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Posterior lamellar keratoplasty
Studený, Pavel ; Dotřelová, Dagmar (advisor) ; Pašta, Jiří (referee) ; Filipec, Martin (referee)
110 9. SUMMARY Introduction The endothelial dysfunction and related corneal oedema with decreased transparency id still the main indication for keratoplasty. Method of posterior lamellar keratoplasty, which is popular in oftalmology in last few years, is suitable method because we exchange just the affected part of the cornea. Nowadays there are more surgical ways and modalities of the technique, but the best way has not been established yet. Purpose Purpose of our study was: to evaluate and analyze the efficacy of new technique of lamella preparation, to evaluate new method of lamela implantation and to analyse anatomical outcomes in experiment and clinical outcomes in practice. Materials and methods Group 1 involves 71 eyes of 55 patients, who underwent posterior lamellar keratoplasty with implantation of a hybrid lamella DMEK-S using a hydroimplantation. In group 2 were enrolled 27 eyes of 22 patients, who underwent posterior lamellar keratoplasty with implantation of a hybrid lamella DMEK-S using glide. In the postoperative period, we evaluated corrected and uncorrected visual acuity and corneal endothelial density. We analyzed and compared clinical outcomes of both groups and we focused especially on the method of implantation. Student t test and Bonferroni test were used for all statistical analysis....
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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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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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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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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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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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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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