[Influence of Luxury Foodstuffs on Glaucoma]. / Einfluss von Genussmitteln auf das Glaukom.

The term "luxury foodstuffs" refers to foods which are not consumed because of their nutritional value. Classic modern luxury foodstuffs are alcohol, caffeine-containing drinks, cocoa, sugar and tobacco. The following review article examines some of these modern luxury foodstuffs in detail, as well as their influence on glaucoma. Thus, small quantities of alcohol lower high intraocular pressure and have a positive influence on the blood circulation of the optic nerve. In addition, red wine polyphenols exert vasoprotective effects. In general, however, alcohol consumption appears to have no significant effect on the prevalence of glaucoma. The most important source of caffeine intake is coffee consumption. In some studies, coffee consumption caused no changes in intraocular pressure, while others reported a rise. A large study showed a connection between heavy coffee consumption and the risk of pseudoexfoliation glaucoma. Green and black teas are rich sources of flavonoids with antioxidant activity. In addition, a slight trend for lowering the intraocular pressure has been measured. As regards chocolate, flavonoid-rich dark chocolate should be favoured, due to its antioxidant activity. It lowers blood pressure and improves endothelium-dependent vascular relaxation. Excessive sugar consumption over many years can lead to increased body mass index (BMI) and type 2 diabetes. Many studies show a positive relationship between BMI and intraocular pressure. Some studies have identified significant correlations between type 2 diabetes and the risk of glaucoma. Smoking is a very widespread stimulant; it narrows the blood vessels and thus reduces the blood circulation of the optic nerve. Otherwise, studies on the role of smoking as a risk factor for glaucoma have been very inconsistent. Luxury foodstuffs may effect glaucoma and should be included in the medical history.

[Preservatives from the perspective of glaucoma surgery]. / Konservierungsmittel aus Sicht der Glaukomchirurgie.

Trabeculectomy is still the gold standard in the surgical treatment of glaucoma patients. Development of a bleb is the primary goal of this procedure and the conjunctival status is therefore decisive. Only a good functioning bleb renders good intraocular pressure (IOP) control. Scar tissue formation leads to bleb failure which is quite common despite the use of antiproliferative agents, such as mitomycin C and 5 fluoruracil. Wound healing is important and is influenced and impaired by the chronic use of topical antiglaucoma drugs. Therefore, complete abstinence is recommended from 4-6 weeks prior to a planned trabeculectomy; however, it seems mandatory to completely abolish preservatives such as drops containing benzalkonium chloride to enhance trabeculectomy success rates.

[Morphological alterations induced by preservatives in eye drops]. / Morphologische Veränderungen durch Konservierungsmittel in Augentropfen.

A large number of experimental and clinical investigations carried out recently have confirmed that the chronic application of eye drops induces significant cytological and histological impairment in ocular tissues. It is also generally accepted that preservatives are the components responsible for the observed changes. The most commonly used preservative in ophthalmology is benzalkonium chloride (BAC), which has a relatively high toxicity. Possible consequences of preservatives on the eye are chronic inflammation and subsequent fibrosis of the subconjunctiva and cell loss and structural changes in the conjunctival epithelium as well as in the epithelial and endothelial layers of the cornea. Frequently, dry eye symptoms occur or deteriorate during therapy. During the last few years new preservatives have been developed which seem to have fewer side effects; however, relatively little data are available with regard to these new substances. To minimize impairments of the eye, preservative-free formulations should be considered for therapy.