The standard technique used for full-thickness reconstruction of the lower eyelid is the Hughes tarsoconjunctival flap. Despite its widespread use, objective postoperative assessments of eyelid morphology and tension remain rare. This cross-sectional clinical study included patients who underwent the Hughes procedure at the Department of Ophthalmology, University of Cologne. Eyelid morphology was evaluated using the VECTRA M3 stereophotogrammetry system in neutral position, manual downward traction, and standardized hook distraction with a 15.9 g eyelid hook. Seventeen anatomical landmarks were identified per eye, measuring eight linear distances, two angles, and eyelid area. Operated and non-operated eyes were compared. Sixteen patients were included; 75 www.springer.com/00266 .

This study aimed to evaluate the intra- and inter-rater reproducibility of periocular tumor measurements using three-dimensional (3D) stereophotogrammetry and to explore its potential clinical feasibility in periocular tumor assessment.Standardized 3D facial images were obtained from 150 patients with a total of 175 periocular tumors using the Vectra M3 imaging system. Surface areas were independently measured by two raters. Intra- and inter-rater reliability were assessed using intraclass correlation coefficients (ICC), mean absolute deviation (MAD), technical error of measurement (TEM), relative error of measurement (REM), and relative TEM (rTEM). Key factors influencing measurement reliability were identified through LASSO regression and random forest analysis.Overall measurement reliability was excellent, with intra-rater and inter-rater ICCs of 0.998 and 0.974, respectively. The mean intra-rater and inter-rater MAD were 0.63 mm2 and 0.40 mm2, while TEMs were 2.29 mm2 and 7.81 mm2. Intra-rater and inter-rater REM values were 1.94% and 1.22%, respectively. Tumors >5 mm showed significantly higher reliability than tumors ≤5 mm (p = 0.010). Tumors with well-defined boundaries had superior reproducibility compared to those with unclear margins (p = 0.026). Localization influenced reliability, with lateral canthus tumors showing the highest consistency (p = 0.008). Tumor color also affected reliability, with brownish-black tumors exhibiting the greatest reproducibility (p = 0.021).Three-dimensional stereophotogrammetry demonstrated high reproducibility for periocular tumor assessment. These findings suggest its potential clinical applicability as an adjunctive tool to support preoperative planning and longitudinal monitoring.

Various inflammatory diseases can occur in the eyelids. Infectious disorders - such as staphylococcal or demodex blepharitis, dermatological diseases such as seborrheic dermatitis, ocular rosacea or ocular cicatricial pemphigoid and rheumatological diseases such as dermatomyositis or sarcoidosis - are just some of these aetiologies. Clinically, these causes of blepharitis can manifest in inflammation of the eyelid margin with collarettes around the eyelash follicles, madarosis, meibomian gland dysfunction, erythema, and nodular tumour. Even if the clinical differential diagnosis between the various blepharitides is difficult, a correct diagnosis can significantly improve the prognosis. As most blepharitides are chronic in nature, regular and careful care of the eyelid margin is necessary to improve the patient's symptoms. Depending on the cause, local or systemic antibiotics or immunosuppressive agents can also help. If no improvement after treatment occurs, the previous diagnosis must be critically questioned so that masquerade syndromes such as sebaceous carcinoma are not overlooked.

After eye loss, a fast supply with a visually appealing prosthetic eye is not just a cosmetic solution, it is the key factor for a successful social, occupational, and psychological rehabilitation. For a long time, prosthetic eye care was based on acquired experiences, and there was a significant lack of systematic studies and peer-reviewed literature on this subject. However, in recent decades, research in the field of ocular prosthetics has been driven forward by ophthalmologists, ocularists, optometrists, ophthalmoplastic surgeons, and psychologists. Many essential findings have been made for improving the care of anophthalmic patients. In this extensive review, the current state of the art regarding prosthetic eye care based on the newest scientific findings is summarized. The broad focus includes important historical aspects in ocular prosthetics, in particular the historical development that led to ocularistic care with different prosthetic materials – cryolite glass and polymethyl methacrylate. Furthermore, epidemiology and etiology of eye loss, surgical techniques of eye removal as well as types and production of prosthetic eyes are set out. Important topics with new insights include psychological issues such as living with a prosthetic eye, treatment of children with anophthalmia and microphthalmia, as well as evidence-based prosthetic eye maintenance and handling. In addition, anophthalmic socket complications and associated treatment options with a focus on the common dry anophthalmic socket and post-enucleation socket syndromes were described in detail. Finally, we will speculate how the field of prosthetic eye care will develop in the future.

Objectives: Aim to develop a nomogram to effectively predict the potential for recurrence after surgical resection in patients with periocular basal cell carcinoma (BCC). Methods: We conducted a retrospective study involving 329 patients with eyelid BCC. Univariate and multivariate Cox proportional risk regression was used to screen for independent factors affecting BCC recurrence. Kaplan-Meier survival curve analysis was performed to evaluate their impact on prognosis. On the basis of the results obtained from Cox regression analysis, a nomogram was established for the 1-, 2-, and 3-year recurrence-free survival (RFS) rates of BCC. Results: In this study, a total of 15 patients out of 329 patients (4.6%) developed local recurrence. Multivariate analysis revealed that age, pathological type, previous history of BCC, and the number of surgeries were independent risk factors for BCC recurrence (p < 0.05, respectively). These risk factors were utilized to construct a nomogram to predict postoperative recurrence for these patients. The C-index of the nomogram was 0.867 (95% CI: 0.817-0.916), and the receiver operating characteristic curves were used to assess the discriminatory degree of the nomogram, with area under the curve values of 0.978, 0.870, and 0.916 at 1, 2, and 3 years, respectively. The calibration curves were basically fitted to the ideal curves. Conclusions: Age, pathological type, previous history of BCC, and the number of surgeries are significant risk factors for periocular BCC recurrence. Establishing a nomogram related to recurrence risk factors can more accurately predict the recurrence-free survival of individual patients.

Maligne Tumoren der Augenlider stellen eine diagnostische und therapeutische Herausforderung dar. Insbesondere in fortgeschrittenen und metastasierten Stadien gewinnen moderne Behandlungsansätze wie zielgerichtete Therapien und Immuntherapien zunehmend an Bedeutung. Diese können jedoch Nebenwirkungen wie Fatigue, Hautreaktionen und gastrointestinale Beschwerden verursachen, was eine engmaschige Überwachung erfordert. Für das fortgeschrittene, metastasierte oder inoperable Basalzellkarzinom bietet die gut steuerbare orale Therapie mit Hedgehog-Inhibitoren eine wirksame Behandlungsoption. Diese innovativen, systemischen Therapieansätze erfordern allerdings ein individuell angepasstes Management, das durch ein interdisziplinäres Tumorboard festgelegt und von einem spezialisierten, multiprofessionellen Team begleitet wird, um eine optimale Patientenversorgung zu gewährleisten.

Beim Basalzellkarzinom, früher als Basaliom bezeichnet, handelt es sich um das häufigste Tumorleiden hellhäutiger Bevölkerungsgruppen. Im Gegensatz zum malignen Melanom, welches zur Fernmetastasierung neigt, tritt es im weitaus überwiegenden Falle lediglich lokal destruierend auf. Als typischer Alterstumor mit durchschnittlichem Inzidenz-Maximum bei 70 Jahren früher in der Hauptsache mit langjähriger Berufsausübung unter starker UV-Exposition assoziiert, verschiebt sich die Altersprävalenz insbesondere bei Frauen zunehmend zu jüngeren Jahrgängen. Vermutlich zurückzuführen auch auf Schönheitsideale wie gebräunten Hautteint und das Phänomen des Massentourismus, lässt sich das Basalzellkarzinom gerade in westlichen Ländern zunehmend als Wohlstandserkrankung begreifen. Hierbei gilt es jedoch, Risikofaktoren syndromaler Genese, aber auch Immunkomprimierung und Schadstoffexposition nicht unerwähnt zu lassen. Auch wenn die chirurgische Exzision nach wie vor als Goldstandard gilt, kommt im Falle eines ausgedehnten Befundes, insbesondere mit orbitaler Invasion, oder der sehr seltenen Metastasierung dem Wissen über die molekularpathologische Genese des Krankheitsbildes und die sich daraus ergebende Therapieoption mit Biopharmazeutika eine besondere Bedeutung zu. Früh erkannt können eine optimale Therapie und eine ästhetische Rehabilitation erreicht werden. Regelmäßigen Nachkontrollen ist im Hinblick auf Rezidive und den Fakt, dass ein Basalzellkarzinom selten isoliert auftritt, ein hoher Stellenwert zuzuschreiben.

Conjunctival melanoma is a rare disease that nevertheless has a high tumor-associated mortality rate. A resection in sano with adjuvant local treatment currently represents the therapeutic gold standard and systemic treatment is used for metastasized conjunctival melanoma and/or very advanced nonresectable local findings. New knowledge on molecular changes in conjunctival melanoma shows a clear similarity to those of cutaneous melanoma. Therefore, many findings on new systemic forms of treatment for cutaneous melanoma can be transferred to conjunctival melanoma. In the clinical application BRAF/MEK inhibitors and immune checkpoint inhibitors are already in use and good response rates have been shown in small retrospective studies and case reports. Due to the rarity of conjunctival melanoma, there are no larger prospective studies comparing different systemic therapeutic agents. In a nonrandomized retrospective comparison, a better overall survival was shown for a combination of BRAF/MEK inhibitors (progression-free 1‑year survival probability of 54.7%; overall survival of 29.1 months) compared to a combination of PD1/CTLA4 antibodies (progression-free 1‑year survival probability of 42%; overall survival of 18 months). The current recommendation is to perform genomic profiling for every conjunctival melanoma, particularly to investigate a BRAF mutation. If a BRAF mutation is present, BRAF/MEK inhibitor treatment should preferably be initiated. Treatment with immune checkpoint inhibitors can be used in the case of BRAF-negative mutation status or treatment failure with BRAF/MEK inhibitors. Monotherapy with the CTLA4 antibody ipilimumab is not recommended due to its inferiority to PD1 antibodies. New knowledge in the genomic profiling of conjunctival melanoma could enable further targeted treatment options in the future.

This study evaluates the reliability and agreement of 3D exophthalmometry, combined with OA2000 measurements, in comparison to traditional Hertel exophthalmometry for assessing ocular protrusion. This study included 110 healthy volunteers assessed for ocular protrusion using both Hertel exophthalmometry and 3D exophthalmometry, complemented by precise measurements of anterior chamber depth (ACD) and central corneal thickness (CCT) via the OA2000. Data were analyzed for intra-operator and inter-operator variability and agreement using paired T-tests, correlation coefficients, and Bland-Altman plots. The 3D exophthalmometry method demonstrated high intra- and inter-rater reliability, with agreements of ±0.53 mm and ±0.69 mm for right and left eyes, respectively. Comparisons between the two methods showed no significant differences (P > 0.05), with a moderate correlation (R = 0.63). Bland-Altman analysis revealed minimal bias (0.3 mm) and consistent agreement between methods. The 3D exophthalmometry technique, supported by OA2000 measurements, provides reliable and reproducible results, and serves as a complementary tool to traditional methods. Further research involving diverse patient populations and comparisons with a gold standard, such as computed tomography, is required to establish its clinical applicability.