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Biomedical subjects

S B Koenig

Publications and source records attributed to S B Koenig.

At least 37 records · Page 2Linked to original sources
PubMed1989

Penetrating keratoplasty and intraocular lens exchange for pseudophakic bullous keratopathy associated with a closed-loop anterior chamber intraocular lens.

We reviewed the records of 20 consecutive eyes with pseudophakic bullous keratopathy associated with a closed-loop anterior chamber lens that underwent penetrating keratoplasty, total anterior vitrectomy, and anterior chamber intraocular lens exchange. On reexamination, all corneal grafts had remained clear during an average follow-up period of 15 months (range, four to 45 months). Seven eyes (35%) attained a visual acuity of 20/40 or better with spectacle correction; however, 15 of 20 eyes (75%) attained a best-corrected visual acuity of 20/40 or better using a pinhole and a gas-permeable contact lens. In five eyes visual acuity was 20/400 or poorer because of cystoid macular edema, as documented by fluorescein angiography, age-related macular degeneration, or optic atrophy. Localized, minimal peripheral anterior synechiae were present on gonioscopy in seven eyes. The one-piece flexible anterior chamber lens implants used for exchange appeared to be well tolerated in this series of patients.

Aged↗
PubMed1989

Filter-culture technique using amoeba saline transport medium for the noninvasive diagnosis of Acanthamoeba keratitis.

Acanthamoeba, a common free-living amoeba, is increasingly incriminated as a cause of keratitis and corneal ulceration. Between March 1986 and July 1988, specimens from seven patients submitted by ophthalmologists to the City of Milwaukee Health Department's Bureau of Laboratories were culture positive for Acanthamoeba. All patients were contact lens wearers. The specimens were transported at ambient temperature in amoebasaline (5.0 mL) and filtered through 13 mm 0.22 microns cellulose filters. The filters were then plated in cocultivation with Escherichia coli on nonnutrient agar and had positive results for Acanthamoeba in two to five days. Contact lens cases were culture positive for Acanthamoeba in three instances. These results indicate that corneal scraping in amoeba saline transport medium can provide an effective way to diagnose Acanthamoeba keratitis when direct culture of such specimens is not possible.

Acanthamoeba↗
PubMed1988

Penetrating keratoplasty for pseudophakic bullous keratopathy after extracapsular cataract extraction.

Seventeen women underwent simple penetrating keratoplasty for pseudophakic bullous keratopathy after extracapsular cataract extraction. Corneal edema occurred an average of eight months after cataract surgery (range, zero to 32 months). Of 17 corneal grafts, 16 (94%) have remained clear during an average follow-up period of 14 months (range, two to 32 months). One eye had a nonimmunologic graft failure. Of 16 eyes with clear grafts, 14 (87%) achieved a visual acuity of 20/40 or better after surgery. Two eyes with a visual acuity of 20/50 and 20/200 had opacified posterior capsules and one demonstrated age-related macular degeneration. One eye with a postoperative visual acuity of 20/40 demonstrated cystoid macular edema. Fifteen of 17 contralateral eyes showed slit-lamp evidence of endothelial dystrophy.

Aged↗
PubMed1988

Respiratory distress after a Nadbath block.

Dysphagia and respiratory distress developed in three patients after administration of a Nadbath block. This complication may have resulted from inadvertent paralysis of the vagus, ipsilateral glossopharyngeal, and spinal accessory nerves causing pooling of oropharyngeal secretions and laryngospasm. Respiratory distress after a Nadbath block may be managed by properly positioning the patient. Short hypodermic needles (less than 12 mm), small volumes of anesthetic solution (less than 3 ml), and omission of hyaluronidase may reduce the incidence of this complication.

Aged↗
PubMed1986

Penetrating keratoplasty after placement of a temporary keratoprosthesis during pars plana vitrectomy.

Five eyes of five patients with opaque corneas underwent penetrating keratoplasty after pars plana vitrectomy. In each case, the Landers-Foulks temporary keratoprosthesis provided visualization of the vitreous cavity and retina, allowed successful removal of hemorrhagic vitreous, and permitted retinal reattachment. Corneal grafts remained clear in two eyes; three grafts developed stromal edema. Useful postoperative vision was achieved in two eyes. However, proliferative vitreoretinopathy, postoperative hypotony, atrophia bulbi, and corneal edema resulted in poor vision in three eyes.

Adolescent↗
PubMed1985

Keratopathy in a family with the ectrodactyly-ectodermal dysplasia-clefting syndrome.

Four members of a family with the ectrodactyly-ectodermal dysplasia-clefting (EEC) syndrome and associated keratopathy are presented. The main features of this syndrome include lobster-claw deformities of the hands and feet, abnormalities of the hair and teeth, cleft lip and palate, nasolacrimal abnormalities, and a progressive keratopathy ranging in severity from an asymptomatic pannus to bilateral dense corneal scarring and neovascularization. Despite congenital limb abnormalities, the major functional disability of three of these patients stems from severe photophobia and decreased visual acuity secondary to the corneal disease. Treatment with cycloplegics, topical steroids, and bandage soft contact lenses was unsuccessful. The EEC syndrome is transmitted in an autosomal dominant manner. The spectrum of keratopathy demonstrated in this family can be explained by the different ages of the patients, by variation in gene penetrance and expressivity and by differing durations and severity of dacryocystitis and related keratoconjunctivitis. The etiology of the keratopathy appears to be primarily a manifestation of the underlying ectodermal dysplasia with probable contributions from associated tearfilm abnormalities and external ocular infection.

Abnormalities, Multiple↗
PubMed1984

Electron microscopic study of intrastromal hydrogel implants in primates.

Three corneas with intrastromal hydrogel implants (surfilcon A) were removed from Green monkey eyes by penetrating keratoplasty and examined by light microscopy, as well as scanning and transmission electron microscopy, in order to assess the tolerance of the primate cornea for this type of synthetic plastic. Placement of these implants in the posterior cornea appears to increase the amount of protrusion into the anterior chamber, which can also be seen clinically on slit-lamp biomicroscopy. Some physiological stress to the cornea was indicated by abnormalities above and below the implant, including thinned epithelium, irregular cell shapes, and vacuolations. It appears that a basement-membrane-like material is produced by keratocytes adjacent to the implant-stroma interface, and that this material fills the spaces and provides some physical continuity between the plastic and the corneal tissue. No inflammatory reaction was seen around the implants, but further long-term studies are necessary to ensure compatibility between the cornea and the implant.

Animals↗
PubMed1984

Histological study of epikeratophakia in primates.

Two primate corneas were analyzed histologically 22 and 25 months after epikeratophakia surgery. Keratocytes had migrated from the host cornea into the lenticule through the surgical disruption of the host Bowman's membrane; the lenticule with the wider connection to the host cornea appeared to have more complete keratocyte repopulation. The lenticule stroma and host Bowman's membrane were continuously apposed along the interface, with a basement membrane-like material composed of collagen fibrils and amorphous matrix filling the interstices.

Animals↗
PubMed1984

Refractive keratoplasty with hydrogel implants in primates.

Histological examination of primate corneas with hydrogel lenses implanted in intrastromal pockets showed the corneal lamella posterior to the implant protruding into the anterior chamber; these eyes had shown no increase in anterior corneal curvature. In an attempt to obtain a dioptric increase without removing a corneal lamella, relaxing incisions were made in Bowman's layer followed by intrastromal implantation of hydrogel lenses. However, no refractive increase resulted, although six of the seven eyes were optically clear eight months postoperatively.

Animals↗
PubMed1983

Corneal iron lines after refractive keratoplasty.

Twenty-three of 55 patients who underwent refractive keratoplasty for the correction of aphakia were found to have a pigmented corneal epithelial line similar to the Fleischer ring. In 21 of 23 cases, the pigmented ring was adjacent to the superficial keratectomy scar that resulted from the keratorefractive operation. In two cases, the pigmented line was located central to the lamellar keratectomy scar. Histopathologic study demonstrated that the line was due to iron in the form of ferritin particles deposited within basal corneal epithelial cells. We believe that the steep anterior corneal curvature (average, 51.45 diopters) and changes in corneal topography at or central to the margin of the lamellar keratoplasty may lead to malapposition of the eyelid to the cornea and cause disturbances in the precorneal tear film. Iron from the tears may then be deposited in the corneal epithelium in areas of tear pooling.

Aged↗
PubMed1983

The ultrastructure of well-healed lenticules in keratomileusis.

Two well-healed hyperopic keratomileusis homoplastica lenticules, one 4 years old, the other 5 months old, were removed from the same patient following postoperative complications of triplopia and aniseikonia. The lenticules were examined by light and electron microscopy. Both lenticules were repopulated with keratocytes throughout the lamellae. Degenerated keratocytes were observed in the 5-month-old lenticule and recipient stroma, and in the 4-year-old lenticule; no degenerated keratocytes were seen in the recipient stroma of the 4-year-old lenticule. These findings may have resulted from toxic constituents of the solutions used to preserve the donor cornea. The basement membrane was thickened in both lenticules. The epithelial cell layer was irregular in the periphery of the lenticule where Bowman's membrane was disrupted. These findings suggest that careful surgical technique that minimizes damage to Bowman's layer and basement membrane may promote more rapid epithelial healing. The histologic results suggest that the cause of this patient's triplopia was irregular astigmatism.

Aniseikonia↗
PubMed1983

Corneal sensitivity after epikeratophakia.

Corneal sensitivity was tested in 60 eyes of 30 patients who underwent unilateral epikeratophakia for the correction of aphakia (20 patients) or keratoconus (10 patients). Postoperative recovery time ranged from 2 months to 21 months (mean: 10 months). Our results indicate a relative hypesthesia of the epikeratophakia lenticule when compared with the peripheral host cornea and contralateral control cornea. However, corneal sensitivity tested in 11 patients with more than 1 year follow-up was increased compared with the sensitivity of 19 patients whose postoperative recovery was less than 1 year. Histopathologic findings in two lenticules from a nonhuman primate demonstrated sparse epithelial axon terminals. Host corneal nerves appear to innervate the lenticules by intraepithelial extension and by penetration of the superficial keratectomy scar.

Animals↗