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Biomedical subjects

T Mönks

Publications and source records attributed to T Mönks.

8 recordsLinked to original sources
PubMed1998

Different suturing techniques variously affect the regularity of postkeratoplasty astigmatism.

OBJECTIVE: This study aimed to determine the effect of various suturing techniques on the regularity of postkeratoplasty astigmatism. DESIGN: A prospective clinical trial. PARTICIPANTS: Sixty-two consecutive patients undergoing penetrating keratoplasty by the same surgeon (MB) participated. INTERVENTION: Each patient was assigned to one of four groups according to the suturing technique used (a = 16 interrupted 10-0 nylon sutures; b = 2 running 10-0 nylon sutures, each with 8 bites; c = 2 running 10-0 nylon sutures, each with 12 bites; d = 2 running 10-0 nylon sutures, each with 16 bites). This was the only parameter permitted to be changed in the standard keratoplasty procedure used for all cases. Corneal topography was performed 1, 3, and 6 months after surgery. The astigmatic patterns seen on the corneal maps then were classified into regular (symmetric or asymmetric bowtie patterns) or irregular (distorted bowtie, multiaxial, or other patterns). MAIN OUTCOME MEASURES: Regularity of postkeratoplasty corneal astigmatism was measured. RESULTS: At all postoperative examination times, the percentage of irregular astigmatic patterns was highest in group a and lowest in group d (chi-square test: P < 0.005). Groups b and c showed intermediate values. The entity of the astigmatic error as measured by the simulated K-readings of the topographic maps did not differ significantly in the four groups. CONCLUSIONS: A suturing technique using 2 running sutures with 16 bites each can minimize irregular postkeratoplasty astigmatism as long as sutures are in place, when compared with interrupted sutures or double-running sutures of less than 16 bites.

Adolescent↗
PubMed1994

Vascularisation of ocular coralline hydroxyapatite implants.

Vascularisation of coralline hydroxyapatite used to replace the enucleated bulb is of critical importance for the uncomplicated implantation of a motility peg connecting the implant with the cosmetic prosthesis. Technetium-99m diphosphopropanedicarboxylic acid (DPD) single-photon emission tomography (SPET) was used to evaluate the rate of vascularisation as well as the time required for completion of vascularisation. Twenty-four patients were enrolled in the study, which was designed to evaluate vascularisation 10 days, 2 months and 4 months after implantation of a coralline implant. Nineteen patients completed the study and the visual impression of the completion of the vascularisation was scored from 0 (no vascularisation) to + (complete vascularisation) for each patient. No tracer accumulation was detected in any patient at the 10-day examination. Increasing vascularisation was demonstrated with time, and full vascularisation of the coralline implant was seen in all but one case by 4 months after implantation. We conclude that vascularisation of ocular coralline hydroxyapatite implants occurs early and is completed by 4 months after implantation in most cases, but should be confirmed at this time by 99mTc-DPD SPET.

Adult↗
PubMed1994

[Modified technique of autologous conjunctival transplantation after corneal chemical burn].

BACKGROUND: A modified conjunctival plastic for the treatment of unilateral alkali burn in presented. This procedure is aimed at both reconstructing the limbal region while eliminating the symblephara, thus allowing free ocular motility and partial recovery of corneal transparency. PATIENTS AND METHODS: Two patients suffering from unilateral alkali burn underwent a conjunctival plastic according to a technique modified from Kenyon. Preoperatively, both patients exhibited a fully vascularized, scarred cornea as well as extensive symblephara. By transplanting both limbal and bulbar autologous conjunctiva from the healthy eye to the injured one, it was possible in the two cases to reestablish the limbal and fornix anatomy. RESULTS: Postoperatively, free bulbar motility was achieved in both cases, while vision improved substantially only in the adult, not amblyopic patient who could obtain an uncorrected visual acuity of 0.05. CONCLUSION: The modified conjunctival plastic employed in the two cases reported herein led to excellent anatomic results while allowing partial recovery of corneal transparency and improvement of vision.

Adult↗
PubMed1994

[Orbital implants of coralline hydroxyapatite as eye replacement after enucleation].

BACKGROUND During the last two decades, hydroxyapatite has become popular as alloplastic material for bone replacement in orthopedic and dental surgery. We investigated prospectively the feasibility of hydroxyapatite spheres as replacement of enucleated eyes. PATIENTS AND METHODS Thirty-three consecutive patients entered a prospective study designed to evaluate the results obtained after either primary (n = 26) or secondary (n = 7) implantation of a hydroxyapatite sphere as replacement of the enucleated eyeball. Each patient was examined preoperatively, 1, 2, and 4 months after surgery, as well as every 6 months thereafter. At each examination time the motility of both coralline sphere and overlying cosmetic prosthesis was evaluated and the conjunctival sac was carefully examined at the slit-lamp. RESULTS The postoperative follow-up averaged 10.5 months for the primary implantations and 7.2 months for the secondary implantations. Two implants had to be removed because of infection unresponsive to antibiotic treatment. Defects in the conjunctiva overlying the implant necessitated wound revision in two cases. A buccal mucosal graft was performed in two additional ones. A temporary cosmetic prosthesis could be fitted in all but two of the remaining patients as early as 3 weeks after surgery. Motility of at least 3 mm in all directions could be obtained in 31 cases. CONCLUSION Our study demonstrated that satisfactory motility and good biocompatibility can be achieved, at least in the medium term, with implantation of coralline hydroxyapatite spheres.

Adolescent↗
PubMed1993

The retinal irradiance and spectral properties of the multiport illumination system for vitreous surgery.

The multiport illumination system was developed as a fiberoptically illuminated pars plana cannula system for vitreous surgery. The retinal irradiance of the multiport illumination system and several other commonly used endoilluminators (light pipes) measured at 5 mm are comparable, ranging from 94 to 256 mW/cm2. In the actual surgical setting, however, the retinal irradiance of the multiport illumination system is far less (56 mW/cm2) because the end of the fiberoptic cables are fixated in the pars plana 16.5 mm away from the retinal surface. A reduction in the maximal intensity (100%) to 50% reduces the retinal irradiance by approximately two thirds to 3.7 mW/cm2. The light emitted by the multiport illumination system used in conjunction with a long-wave pass filter with a cutoff wavelength of 420 nm reduces the amount of short-wavelength light by one third to about 4% of the overall irradiance.

Eye Diseases↗
PubMed1993

Effect of topical 0.5% timolol on tear flow in patients with primary open-angle glaucoma as assessed by fluorophotometry.

The question as to whether or not topical medication with beta blockers causes a decrease in tear production remains unanswered. Earlier studies using filter-paper strip tests have yielded contradictory results. In the present study, computerized objective fluorophotometry was used to assess the effect of topical medication with 0.5% timolol (b.i.d.; OU) on tear volume and tear production in 24 consecutive patients with bilateral primary open-angle glaucoma. Tear-film fluorophotometry was performed before treatment as well as at 7 days, 14 days, and 4-7 months after the onset of treatment. The results showed that by 7 days after the initiation of timolol treatment, both tear volume (-29%, P < 0.01) and tear secretion (-36%, P < 0.01) had decreased significantly. However, at both 14 days and 4-7 months after the onset of treatment, none of the values differed significantly from those obtained before treatment. Thus, topical antiglaucomatous treatment with 0.5% timolol eye drops leads to a transient decrease in tear production. This effect, however, lasts no longer than 14 days after the beginning of treatment.

Administration, Topical↗