[Clinical experience with brilliant blue G staining of the retinal surface]

BACKGROUND

Staining of the retinal surface has improved the intraoperative removal of semitransparent membranes during macular surgery. The purpose of this study was to evaluate the clinical experiences with brilliant blue G (BBG) staining of the retinal surface.

METHODS

BBG (Brilliant peel, Fluoron) was applied during vitrectomy and macular surgery in 43 patients. In 47 % there was a macular hole (MH), whereas 53 % had epiretinal membranes (ERM). Intraoperatively BBG was applied on the retinal surface under infusion or air conditions for 30 - 60 s. In MH the internal limiting membrane (ILM) and in ERM the membrane was removed. Postoperatively all patients were examined on average after 9 weeks.

RESULTS

Although intraoperative BBG staining was less intensive compared to ICG staining, the staining was sufficient to safely remove the semitransparent membranes in all cases. In all patients with MH hole closure was achieved, and in 96 % with ERM the metamorphopsiae decreased. The mean decimal visual acuity increased from 0.25 ± 0.13 to 0.37 ± 0.20 (p < 0.05) and improved in 63 % of the patients. Clinically, there were no toxic side-effects from BBG staining.

CONCLUSIONS

BBG allowed a complete and selective staining of the retinal surface. Thus, ILM and ERM could be removed safely during macular surgery. No clinical retinal toxicity was observed.

Refraktive Langzeitergebnisse nach Huckepackimplantation

BACKGROUND

Piggyback lens implantation is an alternative to exchange of the original intraocular lens (IOL) to treat high anisometropia in pseudophakic eyes. We present our results.

PATIENTS AND METHOD

A second IOL (piggyback) was implanted in 27 patients from 2000 to 2006. Nineteen patients were clinically investigated late postoperatively, and data for the other eight patients were evaluated from the patients' files.

RESULTS

The patients were 65+/-9 years old. Follow-up time was 38+/-25 months. The mean preoperative spherical equivalent (SE) in the myopic eyes was -7.86+/-3.82 D and in the hyperopic eyes was 1.64+/-0.74 D. After surgery, the mean SE in the myopic eyes was -1.77+/-1.82 D and in the hyperopic eyes was -0.09+/-0.51 D. Postoperative anisometropia was reduced from 4.64+/-3.3 D. to 0.9+/-0.82 D.

CONCLUSION

Piggyback lens implantation is a safe and effective surgical procedure and is less traumatic than exchange of the original IOL.

[Therapy refractory blepharoconjunctivitis in a 90 year old patient]

Sebaceous gland carcinoma can clinically mimic benign conditions such as chalazion and blepharoconjunctivitis. This carcinoma should be histologically excluded for every unilateral, recalcitrant chalazion and every unilateral, therapy refractory blepharitis. Autosomal dominant Muir-Torre syndrome should be considered in patients who develop sebaceous gland carcinoma of the ocular adnexa. In this case, the sebaceous gland carcinoma is combined with visceral carcinoma.

Depth from automatic defocusing

This paper presents a depth recovery method that gives the depth of any scene from its defocused images. The method combines depth from defocusing and depth from automatic focusing techniques. Blur information in defocused images is utilised to measure depth in a way similar to determining depth from automatic focusing but without searching for sharp images of objects. The proposed method does not need special scene illumination and involves only a single camera. Therefore, there are no correspondence, occlusion and intrusive emissions problems. The paper gives experimental results which demonstrate the accuracy of the method.

[Iris sutures for refixation of decentered intraocular lenses]

BACKGROUND

Most revisions after intraocular lens (IOL) implantation are due to an insufficiency of the zonular apparatus. Frequently, an inferior decentration can be seen ("sunset syndrome"). In this clinical study, suture refixation of the haptics to the iris was assessed. Functional and morphological results were considered.

METHOD

21 eyes with subluxation of the IOL were treated with iris sutures for refixation. The operation was performed under topical and intracameral anaesthesia. Refixation was achieved by suturing one or both haptics to one or two fixation points in the outer periphery of the iris. Complete zonular dialysis made it necessary to suture at two fixation spots. All eyes were examined preoperatively, at one day and three months postoperatively considering functional results and postoperative IOL centration.

RESULTS

In 15 eyes (71%), the IOL was optimally centred postoperatively. In 5 eyes (24%), a revision had to be performed due to instable centration. In one further case the IOL was minimally decentred, but its position was stable. Best corrected visual acuity was 0.3 +/- 0.2 preoperatively and 0.5 +/- 0.2 after three months. The mean refraction was stable in the postoperative course and astigmatism did not change significantly. There were no major complications intraoperatively or postoperatively, but a localised iris atrophy at the haptic fixation points was noted.

CONCLUSIONS

In the presence of a partially intact zonular apparatus, iris sutures are a safe and minimally invasive method for fixing a decentred IOL. Postoperative centration and functional results were stable after 3 months.