[Explantation of two historical posterior chamber phakic intraocular lenses 31 years after implantation]. / Explantation zweier historischer phaker Hinterkammerlinsen 31 Jahre nach Implantation.

This article reports the case of a 56-year-old male patient who had undergone implantation of posterior chamber phakic intraocular lenses in 1987 in Russia. The patient presented to this clinic 31 years after the initial surgery with anterior cortical cataracts and initial stages of corneal decompensation in both eyes. Strategic planning and execution of surgical treatment and the further clinical course are portrayed in this report.

[Clinical parameters of patients with neovascular age-related macular degeneration : Longterm treatment results of an outpatient clinic]. / Klinische Parameter von Patienten mit neovaskulärer altersbedingter Maculadegeneration : Langzeitbehandlungsergebnisse aus einem ambulanten Versorgungszentrum.

BACKGROUND: The clinical outcome of neovascular age-related macular degeneration (nAMD) depends on constant follow-up and consistent treatment. Data about the long-term course of intensive anti-vascular endothelial growth factor (VEGF) therapy from outpatient clinics are rare. OBJECTIVE: The aim of the study was to characterize a population of nAMD patients with long-term follow-up and intensive anti-VEGF therapy. PATIENTS AND METHODS: In a supra-regional outpatient clinic, we retrospectively identified patients who had received at least 30 intravitreal anti-VEGF injections and were followed for at least 4 years. All patients received an optical coherence tomography(OCT)-controlled Pro-Re-Nata (PRN) therapy regimen according to German guidelines. RESULTS: We identified 43 patients. Visual acuity at baseline was 0.44 ± 0.24 (1.0-0.1) logMAR. At the end of the follow-up period, visual acuity was 0.63 ± 3.6 (1.3-0.1) logMAR. Patients received a mean of 36.3 ± 8.0 (30-62) injections and were followed for a mean of 6.1 ± 1.8 (4-12) years. They received 6.12 ± 1.5 (3.1-9.9) injections per year. The number of injections in treatment-year one was with 3.67 ± 1.9 (1-8) significantly lower than the mean (p < 0.0001). CONCLUSION: Despite intensive PRN therapy, visual acuity slowly decreased over time. The mean number of injections was comparable to that of prospective studies. The low number of injections in treatment-year 1 may have been due to a lack of experience with the new treatment agents. The slow decrease in visual acuity in clinical routine as opposed to clinical studies may be attributed to a delay between occurrence of disease activity and treatment.

[Value of corticosteroids in after-care of patients after cataract extraction and lens implantation]. / Zur Bedeutung der Kortikosteroide in der Nachsorge von Patienten nach Kataraktextraktion und Linsenimplantation.

In two double-blind controlled trials the anti-inflammatory effects of dexamethasone were examined in post-cataract extraction eyes after lens implantation in 321 patients. In the first trial, 103 patients were included. 49 eyes received eye-drops with 0.1% dexamethasone and antibiotics, the control-group of 54 eyes received the same antibiotics without any steroids. The follow-up was 2 months. In the case of unexpected complications, the patients dropped out. This was the case in 48% of the steroid-group and in 79% of the control-group. The main reason for this statistically significant difference were inflammatory complications in the control-group, which are difficult to quantify. The incidence of fibrinous reactions was not significantly different in the two groups, probably because of small numbers. In the second trial, we looked for fibrinous reactions. The follow-up was 3 weeks, 218 patients participated. They were divided into three groups: 71 patients received eyedrops with 0.1% dexamethasone 4x daily, 77 patients received the same drops 4x daily up to the fifth postoperative day, from then on 1x daily. 70 patients received the same drops 1x daily. A mild fibrinous reaction was seen in 10% of the high-dose-group, in 6% of the medium-dose-group and in 21% of the low-dose-group. Only the difference between the last two groups is statistically significant. We conclude that the therapy with corticosteroids after cataract extraction and lens implantation may be reduced early in the postoperative course.