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Biomedical subjects

K D Teichmann

Publications and source records attributed to K D Teichmann.

At least 19 recordsLinked to original sources
PubMed2001

Toxic endothelial cell destruction from intraocular benzalkonium chloride.

PURPOSE: To present a cluster of cases of corneal edema occurring after phacoemulsification. SETTING: Regional hospital in rural Australia. METHODS: This retrospective case series comprised 12 patients from a single surgical list comprising 19 cases who developed persistent corneal edema after having phacoemulsification. RESULTS: After 6 months, the edema improved in 1 patient. Inadvertent intraocular use of balanced salt solution (BSS) preserved with benzalkonium chloride was found to be the cause of this serious complication. CONCLUSIONS: Benzalkonium chloride in concentrations commonly used extraocularly is highly toxic to the corneal endothelium. Every possible safeguard should be taken to prevent inadvertent intraocular use of such preserved solutions.

Acetates↗
PubMed2001

Conjunctival necrobiotic granuloma in xeroderma pigmentosum.

PURPOSE: We report clinical and histopathologic findings of a conjunctival lesion associated with xeroderma pigmentosum. METHODS: A Saudi girl with known xeroderma pigmentosum presented with pain and photophobia of the right eye and an elevated temporally located perilimbal mass. RESULTS: The mass was resected successfully and has not recurred during 1-year follow-up. Histopathologic examination of the tissue showed a necrobiotic granuloma with associated histiocytic infiltration. The patient had no systemic disease, lipid was not detected in the histiocytic lesion, no Touton giant cells were present, and there was no evidence of elastolysis. CONCLUSION: Ocular malignancies occur in association with xeroderma pigmentosum, but benign lesions that mimic a malignancy may occur.

Adolescent↗
PubMed2000

Propionibacterium acnes endophthalmitis requiring intraocular lens removal after failure of medical therapy.

A 52-year-old Saudi man developed intraocular inflammation 7 weeks after uneventful phacoemulsification with implantation of a silicone posterior chamber intraocular lens (IOL). Cultures from the aqueous and vitreous were repeatedly negative, but a temporary response to intracameral and intravitreal injection of vancomycin was noted. A series of 6 intraocular injections given over 5 days failed to resolve the inflammation. It did, however, disappear after the IOL was removed. The IOL provided the only positive culture in this case of Propionibacterium acnes endophthalmitis. Nine months later, a posterior chamber poly(methyl methacrylate) IOL was implanted. Eighteen months later, the patient had no recurrences. He regained a visual acuity of 20/30, corresponding to his best postoperative result.

Anti-Bacterial Agents↗
PubMed2000

Corneal amyloidosis associated with congenital hereditary endothelial dystrophy.

PURPOSE: To report the unusual occurrence of corneal amyloidosis indistinguishable from primary gelatinous drop-like dystrophy in three members of a family with congenital hereditary endothelial dystrophy (CHED). METHOD: Case study of three patients. RESULTS: Three patients, a 5-year-old girl, her 21-year-old maternal aunt, and a 16-year-old paternal uncle, presented with bilateral corneal edema and opacification secondary to CHED. All three underwent penetrating keratoplasty, cases 1 and 3 in one eye and case 2 in both eyes. Histopathology confirmed the diagnosis of CHED in all three patients but also revealed multiple subepithelial nodular deposits of amyloid, consistent with the diagnosis of primary gelatinous drop-like dystrophy, in all four specimens. Three other members of the same family underwent penetrating keratoplasty with histologic confirmation of CHED with no deposits of amyloid. CONCLUSION: To our knowledge, this is the first report of subepithelial corneal amyloid deposits in association with CHED. This may represent the concurrence of two primary dystrophies, although secondary amyloidosis cannot be ruled out. Early manifestation and absence of amyloid in three other family members with CHED lends more weight to a primary etiology.

Adolescent↗
PubMed1999

Terrien's marginal degeneration associated with posterior polymorphous dystrophy.

PURPOSE: To document an association between Terrien's marginal degeneration and posterior polymorphous dystrophy. METHODS: A 23-year-old Saudi man presented with decreased vision, peripheral corneal thinning with vascularization and scarring, and abnormalities of the posterior stroma and Descemet's membrane. RESULTS: Clinical examination, corneal topography, and specular microscopy were consistent with a diagnosis of Terrien's marginal degeneration and posterior polymorphous dystrophy. CONCLUSION: We report the first case, to our knowledge, of the simultaneous occurrence of Terrien's marginal degeneration with posterior polymorphous dystrophy.

Adult↗
PubMed1998

Haptic design for continuous-loop, scleral fixation of posterior chamber lens.

We describe a haptic design for continuous-loop fixation of posterior chamber intraocular lenses (IOLs) to sclera. The haptic ends are broadened to allow two perforations on each haptic through which the sutures are guided. In this manner (satured with continuous loops), a stable four-point fixation is achieved that resists torsional forces, depending only on the mechanical strength of the haptics. Tilt during suture placement can be avoided by inserting the surgical needles and the 27 gauge disposable needles through the sclera at similar angles and distances from the limbus. When tested in a simple experimental model (as well as clinically), the new IOL behaved as predicted. The advantage of this haptic design is a stable, tilt free fixation by a continuous loop that allows the knot to be buried; the disadvantage is that a sophisticated and meticulously executed surgical technique is essential.

Humans↗
PubMed1998

Secondary implantation of scleral-fixated intraocular lenses.

PURPOSE: To evaluate the results of a large series of secondary implantations using scleral-fixated posterior chamber intraocular lenses (IOLs). SETTING: Bellevue Eye Hospital, Kiel, Germany. METHODS: This retrospective review comprised 624 consecutive patients who had secondary implantation of a posterior chamber IOL with scleral fixation between 1988 and 1995. All patients had been aphakic for at least 1 year. An ab interno or ab externo suture technique through the ciliary sulcus was used. Visual outcome and complications 1 year after surgery were determined. RESULTS: Best corrected visual acuity improved or remained unchanged in 92.0% of eyes; 8.0% lost one or two lines. Intraocular lens decentration of more than 1.5 mm occurred in 1.9% of eyes. Suture erosion was observed in 17.9%, cystoid macular edema in 5.8%, retinal detachment in 1.4%, and vitreous hemorrhage in 1.0%. Severe uveitis occurred in 0.5%. CONCLUSION: Secondary IOL implantation with scleral fixation was a safe procedure. Although there was a small risk of significant complications, more than 90% of patients regained or improved their preoperative visual acuity.

Aphakia, Postcataract↗
PubMed1998

Detachment of Descemet's membrane.

PURPOSE: To determine predisposing factors, best method of treatment, and the final outcome in cases of Descemet's membrane detachment. SETTING: A tertiary care teaching eye hospital. METHODS: All cases of Descemet's detachment from January 1986 to May 1994 were retrospectively reviewed. Twelve eyes of 11 patients with partial or total detachment of Descemet's membrane were identified. Patients with small localized detachments at the incision area were excluded. RESULTS: All but one patient had surgical repair. Ten eyes had successful reattachment after up to four attempts at repair. Methods of repair included intracameral air or sulfur hexafluoride (SF6) 20% gas, with or without corneal sutures. After a followup of 3 to 79 months, eight eyes retained clear corneas, four eyes developed corneal edema and scarring, and two required penetrating keratoplasty. No definite predisposing factor could be identified, although four eyes had preoperative diagnoses of glaucoma and recent corneal edema. CONCLUSION: Surgical repair with injection of intracameral air or SF6 20% was successful in most cases of Descemet's membrane detachment. A preoperative diagnosis of glaucoma and a recent episode of corneal edema may increase the risk of detachment.

Aged↗
PubMed1997

Treatment of macular degeneration, according to Bangerter.

Age-related macular degeneration (AMD) is a common cause of visual loss among elderly patients. Although some risk factors have been determined, the ultimate cause of the disease is not known. For a long time, therapeutic nihilism has been the rule among ophthalmologists confronted with such patients. Bangerter has not shared this attitude, especially since the time that he incidentally discovered, more than 40 years ago, the beneficial effects of radiotherapy, in discouraging the growth of new vessels at the posterior pole of the eye. A variety of approaches are combined and used by Bangerter in the treatment of the different types of AMD, including retrobulbar injections of either vasodilating medications (in the dry - or atrophic - type) or corticosteroids (in the wet - or exudative - type), general medical measures aimed at improving metabolic and vascular functions such as supplementation with trace elements, antioxidants, and vitamins; ozone therapy; advice to increase physical fitness, improve nutrition, and abstain from smoking; and protection from excessive light exposure. Being convinced of the usefulness of his type of combination treatment, he has always rejected undertaking controlled clinical trials, of only single aspects of the therapy, as unethical and invalid. For this reason, scientific journals have not proven cooperative in several attempts at publishing his results, as collected in retrospective surveys. Recently, however, some of the several approaches combined by Bangerter in treating AMD have been pronounced effective by other investigators. We present here an overview of his treatment approaches, as few people are aware of them, to clear up misconceptions and to set records straight.

Aged↗