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First studies on stem cell therapy for severe dry eye in Sjögren syndrome showed asafe and effective application of mesenchymal stem cells by injection into the lacrimal gland.

Due to the limitations of currently available replacement tissues, there is aclinical need for the development of new materials for adnexa oculi reconstruction. Constructs grown in vitro with allogeneic and/or genetically engineered cells are slowly making their way into clinical practice. The efficacy and mode of action of stem cells in severe dry eye are subject matters of current clinical trials.
Due to the limitations of currently available replacement tissues, there is a clinical need for the development of new materials for adnexa oculi reconstruction. Constructs grown in vitro with allogeneic and/or genetically engineered cells are slowly making their way into clinical practice. The efficacy and mode of action of stem cells in severe dry eye are subject matters of current clinical trials.The incidence of retinal folds following surgical repair of retinal detachment is underestimated. The extent of retinal folds is variable and can include the complete retina with all layers and an apposition of the photoreceptor outer segments or only partially affect the outer or inner retinal layers. While complete folds can be relatively easily detected by clinical examination, discrete partial folds are sometimes difficult to assess biomicroscopically. In these cases, high-resolution optical coherence tomography (OCT) plays an important role as a tool for differential diagnosis. If macular translocation occurs during the formation of folds, mostly in associated with inferior retinal folds, patients often complain of binocular double vision. A significant reduction of visual acuity and metamorphopsia occur in cases where the folding involves the fovea. In general, retinal folds tend to resolve spontaneously over a prolonged period of follow-up of several months; however, in cases of foveal involvement and corresponding symptoms, a surgical revision can be indicated, although the surgical procedure is not standardized.In the case of thermal or caustic burns of the ocular surface, loss of limbal epithelial stem cells leads to compromised self-renewal of the corneal epithelium. This results in permanent loss of vision. In these situations, transplantation of cultured limbal epithelial cells on an amniotic membrane or fibrin gel as substrate (Holoclar®) can help to regenerate the corneal surface. The required cells are obtained from the healthy partner eye, if available. Adult stem cells from other parts of the body potentially serve as alternative cell sources hair follicles, oral mucosa, mesenchymal stromal cells, or induced pluripotent stem cells (originally, e.g., skin fibroblasts). The reprogramming of such cells can be achieved with the help of transcription factors. In addition, work is being done on biosynthetic or synthetic matrices, which not only serve as substrate material for the transplantation but also support the functional properties of these cells (self-renewal, corneal epithelial-typical phenotype).
The aim of the study was to evaluate the impact of simultaneous amniotic membrane transplantation (AMT), status of the cornea (own cornea vs. graft) and underlying disease on the success and recurrence rates of autologous serum (AS) in therapy-resistant epithelial defects.

Between 2007 and 2019, 990 treatments with AS in 703 eyes of 645 patients were retrospectively examined. The presence of erosion or ulcer, use of AMT, status of the cornea and the underlying disease were recorded. Epithelial closure rate within 4weeks and the recurrence rate after epithelial closure were main outcome measures. The median observation period was 50months.

Epithelial closure was seen in 73.6% and recurrence in 27.4%. AMT was used significantly more often for ulcers (p < 0.001) and recurrences (p = 0.048). Without AMT, there was asignificantly higher epithelial closure rate (p < 0.001) and faster healing tendency (p < 0.001). There was no difference between own corneas and grafts with respect to epithelial closurxpected, due to the higher complexity of the given situation. AS can be used successfully in various underlying diseases, with limitations in case of congenital aniridia.
Immune reaction (IR) after penetrating keratoplasty (PKP) is aserious complication with ahigh risk of graft failure. The aim of this study was to analyze and evaluate the risk factors for IR, in particular, the influence of graft size and centration.

Atotal of 2133patients who underwent PKP between January 2009 and July 2019 were included in this retrospective study. The following endpoints were analyzed frequency of IR, graft origin, donor and patient age, diagnosis, corneal diameter and ratio of the graft size to the recipient cornea size. In addition, the role of graft centration, with the help of distance measurements of the graft margins to the vascularized limbus at four locations, was investigated in detail.

Overall, 8.25% of patients suffered from IR during the observational period. The frequency of IR was significantly correlated (p < 0.001) with the ratio of the graft size to the recipient cornea size. In addition, astatistically significant correlation was found between the occurrence of Ied by the corneal microsurgeon and could possibly be further optimized in the future.
Glaucoma drainage devices (GDD) are an invasive procedure for the treatment of glaucoma. The PAUL® Glaucoma Implant (PGI) has been developed as anew, innovative therapeutic procedure. The PGI differs from previous GDD with regard to the smaller size of the drainage tube.

This study analyses 6‑months results of the PGI in terms of effectiveness and safety.

Adatabase of patients treated with the PGI at the University Eye Hospital Bonn was created and continuously updated based on follow-up controls. Statistical analysis was performed using SPSS Statistics for Windows (IBM Corp., Armonk, NY, USA).

Atotal of 53eyes of the first 51consecutive patients treated with the PGI were included in this study. Mean intraocular pressure was 26.62 mmHg (7-48 mmHg) preoperatively and reduced to 12.20 mmHg (3-22 mmHg) after 6months. Local pressure-lowering therapy was reduced from 3.37 agents preoperatively to 0.30 agents after 6months. The complication rate was low; only 3patients (5.8%) had persistent hypotony. In 16patients, the intraluminal prolene stent was removed in the postoperative course after an average of 2.9months. Thereafter, these patients experienced areduction of intraocular pressure from 22.21 to 11.07 mmHg.

The PAUL® Glaucoma Implant is asafe treatment modality that can successfully reduce intraocular pressure to alow level and reduce pressure-lowering local therapy. It has alow complication rate, particularly regarding postoperative hypotony.
The PAUL® Glaucoma Implant is a safe treatment modality that can successfully reduce intraocular pressure to a low level and reduce pressure-lowering local therapy. It has a low complication rate, particularly regarding postoperative hypotony.
The demands on conjunctival replacement tissues are high they need to be elastic, clinically compatible, surgically feasible and support goblet cell growth.

This article provides an overview of currently applied conjunctival replacement tissues and those under investigation.

Current publications on clinically applied conjunctival replacement tissues and substrates which are the subject of scientific research and those already tested in animal models are presented and discussed.

Replacement tissues in clinical use are autologous and allogenic conjunctiva, nasal and oral mucous membranes, amniotic membrane and decellularized tissues. Autologous conjunctiva shows good results but is not suitable for large defects due to limited availability. In these cases autologous nasal and oral mucous membranes can be used; however, success is limited in cases of autoimmune diseases. Amniotic membranes are frequently applied clinically but goblet cell growth is limited. Different decellularized tissues are used clini biological and synthetic matrices.
The options for glaucoma treatment are quite diverse. The question therefore arises what is considered beneficial and feasible in daily practice. Our anonymized survey among members of the German Ophthalmological Society (DOG) and the Professional Association of Ophthalmologists in Germany (BVA) intends to explore treatment patterns and strategies in routine glaucoma care in Germany.

The current article reflects current opinions of German ophthalmologists regarding glaucoma care, therapeutic strategies, and the role of glaucoma surgery.

The survey was conducted using an online questionnaire with 26 questions (107 items) regarding care practice for glaucoma diagnosis and treatment. Complete responses were available from 1361 participants.

Atotal of 84.8% of responders define a target pressure regularly. Asystemic therapeutic approach is followed by 44.9%. Luzindole datasheet Two thirds consider side effects of eye drops to impair quality of life. Most common are conjunctival hyperemia and burning. Non-adherence to treatment is estimated to occur in 32% of patients. Approximately 5-10% of glaucoma patients are treated surgically. Among interventional treatment options, 90% consider trabeculectomy beneficial, followed by minimally invasive glaucoma surgery (MIGS) and selective laser trabeculoplasty (SLT), which are, however, the most commonly performed procedures.

The choice of treatment should intend along-lasting reduction of intraocular pressure and yet to be reasonable and manageable. There is ademand for more overview and structured care.
The choice of treatment should intend a long-lasting reduction of intraocular pressure and yet to be reasonable and manageable. There is a demand for more overview and structured care.
Glaucoma is the leading cause of irreversible blindness worldwide. The prevalence of glaucoma is particularly high in rural regions of Tanzania. Poverty and an inadequate ophthalmic infrastructure increase the difficulty of glaucoma treatment.

Due to the limited access to eye drops or surgical therapy, the effectiveness of transscleral cyclophotocoagulation in micropulse technology (CPC-M) in advanced glaucoma was investigated in the present study.

We included n = 50eyes of 35adult patients with advanced glaucoma and aglaucoma-typical papillary excavation with cupdisc ratio (CDR) ≥ 0.9, regardless of the glaucoma entity. The mean intraocular pressure (IOP) prior to treatment was 34 mm Hg (± 14 mm Hg). The operation was performed under retrobulbar anesthesia with the A.R.C.FOX 810 diode laser (A.R.C. Laser, Nuremberg, Germany; mean energy 127 J ± 10 J).

An IOP between 6 and 21 mm Hg or an IOP reduction by at least 20% of the initial value was defined as success. The success criteria were met by 71% of reevaluated eyes (n = 21) 3months after treatment, and mean IOP was 19 mm Hg (± 13 mm Hg). Mean IOP 9months postoperatively (n = 20) was 18 mm Hg (± 10 mm Hg) and the success criteria were met in 65% of cases. Seven eyes did not meet the success criteria six eyes had afurther increase in IOP and one eye showed intraocular hypotension.

The CPC‑M represents agood, inexpensive, and easily accessible treatment option for advanced glaucoma in order to reduce the likelihood of blindness in alow-income setting.
The CPC‑M represents a good, inexpensive, and easily accessible treatment option for advanced glaucoma in order to reduce the likelihood of blindness in a low-income setting.
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