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Our study shows that the breakdown of the blood-ocular barrier as determined by aqueous flare is a major risk factor for PVR redetachment. The laser flare-cell meter is a fast, noninvasive, and safe tool that allows predicting the PVR redetachment risk preoperatively. It provides the surgeon with an estimate to choose those patients who could benefit from intravitreal drugs to prevent PVR.

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Even after 1-10 months, the scar tissue was distinctly different in the two groups. These results suggest that the use of MMC has long-term effects in vivo. Surgical failures related to scar formation are possible and not reduced to zero.

ABSTRACT.Purpose: There is evidence that ocular blood flow plays a critical role in the clinical course of glaucoma. Any reduction in ocular blood flow due to topical antiglaucoma treatment should therefore be avoided. This study aimed to evaluate the short-term effect of local latanoprost application on ocular hemodynamics. Methods: Intraocular pressure (IOP), ocular pulse amplitude (OPA), ocular pulse volume (OPV), systemic blood pressure, heart rate and the pulsatile component of ocular blood flow (POBF) were recorded using a pneumotonometer linked to the Langham Ocular Blood Flow System in 24 patients in a prospective, open-label study before and after 1 week of topical latanoprost application in both eyes. Twenty of the subjects had primary open-angle glaucoma and four had ocular hypertension. Results: After 1 week of latanoprost treatment, IOP decreased significantly 6.2 ∫ 2.9 mmHg in OD (P ∞ 0.001) and 6.2 ∫ 3.2 mmHg in OS (P ∞ 0.001). Pulsatile OBF increased significantly by 201.2 ∫ 167.4 mL/min in OD (P ∞ 0.001) and 203.8 ∫ 187.3 mL/min in OS (P ∞ 0.001). Ocular pulse amplitude and OPV showed statistically significant increases (P ∞ 0.05 and P ∞ 0.001 respectively). Blood pressure and heart rate did not change significantly. Conclusion: Our results indicate that 1 week after latanoprost application, POBF, OPA and OPV were significantly increased in the eyes treated. More information on the perfusion of the optic nerve head is needed before the relevance of these findings to optic nerve head blood flow can be interpreted correctly.

The success of many medical treatments is built on compliance. Electronic monitoring is the most accurate tool to quantify compliance by measuring adherence. In order to assess the efficiency of a recently introduced miniature monitoring device for eye drop application, we evaluated adherence in ophthalmic patients undergoing post-operative shortterm topical treatment. This pilot study enrolled 30 outpatients (mean age 61.8 ± 18.5 years) after cataract (n = 24) and glaucoma filtration surgery (n = 6) applying fixed-combination eye drops containing prednisolone and gentamicin five times daily for 2 weeks. Patients received eye drops in conventional bottles each equipped with a miniature monitoring device recording events of application. Two patients failed to bring back the monitoring device; therefore data collected from only 28 patients could be examined. Data showed highly variable results with a mean dose compliance of 50.2%. Dose compliance was below 25% in approximately one out of five patients. Four cataract patients, but no glaucoma patient, discontinued therapy prematurely. The observed mean dosage interval was calculated for each patient and ranged 4.6-19.7 h. Thirty percent of analysed dosage intervals exceeded 12.0 h. Different patterns of compliance behaviour-like early nonpersistence, drug holiday and low treatment frequency could be identified and illustrated using electronic data. Age or gender did not significantly influence compliance rates. Our pilot study demonstrates successful electronic compliance monitoring using a technology capable of continuous data recording over weeks of treatment. The low compliance rate for a relevant part of the patients demonstrates the necessity to study and improve compliance in ophthalmology. In future, new application methods and electronic application devices may improve treatment response in eye care.

In 19 healthy volunteers (9 men, 10 women) we studied the effect of drinking 1000 ml of water within 10 min on aqueous humor dynamics. Fluorescein was applied topically five times, 6 h before measurements. All readings were taken during the afternoon. The Wilcox-on signed-rank test was used to evaluate the statistical relevance of the data. Aqueous humor flow was measured 60 min before (F1) and 10 min (F2), 30 min (F3), 60 min (F4) and 90 min (F5) after drinking 11 of water. Flow (mean +/- SD) changed as follows: F1, 2.25 +/- 1.2 microliters/min; F2, -3.29 +/- 3.4 microliters/min (P < 0.0000); F3, 1.69 +/- 1.0 microliters/min (P = 0.007); F4, 2.39 +/- 0.9 microliters/min (P = 0.25); F5, 2.64 +/- 0.9 microliters/min (P = 0.02). Three to four days later the identical procedure was performed in each individual: F1, 2.06 +/- 1.0 microliters/min; F2, -3.12 +/- 2.4 microliters/min (P < 0.0000); F3, 1.09 +/- 0.6 microliters/min (P < 0.0001); F4, 1.76 +/- 0.6 microliters/min (P = 0.15); F5, 2.54 +/- 0.8 microliters/min (P = 0.01). The correlation coefficient for the left and night eyes (F1-F5, both days) was r = 0.85. The mean flow in the 19 healthy volunteers during the afternoon hours was 2.25 +/- 1.0 microliters/min. Water load consistently led to a reflux of unbound fluorescein into the eye about 10 min later. This is documented as a negative flow.(ABSTRACT TRUNCATED AT 250 WORDS)

A completely encapsulated intraocular pressure (IOP) sensor equipped with telemetric signal and energy transfer is introduced integrated into a silicone disc for implantation into the eye. After implantation into enucleated pig eyes and into rabbit eyes in vivo, the IOP was recorded and compared to established techniques of IOP measurement. Pressure chamber tests showed that the sensor functioned correctly after biocompatible encapsulation in polydimethylsiloxane. In vivo and in vitro tests in rabbit and pig eyes demonstrated that the implanted system worked with the same precision as established techniques for IOP determination. The correlation between the measurements with the implanted device and pneumotonometry in several experiments was between 0.9 and 0.99. This device serves as a functioning model for the realization of a telemetric IOP sensor for integration into an artificial intraocular lens. Such a device will open new perspectives, not only in the management of glaucoma, but also in basic research for mechanisms of glaucoma.