[The Slovak study of the travoprost treatment efficacy]. / Slovenská stúdia efektivity liecby travoprostom.

PURPOSE: To confirm the efficacy of the travoprost treatment during twelve months follow-up in groups of patients: without previous treatment, with different previous anti-glaucomatous treatment, and with different stage of compensation. PATIENTS AND METHODS: The study evaluates the lowering of the intraocular pressure (IOP) in 143 patients (286 eyes). The intraocular pressure was measured by means of aplanation tonometry, before the treatment started, and after 1, 3, 9, and 12 months at 8-9 o'clock a.m. Patients were divided into eight groups according to the previous mono therapy or combined therapy substituted by travoprost mono therapy or its combination. A special group constituted patients with travoprost as a primary treatment. RESULTS: In the first group, with latanoprost substituted by travoprost, the intraocular pressure decreased by 7% (p < or = 0.0001). In the second group of patients, with travoprost as the primary glaucoma treatment, the intraocular pressure decreased by 22% (p < or = 0.0001). In the third group, the beta-blocker was substituted by travoprost, with 22 % (p < or = 0.0001) decrease of the IOP. In the fourth group, the combined therapy of beta-blocker with latanoprost was substituted by combination of beta-blocker and travoprost and the decrease by 8% (p < or = 0.0001) was significant during the first nine months of the follow-up period, later on, the decrease was not significant. The substitution of the combination of beta-blocker and latanoprost by travoprost mono therapy in the fifth group created only no significant lowering of the IOP during the whole follow-up period. If the travoprost mono therapy substituted the combination of beta-blocker with local carboanhydrase inhibitor in the sixth group, the IOP decreased by 20% (p < or = 0.001). In the seventh group, the combination of the local carboanhydrase inhibitor and latanoprost was substituted by combination of the local carboanhydrase inhibitor with travoprost, the IOP lowering was not significant. On the other hand, in the eighth group, different combinations of antiglaucomatics were substituted by travoprost, and this caused significant lowering of IOP by 20% (p < or = 0.0001). In all cases, the lowest decrease of IOP during the whole follow-up period in the eye with worse compensation is given. CONCLUSION: Travoprost lowered effectively the intraocular pressure in 6 out of 8 groups of patients, e.g. in 129 patients (out of 143 patients), the range of lowering was 7-28% bellow the initial level, the follow up period was 12 months. The decrease of the IOP was stable. The drug was well tolerated.

[The pseudoexfoliative syndrome and its significance in cataract surgery]. / Pseudoexfoliatívny syndróm a jeho význam pre operáciu sivého zákalu.

OBJECTIVE: To find out factors or combinations of factors leading to increased occurrence of complications in operation on cataract in patients with pseudoexfoliative syndrome. SETTING: Eye Clinic SPAM, Bratislava. METHODS: Prospective non-randomized study in 2916 patient of different age and sex, followed for 6 months after the operation on cataract. The standardized operation protocol was used. Complications were followed during and after the operation in view of released supporting apparatus, loss of vitreous body, uveal reaction and the occurrence of secondary cataract. RESULTS: PEX occurred in 2.98% of the surgically treated patients of the group, most often in the age group of 75-84 years. The occurrence was independent of sex, but increased with age. There was not any relation between age and the type of cataract, incidence of complications, inflammatory reaction, and width of pupil, endo-telepathy and glaucoma. The incidence of per-operation complications in 13.7% is directly related to the syndrome, a narrow pupil, disorder of supporting (suspension) apparatus and worse visual acuity. From the 34 patients with PEX and increased inflammatory reaction, 22.9% suffered from secondary cataract after 6 months. A relationship between width of the pupil, time factor, hardness of cornea and the incidence of inflammatory reaction was demonstrated in 24.1%. CONCLUSION: PEX itself is the source of most severe complications in operation on cataract. The patients should be in dispensary care and operated on in time by an experience surgeon.

[Additive effects of topical carbonic anhydrase inhibitors]. / Aditívny úcinok lokálnych inhibítorov karboanhydrázy.

The author investigated 23 patients with primary open angle glaucoma treated with pilocarpine, timolol, betoptic and latanoprost. Because of inadequate compensation of the basic disease dorsolamide was added and the patients were followed up for a 12-month period. All combinations decreased significantly the intraocular pressure during the long-term follow up. The greatest decrease was recorded after a combination of a prostaglandin analogue and dorsolamide.

[Capsulectomy via the pars plana--one of the possible definitive treatments for opacification of the posterior capsule] ]. / Kapsulektómia via pars plana--jedna z mozností definitívneho riesenia opacifikácie zadného puzdra.

The author demonstrates on a group of 27 eyes a possible definite solution of a serious complication of successful operation of cataract, i.e. secondary cataract. The latter reduces due to its frequent incidence markedly the visual acuity. The approach with a vitrectome via the pars plana is a simple and permanent solution which beyond doubt has advantages as compared with YAG capsulotomy and polishing of the posterior capsule. The method is effective, cheap and the incidence of complications is minimal. Fluoroangiographic findings confirm its safety.

[Etiopathogenesis of age-related macular degeneration and present possibilities of treatment]. / Etiopatogenéza vekom podmienenej makulárnej degenerácie a súcasné moznosti jej liecby.

Age-related macular degeneration is the frequent cause of central visual acuity loss in the elderly patients group. The authors analyze in detail the pathogenesis of the process. The explanation of pathogenesis enables therapeutical intervention even though its possibilities are limited. Photodynamic therapy induces pharmacological thrombosis without any damage to the retina in the macular area. Pilot studies have demonstrated complete occlusion new vessels without any alteration of the photoreceptor layer. Age-related macular degeneration still remain a challenge for ophthalmologist and it also poses a serious social problem.

Female substance abuse: characteristics and correlates in a sample of inpatient clients.

This article reports on a study of 64 female substance abusers in residential treatment for chemical dependency. This study was conducted with the purpose of describing the associations between: (a) demographic characteristics, (b) presence and severity of addiction, (c) depression, and (d) self-esteem. All participants were drawn from inpatient females, and were administered questionnaires that included the following instruments: (a) Screening/Intake Assessment, (b) the Michigan Alcohol Screening Test, (c) the Addiction Presence and Severity Index, (d) the Provision of Social Relations Scale, (e) the Rosenberg Self-Esteem Scale, and (f) the Costello-Comrey Depression Scale. Multivariate analyses revealed that levels of self-esteem were related to detoxification status and social support. Depression levels were associated with social support, and severity of addiction was more pronounced for White clients than Black clients in this study. Implications for program development are discussed.

[Treatment of recurrent corneal erosion]. / Liecba recidivujúcej erózie rohovky.

The author presents an account on 27 patients with relapsing corneal erosion 6 to 60 months after phototherapeutic keratectomy. The results of this treatment confirm unequivocally that the method is safe, highly effective and relieves the patient rapidly and for a long period (possibly permanently) of complaints. A disadvantage is the high cost of the equipment.

[Use of computer-assisted corneal topography in ophthalmology]. / Vyuzitie pocítacovej rohovkovej topografie v oftalmológii.

The authors give an account of the possible application of corneal computer topography in some diseases of the cornea and in particular in refraction surgery.

[Treatment of recurrent pterygia]. / Liecba recidivujúceho pterýgia.

The author's work confirmed that a single administration of 0.02% mitomycin C with exposure for 3.5 minutes during surgical excision of a pterygium is an effective treatment, which reduces the percentage of recurrences of pterygium and does not induce negative effects of mitomycin C.

[Beta-blockers in the treatment of open-angle glaucoma]. / Betablokátory v liecbe glaukómu s otvoreným uhlom.

Authors report the results of comparative study of three betablockers used in the treatment of primary open-angle glaucoma commonly available on the market. The influence of non-selective betablockers (TIMOPTOL 0.5%, VISTAGAN 0.5%) and selective betablocker (BETOPTIC 0.5%) on the intraocular pressure, pulse frequency, systemic blood pressure and lung capacity was evaluated. Three different groups, each of 20 patients with newly diagnosed primary openangle glaucoma were assigned to be treated by studied drugs independently. Authors conclude that all three drugs reliably lowered intraocular pressure. BETOPTIC and VISTAGAN did not influence on pulse frequency, blood pressure and lung capacity. Apart from the fact that VISTAGAN is considered to be non-selective betablocker, its efficacy is comparable with those of selective betablockers.

[Calculation of the assumed postoperative anterior chamber depth as an important factor in the calculation of optic power of the intraocular lens]. / Výpocet predpokladanej pooperacnej hlbky prednej komory ako dôlezitá súcast výpoctu optickej mohutnosti vnútroocnej sosovky.

The authors studied the possibility to use Binkhorst or Olsen formulas for the calculation of the assumed postoperation anterior chamber depth (ACD), or the necessity to develop their own formula. In the studied group, 25 eyes with implanted intraocular lens (IOL) of 720A type (Pharmacia) were included. No correlation was found between assumed postoperation ACD calculated according to Binkhorst and Olsen and the actual postoperation ACD (ACDpo). The authors have developed their own regression equation for the calculation of assumed ACDpo, where preoperation ACD (ACDpr) and lens thickness had been used as variables. Correlation coefficient of 0.5381 (P < 0.01) was found between assumed ACDpo calculated according to the authors' equation and the actual ACDpo. On the basis of the results achieved in the study, the authors propose that surgeons develop their own regression equations for the calculation of postoperation ACD.

Validity of self-administered symptom scales in clients with schizophrenia and schizoaffective disorders.

Few studies have used self-administered symptom scales as outcome measures with individuals who have schizophrenia. However, with the increase in community-based treatment for the serious and persistently mentally ill and the emphasis on client empowerment, their ability to monitor and report symptoms needs to be assessed. Two forms of self-administered items, symptom distress statements and symptom intensity statements, were formed from 10 BPRS symptoms and administered to 29 individuals with schizophrenia. Both forms of self-administered items were highly correlated with BPRS items, supporting concurrent validity. Self-administered responses for positive symptoms of schizophrenia and nonpsychotic symptoms may be more valid than self-administered responses for negative or deficit symptoms.

[Excimer laser photorefractive keratectomy in myopia]. / Excimer laser fotorefraktívna keratektómia u myopie.

The authors present an account on excimer laser photorefractive keratectomy on 254 myopic eyes with a minimal follow-up period of 6 months. The mean preoperative refraction -6.31 +/- 4.02 D was reduced to -0.92 +/- 1.3 D. A difference between the planned and achieved correction of less than 0.5 was recorded in 33.5% eyes, less than 1.0 D in 59.4% eyes and less than 1.5 D 77.6% eyes. As to complications the following were recorded: astigmatism more than 0.5 D (7.9%), problems with epithelialization (5.5%), steroid induced increased intraocular pressure (3.9%), corneal turbidity higher than 2 (1.2%). Based on the results the authors revealed that excimer laser photorefractive keratectomy is safe and effective refraction surgery for low and medium myopia with the possibility to predict the resulting postoperative refraction.

[Correction of aphakia with transcleral fixation of the lens in the ciliary sulcus]. / Korekcia afakie sosovkou fixovanou transklerálne do ciliárneho sulkusu.

The posterior chamber intraocular lens particularly for ciliary sulcus fixation is a very good solution of correction of aphakia in cases when any part of capsule is missing. With proper surgical technique the obtained results are very good and the number of complications reported can be minimized. The authors demonstrate it in a group of 38 eyes with ciliary sulcus fixation. A very low occurrence of complications and good visual acuity including long follow-up confirm, that this method can be successfully used in the case od correction of aphakic patients.

Reversal theory constructs and cigarette availability predict lapse early in smoking cessation.

The purpose of this study was to investigate the contribution of reversal theory constructs (i.e., metamotivational states) to understanding the outcome of tempting situations that occur in the first 6 weeks of smoking cessation. Cessation program participants (n = 68) were interviewed about tempting situations in which they either smoked or maintained abstinence. Both independent groups and repeated measures analyses indicated that metamotivational state (serious and goal-directed vs. playful and spontaneous) and cigarette availability significantly predicted outcome. Reversal theory constructs correctly predicted outcome of the tempting episode for 70% of the subjects, while cigarette availability was an accurate predictor for 74%. Metamotivational state and cigarette availability together predicted the outcome for 89% of the subjects.

[Relation between preoperative and late postoperative keratometry]. / Vzt'ah medzi predoperacnou a neskorou pooperacnou keratometriou.

The authors in their work compare corneal astigmatism before cataract surgery and the late postoperative corneal astigmatism (min. 18 months after surgery). ECCE was done with IOL implantation with a limbal approach and the wound was sutured with 5-6 single interrupted sutures. Two months after the surgery all sutures were removed in astigmatism with the rule higher than 3.0 D. The average value of the corneal astigmatism with the rule before surgery was 0.42 +/- 1.19 D and late postoperative astigmatism against the rule was 0.19 +/- 1.18 D. 43 eyes (69.4%) had the difference between preoperative and late postoperative corneal astigmatism less than 1.5 D. 19 eyes (30.6%) had the difference higher than 1.5 D. 12 eyes (19.4%) had postoperative corneal astigmatism against the rule higher than 1.5 D. We have found positive correlation between preoperative and postoperative values (P < 0.001) and an important difference was found between preoperative and postoperative corneal astigmatism (0.001 < P < 0.01). Authors recommend not to use biodegraded sutures, to make tight closure of the internal aspect of the wound, to use interrupted sutures, to remove sutures 3-5 months after surgery in high astigmatism with the rule and carefully evaluate the number of removed stitches so that the corneal astigmatism against the rule will not appear.

[Fibrin reaction after implantation of posterior chamber intraocular lenses]. / Fibrínová reakcia po implantácii zadnokomorových IOL.

One of the complications after implantation of posterior chamber intraocular lenses is fibrin reaction. The authors analyse group of 653 patients--659 eyes after the operation of cataract with implantation of posterior chamber IOL operated in 1991-1992 at Postgraduate School of Medicine, Ophthalmology Department in Bratislava. The fibrin reaction was found out in 33 cases (5%). This reaction started between the first and third day after the operation. From this group of 33 patients, 14 (43%) were treated for glaucoma, 11 (33%) had diabetes mellitus and 3 (9%) overcome uveitis in past years. In all cases after the treatment came to the complete loss of fibrin. Finally visual acuity was 5/5 to 5/10.