VISUAL FUNCTIONS AFTER IMPLANTATION OF ACRYSOF MONOFOCAL INTRAOCULAR LENSES.

PURPOSE: The purpose of the study was to evaluate the visual functions after implantation of Acrysof monofocal intraocular lenses Alcon (SA60AT. MA50BM a SN60WF a SN6AT). MATERIALS AND METHODS: Four works are presented in the overview. The first work deals with the effect of eye length. corneal optic power and anterior chamber depth on the uncorrected near visual acuity (UNVA) after IOL implantation. The second work compares the effect of eye position (horizontal and vertical) on the final UNVA. The third work deals with the influence of the spherical lenses (SA and MA) and yellow aspherical lenses (SN) on UNVA. The later work examines the effect of pupil width on UNVA.    Results: The first work showed the dependence of eye axial length (the largest in eyes bellow 22.5 mm. r=0.36) on UNVA.  77.4 % of eyes with axial length below 22.5 mm had UNVA better than 0.5 and 70.49 % of all evaluated eyes had UNVA better than 0.5. Uncorrected far visual acuity (UDVA) better than 1.0 was in 97.54 % eyes in the whole group. In the second work we found a mean correlation in eyes shorter than 22.5 mm with UNVA in horizontal position (r=0.39) and in the vertical position (r=0.49). UNVA improved in these eyes in horizontal position from 0.53 to 0.58 in vertical position of the eye. In all eyes from the group UNVA changed from 0.51 to 0.56. The third work demonstrated the effect of sphericity and chromaticity on UNVA. Better than 0.5 in the group of eyes shorter than 22.5 mm in SA IOL in 67 % and in SN IOL in 60 %. In eyes with mean axial length was UNVA better than 0.5 in SA IOL in 86.5 %. in MA IOL in 81 % and in SN IOL in 75 %. In eyes longer than 23.5 mm was UNVA better than 0.5 in SA IOL in 100 % of eyes, in MA IOL in 60 % and in SN IOL in 33 % of eyes. In the fourth work the effect of pupil size was not demonstrated. CONCLUSION: The works showed excellent results of UNVA and UDVA after implantation of Acrysof monofocal lenses.

[Our two-year experience with the bevacizumab (Avastin) treatment of the age related macular degeneration wet form]. / Nase dvouleté zkusenosti s lécbou vlhké formy vekem podmínené makulární degenerace bevacizumabem (Avastin).

AIM: To evaluate the results of the intravitreal Avastin injection treatment in patients with the wet form of the age related macular degeneration and to point out some problems of this treatment. MATERIAL AND METHODS: The study group consisted of 71 eyes of 71 patients; the follow up period was 6-24 months, on average, 18.5 months. The first subgroup consisted of 31 eyes treated in the first year, the second subgroup 40 eyes treated in the second year of the study. At the beginning of the treatment, the visual acuity in the first subgroup was 0.05-0.8, on average 0.26, in the second subgroup 0.1-0.6, on average 0.3. Most frequently, the occult form of the subretinal neovascular membrane was diagnosed (60.6%). RESULTS: There were applied 1-6 injections, on average, 3.52 injections. The frequency of applications was set according to the PRONTO study schedule for Lucentis application. The neuroepithelium thickness decreased by more than 100 microm in 35.2% of eyes, was stabilized in 46.5% of eyes, and increased by more than 100 microm in 11.3% of eyes. In the first subgroup, the visual acuity stabilized in 90.3% of eyes, in the second one in 95%, and in the whole group in 93% of eyes. Improvement by more than 15 letters of the ETDRS chart was recorded in the whole group in 8 eyes (11.3%) and, on the other hand, the worsening by more than 15 letters in 5 eyes (7%). We recorded no systemic complications; in no eye we had to treat the endophthalmitis, nor the retinal detachment. CONCLUSIONS: Several times lower price, safety, and positive results of intravitreal Avastin injection treatment support its use in the competition with other anti-VEGF substances.

[From Beer's knife to the tunnel incision]. / Od Beerova noze k tunelovému rezu.

The authors present an account on the development of surgical techniques used in operations of cataract. Surgery of cataract was started on April 8, 1745 when the Frenchman Jaques Daviel made the first extraction of an opaque lens by limbal incision. This new method was enforced, however, very slowly and only after 100 years it finally celebrated victory over the hitherto widely used reclination. In the fifties of the present century a great advance in the surgery of cataract was the introduction of cryoextraction; at the First Ophthalmological Clinic a double-jacket instrument was designed which was filled with crushed CO2. The first cryoextraction was made at the authors' department on October 7, 1964, it was the very first operation of this type in Czechoslovakia.

[The clinical picture of Fuch's heterochromic cyclitis]. / Fuchsova heterochromická cyklitida v klinickém obraze.

The authors are presenting their experience with the diagnosis and treatment of Fuchs' heterochromic cyclitis. They followed-up 13 patients with this disease for 0.5-3 years. Most often the patients were sent to the clinic with the diagnosis of recurrent anterior uveitis not responding to the treatment with corticosteroids and mydriatics. Patients underwent numerous investigations including neurological, internal and rheumatological examinations. Antibodies against EBV, HSV and CMV were detected. The examination of humoral immunity and HLA was done. The authors describe the ophthalmological findings, the course of the disease and the treatment. They did not find any correlation in the laboratory investigations and the course of the disease, the diagnosis is based on the clinical picture. They point out the advantage of the small incision in the extracapsular extraction of cataract in these patients.

[Diagnostic problems in uveitis]. / Problematika diagnostiky uveitid.

The authors examined and followed up for two years 102 subjects who were referred to the First Ophthalmological Clinic of the First Medical Faculty, Charles University, Prague on account of idiopathic uveitis. They used a wide range of examination methods by means of which they were able to differentiate idiopathic uveitis from anterior uveitis with the presence of HLA B27, Fuchs disease and Eales disease. A quarter of the patients suffered from general disease, internal or neurological, where uveitis can be one of the symptoms. This disease was not diagnosed at the time of exacerbation of uveitis. The authors describe a series of examination methods and their contribution to the assessment of the correct diagnosis. They discuss the development of views regarding the diagnosis of idiopathic uveitis and views on the treatment of this disease.

[Biocompatibility of retropupillary intraocular lenses]. / Biokompatibilita retropupilárních nitroocních cocek.

The authors give an account on the incidence of two types of reactions in the early postoperative period (within two weeks) after implantation of retropupilar intraocular lenses. In a group of 320 patients they observed them in 51 (16%) incl. 17 diabetics. In the group of diabetic patients the incidence of reactions was twice as frequent. A typical fibrin reaction starting on the third day after operation was recorded in 18 patients (5%), in the remaining 33 patients (11%) there was increased opalescence of the aqueous humour, and exudation of cels and cellular structures to the lens surface was associated with the surgical trauma, in particular in beginner implantologists. The two mentioned types of reactions do not have a substantial influence on the final functional effect.