[Sympathetic ophthalmia following repeated pars plana vitrectomy : Clinical findings and spectral domain OCT follow-up]. / Sympathische Ophthalmie nach zweimaliger Pars-plana-Vitrektomie : Klinische Befunde und Spectralis-OCT-Verlauf.

Sympathetic ophthalmia is a rare form of bilateral granulomatous panuveitis, occurring after penetrating trauma. Hitherto, sympathetic ophthalmia after vitrectomy has only occasionally been described in the literature. This case report presents a female patient with sympathetic ophthalmia after repeated pars plana vitrectomy on the basis of clinical findings and follow-up with fluorescein angiography, spectral domain OCT, and histopathology.

[Immunotherapy of uveal melanoma: vaccination against cancer. Multicenter adjuvant phase 3 vaccination study using dendritic cells laden with tumor RNA for large newly diagnosed uveal melanoma]. / Immuntherapie beim Aderhautmelanom: Vakzination gegen Krebs. Multizentrische adjuvante Phase-III-Impfstudie mit Tumor-RNA-beladenen dendritischen Zellen bei neu diagnostizierten, großen Uveamelanomen.

Uveal melanomas are the most common malignant tumors of the eye. With modern molecular biological diagnostic methods, such as chromosome 3 typing and gene expression analysis, these tumors can be categorized into highly aggressive (monosomy 3, class II) and less aggressive forms. This molecular biological stratification is primarily important for determining the risk of these tumors as no therapy is currently available that is able to prevent or delay metastases. A randomized study of patients with a poor prognosis (monosomy 3) is currently being carried out in order to determine whether a cancer vaccine prepared from autologous (patient's own) dendritic cells and uveal melanoma RNA can prevent or delay progression and further metastases of this extremely aggressive form of cancer. Inclusion in the uveal melanoma study, which hopes to provide a potential therapeutic option for patients, is only possible if patients are referred to an institution that is able to manufacture and provide this vaccination before the patient is operated on or treated with radiation. Untreated tumor material is necessary for producing the vaccine on an individualized patient basis.

[Cross-linking in an artificial human cornea via induction of tissue transglutaminases]. / Vernetzung einer humanen künstlichen Hornhaut durch Induktion von Tissue-Transglutaminasen.

PURPOSE: In recent years many three-dimensional cornea models have been developed. However, they show poor collagen stability in the stroma. Transglutaminases (Tgases) are calcium-dependent proteins which play an important role in cross-linking of the corneal stroma. The purpose of this study was to find out whether it is possible to induce in vitro cross-linking of the stroma in an artificial hemicornea model with the help of Tgases. MATERIALS AND METHODS: For the construction of the hemicornea, human SV40 adenovector corneal epithelial cells (HCE) and human SV40 adenovector corneal keratocytes (HCK) were cultivated. Confluent HCK cells were treated for 24 h with transforming growth factor beta (TGFb) 1, 2 and 3 at different concentrations as well as with other growth factors and the treated cells were compared to untreated cultivated cells. The quantification of the expression of the Tgases by HCKs was examined with the use of real time PCR, Western blot imaging and immunochemistry. RESULTS: All concentrations of TGFbs used resulted in a significant increase of Tgase-mRNA, Tgase protein level and Tgase activity. The Tgases remained unaffected after treatment with other growth factors in comparison to untreated control cells. Treatment of the hemicornea with TGFb2 showed a very strong contraction and haze in comparison to the untreated hemicornea. CONCLUSION: It has been shown for the first time that TGFb induces a strong expression of Tgases in HCK cells. This effect caused an undesired contraction and haze of the human hemicornea model. Further research is necessary in order to find out whether the induction of Tgases in the HCK cells can be regulated without losing stability of the constructed hemicornea.

[Decentration of donor cornea in mechanical and excimer laser trephination for penetrating keratoplasty]. / Dezentrierung der Spenderhornhaut bei mechanischer und Excimerlaser Trepanation für die perforierende Keratoplastik.

BACKGROUND AND PURPOSE: Decentration of the trephination is supposed to be one of the major reasons for high and/or irregular astigmatism after penetrating keratoplasty (PK). The purpose of this study was to assess the amount and direction of donor decentration with conventional mechanical and nonmechanical laser trephination. PATIENTS AND METHODS: In this retrospective analysis 106 consecutive mechanical donor trephinations from the endothelial side (mean diameter 7.30 +/- 0.79 mm), 80 mechanical donor trephinations from the epithelial side (mean diameter 7.30 +/- 0.77 mm), and 89 nonmechanical donor trephinations from the epithelial side (Aesculap-Meditec; spot profile 1.5 x 1.5 mm, pulse energy 18-20 mJ, repetition rate 25/s) along metal aperture masks (mean diameter 7.72 +/- 0.40 mm) were included. Remaining corneoscleral rims were fixed in formalin after trephination and photographed from the endothelial side. On colour prints (13 x 18 cm; total magnification x7.33) the amount and direction of decentration were assessed morphometrically using the SummaSketch (Summagraphics, Seymour, USA) and correlated with the total area of the cornea and the trephination. RESULTS: Mean donor decentration was significantly smaller with laser trephination (0.20 +/- 0.12 mm) than with mechanical trephination from the endothelial side (0.26 +/- 0.14 mm; p = 0.001) and from the epithelial side (0.27 +/- 0.16 mm; p = 0.024). In addition, donor decentration correlated significantly inversely with the trephination area (p < 0.001), but not with the total area of the cornea (p = 0.63). A preferred direction of decentration relative to the microsurgeon could not be detected (p = 0.87). CONCLUSIONS: Centration of donor trephination can be improved by using nonmechanical instead of mechanical trephination of the cornea. Further studies are required to investigate the clinical relevance of the statistically better donor centration on astigmatism and visual acuity after PK.