[Significance of transcanalicular laser assisted dacryocystorhinostomy in modern lacrimal drainage surgery]. / Stellenwert der transkanalikulären Laser-Dakryozystorhinostomie in der modernen Tränenwegschirurgie.

For the treatment of postsaccal lacrimal drainage obstructions transcanalicular laser dacryocystorhinostomy (TCL-DCR) represents a less invasive alternative to external Toti procedures. Herein, a diode laser optical fiber is inserted into the lacrimal sac via the canaliculi. Under visual control with a nasal endoscope laser energy is applied until a patent osteotomy between the sac and nasal mucosa has been created. Published success rates of 70-90% get close to the excellent results of Toti procedures. Besides describing therapy planning and surgical technique, pros and cons of TCL-DCR are discussed.

[The effect of latanoprost 0.005% on pupillary reaction of the human eye]. / Der Einfluss von Latanoprost 0,005% auf die Pupillenreaktion des menschlichen Auges.

PURPOSE: Infrared pupillography was performed to investigate the effect of one week topical treatment with the prostaglandin analogue Latanoprost 0.005% on pupillary reflex to light stimuli in glaucomatous human eyes. METHODS: Infrared pupillography using the compact integrated pupillograph was performed in 20 glaucomatous eyes of 11 patients. After 10 minutes dark adaptation one pupil was stimulated with a blue, yellow and white diode light of 100 ms duration. Measurements of pupil diameter, constriction latency, constriction amplitude and relative constriction amplitude were taken twice for each light source in a time interval of 15 seconds. After a 2 week wash-out period the measurements were performed from 8:00 to 10:00 a.m. before and one week after topical treatment with Latanoprost 0.005% applied as single dose once in the evening. RESULTS: The measurements after 1 week treatment with Latanoprost showed a significantly smaller pupil diameter for blue (p = 0.044) and white stimulus (p = 0.039) and the latency was significantly reduced (p = 0.029) as well. CONCLUSIONS: Although the statistical analysis shows some small significant differences in pupil diameter and constriction latency there were no clinical signs of changes in pupillary response due to Latanoprost. The system turned out as easy to use and showed reliable measurements during the study. How far latanoprost may lead to miosis and a decrease of constriction latency has to be investigated in further studies with larger study populations. Other topics concerning drug influence, diurnal rhythm and glaucomatous damage in pupillary light reaction will be investigated in the near future.