[Technic and results of iridocyclectomy]. / Technik und Ergebnisse der Iridozyklektomie.

From 1972 to 1983 iridocyclectomy was performed in 18 patients because of an invasive growing tumor of the iris and ciliary body. Surgical techniques were those of Mackensen (1972), the trap-door technique, and a trepanation of the sclerocornea with regrafting. In 16 out of 18 cases total removal of the tumor was accomplished; in two cases there was a recurrence. In the other cases it was possible to preserve useful visual acuity.

[Results of radiotherapy in case of juvenile xanthogranuloma of the iris]. / Ergebnisse der Strahlentherapie bei juvenilen Xanthogranulomen der Iris.

The juvenile xanthogranuloma is a rare, benign, cutaneous disease occurring in infants and young children which can be situated in about 10% of the cases on the eye and preferentially on the iris. The reason for consulting an ophthalmologist is mostly a recurrent unilateral hyphemia which is typical for this disease. The diagnosis of the juvenile xanthogranuloma has to be established clinically, based on the characteristic alterations of the iris--heterochromia, vascularized tumor or diffuse thickening of the iris--and the possibly increased intraocular pressure. In order to avoid the deleting consequences of an uncontrollable secondary glaucoma, radiotherapy with a total dose of 300 to 400 cGy combined with a mild local steroid treatment has to be undertaken immediately, if possible. Taking into consideration the indications of literature, the value of a low-dose radiotherapy for this disease shall be demonstrated by five own cases in all of which the concerned eye could be healed and preserved.

Homologous genes for X-linked chondrodysplasia punctata in man and mouse.

X-linked dominant chondrodysplasia punctata is a human gene defect characterized by punctate foci of epiphyseal calcification, cataracts, ichthyosis, and systematized atrophoderma. In a comparative study, the murine X-linked mutant 'bare patches' was found to display strikingly similar skeletal, ocular, and cutaneous anomalies. The human as well as the murine phenotypes occur exclusively in the female sex, apparently because the underlying mutations are lethal for male embryos. In both traits, the cutaneous lesions are arranged in a linear and blotchy pattern reflecting lyonization. The observed similarities constitute strong evidence that the two genes are homologous. The proposed homology is a further example of the evolutionary conservatism of the X-chromosome in mammals.

[Results of treatment with timolol in problematic cases (author's transl)]. / Ergebnisse der Timololbehandlung bei Problemfällen.

The authors report on the effect of timolol in cases of secondary glaucoma and buphthalmus in 143 eyes. Constant regulation of intraocular pressure was achieved by treatment with timolol in 67 eyes. A remarkable effect was observed in cases of complicated buphthalmus. The results were least favorable in cases of hemorrhagic secondary glaucoma.

[Immunological examinations in Vogt-Koyanagi-Harada disease (author's transl)]. / Immunologische Untersuchungen bei der Vogt-Koyanagi-Haradaschen Erkrankung.

In eight patients with clinical sure Vogt-Koyanagi Harada-syndrome (VKHS) immunological examinations were performed. We tested whether there were signs of former or present infections (measles HHT and complement fixation test (C.F.T.), rubella HHT, hepatitis HBs-antigen, adenovirus AG, varicella-zoster C.F.T., herpes simplex C.F.T., cytomegaly IgM and IgG, toxoplasmosis immunofluorescence, tuberculosis Middlebr. Dubois). In none of all cases we could find HLA B12. The rheumatic tests, LDH, albumin an electrophoresis, coeruloplasmin and haptoglobin were negative. The uveal pigment failed to stimulate the leucocyte cultures from VKHS-patients in leucocyte-migration-inhibition-test and in leucocyte-adherence-inhibition-test.

[Conjunctival covering (Harms) (author's transl)]. / Zur Bindehautdeckung nach Harms.

The authors report on 7 cases of conjunctival flap cover in the technique of Harms and Mackensen (1963) in cases of leackage of the bleb after filtering operations. The technique consists in excision of the thin conjunctiva of the bleb, undermining of the conjunctiva until the fold, arched incision of the cornea in front of the bleb, incarceration of the conjunctival lip in the corneal incision with fixation by continuous suture with monophile nylon-string (10X0). In 6 of 7 cases the intraocular pressure was spontaneously regulated after the operation with morphological functioning bleb in 4 cases.

[On the history of ophthalmology and of the eye clinic in Münster (author's transl)]. / Zur Geschichte der Augenheilkunde und der Augenklinik in Münster.

The development of ophthalmology in Münster is described from the itinerant oculists and sooth-sayers of the middle ages to the completion of the enlargements to the eye clinic in the year 1977. After the foundation of the university in 1780 Prof. Anton Sentrup, Professor of Anatomy, held the first lecture in the special field of instruction of ophthalmology. But up to the introduction of a chair for ophthalmology more than a century passed by, after the university in Münster was closed in 1818 in favour of the unversity in Bonn following political changes. In the so's of the 19th century private eye clinics were foundet in Münster. In 1924 the new University in Münster received a chair for ophthalmology. The first director of the eye clinic was Prof. Aurel von Szily. He was followed by Oswald Marchesani, Wilhelm Rohrschneider, Wolfgang Riehm and Fritz Hollwich. The increase in the diagnostic and therapeutic possibilities and the continuously increasing numbers of patients made necessary the enlargement of the clinic by the addition of an operation and ward wing and of an outpatients' department. These additions which were begun in 1968 were completed in summer 1977 under the leadership of Prof. Hollwich.

[Clinical results of the goniothrephining with scleral flap (author's transl)]. / Klinische Ergebnisse der Goniotrepanation mit Skleradeckel.

During 1971-1976 407 goniotrephinings e.g. "Elliot with scleral flap", were performed at the Univ. Eye Hospital Münster. In a follow-up study of 306 operated cases we found 81% primary glaucoma (62.7% simple glaucoma, 18.3% chronic congestive glaucoma) and 19% secondary glaucoma. In 77% of the operated cases the anterior chamber was restored within the first postoperative day. Gonioscopically in 85% the trephining hole was placed within the trabecular meshwork. Nevertheless, this position of the hole had no decisive influence on the later filtration. Postoperatively 2/3 of cases developed a characteristic flat filtering bleb. In 90.4% of the eyes the postoperative IOP was within normal limits. Postoperative follow-up of the visual acuity remained within the limits of age deterioration. Concerning the secondary glaucoma, the pigmentary glaucoma, the traumatic glaucoma and the glaucoma after uveitis, had good results. The results in cases of buphthalmos and hemorrhagic glaucoma were worse. The advantages of goniotrephining are the rapid restoring of the anterior chamber, the protection of the trephining hole by the scleral flap as well as the well "protected" flat and infections-resisting bleb.

[On the operative treatment of tear opening atresia (author's transl)]. / Zur operativen Therapie der Tränenpunktaplasie.

The authors describe a method of identifying and opening tear canaliculi when the openings are closed. For this purpose the common canaliculus under the medial palpebral ligament by the lateral wall of the tear sac is exposed by lamellar dissection under the microscope and opened. The roof of the tear point (where the tear opening should be) is excised over conical sounds laid retrogradely. Finally a vein catheter is placed from the upper and lower tear duct openings through the tear sac into the nasal cavity and left in situ for 12 weeks.

[Clonidine as ointment (author's transl)]. / Clonidin in Salbenform

From 15 eyes in 12 patients with chronic simple glaucoma a comparison of the IOP-diminishing effect between 1 drop 0.25% aqueous solution of Clonidine and a 2 cm long application of 0.2% Clonidine-ointment was made with special regard of local and general side effects, especially on the blood pressure. The reduction of the IOP and the blood pressure was greater and of longer duration after ointment application has a definite depôt-effect. Older patients should be fully digitalized beforehand in order to support the cardiovascular system during Clonidine application.