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Biomedical subjects
Publications and source records attributed to G Mackensen.
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An analysis of histological and clinical findings in 102 keratoplasties confirms that suture loosening is often associated with defects found in Bowman's membrane and in the superficial stroma. These structures of the cornea serve as the major supporting layer for a suture. In cases of more generally weakened corneal tissue, like in keratokonus, suture loosening is also a relatively frequent occurance. In this paper we report on our experiences with correction methods, post-operative care and immunoprophylaxis after correction.
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In this paper we report on a series of 56 eyes which underwent a combined cataract-trabeculotomy operation. After a follow-up of at least 6 months. 63% of the eyes had normal intraocular pressure while 34% of them required further medication to achieve the same. No serious complications were observed.
Report on 36 keratoplasties (30 eyes) in children up to 15 years of age. An efficient postoperative care was of critical importance for the final outcome. The specific problems are discussed. Regarding the fact that generally children are only operated on in case of heavy corneal disease which brings about a higher risk of graft failure our results may be judged as "fair": 63% of the transplants were optically clear; 43% exhibited good and 30% fair functional results. The best results were achieved with keratoplasties in corneal dystrophies (keratoconus included). Another group with good results was that with herpetic corneal disease, whereas transplants after heavy perforating injuries mostly failed. A beter postoperative medical collaboration and consultation is needed to improve final results. This is especially true for correcting operative measures (loosening sutures) and for therapy and prophylaxis of graft reactions.
Between December 1975 and April 1976, 2,300 ophthalmologists in the Federal Republic of Germany and West-Berlin were asked about their experiences with different forms of therapy and prophylaxis for herpetic eye diseases. 15 questions were answered by 965 ophthalmologists (42%). The answers not only reflect their preferences and experiences, but could also initiate a new evaluation of many diagnostic, therapeutic and prophylactic methods.
A method for closing fistulae in drainage blebs after anti-glaucoma surgical procedures is described. Its aim is to line internally and support the wall of the bleb, including the fistula, with subconjunctival tissue. The decisive factor in achieving this is the firm anchoring of the subconjunctival tissue pulled down between the corneo-scleral opening and the thin conjunctival tissue layer.
6 intraocular lenses (type Dannheim) which had given good optical results after implantation had to be removed after 7-19 years because of keratopathy, iritis, and secondary glaucoma. The most important finding was an advanced arrosion of the supporting supramide loops. This often caused breaking of the loops and was a major factor for late complications.
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Absorbable corneal sutures of PGA monofilaments were tested in rabbit eyes. Compared to chromic collagen 8/0 the sutures were tolerated well, but the absorption time of 14.6 days is considered as being too short for corneal surgery.
Monofilaments of the absorbable synthetic thread Dexon made from PGA have properties similar to nylon 10-0. Experiments with intra-lamellar implantation of the monofilament in rabbit corneas showed the same good material tolerance as nylon 10-0. Perforating corneal wounds were closed with interrupted and running sutures from PGA monofilaments, respectively. One week post-operatively, increased intraocular pressure caused a wound rupture but not a thread rupture. Two weeks post-operatively an increased intraocular pressure of more than 300 mm Hg could no longer rupture the wound. Slit lamp and histological examinations revealed symptoms of absorption after the second week. According to our findings, PGA monofilaments may be suitable for corneal surgery in patients.
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With rabbit corneas we did comparative biomicroscopical and histological investigations on material tolerance of the following threads at present used in microsurgery: Barraquer silk (virgin silk), nylon 30 mum (Tübinger nylon), dacron (polyester) 40 mum and plain collagen 7-0. The sutures were implanted into the cornea intra-lamellarly, completely under the microscope. The examinations showed only very little tissue reaction in all these materials.
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