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Biomedical subjects

U Klemen

Publications and source records attributed to U Klemen.

18 recordsLinked to original sources
PubMed2000

Cataract extraction with multifocal intraocular lens implantation: clinical, functional, and quality-of-life outcomes. Multicenter clinical trial in Germany and Austria.

PURPOSE: To compare bilateral implantation of a multifocal intraocular lens (IOL) versus a monofocal lens with respect to visual function, patient satisfaction, and quality of life. SETTING: Seven clinical sites in Germany and 1 site in Austria. METHODS: A prospective randomized masked clinical trial included 124 randomly assigned bilateral pseudophakic individuals, 64 of whom had bilateral implantation of an Array(R) foldable multifocal IOL (model SA-40N, Allergan) and 60 of whom had bilateral implantation of an AMO(R)PhacoFlex II(R) silicone monofocal IOL (model SI-40NB). Clinical data included binocular uncorrected and corrected distance and near visual acuities, complications, adverse events, and reports of halos and glare. Quality-of-life data were collected on 3 occasions using the modified Cataract TyPE Specification instrument. The functional status of the 2 groups was compared from baseline to final postoperative interview. RESULTS: Three months after surgery, a higher proportion in the Array group achieved a Jaeger value of J3 (20/40 Snellen) or better uncorrected binocular near visual acuity and 0.5 (20/40) or better distance-corrected binocular near visual acuity than in the monofocal groups (97% versus 68% and 95% versus 59%, respectively; P <.001). A higher proportion in the multifocal group achieved both 0.5 (20/40) and J3 or better uncorrected binocular distance and near visual acuities (97% versus 66%; P <.001). Those in the Array group were more likely than those in the monofocal group to never wear glasses overall (41% versus 12%; P <.001). Multifocal patients rated their vision without glasses better overall, at near and at intermediate distances (P <.05), and demonstrated better visual function for near tasks and social activities. CONCLUSIONS: Those who had bilateral implantation of the Array multifocal IOL obtained better uncorrected and distance-corrected near visual acuities and reported better overall vision, less limitation in visual function, and less spectacle dependency than patients with bilateral monofocal IOLs.

Aged↗
PubMed1984

Increased angiotensin-converting enzyme activities in diabetes mellitus: analysis of diabetes type, state of metabolic control and occurrence of diabetic vascular disease.

Serum angiotensin-converting enzyme activities were measured in 41 type 1 diabetics (16.4 +/- 4.0 U/ml), in 40 type 2 diabetics (15.0 +/- 5.2 U/ml) and in 52 controls (13.0 +/- 2.7 U/ml, mean +/- SD). Twenty six (32%) of 81 patients presented with serum angiotensin-converting enzyme activities above the normal range. No relation between serum angiotensin-converting enzyme activities and the presence or lack of diabetic vascular diseases in type 1 and type 2 diabetics could be detected. No significant differences in serum angiotensin-converting enzyme activities were found when comparing various types of diabetic vascular disease (retinopathy, neuropathy, renal failure, arterial vascular disease, diabetic vascular disease, coronary artery disease). However, mean serum angiotensin-converting enzyme activities were significantly increased in diabetics with retinopathy when compared with controls (p less than 0.0005). Correlation between metabolic long term control as determined by measuring glycohaemoglobin (HbA1) concentrations and serum angiotensin-converting enzyme activities could not be established. Serum angiotensin-converting enzyme activities did not show any correlations with duration of diabetes, age or sex of patients. A representative number of diabetics (32%) showed elevated serum angiotensin-converting enzyme activities, but a correlation with diabetic vascular disease, metabolic control or type of disease could not be established.

Adult↗
PubMed1981

[A new classification scheme of non-proliferative diabetic retinopathy (author's transl)].

The correlation of the topography of certain areas of the fundus, which exhibit relentless progression of microangiopathy (within the framework of general fluctuations in the course of the disease), as well as the degree of predominance of capillary perfusion and permeability disturbances in these respective areas justifies a classification of non-proliferative diabetic retinopathy into three distinct types: (1) pre-maculopathy/maculopathy in non-proliferative diabetic retinopathy (DR), (2) nonproliferative DR, and (3) non-proliferative DR lacking a tendency towards vasoproliferation or maculopathy. These results are based on regular biannual angiographic examinations of six different standard fundus areas in a total of 365 patients with non-proliferative DR. This scheme of classification has prognostic as well as therapeutic consequences.

Capillary Permeability↗
PubMed1981

[Topographic aspects of the progression of diabetic retinopathy (an experimental set-up for the evaluation of medical influencability) (author's transl)].

Within the past five years fluorescein angiography of six different fundus areas was performed at intervals of six months on a total of 365 patients exhibiting non-proliferative diabetic retinopathy without diabetic maculopathy. Within that period, diabetic maculopathy was observed to develop in 195 eyes, vasoproliferation in 20 eyes. Within the general scope of fluctuation of the angiographic picture of retinal capillary perfusion disturbance, zones of continuous progression were encountered in 246 eyes. In 183 out of 195 eyes which developed diabetic maculopathy the distinct areas of relentless progression were located 2--6 PD's temporal to the macula; in the total 20 eyes which had advanced to the proliferative stage similar areas were encountered, located nasally 2--6 PD's above and below the optic disk.

Capillary Permeability↗
PubMed1980

[Suturing technic in penetrating keratoplasty--comparative study].

From the patients who underwent keratoplasty within the last three years we selected 40 out of a total of 121 with the following common features: diameter of the button 7.1 mm, indication for surgery for optical reasons, healing of the button with sufficient clarity, achieving visual acuity of 0.5 or better. In 20 patients we used a running 10/0 nylon suture; in the remaining 20 cases we combined single 8/0 silk sutures with a runing 10/0 prolene suture. No statistically significant difference between the two groups was found when corneal astigmatism was compared to six to eight months postoperatively (at least two months following suture removal). This also applied in respect of the resultant refraction difference. However, in cases of keratoconus the combined suture technique resulted in a lower degree of astigmatism than the running suture technique alone.

Astigmatism↗
PubMed1980

[Risks associated with photocoagulation in proliferative diabetic retinopathy (author's transl)].

In 185 diabetics with proliferative diabetic retinopathy (d.r.) involving both eyes symmetrically we analyzed the indication for photocoagulation in borderline cases in which, despite complications (such as inducement of vitreoretinal retraction), the beneficial effect of photocoagulation outweighs the likelihoood of a spontaneous deleterious course. In stage 2 of proliferative d.r. the risks associated with photocoagulation (i.e., factors likely to cause traction phenomena) were found to be extensive coagulation of intraretinal and preretinal hemorrhages, and coagulation of feeder vessels as well as of fundus areas located behind vitreal hemorrhages. In stage 3, procoagulative risk factors in the morphological picture comprised the existence of several vitreoretinal insertions with tent-shaped traction folds and extensive preretinal and subvitreal hemorrhages.

Diabetic Retinopathy↗
PubMed1980

[Intravitreal injection of SF6 gas in vitreoretinal surgery (author's transl)].

Within the past 3 years intravitreal injection of SF6 gas was performed in 31 vitreoretinal surgical procedures. In 29 cases an additional vitrectomy was performed, and in 10 cases with massive periretinal proliferation (MPP) epiretinal membranes were stripped. The rate of success following intravitreal injection of SF6 gas as an adjunct to buckling procedures in severe cases of rhegmatogenous retinal detachment was 83%, as an additional measure in cases with giant tears extending over 180-225 degrees, 75%, in cases of tractional detachment due to preretinal and transvitreal strands, 60%, and in cases with MPP, 30%.

Fluorides↗
PubMed1979

[Relationship between loss of sight and mortality in diabetics with retinopathy (a retrospective study over the terminal 5 years) (author's transl)].

1642 diabetics with retinopathy were controlled at half-yearly intervals over 4 to 10 years (6 years on average) using fundus photography, fluoresceinangiography and measurement of visual acuity. 83 of these patients died and the data documented in 43 patients over a mean period of 5.2 years prior to death allowed a retrospective evaluation of the clinical findings and therapeutic results. 27 patients had undergone bilateral and 16 unilateral photocoagulation at the beginning of the observation period. 9 patients were blind already at the outset. Of 13 patients who became blind during the observation period 10 had not undergone photocoagulation of the affected eye. The time span between blindness and death was shorter (1.5 years) in the 3 patients (5 eyes) who had undergone photocoagulation than in the untreated diabetics (4.3 years). All 23 patients in whom the initial visual acuity was maintained had undergone photocoagulation. Presence of florid diabetic retinopathy or nephropathy adversely influenced the results of photocoagulation.

Adult↗
PubMed1979

[Is a general operative prophylaxis of the fellow eye in cases of acute glaucoma necessary? (author's transl)].

The fellow eyes of 136 patients suffering from acute glaucoma were checked during their hospitalization by means of provocation-tests and gonioscopy. Ten cases had a simultaneous attack of both eyes, and 27 were submitted to a peripheral iridectomy prophylactically after a positive provocation-test. Of the remaining 99 patients observed up to 12 years after the operation only 22 developed an attack in the fellow eye; 11 of them were below the age of 60 years, and only 4 over 70.

Acute Disease↗
PubMed1978

[Gluing with fibrin in corneal surgery. An experimental study (author's transl)].

Penetrating corneal incisions of various sizes and forms were microsurgically glued onto 48 rabbit eyes by means of fibrinogen-plasma cryoprecipitate with or without 10x0 nylon sutures. Linear or curved penetrating corneal cuts up to 4 mm in length could be immediately closed water tight by pure gluing and without development of anterior synechiae. The suturing of oblique cuts may prove problematic. The more oblique such cuts were, the better the results they yielded after gluing. In cases of linear penetrating corneal incisions exceeding 4 mm in length, and in star-shaped wounds with radiants over 3 mm in length, anterior synechiae could only be avoided by application of additional sutures. Pure or additional gluing of corneal penetrating cuts accelerated wound healing, but was followed by broader scars than after pure suturing. Hence, the gluing of certain types of penetrating corneal wounds by means of fibrin can be applied only as an auxiliary procedure to microsurgical wound closure with sutures.

Animals↗
PubMed1978

[Growth hormone and diabetic retinopathy (author's transl)].

Changes in the serum level of growth hormone have been studied in 28 diabetics (6 exhibiting no diabetic retinopathy (d. r.), 10 displaying a non proliferative d. r., 6 having proliferative d. r., and 6 Brittle-diabetes) together with a control group consisting of 11 subjects (5 being totally healthy, and 6 having acromegaly without d. r.). Blood samples were obtained before and after arginine and glucagon administration and also following controlled exercise on the ergometer with 50% of the actual working capacity during 20 minutes. The presence of d. r. and its stage has been determined by fluorescein angiography. Our results demonstrate that an increased secretion of growth hormone in diabetics actually constitutes a manifestation of metabolic instability. Apparantly no correlation exists between the appearance of d. r. or its stage and the degree of growth hormone release.

Acromegaly↗
PubMed1977

[Has photocoagulation improved the prognosis of diabetic retinopathy?].

In 192 diabetic retinopathy cases, Xenon light coagulation was performed. Afterwards, the eyes treated were examined half yearly for at least 4 years. Fundus photography and fluorescein angiography were made and the visual acuity was checked. In 64 cases the comparison could have been made in the same patient between one treated and the other untreated eye. The statistical results of this study permit us to assess the therapeutic value of light coagulation for diabetic retinopathy.

Diabetic Retinopathy↗