[Age-related Cataract].

The purpose of this article is a condensed overview of contemporaneous "state of art and knowledge" of age-related cataract. As an introduction, some aspects of terminology, epidemiology, lens anatomy and pathophysiology of age-related cataract, selected for clinical interest and relevance, are outlined. Clinical aspects include signs and symptoms: Objective criteria for cortical, nuclear and posterior subcapsular cataract are described, followed by typical symptoms such as decreased visual acuity, contrast sensitivity and foggy vision, altered colour perception, decreased mesopic and scotopic vision, glare, myopization and monocular diplopia.

Posterior Uveal Effusion after Cataract Surgery.

We report a case of posterior uveal effusion (UE) with a long-term follow-up that has occurred following cataract surgery. A 64-year-old woman presented with diminished vision of the right eye (RE) 3 weeks after an uneventful phacoemulsification and intraocular lens implantation. Complete ophthalmic examination including fluorescein angiography (FA), indocyanine green angiography (ICGA), echography and optical coherence tomography (OCT) were performed.

[Boston keratoprosthesis: 73 eyes from Germany : An overview of experiences from two centers].

Background: The Boston Keratoprosthesis (B-KPro) is a therapeutic option for corneal replacement for visual rehabilitation in eyes with poor a prognosis for penetrating keratoplasty (high-risk eyes). Since 2009, this approach has been used in the MVZ Prof. Neuhann, Munich, and since 2013 also at the Department of Ophthalmology, University of Cologne.

Primary vitrectomy for rhegmatogenous retinal detachment in pseudophakic eyes: 20-gauge versus 25-gauge vitrectomy.

Purpose: To report anatomical and functional outcome of 20-gauge versus 25-gauge primary pars plana vitrectomy for management of complex rhegmatogenous retinal detachment in pseudophakic eyes.

Methods: Prospective single-centre randomized comparative pilot trial. Fifty patients with retinal detachment (RD) not complicated by proliferative vitreoretinopathy grade B or C, who cannot be treated with a single meridional sponge, were randomized (1:1) from November 2006 to January 2010 to either 20-gauge or 25-gauge vitrectomy as first surgical intervention and followed up over a 12-month period, evaluating change in best-corrected visual acuity, anatomical success and intraocular pressure dysregulation.

Mutations in EXOSC2 are associated with a novel syndrome characterised by retinitis pigmentosa, progressive hearing loss, premature ageing, short stature, mild intellectual disability and distinctive gestalt.

Background: Retinitis pigmentosa in combination with hearing loss can be a feature of different Mendelian disorders. We describe a novel syndrome caused by biallelic mutations in the 'exosome component 2' (EXOSC2) gene.

Methods: Clinical ascertainment of three similar affected patients followed by whole exome sequencing.

[Case numbers and revenues of main and affiliated ophthalmological departments: Developments since 2005].

Background: Currently, very little data exist on the development of healthcare-related and financial parameters of both types of inpatient treatment: clinical units run by affiliated physicians and those run by hospital physicians.

Aim: This study used a methodology based on published secondary data to estimate the annual number of cases and revenues for in inpatient ophthalmological treatment differentiated into clinical units run by affiliated physicians and those run by hospital physicians.

Material And Methods: The case-based flat-rate catalogs and accompanying research data published annually by the Institute for the Hospital Remuneration System (Institut für Entgeltsysteme im Krankenhaus, InEK) served as a data source.

Impact of personality characteristics on patient satisfaction after multifocal intraocular lens implantation: results from the "happy patient study".

Purpose: This prospective multicenter study assessed personality characteristics that may influence patient satisfaction after implantation of multifocal intraocular lenses (MIOLs).

Methods: One hundred eighty-three patients who underwent bilateral implantation of different MIOLs were enrolled. Uncorrected and corrected distance visual acuity for distance and near (ie, UDVA, UNVA, CDVA, and CNVA) were assessed preoperatively and 3 and 6 months after implantation.

A methodological approach to identify external factors for indicator-based risk adjustment illustrated by a cataract surgery register.

Background: Risk adjustment is crucial for comparison of outcome in medical care. Knowledge of the external factors that impact measured outcome but that cannot be influenced by the physician is a prerequisite for this adjustment. To date, a universal and reproducible method for identification of the relevant external factors has not been published.

Keratoplasty in patients with intellectual disability.

Purpose: The aim was to report the outcome of keratoplasty in patients with intellectual disability (ID).

Methods: All patients with ID who had undergone keratoplasty at the Eye Department, Red Cross Hospital, Munich, between January 1, 1991, and December 31, 2010, were identified and recalled for examination. In cases of missing data, the information contained in the patient's chart was analyzed and/or his ophthalmologist was contacted.

[Primary vitrectomy for rhegmatogenous retinal detachment without use of heavy liquids].

Purpose: The purpose of this study was to analyse the outcome of vitrectomy for rhegmatogenous retinal detachment without intraoperative use of heavy perfluorocarbon liquids (PFCL).

Material And Methods: All patients who had undergone vitrectomy with a PFCL-free approach during 4/2001-3/2008 by one single surgeon were recruited retrospectively from the electronic database and their data analysed.

Results: A total of 79 patients (42 pseudophakic, 37 phakic) with unilateral surgery were included in the study.

[Potentials and limitations of the planned compulsory quality assurance program for cataract surgery (Qesü)].

Cataract surgery is scheduled for a federal program for quality improvement across the different sectors of care (outpatient care and hospitals). In case of implementation not only ophthalmic surgeons but all ophthalmologists would have to contribute to the documentation. Urgency, potential benefits and limitations of a compulsory compared to a voluntary quality assessment system are analyzed.

Intraocular growth factors and cytokines in patients with dry and neovascular age-related macular degeneration.

Purpose: To analyze intraocular growth factor and cytokine concentrations in eyes with different stages of age-related macular degeneration (AMD) compared with controls.

Methods: The Clinical Age-Related Maculopathy Staging (CARMS) system was used for assignment of patients into the respective categories. Aqueous humor specimens were taken before cataract surgery in 21 controls (CARMS 1) and in 17 early (CARMS 2) and 16 intermediate (CARMS 3) AMD patients.

Intraoperative retinal break formation in 23-/25-gauge vitrectomy versus 20-gauge vitrectomy.

Background: This study was undertaken to examine the possible effect of microcannula-guided entry sites on the rate of intraoperative retinal break formation.

Methods: In this historical cohort study, all patients having undergone vitrectomy with epiretinal or internal limiting membrane peeling performed by one surgeon between January 2005 and March 2009 were included. All procedures with microcannula-guided entry sites (23- and 25-gauge vitrectomy) were compared to procedures without the use of microcannulas (20-gauge vitrectomy).

[Conspicuous crystalline lens foreign body after intravitreal injection].

In January 2011 a 63-year-old woman with retinal branch vein occlusion and a macular edema first presented with a conspicuous foreign body of the crystalline lens. The rare event of an inadvertently into the lens placed Ozurdex® was diagnosed. Due to recurrent macular edema several reinjections of Ozurdex® were necessary.

Intraocular lens calcification after keratoplasty.

Purpose: To report calcification of intraocular lenses (IOLs) after various keratoplasty procedures.

Methods: Clinical data of all cases with calcified IOLs after keratoplasty procedures were analyzed. A total of 6 explanted IOLs were analyzed with light microscopy before and after staining with 1% alizarin red and the von Kossa method.

[Reasons for exchange and explantation of intraocular lenses].

Background: This study was performed to analyse the reasons for explantation/exchange of intraocular lenses (IOL), which had originally been implanted for the correction of aphakia during cataract extraction.

Material And Methods: All cases with IOL explantation, which had been performed at one institution between 1/2008 and 12/2009 were analysed retrospectively.

Results: A total of 105 eyes of 100 patients were analysed.

[Results with the Boston keratoprosthesis].

Background: The Boston keratoprosthesis (BKP) is a surgical therapeutic option in patients with corneal disease and poor prognosis for penetrating keratoplasty. The purpose of this study was to summarize our results with this surgical technique which we have employed at our institution since November 2009.

Methods: All patients who underwent the BKP procedure at our institution between November 2009 and August 2011 were identified retrospectively and the data were analyzed.

[Result-related success rates of cataract operations. Results of a systematic literature review].

This systematic literature review, including 7 publications released since 2000, provides references for outcome indicators of cataract surgery for quality management initiatives. The reported relative numbers of cases achieving visual rehabilitation and refractive accuracy were determined and compared. With one exception the success rates did not represent benchmarks defined as best possible outcome but describe the results of data collected in a population during routine clinical practice.

Determination of valid benchmarks for outcome indicators in cataract surgery: a multicenter, prospective cohort trial.

Objective: To evaluate a systematic approach to derive valid benchmarks for 2 outcome indicators intended to ascertain quality in cataract surgery and to propose benchmark levels drawn from the study results.

Design: Prospective, multicenter cohort trial.

Participants: A total of 1685 patients (206-239 eyes per trial site) were recruited consecutively at 7 study sites.

Static and dynamic rotational eye tracking during LASIK treatment of myopic astigmatism with the Zyoptix laser platform and Advanced Control Eye Tracker.

Purpose: To evaluate the amount of cyclotorsion and the effect of static and dynamic rotational eye tracking with the Advanced Control Eye Tracker (Bausch & Lomb) based on iris recognition in the treatment of myopic astigmatism with LASIK.

Methods: All patients with myopic LASIK and attempted cylinder correction >0.75 diopters (D) on the Zyoptix 217z100 excimer laser platform between May 2005 and May 2007 were identified retrospectively through the existing databank.

Visualization and follow-up of acute macular neuroretinopathy with the Spectralis HRA+OCT device.

Background: Acute macular neuroretinopathy (AMNR) is a rare disease entity, the diagnosis of which is frequently complicated by the subtlety of biomicroscopic findings.

Methods: Two cases of AMNR are presented, in which the diagnosis and follow-up was enabled using the Spectralis HRA+OCT in the absence of clear biomicroscopic findings.

Results: The typical lesions were visualized by hyporeflexion during infrared imaging and faded over time.

Cataract surgery and aniridia.

Purpose Of Review: In the past years, several new options have been developed for the surgical management of aniridia in the course of cataract surgery.

Recent Findings: The lens capsule may be altered - thinned - in aniridia, requiring particular attention in order to avoid complications with possible consequences for the surgical plan. Iris prosthetic devices for complete or partial restoration of an iris diaphragm have been developed and their use described.