Daniel M. Handzel

Augenzentrum Osthessen, Standort Fulda
Marktstr. 8
36037 Fulda
Tel. (0661) 21075
Fax (0661) 9019770

Augenärztliches Operationszentrum AOZ Fulda
Augendiagnostikzentrum Fulda
Kothenbachweg 2-4
36043 Fulda

dhandzel@augenaerzte-fulda.de

Daniel M. Handzel, FEBO is a Specialist in Ophthalmology and a Partner at the Group Practice – Augenärztliche Gemeinschaftspraxis Dr. Goebels und Dr. Handzel in Fulda (Augenzentrum Osthessen), Germany since July 2011. He is also a consultant to the Herz-Jesu-Krankenhaus Fulda (Hospital of the Sacred Heart).

Prior (September 2007 – July 2011), Daniel Handzel was the Ophthalmic Surgeon working at the Eye Clinic Dardenne, Germany – a national centre for ophthalmic surgery, most recently as Senior Physician and a Specialist in cataract and lens surgery and LASIK. His other interests include diagnosis and treatment of the disease group of the so-called "Dysfunctional Tear Syndrome". He is a member of the following professional societies: German Ophthalmological Society (DOG), Association of German Ophthalmic Surgeons (BDOC), German-speaking Society for Intraocular Lens Implantation, Interventional and Refractive Surgery (DGII), the European Society of Cataract and Refractive Surgeons (ESCRS) and others. After studying medicine at Marburg and Munich in 2004, Dr. Handzel was trained as a Specialist in ophthalmology at the University Eye Clinic in Bonn from 2004 till 2007.

Undergraduate education: Phillips-University Marburg, Germany and Ludwig-Maximilians-University, Munich

German Board Examination and European Board of Ophthalmology Diploma in 2009

Scientific Interest: Cataract Surgery, Refractive Surgery, under- and postgraduate medical education, Dysfunctional Tear syndrome, sports medicine and sports ophthalmology

Abstract: Localised distichiasis and trichiasis with resulting keratopathy leads to considerable impairment for the patient. We present a new technique which enables the surgeon to excise the lash with its follicle to prevent regrowth in a single movement. The procedure does not need any preparation, leaving the lid with minimal concomitant trauma which prevents recurrence of trichiasis. The excision is done with a dermatological biopsy punch (Kai Europe GmbH, Solingen, Germany). The punch is placed on the appropriate place perpendicular to the lid margin where the punch is driven 3-4 mm parallel to the lash. Histopathological diagnosis should be obtained not only to prove the principle of this technique: the entire biopsy material should be handed over to the pathologist as distichiasis and trichiasis can be the first sign of lid tumours. The presented technique of hair follicle excision with a biopsy punch is extremely effective. Success can be proven by the results of histological work-up of the biopsy material.

Abstract: The intraoperative floppy iris syndrome (IFIS) describes an ophthalmologically relevant phenomenon which is observed after systemic intake of alpha blockers for treatment of benign prostate hyperplasia. This leads to an increase in intraoperative complications in cataract surgery characterized by a flaccid iris which billows in response to currents with a tendency to prolapse towards the area of surgery. This results in damage to the iris by the instruments used or posterior capsule rupture with loss of lens material. We describe the preoperative and intraoperative measures and techniques to deal with this challenging situation in order to minimize development of IFIS and reduce the complication rate.

Abstract: This report concerns the case of a 10-year-old female patient with congenital ichthyosis who developed bilateral ectropion of the upper eyelids resulting in massive ocular surface alterations due to lagophthalmos. A complex surgical approach with partial excision, tarsal strip refixation and a free skin graft led to normalization of the eyelid positioning and healing of the ocular surface.


Journal articles

2013	DOI PMID D M Handzel, C Feretos, H Aral (2013) [Treatment of trichiasis and distichiasis with a biopsy punch -- an effective and practical method for eyelash follicle excision]. Klinische Monatsblätter für Augenheilkunde 230: 1. 43-45 Jan Abstract: Localised distichiasis and trichiasis with resulting keratopathy leads to considerable impairment for the patient. We present a new technique which enables the surgeon to excise the lash with its follicle to prevent regrowth in a single movement. The procedure does not need any preparation, leaving the lid with minimal concomitant trauma which prevents recurrence of trichiasis. The excision is done with a dermatological biopsy punch (Kai Europe GmbH, Solingen, Germany). The punch is placed on the appropriate place perpendicular to the lid margin where the punch is driven 3-4 mm parallel to the lash. Histopathological diagnosis should be obtained not only to prove the principle of this technique: the entire biopsy material should be handed over to the pathologist as distichiasis and trichiasis can be the first sign of lid tumours. The presented technique of hair follicle excision with a biopsy punch is extremely effective. Success can be proven by the results of histological work-up of the biopsy material. Notes:
	DOI PMID D M Handzel, S Rausch, T Kälble, S Briesen (2013) [Managing complications in intraoperative floppy iris syndrome]. Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft 110: 4. 365-369 Apr Abstract: The intraoperative floppy iris syndrome (IFIS) describes an ophthalmologically relevant phenomenon which is observed after systemic intake of alpha blockers for treatment of benign prostate hyperplasia. This leads to an increase in intraoperative complications in cataract surgery characterized by a flaccid iris which billows in response to currents with a tendency to prolapse towards the area of surgery. This results in damage to the iris by the instruments used or posterior capsule rupture with loss of lens material. We describe the preoperative and intraoperative measures and techniques to deal with this challenging situation in order to minimize development of IFIS and reduce the complication rate. Notes:
	DOI PMID D M Handzel, A A Zubcov-Iwantscheff, H Aral (2013) Lagophthalmos and ectropion of the upper eyelids in congenital ichthyosis. Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft epub ahead of print Apr 5 Abstract: This report concerns the case of a 10-year-old female patient with congenital ichthyosis who developed bilateral ectropion of the upper eyelids resulting in massive ocular surface alterations due to lagophthalmos. A complex surgical approach with partial excision, tarsal strip refixation and a free skin graft led to normalization of the eyelid positioning and healing of the ocular surface. Notes:
2012	DOI PMID D M Handzel (2012) [CME-certified online education in Germany - status in ophthalmology 2011]. Klin Monbl Augenheilkd 229: 6. 636-640 Jun Abstract: The use of the internet is becoming more and more important in every aspect of daily life, also in professional education. Online education and face-to-face learning have proven to be equally efficient. The aim of this study is to evaluate the amount of online education in the German-speaking internet 2011. Notes:
	DOI PMID Daniel M Handzel, Sebastian Briesen, Steffen Rausch, Tilman Kälble (2012) Cataract surgery in patients taking alpha-1 antagonists: know the risks, avoid the complications. Deutsches Ärzteblatt international 109: 21. 379-384 May Abstract: The growing use of alpha-1 receptor antagonists in the treatment of benign prostatic hyperplasia (BPH) has created a new problem in ophthalmic surgery, the so-called intraoperative floppy iris syndrome (IFIS). This consists of a billowing iris, insufficient pupillary dilation with progressive intraoperative miosis, and protrusion of iris tissue through the tunnel and side port incision that are made for access to the anterior chamber during surgery. IFIS presents particular difficulties in cataract surgery which is carried out through the pupil with manipulations in the immediate vicinity of the iris. The complications range from poor visibility of the operative field to iris damage with the surgical instruments and to rupture of the posterior capsule, with loss of lens material into the vitreous body. Notes:

	DOI PMID D M Handzel (2012) [Iritis with destabilization of the intraocular pressure due to dislocation of a posterior chamber intraocular lens]. Ophthalmologe 109: 4. 385-387 Apr Abstract: This report concerns the case of a 67-year-old male patient who underwent uncomplicated phacoemulsification with implantation of a posterior chamber intraocular lens (IOL). After an interval of 2 months the patient developed iritis together with an uncontrollable increase in intraocular pressure. After a detailed examination a dislocated haptic of the IOL was identified as the cause of the symptoms. The dislocation had led to uveitis-glaucoma-hyphema syndrome although no hemorrhage was observed. In addition to this complication the haptic had arroded the zonular complex which made implantation of an anterior chamber lens necessary. Although improvements in operating techniques, lens materials and designs have been made uveitis-glaucoma-hyphema syndrome has to be kept in mind. Surgical intervention is the only therapeutic option. Notes:
2011	D M Handzel, H Aral (2011) Nachsorge nach Lidoperationen – Revision oder Abwarten? Zeitschrift für praktische Augenheilkunde 32: 465–470 October Abstract: Notes:
	Daniel Handzel (2011) FEBO - Das europäische Facharztexamen Der Augenspiegel 57(9): 18 September Abstract: Notes:
	Daniel M Handzel, Sebastian Briesen (2011) Sub-Tenon-Injektion von Triamcinolon – Einsatz in der Behandlung des postoperativen cystoiden Makulaödems Der Augenspiegel 52: 5. 42 May Abstract: Notes:
	DOI PMID Rudolf Andreas Kristof, Daniel Kirchhofer, Daniel Handzel, Georg Neuloh, Johannes Schramm, Christian-Andreas Mueller, Nicole Eter (2011) Pre-existing chiasma syndromes do not entirely remit following transsphenoidal surgery for pituitary adenomas. Acta Neurochir (Wien) 153: 1. 26-32 Jan Abstract: It is not known whether following transsphenoidal surgery for pituitary adenomas the vision of patients with preoperative chiasma syndromes (CS) does improve to the degree of vision of patients without preoperative CS. Notes:
	DOI PMID Daniel M Handzel, L Hesse (2011) Web-based training in German university eye hospitals - Education 2.0? GMS Z Med Ausbild 28: 3. 08 Abstract: To analyse web-based training in ophthalmology offered by German university eye hospitals. Notes:
	DOI PMID D M Handzel, B V Stanzel, S Briesen (2011) [Complication cascade after hyperopic LASIK]. Ophthalmologe 108: 7. 665-668 Jul Abstract: This report concerns the case of a 28-year-old female patient who was treated with topical steroids for 2 years following complicated hyperopic LASIK surgery with a re-treatment including a re-lift of the flap. A steroid-induced rise in the intraocular pressure (IOP) was subsequently observed on the treated eye, together with a glaucomatous subtotal destruction of the optic nerve, resulting in a residual vision of 1/15. An erroneously low IOP measurement, which was probably the reason for the delay in detecting steroid-induced glaucoma, has been reported in several cases concerning LASIK patients. The reason for the unusually severe course in the case in question can only be presumed, namely a possible accumulation of fluid at the interface or altered biomechanics following hyperopic LASIK surgery. The need for a thorough postoperative examination following refractive surgery must be emphasized. This case shows a cascade of complications following hyperopic LASIK surgery resulting in the functional blindness of one eye. Notes:
	DOI PMID Sebastian Briesen, Daniel Martin Handzel, Raimund Remmel, Claudia Dardenne (2011) Usefulness of short-term data for evaluating cataract surgery outcomes. J Cataract Refract Surg 37: 1. 210-211 Jan Abstract: Notes:
	Daniel M Handzel, Sebastian Briesen, Claudia Dardenne, Raimund Remmel (2011) Datenerhebung zur Qualitätssicherung in der Ophthalmochirurgie – Je später, desto besser? Ophthalmo-Chirurgie 23: 85-92 Abstract: Notes:
2010	DOI PMID Rudolf A Kristof, Daniel Kirchhofer, Daniel Handzel, Georg Neuloh, Johannes Schramm, Christian-Andreas Mueller, Nicole Eter (2010) Functional impairments caused by chiasma syndromes prior to and following transsphenoidal pituitary adenoma surgery. Acta Neurochir (Wien) 152: 8. 1283-1290 Aug Abstract: To describe the functional impairment caused by chiasma syndromes (CS) prior to and following transsphenoidal pituitary adenoma surgery. Notes:
Book chapters

2005	Daniel Handzel (2005) Darf’s etwas mehr sein? – Mittel zur Stärkung der Potenz In: Tabletten, Tropfen und Tinkturen Edited by:C. Bartels, H. Göllner, J. Koolmann, E. Maser, K.-H. Röhm. 325-337 WILEY-VCH Verlag GmbH & Co. KGaA isbn:3-527-30263-8 Abstract: Notes:

Journal articles

Book chapters