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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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The evaluation of the effect in supression of the inflammatory reaction by oral intake Relifex (nabumeton) after photodynamic therapy in the treatment of exsudative age-related macular degeneration
Šín, Martin ; Jirásková, Naďa (advisor) ; Sosna, Tomáš (referee) ; Dotřelová, Dagmar (referee)
Purpose: To evaluate photodynamic therapy (PDT) combined with the preferential the cyclooxygenase-2 (COX-2) inhibitor, nabumetone in the treatment of the neovascular age-related macular degeneration (ARMD). Methods: A prospective, double-blind, randomized study on 60 patients with subfoveal CNV secondary to ARMD without any previous treatment. Patients were divided into a nabumetone or placebo group. The main endpoints were the change of best-corrected visual acuity (BCVA), central macular thickness (CRT) and number of required PDT treatments Results: In the nabumetone group, 27 patients (90%) and 28 (93%) in the placebo group completed the follow-up of 12 months. In the nabumetone group, the mean CRT decreased from 332 μm (SD 68 μm) to 220 μm (SD 46 μm). In the placebo group, CRT decreased from 331 μm (SD 72 μm) to 254 μm (SD 61 μm). The mean BCVA was 0.68 log MAR (SD 0.22 log MAR) in the nabumetone group and 0.62 log MAR (SD 0.23 log MAR) in the placebo group at baseline. This stabilised in the placebo group to 0.66 log MAR (SD 0.33) but deteriorated in the nabumetone group to 0.86 logMAR (SD 0.41 logMAR). There was a significant reduction in the number of required PDTs in the nabumetone group, but significant progression of the RPE atrophy area. Conclusion: Combined PDT with oral intake of the COX-2...
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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 study of the role of cell populations in rejection and tolerance of orthotopic corneal transplants
Sedláková, Klára ; Filipec, Martin (advisor) ; Jirásková, Naďa (referee) ; Čejková, Jitka (referee)
Small animal models of orthotopic corneal transplantation offer many advantages for the study of immune mechanisms after grafting - not only because of the similar mechanisms of murine and human corneal transplant rejection but also due to the feasibility of the direct observation of the animal without the need to sacrifice it. The purpose of the thesis was to study this model in mouse and rat. We established allotransplantation (BALB/c to C57BL/6 mouse and Wistar Furth to Lewis rat) and concordant xenotransplantation model (rat to mouse; Lewis to BALB/c and Sprague Dawley to BALB/c) and set up grading schemes for the evaluation of the clinical course after grafting. Initially, we focused on the effect of the suturing technique on the survival of xenografts and on the efficacy of selected immunosuppressants: cyclosporine A, monoclonal antibody against T cells (anti-Thy-1.2) and AMT (a specific inhibitor of inducible nitric oxide synthase, 2- amino-5.6-dihydro-6-methyl-4-H-1.3-thiazine)). The results demonstrate that the suturing technique significantly affects the outcome of transplantation and, importantly, influences the effectiveness of immunosuppressive regimens and therefore must be taken into account when evaluating the efficacy of immunosuppressive drugs. FTY720 is a novel immunosuppressant with a...
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EVALUATION OF POSTERIOR CAPSULE OPACIFICATION AMONG VARIOUS TYPES OF INTRAOCULAR LENS
Pozlerová, Jana ; Jirásková, Naďa (advisor) ; Těšínský, Pavel (referee) ; Synek, Svatopluk (referee)
Purpose: To evaluate posterior capsule opacification (PCO) in patients 7 years after cataract operation with the implantation of three types of intraocular lenses (IOL): rigid polymethylmetacrylate IOL (PMMA) with a round optical edge, foldable hydrophobic acrylate IOL with a sharp edged optic and foldable IOL whose optical part is made from silicone with round edges. For the quantification, two computerized methods were used and the correlation of the two systems was evaluated. Data from both methods were used to compare PCO incidence for the followed IOL and ascertain if some type of IOL showed better qualifications in the prevention of posterior capsule opacification. Patients and methods: We evaluated 73 patients that had undergone cataract operation using the classic ultrasound phacoemulsification method in the time period of 1998-2000 at the Ophthalmology Department of the Hradec Kralove Faculty Hospital. Seven years after the operation, a standard ophthalmologic examination was performed including best corrected visual acuity (BCVA) and a digital photograph of the anterior segment of the eye in mydriasis, focusing on the posterior capsule. On the photograph, posterior capsule opacification were evaluated using the Evaluation of Posterior Capsule Opacification 2000 software (EPCO 2000) and the...
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