[Early emulsification of silicone oil (2000 cs) in minimally invasive transconjunctival vitreoretinal surgery]. / Frühe Emulsifikation des 2000er-Silikonöls nach minimalinvasiver transkonjunktivaler vitreoretinaler Chirurgie.

BACKGROUND: The highly purified polydimethylsiloxane (PDMS) with a viscosity of 5000 centistokes (cs) is the preferred silicone oil endotamponade in vitreoretinal surgery (20 gauge) and shows high stability. In contrast in transconjunctival minimally invasive surgery (23 gauge) the application of 5000 cs. silicone oil shows substantial disadvantages because of time-consuming and difficult application procedure due to the small lumen of the used surgical equipment. Consequently silicone oils with lower viscosity like the 2000 cs silicone oil are being increasingly used in transconjunctival surgery. PATIENTS: We present two cases of early emulsification of the 2000 cs silicone oil (Siluron 2000 ©, Fluoron, Neu-Ulm, Germany) consisting of highly purified PDMS in the course of minimally invasive transconjunctival vitreoretinal surgery. In both cases 23 gauge vitrectomy with application of 2000 cs silicone oil was performed without any complication. The first case is a 34-year-old female with proliferative diabetic retinopathy who had already experienced several vitreoretinal operations. The present indication for vitrectomy was a persistent macular hole and vitreous haemorrhage. The second case is a 55-year-old pseudophakic patient with a retinal detachment after vitrectomy with gas endotamponade following rhegmatogenous retinal detachment. RESULTS: In the first case emulsification of silicone oil was seen on the second postoperative day. In the second case emulsification was discovered two weeks postoperatively. In both cases high intraocular pressure did not occur. CONCLUSION: With emerging performance of minimally invasive vitrectomy techniques the use of silicone oil with low viscosity in patients with conceivable endurance of the endotamponade appears to be beneficial. Up to now 10 patients have undergone 23 gauge vitrectomy with application of 2000 cs silicone oil without any complications in our clinic. In contrast, two cases demonstrated early emulsification of the 2000 cs silicone oil. To the best of our knowledge this complication has not been described before.

[Vasoproliferative retinal tumours]. / Vasoproliferative retinale Tumoren.

Vasoproliferative retinal tumors are benign tumors of unknown origin often accompanied by vitreoretinal inflammation. A 21-year-old female patient presented with acute reduced unilateral visual acuity. A solid yellow vascularized lesion was present in the inferior temporal retina accompanied by localized retinal detachment and accumulation of hard exudations. The only finding was an increased Bartonella henselae titer. Persistence of uveitis and blurred vision led to therapy for Bartonella henselae with macrolide antibiotics and successful tumor regression was achieved by cryotherapy.

[Comparison of the aesthetic outcome and complication rate of reconstructive surgical procedures of the eyelid after basalioma excision]. / Vergleich rekonstruktiver Operationsverfahren des Lides. Ästhetische Ergebnisse und Komplikationsrate nach Basaliomexzision.

BACKGROUND: The therapy of choice of the basalcellcarcinoma is the surgical removal often combined with soft-tissue reconstruction. Aim of this study was to evaluate the subjective aesthetic outcome and the complication rate in consequence of the chosen surgical procedure. METHOD: 57 patients formerly treated by surgery enclosing free grafts, Hughes flaps, interpolated flaps or primary wound closures were included. The patients were examined to evaluate possible surgery derived complications. Furthermore the aesthetic outcome was assessed by a questionnaire. RESULTS: After an interpolated flap nearly 30% of the patients were without any complications and after a Hughes flap 21.4%. In contrast 43.8% of the patients after primary wound closure showed any complications and even 57% of the patients treated with a free graft. Concerning the aesthetic outcome 92.3% of the patients undergoing an interpolated flap were subjective satisfied or even very satisfied with their aesthetic outcome. CONCLUSION: Regarding the complication rate the free graft and the primary wound closure seem to be superior. On the contrary the interpolated flap demonstrated a considerable better estimated aesthetic outcome.

[Surgical treatment of hyperparathyroidism--personal experience]. / Chirurgická lécba hyperparatyreózy--nase zkusenosti.

The authors submit their own experience with the surgical treatment of all types of hyperparathyroidism (HPT). Since 1992 till the end of April 2002 in the Institute of Clinical and Experimental Medicine 151 operations were performed in 132 patients, in particular secondary HPT (69.8%). Among surgical operations partial parathyroidectomy (PTE) predominated, as a rule without peroperative implantation of parts of the removed parathyroid glands(PT)(64.8%). The high ratio of this type of operations was due among others to a recent increase of tertiary posttransplantation HPT. Advanced secondary HPT of haemodialyzed patients was treated by total PTE with implantation of PT tissue. The incidence of surgical complications was low (7.1%) and insignificant from the aspect of the long-term postoperative condition. Persisting or relapsing HPT was revised in 15 patients (in 12.6% of all operations).