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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.

In 153 eyes with idiopathic posterior subretinal neovascularization (IPSN) and myopia of no greater than -6 dpt, the relative risk of this disorder was determined with regard to refraction. It was shown that the probability of developing this condition is directly proportional to the degree of myopia. By using data obtained from the literature for calculating the relative risk regarding refraction, it was demonstrated that the same is true for subretinal neovascularization in degenerative myopia greater than -7.5 dpt (Fuchs' spot). The relative risk for developing one of both disorders increases exponentially with increasing myopia.

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.

In a retrospective study, the authors analyzed visual results and postoperative complications in a series of 14 consecutive patients who had undergone penetrating keratoplasty and implantation of a posterior chamber intraocular lens (PC IOL) in the absence of the posterior capsule. Seven patients suffered from aphakic bullous keratopathy and seven from pseudophakic bullous keratopathy. Postoperative follow-up was 7.6 months on the average. Best-corrected postoperative visual acuity was 20/60 or better in four cases and 20/200 or better in eight. Glaucoma was present before surgery in four eyes, which persisted in all cases and developed in four new cases. Results of gonioscopic examination showed the postoperative development of goniosynechiae in four eyes. Pseudophakodonesis of various extent was present in ten eyes. Preoperatively, cystoid macular edema was diagnosed angiographically in one case. It did not improve after surgery and was seen in three additional eyes postoperatively. Causes for postoperative visual acuity lower than 20/200 were cystoid macular edema in three cases, graft rejection in one case, central retinal scar in one case, and optic nerve atrophy in one case. A distortion of the pupil was seen in three eyes in miosis and in four additional eyes in mydriasis. Corneal thickness as well as anterior chamber depth were within normal limits. Fluorophotometric evaluation of the blood-aqueous barrier showed values comparable with those obtained after intracapsular cataract extraction and implantation of an iris-fixated IOL. Despite the relatively good visual results, the high postoperative incidence of cystoid macular edema and/or glaucoma may discourage the use of this technique.

With an increasing number of in-vivo methods to examine the eyes of laboratory animals, the rat has become an important animal model in experimental eye research. Specular microscopy is a clinical tool to examine the corneal endothelium in-vivo. To evaluate the versatility of this method for small animal eyes, we studied both corneal endothelial cell-count and corneal thickness in normal rats as well as those with diabetic, naphthalene and UV-B cataract. As a reference scanning electron microscopy (SEM) of the corneal endothelium was performed. For cell-counts the correlation coefficient between both methods was found to be sufficient. The comparison of corneal thickness measurement (SEM-values) with specular microscopy and with Scheimpflugbiometry failed to show a satisfactory correlation. The study proves that specular microscopy is a useful tool to document changes also in the endothelium of the rat-cornea.