Klinische Monatsblatter fur Augenheilkunde最新文献

Objectives: To investigate the correlation between postoperative endothelial cell loss (ECL) and donor, host, and surgical parameters, and to assess the clinical impact of maintaining a high endothelial cell density (ECD) of ≥ 1500 cells/mm² 5 years after penetrating keratoplasty (PKP).

Methods: This retrospective cohort study included 216 eyes with 5 years of follow-up, of which 94 had annual visits, and who underwent normal-risk elective PKP for noninfectious indications by one corneal microsurgeon (B. S.) between 2009 and 2016.

Results: Among the 216 eyes, ECL (39.1%) over 5 years postoperative exhibited weak positive correlations with storage solution time (p = 0.024) and postmortem time (p = 0.028), and moderately positively correlations with the preoperative ECD (p < 0.001). The 5-year postoperative ECL differed significantly between in domo-prepared (36.8%) and ex domo donor corneas (46.3%; p = 0.001). In the 94 eyes, no significant differences were found between the two groups for central pupil pachymetry (CCT) and BCVA (p > 0.074). However, CCT increased significantly between 1 and 4 years (p = 0.034) and 1 and 5 years postoperatively (p = 0.012), respectively. BCVA improved significantly at 1 year postoperatively and continued to improve until 2 years postoperatively (p < 0.001).

Conclusion: The Lions corneal bank Saar-Lor-Lux achieved a significantly reduced ECL (36.8%) over 5 years compared to ex domo donor corneas (46.3%). A weak positive correlation was found between ECL with the storage solution time and the postmortem time, as well as a moderate positive correlation with the preoperative ECD. Although CCT increased significantly over 5 years, BCVA improved significantly from the first to the second postoperative year and remained stable thereafter.

Optical biometry has fundamentally transformed cataract surgery, and 2024 marked 25 years since the introduction of the first optical biometer. In the early 1980 s, Fercher and colleagues pioneered the optical noncontact eye length measurement, leading to the first interferometric A-scan of the eye. This innovation, patented and later developed by Zeiss, culminated in the release of the IOLMaster in 1999, enabling more accurate and reproducible eye diagnostics. Over the years, optical biometry has evolved into advanced swept-source optical coherence tomography devices, accompanied by numerous formulas for calculating intraocular lens power. Today, this technology is crucial not only for cataract surgeries, especially in eyes previously treated with refractive surgery, but also in advancing our understanding of diseases across fields like cardiology and oncology.

Recent years have seen formidable advances in artificial intelligence. Developments include a large number of specialised systems either existing or planned for use in scientific research, data analysis, translation, text production and design with grammar checking and stylistic revision, plagiarism detection, and scientific review in addition to general-purpose AI systems for searching the internet and generative AI systems for texts, images, videos, and musical compositions. These systems promise more ease and simplicity in many aspects of work. Blind trust in AI systems with uncritical, careless use of AI results is dangerous, as these systems do not have any inherent understanding of the content they process or generate, but only simulate this understanding by reproducing statistical patterns extracted from training data. This article discusses the potential and risk of using AI in scientific communication and explores potential systemic consequences of widespread AI implementation in this context.

Congenital nasolacrimal duct obstruction (CNLDO) is the most common cause of epiphora in the first year of life. In addition to conservative therapy, there are several invasive methods available. The aim of this retrospective study was to conduct a long-term follow-up of bicanalicular lacrimal duct intubation as the primary intervention in a large cohort of patients with CNLDO. The electronic medical records of 487 patients with CNLDO who underwent bicanalicular tube intubation were reviewed. To determine the long-term outcomes, a telephone interview was conducted. A total of 328 eyes of 235 patients were included in the study. The median average follow-up period was 6.67 (5.58 - 8.67) years. At the time of the survey, 218 patients (92.8%) were symptom free. Mean patient satisfaction with surgical outcome was 10/10. To our knowledge, this study provides the longest follow-up of the largest patient cohort in the literature consisting of patients who underwent probing with bicanalicular lacrimal silicone tube intubation as a primary intervention for CNLDO. This study showed a high long-term postoperative success rate, with high postoperative satisfaction, few complications, and a low need for reintervention.

Today, microendoscopic minimally invasive therapy techniques, such as laser dacryoplasty (LDP) for complete stenosis and microdrill dacryoplasty (MDP) for incomplete stenoses are therapeutic options for PANDO (primary acquired nasolacrimal duct obstructions). Due to excellent prognosis, external DCR is still "gold standard" especially for patients with complex problems.

Background: The increasing use of electronic documentation extends to consultation for the visually impaired. The aim of this project was to develop a set of forms and electronic patient records specifically for low vision care, giving equal consideration to ophthalmological, orthoptic, and optometric specialities, as well as teaching aspects.

Patients and methods: FIDUS software (FIDUS Arztservice Wente GmbH, Darmstadt, Germany) is a well-established tool in ophthalmology practices and clinics. The software was used as a basis to develop digital entry forms with features such as auto-fill, selection recommendations, and inventory management for visual aids. The aim of the project was to maximise clarity and ease of use while also saving time during consultation with visually impaired patients.

Results: This article presents the implementation of these criteria using the electronic FIDUS record card with the corresponding electronic forms for electronic patient records taken during consultation with visually impaired patients. The index card visualises the patient's most important data and findings at a glance. Specifically designed for low vision consultation, the examination form documents visual aids prescribed to the patient in detail while also saving time. Other forms enable direct printing of prescription recommendations, test reports, and certificates. Entry forms can also be printed out for conventional handwritten records.

Conclusions: We have achieved an electronic patient record system specifically geared to ophthalmological and optical care requirements including local inventory for visually impaired patients. Determining the level of acceptance on the part of examiners, patients, and students and optimising the software will require follow-up studies.