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At least 793 records · Page 44Linked to original sources
PubMedDate not supplied

[Unified classification of conditions united by the notion of "diffusive lamellar keratitis (D.L.K.)" in the corneal refractive surgery].

A total of 4810 laser keratomilase surgeries (LASIK) in myopia and hypermetropia were analyzed. The spherical equivalent of clinical refraction in myopia amounted to -6.56 +/- 1.34 diopters, in hypermetropia it amounted to +3.97 +/- 1.74 diopters. The refraction parameters in myopia ranged from 1.5 diopters to 12.0 diopters; in case of astigmatism they ranged from 0.5 diopters to 2.75 diopters, and in hypermetropia they varied from 1.5 to 6.25 diopters. The age of patients ranged from 18.5 to 52; there were 49.3% male patients and 50.7% female patients. The observation period was up to 2 years. The lamellar corneal incision was implemented by three types of microkeratomes: "Hansatome" (Germany), "Moria" (France) and "Nidek" (Japan). Photoablation was carried out by Keracor Techlas 217 (Germany) of the "flying dot" scanning type and by "Profil 500" (Russia). The primary DLK reaction of the dystrophic nature amounted, during the first year of using the method, to 1:75 cases, during the second year it was 1:350 cases. The share of secondary DLK manifestations ranged from 0.1 to 17% with regard for a type of complications. DLK can be characterized by various forms, phases and stages. The reaction can be primary (early) and secondary (delayed). Basically, it is a universal inflammatory response of keratocytes to a prolonged malfunction of lamellar flap due to disadaptation. It is described as a complication of the lamellar surgery as a whole and is, most probably, a response to the sutureless surgery. There are factors, which diminish the frequency of such complication. A new working classification of the DLK response is presented. A new clinical classification of DLK and DLK-like conditions in the corneal lamellar surgery is offered. Finally, notion "lamellar malfunction" is offered for a comprehensive usage in refraction surgery.

Adolescent↗
PubMed2003

[Evaluation of early postoperative astigmatism with respect to anterior chamber opening].

UNLABELLED: The study evaluates amount and direction of postoperative astigmatism after usually performed techniques of cataract surgery. MATERIAL AND METHODS: 90 consecutive patients (120 eyes) mean aged 74.5 years, who underwent cataract surgery with clear corneal superior (Group 1) or temporal incision (Group 2), sclero-corneal tunnel sutureless incision (Group 3) or limbal ECCE incision with x sutures (Group 4), were examined with respect to postoperative astigmatism. Anterior chamber opening was determined by primary astigmatism and nucleus hardness. All measurements were performed based on keratometry. RESULTS: The highest mean value of with the rule astigmatism was assessed in Group 4. From the other hand, the least value were determined in group 2--95% with the rule and 5% oblique and in group 1--40% with the rule, 40% against the rule 20% oblique. In group 3, the value of postoperative astigmatism was higher, as compared with Group 1 and 2. It was assessed with similar proportion as in Group 1. CONCLUSIONS: At present cataract surgery techniques are not free of induced astigmatism. Study demonstrates significance of preoperative primary astigmatism assessment, with respect to surgery technique, to avoid postoperative astigmatism.

Aged↗
PubMedDate not supplied

[Postoperative pain as complication of hernia surgical repair with mesh and plug].

The authors assess the incidence of locoregional chronic pain after inguinal hernia repair. One hundred consecutive patients, with a mean age of 65.4 years, suffering from primary monolateral inguinal hernia, underwent suture-less mesh-plug hernioplasty. In all cases the inguinal nerves were identified. In the early postoperative period, a questionnaire was given to all patients in order to assess the frequency, type and intensity of postoperative locoregional pain and the impact of the pain on their quality of life. Sixty patients were available for follow-up with clinical examination and these were given the same questionnaire 2-4 years after hernioplasty. Pain intensity was scored by means of a visual-analogue scale (from 0 to 10). The incidence of locoregional pain after hernioplasty was 13.0% in the early postoperative period and 25.0% after a longer period of follow-up. None of the patients presented recurrent hernia. The symptomatic patients reported mild or moderate neurogenic pain. Severe pain was not reported. On the whole, the presence of mild-to-moderate chronic pain had no impact on the patients' quality of life. Our study confirms the high incidence of locoregional chronic pain even after sutureless mesh-plug hernioplasty, but that this has no serious effects on the patients' quality of life.

Adult↗
PubMed1992

[Surgical treatment of acute aortic dissection in the aged: a case report].

A 77-year-old woman with Stanford type A acute aortic dissecting aneurysm was successfully treated by the sutureless technique using arringed intraluminal graft. A month after the operation, re-dissection to the distal abdominal aorta occurred. Because of the poor condition of the patient and her great age, we chose an antihypertensive therapy instead of a reoperation. Two years after the operation this patient leads a sound life without any symptoms. In a case of acute aortic dissection of the aged, special consideration may be allowed to a surgical method and a decision-making for a reoperation.

Acute Disease↗
PubMed2004

[Repair of post-infarct left ventricular rupture with pericardial patch].

The devolpment of a left ventricular rupture after myocardial infarction is not a rare complication. We report a case of 70-year-old male patient with clinical and instrumental signs of cardiac tamponade after left ventricular rupture. We repaired this lesion with pericardial patch and biological Glue without extracorporeal circulation and sutureless.

Aged↗
PubMed2004

Learning phacoemulsification. Results of different teaching methods.

We report the learning curves of three eye surgeons converting from sutureless extracapsular cataract extraction to phacoemulsification using different teaching methods. Posterior capsule rupture (PCR) as a per-operative complication and visual outcome of the first 100 operations were analysed. The PCR rate was 4% and 15% in supervised and unsupervised surgery respectively. Likewise, an uncorrected visual acuity of > or = 6/18 on the first postoperative day was seen in 62 (62%) of patients and in 22 (22%) in supervised and unsupervised surgery respectively.

Education, Medical, Continuing↗
PubMedDate not supplied

No-suture aphakic epikeratoplasty.

BACKGROUND: Use of sutures with aphakic epikeratoplasty is time-consuming during surgery and can create significant hazards for the patient. Thus, a surgical technique for aphakic epikeratoplasty without sutures was developed. METHODS: The conventional procedure was modified to use an oversized lenticule tucked evenly in an expanded lamellar pocket with no anchoring sutures. The technique was performed on one eye of 27 consecutive patients over a 9-month period. RESULTS: After a mean follow up of 14 months, results showed refractive and visual parameters comparable to a sutured technique. A 100% success rate at surgery was obtained using the oversized 9-millimeter lenticule. Five eyes (19.2%) developed a partial lenticule edge dislocation postoperatively. Three of the edge dislocations were reposited at the slit lamp without suturing. One lenticule, manufactured undersize, required primary suturing, leaving 24 of 26 (92.3%) patients healed without sutures. Postoperative spectacle-corrected acuity for the group either improved by one or more Snellen lines or remained unchanged. Two patients had reduced vision: one due to unrelated retinal changes and one due to vernal catarhh resulting in a persistent epithelial defect with subsequent epithelial haze. CONCLUSIONS: A sutureless technique can accomplish visual rehabilitation comparable to the conventional procedure. While the technique is not without complication, significant benefits to the patient include reduced morbidity, eliminating hazards of postoperative suture management, and a simplified surgical procedure.

Adolescent↗
PubMed2005

[Balloon compression hemostasis in injuries of parenchymatous organs].

Balloon compression method of hemostasis in injuries of parenchymatous organs is described. Developed device consists of inflatable balloon and double-lumen tube for drainage of abdominal cavity and filling of balloon with air. Hemostasis is achieved due to inflation of balloon and pressure on injured surface. Parameters of pressure and time of compression were determined in experimental study. This device can be used both in open and video-assisted laparoscopic surgeries. Described method was used in 29 patients (22 of them underwent laparoscopic surgery and in 7 patients the device was applied during laparotomy). This method permits to achieve reliable sutureless hemostasis, to control hemostasis and pressure on the wound, to drain abdominal cavity.

Abdominal Injuries↗
PubMed2005

[Therapeutic strategies for postinfarction left ventricular free wall rupture].

We treated 93 patients who developed left ventricular free wall rupture after acute myocardial infarction. Medical management including pericardial drainage was performed in 78 patients (84%), but 67 of them died. All 11 surviving patients showed an oozing type rupture. Surgical repair was performed in 15 patients (16%). As a result, 9 patients died and 6 survived. All but 1 of the patients who died presented with a blow-out rupture. Blow-out type rupture occurred in 3 and oozing type rupture in 3 of the surviving patients. One patient with blow-out type rupture underwent implantation of a left ventricular assist device following percutaneous cardiopulmonary support (PCPS), because of low output syndrome after the operation. The device was successfully removed 7 days after implantation. In all of the 3 patients with oozing type rupture, sutureless technique was successfully performed using fibrin-glue or fibrin-glue sheet fixation. After a mean follow-up period of 7 years after operation, 5 of 6 are still alive. To improve the clinical outcome of left ventricular free wall rupture, it is important for surgeons to closely liaise with physicians, to perform surgical repair as soon as possible, and to utilize a circulatory support system after operation. Therefore, we developed a new PCPS system compatible with emergency cardiac surgery and a new left ventricular assist system draining via the left ventricle.

Aged↗
PubMed2005

A surgical case of ventricular septal perforation after repairing left ventricular free wall rupture.

A 78-year-old woman with diagnosis of acute myocardial infarction (AMI) in the anteroseptal area fell into cardiogenic shock suddenly just before starting percutaneous coronary intervention (PCI). Echocardiography showed left ventricular free wall rupture, then an emergent operation was performed by sutureless patch repair using collagen fleece with fibrinogen-based impregnation. Eight days later from the initial operation, the onset of ventricular septal perforation (VSP) was recognized. Fifteen days after, the infarct exclusion technique with endocardial patch was performed. She has been doing well 4 months after the operation without residual shunt. To our best knowledge, this is the first surgical case report that free wall rupture of left ventricle and VSP which are serious complications after myocardial infarction happened in succession.

Aged↗
PubMed2005

[Clinico-morphological characteristics of the methods of connection of the postoperative wound edges].

The decision for the method of connection of the skin wound edges should be based on specific reconstruction of the injured tissues depending on the suture material and kind of the skin suture. An alternative of the classical suturing of the postoperative wound is a sutureless fixation of the skin edges--a method of using adhesive plaster. The work includes a clinico-morphological comparison of the course of the process of regeneration when using the intracutaneous suture and the adhesive plaster. The macroscopic and pathologic-histological estimation of the healing of the postoperative wound of the skin has shown that a smoother course of the postoperative period is noted in the groups where the adhesive plaster was used.

Adolescent↗
PubMedDate not supplied

Phacoemulsification surgery and foldable intraocular lens implantation in a child with regressed retinoblastoma.

PURPOSE: The management of retinoblastoma has been shifting toward conservative treatment. Visual preservation has become a concern as tumor regression is achieved. To report the surgical approach and outcome of a radiation-induced cataract in an only eye with regressed retinoblastoma. METHODS: Single case report and review of literature. RESULTS: Small incision sutureless phacoemulsification and implant of an acrylic foldable intraocular lens was performed. Best-corrected visual acuity 1 year after surgery was 20/20. No tumor recurrence has been noted after 27 months of follow-up. CONCLUSIONS: Phacoemulsification and foldable intraocular lens implant seemed to be an appropriate therapeutic option for this case.

Cataract↗
PubMed1992

[Initial experiences with the bio-fragmentable Valtrac anastomosis ring].

The biofragmentable ring (Valtrac) to perform a sutureless bowel anastomosis was used in a short period until complications rate became to big. There were six ileo-colostomies with the 28 mm ring and 7 colo-colostomies with the 31 mm ring. In 4 patients additional sutures were placed because the ring was shining through the tissue. Thirteen patients (4 women, 9 men) with a mean age of 63 years (36-78) were included. Complications occurred in 3 men (71, 36 and 63 years old). Two of them had an additional suturing. One demonstrated insufficiency at day four with many small gabs in the anastomotic line according to the ring design. Histology demonstrated perfect microcirculation. The second patient developed a fistula three weeks after operation. Both had an ileo-colostomy. The third operated because of a gastrocolic fistula with cachexia reentered hospital seven weeks postoperatively with a new gastrocolic fistula on X-ray. He died with a cardiac arrest. Postmortem was refused. We conclude from our results that the Valtrac ring should be used only by experienced surgeons, there is no reduction in operation time, and ileo-colostomy needs special care. We believe that surgeons using an extramucosal monofilament running suture for colonic anastomosis are more unlikely to switch to the Valtrac ring than those using other technics.

Adult↗
PubMedDate not supplied

Pattern of intraocular pressure changes following manual small incision cataract surgery.

OBJECTIVES: To find out the pattern of changes in intraocular pressure after manual small incision cataract surgery. METHODS: Consecutive patients (291 eyes of 291 patients) undergoing manual small incision cataract surgery were prospectively evaluated for change in IOP. Patients were further divided into two groups based on whether or not sutures were used to close the scleral tunnel. IOP was serially measured at day 1, 1st, 2nd, 4th, 6th, 8th and 12th week. RESULTS: The mean post operative IOP in eyes where sutures were not applied (12.59+/- 3.02 mmHg, 12.59+/-2.34mmHg, 12.54+/-2.19mmHg and 12.40+/-2.99 mm Hg at day1, 2week and 4weeks respectively) was lower than that where sutures were used to close the wound (15.57+/- 3.86mmHg, 14.05+/-2.52mmHg, 14.43+/-3.39mmHg at day1, 2weeks and 4 weeks respectively). There was a drop of IOP from the preoperative IOP in both suture (1.15+/-3.29mm Hg) and non suture (3.29+/-3.07mm Hg) group at 3 months of follow up. CONCLUSION: There is a small drop of IOP following sutureless MSICS during long term follow up. Eyes where sutures are applied are more likely to have higher IOP than those without sutures at the initial post operative period.

Cataract Extraction↗
PubMedDate not supplied

Laparoscopic ventral hernia repair without sutures--double crown technique: our experience after 140 cases with a mean follow-up of 40 months.

It has been reported that avoidance of recurrences after laparoscopic ventral hernia repair (LVHR) depends on using sutures to secure the mesh. We developed a successful sutureless LVHR. The "Double Crown" LVHR using ePTFE mesh (overlap, 23 cm) was done in 140 cases. Tacks were placed 1 cm apart at the edge of the mesh. A second crown of tacks was placed at the edge of the defect. Three conversions (2.14%) and five bowel perforations occurred intraoperatively (3.57%). Postoperative complications were prolonged ileus (two cases), hematoma (two cases), seroma requiring drainage (three cases), and reoperation in one case for mesh intolerance, three cases for bowel perforation, and one case for small bowel ischemia. The recurrence rate (mean follow-up of 40 months) was 2.14%. The Double Crown LVHR is a safe alternative to LVHR using sutures, with a similar recurrence rate, less pain, fewer incisions and infections, and a shorter operating time.

Adult↗
PubMed2006

[Surgery for acute myocardial infarction].

We discuss the current status and outcome of surgery for acute myocardial infarction (AMI). The optimal timing of surgical revascularization following AMI is a matter of controversy. Early surgery after an AMI involves high risk If elective surgery is possible under mechanical cardiac support cardiac artery bypass grafting (CABG) can be performed with acceptable mortality rates early after AMI. On-pump beating heart revascularization is efficacious in patients in cardiogenic shock or with unstable hemodynamics early after AMI. For postinfarct ventricular septal perforation, an infarct exclusion technique is a standard surgical procedure. For an oozing-type postinfarction left ventricular free wall rupture, a sutureless technique is effective. For papillary muscle rupture, emergent mitral valve replacement concomitant with CABG is recommended.

Aged↗
PubMedDate not supplied

[The results of the surgical treatment of femoral hernias by suture-free alloplasty].

A new method of plasty of hernial hilus for femoral hernias is proposed which consists in sutureless fixation of allotransplants made of silicone having the form of a mushroom-shaped element. The transplant gives good and reliable closure of the hernial hilus without changing the interrelation of tissues. The duration of the operative procedure becomes considerably shorter, any injuries of large vessels were excluded as well as the development of ligature fistulas, suppuration of the wounds and recurrent hernias. An analysis of nearest and long-term results of treatment of 68 patients operated upon shows high efficiency of the method proposed.

Aged↗