A Viestenz

Universitätsklinikum des Saarlandes, Homburg, Saarland, Germany

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Publications (141)140.23 Total impact

  • M Fiorentzis, B Seitz, A Viestenz
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    ABSTRACT: Closed ocular trauma is associated with various retinal complications, such as Berlin's edema, peripheral retinal tears, retinal hemorrhage, choroidal rupture, subretinal bleeding and macular holes. Traumatic macular holes (TMH) are rare and surgical intervention is controversial due to possible spontaneous closure. The positive development in the patient described here indicates that a pars plana vitrectomy with drainage of subretinal hemorrage combined with peeling of the internal limiting membrane (ILM) for a penetrating traumatic macular hole with choroidal rupture can lead to the restoration of visual acuity. The anti-vascular endothelial growth factor (VEGF) therapy (under silicone oil with avastin 0.02 ml) can successfully lead to limitation of posttraumatic choroidal neovascularization (CNV). Patients with ocular contusion require extensive long-term ophthalmological follow-up. Furthermore, prevention, education and information is essential to prevent serious injuries.
  • M Fiorentzis, A Viestenz, B Seitz
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    ABSTRACT: Over the past decade endothelial keratoplasty has become the treatment of choice for patients with corneal endothelial dysfunction. "Descemet stripping automated endothelial keratoplasty" (DSAEK) is one of the most widespread forms of posterior endothelial keratoplasty. An improvement of visual acuity is achieved more quickly after DSAEK and the reduced amount of transplanted tissue in DSAEK seems to result in fewer instances of immunological graft rejection. The clinical signs of immunological graft rejection after DSAEK are not yet well known. Typically, an immunological rejection episode is combined with the presence of corneal edema, Descemet folds and retrocorneal precipitates restricted to the graft but a classical Khodadoust line seems to be rare. The quick response after the combination of high-dose topical and systemic steroid therapy with steroid injection (80 μg fortecortin) in the anterior chamber in our patient confirms the necessity of a prompt and rapid immunosuppression. Although the risk of graft rejection after DSAEK is rare, the use of immunosuppressants is important in both acute and long-term postoperative care of endothelial corneal transplantation.
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    ABSTRACT: Hintergrund und Ziele Die Intraokulardruck (IOD)-Messung in Intubationsnarkose (ITN) ist im Rahmen der Glaukomdiagnostik bei Kindern und in ihrer Kooperation beeinträchtigten Patienten ein wichtiges diagnostisches Mittel. Der IOD kann jedoch durch die ITN erheblich verfälscht werden. Die vorliegende Studie evaluiert das Maß des IOD-Abfalls durch eine ITN. Patienten und Methoden Der IOD wurde bei 229 Patienten am nicht zu operierenden Auge im Liegen vor und 5 min nach Einleitung der ITN mit dem dynamischen Contour-Tonometer (DCT) gemessen. Ergebnisse Der IOD fiel von 19,9 ± 3,7 mmHg vor ITN auf 14,1 ± 3,5 mmHg 5 min nach ITN-Einleitung (p Schlussfolgerungen Bei einer ITN muss ein erheblicher IOD-Abfall von im Mittel 6 mmHg beachtet werden – im Einzelfall sogar bis 13,8 mmHg. Auch das Fallen der OPA um im Mittel 1,5 mmHg und im Extremfall sogar um bis zu 7 mmHg sollte bei der Beurteilung der am intubierten Patienten gemessenen Werte berücksichtigt werden.
    Der Ophthalmologe 12/2014; DOI:10.1007/s00347-014-3180-3 · 0.72 Impact Factor
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    ABSTRACT: AnamneseEin 75-jähriger pseudophaker Patient wurde in unserer Klinik zur operativen Versorgung bei der Diagnose einer hochblasigen Reablatio retinae am rechten Auge vorgestellt. Eine Kataraktoperation war vor 6 Jahren durchgeführt worden. Anamnestisch wurden beide Augen vor 20 Jahren bei Ablatio retinae operiert.Klinischer BefundDer Visus des Patienten betrug 1,0 rechts und 0,8 links. Doppelbilder oder sonstige neuroophthalmologische Beschwerden wurden von dem Patienten verneint. Bei der Bindehautinspektion zeigte sich beidseits eine tumorartige subkonjunktivale Schwellung oben und temporal (Abb. 1). Spaltlampenmikroskopisch stellte sich die Hornhaut klar und die Vorderkammer ohne Zellen dar. Die Intraokularlinse war im Kapselsack zentriert. Am hinteren Pol wurde beidseits eine prominente Netzhaut ohne darunter liegendes retinales Pigmentepithel und Aderhaut in den oberen Quadranten festgestellt (Abb. 2). Die Größe der subretinalen Prominenz betrug sonographisch 10 × 15 mm im Durchmess ...
    Der Ophthalmologe 12/2014; · 0.72 Impact Factor
  • M Fiorentzis, R Khoury, B Seitz, A Viestenz
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    ABSTRACT: The main reasons for the markedly reduced visual acuity in pediatric patients with congenital aniridia are foveal dysplasia and optic nerve hypoplasia. During the lifetime a lack of depth of focus and increased sensitivity to glare due to a partly or completely lacking iris may be accompanied by further complications such as cataracts, various types of glaucoma and corneal opacity. In principal, microsurgical intervention should be as minimally invasive as possible to avoid excessive intraocular fibrosis. It is not advisable to use any type of esthetic iris substitute in phakic eyes. Cataract surgery should be performed via small incisions with a foldable intraocular lens (IOL) but not by using a 10 mm diameter polymethyl methacrylate (PMMA) anirida IOL. The conservative therapy of the often progressive limbal stem cell deficiency of the cornea includes artificial tears containing unpreserved hyaluronic acid, gels, autologous serum and amniotic membrane transplantation. Limbal transplantation of various kinds with and without penetrating keratoplasty and the Boston keratoprothesis type I should be considered only in cases of significant reduction of visual acuity and/or recurrent epithelial defects. Glaucoma surgery should be performed primarily as trabeculotomy. Drainage devices (e.g. Ahmed valve) are suggested as a second line approach. The risk of scarring of the filtering bleb in trabeculectomy with mitomycin C is very high in childhood and adolescence. The stage-related therapy of congenital aniridia should always be based on a global view of the potentially increasing severity of cataract, glaucoma and corneal limbal stem cell deficiency during the lifetime. Each microsurgical intervention should be performed by the appropriate specialist and should be kept as minimally invasive as possible.
    Der Ophthalmologe 12/2014; 111(12). DOI:10.1007/s00347-014-3061-9 · 0.72 Impact Factor
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    ABSTRACT: Coats' disease is a non-hereditary acquired, usually unilateral eye disorder that predominantly occurs in young males (1/100,000) with the onset of symptoms generally appearing in the first two decades of life. Coats' disease is characterized by telangiectatic changes, blood leaks from the defective vessels with retinal exudation followed in advanced stages by retinal detachment.
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    ABSTRACT: Congenital glaucoma is a disease potentially leading to blindness in children. It poses a diagnostic and therapeutic challenge even though new knowledge has been acquired and a sufficient understanding of the pathogenesis has been gained. New discoveries, such as the exact time when Schlemm's canal develops could lead to a prenatal diagnosis and therefore surgical intervention so that other complications including blindness can be avoided. This case report demonstrates that an early prenatal eye screening with ultrasound (after approximately 30 weeks of pregnancy) would be desirable in order to diagnose buphthalmus early and to plan postnatal surgery.
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    ABSTRACT: In cases of contact lens intolerance and/or central corneal scars, corneal transplantation is indicated for advanced keratoconus. This can be performed as deep anterior lamellar keratoplasty (DALK) or as penetrating keratoplasty (PKP). The German keratoplasty registry shows that the proportion of anterior lamellar grafts in Germany has remained stable at approximately 5 % in recent years. Up to now DALK has not been technically standardized but can result in a good visual acuity using the big bubble technique if Descemet's membrane is laid bare intraoperatively. In 10-20 % a conversion to PKP is required if perforation of Descemet's membrane occurs. In cases of advanced keratoconus PKP is still the method of first choice especially after corneal hydrops due to rupture of Descemet's membrane. Non-contact excimer laser trephination seems to be especially beneficial for eyes with iatrogenic keratectasia after LASIK and those with repeat grafts in cases of keratoconus recurrence due to the graft being too small. For donor trephination from the epithelial side, an artificial chamber is used. Wound closure is achieved by a double running cross-stitch suture according to Hoffmann. Graft size is adapted individually depending on corneal size (as large as possible and as small as necessary). Limbal centration is given priority intraoperatively due to optical displacement of the pupil. Prospective clinical studies have shown that the technique of non-contact excimer laser PKP improves donor and recipient centration, reduces vertical tilt and horizontal torsion of the graft in the recipient bed, thus resulting in significantly less all-sutures-out keratometric astigmatism (2.8 D versus 5.7 D), higher regularity of the topography (SRI 0.80 vs. 0.98) and better visual acuity (0.80 vs. 0.63) in contrast to the motor trephine. The stage of the disease does not influence functional outcome after excimer laser PKP. In cases with optimal course DALK achieves the same visual outcome as mechanical PKP but the healthy endothelium can be preserved and endothelial immune reactions are prevented in keratoconus. In contrast to the undisputed clinical advantages of excimer laser keratoplasty with orientation teeth/notches in keratoconus, the major disadvantage of femtosecond laser application is still the necessity of suction and applanation of the cone during trephination.
    Der Ophthalmologe 09/2013; 110(9):839-48. · 0.72 Impact Factor
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    ABSTRACT: Bei Kontaktlinsenintoleranz und/oder zentralen Hornhautnarben ist beim fortgeschrittenen Keratokonus die Korneatransplantation angezeigt. Diese kann prinzipiell als anteriore lamelläre Keratoplastik (bevorzugt als ,,deep anterior lamellar keratoplasty“, DALK) oder als perforierende Keratoplastik (PKP) durchgeführt werden. Das Deutsche Keratoplastikregister weist für die letzten Jahre stabil einen Anteil von etwa 5 % an anterioren lamellären Keratoplastiken aus.Die DALK ist bis heute technisch nicht standardisiert, kann aber mittels Big-Bubble-Technik zu guten Visusergebnissen führen, wenn intraoperativ die Descemet-Membran freigelegt wurde. In 10–20 % der Eingriffe ist bei Perforation der Descemet-Membran die Konversion zur PKP nötig. Bei fortgeschrittenem Keratokonus – besonders bei Zustand nach akutem Keratokonus mit Descemet-Ruptur – wird die PKP nach wie vor für die Methode der Wahl gehalten. Die kontaktfreie nichtmechanische Excimerlasertrepanation bietet sich in besonderem Maße auch für die iatrogene Keratektasie nach Laser-in-situ-Keratomileusis (LASIK) und die Rekeratoplastik bei sog. ,,Keratokonusrezidiv“ wegen zu kleinem Transplantat an. Für die Spendertrepanation von epithelial wird eine künstliche Vorderkammer eingesetzt, der wasserdichte Wundverschluss erfolgt mittels doppelt fortlaufender Naht nach Hoffmann. Die Transplantatgröße wird individuell an die Hornhautgröße angepasst (,,so groß wie möglich, so klein wie nötig“). Der Limbuszentrierung wird wegen der optischen Verlagerung der Pupille intraoperativ der Vorzug gegeben.Publizierte klinische Studien haben gezeigt, dass die Technik der Non-contact-Excimerlasertrepanation die Spender- und Empfängerzentrierung, die ,,vertikale Verkippung“ sowie die ,,horizontale Torsion“ des Transplantates im Empfängerbett verbessert. Daraus resultieren nach Fadenentfernung ein signifikant geringerer Astigmatismus (2,8 vs. 5,7 dpt), eine höhere Regularität der Topografie [Surface Regularity Index (SRI) 0,80 vs. 0,98] und vor allem ein besserer Visus (0,80 vs. 0,63) im Vergleich zum Motortrepan. Die funktionellen Ergebnisse nach Excimerlaser-PKP sind bei Operation im fortgeschrittenen Stadium nicht schlechter als bei Operation in früheren Stadien des Keratokonus.Bei optimalem Verlauf kann die DALK bei Erhalt des eigenen gesunden Endothels zu Visusergebnissen analog denen der PKP führen und endotheliale Immunreaktionen komplett vermeiden. Den unbestrittenen klinischen Vorteilen der Excimerlasertrepanation für die PKP bei Keratokonus steht bei der Femtosekundenlasertrepanation die Notwendigkeit der Ansaugung und Applanation des Konus als gravierender Nachteil gegenüber.
    Der Ophthalmologe 09/2013; 110(9). DOI:10.1007/s00347-013-2822-1 · 0.72 Impact Factor
  • Klinische Monatsblätter für Augenheilkunde 09/2012; 229(S 01). DOI:10.1055/s-0032-1327171 · 0.67 Impact Factor
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    ABSTRACT: Purpose:  The aim of our study was to investigate the biomechanical properties of the cornea in primary congenital glaucoma (PCG) and to identify the potential ocular determinants, which affect the corneal biomechanical metrics. Methods:  Corneal hysteresis (CH), corneal resistance factor (CRF) and central corneal thickness (CCT) were measured in 26 patients with PCG (40 eyes) with the aid of ocular response analyser. In vivo laser-scanning confocal microscopy was used for the estimation of stromal keratocyte density (KD) and the evaluation of corneal endothelium. Twenty normal subjects (40 eyes) served as controls. Student's t-test and Pearson's correlation coefficients were used for statistical analysis. p Values <0.05 were considered statistically significant. Results:  Corneal hysteresis, CRF and CCT were significantly reduced in patients with PCG (all p < 0.05). Corneal hysteresis and CRF negatively correlated with the corneal diameter in both groups (r(1)  = -0.53, r(2)  = -0.66, p < 0.001 for CH and r(1)  = -0.61, r(2)  = -0.69, p < 0.001 for CRF). Moreover, we identified a significant correlation between CH and CRF with CCT in both groups (r(1)  = 0.51, r(2)  = 0.48, p < 0.001 for CH and r(1)  = 0.45, r(2)  = 0.44, p < 0.001 for CRF). Mean KD was significantly reduced both in the anterior and posterior corneal stroma in patients with PCG (764 ± 162 and 362 ± 112 cells/mm(2) , respectively) compared with controls (979 ± 208 and 581 ± 131 cells/mm(2) , respectively) (p < 0.001). There was no significant correlation between the keratocyte density in anterior and/or posterior stroma and CH or CRF in any group (r(1)  = 0.29, r(2)  = 0.31, p < 0.06). Mean endothelial cell density was also significantly reduced in PCG group (2920 ± 443 cells/mm(2) ) compared with control group (3421 ± 360 cells/mm(2) ) (p < 0.001). Pleomorphism and polymegalism were significantly increased in corneal endothelium of patients with PCG. Conclusions:  Our results showed a significant reduction in CH and CRF in PCG. Both CH and CRF were negatively correlated with corneal diameter. A significant correlation of CH and CRF with CCT was identified in both groups. Keratocyte density was decreased in PCG, but did not have a significant impact on CH and CRF. Mean endothelial density was also decreased in PCG. Our results suggest that reduced CCT and increased corneal diameter are major ocular determinants for the modified corneal biomechanical profile in PCG, while cellular alterations in corneal stroma and endothelium have no significant biomechanical impact.
    Acta ophthalmologica 08/2012; 91(1). DOI:10.1111/j.1755-3768.2012.02519.x · 2.51 Impact Factor
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    ABSTRACT: The aim of the study was an assessment of refraction error after implantation of two types of hydrophobic acrylic intraocular lenses and derivation of customized IOL constants for the SRK II, SRK/T, Hoffer Q, Holladay 1 and Haigis formula. The purpose of the present study was to analyze the refractive outcome of two hydrophobic acrylic intraocular lenses and to present a computerized calculation scheme for customization of lens-specific parameters provided by the lens manufacturers based on the refractive results of a surgeon or study center. In this prospective monocentric study 100 consecutive cataract eyes were treated at the Eye Hospital of the Barmherzige Brüder (Compassionate Brothers) in Linz/Austria with a hydrophobic acrylic aspherical intraocular lens (Polytech Y10AS, n = 50) or a hydrophobic acrylic spherical intraocular lens (Hoya PC-60R, n = 50). The biometrical data were assessed preoperatively together with the refractive outcome 8-10 weeks after treatment in order to analyze the deviation of postoperative refraction (spherical equivalent) from target refraction (ΔREF) and to customize the lens constants for the SRK II, SRK/T, Hoffer Q, Holladay 1 and Haigis formula. Based on this data set it could be demonstrated that using the lens constant provided by the manufacturer (ΔREF) the Polytech lens showed a systematic trend to myopia in contrast to the Hoya lens which ranged around zero. This trend could be compensated by selecting appropriate lens specific constants. For the Polytech/Hoya lens median lens constants of: A = 118.0/118.6 (SRK II), A = 117.9/118.6 (SRK/T), pACD = 4.8/5.1 (Hoffer Q), SF = 1.1/1.5 (Holladay I) and d = 4.2/4.6 (Haigis) were extracted and using linear regression a lens constant triplet for the Haigis formula of a(0) = 4.39, a(1) = 0.29, a(2) = 0.11/a0 = 4.73, a(1) = 0.30, a(2) = -0.01 could be derived. Ophthalmic surgeons or surgical centers are encouraged to check (refractive) outcomes after cataract surgery permanently in terms of quality control. If a systematic trend in ΔREF could be extracted from the data set a customization of the lens-specific constants is recommended to eliminate systematic errors. Such customization is only valid for a dedicated environment (e.g. for one surgical center with standardized surgical techniques and measurement equipment) and cannot be generalized.
    Der Ophthalmologe 05/2012; 109(5):468-73. DOI:10.1007/s00347-012-2535-x · 0.72 Impact Factor
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    ABSTRACT: To validate changes in intraocular pressure (IOP) after phacoemulsification with intraocular lens (IOL) implantation without pressure-lowering surgery in previously unoperated eyes of normal and glaucoma patients. University Eye Clinic, Otto-von-Guericke-University, Magdeburg, Germany. Cohort study. The IOP in both eyes of patients was determined by Goldmann applanation tonometry (GAT) and dynamic contour tonometry (DCT) 1 to 2 days before and after uneventful unilateral surgery. Central corneal thickness was used to correct raw GAT readings. Of the 50 patients having unilateral phacoemulsification, 29 had had cataract extraction in the contralateral eye. The mean baseline IOP was 17.4 ± 4.4 mm Hg (GAT) and 16.6 ± 2.9 mm Hg (DCT). Postoperatively, the GAT IOP decreased to 16.4 ± 6.5 mm Hg and the DCT IOP increased slightly to 17.1 ± 4.1 mm Hg. The mean tonometer difference (ΔIOP = GAT - DCT) amounted to ΔIOP(pre) = +0.75 ± 2.69 mm Hg in phakic eyes and ΔIOP(post) = -0.70 ± 3.76 mm Hg in pseudophakic eyes (P=.0011). Consistent results were found in pairs of phakic eyes and pseudophakic eyes (mean IOP 18.0 ± 4.8 mm Hg [GAT] and 17.0 ± 3.3 mm Hg [DCT]). In fellow eyes, the mean GAT reading was 13.4 ± 4.4 mm Hg and the mean DCT value, 14.8 ± 2.4 mm Hg. ΔIOP(phakic) was +1.04 ± 2.75 mm Hg and ΔIOP(pseudophakic) was -1.48 ± 2.78 mm Hg (P=.00000021). The GAT IOP readings in pseudophakic eyes seemed to be falsely low. Hence, special attention in the screening, diagnosis, and management of glaucoma is necessary.
    Journal of Cataract and Refractive Surgery 02/2012; 38(4):683-9. DOI:10.1016/j.jcrs.2011.11.034 · 2.55 Impact Factor
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    ABSTRACT: To perform an objective functional assessment of the impact of blue-light filters on cortical processing to evaluate the potential side effects of the filters on higher tier visual function at the neural level. Department of Ophthalmology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany. Cohort study. Multifocal pattern-reversal visual-evoked potentials (multifocal VEPs) were recorded monocularly in pseudophakic patients with a clear intraocular lens (IOL) under 2 conditions: (1) stimulus perception through a yellow filter with the filter characteristics of an AF-1 YA-60BB IOL (blue filtering); (2) stimulus perception through a neutral filter that homogeneously attenuates the effective stimulus intensity as under the blue-light filtering condition but independent of the wavelength (neutral filtering). Second-order kernel multifocal VEPs were extracted for 60 visual field locations, and amplitude and latency effects were determined for 6 stimulus eccentricities. The study evaluated 20 patients. Typical multifocal VEPs were obtained for the blue-light and neutral filtering conditions at all eccentricities. No significant effects on amplitudes were obtained, and a subtle latency effect (<0.5 millisecond delay for neutral filtering; P<.02) did not reach significance in an eccentricity-specific analysis. The induced short-term change in the spectral composition of the visual stimulus left neural activity at the level of the primary visual cortex largely unaffected, providing an objective account of the integrity of visual processing under this condition.
    Journal of Cataract and Refractive Surgery 01/2012; 38(1):85-91. DOI:10.1016/j.jcrs.2011.06.031 · 2.55 Impact Factor
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    ABSTRACT: For the contactless diagnosis of the human cornea and anterior chamber in clinical routine, two systems have been established besides the slit lamp: the Scheimpflug camera and optical coherence tomography (OCT). A short introduction into these imaging methods is provided along with a comparison with respect to imaging quality and the visibility of relevant ocular structures. We present different examples from special clinical diagnostics such as keratoconus, condition after keratoplasty or tumours in ocular tissue.
    Klinische Monatsblätter für Augenheilkunde 12/2011; 228(12):1052-9. DOI:10.1055/s-0031-1281954 · 0.67 Impact Factor
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    ABSTRACT: A high corneal astigmatism is a major limitation for the attainable visual acuity with spectacle or contact lens correction. In addition, people with higher ametropia may feel discomfort while wearing contact lenses or spectacles which leads to the desire for a permanent correction. Phakic intraocular lenses provide correction possibilities of higher spherocylindrical ametropies beyond those of corneal refractive surgery. For the calculation of toric phakic lenses the matrix formalism for calculation of toric pseudophakic implants is applied. The methods are presented and explained using clinically relevant data examples. A Java-based program JPhakicIOL was used for calculation of the examples and is provided online for teaching and experimental purposes. Phakic IOLs can be calculated using a matrix scheme similar to the one used for toric pseudophakic implants. With the Java programme JPhakicIOL we provide a software tool to assist ophthalmologists in understanding and performing the phakic IOL calculation.
    Klinische Monatsblätter für Augenheilkunde 08/2011; 228(8):690-7. DOI:10.1055/s-0031-1281598 · 0.67 Impact Factor
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    ABSTRACT: A high corneal astigmatism limits the attainable visual acuity and the ability of correction with spectacles or contact lenses. The astigmatism can also be an impairment for visual rehabilitation, especially after penetrating keratoplasty. A pseudohakic toric intraocular lens (T-IOL) can correct high corneal astigmatism during cataract surgery. For the calculation of the correct power for the T-IOL several additional factors need to be considered, which are less relevant for spherical IOL calculation. With the matrix-based vergence transformation an elegant paraxial calculation scheme is available for calculating the optical system "pseudophakic eye" as a closed system. The basic elements of this method are explained in detail along with some clinical examples. The Java-based software JToricIOL is provided online to support comprehension of the examples and to enable readers to make their own calculations for teaching and experimental purposes. The examples mentioned in this article have been calculated with JToricIOL. Toric intraocular lenses are an essential tool for correcting high corneal astigmatism if cataract surgery is needed. For preoperative calculation of the lens power and axis, the matrix method provides a qualified tool for precise calculations. The software JToricIOL enables surgeons and students to reproduce the examples in this paper and to experiment with their own calculations.
    Klinische Monatsblätter für Augenheilkunde 04/2011; 228(8):681-9. DOI:10.1055/s-0029-1246046 · 0.67 Impact Factor
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    ABSTRACT: In concomitant cataract surgery and penetrating keratoplasty (PKP), the sequential procedure is supposed to have a higher accuracy in calculation of the intraocular lens (IOL) power compared to the triple procedure. The purpose of this study was to evaluate the refractive results of cataract surgery in patients after PKP. Our retrospective study included 72 operations on 65 patients. In 35 eyes (group 1, G 1), all corneal sutures had been removed before cataract surgery (median time interval after PKP 3.1 years), while in 37 eyes (group 2, G 2) corneal sutures were in place but removed intra- or postoperatively (median time interval after PKP 1.5 years). Mean age of the patients (65 / 67 years), mean target refraction (-1.8 diopters, D), and mean follow-up interval (2.9 / 3.4 years) were comparable in G1 / G2. Pre- and postoperatively refraction, keratometry, and best corrected visual acuity were recorded. Main outcome measures included the deviation of the spherical equivalent of the real refraction from the target refraction after cataract surgery. In G1 / G2 median visual acuity increased from preoperatively 0.2 / 0.15 to 0.6 / 0.5 after a follow-up period of 3 years on average. Mean deviation from target refraction was -0.3 ± 2.2 (-4.95 to + 3.15) D in G 1 and -0.4 ± 3.0 (-7.3 to + 7.25) D in G 2. After cataract surgery, the steepening of the cornea on average was significantly less in G 1 (0.5 ± 1.6 D) than it was in G 2 (3.3 ± 2.1 D; p = 0.003). Although the mean deviation from target refraction is minimal after cataract surgery following PKP, our results indicate a high level of variability. If corneal sutures have been completely removed before biometry, the accuracy of the IOL power calculation seems to be better.
    Klinische Monatsblätter für Augenheilkunde 11/2010; 228(8):698-703. DOI:10.1055/s-0029-1245640 · 0.67 Impact Factor

Publication Stats

911 Citations
140.23 Total Impact Points


  • 2012–2015
    • Universitätsklinikum des Saarlandes
      Homburg, Saarland, Germany
  • 2006–2012
    • Otto-von-Guericke-Universität Magdeburg
      • Clinic for Ophthamology
      Magdeburg, Saxony-Anhalt, Germany
  • 2010–2011
    • Universität des Saarlandes
      • Experimentelle Pneumologie
      Saarbrücken, Saarland, Germany
  • 2000–2010
    • Friedrich-Alexander Universität Erlangen-Nürnberg
      • Department of Ophthalmology
      Erlangen, Bavaria, Germany
  • 2007
    • Konventhospital Barmherzige Brüder Linz
      Linz, Upper Austria, Austria
  • 2005
    • Universitätsklinikum Erlangen
      Erlangen, Bavaria, Germany
  • 2004
    • Freie Universität Berlin
      Berlín, Berlin, Germany