[Comparative analysis of refractive and topographic changes after eyelid surgery]. / Vergleichende Analyse der Refraktions- und Topographieveränderungen nach lidchirurgischen Eingriffen.

BACKGROUND: There is largely a lack of clarity on the question of whether refraction or topography changes are to be expected after blepharoplasty, levator resection, or a lateral tarsal strip procedure. MATERIALS AND METHODS: Therefore, in the present study, objective refraction, anterior eye segment tomography, and visual acuity tests were carried out pre- and postoperatively in 78 patients and then analyzed. The examination was carried out preoperatively, at suture removal after 10 days, and after 3 months. RESULTS: Neither after blepharoplasty nor after a lateral tarsal strip procedure were significant changes in vision or refraction seen in the topography. In contrast, the Wilcoxon sign test 10 days after levator resection showed a significant increase in the cylinder after 10 days compared to the preoperative level (p = 0.042). However, this change was no longer detectable after 3 months. CONCLUSION: The authors postulate that extensive patient education with regard to temporary visual changes, particularly in the case of levator resections, is essential and that additional refraction and topography control can be useful postoperatively.

[Comparison of subjective improvement in quality of life of patients after open and minimally invasive surgical techniques for recanalization of lacrimal duct stenosis in 2015-2018]. / Vergleich der subjektiven Lebensqualitätsverbesserung von Patienten nach eröffnenden und minimal-invasiven Operationstechniken zur Rekanalisierung von Tränenwegsstenosen in den Jahren 2015 bis 2018.

BACKGROUND: Open and minimally invasive tear duct surgery are among the common surgical indications; however, little is known so far about the respective influences on the quality of life. OBJECTIVE: The aim of this study was to compare the subjective influence on the quality of life of patients after open and minimally invasive surgical techniques for recanalization of dacryostenosis. MATERIAL AND METHODS: From the collective of patients who were surgically treated at the University Medical Center Hamburg-Eppendorf from 2015 to 2018, a total of 169 patients (111 dacryocystorhinostomy, DCR, 58 endoscopy) took part in the survey and answered 9 questions about subjective satisfaction, which were evaluated also comparatively. RESULTS: When asked about postoperative satisfaction, the patients were significantly more satisfied after DCR (p = 0.001) than the patients who underwent a lacrimal endoscopy. There was no significant difference in terms of postoperative complications (p = 0.348). The rate of reoperations, however, was significantly higher in the patient group who underwent lacrimal endoscopy (χ2-test, p = 0.004). CONCLUSION: In summary it can be said that DCR is not inferior to lacrimal endoscopy in terms of patient satisfaction.

[Comparative analysis of refractive and topographic changes after eye muscle surgery]. / Vergleichende Analyse der Refraktions- und Topographieveränderungen nach Augenmuskeloperationen.

BACKGROUND: The question of whether refractive or topographic changes are to be expected after eye muscle surgery is largely unanswered. MATERIALS AND METHODS: Results of pre- and postoperative objective refraction, Pentacam (Oculus, Menlo Park, CA, USA), and visual acuity tests of 229 eyes are included in the present analysis. The examinations took place preoperatively, on the first postoperative day, and after 3 months. RESULTS: After surgery on one or two extraocular recti muscle, there are significant changes in the cylinder (p < 0.001) on the first postoperative day, although values returned to normal after 3 months. Similar changes also appeared in combined operations of extraocular and oblique muscles. CONCLUSION: The authors postulate that extensive patient education with regard to temporary changes in the cylinder is necessary, particularly when the extraocular muscles are involved, and that additional refraction and topography control can be useful postoperatively if visual rehabilitation is inadequate.

[Bilateral 4MRGN Pseudomonas aeruginosa-associated choroidal abscesses in cystic fibrosis : Bilateral enucleation of the eyes as a last resort in a life-threatening situation]. / Bilaterale 4MRGN-Pseudomonas-aeruginosa-assoziierte choroidale Abszesse bei Mukoviszidose : Die bilaterale Enucleatio bulbi als Ultima Ratio bei vitaler Bedrohung.

We present a case of bilateral choroidal abscesses due to a multidrug-resistant gram negative (4MRGN) Pseudomonas aeruginosa lung colonization in a patient with cystic fibrosis under immunosuppression after lung transplantation. Bilateral choroidal and subretinal abscesses were detected by funduscopy, ultrasound, magnetic resonance imaging (MRI) and phacovitrectomy and were accompanied by bilateral acute vision loss. The diagnosis was confirmed by intraoperative subretinal biopsy. Due to therapy resistance a bilateral enucleation for life-saving purposes was performed.

[Acute right proptosis due to spontaneous orbital hemorrhage]. / Einseitiger Exophthalmus mit Orbitaeinblutung.

A 46-year-old woman presented with a sudden onset of non-traumatic periorbital hemorrhage, painless proptosis, conjunctival chemosis and injection as well as motility restriction of the right eye with double vision. Magnetic resonance imaging (MRI) revealed an extraconal mass in the medial orbit with lateral displacement of the medial rectus muscle and the eyeball without optic nerve involvement. A biopsy led to the diagnosis of non-specific inflammation. This case shows that sudden periorbital hemorrhages can be a sign for idiopathic orbital inflammation.

[Biocompatibility of dyes for vitreoretinal surgery]. / Biokompatibilität von Farbstoffen für die vitreoretinale Chirurgie.

For the last 8 years vital dyes have been used to visualize preretinal semitransparent structures in the eye during vitroretinal surgery. However, indocyanine green (ICG), which was the first commonly used dye, proved to be partly toxic to retinal cells and the retinal pigment epithelium in various in vitro and in vivo studies. Therefore, an intensive search for new and safer dyes was started. At present three dyes, trypan blue, patent blue and brilliant blue are predominantly used for vitreoretinal surgery, in addition to ICG. In this article an overview of preclinical biocompatibility studies for common vital dyes is presented. Additionally, a systematic approach for testing of new candidate dyes for vitreoretinal surgery will be proposed.

[Vital dyes in vitreoretinal surgery. Current application concepts]. / Farbstoffe in der vitreoretinalen Chirurgie. Aktuelle klinische Anwendung.

This article reviews the most relevant vital dyes and adjuncts currently available for use in vitreoretinal surgical procedures. The current concepts of intraocular application as well as the staining properties are described, and the issue of biocompatibility is discussed.

[Duplex ultrasound examinations of retinal circulation after inhalation of various mixed respiratory gases]. / Duplexsonographische Untersuchungen zur retinalen Durchblutung nach Inhalation verschiedener Atemgasgemische.

BACKGROUND: Hyperoxic-hypercapnic inhalation is a therapeutic option in vascular disorders of the retina. The effect of hyperoxic and/or hypercapnic inhalation on the perfusion of the retina was examined. METHODS: Twenty-five young adults between 18 and 35 years were investigated in a prospective study. They inhaled one of three different mixtures of breathing gases: (1) 100% O2, (2) Carbogen 240 (95% O2 and 5% CO2), (3) 92% O2 with 8% CO2 and were examined by color Doppler imaging of the CRA and OA before and after inhalation. The resistance index (RI) was calculated. RESULTS: The majority of the subjects showed an Increase in the RI in both ophthalmic vessels after inhalation of pure O2, a decrease after breathing in 92% O2 and 8% CO2 and it remained almost constant with inhalation of 95% O2 and 5% CO2. CONCLUSIONS: Inhalation of 92% O2 and 8% CO2 is a possibility for decreasing the peripheral resistance of OA and CRA. No change in blood flow was observed with Carbogen 240.