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Woltsche N, Posch-Pertl L, Kamper S, Haas AM, Wedrich A. ["The family history brings light into the darkness"]. Ophthalmologe 2021; 119:199-202. [PMID: 33969433 PMCID: PMC8813691 DOI: 10.1007/s00347-021-01401-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 11/24/2022]
Affiliation(s)
- N Woltsche
- Univ.-Augenklinik Graz, Medizinische Universität Graz, Auenbruggerplatz 4, 8036, Graz, Österreich.
| | - L Posch-Pertl
- Univ.-Augenklinik Graz, Medizinische Universität Graz, Auenbruggerplatz 4, 8036, Graz, Österreich
| | - S Kamper
- Institut für Humangenetik, Medizinische Universität Graz, Graz, Österreich
| | - A M Haas
- Abteilung für Augenheilkunde und Optometrie, Klinik Landstraße, Wiener Gesundheitsverbund, Wien, Österreich
| | - A Wedrich
- Univ.-Augenklinik Graz, Medizinische Universität Graz, Auenbruggerplatz 4, 8036, Graz, Österreich
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Langmann G, Gliebe W, Granitz E, Kohlhofer A, Reinisch S, Ivastinovic D, Wedrich A. [Jury prize of the Austrian National Prize 2018 : 12 years European Foundation for Quality Management (EFQM) at the University Eye Clinic Graz]. Ophthalmologe 2020; 118:818-827. [PMID: 33095296 PMCID: PMC8342361 DOI: 10.1007/s00347-020-01234-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/26/2020] [Accepted: 09/02/2020] [Indexed: 12/03/2022]
Abstract
Fragestellung Kann sich ein Non-Profit-Unternehmen wie eine Universitäts-Augenklinik in Konkurrenz zu Profit-Unternehmen erfolgreich für einen Staatspreis des Bundesministeriums für Innovation und Wirtschaftsstandort in Österreich bewerben. Material und Methode Nach erfolgreichen Committed to Excellence (C2E) Assessments 2008/2010 wurde ein 70-seitiger Unternehmensbericht streng nach der EFQM(European Foundation for Quality Management)-Logik (bestehend aus Grundkonzepten, Kriterienmatrix und RADAR-Logik) erarbeitet. Im Assessment 2018 wurde besonderes Augenmerk auf die Entwicklung der Strategie der Universitäts-Augenklinik mit ihren beiden Anteilseignern (Shareholdern), der im Besitz des Landes Steiermark befindlichen Krankenanstalten Gesellschaft (KAGes) und der dem Bundesministerium zugehörigen Medizinischen Universität Graz, gelegt und diese mithilfe der X‑Matrix (nach Hoshin-Kanri) entwickelt und dargestellt. Ergebnisse Das Gesamt-Punktescore im Recognised for Excellence(R4E)-Assessment 2018 war 500 bis 550 Punkte, was die Jury zur Vergabe eines Jurypreises des Österreichischen Nationalpreises (Fokus: partizipative Führung) veranlasste. Verbesserungspotenziale waren die Ausrichtung der Kernprozesse auf die Hauptleistungsindikatoren der Universitäts-Augenklinik, die sich aus ihrer Mission, bestehend aus Patient*innen Versorgung, Forschung, Lehre, Ausbildung und Öffentlichkeitsarbeit, ergeben. Die Entwicklung der Strategie mit den Anteilseignern hat sich gegenüber dem R4E-Assessment von 2017 von einem Potenzial zu einer Stärke entwickelt. Diskussion Schriftliche und mündliche Rückmeldungen aus einem EFQM-Assessment sind der größte Mehrwert („value-added“) aus diversen Preisbewerbungen für eine Universitäts-Augenklinik sowie allgemein für Wirtschaftsunternehmen.
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Affiliation(s)
- G Langmann
- Universitäts-Augenklinik Graz, Medizinische Universität Graz (Med Uni Graz), LKH Universitäts Klinikum Graz, Krankenanstaltengesellschaft der Steiermark (KAGes), Auenbruggerplatz 4, 8010, Graz, Österreich.
| | - W Gliebe
- msi Management Systems International AG, 9490, Vaduz, Fürstentum Liechtenstein
| | - E Granitz
- Universitäts-Augenklinik Graz, Medizinische Universität Graz (Med Uni Graz), LKH Universitäts Klinikum Graz, Krankenanstaltengesellschaft der Steiermark (KAGes), Auenbruggerplatz 4, 8010, Graz, Österreich
| | - A Kohlhofer
- Universitäts-Augenklinik Graz, Medizinische Universität Graz (Med Uni Graz), LKH Universitäts Klinikum Graz, Krankenanstaltengesellschaft der Steiermark (KAGes), Auenbruggerplatz 4, 8010, Graz, Österreich
| | - S Reinisch
- Universitäts-Augenklinik Graz, Medizinische Universität Graz (Med Uni Graz), LKH Universitäts Klinikum Graz, Krankenanstaltengesellschaft der Steiermark (KAGes), Auenbruggerplatz 4, 8010, Graz, Österreich
| | - D Ivastinovic
- Universitäts-Augenklinik Graz, Medizinische Universität Graz (Med Uni Graz), LKH Universitäts Klinikum Graz, Krankenanstaltengesellschaft der Steiermark (KAGes), Auenbruggerplatz 4, 8010, Graz, Österreich
| | - A Wedrich
- Universitäts-Augenklinik Graz, Medizinische Universität Graz (Med Uni Graz), LKH Universitäts Klinikum Graz, Krankenanstaltengesellschaft der Steiermark (KAGes), Auenbruggerplatz 4, 8010, Graz, Österreich
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Abstract
In traditional Chinese medicine (TCM) three syndromes are said to be associated with conjunctivitis sicca: Liver-Yin deficiency, Liver-Yang excess and Liver fire. The diagnosis of one of these syndromes requires the use of a specific combination of points for acupuncture. We used an extensive questionnaire of autonomic nervous system disturbances to suggest points that should be treated on a western medical basis. This prospective study was performed to answer two questions: i. Is it possible to associate the complaints of our patients with a TCM syndrome? ii. Is there any difference between the results using a TCM combination of points and those selected with our western method? Thirty seven patients with conjunctivitis sicca were enrolled in the study and asked to complete two questionnaires. In one, autonomic nervous system complaints were evaluated; in the second, the symptoms of the three relevant TCM syndromes were specifically asked for. The results of both questionnaires were compared. Our “western medical” combination of points for therapy consisted of local points, and points related to the autonomic nervous system complaints and to the five Chinese elements. In total we recorded 29 different symptoms associated with conjunctivitis sicca. According to the TCM questionnaire, 21 patients had a deficit of Liver-Yin, 5 had a Liver-Yang excess and 10 suffered from Liver fire. One patient had symptoms of Liver-Yin and Liver-Yang. Yet all patients had symptoms of more than one Chinese syndrome. Only 4 out of 37 patients seemed to belong clearly to only one TCM syndrome. So the evaluation of symptoms according to the TCM system proved to be inadequate compared with the western “autonomic” system. Points for therapy resulting from the western system were similar to the points proposed by the TCM system. We conclude that the points proposed by both methods are similar for the treatment of conjunctivitis sicca, but we believe that for western medical doctors it is easier to find a successful combination of points with the western method asking about complaints of the autonomic nervous system.
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Affiliation(s)
- Johannes Nepp
- University Eye Hospital of Vienna, Augenklinik B, Währinger-Gürtel 18–20, A-1090 Vienna, Austria
| | - A Wedrich
- University Eye Hospital of Vienna, Augenklinik B, Währinger-Gürtel 18–20, A-1090 Vienna, Austria
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Grechenig C, Cinotti E, Labeille B, Langmann G, Perrot JL, Schatz O, Tarmann L, Wedrich A, Wackernagel W, Zalaudek I, Haybaeck J, Schwab C. Examination of the melanocytes of the Nevus of Ota with in vivo reflectance confocal microscopy: 15 cases. J Eur Acad Dermatol Venereol 2018; 32:e241-e242. [PMID: 29314292 DOI: 10.1111/jdv.14783] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- C Grechenig
- Department of Ophthalmology, Medical University of Graz, Graz, Styria, Austria
| | - E Cinotti
- Department of Medical, Surgical and Neurological Science, Dermatology Section, S. Maria alle Scotte Hospital, University of Siena, Siena, Italy
| | - B Labeille
- Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - G Langmann
- Department of Ophthalmology, Medical University of Graz, Graz, Styria, Austria
| | - J L Perrot
- Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - O Schatz
- Department of Ophthalmology, Medical University of Graz, Graz, Styria, Austria
| | - L Tarmann
- Department of Ophthalmology, Medical University of Graz, Graz, Styria, Austria
| | - A Wedrich
- Department of Ophthalmology, Medical University of Graz, Graz, Styria, Austria
| | - W Wackernagel
- Department of Ophthalmology, Medical University of Graz, Graz, Styria, Austria
| | - I Zalaudek
- Department of Dermatology, Hospital Maggiore, University of Triest, Triest, Italy
| | - J Haybaeck
- Institute of Pathology, Medical University of Graz, Graz, Styria, Austria.,Department of Pathology, Medical Faculty, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - C Schwab
- Department of Ophthalmology, Medical University of Graz, Graz, Styria, Austria
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Michelitsch M, Ardjomand N, Vidic B, Wedrich A, Steinwender G. [Prevalence and age-related changes of corneal astigmatism in patients before cataract surgery]. Ophthalmologe 2017; 114:247-251. [PMID: 27406230 DOI: 10.1007/s00347-016-0323-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The aim of this study was to determine the extent and the distribution of corneal astigmatism in patients awaiting cataract surgery in a mid-European tertiary clinic centre and hence to establish the demand for methods reducing corneal astigmatism. PATIENTS AND METHODS Keratometry measurements of cataract surgery candidates assigned to a university clinic between January 2013 and October 2014 were recorded and analysed retrospectively. RESULTS A total of 6900 eyes of 3450 patients with a mean age of 72.5 ± 12.2 were analyzed. The corneal astigmatism was more than 0.5 dioptres (D) in 5193 eyes (75.3 %), >1.0 D in 2641 eyes (38.3 %), >1.5 D in 1304 eyes (18.9 %), >2.0 D in 644 eyes (9.3 %), >2.5 D in 363 eyes (5.3 %), >3.0 D in 236 eyes (3.4 %) and >3.5 D in 149 eyes (2.2 %). With increasing age a shift from with-the-rule astigmatism towards against-the-rule astigmatism was observed. CONCLUSION Of the patients admitted for routine cataract surgery at our clinic, 2641 eyes (38.3 %) had an astigmatism greater than 1.0 D. Our data could be helpful in establishing a protocol for using toric intraocular lenses and to determine the costs.
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Affiliation(s)
- M Michelitsch
- Universitäts-Augenklinik, Medizinische Universität Graz, Graz, Österreich
| | - N Ardjomand
- Universitäts-Augenklinik, Medizinische Universität Graz, Graz, Österreich
| | - B Vidic
- Universitäts-Augenklinik, Medizinische Universität Graz, Graz, Österreich
| | - A Wedrich
- Universitäts-Augenklinik, Medizinische Universität Graz, Graz, Österreich
| | - G Steinwender
- Universitäts-Augenklinik, Medizinische Universität Graz, Graz, Österreich.
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Langmann G, Wohlfart C, Maier R, Wagner J, Bauer H, Klug U, Hödl R, Wedrich A. EFQM Projekt der Univ. Augenklinik im Rahmen der C2E Rezertifizierung: Management ambulanter PatientInnen ohne Termin. Spektrum Augenheilkd 2011. [DOI: 10.1007/s00717-011-0051-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Hausberger S, Steinbrugger I, Haas A, Rabensteiner DF, Luger T, Borkenstein AF, Renner W, Wedrich A, El-Shabrawi Y, Schmut O, Weger M. Die Rolle der TNF-α -308G>A und -238G>A Genpolymorphismen als Risikofaktoren für den retinalen Arterienverschluss. Spektrum Augenheilkd 2011. [DOI: 10.1007/s00717-011-0024-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Horwath-Winter J, Rabensteiner DF, Wachswender C, Boldin I, Wedrich A, Schmut O. Befragung österreichischer AugenfachärztInnen zum trockenen Auge und zur Blepharitis. Spektrum Augenheilkd 2010. [DOI: 10.1007/s00717-010-0449-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Faschinger C, Kleinert R, Wedrich A. Beidseitiges Einschmelzen der Hornhaut nach beidseitigem simultanen Kollagen-Crosslinking bei Keratokonus und Down-Syndrom. Ophthalmologe 2010; 107:951-2, 954-5. [DOI: 10.1007/s00347-009-2127-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Langmann G, Foussek C, Gliebe W, Klug U, Schneider M, Wackernagel W, Theisl A, Lechner H, Maier R, Klein A, Wedrich A. EFQM Modell Univ.-Augenklinik Graz: Optimierung der ambulanten Prozesse im Arbeitsschwerpunkt "Augentumoren". Spektrum Augenheilkd 2009. [DOI: 10.1007/s00717-009-0372-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Langmann G, Maier R, Lechner H, Theisl A, Klug U, Foussek C, Wedrich A. Aufbau eines umfassenden Qualitätsmanagement (QM) Systems nach EFQM (European Foundation for Quality Management) an der Univ.-Augenklinik Graz – Die Pilotphase. Spektrum Augenheilkd 2009. [DOI: 10.1007/s00717-009-0371-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Langmann G, Wackernagel W, Mayer C, Schneider M, Berglöff J, Wedrich A. Die Integration von ICO bzw. EBO Richtlinien in ein Curriculum in Ophthalmo – Onkologie in Österreich. Spektrum Augenheilkd 2009. [DOI: 10.1007/s00717-009-0362-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Steinbrugger I, Haas A, Renner W, Mayer M, Wedrich A, El-Shabrawi Y, Werner C, Schmut O, Weger M. Die Bedeutung des C3 Arg102Gly Genpolymorphismus als Risikofaktor für die exsudative altersabhängige Makuladegeneration. Spektrum Augenheilkd 2009. [DOI: 10.1007/s00717-009-0355-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Schmut O, Kain R, Peterz I, Rabensteiner DF, Wachswender C, Wedrich A. Die Therapie des Keratokonus mit Riboflavin und UV-A-Licht – biochemische Aspekte. Spektrum Augenheilkd 2009. [DOI: 10.1007/s00717-009-0352-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Weiss K, Steinbrugger I, Weger M, Ardjomand N, Maier R, Wegscheider BJ, Wedrich A, El-Shabrawi Y. Intravitreal VEGF levels in uveitis patients and treatment of uveitic macular oedema with intravitreal bevacizumab. Eye (Lond) 2009; 23:1812-8. [DOI: 10.1038/eye.2008.388] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Kralinger MT, Stolba U, Velikay M, Egger S, Binder S, Wedrich A, Haas A, Parel JM, Kieselbach GF. Acetylsalicylic acid–silicone oil suspension for proliferative vitreoretinopathie: First results of Austrian clinical multicentre study. Spektrum Augenheilkd 2007. [DOI: 10.1007/s00717-007-0214-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ardjomand N, Komericki P, McAlister JC, Faschinger C, El-Shabrawi Y, Wedrich A. 100 Jahre erfolgreiche Hornhauttransplantation. Spektrum Augenheilkd 2007. [DOI: 10.1007/s00717-007-0202-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Stur M, Egger S, Haas A, Kieselbach G, Mennel S, Michl R, Roden M, Stolba U, Wedrich A. Diagnose, Therapie und Verlaufskontrolle der diabetischen Augenerkrankung. Spektrum Augeheilkd 2006. [DOI: 10.1007/bf03163807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Langmann G, Velikay M, Lechner H, Weger M, Schuhmann G, Langmann A, Faschinger C, Wedrich A. Das Grazer Modell der Facharztausbildung, Teil 1: Die Struktur. Spektrum Augenheilkd 2006. [DOI: 10.1007/bf03163501] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Langmann G, Maier R, Koch M, Mossböck G, Schmutzer M, Gruber A, Klein A, Lechner H, Wegscheider B, Faschinger C, Wedrich A. Das Grazer Modell der Facharztausbildung, Teil 2: Der erste Nachtdienst (mit Tabellen). Spektrum Augenheilkd 2006. [DOI: 10.1007/bf03163502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Mozaffarieh M, Wedrich A. Malpractice in ophthalmology: guidelines for preventing pitfalls. Med Law 2006; 25:257-65. [PMID: 16929804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
PURPOSE To provide ophthamologists with guidelines with which to prevent common errors of malpractice and suggest ways to reduce the risk of liability claims by improving the quality of care. METHODS Interview of a vitreoretinal surgeon (AW) and search of the current relevant literature. RESULTS Some of the most common errors leading to ophthalmic malpractice litigation are: 1) failed diagnosis or progression of disease, 2) missing pathology, 3) failed surgery, 4) inadequate patient care, 5) lack of communication, 6) holding back information, 7) no signed informed consent, 8) lack of correct documentation/poor records, 9) poor doctor-patient relationship, 10) no ethical responsibilities, 11) no professional liability insurance coverage, 12) highly pressured hospital set-up, 13) insufficient understanding of law. CONCLUSION The risk for malpractice litigation for ophthalmologists may be reduced by preventing common causes of malpractice and improving the quality of care.
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Affiliation(s)
- M Mozaffarieh
- Department of Opthalmology, University Hospital Basel, Basel, Switzerland
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Stur M, Egger S, Haas A, Kieselbach G, Mennel S, Michl R, Roden M, Wedrich A. Praxis-Richtlinien der Österreichischen Diabetesgesellschaft. Spektrum Augenheilkd 2004. [DOI: 10.1007/bf03163604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sator-Katzenschlager SM, Oehmke MJ, Deusch E, Dolezal S, Heinze G, Wedrich A. Effects of remifentanil and fentanyl on intraocular pressure during the maintenance and recovery of anaesthesia in patients undergoing non-ophthalmic surgery. Eur J Anaesthesiol 2004; 21:95-100. [PMID: 14977339 DOI: 10.1017/s0265021504002030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVE To compare the effects of remifentanil and fentanyl on intraocular pressure during the maintenance and recovery of anaesthesia in patients undergoing elective non-ophthalmic surgery. METHODS Thirty-two patients (ASA I-II) were randomized into two groups to receive either a continuous infusion of remifentanil (0.25-0.5 microg kg(-1) min(-1), n =16, Group R) or an intermittent bolus of fentanyl (2-5 microg kg(-1), n = 16, Group F) during the maintenance of anaesthesia. For the induction of anaesthesia, Group R received remifentanil 1 microg kg(-1) and Group F received fentanyl 2 microg kg(-1); both groups then received propofol 2 mg kg(-1) with vecuronium 0.1 mg kg(-1). Anaesthesia in both groups was maintained with a continuous infusion of propofol 4-8 mg kg(-1) h(-1). Ventilation of the lungs was controlled to a constant end-tidal PCO2 of 4.7-5.4 kPa. Blood pressure, electrocardiography, heart rate and oxygen saturation were monitored throughout anaesthesia. Intraocular pressure was determined before surgery, during the maintenance of anaesthesia, 2 min after emergence and in the recovery room using a Perkins hand-held applanation tonometer by an ophthalmologist blinded to the anaesthetic technique. RESULTS After induction of anaesthesia, a significant decrease in intraocular pressure in the remifentanil group from 13.6 +/- 2.6 to 7.1 +/- 3.1 mmHg (P < 0.001) and in the fentanyl group from 13.7 +/- 2.2 to 9.7 +/- 3.4 mmHg (P < 0.001) was observed and maintained during anaesthesia. Thirty minutes after the end of anaesthesia, intraocular pressure returned to baseline values in both groups (remifentanil: 13.9 +/- 2.8 mmHg, P = 0.28; fentanyl: 13.6 +/- 2.3 mmHg, P = 0.59). The intraocular pressure and haemodynamic variables did not differ significantly between the two groups (intraocular pressure, P = 0.7327; blood pressure, P = 0.1295; heart rate, P = 0.8601). CONCLUSIONS Remifentanil maintains intraocular pressure at an equally reduced level compared with fentanyl.
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Affiliation(s)
- S M Sator-Katzenschlager
- University of Vienna, Department of Anaesthesiology and General Intensive Care (B), Vienna, Austria
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Nepp J, Tsubota K, Goto E, Schauersberger J, Schild G, Jandrasits K, Abela C, Wedrich A. The effect of acupuncture on the temperature of the ocular surface in conjunctivitis sicca measured by non-contact thermography: preliminary results. Adv Exp Med Biol 2003; 506:723-6. [PMID: 12613984 DOI: 10.1007/978-1-4615-0717-8_102] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Johannes Nepp
- Department of Ophthalmology, University of Vienna Medical School, Vienna, Austria
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Sator-Katzenschlager S, Deusch E, Dolezal S, Michalek-Sauberer A, Grubmüller R, Heinze G, Wedrich A. Sevoflurane and propofol decrease intraocular pressure equally during non-ophthalmic surgery and recovery. Br J Anaesth 2002; 89:764-6. [PMID: 12393777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND To provide good control of intraocular pressure (IOP) during anaesthesia and surgery, we conducted a study comparing the effects on IOP during maintenance and recovery of sevoflurane vs propofol anaesthesia in 33 patients (ASA I-II) undergoing elective non- ophthalmic surgery. METHODS Anaesthesia was induced with propofol 2 mg kg(-1), fentanyl 2 micro g kg(-1) and vecuronium 0.1 mg kg(-1). Patients were allocated randomly to receive either propofol 4-8 mg kg(-1) h(-1) (group P; n=16) or 1.5-2.5 vol% sevoflurane (group S; n=17) for maintenance of anaesthesia. Fentanyl 2-4 micro g kg(-1) was added if necessary. The lungs were ventilated with 50% air in oxygen. Blood pressure, heart rate, oxygen saturation and end-tidal carbon dioxide were measured before and throughout anaesthesia and in the recovery room. IOP was determined with applanation tonometry (Perkins) by one ophthalmologist blinded to the anaesthetic technique. RESULTS There was a significant decrease in IOP after induction and during maintenance of anaesthesia in both groups. No significant differences in IOP between the two groups was found. CONCLUSION Sevoflurane maintains the IOP at an equally reduced level compared with propofol.
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Affiliation(s)
- S Sator-Katzenschlager
- Department of Anaesthesiology and General Intensive Care A, University of Vienna, Austria
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Sator-Katzenschlager SM, Oehmke MJ, Kontaratos M, Wedrich A, Heinze G, Weinstabl C. Effect of different doses of cisatracurium on intraocular pressure in sedated patients. Eur J Anaesthesiol 2002; 19:823-8. [PMID: 12442933 DOI: 10.1017/s0265021502001333] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVE The aim was to examine the course of intraocular pressure after relaxation with different doses of cisatracurium. METHODS The investigation was carried out as a prospective, randomized double-blind study in a crossover design in 30 postoperative patients with stable haemodynamic and respiratory function (ASA I and II). To exclude any disrupting factors, patients remained intubated and continuously sedated. Twenty patients received an intubation dose (2 x ED95) of cisatracurium (0.1 mg kg(-1)) compared with atracurium (0.5 mg kg(-1)). In a second series, 10 patients were given an effective dose, ED95 (0.05 mg kg(-1)), and a repeat dose (0.02 mg kg(-1)) of cisatracurium. The intraocular pressure was determined before (T0) as well as 1 (T1), 5 (T5), 10 (T10), 15 (T15), 20 (T20) and 45 (T45) min after bolus administration. RESULTS Intraocular pressure decreased after an intubation dose of either cisatracurium or atracurium, and reached a minimum after 10 min (6.7 +/- 2.2 and 7.9 +/- 2.1 mmHg, respectively). There was no significant difference between either muscle relaxant (P = 0.27). When lower doses of cisatracurium (0.05 and 0.02 mg kg(-1)) were applied, the intraocular pressure also decreased, albeit to a lesser extent and with a delayed onset (8.4 +/- 1.9 mmHg after 10 min, 9.9 +/- 3.4 mmHg after 15 min). There was no significant difference between dosages (p = 0.44). CONCLUSIONS Cisatracurium is a useful drug in patients when a decrease of intraocular pressure is wanted and where muscle relaxation is necessary and acceptable.
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Sator-Katzenschlager S, Deusch E, Dolezal S, Michalek-Sauberer A, Grubmuller R, Heinze G, Wedrich A. Sevoflurane and propofol decrease intraocular pressure equally during non-ophthalmic surgery and recovery. Br J Anaesth 2002. [DOI: 10.1093/bja/89.5.764] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Schrey S, Krepler K, Biowski R, Wedrich A. Midterm visual outcome and progression of diabetic retinopathy following cataract surgery. Midterm outcome of cataract surgery in diabetes. Ophthalmologica 2002; 216:337-40. [PMID: 12424399 DOI: 10.1159/000066179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess the influence of cataract surgery on progression of diabetic retinopathy and visual acuity. METHODS 37 patient eyes with mild to moderate diabetic retinopathy at baseline underwent phacoemulsification and intraocular posterior chamber lens implantation. They were examined 3.3 +/- (SD) 0.7 years after surgery. RESULTS 83.8% of the eyes showed a better final visual acuity, and 67.6% achieved a final visual acuity of 0.5 or better. The retinopathy remained unchanged in 83.8% and progressed in 16.2% of the eyes. No eye progressed to proliferative retinopathy. CONCLUSION Phacoemulsification and implantation of a posterior chamber intraocular lens is a safe procedure for patients with mild to moderate diabetic retinopathy.
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Affiliation(s)
- S Schrey
- Department of Ophthalmology, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
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Nepp J, Schauersberger J, Schild G, Jandrasits K, Haslinger-Akramian J, Derbolav A, Wedrich A. The clinical use of viscoelastic artificial tears and sodium chloride in dry-eye syndrome. Biomaterials 2001; 22:3305-10. [PMID: 11700802 DOI: 10.1016/s0142-9612(01)00167-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study was performed to test viscoelastic artificial tears (VAT) based on both subjective and clinical parameters in patients with keratoconjunctivitis sicca (KCS). Twenty-eight patients were evaluated in a randomized double-blind study. Sodium hyaluronate was used in two different concentrations (0.4%, 0.25%) and in combination with chondroitin sulfate. Each preparation was used for one week preceded by another weekly cycle using a sodium chloride solution. Before and after each cycle, clinical examinations were performed: tear film break-up time, Schirmer's test, lipid-layer thickness and fluorescein staining. Patients kept a record of the drop-frequency, subjective response and side effects. After the study, they were asked to give a rating of the various preparations. The severity of KCS was expressed based on a sicca score and correlated with response to viscoelastic treatment. Both the subjective and the clinical parameters revealed no statistically significant differences between the various viscoelastic agents or between the viscoelastics and the sodium chloride solutions. Severe side effects did not occur. There was a positive correlation of response to viscoelastic treatment with severe KCS (+ 0.36) but not with mild KCS (-0.07). The VAT seems to be indicated in severe cases of dry-eye syndrome. Sodium chloride solutions may be a useful short-term alternative to other tear formulations.
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Affiliation(s)
- J Nepp
- Department of Ophthalmology and Optometry, University of Vienna, Medical School, Austria.
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Dejaco-Ruhswurm I, Kiss B, Rainer G, Krepler K, Wedrich A, Dallinger S, Rieger A, Schmetterer L. Ocular blood flow in patients infected with human immunodeficiency virus. Am J Ophthalmol 2001; 132:720-6. [PMID: 11704033 DOI: 10.1016/s0002-9394(01)01095-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE Alterations of ocular blood flow may play a role in the pathophysiology of human immunodeficiency virus (HIV) related retinal microvasculopathy. In this study ocular blood flow was investigated in patients with HIV infection. DESIGN In a prospective, cross-sectional study ocular blood flow was measured in 37 eyes of consecutive HIV- infected persons and compared with the data of age-matched healthy controls. This sample size was calculated based on an alpha-error of 0.5 and a beta-error of 0.8. METHODS Macular white blood cell flow, fundus pulsation amplitude, and blood flow velocities in the retrobulbar vessels were measured with blue field entoptic technique, laser interferometry, and Doppler sonography, respectively. Immunologic and ophthalmologic status was evaluated from each patient. RESULTS Mean CD4+ cell count of the HIV-infected persons was 206.8 +/- 145.6 cells/mm(3). In five patients HIV-related retinopathy was observed. A significant reduction in leukocyte density was seen in HIV infected persons (82.2 +/- 23.4) as compared with the control group (102.0 +/- 28.4; P =.019). The resistive index in the central retinal artery was higher in HIV infected patients (0.77 +/- 0.05) as compared with the controls (0.74 +/- 0.04; P =.04). The other hemodynamic parameters were not different between groups. No correlation of flow parameters and CD4+ cell count or HIV-related retinopathy was observed. CONCLUSIONS Decreased macular leukocyte density was detected in HIV infected persons. Our study suggests that abnormal retinal hemodynamics in individuals infected with HIV may be involved in the pathogenesis of HIV-related microvasculopathy.
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Affiliation(s)
- I Dejaco-Ruhswurm
- Department of Ophthalmology, University of Vienna Medical Schoool, Vienna, Austria
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Nepp J, Grdser S, Flarrer S, Spacek A, Mudrich C, Stockenhuber D, Wedrich A. Tolosa Hunt Syndrome--intractable pain treatment with acupuncture? ACUPUNCTURE ELECTRO 2001; 25:155-63. [PMID: 11261766 DOI: 10.3727/036012900816356118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE The Tolosa Hunt Syndrome (THS) is a painful granular inflammation of the cerebral vessels followed by pain and disorders of the extrabulbar muscles. The therapy consists of corticosteroids and analgetics. There was a 70 year old woman who suffered from painful paresis of the abducent and oculomotor nerves following an infection with Borrelia Burgdorferi--but without ocular symptoms. The treatment with corticosteroids reduced the palsy but she complained of excessively painful attacks in the region of the first branch of the trigeminal nerve. Opiold analgetic therapy did not bring about any relief. Acupuncture is an irritative method with a physical effect on the nervous system: its pain-reducing effect is caused by the activation of transmitters like endorphins in thalamus and brain stem. Knowing this effect, the THS patient, after informed consent, was treated with acupuncture. To measure the extent of pain, a visual analog scale (0: no pain - 10: maximum pain) was used. Acupuncture was performed according to the empirical rules of the Traditional Chinese Medicine (TCM), during a period of 10 weeks and 12 weeks. There was a significant pain relief after acupuncture from VAS 10 to VAS 5. The effect vanished during the next four months. After a second series of 12 sessions pain reduction was reported from VAS 10 to 4. One year after the last Tolosa Hunt Syndrome - intractable pain pain strength ranged between VAS 4 - 6. Therefore acupuncture seems to be a good additional method for reduction of intractable pain.
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Affiliation(s)
- J Nepp
- Dept of Ophthalmology, University of Vienna, Austria.
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Krepler K, Ries E, Derbolav A, Nepp J, Wedrich A. Inflammation after phacoemulsification in diabetic retinopathy. Foldable acrylic versus heparin-surface-modified poly(methyl methacrylate) intraocular lenses. J Cataract Refract Surg 2001; 27:233-8. [PMID: 11226788 DOI: 10.1016/s0886-3350(00)00694-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate inflammation after cataract surgery in patients with nonproliferative diabetic retinopathy (NPDR) and compare results with 2 intraocular lenses (IOLs): a foldable hydrophobic acrylic and a heparin-surface-modified (HSM) poly(methyl methacrylate) (PMMA). SETTING Department of Ophthalmology, University of Vienna, Vienna, Austria. METHODS Patients with NPDR were randomized for implantation of an HSM PMMA IOL (811C, Pharmacia) through a 6.0 mm sclerocorneal incision (30 patients) or a foldable hydrophobic acrylic IOL (AcrySof, Alcon) through a 4.0 mm sclerocorneal incision (32 patients). Both IOLs had 6.0 mm optics. All patients were treated according to a standardized protocol. The degree of flare in the anterior chamber was measured with the Kowa 1000 laser flare-cell meter 1 day preoperatively and 1 day, 1 week, and 1 and 3 months postoperatively. RESULTS In both IOL groups, flare was highest on the first postoperative day and decreased to preoperative levels by 3 months after surgery. There was no statistically significant difference in relative flare values between the 2 groups. CONCLUSION There was no difference in postoperative inflammation in eyes with a foldable hydrophobic acrylic IOL implanted through a small incision and those with a rigid HSM PMMA IOL. Postoperative inflammation results indicate that the lenses are equally suitable for the use in patients with diabetic retinopathy.
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Affiliation(s)
- K Krepler
- Department of Ophthalmology, University of Vienna, Austria.
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Ries E, Mühlbauer B, Ruhswurm I, Krepler K, Derbolav A, Svolba G, Rieger A, Wedrich A. Evaluation of cytomegalovirus retinitis management. Outcome of four years of cytomegalovirus therapy. Ophthalmologica 2000; 212:239-43. [PMID: 9672212 DOI: 10.1159/000027300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Cytomegalovirus (CMV) is the most common pathogen of opportunistic viral infections in patients with the acquired immunodeficiency syndrome. In this study, we assessed the therapeutic outcome of our treatment regimen of CMV retinitis by analysing retrospectively 33 consecutive patients. The clinical utility of CMV cultures from blood, urine and throat specimens obtained at the time of diagnosis was additionally evaluated. Treatment started with ganciclovir (GCV) therapy. In case of relapsing retinitis, re-induction therapy was initiated, and if unsuccessful, the patient was switched to foscarnet. Patients developing resistant retinitis despite foscarnet therapy were offered a GCV-foscarnet combination therapy. Under primary GCV therapy, the median first stable interval of the whole group was 202 days (mean 238 days). Twenty-five out of 33 CMV retinitis patients (76%) responded to initial GCV therapy. Eleven of these patients showed relapsing retinitis that could be stabilised in 3 patients solely with combination therapy. Eight patients did not respond to primary GCV therapy. Three of them improved with foscarnet, but 3 patients did not respond to either treatment. In 18 (56%) out of 32 patients, CMV cultures yielded positive results. Considering our series, we may conclude that in the majority of patients primary or secondary viral resistance can be overcome by dose increase, switching to the alternative drug or a combination therapy.
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Affiliation(s)
- E Ries
- Department of Ophthalmology, University of Vienna Medical School, Austria
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Krepler K, Kruger A, Tittl M, Stur M, Wedrich A. Intravitreal injection of tissue plasminogen activator and gas in subretinal hemorrhage caused by age-related macular degeneration. Retina 2000; 20:251-6. [PMID: 10872929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
PURPOSE To assess the efficacy and safety of intravitreal injection of recombinant tissue plasminogen activator and sulfur hexafluoride gas for displacement of subretinal hemorrhages in patients with age-related macular degeneration. METHODS The authors injected 25 microg of recombinant tissue plasminogen activator and 0.5 mL sulfur hexafluoride gas intravitreally in 11 patients with subretinal hemorrhages of less than 3 weeks duration. Anatomic and functional results were evaluated. RESULTS Displacement of subretinal blood was successful within the first week after surgery in 10 of 11 patients. This was accompanied by visual improvement in eight patients. After 1 year, visual acuity was better than before surgery in five patients. Diagnosis of a choroidal neovascularization by fluorescein angiography was possible in all patients, and was treated with laser photocoagulation in five. The authors observed no adverse effects of treatment. CONCLUSION Recombinant tissue plasminogen activator and gas effectively displace subretinal blood in patients with age-related macular degeneration. Randomized studies are necessary to prove the benefit of this simple and safe method in patients with subretinal hemorrhage due to age-related macular degeneration.
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Affiliation(s)
- K Krepler
- Department of Ophthalmology, University of Vienna, Austria
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Menapace R, Wedrich A, Mühlbauer-Ries E, Strenn K, Vass C. Phacotrabeculectomy with a small-optic PMMA implant: two-year functional and morphological results. Ophthalmologica 2000; 212:322-7. [PMID: 9693289 DOI: 10.1159/000027316] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
PURPOSE Previous studies have documented good pressure control with combined cataract and filtering surgery. However, relatively high incidences of iridocapsular synechiae (ICS) and cell precipitates on the optic (CPO) were found. Corneal valve incisions preclude intraoperative chamber flattening and iris injury or prolapse. Rigid one-piece PMMA lenses with a small optic maintain a pronounced optic-iris clearance. In a prospective series, the effect of this approach was studied with special regard to the morphological results. METHODS A temporary corneal lip was created in the clear cornea beneath the scleral flap to serve as a temporary valve during cataract extraction. The lip was then widened and a rigid one-piece 5-mm PMMA lens implanted. Lip and trabeculum were finally excised en bloc at a width of 3 mm. Two years' functional and morphological results were evaluated. RESULTS Fifty-four eyes were available for evaluation. After the mean follow-up of 21 months, mean IOP had dropped from 21.6+/-3 mm Hg preoperatively to 13.9+/-2.4 mm Hg, with a mean pressure reduction of 7.7+/-3.4 mm Hg. IOP was 18 mm Hg or less in all cases. The mean medication index dropped from 2.7 to 1.0. Eyes with a preoperative IOP of 21 mm Hg or more showed a significantly greater IOP reduction than eyes with an IOP of 20 mm Hg or less (-9.2+/-3.0 vs. -6.1+/-2.9 mm Hg, p = 0.0003). Intraoperatively, the temporary valve effectively prevented chamber flattening and iris injury or prolapse. Postoperatively, 9 eyes or 6% showed hyphemas, 1 undergoing lavage. Two eyes developed a capsular hematoma, 1 requiring YAG capsulotomy. Ten eyes or 19% developed mild and 2 eyes severe but transient fibrin exudation following hypotony or iridoplasty. One eye showed grade I anterior chamber flattening, 1 developed a ciliolenticular block requiring surgery. Postoperative pressure spikes of 30-35 mm Hg were noted in 4 eyes. Three eyes showed prolonged hypotony associated with transient choroidal effusion. A pronounced optic-iris clearance was found in 87% of the eyes. Iris-optic touch developed in 1 eye with prolonged postoperative anterior chamber flattening and in 3 of the 4 eyes that had undergone intraoperative iridoplasty. Three of the latter developed extensive ICS followed by CPO. The mean optic-iris distance was 1.2 mm and the anterior chamber depth 4.2 mm. CONCLUSION Apart from effectively lowering IOP, the surgical approach used significantly reduced the incidence of ICS and CPO.
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Affiliation(s)
- R Menapace
- Department B, University Eye Hospital, Vienna, Austria
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Abstract
PURPOSE Patients with diabetic retinopathy (DRP) seldom report symptoms of ocular surface irritation, but evaluations of dryness are pathologic. This study was designed to evaluate the correlation between the severity of DRP and dry eyes. METHODS We included 144 eyes of 72 patients. Severity of retinopathy was graded according to the Early Treatment Diabetic Retinopathy Study. The examinations for dry eyes included Schirmer's test, break-up time, lipid layer thickness, fluorescein and rose bengal staining of the cornea, impression cytology, and a questionnaire. A sicca severity score was calculated using a point system of the results of these tests. Patients were divided into three groups: postpanretinal laser coagulation (PPL), postcentral laser coagulation (PCL), and those with no laser treatment (0-L). For statistics, we used the correlation coefficient to determine relationships and the unpaired Student t test for statistical difference. RESULTS The correlation (c) of keratoconjunctivitis sicca (KCS) and DRP after laser treatment was c = 0.24 and after central laser treatment was c = 0.22; the correlation without laser treatment was 0.54. The best correlation is 1 or -1, the worst was 0. The score of those patients with mild to moderate retinopathy was compared to that of patients with severe to proliferative disease. There was a significant statistical difference in the sicca severity score between both groups, (p < 0.006. Student t test). CONCLUSION KCS represents another manifestation of diabetes mellitus and its severity--measured by a many-membered score--correlates with the severity of the DRP.
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Affiliation(s)
- J Nepp
- Department of Ophthalmology, University of Vienna, Medical School Vienna, Austria.
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Findl O, Dallinger S, Rami B, Polak K, Schober E, Wedrich A, Ries E, Eichler HG, Wolzt M, Schmetterer L. Ocular haemodynamics and colour contrast sensitivity in patients with type 1 diabetes. Br J Ophthalmol 2000; 84:493-8. [PMID: 10781513 PMCID: PMC1723479 DOI: 10.1136/bjo.84.5.493] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND There is evidence that altered ocular blood flow is involved in the development and progression of diabetic retinopathy. However, the nature of these perfusion abnormalities is still a matter of controversy. Ocular haemodynamics were characterised with two recently introduced methods. METHODS The cross sectional study was performed in 59 patients with type 1 diabetes with a diabetes duration between 12 and 17 years and an age less than 32 years and a group of 25 age matched healthy controls. Scanning laser Doppler flowmetry and laser interferometric measurement of fundus pulsation amplitude were used to assess retinal and pulsatile choroidal blood flow, respectively. In addition, colour contrast sensitivity along the tritan axis was determined. RESULTS Fundus pulsation amplitude, but not retinal blood flow, increased with the progression of diabetic retinopathy. Retinal blood flow was influenced by plasma glucose levels (r = 0.32), whereas fundus pulsation amplitude was associated with HbA(1c) (r = 0.30). In addition, a negative correlation between the colour contrast sensitivity along the tritan axis and retinal blood flow was observed. CONCLUSIONS The present study indicates that pulsatile choroidal blood flow increases with the progression of diabetic retinopathy. Increased retinal blood flow appears to be related to loss of colour sensitivity in patents with type 1 diabetes.
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Affiliation(s)
- O Findl
- Department of Clinical Pharmacology, University of Vienna, Austria
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Obermayer W, Krepler K, Ries E, Radner W, Wedrich A. Ist die Lasertherapie eines diabetischen Makulaödems bei Visus 0,1 oder weniger sinnvoll? Spektrum Augeheilkd 2000. [DOI: 10.1007/bf03162854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
BACKGROUND Non-penetrating injuries of the cornea are frequent. Complications like corneal infiltrations, or corneal ulcera, may follow. MATERIAL AND METHODS This prospective study included 144 patients with non-penetrating corneal injuries. Records contained epidemiological data, field of activity, profession, cause of the injury, and stress during the trauma. RESULTS 97% of the patients were men, 78% of the injuries occurred during working hours, 41% of the patients were from metal working professions, 73% of the accidents happened with grinding machines and drilling machines. Only 6.9% of patients weared adequate glasses. The cause of trauma was deflection and working without glasses. In 32% of patients stress played a role in the cause of injuries. CONCLUSIONS Most of the corneal, non penetrating injuries happened during the working hours by deflection, and by neglecting safety glasses. With the use of safety glasses the number of corneal non-penetrating injuries could definitely be reduced.
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Affiliation(s)
- J Nepp
- Universitätsklinik für Augenheilkunde und Optometrie, Wien.
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Nepp J, Derbolav A, Haslinger-Akramian J, Mudrich C, Schauersberger J, Wedrich A. [Effect of acupuncture in keratoconjunctivitis sicca]. Klin Monbl Augenheilkd 1999; 215:228-32. [PMID: 10572884 DOI: 10.1055/s-2008-1034704] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Conjunctivitis sicca is a chronic disease of the ocular surface. The substitution of tear deficiency with artificial tears is not satisfying in many patients. In a series of patients successfully treated with acupuncture we observed very different effects on each patient. In this study we evaluate the correlation between the effect of acupuncture and the etiology of the dry eyes treated. PATIENTS AND METHODS 102 patients (87 women, 15 men) with dry-eye syndrome have been needed 10 sessions, once per week, for 30 minutes. We recorded causal factors according to the traditional chinese medicine (TCM): external and internal factors. External factors were: toxic, allergic, drug-induced, ocular surface inflammation and infection, contact lens and generally external irritations. Internal factors were disorders of hormones, immune system, psychic, and vitamin-A deficiency. Ophthalmologic observation included the slit-lamp examination, Schirmers test II, break-up time of tear film (BUT) and a drop-frequency protocol--before and 1 week after acupuncture treatment. RESULTS There was a statistically significant difference (p < 0.001) in Schirmers test, BUT and drop frequency between before and after acupuncture. There was no significant difference between internal and external factors, but the effect on external induced sicca was better. The best effect of acupuncture was found in external factors after inflammation and in patients with imbalance of the autonomic nervous system, the least effects in Sjögren Syndrome. The effect was better in younger then in patients over 50 years. CONCLUSION The study demonstrate, according DeLa Fuye that the best effect of acupuncture is seen on functionally disorders.
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Affiliation(s)
- J Nepp
- Universitätsklinik für Augenheilkunde und Optometrie, Wien.
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Schauersberger J, Amon M, Wedrich A, Nepp J, El Menyawi I, Derbolav A, Graninger W. Penetration and decay of meropenem into the human aqueous humor and vitreous. J Ocul Pharmacol Ther 1999; 15:439-45. [PMID: 10530705 DOI: 10.1089/jop.1999.15.439] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to determine the penetration of intravenously administered meropenem into the human aqueous humor and vitreous. Thirty patients about to undergo cataract surgery and fourteen patients about to undergo vitrectomy received a 2 g dose of meropenem before surgery. Specimens of aqueous humor or vitreous and blood were obtained intraoperatively and analyzed by high performance liquid chromatography (HPLC). The study was designed as a non-randomized prospective trial. Thirty min to 12 hr after administration, mean aqueous humor levels of 13.4 and 1.1 mg/l and vitreous levels between 8.94 and 1.08 mg/l were found, respectively. The peak concentrations are distinctly above the in vitro measured minimum inhibitory concentration of meropenem for 90% (MIC90) of almost all relevant gram-positive and gram-negative organisms, including Pseudomonas aeruginosa and Enterobacteriaceae. With regard to its broad spectrum, high antibacterial activity, and good penetration into ocular fluids, meropenem seems to be an alternative to currently used systemic drugs. Its usefulness in perioperative prophylaxis, as initial therapy after perforating or penetrating injuries, or in the therapy of bacterial endophthalmitis has yet to be proved.
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Ruhswurm I, Ries E, Krepler K, Derbolav A, Rieger A, Armbruster C, Wedrich A. Control of cytomegalovirus retinitis after combination antiretroviral therapy. Acta Ophthalmol Scand 1999; 77:471-3. [PMID: 10463426 DOI: 10.1034/j.1600-0420.1999.770425.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE To report on AIDS patients having combination antiretroviral therapy whose cytomegalovirus (CMV) retinitis remained inactive after discontinuation of anti-CMV maintenance therapy. METHODS We describe the course of CMV-retinitis in 3 patients with AIDS after initiation of combination antiretroviral therapy. RESULTS After cessation of anti-CMV therapy no relapse of CMV-retinitis has been observed for up to 18 months. Two of the patients developed new CMV-retinitis in the first months after initiation of combination therapy, nevertheless after further improvement of immunological parameters retinitis remained stable without anti-CMV therapy. CONCLUSION The sustained immunological effects of combination therapy are possibly sufficient enough to provide protection against CMV-retinitis.
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Affiliation(s)
- I Ruhswurm
- Department of Ophthalmology, University of Vienna, Medical School, Austria
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Derbolav A, Ries E, Krepier K, Nepp J, Wedrich A. Einfluß systemischer Faktoren auf die postoperative Visusentwicklung nach Vitrektomie und Silikonöl bei traktiver diabetischer Makulaabhebung. Spektrum Augeheilkd 1998. [DOI: 10.1007/bf03164242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Polzer I, Nepp J, Derbolav A, Wedrich A. Keim- und Resistenzspektrum der reizfreien Konjunktiva bei Patienten mit diabetischer Retinopathie. Spektrum Augeheilkd 1998. [DOI: 10.1007/bf03164246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Nepp J, Wedrich A, Akramian J, Derbolav A, Mudrich C, Ries E, Schauersberger J. Dry eye treatment with acupuncture. A prospective, randomized, double-masked study. Adv Exp Med Biol 1998; 438:1011-6. [PMID: 9635004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- J Nepp
- University Eye Clinic of Vienna, Austria
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Affiliation(s)
- J Akramian
- Department B of Ophthalmology, University of Vienna, Austria
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Sator MO, Akramian J, Joura EA, Nessmann A, Wedrich A, Gruber D, Metka M, Huber JC. Reduction of intraocular pressure in a glaucoma patient undergoing hormone replacement therapy. Maturitas 1998; 29:93-5. [PMID: 9643522 DOI: 10.1016/s0378-5122(97)00091-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To show the reducing effect of estrogens and progestins on the elevated intraocular pressure (IOP) in the case of a 56-year-old woman showing typical climacteric complaints, who was admitted to the menopause outpatient unit. She also suffered from a primary open-angle glaucoma treated with betaophtiole eye drops with intraocular pressures of 16-20 mmHg under this local therapy. METHODS IOP patterns were monitored by means of standardised daily pressure profiles four times a day before as well as 4 and 12 weeks after the beginning of hormone replacement therapy (HRT). The local glaucoma therapy remained unchanged. RESULTS During HRT, IOP levels were reduced from 16-20 mmHg before therapy to 12-15 mmHg at week 4 and to 13-15 mmHg at week 12 after the beginning of HRT. CONCLUSION The finding of a close chronological relationship between the onset of menopause and the development of a glaucoma is a potentially new indication for HRT.
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Affiliation(s)
- M O Sator
- Department of Obstetrics and Gynecology, General Hospital, University of Vienna, Austria.
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Drexler W, Findl O, Menapace R, Kruger A, Wedrich A, Rainer G, Baumgartner A, Hitzenberger CK, Fercher AF. Dual beam optical coherence tomography: signal identification for ophthalmologic diagnosis. J Biomed Opt 1998; 3:55-65. [PMID: 23015006 DOI: 10.1117/1.429862] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The dual beam version of optical coherence topography can be used for noninvasive, high-resolution imaging of the human eye fundus, enabling in vivo visualization of retinal morphology as well as accurate quantification of the thickness profiles of its layers. Interferometric fundus signals-optical A-scans-and retinal tomograms of patients with glaucoma, diabetic retinopathy, and age-related macular degeneration are compared with those of healthy, normal subjects to elucidate the origin of the signal peaks detected and to investigate and interpret the retinal microstructures contained in the cross-sectional images. © 1998 Society of Photo-Optical Instrumentation Engineers.
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