M P Holzer

Universität Heidelberg, Heidelburg, Baden-Württemberg, Germany

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Publications (59)35.88 Total impact

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    ABSTRACT: In the early postoperative period following uncomplicated cataract surgery, the correlation of corrected distance visual acuity (CDVA) and the increase in corneal thickness and anterior chamber depth (ACD) are investigated. A total of 54 cataract patients with a mean age of 70 ± 8.4 years were included in this prospective study. Surgery was carried out on one eye of each patient according to the study protocol. Refraction, CDVA and ACD were evaluated 1 day and 1 week postoperatively and compared with the pachymetry results measured with the Pentacam. The mean postoperative CDVA significantly improved from 0.31 ± 0.24 logMAR to 0.18 ± 0.22 logMAR after one day and up to 0.06 ± 0.13 logMAR one week after surgery (p < 0.05). The mean spherical equivalent was - 0.52 ± 0.69 D after one day and - 0.50 ± 0.82 D one week after surgery and showed only minimal differences compared to the mean target refraction of - 0.39 ± 0.70 D. Postoperative corneal thickness showed a significant increase compared to the preoperative results (p < 0.05) on both visits: the mean difference was 33.26 ± 50.20 µm (- 17 to 315 µm) on the first day and 20.22 ± 23.15 µm (- 10 to 99 µm) one week after surgery. Up to 7 days postoperatively the increase in corneal thickness and CDVA showed only moderate or no correlations (r = 0.465 vs. r = 0.072, respectively). Regarding pachymetry and ACD values, no or only low correlations were found. The significant increase in corneal thickness on the first and seventh day shows no to moderate correlation to the CDVA. Nevertheless, a good and early rehabilitation of visual acuity following uncomplicated cataract surgery is possible. Intraocular pressure measurement can lead to false high results due to an increase in corneal thickness.
    No preview · Article · Jun 2015 · Der Ophthalmologe
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    ABSTRACT: Purpose: The purpose of this study was to evaluate the functional results and quality of vision after implantation of an aspheric, aberration-neutral, monofocal toric intraocular lens (IOL). Patients and Methods: 18 eyes of 13 patients were enrolled in this prospective clinical study. The T-flex aspheric, aberration-free toric IOL (Rayner Intraocular Lenses Limited, U. K.) was implanted after femtosecond or standard phacoemulsification. Follow-up examinations were performed two to four months after surgery; these included subjective refraction, ETDRS uncorrected (UDVA) and corrected distance visual acuity (CDVA), wavefront analysis, measurements of stray light (C-Quant), and a questionnaire. Results: Median UDVA was 0.06 logMAR (range: 0.30 to - 0.18 logMAR) postoperatively. Median CDVA increased from 0.20 logMAR (range: 0.64 to 0.00 logMAR) preoperatively to - 0.07 logMAR (range: 0.16 to - 0.26 logMAR) postoperatively. The median difference between achieved versus intended spherical equivalent was - 0.08 D (range: - 1.25 to + 0.65 D). Median subjective cylinder improved from - 2.00 D (range: - 6.50 to - 0.25 D) preoperatively to - 0.50 D (range: - 1.25 to 0.00 D) postoperatively. The median spherical aberrations (6 mm pupil size) were - 0.38 µm (range: - 0.69 to - 0.10 µm) postoperatively. Measurements of stray light (C-Quant) revealed a median value of 1.28 log(s) (range: 0.92 to 1.61 log[s]). Conclusion: The T-flex aspheric toric IOL provided beneficial and predictable functional results after surgery. The implantation of the T-flex is an effective method to correct a large range of corneal astigmatism. Georg Thieme Verlag KG Stuttgart · New York.
    No preview · Article · Apr 2015 · Klinische Monatsblätter für Augenheilkunde
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    ABSTRACT: Purpose: The aim of this study was to perform a clinical evaluation of the functional results and quality of vision after implantation of an aspheric, aberration-neutral, monofocal intraocular lens (IOL). Patients and methods: 47 eyes of 34 patients (median age: 68 years) with cataract were enrolled in this prospective clinical study that had Ethics Committee approval. The C-flex or Superflex aspheric IOL (Rayner, UK) was implanted after phacoemulsification. Follow-up examinations were performed two to four months after surgery including subjective refraction, ETDRS uncorrected (UDVA) and corrected distance visual acuity (CDVA), wavefront analysis, analysis of stray light (C-Quant), contrast sensitivity under different lighting conditions (F. A. C. T.) and a questionnaire. Results: Two to four months after surgery, median UDVA was 0.08 logMAR (range: 0.64 to - 0.18 logMAR, n = 41). Median CDVA increased from 0.30 logMAR (range: 1.00 to - 0.02 logMAR) preoperatively to - 0.08 logMAR (range: 0.16 to - 0.22 logMAR) postoperatively (n = 47). Median difference between achieved vs. intended (Holladay 1-formula) spherical equivalent was + 0.06 D (range: - 1.06 to + 0.87 D). Median total HOA RMS (6 mm pupil size) was 0.66 µm (range: 0.41 to 1.19 µm). The median spherical aberrations were - 0.36 µm (range: - 0.70 to - 0.17 µm). Analysis of stray light (C-Quant) revealed a median value of 1.21 log(s) (range: 0.79 to 1.57 log[s]). Conclusion: The C-flex and Superflex aspheric IOLs provide good and predictable functional results. Patients are not negatively influenced by stray light and show slightly negative spherical aberrations.
    No preview · Article · Sep 2014 · Klinische Monatsblätter für Augenheilkunde
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    ABSTRACT: Hintergrund Ziel der Studie war es, die Ergebnisse nach bilateraler Presbyopiekorrektur mittels intrastromaler Femtosekundenlaserbehandlung (INTRACOR) zu evaluieren. Material und Methoden In diese prospektive Studie wurden 17 Patienten eingeschlossen, die zuvor zweizeitig bilateral behandelt wurden. Postoperativ (4 bis 8 Monate) wurden die Ergebnisse mit einer unilateral am nichtdominanten Auge behandelten Kontrollgruppe (n = 17, 24 Monate postoperativ) verglichen. Ergebnisse Der binokulare fernkorrigierte Nahvisus (DCNVA) zeigte bei gleichem Median eine geringere Streuung nach bilateraler Behandlung [logMAR (min/max): 0,10 (0,30/− 0,10; Studie) vs. 0,10 (0,50/− 0,10; Kontrolle)]. In der Studiengruppe fand sich jedoch ein höherer Zeilenverlust des binokularen korrigierten Fernvisus (CDVA; 0, − 1, − 2 Zeilen): 23,5%, 70,6%, 5,9% (Studie) vs. 35,3%, 64,7%, 0% (Kontrolle). Schlussfolgerung Im Hinblick auf die CDVA-Reduktion sollte die INTRACOR-Behandlung initial nur am nichtdominanten Auge erfolgen. In ausgewählten Fällen kann eine bilaterale Korrektur bei sorgfältiger Risiko-Nutzen-Abwägung sowie Patientenaufklärung den DCNVA verbessern.
    No preview · Article · Dec 2013 · Der Ophthalmologe
  • S Schmidt · M P Holzer · R Khoramnia · G U Auffarth

    No preview · Article · May 2013 · Der Ophthalmologe
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    ABSTRACT: PURPOSE: The purpose of this study was to evaluate the results of bilateral intrastromal femtosecond laser correction of presbyopia (INTRACOR). METHODS: In a prospective study 17 patients were enrolled who had previously received binocular treatment in a two-step approach. Postoperative (4-8 months) outcomes were compared with a matched control group who had undergone only unilateral surgery of the non-dominant eye (n = 17 patients, 24 months after surgery). RESULTS: The binocular distance corrected near visual acuity (DCNVA) showed the same median but lower scattering of values after bilateral treatment: 0.10 (median in logMAR) (0.30/- 0.10 min/max) (study) versus 0.10 (0.50/- 0.10) (control). In the study group, however, a higher loss of binocular corrected distance visual acuity (CDVA) was found: 23.5 %, 70.6 %, 5.9 % (0, - 1, - 2 lines) (study) versus 35.3 %, 64.7 % and 0 %, repectively (control). CONCLUSIONS: Regarding the reduced CDVA INTRACOR should initially only be performed in the non-dominant eye. In selected cases binocular treatment can improve DCNVA; however, careful risk-benefit assessment and informed consent are necessary.
    No preview · Article · Jan 2013 · Der Ophthalmologe
  • M.P. Holzer
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    ABSTRACT: The surgical correction of presbyopia is gaining more and more popularity in the field of refractive surgery. Besides intraocular treatment with multifocal or accommodative intraocular lenses more and more corneal laser approaches are being established. These are performed either with the Excimer laser as laser in situ keratomileusis (LASIK) or the femtosecond laser. The femtosecond laser treatment is done purely intrastromally without dissection of the epithelium and is characterized by an extremely low risk of infection and inflammation. The procedure leads to a central corneal steepening with more prolate shape and increase in depth of field. This leads to a better uncorrected near visual acuity, however, corrected distance visual acuity might be reduced due to these changes.
    No preview · Article · Jan 2013 · Der Ophthalmologe
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    ABSTRACT: Die kontralaterale autologe Keratoplastik ist eine selten angewandte Therapieoption bei vorliegender funktioneller Einäugigkeit. Hierbei erfolgt der Transfer gesunden Hornhautgewebes vom sehbehinderten Partnerauge zum erkrankten Oculus ultimus. Wir berichten im Folgenden über den Fall einer immunologischen Transplantatabstoßung nach autologer Keratoplastik bei gleichzeitigem Überleben des homologen Transplantats eines Fremdspenders am Partnerauge.
    No preview · Article · Oct 2012 · Der Ophthalmologe
  • A Fitting · N Menassa · G.U. Auffarth · M.P. Holzer
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    ABSTRACT: The aim of this study was to examine the mesopic contrast sensitivity (CS) and glare sensitivity following intrastromal femtosecond laser correction of presbyopia (INTRACOR). In this study 25 patients with slight hyperopia and presbyopia underwent femtosecond laser correction in the non-dominant eye. Mesotest II measurements (OCULUS Optikgeräte, Wetzlar, Germany) were performed with and without glare at each of four different contrast levels preoperatively as well as 3, 6, 12, 18 and 24 months postoperatively. Data were compared using the Wilcoxon-test with a level of significance of p < 0.05. After 24 months the median CS decreased from 1:2 to 1:2.7 without glare and from 1:23 to 0 with glare. Of all patients 36% showed loss in CS without and 52% with glare and CS did not show any statistically significant differences between the treated and the untreated fellow eyes after 12 and 24 months. Overall 9 out of 18 monocular treated patients showed no binocular night driving ability according to the recommendations of the German Society of Ophthalmology (DOG) and the Professional Association of German Ophthalmologists (BVA) 24 months following INTRACOR. INTRACOR can lead to a slight reduction of mesopic contrast sensitivity and an increase of glare sensitivity. Possible consequences on night driving ability should be discussed with the patients prior to treatment.
    No preview · Article · Jul 2012 · Der Ophthalmologe
  • S Schmidt · M P Holzer · R Khoramnia · G U Auffarth
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    ABSTRACT: Autologous keratoplasty from an amblyopic eye to the fellow oculus ultimus is a rarely used procedure. This is due to the relatively uncommon constellation of pathology. The following article reports the case of a graft rejection after autologous keratoplasty, while the homologous graft on the amblyopic fellow eye remained clear.
    No preview · Article · Apr 2012 · Der Ophthalmologe
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    ABSTRACT: Zusammenfassung Hintergrund Multifokale Intraokularlinsen (MIOL) rufen entsprechend dem individuellen optischen Prinzip mehr oder weniger optische Phänomene hervor. Anhand der Streulichtmessung mit dem C-Quant (Oculus, Deutschland) und einem individuellen Fragebogen sollen 3 verschiedene Multifokallinsenmodelle und -prinzipien verglichen werden. Patienten und Methoden Die AMO ReZoom (refraktiv, n=10), die AMO ZM900 (diffraktiv, n=10) und die Oculentis Mplus (Segment-MIOL, n=10) wurden verglichen. Es wurden sowohl Katarakt- als auch refraktive Patienten eingeschlossen. Mindestens 3 Monate postoperativ wurden funktionelle Ergebnisse untersucht, der Streulichtparameter gemessen und eine subjektive Befragung der Patienten durchgeführt. Ergebnisse Alle Operationen wurden komplikationslos durchgeführt. Die Gruppen wurden entsprechend Alter, IOL-Stärke und bestkorrigiertem Fernvisus angeglichen. Die MIOLs unterscheiden sich hinsichtlich des Streulichtparameters (Median) signifikant (Kruskal-Wallis-Test, p
    No preview · Article · Oct 2011 · Der Ophthalmologe
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    ABSTRACT: Background The goal of this study was to determine the accuracy of autorefraction measurements in patients after INTRACOR intrastromal femtosecond laser treatment of presbyopia by comparing the agreement between the subjective and objective refraction. Patients and methods In this study the data of 19 patients with a mean age of 56.5±6.0 years following INTRACOR treatment were analyzed pre-operatively and 12 months postoperatively. Measurements of the subjective refraction and the results of the autorefractor Nidek-660A in miosis were compared. INTRACOR is a refractive intrastromal femtosecond laser treatment to correct presbyopia. During the procedure a series of five concentric rings in the central stroma are cut which cause a change in the curvature of the cornea. Results The differences in sphere and spherical equivalent between subjective refraction and autorefraction were not significant (t-test p>0.05 and Wilcoxon test p>0.05). Comparing the cylinder of the two measurements a significant difference (t-test p<0.05) was found. Focusing on the difference of the postoperative measurements of the subjective refraction and autorefraction a correlation (within ±0.5 D) of 89% in the sphere, 100% in cylinder and 68% in the spherical equivalent was detected. With one exception the differences in sphere, cylinder and the spherical equivalent were within ±1.25 D. In several patients the performance of the autorefraction with the Nidek-660A was somewhat complicated and the measures had to be repeated frequently. Conclusion The agreement between subjective refraction and objective measurements of the Nidek-660A of patients following INTRACOR-treatment was good. However there was a significant difference in the cylinder values. Therefore thorough comparison of measurements obtained with the autorefractor and the subjective refraction is recommended.
    No preview · Article · Sep 2011 · Der Ophthalmologe
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    ABSTRACT: Multifocal intraocular lenses (MIOL) are known to induce various photic phenomena depending on the optical principle. The aim of this study was to investigate the correlation between stray light measurements performed with the C-Quant (Oculus, Germany) and the results of a subjective patient questionnaire. In this study three different MIOLs were compared: AMO ReZoom (refractive design, n=10), AMO ZM900 (diffractive design, n=10) and Oculentis Mplus (near segment design, n=10). Cataract and refractive patients were enrolled in the study. Functional results were evaluated at least 3 months postoperatively followed by stray light measurements and a subjective questionnaire. Surgery was performed for all patients without complications. The three groups were matched for age, IOL power and corrected distance visual acuity (CDVA). Significantly different stray light (median) values log(s) were found (Kruskal-Wallis test, p<0.05): 1.12 log (refractive), 1.13 log (segment) and 1.28 log (diffractive). The subjective questionnaire did not show differences in glare perception but refractive MIOL patients noticed more halos surrounding light sources than the diffractive and segment MIOL patients. Stray light and subjective photopic phenomena do not show any basic correlation. Measurements in patients with refractive MIOLs showed less stray light than near segment or diffractive MIOLs. However, refractive MIOLs induced more halos compared to the other groups analyzed.
    No preview · Article · Aug 2011 · Der Ophthalmologe
  • A.L. Hildebrandt · G.U. Auffarth · M.P. Holzer
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    ABSTRACT: Background Biometric measurements and the knowledge of interrelationships of structures within the eye are especially mandatory for cataract and refractive surgery. As the number of pseudophakic patients steadily increases because cataract surgery becomes more easily available all over the world, exact biometry of eyes with crystalline lenses as well as pseudophakic eyes is gaining interest. In the present study we compared biometric measurements in pseudophakic eyes using a new optical low-coherence reflectometry (OLCR) device with results measured by the IOLMaster. Patients and methods In this prospective study 140 pseudophakic eyes from 123 adult volunteers following uneventful cataract surgery and IOL implantation were examined at the International Vision Correction Research Centre (IVCRC) at the University of Heidelberg, Germany. The aim of this study was to evaluate a functional prototype of the new LENSTAR LS 900 (Haag-Streit)/ALLEGRO BioGraph (Wavelight) biometer and the IOLMaster V.5 (Carl Zeiss Meditec) and to compare axial length (AL) and keratometry measurements with those obtained by the IOLMaster. Additionally we investigated whether the LENSTAR/BioGraph can detect anterior chamber depth (ACD) and the effective lens position (ELP) of IOLs by OLCR in pseudophakic eyes. Patients with corneal or intraocular pathology and patients who had undergone other surgery in the investigated eye or whose cataract surgery dated back less than 4 weeks were not included in the study. Measurements were repeated with both devices as recommended by the manufacturers. Results were compared using Bland-Altman plots, Passing Bablok regression analysis and Pearson correlation calculations (MedCalc version 7.3.0.1). Results Valid axial length measurements were available in 137 eyes. The mean values were 23.75 mm for both devices (SD±2.08 with the IOLMaster, ±1.7 with the LENSTAR/BioGraph). The mean corneal radius (R) was 7.7±0.27 mm (IOLMaster) vs. 7.74±0.29 mm (LENSTAR/BioGraph). Valid ACD measurements with the LENSTAR/BioGraph were achieved in 30% of all cases. In 98.6% of the eyes in which ACD was analyzed manually a mean ACD of 4.73±0.53 mm was found. Conclusions Both devices tested in this study showed a high correlation for AL and keratometry measurements. ACD measurements performed with the LENSTAR/BioGraph showed a measurable signal but the prototype calculated a value only in the minority (30%) of cases. This study showed that on the one hand the LENSTAR/BioGraph has the potential to be a reliable and useful machine for clinical everyday routine: This space and time-saving device includes several features which make it a patient and user friendly tool for diagnostics as well as screening. On the other hand we found that the software used in the prototype could be improved especially in order to identify IOLs and to measure reliable ACD values in pseudophakic patients. IOL surfaces did not generate sufficient interference signals in the LENSTAR/BioGraph and although the light reflected by the IOL surfaces was recognized by the device the software version used in this study did not generate numerical results for ACD.
    No preview · Article · Aug 2011 · Der Ophthalmologe
  • A Fitting · A Ehmer · T M Rabsilber · G U Auffarth · M P Holzer
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    ABSTRACT: The goal of this study was to determine the accuracy of autorefraction measurements in patients after INTRACOR intrastromal femtosecond laser treatment of presbyopia by comparing the agreement between the subjective and objective refraction. In this study the data of 19 patients with a mean age of 56.5±6.0 years following INTRACOR treatment were analyzed pre-operatively and 12 months postoperatively. Measurements of the subjective refraction and the results of the autorefractor Nidek-660A in miosis were compared. INTRACOR is a refractive intrastromal femtosecond laser treatment to correct presbyopia. During the procedure a series of five concentric rings in the central stroma are cut which cause a change in the curvature of the cornea. The differences in sphere and spherical equivalent between subjective refraction and autorefraction were not significant (t-test p>0.05 and Wilcoxon test p>0.05). Comparing the cylinder of the two measurements a significant difference (t-test p<0.05) was found. Focusing on the difference of the postoperative measurements of the subjective refraction and autorefraction a correlation (within ±0.5 D) of 89% in the sphere, 100% in cylinder and 68% in the spherical equivalent was detected. With one exception the differences in sphere, cylinder and the spherical equivalent were within ±1.25 D. In several patients the performance of the autorefraction with the Nidek-660A was somewhat complicated and the measures had to be repeated frequently. The agreement between subjective refraction and objective measurements of the Nidek-660A of patients following INTRACOR-treatment was good. However there was a significant difference in the cylinder values. Therefore thorough comparison of measurements obtained with the autorefractor and the subjective refraction is recommended.
    No preview · Article · Jul 2011 · Der Ophthalmologe
  • AL Hildebrandt · G U Auffarth · M P Holzer
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    ABSTRACT: Biometric measurements and the knowledge of interrelationships of structures within the eye are especially mandatory for cataract and refractive surgery. As the number of pseudophakic patients steadily increases because cataract surgery becomes more easily available all over the world, exact biometry of eyes with crystalline lenses as well as pseudophakic eyes is gaining interest. In the present study we compared biometric measurements in pseudophakic eyes using a new optical low-coherence reflectometry (OLCR) device with results measured by the IOLMaster. In this prospective study 140 pseudophakic eyes from 123 adult volunteers following uneventful cataract surgery and IOL implantation were examined at the International Vision Correction Research Centre (IVCRC) at the University of Heidelberg, Germany. The aim of this study was to evaluate a functional prototype of the new LENSTAR LS 900 (Haag-Streit)/ALLEGRO BioGraph (Wavelight) biometer and the IOLMaster V.5 (Carl Zeiss Meditec) and to compare axial length (AL) and keratometry measurements with those obtained by the IOLMaster. Additionally we investigated whether the LENSTAR/BioGraph can detect anterior chamber depth (ACD) and the effective lens position (ELP) of IOLs by OLCR in pseudophakic eyes. Patients with corneal or intraocular pathology and patients who had undergone other surgery in the investigated eye or whose cataract surgery dated back less than 4 weeks were not included in the study. Measurements were repeated with both devices as recommended by the manufacturers. Results were compared using Bland-Altman plots, Passing Bablok regression analysis and Pearson correlation calculations (MedCalc version 7.3.0.1). Valid axial length measurements were available in 137 eyes. The mean values were 23.75 mm for both devices (SD±2.08 with the IOLMaster, ±1.7 with the LENSTAR/BioGraph). The mean corneal radius (R) was 7.7±0.27 mm (IOLMaster) vs. 7.74±0.29 mm (LENSTAR/BioGraph). Valid ACD measurements with the LENSTAR/BioGraph were achieved in 30% of all cases. In 98.6% of the eyes in which ACD was analyzed manually a mean ACD of 4.73±0.53 mm was found. Both devices tested in this study showed a high correlation for AL and keratometry measurements. ACD measurements performed with the LENSTAR/BioGraph showed a measurable signal but the prototype calculated a value only in the minority (30%) of cases. This study showed that on the one hand the LENSTAR/BioGraph has the potential to be a reliable and useful machine for clinical everyday routine: This space and time-saving device includes several features which make it a patient and user friendly tool for diagnostics as well as screening. On the other hand we found that the software used in the prototype could be improved especially in order to identify IOLs and to measure reliable ACD values in pseudophakic patients. IOL surfaces did not generate sufficient interference signals in the LENSTAR/BioGraph and although the light reflected by the IOL surfaces was recognized by the device the software version used in this study did not generate numerical results for ACD.
    No preview · Article · May 2011 · Der Ophthalmologe
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    ABSTRACT: HintergrundZiel dieser Untersuchung ist es, den Einfluss der Applanationstonometrie auf die Präzision der Biometrie sowie auf die Reliabilität von Keratometriemessungen zu analysieren. Patienten und MethodenIn diese klinisch-prospektive Studie wurden 30 Augen von 16 Kataraktpatienten eingeschlossen. Präoperativ wurde eine IOLMaster-Biometrie vor und 10min nach Applanationstonometrie (Lokalanästhesie: Oxybuprocain 0,4%) durchgeführt. ErgebnisseDie absolute mittlere Differenz der Intraokularlinsenstärke für Emmetropie betrug 0,31±0,3dpt mit Abweichungen von −1,56 bis +1,12dpt. Die mittlere Standardabweichung für die Hornhautradien R1 und R2 (n=28 Augen) lag bei 0,014±0,013mm vor und bei 0,024±0,021mm nach der Tonometrie. Dieser Unterschied war statistisch signifikant (t-Test, p<0,01). Gelegentlich wurden starke korneale Oberflächenunregelmäßigkeiten beobachtet, durch die die notwendige Anzahl an fehlerfreien Keratometriemessungen nicht erhoben werden konnten. SchlussfolgerungDie Biometrie sollte zu Beginn der präoperativen Untersuchung durchgeführt werden, da Lokalanästhesie und Applanationstonometrie die Messgenauigkeit reduzieren können. BackgroundThe aim of this study was to investigate the effect of applanation tonometry on the accuracy of biometric measurements and the reproducibility of keratometric measurements. Patients and methodsIn this clinical prospective study a total of 16 patients were enrolled who presented for cataract surgery on 30 eyes. Biometry measurements were made using an IOLMaster optical biometer before and 10min after standard Goldmann applanation tonometry. Local anesthesia was achieved by administering one drop of fluorescein-stained oxybuprocaine 0.4%. ResultsThe mean absolute difference of intraocular lens power for emmetropia was 0.31±0.33D (range −1.56 to +1.12D) and the mean standard deviation for R1 and R2 (n=28 eyes) was 0.014±0.013mm before and 0.024±0.021mm after tonometry. This difference was statistically significant (t-test, p<0.01). Moderate to severe irregular corneal surfaces were noted in some cases after tonometry. ConclusionsLocal anesthesia and applanation tonometry reduced the accuracy of IOL power calculations with differences exceeding ±1D and the reliability of consecutive keratometry measurements decreased significantly. Therefore, it is advisable to perform biometry measurements at the very beginning of the preoperative examination. SchlüsselwörterBiometrie–Tonometrie–Applanation–Intraokularlinsenberechnung–Lokalanästhesie KeywordsBiometry–Tonometry–Applanation–Intraocular lens power–Local anesthesia
    No preview · Article · Jan 2011 · Der Ophthalmologe
  • T M Rabsilber · S Bueltmann · M P Holzer · G U Auffarth
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    ABSTRACT: The aim of this study was to investigate the effect of applanation tonometry on the accuracy of biometric measurements and the reproducibility of keratometric measurements. In this clinical prospective study a total of 16 patients were enrolled who presented for cataract surgery on 30 eyes. Biometry measurements were made using an IOLMaster optical biometer before and 10 min after standard Goldmann applanation tonometry. Local anesthesia was achieved by administering one drop of fluorescein-stained oxybuprocaine 0.4%. The mean absolute difference of intraocular lens power for emmetropia was 0.31 ± 0.33 D (range -1.56 to +1.12 D) and the mean standard deviation for R1 and R2 (n=28 eyes) was 0.014 ± 0.013 mm before and 0.024 ± 0.021 mm after tonometry. This difference was statistically significant (t-test, p<0.01). Moderate to severe irregular corneal surfaces were noted in some cases after tonometry. Local anesthesia and applanation tonometry reduced the accuracy of IOL power calculations with differences exceeding ± 1 D and the reliability of consecutive keratometry measurements decreased significantly. Therefore, it is advisable to perform biometry measurements at the very beginning of the preoperative examination.
    No preview · Article · Oct 2010 · Der Ophthalmologe

  • No preview · Article · Feb 2010 · Klinische Monatsblätter für Augenheilkunde
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    ABSTRACT: We report on a 23-year-old woman who presented with elevated serum ferritin values at our department. She had undergone cataract surgery at the age of 14 and her family pedigree showed hereditary autosomal-dominant cataract. The combination of isolated hyperferritinemia with autosomal-dominant hereditary cataract led to the diagnosis of the hereditary hyperferritinemia cataract syndrome (HHCS) which we now describe in a German family for the first time. HHCS was confirmed by detection of a causal mutation at position 32 within the iron responsive element (IRE) of L-ferritin leading to a guanine to adenine exchange and the pathognomonic star-shaped cataract. This mutation interrupts the post-transcriptional control of L-ferritin. It prevents binding of the iron regulatory protein 1 (IRP1) to the 5alpha untranslated region of L-ferritin resulting in uncontrolled L-ferritin synthesis and high serum ferritin levels independent of the body iron stores. Premature cataract is eventually caused by deposition of L-ferritin crystals in the lens of the eye. Our family shows the typical autosomal-dominant inheritance of HHCS over four generations affecting a total of 17 family members. The causal mutation, star-shaped cataract and typical laboratory configuration were confirmed in five patients. Thus, in gastroenterological practice, HHCS should be added as a differential diagnosis of hyperferritinemia in Germany. Importantly, patients with HHCS can be spared from invasive diagnostics such as liver biopsy.
    No preview · Article · Dec 2009 · Zeitschrift für Gastroenterologie