Biomedical subjects
Publications and source records attributed to H Busse.
The authors described a modified version of Neubauer's foreign body extractor. The holding device consists of flexible, silicone-covered loop branches, which adapt themselves to the shape of the foreign body and completely surround it.
An analysis of 1,959 cataract operations with intraoperative loss of vitreous body in 114 cases (5.8%) is described. The most common late complications (21% of all cases) were retinal detachments (7.9%) and secondary glaucomas (3.5%). As a consequence the authors call for regular follow-up examinations by an ophthalmologist.
The authors report on the results of a comparative study on vitreous loss in connection with cataract surgery before and after the introduction of oculopressure (Vörösmarthy). As a result of the preoperative reduction in vitreous volume caused by oculopressure the percentage of vitreous loss was reduced from 11% in 381 extractions to 6.2% in 802 cataract operations. A third group in which oculopressure, mannitol infusions and alphachymotrypsin zonulolysis was performed, did not show another significant reduction in the vitreous complication rate (from 6.2 to 5.5% in 506 operations). Nevertheless the authors recommend routine application of all three techniques used in the third group.
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The authors report on the transplantation of auricular cartilage grafts in the Kuhnt-Meller ectropion operation to stabilize the tarsus. In three cases with spastic and paralytic ectropion the technique was successful.
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After a short historical survey the indication and technique of the intravitreal injection of SF6-gas within the limits of the actual retinal surgery are discussed and by means of 10 cases demonstrated. The main indications are the tamponade of 1. oral and preoral gigantic tears, 2. central retinal foramina, 3. equatorial gigantic holes of 1 to 2 quadrants as well as tear groups and 4. SF6-gas as substitute of the vitreous body.
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In our 114 patients with vitreous loss during a cataract operation there were 21 cases (18.4%) which resulted in severe after-effects leading to the conclusion that vitreous loss during a cataract operation provokes a more frequent development of postoperative complications. Therefore a careful surgical procedure with exact repositioning of the vitreous-free anterior chamber, as well as regular and careful follow-up examinations are required. At our hospital we regularly carry our a three-mirror-contact lens examination after four weeks to enable us to perform a preventive treatment of the retina if necessary. In the event of incarceration of the vitreous with traction, a vitrectomy must be considered. As far as initial maculopathies are concerned we observed in a few cases a positive effect that parabulbar cortisone prevented further development of the disease. Finally, we would recommend regular IOP controls in order to recognize secondary glaucoma at an early stage.
By means of postmortem dacryocystograms and photomicrographs of histological slides, the topography and morphology of the lacrimal passages in premature and mature newborn infants are demonstrated. Because of the bends in the course of the lower tear duct, a percentage of probings will fail to effect satisfactory perforation of Hasner's membrane. In most cases the soft texture of this membrane requires no more than syringing under pressure using a hollow probe.
The authors report about the findings in 102 children with congenital glaucoma. The intraocular pressure was normalized in 90% after goniotomy and trabeculotomy. The postoperative average i.o. pressure was 16,6 mmHg.
The results of the investigations reported here show that contrary to expectations, the drop in mean arterial blood pressure (up to 57 mm Hg) during extracorporal circulation does not result in a simultaneous drop in intra-ocular pressure. Other factors, affect intra-ocular pressure during extracorporal circulation, causing it to rise. Postoperative studies of vision led to the conclusion that the elevations of intraocular pressure measured during extracorporal circulation with the heart-lung machine do not adversely affect ocular function.
The authors report on a case of total keratomalacia due to abusive contact lens wearing. An analysis of the case showed that the condition was caused by a poorly fitted lens, lack of information given to the patient and a lack of ophthalmological check-ups.
The authors report on the fairly inexpensive Kaufman-II vitrector which has proved useful and appropriate in "open-sky" vitrectomy. It has been successfully employed in the following applications: 1) aspiration of vitreous, e.g., in the event of vitreous loss during cataract operations; 2) in cases of perforating injuries with prolapse of vitreous; 3) in cases of vitreous abscesses after cataract operations; 4) in cases of hemorrhage into the anterior segment; 5) removal of lens capsule remnants and dense vitreous membranes behind the pupillary plane which render examination of the fundus impossible.
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After a brief survey on the indications of the Lincoff buckling technique, the limits of this method are demonstrated by means of varions cases. Then the application of the intraocular gas tamponade with sulfur hexafluoride (SF6) as an additional measure is recommended and described. The combination with vitrectomies in cases of advanced vitreous complications (MPP, proliferations, haemorrhages) is indicated.