[Morbus Morbihan : A rare cause of edematous swelling of the eyelids]. / Morbus Morbihan : Seltene Ursache ödematöser Lidschwellungen.

Morbus Morbihan is a rare disease characterized by persistent erythema and edema of the central and upper half of the face, mainly restricted to the forehead, glabella, eyelids, nose and cheeks. It is thought to be a rare complication of rosacea and may lead to fibrotic induration. The characteristic features are a typical clinical picture with histological alterations. Diagnosis and treatment are difficult because of the absence of specific laboratory findings and in most cases resistance to clinical therapy.We report the first case of morbus Morbihan in the ophthalmic literature. A 53-year-old woman complained of erythematous and edematous eyelids which caused a significant visual field defect for 4 years. The typical clinical picture, histological findings and the exclusion of several differential diagnoses led to the diagnosis of morbus Morbihan. Oral rosacea treatment did not result in any improvement, therefore, eyelid reduction surgery followed by lymphatic drainage was performed. Apart from cosmetic improvement a significant reduction of visual field defects was observed postoperatively.

Alveolar rhabdomyosarcoma of the clivus with intrasellar expansion: Case report.

Rhabdomyosarcomas are common tumors of the head and neck region in children. However, a primarily intracranial localization of this tumor entity is rare. We report on a 3-year-old boy presenting with double vision due to left VI (th) nerve palsy. No other neurological deficits were recognized by clinical inspection. MRI scans visualized an enhancing mass lesion in the upper clivus compressing the cavernous sinus and the pituitary gland. Transsphenoidal biopsy was performed and histopathological examination as well as molecular diagnostics confirmed the diagnosis of an alveolar rhabdomyosarcoma (ARMS). Staging identified a metastatic lesion in the fourth thoracic vertebra resulting in the diagnosis of stage IV disease. Treatment modality included stereotactic radio- and chemotherapy.

[Mitomycin C in refractive corneal surface surgery with the excimer laser: first experience and review of the literature]. / Mitomycin C bei oberflächlichen Hornhautablationen mit dem Excimer-Laser: Eigene Erfahrungen und Literaturübersicht.

Haze formation with loss of corneal transparency and surface irregularities and myopic regression are the major complications after corneal refractive surface surgery. The use of mitomycin C (MMC) with its antibiotic and antineoplastic properties is intended to inhibit wound healing mechanisms leading to subepithelial fibrosis. We report the use of MMC to achieve visual rehabilitation in the re-treatment of 3 eyes of 2 patients following refractive corneal surgery. According to the literature, the local use of MMC 0.02 % for 2 minutes is safe and enables one to treat and prevent stromal haze and myopic regression and allows a reduction of the postoperative topical pharmacotherapy. Results are still limited due to small case numbers and short follow-up periods.

[Is a cataract avoidable? Current status with special emphasis on the pathophysiology of oxidative lens damage, nutritional factors, and the ARED study]. / Ist die Katarakt vermeidbar? Eine aktuelle Bestandsaufnahme unter besonderer Berücksichtigung der Pathophysiologie oxidativer Linsenschäden, nutritiver Einflussfaktoren und der ARED-Studie.

The benefit of long-term nutrient intake to reduce the risk of age-related ocular disease such as cataract or macular degeneration is subject to controversy. Conclusions about the benefits and risks of antioxidant supplements can be expected after reviewing the current literature concerning oxidative-induced lens damage and nutritional effects. Identification of influenceable risk factors for senile cataracts could achieve immense economical relevance. In contrast to former longitudinal epidemiological studies, the AREDS report failed to verify protective properties of highly concentrated vitamin supplements on cataract formation. Although there are enough epidemiological indications for reducing the risk of cataracts by the intake of antioxidants, a general recommendation for the use of supplements is untimely or even wrong until stringent evidence of efficacy is provided. The usefulness of cataract prevention is discussed.

[Keratopathy as a sign of multifocal congenital sensory polyneuropathy. A case report]. / Keratopathie als Zeichen einer multifokalen kongenitalen sensiblen Polyneuropathie. Eine Fallbeschreibung.

PATIENT: A 63-year-old female with bilateral recurrent corneal ulcerations for 10 years, suffered from vascularisation of the cornea and absence of corneal sensitivity. Other symptoms were multifocal hypoaesthesia with hypalgesia of hands and legs, generalised lack of deep tendon reflexes, absence of somato-sensory evoked potentials (SSEP) and of sensory nerve action potentials (SNAP) in these regions. A sural biopsy demonstrated extreme lack of myelinated fibres. Acquired causes for polyneuropathy were excluded. THERAPY: Subsequent to local ocular treatment we carried out a perforating corneal transplantation of the left eye because of corneal scars. This had to be repeated 2 years later because of vascularisation of the transplant. The visual function of the left eye could be stabilised at values between 0.2 and 1/50. CONCLUSION: Anamnesis and clinical symptoms of the patient are compatible with the diagnosis of hereditary sensory neuropathy type II (HSN II) affecting the trigeminal nerves. In patients with neuropathy and impaired corneal sensitivity, a favourable prognosis may be achieved by a corneal transplant.

Effect of large positioning holes on capsule fixation of plate-haptic intraocular lenses.

PURPOSE: To compare the centration and fixation of silicone plate-haptic intraocular lenses (IOLs) with different-sized positioning holes. SETTING: Eye Clinic of the Johannes Gutenberg-University Mainz, Mainz, Germany. METHODS: In a prospective randomized study, 51 Chiroflex C10 and 56 Chiroflex C11 IOLs were implanted under standardized conditions by the same surgeon. The IOL position was documented at the end of surgery and by retroillumination on the first day and 5 months postoperatively. The positioning-hole area was evaluated by ultrasound biomicroscopy (50 MHz) 5 months postoperatively. RESULTS: One day postoperatively, no IOL in either group was decentered more than 1.0 mm. After 5 months, 33% of the C10 and 42% of the C11 IOLs were decentered between 0.5 and 1.0 mm, and 11% of the C10 and 8% of the C11 IOLs were decentered more than 1.0 mm (maximum 1.23 mm and 1.41 mm, respectively). Up to the first postoperative day, 20% of the C10 and 22% of the C11 lenses were rotated more than 15 degrees. At 5 months, an additional 15% of the C10 and 19% of the C11 lenses were rotated. Ultrasound biomicroscopy showed no tissue or capsule adhesion in the holes in most cases (85% C10 group; 71% C11 group). No difference was statistically significant. CONCLUSIONS: Larger positioning holes did not prevent IOL decentration or rotation; thus, this IOL design appears unsuitable for correcting astigmatism. Because tissue in the positioning hole was rare with both lens types, it is doubtful that enlarged plate-haptic perforations will prevent IOL luxation into the vitreous cavity after capsulotomy.