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Biomedical subjects

R Menapace

Publications and source records attributed to R Menapace.

126 records · Page 7Linked to original sources
PubMed1987

[Initial experiences with primary silicone oil administration into the vitreous cavity in complicated eye injuries].

The authors report on five cases of severe perforating injury of the posterior segment which were initially treated by vitrectomy and subsequent filling of the vitreous cavity with silicone oil. The results so far have been satisfactory in all eyes. The advantages of the method (e.g., tamponade of retinal tears, facilitation of postoperative laser treatment) are emphasized and possible side effects are discussed.

Eye Foreign Bodies↗
PubMed1987

High-energy electrons used to inhibit experimental intraocular proliferation and detachment.

Irradiation of rabbit eyes with high-energy electrons was used to test the inhibition of experimental intraocular proliferation and retinal detachment, produced by intravitreal implantation of 250,000 homologous fibroblasts. After irradiation with 2,000 rad, started 5 days after implantation, 45% of eyes (9 of 20) still manifested traction detachment. When the dose was increased to 3,000 rad and radiation treatment was started 1 day after implantation, proliferation and traction detachment were observed in only 10% of eyes (2 of 20). No acute damage to retinal tissue or nerve fibers was observed. Because it is easily available, simple in application and dose adjustment, and without toxic side effects, radiation therapy should be considered as an effective alternative to drug treatment for the inhibition of intraocular proliferation and detachment. Statistically significant results of this investigation suggest its use combined with surgery in certain reproliferative cases in man.

Animals↗
PubMed1986

[Argon laser trabeculoplasty in simple glaucoma].

In June 1984 the authors started a prospective study on the treatment of open-angle glaucoma with argon laser trabeculoplasty. The technique used was to treat 180 degrees of the anterior nonpigmented part of the trabecular meshwork with 80 to 100 burns. For retreatment the posterior pigmented part of the trabecular meshwork was coagulated with 80 to 100 burns. The burns were always applied to the pretreated half of the meshwork. At present the study includes 47 eyes treated posteriorly. Of these cases 12 eyes required retreatment. Five eyes had previously undergone an unsuccessful trabeculectomy. The preliminary results are satisfactory. The average reduction in intraocular pressure was 5.9 mm Hg; the mean intraocular pressure before therapy was 23 mm Hg. In 8 cases the trabeculoplasty failed, making a fistulating procedure necessary. The treatment was always well tolerated and there were only minor side effects which never led to any lasting damage.

Adult↗
PubMed1986

[Temporary silicone oil implantation following vitrectomy in proliferative diabetic retinopathy].

Report on 23 patients with proliferative diabetic retinopathy who underwent silicone oil implantation due to recurrent intravitreal hemorrhages following pars plana vitrectomy. Postoperatively, it was possible to perform panretinal laser photocoagulation without difficulty or haste. After an average period of 4 months, silicone oil was removed from 10 eyes. Subsequent hemorrhages in 4 of these eyes are due to diabetic retinopathy, not to silicone oil. In 6 cases, silicone oil removal is planned for the near future; in a further 7 cases, silicone oil removal has been postponed because of the potential danger of further traction retinal detachment.

Diabetic Retinopathy↗
PubMed1985

[CAU--an accessory device for automatic monitoring and evaluation of fixation with the computer perimeter Competer].

During perimetry with the "Competer" fixation is tested by random switching of a projector lamp which has to be directed manually into the individual blind spot before the test is started. In order to improve efficiency with regard to time required, acceptance, and validity of the test, a device has been designed which rapidly locates the center of the blind spot and verifies it by random checks. Both the test logic and the design and operating features of this device, which works independently of the parent apparatus, are described in detail.

Computers↗
PubMed1985

[Experiences with a new attachment for automatic monitoring and evaluation of fixation with the Competer computer perimeter].

During perimetry with the Competer fixation is controlled by random switching of a projector lamp which has to be directed manually into the individual blind spot before the test is started. In order to improve efficacy with regard to time taken, acceptance and validity, a device has been designed which locates and checks the blind spot automatically. An evaluation of relevant data is presented showing that the prototype is already performing satisfactorily.

Computers↗
PubMed1985

[Treatment of recurrent conjunctival melanoma by lamellar resection and contact irradiation].

The author reports on a 43-year-old patient who, having been treated for a conjunctival melanoma by local resection, presented 6 years later with a recurrent melanoma of a superficial spreading type, having a nodular and a flat component. While lamellar corneal excision was performed on the nodular component, the flat portion was treated with beta-contact radiation. The results are described and the argument for this therapy discussed.

Combined Modality Therapy↗
PubMed1985

[Immunosuppressive therapy with cyclosporin A following penetrating keratoplasty].

Report on 11 patients who underwent penetrating keratoplasty and were treated with Cyclosporin A for an average of 6 months because of excessive superficial and deep vascularization of the recipient cornea. In none of the patients was a permanent Cyclosporin A-induced side-effect observed. After an average follow-up period of 11 months 9 grafts remained completely clear; however, an allograft-reaction occurred in 2 cases in spite of the immunosuppressive therapy.

Corneal Diseases↗
PubMed1985

[A procedure for the determination of dose performance of radioactive eye applicators (106-Ru/106-Rh) and their significance for indications and treatment in malignant choroid melanomas].

Choroidal melanomas occasionally respond very differently to irradiation by ruthenium beta-ray applicators. In order to clarify the role of the radiation parameters on the one hand and the tumor properties on the other, more precise data on the actual surface does rate than those furnished by the supplier are indispensable. With the aid of a measuring method based on the principle of thermoluminescence, the deviation was halved a +/- 15%. The measuring instrument is described, and its impact pact on therapeutic safety and indication limits is discussed.

Choroid Neoplasms↗
PubMedDate not supplied

Comparison of results and complications following combined ECCE-trabeculectomy versus small-incision-trabeculectomy and posterior chamber lens implantation.

PURPOSE: To compare the efficacy and complication rate of two standard cataract extraction techniques with different incision lengths when combined with trabeculectomy. METHODS: 54 eyes after combined ECCE, posterior chamber lens implantation and trabeculectomy (ECCE-group) are compared with 49 eyes following phacoemulsification, trabeculectomy and implantation of a folded flexible posterior chamber lens (small-incision group). Minimum follow-up was 24 months. RESULTS: Glaucoma control was achieved in all eyes of both groups. There was a tendency towards a higher number of patients without therapy in the small-incision group (82% versus 65%, p = 0.07). Final mean IOP (14.2 +/- 3.0 mmHg versus 15.5 +/- 2.7 mmHg, p = 0.02) and mean therapy index (0.2 +/- 0.5 versus 0.4 +/- 0.6, p = 0.03) were significantly lower in the small-incision group. Postoperative complications such as severe fibrin effusion (41% versus 18%, p = 0.018), early postoperative IOP rises > 25 mmHg (18% versus 2%, p = 0.009), filtering bleb scarring (63% versus 8%, p < 0.0001) and the total number of complications (87% versus 63%, p = 0.006) were significantly higher in the ECCE-group. CONCLUSION: With the decrease of the incision size necessary for the cataract extraction a reduction of postoperative complications and better functional results are achieved in combined cataract/glaucoma surgery.

Aged↗
PubMedDate not supplied

The use of recombinant tissue plasminogen activator for intracameral fibrinolysis following cataract surgery.

In a prospective study performed between June 1992 and March 1994 19 eyes of 19 patients with dense fibrinous pupillary membranes following cataract surgery were treated with intracameral injections of 25 micrograms recombinant tissue plasminogen activator (r-tPA). Injections were performed between the second and twenty-third postoperative day (mean 5.6 +/- 6.9 days). Complete fibrinolysis within one to 4 hours (mean: 3.3 +/- 0.89 hours) was observed in 18 (94.7%) eyes. In one (5.3%) eye fibrinolysis was incomplete despite a second injection. In 2 (10.5%) eyes. No recurrence of a distinct fibrinous membrane was noted which then cleared spontaneously with topical treatment. A small hyphema developed in 2 (10.5%) eyes and intraocular pressure exceeded 25 mmHg in 2 (10.5%) eyes. No increase of keratopathy nor any toxic intraocular side effect of 25 micrograms intracameral r-tPA was observed throughout the study. The intracameral injection of r-tPA clinically proved to safely accelerate the resorption of dense fibrinous membranes following cataract surgery and thus enhance visual recovery minimizing subsequent complications and systemic or subconjunctival anti-inflammatory treatment.

Adult↗
PubMedDate not supplied

Long-term course of induced astigmatism after clear corneal incision cataract surgery.

PURPOSE: To determine whether a small clear corneal temporal incision produces less surgically induced astigmatism than a larger incision. METHODS: One hundred three consecutive cases of postoperative astigmatism after clear corneal incision cataract surgery were studied for a minimum of 1 year. Only self-sealing incisions from the temporal side were made as follows: 3.2 mm (Group A); 4.0 mm (Group B); 5.2 mm (Group C). We considered the amount and axes of the keratometric readings at different times as well as their course over time. Induced astigmatism was calculated using three methods. Axial changes were also analyzed. RESULTS: Immediately after the surgery, there was a small, surgically induced, with-the-rule astigmatic shift in all groups, which in most cases decreased to near preoperative levels with time. One year postoperatively. mean induced astigmatism was 0.09 diopter (D) in Group A, 0.26 D in Group B, and 0.54 D in Group C. Most cases had minimal axial changes. In Group A, 86% had an axial change of fewer than 30 degrees; in Group B, 76%; and Group C, 73%. CONCLUSIONS: The smallest incision group had the least surgically induced astigmatism and axial change. All incision groups remained stable and had satisfactory clinical results.

Astigmatism↗
PubMedDate not supplied

Intracameral tissue plasminogen activator to treat severe fibrinous effusion after cataract surgery.

PURPOSE: To evaluate the efficacy and complications of intracameral recombinant tissue plasminogen activator (r-tPA) in the treatment of severe fibrinous effusion after cataract and combined cataract and glaucoma surgery. SETTING: University Eye Hospital Vienna, Austria. METHODS: In a prospective study, 40 eyes of 39 patients with severe fibrinous anterior chamber reaction in the early postoperative course received 25 microg r-tPA intracamerally through a temporal paracentesis. The main outcome measures were rate of complete fibrinolysis, time of maximal effect, and complications. RESULTS: Complete fibrinolysis occurred in 33 eyes (83%) after a mean of 3.2 hours +/- 0.9 (SD). The rate of complete fibrinolysis was higher in eyes having cataract surgery only (24 eyes, 89%) than in those having combined surgery (9 eyes, 69%). Recurrent fibrin was seen in 3 eyes (7%), small anterior chamber hemorrhage in 7 (18%), increased intraocular pressure in 3 (7%), and posterior synechias in 13 (33%). Complications were managed conservatively. CONCLUSION: The intracameral injection of 25 microg r-tPA proved to be a safe, efficient, and low-risk supplement in the treatment of severe postoperative fibrinous reactions.

Aged↗
PubMedDate not supplied

Improved algorithm for statistical batch-by-batch analysis of corneal topographic data.

PURPOSE: To describe an improved algorithm for topographic batch-by-batch analysis and evaluate the effect of artifact correction on the reproducibility of topographic records. SETTING: University Eye Hospital Vienna, Austria. METHODS: We twice examined 22 eyes of 22 patients (volunteers) using the TMS-1 computer-assisted videokeratoscope (Computed Anatomy, Inc.). Entry criteria were age more than 60 years and lack of corneal pathology. A batch-by-batch analysis of the paired differences was performed. The software consisted of special macro functions for a programmable computer database to eliminate small local artifacts, as well as rotate data, produce mirror images, calculate averaged differences for an entire group, and reduce data to 225 areas in 7 concentric rings. The reduced set of data was used for statistical analysis and correction of defocus artifacts. Reproducibility was evaluated by calculating the absolute deviations between the areas of paired measurements. RESULTS: The absolute deviations were below 0.9 diopter (D) in over 50% of the areas in 90% of the patients with the uncorrected data; after correction for local artifacts, defocus artifacts, and both local and defocus artifacts, these values were 0.9 D, 0.8 D, and 0.5 D, respectively. Absolute deviations were above 1.0 D in 10% of the patients in 66, 40, 29, and 0 of 225 areas, respectively. CONCLUSION: Correction for both local and defocus artifacts yielded a two-fold improvement in the reproducibility of topographic records.

Aged↗
PubMedDate not supplied

Corneal topographic changes after frown and straight sclerocorneal incisions.

PURPOSE: To compare the corneal topographic changes following cataract surgery with two types of sclerocorneal tunnel incisions for implantation of 6.0 mm optic poly(methyl methacrylate) intraocular lenses. SETTING: University Eye Hospital, Vienna, Austria. METHODS: This prospective, unmasked, and unrandomized study comprised 48 otherwise healthy eyes scheduled for cataract surgery. A 4.5 mm sutureless frown incision was made in 22 eyes and a 6.0 mm straight sclerocorneal incision with a horizontal 10-0 nylon infinity suture in 26 eyes. Preoperatively and 1 week and 1 and 3 months postoperatively, corneal topography was recorded by the TMS-1 computer-assisted videokeratoscope (Computed Anatomy, Inc.). The data were evaluated by batch-by-batch analyses of the paired differences between the records. The significance of topographic changes was calculated by paired Wilcoxon tests; group comparisons were made using Wilcoxon tests. RESULTS: In both groups, horizontal steepening and lower corneal flattening were consistently 0.4 diopter (D). Upper peripheral corneal flattening at 1 week and 1 and 3 months postoperatively was 0.7, 0.7, and 0.7 D, respectively, in the straight-incision group and 0.7, 0.4, and 0.3 D, respectively, in the frown-incision group. Vertical flattening and horizontal steepening were significant in both groups (P < .01). Group comparisons revealed significant differences in only 15 of 225 areas (P < .05). CONCLUSION: There were no major differences between the two incision groups in surgically induced topographic changes.

Aged↗