Background/Objectives: Different surgical techniques are available in cases of missing or insufficient capsular bag support. Next to the anterior chamber or iris-fixated intraocular lenses (IOL), the implantation of the Carlevale IOL provides a sutureless and scleral fixated treatment method. Methods: In a retrospective single-center study, the perioperative data of 100 patients who consecutively received a scleral fixated Carlevale IOL combined with a 25 gauge (G) pars plana vitrectomy between September 2021 and June 2024 were investigated. The intraoperative and postoperative results were analyzed in terms of complication rates and refractive outcomes. Results: IOL dislocation was the most common surgical indication (50%) for sutureless Carlevale IOL implantation, followed by postoperative aphakia in 35 patients (35%). Nearly every fourth patient (24%) had a preoperative traumatic event, and 21% had pseudoexfoliation (PEX) syndrome. The average surgery time was 60.2 (±20.1) min. Intraoperative intraocular hemorrhage occurred in seven cases, and IOL haptic breakage in two patients. Temporary intraocular pressure fluctuations represented the most common postoperative complications (28%). Severe complications such as endophthalmitis or retinal detachment were not observed in our cohort. The mean refractive prediction error was determined in 67 patients and amounted to an average of −0.7 ± 2.0 diopters. The best corrected visual acuity (BCVA) at the last postoperative follow-up showed an improvement of 0.2 ± 0.5 logMAR (n = 76) compared to the preoperative BCVA (p = 0.0002). The postoperative examination was performed in 72% of the patients, and the mean follow-up period amounted to 7.2 ± 6.4 months. Conclusions: Overall, sutureless and scleral fixated implantation of the Carlevale IOL represents a valuable therapeutic option in the treatment of aphakia and lens as well as IOL dislocation in the absence of capsular bag support with minor postoperative complications and positive refractive outcomes.

Background/Objectives: Coronary artery bypass surgery (CABG) with multiple arterial grafting (MAG) has shown potential to improve patient survival compared to single arterial bypass grafting. Whether this superiority in survival also exists in diabetics is uncertain. We therefore aimed to compare short and long-term outcomes of MAG in diabetic versus non-diabetic patients. Methods: In this retrospective study, we investigated short- and long-term clinical outcomes of diabetic (n = 256) and non-diabetic (n = 800) patients undergoing CABG with MAG between January 1999 and December 2019 at our institution. Results: Diabetics had a significantly higher EuroScore II (1.37 ± 2.4 vs. 0.88 ± 1.58, p < 0.0001) and underwent significantly less bilateral internal thoracic artery (BITA) grafting (51.95% vs. 67.75%; p < 0.0001) compared to non-diabetics. The incidence of postoperative adverse events, such as pneumonia, stroke, and sepsis, did not differ between the two groups. However, diabetics suffered significantly more often from post-cardiotomy cardiogenic shock, renal failure requiring dialysis, and sternal wound infections over the entire follow-up period. Non-diabetics had a significantly higher median survival time of 19.6 years compared to 14.54 years found in diabetic patients (p < 0.0001). Conclusions: Among patients undergoing MAG, diabetic individuals were found to have a significantly lower overall median survival. This emphasizes the importance of diabetes as a risk factor in choosing individual surgical strategies.

(1) Background: Congenital cataract is a rare but severe childhood ocular disorder that can lead to permanent visual impairment if left untreated. Factors influencing long-term visual outcomes are insufficiently defined. The aim of this study was to evaluate long-term visual outcomes after congenital cataract surgery and to identify factors associated with visual acuity impairment and reoperation rates. (2) Methods: This retrospective cohort study included 173 eyes of 116 patients who underwent surgery for congenital cataract at the University Hospital Essen between 2000 and 2018. Patients with a minimum postoperative follow-up of six years were included. Best-corrected visual acuity (BCVA) was analyzed according to binocular condition, age at surgery and the presence of comorbidities. Postoperative complications and the need for additional surgical interventions were evaluated. (3) Results: Unilateral cataract was present in 48% (n = 56) and bilateral cataract in 52% (n = 60) of patients. Age at surgery ranged from 2.1 weeks to 15.6 years in unilateral cases and from 3.1 weeks to 8.7 years in bilateral cases. Six years after surgery, mean BCVA was 1.0 logMAR (Snellen 20/200) in unilateral cases and 0.4 logMAR (Snellen 20/50) in bilateral cases. No significant association was found between long-term BCVA and either age at surgery or ocular or systemic comorbidities. Patients with microphthalmia and those born prematurely showed significantly higher rates of additional surgical procedures. (4) Conclusions: Bilateral cases of congenital cataract achieved a significantly better visual acuity than unilateral cases after surgery. In this cohort, neither age at surgery nor the presence of comorbidities was significantly associated with visual acuity, whereas microphthalmia and prematurity were linked to an increased likelihood of additional surgical interventions.