Purpose: To investigate through a case-matched analysis whether failed ab interno XEN45 Gel Stent implantation exerts an influence on the outcome after subsequent implantation of a Preserflo MicroShunt. Methods: In this retrospective study, 70 eyes from 70 participants who underwent Preserflo MicroShunt implantation were included. Thirty-five eyes each underwent primary stent implantation (control group) or had previously undergone failed XEN45 Gel Stent implantation (post-XEN group). The two groups were matched at a 1:1 ratio based on the following criteria: preoperative and maximum intraocular pressure (IOP), preoperative medication score, cup/disc-ratio, follow-up time, and age. Surgery was defined as either “success” or “failure” based on the following three scores: an IOP reduction of >20% and IOP at the longest follow-up <21 mmHg (Score A) or <18 mmHg (Score B) or IOP ≤15 mmHg and an IOP reduction ≥40% (Score C). In all scores, revision surgery was considered a failure. Furthermore, we compared postoperative IOP and medication score, side effects, and revision rate between both groups. Results: Mean IOP decreased from 28.9 to 12.2 mmHg in the post-XEN group and from 27.7 to 12.9 mmHg in the control group, while the mean medication score decreased from 2.1 in the post-XEN group and from 2.6 in the control group to 0.3, respectively. Comparative analyses between the two groups did not reveal a significant difference in postoperative IOP, medication score, side effects, revision, or success rate. Conclusion: Preserflo MicroShunt implantation can be considered a viable option for repeat surgery in patients with bleb failure after prior XEN45 Gel Stent implantation.

Purpose:To determine differing outcomes among pseudophakic patients with exfoliation glaucoma who underwent combined trabectome surgery and trabecular aspiration and phakic patients treated by a triple procedure with additional phacoemulsification. Methods:This retrospective study involved 75 eyes of 75 participants, of which 25 eyes received combined ab-interno trabeculectomy and trabecular aspiration (Trabectome + TA group), and 50 eyes underwent a triple procedure with additional phacoemulsification (triple group). The groups were matched at a 1:2 ratio, based on the following criteria: preoperative intraocular pressure (IOP), maximum known preoperative IOP, preoperative medication score, cup/disc ratio, follow-up time, and age. Successful surgery was defined by three scores: IOP at longest follow-up <21 mmHg (Score A) or <18 mmHg (Score B), without re-surgery and an IOP reduction >20% or IOP ≤15 mmHg without re-surgery and an IOP reduction ≥40% (Score C). Results:The preoperative IOP was 23.7 ± 5 mmHg, respectively, and decreased to 15.2 ± 4 mmHg in the triple group, which is significantly lower than postoperative IOP in the Trabectome + TA group, being 18.6 ± 8 mmHg during an average follow-up period of 33.4 ± 26 months (P = 0.02). The success rate in the triple group was significantly higher than in the Trabectome + TA group, according to Score A (78% vs. 40%) and Score B (70% vs. 36%). When aiming at a lower target IOP (Score C), the success rates did not differ significantly (36% vs. 24%). Conclusions:Cataract extraction, as a part of a triple procedure, seems to contribute to more effective IOP-lowering than trabectome surgery and trabecular aspiration alone in patients who underwent standalone phacoemulsification previously.

The purpose of this retrospective study was to compare the outcomes after combined phacoemulsification and ab-interno trabeculectomy via Kahook Dual Blade (KDB) and Trabectome, being represented in two groups of patients of Caucasian ethnicity with matched baseline criteria. We included 60 eyes of 49 participants being treated for cataract, of which 30 eyes underwent additional ab-interno trabeculectomy via KDB (Kahook group) and 30 eyes received additional Trabectome surgery (Trabectome group). For this comparative analysis, the Kahook group and Trabectome group were matched at a 1:1-ratio, based on the following criteria: preoperative IOP, maximum known preoperative IOP, preoperative medication score, cup/disc-ratio, follow-up time, best-corrected visual acuity and age. Successful surgery was defined by three scores: IOP at longest follow-up < 21 mmHg (Score A) or < 18 mmHg (Score B) without re-surgery and an IOP reduction > 20% or IOP ≤ 15 mmHg without re-surgery and an IOP reduction ≥ 40% (Score C). Furthermore, we compared postoperative IOP, as well as medication score, and side effects between both groups. Both surgical techniques led to a relative IOP reduction of 29% within their respective groups. Specifically, preoperative IOP decreased from 19.5 ± 5.0 mmHg to 13.8 ± 3.9 mmHg in the Kahook group, and from 19.8 ± 4.5 mmHg to 14.0 ± 3.9 mmHg in the Trabectome group during an average follow-up period of 23–24 months. There was no statistical significant difference noted. Both the KDB and Trabectome yielded similar success rates, according to Score A (67% vs. 70%), Score B (63% vs. 67%) and Score C (33% vs. 23%). There were no severe side effects notes in either group. In conclusion, the KDB and Trabectome showed similar IOP-lowering properties and safety profiles within our two matched groups of Caucasian patients.

To compare the success and safety of microcatheter-assisted 360° trabeculotomy (MCAT) with conventional probe trabeculotomy in a large, heterogeneous cohort of children with primary or secondary glaucoma. In this prospective, multicenter, observer-blinded, randomized controlled trial, 76 children (152 eyes) with bilateral primary or secondary childhood glaucoma aged ≤ 12 years will be included. Each child acts as own control using a paired-eye design: One eye is allocated to MCAT (experimental intervention), achieving a 360° trabeculotomy, the other eye to the probe trabeculotomy (control intervention) which enables a trabeculotomy over 90 to 120°. Each child receives both procedures (paired-eye design). The worse eye is treated first; the surgical method is randomized. Patients and observers are masked to the procedures. The patients are followed up for 24 months. The primary endpoint is complete success (IOP < 18 mmHg at 24 months without medication and revision surgery; with MCAT: successful probing of > 120° is also required for success) at 24 months of follow-up. The primary analysis is performed in the intention-to-treat population using McNemar test stratified by center. The PIRATE study is a multicenter randomized controlled study comparing MCAT with conventional probe trabeculotomy in a large and heterogeneous childhood glaucoma population. It will provide data on the success and safety of both techniques and clarify if MCAT is superior to probe trabeculotomy. German Clinical Trials Register, DRKS-ID: DRKS00034139. Registered on April 24, 2024. https://drks.de/search/en/trial/DRKS00034139 . https://trialsearch.who.int/Trial2.aspx?TrialID=DRKS00034139 .

To assess the practicality of two novel perimetry devices for glaucoma in daily clinical practice: a head-mounted virtual reality headset and a tablet-based perimeter. Both were compared to conventional bowl perimetry and glaucoma experts qualitatively assessed the results. The study included 363 eyes from 199 patients. All patients performed two perimetry examinations with one or both eyes: standard automated perimetry on a conventional bowl perimeter (CBP; Octopus 900, Haag-Streit) and subsequently one of two novel perimetry methods: virtual reality perimetry (VRP; n=100 patients; “PalmScan VF2000” MicroMedicalDevice) or tablet-based perimetry using the Melbourne Rapid Fields application (MRF; n=99 patients; Glance Optical Pty.Ltd.). Additionally, a panel of 10 glaucoma experts was asked to evaluate the new methods. There was a very high correlation between VRP and CBP for mean deviation and pattern standard deviation (ICC 0.956 and 0.825, respectively). The correlation was moderate to high with the tablet-based perimetry using the MRF application (0.832 for mean deviation and 0.566 for pattern standard deviation). 74.6

Purpose:To investigate the efficacy of MINIject® (suprachoroidal stent) in lowering intraocular pressure (IOP) in eyes following failed filtering glaucoma surgery. Methods:In this single-center retrospective study, 18 patients who had undergone suprachoroidal stent implantation after failed filtering surgery were analyzed. Follow-up was at least 12 months, and surgical success was measured by 12-month postoperative intraocular pressure (IOP), glaucoma medication, and revision surgery (criteria A: IOP < 21 mmHg, IOP reduction >20%, no revision surgery; criteria B: IOP < 18 mmHg, IOP reduction >20%, no revision surgery; criteria C: IOP ≤ 15 mmHg, IOP reduction ≥40%, no repeat surgery). Results:After a follow-up period of 12 months, the mean IOP decreased from 27.11±5.65 mmHg to 15.94±9.56 mmHg (p<0.01). The median 12-month postoperative IOP was 14.0 mmHg (IQR: 10.0-20.0 mmHg). The probability of surgical success was 66.66% for criteria A and B and 50% for criteria C. The identical success rates for criteria A and B were due to overlapping responder groups in this limited sample. Topical medication was significantly reduced from 4.06±1.08 to 2.13±1.36 (p<0.0001). Conclusion:Supraciliary stent implantation provided an effective and safe treatment option for advanced glaucoma following failed filtering surgery and demonstrated significant intraocular pressure reduction. However, the small sample size limits the generalizability of these findings.

Purpose To assess the prevalence of anxiety and depression among individuals diagnosed with glaucoma, using standardised psychometric instruments, to define factors associated with these psychological diseases, and to identify a potential healthcare gap. Methods In this cross-sectional study, 249 patients with glaucoma were assessed using the 7-item Generalised Anxiety Disorder (GAD-7) scale and the Patient Health Questionnaire (PHQ-9). Correlation analyses explored links between psychometric scores, general mental and physical health functioning, vision-related quality of life and biosocial factors. Results Among participants, 1.2% had a prior anxiety diagnosis and 11.2% a depression diagnosis, yet screening revealed higher rates: 42.2% for anxiety and 34.9% for depression, indicating significant underdiagnosis (p<0.001, respectively). PHQ-9 and GAD-7 scores correlated strongly (p<0.001). Higher PHQ-9 scores were linked to poorer mental and physical health functioning as well as lower vision-related quality of life (p<0.001, respectively), female gender, living alone (p=0.02, respectively), younger age and lower income (p=0.01, respectively). Similarly, higher GAD-7 scores were associated with worse mental health functioning and vision-related quality of life (p<0.001, respectively), female gender (p=0.003), reduced physical health functioning (p=0.03) and lower income (p=0.002). Conclusion Anxiety and depression are frequently underdiagnosed in patients with glaucoma, highlighting a significant healthcare gap. The higher prevalence of these conditions in patients with glaucoma compared with the general population underscores the need for routine psychometric screening to enhance detection and management. Bridging this gap calls for an integrated care model that incorporates psychological evaluation and support into standard protocols, enabling comprehensive, patient-centred care tailored to age, gender, vision-related and socioeconomic factors.

(Deutsch) Hintergrund: Ziel dieser Studie war es erstmalig in Deutschland die Akzeptanz von innovativen Perimetriemethoden, wie die Virtual Reality-Brillenperimetrie (VRP) und die Tablet-basierte Perimetrie (TBP) im Vergleich zur konventionelle Halbkugelperimetrie (HKP) bei Glaukompatienten zu untersuchen. Patienten und Methoden: 204 Glaukompatienten wurden mit dem 30-2 TOP Programm (Octopus, Haag-Streit) untersucht und anschließend mit einer der beiden neuen Methoden: Gruppe 1 (VRP; n=101) und Gruppe 2 (TBP mittels der Melbourne Rapid Fields Glaucoma App; n=103). Anschließend wurde einen Fragebogen über die Erfahrung mit der neuen Untersuchung im Vergleich zur konventionellen Untersuchung beantwortet. Ergebnisse: 77% der Patienten aus Gruppe 1 (VR) und 89.9% der Patienten aus Gruppe 2 (TBP) beurteilten die Untersuchung mit der jeweiligen neuen Untersuchungsmethode als „einfacher“ oder „viel einfacher“ im Vergleich zur konventionellen HKP. Hinsichtlich der Bequemlichkeit gaben 86% bzw. 90.9% der Patienten der Gruppe 1 bzw. Gruppe 2 an, die jeweils neue Methode zu bevorzugen. Die Dauer der Untersuchung betrug mit der HKP 2,67±0,98 Minuten (Mittelwert ± Standardabweichung), mit der VR-Brille 6,26±1,88 Minuten (Mittelwert ± Standardabweichung) und mit dem Tablet bei 4±0,71 Minuten (Mittelwert ± Standardabweichung). Bezogen auf diesem Aspekt, fanden die Mehrheit der Patienten beide Untersuchungen (HKP und VR) zu 51% gleich und bei dem Vergleich zu dem Tablet, bevorzugten die Mehrheit zu 54% das Tablet der HKP gegenüber. 80% bzw. 81,8% der Patienten aus Gruppe 1 bzw. 2 konnten sich vorstellen jeweils die neue Perimetriemethode regelmäßig als Verlaufskontrolle zu verwenden. Schlussfolgerung: Die Mehrheit der befragten Glaukompatienten empfanden die Untersuchung mit der Virtual Reality Brillenperimetrie und der Tablet-basierte Perimetrie durchweg als positiv und bevorzugten diese gegenüber der konventionelle Halbkugelperimetrie. Abstract (Englisch) Purpose: The aim of this study was to investigate the acceptance of innovative perimetry methods such as virtual reality perimetry (VRP) and tablet-based perimetry (TBP) in comparison to conventional bowl perimetry (HKP) in glaucoma patients for the first time in Germany. Patients and Methods: 204 glaucoma patients were examined with the 30-2 TOP programme (Octopus, Haag-Streit) and then with one of the two new methods: Group 1 (VRP; n=101) and Group 2 (TBP using the Melbourne Rapid Fields Glaucoma App; n=103). Subsequently, a questionnaire was answered about the experience with the new examination compared to the conventional examination. Results: 77% of patients from group 1 (VR) and 89.9% of patients from group 2 (TBP) rated the examination with the respective new examination method as "easier" or "much easier" compared to conventional HKP. With regard to convenience, 86% and 90.9% of patients in Group 1 and Group 2 respectively stated that they preferred the new method. The duration of the examination was 2.67±0.98 minutes (mean ± standard deviation) with the HKP, 6.26±1.88 minutes (mean ± standard deviation) with the VR perimetry and 4±0.71 minutes (mean ± standard deviation) with the tablet. Regarding this aspect, the majority of patients found both examinations (HKP and VR) to be 51% the same and when compared to the tablet, the majority preferred the tablet to the HKP by 54%. 80% and 81.8% of patients in groups 1 and 2 respectively could imagine using the new perimetry method regularly as a follow-up. Conclusion: The majority of the glaucoma patients surveyed found the examination with virtual reality spectacle perimetry and tablet-based perimetry to be consistently positive and preferred them to conventional hemispherical perimetry.

PURPOSE:The aim of this study was to investigate the acceptance of innovative perimetry methods such as virtual reality perimetry (VRP) and tablet-based perimetry (TBP) in comparison to conventional hemisphere perimetry (HP) in glaucoma patients for the first time in Germany. PATIENTS AND METHODS:We examined 204 glaucoma patients using the 30 - 2 TOP algorithm (Octopus, Haag-Streit) followed by one of the two new methods: Group 1 (VRP; n = 101) and Group 2 (TBP using the Melbourne Rapid Fields Glaucoma App; n = 103). Subsequently, patients were asked to fill out a questionnaire on their experience with the new examination compared to the conventional examination. RESULTS:More than three-quarters of patients at 77% in Group 1 (VR) and 89.9% of patients in Group 2 (TBP) found the respective new examination method "easier" or "much easier" than the conventional HP. An overwhelming majority of patients in Group 1 and Group 2 found the new method more comfortable at 86% and 90.9%, respectively. Examination durations were: 2.67 ± 0.98 min for HP, 6.26 ± 1.88 min for VR perimetry, and 4 ± 0.71 min for the tablet method; figures given as means ± standard deviation. Just over half the patients at 51% found HP and VR headset to be similar for duration with 54% preferring the tablet over conventional hemisphere perimetry. By far the most patients in Groups 1 and 2 at 80% and 81.8%, respectively, reported willingness to use the new perimetry method regularly in future follow-up examinations. CONCLUSION:Most glaucoma patients surveyed consistently responded favourably to VR headset and tablet-based perimetry, preferring these examinations to conventional hemispherical perimetry.

Eine Thrombose der Vena ophthalmica superior (VOS) ist selten. Sie kann sich mit heterogenen Symptomen präsentieren und erfordert eine sorgfältige diagnostische Abklärung mittels verschiedener bildgebender Verfahren (CT, MRT, DSA). Wir berichten über eine Fallserie von 3 Patientinnen (Alter bei Erstvorstellung 85, 69 und 93 Jahre) mit Thrombose der VOS. Außerdem führten wir eine ausführliche Literaturrecherche mittels Pubmed durch. Trotz heterogener Leitsymptomatik zeigte sich bei allen Patientinnen eine Trias aus Motilitätseinschränkung, Exophthalmus sowie eine Differenz des Intraokulardrucks (IOD) mit höherem IOD auf der Seite der Protrusio bulbi. Die Ätiologie der Thrombose war in allen Fällen unterschiedlich: Zwei Fällen war gemeinsam, dass eine bestehende Antikoagulationstherapie kurz vor dem Ereignis pausiert worden war. Als Kofaktoren kamen im ersten Fall differenzialdiagnostisch eine intraorbitale venöse Abflussbehinderung durch eine unklare Raumforderung in der Orbitaspitze, im zweiten Fall eine Hyperkoagulabilität aufgrund einer Tumorerkrankung hinzu. Im dritten Fall bestanden beidseitige Sinus-cavernosus-Fisteln und auf der Seite der VOS Thrombose eine Orbitaphlegmone. Die Diagnose sollte nicht nur bei Patienten mit dilatierten Gefäßen des vorderen Augenabschnittes, sondern auch bei unklaren Fällen von Protrusio bulbi, Motilitätsstörungen oder einseitig erhöhtem IOD differentialdiagnostisch erwogen und gegebenenfalls radiologisch abgeklärt werden.

Background Thrombosis of the superior ophthalmic vein (SOV) is rare. It can present with heterogeneous symptoms and requires a careful diagnostic work-up. Methods This article reports on a case series of three female patients with thrombosis of the SOV and performed an extensive review of the existing literature in PubMed. Results All three patients showed different leading symptoms but all had a triad of restricted eye motility, exophthalmos and a difference in intraocular pressure with the higher pressure on the side of the protruded eyeball. The pathophysiological background differed in all cases: in the two first cases a pre-existing anticoagulation treatment had been paused shortly before the event. Cofactors were an intraorbital venous outflow obstruction due to an unclear mass in the orbital apex in one case and hypercoagulability due to a malignant disease in the other case. In the third case, there was a cavernous sinus fistula. Conclusion The diagnosis should be considered not only in patients with dilated vessels of the anterior segment but also in unclear cases of exophthalmos or unilateral elevated intraocular pressure (IOP).

PURPOSE:To determine differing outcomes among either phakic or pseudophakic patients who received standalone XEN45 Gel Stent (Allergan, an AbbVie Company, CA, USA) implantation and patients who underwent combined surgery with phacoemulsification. METHODS:This retrospective single-center study involved 180 eyes of 180 participants who underwent XEN45 Gel Stent implantation, of which 60 eyes received combined surgery with phacoemulsification (combined group). Standalone stent implantation was performed on 60 phakic (phakic group) and on 60 pseudophakic eyes (pseudophakic group). The groups were matched in a ratio of 1:1:1 based on multiple criteria. Successful surgery was defined by three scores: IOP at the longest follow-up of < 21 mmHg (Score A) or < 18 mmHg (Score B) and an IOP reduction > 20% or IOP ≤ 15 mmHg and an IOP reduction ≥ 40% (Score C). In all scores, one open conjunctival revision was allowed, and additional repeat surgery was considered a failure. RESULTS:After an average follow-up time interval of 20.6 ± 12.6 months, there was a mean IOP-reduction by 37% among the entire cohort. Comparative analysis between the three groups did not show significant differences regarding postoperative IOP, postoperative medication score, side effects, revision rate, repeat surgery rate or success rate. A dysfunctional stent was detected in eight eyes (4%) during open conjunctival revision in 76 eyes. CONCLUSION:The clinical endpoints investigated did not differ significantly among either phakic or pseudophakic patients who received standalone stent implantation and patients who underwent combined surgery. However mean latency between primary stent implantation and first revision surgery after combined surgery was markedly shorter.

To investigate in combined iStent inject implantation with phacoemulsification carried out bilaterally, whether intraocular pressure (IOP)‐lowering effectiveness in the first eye has a predictive potential for the outcome of the second eye in primary open‐angle glaucoma (POAG).

PurposeThe aim of the underlying study was to present a new surgical method in PreserFlo MicroShunt surgery for glaucoma. A removable polyamide suture was placed into the lumen of the MicroShunt during implantation to prevent early postoperative hypotony.MethodsThirty-one patients undergoing stand-alone glaucoma surgery with implantation of a PreserFlo MicroShunt and an intraluminal occlusion were retrospectively reviewed and compared to a control group without occlusion. Inclusion criteria were diagnosis of primary open-angle glaucoma or secondary open-angle glaucoma due to pseudoexfoliation or pigment dispersion. Patients with a history of filtrating glaucoma surgery were excluded.ResultsIOP decreased from 26.9 +/- 6.6 to 18.0 +/- 9.5 mmHg at the first postoperative day after PreserFlo MicroShunt implantation. Postoperative removal of the occluding suture resulted in a mean IOP reduction in 11.1 +/- 7.6 mmHg. Mean visual acuity was 0.43 +/- 0.24 logMAR during the first postoperative examination. The interval with the occluding intraluminal suture in place varied from days to 2-3 weeks. Patients were followed up to 1 year.ConclusionImplantation of a PreserFlo MicroShunt combined with an intraluminal suture prevented postoperative hypotony in all patients. Mean postoperative pressure was reduced despite the occluding suture in place.

To determine the predictability of success and the risk of open conjunctival revision in the subsequent eye after XEN45 Gel Stent implantation according to lens status. This was a retrospective single-centre study involving 132 eyes of 66 participants who had undergone intraocular pressure (IOP)-lowering XEN45 Gel Stent implantation, either as a standalone procedure in phakic and pseudophakic eyes or in combination with phacoemulsification. Successful surgery was defined by three scores: IOP at follow-up < 21 mmHg (score A) or < 18 mmHg (score B) and an IOP reduction > 20% or IOP ≤ 15 mmHg and an IOP reduction ≥ 40% (score C). In all scores, one open conjunctival revision was allowed, and additional repeat surgery was considered a failure. The predictability of success and revision rate depending on the outcome of the first eye were calculated using Bayes’ theorem. IOP-lowering did not differ significantly between the first and second eyes. Success rates of standalone surgery in the second eye after successful surgery in the first eye significantly exceed rates after prior failure. For the combined procedure, the rates did not differ significantly. For score A, we determined a 76.6% chance of success following a prior success and a 57.9% chance, if prior surgery failed. The corresponding probabilities were 75% and 59.1% for score B, while 66.7% and 15.7% for score C, respectively. We calculated a 60% risk for revision surgery in the standalone phakic group. If the first eye was not revised, the risk of revision in the subsequent eye was 20%. The corresponding risks were 72.7% and 5% for the standalone procedure in pseudophakic patients and 38.4% and 41.7% for the combined procedure, respectively. The results of our study offer a tool to predict the outcome of subsequent eye surgeries based on either the outcome in the initial eye and the type of surgery performed, owing to the high predictive potential.

To evaluate the dynamics of Bruch’s membrane opening-based morphometrics of the optic nerve head (ONH) using spectral-domain optical coherence tomography (SD-OCT) during the first week after glaucoma surgery by trabeculectomy with mitomycin C. Prospective, longitudinal analysis of 25 eyes of 25 patients treated by trabeculectomy. Twenty-four eyes had evaluable postoperative SD-OCT examinations. Bruch’s membrane opening minimum rim width (BMO-MRW) and peripapillary retinal nerve fiber layer (RNFL) thickness were analyzed at baseline before surgery, 1 day, 2 to 3 days, and 1 week after surgery. Changes compared to baseline were correlated to intraocular pressure (IOP). One day after surgery, the mean BMO-MRW changed by + 26.17 µm, p = 0.001 (mean IOP reduction by 17.01 mmHg). This increase persisted on day 2–3 with a mean increase of BMO-MRW of + 25.33 µm, p = 0.001 (mean IOP reduction by 20.46 mmHg) and by week 1 with a mean BMO-MRW increase of + 33.17 µm, p < 0.001 (mean IOP reduction by 22.55 mmHg). The increase in BMO-MRW correlated significantly with the reduction of IOP on day 1 (Spearman’s rho ρ = 0.656, p = 0.003) and d2–3 (Spearman’s rho ρ = 0.479, p = 0.038). There was no statistically significant correlation found between the IOP and the increase in BMO-MRW in week 1. RNFL thickness showed no significant changes at day 1 as well as days 2–3 (p ≥ 0.078, respectively). It showed a small but significant increase in week 1 by 3.94 µm, p = 0.015. Structural reversal of disc cupping in BMO-MRW occurs as early as 1 day after trabeculectomy and correlates to the extent of the IOP reduction. During the whole first week after surgery, a strong increase in BMO-MRW can be noted. The changes in BMO-based parameters need to be considered when evaluating patients’ longitudinal follow-up.

2,4-Dinitrofluorobenzene (DNFB) reacts with glutathione to form a stable product similar to that formed with the model glutathione-S-transferase (GST) substrate, 1-chloro-2,4-dinitrobenzene (CDNB). DNFB is approx. 40 times als reactive as CDNB in this chemical reaction. The enzymatic defluorination of DNFB also proceeds at a more rapid rate than that of CDNB in the GST assay. Fluoroacetamide (FAM), like fluoroacetate (FAC), undergoes no discernable chemical defluorination. Its enzymatic defluorination is approx. 10% of that observed for FAC and only 0.2% of the rate for DNFB. An antibody raised to the fluoroacetate specific dehalogenase (FSD) precipitated both FAC and FAM defluorinating activity but had no effect on either CDNB or DNFB activity. The data are consistent with the hypothesis that DNFB is metabolized by the GST while FAM is metabolized by the FSD.

Kongenitale Hornhauttrübungen sind vergleichsweise seltene Erkrankungen mit hohem amblyogenem Potenzial. Die vorliegende Arbeit gibt eine Übersicht der Diagnostik, Klinik und Genetik kongenitaler Hornhauttrübungen. Es erfolgte eine Literaturrecherche zur Erstellung einer Übersichtsarbeit und Illustration mit eigenen Fallbeispielen. Eine differenzierte Diagnostik ist von hoher Bedeutung bei der Behandlung von Patienten mit kongenitaler Hornhauttrübung. Dabei ist eine enge Zusammenarbeit zwischen den beteiligten medizinischen Fachbereichen und auch den Eltern unbedingt erforderlich. Die strukturierte Einteilung der kongenitalen Hornhauttrübungen bietet die Grundlage für eine gezielte Therapie. Die Ursachen und die Klinik der kongenitalen Hornhauttrübungen sind vielfältig. Die korrekte Diagnose sollte frühzeitig und interdisziplinär gestellt werden. Darauf aufbauend können konservative und operative therapeutische Maßnahmen geplant werden, und es kann einer drohenden Amblyopieentwicklung gezielt entgegengewirkt werden.