[Safety of Hyaluronic Acid in Postoperative Treatment after Penetrating Keratoplasty]. / Verträglichkeit von Hyaluronsäure zur Oberflächenpflege nach perforierender Keratoplastik.

BACKGROUND: The objective of this clinical trial was to confirm the safety of phosphate-free high molecular weight hyaluronate (HYLO®-GEL) as lubricant for postoperative care after penetrating keratoplasty. PATIENTS AND METHODS: 51 eyes were followed up 6 weeks after penetrating keratoplasty under therapy with phosphate-free high molecular weight hyaluronate. Visual acuity, intraocular pressure, conjunctival hyperaemia, conjunctival chemosis, corneal fluorescein staining, corneal infiltrates, corneal endothelial-epithelial decompensation, Descemet's folds, Tyndall effect, cells in the anterior chamber and subjective assessment of lacrimation, foreign body sensation, pressure sensation, burning, mucus and itching were recorded on the first, third and fifth postoperative days and six weeks postoperatively. Tolerance was rated by the patient and the attending ophthalmologist. RESULTS: The following objective parameters improved significantly from day 1 to week 6 in patients treated with phosphate-free high molecular weight hyaluronate: visual acuity, conjunctival hyperaemia, conjunctival chemosis, corneal fluorescein-staining, corneal endothelial-epithelial decompensation, Descemet's folds, the maximum diameter of corneal erosion, Tyndall effect and cells in the anterior chamber. In addition, there was significant improvement in the course of the following subjective complaints: lacrimation, foreign body sensation, pressure sensation and itching. In total 63 % (32/47) of the study patients reported excellent local tolerance of phosphate-free high molecular weight hyaluronate on day one postoperatively. This proportion rose to 86 % (37/43) 6 weeks postoperatively. The safety of phosphate-free high molecular weight hyaluronate was rated by the ophthalmologists as "perfect" in 92 %, as "acceptable" in 6 % and as "unacceptable" in 2 % of eyes. CONCLUSION: Therapy with phosphate-free high molecular weight hyaluronate results in significant improvements in objective findings and subjective symptoms after penetrating keratoplasty. Tolerance was rated as "excellent" by the ophthalmologist in 92 % of patients in the early postoperative follow-up.

[Ultrasound biomicroscopy in giant cell arteritis]. / Ultraschallbiomikroskopie bei Riesenzellarteriitis.

Giant cell arteritis may lead to irreversible blindness due to an anterior ischemic optic neuropathy or central retinal artery occlusion. Diagnosis of the giant cell arteritis is sometimes a problem: Difficulties may arise since a negative biopsy can not rule out the diagnosis. This case report demonstrates acute changes in the temporal artery as demonstrated by Ultrasound Biomicroscopy and documents its course during therapy with corticosteroids.

[Interobserver and intraobserver reliability of corneal surface temperature measurements with the TG-1000 thermograph in normal eyes]. / Inter- und Intraobserverreliabilität der kornealen Oberflächentemperaturmessung mit dem TG-1000 bei Normalaugen.

PURPOSE: The aim of this study was to analyze the reliability of temperature measurements with the ocular TG-1000 thermograph in a setup of sequential measurements performed by one observer (intraobserver) and a sequence of measurements performed by different observers (interobserver) in normal subjects without pathologies of the anterior segment of the eye. PATIENTS AND METHODS: A total of 50 right eyes from 50 individuals (mean age 29.1 ± 7.9 years) without ocular pathologies or history of ocular surgery were enrolled in this prospective monocentric clinical case series. Eyes with signs of dry eye syndrome (based on a positive McMonnies questionnaire) were excluded from the study. Corneal surface temperature measurements were performed by three examiners to assess interobserver reliability. In addition, in a subgroup of 22 individuals, a sequence of 3 measurements were performed by 1 of the examiners to examine intraobserver reliability. Corneal surface temperature was measured within an interval of 10 s (11 frames) on a region of interest of 16 ± 12 mm (320 ± 240 pixels). Central and mid-peripheral local temperatures at 3 mm (3, 6, 9 and 12 o'clock) were extracted and analyzed from the raw data. RESULTS: The ocular TG-1000 thermograph yielded consistent results for the interobserver as well as intraobserver conditions in measuring corneal surface temperature in the center as well as mid-periphery of the cornea. Cronbach's alpha was 0.9 or higher at all corneal locations, which proves a high consistency of results for the interobserver and intraobserver measurements. The average corneal surface temperature ranged between 34.0 °C and 34.7 °C with a slight decrease from the upper temporal (9 and 12 o'clock) to the lower nasal (3 and 6 o'clock) quadrants. CONCLUSION: The TG-1000 thermograph yielded consistent results of corneal surface temperature in individuals without anterior segment pathologies or history of ocular surgery. With the option of raw data export (11 frames within 10 s with a lateral resolution of 320 × 240 pixels) the thermograph offers a wide range of new diagnostic options for a spatiotemporal analysis of corneal surface temperature.