Klinische Monatsblätter für Augenheilkunde
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Klin Monbl Augenheilkd · Aug 2001
Case Reports[Conjunctival cyst: subconjunctival luxation of the lens following ocular contusion - a case report].
Presentation of a 75-year-old female with subconjunctival lens luxation, that was initially misdiagnosed as conjunctival cyst. Initial examination had been difficult due to vascularized stromal corneal scars and a large hyphema. The ocular history revealed an ocular contusion 11 months ago. Aphakia with subconjunctival lens luxation, iris incarceration, iridodialysis and covered scleral rupture were diagnosed by inspection, palpation, slit-lamp biomicroscopy, gonioscopy and ultrasound biomicroscopy. The lens and incarcerated iris tissue were removed, the scleral wound was sutured and a penetrating keratoplasty was performed in combination with anterior vitrectomy and implantation of a transclerally sutured posterior chamber lens. The histologic investigation of the subconjunctival tissue showed the complete lens with intact lens capsule and surrounding subconjunctival connective tissue. ⋯ Hyphemas following ocular contusion are frequent findings. A large hyphema may masquerade alterations of other ocular structures. The differential diagnosis of posttraumatic prominent conjunctival "tumors" should include subconjunctival luxation of the lens.
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Klin Monbl Augenheilkd · Jul 2001
Randomized Controlled Trial Clinical Trial[Biochemical stress monitoring during cataract surgery; phenylephrine 10% shows no changes in serum-catecholamines in comparison with phenylephrine 5%].
There is a controversy about the concentration of topical phenylephrine recommended for diagnostic or therapeutic mydriasis. Phenylephrine 10% leads to a faster and more pronounced mydriasis but cardio-vascular side-effects like hypertension and arrhythmia have been reported. A maximal pupillary dilatation is a prerequisite for successful cataract surgery. The aim of this study was to evaluate the risk-benefit ratio of phenylephrine 10% in comparison to 5% in the daily practice of the cataract-surgery unit in our clinic by clinical assessment and monitoring of biochemical stress parameters. ⋯ These results demonstrate that a controlled application of phenylephrine 10%--under observation of contraindications--yields no increased risk for the occurrence of cardio-vascular side-effects in comparison with phenylephrine 5%. Therefore, we recommend the use of phenylephrine 10% in the described dosage as routine medication for cataract surgery.
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Pupillary observation in the dark is always a problem in a general ophthalmological practice or an outpatient clinic without specialized equipment. We present two methods for observation of the pupils in darkness: 1) illumination of the pupils with the skiascope as a routine examination and 2) infrared observation of the pupils with a consumer digital video camera. ⋯ Observation of the pupillary reflex with the skiascope proved a useful tool that is available in practically every ophthalmological office. Use of the infrared digital consumer video camera (available at low prices) is a highly sophisticated tool for observation and documentation of pupillary reflex in darkness.