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Biomedical subjects

S Roters

Publications and source records attributed to S Roters.

14 recordsLinked to original sources
PubMed2004

[Implant exposure after viscocanalostomy with reticulated hyaluronic acid (SK-GEL)].

BACKGROUND: Lately, the application of intrascleral implants has been increasingly discussed to improve success rates of nonpenetrating surgery for the treatment of open-angle glaucoma. PATIENTS AND METHODS: A 36-year-old male patient with medically uncontrolled pigmentary glaucoma underwent viscocanalostomy with intrascleral implantation of reticulated hyaluronic acid (SK-GEL) in his right eye. RESULTS: The immediate postoperative course was unremarkable with control of intraocular pressure without additional glaucoma medications. At first follow-up, 2 weeks post surgery, conjunctival dehiscence with partial extrusion and exposure of the reticulated hyaluronic acid implant was observed. Under topical tobramycin ointment a gradual limbal readaptation of the conjunctiva over the surface of the exposed parts of the implant with formation of a filtration bleb was noted. Therefore, surgical revision remained unnecessary. CONCLUSIONS: Implant exposure following nonpenetrating antiglaucomatous surgery is a specific complication, which can appear whenever intrascleral implants are used. Depending on the local situation nonsurgical treatment may be successful.

Adult↗
PubMed2002

Ultrasound biomicroscopy and its value in predicting the long term outcome of viscocanalostomy.

AIMS: To examine whether the early postoperative morphology at the site of sclerectomy, as visualised by ultrasound biomicroscopy (UBM), is an indicator of the mechanisms that lower intraocular pressure (IOP) and/or predictors of the long term outcome of viscocanalostomy. METHODS: 15 eyes of 14 patients with medically uncontrolled open angle glaucoma and no history of surgery underwent viscocanalostomy according to Stegmann's technique. Ultrasound biomicroscopy was performed during the first month after surgery. The following parameters were assessed: dimensions of the intrascleral "lake," presence of a filtering bleb, presence of a subconjunctival cavity or a suprachoroidal hypoechoic area, and the thickness of the residual trabeculocorneal membrane. A complete ophthalmological examination was performed the day before and the day after surgery. Follow up visits were scheduled 1 week, 4 weeks, 6 months, and 12 months after surgery. RESULTS: At 1 year successful control of IOP (<20 mm Hg) was achieved without further manipulation or medication in six of 15 eyes. The size of the intrascleral "lake" (average 0.62 mm(3)) did not correlate with later IOP; however, a visible route under the scleral flap and accidental perforation of the trabeculocorneal membrane were associated with long term lowering of IOP. Normal thickness of the trabeculocorneal membrane (0.10-0.15 mm) was indicative of IOP control with and without medication. When UBM showed an early collapse of the intrascleral cavity, control of IOP was not achieved. Other UBM findings did not predict long term function. CONCLUSION: In accordance with previous studies, the authors found that UBM examination is a useful method to evaluate outflow mechanisms after glaucoma surgery. This study shows that UBM imaging of external filtration during the early postoperative period can be used to predict the success of viscocanalostomy. However, to establish conclusively what parameters of UBM predict successful viscocanalostomy a larger number of patients must be studied.

Adult↗
PubMed2001

Ultrasound biomicroscopy of chronic hypotony after cataract extraction.

Ultrasound biomicroscopy was performed with a UBM 840 (Zeiss-Humphrey) equipped with a 50 MHz probe on a patient with chronic hypotony 1 year after cataract surgery by phacoemulsification with intraocular lens implantation in the capsular bag. This sonographic technique, which provides high-resolution imaging of the anterior segment, showed aqueous humor leakage through the former scleral tunnel incision. Ultrasound biomicroscopy helped detect this patient's postoperative complication and is a good tool for diagnostic procedures in patients with chronic hypotony.

Aged↗
PubMed2001

[Painless acanthamoeba keratitis].

BACKGROUND: Acanthamoeba keratitis is a severe, painful corneal infection found in contact lens wearers. The entity can easily be confused with herpetic or fungal keratitis, especially if no ocular pain is reported. HISTORY AND SIGNS: A 32-year old myopic female presented a unilateral keratitis of unknown etiology since 3 weeks. Administration of topical antiviral substances and corticosteroids led only to temporary improvement of the condition. The patient complained of photophobia but not of ocular pain. The affected eye showed corneal edema, central stromal thickening, descemet's striae as well as fibrin deposits on the corneal endothelium and in the anterior chamber. DIAGNOSIS: An aqueous specimen was negative for a viral infection. A culture for bacteria was negative. Staphylococci were cultured from corneal scrapings and Enterococci from the contact lens solution. Another corneal scraping revealed Acanthamoeba class II (6 weeks after the onset of symptoms). CLINICAL COURSE: Under treatment with propamidine, polymyxin b, neomycin, gramicidin and polyhexidine (topical) as well as fluconazole/ketoconazole (systemic) the diameter of the annular infiltrate, which had developed decreased, but the infiltrate persisted. In the further course, the infiltrate persisted while the amount of fibrin in the anterior chamber increased. Penetrating keratoplasty was performed. Histologic examination of the host corneal tissue revealed massive infiltration with Acanthamoeba. CONCLUSIONS: Severe pain and history of wearing contact lenses are features suggestive of Acanthamoeba keratitis. The patient presented here had a history of contact lens wear, but no ocular pain was reported. The characteristic annular infiltrate had a late onset. Bacterial superinfection could not be ruled out. Therapeutic penetrating keratoplasty had to be performed as the condition deteriorated inspite of intensive chemotherapy. With penetrating keratoplasty a good visual acuity could be regained.

Acanthamoeba Keratitis↗
PubMed2001

The suitability of the ultrasound biomicroscope for establishing texture in giant cell arteritis.

AIM: To establish whether ultrasound biomicroscope (UBM) is a helpful tool in locating the arterial segment responsible in patients with segmental attacks in giant cell arteritis METHODS: The superficial temporal arteries of 19 patients with suspected giant cell arteritis were examined with the UBM before biopsy. RESULTS: 20 specimens provided the histological proof of giant cell arteritis in five patients. Side differences, a dark perivascular halo, and high reflexivity of the intra-arterial space were found. CONCLUSION: it is assumed that there are two types of arteritic inflammation: (1) the occlusion of intra-arterial space due to intimal fibrosis (UBM: high reflexive "filling"), and (2) inflammation of the perivascular zone with oedematous thickening and infiltration of the media (UBM: dark halo) and its combination. UBM is helpful in obtaining an indication of the side and segment for biopsy.

Aged↗
PubMed2000

[Significance of postoperative face-down positioning after surgery for idiopathic macular holes: consecutive case-control study].

BACKGROUND: Postoperative face-down positioning is considered to be a critical part in macular hole surgery with short-acting gas. However, the significance of this posturing remains uncertain using long-acting gas tamponade. PATIENTS AND METHODS: Fifty consecutive eyes with idiopathic full-thickness macular holes underwent macular hole surgery with a follow up time of 6-12 months. The results of a cohort (25 eyes) with complete C3F8 (16%) vitreous fill without posturing was compared to a cohort (25 eyes) with SF6 (20%) with strict postoperative face-down positioning for two weeks. RESULTS: With SF6 tamponade the anatomic success rate was 64% in the C3F8 cohort a complete closure was achieved in 88%. In the SF6 cohort, visual recovery of three lines or better was attained in 44%, resulting in a visual acuity of 20/50 or better in 12%. The mean postoperative visual acuity was 20/125 with a mean rise of 1.4 lines. In the C3F8 cohort, 72% improved for at least three lines with a mean postoperative visual acuity of 20/63 and a mean visual recovery of 3.3 lines. Visual acuity of 20/50 or better was noted in 48% of eyes. CONCLUSION: The significantly higher success rate using C3F8 tamponade without positioning compared to SF6 gas tamponade with positioning confirms the cumulative tamponade duration being a crucial factor in macular hole surgery. Using a tamponade with short-acting gas only strict postoperative positioning ensures the contact of the gas bubble with foveal tissue and gains significance with reducing bubble size. While a potential for significant visual recovery in certain cases is evident, all in all a broad variability of the postoperative success rate can be stated. In contrast, even in supine position C3F8 attains a continuous tamponade enforcing a sufficient glial wound healing without any positioning.

Aged↗
PubMed1997

The effect of latanoprost 0.005% once daily versus 0.0015% twice daily on intraocular pressure and aqueous humour protein concentration in glaucoma patients. A randomized, double-masked comparison with timolol 0.5%.

BACKGROUND: Latanoprost is a PGF2 alpha analogue which reduces the intraocular pressure (IOP) by increasing the uveoscleral outflow. The objective of this study was to investigate the effect of two different regimens of latanoprost on the diurnal IOP and also the effect of latanoprost on the blood-aqueous barrier measured with a laser flare cell meter (Kowa FM-500). Moreover, the safety aspects of the two regimens regarding hyperemia were studied. METHODS: A double-masked, randomized study was performed in 30 patients (9 males, 21 females; mean age 61.9 years) with primary open-angle glaucoma or pseudoexfoliation glaucoma. Twenty patients were treated with latanoprost 0.0015% twice daily or 0.005% once daily for 3 weeks in a cross-over design. Ten patients received timolol 0.5% twice daily as control. RESULTS: Latanoprost 0.005% once daily reduced IOP (+/- SEM) more effectively than latanoprost 0.0015% twice daily (9.8 +/- 0.9 mm Hg and 6.7 +/- 0.9 mm Hg, respectively). There was a statistically significant increase in the aqueous humour protein concentration within the timolol group (P = 0.004), but not within the latanoprost group (P = 0.97). There was no statistically significant difference in the change in aqueous humour protein concentration from baseline between latanoprost and timolol groups (P = 0.08). No statistically significant difference in conjunctival hyperemia between the two latanoprost regimens was found (P = 0.37). CONCLUSION: Latanoprost 0.005% once daily reduced IOP more effectively than latanoprost 0.0015% twice daily (P < 0.001). Latanoprost had no statistically or clinically significant effect on the blood-aqueous barrier. There was no difference in hyperemia between the two regimens. Both concentrations of latanoprost reduced IOP at least as well as timolol 0.5% eye drops.

Adrenergic beta-Antagonists↗
PubMed1996

The influence of dexamethasone 0.1% eye drops on plasma cortisol and ACTH concentrations after cataract surgery.

The present study evaluates the systemic absorption after the application of dexamethasone 0.1% eye drops every hour in patients following cataract surgery. The changes of the plasma cortisol concentrations, ACTH concentrations, saliva and urine cortisol concentrations were examined before and after cataract surgery. The above-mentioned parameters were analyzed in 13 patients following phacoemulsification and IOL implantation. The data were determined before and on the third postoperative day. Dexamethasone 0.1% eye drops were applied after surgery to the operated eye every hour for 3 days. All cortisol levels decreased on average. On the third postoperative day, saliva cortisol (measured hourly from 8 a.m. to 10 p.m.), urine cortisol (24 h) and plasma cortisol were lowered compared to the first preoperative examination. In contrast, the ACTH concentrations increased on average. The decrease in plasma cortisol from 12.3 +/- 7.1 to 8.05 +/- 3.7 micrograms/dl was statistically significant (p < 0.05) as well as the flattening of the sputum cortisol concentrations on the third postoperative day. All data were within the physiological range. The present study demonstrates considerable systemic absorption of ophthalmic dexamethasone 0.1% eye drops which results in decreased plasma cortisol concentrations and lowering of the saliva cortisol concentration at certain hours of the day with no change of the circadian rhythm.

Absorption↗
PubMedDate not supplied

Isolation and characterization of the inflammatory infiltrate in the central nervous system of the guinea-pig with experimental allergic encephalomyelitis.

The inflammatory infiltrate of the central nervous system in acute experimental allergic encephalomyelitis (EAE) in the guinea-pig has been isolated and characterized. Inflammatory cells found over the surface of the brain and spinal cord and within the leptomeninges have been isolated by washing, and were subsequently identified by a number of methods. By light microscopy approximately 60% were lymphocytes, 30% were cells of the mononuclear phagocyte series, and 5% were neutrophils: the occasional plasma cell and eosinophil were also identified. E, EA and EAC rosetting tests were used to determine the proportions of T lymphocytes (both early and late), and cells with Fc and C3 receptors respectively. Particular attention was paid to cells of the mononuclear phagocyte series bearing Fc and C3 receptors to determine whether any change or loss of these receptors was apparent. The percentage of phagocytic cells from the brain and spinal cord washes was also determined. Transmission and scanning electron microscopy showed that a large proportion of the inflammatory infiltrate consisted of cells of the mononuclear phagocyte series. This study therefore confirms that the cells of the mononuclear phagocyte series play a predominant role in EAE.

Brain↗