A comparison of tear lysozyme and tear secretory IgA, determined by micropipette sampling and immunoassay technique, between 18 long-term contact lens wearers (median age 35 years, median lysozyme concentration 1.93 g/l, median IgA concentration 0.72 g/l) and 42 non-contact lens wearers (median age 41 years, median lysozyme concentration 2.21 g/l, median IgA concentration 2.42 g/l) disclosed a significant decrease (P less than 0.01) of secretory IgA in the contact lens group. The decrease of secretory IgA was associated (P less than 0.01) with the presence of deposits on lens surface. No differences in lysozyme concentration was found between the two groups (P greater than 0.05). The duration of lens wear was 8.5 years in average ranging from 1 to 23 years. These findings of decreased secretory IgA might partly explain the fact that contact lens wearers are more exposed to infectious corneal and conjunctival complications than non-contact lens wearers.

In 64 patients treated with timolol eye drops (0.25% and 0.50%) seven patients developed transitory sensation of dry eyes. Two of these subjects also had xerostomia. Conjunctival and corneal defects were disclosed simultaneously with rose bengal staining. Morphologically, some of these lesions might have the same appearance as of the early stages of kerato-conjunctivitis sicca. A reduction of Schirmer test and break-up time was noted. The duration of symptoms ranged from 3 to 13 days. The mean time of treatment at the début of symptoms was 30 weeks (range 23--43 weeks). A pathogenesis of these seemingly harmless findings is at the present obscure. In none of our patients was the treatment discontinued and the symptoms did not reappear.

The corneal thickness and the specular appearance of the corneal endothelium are reported in 100 patients with unilateral intraocular lens implantation. Post-operative time ranged from one to 42 months. An average central endothelial cell loss of uncomplicated cases of 46%, range 1 to 83%, with no correlation with time after the operation was found. A significantly higher cell loss was found in cases with technical complications, shallow anterior chamber or increased intraocular pressure post-operatively. No correlation was found between the corneal thickness and the endothelial cell loss. In two patients, however, with a cell density below 500 cells/mm2, a slight increase in corneal thickness was noted. Thirty patients presented a guttate endothelium. Irrespective of the occurrence of surgical complications the presence of a guttate endothelium was found to be a major determinant of the corneal thickness increase and could be ascribed as a cause of persistent corneal swelling in six of twelve patients with elevated corneal thickness. The progression of guttate changes occurred independently of the cell loss.

Determination of tear lysozyme, alfa-1-antitrypsin and serum albumin was performed in the tear fluid of 24 glaucoma patients on maintenance treatment with timolol. In 7 patients with symptoms of dry eye decreased levels of tear lysozyme and increased levels of alfa-1-antitrypsin and serum albumin were disclosed in contrast to 17 timolol treated patients without dry eyes and to healthy controls. The timolol treated patients with ocular dryness also showed hyperosmolality of tear fluid, abnormal corneal staining with rose bengal and decreased break-up time and Schirmer-I-test. It is concluded that decreased concentration of tear lysozyme in glaucoma patients on topical treatment with timolol may indicate some impairment of the tear gland function provoked by the treatment.

In 287 consecutively intracapsular cataract extracted eyes with a Federow intraocular lens implant (IOL) and 290 eyes with consecutively performed intracapsular cataract extractions (ICCE) the final visual outcome and complications were examined in a retrospective study. The average observation time was 31 months in the IOL group and 37 months in the ICCE group. Seventy-five per cent in the IOL group and 77% in the ICCE group achieved a visual acuity greater than or equal to 0.5. The main cause of a visual acuity less than 0.5 was maculopathy pre-operatively recognized. A visual acuity less than 0.5 due to post-operative complications occurred more frequently in the IOL group (28 eyes) compared with the ICCE group (13 eyes) - P less than 0.01. Twelve intraocular implants (4.3%) had to be removed. The most important cause was dislocation of the IOL (9 eyes). During our first 12 months of IOL implantation 8 dislocations occurred out of 56 implanted eyes (14.3%). The remaining 6 dislocations occurred among the last 231 IOL eyes (2.6%). It is concluded that complications are few, but often serious in intraocular lens implant surgery. Careful pre-operative examination and surgical experience are mandatory.