Biomedical subjects
Publications and source records attributed to O Geyer.
Detachment of the host's Descemet membrane inadvertently occurred while removing the decompensated graft in a patient undergoing rekeratoplasty. The membrane was purposefully left intact and the new graft sutured on top of it. In this way, opening of the anterior chamber was avoided and the operation completed as an 'extraocular' procedure. The graft and the membrane have remained clear during 3 years of follow-up.
We studied the ability of topical clonidine, an alpha-agonist, to suppress the acute rise in intraocular pressure (IOP) following neodymium-YAG posterior capsulotomy (YPC). In a randomized controlled trial 63 eyes were pretreated with one drop of either 0.25% clonidine or saline 1 h before performing YPC and immediately following the procedure. The greatest IOP rise in the saline treated eyes occurred in the second hour after YPC, when the mean (+/- SD) IOP rose from a baseline pressure of 12.7 +/- 3.2 to 18.7 +/- 10.7 mmHg. In clonidine treated eyes, the IOP fell from a mean of 11.9 +/- 3.4 to 9 +/- 3.3 mmHg 2 h postoperatively. In the saline treated group 9 eyes (27%) developed an IOP rise greater than 10 mmHg. Clonidine proved to be highly effective in preventing the rise in IOP following YPC.
A pseudophakic pilot of the Israeli air force flying an F-15 (Eagle) aircraft was followed up for three years. He experienced about 100 flying hours, 5% of the time under high g stress. The intraocular lens did not dislocate and no complications were observed. It seems that flying high performance fighter aircraft is not contraindicated in pseudophakic pilots.
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Two cases are reported in which pupillary pigment occlusion occurred after argon laser iridotomy, reducing visual acuity and preventing fundus visualization. Laser-induced inflammation and subsequent long-term miotic therapy are probably responsible for this complication. Periodic pupillary dilatation is recommended in eyes that require miotics to control their intraocular pressure after laser iridotomy.
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A case of acute orbital haemorrhage induced by labour is reported in a woman giving birth for the eighth time. The diagnosis was confirmed by computed tomography. The haemorrhage subsided spontaneously within three weeks. The mechanism of orbital haemorrhage following certain kinds of strain is discussed.
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Blurred vision, a well-known complication of uncontrolled diabetes mellitus, is occasionally overlooked as the first and only presenting symptom of type I diabetes mellitus. In this report we describe six type I diabetic patients whose first and only symptom of the disease was blurred vision, as documented by increased glycosylated hemoglobin. Institution of therapy was delayed until the classical symptoms of diabetes mellitus appeared.
A 75-year-old woman with corneal argyrosis was treated by a Q-switched Nd-YAG laser iridotomy after acute angle closure glaucoma. Each laser shot caused clearance of the argyrotic deposits anterior to the iridotomy site. The same effect was seen when a preventive iridotomy was performed in the other eye. The areas of clear cornea remained unchanged for a follow-up period of eight months.
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Acute allergic blepharoconjunctivitis with mucopurulent discharge due to phenylephrine eye drops is reported. The reaction begins 3-4 hours after drug application, persists for 12 hours and regresses gradually within 72 hours. This clinical picture occurs with a phenylephrine concentration as low as 0.1%. Conjunctival biopsy of the inflamed eyes reveals marked infiltration by lymphocytes, plasma cells and eosinophiles, without predominance of any of these cells.
Fifty-one patients with raised intraocular pressure (IOP) were treated for up to four years with one of three ophthalmic solutions: 0.5% levobunolol, 1% levobunolol, or 0.5% timolol. The study was conducted as a double-masked, randomised trial in which medications were administered twice daily to both eyes. Levobunolol and timolol were equally effective in reducing overall mean IOP; reductions were greater than 8.8 mmHg in all three treatment groups. The study showed levobunolol to be as safe and effective as timolol in the long-term control of raised IOP.
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