Darstellung vitreoretinaler Adh?renzen in Partneraugen von Patienten mit durchgreifenden Makulaforamina in der optischen Koh?renztomographie

Hintergrund. Glask?rperadh?renzen spielen eine wichtige Rolle bei der Entstehung des Makulaforamens. Wir untersuchten vitreoretinale Adh?renzen mit der OCT, um die Entstehung von Makulaforamen zu analysieren.     

Rehabilitation des chronisch unspezifischen Kreuzschmerzes

In this study we documented the effectiveness of a 3-week multidisciplinary rehabilitative intervention in patients with chronic nonspecific low back pain. We compared the therapy group (136 patients: 91 female, 45 male) with a waiting list control group (34 patients: 25 female, 9 male). The patients showed chronic pain grades 1 and 2 (according to the Mainz Pain Staging System) and mild restriction of activity. Pain intensity, activity, participation, and health-related quality of life improved significantly in the intervention group (VAS from 46.34 to 25.91; FFbH-R from 19.79 to 18; PDI from 21.02 to 14.57; NHP from 161.83 to 120.97); the waiting list control group remained unchanged. The improvement was independent of age, gender, duration of disease, work status, or workplace satisfaction.     

Evaluation der zentralen Hornhautbrechkraft nach myoper LASIK

PURPOSE: Comparison of the central corneal refractive power before and after myopic LASIK using the Keratograph and the Pentacam. The Scheimpflug technique (Pentacam) enables the measurement of the corneal refractive power by examining the anterior and posterior corneal curvature. METHOD: The corneal refractive power of 59 eyes was examined before, 3 months and 6 months after myopic LASIK. The refractive power was measured at the corneal apex and at a distance of 2 and 4 mm. Statistical analysis was performed using the Wilcoxon signed rank test; a p value of 0.05 or less was considered statistically significant. RESULTS: At the corneal apex and at a distance of 2 mm the findings with the Keratograph showed a higher refractive power of up to 1.05 D. The differences were statistically significant at all times. At a distance of 4 mm from the corneal apex postoperatively there was no statistically significant difference. CONCLUSION: The results using the Pentacam system showed a lower corneal refractive power following myopic LASIK at all times. Its measuring principle compared to that of the Keratograph should be preferred when detecting changes of the refractive power of the central cornea after corneal refractive procedures.     

Eccentric lamellar keratolimbal grafts harvested with a manually guided microkeratome. Technical report

BACKGROUND: To perform lamellar keratolimbal allograft transplantation in a one-step procedure with a single graft, we investigated the feasibility of harvesting eccentric lamellar keratolimbal grafts from conventionally processed corneoscleral buttons using a manually guided microkeratome in conjunction with an artificial anterior chamber system. METHODS: We used the Moria LSK-One microkeratome and the automated lamellar therapeutic keratoplasty (ALTK) system (Antony, France). Ten human donor eyes were used to obtain single-piece lamellar keratolimbal grafts. Specimens were processed for light and electron microscopy. RESULTS: Eccentric keratolimbal grafts could be obtained from all human donor buttons. Grafts include a crescent-shaped limbal and a large corneal portion. No visible damage to the limbal region was discernible. CONCLUSION: Our data show that the LSK-One microkeratome in conjunction with the ALTK system allows harvesting eccentric keratolimbal grafts from donor corneoscleral buttons.     

Darstellung vitreoretinaler Adhärenzen in Partneraugen von Patienten mit durchgreifenden Makulaforamina in der optischen Kohärenztomographie

Background. Vitreoretinal adhesions play a crucial role in the development of a macular hole. To visualize vitreoretinal adhesion we used optical coherence tomography to investigate fellow eyes of patients with macular holes. Methods. In a prospective study we scanned the retina in 188 patients with a macular hole stage III or IV (Gass classification). The foveal shape and vitreous were classified into grades. Results. Of the 188 patients 45% showed no vitreous reflex, 45% a partial vitreous detachment with foveolar adhesions, and 10% a vitreous detachment with complete separation from the fovea. While eyes with normal foveolar shape displayed partial vitreous detachment in 33%, this figure rose to 66% in eyes with a macular hole stage I. Conclusion. Diffuse thickening of the fovea is followed by an intraretinal split and formation of a cyst. The shape of the foveolar adhesion suggests that continuing anteroposterior vitreal traction leads to a retinal break and formation of a full-thickness macular hole.     

Phototherapeutic keratectomy in children

PURPOSE: Children with dense superficial opacities of the cornea are at risk for developing amblyopia. This study evaluated the efficacy of phototherapeutic keratectomy (PTK) in severe cases of anterior stromal scarring. METHODS: Five eyes of five patients, aged 6 to 8 years, were included. Three children suffered from uveitis-associated band keratopathy, one child had anterior corneal stromal scarring due to viral infection, and one child had anterior basement membrane dystrophy. Phototherapeutic keratectomy was performed under general anesthesia using the 200 Hz ALLEGRETTO excimer laser. Optical treatment zone was 7.0 mm (one eye) and 8.0 mm (four eyes), and ablation depths were between 20 and 100 microm. Postoperative treatment consisted of bandage soft contact lens, topical preservative-free antibiotics, steroids, and artificial tears. Part-time occlusion therapy was continued, as prior to PTK. Because of the small cohort, statistical evaluation was not performed. RESULTS: Mean follow-up was 23.4 +/- 13.7 months (range: 10 to 41 months). Surgery and postoperative follow-up were uneventful, and no signs of infection or haze were noted. Preoperative best spectacle-corrected visual acuity was 0.4 to 3.0 logMAR (mean: 1.22 +/- 1.07 logMAR). Best spectacle-corrected visual acuity improved in four eyes and stabilized in one eye due to uveitis recurrence (mean 0.64 +/- 0.65 logMAR). Mean preoperative keratometric values changed from 45.60 +/- 0.90 to 44.90 +/- 3.00 diopters postoperatively. CONCLUSIONS: Dense superficial corneal opacity in children may be successfully treated with PTK. Phototherapeutic keratectomy was performed to increase corneal transparency and corneal surface smoothing thereby avoiding amblyopia.