Anterior movement of the crystalline lens in the process of accommodation in children.

PURPOSE: To investigate changes of crystalline lens position during accommodation in children with emmetropia, myopia, and hyperopia. METHODS: A total of 188 children (372 eyes) from 4 to 19 years old (mean age 11.3+/-4.43) with cycloplegic refractive error within a range +9.00 D to -9.00 D were enrolled. After a general ophthalmic examination, ultrasound biometry was performed, with the eye at a maximal accommodative effort. Cycloplegia was induced by triple installation of 1% tropicamide drops and 30 minutes later the biometric examination was repeated. RESULTS: In emmetropic eyes in the process of accommodation, the anterior pole of the crystalline lens moved forward by 0.144+/-0.14 mm (p< or =0.001); the position of the posterior pole did not change. In myopic eyes, the anterior pole moved forward by 0.071+/-0.13 mm (p< or = 0.001) and the posterior pole moved backward by 0.039+/-0.10 mm (p=0.003). In hyperopic eyes, the whole lens translocated anteriorly: anterior pole moved forward by 0.242+/-0.16 mm (p< or = 0.001) and posterior pole moved forward by 0.036+/-0.09 mm (p< or = 0.001). Differences among emmetropia, myopia, and hyperopia were statistically significant. Forward movement of the posterior pole correlated with a low axial length of the eye, and also with plus refractive error and with a smaller accommodative increase of lens thickness. CONCLUSIONS: In children, accommodative changes of the crystalline lens position depend on refractive status.

Retinal imaging by spectral optical coherence tomography.

PURPOSE: To demonstrate applicability of high speed spectral optical coherence tomography (SOCT) method for imaging retinal pathologies in clinical conditions. METHODS: SOCT was performed in 67 eyes with different macular diseases. Examinations were carried out with the prototype SOCT instrument constructed in the Institute of Physics, Nicolaus Copernicus University, Torun, Poland. A broadband superluminescent diode was used as a light source. RESULTS: The disturbances of retinal layer structure concerning mainly outer segments of photoreceptors were observed in case of central serous chorioretinopathy and choroidal neovascularization in age-related macular degeneration. Large drusen were often related to significant changes of outer nuclear layer thickness and reflectivity. CONCLUSIONS: SOCT detects small disturbances of the retinal structure and helps to precisely determine layers involved in different pathologies.

[Evaluation of the surface of the new intraocular lenses in the scanning electron microscope]. / Ocena powierzchni nowych soczewek wewnatrzgalkowych w elektronowym mikroskopie skaningowym.

PURPOSE: To evaluate the surface of the new PC IOLs commercially available in Poland in 2000. MATERIAL AND METHODS: Representative samples of new posterior chamber IOLs produced by 6 different companies (Alcon, Lensita, Medicontur, Opsia, Rayner, Storz), 5 of each, underwent surface examination with Novoscan 30 scanning electron microscope. RESULTS: Although, in general, smooth surface of optic and haptic parts were observed, three samples with irregularities were found. CONCLUSIONS: Comparing to previous evaluation performed in 1994, significant improvement in quality of IOLs surface was noted. No considerable differences in this field between above mentioned producers were observed.

[Retrospective evaluation of PC IOL power after extracapsular cataract extraction]. / Retrospektywna ocena mocy soczewki wszczepionej podczas zewnatrztorebkowego wydobycia zacmy.

PURPOSE: Retrospective evaluation of PC IOL power calculation accuracy and comparison of the refractive errors after ECCE resulted from different methods of calculation. MATERIAL AND METHODS: The PC IOL power in 100 eyes with senile cataract without significant refractive errors, was calculated using SRK II formula with two different biometers and based on primary refraction. The final IOL power was established by surgeon based on all mentioned calculations (surgeon choice). Half a year after surgery the refractive error was measured. The proper IOL power, which did not require additional correction, was calculated (ideal lens). RESULTS: 48 eyes did not require any distance correction. In 44 eyes small hyperopia (to +2.0 D) appeared and in 8 eyes myopia (to -1.5 D). The smallest error was made in cases where we implanted lenses according to surgeon choice. The average power of ideal lens was 20.32 D. We observed statistically significant difference between both ultrasound biometers. CONCLUSIONS: The most accurate results were achieved in cases where IOL power was chosen by the surgeon based on SRK II formula and primary refraction. Possible source of errors can be inadequate indications of biometers.

[Post-steroid elevations of intraocular pressure in patient after radial keratotomy]. / Posteroidowe zwyzki cisnienia wewnatrzgalkowego u osób po keratotomii radialnej.

PURPOSE: The evaluation of frequency and amplitude of IOP elevations in patients after RK who were administrated topically dexamethasone. MATERIAL AND METHODS: RK was carried out in 90 eyes (55 patients). All these patients had been treated topically with 0.1% dexamethasone (Maxitrol, Alcon) since the first day after surgery till the period of 3 months in lowering doses. IOP was measured using air-puff tonometer (Reichert, USA) before surgery and on 1, 2, 3, 14, 30, 50, 90 day after RK. In case of IOP elevations the measurements were made more often. RESULTS: The mean IOP before surgery was 14.88 +/- 2.86 mm Hg for women and 16.14 +/- 2.83 mm Hg for men. In the period of 3 months after RK maximum IOP increased significantly both for women (mean: 21.46 +/- 7.51 mm Hg) and men (mean: 26.14 +/- 8.87 mm Hg). IOP higher than 25 mm Hg was observed in 35 eyes (37.7%). These IOP elevations were observed more often in men than women but this difference was not statistically significant. There was no correlation between frequency of IOP elevations and preoperative refractive error or the age of patients. CONCLUSIONS: The usage of steroids after RK requires careful monitoring of IOP. This subject needs further studies to answer if these IOP elevations can damage eye functions.

Induction therapy with carboplatin/paclitaxel followed by concurrent carboplatin/paclitaxel and dose-escalating conformal radiotherapy in the treatment of locally advanced, unresectable non-small cell lung cancer: preliminary report of a phase I trial.

Locally advanced non-small cell lung cancer is optimally managed with chemotherapy and thoracic irradiation, although the most appropriate strategy is not yet defined. In this phase I trial, we use two 21-day cycles of induction chemotherapy with paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) (225 mg/m2 over 3 hours) and carboplatin (area under the concentration-time curve = 6) followed by concurrent weekly paclitaxel (45 mg/m2/wk x 6) and carboplatin (area under the concentration-time curve = 2/wk x 6) and thoracic irradiation. Patients undergo three-dimensional treatment planning (conformal radiotherapy) to define the cancer target volume precisely. The phase I question being addressed in this study is the maximum tolerated radiation dose given concurrently with low-dose paclitaxel and carboplatin. The initial radiation dose is 60 Gy, with dose escalations to 66 Gy, 70 Gy, and 74 Gy being planned. Ten patients have been entered thus far (eight men and two women). Their median age is 67 years (range, 59 to 78 years), and none of the patients has had greater than 5% pretreatment weight loss. Seven of 10 are evaluable for response to induction carboplatin and paclitaxel, with a response rate of 57% (three partial responses and one minor response). Three patients had stable disease and none of the patients had evidence of progressive disease during induction chemotherapy. Three patients have completed all treatment at 60 Gy and one has completed all treatment at 66 Gy. Three of the four patients have had partial responses (75%), with the remaining patient having stable disease. Toxicity in the concurrent chemoradiotherapy portion of the trial thus far has consisted of grade 3 neutropenia in one patient and grade 4 lymphocytopenia in all four patients. No grade 3 or 4 nonhematologic toxicity has been seen. The trial data are not yet mature enough to report on survival. Accrual and treatment is continuing at the 66 Gy radiation dose level.