Purpose: The aim of this study was to evaluate ocular and systemic risk factors for posterior chamber intraocular lens dislocation, as well as forms of manifestation. Methods: A retrospective case–control study were all patients presented in the period 2012–2016 having intraocular lens dislocation and being treated with implantation of an iris-fixated intraocular lens was conducted at the University Hospital Mainz. As controls, pseudophakic patients presenting for other reasons were included. Results: 150 eyes of 150 patients (mean age 72.7 ± 12.4 years, range 24–93 years) with IOL dislocation and 150 eyes of 103 controls were included in this study. The average time between primary implantation and IOL luxation was 86 months (iQR: 39.25–127 months) for all dislocations. Previous pars plana vitrectomy (PPV) (crudeOR = 2.14 (95% CI 1.23, 3.72), p = 0.011) and PEX (crudeOR = 11.6 (4.79, 28.12), p < 0.001) was linked with a higher risk of IOL luxation. Luxation occurs also earlier in patients with previous PPV and PEX than in eyes with neither PEX nor previous PPV (82.2 vs. 127 months). Rhegmatogenous retinal detachment was the major pathology that required a previous PPV for eyes with an IOL dislocation (57%). The average time between PPV and IOL dislocation was 74.67 months (range 0–186 months). Conclusion: Patients with a coexistence of both: PEX and a previous PPV had an elevated risk of IOL dislocation, and also had a shorter time interval between primary IOL implantation and IOL dislocation followed by eyes with PEX only and eyes with only a previous PPV.

Background/aim To describe the clinical outcome of allogenic simple limbal epithelial transplantation (alloSLET) utilising tissue from cadaveric donor eyes after failed re-epithelialisation of the corneal surface. Methods Medical records of 14 eyes from 14 patients treated for persistent corneal epithelial defects with alloSLET were reviewed. The primary outcome measure was complete epithelialisation of the corneal surface. Secondary outcome measures were best corrected visual acuity (BCVA) and postoperative side effects due to surgery or medical therapy. Results Of the 14 eyes, 7 received alloSLET only and 7 alloSLET together with penetrating keratoplasty (PK). Thirteen (92.9%) of 14 eyes had an epithelialised corneal surface 3 and 6 months after surgery and 10 (71.4%) of 14 eyes displayed an epithelialised corneal surface 12 months after surgery. In both subgroups, alloSLET only and alloSLET with PK, respectively, 5 (71.4%) of 7 eyes had a stable corneal epithelium 12 months after surgery, respectively. Postoperatively, BCVA improved markedly in the whole patient collective. However, the increase was not significant when looking at the two individual subgroups. One patient lost his bandage contact lens several times within the first postoperative month and had a partial detachment of the amniotic membrane. The ocular surface of this patient failed to epithelialise. In three patients, limbal donor pieces translocated to the centre of the cornea, which possibly prolonged the improvement of BCVA. Conclusion AlloSLET appears to be an effective treatment option in eyes with non-healing corneal epithelial defects when autologous limbal tissue is not available.

Purpose. The Acrysof Cachet® angle-supported phakic intraocular lens (pIOL) (Alcon Laboratories, Inc., Fort Worth, TX) is designed to correct high refractive errors in human eyes. The aim of this study was to evaluate the outcome of AcrySof Cachet® angle-supported pIOL implantation with particular regard to efficacy and safety of the implant over a 60-month follow-up period. Design. Retrospective consecutive clinical case study. Methods. Prior to pIOL implantation, patients had a complete ophthalmologic examination including objective and subjective refraction, uncorrected visual acuity (UCVA) and corrected distance visual acuity (CDVA), endothelial cells density (ECD), slit lamp photography, optical coherence tomography (OCT), Scheimpflug digital videokeratoscopy, optical biometry, slit lamp examination, intraocular pressure (IOP) measurement, and pupillometry. Postoperatively, patients received yearly a complete eye examination. Results. Thirty-one eyes of 16 patients were included in this study. The mean age was 36.2±8.1 years. UCVA (logMAR) improved from 1.33±0.20 before surgery to 0.08±0.14 one year after surgery and was 0.20±0.20 five years after surgery. CDVA (logMAR) improved from 0.10±0.10 before surgery to 0.05±0.13 one year after surgery and was 0.04±0.14 five years postoperatively. The mean percentage of endothelial cells loss (ECL) was 11.51 over the first year and 15.95 five years after surgery. There were no intraoperative complications in any of the eyes. Conclusions. Our results up to five years after implantation of the AcrySof Cachet® angle-supported pIOL demonstrated very good outcomes in all above shown measurements, including CDVA, UCVA, and ECD. However, since major endothelial cell loss may occur in some patients with this type of pIOL, regular follow-up visits are required.

Zusammenfassung: Hintergrund: Die Implantation der Artificial Iris® (Human Optics AG, Erlangen) wird zur Pupillen- und Irisrekonstruktion bei Patienten mit einer partiellen oder kompletten Aniridie eingesetzt. Bisher liegen nur wenige Fallberichte und kurzfristige Ergebnisse in der Literatur vor. Ziel der Arbeit: Ziel dieser Analyse ist es, die verschiedenen Indikationsstellungen sowie das funktionelle Ergebnis darzustellen. Material und Methode: Es wurden 51 Augen von 50 Patienten, bei denen eine Artificial Iris® implantiert wurde, in dieser retrospektiven konsekutiven Fallstudie analysiert. Alle Operationen wurden vom selben Ophthalmochirurg (UV) an der Universitäts-Augenklinik Mainz durchgeführt. Die Ausgangsbefunde wurden in Bezug zur Indikationsstellung gesetzt und funktionelle Ergebnisse untersucht. Ergebnisse: Es wurden 51 Augen von 50 Patienten mit einem mittleren Alter von 57 ± 16,5 Jahren (16 Frauen und 34 Männer) analysiert. Während der Großteil der Patienten unter einer traumatischen partiellen oder kompletten Aniridie litt, zeigte die Minderheit angeborene Irisdefekte. Der Visus konnte bei 53 % der Patienten (p = 0,0001) postoperativ verbessert werden. Schlussfolgerung: Diese Analyse zeigt die verschiedenen und vielfältigen Indikationen zur Implantation einer Artificial Iris® auf. Der postoperative Visusgewinn ist hierbei nicht immer die primäre Zielsetzung, vielmehr stehen die Reduktion der Blendung und zum Teil auch die kosmetische Rehabilitation – bei den zum Großteil stark vorgeschädigten Augen – im Vordergrund. Die Langzeitergebnisse werden zurzeit in einer Studie analysiert und baldmöglichst veröffentlicht.