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Biomedical subjects

Shu Kachi

Publications and source records attributed to Shu Kachi.

21 records · Page 2Linked to original sources
PubMed2004

Ultrastructure of internal limiting membrane removed during plasmin-assisted vitrectomy from eyes with diabetic macular edema.

PURPOSE: To study the effect of autologous plasmin enzyme (APE) on the adhesion of the vitreous cortex to the internal limiting membrane (ILM) in eyes with diabetic macular edema. DESIGN: Nonrandomized, comparative, interventional case series. PARTICIPANTS: Ten eyes of 10 patients with diabetic macular edema without a posterior vitreous detachment (PVD), which were treated with APE as an adjunct to conventional pars plana vitrectomy, and 10 eyes of 9 patients without a PVD, which underwent pars plana vitrectomy without APE, were studied. METHODS: In the APE group, 0.4 IU of APE was injected into the midvitreous cavity in 9 eyes, and 0.8 IU of APE in 1 eye. Thirty minutes after plasmin injection, the eyes underwent pars plana vitrectomy with ILM peeling. All eyes in the control group had conventional vitreous surgery with ILM peeling. The removed ILMs were investigated for the presence of vitreous and for ultrastructural differences by transmission and scanning electron microscopy. MAIN OUTCOME MEASURES: The status of the vitreous and induction of a PVD during surgery, and the presence of vitreous and ultrastructural differences of the removed ILM by transmission and scanning electron microscopy. RESULTS: In APE-treated eyes, the degree of liquefaction of the vitreous was graded as high in 4 eyes. Spontaneous PVD occurred in 2 eyes, whereas core vitrectomy with a maximum vacuum of 100 mmHg induced a PVD in 2 additional eyes. In the control group, 8 eyes required suction with a maximum of 200 mmHg to induce the PVD. Scanning electron micrography of the removed ILM in the APE-treated eyes showed a smooth surface on the vitreous side in 8 eyes and only sparse collagen fibers in 2 eyes. Conversely, in the control group, dense vitreous fibers were found in 4 eyes, sparse collagen fibrils in 3 eyes, and a smooth retinal surface in 3 eyes. CONCLUSIONS: These findings indicate that APE helps separate the vitreous hyaloid from the ILM surface and may be a useful adjunct to conventional vitreous surgery for diabetic macular edema.

Adult↗
PubMed2002

Ultrasonographic biomicroscopic study of an intracorneal hematoma.

PURPOSE: To demonstrate the importance of ultrasonographic biomicroscopy for following the clinical course of an intracorneal hematoma of unknown origin. METHODS: A 64-year-old woman was referred to the Nagoya University Hospital because of a decrease in vision in her left eye. Her visual acuity was 20/70 (uncorrectable) in the left eye and the slit-lamp biomicroscopic examination showed a dark red-colored intracorneal hematoma in the central area of the left eye at the pre-Descemet's membrane level. Because the hematoma was small without any epithelial involvement and ultrasonographic biomicroscopy (UBM) and slit-lamp biomicroscopy showed a low risk of a pupillary block, she was followed without surgical treatment. RESULTS: The hematoma turned yellow and grew smaller, and UBM images showed an internal liquified cyst 10 months after her initial visit. The cystic legion was detected as a low-echoic cavity by UBM 2 months before it was observed by slit-lamp biomicroscopy. The hematoma was almost resolved 2.5 years after the onset, and the visual acuity OS improved to 20/30. CONCLUSION: The intracorneal hematoma occurred without any obvious cause and should be classified as spontaneous. UBM combined with slit-lamp biomicroscopy was useful in estimating the extent of the hematoma and thus the risk of pupillary block. It was also helpful in deciding whether surgical treatment was necessary.

Corneal Diseases↗