[Long-term stability of astigmatism outcome after arcuate lamellar keratotomy. 3-year results of a prospective study]. / Langfristige Stabilität der Astigmatismusänderung nach bogenförmiger lamellierender Keratotomie (BLK). Dreijahresergebnisse einer prospektiven Studie.

INTRODUCTION: The correction of low to moderate astigmatism is possible today by means of photoablation (PRK), while the treatment of moderate and higher astigmatism still involves refractive keratotomy. Experience has shown that cataract surgery, using modern tunnel techniques with self-healing incisions, results in earlier stability in both the refractive outcome and wound healing. In this study, we attempted to combine the advantages of lamellar keratotomy with those of a pair-wise T-incision as arcuate lamellar keratotomy (ALK). PATIENTS AND METHODS: The clinical outcome of 41 patients who underwent ALK was investigate in a prospective study over a period of 3 years. The pre- and postoperative investigations undertaken included the measurement of astigmatism using a Zeiss keratometer, uncorrected visual acuity, and corrected glare vision using a Humphrey autorefractor. All patients had astigmatism between 2.0 and 7.0 D. Together with a uniform arcuate incision, we used 7 mm (n = 26) and 8 mm (n = 15) mm zones for correction. RESULTS: The average preoperative astigmatism was 4.01 +/- 1.90 (median, 3.50) D. After a 3-year follow-up the average postoperative astigmatism was 1.59 +/- 1.29 (median, 1.38) D. The astigmatic change induced (Jaffé) after 3 years was about 3.23 +/- 2.23 (median, 3.16) D. The average uncorrected visual acuity (log MAR) before ALK was 0.20 +/- 0.12 (median, 0.22) and after follow-up, 0.41 +/- 0.14 (median, 0.39). Corrected glare vision before surgery was 0.23 +/- 0.19 (median, 0.10) and afterwards, 0.25 +/- 0.22 (median, 0.14). CONCLUSIONS: Arcuate lamellar keratomy (ALK) stood the test as a routine clinical procedure for correction of moderate astigmatism with stable postoperative functional outcomes. We did not find impairment of glare vision following this procedure.

[Use of high resolution color Doppler sonography in diagnosis of temporal arteritis]. / Einsatz der hochauflösenden Farb-Doppler-Sonographie in der Diagnostik einer Arteriitis temporalis.

PURPOSE: To define sonographic signs of arteritis temporalis using color coded duplex sonography. METHODS: 20 patients with clinically suspected temporal arteritis were examined with color coded Doppler ultrasound prior to temporalis biopsy. The investigation included the temporal artery on both sides and documentation was performed with color prints of the longitudinal orientation of both temporal arteries. All patients had an unilateral biopsy of the temporal artery. RESULTS: 6/20 patients had histologically confirmed temporal arteritis. All patients showed a paravasal zone of lower echogenicity (halo-sign) along the temporal artery. 12/14 patients without temporal arteritis showed no halo-sign. However, a halo-sign was found in 2/14 patients without temporal arteritis which could not be distinguished from the halo-sign observed in patients with temporal arteritis. CONCLUSIONS: A halo-sign could be detected in the majority of patients with arteritis temporalis in concordance with the recent published findings of Schmidt et al. However, a definite specificity of this halo-sign must be rejected.