[The Influence of Intravitreal Injections on Outpatient Cataract Operations in Germany]. / Der Einfluss der intravitrealen Injektionen auf die ambulante Intraokularchirurgie in Deutschland.

PURPOSE: The number of outpatient operations in Germany is not registered in a centralised manner. To estimate the development of the outpatient intraocular surgery especially since the implementation of the intravitreal injections, surveys among ophthalmic surgeons were analysed. METHODS: Between 2006 and 2013 surveys were done among ophthalmic surgeons in Germany using questionnaires. An average of 318 completed questionnaires were sent back. The mean participation ratio was 37 %. RESULTS: Between 2006 and 2013 an extrapolated mean of 347 564 cataract operations and 139 946 intravitreal injections were reported. Whereas the number of cataract operations was constant in the observation period, the number of injections increased considerably from 35 135 in 2006 to 274 714 in 2013. CONCLUSION: A saturation in the development of the numbers of the intravitreal injections could not yet be observed. Other outpatient operations, especially cataract procedures were not replaced by the increase of the injections in the recent years.

[Resection of the Müller muscle. Indications, technique and results]. / Die Müller-Muskel-Resektion. Indikation, Technik und Ergebnisse.

From 1987 to 1992, 582 operations for blepharoptosis were performed in our department. Twenty-five cases of superior tarsal muscle resection in 22 patients were reviewed retrospectively and serve as the basis of the present study. The blepharoptosis was mild to moderate (up to 4 mm) in 20/25 cases. Preoperatively, the phenylephrine eye drops test was positive in 20/25 cases. The indication for both congenital and acquired blepharoptosis was independent of the activity of the levator muscle. The resection was performed by a conjunctival approach. Three techniques of muscle stump refixation were tested without any significant difference in the results. A satisfactory eyelid elevation of more than 2 mm was achieved in 16/25 operations. A moderate effect (1-2 mm) was measured in 5/25 and an unsatisfactory effect (< 1 mm) in 4/25 cases. In contrast to the Fasanella-Servat procedure, the above-mentioned technique leaves all other structures of the upper eyelid intact, especially the accessory lacrimal glands.

[Orbital exenteration. A preventable course in tumor treatment?!]. / Exenteratio orbitae. Vermeidbarer Verlauf in der Tumorbehandlung?!

We reviewed the conditions leading to the mutilating procedure of orbital exenteration in 24 patients at our institution between 1980 and 1993. In 17 cases, including 16 of 17 patients with malignant tumours of the eyelid, this operation could potentially have been avoided. Three of these 17 patients first saw a doctor at an extremely advanced and otherwise untreatable stage of the tumour. The other 14 patients had at least one previous treatment attempt. Six patients with basal cell carcinoma had been primarily treated with radiation alone; two of them developed a squamous cell carcinoma subsequently. In six cases primary reconstruction was performed despite incomplete resection. In one patient a meibomian gland carcinoma was misdiagnosed as a chalazion and excised without histological examination. In another case of squamous cell carcinoma a cutaneous incisional biopsy 6 months prior to orbital exenteration revealed a papilloma. These results emphasize the necessity of careful histological examination in the treatment of lid tumours.