[Evaluation of the posterior capsule opacification in different types of artificial intraocular lenses]. / Hodnocení opacit zadního pouzdra u ruzných typu umelých nitroocních cocek.

PURPOSE: To evaluate and compare posterior capsule opacification (PCO) incidence and the best-corrected visual acuity (BCVA) in patients who underwent the implantation of intraocular lens (IOL) made of polymethylmethacrylate (PMMA), or hydrophobic acrylic material, or silicone material. All patients were examined 7 years after the surgery at the Department of Ophthalmology, University Hospital, Hradec Králové, Czech Republic, E.U. METHODS: In this 60 study, sixty eyes (44 patients) were evaluated; 20 eyes with IOLs made of PMMA with round edge, 20 eyes with IOLs made of hydrophobic acrylic material with square edge and 20 eyes with IOLs made of silicone material with round edge. They were examined 7 years after surgery. The eyes treated with Nd:YAG laser capsulotomy were excluded from the EPCO 2000 evaluation. The EPCO 2000 software (Evaluation of Posterior Capsule Opacification) was used for PCO assessment. The density of the opacification was graded clinically from 1 to 4. The BCVA, the PCO index for every PCO grade and total PCO index were compared. RESULTS: Mean of total PCO index for PMMA IOLs was 0.451 +/- 0.619; for hydrophobic acrylic IOLs 0.361 +/- 0.397; and for silicone IOLs 0.552 +/- 0.372. During the examination, we have found the BCVA mean to be for PMMA IOLs 0.79 +/- 0.26, for hydrophobic acrylic IOLs 0.87 +/- 0.19, and silicone IOLs 0.78 +/- 0.29 respectively. Twenty eyes of twenty patients required Nd:YAG laser capsulotomy: twelve eyes with PMMA IOLs, two eyes with hydrophobic acrylic IOLs, and six eyes with silicone IOLs. CONCLUSIONS: In this study, the difference in PCO incidence and BCVA among PMMA, hydrophobic acrylic, and silicone IOLs were not statistically significant. The highest incidence of the Nd:YAG laser capsulotomy was in the group of PMMA IOLs, then in silicone IOLs, and the lowest incidence was in the group of hydrophobic acrylic IOLs.

[Microbiological examination of the aqueous humor after implantation of the intraocular lens CORNEAL]. / Mikrobiologické vysetrení komorové tekutiny po implantaci nitroocni cocky CORNEAL.

PURPOSE: To compare the results of the microbiological examination of aqueous humor after implantation of the intraocular lens (IOL) CORNEAL using either injector or forceps. MATERIALS AND METHODS: In this prospective randomized clinical study 46 eyes (43 patients) were implanted with the hydrophylic acrylic IOL CORNEAL ACR6D SE. Injector was used in 23 eyes and folding and implantation forceps in 23 eyes. After delivery of the IOL in the capsular bag, viscoelastic material was removed using bimanual I/A and the specimen for microbiological examination was obtained. The anterior chamber was filled with balanced salt solution, intracameral antibiotics were injected and the stroma alongside the primary incision and the side port incisions were lightly irrigated to form a fairly secure seal. RESULTS: The results of primary cultivation were negative in all specimen. Only threetimes sporadic colonies of Staphylococcus plasmacoag. neg. were isolated from the liquid medium after reincubation, that were described by microbiologist as very probably contamination of the sample. At two from these three cases forceps were used for implantation, once injector. Anaerobic and mycologic examinations of all samples were negative. There was no evidence of postoperative inflammation in any case. CONCLUSION: Both implantation techniques proved to be safe with no significant differences comparing the microbiological examination and postoperative outcome.

[Posterior capsule opacification in patients with type 2 diabetes mellitus]. / Opacity zadního pouzdra u pacientu s diabetes mellitus 2. typu.

PURPOSE: To compare the degree of posterior capsule opacification (PCO) after cataract surgery in patients with type 2 diabetes mellitus (DM) and in nondiabetic patients. PATIENTS AND METHODS: All surgeries were done at Department of Ophthalmology, University Hospital in Hradec Králové and three-piece Alcon AcrySof intraocular lens (MA60BM or MA30BA) was implanted in all eyes. Seven years after surgery, examination of eyes was done including best corrected Snellen visual acuity (BCVA) measurement. Digital retroillumination photographs of mydriatic anterior segments were taken and PCO was assessed using EPCO 2000 software for PCO quantification. Patients enrolled in the study were devided into two groups--with type 2 DM and without DM. EPCO index for 4 PCO severity grades and Total EPCO index for entire IOL were compared between the groups. The incidence of Nd:YAG laser capsulotomy and operative Elschnigg pearls removal, as well as BCVA, were also evaluated. Statistical analysis was performed using nonparametric tests. RESULTS: 82 patients (140 eyes) were analyzed. 26 of them (36 eyes) were type 2 diabetics (DM group), none type 1 diabetics, remaining 56 nondiabetic patients (104 eyes) were enrolled in the control group. Total EPCO index for the DM group was 0.531 +/- 0.543, for the control group 0.492 +/- 0.532, no significant difference (P = 0.66). No significant different in Nd:YAG capsulotomy rate (22.2% for DM vs. 17.3% for control, P = 0.62) and operative Elschnigg pearls removal (8.3% for DM vs. 1.9% for control, P = 0.11) was proved. BCVA in the DM group was 0.80 +/- 0.29, in the control group 0.82 +/- 0.22, no significant difference (P = 0.78). CONCLUSION: No significant difference in PCO extent, Nd:YAG capsulotomy rate and operative PCO treatment was proved between the patients with type 2 DM and the control group. However, all outcomes were nonsignificantly worse in the diabetic patients.

[Postoperative results of hydrophilic expandable intraocular lenses ACQUA (Mediphacos) implantation]. / Pooperacní výsledky expandibilní nitroocní cocky ACQUA (Mediphacos).

PURPOSE: To assess postoperative outcomes of implanted hydrophilic expandable intraocular lenses ACQUA. MATERIAL AND METHODS: One hundred eyes of 75 patients with implanted intraocular lens (IOL) ACQUA were involved. IOLs were implanted during the period 2004 to 2005. The uncorrected visual acuity (UCVA) and the best-corrected visual acuity (BCVA), refractive error and its spherical equivalent (SE) were measured preoperatively and 1 day, 1, 6, 12 months postoperatively. Possible postoperative complications were evaluated as well. The patients were divided into two groups: first group with the age-related macular degeneration (ARMD) and the second one without it. RESULTS: Sixty-five patients (90 eyes) finished the one-year follow-up period. Preoperative UCVA was 0.23 +/- 0.19, BCVA 0.43 +/- 0.23 and SE + 0.15 +/- + 2.06 D (dioptres). Statistically significant differences between UCVA and BCVA one day and one month postoperatively were established. Six months after the operation and later on, the mean UCVA and BCVA were 0.61 +/- 0.26, and 0.82 +/- 0.23 respectively in all eyes, and 0.67 +/- 0.24, and 0.9 +/- 0.17 respectively in the group of eyes without ARMD. Spherical equivalent was stable during the whole follow-up period, one year after the surgery it was -0.1 +/- 1.12 D in the group of all 90 eyes. The IOL central positioning in the bag was excellent in 86 eyes. Nd:YAG laser anterior capsulotomies were performed in two eyes due to the stricture of the anterior capsule and posterior capsulotomy was performed in one eye due to the fibrous secondary cataract. The ACQUA IOL had to be explanted from one eye because of recurrent acute non-infectious inflammation of the anterior segment. CONCLUSION: According to our experience, the IOL ACQUA Mediphacos shows good and stable postoperative outcomes.

[Comparison of posterior capsule opacification in 2 types of implanted artificial intraocular lens]. / Porovnání opacit zadního pouzdra u dvou typu implantovaných umelých nitroocních cocek.

PURPOSE: To compare posterior capsule opacification (PCO) incidence and the best corrected visual acuity (BCVA) in patients who had the soft intraocular lens (IOL) made of hydrophobic acrylic material (AcrySof MA30BA, MA60BM) implanted in their one eye and IOL made of silicone material (Allergan SI-30NB) implanted in their second eye. All patients included in this study were operated on at Department of Ophthalmology, University Hospital, Hradec Králové, Czech Republic during the period from 1999 to 2002. METHODS: Twenty-four patients (8 males, 21 females) were included in this study; they were 3 to 6 years after surgery (median 5 years). The EPCO 2000 software (The Evaluation of Posterior Capsule Opacification) was used for PCO assessment. Eyes treated with Nd: YAG laser capsulotomy were excluded from EPCO 2000 evaluation. The density of the opacification was graded clinically from 1 to 4. We compared BCVA, PCO index for every PCO grade and total PCO index. RESULTS: Seven eyes of five patients required Nd: YAG laser capsulotomy, 2 eyes with AcrySof IOL, 5 eyes with Allergan IOL. Median of total PCO index for 48 eyes of 24 patients was for AcrySof IOL 0.496 vs. 0.315 for Allergan IOL. On the evaluation, median of BCVA was for AcrySof IOL 1.0 vs. 0.67 for Allergan IOL. CONCLUSIONS: The difference in PCO incidence and BCVA between the silicone and the soft acrylic IOLs were not conclusive in this study. But Nd: YAG laser capsulotomy incidence was higher in the silicone IOLs.