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Background: Chemical or thermal burns of the ocular surface are an urgent ophthalmologic emergency. Consecutive epiphora causes a high level of suffering for affected patients., Method: Based on a review of current literature, and our own longstanding experiences, recommendations are given on the treatment of secondary lacrimal duct obstruction due to ocular surface damage after chemical or thermal burns., Results: An initial evaluation of the tissue damage is crucial. Necrotic tissue should be removed. The patency of the lacrimal passage has to be proved in respect. In case of primary involvement of the lacrimal ducts, treatment is necessary. Here, recanalization can be achieved by using conical probes or lacrimal cannulas. Lacrimal intubation has to be performed. Scar formation should be completed if a secondary reconstruction is required., Conclusion: Lacrimal stenosis after chemical or thermal burns of the ocular surface is a rare complication. Initial surgical intervention should be performed if primary lacrimal involvement can be ensured. If possible, surgical reconstruction should not be performed prior to 6 months after the trauma., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (Georg Thieme Verlag KG Stuttgart · New York.)

Background: Dacryoendoscopy (DE) is an established method in lacrimal surgery. Long-term follow-up-analyses of this surgery are of great interest. Here, factors influencing postoperative success rates should be considered to elect suitable patients., Methods: In this retrospective study, patients having had dacryoendoscopic surgery were included. Using a questionnaire, a prospective follow-up analysis was made. Pre- and intraoperative factors were correlated with treatment success, which was defined as improved epiphora, absence of a second lacrimal surgery and no signs of chronic dacryocystitis (secretion, pain at the lacrimal sac). Additionally, we asked for patient's satisfaction with the postoperative result (categorized in "very good", "good", "poor", and "bad")., Results: Overall, 215 DE of 182 patients (130 women, 52 men) were studied. Mean patient age was 58 ± 17 years (range: 18 to 91 years). Follow-up was 31 to 77 months (median: 55 months). Treatment success after this time was 59.1%, in which neither patient's age nor sex showed significant influences. In comparison to complete stenosis, incomplete obstruction could be treated successfully twice as often (p = 0.02). Patients suffering from ectatic lacrimal sacs had a risk of 1.9 for failing therapy (p = 0.01). A trend concerning worse cure rates could be observed in patients with postsaccal localization of stenosis (p = 0.2) and an age of older than 49 years (p = 0.1). Surgical results evaluated by the patients were "very good" in 32.1% and "good" in 30.2%., Conclusion: Dacryoendoscopy with its minimally invasive approach is suitable as a first-step procedure in lacrimal surgery. The absence of a scar and the quick recovery are vitally important for the patients. Medically important is that the topographic anatomy is preserved by using dacryoendoscopy, so other surgical techniques can be performed later without limitations, if necessary. Patients with incomplete obstructions and a localization of stenosis, being pre- to intrasaccal, profit from this treatment method in particular., Competing Interests: Interessenkonflikt: Die Autoren geben an, dass kein Interessenkonflikt besteht., (Georg Thieme Verlag KG Stuttgart · New York.)

For the drug application of the already known active ingredient dexamethasone dihydrogen phosphate disodium salt (CAS 2392-39-4) for ocular use clinical data on the efficacy and safety were required by the drug regulatory agency. The comparison of the pharmaceutical properties had already shown that no differences in clinical use had to be expected. The results of a double-blind, randomised, comparative clinical study on 210 patients prove that no differences between test and comparator product could be observed. This case shows that the demand for clinical trials to proof therapeutic equivalence should be done with a sense of proportion related to the specific situation.