Biomedical subjects
Publications and source records attributed to G van Rij.
The tissue reaction to 10-0 nylon sutures sterilized with gamma-rays was compared to the reaction caused by 10-0 nylon thread sterilized with ethylene oxide. In a vascularized cornea more tissue reaction was seen to 10-0 nylon thread sterilized with gamma-rays than to sutures sterilized with ethylene oxide gas.
In seven patients white branched crystalline opacities, which grew very slowly, were seen in the corneal stroma. They were associated with very little inflammatory activity, so that the clinical picture at first did not suggest an infectious etiology. Pathological examination, however, demonstrated colonies of bacteria between intact corneal lamellae. On bacterial examination gram-positive commensals were mainly found. All the patients described so far were found to be taking corticosteroids regularly, sometimes in combination with antibiotics. The immunosuppression brought about by corticosteroids is probably an important factor in the development of these crystalline opacities. The therapy for this infectious crystalline keratopathy is difficult and lengthy. It consists of local bactericidal antibiotics and the lowest possible dosage of corticosteroids, if necessary combined with a partial lamellar keratectomy and removal of the affected corneal tissue by fraising.
In 1986, conjunctival transplantations were performed on 54 patients. Patients with severe corneal ulcers, who did not react adequately to local therapy, formed the largest group who were treated in this way, in particular patients in whom the prognosis for a perforating corneal graft was poor. Other indications are: bullous keratopathy, pterygium, trauma, symblepharon, etc,. In general other forms of therapy are tried first before conjunctival transplantations are performed.
A questionnaire was sent to 240 members of the Netherlands Intraocular Implant Club (NIOIC) to register their policy followed in 1993 with regard to anticoagulant therapy (ACT) and the use of aspirin in patients having cataract surgery. Ninety-one (32%) forms were suitable for analysis. Most eye surgeons (76%) declared to discontinue anticoagulant therapy and the use of aspirin prior to cataract surgery, especially when using local anesthesia. After stopping anticoagulant therapy and the use of aspirin serious systemic complications were reported. Furthermore, ocular complications were reported due to continuation of ACT and the use of aspirin during surgery. Although the response rate to the enquiry was 32% only, we would suggest that continuation of ACT and the use of aspirin during surgery is to be recommended because of the possible life threatening complications related to discontinuing ACT and the use of aspirin. Risks of bleeding can be minimized further by using topical anesthesia, sub-tenon anesthesia and clear corneal surgery.
BACKGROUND: Phakic anterior chamber lenses is one of the modalities used to correct high myopia. We report the initial results of our prospective study on the Worst myopia claw intraocular lens (IOL) that is fixated to the anterior iris. METHODS: We studied 35 eyes in 18 patients with a preoperative myopia ranging from -6.00 to -28.00 diopters (D). The follow up ranged from 6 months (n = 15) to 12 months (n = 20). RESULTS: In 26 (74.3%) eyes, the postoperative spherical equivalent refractive error was within 1.00 D of emmetropia. The mean refraction was stable between 1 to 2 months and 12 months. The mean spectacle-corrected visual acuity improved from 20/50 to 20/40. The straylight measurements did not show a significant increase postoperatively (p = .64). The mean endothelial cell loss was 5.6% (range, +6.3% to -22.6%) at 6 months, and 8.9% (range, +0.77% to -23.5%) at 12 months. We did not encounter major complications. CONCLUSION: Implanting a Worst myopia claw IOL in high myopic eyes resulted in a stable, reasonably accurate refractive outcome. This group of patients will be followed longer because of concern over ocular complications with this technique.
PURPOSE: To investigate the effect of circular keratotomy depth and diameter on corneal astigmatism. METHODS: High astigmatism was induced in 25 human donor eyes by an anterior radial 7-0 silk suture across the corneoscleral limbus. With a 6.0, 6.5, 7.0, or 7.5 mm trephine, a 0.3 mm deep circular incision was made in 20 donor eyes. In 5 donor eyes 5 circular incisions were made with a diamond knife set at 0.1, 0.2, 0.3, 0.4, and 0.5 mm depths. RESULTS: The reduction of astigmatism between the 4 groups in which different trephination diameters were used showed no statistically significant difference (P > .1). The relationship between incision depth and reduction of astigmatism was statistically significant (P < .001). CONCLUSION: Artificially induced corneal astigmatism was reduced by a circular keratotomy in this donor eye model. Deeper incisions showed a greater effect.
PURPOSE: Anterior chamber phakic intraocular lenses (PIOLs) are one of the modalities used to correct high myopia. We report the long-term results of our prospective study on the Artisan 5-mm optic myopia lens. METHODS: We studied 67 eyes of 38 consecutive patients with preoperative myopia ranging from -5.38 to -28.00 D. All patients were operated by one surgeon. Mean follow-up was 35 months (24 months in 67 eyes and 36 months in 61 eyes). RESULTS: In 45 eyes (67.2%), postoperative residual refraction was within +/- 1.00 D of emmetropia. The mean refraction was stable statistically during the entire follow-up period. Mean best spectacle-corrected visual acuity improved from 20/40 to 20/32. Mean endothelial cell loss at 6 months was 5.5% (range, -52.4% to +9.3%), at 12 months, 7.21% (range, -53.2% to +20.1%), at 24 months, 9.1% (range -43.6% to +13.6%), and at 36 months, 10.9% (range, -43.0O% to +11.4%). The majority of eyes had an increase in best spectacle-corrected visual acuity; 5 eyes lost best spectacle-corrected visual acuity. We encountered no major complications. CONCLUSION: Implanting the Artisan 5-mm optic myopia lens in high myopic eyes resulted in a stable and accurate refractive outcome. The apparent progressive corneal endothelial cell loss remains a matter of concern.
PURPOSE: To evaluate the efficacy, safety, predictability, and stability of implanting a polymethylmethacrylate (PMMA) phakic intraocular lens (PIOL) (the Artisan myopia lens) to correct high myopia. METHODS: An Artisan myopia lens was implanted in 78 consecutive eyes of 49 patients with preoperative myopia that ranged from -6.25 to -28.00 D. Mean patient age was 42.4 years. Mean follow-up was 10.7 months and all patients were followed for at least 6 months; 45 eyes had follow-up of 12 months, and 10 eyes had 24 months. The desired outcome was emmetropia in all eyes except for those eyes with preoperative myopia greater then -23.00 D. RESULTS: Fifty-three eyes (67.9%) had a postoperative refraction at the last follow-up examination within +/-1.00 D of emmetropia, and 39 eyes (50.0%) had a postoperative refraction +/- within 0.50 D of emmetropia. The postoperative refraction remained stable during the entire follow-up period. Mean spectacle-corrected visual acuity improved from 20/32 preoperatively to 20/25 postoperatively. Mean postoperative uncorrected visual acuity was 20/32. There was no significant change in endothelial cell density from baseline. We did not encounter major complications. CONCLUSION: Implantation of the Artisan myopia lens to correct high myopia resulted in a stable and fairly predictable refractive outcome. A significant endothelial cell change was not detected.
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