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ObjectiveTo evaluate the long-term outcomes of trabeculectomy (TE) surgery in a large cohort with a minimum follow-up of 3 years.DesignRetrospective cohort study.SettingUniversity Eye Hospital, Germany.ParticipantsThree hundred and seventy-nine patients with open-angle glaucoma underwent TE with mitomycin C (MMC) between January 2013 and February 2017 with a minimal follow-up of 3 years. Eligible patients were identified via an electronic surgical case register.InterventionsAll patients had undergone TE with MMC following a set surgical protocol. To assess the influence of cataract surgery following TE, eyes which underwent cataract surgery at least 6 months after TE were matched 1:3 by sex and age to eyes who did not undergo cataract surgery during the follow-up period.Main outcome measuresPrimary outcome was the proportion of surgical success based on intraocular pressure (IOP), surgical complications, the need for revision surgery, loss of light perception and the need for additional pressure-lowering medication.ResultsThe mean follow-up time was 6 (±0.8, IQR: 5.4–6.5) years. Seventy-three per cent of eyes achieved qualified surgical success at the last follow-up (IOP≥5 mm Hg and ≤18 mm Hg, without surgical complications or complete loss of vision) but necessitated additional medical therapy, complete surgical success with no additional medical therapy was achieved in 69% of eyes. There was no significant difference in the success probability between eyes that had undergone cataract surgery after TE and those that had not (p=0.45).ConclusionsThe results demonstrate a high and stable success rate of TE after a mean follow-up time of approximately 6 years, that is, not affected by later cataract surgery.

Simultaneous stereoscopic fundus photography is an important tool for classification and follow-up of glaucomatous optic neuropathy. The use of conventional film-based simultaneous stereoscopic fundus cameras is complicated and time-consuming due to film processing and the sensitivity of its mechanical components. Digital simultaneous stereoscopic fundus cameras are not available in Germany, since the existing ones are lacking the CE certificate. The authors realised a solution by transforming a conventional stereophotographic film-based fundus camera into a digital one. The analogue camera of the conventional stereophotographic device was replaced by a digital 36×24 mm full-frame complementary metal oxide (CMOS) camera.

Orbital exenteration is a radical surgery reserved for the treatment of locally invasive or potentially life-threatening orbital tumours.1 Complications occur after 20–25% of exenterations and include tissue necrosis (6%) and infection (3–4%).2–4 In the present report, we describe the management of a post-exenteration orbital infection by the use of maggots. An 82-year-old multimorbid man presented with a fist-sized painless tumour of the left orbit (fig 1A). Computed tomography demonstrated an orbital mass clearly demarcated from the surrounding tissue (fig 1B). After biopsy, the neoplasm was classified as a borderline-malignant extrapleural solitary fibrous tumour. Therefore, a total orbital exenteration was performed, and the wound was left open to …