Biomedical subjects
Publications and source records attributed to B Biedner.
Bilateral lateral rectus resection was performed on both previously recessed medial rectus muscles in 23 patients with residual esotropia. The operation reduced the deviation in all patients, but successful treatment was achieved only in 52%. The advantages and disadvantages of this surgical approach are discussed.
Patients with congenital esotropia and high myopia were surgically treated by recession of both medial rectus muscles. The results are presented and discussed.
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A case of anhidrotic ectodermal dysplasia associated with relapsing uveitis in both eyes is reported. To our knowledge, no similar case has been reported.
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All eyes of children above the age of 1 year referred because of glaucoma were treated with trabeculotomy as the primary procedure. The surgery was modified by the excision of a rectangle of tissue in the deep scleral bed under the scleral flap instead of the classical radial incision. This serves to exteriorise Schlemm's canal while thinning the scleral tissue, without, however, entering the anterior chamber. A total of 7 eyes in 5 children between the ages of 1 and 9 years were operated upon. In 6 of the 7 eyes intraocular pressure has remained under 20 mmHg without treatment after follow-up of between 18 months and 4 years. In the seventh eye intraocular pressure was controlled for 2 years but has since required epinephrine drops twice daily for the maintenance of pressure below 20 mmHg. In 4 of the 7 eyes flat, diffuse conjunctival filtering blebs are present, but no complications have been encountered. We consider that trabeculotomy may be recommended for children with late-onset congenital glaucoma.
A case is presented of permanent visual loss and optic atrophy following irrigation of the lower canaliculus after probing, with a 20% solution of chloramphenicol. A false passage had apparently been created allowing the solution to gain access to the orbital tissues. The ensuing orbital edema probably caused a central retinal artery occlusion. This is a previously unreported complication of a common ophthalmologic procedure.
In order to investigate the correlation between the occurrence of pterygium and dryness of the eyes, a Schirmer's No. 1 test was done on both eyes in 60 patients with unilateral pterygia. No difference was found between the mean basic secretion of tears in the diseased eyes (15.33 +/- 8.09 mm) and the fellow eyes (15.65 +/- 7.89 mm), and both were in the normal range for this test. This data suggest that dryness of the eyes cannot be regarded as the cause of pterygium.
For the pilocarpine therapeutic test that we have devised, one drop (0.1 ml) of 2% pilocarpine hydrochloride (an arbitrarily chosen concentration) is instilled in the glaucomatous eye to be treated, and the intraocular pressure is measured hourly for four hours. If the IOP does not fall below 24 mm Hg, which is our chosen pressure limit, the response is considered to be inadequate therapeutically. Our study showed that if an inadequate therapeutic response is obtained, initiation of treatment with 2% pilocarpine is not indicated, since in patients with such a response, continued treatment with 2% pilocarpine will be ineffective in controlling IOPs on subsequent clinical visits. In only those cases of patients with an adequate response to the pilocarpine therapeutic test (with a fall in pressure below 24 mm Hg) was there the likelihood of having the glaucoma controlled with continued 2% pilocarpine treatment.
A case of fibrous histiocytoma of the orbit occurred in a 1-year-old infant. The tumor was excised, and no recurrence has been evident.
Increased intraocular pressure in the immediate postoperative period commonly occurs after cataract extraction. We compared a series of patients operated on through a limbal section to a series operated on through a corneal section. The incidence of increased IOP was significantly lower in the corneal section group. This supports the theory that trabecular damage is a major factor in causing early increased IOP after cataract extraction.
Two cases with special indications for intraocular lens implants are presented. The first case was of a 60-year-old monocular patient with congenital absence of the external nose and multiple limb deformities. The second case was of a young Bedouin girl with bilateral developmental cataracts who had poor living conditions and social objections to wearing spectacles. Intraocular lenses restored good vision.
Eight weeks after intracapsular cataract extraction with implantation of a Binkhorst iris-clip lens joined with a suture to a peripheral iridectomy at the 12 o'clock position, a 52-year-old woman struck the right side of her head. The corneoscleral wound ruptured for three fourths of its length and the artificial lens was located in the subconjunctiva in the superior-nasal quadrant of the eye. The lens was removed, the iris reposited, and the anterior chamber reformed, and the wound resutured. Her vision was 6/12 (20/40) at the time of discharge.
A 47-year-old factor VIII deficient haemophiliac successfully underwent bilateral cataract extraction. The use of cryoprecipitates to achieve haemostasis permitted retrobulbar anaesthesia and a peripheral iridectomy without complication. We consider that the use of cryoprecipitated factor VIII concentrate allows safe elective ocular surgery in patients with classic haemophilia.
Three cases are presented of late flat anterior chambers which were cured by echothiophate iodide treatment. Two of the cases required repeated instillations to achieve permanent restoration of normal chamber depth. We now recommend that echothiophate treatment be considered in cases of late flat anterior chamber unresponsive to standard medical treatment.
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