[The treatment of psoriasis in a day care center]. / Behandeling van psoriasis in een dagbehandelingscentrum.

We describe the treatment of 196 patients with psoriasis, in the psoriasis day care centre at Ede. Treatments involve salt water baths followed by radiation of UVB, additional radiation of the scalp and therapy-resistant parts of the skin and anthralin 'short contact therapy'. During the anthralin therapy the hairy scalp is treated with liq. carb. dexerg. 5% in soya oleum. The results were evaluated by means of the psoriasis area and severity index (PASI) and of a questionnaire which was completed by 144 patients. In an average course of 28.4 treatment sessions (range 9-51), the PASI decreased by 84.3%. Evaluation of the PASI included the hairy scalp, the axillae and the inguinal region. The answers to the questionnaire indicated a risk of rather rapid relapse however, according to many patients, only a small part of the skin surface was affected. The additional value of the treatment is attributed to the setting of the psoriasis day care centre and the relatively safe therapeutic possibilities offered there.

The van Andel transparent glass microsurgical cannula.

We present a disposable 21-gauge transparent glass cannula that provides optimal visual control of aspiration-irrigation procedures in cataract surgery. It is especially useful in iris coloboma repair.

Glass-metal keratoprosthesis: light and electron microscopical evaluation of experimental surgery on rabbit eyes.

A keratoprosthesis (KP) is the last and only surgical resort to regain some visual acuity in eyes with severely damaged corneae. Corneal blindness represents an important percentage of the blind in the economically poor countries. Commercially available KP's, e.g. those made of PMMA, which are difficult to sterilize and vulnerable to surface damage, are too expensive in these countries. To overcome these disadvantages, we developed a new KP, made of a glass core melted into a platinum cylinder with flange. They were implanted unilaterally in eyes of ten Hollander rabbits intralamellarly. They were fixated by two stainless steel traction threads passed around the whole eyeball. We investigated this type of KP in the rabbit cornea, its acceptance by stroma, epi- and endothelium, and its hydro-mechanical dynamics in situ. No signs of infection or extrusion were observed. No epithelial downgrowth, nor adverse tissue reaction could be detected. LM and SEM showed endothelialization of the newly formed stroma around the central column of the KP. We conclude that this type of KP (although optically still to be optimized) has been accepted by the rabbit cornea and a clinical trial on cornea-blind patients is justified.

Stainless steel as suturing material in human- and rabbit corneas: a SEM-study.

Stainless steel wire, dia. 50 microns, was used as suturing material in rabbit corneas for periods of 1.5, 3 and 7 months respectively, in order to test its inertness and acceptance by the corneal tissue. One clinical case of stainless steel wire used for fixation of an I.O.L.-implantation, after a 5-year residence in the eye, is reported as well. After 1.5 months' residence, the suture margins were well covered with tissue containing irregularly shaped endothelial cells, some fibroblastic-type cells and various kinds of collagenous fibre material. The buckled surface was partly covered with a very thin membrane of collagenous material, strands of collagenous fibres and a few fibroblastic-type cells. After 3 months' residence the buckle was almost completely covered with an endothelial cell layer. The individual cells had a somewhat irregular hexagonal shape. At a few local sites closure was still progressing, with filopodia and other collagenous matter generated by neighbouring cells on top of previously deposited Descemet's membrane. After 7 months' residence, the buckle was completely covered with normal endothelium. The fixation suture in the human case showed perfect acceptance by the corneal tissue.