Zusammenfassung
Fragestellung Ziel der Studie ist ein Vergleich hinsichtlich der Komplikationsraten von Kataraktoperationen zwischen einem digitalen 3-D-Monitor-„Heads-up“-System und einem
konventionellen binokularen Mikroskopsystem in einer großen Serie von Kataraktoperationen, durchgeführt von einem Operateur.
Methodik Die retrospektive Analyse umfasst eine konsekutive Serie von 2000 Augen, die wegen einer Katarakt operiert wurden, davon n = 1000 (3-D-Gruppe) unmittelbar nach Einführung
eines 3-D-Systems (Alcon Ngenuity) und n = 1000 als letzte Gruppe vor dessen Einführung mit einem konventionellen binokularen Operationsmikroskop (BM-Gruppe). Dabei wurde das 3-D-System auf
das vorhandene Mikroskop angepasst, sodass die Mikroskopoptik unverändert blieb. In beiden Gruppen wurde entweder eine Femtosekundenlaser-Kataraktoperation (Femto-Cat) oder eine
traditionelle Phakoemulsifikation durchgeführt. Es wurden retrospektiv Komplikationen erfasst und analysiert.
Ergebnisse Der Anteil von Femto-Cat betrug in der 3-D-Gruppe 19,8% und in der BM-Gruppe 18,6%. Eine Kapselruptur trat bei 10 Augen auf (3-D: n = 4 Augen [0,4%], vordere Vitrektomie:
n = 2, Pars-plana-Vitrektomie: n = 1; BM: n = 6 [0,6%], vordere Vitrektomie: n = 4, Pars-plana-Vitrektomie: n = 1). Ein vorübergehender Irisprolaps trat bei 3 Augen auf (3-D: n = 2, BM:
n = 1). In 2 Augen kam es zu einer Zonulolyse (3-D: n = 1, BM: n = 1). Insgesamt zeigte sich kein statistisch signifikanter Unterschied zwischen den beiden Gruppen (p > 0,5). Die OP-Zeit
verlängerte sich mit dem 3-D-System nicht signifikant.
Schlussfolgerung In einer großen Serie von 2000 Augen zeigte sich hinsichtlich des Sicherheitsprofils bei Kataraktoperationen kein signifikanter Unterschied zwischen der 3-D- und der
BM-Chirurgie. Die 3-D-Chirurgie ist für die Katarakt-OP ohne zusätzliches Risiko einsetzbar.
In retinal pigment epithelium tears secondary to age-related macular degeneration, monthly intravitreal ranibizumab therapy results in stabilization of visual acuity over 12 months.
A routine examination of the right eye of an asymptomatic 7-year-old boy disclosed slightly prominent, elliptically configured yellowish alterations with irregularly configured central hyperpigmentation temporal to the fovea. On spectral domain optical coherence tomography a well-defined corresponding detachment of the neurosensory retina was identified. The findings are compatible with torpedo maculopathy a rare congenital, usually unilateral lesion Which is normally asymptomatic and shows no progression.
The aim of this study is to investigate patients´ treatment preference between the pro re nata (PRN) and treat and extend (T&E) regimens and their feelings and contentment undergoing intravitreal injections (IVI) with anti-vascular endothelial growth factor (anti-VEGF) agents. Methods Six months after the switch of the treatment regimen from PRN to T&E, answers of a 16-item questionnaire of 105 patients under IVI therapy regarding age, sex and treatment preference (T&E or PRN regimen), as well as burden and anxiety resulting from therapy, were evaluated. Analysis of associations between answers of the questionnaire was executed using Pearson's Chi 2 test and Mann-Whitney U test. P values ≤ 0.05 were considered statistically significant. Results Nearly all patients (90.5%) felt well informed about disease and therapy. Comparing treatment regimen, 13.7% thought PRN was better and 23.3% felt T&E was better. The majority considered PRN and T&E to be equal (60.3%). No significant association between treatment regimen and age (p = 0.15), gender (p = 0.35) and duration of IVI therapy (p = 0.42) was seen. The examination results are associated with fear in the majority of patients (53.3%). Fear about the IVI was indicated by 47.6% of individuals and was significantly associated with pain during treatment (p = 0.0003), pain after treatment (p = 0.004) and fear about unfavourable examination results regarding disease activity (p = 7.94 × 10 −7 ). Conclusions Most patients are satisfied with the IVI therapy and the treatment regimen. Fear of the IVI and particularly of unfavourable examination results demonstrate the high treatment burden for patients undergoing anti-VEGF therapy. These aspects should be taken into account by healthcare professionals.
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