[Findings in retinal surgery of pseudophakic eyes]. / Erfahrungen bei Netzhautoperationen am pseudophaken Auge.

The author reports on experience gathered in retinal detachment surgery in 7 of his own cases with intraocular lens implants. The paper deals with pre-operative diagnosis, intraoperative management and xenon or argon laser coagulation. It is pointed out that the image quality of the intraocular lens implants needs to be improved for successful diagnosis at the periphery of the fundus. After 7 episcleral buckling procedures (Custodi's technique) and 2 encircling procedures (Schepens) reattachment was accomplished in all 7 cases. The detachment surgery in these cases was more difficult than in eyes without intraocular lens implants, not least as a result of the poor image quality of the artificial lenses.

[Eye manifestations of subacute sclerosing panencephalitis]. / Augenbefunde bei der subakut sklerosierenden Panenzephalitis.

A report is given on 10 children with subacute sclerosing panencephalitis (SSPE) whose clinical illness began with visual or mental impairment. All patients showed typical clinical and neurologic features and various ophthalmological manifestations. The latter correspond to lesions generally dealt with in a number of reports and demonstrate for the individual case that ophthalmological manifestation can precede clinical manifestation. The ophthalmologist can give an important contribution to the diagnosis. In some cases the focal retinal lesions can be similar to retinal lesions in the case of toxoplasmosis. A positive antibody titer for toxoplasmosis, which can occur parallel with the typical measles or SSPE virus antibody titer, occasionally causes the misdiagnosis of toxoplasmosis acquisita. In the 10 cases reported on, the diagnosis SSPE was confirmed on the basis of the typical clinical features and elevated measles virus antibody titer. In no case the permission for autopsy was gained. The genesis of SSPE is discussed with reference to a genetic defect, to an autoimmune reaction, or as a result of a measles virus-like infection. In the diagnosis, primarily unclear 'focal retinal lesions' should be at any rate investigated with respect to measles or SSPE virus antibody titer.

[Value of therapeutic soft contact lenses in the treatment of recurrent corneal erosions]. / Die Bedeutung der therapeutischen Weichlinse in der Behandlung der rezidivierenden Erosio corneae.

Among 100 patients treated with soft contact lenses there were 26 showing recurrent corneal erosions. In these particular cases the application of soft contact lenses proved successful if conservative treatment had proved a failure. The treatment is simple under regular slitlamp microscopic control, can be applied to outpatients and does not lead to any complications.

[Results with non-fixed silicone implants in the treatment of blow-out-fracture and fracture of the orbit]. / Ergebnisse nichtfixierter Silikonimplant in der Versorgung der Blow-out-Fraktur und Orbitatrümmer fraktur.

The number of difficult maxillofacial fractures increases with the number of traffic accidents. 80% of all accidents of this kind are accompanied by juries of the head. In the treatment of combined blow-out-fracture and fracture of the orbit, the most important task is a repair of all orbital structures in collaboration of the ophthalmologist with the otolaryngolist and the oral surgeon. A knowledge of all orbital fractures (stages according to Bleeker) is an essential basic requirement. Bigger defects of the orbital walls are closed by me with one, two or three perforated silicon implants in accordance with Whyte. The open repair of the orbital ring with intraosseous fixation is the modern method of treatment of dislocated orbital bones. After a detailed description of my own operative procedure the treatment results of 75 combined blow-out-fractures--among them 4 orbital fractures of the floor, walls, roof and margins--are given. The following complications are listed: 1 case of orbital hemorrhage, 36 cases of persistent lower lid edema, 4 cases of tissue reaction to the alloplast, 3 cases of infection )amoung them one otolaryngolical case) and 5 cases of extrusion of the implant.

[Clinical conditions and prognosis of retinal detachment in retolental fibroplasia]. / Klinishces Bild und Prognose der Ablatio retinae bei retrolentaler Fibroplasie.

In this report two groups of infants with retrolental fibroplasia and retinal detachment are described according to the Tasman classification. In our case report the retinal detachment developed in a 9-year-old girl. The following diagnosis was given when the retina was in the process of detaching: cicatricial retrolental fibroplasia (Owens II-III) with excessive myopia. After episcleral buckling procedure (polyviol, Custodis method) the retina reattached. Follow-up examinations are important because when prompt diagnosis of retinal detachment is made, the involved eye can often be salvaged by surgery.

[Tectonic keratoplasty in the case of infected Elliot's trephination]. / Tektonische Keratoplastik bei Infizierter Elliotscher Trepanation.

A case is reported with respect to the method concerning the treatment of late infection of the filtering blebs after anti-glaucoma surgical procedures. The infected conjunctival flap and the adjoining scleral tissue was excised with the help of a tectonic keratoplasty and the defect was made watertight in the region of the cornea with a running suture and in the region of the sclera with single sutures. In the case reported the tectonic keratoplasty healed up without any complications. The intraocular pressure remained normal. The indication leading to this operation after a late infection of glaucoma filtering blebs is especially reserved for cases in which the conjunctival flap is unmoveable.

[Microsurgery for the treatment of windshield injuries]. / Mikrochirurgie in der Versorgung von Windschutzscheiben-Verletzungen.

During the last few years, eye injuries caused by fragments of shattered windscreen have increased enormously in the Federal Republic of Germany and in West Berlin. About 1000 people per year suffer severe eye- and eyelid injuries due to traffic accidents. Microsurgery of ocular injuries allows particular attention to be paid to each part of the eye and restoration of its functions. Although the prognosis of such injuries has been improved by a more developed surgery technique using microscopes, the eye specialist as well as legislation should make every possible effort to diminish eye injuries and their serious consequences for the patients.

[Hemihypertrophy, nevus sebaceous, multiple bone cysts and cerebroretinal angiomatosis: a complex phakomatosis]. / Hemihypertrophie, Naevus sebaceus, multiple Knochenzysten und zerebroretinale Angiomatose: eine komplexe Phakomatose

Report on a girl, who died at the age of 6 1/2 years having exhibited different dysplasias which are characteristic features of several phakomatoses: congenital cutaneous pigmentations, fibrolipoma of the scalp, hypertrophy of the right leg, multiple cysts of the long bones (fibrous dysplasia), and an aneurysma racemosum of the retina and mid-brain (syndrome of Bonnet-Blanc-Dechaume).

An ultrastructural study of the retina in the Jansky-Bielschowsky type of neuronal ceroid-lipofuscinosis.

A 7 1/2-year-old boy died of the Jansky-Bielschowsky type of neuronal ceroidlipofuscinosis. Although an electroretinogram showed reduced activity, pigmentary retinal atrophy was not demonstrable by ophthalmoscopy two years before death. At autopsy, the retina had severe loss of photoreceptor cells, pigment displacement, gliosis, and uniformly structured lipopigment bodies with an internal structure of curvilinear profiles in ganglionic and Müller cells, in pigment epithelia, in the remaining photoreceptors, and in the elements of the inner nuclear layer. These findings conformed to those in the juvenile type of neuronal ceroid-lipofuscinosis, differing only as to the severity.

[Misdiagnosis of intraocular iron foreign bodies (author's transl)]. / Fehldiagnosen bei intraokularem Eisensplitter

Out of 393 intraocular foreign bodies (1961-1975) 361 were magnetically removed and 32 non-magnetically (copper 7,brass,2,lead 5, glass 10, stone 3, wood 4 and plastic 1).60% of the foreign bodies were caused by hammer and chisel injuries.73 foreign bodies were diagnosed too late, in 71 cases no x-ray was made. The incidence of complications (infection, siderosis, retinal detachment was considerably increased where the foreign bodies were removed late. From the 73 foreign bodies (18.5%) the patient did not consult a doctor in 37 cases because of "insignificance". 4 times the family doctor was consulted, who treated the patient symptomatically. In 4 cases occurring in the weekend no eye-specialist could be ostensibly found. In 26 cases the ophthalmologist performed no x-ray control, and small foreign bodies were twice described as "x-ray plate artefacts" from the roentgen specialist. It must be an absolute rule in the eye-doctor's practice that every injury received while working with metals necessitates an x-ray control!

[Autologous corneal transplants in recurring herpes corneae (author's transl)]. / Autologe Hornhauttransplantation bei rezidivierendem Herpes corneae

This paper reports the results of penetrating corneal autokeratoplasty of a man 49 years of age with chronic herpetic keratitis in his good right eye. The keratoplasty was taken from the patient's left eye with amblyopia. The diameter in both keratoplasties was 7.1 mm. In both eyes clear grafts were obtained. Visual acuity of the right eye improved to 0.5! One year after the autokeratoplasty the grafts remained clear, showed no immune reactions and no tendency towards vascularization.