[Perimetric aspects in optic nerve drusen]. / Aspecte perimetrice în drusenul papilei nervului optic.

The drusen of the optic nerve head is a relative rare occurrence in ophthalmologic practice, but it induce more or less important functional alterations. In this issue we present some characteristics of visual field impairment present at the patients with drusen of optic nerve head.

[Cataract surgery in biphakia patients]. / Chirurgia cataractei la ochii cu bifachie.

INTRODUCTION: Although the IOL implantation was used initially just for cataract surgery, in the last period IOLs are used in treating myopia more than -12D and hyperopia more than +4D, in phakic eyes, when the indications of excimer laser are limited. OBSERVATION: We present the case of a 40 years old patient with the diagnosis: biphakia, complicated cataract and high myopia in both eyes. VA-RE = 2/50 cc, VA-LE = 3/50 cc, IOP-RE:15 mmHg, IOP-LE:16 mmHg. We performed, in two separate surgeries, the explantation of the intraocular lens, then the extraction of the opacified crystalline lens through the same incision and the implantation of an AcrySof foldable lens with an adequate power, in the bag. We discuss the causes of cataract formation in eyes with posterior chamber phakic intraocular lens, the choice of the IOL power, the incision for explantation and implantation, and the intraoperative technical difficulties. CONCLUSIONS: The association of phakic IOLs and cataract represents a new challenge to the ophthalmic surgeon, taking into account that these IOLs are becoming more and more popular to correct high refractive errors.

[Phacoemulsification and intraocular lens implantation in myopic eye]. / Facoemulsificarea si implantul de cristalin artificial la ochiul miop.

UNLABELLED: The purpose of this study is to estimate the technical difficulties and the intraoperative complications which appear in patients with high myopia who had been operated on cataract through phacoemulsification technique; to establish the IOL refractive power and to estimate the functional results at 45 days postoperative. MATERIAL AND METHOD: We performed a study on 44 eyes with high myopia and cataract operated in the Emergency Military Hospital from Cluj-Napoca during 15th of January -15th of June 2003. We analyzed the patients' age, the technical difficulties and intraoperative complications, the IOLs choosing and the functional results. RESULTS: The greatest frequency of patients with high myopia and cataract met into the study was between 50-60 years old (43.18%). The intraoperative complications were represented by the posterior capsule's refraction without loss of vitreous in one case, zonular rupture in one case and one case with loss of the nucleus into vitreous. CONCLUSIONS: In patients with high myopia and cataract the surgical procedure solves both visual problem and refractive deficiency. For the myopic eye is important to use IOL with 6 mm, 6.5 mm diameter.

[Phacoemulsification in white cataract]. / Facoemulsificarea în cataracta alba, intumescenta.

PURPOSE: The study presents the technical difficulties of the capsulorhexis and phacoemulsification in the white, intumescent cataract and the incidences occurred during the foldable IOL implantation with the Monarch II injector. METHODS: The clinical study comprises a number of 70 eyes with white intumescent cataract operated during 15 January-15 December 2003 by the same surgeon. The surgical intervention consisted of lens extraction by phacoemulsification with clear corneal incision, using the Monarch II injector for the foldable IOL implantation. In 56 eyes, the anterior capsule was stained with trypan blue. RESULTS: The intraoperative complications include: failed capsulorexis in 4 cases (5.71%), rupture of posterior capsule in 1 case (1.43%) and the conversion to classical extracapsular extraction in 3 cases (4.29%). IOL implantation was made with the help of the Monarch II injector in 67 cases (95.71%). The foldable IOL implantation in the bag was realised a single time in 44 cases (62.9%). We had the following incidences in the other cases: the upside down turning of the IOL during unfolding in 2 cases, the second haptic capture in the tunnel of the cartridge in 2 cases, the second haptic stucks outside or in the anterior chamber in 18 cases, the first haptic stays in the sulcus and the second one stays outside in 1 case. CONCLUSIONS: In eyes with 1 intumescent cataract we can perform the continuous curvilinear capsulorhexis using trypan blue, but also without staining the anterior capsule using mechanical or manual aspiration of the liquefied cortex and viscoelastic substances. The foldable intraocular lens implantation with the injector proves to be an easy and comfortable method after it has been practiced for a longer period of time if the right size of the cartridge is used.

[Phacoemulsification in posterior polar cataract]. / Facoemulsificarea in cataracta polara posterioara.

PURPOSE: To evaluate the technical particularities of phacoemulsification and the intraoperative complications in posterior polar cataract. MATERIAL AND METHODS: Prospective study which comprises 10 eyes with posterior polar cataract (8 patients), operated on between May 2001 and April 2004 in the ophthalmology department of the Military Hospital Cluj-Napoca, by the same surgeon. Phacoemulsification with low parameters was performed in all cases, and acrylic and PMMA intraocular lenses were implanted in 9 eyes. RESULTS: The patients' age was between 24 and 80 years, with a mean age of 55.12 years. The majority of the patients presented bilateral posterior polar cataract (70%), but only 2 patients were operated on the both eyes in the analyzed period. The posterior capsule rupture occurred in 4 eyes (40%). A posterior residual plaque was attended in one case, but did not influence the short term visual acuity. The visual acuity of the 3 cases which were affected unilaterally was not influenced by the surgery, which was without complications in 2 cases. The causes were preexisting amblyopia. CONCLUSIONS: The study confirms the high risk to posterior capsule rupture during posterior cataract surgery and the high incidence of the bilateral form (70%).