Klinische Monatsblätter für Augenheilkunde
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Klin Monbl Augenheilkd · Aug 1991
[Quantitative determination of corneal sensitivity in idiopathic trigeminal neuralgia and after neurosurgical interventions on the trigeminal nerve].
The purpose of our study was to determine, by use of the electronic Draeger esthesiometer in quantitative, reproductive measurements, the corneal sensitivity in 55 patients with medically treated idiopathic trigeminal neuralgia before and after surgical treatment of the trigeminal nerve and root. 37 patients were included in a prospective study with measurements before and after glycerol rhizotomy, radiofrequency rhizotomy and microvascular decompression (MVD) of the trigeminal root. Moreover, 18 patients were examined retrospectively 7 to 17 years after retrogasserian rhizotomy according to Spiller/Frazier. Corneal sensitivity was determined by the mean value of 3 measurements in each of 5 positions on both eyes. ⋯ Sensitivity affected by prior medical or surgical treatment does not necessarily decrease by further surgical therapy. Postoperatively up to six weeks, corneal sensitivity remained almost the same as shortly after surgical procedure. Keratitis was observed in only one case retrospectively.
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Four cases of injury of the orbit by a big foreign body without damage to the bulbus are described. The bodies were extracted and the healing was without complications. Two of these bodies penetrated into the brain and in one case surgical intervention was necessary. In both instances vision was lost because of damage to the optic nerve.
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Klin Monbl Augenheilkd · Dec 1990
Randomized Controlled Trial Clinical Trial[Ocular circulatory changes caused by retrobulbar anesthesia with and without added adrenaline].
In 80 patients, retrobulbar anesthesia (RBA; 5 ml of a lidocaine-bupivacaine mixture with hyaluronidase) with or without addition of adrenaline (after-mixing concentration 1:500,000) was performed preoperatively. In 2 examination series, the acute and medium-term effects of RBA on the following ocular circulatory variables were investigated: ocular pulsation volume (PVoc), systolic ciliary and retinal perfusion pressures or blood pressures, respectively (method: oculo-oscillo-dynamography). ⋯ The lowering of PVoc--which variable is determined mainly by the pulsatile choroidal blood flow--in concert with the lowered ciliary perfusion and blood pressures is indicative of a reduced ciliary blood flow during RBA. Because of the decreased retinal perfusion and blood pressures, there is also a higher risk of reduced blood supply to the retina. Only to some degree, the observed inhibitory RBA effects on ocular circulation can be explained by adrenaline, and to an even smaller degree by the only transient Pio elevation.
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Klin Monbl Augenheilkd · Apr 1990
[Tonometer sterilization. The inactivation of herpes simplex virus type 1 (HSV-1) and adenovirus (type 2) by ultraviolet radiation].
Thirty seconds of ultraviolet radiation was sufficient to completely sterilize the probes of hand applanation tonometers highly contaminated with herpes simplex virus type I and adenovirus type 2. Application of the method and clinical consequences are discussed.
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Klin Monbl Augenheilkd · Jan 1990
[Changes in the circulation of the eye caused by Vörösmarthy preoperative ocular pressure].
Prior to, directly after and 15 minutes after preoperative Vörösmarthy oculopression (30, 40, or 50 mm Hg; 15 min), 30 patients were examined by oculooscillodynamography after Ulrich. Systolic retinal and ciliary perfusion pressures were higher directly after oculopression, whereas the systolic and diastolic ocular blood pressures (intramural pressures) were lower. These changes did not depend significantly on the level of oculopression. ⋯ The hemodynamic changes observed reflect the decrease in intraocular pressure resulting from oculopression. The changes are thought to have a beneficial effect on ocular perfusion (reduction in tissue pressure, decrease in vascular resistance, increase in transmural pressure). The authors' results are consistent with the finding in animal experiments that blood flow to the retina, optic nerve, and uvea increases for a short time after oculopression (Jay et al., Acta Ophthalmol. 1986).