Abstract:
BACKGROUND:The gold standard therapy for full-thickness macular holes (FTMH) is vitrectomy (PPV) with peeling of the internal limiting membrane (ILM), gas tamponade of the vitreous cavity and postoperative face-down positioning. Nevertheless, eyes with large macular holes (> 400 µm) and surgical failures remain difficult to manage. Recently, ILM transplantation (ILM-TX) techniques were developed with acceptable results, advocating different mechanisms of hole closure: in such a setting, the ILM could serve as a scaffold for neuronal tissue in the pedicle ILM flap technique or the ILM could induce a contraction of the FTMH rims through shrinking of a folded ILM plug. PATIENTS/MATERIAL AND METHODS:This retrospective study evaluates the functional and anatomic outcomes following ILM-TX for large FTMH and failed FMTH surgery. Large holes (group 1) were treated by the pedicle flap and the plug technique. Persistent holes following vitrectomy and ILM peeling (group 2) were treated with the plug technique. All ILM-TX were performed under perfluorocarbon liquid (PFCL) with a subsequent silicone oil tamponade. RESULTS:In group 1 (6 eyes), three eyes had a free ILM graft and three eyes underwent a pedunculated ILM-TX. The mean best corrected visual acuity (BCVA, LogMar) before primary ILM-TX was 1.18 ± 0.54 with a mean initial hole size of 681 ± 106 µm and a photoreceptor defect (PRD) of 1829 ± 474 µm. Five of six eyes showed a postoperative anatomical macular hole closure (83%). The mean BCVA after a mean follow-up of 9.3 ± 5.1 months was 0.83 ± 0.31 after a free ILM graft and 0.95 ± 0.79 after a pedunculated ILM flap. The PRD reduced to 1781 ± 713 µm after a free ILM graft and 1148 ± 378 µm after a pedunculated ILM flap. In group 2 (7 eyes), all patients had failed initial macular hole surgery closure. Prior to free ILM-TX BCVA was 1.05 ± 0.41, the hole size was 433 ± 183 µm and PRD was 2012 ± 718 µm. After a mean of 9.6 ± 4.1 months following ILM-TX, in six of seven eyes the FTMH hole was closed (86%), BCVA improved to 0.53 ± 0.34 and the PRD shortened to 843 ± 291 µm. CONCLUSION:In most cases, with large FTMH or holes after failed vitrectomy plus ILM peeling, ILM-TX allows a hole closure. Functional outcomes show stabilization and sometimes even a slight improvement. HINTERGRUND:Der Goldstandard beim durchgreifenden Makulaforamen (MF) ist die Vitrektomie (VE) mit Peeling der Membrana limitans interna (ILM), Gastamponade und postoperativer Kopftieflagerung. Größere MF (> 400 µm) und voroperierte Makulaforamina bleiben weiterhin schwierig behandelbar. Kürzlich wurden neue ILM-Transplantationstechniken (ILM-TX) mit akzeptablen Resultaten entwickelt. Diese greifen auf verschiedene Verschlussmechanismen zurück: ILM als Leitschiene für Migration des neuronalen Gewebes beim gestielten ILM-Flap oder Kontraktion der MF-Ränder durch Schrumpfung eines ILM-Pfropfens. PATIENTEN/MATERIAL UND METHODEN:Diese retrospektive Studie evaluiert die funktionellen und anatomischen Ergebnisse nach ILM-TX bei großen MF und nach Vitrektomie mit ILM-Peeling bei persistierenden MF. Für die großen MF (Gruppe 1) wurde der gestielte ILM-Flap oder die freie Faltung des ILM-TX in das MF angewandt. Persistierende MF nach VE mit ILM-Peeling (Gruppe 2) wurden mittels Faltung eines freien ILM-TX in das Foramen behandelt. Bei allen Augen erfolgte die ILM-TX unter Perfluorocarbon-Liquid-Schutz und Silikonöltamponade. ERGEBNISSE:In der Gruppe 1 (6 Augen) erhielten 3 Augen eine freie ILM-TX in das Foramen und 3 Augen erhielten eine gestielte ILM-TX. Die durchschnittliche bestkorrigierte Sehschärfe (BCVA, angegeben in LogMar) lag präoperativ bei 1,18 ± 0,54. Die präoperative MF-Größe belief sich auf 681 ± 106 µm mit einem Photorezeptorbanddefekt (PRD) von 1829 ± 474 µm. In 5 von 6 Augen konnte ein Verschluss des MF erzielt werden (83%). Nach einem Follow-up von durchschnittlich 9,3 ± 5,1 Monaten fand sich eine BCVA von 0,83 ± 0,31 nach freiem und 0,95 ± 0,79 nach gestieltem ILM-TX. Der mittlere PRD reduzierte sich auf 1781 ± 713 µm bei den freien und auf 1148 ± 378 µm bei den gestielten ILM-TX. In Gruppe 2 (7 Augen) mit persistierenden MF nach Standardvitrektomie und ILM-Peeling lag der Visus vor der sekundären ILM-TX bei 1,05 ± 0,41. Die initiale MF-Größe betrug 563 ± 183 µm. Der durchschnittliche PRD betrug 2012 ± 718 µm vor der sekundären ILM-TX. Nach der sekundären ILM-TX, nach einem mittleren Follow-up von 9,6 ± 4,1 Monaten, zeigten 6 von 7 Augen einen Verschluss des MF (86%). Die Sehschärfe betrug dabei 0,53 ± 0,34 und der PRD reduzierte sich auf 843 ± 291 µm. SCHLUSSFOLGERUNG:ILM-TX führt bei großen MF oder persistierenden MF nach VE mit ILM-Peeling meist zum Verschluss des MF. Die funktionellen Ergebnisse zeigen eine Stabilisierung und manchmal sogar eine Verbesserung.
journal_name
Klin Monbl Augenheilkdjournal_title
Klinische Monatsblatter fur Augenheilkundeauthors
Hess JA,Michels S,Becker MDdoi
10.1055/s-0043-121032subject
Has Abstractpub_date
2018-10-01 00:00:00pages
1159-1164issue
10eissn
0023-2165issn
1439-3999journal_volume
235pub_type
杂志文章abstract::The beta-blocker Metipranolol is discussed with reference to a pilot study and a double-blind study. It was found to be remarkably effective in lowering intraocular pressure. No statistically significant difference was found between Metipranolol and Timolol with regard to their effect on intraocular pressure and blood...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 临床试验,杂志文章
doi:10.1055/s-2008-1054859
更新日期:1983-06-01 00:00:00
abstract:BACKGROUND:Bilateral stromal corneal opacifications are a differential diagnostical challenge to identify associated systemic diseases. CASE-REPORT:A 47-year old civil engineer (height 167 cm) with bilateral stromal corneal clouding presented with visual loss for the last 27 years: VA 20/100 OD and 20/50 OS (following...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2002-35688
更新日期:2002-10-01 00:00:00
abstract::This paper discusses the clinical application of a simplified irrigation-aspiration system for extracapsular cataract extraction. This simplified apparatus represents a reasonably-priced alternative to the existing expensive and complicated systems. When the surgeon has gained sufficient practice in the use of this me...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1984-12-01 00:00:00
abstract::The present paper reports on experience gathered with the first 140 implantations of the Kelman II anterior chamber lens following intracapsular cataract extraction (ICCE). The technique of ICCE combined with lens implantation is described; the possible complications and the advantages of this new lens type are pointe...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1054555
更新日期:1984-06-01 00:00:00
abstract:BACKGROUND:Can the capsulotomy with small radial incisions compared to the continuous curvilinear capsulorhexis with perfect IOL centration still be recommended? This problem should be clarified under standard conditions. METHOD:On 100 patients both procedures were applied alternating with corneoscleral incision, phac...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1035520
更新日期:1994-04-01 00:00:00
abstract:PURPOSE:The purpose of this study was to assess the vasoconstrictor effect of the prostaglandin F2 alpha analog latanoprost in isolated porcine ciliary arteries. MATERIAL AND METHODS:With a myograph system to measure isometric forces, porcine ciliary arteries were exposed, in a cumulative manner, to increasing concent...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2001-15904
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Laser therapy is an important treatment option in retinal diseases, especially in cases of vascular involvement. Most approaches are based on coagulation of retinal structures. As there is increasing use of agents targetting vascular endothelial growth factor in the treatment of macular diseases, indications...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章,评审
doi:10.1055/s-0042-123831
更新日期:2018-12-01 00:00:00
abstract::Even in patients with consecutive strabismus who had a partial or total tenotomy 10 to 50 years ago, reoperation is worthwhile. In 73% of the author's cases the squint angle was reduced to between -5% degrees and +5 degrees postoperatively; adduction or abduction were improved or normalized in 66%, convergence in 20%....
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1050239
更新日期:1988-08-01 00:00:00
abstract:BACKGROUND:In April 1986, numerous reactor workers and firemen were exposed to high doses of ionizing radiation during the Chernobyl nuclear power plant accident. Apart from high ambient gamma-ray exposures they received inhomogeneous contamination with beta-rays from fission products, resulting in severe skin exposure...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1034732
更新日期:1999-12-01 00:00:00
abstract:BACKGROUND:In spite of the worldwide declining number of syphilis cases, there has been stable rate of syphilis infections in Switzerland from 2006 - 2008. In the year 2008 672 case were reported. Uveitis is the most common ocular finding in syphilis. It occurs in 2.5 %-5 % of all cases. HISTORY AND SIGNS:Six patients...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0031-1273229
更新日期:2011-04-01 00:00:00
abstract::The re-examinations of 28 complete sector and 27 peripheral iridectomies, performed because of acute glaucoma, showed an equally good regulation of IOP from both methods, even in longstanding cases (stadium III of Leydhecker) and when an operation during an attack is necessary. The postoperative reduction in vision ma...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1976-12-01 00:00:00
abstract::A thorough examination, planned jointly by an internist and an ophthalmologist, is advocated for patients with uveitis. Close cooperation with all medical subspecialties is mandatory in order to save the time and money of both the physician and the patient. One or more relevant concomitant diseases were diagnosed in 7...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1054563
更新日期:1984-07-01 00:00:00
abstract::Laser treated rat fundi were observed angiographically and with the fluorescence microscope for 3 months. Angiographically diffusions have been observable up to about one week post laser, fluorescence microscopically, however, for the whole observation time of 3 months. From the 2nd week, these diffusions were produce...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1976-04-01 00:00:00
abstract::The amphiphilic surfactant proteins B (SP-B) and C (SP-C) are tightly bound to phospholipids. These proteins play important roles in maintaining the surface tension-lowering properties of pulmonary surfactant. Surfactant protein A (SP-A) and D (SP-D) are hydrophilic and are thought to have a role in recycling surfacta...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章,评审
doi:10.1055/s-0029-1245609
更新日期:2010-11-01 00:00:00
abstract:PURPOSE:To evaluate the effect of soft contact lenses with different lens power on the measured value of the intraocular pressure with non-contact pneumotonometry. METHODS:120 eyes (80 healthy volunteers: 50 women, 30 men, aged 22 to 61 years) were included in this study. Intraocular pressure was measured with a pneum...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2003-812564
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND:Antibodies (Ab) against the acetylcholine receptor (AChR) are found in 80 - 90 % of generalized myasthenia gravis (MG), but only in 50 % of pure ocular MG. Furthermore, Ab against the muscle-specific receptor tyrosine kinase (MuSK) were detected in 38 - 54 % of patients with AChR-Ab-negative ("seronegative")...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2005-858629
更新日期:2006-01-01 00:00:00
abstract::The prevalence of glaucoma in patients with intra- or extraocular inflammation is five to twenty percent. The etiopathogenesis is manifold, including classical secondary open and closed angle mechanisms as well as specific inflammatory elements. Diagnosis and follow-up studies of inflammatory glaucomas are often diffi...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章,评审
doi:10.1055/s-2005-858310
更新日期:2005-10-01 00:00:00
abstract::Fifty patients with open-angle glaucoma were treated twice daily for one year with topical 0.5% levobunolol, 1% levobunolol, or 0.5% timolol. Both concentrations of levobunolol were as effective as timolol in reducing intraocular pressure over the one-year period. At the concentrations tested, levobunolol and timolol ...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1055/s-2008-1054395
更新日期:1985-12-01 00:00:00
abstract::Scheimpflug photography gives increased depth of field, enabling a sharp optical section through the whole anterior segment of the eye to be obtained without leaving any structures out of focus. With the Topcon SL-45 the Scheimpflug optical section can be reproduced exactly. It is the method of choice for observing le...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1054721
更新日期:1983-01-01 00:00:00
abstract:BACKGROUND:Cat scratch disease (CSD) is a common infectious disease, however its association with a disciforme keratitis is to our knowledge a previously unreported ocular complication. PATIENT:A 65-year old female was treated unsuccessfully with topical antibiotics, acyclovir and corticosteroids for several weeks bec...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2000-10372
更新日期:2000-11-01 00:00:00
abstract::By means of a new optical device developed by Reiner, an "optical implantation" of 6 different bi- and multifocal intraocular lenses (MIOLs) was performed in 20 young healthy subjects, and results were compared with those of a monofocal reference IOL. The following parameters were investigated: distance and near visua...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1045916
更新日期:1992-12-01 00:00:00
abstract::A 55-year-old man was referred to our clinic with a mature, swollen cataractous lens and a secondary phakolytic glaucoma. However, the patient refused to undergo surgery. Twelve years later he returned. Meanwhile the lens had been almost completely absorbed; visual acuity was 20/32 and there had been no severe damage...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1055071
更新日期:1982-04-01 00:00:00
abstract::The results of parenteral treatment with Etaretin in 40 patients (79 eyes) suffering from senile maculopathy are reported. In 84% of the cases there was a degeneration of the dry type and in 16% a disciform exudative maculopathy. The cases of dry maculopathy responded well within a floow-up period of 8 to 18 months. ...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1050732
更新日期:1986-06-01 00:00:00
abstract::By means of nyctometry we examinated in a group of normal persons and in a group of juvenile diabetics if the adaptability of the adaptation system in possible under various conditions of initial adaptation. It appears, that nondiabetics possess a sufficiently reactive functional system, while in diabetics, we found a...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1976-09-01 00:00:00
abstract:BACKGROUND:Computer programmes for visual stimulation may give new impulses to the field of amblyopia treatment by offering an option to shift the apparative visual training into the domestic sphere. Regarding this aspect we report on a placebo controlled study on a newly developed vision training consisting of a backg...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 临床试验,杂志文章
doi:10.1055/s-2001-14921
更新日期:2001-04-01 00:00:00
abstract:PATIENTS:Since Mai 1991 we performed a total of 17 endonasal dacryocystorhinostomies under transillumination of the lacrimal sac on 15 patients with lacrimal obstruction aged 11 to 88 years. 11 patients with 12 operations were followed up between 40 and 393 days (mean of 5.6 months). RESULTS:In all cases the connectio...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1994-05-01 00:00:00
abstract::A Study is described of a family in which four children of the same generation died during early childhood; three of them had an obvious hydrocephalus. Two of the latter could be examined clinically, and their eyes removed for pathology. One of them presented clinically bilateral leucocoria; histology showed a total d...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:
更新日期:1978-04-01 00:00:00
abstract::Noninfectious ulceration of the peripheral cornea remains a major diagnostic and therapeutic challenge. The pathogenesis in most of these disorders is unclear, however, on the basis of systemic connective tissue diseases, autoimmune mechanisms are most likely involved. The peripheral cornea has distinct morphological ...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1035173
更新日期:1996-02-01 00:00:00
abstract::An objective procedure for assessing damage to corneal endothelium is described; it is based on photometrical determination of the dye toluidine blue absorbed by damaged cells. This inexpensive quick test is suitable both for preoperative assessment of grafts and for checking procedures for cornea conversation. The us...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1055013
更新日期:1982-01-01 00:00:00
abstract:BACKGROUND:TINU syndrome probably is a frequently overlooked disease where uveitis occurs in association with acute tubulointerstitial nephritis. Diagnostic criteria have been published recently. PATIENTS AND METHODS:In this retrospective case series the charts of four consecutive patients with TINU syndrome (follow-u...
journal_title:Klinische Monatsblatter fur Augenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2002-33583
更新日期:2002-07-01 00:00:00