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Biomedical subjects

P Senn

Publications and source records attributed to P Senn.

6 recordsLinked to original sources

[The Excimer laser. I. The Lucerne evaluation procedure for Excimer therapy].

The Excimer laser has been available for clinical applications in the Lucerne Eye Hospital since September 1990. Excimer laser keratectomy as a refractive therapy option is meeting with widespread interest among patients. As this is an invasive method whose complications cannot be neglected and for which long-term experience is so far lacking, this interest has to be balanced by extremely strict and responsible diagnosis by those offering the therapy. The authors present their evaluation concept here. The figures below document the reticence exercised in diagnosis: 1100 information leaflets dispatched are contrasted in the final analysis with only 34 laser treatments in a period of 10 months. 50 of the 200 patients admitted (referred by specialists) for preliminary examinations were definitively excluded from treatment in Lucerne as early as the administrative stage, and 61 during the clinical evaluation proper.

Cornea

[The Excimer laser. II. Initial experiences with the Excimer laser in Lucerne].

In the period between September 1990 and July 1991, 35 patients (46 eyes) were treated with the Excimer Laser. In 25 patients (34 eyes), a Myopia-Laser-Shaping was performed, one patient was treated for both myopia and astigmatism. In eight patients (10 eyes) correction of astigmatism was carried out. Two patients with recurrent erosions and one patient with superficial scarring of the cornea were treated. The authors review their initial experience with the Excimer Laser. The decision to initiate treatment must not be undertaken lightly, because the possibility of serious complications may not be neglected. This method shows promise in selected patients with light to medium degrees of myopia. In cases of severe myopia, our experience is encouraging. Subjectively, the patients are satisfied with the results, which do not fall short of their expectations. Further research and clinical experience in this area is urgently required.

Astigmatism

[Practical experiences in conversion to the wide angle observation systems for vitreous surgery BIOM, SDI, VPF].

The wide-angle observation system for vitreous surgery introduced by Spitznas und Reiner has the following advantages: Wide angle of view. Large depth of field. Good view to the periphery even with narrow pupil. Easy gas fluid exchange in a phacic eye. Free mobility of the eye when working in the periphery. Changing from the conventional vitrectomy lens system to the BIOM an experienced surgeon is familiar with the new system in a very short time.

Equipment Design

[Pars plana vitrectomy and cerclage after successful glaucoma operation with Molteno implant].

A single or double plate Molteno Implant may control IOP in otherwise desperate cases. Fibrosis of the filtration bleb will lead to failure. We report about 4 patients (age 12 to 77 years--3 neovascular glaucoma, 1 with postinflammatory goniosynechia) who had good IOP after the implantation of a Molteno device. 10 to 26 weeks (mean 18.25) after glaucoma surgery we performed a pars plana vitrectomy because of different reasons: proliferative diabetic retinopathy, proliferative retinopathy due to central venous occlusion, ciliovitreal block mechanism, PVR D3. One aphakic eye was treated with silicone oil and an encircling band. 19 to 30 weeks after posterior segment surgery (mean 24.5) IOP remained controlled. We describe the technique of pars plana approach and putting an encircling band without destroying the preformed filtration bleb. Encircling techniques, pars plana vitrectomy and silicone oil in aphacic eyes seem to bee possible without loss of the filtration effect of the Molteno operation.

Adolescent

[Nd:YAG laser synechiolysis in glaucoma due to iridocorneal angle synechiae].

Seven patients with chronic angle-closure glaucoma and medically uncontrollable intraocular pressure were treated with the Q-switched Nd:YAG laser. Goniosynechiolysis was achieved at least partially. Follow-up time was 6-17 months. By means of additional monotherapy with a local beta-blocking agent where necessary, intraocular pressure was regulated to below 21 mm Hg in 5 of 7 patients. There were no severe complications. In selected cases Nd:YAG goniosynechiolysis may represent an effective means of lowering intraocular pressure.

Acetazolamide

[Reduced visual function in relation to compensation questions].

In cases of visual impairment due to an accident it is the ophthalmologist's task to assess the functional loss. For the purposes of legal equality norms have been established for functional loss. Differences in the assessment of disability and loss of integrity in various countries are discussed.

Blindness