUND: Ophthalmological diseases caused by parasites are a very rare entity in middle europe. Ophthalmomyiasis caused by parasites living in our country are only reported as case history in literature. PATIENT: We report on a 28-year old patient, seen in our department in august 1997 suffering from ophthalmomyiasis externa. CASE HISTORY: The male patient was riding on a motorbike when a fly gets into his right eye. 12 hours later he had a feeling of pain in the eye. When having a closer look to his right eye, he found some fly larva (2.0! 0.8 mm) in the conjunctival sack. The patient could extract the fly larva from the conjunctival sack by himself. On examination at our department we found a unspecific irritation of the conjunctiva. The fly larva was identified as larva of oestrus ovis ("Schafsbremse"). CONCLUSION: Although ophthalmomyiasis is a very rare entity in middle europe single appearance is possible even in our country. No specific therapy was necessary in this case.

Adult↗
PubMed1998

[Cataract surgery in patients with retinitis pigmentosa].

BACKGROUND: Because of the retinal alterations visual acuity of patients with retinitis pigmentosa is more affected by loss of contrast than in normal persons. Therefore cataract in retinitis pigmentosa (mostly posterior subcapsular cataract) leads earlier to decreasing visual acuity than is expected from the lens opacity. In a retrospective study we have looked up all patients with retinitis pigmentosa and cataract which were operated between 1989 and 1997 at our department. PATIENT AND METHODS: Between 1989 and 1997 50 eyes of 36 patients (21 female, 15 male; mean age 51 +/- 11.4 years) with the diagnosis of retinitis pigmentosa and cataract underwent extracapsular cataract extraction and IOL-implantation. In a retrospective study we studied all case histories of these patients. Mean follow up time was 1.2 +/- 1.2 years. RESULTS: Preoperative visual acuity was 0.1 +/- 0.1, best postoperative visual acuity was 0.3 +/- 0.2. Visual field was not affected by cataract-surgery. Postoperative complications were not found. 2/3 of all patients were satisfied with the postoperative visual acuity, 1/3 of all patients did not give comments. CONCLUSION: In patients with retinitis pigmentosa cataract surgery leads to significant increase of visual acuity. Cataract extraction should not be with held from patients with retinal dystrophy.

Adult↗