A new mobile armrest

We have developed a weight-and-pulley armrest for surgeons to use during ocular microsurgery. The armrest is mobile, sterilizable, and allows the weight stress on the forearm to be regulated.

The single point cam guided trephine: an interim report

The development of the single point cam guided cornea trephine frees the cornea surgeon from always cutting a round recipient window perpendicular to the visual axis of the eye. This new trephine allows for any angle of cut relative to the visual axis of the eye and any shaped window, be that window round, ellipse, oval or "other than round." Full development of the technique lies in the future with the development of more complete topographical measuring techniques and the integration of the measurement into a computer program wherein the computer controls the indexing of the blade cutting the recipient window and the angle of the blade while the blade is making the incision.

A new operating table for the management of giant retinal breaks

For management of giant retinal breaks, I have developed an operating table that can rotate around its longitudinal and transverse axes 360 degrees. When this table is used in conjunction with intravitreal injection of air, a giant break can easily be tamponaded, regardless of its location.

A counter for fixed-frame endothelial cell analysis

We developed a simple electronic counter for fixed-frame endothelial cell analysis by modifying an ink cartridge pen and an inexpensive pocket calculator.

The effect of total vitrectomy on filtration surgery in the aphakic eye

The influence of total vitrectomy on the success rate of filtration surgery was investigated, with 47 operations (6 reoperations) being performed on 41 patients. At six months postoperatively, successful control (IOP less than 21 mm Hg) was achieved in 32 of 41 patients (78%). Twenty-four patients had filtration blebs present. Total vitrectomy favorably influences the result of filtration surgery. However, the morbidity rate (two retinal detachments and two cases of cystoid macular edema) is higher than in standard filtration procedures.

[Four methods of cyclodeviation measurement, especially the Cüppers deviometer (author's transl)]

A comparison of four methods of cyclodeviation measurement was made (Cüppers Deviometer, Scale Maddox cylinder glass, Aulhorn Phase difference haploscope, Cüppers Synoptometer) with 25 complaint-free controls without cyclovertical deviations; the advantages and disadvantages of the instruments are described. Physiological peculiarities in the measurement of the subjective horizontals are demonstrated by the clinical example of a patient with decompensated paresis of the m. obliquus superior. The extent of cycloduction depends on the direction of rotation, from which the measurement is made, on the test object, and on the influence of normal environmental experiences ("Erfahrungsmotive" according to Bielschowsky). It is shown that a unilateral paresis of the m. obliquus superior can be compensated motorically by cycloversion. With "Erfahrungsmotiven" excycloduction can be found neither subjectively (subjective horizontal) nor motorically (regular position of the blind spot).

A modified Flieringa-Legrand ring for use in trabeculectomy

The Flieringa-Legrand ring has been modified for use in trabeculectomy. It may be used with the Forbes scleral support system, which is designed to prevent posterior infolding of the sclera. This combination is particularly suited for filtration surgery on infantile and juvenile glaucoma and in high myopia, where vitreous loss is a potential threat.

Specular microscopy with intraocular lens implantations

Specular microscopy performed six months postoperatively on 122 lens implant patients showed that endothelial cell loss rates varied according to method of cataract extraction and type of lens implant. Phacoemulsification with implantation of a Platina-style lens was associated with the highest cell loss; planned extracapsular cataract extraction with implantation of a Choyce-style or J-loop lens was associated with the lowest cell loss. The presence of marked striate keratopathy on the first postoperative day was directly related to endothelial cell loss.

Aniseikonia in patients with a unilateral artificial lens, measured with Aulhorn's phase difference haploscope

Aniseikonia was measured in unilaterally pseudophakic patients using Aulhorn's phase difference haploscope. Mean values of aniseikonia were 1.5% horizontally and 2.0% vertically without correction, and 2.1% horizontally and 2.3% vertically with correction. With spectacle correction, the greater the dioptric difference between two eyes, the greater the amount of aniseikonia. In either case, patients tolerated these amounts of aniseikonia according to our criteria of aniseikonia tolerance.

Corneal sensitivity in pregnancy

Only few studies are available on changes in corneal sensitivity during pregnancy, and most of the earlier work was done with instruments which gave only a rough approximation of the threshold of corneal sensitivity to touch. The new esthesiometer developed by Draeger permits, for the first time, an exact and reproducible determination of the threshold of corneal sensitivity to touch. We studied corneal sensitivity in 86 pregnant women between the 13th and 40th week of gestation. The thresholds were significantly higher in the study as compared to a control group of non-pregnant women. The decrease in corneal sensitivity was not related to duration of gestation, weight gain during pregnancy or mean arterial pressure at the time of examination. Possible mechanisms responsible for changes in corneal sensitivity in pregnancy are discussed.

[Comparative investigation of the mesoptometer and the nyktometer (author's transl)]

Mesopic vision and sensitivity to glare were measured in 31 patients, using the Nyktometer and the Mesoptometer, which work on different principles. The results obtained with the two devices were remarkably similar.

Intraocular pressure reduction and regulation system

The IOP reduction and regulation system performs certain specific functions: it can be used to lower (or raise) IOP in a controlled way; it responds rapidly to maintain a selectable, set, minimum IOP under variable flow demands; and it reduces the rapid dynamic increases in IOP resulting from loads applied to the eye. The system has been tested and evaluated in the laboratory with a small test chamber and excised animal eyes and subsequently with anesthetized live animals. The system has also had limited clinical use in selected patients. An expanded program of laboratory and clinical investigations is planned.

The latent period of the pupil light reflex in lesions of the optic nerve

The latent period of the pupil light reflex was investigated by means of infrared pupillography in patients suffering from optic neuritis (retrobulbar neuritis, papillitis), papilledema, optic atrophy or anterior ischemic optic neuropathy. The inflammatory diseases of the optic nerve and the optic atrophy cause significant prolongation of the latent period of the pupil light reflex. Conversely, in papilledema no prolonged latent period could be demonstrated. The vascular diseases of the optic nerve affect the pupil latent period also, however, to a lower degree.