[Anatomical and functional results of pars plana vitrectomy with the internal limiting membrane removal in patients with rhegmatogenous retinal detachment]. / Ocena anatomiczna i funkcjonalna wyników leczenia przedarciowego odwarstwienia siatkówki metoda witrektomii przez czesc plaskqa ciala rzeskowego z usunieciem blony granicznej wewnetrznej.

AIM: To evaluate the benefits of the internal limiting membrane removal in patients with rhegmatogenous retinal detachment who underwent pars plana vitrectomy. MATERIAL AND METHODS: The first study group (B) consisted of 26 patients who underwent vitrectomy with the internal limiting membrane peeling. The second control group (K) consisted of 15 patients, in whom vitrectomy was performed without he internal limiting membrane peeling. Macular detachment was confirmed preoperatively in all patients. Ophthalmic examination was performed 6 months after surgery. This included the best corrected visual acuity for distance and near, M-Charts, fundus examination and spectral domain--optical coherent tomography. RESULTS: The results were statistically analyzed using the Shapiro-Wilk test and the Ch2 test of homogeneity. In the study group (B), the mean postoperative best corrected visual acuity for distance was 0.46, while in the control group (K) it was 0.35 (p = 0.35). The best corrected visual acuity for near in group B was 0.83 and 1.01 (p = 0.63) in group K. Central retinal thickness in group B was 268.64 µm, while in group K it was 335.07 µm (p = 0.20). The statistical analysis revealed significant differences between the two groups regarding the prevalence of defects in the ellipsoidal layer (p = 0.004). They were found to occur more frequently in group K (64.29%) than in group B (20.00%). The prevalence of epiretinal membrane was higher in group K (28.57%) than in group B (3.85%) (p = 0.02). CONCLUSIONS: The internal limiting membrane peeling reduces the risk of secondary epiretinal membrane, restores the ellipsoidal layer integrity and does not affect the visual acuity for distance and near.

[Surgical management of suprachoroidal haemorrhages induced by cataract surgery--case series]. / Postepowanie chirurgiczne w krwotokach nadnaczyniówkowych wywolanych operacjq zacmy--seria przypadków.

PURPOSE: Suprachoroidal hemorrhage (SCH) is a rare complication occurring during surgery (early SCH) or 3-5 days after operation as a delayed suprachoroidal hemorrhage. It occurs more often in patients who have complicated cataract surgery with vitreous loss or lens dislocation. The purpose of this study was to present surgical treatment of 7 patients with suprachoroidal hemorrhage due to cataract surgery. MATERIAL AND METHODS: Mean age of patients was 72,4 years old. There were 3 female and 4 male. Six patients were operated using phacoemulsification, one patient- using ECCE. In 3 cases the vitreous loss and lens dislocation occurred during operation. RESULTS: Suprachoroidal drainage was performed in 4 patients. In 3 patients suprachoroidal drainage was followed by vitrectomy. In this group in 2 patients injection of silicone oil was done. Anterior infusion line was used in all cases. Drainage sclerotomies were created in the quadrants of the involved SCH, confirmed by ultrasonography. In all treated patients reattachment of the choroid was obtained. The visual acuity improved significantly (final v. a. was between 0. 02 and 0. 5). CONCLUSIONS: According to our observation, the implementation of the suprachoroidal drainage combined with vitrectomy might improve the prognosis and facilitate the achievement of functional vision.

Surgical treatment of cataract and glaucoma in nanophthalmic eye--case report.

Work presents surgical strategy in case of cataract and glaucoma in patient with simple nanophthalmus. Moreover optimal manner of calculation of the IOL and treatment in case of occurrence of complication from disturbed structure of eyeball. Surgical procedure included removal of cataract by using phacoemulsification, implantation of artificial Acri.Lyc Extreme lens, account from Haigis rule. Because of high intraocular pressure in early postoperative period we decided to implant Ahmed devices--children's type with drain placed in posterior chamber combined with posterior vitrectomy. We obtained stabilization of intraocular pressure and effective visual acuity.

[Application of polymerase chain reaction method (PCR) in diagnosis of endophthalmitis]. / Zastosowanie metody lancuchowej reakcji polimerazy (PCR) w diagnostyce zakazen wnetrza galki ocznej.

PURPOSE: The goal of this study is to determine the usefulness of the PCR method in the diagnosis of endophthalmitis. MATERIALS AND METHODS: 30 clinical specimens 18 AH and 12 VF were obtained from 20 eyes with the clinical diagnosis of endophthalmitis. These included: 14 cases after cataract surgery, 1 case post trabeculectomy, 2 cases after penetrating traumas, and 3 cases after endogenous endophthalmitis. The same samples were analysed using 2 different methods: 1. conventional microbiological techniques (microscopy and diagnostic culture) and 2. PCR directed at 16S rDNA using universal primers. RESULTS: In the aqueous humor the causative pathogen was identified in one case (5.2%) by using diagnostic culture compared with seven cases (39%) by using PCR methods. In the vitreous samples the pathogen was identified in one case (9%) by using conventional method compared with five cases (50%) by using PCR. Microscopic preparation was difficult to evaluate in all samples. CONCLUSIONS: PCR performed on aqueous humor and vitreous fluid is a reliable tool for diagnosis of causative organism particularly in smear and culture negative specimens. By using universal primers we are able to detect the presence of pathogen in case of endophthalmitis and than potentially by using DNA probe hybridization to determine the species of the bacteria. The discrimination between infection or non-infection endophthalmitis plays the main role in a succesful therapy.

[Identification of bacterial flora of conjunctival sac in congenital nasolacrimal duct obstruction in children]. / Identyfikacja flory bakteryjnej spojówek towarzyszqcej wrodzonej niedroznosci przewodu nosowo-lzowego u dzieci.

PURPOSE: The aim of the study was to evaluate the species of the microorganisms and their susceptibility to antibiotics in congenital nasolacrimal duct obstruction in children. MATERIAL AND METHODS: The pus secretion after lacrimal sac massage was obtained from 81 children with congenital nasolacrimal duct obstruction. The laboratory diagnostics was performed using typical microbiological procedures. The modification of these procedures was 24-hour pre-incubation in sugar boullion. RESULTS: The most frequently isolated bacteria were Staphylococcus epidermidis (28%) and Staphylococcus aureus (22%). The isolated staphylococci (only coagulase-negative species MRSE) were resistant to methicillin in 2 cases. Streptococci were obtained in 20% isolations: Streptococcus pneumoniae (14%), Streptococcus viridans (6%). Gram-negative bacilli Pseudomonas aeruginosa and Moraxella spp. and Candida albicans were isolated in a few cases. Negative results of the cultures were obtained in 25% cases. CONCLUSIONS: The microorganisms typically constituting physiological flora of conjunctival sac may become the pathogens in the complications of congenital nasolacrimal duct obstruction in children.

[Antiphospholipid syndrome and changes in the eye]. / Zespót antyfosfolipidowy a zmiany w narzadzie wzroku.

Antiphospholipid syndrome (APS) is one of the most often secondary thrombophilic state, characterized by recurrent arterial and venous thrombosis, recurrent pregnancy loss, and the presence of circulating antiphospholipid antibodies. Ophthalmologic features are present in 15-88% of the patient with primary APS. In this article pathogenesis and clinical picture, especially ocular complications are presented.

[Changes in bacterial flora of conjunctival sac in patients prophylacticaly treated with antibiotic before cataract operation]. / Zmiany flory bakteryjnej worka spojówkowego pacjentów, u których stosowano profilaktycznie antybiotyk przed operacja zacmy.

PURPOSE: The aim of the study was to estimate changes in bacterial flora of conjunctival sac changes in patients prophylacticaly treated with different antibiotics (chloramphenicol, gentamycin, ofloxacin, norfloxacin) before cataract operation. MATERIAL AND METHODS: The studied group consisted of 166 patients hospitalized for cataract surgery. The control group consisted of 33 persons, neither treated topically with antimicrobial drugs nor suffering from infectious or inflammatory diseases. On the first day and on the operation day conjunctival swabs were obtained and typical microbiological diagnosis was performed. During hospitalization only one antimicrobial drug was administrated topically (chloramphenicol, gentamycin, ofloxacin or norfloxacin) in the studied group. RESULTS: Prophylaxis with antibiotics before cataract surgery changes bacterial flora of conjunctival sac: quantitative changes were observed most frequently, but also hospital antibiotic resistant strains were detected. None of tested antibiotics caused total elimination of conjunctival flora in all patients. CONCLUSIONS: None of the antibiotics used in our study could cause total elimination of conjunctival flora. According to our results, the most effective antibiotics in prophylaxis before eye surgery are fluoroquinolones. Some patients before eye surgery have the pathogenetic conjunctival flora not causing the disease, yet increasing the risk of postoperative endophthalmitis.

[Antibodies to beta-2 glycoprotein I in serum and aqueous humor of patients with glaucoma and their influence on the static perimetry]. / Poziom przeciwcial skierowanych przeciwko beta-2 glikoproteinie I w surowicy i cieczy wodnistej pacjentów z jaskra i ich wplyw na wystepowanie zmian w perymetrii statycznej.

PURPOSE: The evaluation of the relationships between the antibodies anti beta-2 glycoprotein I in serum and aqueous humor of the glaucoma patients to the visual field defects. MATERIAL AND METHODS: 48 persons (38 women and 17 men), aged 30-86 (mean age 70), suffering from glaucoma was examined. There were 19 with POAG, 18 with PACG and 11 with PEXG. All patients have undergone trabeculectomy. In plasma and anterior chamber fluid the level of antibodies to beta-2 glycoprotein I classes IgA and IgG were measured using ELISA method (commercial kits produced by Euroimmun), according to producer's instruction. The visual field defects were examined with Humphrey static perimetry. Statistical analysis was performed using Spearman test. RESULTS: There were no significant correlations between antibodies anti beta-2 glycoprotein I, static perimetry, age and duration of the disease. CONCLUSIONS: There have not been stated any relationships between the static perimetry to antiphospholipid antibodies level in serum and aqueous humor in patients with glaucoma. It is the preliminary communication.

[Serum and aqueous humor antibodies to beta-2 glycoprotein I in patients with glaucoma and cataract]. / Przeciwciala przeciwko beta-2 glikoproteinie I w surowicy i cieczy wodnistej chorych na jaskre i zacme.

PURPOSE: Evaluation of the serum and aqueous humor antibodies to beta-2 glycoprotein I in patients with glaucoma. MATERIAL AND METHODS: 48 persons (38 women and 17 men), aged 30-86 (mean age 70), suffering from glaucoma was examined. There were 19 with POAG, 18 with PACG and 11 with PEXG. All patients have undergone trabeculectomy. The group of 20 operated patients, because of age-related cataracta (7 men and 13 women), aged 47-82 (mean age 65), constituted a control group. All patients agreed with samples collection. In plasma and anterior chamber fluid, the level of antibodies to b-2 glycoprotein I classes IgA and IgG were measured using ELISA method (commercial kits produced by Euroimmun), according to producer's instruction. Statistical analysis was performed using U Mann-Whitney test when both groups were compared and Spearman test to comparisons concerning single group. RESULTS: Significant changes between glaucoma and cataract patients were observed in anti-b-2 glycoprotein I antibodies class IgA in aqueous humour (p=0.04) and in serum (p=0.03). CONCLUSIONS: Knowledge of the immunological pathogenesis in the glaucomatous nerve damage can be curtailed or even prevented with the use of proper agents. Indeed, there are many intriguing new therapeutic possibilities on the horizon. To determine the clinical potential of serum antibodies in glaucoma patients, a randomized clinical trial would be necessary. It is the preliminary communication.

[Levels of antiphospholipid antibodies in the serum and aqueous humor of glaucoma patients]. / Poziom przeciwcial antyfosfolipidowych w surowicy i cieczy wodnistej pacjentów z jaskra.

PURPOSE: Evaluation of antiphospholipid antibodies in the serum and aqueous humor in patients with glaucoma. MATERIAL AND METHODS: 48 persons (38 women and 17 men), aged 30-86 (mean age 70), suffering from glaucoma was examined. There were 19 with POAG, 18 with PACG and 11 with PEXG. All patients have undergone trabeculectomia. The group of 20 operated, because of age-related cataracta patients (7 men and 13 women), aged 47-82 (mean age 65) constituted a control group. All patients agreed to samples collection. In plasma and anterior chamber fluid the level of antiphospholipids antibodies classes IgM and IgG were measured, using ELISA method (commercial kits produced by Euroimmun) according to producent's instruction. Statistical analysis was performed using U Mann-Whitney test. RESULTS: The mean values of antiphospholipids in both group are put in the table. The significant differences between glaucoma and no-glaucoma patients were observed in levels of IgG in serum (p=0.014) and in levels of IgM antibodies in aqueous humor (p=0.013). CONCLUSIONS: The presence of elevated levels of antiphospholipid antibodies in aqueous humor and serum may be a risk factor in progression of glaucomatous neuropathy.

The occurrence of primary open angle glaucoma in a family.

The occurrence of primary open glaucoma (POAG) in families proves the hypothesis that POAG is a disease with underlying genetic factors. This work describes a family of four generations, in which eight members suffered from POAG. In the 3rd and 4th generation members, the disease occurred at an early age (between the age of 20-40 years), i.e. at a much earlier age than it could be expected. Therefore, a need arises to keenly observe families in which POAG is present.