Zusammenfassung Fragestellung Bestimmung der Enukleationsrate sowie der Auswirkungen der COVID-19-Pandemie auf diese in Deutschland. Methodik Für die Bestimmung der Enukleationsraten der Jahre 2019 und 2020 in Deutschland erfolgten der Export der Prozedurenschlüssel 5‑163.0 bis 5‑163.23 und 5‑163.x aus dem Diagnosis Related Group(DRG)-Register und die statistische Auswertung dieser Daten. Ergebnisse Die Zahl der Enukleationen verringerte sich 2020 um 16,6 % im Vergleich zu 2019 von 1295 auf 1080 Fälle (p = 0,17); 54,1 % der Patienten waren männlich. Im Jahr 2019 waren 53 % der Patienten zum Zeitpunkt der Enukleation älter als 65 Jahre, im Jahr 2020 56 % der Fälle. Die häufigste Indikation zur Enukleation war in beiden Jahren Phthisis bulbi (n = 373 bzw. n = 307) mit 29,7 % der Fälle, gefolgt von Malignomen der Aderhaut (24 %). Die Enukleation mit gleichzeitigem Einbringen eines alloplastischen Augenhöhlenimplantats in die Tenonkapsel stellte das häufigste Verfahren dar (38,7 % kombinierter 2‑Jahres-Durchschnitt), gefolgt von einer umhüllten Variante (26,6 %) und einem bulbären Implantat aus nichtresorbierbaren mikroporösen Materialien (16,8 %), ohne signifikante Veränderung zwischen den Jahren. Enukleationen ohne Einbringen eines Implantats stiegen von 7,8 % im Jahr 2019 auf 11,1 % im Jahr 2020 (p = 0,006). Der Anteil der Patienten, die sich einer Reoperation unterziehen mussten, stieg leicht von 5,6 auf 8 % (p = 0,018). Die meisten Eingriffe (65,6 %) wurden in großen öffentlichen Krankenhäusern (≥ 1000 Betten) durchgeführt. Schlussfolgerungen Trotz des Rückgangs der Gesamtzahl der durchgeführten Eingriffe wurde die Enukleationsrate in Deutschland durch die COVID-19-Pandemie nicht signifikant verändert. Die Enukleationsrate ohne Implantate und Reoperationen nahm signifikant zu.

Purpose: to evaluate the clinical significance of intraoperative spectral domain optical coherence tomography (iOCT) in cataract surgery with implantation of different types of intraocular lenses (IOL). Methods: In this retrospective observational study, the iOCT image data of 151 cataract cases with different types of implanted IOLs were analysed. For intraoperative imaging a Rescan® 700 was used and the following image criteria were traced: standard surgical steps, IOL optic position, IOL haptic position. Patient eyes were divided into: group 1: n = 101 eyes with lens‐in‐bag (LIB); group 2: n = 15 eyes with bag‐in‐the‐lens IOL (BIL); group 3: 5 eyes with iris‐claw IOL (ICL); group 4: 15 eyes with intrascleral fixated 3‐piece IOL (3‐IOL); group 5: 15 eyes with intrascleral fixated Carlevale IOL (C‐IOL). The data were post‐processed and evaluated statistically. Results: iOCT enabled an additional control of subsequent surgical steps in all studied cases: LIB: the completeness of hydrodissection and hydrodelineation, condition of hydrated paracentesis (in 11% of cases ‐ an incomplete adaptation of paracentesis); BIL: separation of anterior hyaloid and correct implantation of capsular edges into the IOL; ICL: thickness of the iris fold between IOL claws; 3‐IOL/C‐IOL: the position of optic with regard to the iris and position of the haptic in the intrascleral space. Conclusions: The application of iOCT assisted cataract surgery with different IOLs generates useful live data that potentially reduce the risks of intra‐ and postoperative complications (posterior capsule rupture, hypotony, etc.). It can confirm the correct positioning of alternative IOL types intraoperatively, which is crucial to facilitate an optimal IOL performance. The use of iOCT shall be considered during learning process in cataract surgery.

Purpose: To analyse the clinical significance of signal shadowing during intraoperative optical coherence tomography (iOCT) assisted vitreoretinal surgery (PPV) caused by vitreoretinal instruments (VRI), dyes, and vitreous substitutes and to quantify its impact on iOCT imaging. Methods: In this retrospective observational study, imaging data from thirty‐five (35) patients undergoing an iOCT‐assisted PPV with Rescan® 700 (Zeiss, Oberkochen, Germany) were analysed. The iOCT image data were divided into three groups: VRI (17 cases), tissue dyes (8 cases), and vitreous substitutes (10 cases). The images were then post‐processed using a graphic software (histogram, grey level (GL)) and compared with paired image controls without clinically perceptive interference to measure the grade of picture quality distortion. Data were statistically analysed. Results: The intraocular portion of all VRI caused a high average GL interference compared to controls (26.9 ± 2.3 vs. 35.9 ± 0.83; p < 0.05), obscuring the area of interest. The instruments' tips produced a low‐grade shadowing, allowing the underlying tissue to be distinguished. The stains analysed demonstrated a wide interference range, indocyanine green (9.2 ± 1.4) and triamcinolon acetonide (13.9 ± 10.0) showed a high shadowing, while lutein‐based dye (38.4 ± 6.4) and Brilliant Blue (39.9 ± 3.3) exhibited no significant distortion. All vitreous substitutes analysed showed an insignificant shadowing effect on iOCT (Air 42.9 ± 5.1, PFCL 46.0 ± 5.1 vs. 44.5 ± 0.32; p < 0.05). Conclusions: All intraocular instruments showed a significant image interference during iOCT assisted surgery. All dyes except Brilliant Blue produced additional shadowing effect compared to controls. Implementation of new imaging techniques or/and materials with low‐grade interference for surgical instruments could overcome a clinically relevant shadow effect on iOCT and maximize the technology's visual accuracy.