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Simulation of the influence of intrastromal corneal lenticule implantation
Poláchová, Martina ; Studený, Pavel (advisor) ; Rozsíval, Pavel (referee) ; Mahelková, Gabriela (referee)
SIMULATION OF INFLUENCE OF INTRASTROMAL CORNEAL LENTICULE IMPLANTATION Background: Corneal stromal lenticule is a part of corneal stroma, which arises as a by-product of a refractive procedure ReLex SMILE. Its implantation has successfully been used in treatment of wide spectrum of severe diagnoses such as nonhealing corneal defects or ectasia. There have also been published cases where the lenticule was used in refractive indication such as hyperopia or presbyopia correction. In these indications, a greater emphasis on the refractive outcome is necessary, however, there is still not enough data available on the basis of which we would be able to choose the most suitable lenticule for a specific patient. Purpose: To evaluate changes in corneal refractive parameters after implantation of a stromal lenticule of different thickness. We assume that the refractive outcome depends on optical power of the used lenticule. The other important goal is to analyse possible methods of corneal lenticule preparation and storage and prove the possibility of using one donor cornea for more patients. We want to build a safe approach which would increase the efficiency of the surgery and shorten the waiting time for donor corneal tissue. Methods: We performed an ex vivo non-human study on normotonic porcine eyeballs...
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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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název v anglickém jazyce není uveden
Vítová, Andrea ; Filipec, Martin (advisor) ; Rozsíval, Pavel (referee) ; Stříž, Ilja (referee)
ZÁVĚR 1) Naše výsledky rozšířily pohled na obranné mechanismy zajišťované buňkami rohovkové tkáně o schopnost stromálních buněk rohovky selektivně potlačovat produkci některých (IL-4 a IL-10) protizánětlivých cytokinů. 2) Porovnáním účinnosti léčby imunosupresivními léky nebo mAb u dvou rizikových modelů myších příjemců jsme zjistili, že pro prevenci rejekce rohovkového alotransplantátů je efektivnější léčba mAb proti CD4+ buňkám než mAb proti CD8+ buňkám či imunosupresivními léky MMF, CsA nebo jejich kombinací. Léčba pomocí mAb byla efektivní pouze u příjemců s prevaskularizací rohovky. 3) Podávání séra s obsahem cytotoxických protilátek specifických proti antigenům dárce urychlilo nástup rejekce a významně zkrátilo přežívání alotransplantátů i xenotransplantátů rohovky. Z výsledků vyplývá, že na procesu rejekce aloi xenotransplantátů rohovky se může přímo podílet protilátkami zprostředkovaná imunitní odpověď. 4) Analýzou syngenních a xenogenních transplantátů rohovky ve zvolených obdobích po transplantaci jsme zjistili, že IFN-y a NO hraje podstatnou roli při rejekci rohovkových xenotransplantátů, zatímco exprese genů pro IL-2, IL-4 a IL-10 není pro rejekci vyžadována. Tato dizertační práce se zabývala molekulárními a buněčnými mechanismy probíhajícími ve zdravé a rejekované rohovkové tkáni. Pochopení...
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The role of microorganisms and other factors in the process of autoimmune uveitis
Dušek, Otakar ; Heissigerová, Jarmila (advisor) ; Rozsíval, Pavel (referee) ; Krulová, Magdaléna (referee)
The role of microorganisms and other factors in the process of autoimmune uveitis Abstract The aim of this work was to gain new knowledge about the influence and the mechanisms of the effect of microorganisms in the process of autoimmune uveitis. A mouse model of experimental autoimmune uveitis (EAU) was used and the influence of oral broad-spectrum antibiotic, i.e. metronidazole, as well as probiotic bacteria Escherichia coli O83:K24:H31 (EcO) nad Escherichia coli Nissle 1917 (EcN) were tested in preventive and therapeutic regimens. The grade of inflammation was assessed clinically in vivo and histologically post mortem. Immunological analysis of lymph nodes and Peyer's patches were performed. Evaluation of the effect of metronidazole proved significant reduction of inflammatory activity in both regimes - intitiation 1 week or 2 weeks before the EAU induction. In case of probiotics, protective effect was proved only in case of live EcN administered 2 weeks before or from the time of EAU induction. Its protective effect was accompanied with decreased interphotoreceptor retinoid-binding protein (IRBP)-specific T-lymphocyte response in the sentinel lymph nodes of the site of immunization 7 days after the induction of EAU and cervical lymph nodes as soon as there were apparent clinical signs of intraocular...
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Vitreoretinal interface in relation to surgery on macular disorders
Kalvoda, Jan ; Dušková, Jaroslava (advisor) ; Dotřelová, Dagmar (referee) ; Rozsíval, Pavel (referee)
1 Abstract Introduction The vitreoretinal (VR) interface of the eye is a dynamically evolving environment which significantly influences and indicates the course of macular disorders. The main topic of the presented paper is research on the VR interface in relation to surgery on diabetic macular edema (ME), partial macular defects (PMD) and idiopathic macular holes (IMH). Aims The aims of the research were to find out new knowledge about specific characteristics of and changes in the VR interface in eyes with diabetic ME, PMD and IMH, namely with main attention focused on the internal limiting membrane (ILM) of the retina and the epimacular membrane (EMM). Methods Histopathologic and morphometric analyses were carried out on samples of the ILM of the retina and the EMM which were taken during pars plana vitrectomy (PPV) of eyes of sets of patients with diabetic ME, PMD and IMH. The analytic results were statistically evaluated and interpreted in relation to clinical factors and anatomical results of the PPV. Results Treatment of diabetic ME with removal of the ILM resulted in improved visual acuity (VA), at minimum 2 lines on the ETDRS table, in 51.8% surgically treated eyes and remained the same in 33.9% of eyes. A comparison study confirmed that PPV with preserving of the ILM achieved a long-term...
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Study of immunopathological mechanisms of autoimmune uveitis and the determination of new therapeutical options.
Seidler Štangová, Petra ; Svozílková, Petra (advisor) ; Rozsíval, Pavel (referee) ; Farghali, Hassan (referee)
The aim of this work was to gain new knowledge about mechanisms of autoimmune uveitis and to test new therapeutic possibilities that have not yet been studied in uveitis or whose effect is questionable. The main emphasis was placed on the role of microorganisms in the process of uveitis. A mouse model of experimental autoimmune uveitis including a germ-free model was used to achieve the aims and samples of patients' intraocular fluids were analyzed. In the experimental model, the intensity of inflammation was evaluated in vivo clinically and post mortem histologically. The effect of immunomodulatory treatment was evaluated. The intensity of inflammation was compared between groups of germ-free and conventional mice. The therapeutic effect of antibiotics administered to affect microbiome was investigated in conventional mice. In intraocular fluid samples of patients with autoimmune uveitis signs of infection were monitored and levels of cytokines and other factors were evaluated. Evaluation of the effect of immunomodulatory therapy has demonstrated the efficacy of mycophenolate mofetil, which supports its wider use in the treatment of autoimmune posterior uveitis in human medicine. The decrease in bacterial load has led to a decrease in the intensity of inflammation, thereby confirming the importance 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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Postoperative care for patiens after vitrectomy with focus on secondary glaucoma
Procházková, Lidmila ; Rozsíval, Pavel (advisor) ; Těšínský, Pavel (referee) ; Hlinomazová, Zuzana (referee)
Postoperative care for patiens after vitrectomy with focus on secondary glaucoma The first part of the thesis discusses the relationship between the occurence of secondary glaucoma (SG) after pars plana vitrectomy (PPV) and individual surgical techniques, taking into consideration functional outcomes of the treatment - visual acuity and intraocular pressure (IOP). SG after PPV occurred in 126 eyes, i.e. in 16,5%. In all patients with SG a meticulous ocular examination was carried out after 3, 6, 12 and 18 months, and a final examination after 43,6 months. Overall 69% of eyes with SG underwent a PPV because of retinal detachment and 19,8% because of vitreous hemorrhage. High viscosity silicon oil tamponade (SO) was employed in 75,4% of eyes, low viscosity tamponade in mere 1,6% of eyes, a tamponade by SF6 gas in 10,3% of eyes and by BSS solution in 12,7% of eyes. Following are the functional outcomes of the treatment: a) visual acuity improved from 0,1 to 0,2, however, by the final examination we registered an increase of incerta caused by decompensation of eyes with secondary neovascular glaucoma (SNVG); b) after a year 74,6% of eyes showed a stabilized IOP of ≤ 22 mm Hg, after 18 months 76,7% and by the final examination 81,8%; c) by the final examination 26,4% of eyes did not require any...
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