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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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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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Evaluation of visual functions after laser correction of ammetropia
Kyprianou, Georgia ; Langrová, Hana (advisor) ; Baráková, Drahomíra (referee) ; Těšínský, Pavel (referee)
Summary: Evaluation of visual functions after laser correction of ammetropia 1. We evaluated the quality of vision of 55 pacients (110 eyes) with myopia from - 0,5 dpt to -6,00 dpt after laser correction with PRK and LASIK. We compaired the results between group A after laser correction with the excimer laser Esiris (Schwind, Germany) and group B after correction with Amaris (Schwind, Germany). We investigated subjective visual perception, standardized visual acuity and contrast sensitivity under photopic and mesopic conditions as well as glare sensitivity at 1, 3, 12 and 24 months postoperatively. 2. Subjective perception: One month after the procedure, there were significant differences in questions concerning the overall visual quality, while watching TV and driving during the day and at night, with group B patients significantly more satisfied. Twelve months after the procedure, 100% of the patients of both groups were satisfied with their quality of vision. 3. Visual acuity: In group A, photopic and mesopic visual acuity significantly decreased 1 month after the procedure and then increased and differed only insignificantly from the preoperative values. In group B, photopic and mesopic visual acuity was changing insignificantly upto 3 months after the procedure and then increased significantly to...
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The treatment modification of progressive kretoconus using the corneal collagen cross-linking with riboflavin and UVA irradiation
Veselá, Martina ; Raiskup, Frederik (advisor) ; Baráková, Drahomíra (referee) ; Pašta, Jiří (referee)
SOUHRN Modifikace léčby progredujícího keratokonu zesíťováním kolagenu rohovky pomocí riboflavinu a UVA záření. Úvod: Cílem mé práce je porovnání modifikace léčby progredujícího keratokonu zesíťováním kolagenu rohovky pomocí riboflavinu a UVA záření. Metodika: Soubor retrospektivní studie zahrnuje celkem 35 očí 28 pacientů, kteří podstoupili na našem pracovišti corneal cross-linking. Soubor tvoří dvě skupiny. Skupina A zahrnuje 15 očí s abrazí epitelu rohovky v dolní polovině velikosti 8 mm. Skupina B zahrnuje 20 očí s plošním odstraněním epitelu rohovky kruhovitého tvaru velikosti 8-9 mm. Postup při provedení zesíťování rohovky byl v obou skupinách stejný. Sledovací doba skupiny A i skupiny B je jeden rok po provedení CXL. Výsledky: Pro vyhodnocení výsledků zákroku se sledovaly, porovnávaly a vyhodnotily následující parametry: rychlost hojení rohovkového epitelu, intezita vnímání bolesti po odstranění epitelu, přítomnost Vogtových strií, korneální zkalení (haze) a jeho perzistence, počet endotelových buněk (ECC), nekorigovaná zraková ostrost (UCVA), nejlépe korigovaná zraková ostrost (BCVA), objektivní sférická a cylindrická refrakce, osa astigmatismu. Na Pentacamu se sledovaly: keratometrie v plochém a strmém meridiánu (K1, K2) a změny v nejstrmějším místě rohovky (Kmax), elevace přední (EF) a zadní...
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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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Possibilities of treatment of diplopia when suffering from paralitic strabismus with the use of conservative methods
Pražáková, Lenka ; Jirásková, Naďa (advisor) ; Těšínský, Pavel (referee) ; Baráková, Drahomíra (referee)
Summary: Possibilities of treatment of diplopia when suffering from paralitic strabismus with the use of conservative methods Purpose The aim of this thesis is to assess the effectiveness of ambulant pleoptic-ortoptic exercises complemented by domiciliary rehabilitation using specially adapted software - applied to patiens with suddenly occured eye movement disorder and diplopia. Methods Representative sample was composed od 86 adult patients suffering from sudden eye movement disorder and diplopia, containing 33 rehabilitating ones in treatment group and 53 not rehabilitating patients in control group. The eye movement disorder was caused by cerebrovascular accident, craniocerebral injury or vascular disease. All the patients underwent complex eye and ortoptic examination as well as objectification of the eye movement disorder and diplopia by Hess-Lancaster test. Both treatment and control group have been observed for 3 - 6 months. Results An average improvement of 96.8 % (P ≤ 0,01) was reached in the treatment group - in case of the extent of horizontal deviation of strabismus (for rehabilitating adults having the infliction n. VI of one eye). In the control group 28.1 % (P ≤ 0,00001) was noticed. The patients having the infliction n. III and n. IV of one eye improved of 73.7 % (P ≤ 0,0008) in the...
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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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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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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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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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