Optical biopsy of human bladder neoplasia with in vivo confocal laser endomicroscopy.

PURPOSE: Confocal laser endomicroscopy is a new endoscopic imaging technology that could complement white light cystoscopy by providing in vivo bladder histopathology. We evaluated confocal laser endomicroscopy by imaging normal, malignant appearing and indeterminate bladder mucosa in a pilot study. MATERIALS AND METHODS: Patients scheduled to undergo transurethral resection of bladder tumors were recruited during a 3-month period. After standard cystoscopy fluorescein was administered intravesically and/or intravenously as a contrast dye. A 2.6 mm probe based confocal laser endomicroscope was passed through a 26 Fr resectoscope to image normal and abnormal appearing areas. The images were collected with 488 nm excitation at 8 to 12 frames per second. The endomicroscopic images were compared with standard hematoxylin and eosin analysis of transurethral resection of bladder tumor specimens. RESULTS: Of the 27 recruited patients 8 had no cancer, 9 had low grade tumors, 9 had high grade tumors and 1 had a low grade tumor with a high grade focus. Endomicroscopic images demonstrated clear differences between normal mucosa, and low and high grade tumors. In normal urothelium larger umbrella cells are seen most superficially followed by smaller intermediate cells and the less cellular lamina propria. In contrast, low grade papillary tumors demonstrate densely arranged but normal-shaped small cells extending outward from fibrovascular cores. High grade tumors show markedly irregular architecture and cellular pleomorphism. CONCLUSIONS: We report the first study to our knowledge of in vivo confocal laser endomicroscopy in the urinary tract. Marked differences among normal urothelium, low grade tumors and high grade tumors were visualized. Pending further clinical investigation and technological improvement, confocal laser endomicroscopy may become a useful adjunct to conventional cystoscopy.

[Trans-sclerally fixated PC-IOLs: six year of investigations]. / Soczewki wewnatrzgalkowe tylnokomorowe mocowane do twardówki--szesc lat doswiadczen.

PURPOSE: To present the results of PC IOLs transscleral fixation to the ciliary sulcus in six years follow-up. MATERIAL AND METHODS: 152 eyes in 3 groups: 15 eyes with primary fixations of PC IOLs, 92 eyes with secondary fixations of PC IOLs and 45 eyes with secondary fixations of PC IOLs combined with penetrating keratoplasty. RESULTS: Postoperative corrected visual acuity was 0.5 or better in 32.2% of cases, the most common complications in our material was CME (9.9%), lens tilt (4.6%) and increase of IOP (3.95%). CONCLUSION: Transscleral fixation of PC IOLs offers good visual outcome with relatively low rate of complications and is recommended in cases with inadequate posterior capsule support.

[Glaucoma after penetrating keratoplasty in the material of the ocular department of the Mountain Hospital in Sosnowiec]. / Jaskra po keratoplastyce drazacej w materiale oddzialu okulistycznego szpitala górniczego w Sosnowcu.

PURPOSE: To evaluate the necessity of antiglaucoma therapy in patients after penetrating keratoplasty (PK). MATERIAL AND METHODS: An analysis of 537 penetrating keratoplasties performed in our department was undertaken. Incidence of glaucoma after penetrating keratoplasty procedure, necessity of pharmacological antiglaucoma treatment as well as the kind of surgical procedure and its influence on the graft transparency were estimated. RESULTS: The incidence of post keratoplasty glaucoma was 11.2% (60/537). 42 patients required pharmacological treatment (42/60) and the remaining 18 required surgery. 12 trabeculectomies, 6 drainage devices procedures and 1 cyclokrytherapy were performed and stabilization of intraocular pressure was obtained. 14 of the grafts treated surgically lost their transparency. CONCLUSIONS: Multiple surgical treatment of post-penetrating keratoplasty glaucoma, despite the stabilisation of the intraocular pressure, may lead to loss of graft transparency in most cases.