[The problem of glaucoma in Africa--progress report from Cameroon]. / Zur Problematik des Glaukoms in Afrika -- ein Erfahrungsbericht aus Kamerun.

BACKGROUND: Glaucoma is one of the most common causes of blindness in the world. This aspect is well known for the developed countries, however in Africa blindness mainly occurs due to cataract, trachoma and onchocercosis. Glaucoma is not mentioned enough. Patients present with severe findings after a long-lasting history of disease. PATIENTS AND METHODS: In our project experienced surgeons and young medical doctors have been practising regularly in Cameroon since 2001. By means of support from the "Komitee zur Verhütung von Blindheit" and medical industries we keep in contact with a local ophthalmologist. During the consultation of hundreds of patients we have often seen highly advanced glaucoma cases. RESULTS: The medical therapy of glaucoma and also the surgical procedures are limited -- modern antiglaucomatosa are not available. We achieved sufficient regulation of intraocular pressure after trabeculectomy with or without cataract surgery in many cases. The success rate was decreased by severe scar reactions especially in young black people. In advanced glaucoma cases and oculus ultimus we also used the old techniques of iridencleisis. There was a good postoperative regulation of eye pressure, but sometimes we saw a giant filtering bleb after this iris-mutilating procedure. CONCLUSIONS: Glaucoma is a very complex problem, also in Cameroon. Although the diagnostic possibilities are limited, the therapeutic spectrum is differentiated. The introduction of a robust laser for cyclophotocoagulation would be a useful alternative.

[Measuring corneal volume. A possible quality parameter in cataract surgery?]. / Messung des Hornhautvolumens. Ein möglicher Qualitätsparameter in der Kataraktchirurgie?

BACKGROUND: Phacoemulsification of the lens induces changes in the inner corneal architecture. This study quantified the corneal pre- and postoperative volumes. METHODS: Corneal volume was measured by noninvasive corneal topography using Orbscan. Following phacoemulsification with lens implantation, 56 eyes of 55 persons were examined by three Orbscan tests: preoperatively and 6 h and 24 h after cataract surgery. Healon was used as viscoelastic medium. RESULTS: The mean corneal volume in the 3-mm central corneal diameter was 4.64 mm3 preoperatively, 5.36 mm3 6 h postoperatively, and 5.05 mm3 24 h postoperatively. Corneal volume thus increased by 0.72 mm3 within 6 h after phacoemulsification and decreased by 0.31 mm3 over the following 18 h. CONCLUSION: Orbscan offers a noninvasive method for obtaining useful and accurate information in defining the corneal volume. This method may represent a new parameter for describing the function of corneal endothelial cells in cataract surgery.