[Comparison of laser treatment of patients with the replace with "computer-based laser" between experienced and unexperienced operators]. / Vergleich der laserbehandlung mit einem computergestützten lasersystem durch einen erfahrenen versus einen unerfahrenen behandelnden arzt.

INTRODUCTION: The aim of this study was to compare individual accuracy and speed of laser application using the Navilas laser system in patients with diabetic and vascular macular oedema. METHODS: The Navilas laser system was used by an experienced retina specialist and a relatively inexperienced ophthalmologist. Obtained results were retrospectively assessed with regard to precision and speed of laser application. RESULTS: Precision of laser therapy was quite similar, 88 % and 84 % for experienced and inexperienced operators, respectively. The treatment procedure took on average 5.5 minutes and 5.34 minutes for experienced and inexperienced operators, respectively. CONCLUSIONS: Precision and duration of therapy using the Navilas laser system do not seem to be correlated with the individual experience of the treating physician.

[Traumatic proptosis]. / Traumatische Proptosis.

The emergency consultation of a female patient revealed a left-sided prolapse of the eyeball with visual loss. The patient had fallen against an object hitting the left eye 40 min prior to the consultation. Motility of the eye was severely restricted and retinoscopy was impossible due to a corneal edema. The pupil was moderately dilated and non-reactive. The ocular pressure was 50 mmHg. Spontaneous repositioning was unsuccessful and an immediate lateral canthotomy was performed. The follow-up control showed that the patient had recovered good visual acuity with a reduction of intraocular pressure and pain. The latest findings were uneventful.

Early foveal recovery after macular hole surgery.

AIMS: To evaluate morphological and functional recovery after macular hole surgery using pars plana vitrectomy (PPV), inner limiting membrane (ILM) peeling, air-tamponade and short-time limited face-down positioning. DESIGN: Retrospective, interventional, non-comparative consecutive case series. PATIENTS: Thirty eyes in 30 patients (30 eyes) with unilateral full-thickness macular hole (stage II-IV). INTERVENTION: All eyes underwent PPV, ILM peeling and fluid-air exchange followed by postoperative face-down positioning for 2 days. MAIN OUTCOME MEASURES: Best corrected visual acuity, optical coherence tomography (OCT) assessment of macular integrity, and biomicroscopy at days 3 and 7, and months 1, 3, 6 and 12. RESULTS: On postoperative day 3, OCT demonstrated macular hole closure in 28 eyes (93%). One eye required vitrectomy 7 weeks after initial surgery due to retinal detachment. CONCLUSIONS: In the present case series, PPV with Trypan Blue-assisted ILM peeling, short-acting internal tamponade and thus shorter face-down positioning was associated with a 93% macular hole closure rate.

Early postoperative recovery of idiopathic macular hole in a young adult.

BACKGROUND: Idiopathic macular holes usually develop in the elderly. We report the case of a spontaneous macular hole in a 23-year-old man. HISTORY AND SIGNS: The patient noticed decreased central vision in his left eye since 5 days without any history of trauma or intraocular inflammation. On examination the best corrected visual acuity was 20/20 in the right eye and 20/50 in the left. Fundus biomicroscopy and OCT showed a full-thickness macular hole. Microperimetry demonstrated a scotoma within the macular hole. THERAPY AND OUTCOME: 2 months later the patient underwent pars plana vitrectomy, ILM-peeling with trypan blue staining and fluid-air exchange followed by face down positioning for 12 h a day for 2 days. On the 4th post-surgical day visual acuity was 20/32 and OCT showed a complete closure of the macular hole. During the further follow-up visual acuity in the left eye improved to 20/20. OCT examination showed a restored foveal depression, and microperimetry demonstrated an increased foveal sensitivity in the area of the previous scotoma. CONCLUSIONS: The aetiology of the macular hole in this patient is unclear. It is most likely an idiopathic macular hole in a young person. Post-surgical follow-up OCTs and microperimetry disclosed an early recovery of the foveal anatomy and function.