Enucleation combined with orbital implants for malignant melanoma of the uvea.

Advanced malignant melanomas of the uvea unsuited for an eye salvaging approach require enucleation of the tumor containing eye. A series of 68 patients is reported who underwent enucleation combined with insertion of a spherical dura-encased implant after 30 Gray pre-irradiation therapy of the orbit. Postoperative results with special attention to cosmetic outcome and motility of the prosthesis suggest that the insertion of an orbital implant should be preferred to the enucleation with no implant.

Glued fixation of split-skin graft to the bony orbit following exenteration.

A technique is described to fix a split-skin graft to the bony orbit with a new homologous fibrin adhesive system. This shortens the time between the exenteration and the fitting of an epithesis to the bony orbit as compared with the granulation technique or fitting the graft with a prolonged pressure bandage. The advantages and risks connected to the glue system are discussed.

Sideways displacement and curved path of recti eye muscles.

We investigated the sideways displacement of recti muscles with the eye in various gaze-positions by making computed tomographic (CT) scans in a plane perpendicular to the muscle cone, posterior to the globe. We found no consistent sideways displacement of the horizontal recti in the up or down gaze or the vertical recti in the left or right gaze. We found a substantial displacement, however, of the contracting and relaxing muscles. Consequently, we made CT scans in a horizontal plane through medial and lateral recti and found that, with the eye in primary position, the recti muscles follow a curved path. The curvature of the path increased following muscle relaxation and decreased following muscle contraction.

[Surface changes in glass eye prostheses]. / Oberflächenveränderungen von Glasaugenprothesen.

The exposed surface of new glass eye protheses becomes rough and is destroyed in use. The changes in the exposed surfaces have been demonstrated by scanning electron microscopy and with thin sections under optical microscopes. The alteration process depends on the length of time the artificial eye is worn. The main cause is chemical attack of the glass surface in the tear fluid, which is usually slightly alkaline. Chronic conjunctival inflammation, appearing after a long period of wearing the same artificial eye, may be caused by mechanical irritation from the surface roughness.

Thermal conductivity of bovine and pig retina: an experimental study.

All known mathematical models for calculating coagulation processes use the thermophysical constants of water. If these calculations are to be improved, it is necessary to know the constants exactly. We developed an instrument and measured the thermal conductivity, which we found definitely different from that of water. The measuring procedure is discussed as well as the problems of dealing with material which changes nature during the procedure.

[Experimental findings with a fibrin tissue adhesive in conjunctival and skleral surgery in a rabbit model (author's transl)]. / Tierexperimentelle Erfahrungen mit dem Fibrinkleber in der Bindehaut- und Sklerachirurgie.

The authors investigated the wound closure of conjunctival wounds with fibrin adhesive as compared to a suture technique in rabbits. Similarly, the fixation of a transplant of lyophilized dura mater on the sclera by fibrin adhesive was also compared with a suture technique. Both clinically and histologically, there were only negligible differences in wound healing in the two series. In particular, no toxic reaction caused by the adhesive substance was observed. To avoid failures in wound closure with the investigated tissue adhesive there must be no tension at the edges of the wound.

[Modification of Mackensen's and Corydon's technique for reattaching the ciliary body (author's transl)]. / Modifikation des Operationsverfahrens zur Anheftung des Ziliarkörpers nach Mackensen und Corydon.

The weakness of Mackensen's and Corydon's method of reattaching the ciliary body in hypotonic syndrome lies in the closure of the scleral wound. We therefore recommend additional fibrinous cementing of the scleral suture with lyophilized dura mater. Since we adopted this technique we have observed no cases of wound dehiscence.