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Purpose: To evaluate treatment of epiphora caused by obstructions of the nasolacrimal duct system with balloon dilatation and stent implantation., Material and Methods: 28 dacryocystoplasties were performed in 20 patients with complete (n = 7) or incomplete (n = 13) obstruction of the nasolacrimal duct system., Results: Dacryocystoplasty was technically successful performed in 26 cases (93%). Recanalisation was not achieved in two patients with complete obstructions. 17 patients showed complete or partial resolution of epiphora during follow-up of up to two years (clinical success 85%). Complete reobstruction occurred only in one patient 9 months after balloon dilatation and recanalisation was not possible., Conclusion: With a technical success rate of 93% and a clinical success rate of 85% dacryocystoplasty is a non-operative alternative for treatment of epiphora caused by obstructions of the nasolacrimal duct system.

Purpose: To free both of the surgeon's hands for bimanual work in the vitreous cavity, Koch and coworkers developed the multiport illumination system, which, however, requires enlarged sclerotomies., Patients and Methods: To evaluate the safety of the multiport illumination system we analyzed the first postoperative year of those 104 vitrectomies, that were performed using this system between January and December 1991. It was used only for patients suffering from advanced vitreoretinal changes that most likely require bimanual surgery., Results: No specific intraoperative or postoperative complications were encountered that might possibly have been caused by the multiport illumination system. Postoperative fibrinous reactions were noted in the vitreous cavity of 7 patients, and in the anterior chamber of 15 patients. Rebleeding was observed in a total of 17 patients., Conclusion: When these complications were compared to data from other retrospective studies of vitrectomy and its complications, the multiport illumination, system was found to be as safe as conventional devices.

The small degree of morbidity and a better postoperative visual acuity are the advantages of pneumatic retinopexy in comparison to encircling procedures in the treatment of retinal detachment. The injection of air or gas into the vitreous cavity can theoretically induce a cataract postoperatively. Two months after pneumatic retinopexy (SF6-gas) Scheimpflug photography and microdensitometric evaluation of the negative were performed on 22 pairs of phacic eyes showing changes in the transparency of the lens. The deterioration of transparency in the operated eye was small but higher than that of the non-operated eye. Due to the short follow up period no prognosis is possible as to the future lens transparency changes.

When performing a pneumatic retinopexy, air or gas is injected into the vitreous cavity to reattach a primary, rhegmatogenous retinal detachment. SF6 gas, for examples, remains in the vitreous cavity for up to 2 weeks before it is completely absorbed. It is conceivable that the injection of SF6 gas into the vitreous cavity interferes with lens metabolism, thus causing opacities of the lens. Even minor early changes in lens transparency can be monitored by Scheimpflug photography. Two months after performing a pneumatic retinopexy, 31 out of 100 consecutive eyes showed a loss of lens transparency, which was not pronounced or statistically significant. Six months after surgery the loss of transparency was more pronounced in all lens layers, increasing from the front to the back. The increment was statistically significant for the anterior lens cortex. Further investigations are needed to determine whether lens changes are the result of the intraocular tamponade with SF6 gas or are related to other factors, such as the surgical maneuver itself.

Delayed resorption of pooled subretinal fluid has been reported to cause impaired visual acuity due to involvement of the macula in up to 10% of all case. In our series of 60 eyes treated consecutively with pneumatic retinopexy for retinal detachment, 9 eyes experienced delayed absorption of subretinal fluid. Only 6 eyes showed the phenomenon of pooled, localized subretinal fluid without peripheral extension to the ora serrata. The time for complete absorption of these circumscribed subretinal bullae ranged from 8 to 52 weeks (mean 22.7 weeks). Impaired visual acuity could not be detected in any of these cases. This may be due to the location of these bullae, which never involved the macula. Therefore, we do not consider the occurrence of this phenomenon to be a reason not to carry out pneumatic retinopexy.