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Biomedical subjects

P Ruusuvaara

Publications and source records attributed to P Ruusuvaara.

At least 19 recordsLinked to original sources
PubMed1999

Follow-up study of human corneal endothelial cells, photographed in vivo before enucleation and 20 years later in grafts.

PURPOSE: To evaluate the long-term (20-year) survival of transplanted human corneal endothelial cells. METHODS: The donor endothelium had been photographed 20 years ago with a specular microscope both before enucleation in the melanomatous eye and in situ after keratoplasty. The same donor endothelial cells were now photographed again 20 years later with a modern specular microscope to ascertain the morphology and cell density of the grafts. RESULTS: In the earlier study the mean postoperative endothelial cell density was 1357+/-543 cells/mm2, the average cell loss 11 months postoperatively being 48.2%; 20.5 years postoperatively the cell loss was 62.9% of the preoperative cell count. In our well-documented patient population the endothelial cell loss during the last 19 years had been only 14.7%, which amounts to a cell loss of less than 1% per year. CONCLUSION: In transplanted corneas, the main endothelial cell loss seems to take place during the first 1-2 postoperative years.

Cell Count↗
PubMed1999

Effects of experimental exposure to triethylamine on vision and the eye.

OBJECTIVES: To determine the effect of triethylamine (TEA) on the cornea and to evaluate the cause of blurred vision. To find the lowest observed effect concentration of exposure to TEA. METHODS: Four people were exposed to TEA for 4 hours at concentrations of 40.6, 6.5, and 3.0 mg/m3. Before and after every exposure, symptoms and ocular microscopy findings were recorded. Binocular visual acuity and contrast sensitivity at 2.5% contrast were also measured. Also, before and after the 40.6 mg/m3 exposure, corneal thickness was measured and ocular dimensions were recorded by ultrasonography, endothelial cells of the cornea were analysed, and serum and lacrimal specimens were collected for the analysis of TEA. RESULTS: After exposure to 40.6 mg/m3 TEA there was a marked oedema in the corneal epithelium and subepithelial microcysts. However, corneal thickness increased only minimally because of the epithelial oedema. The lacrimal concentrations of TEA were, on average (range) 41 (18-83) times higher than the serum TEA concentrations. The vision was blurred in all subjects and visual acuity and contrast sensitivity had decreased in three of the four subjects. After exposure to TEA at 6.5 mg/m3 two subjects experienced symptoms, and contrast sensitivity had decreased in three of the four subjects. There were no symptoms or decreases in contrast sensitivity after exposure to a TEA concentration of 3.0 mg/m3. CONCLUSIONS: TEA caused a marked oedema and microcysts in corneal epithelium but only minor increases in corneal thickness. The effects may be mediated by the lacrimal fluid owing to its high TEA concentration. Four hour exposure to a TEA concentration of 3.0 mg/m3 seemed to cause no effects, whereas exposure to 6.5 mg/m3 for the same period caused blurred vision and a decrease in contrast sensitivity.

Adult↗
PubMed1998

Effects of long-term contact lens wear on the corneal endothelium.

PURPOSE: To analyze the long-term effects of soft and hard (PMMA) contact lenses (CL) on the human corneal endothelium. METHODS: One hundred and one contact lens wearers with > or =10 years' wearing time and 50 healthy control subjects were examined with specular microscope. RESULTS: The mean corneal endothelial cell densities of the CL wearers (2846 cells/mm2) and of the control eyes (2940 cells/mm2) differed by 94 cells/mm2 (p<0.05). The mean values for the coefficient of variation (CV) differed significantly (p<0.0001); for all CL wearers: mean CV=0.31, vs. for controls: 0.22. The mean endothelial cell density of the eyes exposed to CL wear for more than 25 years (30 eyes) was 2575 cells/mm2 (mean CV: 0.36). Rather low densities (<2000 cells/mm2) were observed in 16 eyes of the CL group (8%). Cell densities less than 2500 cells/mm2 were observed in a total of 41 eyes (20%) in the CL group, whereas in the control group (100 eyes) all of the subjects, except one, had cell densities of more than 2500 cells/mm2 in both eyes. CONCLUSION: A subgroup of PMMA as well as soft contact lens wearers react not only with high pleomorphism and polymegethism but also with a decrease in endothelial cell density.

Adult↗
PubMed1995

Comparison of etidocaine and bupivacaine + lidocaine in retrobulbar anaesthesia.

Etidocaine (15 mg/ml) was compared with bupivacaine (5 mg/ml) combined with lidocaine (10 mg/ml) in retrobulbar anaesthesia. One hundred and twelve patients were randomised into two groups. Supplemental anaesthesia was needed in 41% of cases of the etidocaine group and 32% of the bupivacaine-lidocaine group. Akinesia was evaluated by the surgeon both pre- and postoperatively and was found to be good or complete in more than 95% of both groups. Recovery from the motor and sensory block was investigated three times during the first 24 postoperative hours. The motor block of the orbicular muscle disappeared earlier than that of the globe. Akinesia lasted significantly longer in the etidocaine group than in the bupivacaine-lidocaine group: after 14 h 69% vs 100%, respectively, of the eyes showed normal movements. Sensation in the cornea was also regained more rapidly in patients treated with the mixture.

Anesthesia, Local↗
PubMed1992

Ptosis following periocular or general anaesthesia in cataract surgery.

The incidence and duration of postoperative ptosis was investigated in 64 patients undergoing cataract surgery. Thirty-two patients had a 2-point periocular regional anaesthesia while 32 others were given general anaesthesia. The palpebral aperture and the levator muscle function were measured preoperatively and then on the 1st, 2nd, 4th and 7th postoperative days or as long as ptosis persisted. On the 1st postoperative day, about half of the patients in both groups demonstrated ptosis. On the 2nd day, ptosis was more common in the general anaesthesia group. The ptosis persisted 1 week postoperatively in 2 patients, both belonging to the general anaesthesia group. It is concluded that postoperative ptosis is common both after local and general anaesthesia. In most cases it is shortlasting and may be related to the volume or myotoxicity of a local anaesthetic drug. The use of a superior rectus muscle bridle suture and/or lid speculum may be important in provoking ptosis of longer duration.

Aged↗
PubMed1992

Visual evoked potentials after retrobulbar or periocular anaesthesia.

The effect of the local anaesthetic agent, etidocaine, on the optic nerve function was examined at regional ophthalmic anaesthesia. Visual evoked potential (VEP) was recorded before and 15 minutes after injection of the anaesthetic agent in 19 patients scheduled for elective cataract surgery (seven retrobulbar and 12 periocular). Both the anaesthetised--that is, the eye to be operated on--and the fellow eye were examined. In the retrobulbar group, two patients displayed non-recordable VEPs while one had virtually non-detectable waves following the anaesthesia. In two retrobulbarly anaesthetised eyes, later peaks were unidentifiable while two other eyes had decreased amplitudes. In the periocular group, in nine patients, there was no clearcut effect on VEP resulting from the anaesthetic. In three patients of this group mild changes in the anaesthetised eyes were found. The differences in the effect of retrobulbarly or periocularly injected anaesthetics on VEP are probably due to the different concentration of the anaesthetic agent around the optic nerve.

Aged↗
PubMed1991

Comparison of retrobulbar and periocular injections of lignocaine by computerised tomography.

Ten patients undergoing cataract surgery were given a local anaesthetic with lignocaine solution which was mixed with iohexol contrast medium. The location of the needle and the substance injected was determined by computerised tomography following retrobulbar or periocular anaesthesia. The retrobulbarly inserted needles were within the muscle cone, directed towards the optic foramen. The periocular needles were outside the muscle cone, tangentially along the orbital floor or pointing slightly upwards. After the retrobulbar injection the contrast medium was seen within the cone immediately after the injection and outside the cone as early as 3 minutes after the injection. With the periocular technique, however, diffusion of the anaesthetic in the opposite direction (that is, into the muscle cone) was rapid. The contrast medium was identified inside the muscle cone 2 minutes after the injection. Compression with an intraocular pressure reduction device after both of these techniques prevented exophthalmos. It is concluded that retrobulbar-like anaesthesia can also be induced by an appropriate periocular technique.

Adult↗
PubMed1990

Corneal endothelium in pigmentary glaucoma and pigment dispersion syndrome.

Corneal endothelial cell density was determined in 64 eyes (32 patients) with pigmentary glaucoma and in 18 eyes (9 persons) with pigment dispersion syndrome without glaucoma. Twenty-eight healthy eyes served as controls. The glaucomas were stabilized with topical treatment or following laser trabeculoplasty or filtration surgery. The mean duration of the glaucoma was 7.6 years (SD 6.1 years) subsequent to diagnosis. Neither in the glaucomatous, nor in the pigment dispersion syndrome eyes, could any statistically significant difference in cell density be noted compared to the control series. Within the glaucoma group pressure level, topical treatment, laser trabeculoplasty and trabeculectomy did not have any statistically significant effect on cell counts. Distinct pleomorphism and polymegatism of the endothelial cells were observed in the study groups. The endothelial cell density decreased linearly with age.

Adult↗
PubMed1990

Effect of sodium hyaluronate on immediate postoperative intraocular pressure after extracapsular cataract extraction and IOL implantation.

We studied 129 eyes which were undergoing extracapsular cataract extraction with IOL-implantation. The amount of residual Healon had a clearcut effect on the IOP elevations postoperatively. In eyes operated on with the intercapsular techniques, pressure elevations and the mean values during the first 6 postoperative hours were significantly higher than in eyes operated on with the planned ECCE (can opener-technique) (P less than 0.01). The pressure elevation reached the maximal values 8-12 h postoperatively and had normalized already at 24 h in most cases, except in glaucomatous eyes which at that time had significantly higher mean IOP values than the non-glaucomatous eyes (P less than 0.01). When operations were done with an air bubble no clearcut postoperative pressure increases could be observed. Our study indicates that a comparatively small amount of Healon may cause a pressure elevation and the amount left in the eye has a greater effect upon the level of the pressure than the duration of the pressure elevation. The less we inject Healon into the eye and the more we avoid leaving it there, the less risk we have of the possibility of vision deteriorating high postoperative intraocular pressure.

Aged↗
PubMed1990

Periocular anaesthesia: technique, effectiveness and complications with special reference to postoperative ptosis.

The effectiveness of periocular anaesthesia and its complications were examined in 100 successive cataract operations. The patients were divided into 3 groups according to the duration of ocular compression with an Autopressor device after administration of periocular anaesthesia. In the control group, no compression was used (C-O, n = 36 patients). In the other two groups, compression was used for 10 (C-10, n = 32) and for 20 (C-20, n = 32) min. No differences in globe or orbicular akinesia were found between the groups. At 10 min, immobilisation of the globe in different directions was attained in 60.1-84.5% of the patients. Compression for an additional 10 min did not significantly improve the akinesia. In contrast, the hitherto undescribed loss of light perception increased with time: 15 patients at 10 min and 22 at 20 min were unable to see light. Chemosis and haematomas in the upper eyelid occurred more often in C-0 than in the other 2 groups. One day postoperatively the average palpebral aperture was smaller in C-0 than in the other two groups. The frequent postoperative ptosis (74.3% on the 1st day) decreased rapidly, but on postoperative day 7, 9 patients still had ptosis. In only one patient was ptosis still recognizable at 6 weeks postoperatively. No serious complications occurred. This study demonstrates that periocular anaesthesia with ocular compression is a suitable method for cataract surgery.

Adult↗
PubMed1990

Effect of ocular compression (Autopressor) on intraocular pressure in periocular anaesthesia.

One hundred successive patients were operated on for cataract under periocular anaesthesia. The patients were divided into 3 groups to study the effect of extraocular compression on intraocular pressure. In the control group (C-O), no compression was used. In the other 2 groups, compression was applied immediately after local injection of the anaesthetic for either 10 (C-10) or 20 min (C-20). In the control group, a periocular local anaesthetic increased the IOP in 27 of 36 patients, the average increase being 3.8 mmHg (at 10 min). Postanaesthetic compression of the eye led to a decrease in intraocular pressure, which is beneficial for the operative procedure. During the first 10 min, the mean intraocular pressure decreased by 3.1 and 4.0 mmHg in groups C-10 and C-20, respectively. In the C-20 group, there was a further (1.3 mmHg) reduction in intraocular pressure between 10 and 20 min.

Anesthesia, Local↗
PubMed1990

Long-term treatment of involuntary facial spasms using botulinum toxin.

Botulinum toxin, a powerful pre-synaptic neurotoxin produced by Clostridium botulinum, interferes with the release of acetylcholine from nerve terminals. Since September 1985, we have been using this toxin to treat altogether 62 patients with benign facial spasms. Most of the patients had been on drugs or psychotherapy, 2 had received alcohol injections, 2 had undergone surgery of the orbicular branch, and 2 electrocoagulation of the facial nerve. In essential blepharospasm the duration of the beneficial effect after each treatment with botulinum toxin was about 3 1/2 months. In patients with hemifacial spasm the response was clearly longer, nearly 5 months in most cases. The treatment gave the best and longest-lasting relief of symptoms in patients suffering from disturbing myokymia. Response was poorest in patients suffering from facial spasms who simultaneously had a severe psychiatric disease. The most frequent side effect was mild or moderate ptosis (22.6%). Some patients complained of dry eyes and a few cases displayed facial nerve paresis. Side effects caused by botulinum toxin injections are transient but so also, unfortunately, is the beneficial effect on facial spasms.

Adult↗
PubMed1990

Granular corneal dystrophy with early stromal manifestation. A clinical and electron microscopical study.

We describe a family tree from central Finland with 19 members of which 10 had typical granular corneal dystrophy (Bücklers 1938). This granular dystrophy seems to start from the subepithelial and anterior stromal region. In quite early ages the granules spread not only into the midstromal layers but also into the most posterior stroma between the stromal lamellae and Descemet's membrane. Corneal epithelial erosions were not noticed in this family. The central cornea was mostly affected and 2-3 mm of the corneal periphery was clear. No endothelial changes were found from the corneal midperiphery by specular microscopy. To date, two female patients have needed penetrating keratoplasty; one in her late thirties and the other in her early forties. Their corneal buttons were studied by electron microscopy and histochemically. Granular material was found between the stromal lamellae and also inside the stromal keratocytes. Bowman's membrane was disrupted and degenerated in the areas where the deposits were situated in the subepithelial region. Recurrence of the disease was observed in the corneal transplants of the two operated patients 3 years postoperatively, starting again in the subepithelial region and mostly in central areas of the transplant. This disease entity seems to be different from the granular dystrophy also reported from Finland by Forsius et al. (1983).

Adolescent↗
PubMed1989

Silicone oil in retinal detachment surgery. Results and complications.

Results and complications with the use of intraocular silicone oil in 25 eyes operated on for complicated retinal detachment are reported. Most eyes had undergone several operations for detachment before silicone injection. The follow-up time after silicone injection was 12-48 months. In perforating injuries the outcome was quite poor, 27% received anatomic success (attached retina) compared to primary rhegmatogenous detachments with 57% success rate. Visual acuity was counting fingers 1 m or better in 56% in the whole group examined. Silicone oil was removed in 5 eyes. Of the late complications, keratopathy occurred in 3 eyes (12%), increased intraocular pressure in 4 eyes (16%), and cataract in 2 of 3 phakic eyes. Angiographic signs of iris neovascularization were obvious or suspected in 3 of 9 eyes examined.

Adolescent↗
PubMed1989

Changes in corneal endothelium after treatment of retinal detachment with intraocular silicone oil.

Keratopathy represents one of the most frequent late complications in eyes with complicated retinal detachment treated with intraocular silicone oil. Corneal examinations including endothelial specular photography were done on 18 silicone treated eyes, 16 of which were aphakic. In addition to widespread silicone oil endothelial contact in 2 eyes, a bubble or droplets of silicone oil were observed in the anterior chamber in 8 eyes. The mean endothelial cell density was lower in the silicone eyes (2076 +/- 196 cells/mm2) as compared to the control fellow eyes (2738 +/- 86 cells/mm2) (P = 0.004). In eyes with silicone oil in the anterior chamber the endothelial cell density was significantly decreased (1857 +/- 232 cells/mm2) (P = 0.005). Obvious endothelial degeneration was noticed when silicone oil had been in the eye for more than a year. Also small droplets of oil with transient contact contributed to its development.

Adolescent↗