[40% Glucose eyedrops for corneal oedema. A rare side-effect].
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Corneal Edema↗
Biomedical subjects
A Berta
Publications and source records attributed to A Berta.
A comparison of accommodation amplitudes in pseudophakic eyes measured with three different methods.
PURPOSE: To compare the accommodative amplitudes with three different methods in pseudophakic eyes with different types of intraocular lenses (IOLs). METHODS: Fifty-one pseudophakic eyes of 44 patients (age: 72.02+/-8.53 years) were studied. One of two different types of IOL were implanted (N=30, three-piece Alcon Acrysof MA60AC and N=21, one-piece Alcon Acrysof SA60AT) in-the-bag after standard phacoemulsification. The time of the examinations was 13.85+/-7.35 months postoperatively. We measured the amplitude of accommodation with three different methods: (1) subjective minus-lenses-to-blur method; (2) a new optical device (ACMaster, Carl Zeiss, Jena, Germany) using partial coherence interference (PCI) technique under physiological stimulus; and (3) objective anterior chamber depth measuring with a standard A-scan ultrasonic device (Ultrascan Imaging System, Alcon Laboratories, Forth Worth, TX, USA) before and after pharmacological relaxation of ciliary muscle. RESULTS: We measured -0.83+/-0.63 D amplitude of accommodation with subjective minus-lenses-to-blur method. The IOL position did not change significantly during physiological accommodation effort measured with PCI method (-0.026+/-0.134 mm). The change in the IOLs position between near fixating and after ciliary muscle relaxation was -0.18+/-0.28 mm measured with ultrasound. There were no significant differences between values of one-piece and three-piece IOL groups. CONCLUSION: The amplitude of accommodation measured by subjective and objective methods are different and are not comparable with each other. We did not observe any difference between values of examined two types of IOLs.
Accommodation, Ocular↗
Corneal endothelial function after phacoemulsification using the fluid-based system compared to conventional ultrasound technique.
AIM: To quantitatively assess corneal endothelial changes after phacoemulsification with the fluid-based system compared to conventional ultrasound technique. METHODS: This prospective, randomized clinical study included patients with cataract who were randomly assigned either to have phacoemulsification with the fluid-based system (30 eyes of 30 patients--Group 1) or with traditional ultrasound (30 eyes of 30 patients--Group 2). Patients who were available at each follow-up visit (25 eyes in both groups) were enrolled in the statistical analysis. Endothelial function was evaluated by measuring central corneal thickness, central endothelial cell density (ECD), mean cell size, and coefficient of variation in cell size preoperatively, 10 days, 1 and 3 months, and 1 year after surgery. Statistical analyses were performed using two-way repeated measure ANOVA. RESULTS: An acute, reversible increase of central corneal thickness (CCT) was found 10 days after surgery, which was similar in both groups (P=0.35). ECD decreased, whereas mean cell size increased significantly immediately after surgery. However, the impairments were finished after 1 month. The alterations were similar in both groups (ECD: P=0.99; mean cell size: P=0.85). The coefficient of variation in cell size remained stable after surgery (P=0.08), and significant difference was not found between groups (P=0.99). The endothelial cell loss (ECL) was 6.5+/-8.4% in Group 1 and 6.5+/-11.7% in Group 2 (P=0.69). CONCLUSIONS: Corneal endothelial changes were similar using the fluid-based system compared to the traditional ultrasound technique. The fluid-based method proved to be as safe as conventional ultrasound in cataract surgery.
Aged↗
[Initial experience with transpalpebral orbital lipectomy].
PURPOSE: The aim of this study was to evaluate the short-term effectiveness of transpalpebral orbital lipectomy. METHOD: Using a transpalpebral approach, 2.0-6.5 ml connective tissue was removed from 50 orbits of 33 patients with mild to severe Graves' orbitopathy (25 females, 8 males) over a 5-year period. Indications for surgery comprised cosmetic correction of exophthalmos (27/33 patients), corneal damage (5/33), and rapid bilateral deterioration of visual acuity in 1 patient. RESULTS: In 27 patients undergoing correction for aesthetic purposes no change in visual acuity ensued; in 4 of 5 keratopathy patients an improvement in visual acuity was detected. Diplopia ceased in 4 of 13 patients, diminished in 3 of 13 cases, and constantly increased in 2 of 13 cases. The high intraocular pressure returned to normal in 8 of 13 patients. The proptosis was reduced at 3.2+/-1.3 mm. CONCLUSION: Transpalpebral orbital lipectomy is a low-risk, highly effective technique for orbital decompression in both acute and chronic cases of Graves' orbitopathy.
Adolescent↗
[The role of infection control in the prevention of postoperative endophthalmitis].
INTRODUCTION: Infection control programs play an important role in the fight against nosocomial infections. They include all written protocols used and practical procedures performed before, during and after surgery. The authors describe the role of infection control in the prevention of postoperative endophthalmitis. PATIENTS AND METHODS: Retrospective data of endophthalmitis cases following elective eye penetrating surgeries performed at the Departments of Ophthalmology of the University of Debrecen and of the Hajdú-Bihar County Hospital in the periods between 1997-2001 and 2002-2003 were evaluated. Infection control methods for prevention have been in use in both institutes since 2002. RESULTS: The incidences of postoperative endophthalmitis before and after 2002 were 0.09 % and 0.07 %, respectively. Endophthalmitis cases in both periods occurred sporadically. Between 1997 and 2001 women accounted for 63.6 %, while they made up 80 % between 2002 and 2003; In the first period 63.6 % were older than 60 years whereas this group made up and 100 % in the second period. During the two periods accompanying chronic systemic diseases also had to be taken into consideration in 80 % and in 63.6 % of the cases, respectively. Intraoperative loss of the vitreous body was present in 27.2 % (1997-2001), and in 20 % (2002-2003) of the cases. CONCLUSIONS: We did not find any statistically significant difference between the incidence of postoperative endophthalmitis in the two periods. We think, however, that further studies involving more patients and longer study periods will reveal a correlation between the use of infection control methods and the prevention of both sporadic and epidemic cases of endophthalmitis, therefore all available data concerning this problem should be published. Moreover, the introduction of infection control policies into clinical practice will make prevention deliberate and more effective.
Aged↗
[Clinicopathological characteristic of keratoglobus].
BACKGROUND: This study describes the clinical, topographical, pachymetrical, and histological features of a unique corneal disorder: keratoglobus. CASE REPORT: Ultrasound pachymetry proved that the structure of the cornea was evenly thinning towards the periphery. Histological examinations disclosed the absence of Bowman's membrane and the thinning of the stromal lamellae. CONCLUSION: On account of the thickness of the recipient's periphery, penetrating keratoplasty proved to be a reasonable surgical procedure in this case.
Child↗
[Tear examinations in primary peripheral lipid keratopathy].
The authors report a case of a bilateral peripheral lipid keratopathy, rising differential diagnostic points as well. After several year-long follow-up period the peripheral corneal opacity left the center unaffected. The diagnosis was confirmed by tear examinations which disclosed elevated level of fatty and phosphorous content compared to healthy control eyes.
Chromatography, Gas↗
The Madrid triple classification of dry eye.
From the clinical point of view, there are many etiologic causes, several combinations of anatomo-pathologic manifestations, and different grades of severity of Dry Eye diseases in the dysfunctional tear film syndrome. The dacryologist doctor must recognize these three parameters, quantify them, and establish the most appropriate treatment. The present triple classification has been elaborated for this purpose. First, there is an etiologic distribution in ten groups: age-related, hormonal, pharmacologic, immunopathic, hyponutritional, dysgenetic, inflammatory, traumatic, neurodeprivative, and tantalic. Each of these groups comprise many variants. Second, there is an anatomo-pathologic classification named ALMEN classification from the acronym of aquodeficiency, lipodeficiency, mucodeficiency, epitheliopathy, and non-ocular exocrine affectations. Finally, there is a severity classification in five grades: subclinical (symptoms only when overexposure), mild (habitual symptoms), moderate (symptoms plus reversible signs), severe (symptoms plus permanent signs), and disabling (all the above, plus visual discapacity).
Dry Eye Syndromes↗
Antioxidant properties of calcium dobesilate in ischemic/reperfused diabetic rat retina.
Calcium dobesilate possesses antioxidant properties and protects against capillary permeability by reactive oxygen species in the rat peritoneal cavity, but whether a similar action can take place in the diabetic rat retina is unknown. We investigated the oral treatment of diabetic rats with calcium dobesilate on the prevention of free radical-mediated retinal injury induced by ischemia/reperfusion (90 min ischemia followed by 3 min and/or 24 h of reperfusion). Streptozotocin-induced diabetic rats were orally treated with 50 and 100 mg/kg of calcium dobesilate for 10 days (n=12 in each group). In the first series of studies, calcium dobesilate was found to significantly reduce the maldistribution of ion content in diabetic ischemic/reperfused rat retina. Thus, in diabetic rats treated with 100 mg/kg/day calcium dobesilate, ischemia/reperfusion provoked: (i) 27.5% increase in retinal Na(+) content compared to 51.8% in the vehicle-treated group (P<0.05), and (ii) 59.6% increase in retinal Ca(2+) content compared to 107.1% in vehicle-treated animals (P<0.05). In the second series of studies, calcium dobesilate was found to significantly protect diabetic rat retina against inhibition of Na(+)/K(+)-ATPase and Ca(2+)/Mg(2+)-ATPase activities by ischemia/reperfusion (54% and 41% reduction, respectively, with 100 mg/kg of calcium dobesilate) and also against changes in retinal ATP, reduced glutathione (GSH), and oxidized glutathione (GSSG) contents. In the third series of experiments, rats treated with 100 mg/kg of calcium dobesilate reduced the hydroxyl radical signal intensity to 41% (measured by electron paramagnetic resonance), induced by ischemia/reperfusion in diabetic rat retina. Finally, 100 mg/kg calcium dobesilate significantly reduced retinal edema (measured by the thickness of the inner plexiform layer) in diabetic rats. In conclusion, oral treatment with calcium dobesilate significantly protected diabetic rat retina against oxidative stress induced by ischemia/reperfusion. Whether the antioxidant properties of calcium dobesilate explain, at least in part, its beneficial therapeutic effects in diabetic retinopathy deserves further investigation.
Adenosine Triphosphate↗
[Palliative treatment of deep penetrating tumors in the medial eyelid eyelid with carbon dioxide laser].
A deep penetrating tumor was removed from the medial lid angle with a carbon dioxide laser knife for palliative reasons. After an early recurrence, which was also removed with the laser knife, we observed a satisfactory healing per secundam intentionem. After carbon dioxide laser excision no plastic covering is necessary. This quick and easy method is especially advantageous for patients with a bad compliance.
Carcinoma, Squamous Cell↗
Demonstration of increasing standard pH value of lacrimal fluid with increase of flow rate.
PURPOSE: To test the hypothesis that pH value of human tears is affected by flow rate. METHODS: After stimulation with a drop of 70% alcohol into the ipsilateral nasal cavity tears from the left eyes of 30 healthy volunteers were collected with glass capillaries while flow rate of tear secretion was registered. The pCO(2), actual and standard pH were determined in the collected samples with the Astrup method: Standard pH is defined as the pH of the sample that has been equilibrated at 37 degrees C with a gas mixture having pCO(2)=40 mmHg. RESULTS: The flow rate correlated positively and significantly with both the standard pH value (r=0.503, p<0.01) and the pCO(2) (r=0.517, p<0.01) while there was no correlation between the actual pH and the flow rate. CONCLUSION: Loss of CO(2) from the sample is a cause of serious uncertainty in tear pH determination. A positive flow rate-pH relationship was found for human tears when the uncertainty was removed by determination of the standard pH.
Acid-Base Equilibrium↗
Mutation of the RB1 gene caused unilateral retinoblastoma in early Age.
Fluorescence in situ hybridization (FISH) was applied for the detection of the retinoblastoma tumor-suppressor gene deletion on retinoblastoma tumor cells obtained from the unilateral tumor of a 3-month-old boy. Both retinoblastoma tumor cells and peripheral lymphocytes of the patient showed one hybridization signal per cell at the retinoblastoma-1 locus, indicating that one copy of the gene was deleted. Peripheral blood lymphocytes obtained from the patient's parents had two copies per cell for the gene. Retinoblastoma nuclear phosphoprotein expression could not be detected in the tumor tissue. No copy number alterations were detected with ten different centromeric DNA probes in the tumor cells. The deletion at the RB1 locus detected by FISH suggested that this gene alteration was heritable. The parental peripheral blood lymphocytes did not show the loss of the gene; thus the first deletion may have taken place in either of the parental germ cells. The second somatic mutation of the RB1 gene was probably under the detection limit of FISH. The second allelic alterations were detected by using the polymerase chain reaction for all exons of the retinoblastoma gene.
Genes, Retinoblastoma↗
Serious fireworks-related eye injuries.
OBJECTIVE: To analyze and compare epidemiological and clinical information on serious fireworks-related eye injuries from two affiliates of the United States Eye Injury Registry. METHOD: Retrospective review. RESULTS: In the Eye Injury Registry of Alabama (EIRA) database, 185 of the 4150 injuries (4.4%) were caused by fireworks. In the Hungarian Eye Injury Registry database, only two of the 1245 cases (0.1%, p=0.000001) were fireworks-related. In the EIRA, 79% of patients were males and 87% were under 31 years. A bystander was injured in 67% of the cases, being an average of 23 feet away; 39% of bystanders had a final vision < or =19/200. No injured person wore eye protection. Bottle rockets caused 80% of the 185 injuries. Overall, 20% of eyes had <5/200 final visual acuity. Twenty-five percent of bottle rocket-injured eyes, compared to 64% of those injured by other devices, had > or =20/40 final vision (p=0. 000004). CONCLUSIONS. The rate of fireworks-related serious eye injuries has not decreased in Alabama in the last 16 years; most patients are young males. Since bystanders are at a measurable risk even at a distance of 100 feet, wearing eye protection is recommended to both bystanders and operators. Bottle rockets cause most of the injuries and the more severe ones, and should be the prime target for prevention. The benefit of a strict and enforced legislative ban on private fireworks displays is demonstrated by the much lower incidence figure in Hungary. Such a ban should be considered in other countries where fireworks-related eye injuries are common.
Adolescent↗
Plasminogen activator activity in tears after excimer laser photorefractive keratectomy.
PURPOSE: To quantify changes of plasminogen activator activity in tear fluid during corneal re-epithelialization after excimer laser photorefractive keratectomy (PRK). METHODS: Tear samples were collected with glass capillaries from 77 eyes of 42 patients immediately before and immediately after PRK treatment and on postoperative days 3 and 5. In 20 patients, the contralateral eye was similarly sampled to serve as control. Plasminogen activator activity in the tear samples was measured by a spectrophotometric method using human plasminogen and chromogenic peptide substrate, D-valyl-L-leucyl-L-lysine-p-nitroanilide (S-2251). RESULTS: In tears of all eyes that underwent PRK, the plasminogen activator activities were lower immediately after PRK than were the preoperative values. For patient eyes with normal wound healing, tear plasminogen activator activities were significantly elevated above the preoperative level on the third postoperative day and then returned to the preoperative level by the fifth postoperative day. In contrast, tear plasminogen activator activities remained low through the third postoperative day in all (six) eyes in which haze developed after 3 to 6 months. The contralateral control eyes showed no appreciable change in plasminogen activator activity over the 5-day period. CONCLUSIONS: Plasminogen activator activity levels measured in tears of excimer laser PRK-treated eyes may serve as a predictor of wound healing. Extended low levels of plasminogen activator activity through the third postoperative day correlate with the development of corneal healing abnormalities (haze). The low plasminogen activator activity could be not only an accompanying sign but also a cause of defective corneal wound healing.
Adolescent↗
Immunohistochemical detection of betaIG-H3 in scarring human corneas.
BACKGROUND: BetaIG-H3 is a recently described extracellular matrix protein that is present in various organs. In rabbit corneas, increased betaIG (the rabbit form of betaIG-H3) mRNA levels were shown during corneal development and wound healing. In this study, we investigated the localization of betaIG-H3 protein in scarring human corneas. METHODS: Corneal buttons obtained during keratoplasty were examined. Immunohistological detection using a polyclonal antipeptide antibody against the betaIG-H3 protein was performed on 24 pathological corneas (9 ulcerations, 8 alkali burns, 2 perforating injuries, 5 bullous keratopathy) and 2 normal corneas. RESULTS: In normal corneas, strong staining was present in the basal layer of the epithelium and in the endothelium; the stromal fibers showed faint, uniform immunoreactivity. In all scarring corneas, the epithelium was usually thickened and all of its layers were reactive with the betaIG-H3 antibody. The cytoplasm of the stromal fibroblasts, as well as the stromal fibers around them also showed staining with the antibody. These changes were present in all scarring corneas, irrespective of the pathological process leading to scar formation. CONCLUSION: These results prove, at the protein level, the presence of increased amounts of betaIG-H3 at the sites of scarring in human corneas.
Alkalies↗
Expression of betaig-h3 is lower than normal in keratoconus corneas but increases with scarring.
PURPOSE: Keratoconus is a progressive ectatic disease of the cornea. Despite extensive clinical and laboratory investigations, its pathogenesis remains unclear. In this study, we examined the localization of betaig-h3, a recently described extracellular matrix protein in keratoconus corneas both in the absence and presence of subepithelial scarring. METHODS: Two normal corneas and central corneal buttons of 10 patients with keratoconus were excised during perforating keratoplasty and examined, including one case with acute corneal hydrops. In one case, keratoconus was associated with Down syndrome. Immunodetection was done with an antipeptide antibody reacting with the N-terminal part of betaig-h3. RESULTS: We found decreased betaig-h3 levels in the basal epithelial layer and keratocytes of keratoconus corneas. In the scarred corneas, however, betaig-h3 levels were increased in the basal epithelial layers and in activated keratocytes at the places of scarring. In the cornea of the patient with Down syndrome, we found an additional betaig-h3-positive zone in the anterior stroma. CONCLUSIONS: The decreased levels of betaig-h3 corneas seem to be specific for keratoconus. Considering the putative role of betaig-h3 as a cellular-attachment protein, paucity of betaig-h3 in the corneal stroma may lead to decreased mechanical stability and contribute to the development of keratoconus.
Adolescent↗
Corneal transplantation in children.
Authors discuss the special problems related to childhood keratoplasties. They evaluate the results of the keratoplasties carried out in children during the past 10 years in their service. They review the concerning literature and summarize their opinion on the corneal transplantations of this age group.
Child↗
The continuous-injection technique to reduce complications during retrobulbar anesthesia.
Retrobulbar as well as peribulbar anesthesia remain relatively risky procedures; retrobulbar hemorrhage and especially globe penetration or perforation can have blinding consequences. Our continuous-injection-technique greatly reduces these risks whether used for retrobulbar or peribulbar anesthesia. If the ophthalmologist starts injecting the agent while advancing the needle, the fluid pushes tissues away, possibly preventing a hemorrhage. Since resistance against the plunger is instantaneously experienced if the needle impacts the sclera, the ophthalmologist is adequately warned before actual perforation of the sclera occurs.
Anesthesia, Local↗