Peter Vangsted

Results of repeated tuboplasties

The cumulative conception rate of 31 infertile women undergoing a second tuboplasty using microsurgery was compared with that of 71 women undergoing a single microsurgical tuboplasty. The follow-up period ranged from 1 to 6½ years. Five (16%) of the patients in the repeat tuboplasty group conceived; there were 3 (10%) live births, 1 (3%) tubal pregnancy, and 1 (3%) spontaneous abortion. In the single tuboplasty group 42 (59%) of the patients conceived, with the result of 31 (44%) live births, 6 (9%) tubal pregnancies, and 5 (7%) spontaneous abortions. Reocclusion of both tubes occurred in 16% and 7% of the patients in the two groups, respectively. It is concluded that the poor results of repeated tuboplasties mainly are due to mucosal lesions, which in the majority of cases seem to be irreversible.

Long-term natural and modified course of surgically induced astigmatism after extracapsular cataract extraction

Abstract A prospective study was carried out to investigate the long‐term course of surgically induced astigmatism after extracapsular cataract extraction. Sixty‐one eyes were followed for 36 months. In 27 eyes with postoperative astigmatism > 4D widi‐the‐rule, one or two sutures were cut in the steeper meridian after 3 months. In another group of 34 eyes with only minor or no postoperative astigmatism with‐the‐rule, no suture was cut. We found that 1) postoperative astigmatism was significantly increased in all eyes after 1 week and 3 months, but decreased in time approaching preoperative values after 3 years, 2) surgically induced astigmatism was with‐the‐rule at 1 week and 3 months but turned against‐the‐rule in rime in both groups. Astigmatism decay rate was significantly steeper in eyes with suture cutting, 3) the keratometric axis was exclusively with‐the‐rule after 1 week, but turned against‐the‐rule in both groups, approaching the preoperative distribution of axis after 3 years. We concluded that surgically induced astigmatism is a dynamic feature showing changes in size and axis even in the period 1–3 years postoperatively. Suture cutting seems to intensify the decrease in the induced astigmatism and accelerate the shift in astigmatic axis, turning astigmatism against‐the‐rule compared to eyes with intact sutures.

Conjunctival cell glycoprotein pattern of healthy persons and of patients with primary Sjögren's syndrome--light microscopical investigation using lectin probes.

Formalin-fixed biopsies of conjunctival tissue from the lower fornix of 10 healthy persons and of 10 patients with primary Sjögrens syndrome (primary SS) were examined by light microscopy. Deparaffinized, rehydrated sections of 5 microns were incubated overnight, each with one of 15 different biotinylated lectins. Bound lectins were visualized using avidin-HRP-substrate complexes. Five lectins did not bind to conjunctival cells, and further six lectins bound in an unspecific manner to conjunctival cells of both healthy persons and of primary SS patients. Jacalin lectin bound selectively to goblet cells of all specimens. Peanut agglutinin (PNA) and wheat germ agglutinin (WGA) bound significantly stronger to basal conjunctival epithelial cells of patients with primary SS. This binding pattern may be of diagnostic value.

Light microscopical and scanning electron microscopical examinations of deposits on disposable constant wear lenses.

Abstract. An inexpensive, disposable soft contact lens for extended wear (DanaLens) has been developed. The lens is polymerized moulded in the wet state from hydroxyethyl methylacrylate and hydroxyethyl acrylate. Twenty‐two pairs of the lens have in an open study been worn permanently from 1 to 43 days. light microscopical and scanning electron microscopical examinations of the used lenses showed: superficial deposits on the front surfaces of the lenses of a mucous‐like, easily removable material. Neither bacteria nor fungi were demonstrated.

Alterations to eye structures in hairless mice by long-term ultraviolet irradiation. A histopathological study.

Abstract. The eyes of 75 Hr/Hr hairless mice were irradiated with one minimal erythema dose/day of UV light for a period of 12 months, and then observed for a further 6 months. The mice were diviede into 3 subgroups, – one without protectans, – one protected by the sun protection lotion Sea and Ski, factor 5, – and one by Piz Buin, Factor 6. The eyes of 75 non‐irradiated mice of the same type, subdivided into 3 comparable groups, served as controls. Animals which died during the test period were examined immediately. After the 18 months period, eyes and adnexa of the surviving animals were examined macroscopically and by light microscopy. The lifespan of unprotected, irradiated mice was significantly shorter than the protected groups. The eyelids of irradiated mice presented hyperplasia, actinic keratosis and invasive carcinoma, the latter in 20%. No melanotic tumours were recorded. Since the sun lotion protected animals had a significantly longer lifespan they showed a higher number of palpebral tumours. No irradiation lesions could be demonstrated in the lens, the vitreous or the retina.

Tubal surgery and subsequent artificial insemination by donor

Abstract. The conception rate of 32 infertile women undergoing tubal microsurgery and subsequent artificial insemination by donor (AID) was compared with that of 71 women undergoing tubal microsurgery alone. The follow‐up period ranged from 1 to 6 12; years. Nine (28%) of the patients in the AID group conceived, resulting in 8 (89%) live births and 1 (11%) spontaneous abortion. In the normal semen group 42 (59%) of the patients conceived, resulting in 31 (74%) live births, 6 (14%) tubal pregnancies and 5 (12%) spontaneous abortions. In the AID group the following term pregnancy rates were achieved: 40% after bilateral lysis of periadnexal adhesions, 25% after fimbriolysis and 14% after salpingostomy. The corresponding figures in the group with normal semen analysis was 67%, 64% and 29%, respectively. It is concluded that patients who in addition to tubal microsurgery have been treated with AID for 9–12 menstrual cycles seem to have about a 50% poorer chance of achieving a term pregnancy compared with patients whose husbands have normal semen quality.

GALACTOSAEMIA WITH CATARACT AND PERSISTENT HYALOID ARTERY: A Clinicopathological Case Report

A boy with galactosaemia and bilateral cataract developed large intraocular haemorrhages in the left eye which was enucleated.

Late Intraocular Pressure and Complications after Extracapsular Cataract Extraction Using Two Different Viscoelastic Agents: Healon® vs Methylcellulose 2%

OBJECTIVE: Evaluation of late intraocular pressure and late complications after planned extracapsular cataract extraction (ECCE) with posterior chamber lens implantation (PCL) using two different viscoelastic agents. STUDY DESIGN: A prospective open non-randomized study of the intraocular pressure (IOP) and late complications 3, 12 and 36 months after surgery. SETTING: Department of Ophthalmology, Gentofte Hospital, University of Copenhagen, Denmark. PATIENTS: 189 consecutive in-patients (eyes) were operated on using either Healon® or Methylcellulose 2% as viscoelastic agent during surgery. MAIN OUTCOME MEASURES: Late intraocular pressure, late postoperative complications. RESULTS: Compared to the preoperative IOP both the Healon® and the Methylcellulose group showed a significant decrease in IOP after 36 months, P > 0.05. No significant difference in IOP was found between the two groups at corresponding time intervals, P > 0.05. Late complications including persistent iritis, consistently raised IOP, posterior capsular opacity, requirement for Nd:YAG laser capsulotomy, cystoid macular oedema and aphakic retinal detachment were equal in the two groups, P > 0.05. CONCLUSIONS: By extending the observation period up to 36 months, the study provides evidence that eyes operated on with Healon® or Methylcellulose have equal postoperative complication rate. The reduction in IOP seen 12 months postoperatively continues at least up to 36 months. Late complications occurred equally in the two groups.

Surgically Induced Astigmatism Three Years after Extracapsular Cataract Extraction with Posterior Chamber Lens Implantation: Corneoscleral vs Scleral Tunnel Incisions and 10-0 Nylon Interrupted vs 10-0 Nylon Shoelace Suture Closure

Abstract OBJECTIVE: Long-term evaluation of surgically induced astigmatism after ECCE with posterior lens implantation using different incision and closure techniques. STUDY DESIGN: A prospective open non-randomized study of keratometric astigmatism 3, 12 and 36 months after surgery. PATIENTS: 112 in-patients were followed for 36 months. In the incision study, 61 patients had either a corneoscleral or a Scleral incision with a 10-0 interrupted Nylon closure. In the closure study, 51 patients had a corneoscleral incision combined with either a 10-0 interrupted Nylon or a 10-0 Shoelace Nylon closure. MAIN OUTCOME MEASURES: Keratometric astigmatism, unaided and best corrected visual acuity. RESULTS: In the incision study, corneoscleral incisions had significantly higher astigmatism than scleral incisions at 3 months ( P P

Results of Repeated Tuboplasties

The cumulative conception rate of 31 infertile women undergoing a second tuboplasty using microsurgery was compared with that 71 women undergoing a single microsurgical tuboplasty. The follow-up period ranged from ranged from 1 to 61/2 years. Five (16%) of the patients in the repeat tuboplasty group conceived; there were 3 (10%) live births, 1 (3%) tubal pregnancy, and 1 (3%) spontaneous abortion. In the single tuboplasty group 42 (59%) of the patients conceived, with the result of 31 (44%) liver births, 6 (9%) tubal pregnancies, and 5 (7%) spontaneous abortions. Reocclusion of both tubes occurred in 16% and 7% of the patients in the two groups, respectively. It is concluded that the poor results of repeated tuboplasties mainly are due to mucosal lesions, which in the majority of cases seem to be irreversible.