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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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Assessment of the Efficacy of Photodynamic Therapy in Patients with Chronic Central Serous Chorioretinopathy
Myslík Manethová, Kateřina ; Jirásková, Naďa (advisor) ; Hejsek, Libor (referee) ; Chrapek, Oldřich (referee)
Assessment of the efficacy of photodynamic therapy in patients with chronic central serous chorioretinopathy The presented postgraduate thesis deals with the issue of macular edema based on central serous chorioretinopathy (CSC) and the current possibilities of therapeutic solution of this disease. Although in most cases central serous chorioretinopathy does not belong to frequent and vision-threatening diseases, it can, especially its chronic form, lead to impaired vision. The aim of the theoretical part of this work is to characterize this chorioretinal disease and describe the basic principles of treatment. The work also describes the pathogenesis of CSC, the examination methods, the up-to-date accepted CSC classification and the therapeutic modalities of the treatment of the disease. The clinical part of this work is a prospective study of 52 patients (54 eyes), aged 30- 75, with chronic form of central serous chorioretinopathy treated at the Eye Clinic of the 1st Faculty of Medicine of Charles University and Military University Hospital Prague in the years 2012 to 2018. The aim of this prospective study is to evaluate the anatomical and functional results of the treatment of 54 eyes with chronic form of central serous chorioretinopathy using photodynamic therapy in a reduced (half) dosing...
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Improvement in the Quality of Life in Patients with Stable Maculopathy by Scharioth Macula Lens Implantation and Visual Plasticity Modulation by Transcranial Electrical Stimulation
Středová, Markéta ; Jirásková, Naďa (advisor) ; Pašta, Jiří (referee) ; Skorkovská, Šárka (referee)
Improvement in the quality of life in patients with stable maculopathy by Scharioth macula lens implantation and visual plasticity modulation by transcranial electrical stimulation Aim: To evaluate the change in the quality of life in patients with stable maculopathy after Scharioth macula lens (SML) implantation followed by transcranial electrical stimulation (tES) and visual rehabilitation. Methods: Our prospective study included 14 patients with dry age-related macular degeneration (AMD) who underwent SML implantation from May 2018 to September 2019 at the Ophthalmology Clinic of the University Hospital in Hradec Kralove. The follow-up period was 6 months. The evaluated parameters were distant best corrected visual acuity (BCVA), near uncorrected visual acuity (UNCVA), intraocular pressure (IOP), central retinal thickness (CRT) and visual plasticity in the form of visual evoked potentials (VEP). The occurence of any complications and subjective satisfaction were also assessed. Results: The mean preoperative distant BCVA was 0.23 ± 0.09 and 0.17 ± 0.06 at 6 months. The mean preoperative near UNCVA was Jäger (J) 14.9 ± 2.1 and J 4.2 ± 3.1 at 6 months. Preoperative mean near visual acuity (VA) with addition of +6 diopters was J 5.0 ± 2.3. There was no statistically significant difference in the near...
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Use of Optical Coherence Tomography and Visual Evoked Potentials Recording in Preoperative and Postoperative Monitoring of Patients with Optic Chiasm Compression
Póczoš, Pavel ; Jirásková, Naďa (advisor) ; Lešták, Ján (referee) ; Skorkovská, Karolína (referee)
Use of optical coherence tomography and visual evoked potentials recording in preoperative and postoperative monitoring of patients with optic chiasm compression The objective of this prospective study is to explore the benefits of optical coherence tomography (OCT), resp. visual evoked potentials (VEP), in cases of optic chiasm (OC) compression by measuring the thickness of the retinal nerve fiber layer (RNFL) and the ganglion cell layer (GCL), resp. the implicit time and the amplitude resulting from pattern- reversal VEP (R-VEP) and motion-onset VEP (M-VEP). Material and methods: 16 patients (32 eyes) with chiasmal compression were included in the study. They presented no other pathology of the visual pathway or of the eye globe. The second inclusion criterion was a subsequent indication of decompressive surgery. Measurements of visual acuity, visual field, RNFL, GCL, R-VEP and M-VEP were performed once preoperatively and three times postoperatively (one week, 3 and 6 months postoperatively). The degree (grade 0-5) of chiasmal compression was determined on preoperative brain magnetic resonance imaging (MR). In need of some data analysis, participants were split into a group with no or minimal (grade 0-1) and with substantial pressure (grade 2-4) on OC. Results: The median global peripapillary RNFL...
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Correction of Myopia and Myopic Astigmatism by Implantation of Phakic Posterior Chamber Implantable Collamer Lens
Řeháková, Tereza ; Jirásková, Naďa (advisor) ; Pašta, Jiří (referee) ; Skorkovská, Šárka (referee)
Aim: We analysed two years results in patients with correction of moderate-to-high myopia or myopic astigmatism by implantation of posterior chamber phakic intraocular Impantable Collamer Lens (ICL). Methods: To the retrospective study were included 63 eyes of 32 patients (3 men, 29 women), who underwent implantation of ICL between 2007 - 2016 in the outpatient Department of Ophthalmology clinic, University Hospital in Hradec Králové, to correction moderate-to-high myopia or myopic astigmatism. We assess uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA), subjective refraction, intraocular pressure (IOP), endothelial cell density (ECD) and the incidence of complications in the two years follow-up period. Results: At the time of implantation the mean patient's age was 28,14 ± 5,35 years (range 21 to 36 years). The mean preoperative subjective refraction improved from -7,8 ± 2,7 D sf (range - 14 to -3,25 D sf) and -0,65 ± 0,8 D cyl (range -3,25 to 0 D cyl) to -0,01 ± 0,1 D sf (range -0,75 to 0 D sf) and -0,05 ± 0,16 D cyl (range -0,55 až 0 D cyl). The mean ECD value was 3270,5 ± 454,7 cells/mm2 (range 2155 to 4201 cells/mm2 ) compared to 2803,4 ± 441,8 cells/mm2 (range 2079 to 4184 cells/mm2 ) at the end of our follow-up period. The percentage loss of ECD two years...
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Mapping of Changes in Oxygen Saturation in Retinal Vessels Related to the Extent of Periperal Nonperfusion in Patients with Retinal Vein Occlusion
Šínová, Irena ; Jirásková, Naďa (advisor) ; Pašta, Jiří (referee) ; Skorkovská, Šárka (referee)
Mapping of changes in oxygen saturation in retinal vessels related to the extent of peripheral nonperfusion in patients with retinal vein occlusion Purpose: The aim of this study was to evaluate the relationship between the ischemic index and the oxygen saturation in retinal vessels in patients with retinal vein occlusion. Methods: We performed a prospective, cross-sectional study. The cohort consisted of 43 eyes of 43patients with retinal vein occlusions (RVO), 23 of whom had central retinal vein occlusions (CRVO) and 20 who had branch retinal vein occlusions (BRVO). We evaluated the retinal vessel saturation using an automatic retinal oximetry device (Oxymap Inc., Reykjavik, Iceland). The retinal ischemic index (ISI) was determined using ultra-wide-field fluorescein angiography (Heidelberg Engineering GmbH, Heidelberg, Germany). Results: Mean arterial saturation (± SD) was 100 ± 11 %, mean vein saturation was 52 ±13 % and mean A-V difference was 48 ± 16 % in eyes with BRVO. The average ISI inthe same group was 0.48 (range 0-1). There was no statistically significant correlation between the retinal ischemic index and retinal saturation in the BRVO group. The affected eye in the CRVO group had a mean arterial saturation of 101 ± 6 %, vein saturation of 44 ± 11 % and A- V difference of 58 ± 10 %. The...
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Retinal nerve fiber layer measurement in patients with Alzheimer's disease
Kasl, Zdeněk ; Jirásková, Naďa (advisor) ; Pašta, Jiří (referee) ; Skorkovská, Šárka (referee)
Retinal nerve fiber layer measurement in patients with Alzheimer's disease The current ophthalmologist's possibilities in diagnostics of Alzheimer's disease Alzheimer disease (AD) is the most common cause of dementia syndrome and mild cognitive impairment. To enroll the disease most securely there are used so called biomarkers using evidence of changed brain metabolism by pozitron emission tomography (PET) and in cerebrospinal fluid or the brain's structure magnetic resonance imaging (MRI). These methods are expensive, organisationally and temporally challenging and burdening for the patients. According to that reasons we are still seeking for alternative attitudes suitable for early diagnosis. The evaluation of thickness of retinal nerve fiber layer (RNFL) which is well accessible to examination through optical aparatus of the eye could be one of the options. The aim of our work was to present current knowledges about Alzheimer's disease targeting relations of Alzheimer's disease and an ophthalmological finding. In the next part of this paper we introduce the retinal nerve fiber layer measurement by optical coherence tomography (OCT) as a potential diagnostics method by screening of patients with Alzheimer's disease and to present our results measured in our cohort of patients. The studied cohort...
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Research of the secondary cataract, the possibilities of it's prevention by the choice of surgical techniques and intraocular implants
Stepanov, Alexandr ; Jirásková, Naďa (advisor) ; Baráková, Drahomíra (referee) ; Těšínský, Pavel (referee)
Research of the secondary cataract, the possibilities of it's prevention by the choice of surgical techniques and intraocular implants Summary Aim: To compare the degree of posterior capsule opacification (PCO) in two groups of patients after cataract surgery using two types of software. Design: Prospective clinical trial. Methods: Best corrected visual acuity vas evaluated using Snellen optotypes, biomicroscopy of the eye on the slit lamp, keratometry and axial length was measured preoperatively. AquaLase was used in the right eye and NeoSoniX in the left eye of each patient in the first group. The same hydrophobic acrylic artificial intraocular lens AcrySof SA60 (Alcon Laboratories, Fort Worth, Texas, USA) was implanted in all eyes, and evaluation was conducted during eight-year follow-up. Torsional mode (OZil) phacoemulsification was used in the second group and hydrophobic-hydrophilic intraocular lens EriFlex FAB 877 (Videris, CZ) was implanted. Evaluation of the second group was performed 1 year after cataract surgery. PCO quantification was done using a subjective PCO software - EPCO 2000 (Evaluation of Posterior Capsule opacification) and objective system - OSCA (Open-Access Systematic Capsule Assessment) with open access. Results: Thirty seven patients were analyzed 8 years after cataract surgery in...
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Flaps transmissions in surgeries of basal cell carcinomas of eye lids
Zikmund, Lukáš ; Jirásková, Naďa (advisor) ; Pašta, Jiří (referee) ; Říčařová, Renata (referee)
Flaps transmissions in surgeries of basal cell carcinomas of eye lids Purpose: The main target of the dissertation is to evaluate our own sample of patients, and by analysis of the monitored parameters confirm the effectiveness and possibilities of the local skin flaps advance in dealing with defects after excisions of basal cell carcinomas of the eyelids and periorbital area. Specifically, in the case of defects for which it is not possible to use a range of simple suture wounds. The aim was to compare the results of surgical procedures performed either by the local rotary flaps or free flaps. Methods: The sample consisted of 133 patients with basal cell carcinoma, which claimed covering defect by skin flaps. In 108 cases, local rotary flap in defect has been used and in 25 cases transfer of the tissue into the defect by free flap. In the group of rotary flaps was in 6 cases simultaneously transplanted part of the tarsal plate cartilage of the ear auricle and in 2 patients a surgical procedure multi flap movements was used. The follow up period in both groups was 2 years. Results: Rate of recurrence within 2 years for excision 2 mm safety rim was 5.3%. Patients with recurrence have a significantly larger surface excision (p = 0.01) and lobe (P = 0.004). Recurrences are significantly more frequent...
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