Our experiences in planned extracapsular cataract extraction in the exfoliation syndrome.

We noticed a tenfold higher incidence of zonular rupture during planned extracapsular cataract extraction (e.c.c.e.) in patients with exfoliation syndrome compared to patients without this disease. The exfoliation glaucoma is an especially bad precondition for e.c.c.e. The postoperative complication rate (toxic lens syndrome, iridocyclitis) is remarkably high when there is an increased fluorescein leakage of the iris vessels before the operation. Also changes of the vitreous as shown by biomicroscopy or ultrasonography in the case of hazy optical media of the eye are a bad precondition. An intracapsular cataract extraction without lens implantation should be considered in cases of two or more worsening preoperative conditions.

[History of the Berlin Ophthalmology Society]. / Aus der Geschichte der Berliner Augenärztlichen Gesellschaft.

To mark the congress of the Berlin Ophthalmological Society in December 1989, the authors review the development of ophthalmology in Berlin and in particular the history of this ophthalmological society. The review was prompted by the political changes which began in October 1989, enabling ophthalmologists from the eastern part of the city to attend the congress in West Berlin for the first time in 28 years.

[Local mitomycin C therapy after excision of pterygium]. / Lokale Mitomycin-C-Therapie nach Pterygiumexzision.

In order to prevent recurrence of pterygium after excision we treated 21 patients postoperatively with Mitomycin-C-eye drops 0.02%. In a mean follow up of 1 1/2 years, we have not seen any recurrence or side effect. We conclude, Mitomycin-C 0.02% is a safe, simple and effective treatment to prevent recurrence of pterygium and we suggest to continue for a further experience.

The exfoliation in the Scheimpflug photography.

Scheimpflug photography is a very useful method in the diagnosis of exfoliation. It helps to differentiate between tiny subcapsular opacifications and supracapsular appositions. It is a valuable aid in the detection of early stages of exfoliation still unvisible at ordinary slit lamp examination. New phenomenons might be detected in the future like the elevation of a precapsular membrane in one of our patients.

Densitometric control of retinal vascular reactions after mandibular nerve anesthesia.

In a group of 44 patients, fundus photographs were taken before and after mandibular nerve anesthesia and examined by densitometry. These patients were divided into subgroups receiving 4 cm3 of Xylocitin 2% alone or in combination with 0.005% norepinephrine, or 0.00125 or 0.002% epinephrine. In the presence of epinephrine, the retinal arterioles reacted with a temporary age-dependent narrowing. A placebo group received normal saline or had just the needle inserted. With one interesting exception, the reactions were minimal. The cause of this reaction is a multifactorial one. In the first period, vagovagal reflexes are important; in the later phase, processes comparable to autoregulation play the main role.

The sharpness of incision instruments in corneal tissue.

Because breadths of surgical blades are very difficult to measure directly, we designed a method to measure sharpness of a variety of instruments by determining the power they required to incise corneal tissue to a uniform depth. Diamond knives were the sharpest, followed by razor blade pieces individually prepared by a special new method. Ruby knives varied considerably. The method of measuring sharpness described may allow manufacturers to improve and stabilize production methods, as well as enable surgeons with such knowledge in advance of surgery to optimize wound healing and maximize cost-effectiveness.

Microscopic-cytologic investigations on explanted intraocular lenses.

Nine iris supported anterior chamber lenses were removed during keratoplasty, eight of them on account of bullous pseudophakic keratopathy. They were examined cytologically according to the method of WOLTER. No one revealed a complete cellular--membraneous capsule. This membrane has with great probability a protective function. Four basic types of cells could be characterized. All cells of the borders of the eye chambers are involved but predominantly mobile and sessile macrophages are the source of the covering cells. The cellularity depends on the type of the lens and the material of the lens and on the clinical picture of the disease. Supramid is worse than prolene. Dangerous are pseudophakodonesis and endothelial contact.