Klinische Monatsblatter fur Augenheilkunde最新文献

{"title":"Expanding Horizons: Visual Outcomes with a 7.7 mm Optical Zone in KLEx Surgery.","authors":"David Dietrich Beckers, Florian Kretz, Fabian Höhn, Karen Glandorf, Detlev R H Breyer, Anke Messerschmidt-Roth, Lena Beckers","doi":"10.1055/a-2661-4897","DOIUrl":"10.1055/a-2661-4897","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the visual and corneal outcomes of Keratorefractive Lenticule Extraction (KLEx) using a large lenticule diameter with a 7.7 mm optical zone and 7.9 mm cap diameter. The study aimed to determine the feasibility, refractive precision, and potential benefits of larger optical zones in improving visual quality and reducing myopic regression, particularly in patients with larger scotopic pupils.</p><p><strong>Methods: </strong>This retrospective case series included 40 eyes from 20 patients who underwent KLEx surgery with the VisuMax800 femtosecond laser. The programmed lenticule diameter was 7.7 mm, and the cap diameter was 7.9 mm, with a cap thickness of 140 µm and a 2.5 mm incision. Preoperative spherical equivalents ranged from - 1.5 D to - 4.75 D. Postoperative evaluations were conducted at 3 months, and assessed refractive outcomes, uncorrected visual acuity (UCVA), and residual astigmatism. Surgical planning was based on a personalized nomogram with refractive adjustments for low astigmatic values.</p><p><strong>Results: </strong>At 3 months, 100% of eyes achieved a UCVA of 20/20, and 25% reached 20/16 or better. The mean postoperative spherical equivalent was + 0.14 ± 0.27 D. Refractive predictability was high, with 97.5% of eyes within ± 0.5 D of intended spherical correction and 90% within ± 0.5 D of cylindrical correction. Residual astigmatism was ≤ 0.50 D in 87% of cases. No adverse events were reported.</p><p><strong>Conclusions: </strong>KLEx using large lenticules is safe, effective, and highly accurate. Larger optical zones may enhance refractive stability and visual quality in patients with large pupils.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cystoid Macular Oedema (CME) and Immune Responses after DMEK/Triple DMEK: Real Life Data from Oregis.","authors":"Johanna Wiedemann, Christopher Dicke, Björn O Bachmann, Lebriz Altay, Claus Cursiefen","doi":"10.1055/a-2650-9712","DOIUrl":"10.1055/a-2650-9712","url":null,"abstract":"<p><strong>Background: </strong>Oregis is the multi-centre registry of the German Ophthalmological Society, that systematically collects a comprehensive data set on ophthalmological care in Germany. Here we present the first analysis of Descemet Membrane Endothelial Keratoplastic (DMEK). Only two of the following centres provided the data presented here, but, in the future, participation in Oregis will increase so that data from different eye hospitals and clinics and outpatient and inpatient treatments will be covered.</p><p><strong>Objectives: </strong>Overview of real-life care after DMEK in Germany.</p><p><strong>Methods: </strong>The data was analysed using SweetVIZ 2.1.4. SweetViz is an open-source Python library for automated exploratory data analysis (EDA). Statistical tests were performed using R.</p><p><strong>Results: </strong>Cystoid macular oedema (CME) and immune response are significant complications of DMEK, and both are treated by corticosteroids.</p><p><strong>Discussion: </strong>The future expansion of the register will provide data on the current situation and indicate possible improvements in postoperative care in Germany.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Wenn Fuchs auf Keratokonus trifft: Eine seltene doppelte Herausforderung für die Hornhaut - zwei Fallberichte].","authors":"Ayse Bozkurt Oflaz, Sema Uzum, Elif Kılıc, Banu Bozkurt","doi":"10.1055/a-2705-5029","DOIUrl":"https://doi.org/10.1055/a-2705-5029","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Change in Corneal Endothelial Cells after Gonioscopy-Assisted Transluminal Trabeculotomy.","authors":"İhsan Çakır, Gizem Taşkın, Neşe Alagöz, Gülay Yalçınkaya Çakır, Çiğdem Altan, Tekin Yaşar","doi":"10.1055/a-2679-3120","DOIUrl":"10.1055/a-2679-3120","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the change in corneal endothelial cell density (ECD) after gonioscopy-assisted transluminal trabeculotomy (GATT) surgery alone or in combination with phacoemulsification (phaco).</p><p><strong>Methods: </strong>In this prospective monocentric comparative study, consecutive patients were enrolled with open angle glaucoma (OAG) and who had been treated with GATT or phaco + GATT, with complete endothelial cell data and at least 6 months of follow-up. Patients who underwent phaco surgery alone during the same period were recorded as the control group. The main outcomes were ECD changes.</p><p><strong>Results: </strong>The study included 64 OAG (40 eyes in the GATT and 24 eyes in the GATT + phaco groups) and 30 control eyes (phaco group). There was a significant decrease in mean ECD compared to baseline in the GATT, phaco + GATT, and phaco groups (p < 0.001 for all). At the end of follow-up, percent cumulative ECD reduction values were 6.89%, 14.47% and 10.32% in the GATT, phaco + GATT, and phaco groups, respectively (p = 0.01 for all groups). The ECD reduction in the phaco + GATT group (p = 0.02) and in the phaco group (p = 0.04) was significantly higher than in the GATT group. ECD reduction was similar in the phaco + GATT and phaco groups (p = 0.69).</p><p><strong>Conclusions: </strong>A significant ECD loss was observed in 6 months period after GATT surgery compared to the baseline. The ECD reduction observed after GATT combined with phacoemulsification was greater than with GATT alone. There was no significant difference between phaco-GATT combined surgery and phaco alone.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: The Effectiveness of Corneal Epithelial Debridement Performed with an Alcohol-Impregnated Sponge.","authors":"Deniz Altinbay, Ibrahim Taskin","doi":"10.1055/a-1451-6779","DOIUrl":"10.1055/a-1451-6779","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"e4"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25522966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Outcome of Aflibercept 8 mg for Neovascular AMD in the Real-world Setting.","authors":"Michael Grün, Kai Rothaus, Albrecht Peter Lommatzsch, Henrik Faatz","doi":"10.1055/a-2655-8854","DOIUrl":"10.1055/a-2655-8854","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the early outcome of intravitreal aflibercept 8 mg in treating neovascular age-related macular degeneration (nAMD) of eyes that either received prior intravitreal anti-VEGF treatment or were treatment-naïve - under real-world conditions.</p><p><strong>Methods: </strong>This is a retrospective study of a total of 83 eyes with nAMD treated with aflibercept 8 mg. 61 of these eyes completed an initial loading phase of 3 monthly intravitreal injections (IVI) and were included in further analyses. Outcome parameters included best-corrected visual acuity (BCVA, logMAR), presence of intraretinal (IRF) and subretinal fluid (SRF), extent of pigment epithelium detachment (PED height, µm) and central subfield retinal thickness (CSRT, µm) in spectral domain optical coherence tomography (SD-OCT). Patients were assessed at the beginning of aflibercept 8 mg treatment and 4 weeks after completing the loading phase. The McNemar test was used to test for changes in distribution of eyes showing IRF and SRF, and the paired t test was performed to test for changes in BCVA, PED height and CSRT.</p><p><strong>Results: </strong>51 eyes had been previously treated with intravitreal anti-VEGF, while 10 eyes were treatment-naïve. Mean BCVA after completed loading phase was 0.49 ± 0.31 logMAR and did not show changes to baseline BCVA, which was 0.49 ± 0.32 logMAR (p = 0.89). A significant reduction was observed in all disease activity parameters in SD-OCT. The proportion of eyes showing IRF and SRF decreased from 54.1% to 26.2% (p < 0.001) and 65.6% to 24.6% (p < 0.001), respectively. A reduction in PED height from 227.7 ± 114.6 µm at baseline to 191.9 ± 111.4 µm (p < 0.001) and a decrease in CSRT from 375.2 ± 126.2 µm to 308.8 ± 93.7 (p < 0.001) were recorded. Of all eyes (n = 83) that had received at least one IVI aflibercept 8 mg, 5 eyes (6.0%) developed symptomatic, non-infectious intraocular inflammation (IOI), which resolved completely with topical treatment.</p><p><strong>Conclusion: </strong>Our results demonstrate good effectiveness of intravitreal aflibercept 8 mg in the real-world setting, with significant reduction in disease activity parameters in SD-OCT after the loading phase with 3 monthly injections - while BCVA remained stable. While the PULSAR trial only included treatment-naïve eyes, our study underlines the value of aflibercept 8 mg, even for pre-treated eyes that responded insufficiently to previous anti-VEGF treatment. Further studies are needed to evaluate long-term outcome in real-world setting, in order to verify the extended IVI intervals shown in the PULSAR trial.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on Artificial Intelligence in Neovascular Age-Related Macular Degeneration.","authors":"Thiago Gonçalves Dos Santos Martins","doi":"10.1055/a-2487-5978","DOIUrl":"10.1055/a-2487-5978","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"901"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated Diabetic Retinopathy Screening in Out-patient Diabetes Care - Comparison of Two Artificial Intelligence Algorithms: RetCAD and OphtAI.","authors":"Florian Maria Bauer, Annette Sauerbeck, Wolfgang Hitzl, Nick Piravej, Josef Schmidbauer","doi":"10.1055/a-2620-1956","DOIUrl":"10.1055/a-2620-1956","url":null,"abstract":"<p><strong>Objective: </strong>The artificial intelligence (AI) can be applied to screening for diabetic retinopathy (DR) from colour fundus photographs. The prerequisite for this is that the AI used can achieve a similar performance in the real world in different study conditions. The aim of this study is therefore to test and compare the latest version of the AI-based algorithms RetCAD and OphtAI for DR screening in a diabetes outpatient clinic.</p><p><strong>Methods: </strong>In the period from August 2023 to November 2023, 150 diabetics were recruited at the outpatient diabetes center of the University Hospital. For each study participant, images were taken with the handheld retinal camera Aurora (Optomed Plc, Oulu, Finland) in Miosis. The images were examined by the ophthalmologist and by the AI-based algorithms RetCAD version 2.2.0 (Thirona Retina, Nijmegen, Netherlands) and OphtAI version 2.3.4 (Groupe Evolucare Technologies, Le Pecq, France) for the presence of DR. The severity of DR was classified using the International Clinical Diabetic Retinopathy (ICDR) scale. Patients with no retinal changes or a mild DR were advised to have an ophthalmological check-up in one year. In the presence of a moderate, severe or proliferative DR, a referral to the treating ophthalmologist was made. For this reason, the severity levels of moderate, severe and proliferative DR have been summarised under the umbrella term of referable DR.</p><p><strong>Results: </strong>No DR was detected in 123 out of 143 (86.0%) diabetics and mild DR was detected in 10 (7.3%). All patients with moderate DR 7 (5.0%), severe 2 (1.5%) and proliferative DR 1 (0.7%) were grouped together as refererable DR and represented a proportion of 7.3%. The AI-based algorithm RetCAD version 2.2.0 achieved a sensitivity of 90% and a specificity of 100% for the detection of a referable DR compared to ophthalmological image assessment. RetCAD rated 98% of the images for image analysis as sufficient or better. In contrast, the second AI-based algorithm OphtAI version 2.3.4 achieved a sensitivity of 70% and a specificity of 100% for the detection of a referable DR. The OphtAI software was able to perform image analysis on all images.</p><p><strong>Conclusion: </strong>The results for the detection of a referable DR were consistent under study conditions and in clinical use for the AI-based algorithm RetCAD. The AI-based algorithm OphtAI, on the other hand, detected fewer patients with moderate DR, which was reflected in lower sensitivity. Both algorithms correctly assigned all patients with severe and proliferative DR. The AI-based algorithms RetCAD and OphtAI tested appear to be suitable for use in a diabetes outpatient clinic and primary care setting, respectively.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"912-919"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seasonality of Herpes zoster and Herpes zoster ophthalmicus in Germany - a 14-year Single Centre Study.","authors":"Rebecca Diehl, Daniel Böhringer, Simone Nuessle, Thomas Reinhard, Cornelius Wiedenmann","doi":"10.1055/a-2663-0166","DOIUrl":"https://doi.org/10.1055/a-2663-0166","url":null,"abstract":"<p><strong>Background: </strong>While the incidence of herpes zoster has been reported to exhibit seasonal patterns in different global regions, with some studies suggesting correlations with weather data, data specific to Germany has been lacking. We investigated the seasonality of herpes zoster incidence in Germany and compared weather data.</p><p><strong>Patients and methods: </strong>We conducted a single centre, interdisciplinary retrospective analysis of all herpes zoster cases at the Department of Dermatology and the Eye Centre from the Medical Centre, University of Freiburg from January 1st 2009 to December 31st 2022. 2,829 patients were identified using ICD-10 code B02.0 - 9. Monthly and cumulative daily incidences were calculated and plotted. Weather data were compared, including mean monthly temperature, sunshine duration, and UV-index.</p><p><strong>Results: </strong>The analysis revealed two distinct incidence peaks: a summer peak correlating with weather factors, and an unexpected winter peak from late December through early January that did not correlate with the investigated weather parameters.</p><p><strong>Conclusions: </strong>Our findings suggest that weather factors, like temperature, and UV-index, influence the incidence of herpes zoster in Germany. The previously undescribed \"new year spike\" indicates that additional, non-meteorological factors may trigger herpes zoster reactivation. This study provides insights into herpes zoster epidemiology in Germany and highlights the need for further research into trigger factors.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"242 9","pages":"920-926"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Safety and Risk Management in an Accumulation of Postoperative Endophthalmitis Cases after Vitrectomy in a University Eye Clinic.","authors":"Carsten Framme, Helmut G Sachs, Maria Cartes, Ella Ebadi, Claas Baier, Dorothee Brockmann, Martin Bartram, Heike Alz, Terence Krauß, Frank Lammert, Jan Tode, Karsten Hufendiek","doi":"10.1055/a-2663-5981","DOIUrl":"https://doi.org/10.1055/a-2663-5981","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the risk management at a university eye hospital after two outbreaks of nosocomial endophthalmitis cases after pars plana vitrectomy.</p><p><strong>Methods: </strong>In two series of postoperative endophthalmitis cases after in-house vitrectomy, the basic workflows in direct patient care were evaluated with regard to patient safety. Hygienic microbiological environmental examinations were performed on relevant materials and surfaces. In particular, the direct surgical utensils were inspected with regard to possible bacterial colonisation.</p><p><strong>Results: </strong>Pathogens (Staphylococcus aureus) were detected in 2 of 7 endophthalmitis cases. The S. aureus strains showed no clonality. The procedures were 23 G and 25 G vitrectomies for retinal detachment (3× rhegmatogenous, 1× PVR), subretinal macular hemorrhage (1×) and vitreous haemorrhage for proliferative retinopathy (2×). The duration of surgery was between 20 min and 65 min; the time between initial vitrectomy and the surgery for endophthalmitis was between 2 and 5 days (mean 3.6 days). A silicone oil filling was instilled once during the first operation and otherwise the eye was tamponaded with gas (4×) or air (2×). The surgical teams were heterogeneous; n = 5 surgeons were involved and the initial procedures took place in n = 4 different operating theatres. In all cases, general anaesthesia was applied (6× laryngeal mask, 1× endotracheal intubation). No definitive source of infection was found. The interventions with regard to patient safety were therefore aimed at strengthening compliance with existing measures for preventing infection and adapting work processes. In the acute phase, antibiotics were instilled intraoperatively into the anterior chamber after vitrectomy, contrary to the usual in-house procedure. Other types of intraocular surgery were not affected.</p><p><strong>Conclusion: </strong>The accumulation of in-house endophthalmitis cases is a catastrophic event in an eye clinic and stringent risk management is required to identify the causes. Openness and transparency are essential factors for an adequate workup. This manuscript shows what the individual steps could look like and how the results can be dealt with. The problem of not having found a clear point source for the infections is discussed.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}