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Issues in local and systemic side effects of chemotherapeutics after their experimental intraocular and periocular delivery
Petrušková, Denisa ; Dotřelová, Dagmar (advisor) ; Baráková, Drahomíra (referee) ; Jirásková, Naďa (referee)
achieving control over retinoblastoma cells floating within the vitreous cavity in advanced retinoblastoma of grade C, D and E. Periocular and intravitreal drug injection is a promissing route for maximum bioavailability to the vitreous but it requires a well defined dose for achieving tumor control while limited toxicity to the ocular structures. Objective: 1. Experimentally evaluate local ocular toxicity of carboplatin and topotecan on the model of rabbit eye after periocular and intravitreal administration. 2. To evaluate the clinival applicability of the new method of intravitreal application of chemotherapeutics using transcorneal approach. Material and methods: In vivo experiment was conducted on the model of 54 New Zealand White rabbits, which were dividend into groups of six rabbits according to protocol. Only right eyes were applicated and received: 1. periocular carboplatin at a dose of 15 mg and 30 mg and periocular topotecan at a dose of 2 mg, 2. intravitreal carboplatin at a dose od 0,05 mg a 0,008 mg and intravitreal topotecan at a dose of 1 μg a 2 μg. Left eyes received the same amount of saline. Concentrations of carboplatin in the vitreous humor and plasma were determined by atomic absorption analysis, topotecan concentrations by high performance liquid chromatography and concentrations of...
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Femtosecond Laser in Lower and Higher Myopia
Kacerovská, Jana ; Rozsíval, Pavel (advisor) ; Vlková, Eva (referee) ; Baráková, Drahomíra (referee)
2. SUMMARY Goal: The goal of this study was to evaluate the results and the efficiency of laser interventions where we use the femtosecond laser - FS-LASIK and ReLEx SMILE. We performed a retrospective data analysis by comparing the post-operational visual acuity development in a group of one hundred patients with lower and higher myopia and astigmatism. We also compared the influence of laser on the tear film and the macular thickness. Method: The studied cohort of patients consisted of two major groups. The first group included patients with lower myopia and the second group included patients with higher myopia. In each group, one half of the patients underwent the femtoLASIK surgery and the other half underwent the ReLEx SMILE surgery. We thus observed 50 patients (100 eyes) with lower myopia and 50 patients (100 eyes) with higher myopia. In the retrospective data analysis, we included patients younger than 45 years with the spherical equivalent of the myopic refractive error ranging from -0,75 to -4,12, concerning the group suffering from lower myopia, and ranging from -6,25 to -11,5, concerning the group suffering from higher myopia. Before the operations, we measured the uncorrected visual acuity of 1,0 in all patients. Results: During post-surgical check-ups, the values of uncorrected visual acuity...
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Changes in the Anterior Segment after 25G+PPV
Kopecký, Adam ; Pašta, Jiří (advisor) ; Baráková, Drahomíra (referee) ; Studený, Pavel (referee)
Univerzita Karlova 1. lékařská fakulta Studijní program: Zobrazovací metody v lékařství (P5150) Studijní obor: Zobrazovací metody v lékařství (5103V000) MUDr. Adam Kopecký Změny na předním segmentu po 25G+ PPV Changes in the Anterior Segment after 25G+ PPV Abstract Vedoucí závěrečné práce/Školitel: doc. MUDr. Jiří Pašta, CSc., FEBO Praha, 2019 Abstract: Pars plana vitrectomy is a dominant surgical method in posterior segment surgery of the eye. The principle of this method is the surgical approach via the pars plana anatomical region. With this approach, surgeon performs the posterior segment surgery without directly affecting the anterior segment of the eye. Short-term effect of pars plana vitrectomy on the anterior segment of the eye has been repeatedly proven. That might be an important factor both in assessing the complications of this method and planning the surgery in complicated patients. Generally, it is presumed that we do not observe long-term effects on anterior segment after pars plana vitrectomy. The aim of our work is to evaluate the long-term changes in the anterior segment after the uncomplicated 25G + PPV with gas tamponde. The group of 20 patients was selected according to strict indication criteria. Using a series of examinations, we examined specific parameters such as: intraocular...
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Evaluation of cytostatic in vitreal space of rabbit eye after subconunstival and transcorneal administration
Pochop, Pavel ; Vajner, Luděk (advisor) ; Baráková, Drahomíra (referee) ; Gerinec, Anton (referee)
The aim of this study was to determine platinum (Pt) and etoposide concentrations and area under the concentration versus timecurve (AUC) of the vitreous humor after periocular or transcorneal intravitreal administration of carboplatin in rabbits and to characterize the extent of toxicity of local carboplatin administration. New Zealand White male rabbits were treated with: a single periocular injection of 15 mg of carboplatin (group I, n=6), a single periocular injection of 30 mg of carboplatin (group II, n=6), a single transcorneal intravitreal injection of 0.05 mg of carboplatin (group III, n=6) and then repeated injections of 0.05 mg (group IV, n=6) and 0.008 mg (group V, n=6). Periocular injections of 2.5 mg (group VI, n=6) and intravitreal injections of 0.5 mg (group VII, n=6) of etoposide were administered in the same way. Vitreous sampling under dissociative anaesthesia were performed at 1 h, 2 h, 6 h, in 1, 2 and 7 days and in 2 (groups I, III, VI and VII) or 3 (group II) weeks. Carboplatin and etoposide concentrations in vitreous and plasma samples were assessed. Clinical and histological evidence of toxicity was graded as four grades. Periocular administration fails to achieve therapeutic levels of chemotherapeutics in the vitreous of rabbits. We found therapeutic levels in the vitreous by...
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Implantation of artificial corneas AlphaCor and KeraKlear in patients with severe corneal disorder: long-term outcomes
Burova, Mariya ; Jirásková, Naďa (advisor) ; Těšínský, Pavel (referee) ; Baráková, Drahomíra (referee)
Implantation of artificial corneas AlphaCor and KeraKlear in patients with severe corneal disorder: long-term outcomes. Purpose: To assess the long-term results of AlphaCor and KeraKlear implantation, to evaluate the main complications and risk factors. Methods: An artificial cornea AlphaCor was implanted in 15 eyes of 15 patients. KeraKlear has been used in 4 eyes of 4 patients. All patients before the surgery were examined in detail. The evaluation of best corrected visual acuity (BCVA) and slit-lamp examination of anterior segment of the eye were performed. The status of posterior segment of the eye was assessed with B-scan ocular ultrasaund examination. Corneal pachymetry was performed in patients before the KeraKlear implantation. Digital photographs of anterior segment of the eye in all cases were obtained. Intraocular pressure (IOP) was satisfactory controlled before AlphaCor and KeraKlear surgery in all eyes. Postoperatively evaluation of BCVA and IOP, slit-lamp examination with digital photography of anterior segment of the eye and B-scan ocular ultrasaund examination were regularly performed. Results: Best corrected visual acuity after AlphaCor surgery ranged from hand movement to 0.8. The survival rate of the AlphaCor at 1, 2, 3 and 4 years was 80%, 53%, 40% and 27%, respectively. The...
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Evaluation of posterior capsule opacification after cataract surgery
Kalfeřtová, Marie ; Jirásková, Naďa (advisor) ; Baráková, Drahomíra (referee) ; Těšínský, Pavel (referee)
Purpose: To study effect of AquaLase method used for final management of posterior capsule during cataract surgery on the posterior capsule opacification (PCO) creation and to verify safety of this method for the corneal endothelium. Methods: The prospective clinical study involving 56 patients with bilateral cataract having lens removal at the Department of Ophthalmology, University Hospital Hradec Králové in the period from September 2007 to March 2009. During the surgery lens was removed using torsional phacoemulsification and bimanual irigation/aspiration. Cleaning of the posterior capsule of the right eye was performed using AquaLase method (Alcon Laboratories, Forth Worth, Texas, USA) based on pulsed warm, naturally balanced surgical solution. Intraocular lens AcrySof SA60AT was implanted bilaterally to all patients. All patients were examined preoperatively and 3, 6, 12 and 24 months after surgery. Each examination covered best corrected visual acuity (BCVA), endothelial cell count (ECC) and corneal pachymetry. Moreover postoperatively digital retroillumination photographs of the anterior segment focused on the posterior capsule were always obtained. The Evaluation of Posterior Capsule Opacification (EPCO 2000) software and the Open-Access Systematic Capsule Assessment (OSCA) system were used...
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The occurence of ocular disorders in patients with Turner syndrome
Brunnerová, Renáta ; Raiskup, Frederik (advisor) ; Baráková, Drahomíra (referee) ; Autrata, Rudolf (referee)
The occurrence of ocular disorders in patients with Turner syndrome Turner syndrome is among the most common chromosomal aberrations. It is caused by a missing or structural anomaly of one X chromosome, alternatively a chromosomal mosaicism. It is often connected with a more frequent occurrence of some ocular diseases. In our study 81 girls and women with Turner syndrome from the age of 5 to 23 years old were repeatedly examined. The occurrence of ocular diseases and their possible connection with karyotype was the main focus of our attention. Myopia (29 %) had the highest incidence in these girls, further there were hyperopia (24 %), epicanthus (20 %), colour vision deficiency (17 %), amblyopia (12 %), strabismus (10 %) and ptosis (5 %). Colour vision deficiency was defined as protanopia in 8.5 %, deuteranopia in 3.4 % and tritanopia in 5.2 %. The occurrence of colour vision deficiency was higher than in the general population where it differs in sexes. It is more often found in men. It is connected with the gene location for the red and green photo pigment which is localized on the long arm of the X chromosome. The occurrence of strabismus and ptosis was higher than in the general population. The total range of refractive errors was slightly higher than in the general population, with a different...
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Changes in the Anterior Segment after 25G+PPV
Kopecký, Adam ; Pašta, Jiří (advisor) ; Baráková, Drahomíra (referee) ; Studený, Pavel (referee)
Univerzita Karlova 1. lékařská fakulta Studijní program: Zobrazovací metody v lékařství (P5150) Studijní obor: Zobrazovací metody v lékařství (5103V000) MUDr. Adam Kopecký Změny na předním segmentu po 25G+ PPV Changes in the Anterior Segment after 25G+ PPV Abstract Vedoucí závěrečné práce/Školitel: doc. MUDr. Jiří Pašta, CSc., FEBO Praha, 2019 Abstract: Pars plana vitrectomy is a dominant surgical method in posterior segment surgery of the eye. The principle of this method is the surgical approach via the pars plana anatomical region. With this approach, surgeon performs the posterior segment surgery without directly affecting the anterior segment of the eye. Short-term effect of pars plana vitrectomy on the anterior segment of the eye has been repeatedly proven. That might be an important factor both in assessing the complications of this method and planning the surgery in complicated patients. Generally, it is presumed that we do not observe long-term effects on anterior segment after pars plana vitrectomy. The aim of our work is to evaluate the long-term changes in the anterior segment after the uncomplicated 25G + PPV with gas tamponde. The group of 20 patients was selected according to strict indication criteria. Using a series of examinations, we examined specific parameters such as: intraocular...
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Treatment of Keratoconus Using Accelerated Corneal Cross-Linking
Veliká, Věra ; Raiskup, Frederik (advisor) ; Pašta, Jiří (referee) ; Baráková, Drahomíra (referee)
Summary: Treatment of keratoconus using Accelerated Corneal Cross-Linking Aim: This study evaluates the efficacy of treatment of progressive keratoconus using Accelerated Corneal Cross-linking (ACXL) method. Methods: The study included 35 eyes of 32 patients, who underwent ACXL at the Deparment of Ophthalmology of University Hospital in Hradec Králové. Uncorrected distance visual acuity (UCVA), best corrected distance visual acuity (BCVA), flat and steep keratometry (K1, K2), maximum keratometry (Kmax), corneal astigmatism and corneal pachymetry in the thinnest location were measured preoperatively and in 6 months, 1 year and 2 years after the surgery. Results: There was not found the statistically significant difference between preoperative and postoperative values of UCVA, BCVA, K1 and Kmax. Steep keratometry (K2) and corneal astigmatism was statistically significant decreased. The pachymetry in the thinnest location was preoperatively 469 ± 33 μm. The value was statistically significant decreased in 6 month and 1 year after the surgery by comparison with preoperative value. 2 yaers postoperatively there was not the statistically significant difference by comparison with preoperative value. Conclusion: Our results in patients with progressive keratoconus found ACXL is an effective and safe method to treat...
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