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Biomedical subjects

R Klöti

Publications and source records attributed to R Klöti.

At least 19 recordsLinked to original sources
PubMed1992

[Anterior high frequency capsulotomy. I. Experimental study].

Basing on the bipolar-coaxial wetfield-diathermy, introduced in microsurgery 1974 by the author, an anterior capsulotomy instrument using a modulated RF-current was published in 1984. In the meantime several patients have been operated successfully with this technique. However, further experimental studies allowed a refining of the instrument, an improvement of the electronic control device and a perfection of the surgical technique. Today, this technique has four considerable advantages compared with other methods: the size of the capsulotomy opening is not casual but determined by the surgeon, the presence of a viscous substance in the anterior chamber definitely facilitates the optical control of the surgical procedure, the border of the capsulotomy is astonishingly resistant to mechanical forces, therefore the risk of radial capsular tears is highly reduced, the border of the capsulotomy is well defined by a tiny grayish coagulation line which facilitates the implantation. The experimental results are demonstrated. The clinical and surgical results are presented in the same journal by Coester et al.

Animals↗
PubMed1992

[Anterior high frequency capsulotomy. II. Clinico-surgical experiences].

Using an instrument developed by Klöti, the author performed anterior capsulotomy by means of a radio-frequency current in 21 cases of extracapsular cataract extraction. This group is compared with 21 control cases. The advantages and limits of this technique are discussed. The procedure was found to be simple and very helpful to the surgeon. There was no evidence of any damage to structures in the patient's eye.

Cataract Extraction↗
PubMed1988

Anterior capsulotomy by means of bipolar radio-frequency endodiathermy.

Anterior capsulotomy, a crucial step in extracapsular implant surgery, is performed by several methods. All must deal with the inherent capriciousness of the tense anterior capsule and so their precision is questionable. An anterior capsulotomy instrument that uses bipolar radio-frequency endodiathermy is described. The modulated high frequency current enables the surgeon to open the anterior capsule more accurately under controlled conditions.

Anterior Chamber↗
PubMed1988

[Pars plana vitrectomy in chronic uveitis].

Statistical analysis of 54 eyes with chronical endogenous uveitis, mostly juvenile, treated with simple or combined pars plana vitrectomy. Most striking is the high frequency of localized or combined cyclitis with good functional results, although complications of the disease (retinal detachment, vasculitis, PVR, macular damage) are extremely frequent in cyclitis, and this group also includes, three cases of postoperative phthisis. The best argument in favor of an chronic uveitis is the fact that an overwhelming majority of the patients were able to switch from rigorous systemic preoperative medication to simple eye drops or no treatment at all.

Adult↗
PubMed1984

[Bipolar wet-field diathermy in microsurgery].

The author describes a miniature bipolar diathermy unit which can be used for several microsurgical purposes. It was developed from a standard endodiathermy instrument which has been in use for pars plana vitrectomy since 1973. It features bipolar forceps which can be used for welding conjunctival flaps and macrohemostasis in strabismus, orbital and lid surgery; bipolar electrodes with and without infusion, for extraocular hemostasis and intraocular microhemostasis in the anterior and posterior segments; bipolar electrodes with infusion for special purposes (still at the experimental stage), for capsulotomy of the anterior lens capsule for extracapsular cataract extraction, section of intraocular strands and membranes and sector iridectomy for tumors or rubeosis of the iris.

Cataract Extraction↗
PubMed1983

[Water-cushion contact lens for pars plana vitrectomy].

Our water-cushion contact lens satisfies same requirements as the lenses we used previously: stabilization of the anterior segment, perfect attachment to the eye, freedom of movement of the eye in all directions. A rather important additional advantage is achieved by virtue of the fact that the lens floats on a constantly renewed fluid layer in a ring-shaped pool. Even in diabetic patients postoperative damage to the corneal epithelium no longer occur. A planoconcave or prismatic quartz lens may be placed into the pool. The lenses are scratch-resistant and have an antireflective coating. Direct observation of the equatorial area in phakic and of the oraserrata area in aphakic eyes is possible with this perfect optical system.

Contact Lenses↗
PubMed1983

From vitreous loss to vitrectomy.

The author presents a simple surgical device enabling ophthalmic surgeons to manage vitreous loss in cataract surgery or perforating injuries in a safer and simpler way and with less postoperative complications. The instrument set-up has the following specifications: perfectly cutting vitrectomy microinstrument, mechanical device for repeated use of the cutting edge of the trephine. The instrument set is ready for use in less than 1 min. The same instrument device can be used for several other purposes in anterior and posterior segment surgery, especially for delicate problems in pars plana vitrectomy.

Anterior Chamber↗
PubMed1982

[Vitreous - loss less dangerous with the microstripper (author's transl)].

The author presents a simple surgical device which enables all ophthalmic surgeons to manage vitreous loss in cataract surgery or perforating injuries in a safer and simpler way, and with fewer postoperative complications. The instrumentarium has the following specifications: perfectly cutting vitrectomy microinstrument. Mechanical device for repeated use of the cutting edge of the trephine. The instrument set is ready for use less than 1 minute. The same instrument can be used for several other purposes in anterior and posterior segment surgery, especially for special problems in pars plana vitrectomy.

Cataract Extraction↗
PubMed1981

[Vitrectomy general considerations (author's transl)].

On the basis of approximately 700 pars plana vitrectomies performed by the author during the past nine years, some general aspects of this new surgical technique are discussed. Since we remove the vitreous in some cases today, whereas ten years ago we took the utmost care to preserve it, some speculations on the function of the vitreous are discussed. The importance of the clinical examination for the indication for vitrectomy is pointed out. Finally, some general results are given and the further development of vitrectomy is outlined.

Eye Diseases↗
PubMed1981

[Retinal holes - cause and therapeutical key of retinal detachments. Iatrogenic holes (author's transl)].

The author reports on 20 hopeless cases of retinal detachment with no visible retinal hole after vitrectomy and membrane-peeling procedures. Nearly all these cases showed a funnel-shaped rigid retinal detachment. In order to perform an internal drainage and air tamponade from inside a iatrogenic hole was cut in the periphery of the retina. The hole was necessary for the internal drainage of the subretinal fluid. The air tamponade forced the retina to unfold. Astonishingly, in 12 out of these 20 cass the retina became reattached.

Drainage↗
PubMed1980

[Androgen-producing hilus cell tumor (Leydig cell tumor) of the ovary: case contribution to the differential diagnosis of virilization in the adult woman].

Severe hirsutism, deepening of the voice and enlargement of the clitoris developed in the course of two years in a 55-year old hysterectomized woman. Laboratory examinations showed markedly elevated plasma concentrations of testosterone and androstenedione and a moderately increased urinary excretion of 17-ketosteroids. Gaschromatographic analysis of the urinary steroids, revealed that she mainly excreted etiocholanolone, androsterone and pregnanetriol. Plasma androgens and urinary 17-ketosteroids were not suppressed by dexamethasone treatment. During catheterization of the vena cava blood samples were selectively taken from the ovarian veins. Androgen concentrations were the highest in the plasma from the right ovarian vein. However, phlebography as well as adrenal scanning with 131I-adosterol indicated a tumor of the right adrenal gland. During laparoscopy the right ovary was found to be enlarged, and it was subsequently removed. It contained a tumor 2.5 cm in diameter which had the histological features of a hilus cell tumor (Leydig cell adenoma). Two years later, the patient underwent surgery for suspected tumor of the left kidney. A functionless atrophic left kidney was removed. There was a complete thrombosis of the left renal and ovarian veins. Possibly, this severe lesion of the two vessels had been caused by their previous catheterization.

Androgens↗
PubMed1977

What is the present status of pars plana vitreous surgery in Zurich?

Although we have not changed the principles of our technique, increasing experience has made it possible to refine some details of the instrument set and the surgical technique. The electrical part of the vitreous stripper is safer, and a diathermy source for endodiathermy belonging to theinstrument set has been developed. Not only the slit lamp for the microscope, but also the fibre-optic illumination are in their final form. A new contract lens facilitates bimanual operation in the vitreous space. Progress in surgical technique has been made in the simultaneous extraction of the cataract in diabetic patients, in the extraction of non-magnetic foreign bodies, and in the combined vitreous-retinal detachment surgery.

Cataract Extraction↗