[Decrease of the postoperative inflammatory reaction during pars plana vitrectomy (PPV) after administration of triamcinolone acetonide]. / Zmniejszenie pooperacyjnego odczynu zapalnego wskutek zastosowania octanu triamcynolonu podczas witrektomii pars plana.

PURPOSE: To prospectively evaluate the effect on postoperative inflammatory reaction and recovery after application of triamcinolone acetonide (TA) during pars plana vitrectomy (PPV), to visualize the vitreous. MATERIAL AND METHODS: Pars plana vitrectomy (PPV) was performed in 45 patients (21 males, 24 females) (29 with retinal detachment, 6 with macular hole, 1 with cystoid macular edema, 3 with diabetic retinopathy, 3 with vitreous haemorrhage, 1 with preretinal membrane, 1 with PVR and 1 with lens luxation). After surgical separation of the posterior vitreous and removal of any visible epiretinal membrane, TA was injected over the posterior pole. For the control group we used 15 patients (10 with retinal detachment, 2 with macular hole, 1 with preretinal membrane, 1 with lens luxation and 1 with vitreous haemorrhage) (10 males, 5 females) treated with PPV but without TA administration. To evaluate the degree of postoperative inflammation and to monitor the dynamics of the blood-aqueous barrier disruption, the laser flare cell meter (Kowa FM-500) was used. RESULTS: Tyndalometric mean values in the control group of eyes recorded 1 day after PPV were 32.41 +/- 6.1 ph/ msec while values in TA-treated group were significantly lower (20.26 +/- 2.4, p < 0.02). 10 days after surgery in TA group results were still significantly lower as compared to the control group (16.4 +/- 2.6 vs 32.5 +/- 9.6, p < 0.005). As observed 6 weeks after PPV, tyndalometric recordings in TA-treated group remained lower as those observed in the control group (16.1 +/- 3.1 vs 32.0 +/- 8.1, p < 0.01). CONCLUSIONS: The eyes which received TA-assisted PPV showed significantly less breakdown of the blood-ocular barrier than those with routine PPV. Intraoperative administration TA facilitates postoperative recovery after surgery lowering the inflammatory reaction.

[Corneal endothelial density in glaucoma patients]. / Gestosc sródblonka rogówki u chorych z jaskra.

PURPOSE: To asses mean endothelial cell density in glaucoma patients. MATERIAL AND METHODS: Examinations were conducted and registered using the Noncon Robo (Konan) non-contact specular microscope between years 2000 and 2004, in Tadeusz Krwawicz Chair of Ophthalmology and 1st Eye Hospital, Medical University of Lublin. The results of 159 patients (233 eyes) with glaucoma and 37 patients (44 eyes) with pseudoexfoliation syndrome were analyzed. Patients, 22-91 years old, were divided into 8 groups according to the clinical diagnosis and for each group an adequate control group was matched. Statistical analysis was carried out to compare the examined and control groups using the non-parametric U Mann-Whitney test. RESULTS: Corneal endothelial cell density were significantly lower in all groups of glaucoma patients. There was a significant reduction in cell count in patients with chronic angle-closure glaucoma: 2333 +/- 476/mm2, control group (C): 2809 +/- 378/mm2, p< 0.001), acute angle-closure glaucoma 2136 +/- 620/mm2, C. 2780 +/- 384/mm2, p< 0.001, pigmentary glaucoma 2537 +/- 355/mm2, C. 3003 +/- 335/mm2, p< 0.05, juvenile glaucoma 2337 +/- 277/mm2, C. 3001 +/- 168/mm2, p< 0.001, primary open angle glaucoma 2326 +/- 231/mm2, C. 2779 +/- 398/mm2, p< 0.001, normal tension glaucoma 2343 +/- 394/mm2, C. 2732 +/- 356/mm2, p< 0.01, capsular glaucoma 2128 +/- 483/mm2, C. 2753 +/- 354/mm2, p< 0.001 and in patients with pseudoexfoliation syndrome 2255 +/- 299/mm2, C. 2721 +/- 352/mm2, p< 0.001. CONCLUSIONS: Patients with glaucoma have lower mean corneal endothelial cell density than control groups. The density of corneal endothelial cells depends on the type of glaucoma.