Die Ophthalmologie最新文献

Background: A large number of physicians with a migration background work in Germany. Political changes in their countries of origin might affect the healthcare situation in Germany. In the case of Syria, the consequences of possible emigration of Syrian doctors have already been publicly discussed. The aim of this study was to survey the self-assessment of Syrian doctors in Germany regarding their future professional orientation.

Method: Anonymous exploratory survey among Syrian doctors and medical students. Data collection took place from January to March 2025 using REDCap (Vanderbilt University, Nashville, TN, USA). The survey was distributed via the Syrian Society of Physicians and Pharmacists in Germany (SyGAAD e.V.), the German-Arab Ophthalmological Society (DAOG e.V.) and all medical student councils in Germany. Information collected included training status, current employment, the timeframe in which respondents could imagine working in Syria, and the reasons influencing their decision-making. The distribution of participants by federal states was assessed descriptively.

Results: 191 Syrian doctors, including 92 ophthalmologists, and 41 medical students participated. 91% of the doctors were born in Syria, 83% completed their medical studies in Germany. 41% were younger than 35 years. Of the ophthalmology specialists, 32% worked in hospitals and 66% in practices. Overall, 27% of all participating Syrian doctors could imagine working in Syria within the next five years, and another 35% within the next ten years. Political, religious, or cultural reasons (60%) and family factors (52%) were selected far more frequently than economic (29%) or career reasons (23%). The highest proportion of participating Syrian doctors was in Saarland and the lowest was in Schleswig-Holstein.

Conclusion: The data suggest that Syrian doctors in Germany are predominantly young and mostly trained in Germany. Almost two-thirds could imagine working in Syria within the next ten years. Representative surveys of the regional distribution could help assess the risk of healthcare shortages more accurately. The Federal Ministry for Economic Cooperation and Development plans programs for German-Syrian hospital partnerships that could be beneficial for both countries.

Background: Keratoconus is a progressive corneal disease that can lead to substantial impairment of vision. While conventional treatment, such as glasses, contact lenses or corneal grafting are well established, minimally invasive tissue-additive procedures are becoming increasingly more important. The goal is to achieve biomechanical stabilization and optical reconstruction of the cornea with minimal invasiveness.

Objective: This review explores what role novel tissue-additive procedures, such as stromal lenticule addition keratoplasty (SLAK), Bowman membrane transplantation and xenotransplantation, play in modern keratoconus treatment and how effective they are in terms of vision improvement and corneal stabilization.

Material and methods: Review paper presenting the physiological principles, technical implementation and clinical results of various tissue-additive procedures. Case series, clinical studies and meta-analyses on efficacy and safety were included.

Results: Tissue additive procedures, such as SLAK showed significant improvements in visual acuity and corneal topography. The central corneal thickness also increased. Combinations with corneal crosslinking (CXL) enable an expanded range of applications. Bowman's membrane transplantation also showed structural improvements in advanced keratoconus. Xenogeneic transplants from porcine stroma are promising but require further evaluation.

Conclusion: Tissue additive techniques offer customizable, reversible alternatives to traditional transplantations with shorter recovery times. The combination with CXL improves long-term stability. Limitations include tissue availability and standardization of procedures. In the future, artificial intelligence (AI)-supported planning and image-guided treatment customization could further improve precision and outcomes.

Ocular toxoplasmosis is the leading cause of infectious posterior uveitis worldwide and a daily challenge for ophthalmologists. Most cases of ocular toxoplasmosis are acquired postnatally, mainly through ingestion of contaminated meat or contact with cat feces. The diagnosis relies on clinical findings such as focal retinochoroiditis, vitritis and retinal scarring. The treatment can include antiparasitic drugs and in selected cases requires the combination with corticosteroids. The recurrence rates are high, particularly in older or immunocompromised patients. Early diagnosis and individualized treatment strategies significantly improve the prognosis and visual function.