Purpose.: We investigated the safety of a telemetric IOP sensor and the accuracy of its IOP measurements in six patients with open-angle glaucoma and cataract. Methods.: The study design was a prospective, single-center clinical trial. Here we present 1-year follow-up data. A ring-shaped telemetric IOP sensor was implanted in the ciliary sulcus after implantation of the intracapsular lens, during planned cataract surgery. The sensor is encapsulated in silicone rubber and consists of a miniature device with eight pressure-sensitive capacitors and a circular microcoil antenna. IOP measurements are performed with a reader unit held in front of the eye. IOP is calculated as the differences between the absolute pressure inside the eye (pressure sensor) and that outside the eye (reader unit). Results.: The sensor was successfully implanted in all patients. Four patients developed sterile anterior chamber inflammation that resolved completely within 9 days after surgery with anti-inflammatory treatment. All patients showed mild to moderate pupillary distortion and pigment dispersion after surgery. Telemetric IOP measurement was performed in all patients at all visits, and the patients successfully performed self-tonometry at home after receiving instructions. Telemetric IOP values showed similar profiles compared to those of Goldmann applanation tonometry (GAT). Three patients showed a relevant IOP step during follow-up, and in one patient, negative values were obtained throughout the study. Conclusions.: Despite early postoperative anterior chamber inflammation, the IOP sensor was well tolerated by all patients. We describe the first prospective clinical study of a noncontact IOP sensor that potentially enables continuous IOP monitoring in patients with glaucoma. The sensor shape and size needs to be adapted to avoid pupillary distortion and to confirm that IOP measurements are accurately recorded in comparison to those of GAT. ( www.germanctr.de; number DRKS00003335.)

Purpose. Most studies about retinal detachment cover a limited follow-up period. The purpose of this research is to assess the long-term results after pars plana vitrectomy (PPV) and scleral buckle (SB) surgery in patients with rhegmatogenous retinal detachment (RRD). Methods. 155 patients with RRD are treated either with SB or PPV with a mean follow-up of more than 5 years. Retrospective analysis of patient data with RRD was performed between January 2006 and June 2008 at a tertiary eye clinic. Results. Overall primary success rate was 85.2% (PPV: 84.6%, SB: 89.5%; p=0.57). 90.5% of redetachments appeared within the first 124 days. No significant different success rate was found for vitrectomy with and without additional encircling band (p=0.09). No advantage of a supplemental encircling band in cases of preoperative inferior breaks was seen (p=0.81). Patients of SB group were treated more frequently in follow-up time because of epiretinal membrane (ERM) (SB: 15.5% versus PPV: 7.3%). No patient of the PPV group without intraoperative use of endolaser cerclage (14.7%) had any peeling surgery postoperatively. Conclusion. Redetachment rates of both methods are comparable in a clinical setting where PPV is considered a suitable method for pseudophakic patients and in complex cases and SB was performed in younger phakic patients with clearly identified retinal tears. PPV seems to show a more heterogenous pattern of complications. No advantage of a supplemental encircling band could be found in these case series of patients with primary RRD. No relevant long-term risk of redetachment was seen after SB.

Importance: To investigate the long‐term safety of a novel intraocular telemetric pressure sensor.Background: Acquisition of accurate intraocular pressure (IOP) data is vital for sufficient medical care of glaucoma patients. Non‐invasive self‐tonometry with a telemetric IOP sensor can provide important information regarding the individual IOP profile.Design: Retrospective analysis of long‐term follow‐up data assessed during outpatient visits in a university hospital.Participants: Six patients with open‐angle glaucoma were included. Unfortunately, one patient passed away shortly after completion of the original 1‐year study.Methods: Within the scope of a prospective 1‐year pilot clinical trial, a telemetric IOP sensor was inserted into the ciliary sulcus after intracapsular lens implantation during planned cataract surgery. Patients were regularly examined as outpatients even beyond the duration of the 1‐year study. Data concerning sensor functionality, safety parameters and home self‐tonometry were assessed.Main Outcome Measures: Long‐term sensor functionality and safety.Results: Sensor measurements were always successful in every patient. Additionally, home self‐tonometry was conducted without any problems by every patient. The average follow‐up period was 37.5 months (21–50 months). During this period, the average number of IOP measurements performed per patient was 1273 (223–2884 measurements). No severe adverse events were reported. A varying degree of pupillary distortion was observed after 6–12 months in every patient; this remained unchanged thereafter with only one exception.Conclusions and Relevance: Telemetric IOP sensors showed good functionality and tolerability during long‐term follow‐up. Non‐invasive self‐tonometry with a telemetric IOP sensor can provide useful additional data for future monitoring of patients with glaucoma.

Purpose. Reliable and regular assessment of intraocular pressure (IOP) is important for the monitoring of patients with glaucoma. The purpose of this study was to evaluate the feasibility of a novel system for the automated, noncontact measurement of IOP. Patients and Methods. A first-generation telemetric IOP sensor was previously implanted in the ciliary sulcus of six patients with open-angle glaucoma during cataract surgery. Using this technology, automated noninvasive tonometry may be performed in a home setting. In the present study, a modified sleep mask and a modified eyepatch with incorporated coil antennae for measurements during nighttime and daytime, respectively, were tested on a single patient. Results. In this feasibility study, the 24 h wear of the prototype measuring apparatus was well tolerated. Three sequences of 24 h IOP measurements with at least 200 IOP measurements per day were performed (Sequence 1: mean 19.6 ± 2.7 mmHg, range 13.4–28.7 mmHg; Sequence 2: mean 21.0 ± 3.0 mmHg, range 13.1–30.5 mmHg; Sequence 3: mean 19.9 ± 2.4 mmHg, range 12.6–27 mmHg). Conclusions. For the first time, repeated and automated 24-hour measurements are possible using a prototype noncontact reading system after implantation of a novel telemetric IOP sensor in patients with glaucoma.

Hintergrund: Bei der Betreuung von Glaukompatienten spielt die gute Erfassung der Augendruckwerte und insbesondere deren mögliche Kurzzeit- aber auch Langzeitschwankungen eine wichtige Rolle. Die nicht invasive Selbsttonometrie durch die Patienten mit einem telemetrischen intraokularen Drucksensor kann wichtige Daten zum individuellen Augendruckprofil liefern. Patienten/Material und Methoden: Im Rahmen einer prospektiven klinischen monozentrischen Pilotstudie wurde bei 6 Patienten mit Offenwinkelglaukom die Implantation eines telemetrischen Drucksensors (ARGOS01) im Rahmen der Kataraktchirurgie in den Sulcus ciliaris durchgeführt. Im 5. Monat nach der Implantation wurde gemäß dem Studienprotokoll ein Lesegerät zur Selbsttonometrie für 1 Monat den Patienten mitgegeben. Die Patienten wurden aufgefordert, mindestens 1-mal pro Tag bzw. möglichst mehrfach zu messen. Ausgewertet wurde einerseits die 1. Messung des Tages (wobei 1 Messung pro Tag an 20 Tagen innerhalb des Intervalls erfasst wurde) sowie andererseits die Aufteilung der Werte nach Frühphase (5–11 Uhr), Mittagsphase (11–16 Uhr) und Spätphase (16–23 Uhr) (Einschluss von Patienten mit mindestens 10 Werten und max. 20 Werten). Es erfolgte eine deskriptive Statistik mit Erfassung der Perzentile und Erstellung von Boxplots. Dabei wurden die Originalwerte des ARGOS-Systems verwendet. Ergebnisse: Bei allen Patienten konnte die Selbsttonometrie nach kurzer Anleitung problemlos durchgeführt werden. Bei der Auswertung der 1. Messung des Tages konnte eine sehr heterogene interindividuelle Spannweite der Augendruckwerte festgestellt werden (zwischen 3,1 mmHg bei Patient 5 und 21,7 mmHg bei Patient 4). Bei der Auswertung der Aufteilung der Werte nach der Tagesphase zeigten sich bei Patient 1 signifikant erhöhte Druckwerte in der Spätphase. Bei Patient 5 waren die Mittagswerte im Vergleich zur Früh- und Spätphase signifikant erhöht. Bei Patient 3 und Patient 4 konnten keine signifikanten Schwankungen während des Tages festgestellt werden. Schlussfolgerung: Die Selbsttonometrie ermöglicht eine aktive Beteiligung des Patienten bei seiner Erkrankung und ermöglicht nicht invasiv eine gute Erfassung der Augendruckwerte zu verschiedenen Uhrzeiten und Aktivitäten. Wir müssen aber diese neuen Daten und deren klinische Bedeutung in Relation zur Goldmann-Applanationstonometrie interpretieren lernen. Background: Accurate acquisition of intraocular pressure (IOP) data, particularly short-term and long-term fluctuations, plays an important role in the medical care of glaucoma patients. Non-invasive self-tonometry with a telemetric IOP sensor can provide important data on the individual IOP profile. Methods: Within the framework of a prospective, single-centre pilot clinical trial, a ring-shaped telemetric IOP sensor was inserted into the ciliary sulcus after implantation of the intracapsular lens during planned cataract surgery. In accordance with the protocol, at the 5-month visit, all patients received a reading unit for one-month self-tonometry assessment. All patients were asked to measure the IOP at least once daily, and, if possible, at many different times. The first IOP measurement of each day was evaluated (covering one measurement daily per patient on 20 different days within the assessment interval). Furthermore, IOP data were analysed according to the time of day, divided into early phase (5 am to 11 am), midday (11 am to 4 pm) and late phase (4 am to 11 pm) (patients with at least 10 measurements and max. 20 measurements were included). Descriptive statistics of the original ARGOS system values were calculated, with evaluation of the percentiles and presentation in box plots. Results: All patients successfully performed self-tonometry at home after receiving brief instructions. The first IOP measurement of each day covered a very wide interindividual range (between 3.1 mmHg in patient 5 and 21.7 mmHg in patient 4). Analysis of IOP values by time of day showed that patient 1 had significantly higher IOP values in the late day phase. For patient 5, the highest values were at midday. Patients 3 and 4 showed no significant fluctuations during the day. Conclusions: Self-tonometry encourages patients to be actively involved in the management of their own illness and allows non-invasive assessment of IOP at different times and during diverse activities. However, the analysis and interpretation of these new data require further study, especially in relation to Goldmann applanation tonometry.