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Atmospheric observations of CO2 and other greenhouse gases have been widely used to constrain estimates of terrestrial and oceanic CO2 fluxes through atmospheric inverse modelling. Yet, applying these methods at national scale to verify and improve the National Inventory Report (NIR) and support the Paris agreement remains at the frontier of CO2 science.We use inverse modelling to estimate New Zealand’s carbon uptake and emissions using atmospheric measurements and model. This effort is part of a five year CarbonWatch-NZ research programme, which aims to develop a complete top-down picture of New Zealand's carbon balance using national inverse modelling and targeted studies of New Zealand’s forest, grassland and urban environments. In addition to quantifying New Zealand’s carbon emissions on a national scale, we also focus on identifying the prevailing processes driving CO2 changes in New Zealand to support climate mitigation.In an initial study based on the inversion system used in CarbonWatch-NZ, a significantly stronger (30-60 %) sink was found relative to the NIR (Steinkamp et al., 2017), suggesting a strong CO2 uptake in Fiordland, a region covered by indigenous temperate rainforest in New Zealand's South Island. Here, we present new results of CarbonWatch-NZ by expanding the studied time period from 2011-2013 to 2020, expanding our atmospheric observing network from two (Baring Head, 41.41°S, 174.87°E and Lauder, 38.33°S, 176.38°E) to a total of eleven in situ greenhouse gas measurement sites and improving our atmospheric model resolution by roughly a factor of ten (NAME model, 1.5 km).Our new results suggest that the strong sink observed in 2011-2013 did not diminish, but for recent years we have found an even stronger sink than for before. Additional measurements collected in the Fiordland region (i.e., mixing ratios, CO2 isotopes, carbonyl sulphide) also suggest a stronger CO2 uptake, supporting our inversion results. Both the measurements and inversion results show that the CO2 uptake does not seem to shut down completely during winter time, suggesting that there might be something about this ecosystem that we do not yet understand. This winter uptake signal is also present in independent data collected in and around New Zealand as part of the ATom campaigns (Atmospheric Tomography Mission). Implementing observations from an additional site in the North Island (Maunga Kakaramea, 45.034°S, 169.68°E) has increased the strength of the sink, pointing to additional strong sink region at the top of the North Island. ReferencesKay Steinkamp, Sara E. Mikaloff Fletcher, Gordon Brailsford, Dan Smale, Stuart Moore, Elizabeth D. Keller, W. Troy Baisden, Hitoshi Mukai and Britton B. Stephens, Atmospheric CO2 observations and models suggest strong carbon uptake by forests in New Zealand, Atmospheric Chemistry and Physics, 2017.

We present 60 years of Δ14CO2 measurements from Wellington, New Zealand (41° S, 175° E). The record has been extended and fully revised. New measurements have been used to evaluate the existing record and to replace original measurements where warranted. This is the earliest direct atmospheric Δ14CO2 record and records the rise of the 14C bomb spike and the subsequent decline in Δ14CO2 as bomb 14C moved throughout the carbon cycle and increasing fossil fuel CO2 emissions further decreased atmospheric Δ14CO2. The initially large seasonal cycle in the 1960s reduces in amplitude and eventually reverses in phase, resulting in a small seasonal cycle of about 2 ‰ in the 2000s. The seasonal cycle at Wellington is dominated by the seasonality of cross-tropopause transport and differs slightly from that at Cape Grim, Australia, which is influenced by anthropogenic sources in winter. Δ14CO2 at Cape Grim and Wellington show very similar trends, with significant differences only during periods of known measurement uncertainty. In contrast, similar clean-air sites in the Northern Hemisphere show a higher and earlier bomb 14C peak, consistent with a 1.4-year interhemispheric exchange time. From the 1970s until the early 2000s, the Northern and Southern Hemisphere Δ14CO2 were quite similar, apparently due to the balance of 14C-free fossil fuel CO2 emissions in the north and 14C-depleted ocean upwelling in the south. The Southern Hemisphere sites have shown a consistent and marked elevation above the Northern Hemisphere sites since the early 2000s, which is most likely due to reduced upwelling of 14C-depleted and carbon-rich deep waters in the Southern Ocean, although an underestimate of fossil fuel CO2 emissions or changes in biospheric exchange are also possible explanations. This developing Δ14CO2 interhemispheric gradient is consistent with recent studies that indicate a reinvigorated Southern Ocean carbon sink since the mid-2000s and suggests that the upwelling of deep waters plays an important role in this change.

A regional atmospheric inversion method has been developed to determine the spatial and temporal distribution of CO2 sinks and sources across New Zealand for 2011–2013. This approach infers net air–sea and air–land CO2 fluxes from measurement records, using back-trajectory simulations from the Numerical Atmospheric dispersion Modelling Environment (NAME) Lagrangian dispersion model, driven by meteorology from the New Zealand Limited Area Model (NZLAM) weather prediction model. The inversion uses in situ measurements from two fixed sites, Baring Head on the southern tip of New Zealand's North Island (41.408° S, 174.871° E) and Lauder from the central South Island (45.038° S, 169.684° E), and ship board data from monthly cruises between Japan, New Zealand, and Australia. A range of scenarios is used to assess the sensitivity of the inversion method to underlying assumptions and to ensure robustness of the results. The results indicate a strong seasonal cycle in terrestrial land fluxes from the South Island of New Zealand, especially in western regions covered by indigenous forest, suggesting higher photosynthetic and respiratory activity than is evident in the current a priori land process model. On the annual scale, the terrestrial biosphere in New Zealand is estimated to be a net CO2 sink, removing 98 (±37) Tg CO2 yr−1 from the atmosphere on average during 2011–2013. This sink is much larger than the reported 27 Tg CO2 yr−1 from the national inventory for the same time period. The difference can be partially reconciled when factors related to forest and agricultural management and exports, fossil fuel emission estimates, hydrologic fluxes, and soil carbon change are considered, but some differences are likely to remain. Baseline uncertainty, model transport uncertainty, and limited sensitivity to the northern half of the North Island are the main contributors to flux uncertainty.

Early embryonic loss may be related to untimely secretion of prostaglandin F2α. The objective of this study was to examine the effect of aspirin, a nonsteroidal anti-inflammatory drug (NSAID), on prostaglandin F2α secretion and luteal function in lactating dairy cows by characterizing plasma prostaglandin metabolites (PGFM) and progesterone (P4) during the luteal phase. Estrous cycles were synchronized in 23 lactating Holstein cows using a 5-d CIDR-Ovsynch protocol. Transrectal ultrasonography was performed to confirm ovulation and formation of a corpus luteum. On d 14, after after the second injection of gonadotropin-releasing hormone, cows were assigned randomly to receive aspirin (n = 11, 46.65 g/dose) orally on d 14 (2×) and d 15 (1×), 12 h apart, or no aspirin (n = 12, control). On d 15, hourly blood samples were collected for PGFM, and daily blood samples were collected (d 14 to 22) for P4 concentrations. Mean P4 concentrations before treatment (d 14) did not differ between groups. There was an effect of treatment and treatment × time on PGFM (P < 0.05). Mean PGFM concentrations decreased (P < 0.05) after treatment and remained low for 11 h after last aspirin dose, whereas in the control PGFM remained unchanged. For cows that underwent luteolysis (n = 16), P4 concentrations were greater (P = 0.05), and the days to luteolysis tended (P = 0.09) to be longer for the aspirin compared with the control. This study indicated that oral administration of aspirin may suppress prostaglandin F2α secretion during d 14 to 15 after estrus and may prevent early luteal tissue regression.

From 1980 until 2010, the combined CO2 sink strengths of ocean and land increased by nearly 50% (−0.55 Pg C yr−1 decade−1), but the spatial distribution of this trend is not well known. We address this by performing a joint cyclostationary ocean-atmosphere inversion for the three decades 1980–1989, 1990–1999, and 2000–2008, using only carbon data from the ocean and atmosphere as constraints, i.e., without applying any prior information about the land fluxes. We find that in the inversion, most of the 30 year sink trend stems from the ocean (−0.44 Pg C yr−1 decade−1). The contribution of the terrestrial biosphere is commensurably smaller but has more decadal variability. First, the land sink strength intensified in the 1990s by 0.4 (±0.3) Pg C yr−1 compared to the 1980s but then weakened slightly by 0.2 (±0.4) Pg C yr−1 in the 2000s. The different land regions contributed very variedly to these global trends. While the northern extratropical land acted as an increasing carbon sink throughout the examined period primarily driven by boreal regions, the tropical land is estimated to have acted as an increasing source of CO2, with source magnitude and trend dominated by enhanced release in tropical America during the Amazon mean wet season. This pattern is largely unchanged if the oceanic inversion constraint, which is based on a stationary ocean circulation, is replaced by an estimate based on simulation results from an ocean biogeochemical general circulation model that includes year-to-year variability in the air-sea CO2 fluxes and also has a trend (−0.07 Pg C yr−1 decade−1) that is at the very low end of current estimates. However, the land/ocean partitioning of the trend contribution is adjusted accordingly. Oceanic carbon data has a major impact on carbon exchange for all tropical regions and southern Africa but also for observationally better constrained regions in North America and temperate Asia. The European trend exhibits a strong sensitivity to the choice of the atmospheric CO2 network.

[1] We have estimated global surface fluxes of carbon dioxide for the period 1992–1996 using an inverse approach that sequentially considers four constraints: (1) atmospheric CO2, (2) ocean interior DIC (dissolved inorganic carbon) interpreted through an ocean interior inversion and surface ocean pCO2 (partial pressure of CO2), (3) annual prior fluxes for selected land regions, and (4) atmospheric model selection based on vertical transport skill. Estimated fluxes are monthly resolved for each of the 22 Transcom regions over land and ocean. The ocean constraint is particularly valuable, as it does not only add prior information about air-sea fluxes to the inversion problem but also preserves the regional variance-covariance structure from the underlying ocean interior inversion. It allows to constrain annual oceanic uptake of 1.8 PgCyr−1 to within 0.2 PgCyr−1, which implies a net annual land uptake of 1.3 (±0.3) PgCyr−1. Furthermore, it leads to a pronounced asymmetry in the seasonal pattern of global land uptake, which was not seen in previous atmosphere-only inversions. Tropical land is consistently estimated to be a source of carbon, though the source magnitude is reduced as more constraints are applied. With all four constraints, the inversion suggests a net tropical source of 1.1 (±0.9) PgCyr−1, which is comparable to global estimates of deforestation rates in tropical forests and therefore implies an annually balanced tropical land biosphere flux. This balance is not found, however, at the regional level: For the Amazonian region and after accounting for deforestation, we find a biospheric source of 0.6 (±0.5) PgCyr−1. This is at the upper range of estimates from bottom-up methods, which tend to identify the region as a sink.

Es wurden Sicherheit, Wirksamkeit, Vorhersagbarkeit, Stabilitat sowie Komplikationen der LASIK zur Korrektur von Hyperopie und hyperopem Astigmatismus mit einem Scanning-Spot-Ecximer-Laser untersucht. Eingeschlossen wurden 64 konsekutive LASIK-Operationen. Schnittgerat fur die Keratomileusis war das Hansatome™-Mikrokeratom mit superiorem Hinge, die Laserablation wurde mit einem Scanning-Spot-Excimerlaser und einer optischen Zone von 6 mm durchgefuhrt. Untersuchungen fanden praoperativ, nach 1 und 7 Tagen sowie nach 1, 4 und 12 Monaten statt. Nach 1 Jahr lagen 91% der Augen im Bereich von ±1 Zeile an bestkorrigiertem Sehvermogen; 50 Augen erreichten einen unkorrigierten Visus von ≥0,5, 32 ≥0,8 und 16 ≥1,0; 24 Augen lagen bei ±0,5 dpt, 44 bei ±1,0 dpt und 55 bei ±2,0 dpt. Das mittlere spharische Aquivalent betrug nach 1 Jahr +0,17±0,85 dpt. Die LASIK-Operation ist zur refraktiven Behandlung von Hyperopie und hyperopem Astigmatismus geeignet. Die Ergebnisse bei niedriger Hyperopie waren besser als bei mittlerer Weitsichtigkeit. Die refraktiven Ergebnisse zeigten wahrend des 12-monatigen Untersuchungszeitraums eine gute Stabilitat, in einigen Fallen kam es jedoch zu einer deutlichen Regression.

The purpose of this study was to evaluate the feasibility of microvascular imaging using contrast-enhanced color and power Doppler sonography. Ten patients with a focal lesion of the kidney were examined. Three patients were investigated with the polymeric butylcyanacrylate-based contrast agent SHU 563A, and the remaining patients were investigated with the galactose-based agent Levovist. It was possible to observe the microvascularization with Levovist during the blood pool phase of the agent over a period of 1 to 3 s at 1 min and 2 min after injection. With SHU 563A, microvascular imaging was possible 0.50 s after injection and lasted for 10.35 min. No intratumoral signals were seen in cysts (n = 6) and the investigated abscess. Weak intratumoral polychromatic effects were observed in both renal cell carcinomas in this series. Metastasis could be differentiated from healthy parenchyma due to lack of the polychromatic effect. SHU 563A is appropriate for performing microvascular imaging. The Levovist-induced polychromatic effects are smaller, of shorter duration, and observable only during the blood pool phase; thus, the expected diagnostic benefit is limited.

Hintergrund. Die Biokompatibilitat von Intraokularlinsen aus unterschiedlichen faltbaren Materialien (hochrefraktives Silikon- und hydrophobes Acrylatmaterial) sollte im intraindividuellen Vergleich untersucht werden. Material und Methoden. In einer prospektiven, randomisierten Studie wurden 35 Patienten beidseits mittels selbstdichtender Tunnelinzision und Phakoemulsifikation operiert. Nach Randomisierung wurde in ein Auge eine faltbare Intraokularlinse mit 6-mm-Optik aus hochrefraktivem Silikon (Allergan SI40NB) und in das andere eine faltbare Intraokularlinse mit 6-mm-Optik aus hydrophobem Acrylatmaterial (Alcon Acrysof MA60BM) implantiert. Postoperative Kontrolluntersuchungen fanden nach 7 Tagen, 1–3 und 6 Monaten sowie 1 Jahr statt. Ergebnisse. Die Patienten erreichten nach 1–3 Monaten ein bestkorrigiertes Sehvermogen von 0,9±0,12/0,89±0,13 (SI40NB/MA60BM), dieses lag nach 1 Jahr bei 0,9±0,12/0,87±0,14 (SI40NB/MA60BM). Es zeigte sich kein signifikanter Unterschied beim errmittelten Endothelzellverlust. Die Laserflare-Werte (photon counts/ms) stiegen nur im fruhpostoperativen Bereich (7 Tage) geringfugig an (SI40NB/MA60BM: 14,2±8,68/15,49±7,2; statistisch nicht signifikant). Nach 3 Monaten lagen diese Werte wieder im Normbereich. Die mittlere Dezentrierung (in mm) lag 1 Jahr postoperativ bei 0,29±0,14/0,3±0,15 (SI40NB/MA60BM). Vierzig Prozent der MA60BM-IOLs zeigten in der Scheimpflug-Spaltaufnahme “Glistenings”. Nach 1 Jahr wurde kein signifikanter Unterschied in der Nachstarbildung (Scheimpflug-Analyse) gefunden. Schlussfolgerung. Ein Jahr nach der Implantation faltbarer hochrefraktiver Silikon- und hydrophober Acrylatintraokularlinsen uber eine Tunnelinzision nach Phakoemulsifikation ergaben sich hinsichtlich funktioneller und morphologischer Aspekte im intraindividuellen Vergleich zufrieden stellende Resultate ohne signifikante klinische Unterschiede zwischen den beiden faltbaren IOL.

Background Photorefractive keratectomy (PRK) is an accepted procedure to correct myopia in Germany. The purpose of this study was to evaluate photoastigmatic refractive keratectomy (PARK) for myopic astigmatism. Material and methods PARK using the VISX 20/20 excimer laser was performed in 50 eyes of 36 patients (25 female, 16 male) aged 22 to 68 years (mean 38 +/- 10 years) in the period of 1995 to 1996. Retrospective evaluation was done after dividing the patients into three astigmatic groups between -0.5 diopters (D) and -1.5 D (group I, n = 28), between -1.75 D and -3.0 D (group II, n = 16) und between -3.25 D and -5.5 D (group III, n = 6). The correction of myopic astigmatism was assessed concerning the criteria safety, efficacy, predictability and stability. Mean follow-up was 12 months (8-15 months). Results Seventy-eight % of all eyes achieved an uncorrected visual acuity of > 0.5. Sixty-eight % of the eyes were within +/- 1.0 D of the desired correction. Loss of 2 or more lines of best corrected visual acuity occurred in 6 eyes (12.0%). We observed in group I an astigmatic reduction of 36.0%, in group II of 66.5% and in group III of 68.0%. The surgically induced astigmatism was calculated with 1.29 +/- 1.0 D. Mean axis rotation of the refractive cylinder was 22.12 +/- 23.05 degrees. Conclusions PARK using the VISX 20/20 excimer laser is an acceptable procedure to correct myopic astigmatism. However, the study revealed that astigmatic reduction with a broad beam laser is not yet perfect in terms of efficacy, predictability and safety.

AIMS—This study investigated the effect of tissue plasminogen activator (tPA) in patients with severe intracameral fibrin after extracapsular cataract extraction or phacoemulsification with posterior chamber intraocular lens implantation. METHODS—A randomised prospective multicentre study was carried out in 86 patients with intraocular fibrin formation 2-8 days after cataract surgery. While the first group (n=41) received only anti-inflammatory drugs, a single anterior chamber injection of tPA (10 µg) as an additional treatment to the standard was given in the second group (n=44). On days 1, 2, 14, and 90 after randomisation, the visual acuities, slit lamp findings, and intraocular pressures were documented in standardised protocols. Efficacy of treatment was judged by the rate of fibrinolysis (primary objective), the frequency of synechiae, and central capsular fibrosis (secondary objectives). RESULTS—The incidence and quantity of intraocular fibrin were significantly lower in the patients treated with tPA than in the control group (p

The advent of the excimer laser has brought about the potential for improved vision in many individuals with myopia and astigmatism. However, photoastigmatic refractive keratectomy (PARK) remains a matter of controversy. The purpose of our study was to determine the predictability of VISX 20/20 excimer laser photorefractive keratectomy in the treatment of myopic astigmatism. Patients and methods: Our study comprised 31 eyes of 22 patients with myopic astigmatism. All patients underwent treatment with a VISX 20/20 excimer laser and were followed up for 6 months. Complete 12-month follow-up data were available from 18 eyes. Park was performed in eyes with myopia between −1.5 and −10.0 D and with astigmatism between −0.5 and −5.5 D. Thus, the corresponding spherical equivalent ranged from −1.75 to −10.5 D. Results: Six months postoperatively, 21/31 (62 %) eyes were within ± 1.0 D of the target refraction and 13/31 (42 %) within ± 0.5 D of the target refraction. In 13 of 15 eyes (87 %) with myopia less than −6.0 D, an uncorrected visual acuity of at least 0.8 was noted. In eyes with myopia greater than −6.0 D, 9/16 (56 %) showed an uncorrected visual acuity of at least 0.5. Six months after PARK, an increase of one line on the Snellen Visual Acuity Chart was observed in 8/31 (26 %) and an increase of two lines was noted in eyes 3/31 (10 %). One of 31 eyes (3 %) showed an increase of three lines. A decrease in visual acuity of 1 line on the Snellen Visual Acuity Chart was found in 4/31 (13 %), and in 3/31 eyes (10 %) a decrease of 2–4 lines was noted. Overall, we observed a statistically significant reduction of astigmatism from 1.93 ± 1.43 D to 0.93 ± 0.63 D. Reduction of corneal astigmatism less than −1.25 D was not statistically significant. In eyes with astigmatism ranging from −1.25 to −2.5 D or greater than −2.75 D, a significant reduction of the mean astigmatism was noted. The postoperative regression of astigmatic correction was low. However, an axis shift of more than 15 ° was found in 42 %/35 % of eyes by subjective refraction (miosis/cycloplegia) and in 33 % in corneal topography. No central islands were noted. Conclusion: Photoastigmatic refractive keratectomy (PARK) constitutes a potential means of correcting myopic astigmatism. In eyes with astigmatism greater than −1.0 D a significant reduction of 60 % of the mean astigmatism was noted. However, the considerable proportion of eyes with a postoperative axis shift greater than 15 ° and a decrease in visual acuity of two or more lines indicates that further research is needed on excimer laser surgery to improve the reliability and safety.

Fibrinolytic therapy aimed at early restoration of blood flow appears to be a promising therapeutic approach in haemorrhagic retinopathy. The risk of bleeding complications, a major problem with fibrinolysis, can be reduced by the use of low-dose thrombolytic regimens. In our study, 14 patients with ischaemic central (CRVO) or branch (BRVO) retinal vein occlusion who presented with severe visual loss and recent onset of symptoms were treated with a low dose (50 mg) of recombinant tissue plasminogen activator (rt-PA) and intravenous heparin. In 10 of 14 patients (7 CRVO, 3 BRVO), an increase in visual acuity of one line or more on the logarithmic visual acuity chart was noted and in 8 patients (6 CRVO, 2 BRVO) a reduction of areas of capillary non-perfusion was observed, suggesting that a restoration of retinal capillary blood flow can be achieved if fibrinolysis is initiated in the early phase of haemorrhagic retinopathy. In view of the poor prognosis in the natural course of haemorrhagic retinopathy and the potential haemorrhagic risk in fibrinolysis, the use of low-dose rt-PA appears to constitute an encouraging approach in the management of this disease.

Transport of animals is a stressful procedure often resulting in significant losses for the slaughter plant. This study aimed to determine whether or not pigs would benefit from a loading density (low density (LD)) (179 kg/m2) below the normal EU standard loading density (normal density (ND)) (235 kg/m2). Eight similar, 550-km-long road journeys, were followed in which fattening pigs were transported across Germany from farm to slaughter plant. During each journey all pigs were transported at LD (n=4) or ND (n=4). Twelve female pigs per journey (total n=96) were randomly selected for measurement and monitoring of body temperature, behaviour, heart rate and blood parameters. Throughout the journeys, LD pigs displayed more resting behaviour than ND pigs. Average body temperature was lower (P

22 Patienten mit ein- oder beidseitiger Myopie wurden nach Implantation einer Hinterkammerlinse bezuglich der visuellen Funktionen einschlieslich Stereosehen untersucht. Die mit einem Computerprogramm berechneten Werte der Fern-Aniseikonie zeigen keine sichere Beziehung zur Qualitat des Stereosehens. Die subjektive am Phasendifferenz-Haploskop bestimmte Aniseikonie ist meist deutlich geringer als die berechnete. Die Berechnung der Kunstlinsenstarke sollte bei myopen Patienten mehr auf eine Reduzierung der Myopie und auf eine geringe Anisometropie als auf eine Iseikonie ausgerichtet werden.

Nachdem das Fibrinolytikum rt-PA in der systemischen Therapie von arteriellen und venosen Gefasverschlussen erfolgreich eingesetzt wird, steht uns nun dieses Medikament als Injektionslosung zur lokalen Applikation im Auge zur Verfugung. rt-PA wandelt Plasminogen in Plasmin um, Plasmin lysiert Fibrin und Fibrinclots. Zur Fibrinbildung im Auge kann es durch intraokulare Eingriffe, Traumata oder entzundliche Prozesse kommen. In allen Fallen stellt Fibrin eine Komplikation dar, die in der Regel mit hochdosierten Steroiden nur langsam und oft unzureichend behandelt werden kann. Patienten: Bei 8 Patienten im Alter zwischen 59 und 75 Jahren wurde bei Fibrinbildung nach kombinierter Goniotrepanation und Phakoemulsifikation mit HKL-Implantation 10 µg rt-PA intraokular injiziert. Am 1., 2. und 8. Tag nach der lokalen Fibrinolyse wurde der Verlauf des intraokularen Reizzustands mittels biomikroskopischem Befund, Fotodokumentation und Laser-Flare-Tyndallometrie beobachtet. Ergebnisse: Bei samtlichen behandelten Fallen kam es zur vollstandigen Auflosung des Fibrinclots. Eine Rezidivbildung trat nicht ein, unerwunschte Nebenwirkungen zeigten sich nicht. Schlusfolgerung: Die intraokulare Anwendung von rt-PA fuhrt zu einer sicheren Fibrinolyse und verhindert somit mogliche Spatkomplikationen aufgrund von Fibrinbildung nach kombinierter Glaukom- und Kataraktoperation.

The purpose of this investigation was to evaluate the safety, efficacy, predictability, stability and complications of LASIK for the treatment of hyperopia and hyperopic astigmatism using a scanning spot excimer laser.A total of 64 consecutive LASIK operations (37 patients, mean age 41 years, range 22-68 years) have been evaluated. The Hansatome microkeratome producing a superior hinge (flap diameter 9.5 mm) and a scanning spot excimer laser with an optical zone of 6.0 mm were used. Examinations were performed preoperatively, after 1 day, 7 days, 1 month, 4 and 12 months.One year after the primary procedure only 1 eye lost 2 or more lines of best-corrected visual acuity, 91% were within +/-1 line and 4 eyes gained 2 lines. Of these eyes 50 (86%) reached an uncorrected visual acuity ofor=0.5, 32 (55%)or=0.8, 16 (28%)or=1.0, 24 eyes (41%) needed a refractive correction of +/-0.5 D, 44 eyes (76%) of +/-1.0 D and 55 eyes (95%) of +/-2.0 D. The mean spherical equivalent after 1 year was +0.17+/-0.85 D.LASIK is suitable for the correction of hyperopia (up to a maximum of +5 D) and for hyperopic astigmatism (up to a maximum of -5 D). However, results were better in lower hyperopia (up to +3 D) than in the moderate hyperopia. The refractive results showed overall a good stability during the 12-month study period, but higher regression occurred in a few cases.

The ischemic type of central retinal vein occlusion (CRVO) is associated with a poor visual and ocular prognosis. Although several reports have indicated that hemodilution or thrombolytic therapy may be of benefit, there is still no consensus among ophthalmologists about the management of this disorder. In our study, we retrospectively evaluated the visual outcome after medical treatment in 58 patients with ischemic CRVO and severe visual loss (≤20/50). We separately investigated three different groups, depending on the following criteria: onset of symptoms within 11 days prior to admission and thrombolytic treatment with 50 mg of recombinant tissue plasminogen activator (rtPA) and intravenous heparinization (n = 23) or hemodilution therapy (n = 22) or onset of symptoms >11 days before the initial visit and hemodilution (n = 13). An advancement of 2 or more lines on the logarithmic visual acuity chart was noted in 10 cases (44%) in the rtPA group and in 3 subjects (14%) in the early-phase hemodilution group, whereas only 1 patient in the late-phase hemodilution group showed a comparable improvement. Our findings suggest that treatment with low-dose rtPA or hemodilution aimed at early restoration of blood flow has the potential to improve the visual prognosis in ischemic CRVO. The finding that thrombolysis had a favorable outcome supports the hypothesis that specific subgroups of patients may benefit from this therapeutic approach. Further investigation will be required to definitively prove the effectiveness of fibrinolytic agents.

Purpose: To evaluate the efficacy and safety of intracameral recombinant tissueplasminogen activator (rt-PA) application for fibrinolysis of fibrin formation after cataract surgery in children. Setting: Johann Wolfgang Goethe-University, Department of Ophthalmology; Frankfurt am Main, Germany. Methods: This study comprised 11 eyes of 10 patients aged 3 to 13 years (mean7.2 ± 3.68 [SD]) who developed severe fibrin formation after cataract surgery and IOL implantation despite intensive topical steroid therapy. Under general anesthesia, fibrinolysis was performed with 10 μg of rt-PA 7.18 ± 2.04 days after intraocular surgery. Follow-up included slitlamp examination, tonometry, visual acuity testing, and ophthalmoscopy. Anterior chamber flare measurements could be performed in 6 eyes. Results: Complete resolution of fibrin formations occurred in 90% of the patients. Inthese cases, no recurrent fibrinous reaction or adverse effects were noted. In 2 eyes of the same patient with a history of juvenile rheumatoid arthritis and chronic uveitis, fibrin clot dissolution was incomplete. A recurrent fibrinous formation could be observed after 2 and 4 weeks, respectively. A beginning band kenatopathy excluding the central and limbal cornea, was noted after 6 and 8 weeks, respectively. Conclusion: Intraocular application of rt-PA 'appears to be a safe and efficacious therapeutic approach in the management of severe fibrinous reactions after pediatric cataract surgery.

Der VISX-20/20-Excimerlaser erlaubt die kontrollierte Ablation kornealen Gewebes zur Korrektur astigmatischer Fehlsichtigkeiten. Bei einem Ausgangsastigmatismus bis 1,5 dpt war 1 Jahr postoperativ eine Astigmatismusreduktion von 36%, bei einem Ausgangsastigmatismus zwischen 1,75 und 3,0 dpt von 66,5% und bei einem Ausgangszylinder von 3,25-5,5 dpt von 68% erzielbar. In der Gruppe mit niedrigem Ausgangsastigmatismus zeigten sich geringe operativ induzierte Astigmatismuswerte, wohingegen bei hoheren Ausgangsastigmatismen mittel- bis hochgradige operativ induzierte Astigmatismuswerte nachweisbar waren. Der Streubereich nahm dabei mit Hohe des Ausgangsastigmatismus zu. Es trat eine mittlere Achsenverschiebung von 22,12±23,08 Grad auf. Insgesamt zeichnete sich 1 Jahr postoperativ jedoch eine deutliche Tendenz zur Unterkorrektur und Regression ab. Die Refraktion des Astigmatismus bestatigte, das in der Gruppe mit geringem Ausgangsastigmatismus auch geringe Astigmatismen postoperativ bestehen bleiben, wohingegen bei hoheren Astigmatismen mittelgradige Restastigmatismen zu erwarten sind.

Einleitung: Hohe Astigmatismuswerte nach perforierender Keratoplastik konnen das Operationsergebnis bei klarem Transplantat erheblich einschranken. Bisher bekannte operative Verfahren zur Astigmatismusreduzierung konnten sich wegen der masigen refraktiven Vorhersehbarkeit bisher nicht etablieren. Mit der photorefraktiven Excimerlaserkeratektomie steht ein neuartiges Behandlungsverfahren zur Verfugung.

Die photorefraktive Keratektomie (PRK) von Myopien und myopem Astigmatismus ist bis zu einem spharischen Aquivalent von -6 dpt eine zuverlassige Methode, die in uber 80 % der Falle ein sehr gutes postoperatives Ergebnis mit einer sehr hohen Patientenzufriedenheit ergibt. Trotz optimaler Vorbereitung, Behandlung und Nachbetreuung der Patienten gibt es jedoch Falle, die mit unerwunschten Effekten verbunden sind: 12 Monate postoperativ fanden wir eine Unterkorrektur > -1 dpt bei 24%, eine Uberkorrektur > +1 dpt bei 3% der Augen. Bei 4,5% der Augen beobachteten wir eine Verminderung der bestkorrigierten Sehscharfe (BCVA) um mindestens 2 Visusstufen. Bei 11,4% zeigte sich postoperativ eine Verminderung des Blendvisus im Vergleich zur BCVA. Knapp 26% der Augen konnten postoperativ, bei normalen Ausgangswerten, nicht mehr die Kontraststufe 1:2,7 erkennen. Hornhauttrubungen > Grad 2 fanden wir postoperativ bei 9% und Dezentrierungen um 1–1,5 mm bei 6% der Augen. Wegen der Moglichkeit der Verschlechterung der Dammerungssehscharfe und des Blendvisus sollte eine Indikation zur PRK z. B. bei Berufskraftfahrern sehr kritisch gestellt werden.

Die Moglichkeit der optischen Rehabilitation nach einer perforierenden Keratoplastik (PKP) ist bei einem hohen Astigmatismus vermindert. Von 1990–1992 wurde an 9 Patientinnen im Alter von 68 ± 19 Jahren zur Astigmatismusreduktion nach PKP mit einfach fortlaufender Hornhautnaht eine Nahtkorrektur („suture adjustment“) durchgefuhrt. Hierbei kam es aufgrund der induzierten Umverteilung der Fadenspannung zu einer statistisch hochsignifikanten Astigmatismusreduktion von im Mittel praoperativ 11,0 ± 2,8 dpt auf postoperativ 3,7 ± 0,1 dpt (p < 0,001). Nach Fadenentfernung kam es zu keiner signifikanten Astigmatismusanderung mehr, so das bei einem Nachbeobachtungszeitraum von 54 ± 13,5 Monaten von einem langzeitstabilen Effekt auszugehen ist. Komplikationen wie eine Astigmatismuserhohung, Fadenruptur oder Keratitis traten nicht auf, so das die fruh-postoperative Astigmatismuskorrektur mittels Nahtkorrektur eine sichere und langzeitstabile Behandlungsmethode darstellt.

TPA („tissue plasminogen activator“) wird in der internistischen Fibrinolysetherapie bei Gefasverschlussen seit Jahren als Standardtherapeutikum angewendet. In der Ophthalmologie bietet sich der Einsatz des Gewebsplasminogenaktivators zur Behandlung von okularen Gefasverschlussen insbesondere aber auch als lokales Fibrinolytikum zur Therapie intraokularer fibrinoser Reizzustande an. TPA ist der wichtigste physiologische Plasminaktivator im Gefassystem, katalysiert die Umwandlung von Plasminogen in Plasmin und fordert hierdurch die Fibrinolyse. Als Therapeutikum steht rt-PA, ein gentechnologisch hergestellter Plasminogenaktivator zur Verfugung. In einer Dosierung von 10 µg lassen sich gute Ergebnisse bei der Behandlung fibrinbedingter Reizzustande unterschiedlicher Atiologie im vorderen Augenabschnitt erzielen. In diesem Ubersichtsartikel werden die Physiologie des TPA, ein historischer Uberblick uber die Anwendung am Auge, Technik und Indikationen fur den Einsatz im vorderen Augenabschnitt sowie mogliche Weiterentwicklungen dieses fibrinolytischen Therapiekonzeptes dargestellt. Die bisherigen Ergebnisse zeigen, das mit dem rt-PA ein effizientes, sicheres und komplikationsarmes Fibrinolytikum zur intraokularen Anwendung am vorderen Augenabschnitt zur Verfugung steht.

Hohe Astigmatismen nach perforierender Keratoplastik erschweren trotz klaren Hornhautransplantates die optische Rehabilitation des Patienten.

Bei 46 Augen von 42 Patienten wurde nach zirkularer Kapsulorhexis und Phakoemulsifikation eine one-piece-Hinterkammerlinse aus PMMA in den Kapselsack implantiert. Am 2. postoperativen Tag und zwischen dem 6. und 9. postoperativen Monat wurde photographisch in maximaler medikamentoser Mydriasis die Position der Hinterkammerlinse im Bezug zur Pupillenmitte bestimmt. Die durchschnittliche Dezentrierung der Intraokularlinse stieg von 0,24 mm nach 2 Tagen auf 0,27 mm nach 6 Monaten bei einem maximalen Wert von 0,65 mm an. 94% der Intraokularlinsen waren nach 6 Monaten weniger als 0,5 mm dezentriert. In der Horizontalen waren 6 Monate postoperativ 70% der Hinterkammerlinsen nach nasal und in der Vertikalen 78% nach oben dezentriert. 55% der Hinterkammerlinsen verschoben sich aus ihrer anfanglichen postoperativen Lage innerhalb der ersten 6 Monate durch Kontraktionsprozesse des Kapselsacks um mittlere 0,16 mm nach nasal. 27% um mittlere 0,11 mm nach temporal. Diejenigen Linsen, deren Optik zirkular vom vorderen Kapselrand uberlappt war, wiesen die relativ geringste Dezentrierung auf.

Cataract patients and healthy subjects have been examined with the Miller-Nadler Glare-Tester to prove if the results of the glare test show any correlation between the glare disability score and the outdoor visual acuity facing sun. The outdoor vision of cataract patients with a high glare disability score was clearly impaired compared with their indoor vision. Healthy eyes with a normal glare disability score did not show any impairment of visual acuity facing sun. The results of the glare disability examination can therefore be used as a reference for the decision of a cataract operation.