Klinische Monatsblatter fur Augenheilkunde最新文献

Purpose: To evaluate the incidence of bleeding complications of oculoplastic procedures performed under antithrombotic therapy and local anaesthesia.

Materials and methods: A prospective study of patients on antithrombotics undergoing pre-septal and post-septal oculoplastic procedures under local anaesthesia over a 12-month period. The type of antithrombotic, surgical details, intra and post-operative complications were documented. Exclusion criteria were high bleeding-risk procedures, such as orbital surgery and dacryocystorhinostomy.

Results: 302 patients were included, mean age was 70.7 ± 14.7. years (19 - 98). 77 patients (25.5%) on antithrombotics were advised to continue their medication prior to surgery. The types of antithrombotics taken by patients at the time of surgery were 60.9% antiplatelets, 33.3% anticoagulants and 5.8% combination therapy. Amongst patients who continued taking their oral antithrombotic medications, there was no major intraoperative or perioperative bleeding complications, and no patients required additional surgical or medical reintervention. One self-resolving postoperative bleed occurred after upper-lid blepharoplasty in a patient on aspirin and rivaroxaban. Bleeding rates did not differ between patients who continued antithrombotics and those not receiving antithrombotics (p = 1.00).

Conclusion: This study found no incidence of severe bleeding complications in oculoplastic procedures among patients continuing anticoagulant or antiplatelet therapy, consistent with existing literature. Continuation of anticoagulants and antiplatelets appears safe for selected procedures, simplifying patient management and minimizing thromboembolic risk. Emphasis should be placed on meticulous intraoperative haemostasis rather than discontinuation of antithrombotic therapy.

Background: The Tecnis Eyhance Toric intraocular lens (IOL) model DIU00 (Johnson & Johnson) is a monofocal IOL with a slightly enhanced depth of focus, designed to improve intermediate vision while correcting corneal astigmatism in cataract surgery. While its optical concept has been validated in clinical trials, evidence from routine practice is still limited. The purpose of this study was to evaluate real-world visual and refractive outcomes, postoperative astigmatism, and patient satisfaction following implantation of the Eyhance Toric IOL.

Methods: A total of 160 eyes from 97 consecutive patients were analysed, including 63 patients who underwent a bilateral procedure and 34 who had unilateral surgery with Eyhance Toric implantation. Preoperative biometry comprised axial length, anterior chamber depth, lens thickness, sulcus-to-sulcus distance, and keratometry values. At 1 month, monocular and binocular visual acuities (uncorrected [UDVA], corrected [CDVA], uncorrected intermediate [UIVA], distance-corrected intermediate [DCIVA], uncorrected near [UNVA], distance-corrected near [DCNVA]), manifest refraction, and keratometry were evaluated.

Results: At 1 month, mean monocular UDVA, CDVA, UIVA, DCIVA, and UNVA were 0.12, 0.05, 0.06, 0.07, and 0.29 logMAR, respectively. Binocular UDVA, UIVA, and UNVA were 0.04, 0.03, and 0.24 logMAR, respectively. Mean corneal astigmatism decreased from - 1.70 ± 0.91 D to a postoperative refractive astigmatism of 0.31 ± 0.24 D (p < 0.0001). No IOL rotations were required. Spectacle independence was achieved in 13 patients (20.64%), while 50 (79.36%) required reading glasses. Among those targeted for bilateral emmetropia, 35 (87.5%) of 40 needed reading spectacles, compared with 15 (65%) of 23 patients with a mini-monovision refractive targe (p = 0.048). No disturbing dysphotopsias such as halos or glare were reported.

Conclusion: The Tecnis Eyhance Toric IOL demonstrated favourable outcomes for distance and intermediate vision, reliable astigmatism correction, and high patient satisfaction.

Background: Chronic central serous chorioretinopathy (cCSC) is an exudative maculopathy characterised by persistent subretinal fluid and potential visual deterioration. Photodynamic therapy (PDT) with verteporfin is an established treatment option, particularly in refractory or chronic cases. This retrospective, single centre study aimed to evaluate the functional and morphological efficacy of PDT in patients with cCSC at Hanusch Hospital, Vienna.

Patients/materials and methods: We analysed 49 eyes of 38 patients who underwent PDT between 2020 and 2025. Best-corrected visual acuity (decimal), central retinal thickness (CRT, µm), and subretinal fluid (SRF, µm) were assessed using spectral domain OCT before and after treatment. Statistical analyses included the Shapiro-Wilk test for normality and the Wilcoxon signed-rank test for paired samples. Subgroup analyses were conducted for repeat PDT (Re-PDT) and secondary choroidal neovascularisation (CNV).

Results: Overall, PDT led to a significant improvement in visual acuity (p = 0.041) and a highly significant reduction in both CRT and SRF (each p < 0.001). In the Re-PDT subgroup (n = 6), significant morphological improvement (p = 0.028 for CRT and SRF) was observed without a statistically significant gain in vision (p = 0.109). No significant therapeutic effect was found in patients with secondary CNV. There was a significant negative correlation between visual acuity and CRT (r = - 0.42; p = 0.005) and between visual acuity and SRF (r = - 0.37; p = 0.012).

Conclusion: PDT appears to be an effective treatment for achieving anatomical and functional stabilisation in cCSC. The limited visual improvement in Re-PDT and CNV subgroups underscores the importance of early treatment and tailored decision-making in cases of secondary neovascularisation.