35 results on '"Martin Hermel"'
Search Results
2. Tag 1: Linse
- Author
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Martin Hermel
- Abstract
In diesem Kapitel geht es um die physiologischen und anatomischen Aspekte der Linse. Unter anderem werden die Presbyopie, die Ectopie lentis sowie Entwicklungsstorungen behandelt. Ein weiterer Abschnitt widmet sich den Linsentrubungen (Katarakt).
- Published
- 2017
3. Tag 1: Lider und Tränenwege
- Author
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Martin Hermel
- Abstract
Dieses Kapitel widmet sich den physiologischen und pathologischen Komponenten der Lider und Tranenwege. Hierzu zahlen etwa virale und bakterielle Infektionen, allergische Reaktionen und fungide Infekte. Ferner geht es um Lidfehlstellungen und -tumore.
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- 2017
4. Tag 1: Bindehaut und Hornhaut
- Author
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Martin Hermel
- Abstract
In diesem Kapitel geht es um die Physio- und Pathologie der Bindehaut und Hornhaut. Hierzu zahlen etwa die Konjunktivitis, die Keratoconjunctivitis sicca, aber auch die Keratektasen und Hornhautdegenerationen.
- Published
- 2017
5. Conjunctival and intraocular swabs for the microbiological assessment of donor corneas
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Matthias Fuest, Martin Hermel, Wolfgang Joachim Plum, Sabine Salla, and Peter Walter
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Male ,0301 basic medicine ,Pathology ,medicine.medical_specialty ,Conjunctiva ,Anterior Chamber ,Cornea ,Corneal Transplantation ,03 medical and health sciences ,Organ Culture Techniques ,0302 clinical medicine ,Ophthalmology ,Staphylococcus hominis ,medicine ,Humans ,Microbial colonization ,Candida albicans ,Aged ,Aged, 80 and over ,Bacteriological Techniques ,Bacteria ,biology ,business.industry ,General Medicine ,Middle Aged ,biology.organism_classification ,Tissue Donors ,eye diseases ,Culture Media ,Disinfection ,030104 developmental biology ,medicine.anatomical_structure ,030221 ophthalmology & optometry ,Female ,Tissue Preservation ,sense organs ,business - Abstract
Purpose In this study, we investigated the associations between conjunctival (co) and intraocular (io) swabs and their implications for the contamination rates of organ-cultured corneas. Methods A total of 4177 swabs from 1054 corneas of 527 donors were acquired from the conjunctiva, after disinfection with 5% polyvinylpyrrolidone–iodine solution, and also from the anterior chamber after corneoscleral trepanation (io). Samples were incubated at 22.5 ± 2.5°C and 32.5 ± 2.5°C in thioglycollate broth for 14 days. Donor corneas were cultured in a closed system at 31°C. Microbial differentiation was performed for positive cultures. Results A higher temperature (32.5°C) and the intraocular swab retrieving localization led to significantly higher swab positive rates (32.5°C versus 22.5°C, odds 1.65, p
- Published
- 2015
6. Role of the Endothelial Layer in the Deswelling Process of Organ-Cultured Human Corneas Before Transplantation
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Martin Hermel, Peter Walter, Anne Christine Schnitzler, Nicole Hamsley, Sabine Salla, Ansgar Flammersfeld, and Matthias Fuest
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Organ Culture Technique ,medicine.medical_specialty ,genetic structures ,Endothelium ,Cell Survival ,medicine.medical_treatment ,01 natural sciences ,010309 optics ,Corneal Transplantation ,03 medical and health sciences ,0302 clinical medicine ,Organ Culture Techniques ,Ophthalmology ,0103 physical sciences ,medicine ,Humans ,Process (anatomy) ,Cell survival ,Corneal transplantation ,Aged ,Aged, 80 and over ,Chemistry ,Corneal Edema ,Endothelium, Corneal ,Corneal Transplant ,Dextrans ,Middle Aged ,eye diseases ,Tissue Donors ,Endothelial stem cell ,Transplantation ,medicine.anatomical_structure ,Debridement ,030221 ophthalmology & optometry ,sense organs ,Tissue Preservation ,Tomography, Optical Coherence - Abstract
Before corneal transplant surgery, a deswelling process of organ-cultured corneas is required. This study compares the deswelling kinetics of corneas with an intact endothelial cell layer and disrupted or removed endothelium by measuring central corneal thickness (CCT) over time using anterior segment spectral domain optical coherence tomography.Ten donor pairs were cultured in organ culture. The right and left corneas were alternately assigned to one of 2 deswelling groups. Deswelling in the first group [endothelial group (EG)] was induced using a medium with dextran 5%. Corneas of the second group [nonendothelial group (NEG)] were deprived of their endothelial cell layer by trypsinization and were then placed in the same deswelling medium. CCT (mean ± SD) was measured by anterior segment spectral domain optical coherence tomography before deswelling (0 hours) and after 1, 2, 3, 6, 12, 24, 48, 72, and 144 hours. Deswelling kinetics was analyzed through the nonlinear platform in SAS/JMP11 Pro.Before deswelling, CCT was 1071.0 μm (±129.6 μm) and 1133.8 μm (±124.3 μm) in the EG and NEG, respectively. Minimum corneal thickness was obtained after 24 hours in the EG (531.9 ± 47.5 μm) and 6 hours in the NEG (645 ± 81.2 μm). CCT was significantly (P0.01) higher in the NEG than EG after more than 6 hours.Corneal dehydration after organ culture seems to be a multifactorial process, which not only depends on osmotic effects of the deswelling compound but also requires the presence of an intact endothelial cell layer.
- Published
- 2016
7. Changing Indications in Penetrating Keratoplasty: A Systematic Review of 34 Years of Global Reporting
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Ludwig M. Heindl, Martin Hermel, Mario Matthaei, Claus Cursiefen, Heike Sandhaeger, Albert S. Jun, and Werner Adler
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Transplantation ,medicine.medical_specialty ,Multivariate analysis ,Time Factors ,Practice patterns ,business.industry ,Treatment outcome ,MEDLINE ,03 medical and health sciences ,Tissue transplantation ,0302 clinical medicine ,Treatment Outcome ,Multivariate Analysis ,030221 ophthalmology & optometry ,medicine ,Humans ,Healthcare Disparities ,Practice Patterns, Physicians' ,Intensive care medicine ,business ,030217 neurology & neurosurgery ,Keratoplasty, Penetrating - Abstract
Penetrating keratoplasty (PK) ranks among the oldest and most common kinds of human tissue transplantation. Based on the hypothesis that reported indications for PK significantly vary between global regions and over time, the present systematic review aimed to provide a thorough overview of global PK indications as reported in peer-reviewed manuscripts.A literature search of PubMed and MEDLINE was conducted to retrieve articles published from January 1980 to May 2014. Indications for PK within 7 global regions were compared using a modified classification system for PK indications and analyzed via multivariate regression.A total of 141 publications from 37 countries were included, recording 180 865 PK cases. Postcataract surgery edema was the predominant indication in North America (28.0%) and ranked second in Europe (20.6%), Australia (21.1%), the Middle East (13.6%), Asia (15.5%), and South America (18.6%). Keratoconus was the leading indication in Europe (24.2%), Australia (33.2%), the Middle East (32.8%), Africa (32.4%), and South America (22.8%). It ranked third in North America (14.2%). Keratitis was the primary indication in Asia (32.3%). Fuchs endothelial corneal dystrophy was the fourth most common indication in North America (12.9%) and Europe (10.2%) and fifth in South America (3.8%). Multivariate analysis supported these results and revealed individual regional changes over time.Systematic analysis reveals characteristic chronological and regional differences in reported global PK indications. Leading reported indications for PK between 1980 and 2014 were keratoconus (Europe, Australia, the Middle East, Africa, and South America), pseudophakic bullous keratopathy/aphakic bullous keratopathy (North America), and keratitis (Asia).
- Published
- 2016
8. Gebauer SLc Original and Moria One-Use Plus automated microkeratomes for ultrathin Descemet's stripping automated endothelial keratoplasty preparation
- Author
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Wolfgang Joachim Plum, Peter Walter, Anne Christine Schnitzler, Sabine Salla, Matthias Fuest, Niklas Plange, David Kuerten, Stephan Rütten, and Martin Hermel
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medicine.medical_specialty ,Stripping (chemistry) ,Corneal Pachymetry ,medicine.medical_treatment ,Visual Acuity ,Cell Count ,03 medical and health sciences ,0302 clinical medicine ,Ophthalmology ,medicine ,Humans ,Corneal pachymetry ,Corneal transplantation ,Aged ,medicine.diagnostic_test ,Chemistry ,Endothelium, Corneal ,Ultrasound pachymetry ,General Medicine ,Anatomy ,Middle Aged ,Tissue Donors ,Endothelial cell density ,Lamella (surface anatomy) ,Posterior lamella ,Descemet Stripping Endothelial Keratoplasty ,030221 ophthalmology & optometry ,Microscopy, Electron, Scanning ,Tissue and Organ Harvesting ,Tissue Preservation ,030217 neurology & neurosurgery ,Tomography, Optical Coherence - Abstract
Purpose We compared the SLc Original (SLc) and One-Use Plus (OUP) microkeratomes for ultrathin Descemet's stripping automated endothelial keratoplasty (DSAEK) lamella preparation and storage, vis-a-vis accuracy, endothelial cell loss (ECL) and lamellar surface roughness (LSR). Methods Twenty-five human corneas were dissected with single-use heads of different sizes aiming for a posterior lamella (PL) thickness of 85 μm, after which they were incubated for 6 days in a 5% dextran medium. Before preparation (0 hr) and 1, 24, and 144 hr after dissection, ECL and corneal thickness (CCT) were measured by ultrasound pachymetry (USP) and optical coherence tomography (OCT). Lamellar surface roughness (LSR) was assessed by scanning electron microscopy (SEM) and evaluated by two masked observers. Results Prior to cutting, CCTs did not differ between OCT and USP measurements, with a high correlation between the two modalities (r2 = 0.8; p
- Published
- 2016
9. The role of corneal endothelial morphology in graft assessment and prediction of endothelial cell loss during organ culture of human donor corneas
- Author
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Matthias Fuest, Sabine Salla, Martin Hermel, and Peter Walter
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Cell Survival ,Cell ,Cell Count ,Organ culture ,Eye Banks ,Andrology ,03 medical and health sciences ,0302 clinical medicine ,Organ Culture Techniques ,Cornea ,Polymegethism ,medicine ,Humans ,Retrospective Studies ,Fetus ,business.industry ,Endothelium, Corneal ,General Medicine ,Organ Preservation ,Corneal Endothelial Cell Loss ,Middle Aged ,Surgery ,Endothelial stem cell ,Ophthalmology ,medicine.anatomical_structure ,Vacuolization ,Pleomorphism (cytology) ,030221 ophthalmology & optometry ,Female ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
Purpose Endothelial assessment is crucial in the release of corneas for grafting. We retrospectively analysed the role of endothelial morphology parameters in predicting endothelial cell loss during organ culture. Methods Human donor corneas were cultured in minimal essential medium with 2% fetal calf serum and antibiotics. Initial endothelial morphology was assessed microscopically using score parameters polymegethism (POL), pleomorphism (PLE), granulation (GRA), vacuolization (VAC), segmentation of cell membranes (SEG), Descemet's folds (DF), trypan blue-positive cells (TBPC) and endothelial cell-free areas (ECFA). Some corneas were primarily rejected based on endothelial assessment. Endothelial cell density (ECD) was assessed at the beginning (I-ECD) and end of culture. Corneas were then placed in dehydration medium (as above + 5% dextran 500). In a subgroup, ECD was reassessed after dehydration. Endothelial cell loss during culture (ECL@Culture) and culture+dehydration (ECL-Culture&Dehydration) were calculated. Data were given as mean ± SD and analysed using multiple linear and logistic regression. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. Result I-ECD was 2812 ± 360/mm2 (n = 2356). The decision to reject a cornea due to endothelial assessment was associated negatively with I-ECD (OR = 0.77/100 cells, CI 0.7-0.82) and positively with ECFA (OR = 2.7, CI 1.69-4.35), SEG (OR =1.3, CI 1.01-1.68) and donor age (OR = 1.26/decade, CI 1.33-1.41). ECL@Culture was 153 ± 201/mm2 (n = 1277), ECL@Culture&Dehydration was 169 ± 183/mm2 (n = 918). ECL@Culture was associated positively with donor age, I-ECD, GRA and TBPC, and negatively with PLE, and DF. ECL@Culture&Dehydration was associated positively with age, sex, initial ECD, POL, PLE, VAC and TBPC. Conclusion Morphological parameters displayed associations with the exclusion of corneas from culture and with endothelial cell loss. Appropriate parameter selection for screening purposes may help improve graft quality.
- Published
- 2015
10. A disposable system for rapid purification of autologous plasmin as an adjunct to vitrectomy — performance and safety profile
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Michael T. Trese, Martin Hermel, Michael Hartzer, and Wendelin A Dailey
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Pathology ,medicine.medical_specialty ,Plasmin ,medicine.medical_treatment ,Streptokinase ,Balanced salt solution ,Vitrectomy ,Vitreoretinal Surgery ,Vitreous Detachment ,Posterior vitreous detachment ,Chromatography, Affinity ,Cellular and Molecular Neuroscience ,chemistry.chemical_compound ,Fibrinolytic Agents ,Potassium phosphate ,Ophthalmology ,Electroretinography ,medicine ,Animals ,Humans ,Fibrinolysin ,Disposable Equipment ,medicine.diagnostic_test ,business.industry ,medicine.disease ,Combined Modality Therapy ,Sensory Systems ,Vitreous Body ,chemistry ,Toxicity ,Electrophoresis, Polyacrylamide Gel ,Rabbits ,Reagent Kits, Diagnostic ,business ,medicine.drug - Abstract
The generation of an atraumatic posterior vitreous detachment (PVD), a common goal in vitreoretinal surgery, is a challenge particularly in children and young trauma patients. Plasmin has been proposed as a surgical adjunct to enzymatically generate a PVD. This study assesses the performance and safety of a new system for rapid purification of plasmin as an adjunct to vitrectomy. Plasminogen was isolated from human plasma by affinity chromatography using a disposable rapid purification kit, and activated to plasmin with streptokinase. Activities were assessed spectrophotometrically. For safety studies, 38 rabbits received intravitreal injections of one of the following compounds in 0.1 ml respectively: 4.7, 12.7 and 24 IU plasmin, 15 mg dextran, 4,100 U streptokinase, 500 μg e-aminocaproic acid, 0.1 M potassium phosphate or balanced salt solution (BSS). Thirty min after injection, a two-port vitrectomy was performed. Rabbits were followed clinically and with bright flash electroretinography (ERG) for up to 9 months. The eyes were investigated by light and transmission electron microscopy. The specific plasmin activity obtained from blood of healthy volunteers averaged 42.3 ± 6.6 IU/ml (range 21.6 IU/ml to 54.5 IU/ml). The identity and purity of the enzyme was confirmed by several methods. Clinically, a mild to moderate inflammatory response was seen in most eyes on day 1, but had disappeared by day 7. ERG showed moderate depressions of a- and b-wave amplitudes on day 2, particularly in the potassium phosphate (a: −29.16 ± 4.56, b: −21.23 ± 6.31), 4.7 (a: −34.38 ± 6.64, b: −26.66 ± 6.06) and 24 IU (a: −38.25 ± 4.05, b: −23.38 ± 14.29) plasmin groups, but also in the BSS- (a: −11.19 ± 21.78, b: −11.41 ± 15.47) and dextran- (a: −17.86 ± 14.18, b: −6.67 ± 18.14) treated eyes. ERG changes recovered during follow-up. One rabbit each from the 12.7 and the 24 IU plasmin groups showed a minimal discoloration of one medullary ray after 9 months. Histology did not reveal morphologic signs of toxicity. The isolation system generated plasmin with a high degree of purity. A failure-mode analysis did not reveal significant risks of toxicity. A single preparation can provide a maximum dose of 10.9 IU/200 μl, the likely target clinical dose being 1.88 IU. Plasmin doses of at least 12.7 IU appear be safe when injected into rabbit eyes, followed by vitrectomy.
- Published
- 2010
11. Bitte um Einverständnis in eine Hornhautspende
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Sabine Salla, Peter Walter, Lukas Radbruch, André Steinfeld, Stephanie Stiel, and Martin Hermel
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Gynecology ,Ophthalmology ,medicine.medical_specialty ,Political science ,medicine - Abstract
Durch den hohen Bedarf und der deutlich geringeren Verfugbarkeit von Hornhauten des Auges besteht eine grose Hoffnung auf das Gelingen arztlicher Akquisegesprache mit Angehorigen zum Einverstandnis in eine Gewebespende. Neben der Steigerung des Erfolgs in der Spendergewinnung sollen Akquisegesprache schutzend fur Angehorige verlaufen und die Arbeitsbelastung des Fachpersonals gering gehalten werden. Diese Arbeit erfasst den Bedarf und Erwartungen an ein Kommunikationstraining zur Vorbereitung auf die Akquisetatigkeit. Im September und Oktober 2009 wurde unter allen Akquisearzten, die in der Hornhautbank arbeiten bzw. gearbeitet haben, eine Bedarfanalyse fur ein Kommunikationstraining vorgenommen. Auf 10-stufigen numerischen Rangskalen wurde das Ausmas der fachlichen, emotionalen und personlichen Vorbereitung, das Ausmas der Einschatzung eines Kommunikationstrainings als sinnvoll, notwendig und hilfreich sowie die durchschnittliche und hochste Belastung und Bereitschaft zur Ausubung der Akquise erfragt. Die Studienteilnehmer fuhlten sich fachlich, emotional und in ihrer personlichen Uberzeugung nur mittelmasig auf die Tatigkeit vorbereitet und erachteten ein Kommunikationstraining fur in hohem Mas sinnvoll, notwendig und hilfreich. Bei mittlerer durchschnittlicher Arbeitsbelastung mit kurzfristigen Hochbelastungsphasen bestand nur eine moderate Bereitschaft zur weiteren Ausfuhrung dieser Tatigkeit. Durch klare Hinweise auf eine nicht als ausreichend empfundene Vorbereitung auf die Akquisetatigkeit und als hoch empfundene Arbeitsbelastung wurde ein Kommunikationsseminar mit einem spezifischen Training der Akquisetelefonate entwickelt. Dieses Training entspricht bedarfsgemas sowohl den Wunschen und Erwartungen des arztlichen Personals als auch den am ehesten beeinflussbaren Variablen im Hinblick auf die Erfolgsquote bei der Spendenakquise.
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- 2010
12. New Treatment Option for Adult-onset Limbal Xanthogranuloma
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Andreas Donner, Andreas Remky, and Martin Hermel
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Adult ,Male ,Intraocular pressure ,medicine.medical_specialty ,Triamcinolone acetonide ,Juvenile xanthogranuloma ,Ultrasound biomicroscopy ,Injections, Intralesional ,Limbus Corneae ,Triamcinolone Acetonide ,Corneal Diseases ,Lesion ,Ophthalmology ,Biopsy ,medicine ,Humans ,Glucocorticoids ,medicine.diagnostic_test ,business.industry ,CD68 ,medicine.disease ,eye diseases ,Giant cell ,medicine.symptom ,business ,Xanthogranuloma, Juvenile ,Biomarkers ,Follow-Up Studies ,medicine.drug - Abstract
PURPOSE The purposes of this study are to report a case of adult-onset juvenile xanthogranuloma and suggest a new treatment option. METHODS A 35-year-old man presented with an isolated mass of the limbus. Biopsy revealed a histiocytic tumor with Touton's giant cells staining positive for CD68 and S-100 but negative for CD1a, consistent with JXG. Two intratumoral injections of triamcinolone acetonide 6 weeks apart were performed. The main outcome measure was 6-months follow up clinically and by ultrasound biomicroscopy. RESULTS The lesion regressed, and corneal thickness returned to normal 3 months after the first injection. An increase in intraocular pressure required topical treatment. No recurrence was seen throughout follow up. CONCLUSION Limbal juvenile xanthogranuloma can be successfully treated with intralesional triamcinolone acetonide, thus avoiding a lamellar keratectomy approach.
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- 2010
13. Effect of intravitreal plasmin on vitreous removal through a 25-gauge cutting system in the rabbit in vivo
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Jonathan L. Prenner, Michael Hartzer, Wendy A Dailey, Motaz Alabdulrazzak, and Martin Hermel
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Microsurgery ,medicine.medical_specialty ,genetic structures ,Plasmin ,medicine.medical_treatment ,Hyaluronoglucosaminidase ,Vitrectomy ,Posterior vitreous detachment ,Injections ,Cellular and Molecular Neuroscience ,Fibrinolytic Agents ,In vivo ,Ophthalmology ,medicine ,Animals ,Fibrinolysin ,Chemistry ,Rabbit (nuclear engineering) ,medicine.disease ,eye diseases ,Sensory Systems ,Surgery ,Vitreous Body ,Rabbits ,sense organs ,circulatory and respiratory physiology ,medicine.drug - Abstract
Intravitreal plasmin creates a posterior vitreous detachment, but may also liquefy the vitreous. This study measures the rate of vitreous removal from rabbit eyes after plasmin injection in vivo.Intravitreal injections of 150 IU hyaluronidase (n = 5), 0.5 activity units (AU, n = 6) or 0.9 AU of streptokinase-activated human plasmin (n = four groups of 6) in 0.1 ml were performed in rabbits, the fellow eyes received 0.1 ml BSS. After 30 min (hyaluronidase), 30 min, 4 h, 12 h or 24 h (0.9 AU plasmin) or 24 h (0.5 AU plasmin), 1 ml of vitreous was removed from each eye without infusion, using a 25-gauge cutter and a standardized protocol. Animals were sacrificed after surgery.Compared to fellow eyes, the average rate of vitreous removal was increased by hyaluronidase by 68.9 +/- 6.3% (p0.05) and by 0.5 AU plasmin (24 h) by 26.8 +/- 3.3% (p0.05). 0.9 AU of plasmin increased removal rates by 0.8 +/- 10% (n.s.), 15.4 +/- 6.3% (p0.05), 40.3 +/- 3.1% (p0.05), and 71.9 +/- 32.4% (p0.05) after 30 min, 4 h, 12 h and 24 h incubation respectively. The ratios of removal rates of treated/control eyes in the 0.9 AU groups showed a linear correlation with incubation time (r = 0.783, p0.0001).Intravitreal plasmin increases the rate of vitreous removal in rabbits.
- Published
- 2008
14. Sterilization and preservation influence the biophysical properties of human amnion grafts
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Martin Hermel, Jakob Becker, Frauke von Versen-Hoeynck, André Steinfeld, Uwe Hesselbarth, and Werner Rath
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Experimental control ,medicine.medical_specialty ,Cell Membrane Permeability ,Biophysics ,Transplants ,Bioengineering ,Applied Microbiology and Biotechnology ,Biophysical Phenomena ,Andrology ,Oxygen permeability ,chemistry.chemical_compound ,Pregnancy ,Tensile Strength ,Peracetic acid ,Ultimate tensile strength ,medicine ,Humans ,Amnion ,Ophthalmic surgery ,Pharmacology ,General Immunology and Microbiology ,Chemistry ,Sterilization ,Water ,General Medicine ,Sterilization (microbiology) ,Surgery ,Oxygen ,Transplantation ,medicine.anatomical_structure ,Female ,Tissue Preservation ,Algorithms ,Biotechnology - Abstract
The introduction of amniotic membrane (AM) transplantation in ophthalmic surgery holds great promise and in many clinical situations it offers an alternative to existing management options. The purpose of this study was to examine the influence of established sterilization and preservation procedures on biophysical and histological properties of AM grafts. Amnion was sterilized by peracetic acid/ethanol sterilization [PES] and preserved by air-drying (sterile laminar flow) [AD] or in glycerol [GLYC]. Unsterilized AM were preserved at -80 degrees C [-80 degrees C] and served as an experimental control. Amnion allografts were characterized by the determination of their thickness, moisture vapour permeability (MVP), oxygen permeability (OPERM), tensile strength and sulphur content. Immunostaining for tissue-specific and basement membrane-related proteins was performed. Differences in biophysical parameters were found between the unsterilized allografts and the sterilized, air-dried or glycerol-preserved allografts. [PES/AD] showed the highest MVP and OPERM, the highest tensile strength and the lowest sulphur content and thickness. [PES/GLYC] exhibited the lowest OPERM and the highest thickness compared to [-80 degrees C] and [PES/AD]. Collagen types V and VII were preserved the best in the control group. Sterilization and preservation affect biophysical properties important for the use of AM as allogenic grafts. It has to be determined if any change, as noted, has a clinical impact.
- Published
- 2008
15. Comparison of Gebauer SLc and Moria CBm Carriazo-Barraquer ALK Microkeratomes for Descemet's Stripping Automated Endothelial Keratoplasty Preparation
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Martin Hermel, Matthias Fuest, Sabine Salla, Ansgar Flammersfeld, Niklas Plange, David Kuerten, and Peter Walter
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medicine.medical_specialty ,Corneal Pachymetry ,medicine.medical_treatment ,Cell Count ,Stripping (fiber) ,Corneal Diseases ,Cellular and Molecular Neuroscience ,Organ Culture Techniques ,Optical coherence tomography ,Ophthalmology ,Microkeratome ,medicine ,Humans ,Corneal transplantation ,Aged ,Aged, 80 and over ,medicine.diagnostic_test ,Chemistry ,Endothelium, Corneal ,Ultrasound pachymetry ,Corneal Endothelial Cell Loss ,Middle Aged ,Sensory Systems ,Tissue Donors ,Surgery ,Fully automatic ,Microscopy, Electron, Scanning ,Tissue and Organ Harvesting ,Descemet Stripping Endothelial Keratoplasty ,Tomography, Optical Coherence - Abstract
We compared the hand-guided Moria Carriazo-Barraquer (CBm) microkeratome with the fully automatic SLc microkeratome for Descemet's stripping automated endothelial keratoplasty (DSAEK)-lamella preparation and storage, vis-à-vis accuracy, endothelial cell loss (ECL), and lamellar surface roughness (LSR).A total of 18 human corneas were dissected with both the 300 μm CBm multi-use (n = 9) and the 300 µm SLc (n = 9) single-use heads, after which they were incubated for 6 d in a 5% dextran medium. Before preparation (0 h) and 1, 24, and 144 h after dissection, ECL and corneal thickness (CT) were measured by ultrasound pachymetry (USP) and optical coherence tomography (OCT). LSR was assessed by scanning electron microscopy (SEM) and evaluated by three masked observers.Prior to cutting, CTs did not differ significantly between OCT or USP measurements, with a high correlation between the two modalities (r(2)= 0.94, p 0.0001). One hour after preparation the anterior lamella showed a significantly higher dissection depth with the CBm (429.4 ± 21.8 µm) than the SLc (311.7 ± 54.8 µm, p = 0.0006), with the variance of the SLc system showing a trend towards higher values (p = 0.07). Anterior and posterior lamellae swelled significantly in the subsequent culture period. Both groups showed a significant ECL 1 h after preparation (p 0.0001) with no significant difference between the systems (1 h: p = 0.44; CBm: - 9.4%, SLc: -11.7%), which stabilized over 144 h (144 h CBm: -13.9%, 144 h SLc: -10.3%). LSR did not differ significantly between both systems (p = 0.60).The SLc system agrees more with the designated cutting depth than the CBm. The dissection produced a comparable LSR and a ∼10% ECL independently of the system. Further incubation of the prepared lamellae led to a swelling, but no further ECL.
- Published
- 2015
16. Safety profile of the intravitreal streptokinase-plasmin complex as an adjunct to vitrectomy in the rabbit
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Tamer E. Youssef, H Raza, M. I. Azrak, Michael Hartzer, C. Alldredge, M. Mahgoub, George A. Williams, Martin Hermel, and Michael T. Trese
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medicine.medical_specialty ,Plasmin ,medicine.medical_treatment ,Streptokinase ,Vitrectomy ,Vitreous Detachment ,Posterior vitreous detachment ,Chromatography, Affinity ,Retina ,Injections ,Cellular and Molecular Neuroscience ,Electroretinography ,medicine ,Animals ,Humans ,business.industry ,Low dose ,Plasminogen ,Vitreoretinal surgery ,medicine.disease ,Combined Modality Therapy ,Sensory Systems ,Adjunct ,Surgery ,Vitreous Body ,Drug Combinations ,Ophthalmology ,Safety profile ,Rabbits ,business ,Photic Stimulation ,medicine.drug - Abstract
The generation of an atraumatic posterior vitreous detachment (PVD), a common goal in vitreoretinal surgery, is a challenge, particularly in children and young trauma patients. Plasmin has been proposed as an adjunct to vitrectomy to enzymatically generate a PVD. Low doses of streptokinase-activated plasmin were tested in human pilot studies. This dose-escalation study assesses the safety range of intravitreal human streptokinase-plasmin in rabbits.Plasminogen was isolated from human plasma by affinity chromatography, followed by activation with streptokinase (1:1), to generate the streptokinase-plasmin complex. Enzyme doses from 0.1-7 activity units (AU, in 0.1 ml) were injected into the mid-vitreous of 35 eyes; six control eyes were injected with balanced salt solution (BSS, 0.1 ml). Thirty minutes after injection, a two-port vitrectomy was performed. Fundus and slit lamp examinations were performed on days 1 and 7. On days 2 and 7, bright flash electroretinography was performed and compared with preoperative recordings. Some animals receiving higher doses of streptokinase-plasmin (1-7 AU) were followed clinically and with electroretinography for up to 9 months.A mild-to-moderate inflammatory response was seen in both control and plasmin-treated eyes on day 1, but had disappeared completely by day 7 in most eyes. In the 7 AU group, inflammation was stronger and more protracted. Two of three eyes from this group developed wrinkling of the medullary rays; one of them showed discoloration and traction at the medullary rays in the late follow-up. Electroretinograms (ERGs) of vitrectomized control eyes showed the following changes from preoperative values: 48 h, a-wave -11.10% [no significant (n.s.)], b-wave -14.62% (P=0.046); 7 days, a-wave +9.18% (n.s.), b wave +11.69% (n.s.). For the enzyme-treated eyes: 48 h: a-wave -20.43% (P0.001), b-wave -9.57% (p0.001); 7 days: a wave -14.21% (P0.001), b-wave +2.48% (P0.001). There was no evidence of dose-dependent ERG changes in enzyme-treated eyes at doses up to 5 AU. Groups of up to 3 AU were investigated by light and transmission electron microscopy, without evidence of toxicity.Streptokinase-plasmin doses up to 3 AU were found to be safe when injected into rabbit eyes followed by vitrectomy.
- Published
- 2005
17. Ascorbic acid reversibly inhibits proliferation of retinal pigment epithelial cells
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A. Heckelen, Martin Hermel, B. Kondring, and Norbert Schrage
- Subjects
Proliferative vitreoretinopathy ,Necrosis ,Cell growth ,Cell ,Retinal ,Biology ,medicine.disease ,Ascorbic acid ,Molecular biology ,Ophthalmology ,chemistry.chemical_compound ,medicine.anatomical_structure ,chemistry ,Biochemistry ,Cell culture ,Apoptosis ,medicine ,medicine.symptom - Abstract
Purpose: Proliferation control in adult retinal pigment epithelial (ARPE) cells is an essential factor in the clinical management of proliferative vitreoretinopathy (PVR). Factors which inhibit PVR and which are without toxic potential are therefore of interest in controlling proliferation. The aim of the present study was to gain insight into a possible function of high intraocular ascorbic acid levels as a physiological modulator of proliferation. Methods: Adult retinal pigment epithelial cells were incubated in vitro with increasing concentrations of ascorbic acid (0.5–4 mmol, pH 7.4). Cell proliferation was assayed by the bromide-deoxy-uridine (BrdU) assay. The culture medium (CM) containing ascorbic acid was replaced with normal CM and the recovery of proliferation was measured after 24 hours. In order to be able to distinguish between proliferation inhibition, apoptosis, necrosis and recovery of proliferation, we performed TUNEL assays and fluorescence analysis cell-counter (FAC) analysis. Results: Ascorbic acid significantly inhibits ARPE cell proliferation if it is present in concentrations above 2 mmol. Proliferation resumed in all ARPE cell cultures after pre-incubation with ascorbic acid, indicating that direct toxicity of ascorbic acid is a negligible factor. The time-point and extent of recovery in proliferation was dependent on the initial ascorbic acid concentration. Fluorescence-labelled cell counts on apoptosis markers (FAC) data showed some induction of apoptosis and necrosis after incubation with 4 mmol ascorbic acid. Conclusions: Ascorbic acid has a dose-dependent influence on the proliferation of vital ARPE cells. This possibly reflects the role of ascorbic acid at a physiological level within the vitreous cavity in preventing proliferative vitreoretinopathy (PVR). These findings may stimulate the development of new strategies in the clinical treatment of PVR.
- Published
- 2004
18. Chirurgie des idiopathischen Makulaforamens: Erfahrungen mit autologem Thrombozytenkonzentrat und Indocyaningrünapplikation
- Author
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Martin Hermel, Norbert Schrage, Thomas Kube, Bernd Kirchhof, Claudia Dahlke, and Gabriele Hutschenreuter
- Subjects
medicine.medical_specialty ,Visual acuity ,genetic structures ,business.industry ,Eye disease ,medicine.medical_treatment ,Vitrectomy ,medicine.disease ,eye diseases ,body regions ,Ophthalmology ,chemistry.chemical_compound ,Platelet transfusion ,chemistry ,medicine ,Maculopathy ,sense organs ,medicine.symptom ,business ,Indocyanine green ,Macular hole ,Retinopathy - Abstract
Background To report on our clinical experience with autologous platelet concentrate and indocyanine green(ICG)-assisted internal limiting membrane (ILM) peeling in macular hole surgery. Patients and methods Standard 3-port vitrectomy was performed in 107 eyes of 101 patients (m: f = 27 : 74; mean age 60 +/- 9, range 30 - 80 years) with idiopathic macular hole stages II - IV. After fluid/air exchange, autologous platelet concentrate was applied (1.9 +/- 0,1 x 10(8) thrombocytes). ILM peeling, which was preceded by ICG staining in 19 eyes, was performed in 34 patients. Results After one procedure, anatomic success (hole closure) could be achieved in 85 % (n = 68), 75 % (n = 27) and 100 % (n = 3) of the eyes with stage II, III and IV holes, respectively. The mean visual acuity improved by 1 line. The overall initial closure rate of 82 % could be further enhanced to 96 % with a second procedure. In eyes pretreated with ICG, an initial rate of hole closure in 94 % and an improvement of visual acuity by 2 lines was observed. Conclusion Autologous platelet concentrate appears to be a safe and reliable adjunct to improve the anatomical outcome of conventional macular hole surgery. Functional results can be further enhanced by ICG-assisted ILM peeling
- Published
- 2002
19. Indocyanine-green-assisted internal limiting membrane peeling in macular hole surgery – a follow-up study
- Author
-
Martin Hermel, Burkhard Schlossmacher, Bernd Kirchhof, Andreas W. A. Weinberger, Claudia Dahlke, and Norbert Schrage
- Subjects
Indocyanine Green ,medicine.medical_specialty ,Visual acuity ,genetic structures ,medicine.medical_treatment ,Eye disease ,Visual Acuity ,Vitrectomy ,Ophthalmologic Surgical Procedures ,Fundus (eye) ,Cataract ,Cellular and Molecular Neuroscience ,chemistry.chemical_compound ,Postoperative Complications ,Epiretinal Membrane/diagnosis/pathology/physiopathology/surgery ,Ophthalmology ,Humans ,Medicine ,Coloring Agents ,Macular hole ,business.industry ,Lasers ,Epiretinal Membrane ,Retinal Perforations ,medicine.disease ,eye diseases ,Sensory Systems ,Surgery ,Ophthalmoscopy ,Cataract/etiology/physiopathology ,body regions ,Retinal Perforations/pathology/physiopathology/surgery ,chemistry ,Ophthalmoscopy/methods ,Maculopathy ,sense organs ,medicine.symptom ,business ,Indocyanine green ,Follow-Up Studies ,Retinopathy - Abstract
Background. Macular hole surgery including vitrectomy and peeling of epiretinal membranes and the internal limiting membrane (ILM) has become a standard procedure in retinal surgery. Poor visualization of the ILM is an obstacle for successful surgery. Recently, indocyanine green (ICG) has been reported to be a helpful intraocular substance in identifying these membranes. Patients and methods. Eighteen eyes with macular holes stages 2–4 were included. Intraoperatively, the ILM was stained with three drops of 1:9-diluted ICG. After 1 min incubation, the vitreous cavity was rinsed with Ringer's lactate solution, and the ILM was peeled. Autologous thrombocytes were applied to the macular hole and the eye was endotamponaded with 20% SF-6 gas. Preoperatively, 6 weeks postoperatively, and in 3-month intervals thereafter, visual acuity, fundus photographs, scanning laser ophthalmoscope imaging, and Humphrey 24–2 static perimetry was performed. Results. Intraoperatively, the ILM could be nicely visualized by ICG, which allowed easier and less traumatic peeling. At 6 weeks follow-up, visual acuity had improved in 14 of 18 patients, and the macular hole was closed 6 weeks after surgery. Scanning laser imaging revealed a strong signal. During prolonged follow-up, visual acuity declined due to cataract formation. Conclusion. ICG as an intraocular tool for staining of the ILM is helpful in macular hole surgery. We observed no negative effects on retinal function, but patients should be followed.
- Published
- 2002
20. Reply to the letter by C. Haritoglou et al.:Indocyanine-green-assisted internal limiting membrane peeling in macular surgery—a follow-up study
- Author
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Martin Hermel, Jakob Becker, Burkhard Schlossmacher, Norbert Schrage, Bernd Kirchhof, Andreas W. A. Weinberger, and Claudia Dahlke
- Subjects
medicine.medical_specialty ,business.industry ,Internal limiting membrane ,Follow up studies ,Macular surgery ,Sensory Systems ,Surgery ,Cellular and Molecular Neuroscience ,Ophthalmology ,chemistry.chemical_compound ,chemistry ,medicine ,business ,Indocyanine green - Published
- 2003
21. Serum-free cornea culture with hydroxyethyl starch as a deswelling agent
- Author
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Peter Walter, L Bauer, Sabine Salla, Nicole Hamsley, Martin Hermel, and P.A. Steinfeld
- Subjects
General Medicine ,Hydroxyethyl starch ,Organ culture ,Staining ,Endothelial stem cell ,Transplantation ,Andrology ,Ophthalmology ,chemistry.chemical_compound ,medicine.anatomical_structure ,Dextran ,chemistry ,Annexin ,Cornea ,Immunology ,medicine ,medicine.drug - Abstract
Purpose Varying states of hydration during organ culture and subsequent dehydration of corneas with Dextran prior to transplantation cause endothelial cell damage. Hydroxyethyl starch 130 (HES) has been suggested as a permanent dehydrating agent in serum-free cornea culture. This study compares corneas stored in a synthetic medium containing HES with corneas stored and dehydrated under standard conditions. Methods Twenty pairs of human donor corneas were cultivated in MEM with antibiotics at 31°C for 16 days (groups A and B) or 28 days (groups C and D, n=10). Media contained 2%FCS in group A and C, and 7.5 % HES 130 plus 1mU/l human insulin in groups B and D. On day 15 or 27, corneas from group A and C were placed in dehydration medium (MEM + antibiotics + 2%FCS + 5% dextran 500). Endothelial cell density and morphology were investigated at the beginning and end of culture. Corneal thickness was assessed by pachymetry. Keratocyte viability was assessed by TUNEL and Annexin V staining. Results Endothelial cell loss was higher in group A (278.5+/-184.2) vs. B (156.6+/-154; p=0.0293), and in group C (490+/-156.3) vs. D (301.8+/-189.6; p=0.0195), with similar morphology. Final corneal thickness was 882+119µm and 914+119µm in groups A and B, and 889+99µm and 957+87µm in groups C and D, resp. (n.s.). No significant differences were found in TUNEL and Annexin staining. Conclusion The synthetic medium supplemented with HES 130 and insulin improves endothelial cell survival during cornea culture, without adverse effects ion keratocyte viability. It is thus feasible to store donor corneas in fully synthetic medium without the chemically undefined FCS and without the need for dehydration, resulting in increased safety and faster transplant availability.
- Published
- 2012
22. Inhibitory effect of ascorbic acid on human retinal pigment epithelial cell proliferation compared to cytostatic drugs - influence of histamine
- Author
-
A. Heckelen, Norbert Schrage, Martin Hermel, and Bernd Kirchhof
- Subjects
Pharmacology ,Allergy ,Cell growth ,Immunology ,Ascorbic Acid ,medicine.disease ,Retinal pigment epithelial cell ,Ascorbic acid ,Antioxidants ,Epithelium ,Cell Line ,chemistry.chemical_compound ,medicine.anatomical_structure ,chemistry ,medicine ,Cytostatic drugs ,Humans ,Pigment Epithelium of Eye ,Inhibitory effect ,Cell Division ,Histamine - Published
- 2001
23. Eignung von Verstorbenen auf Palliativstationen als Hornhautspender
- Author
-
S Stiel, Martin Hermel, and L Radbruch
- Published
- 2010
24. Efficacy of plasmin, microplasmin, and streptokinase-plasmin complex for the in vitro degradation of fibronectin and laminin- implications for vitreoretinal surgery
- Author
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Martin Hermel, Wendelin A Dailey, and Michael Hartzer
- Subjects
Plasmin ,Streptokinase ,Proteolysis ,medicine.medical_treatment ,Tissue plasminogen activator ,Retina ,Cellular and Molecular Neuroscience ,Laminin ,Vitrectomy ,Fibrinolysis ,medicine ,Humans ,Fibrinolysin ,Urokinase ,biology ,medicine.diagnostic_test ,Chemistry ,Plasminogen ,Sensory Systems ,Peptide Fragments ,Fibronectins ,Fibronectin ,Ophthalmology ,Drug Combinations ,Biochemistry ,biology.protein ,Electrophoresis, Polyacrylamide Gel ,circulatory and respiratory physiology ,medicine.drug - Abstract
Plasmin enzyme generates vitreoretinal separation by degradation of laminin and fibronectin in the vitreoretinal interface. It can be activated from plasminogen by urokinase, tissue plasminogen activator, or by formation of a 1:1 complex with streptokinase. The latter is then converted into a streptokinase-plasmin-complex (SK-P), which displays fibrinolytic activity and can generate free plasmin by proteolysis of plasminogen. We compared the efficacy of SK-P, SK-P activated plasmin, urokinase activated plasmin (UK-P), and microplasmin, a truncated form of plasmin, in cleaving laminin and fibronectin.Streptokinase (SK) was added to human plasminogen in molar ratios between 1:100 and 2:1, generating SK-P at ratios1:1, and mixtures of SK-P and free plasmin (SK-P/plasmin) at lower ratios. SK-PL, SK-P/plasmin, UK-P, and microplasmin were added to laminin and fibronectin, incubated at 37 degrees C for 30 min-22 hr and processed for SDS-PAGE.Proteolysis using SK-activated plasminogen increased when the SK/plasminogen ratio was decreased, generating increasing amounts of free plasmin. Microplasmin and urokinase-activated plasmin displayed similar proteolysis of both laminin and fibronectin as SK/plasminogen at ratios of 1:10 or lower.The mode of plasminogen activation influences the efficacy of proteolysis for laminin and fibronectin and should be considered when plasmin is used in vitreoretinal surgery.
- Published
- 2010
25. Efficacy of plasmin enzymes and chondroitinase ABC in creating posterior vitreous separation in the pig: a masked, placebo-controlled in vivo study
- Author
-
Martin Hermel and Norbert Schrage
- Subjects
Pathology ,medicine.medical_specialty ,genetic structures ,Plasmin ,Swine ,medicine.medical_treatment ,Vitrectomy ,Chondroitin ABC Lyase ,Placebo ,Vitreous Detachment ,Posterior vitreous detachment ,Basement Membrane ,Retina ,Injections ,Cellular and Molecular Neuroscience ,In vivo ,medicine ,Animals ,Fibrinolysin ,Vitreous separation ,chemistry.chemical_classification ,business.industry ,medicine.disease ,eye diseases ,Sensory Systems ,Vitreous Body ,Ophthalmology ,Enzyme ,medicine.anatomical_structure ,chemistry ,Microscopy, Electron, Scanning ,Female ,sense organs ,business ,medicine.drug - Abstract
Induction of posterior vitreous detachment (PVD) during vitrectomy helps to prevent proliferative complications, but can be traumatic to the retina, particularly in young patients. Adjunct enzymes have been proposed to facilitate PVD. We investigated the efficacy of enzymes in creating PVD as an adjunct to vitrectomy in the pig. Five groups of 8 pigs received a masked intravitreal injection of chondroitinase (1 IU), human (0.4 or 1.3 activity units [AU]) or porcine plasmin (0.18 AU or 0.47 AU) into one eye, and osmolarity adjusted control into the other. After incubation, a core vitrectomy was performed on each eye at low suction, without vitreous peeling. The occurrence of spontaneous PVD and its extent were graded. Eyes were investigated using scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Vitreous remnants on the retina were quantified in SEM. Data were analyzed using McNemar’s test for paired observations and Wilcoxon paired signed rank test. Spontaneous PVD occurred more frequently in human plasmin-treated eyes (p
- Published
- 2006
26. Longer-term outcomes of transconjunctival sutureless 25-gauge vitrectomy
- Author
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Jonathan L. Prenner, Martin Hermel, Michael S. Ibarra, and Tarek S Hassan
- Subjects
Male ,Intraocular pressure ,medicine.medical_specialty ,Visual acuity ,genetic structures ,medicine.medical_treatment ,Visual Acuity ,Vitrectomy ,Refractory ,Retinal Diseases ,Ophthalmology ,medicine ,Humans ,Intraoperative Complications ,Macular hole ,25 gauge vitrectomy ,Intraocular Pressure ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Suture Techniques ,Middle Aged ,medicine.disease ,eye diseases ,Surgery ,Vitreous Hemorrhage ,Treatment Outcome ,Vitreous hemorrhage ,Female ,sense organs ,Epiretinal membrane ,medicine.symptom ,business ,Conjunctiva ,Follow-Up Studies - Abstract
To report longer-term outcomes in eyes undergoing 25-gauge transconjunctival sutureless vitrectomy.Retrospective, noncomparative, case series.Chart review of the initial 45 consecutive patients (45 eyes) that underwent TSV by one surgeon (T.S.H.) for idiopathic epiretinal membrane (n = 15), refractory diabetic macular edema (n = 11), idiopathic macular hole (n = 10), and nonclearing vitreous hemorrhage (n = 9). All patients had at least 6-month follow-up. Main outcome measures included visual acuity (VA), intraocular pressure, intraoperative complications, and postoperative complications.Mean follow-up was 13 months (range 6 to 25 months). Mean overall preoperative VA vs last postoperative VA was 20/229 and 20/65, respectively (P.0001). Statistically significant VA improvement was seen for each patient subgroup. Mean preoperative intraocular pressure was 16.9 mm Hg (range 10-26 mm Hg). On postoperative day 1, week 1, and week 4, median intraocular pressure was 14.6 mm Hg (range 8-17 mm Hg), 17.6 mm Hg (range 8-38 mm Hg), and 17.7 mm Hg (range 9-33 mm Hg), respectively. No intraoperative complications occurred. Postoperative complications were 1 inferior retinal detachment (2.2%) 4 weeks after macular hole repair, 1 macular hole (2.2%) 6 months after epiretinal membrane peel, and 23 worsening cataracts in 29 phakic eyes (79.3%).Less surgically complex vitreoretinal pathology may be successfully repaired with TSV. After a mean follow-up of more than 1 year, minimal complications were seen, and none was specifically related to the sutureless nature of the procedure.
- Published
- 2004
27. Internal limiting membrane staining with various concentrations of indocyanine green dye
- Author
-
Martin Hermel, Bernd Kirchhof, Andreas W. A. Weinberger, Burkhard Schlossmacher, Norbert Schrage, and Claudia Dahlke
- Subjects
medicine.medical_specialty ,Retinal Perforations/surgery ,Internal limiting membrane ,Coloring Agents/administration & dosage ,Indocyanine Green/administration & dosage ,Surgery ,Staining ,Ophthalmology ,chemistry.chemical_compound ,chemistry ,Fluorocarbons/administration & dosage ,medicine ,Biophysics ,Humans ,Basement Membrane/drug effects ,Indocyanine green ,Staining and Labeling/methods - Published
- 2004
28. [Macular hole surgery: experience with autologous platelet concentrate and indocyanine green-assisted internal limiting membrane peeling]
- Author
-
Thomas, Kube, Martin, Hermel, Claudia, Dahlke, Gabriele, Hutschenreuter, Norbert, Schrage, and Bernd, Kirchhof
- Subjects
Adult ,Aged, 80 and over ,Blood Platelets ,Indocyanine Green ,Male ,Epiretinal Membrane ,Platelet Transfusion ,Middle Aged ,Retinal Perforations ,Blood Transfusion, Autologous ,Treatment Outcome ,Vitrectomy ,Humans ,Female ,Macula Lutea ,Ophthalmic Solutions ,Aged - Abstract
To report on our clinical experience with autologous platelet concentrate and indocyanine green(ICG)-assisted internal limiting membrane (ILM) peeling in macular hole surgery.Standard 3-port vitrectomy was performed in 107 eyes of 101 patients (m: f = 27 : 74; mean age 60 +/- 9, range 30 - 80 years) with idiopathic macular hole stages II - IV. After fluid/air exchange, autologous platelet concentrate was applied (1.9 +/- 0,1 x 10(8) thrombocytes). ILM peeling, which was preceded by ICG staining in 19 eyes, was performed in 34 patients.After one procedure, anatomic success (hole closure) could be achieved in 85 % (n = 68), 75 % (n = 27) and 100 % (n = 3) of the eyes with stage II, III and IV holes, respectively. The mean visual acuity improved by 1 line. The overall initial closure rate of 82 % could be further enhanced to 96 % with a second procedure. In eyes pretreated with ICG, an initial rate of hole closure in 94 % and an improvement of visual acuity by 2 lines was observed.Autologous platelet concentrate appears to be a safe and reliable adjunct to improve the anatomical outcome of conventional macular hole surgery. Functional results can be further enhanced by ICG-assisted ILM peeling
- Published
- 2003
29. Severe ulcerative keratitis in ocular cowpox infection
- Author
-
Martin Hermel, Niklas Plange, Andreas Kurth, and Hendrik Schwarzer
- Subjects
medicine.medical_specialty ,business.industry ,Cowpox ,medicine.disease ,Virology ,Dermatology ,Sensory Systems ,Keratitis ,Cellular and Molecular Neuroscience ,Ophthalmology ,chemistry.chemical_compound ,chemistry ,Ulcerative keratitis ,medicine ,Limbal stem cell ,business ,Cidofovir - Published
- 2012
30. Cornea donation from patients deceased at a palliative care unit
- Author
-
Lukas Radbruch, Martin Hermel, and Stephanie Stiel
- Subjects
medicine.medical_specialty ,Tissue and Organ Procurement ,Palliative care ,medicine.medical_treatment ,Decision Making ,MEDLINE ,Unit (housing) ,Cornea ,Corneal Transplantation ,Professional-Family Relations ,Germany ,medicine ,Humans ,Family ,Intensive care medicine ,Third-Party Consent ,Corneal transplantation ,business.industry ,Palliative Care ,General Medicine ,Tissue Donors ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Donation ,business - Published
- 2011
31. Recurrent suprachoroidal dislocation of an anterior chamber intraocular lens
- Author
-
Andreas Remky, Martin Hermel, and Anke Weber
- Subjects
Male ,medicine.medical_specialty ,genetic structures ,Anterior Chamber ,medicine.medical_treatment ,Intraocular lens ,Vitrectomy ,Foreign-Body Migration ,Lens Implantation, Intraocular ,Suprachoroidal space ,Recurrence ,Ophthalmology ,Humans ,Medicine ,Ultrasonography ,Aged, 80 and over ,Lenses, Intraocular ,business.industry ,Choroid Diseases ,equipment and supplies ,Trabeculotomy ,eye diseases ,Sensory Systems ,Surgery ,Posterior chamber intraocular lens ,medicine.anatomical_structure ,Choroidal detachment ,sense organs ,Choroid ,business - Abstract
We present a patient with a history of posterior chamber intraocular lens (PC IOL) implantation and trabeculotomy 9 years previously who recently had IOL exchange for an angle-based anterior chamber IOL. Twenty-four hours after the exchange, he was referred to us with hypotony and "loss" of the IOL. Ultrasound revealed a rigid choroidal detachment and echoes suggestive of a suprachoroidally dislocated IOL. Anterior vitrectomy and resuturing of the incision were performed. Subsequently, the IOL repeatedly migrated in and out of the suprachoroidal space, allowing atraumatic removal. Angle-based IOL implementation should be avoided in eyes with a history of trabeculotomy or cyclodialysis.
- Published
- 2008
32. Comment on papers by Ashikari, Ozeki, Tomida, Sakurai, Tamai, Ogura: retention of dye after indocyanine-green assisted internal limiting membrane peeling, and by Ciardella, Schiff, Barile, Vidne, Sparrow, Langton, Chang: persistent indocyanine green fluorescence after vitrectomy for macular hole
- Author
-
Norbert Schrage, Martin Hermel, Bernd Kirchhof, Andreas W. A. Weinberger, Claudia Dahlke, and Burkhard Schlossmacher
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Internal limiting membrane ,Vitrectomy ,medicine.disease ,Ophthalmology ,chemistry.chemical_compound ,Optics ,chemistry ,medicine ,business ,Indocyanine green ,Macular hole ,Indocyanine green fluorescence - Published
- 2004
33. Juvenile Xanthogranuloma of the Corneal Limbus. Report of 2 Cases and Review of the Literature
- Author
-
Martin Hermel, Andreas Remky, and Andreas Donner
- Subjects
Corneal limbus ,Ophthalmology ,medicine.medical_specialty ,medicine.anatomical_structure ,business.industry ,Juvenile xanthogranuloma ,medicine ,business ,medicine.disease - Published
- 2010
34. Efficacy of plasmin enzymes and chondroitinase ABC in creating posterior vitreous separation in the pig: a masked, placebo-controlled in vivo study.
- Author
-
Martin Hermel and Norbert Schrage
- Subjects
- *
PLASMIN , *CHONDROITIN , *CARBOHYDRATES , *SERINE proteinases - Abstract
AbstractBackground??Induction of posterior vitreous detachment (PVD) during vitrectomy helps to prevent proliferative complications, but can be traumatic to the retina, particularly in young patients. Adjunct enzymes have been proposed to facilitate PVD. We investigated the efficacy of enzymes in creating PVD as an adjunct to vitrectomy in the pig.Methods??Five groups of 8 pigs received a masked intravitreal injection of chondroitinase (1?IU), human (0.4 or 1.3 activity units [AU]) or porcine plasmin (0.18?AU or 0.47?AU) into one eye, and osmolarity adjusted control into the other. After incubation, a core vitrectomy was performed on each eye at low suction, without vitreous peeling. The occurrence of spontaneous PVD and its extent were graded. Eyes were investigated using scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Vitreous remnants on the retina were quantified in SEM. Data were analyzed using McNemar?s test for paired observations and Wilcoxon paired signed rank test.Results??Spontaneous PVD occurred more frequently in human plasmin-treated eyes (p<0.025) and all plasmin eyes (p<0.025) than in placebo controls. The extent of PVD appeared larger in human plasmin (p<0.025) and all plasmin-treated eyes (p<0.025). In plasmin-treated eyes, SEM morphometry showed a significant reduction in the vitreous-covered retina areas. Chondroitinase failed to produce an effect.Conclusions??Plasmin may prove a useful adjunct to conventional vitrectomy. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
35. Reply to the letter by C. Haritoglou et al.:Indocyanine-green-assisted internal limiting membrane peeling in macular surgery?a follow-up study.
- Author
-
Andreas W. A. Weinberger, Burkhard Schlossmacher, Claudia Dahlke, Martin Hermel, Jakob Becker, Bernd Kirchhof, and Norbert F. Schrage
- Published
- 2003
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