Klinische Monatsblatter fur Augenheilkunde最新文献

{"title":"Comparison of Two Surgical Methods for the Treatment of Convergence Excess: Y-Split and Retro-equatorial Myopexy of the Medial Rectus Muscle.","authors":"Christoph Kalantari, Oliver Ehrt, Martin M Nentwich","doi":"10.1055/a-2543-1425","DOIUrl":"https://doi.org/10.1055/a-2543-1425","url":null,"abstract":"<p><strong>Background: </strong>In addition to the bimedial recession of the rectus muscle, two surgical procedures are available to reduce torque: retro-equatorial myopexy (Cüppers-Fadenoperation) and the Y-split of the medial rectus muscle. The aim of this study is to compare the safety and efficacy of the latter two surgical techniques.</p><p><strong>Methods: </strong>Data from 113 consecutive patients who presented for surgical treatment of convergence excess at the University Hospital of Würzburg between October 2006 and October 2020 were retrospectively analysed. In 2006 - 2014. All patients underwent retro-equatorial myopexy, whereas from 2015 onwards, Y-splitting was the treatment of choice. Orthoptic examinations were performed preoperatively, on the first postoperative day, four months postoperatively and in the longer postoperative course - always with full correction of hyperopia as measured in cycloplegia. The distance and near squint angles in the alternating cover test, the convergence excess and the complication rate as well as the need for repeat surgery were measured.</p><p><strong>Results: </strong>Both retro-equatorial myopexy and Y-splitting significantly reduced the far and near strabismus angles and convergence excess in all postoperative controls, with no significant difference between the two groups at the four-month follow-up (Levene's variance homogeneity test [far angle p = 0.151; near angle p = 0.114]). The incidence of intraoperative complications and the need for reoperation for over- and undercorrection were slightly lower with the Y-split.</p><p><strong>Conclusion: </strong>Both retro-equatorial myopexy and Y-splitting of the medial rectus muscle are suitable surgical procedures for the treatment of convergence excess. Y-splitting appears to be safer intraoperatively and easier to learn, due to the absence of retro-equatorial fixation, which is associated with fewer complications. However, revision may be more difficult, this should be considered in the event of loss of information regarding the Y-splitting technique and written documentation of the procedure should always be provided.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"242 5","pages":"570-577"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120111","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":"Twelve-Month Outcomes of Combined Phacoemulsification with Ab Interno Canaloplasty Versus Single-Use Dual Blade Goniotomy in Glaucoma Patients.","authors":"Julia Prinz, Niklas Plange, Hannah Schellhase, Peter Walter, Matthias Fuest, Antonis Koutsonas, David Kuerten","doi":"10.1055/a-2512-8141","DOIUrl":"10.1055/a-2512-8141","url":null,"abstract":"<p><strong>Background: </strong>To compare the efficacy and safety of combined phacoemulsification with ab interno canaloplasty (Phaco-AbiC) versus single-use dual blade goniotomy (Phaco-DBG).</p><p><strong>Material and methods: </strong>In this prospective consecutive case series, intraocular pressure (IOP), the number of IOP-lowering medications, the mean deviation (MD) of visual field testing, and surgery-related complications were evaluated in 25 eyes following Phaco-AbiC and 20 eyes following Phaco-DBG through 12 months of follow-up. Qualified or complete success was defined as postoperative IOP lower than 21, 18, and 16 mmHg with or without IOP-lowering medications.</p><p><strong>Results: </strong>At the 12-month follow-up, IOP was significantly reduced compared to baseline in the Phaco-AbiC (14.2 ± 2.7 versus 19.2 ± 4.7 mmHg, p < 0.001) and Phaco-DBG groups (16.7 ± 3.4 versus 19.9 ± 3.9 mmHg, p < 0.001). At the 12-month follow-up, IOP was significantly higher following Phaco-DBG than Phaco-AbiC (p = 0.011). Compared to baseline, the number of IOP-lowering medications was significantly reduced in the Phaco-AbiC (1.2 ± 1.4 versus 2.4 ± 1.0, p < 0.001) and Phaco-DBG groups (0.8 ± 0.9 versus 2.1 ± 0.9, p < 0.001) at the 12-month follow-up. For IOP lower than 16 mmHg, the complete and qualified success rate was significantly higher following Phaco-AbiC (36.0 and 76.2%, respectively) than Phaco-DBG (17.5 and 40.6%; p = 0.037; p = 0.007, respectively). No severe intra- or postoperative complications occurred.</p><p><strong>Conclusion: </strong>Both Phaco-AbiC and Phaco-DBG achieved a significant reduction in IOP and IOP-lowering medications at the 12-month follow-up. IOP was significantly lower 12 months following Phaco-AbiC than Phaco-DBG.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"562-569"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523889","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":"[Definition of Contrast in the Context of Traffic-related Testing of Twilight Vision and Glare Sensitivity - Statement of the Traffic Committee of the German Society of Ophthalmology (DOG) and the German Professional Association of Ophthalmologists (BVA). Status: 10 January 2025].","authors":"","doi":"10.1055/a-2548-2038","DOIUrl":"https://doi.org/10.1055/a-2548-2038","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"242 5","pages":"614-616"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120061","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":"The Effect of Glaucoma Treatment on Aniridia-Associated Keratopathy (AAK) - A Report from the Homburg Register for Congenital Aniridia.","authors":"Fabian Norbert Fries, Annamária Náray, Cristian Munteanu, Tanja Stachon, Neil Lagali, Berthold Seitz, Barbara Käsmann-Kellner, Nóra Szentmáry","doi":"10.1055/a-2194-1580","DOIUrl":"10.1055/a-2194-1580","url":null,"abstract":"<p><strong>Background: </strong>Congenital aniridia is a severe malformation of almost all eye segments. Aniridia-associated keratopathy (AAK) and secondary glaucoma, which occur in more than 50% of affected individuals, are typically progressive and pose a high risk of blindness for patients with congenital aniridia. Our aim was to investigate the effect of glaucoma treatment on AAK in patients of the Homburg Aniridia Center.</p><p><strong>Methods: </strong>Our retrospective monocentric study included patients who underwent a comprehensive ophthalmological examination at the Homburg Aniridia Center between June 2003 and January 2022.</p><p><strong>Results: </strong>There were 556 eyes of 286 subjects (20.1 ± 20.1 years; 45.5% males) included. In 307 (55.2%) eyes of 163 subjects (27.5 ± 16.3 years; 43.1% males), glaucoma was present at the time of examination. The mean intraocular pressure in the glaucoma group was 19.0 mmHg (± 8.0), while in the non-glaucoma group, it was 14.1 mmHg (± 3.6) (p < 0.001). In the glaucoma group, 68 patients used antiglaucomatous topical monotherapy, 51 patients used 2 agents, 41 patients used 3 agents, 7 patients used quadruple therapy, and 140 did not use topical therapy (e.g., after pressure-lowering surgery, pain-free end-stage glaucoma, or incompliance). Patients were classified according to the following stages of AAK: Stage 0 (96 eyes [17.2%], no keratopathy), Stage 1 (178 eyes [32.0%]), Stage 2 (107 eyes [19.2%]), Stage 3 (67 eyes [12.0%]), Stage 4 (62 eyes [11.1%]), Stage 5 (45 eyes [8.0%]). The mean stage of AAK was 1.4 (1.2 - 1.5) in the group without eye drops, 1.9 (1.5 - 2.2) in the group with monotherapy, 1.8 (1.5 - 2.1) in the group with 2 drugs, 1.9 (1.5 - 2.2) in the group with 3 drugs, 3.4 (2.3 - 4.6) in the group with 4 drugs, and 3.3 (3.1 - 3.6) after antiglaucomatous surgery. The stage of AAK was significantly positively correlated with the number of pressure-lowering eye drops (p < 0.05) and prior pressure-lowering surgery (p < 0.05). Prostaglandin analogues were not correlated with a higher AAK stage compared to the other drug groups.</p><p><strong>Conclusions: </strong>At the Homburg Aniridia Center, patients using topical antiglaucomatous quadruple therapy or who had previously undergone antiglaucomatous surgery had by far the highest AAK stage. The different drug groups had no influence on the AAK stage.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"578-583"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12094848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49679121","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":"[Insights into the practice of minimally invasive glaucoma surgery].","authors":"Stefan Steiner, Clemens Vass","doi":"10.1055/a-2217-6851","DOIUrl":"10.1055/a-2217-6851","url":null,"abstract":"<p><p>Minimally invasive glaucoma surgeries (MIGS) offer an alternative approach, aiming to be both safe and effective. Defined by their ab interno technique, which avoids creating a bleb, MIGS procedures seek to reduce intraocular pressure (IOP) by enhancing the outflow pathways of aqueous humor. Techniques include stenting, incisions, and excisions of the trabecular meshwork, canaloplasty of Schlemm's canal, and drainage implants that enhance uveoscleral outflow to the subchoroidal space. Many of these methods show promise in reducing intraocular pressure and decreasing the need for medication. Nevertheless, with the increasing number of these procedures and devices on the market, it is difficult to keep track of the evidence supporting these methods. Although randomized controlled trials exist for many of the new MIGS procedures, the sample sizes are often small, and follow-up periods are limited. Additionally, there are no randomized controlled trials comparing different MIGS techniques or MIGS with traditional glaucoma surgery. These factors continue to make it challenging to select the most appropriate method for each patient. Therefore, it is essential to persist in conducting randomized controlled long-term studies to gain a deeper understanding of the applications of MIGS.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"585-604"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983930","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 Comprehensive Analysis of Preoperative Biometric Parameters in Cataract Patients: A Retrospective Study of over 6000 Eyes.","authors":"David Beckers, Florian Kretz, Karen Glandorf, Salah Abdassalam, Mohamed Amer, Detlev R H Breyer, Hakan Kaymak, Karsten Klabe, Lena Beckers","doi":"10.1055/a-2541-4942","DOIUrl":"10.1055/a-2541-4942","url":null,"abstract":"<p><p>Cataract surgery is one of the most successful surgical procedures, improving vision and quality of life for millions globally. An accurate preoperative measurement is crucial for predicting outcomes, particularly in minimizing postoperative refractive errors through precise intraocular lens (IOL) selection. This study aimed to analyze preoperative biometric data in cataract patients to identify key parameters relevant for clinical decision-making. The study also sought to understand patient demographics and biometrics in a representative population. An automated retrospective analysis was conducted on the preoperative biometric data of 6 163 eyes from 3 118 patients who underwent cataract or clear lens extraction (CLE) surgery in a German clinic over the past 2 years. All measurements were taken using the IOL Master 700 (Carl Zeiss Meditec, Jena, Germany), and data were automatically transferred for analysis using a dedicated software tool. Biometric parameters assessed included axial length (AL), keratometry values (K, TK), anterior chamber depth (ACD), lens thickness (LT), and vitreous length (VL). The age and gender distribution of the cohort was also considered. The biometric data from this large patient cohort largely aligns with published norms for cataract patients. The majority of eyes exhibited ALs and corneal curvatures within expected ranges, supporting accurate IOL power calculations. The study also confirmed a high prevalence of mild astigmatism, suggesting that toric IOLs could address residual astigmatism for better visual outcomes. This study's large sample size adds valuable insights into preoperative cataract patient data and shows the value of an automated analysis.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"555-561"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730726","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":"[Ethical Aspects of the Development, Authorization, and Implementation of Applications in Ophthalmology Based on Artificial Intelligence - Statement of the German Ophthalmological Society (DOG) and the Professional Association of German Ophthalmologists (BVA), Developed by DOG-AG Ethics in Ophthalmology].","authors":"","doi":"10.1055/a-2542-5742","DOIUrl":"https://doi.org/10.1055/a-2542-5742","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"242 5","pages":"605-613"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120063","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":"Paediatric Ophthalmological Care in Large Ophthalmology Centres in Comparison to the Entire Specialist Group.","authors":"Ursula Hahn, Joerg Michael Koch, Ulrich Kellner","doi":"10.1055/a-2556-4235","DOIUrl":"https://doi.org/10.1055/a-2556-4235","url":null,"abstract":"<p><strong>Background: </strong>Paediatric ophthalmological care is suffering from a thinning care network. Two (of several) possible causes are the increasing number of new forms of organisation (large contract medical facilities in terms of number of patients, doctors and locations) and medical care centres (MVZ) in non-physician ownership.</p><p><strong>Methods: </strong>In a network of large ophthalmological care facilities, paediatric ophthalmological care activities per provider were surveyed for 2019 for all providers according to the proportion of the number of cases and structural characteristics (number of locations with orthoptists and sites with paediatric surgery), evaluated overall and in the subgroups according to ownership (non-physician or physician ownership) and compared with specialist group-related comparative data.</p><p><strong>Results: </strong>With the one exception of a physician ownership provider, all providers (total n = 15, 12 of which were physician-owned) treated children < 6 years. In 2019, a total of 90,461 statutory health insurance (SHI) cases of children < 6 years were treated (9.3%of all SHI cases in children < 6 years in Germany). In the entire cohort, their share of all SHI cases was 3.7% (physician ownership: 4.8%, non-physician ownership: 3.2%). For the specialist group of all ophthalmologists in Germany, the average was 3.2% (difference not significant). Orthoptists worked at a total of 98 locations (58 physician ownership, 40 non-physician ownership, difference significant [p = 0.03]). Outpatient and inpatient paediatric surgery were offered by all non-physician owned providers and some physician owned providers.</p><p><strong>Conclusions: </strong>In this first large study on paediatric ophthalmic care in relation to the provider, the contribution of the newer types of organisation was evaluated. In comparison to traditional practices, there was no systematically different orientation - either for the whole study group or for any type of provider, as based on the relative proportion of children with SHI insurance or structural indicators (orthoptists or, outpatient or inpatient surgical care).</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"242 5","pages":"546-554"},"PeriodicalIF":0.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120180","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":"[Edvard Munch's Intravitreal Birdcage].","authors":"Marie Elisabeth Burghardt, Arne Viestenz","doi":"10.1055/a-2549-3349","DOIUrl":"https://doi.org/10.1055/a-2549-3349","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971452","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":"[Intravitreal Faricimab Injections for Coats Disease: a Case Report].","authors":"Solveig Severin, Filip S Filev, Burkhard von Jagow","doi":"10.1055/a-2556-6303","DOIUrl":"https://doi.org/10.1055/a-2556-6303","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000834","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}