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Biomedical subjects

H D Gnad

Publications and source records attributed to H D Gnad.

At least 37 records · Page 2Linked to original sources
PubMed1985

[Glaucoma, ocular hypertension and diabetic retinopathy].

71 out of 4803 diabetics attending the special outpatient clinic for diabetic eye complications at the 1st Eye Department of the University of Vienna were found to be suffering from glaucoma. Ocular hypertension was observed in 717 cases. Neither the course of diabetic retinopathy nor the correlation between duration of diabetes mellitus and the manifestation of retinal changes differed from the findings in diabetics with normal ocular pressure. The hypothesis that increased ocular pressure in response to the topical application of steroids might be of beneficial influence on the course of diabetic retinopathy was not confirmed by these observations.

Diabetes Mellitus, Type 1↗
PubMed1985

[Results after planned extracapsular cataract extraction with the Klöti stripper and implantation of UV light-absorbent Simcoe lenses with a 10-degree loop tilt].

Planned ECCE remains a valuable alternative to phacoemulsification due to its protection of the endothelial cells of the cornea. In contrast to the most commonly used infusion-aspiration systems, Kloeti's vitreous stripper provides, in addition, an excellent cutting mechanism enabling the removal of hard parts of the parenchyma or capsular remnants. The aspheric shaped UV light absorbing Simcoe lenses with a 10 grade loop angle used as lens replacement over the past 2 years in 300 cases did not cause any noteworthy complications. In 94% of cases a visual acuity of at least 0.5 was achieved; no case of cystoid macular edema has been observed so far.

Cataract Extraction↗
PubMed1985

[Treatment of cystoid macular edema after intracapsular cataract extraction and implantation of the Binkhorst 4-loop lens].

This paper presents a report on 8 eyes in which cystoid macular edema developed between 6 months and 3 years after intracapsular cataract surgery combined with 4 loop lens implantation. Topical indomethacin treatment undertaken for at least 3 months proved ineffective. In view of additional progressive damage to the inferior part of the iris due to the inferior lens loops as well as recurrent microhaemorrhages in the anterior chamber, the iris clip lens was removed and after thorough anterior vitrectomy with Kloeti's stripper a Shepard anterior chamber lens was implanted. Indomethacin treatment 3 to 4 times daily was continued postoperatively for up to 8 months. Evident improvement in visual acuity was noted in 5 eyes, whilst in the remaining 3 eyes the procedure had probably been carried out too late.

Aged↗
PubMed1985

[Recurrence of vasoproliferative activity after photocoagulation. A fluorescence-angiographic study].

Although photocoagulation is no cure for diabetic retinopathy, it slows down or, in favourable cases, prevents further progression. In order to achieve the desired therapeutic effect, photocoagulation has to include the ischaemic mid-periphery of the retina. Following a latency period of varying duration during which no further progression is evident either on ophthalmoscopic examination or fluorescein angiography, recurrence of neovascularization is observed in some cases. The therapeutic management entails additional panretinal photocoagulation, in particular at the periphery. The authors report on 75 patients who, following panretinal photocoagulation, were treated by additional argon-laser coagulation.

Diabetic Retinopathy↗
PubMed1985

[Treatment of recurrent conjunctival melanoma by lamellar resection and contact irradiation].

The author reports on a 43-year-old patient who, having been treated for a conjunctival melanoma by local resection, presented 6 years later with a recurrent melanoma of a superficial spreading type, having a nodular and a flat component. While lamellar corneal excision was performed on the nodular component, the flat portion was treated with beta-contact radiation. The results are described and the argument for this therapy discussed.

Combined Modality Therapy↗
PubMed1985

[Surface atypia following recurrent corneal lesions (light and electron microscopy findings)].

A case of recurrent herpetic keratitis was followed by therapy-resistant corneal opacities. Histological sections revealed epithelial ectopias in superficial stromal layers of the cornea; their formal pathogenesis appears to be due to defects in Bowman's membrane. Another patient developed several intraocular complications after a penetrating corneal injury, and each surgical intervention resulted in increasing corneal decompensation. Semithin and ultrathin sections of the explant revealed endothelial metaplasia with fibroblastic activity.

Cornea↗
PubMed1985

[Immunosuppressive therapy with cyclosporin A following penetrating keratoplasty].

Report on 11 patients who underwent penetrating keratoplasty and were treated with Cyclosporin A for an average of 6 months because of excessive superficial and deep vascularization of the recipient cornea. In none of the patients was a permanent Cyclosporin A-induced side-effect observed. After an average follow-up period of 11 months 9 grafts remained completely clear; however, an allograft-reaction occurred in 2 cases in spite of the immunosuppressive therapy.

Corneal Diseases↗
PubMed1985

[Extracapsular cataract operation with implantation of posterior chamber lenses following fistulating glaucoma operations].

In 78 eyes treated by different fistulizing procedures (57 by goniotrepanation or trabeculectomy, 13 by Elliot trepanation and 8 by iridencleisis) extracapsular cataract extraction with implantation of posterior chamber lenses was performed. A sector iridectomy had to be performed in about 40% of the eyes because of difficulties in dilatation of the pupils and posterior synechiae. Postoperatively the IOP was regulated in 83% of all eyes without additional topical medication; a second fistulizing procedure was only necessary in one eye. Complications such as keratopathies, posterior capsule fibrosis, and dislocations of the posterior chamber lenses were not found to be more frequent compared with nonglaucomatous eyes treated by extracapsular cataract extraction with implantation of posterior chamber lenses.

Aged↗
PubMed1985

[Use of the neodymium YAG laser following posterior chamber lens implantation].

The authors report on the neodymium-YAG laser used after extracapsular cataract extraction with the implantation of a posterior chamber lens in 1726 patients. The most common indication was capsular fibrosis necessitating posterior capsulotomy. The alternative to the YAG laser would be a bulbus-opening procedure via pars plana using a Sato knife. The advantage of the YAG laser in comparison with capsulotomy with a Sato knife is that there is no danger of intraocular infection or bleeding (which may result from tension on the fibers with the first method). A disadvantage of the YAG laser method is a possible transitory increase in intraocular pressure and an endothelial cell loss. In 1726 cases with posterior chamber lenses 45 capsulotomies using the YAG laser were necessary. A further indication for the YAG laser are posterior chamber lenses decentered by capsular fibrosis (3 cases). A third indication is chorepraxia after posterior chamber lens implantation. In three cases with posterior chamber lenses a flattening of the pupil occurred because remnants of the anterior capsule had shifted into the anterior chamber. In two cases a pupil became decentered for no apparent reason. In these cases YAG laser therapy is indicated. In at least three cases pupillary membranes were cut with the YAG laser. The authors treated their patients with the Lasertec model 135 YAG laser (Q-switched mode).

Humans↗
PubMed1985

[Change in corneal refractive power following artificial lens implantation].

Report on the changes in the corneal refractive power of 284 eyes surgically treated for cataract, in which an IOL had been implanted. The mean corneal refractive power of the eyes was 43.31 +/- 1.43 D preoperatively and 43.39 +/- 1.46 D postoperatively (16th week). The postoperative astigmatism of 215 eyes in which a PCL had been implanted after ECCE was not higher than 1.1 +/- 1.1 D in the 16th postoperative week after selected removal of the nylon sutures. This study demonstrates that there is no statistically significant change in the mean corneal refractive power after cataract surgery with IOL implantation.

Astigmatism↗
PubMed1985

[Follow-up of central diabetic retinal changes following peripheral photocoagulation].

One eye of each of 27 patients suffering from preproliferative diabetic changes in the periphery of the retina was treated by panretinal photocoagulation; in the fellow eye photocoagulation was only performed in the peripheral zones of the fundus. Follow-up observations over an average period of 1.5 years showed a centripetal progression of capillary obliterations in only 5 eyes after peripheral photocoagulation and a less pronounced tendency to development of a diabetic maculopathy as compared to eyes treated by panretinal photocoagulation.

Adult↗
PubMed1985

Fosfomycin levels in human aqueous humor after intravenous administration.

Following intravenous infusion of an 8 g single dose of the antibiotic agent fosfomycin, its penetration into human primary aqueous humor was investigated. 1-2 h after the start of infusion, peak values of 35 to 60 micrograms/ml were reached. These concentrations in the aqueous humor would inhibit a high percentage of gram-positive and gram-negative strains commonly causing bacterial endophthalmitis. The infusion of an 8 g dose of fosfomycin immediately preceding intraocular surgery thus constitutes effective peri-operative prophylaxis. Moreover, as a broad-spectrum antibiotic, fosfomycin is indicated as initial therapy in intraocular bacterial infections.

Aged↗
PubMed1983

[Intraocular penetration of netilmicin].

The penetration of netilmicin, a semisynthetic aminoglycosid into the primary human aqueous humor was determined. The antibacterial spectrum of netilmicin is adequate to gentamicin. The efficacy also covers gentamicin resistant strains. After intramuscular injection of 5 mg/kg body weight aqueous levels higher than the minimum inhibitory concentration (MIC) of staphylococcus aureus, Escherichia coli, Klebsiella, Enterobacter, Citrobacter and Proteus morganii were obtained. In the therapy of bacterial endophthalmitis the synergistic effect of netilmicin with beta-Lactam antibiotics in the form of a combined therapy should be made use of. For perioperative prophylaxis the newer aminoglycosids are not indicated because there is the danger of a development of resistant strains.

Aged↗
PubMed1983

[Interstitial radiotherapy for malignant melanoma of the choroid: implantation of radioactive gold grains by means of a gun-shaped applicator].

Four years after enucleation of one eye of a 49-year-old patient because of malignant melanoma of the choroid, the same kind of tumor developed in the remaining eye. The size of the melanoma and its location close to the pole prompted an unconventional therapeutic approach. After external beam radiation a radioactive gold seed sheathed with platinum was deposited directly above the tumor through the hollow needle of a pistol-shaped applicator, thus increasing the radiation dose to the required 8500 rad, which is considered sufficient for reliable destruction of malignant melanoma. After a one-year period of observation the patient is still in good health, the melanoma having been replaced by a flat chorioretinal scar; the surrounding retina, as well as the optic nerve and the lens lack any sign of radiation damage. Visual acuity of 0.8/Jg I has been preserved. The technique and possible indications for treatment by this method are described.

Choroid Neoplasms↗
PubMed1983

[Circulating immune complexes in uveitis].

The serum of 63 patients suffering from various clinical types of endogenous uveitis with unknown etiology was investigated for the presence of circulating immune complexes (CIC). None of the patients was suffering from a systemic disease usually associated with CIC. Significantly elevated CIC levels were detected in 2 women with chronic cyclitis. One of them was also suffering from paresis of the facial nerve. The investigation reported here indicates that C1q-binding CIC are of no importance in the pathogenesis of endogenous uveitis. On the one hand one should consider the possibility of local IC formation, on the other hand one should be aware of the fact that IC does not always represent a pathogenic factor but that it may also occur as a secondary phenomenon after non-immunologic tissue destruction.

Adolescent↗