Especially after LASIK for hyperopia, the objective refraction determined with the Nidek AR-K 900 autorefractor delivered erroneous results, which have implications for postoperative care and preoperative measurements for ocular surgery such as enhancement procedures or cataract surgery.
We present three patients who had laser in situ keratomileusis (LASIK) after corneal surgery as follow: 15 months after automated lamellar keratoplasty (ALK) for hyperopia, 6 months after ALK for hyperopia, and 2 years after penetrating keratoplasty (PKP). Although the first case was uneventful, intraoperative complications arose in the second case because the connection of the ALK-related flap to its stromal bed was insufficient. In the third case, the refractive error caused by PKP was corrected as shown by corneal topography and visual acuity measurement. In conclusion, LASIK after PKP can be considered a precise and safe procedure if 2 to 3 years pass between the procedures. An interval of 6 months between ALK and LASIK was too short, whereas 15 months after ALK for hyperopia, LASIK was performed without problems and delivered a good result.
To determine the feasibility and efficacy of structured education in intensive insulin therapy (IIT) in patients with Type 1 diabetes mellitus commonly attended by primary care physicians, a prospective case-control study was carried out in co-operation with 26 general practitioners in rural Alpine region and the diabetes service at the University of Vienna, Medical School, Austria. From 89 rural Type 1 diabetic patients on conventional insulin therapy (CIT), those volunteering for better diabetes care (n = 52) were trained in IIT in the diabetes education centre and subsequently received their outpatient service by their general practitioners, as did those remaining on CIT (n = 37). Patients were matched as case-controls (n = 36 in each therapy group) for metabolic control at baseline (IIT/CIT: HbA1c 8.2 +/- 1.8 vs 8.1 +/- 2.0%, ns), age, duration of diabetes, incidence of retinopathy and nephropathy. Analysing an observation period of > 4.5 years, patients trained in IIT presented with improved metabolic control as compared to those on CIT (Mean HbA1c: IIT, 6.9 +/- 1.0%; CIT, 7.9 +/- 1.3%, p < 0.05, ANOVA). No difference between groups was, however, observed at the end-point of the study in HbA1c (IIT, 7.3 +/- 1.3%; CIT, 7.8 +/- 1.4%; IIT vs CIT, p = 0.14) and in the development of diabetic microangiopathy, frequency of reported severe hypoglycaemic episodes, and increase in body weight.(ABSTRACT TRUNCATED AT 250 WORDS)
On the basis of preliminary investigations completed in 1978 dealing with computer-assisted analysis of infrared photographs of the ocular fundus, multispectral photograph analysis methods were tested as to their usefulness in improving differential diagnosis. The computer used in this case was a process control computer with special peripheral equipment. Computer programs were developed to solve problems relating to photograph analysis and classification. Information obtained by computer processing should prove helpful in the differential diagnosis of pigmented changes in the fundus. Since melanomas cannot always be clearly differentiated by purely visual examination, and since the "extra-visual" spectra are often more easily interpreted with the aid of computerized photograph analysis, this paper presents examples illustrating the anticipated practical value of our investigations.
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