Klinische Monatsblatter fur Augenheilkunde最新文献

{"title":"Keratorefractive Lenticule Extraction - KLEx.","authors":"Marcus Blum, Ramin Khoramnia, Walter Sekundo","doi":"10.1055/a-2650-7508","DOIUrl":"https://doi.org/10.1055/a-2650-7508","url":null,"abstract":"<p><p>The clinical use of femtosecond lasers has led to significant progress in a number of surgical procedures in ophthalmology. In the field of corneal refractive surgery, a one-step intrastromal laser procedure without a flap has been established for the first time. This review follows the development of this surgical procedure.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"242 8","pages":"795-802"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959406","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":"Katarakt und refraktive Chirurgie: Erweiterung des Spektrums.","authors":"Ramin Khoramnia, Thomas Kohnen","doi":"10.1055/a-2579-7687","DOIUrl":"https://doi.org/10.1055/a-2579-7687","url":null,"abstract":"","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"242 8","pages":"793-794"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959412","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":"Needs and Satisfaction Analysis of Patients and Referring Physicians in an Outpatient Cataract Service.","authors":"Daniel Bernhard Zander, Philipp M Mähner, Thomas Reinhard, Dieter K Tscheulin, Katrin Wacker","doi":"10.1055/a-2148-9290","DOIUrl":"10.1055/a-2148-9290","url":null,"abstract":"<p><strong>Background: </strong>To ensure efficient use of resources within outpatient services, constant patient flow is vital. This can be achieved by addressing the wishes and needs of all relevant stakeholders.</p><p><strong>Materials and methods: </strong>The present study aims to show how the needs and present satisfaction of patients and referring physicians can be determined in the context of an outpatient cataract service. It presents the conclusions that can be drawn for the design of the service. To assess needs and satisfaction, we developed a patient questionnaire and a referring physician questionnaire. Promoters and detractors for referral were identified following the concept of the net promoter score, a market research instrument.</p><p><strong>Results: </strong>339 (38%) patients and 26 (45%) referring physicians of the main referring group answered the questionnaires. The most important characteristics for referring physicians were quality of treatment, patient satisfaction, and communication in case of queries as well as speed of sending the doctor's letter. When making their decision on a cataract centre, the patients prioritised professional reputation, previous experience with the clinic, and recommendation of their ophthalmologist as well as customary appointment scheduling.</p><p><strong>Conclusion: </strong>The two groups influence each other's recommendation or choice. Simultaneous analysis of patients and referring physicians is therefore essential. Overall, patients and referring physicians are highly satisfied with the cataract service of the university medical centre. Beyond that, however, various potentials for improvement could be identified. In summary, this report describes a comprehensive approach to assess needs and satisfaction of patients and referring physicians in an outpatient clinic trying to sustainably improve patient care.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"846-854"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10296194","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":"Corneal Allogeneic Intrastromal Ring Segments (CAIRS): The New Kid on the Block.","authors":"Hyeck-Soo Son, Victor A Augustin, Maximilian Friedrich, Timur M Yildirim, Ramin Khoramnia, Gerd U Auffarth","doi":"10.1055/a-2621-5109","DOIUrl":"10.1055/a-2621-5109","url":null,"abstract":"<p><p>Corneal allogeneic intrastromal ring segments (CAIRS) have recently been introduced as a novel therapeutic modality for keratoconus and corneal ectatic conditions. As with synthetic intracorneal segments, CAIRS are transplanted into intrastromal channel created via femtosecond laser, in order to regularise the corneal geometry, reduce myopia and astigmatism as well as higher-order aberrations, thus ultimately improving visual and topographic parameters. A growing body of clinical evidence supports the efficacy and safety of this approach, and CAIRS has thus become a paradigm shift in keratoconus treatment. This article provides a brief overview of CAIRS, its surgical indication, and graft preparation and possible customisation.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"803-806"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150969","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":"Cataract Surgery and DMEK: Decision-making and the Timing of the Respective Interventions.","authors":"Victor A Augustin, Maximilian Friedrich, Hyeck-Soo Son, Timur M Yildirim, Gerd U Auffarth, Ramin Khoramnia","doi":"10.1055/a-2650-7436","DOIUrl":"https://doi.org/10.1055/a-2650-7436","url":null,"abstract":"<p><p>With the introduction of Descemet membrane endothelial keratoplasty (DMEK), the treatment of endothelial corneal diseases such as Fuchs' corneal endothelial dystrophy (FECD) has been significantly optimised. Thanks to rapid and good visual rehabilitation, surgery is advised in earlier stages of the disease. When patients are 50 - 70 years old, not only the FECD, but also cataract can become increasingly functionally relevant. It is therefore important to accurately assess and quantify the functional limitations of both conditions, in order to determine which surgery (DMEK and/or cataract surgery) is more useful and imminent. One possibility is to perform a so-called triple DMEK (DMEK combined with cataract surgery). This is an option for phakic patients who are no longer able to accommodate and have clinical or subclinical, tomographic corneal oedema, as this would avoid early DMEK subsequent to cataract surgery. However, if cataract patients with FECD do not exhibit any relevant (clinical or subclinical) corneal oedema, they may benefit from cataract surgery alone without DMEK. Nevertheless, visual quality may remain limited by the corneal guttae and DMEK may still be necessary later. The third option is to perform DMEK without cataract surgery in phakic patients. This may be considered in young FECD patients without cataract who are still accommodating FECD. However, it is important to note that when cataract surgery is required later, the endothelial cell loss resulting from cataract surgery may lead to earlier DMEK graft failure. Overall, in patients with FECD and an age-related lens opacification or incipient cataract, the need and timing of the respective intervention must be determined individually, in order to achieve the optimal therapeutic success. The procedure described in this manuscript can help support decision-making and the timing of the respective interventions.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"242 8","pages":"807-812"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959401","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":"[Age-related macular degeneration - Part 2: therapeutic options for AMD].","authors":"Albrecht Peter Lommatzsch, Henrik Faatz","doi":"10.1055/a-2515-9138","DOIUrl":"10.1055/a-2515-9138","url":null,"abstract":"<p><p>Currently, intravitreal anti-VEGF therapy is the only way to maintain function with continuous monitoring in neovascular AMD. Several robust morphological biomarkers, such as intraretinal and subretinal fluid, are important to guide treatment decisions at baseline and during the course of the disease. Higher concentrations of anti-VEGF agents and the development of bispecific antibodies combining anti-VEGF and anti-angiopoietin-2 antibodies have been shown to prolong the duration of action in pivotal trials. In particular, a longer duration of action may improve patient adherence by reducing the treatment burden. Several ranibizumab biosimilars are also approved and available for the treatment of neovascular AMD. In addition, bevacizumab is now approved in its originator form for the treatment of neovascular AMD in Europe. For the treatment of geographic atrophy, the intravitreal complement inhibitors approved in the US are not approved in Europe. With these drugs, continuous monthly or bimonthly injections were associated with significantly slower growth of the atrophic area in registration studies. Visual function after two years of treatment showed no difference compared to untreated eyes. In a post-hoc analysis of the largest supplementation studies AREDS and AREDS2, a significantly slower increase in RPE atrophy from the atrophic edge to the fovea was observed compared to placebo (AREDS [n = 208]: p = 0.012; AREDS2 [n = 392]: p = 0.011). This effect needs to be confirmed in controlled randomised trials.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"855-867"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102167","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":"Reverse Pupillary Block - a Complication of Sutureless Scleral-fixated Intraocular Lenses.","authors":"Pirmin Frey, Arthur Mueller, Monica Markstaller, Youssef Botros, Isabella Diana Baur","doi":"10.1055/a-2635-2506","DOIUrl":"https://doi.org/10.1055/a-2635-2506","url":null,"abstract":"<p><p>Reverse pupillary block (RPB) is a posterior bowing of the iris, which is most likely caused by a flap-valve-like mechanism between the lens and the iris. It can lead to iris chafing, pigment dispersion glaucoma and uveitis-glaucoma-hyphema syndrome. In this study we examine patients who underwent sutureless scleral-fixated IOL implantation due to IOL luxation or aphakia. At the follow up visit, a slit-lamp examination, a measurement of the intraocular pressure and an anterior segment OCT (Anterion) were performed. Of 41 eyes, eleven showed the constellation of an RPB. This condition is not necessarily associated with elevated intraocular pressure, but can lead to the above-mentioned complications in the long term. We found that YAG-Laser iridotomy was effective to treat RPB in cases with adequate visualisation of the iris, but surgical idridectomy may be needed in cases with anterior chamber haemorrhage. In our opinion, in patients with a flaccid iris, manifesting as iridodonesis or floppy iris syndrome, as well as in patients who develop RPB postoperatively, either an intraoperative iridectomy or a YAG-laser-iridotomy should be performed.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"242 8","pages":"813-818"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959437","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":"In-vitro Comparison of Trifocal Intraocular Lenses of Different Optical Zone Diameter and Design Across Pupil Sizes.","authors":"Grzegorz Łabuz, Ava Niknahad, Weijia Yan, Hyeck-Soo Son, Ramin Khoramnia, Gerd U Auffarth","doi":"10.1055/a-2648-8929","DOIUrl":"https://doi.org/10.1055/a-2648-8929","url":null,"abstract":"<p><strong>Background: </strong>Trifocal intraocular lenses (IOLs) for the correction of cataracts allow patients to enjoy good uncorrected intermediate and near visual acuity, and allow them to be independent of spectacles. While clinical studies robustly support their advantages, laboratory evaluations of their objective performance are important. This study evaluated novel trifocal IOLs with 6.0 or 7.0 mm optical zone - Triva-aAY or Triva-aXAY - and compares them to a classic trifocal (Acrysof IQ PanOptix) and an extended-depth-of-focus trifocal (Triumf POD L GF).</p><p><strong>Methods and material: </strong>The optical quality of two samples of each IOL model with a diopter power of 20 D was evaluated at 3-, 4.5-, and 6-mm apertures with OptiSpheric IOL PRO2 and measured per ISO 11 979 standard. The resulting modulation transfer functions (MTF), through focus area under the MTF curve (MTFa) and simulated visual acuity (VA) were assessed at near, intermediate, and far distances. Additionally, IOL's tolerance to misalignment was measured by inducing up to 0.7 mm of vertical decentration and 5° tilt. Measurements were repeated with the 1951 United States Air Force (USAF) resolution test chart.</p><p><strong>Results: </strong>The Triva-aXAY and Triva-aAY had equivalent optical performance at all apertures. For the 3- and 4.5-mm pupil, the Triva IOLs showed MTF levels close to that of the PanOptix but had a slightly extended focus range at a near distance. The MTF analysis did not reveal any difference in optical quality between the Triva IOLs at 6 mm. Although at far and intermediate focus, the Triumf's MTF was above the level of the other models, it was at the expense of the near focus. Triumf was the least tolerant of misalignment. All findings were supported by the USAF resolution test charts.</p><p><strong>Conclusion: </strong>Triva-aXAY and Triva-aAY IOLs have an equivalent optical performance at all apertures, with a slightly extended focus range compared to PanOptix at near focus, comparable MTF at intermediate focus, and lower optical quality than Triumf at far focus. The latter, however, may provide insufficient performance at reading distance. IOL misalignment affects the optical quality of the trifocal models and is design-dependent.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":"242 8","pages":"819-827"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959459","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":"Cataract Surgery Training in Germany: A Survey by the European Board of Ophthalmology.","authors":"Rémi Yaïci, Johannes Schiefelbein, Sorcha Ní Dhubhghaill, Massira Melanie Sanogo, François Lefebvre, Wagih Aclimandos, Rimvydas Asoklis, Huban Atilla, Catherine Creuzot-Garcher, Denise Curtin, Barbara Cvenkel, Lisa Flanagan, Tero T Kivelä, Anna Maino, Rafael Martinez Costa, Helena Prior Filipe, Marcin Stopa, Brendan Strong, Jörg Peter Egon Stürmer, Marie-José Tassignon, Renata Ivekovic, Siegfried Priglinger, Tristan Bourcier","doi":"10.1055/a-2462-8222","DOIUrl":"10.1055/a-2462-8222","url":null,"abstract":"<p><strong>Introduction: </strong>Phacoemulsification is a fundamental surgical skill for ophthalmology residents and the most commonly performed operation in the ever-evolving field of ophthalmology. A comprehensive study conducted between 2018 and 2022 showed wide variation in the experiences of European residents. The aim of this study was to study the data from Germany in the European data context.</p><p><strong>Methods: </strong>This study analyses survey results from German participants in European Board of Ophthalmology (EBO) examinations (2018 - 2022) and classifies the results in overall European comparison. We also performed a regional analysis by federal state.</p><p><strong>Results: </strong>Of a total of 445 addressees, 136 (30.6%) responded to the questionnaire. Around two-thirds or 67.7% had taken the EBO exam between 2021 and 2022; most of the study participants were women (59.6%) and the average age was 34 ± 2. By far the most at 89.7% were right-handed and came from fourteen different federal states, mostly from North Rhine-Westphalia, Baden-Württemberg, Bavaria, and Berlin. Under a quarter of respondents at 22.8% stated that they had carried out at least ten training sessions on animal eyes. Very few at 5.1% reported completing training sessions on synthetic eyes compared to 16.9% stating that they had trained on a virtual reality simulator. Having taken more than ten training sessions correlated significantly with higher confidence at performing cataract surgery (p < 0.001). Eighty-three respondents (61%) had not performed any of the steps taken in cataract surgery on patients during specialty training in Germany. This was well above the European average. Women were statistically significantly overrepresented in this subgroup, accounting for 67.5% (p = 0.019) of the subgroup.</p><p><strong>Discussion: </strong>In the European context, the German national specialty training curriculum does not require cataract operations in any set numbers. This model may have contributed to the significant gender differences. Simulation-based medical training may address this problem as an additional tool for more equitable access to surgical training.</p><p><strong>Conclusion: </strong>Intra-European comparison and exchange may help improve guidelines for ophthalmological specialty training. This might standardise and improve training standards in both conservative and surgical ophthalmology throughout Europe.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":"836-845"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531726","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":"[Visual side effects of chemotherapeutic drugs].","authors":"Louisa M Bulirsch, Karin U Löffler, Matthias Marten Mauschitz, Martina C Herwig-Carl","doi":"10.1055/a-2563-4912","DOIUrl":"https://doi.org/10.1055/a-2563-4912","url":null,"abstract":"<p><p>Chemotherapeutic agents can lead to serious visual side effects in the eye, which can affect both the anterior and posterior segment. This article presents a selection of the most important chemotherapeutics causing ocular side effects. We will discuss side effects of chemotherapeutic agents that are applied directly to the eye for the treatment of an ocular neoplasia as well as side effects of systemically applied chemotherapeutic agents. Furthermore, the corresponding therapy and possible necessary adaptions of the chemotherapy are explained. Most importantly the ophthalmologist should stay in close contact with the other treating specialists.</p>","PeriodicalId":17904,"journal":{"name":"Klinische Monatsblatter fur Augenheilkunde","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698931","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}