RESULTS OF POSTERIOR LAMELLAR KERATOPLASTIES IN PHAKIC EYES.

PURPOSE: To evaluate the results of posterior lamellar keratoplasties (DMEK and PDEK) in phakic eyes. MATERIAL AND METHODS: Retrospective analysis of surgeries performed in our department between June 2016 and December 2019. The main focus was put on postoperative visual acuity, corneal endothelial cell density and possible peroperative and postoperative complications including cataract formation. RESULTS: We performed 12 surgeries on 11 eyes of 7 patients. The most prevalent primary diagnosis was Fuchs endothelial dystrophy (7 eyes), followed by bullous keratopathy after phakic anterior chamber IOL implantation (2 eyes) and ICE syndrome (2 eyes). The average length of follow-up was 12.5 months. Clinically significant complicated cataract had developed and was removed in 3 eyes, one eye required rebubbling due to graft detachment and one eye required rePDEK due to graft failure. At the end of follow-up, the average visual acuity was 0.87, while 82% of eyes achieved VA 0.8 or better, and the average endothelial cell density was 1589 cells/mm2. CONCLUSION: Posterior lamellar keratoplasties (DMEK and PDEK) can be performed on phakic eyes. When performed by an experienced surgeon, these are safe procedures with good postoperative results and significant advantage in preserving younger patients accommodation.

The Importance of Evaluating the Development of Oct Findings During Conservative Treatment of Vitreomacular Traction Complicated by Macular Hole Formation.

Macular hole (MH) was considered untreatable condition for a long time until Kelly and Wendel described the posibility of surgical treatment with pars plana vitrectomy (PPV) in the nineties of the twentieth century. Since then have both surgical instruments and operation techniques developed rapidly and PPV has become the mainstay of MH therapy. Only stage I according to Gass classification which equates vitreomacular traction (VMT) according to Vitreomacular Traction Study group classification is routinely treated conservatively with observation only. It is however necessary to assess each case individually as some small and favourable MHs may close spontaneously. Here we present a case report of 59 years old woman with mild myopia and best corrected visual acuity (BCVA) 6/6 bilaterally. She presented on July 2017 with blurry vision in her right eye and was diagnosed with bilateral VMT according to optical coherence tomography. BCVA was 6/9 in her right eye and 6/6 in her left eye. During five weeks a full thickness MH developed in left eye that was accompanied by a decrease in BCVA to 6/12p. Considering favourable size and configuration of MH and the fact that the patient preferred conservative approach, we postponed the surgery, observed the MH and recommended bed rest. The MH closed spontaneously during five weeks with resulting BCVA 6/6. In her right eye the VMT released during four months with resulting BCVA 6/6 as well. The authors of the study declare that the formation and theme of the professional report and its publication are not in conflict of interest or supported by any pharmaceutical company.

[Recurrent retroperitoneal sarcoma]. / Recidiva sarkomu retroperitonea.

Retroperitoneal sarcomas are rare malignant neoplasms that are often diagnosed late because of their typical nonspecific symptomatology. Radical surgical resection, if possible given the local anatomical conditions, is the most important treatment modality. However, even if the surgery is feasible and successful, the prognosis of retroperitoneal sarcoma is not good. The most frequent type of recurrence is local recurrence, and radical surgical resection remains the most important treatment modality even in such cases.Our study presents a case report of a patient with a retroperitoneal leiomyosarcoma that was radically (R0) removed. Two years later a local recurrence developed, which was eventually diagnosed by MRI. Again, radical (R0) surgical resection was approached (because of tumor invasion into inferior caval vein, the vein had to be partially resected as well and substituted with a vascular prosthesis).The report describes a relatively typical case of retroperitoneal sarcoma, while pointing out the importance of timely diagnosis (which is definitely not easy to achieve) and especially of radical surgical treatment.Key words: retroperitoneal sarcoma recurrence surgery.