Interchangeability in Automated Corneal Diameter Measurements Across Different Biometric Devices: A Systematic Review of Agreement Studies.

PURPOSE: To provide an up-to-date review of the agreement in automated white-to-white (WTW) measurement between the latest topographic and biometric devices. METHODS: In this systematic review, PubMed, Web of Science, and Scopus databases were searched for articles published between 2017 and 2023, focusing on WTW agreement studies on adult, virgin eyes, with or without cataract and no other ocular comorbidities. Studies evaluating WTW measurements performed with autokeratometers, manual calipers, or manual image analysis were excluded. When available, the following metrics for the agreement of WTW measurements between pairs of devices were included: mean difference ± standard deviation, 95% limits of agreement (LoA), LoA width, 95% confidence interval (95 CI%), and intraclass correlation coefficient (ICC). RESULTS: Forty-one studies, covering comparisons for 19 devices, were included. Altogether, 81 paired comparisons were performed for 4,595 eyes of 4,002 individuals. The mean difference in WTW measurements between devices ranged from 0.01 mm up to 0.96 mm, with varying CI. The 95% LoA width ranged from 0.31 to 2.45 mm (median: 0.65 mm). The majority of pairwise comparisons reported LoA wider than 0.5 mm, a clinically significant value for phakic intraocular lens sizing. CONCLUSIONS: Nearly all analyzed studies demonstrated the lack of interchangeability of the WTW parameter. The corneal diameter, assessed by means of grayscale en-face image analysis, tended to demonstrate the lowest agreement among devices compared to other measured biometric parameters. [J Refract Surg. 2024;40(3):e182-e194.].

Assessment of the eye surface and subjective symptoms after using 0.1% dexamethasone drops with and without preservatives in patients after cataract surgery.

Cataract surgery can cause dry eye symptoms. One of the many factors compromising the ocular surface is the use of benzalkonium chloride (BAC)-preserved topical eye drops administered during the postoperative period. In this open-label, prospective, randomized, comparative clinical trial, 40 patients not previously affected by dry eye disease were assigned to receive either preservative-free (PFD) or preserved (PD) dexamethasone 0.1% eye drops for two weeks after a standard phacoemulsification procedure. Fluorescein break-up time, ocular surface staining score, Schirmer test, Ocular Surface Disease Index and anterior chamber (AC) cells were evaluated at baseline prior to the surgery and 2 weeks after surgery. No statistically significant differences in baseline assessments were observed between groups. At week 2, a significant increase in corneal staining scores (p = 0.003) and foreign body sensation (p = 0.04) was observed for the PD group only. The conjunctival staining score was significantly higher in both groups. The mean AC cell grading was higher in the PFD group than in the PD group (0.28 ± 0.30 and 0.07 ± 0.18, respectively; p = 0.013). Preservative-free dexamethasone eye drops after cataract surgery caused milder dry eye symptoms as compared with preserved dexamethasone. The AC inflammation control comparison may require a larger study group. Trial registration: ClinicalTrials.gov identifier NCT05753787, 03/03/2023.

The corneo-scleral junction assessed with optical coherence tomography.

PURPOSE: To evaluate corneo-scleral junction (CSJ) using anterior segment optical coherence tomography (AS-OCT) and describe the pattern of cornea and sclera interfusion based on tissue reflectivity. METHODS: This prospective observational study enrolled candidates for vision correction. Eyes with previous ocular surgery or irregular corneas were excluded. Temporal and nasal CSJ width and reflectivity patterns were assessed with AS-OCT horizontal scans. Correlations between manual and automated variables and multivariate linear regression analyses with age and spherical equivalent were performed. RESULTS: 101 right eyes were analysed. Temporal CSJ was wider (median 1.62; 1.13 to 2.22 mm) compared to the nasal side (median 1.18; 0.73 to 1.80 mm) (p<.0001). The temporal CSJ width showed negative correlation with ipsilateral anterior chamber angle measurements and positive correlation with horizontal visible iris diameter (HVID). These relationships were not statistically significant for the nasal CSJ width. No significant correlations with age or refractive error were observed at both sides. The pattern of temporal CSJ reflectivity was mostly V- or U-shaped. The eyes with V-shaped temporal CSJ had significantly larger HVID than the eyes with irregular temporal CSJ. The nasal CSJ presented irregular reflectivity in 47% of cases. CONCLUSIONS: The temporal CSJ was wider and had regular (V or U-shaped) reflectivity patterns, while nasal CSJ was narrower and more irregular. The CSJ width was independent of age and refractive error and could not be predicted from other parameters. The HVID measurement accuracy may benefit from CSJ analysis based on AS-OCT.

The efficacy of ocular surface assessment approaches in evaluating dry eye treatment with artificial tears.

This study evaluates the effectiveness of objective techniques in assessing dry eye disease (DED) treatment compared with the subjective assessment commonly used in clinical practice. Thirty subjects were recruited for two visits separated by 28(± 3) days of treatment with artificial tears. A buttery of common subjective assessment methods were accompanied by a set of objective techniques including measurement of noninvasive tear film break-up time (NIBUT), lipid layer thickness (LLT), and quantitative evaluation of tear film surface quality and dynamics (TFD). Additionally, meibography was performed. Two commercially available videokeratoscopes and a prototype of a lateral shearing interferometer were used for the measurements. Both subjective and objective techniques showed a positive effect of artificial tears in DED treatment. Statistically significant improvements were observed in subjective symptoms (from P < 0.001 for Ocular Surface Disease Index, OSDI to p = 0.019 for tearing), conjunctival redness (P = 0.022), ocular staining (P = 0.012), fluorescein tear film break-up time (P = 0.015), NIBUT (P = 0.037), LLT (P < 0.001), and TFD (P = 0.048). In general, weak or statistically insignificant correlations were observed between subjective and objective assessment methods. The apparent lack of correlation between these methods might indicate the complementary character of objective techniques that likely assess other characteristics of ocular surface health than those assessed subjectively.

Measurements of Anterior and Posterior Corneal Curvatures with OCT and Scheimpflug Biometers in Patients with Low Total Corneal Astigmatism.

Background: Posterior keratometry measurements are evolving features of the optical biometers. The differences between devices have bigger impact for the low astigmatism values. The majority of adults present the corneal astigmatism below 1.5 D. Objectives: To compare the total corneal astigmatism measured with two different technologies in cataract patients with corneal astigmatism below 1.5 D. Material and Methods: Three automated exams were performed on each of the two devices: swept-source optical coherence tomography (SS-OCT) and Scheimpflug biometers. The anterior and total corneal astigmatism and power were analysed. Statistical comparisons were performed for within-subject standard deviation, repeatability, Bland−Altman and vector analysis. Results: Twenty-nine eyes of twenty-seven patients were included. The limits of agreement between anterior and total corneal astigmatism were narrower for the SS-OCT than for the Scheimpflug biometer (−0.16 to 0.29 D and −0.40 to 0.39 D, respectively). The >0.5 D difference between SS-OCT and Scheimpflug total astigmatism was noticed in 5 (17%) of cases. The difference between mean total keratometric power for both devices was statistically significant (0.2 D, p < 0.001). SS-OCT total corneal flat measurements had worse repeatability than Scheimpflug (p = 0.007). Conclusions: For the corneal astigmatism <1.5 D, the difference between anterior and total corneal astigmatism measured with SS-OCT was clinically not significant. The mean anterior and total keratometry values obtained with Scheimpflug and SS-OCT biometers are not interchangeable.

Horizontal and anterior chamber diameter for phakic intraocular lens sizing.

CLINICAL RELEVANCE: Proper selection of phakic intraocular lens diameter is necessary to avoid complications related with excessive vaulting after its implantation. BACKGROUND: Horizontal corneal diameter, measured as white-to-white distance, is one of the parameters used for phakic intraocular lens diameter calculation. Agreement was assessed between three parameters: white-to-white distance obtained with swept source optical coherence tomography, and white-to-white distance obtained with Scheimpflug camera and angle-to-angle parameter obtained with anterior segment optical coherence tomography. METHODS: This study included 55 eyes of 43 patients. The white-to-white distance was measured with two biometry techniques: swept source optical coherence tomography and Scheimpflug camera. The angle-to-angle was measured with anterior segment optical coherence tomography. Analysis of agreement was performed by the Bland-Altman method. For every patient, simulation of Visian Implantable Collamer Lens (ICL) sizing was performed using the Online Calculation and Ordering System with different white-to-white distance or angle-to-angle. RESULTS: Statistically significant differences were found between swept source optical coherence tomography biometer and anterior segment optical coherence tomography (p = 0.001) and between swept source optical coherence tomography and Scheimpflug camera (p < 0.001). However, there was a good correlation between swept source optical coherence tomography and Scheimpflug camera (intraclass correlation co-efficient = 0.623), with a shift toward higher white-to-white distance values on swept source optical coherence tomography. A relatively high correlation intraclass correlation co-efficient (0.772) and lack of statistically significant differences (p = 0.068) between anterior segment optical coherence tomography and Scheimpflug camera results were observed. Simulation of phakic intraocular lens sizing showed that swept source optical coherence tomography white-to-white distance should not be used interchangeably with Scheimpflug camera white-to-white distance or angle-to-angle. CONCLUSION: White-to-white distance measured with swept source optical coherence tomography was significantly different from values obtained with other methods. Angle-to-angle may support ICL sizing, helping in verification of white-to-white distance values obtained with other devices.

Application of a Partial Least Squares Regression Algorithm for Posterior Chamber Phakic Intraocular Lens Sizing and Postoperative Vault Prediction.

PURPOSE: To develop and validate a new algorithm for predicting the postoperative vault of the myopic EVO Visian Implantable Collamer Lens (ICL) V4c (STAAR Surgical AG). METHODS: This study included 81 eyes of 43 patients who had undergone ICL implantation. Preoperative data obtained by swept-source optical coherence tomography, Scheimpflug camera, and anterior segment optical coherence tomography were applied to develop a new partial least squares (PLS) regression algorithm. ICL sizing was performed using the standard white-to-white method with the online calculation and ordering system. The postoperative vault was assessed based on anterior segment optical coherence tomography. The PLS approach was applied to create the calibration model for predicting the postoperative vault. The new PLS model was cross-validated using the leave-one-out method and compared to a recently published linear regression model. Agreement between the actual and predicted vault values for the two methods was assessed by the Bland-Altman method. RESULTS: There was a statistically significant correlation (P < .001, r = 0.73) between the postoperative vault values and those predicted by the PLS algorithm. Validation of the PLS model yielded lower mean differences and limits of agreement (0 and 410 µm, respectively) than the linear regression method (400 and 750 µm, respectively). CONCLUSIONS: The PLS algorithm increases the precision of ICL vault prediction. However, it shows a tendency to overestimate small vault values and underestimate high vaults. [J Refract Surg. 2020;36(9):606-612.].

Methods for evaluating quality of life and vision in patients undergoing lens refractive surgery.

PURPOSE: Cataract surgery has evolved into a procedure that generally yields the best postoperative refractive result attainable. Patients with multifocal intraocular lenses (IOLs) present higher rates of spectacle independence, although reduced intermediate vision, dysphotopsias, and a loss of image quality might also be experienced. The aim of the study was to review the methods for assessing quality of life and vision in patients undergoing lens refractive surgery in randomized controlled trials. METHODS: We reviewed the PubMed web platform to identify relevant studies using the following keywords: quality of life, quality of vision, lens surgery, lens exchange, refractive lens exchange, cataract, cataract surgery, intraocular lens, IOL, multifocal, and monovision. RESULTS: An increasing number of studies have focused on patient-reported outcomes (PROs). Only a few of the available visual function questionnaires can be regarded as useful in lens refractive surgery with multifocal IOL implantation. Many self-developed questionnaires have emerged that have not been adequately validated or found to feature properly evaluated repeatability, hampering the possibility of comparing outcomes. CONCLUSIONS: This review describes the existing PROs instruments and informs the choice of an appropriate measure in lens refractive surgery. Rasch-developed tools should be utilized for measuring quality of life and vision in patients undergoing lens refractive surgery and there is a number of highly robust tools available.

Comparison of anterior segment parameters and axial length measurements performed on a Scheimpflug device with biometry function and a reference optical biometer.

PURPOSE: To compare measurements of axial length (AL), corneal curvature (K), anterior chamber depth (ACD) and white-to-white (WTW) distance on a new device combining Scheimpflug camera and partial coherence interferometry (Pentacam AXL) with a reference optical biometer (IOL Master 500). To evaluate differences between IOL power calculations based on the two biometers. METHODS: Ninety-seven eyes of 97 consecutive cataract or refractive lens exchange patients were examined preoperatively on IOL Master 500 and Pentacam AXL units. Comparisons between two devices were performed for AL, K, ACD and WTW. Intraocular lens (IOL) power targeting emmetropia was calculated with SRK/T and Haigis formulas on both devices and compared. RESULTS: There were statistically significant differences between two devices for all measured parameters (P < 0.05), except ACD (P = 0.36). Corneal curvature measured with Pentacam AXL was significantly flatter then with IOL Master. The mean difference in AL was clinically insignificant (0.01 mm; 95% LoA 0.16 mm). Pentacam AXL yielded higher IOL power in 75% of eyes for Haigis formula and in 62% of eyes for SRK/T formula, with a mean difference within ± 0.5 D for 72 and 86% of eyes, respectively. CONCLUSIONS: There were statistically significant differences between AL, K and WTW measurements obtained with the compared biometers. Flatter corneal curvature measurements on Pentacam AXL necessitate formulas optimisation for Pentacam AXL.

Iris characteristics affecting far peripheral vision and negative dysphotopsia.

PURPOSE: To evaluate how the iris obstructs rays at large visual angles. SETTING: Simpson Optics, Arlington, Texas, USA, and Spektrum Eye Clinic, Wroclaw, Poland. DESIGN: Retrospective case study. METHODS: Anterior segment optical coherence tomography (AS-OCT) (Visante) images were exported for normal, short, and long eyes and eyes with negative dysphotopsia. Iris characteristics were manually identified, including the maximum iris thickness and its distance from the pupil, and the gap between the iris and intraocular lens (IOL). Ray-tracing software was used for optical modeling. RESULTS: The study comprised AS-OCT images of 63 eyes (21 normal eyes, 20 short eyes, and 19 long eyes, as well as 3 eyes with negative dysphotopsia). Preoperative and postoperative iris dimensions were similar, with a mean maximum thickness of 0.47 mm ± 0.08 (SD) at 0.94 ± 0.19 mm radially from the pupillary margin. The mean pupillary plane distance from the corneal epithelium moved from 3.23 ± 0.50 mm preoperatively to 3.99 ± 0.26 mm postoperatively, and the mean gap between the posterior iris and the IOL was 0.50 ± 0.24 mm, with a systematic increase with axial length for both parameters. The anterior iris surface obstructed light at very large angles and contributed to the limiting visual angle for rays focused by the IOL (although light from lower angles also bypassed the IOL). Models for the eyes with negative dysphotopsia had dark retinal regions between the focused image and peripheral light for small pupils. CONCLUSIONS: Rays at very large angles can be obstructed by the anterior iris surface, which can be modeled to have a triangular profile near the pupillary margin. This limits the visual field for light focused by the IOL.

Anterior chamber depth and iris and lens position before and after phacoemulsification in eyes with a short or long axial length.

PURPOSE: To evaluate changes in anterior segment parameters after phacoemulsification in short eyes and long eyes. SETTING: Spektrum Eye Clinic, Wroclaw, Poland. DESIGN: Prospective comparative study. METHODS: Anterior segment parameters were examined before and after phacoemulsification in 3 groups of eyes as follows: short (axial length [AL] <22.0 mm), normal (AL 22.5 to 25.0 mm), and long (AL> 25.5 mm) with optical biometry based on partial coherence interferometry (IOLMaster) and anterior segment optical coherence tomography (Visante). RESULTS: The study comprised 20 short eyes, 22 normal eyes, and 19 long eyes. The anterior chamber angle increased after surgery in all eyes (P < .05). The relative change in anterior chamber depth (ACD) was larger in short eyes (57%) than in normal eyes (44%) or long eyes (42%) (P < .017). The change in iris position after phacoemulsification was larger in short eyes than in normal or long eyes (mean change 0.93 mm, 0.70 mm, and 0.43 mm, respectively) (P < .017). The change in lens position after phacoemulsification in relation to the iris was smaller in short eyes (mean 0.51 mm) than in normal or long eyes (mean 0.82 mm and 1.10 mm, respectively) (P < .017). CONCLUSIONS: The relative change in ACD after phacoemulsification was larger in short eyes than in normal eyes and long eyes. The largest change in iris position occurred in short eyes. The largest change in the lens versus the intraocular lens (IOL) position occurred in long eyes, with the IOL moving back from the iris. Optical biometry might underestimate the postoperative ACD. FINANCIAL DISCLOSURE: Neither author has a financial or proprietary interest in any material or method mentioned.

[Quality of life in patients with age-related macular degeneration - medical and social problem]. / Jakosc zycia chorych na zwyrodnienie plamki zwiazane z wiekiem--problem medyczny i spoleczny.

UNLABELLED: Age-related macular degeneration (AMD) is a leading cause of blindness over the age of 50 in western countries. People with AMD are suffering from serious vision-related disability and their social life is compromised. PURPOSE: The aim of our study was to assess quality of life (QoL) in patients with exudative AMD. MATERIAL AND METHODS: The study group was 100 patients treated for AMD, the control group were 30 age and sex matched subjects without ophthalmic disorders. Patients were treated with anti-VEGF therapy, by means of National Eye Institute Visual Function Questionnaire (NEI VFQ-25). As well as visual function, the NEI-VFQ investigates social functioning, mental health and dependency. RESULTS: There was statistically significant difference in QoL overall score between study group and control group. Patients with AMD obtained 51.1 (+/- 20.5 ) overall score, control group reached 83.7 (+/- 11.7) overall score, p = 0.001. Detailed analysis of study group revealed low acceptance of the disease and strong dependency. CONCLUSIONS: QoL in patients with AMD assessed with NEI VFQ-25, is significantly impaired. Low quality of life and difficulties in performing daily activities point at the need of formal psychological and social care.

Phacoemulsification in eyes with neovascular AMD treated with anti-VEGF injections.

PURPOSE: To evaluate visual results of phacoemulsification in eyes with neovascular age-related macular degeneration (AMD) treated with anti-vascular endothelial growth factor (VEGF) intravitreal injections. METHODS: This retrospective noncomparative interventional case-series study assessed best-corrected visual acuity (BCVA) at 4 timepoints: 1) baseline, immediately before first anti-VEGF injection; 2) preoperative, immediately before phacoemulsification; 3) postoperative, 1 month after phacoemulsification; 4) endpoint, at the last visit. Anti-VEGF retreatment regimen was based only on optical coherence tomography. The median time between anti-VEGF injections was evaluated for the time period before and after phacoemulsification. RESULTS: Sixteen eyes of 16 patients were included. The median (range) baseline, preoperative, postoperative, and endpoint BCVA was 0.7 (0.3-1.3), 0.72 (0.4-1.3), 0.5 (0.05-1.0), and 0.36 (0.0-1.0) logMAR, respectively. Best-corrected visual acuity significantly improved after phacoemulsification (mean 3 logMAR lines) and remained stable during follow-up (median 14 months, range 7-28). There was no statistically significant difference in the median time interval between injections before phacoemulsification and after phacoemulsification. CONCLUSIONS: Phacoemulsification significantly improved BCVA in patients with choroidal neovascular AMD. This effect persisted during follow-up with no increased need for anti-VEGF injections to keep macula dry.

[Safety and efficacy of using bevacizumab in the treatment of exudative age-related macular degeneration]. / Skutecznosc i bezpieczenstwo stosowania bevacizumabu w leczeniu wysiekowego zwyrodnienia plamki zwiazanego z wiekiem.

PURPOSE: To evaluate the efficacy and safety of intravitreal bevacizumab administered on "as required" basis in patients with exudative age-related macular degeneration (AMD). MATERIAL AND METHODS: A prospective uncontrolled cohort study of patients with exudative AMD treated with intravitreal bevacizumab administered "as required" based on PRONTO reinjection criteria. Main outcome measures include standardized best-corrected visual acuity (BCVA) and central macular thickness (CMT) measured with optical coherence tomography (Stratus OCT). RESULTS: 153 eyes of 153 consecutive patients with AMD were treated with intravitreal bevacizumab injection, followed monthly and reinjected "as required". Mean follow-up time was 14.2 weeks (4-52 weeks). Distance BCVA improved from 0.79 log MAR at baseline to 0.69 at 4 weeks, 0.7 at 8 weeks, 0.64 at 12 weeks, 0.71 at 16 weeks and 0.63 at 20 weeks (p<.05). Near BCVA improved from 0.13 at baseline to 0.22 at 4 and 8 weeks, 0.25 at 12 weeks, 0.22 at 16 weeks and 0.28 at 20 weeks (p<.05). Mean CMT decreased from 395 microm at baseline to 265 at 4 weeks, 260 at 8 weeks, 268 at 12 weeks, 255 at 16 weeks and 257 at 20 weeks (p<.05). Mean time between first and second injection was 91.9 days, and between second and third injection 99.7 days. No adverse events were observed. CONCLUSIONS: Short-term results suggest that intravitreal bevaciuzmab administered "as required" is safe and effective in patients with exudative AMD. "As required" schedule may decrease the risk of adverse events and lower the cost of treatment.

[Secondary epithelial cyst of the iris--case report]. / Wtórna nablonkowa torbiel teczówki--opis przypadku.

Authors present a case of 33 years old man who developed implantation secondary cyst of the iris, after penetrating trauma in a childhood. He was treated with cyst aspiration and endolaser photocoagulation of the cyst base. Postoperatively visual function significantly improved. No recurrence of cyst was observed. Within 6 months cataract developed with pupillary obstruction caused by irydocorneal adhesions, which required reoperation. Authors indicate that management of secondary cyst of the iris may require repeated laser or surgical treatment.

[Vitrectomy with peeling retinal limiting membrane (ILM) in eyes with diabetic macular edema]. / Witrektomia z usunieciem blony granicznej wewnetrznej siatkówki w leczeniu cukrzycowego obrzeku plamki.

PURPOSE: To evaluate the efficacy of pars plana vitrectomy with retinal internal limiting membrane (ILM) peeling in eyes with diabetic macular edema. MATERIAL AND METHODS: Twenty five eyes of 25 patients with diabetic macular edema. All eyes underwent a pars plana vitrectomy including separation of the posterior hyaloid, ILM peeling and air endotamponde. Preoperatively visual acuity (VA), funduscopic examination and the presence or absence of posterior vitreous detachment, were evaluated. Fluorescein angiography was performed in all patients prior to surgery. Eyes with cystoid macular edema or macular ischaemia were excluded. Postoperative VA, anatomic results, and complications were recorded. The follow-up was 7 to 27 months (mean 17). RESULTS: Intraoperatively, thick posterior hyaloid was found to be attached to the posterior pole in 20 cases. The mean postoperative VA (0.2) was significantly better than the preoperative VA (0.08) (p = 0.0001). VA improved postoperatively in 21 eyes (84%), at least two lines on the Snellen chart in 8 eyes (32%). It remained unchanged in 4 eyes (16%). Confluent hard exudates in fovea were present significantly more frequently in eyes without VA improvement (p = 0.004). The postoperative VA was better in eyes that had not undergone photocoagulation (improvement by 0.14 line) than in others (improvement by 0.11 line) but the difference was non-significant. Reduction of macular exudates was noted in every case in the follow-up over 6 months. Postoperative complication included retinal detachment were treated by re-vitrectomy with oil endotamponade. Cataract has been noted in six eyes. CONCLUSIONS: Vitrectomy including removal of ILM in diabetic macular edema, leads to improvement of visual acuity and long-term stabilization of visual function.

[Outcome results in macular hole surgery with internal limiting membrane removal]. / Wyniki usuniecia blony granicznej wewnetrznej siatkówki w chirurgii otworu w plamce.

PURPOSE: To determine the visual outcome and anatomic closure rate of macular hole surgery using pars plana vitrectomy with internal limiting membrane (ILM) peeling. MATERIAL AND METHODS: Fifty three eyes of 52 consecutive patients with a full-thickness idiopathic macular holes (stage 3 or 4). All eyes underwent a pars plana vitrectomy including separation of the posterior hyaloid, ILM peeling with trypan blue (TB) or indocyanine green (ICG) and gas endo-tamponade with instructions to the patient, to be face down for 4-5 days. Postoperative anatomic results, visual acuity (VA), and complications were recorded. The follow-up was 3 to 22 months. RESULTS: VA improved postoperatively in 45 eyes (84.9%), at least two lines on the Snellen chart in 24 eyes (45.3%). It remained unchanged in 6 eyes (11.3%) and deteriorated in 2 eyes (3.80%). The mean preoperative VA was 0.1 +/- 0.04 and does not differ significantly between stage 3 and 4. The improvement of postoperative VA was statistically significantly better in stage 3, in comparison to stage 4. The anatomical success rate (flat/closed) was 88.7% (47 eyes). There were no differences in VA improvement between TB- or ICG-stained eyes. CONCLUSIONS: 1. Vitrectomy with ILM removal in macular holes provides with meaning improvement in visual acuity. 2. Patients with macular hole in stage 3 have a better prognosis for visual rehabilitation. 3. A kind of dye and preoperative VA do not influence postoperative visual function improvement.

[Vitrectomy in treatment of ocular tuberculosis--case report]. / Witrektomia w leczeniu gruzlicy ocznej--opis przypadku.

The authors present a case of ocular tuberculosis in otherwise healthy young men, diagnosed with positive tuberculin test and positive PCR for Mycobacterium tuberculosis in conjunctiva and vitreous samples. An early vitrectomy and typical systemic treatment (tuberculostatic drugs) resulted in regression of the disease.

[Surgical treatment of giant retinal tear]. / Leczenie chirurgiczne otworów olbrzymich siatkówki.

PURPOSE: The purpose of the study was to evaluate anatomical and functional results of pars plana vitrectomy in giant retinal tears. MATERIALS AND METHODS: Ten eyes with giant retinal tears underwent pars plana vitrectomy. The time of observation after surgical intervention was 3 months to 2.5 years. RESULTS: Retinal reattachment was obtained in 9 eyes (90%). In one eye, despite second vitrectomy, there was no positive effect due to massive vitreo-retinal proliferation. CONCLUSIONS: Surgical treatment of giant retinal tear yields good anatomical and functional results. Rarely massive vitreo-retinal proliferation may cause the redetachment. Perfluorodecalin used during surgery facilitates unfolding and flattening of the retina.

[Vitrectomy in the treatment of endogenous fungal endophthalmitis in a patient after renal transplantation]. / Zastosowanie witrektomii w leczeniu endogennego grzybiczego zapalenia wnetrza galki ocznej u pacjentki po przeszczepie nerek.

The authors present a case of fungal endophthalmitis in the immunosuppressed patient after renal transplantation. The treatment comprised pars plana vitrectomy with silicone oil tamponade, peribulbar injections of Fungizone and intravenous Diflucan. Diagnostic and therapeutic difficulties in endogenous endophthalmitis are discussed.