RECURRENT PERIOCULAR BASAL CELL CARCINOMA. CASE REPORT.

AIM: We present the management of a severe case of recurrent periocular basal cell carcinoma, orbital invasion and exenteration. CASE REPORT: The present case is of a recurrent basal cell carcinoma in a 84-year-old male presenting with non-healing lesion above right eyelid. A tumor excision was performed in May 2014. Histopathology revealed a basal cell carcinoma (dg. C44.1 ICD-10-CM) with positive margins. The re-excision of the lesion was performed. After two years, there was a local recurrence and orbital invasion. Indication for external curative radiation therapy. Plastic surgery of the upper eyelid. Orbital exenteration was indicated in January 2018. After another year, a recurrence of the tumor was once again noted. Histopathology revealed a basal cell carcinoma (dg. C44.1 (TNM 7, pMx, pNx, pTx)). The patient was indicated for external radiotherapy. There were no indications for biological treatment. After another year, a progression of the local finding was noted. CONCLUSION: Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer of the periocular region. Primary treatment of basal cell carcinoma is surgical. Advanced lesions require extensive surgical interventions and other available treatment modalities. In some cases, mutilating surgery - exenteration of the orbit is inevitable. Despite a relatively small percentage of invasive diseases today, advanced stages may still occur; either as a result of the patient's late presentation, inadequate initial therapy aimed at maintaining critical periorbital structures, or due to high tumor aggression. The case report highlights necessity of radical resection of primary tumor with histological examination.

[Aflibercept in clinical practice]. / Aflibercept v klinickej praxi.

In this article we have tried to evaluate first clinical experience with the effectiveness and safety of aflibercept in the treatment of the wet form of age related macular degeneration in all types of subretinal neovascular membranes for the period of the first 10 months of treatment in our clinic.

[Diagnosing of Acanthamoeba keratitis]. / Diagnostika akantamébovej keratitídy.

Acanthamoeba keratitis is rare corneal disease, its etiology is caused by amoebae of the Acanthamoeba spp. In this paper, the newest findings about the diagnostic and treatment procedures of the disease and epidemiology and preventive issues from the point of public health are presented. The article presents results of the water quality monitoring (according to the Acanthamoeba which is possible to cultivate at 36 degrees C and 44 degrees C) in man-made swimming pools during the period 2004-2008 at the Department of environmental biology of the Regional Public Health Institute in Banská Bystrica, Slovakia, E.U. The examination methods present the techniques of the clinical sampling and taking samples from the environment. The results underline the use of the new effective criteria in controlling of recreational resorts as well as changes of the legal criteria for the water quality used by the public. The results show that the presence of Acanthamoeba spp. in the environment is common, so the water monitoring is perceived as substantial preventive issue to prevent the disease to emerge. The collaboration between the public heath departments and ophthalmologists during the examination of the clinical and environmental samples may help to prevent and diagnose the Acanthamoeba keratitis.

[Refractive surgery in Slovakia]. / Refrakcná chirurgia na Slovensku.

Since 1991 the chief specialist evaluates different spheres of ophthalmology based on data provided by all departments in Slovakia. In the submitted article the author summarizes the 10-year period of refractive surgery in Slovakia.

[Sympathetic ophthalmia]. / Sympatická oftalmia.

The authors give an account of a case of sympathetic ophthalmia which was successfully managed by reoperation of the injured eye, corticoids and immunosuppressive drugs. Sympathetic ophthalmia developed after perforation of the cornea along with traumatic cataract one month following the accident. It was manifested by irritation of the anterior segment of both eyes and marked exudation into the area of the posterior pole of the sympathizing eye. On the injured eye surgical reconstruction of the anterior segment was performed and concurrently broad spectrum antibiotics and corticoids were administered. On this therapy the anterior segment of both eyes began to improve, while the exudation into the area of the posterior pole of the sympathizing eye proceeded; therefore immunosuppressive therapy was started. The manifestations of sympathetic ophthalmia receded gradually. After an alternative way of corticoid reduction was started, a relapse of sympathetic ophthalmia occurred. The relapse was suppressed by a temporary increase of the dosage. Three months after the development of sympathetic ophthalmia, using the treatment described, the uveal inflammation of both eyes receded. At present, two years after the accident, both eyes are in a satisfactory condition with normal visual acuity--on the injured eye with an aphakic correction.

[Retropupillary pseudophakia after extracapsular cataract extraction]. / Retropupilárna pseudofakia po extrakapsulárnej extrakcii katarakty.

Implantation of a retropupillary artificial intraocular lens into the capsule of the lens is from the anatomical aspect the most physiological type of pseudophakia. The authors compare the early results of implantation of two models of retropupillary intraocular lenses, i.e. an intraocular lens made from one piece (PMMA loop) and an intraocular lens with polypropylene loops Intraocular lenses with PMMA loops are more difficult to insert in the capsule, they keep, however, better in position than intraocular lenses with a polypropylene loop. Greater traumatisation of surrounding tissues during implantation of intraocular lenses with a PMMA loop leads to a higher incidence of posterior synechia and deformation of the pupil. The differences between the two groups are statistically significant. No statistical correlation was found when the functional results were compared. The same applies to peroperative and other postoperative complications (uveitis, non-infectious endophthalmitis, sy. of transillumination and dispersion of pigment and CEM. No case of secondary glaucoma, bullous keratopathy or detachment of the retina was recorded. A corrected vision of 5/15 or better was achieved in 97.50%.