[Postoperative follow-up after goniotrepanation with fornix-based conjunctival flap]. / Postoperativer Verlauf nach Goniotrepanation mit Fornix-basalem Bindehautlappen.

Goniotrephination with a fornix-based conjunctival flap was performed in 60 glaucomatous eyes. The postoperative course was monitored with special reference to intraocular pressure, anterior chamber depth, choroidal detachment and external fistulation. Some degree of choroidal detachment was observed in 1/3 of cases, extending centrally to the equator in only 11% and centrally to the vessel arcade in none. The anterior chamber was found to have become shallow in 16%, but this persisted longer than 3 days in only 6.7%. In 13.3% a external fistula arising from the conjunctival wound persisted for more than 1 day. The described technique with a fornix-based conjunctival flap and meander-like suture at the limbus further reduces the frequency and severity of complications in filtering surgery.

Randomized placebo-controlled study on the characteristics and duration of action of surfactant treatment in premature lambs.

In a placebo-controlled study, the characteristics and duration of action of a commercially available bovine lung surfactant factor (LSF; 50 mg/kg body weight) were investigated in premature lambs at 124-127 days gestational age. Exact mating of ewes was controlled by progesterone hormone analysis. To minimize unwanted effects of narcotics through transplacental transfer to the fetus, spinal anaesthesia of the ewes was performed. The physiological status 'in utero' was demonstrated by arterial blood gas analysis (partial arterial oxygen pressure (PaO2), partial arterial carbon dioxide pressure (PaCO2) and arterial blood pH) of the fetus before umbilical cord ligature. The values for blood gases, blood pressure and lung mechanics measured after onset of ventilation and before LSF treatment were indicative of fetal maturity. Immediately after LSF treatment, PaO2 increased significantly, then decreased for about 2 h and finally stabilized on a plateau until the end of the experiment. In contrast, arterial blood pH and PaCO2 values normalized more slowly and remained normal for a longer period in the LSF group, whereas both parameters did not normalize in the placebo group. Total dynamic lung compliance also showed a slow improvement and remained on a higher level for a longer period than PaO2. Using a low respiratory rate it was possible to ventilate at lower peak inspiratory pressures and this resulted in higher compliance values. In conclusion, the presented data suggest that artificial ventilation greatly influences lung mechanics. Due to a relatively short substance effect concerning PaO2 we assume that higher or repeated doses of LSF may be necessary to produce sustained improvements in clinical trials.