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Biomedical subjects

P Ruusuvaara

Publications and source records attributed to P Ruusuvaara.

At least 37 records · Page 2Linked to original sources
PubMed1989

Contact lens intolerance induced by DM rupture and secondary endothelial degeneration. A specular microscopic study.

Breaks or tears in the endothelium and Descemet's membrane (DM) are easily noticed in exact biomicroscopical ophthalmological examination. We present 2 patients with a large unilateral horizontal rupture in Descemet's membrane and abnormal corneal endothelia. In the area of the rupture the endothelial mosaic was highly abnormal, and there was no cell reflex. At the site of the rupture and at the periphery of the cornea of the affected eye the endothelial cell density was distinctly lowered, with pleomorphism and polymegathism. In an eye with a DM rupture and degenerated endothelium, difficulties in contact lens wear seem to be due to the hypoxia caused by soft contact lenses. For such patients, only gas-permeable hard lenses with short wearing times should be recommended. Check-ups should be frequent and meticulous. To ensure that endothelial degeneration is noticed well before corneal damage is clinically evident, the endothelial cells must be counted and changes sought for by specular microscopy.

Adolescent↗
PubMed1989

Alport syndrome with hereditary macular degeneration.

We present two patients, a mother and son, with Alport's syndrome (hereditary nephritis and perceptive deafness). Only the son had the typical lenticonus and perimacular flecks. Both patients had macular degeneration, the clinical manifestation of which resembled that seen in cone dystrophy. Colour vision was affected, the cone-mediated b-wave implicit times were increased in mother and in both her eyes the amplitudes were small, both to single flash stimuli and to 30 Hz white flicker. The macular changes in the son, though slight, were similar to those seen in the mother.

Adult↗
PubMed1989

Acute bilateral corneal hydrops caused by high temperature and high moisture in the Finnish sauna. A clinical and histological case report of a patient with keratoconus.

A 44-year-old healthy male with bilateral keratoconus developed acute hydrops of both his corneas with an interval of 3 years. On both occasions he had bathed in a hot, humid Finnish sauna the preceding evening. Penetrating keratoplasty had to be performed in the acute stage in both instances, as medical therapy brought no improvement. The contributory role of hot, moist air to the development of acute hydrops is discussed. Histopathological examination of the corneal buttons revealed clear-cut breaks in Descemet's membrane with marked posterior stromal oedema.

Acute Disease↗
PubMed1989

Orbital metastasis from cutaneous malignant melanoma.

Orbital metastasis is a rare presenting sign of a cutaneous malignant melanoma. Fewer than 30 cases of orbital metastases have been published so far. A 69-year-old man was remitted to our clinic for removal of an orbital tumour verified with CT. Fine-needle aspiration biopsy revealed the tumour to be a metastasis from a cutaneous malignant melanoma diagnosed 4 years earlier. The patient died 3 months after detection of the orbital metastatic tumour. This case illustrates the value of simple fine-needle aspiration biopsy in the diagnosis of orbital tumours.

Aged↗
PubMed1988

Respiratory arrest after retrobulbar block.

We describe a patient who suffered respiratory arrest some minutes after retrobulbar block before cataract extraction. She was managed by artificial respiration for 20 min, and after the had recovered from this potentially fatal complication cataract extraction was performed without complications and without any neurological sequelae. Retrobulbar blocks, as well as other retrobulbar, injections, should be performed only in safe situations. Individuals trained in airway maintenance and ventilatory support should be immediately available, and the patient must be monitored for at least 10 min after the retrobulbar injection.

Adult↗
PubMed1988

Long-term follow-up of cryopreserved corneal endothelium. A specular microscopic study.

This paper deals with the long-term survival of corneal transplant endothelial cells. Endothelia of 17 cryopreserved corneal transplants were photographed with a specular microscope, first 1.5 years (mean) following transplantation, and again 10 years later. All transplants were absolutely clear. The mean cell loss was 23% in 12 years. After 2 to 14 years post-operatively the cell loss was noticed to be only 13.6% (from 990 +/- 255 cells/mm2 to 855 +/- 213 cells/mm2). It seems that endothelial cells of cryopreserved corneal grafts, although few in number, are still quite resistant and viable after a long follow-up time and survive like endothelial cells after preservation in tissue culture media.

Adult↗
PubMed1988

Corneal graft endothelial cell densities after preservation in M-K, K-sol and MEM tissue culture media. A clinical and specular microscopic study.

The endothelial cell densities of corneal transplants of 30 keratoconus patients have been studied. All operations were performed by the senior author using the same technique. Preservation systems M-K medium, MEM-solution and K-sol were used; ten grafts in each group. The average endothelial cell density for all 30 transplants was 1815 +/- 869 cells/mm2. The mean cell density was the lowest (1128 +/- 587 cells/mm2) and the mean follow-up time longest (2 years and 9 months) in M-K medium stored grafts. K-sol is the newest preservation method used in our hospital. It gave the best graft endothelial cell densities (2302 +/- 938 cells/mm2). The mean follow-up time was shortest in K-sol (8 months). The mean endothelial cell density for grafts from MEM-solution was 2015 +/- 614 cells/mm2) with the mean follow-up time of 1 year, 4 months.

Adolescent↗
PubMed1988

Corneal endothelium in Marfan syndrome. A clinical and specular microscopic study.

Marfan syndrome is classified as a heritable disorder of connective tissue, and it has been assumed to be an inborn error of protein metabolism particularly in collagen or elastin. We examined 41 Marfan syndrome patients and found in the corneal endothelium guttata-formation, considerable cell pleomorphism, non-reflecting endothelial black spots and in some cases abnormal looking endothelial cells. The relation of pathological endothelium to lens subluxation, axial length and other corneal findings is discussed.

Adolescent↗
PubMed1987

Keratoendotheliitis fugax hereditaria. A clinical and specular microscopic study of a family with dominant inflammatory corneal disease.

A peculiar hereditary corneal disease seen in one pedigree is presented. The disease manifests itself as transient attacks of kerato-endotheliitis. These attacks last from a few days to some weeks. Clinically, corneal oedema and endothelial guttata-like changes with very slight anterior chamber reaction can be seen; after many attacks there may be permanent opacities in the stroma. Endothelial specular photography during an attack reveals dramatic changes: large black nonreflecting areas between quite normal-looking hexagonal cells. Also between the attacks and among family members who have no clinical corneal disease, changes in the endothelium: black spots in the centres of endothelial cells and marked pleomorphism, are to be seen. Among the family members a high incidence of collagen diseases was found.

Adult↗
PubMed1987

The triple procedure. Penetrating keratoplasty, extracapsular cataract extraction and posterior chamber lens implantation. A clinical and specular microscopic study.

The combination of penetrating keratoplasty, cataract extraction and intraocular lens implantation, the triple procedure, is the surgical choice for the patients with corneal disease and cataract. The success of the corneal graft depends chiefly on the endothelium of the transplanted cornea. Preservation, donor age, cadaver time, histocompatibility and operation itself affect endothelial cells. We present clinical results including endothelial evaluation of 20 patients who have undergone the triple procedure during the years 1984-1986. Mean age was 73 years. The follow-up time varied from 1 to 30 months. The visual recovery was very good. Every patient had better visual acuity post-operatively than pre-operatively. We had no operative complications. Three patients had rejection episodes which all were cured with cortisone. No re-transplantations were needed. The mean endothelial cell density was 1723 cells/mm2. The possible factors affecting the outcome are discussed.

Aged↗
PubMed1987

Use of botulinum toxin in blepharospasm and other facial spasms.

Essential blepharospasm is an involuntary spasmodic closure of the eyelids. It frequently makes normal social human life such as reading, driving and even walking almost impossible. Botulinum toxin has been approved for investigational use for treatment of blepharospasm. We report the results and side-effects of botulinum A toxin treatment of the first 13 patients in Finland. Temporary control of spasms was achieved in all patients varying from 1 to 38 weeks with a mean of 11 weeks after the first injection. Most patients needed re-treatment after varying intervals. All complications were transient.

Adult↗
PubMed1987

Bilateral absolute phakolytic glaucoma. A clinical and ultrasonographic case study.

We describe an unusual case of absolute bilateral phakolytic glaucoma. On admission for cataract surgery the 75-year-old patient was found to be totally blind, no light perception in either eye. The ocular tensions were about 75 mmHg in both eyes, corneas hazy, the fundi could not be seen. The swollen lens of the right eye had slightly subluxated downwards. In the left eye the ultrasound showed a luxated swollen lens in the vitreous space. The ultrasound also revealed totally excavated optic discs. This patient had been on the waiting list for 8 months. Information of the stage of the cataracts of patients on the waiting lists for operation is of paramount importance in the prevention of lens induced problems which may lead to irreversible visual deterioration.

Aged↗
PubMed1980

Endothelial cell densities in donor and recipient tissue after keratoplasty.

A specular microscope was used to photograph the cell densities of the central cornea of the graft and the peripheral recipient cornea in a total of 32 human eyes. The follow-up period varied from 8 months to 13 years, with an average of 4.7 years. The mean endothelial cell count in the graft was 997 +/- 356 cells/mm2 and 1410 +/- 584 cells/mm2 in the recipient's peripheral cornea. The mean difference in cell counts between donor and recipient tissues was 413 +/- 718 cells/mm2 (29%). There were great disparities between graft and recipient cell densities. One patient with keratoconus had a graft/recipient differential in cell density of 3 to 1. In four cases the cell density was higher in the graft than in the recipient. Of these grafts, two had been stored in M-K medium and two had been cryopreserved. The great difference in cell density observed between the graft and recipient corneas strongly suggests that little, if any, cell migration occurs between graft and recipient. This suggests that the scar tissue forms a barrier to cell migration between graft and recipient.

Adult↗
PubMed1980

The fate of preserved and transplanted human corneal entothelium.

This paper evaluates the numbers of corneal endothelial cells that survive transplantation. The donor endothelium was photographed with a specular microscope both before enucleation and in situ after keratoplasty. The cell density was measured in 16 corneas from donors with choroidal melanoma. Of these donor corneas 12 were cryopreserved, two were preserved in McCarey and Kaufman's (M-K) medium and two were transplanted fresh. The average follow-up period after keratoplasty was 11 months. The mean endothelial cell loss for the whole series was found to be 49%. The mean cell loss for the cryopreserved corneas was 55%. In the four other recipients, with donor corneas that had been stored in M-K medium or transplanted fresh, the mean cell loss was 32%. The corneas preserved in M-K medium had the highest cell density in the transplants, with cell losses of 21 and 22%. Cell losses in the two corneas transplanted fresh were 40 and 44%. Cell losses, in the cryopreserved grafts had a wide variation, 33-77%. No correlation could be found between cell loss and either the age of the donor or the duration of perservation. Freezing and thawing was found to damage a proportion of the cells so that they did not stain with para-nitro-blue tetrazolium (p-NBT) after preservation. Transmission and scanning electron microscopy also revealed changes in the intercellular spaces and some cell disruption in cryopreserved grafts.

Adolescent↗
PubMed1979

Effects of corneal preservation, donor age, cadaver time and postoperative period on the graft endothelium. A specular microscopic study.

The endothelia of 102 clear human corneal grafts in 95 patients were photographed in vivo with a specular microscope. The endothelial cell densities of the grafts were counted from a area of 0.01 mm2. The follow-up period averaged three years. The patients' ages ranged from 16 to 77 years and that of the donors from 8 to 89 years. The average endothelial cell density for all 102 transplants was 1169 +/- 478 cells/mm2. Corneal transplants stored in MK medium (N = 19) have more cells than cryopreserved grafts (N = 42) or grafts stored in the moist chamber (N = 41); this last group was used as control material. The differences in cell densities were statistically significant. The cell density of cryopreserved grafts was significantly higher than in grafts stored in moist chamber. Only in those grafts in which moist chamber storage had been used was endothelial cell density dependent on time of storage. With an increase in cadaver time (time from death to enucleation), the endothelial cell density of the graft decreased. An inverse correlation was found between the cell density of the graft and donor age. Good results were still found with healthy donors over 60 years. The endothelial cell density of the grafts showed a steady decrease during the long-term post-operative period, the rate of cell loss being much higher in graft endothelium than in normal endothelium during ageing.

Adolescent↗