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Lutz Pillunat

Publications and source records attributed to Lutz Pillunat.

4 recordsLinked to original sources

Measurement of the intraocular pressure with the "transpalpebral tonometer" TGDc-01 in comparison with applanation tonometry.

BACKGROUND: An irregular corneal surface compromises IOP measurement by Goldmann applanation tonometry. In such cases accurate measurement without corneal contact would be desirable. The new eyelid tonometer TGDc-01 measures IOP without corneal contact through the eyelid. The aim of the study was to evaluate the accuracy of the eyelid tonometer compared with Goldmann applanation tonometry (cornea thickness-corrected values) in subjects without corneal alterations. METHODS: IOP was measured in 199 eyes of 103 subjects without corneal alterations by means of two different methods. Measurements with the transpalpebral tonometer TGDc-01 and the Goldmann applanation tonometer were performed within 5 min in random order. RESULTS: The mean difference between lid tonometry and Goldmann applanation tonometry was 0.71 mmHg, SD +/-2.467 mmHg. In the reliability analysis the intraclass correlation coefficient was 0.8620. Compared with Goldmann applanation tonometry 66.4% of the IOP readings measured by lid tonometry were in an interval of +/-2 mmHg, 81.0% in an interval of +/-3 mmHg. The maximum of deviation was -6 mmHg and +6 mmHg, respectively. The Bland and Altman plots are shown. CONCLUSIONS: Lid tonometry correlates sufficiently with Goldmann applanation tonometry, but in more than 10% of the measurements the IOP readings differed by more than 3 mmHg. The eyelid tonometer may be helpful as a screening tool when Goldmann applanation tonometry is not applicable.

Adolescent↗

Corneal endothelial cytotoxicity of riboflavin/UVA treatment in vitro.

Recently, we have developed collagen crosslinking induced by combined riboflavin/UVA treatment, thus increasing the biomechanical rigidity of the cornea to treat progressive keratoconus. The present safety study was performed to evaluate possible cytotoxic effects of combined riboflavin/UVA treatment on the corneal endothelium in vitro. Endothelial cell cultures from porcine corneas were treated with 500 microM riboflavin solution, exposed to various endothelial UVA irradiances (370 nm) ranging from 0.1 to 1.6 mW/cm2 for 30 min and evaluated 24 h later using trypan blue staining and Yopro fluorescence staining. The effect of either treatment alone (UVA irradiation ranging from 0.2 to 6 mW/cm2) was also tested. An abrupt cytotoxic threshold irradiance level was found at 0.35 mW/cm2 after combined treatment with riboflavin plus UVA irradiation and at 4 mW/cm2 with UVA irradiation alone. Riboflavin alone was not toxic. A cytotoxic effect of the combined riboflavin/UVA treatment on corneal endothelial cells is to be expected with a corneal thickness of less than 400 microm. Therefore, pachymetry should be routinely performed before riboflavin/UVA treatment to exclude patients at risk.

Animals↗

Cross-linking of human amniotic membrane by glutaraldehyde.

PURPOSE: The transplantation of cryopreserved human amniotic membrane has been introduced recently for the reconstruction of the ocular surface. However, in some diseases the transplant usually dissolves rather quickly and early detachment may occur. Therefore, we tried to stabilize the amniotic transplant by applying glutaraldehyde for collagen cross-linking of the membrane. METHODS: 18 human amnions were prepared. 4 x 4 cm pieces of amnion were treated with 0.1% glutaraldehyde solution for 30 min. Biomechanical force-elongation measurements were performed and resistance to enzymatic digestion by 0.1% collagenase solution was tested and compared to cryopreserved and untreated fresh amnion. 8 patients with various ocular surface defects were treated with cross-linked amnion and compared to 5 patients with cryopreserved amnion. RESULTS: The force of the amnion cross-linked with glutaraldehyde at 2.5 mm elongation was increased statistically significant by 175% versus fresh amnion and 76.8% versus the cryopreserved amnion. Glutaraldehyde-treated membranes were virtually completely resistant to enzymatic digestion, while fresh and cryopreserved amnions were dissolved completely by day 7. In patients, the cross-linked membrane was preserved for up to 90 days without any signs of dissolution of the membrane and good transparency. CONCLUSIONS: Collagen cross-linking using glutaraldehyde leads to a significant increase in the biomechanical strength and enzymatic resistance of amnion, better transparency and less wrinkling. The cross-linked membrane does not dissolve for months and is well suited for the surface reconstruction of the cornea.

Amnion↗