ABSTRACT.Purpose: To compare limbal and pars plana silicone oil removal (SOR) in aphakic eyes and to evaluate the acute effect of silicone oil flow to the corneal endothelium. Methods: Sixteen aphakic patients with silicone oil endotamponade requiring SOR were recruited for this prospective study and randomly scheduled for limbal or pars plana SOR. The central corneal thickness (CCT), visual acuity (VA) and intraocular pressure were measured preoperatively, on the first postoperative day and 4 months after surgery. Endothelial cell density (ECD) was measured preoperatively and at the end of follow-up. The in vitro study was performed on ten enucleated porcine eyes. Corneoscleral discs were prepared and fixed on artificial anterior chamber followed by 2.5-mm limbal incision and 5-ml silicone oil injection in six cases and 5 ml balanced salt solution (BSS) in four cases. Results: The ECD decreased by 239.2 ± 86.7 (13.9%) and 86.7 ± 22.4 cells ⁄ mm 2 (5%) after limbal (n = 8) and pars plana SOR (n = 8), respectively (p < 0.001 for both). The difference between the groups was significant (p < 0.001). A significant increase in CCT and corresponding decrease in VA was noted on the first postoperative day using both procedures. At the end of follow-up, the CCT and VA were comparable to initial values. Postoperative hypotony (£6 mmHg) was observed more frequently after limbal SOR. In the experiment, lamellar abrasions of corneal endothelium were observed after silicone oil injection, whereas no changes were observed after BSS injection. Conclusion: Limbal SOR causes more considerable damage to the corneal endothelium than the pars plana approach because of mechanical abrasion.
The results indicate that implantation of the nerve prosthesis allows for good and effective neural regeneration. This new and simple treatment option for peripheral nerve injuries can be performed in any hospital with surgical facilities as it does not involve the demanding microsurgical suture technique that can only be performed in specialized centers.
Background The Department of Ophthalmology of the Medical University of Graz has set the common goal to improve the quality of ophthalmic resident training with the EFQM-model and unified learning targets based on international guidelines (ICO, EBO). Now there is a central request to implement additional in-depth curricula in Ophthalmology. Aim of this paper is to present a detailed 6 months curriculum in ophthalmic resident training in Strabology within the training period for a general ophthalmologist. Materials and Methods Based on the desire to establish different curricula for in-depth training of residents in Ophthalmology, a structured curriculum in accordance with international criteria and a feedback system-with the RADAR logic based on the EFQM quality modelwas introduced. A self-assessment-a "quick scan" and "should stand survey"-was performed and, based on that, a concept was created by three working groups. Results The self-assessment showed that there is partially a lack of a structured training according to international criteria with goals and a feedback system. A concept with a defined training aim was set, an initial phase, an implementation phase, an evaluation phase and an ongoing feedback system were established. The curriculum is approved and it consists of a clearly structured process of a six-month training. The learning targets are accorded with international education levels and there are clear responsibilities of certain educators. For the purposes of the EFQM model a feedback system was implemented during and at the end of the 6-month training set. Conclusion The EFQM model and the RADAR-logic is a suitable system to establish successfully in-depth training for residents in Ophthalmology. With its strategic feedback system it is responding to the needs of constant restructuring procedures of the curricula.
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