BACKGROUND Combining pars plana vitrectomy with phacoemulsification and implantation of an intracapsular IOL provides many advantages and is performed as a routine operation. MATERIALS AND METHODS Over a period of 3 years we compared foldable acrylic lenses AcrySof (Alcon) to heparin-modified PMMA lenses (Pharmacia) in a prospective study. The last implanted lenses had a follow-up period of at least 1 year. Out of 396 eyes from 329 patients we implanted 182 AcrySof lenses and 214 heparin-modified lenses. RESULTS Both a smaller scleral tunnel incision and a lower rate of secondary cataract are advantages of foldable AcrySof lenses. Higher vulnerability of an AcrySof lens and a less stable lens-iris-diaphragm are of disadvantage. Heparin-modified PMMA lenses do not show these disadvantages, however, in consequence of using them you have to accept the wider scleral tunnel incision and a higher adhesion to cells. Furthermore, we found slightly more posterior synechiae with these lenses. CONCLUSIONS In all, both types of intraocular lenses are suitable for combined surgery. We recommend using heparin-modified PMMA lenses in case of pre-existent instability of the lens-iris diaphragm or of patients' inability to maintain the prone position.

BACKGROUND:Foreign-body-reactions with granulomas after use of silicone-containing biomaterials are of clinical importance [4].HISTORY AND SIGNS:A 4-year old patient entered our hospital with a reddish vascularised tumor. The tumor's origin was in the conjunctiva of the nasal lid-angle of the right eye.THERAPY AND OUTCOME:After a traumatic disconnection of the canaliculus lacrimalis inferior, a bicanalicular silicon-tube intubation had been performed with the patient in the age of one year. Only 3 years after this intervention a secondary clinical examination could be performed. At this time, an extended solid conjunctival-tumor appeared at the operated eye. After removal and histological examination it could be classified as a foreign body granuloma.CONCLUSIONS:The blood- and tissue compatibility of silicone is only insufficiently guaranteed on the basis of the hydrophobic material-surface. After reconstructive lacrimal surgery postoperative care and the removal of the stabilizing silicone material is necessary.

Under the contemporary conditions of mental health care, the first contact with mental health services of persons falling ill with schizophrenia is usually precipitated by the dramatic symptoms of the first psychotic episode. In most cases this event is preceded by an extended period of a more or less rapid accumulation of non-specific, negative and, finally, positive symptoms, which was already more or less known to Emil Kraepelin (1909–1915) and Eugen Bleuler (1911), the creators of the disease concept. In 1909 Kraepelin identified as the “…prodromal signs of schizophrenia: small changes- in emotional life, irritability, loss of interest, overactivity and poor concentration”. The early, almost hidden illness phase is of great theoretical interest, but not easily accessible by research tools. For this reason it was long paid remarkably little attention.

The ABC (age, beginning, course) schizophrenia study was commenced in 1987 to generate and test hypotheses about pathogenic aspects of schizophrenia. One of the main branches of the study focused on how gender influences the age distribution of onset, symptomatology, illness behavior, and early course in schizophrenia. Proceeding from one of the rare, strikingly deviating, consistent findings--the gender difference in age at first admission--we launched a systematic search for explanations by generating and testing hypotheses in a series of substudies. We moved from the epidemiological to the neurobiological and finally to the clinical level. The present article is an attempt to provide a brief overview of the individual stages of the ABC study and the different levels of investigation involved in formulating and testing the estrogen hypothesis in animal experiments and in demonstrating its applicability to human schizophrenia. From these results, three hypotheses were formulated and tested on data from an ABC study sample of 232 first-episode cases of schizophrenia. The analyses described here represent the latest stages of the ABC study.