[Is it possible to accurately measure intraocular pressure after refractive surgery?]. / Je mozné presné meranie vnútroocného tlaku po refrakcných operáciách?

OBJECTIVE: To evaluate how the change of thickness or curving of the cornea after refraction operations (PRK or LASIK) influences the intraocular pressure (IOP) during assessment with a noncontact tonometer. PLACE OF INVESTIGATION: Ophthalmological Clinic SPAM and Ophthalmological ambulance EXCIMER. MATERIAL AND METHODS: With regard to the performed refraction operation the patients were divided into two groups. The first group comprised 87 patients where PRK was performed to correct myopia. The mean myopia in this group was -5.27 D +/- 2.32. The second group comprised 62 patients where LASIK surgery was performed to correct myopia. The mean myopia in this group was -10.18 +/- 4.36. IOP was assessed by means of a noncontact tonometer before and 6 months after surgery. RESULTS: In the first group a mean reduction of IOP by 4.8 +/- 2.1 mm Hg occurred. The central thickness of the cornea declined on average by 55.69 +/- 28.9 micros and the curving of the cornea diminished on average by 3.72 D +/- 1.76 D. In the second group of patients the IOP declined on average by 7.97 +/- 2.04 mm Hg. The central thickness of the cornea diminished by 78.75 microns +/- 42.26 and the curving of the cornea by 4.65 D +/- 2.07. In both groups a significant correlation was found between the reduction of IOP and the central thickness and curving of the cornea. CONCLUSION: Diminution of the thickness of the central cornea and diminution of the curving lead to lower values of the IOP. There is a direct correlation between thinning of the cornea and the decline of IOP.

[Excimer laser photorefractive keratectomy in myopia]. / Excimer laser fotorefraktívna keratektómia u myopie.

The authors present an account on excimer laser photorefractive keratectomy on 254 myopic eyes with a minimal follow-up period of 6 months. The mean preoperative refraction -6.31 +/- 4.02 D was reduced to -0.92 +/- 1.3 D. A difference between the planned and achieved correction of less than 0.5 was recorded in 33.5% eyes, less than 1.0 D in 59.4% eyes and less than 1.5 D 77.6% eyes. As to complications the following were recorded: astigmatism more than 0.5 D (7.9%), problems with epithelialization (5.5%), steroid induced increased intraocular pressure (3.9%), corneal turbidity higher than 2 (1.2%). Based on the results the authors revealed that excimer laser photorefractive keratectomy is safe and effective refraction surgery for low and medium myopia with the possibility to predict the resulting postoperative refraction.

[Therapy of the fibrin reaction after intraocular surgery using fibrinolytic agents]. / Liecba fibrínovej reakcie po vnútroocných operáciách fibrinolytikami.

The presence of fibrinous reaction after some intraocular surgery causes in some cases the reduction of visual acuity. In our study we aimed at fibrinous response after ECCE with posterior chamber IOL implantation and the possibility of affect and treatment of the fibrinous reaction. From January 1991 to December 1993, 1160 ECCE with implantation IOL were performed at Department of Ophthalmology Postgraduate Institute in Bratislava, Slovakia. The fibrinous reaction was encounted in 110 eyes (9.48%). Some of fibrinolytics which are commonly applied on the treatment of internal medicine can be used safely for fibrinous reaction after intraocular surgery. We used Fraxiparine (Sanofi, Choay), which was applied subconjunctivally in dose of 500 U.I.Axa. The treatment of fibrinous reaction with corticosteroids and Fraxiparine was compared. The results proved that after treatment with Fraxiparine the fibrinous reaction disappeared sooner. We have not found out any complications after application of Fraxiparine.

[Relation between preoperative and late postoperative keratometry]. / Vzt'ah medzi predoperacnou a neskorou pooperacnou keratometriou.

The authors in their work compare corneal astigmatism before cataract surgery and the late postoperative corneal astigmatism (min. 18 months after surgery). ECCE was done with IOL implantation with a limbal approach and the wound was sutured with 5-6 single interrupted sutures. Two months after the surgery all sutures were removed in astigmatism with the rule higher than 3.0 D. The average value of the corneal astigmatism with the rule before surgery was 0.42 +/- 1.19 D and late postoperative astigmatism against the rule was 0.19 +/- 1.18 D. 43 eyes (69.4%) had the difference between preoperative and late postoperative corneal astigmatism less than 1.5 D. 19 eyes (30.6%) had the difference higher than 1.5 D. 12 eyes (19.4%) had postoperative corneal astigmatism against the rule higher than 1.5 D. We have found positive correlation between preoperative and postoperative values (P < 0.001) and an important difference was found between preoperative and postoperative corneal astigmatism (0.001 < P < 0.01). Authors recommend not to use biodegraded sutures, to make tight closure of the internal aspect of the wound, to use interrupted sutures, to remove sutures 3-5 months after surgery in high astigmatism with the rule and carefully evaluate the number of removed stitches so that the corneal astigmatism against the rule will not appear.

[Fibrin reaction after implantation of posterior chamber intraocular lenses]. / Fibrínová reakcia po implantácii zadnokomorových IOL.

One of the complications after implantation of posterior chamber intraocular lenses is fibrin reaction. The authors analyse group of 653 patients--659 eyes after the operation of cataract with implantation of posterior chamber IOL operated in 1991-1992 at Postgraduate School of Medicine, Ophthalmology Department in Bratislava. The fibrin reaction was found out in 33 cases (5%). This reaction started between the first and third day after the operation. From this group of 33 patients, 14 (43%) were treated for glaucoma, 11 (33%) had diabetes mellitus and 3 (9%) overcome uveitis in past years. In all cases after the treatment came to the complete loss of fibrin. Finally visual acuity was 5/5 to 5/10.

[Initial experience with block excision of choroidal tumors]. / Nase prvé skúsenosti s blokovou excíziou nádorov chorioidey.

The authors present their experiences with the microsurgical method of therapy of choroidal malignant melanoma. During the last two years 10 patients have been admitted to the hospital that had malignant melanoma of uvea, eight of them had choroidal melanoma. In 5 patients local excision of choroidal melanoma was made, according to Peyman's criteria. One patient has reached the visual acuity of 5/10, other two patients had vitreous hemorrhages after the operation without absorption. Fourth patient has developed hypotony and in one patient the operation had to be interrupted and the enucleation of the eye was made. Local excision seems to be a promising operation method, which can preserve the eye and its good visual acuity in indicated cases.

[Initial experience with implantation of disc-type intraocular lenses]. / Nase prvé skúsenosti s implantáciou diskových vnútroocných sosoviek.

The authors present their postoperative results of extracapsular cataract extraction with implanted disc intraocular lens CD 801 A (Pharmacia). In 1991 within 6 months 62 of these lenses had been implanted. A year after the operation, the location of the intraocular lens, transparency of posterior capsule, the shape of the pupil and visual acuity (correction) had been followed. In 6 patients (9.7%) dislocated lenses had been found, 11 patients (17.7%) developed decreased transparency of the posterior capsule, and in 30 patients (48.4%) circular shape of the pupil was in different way distorted. 48 eyes (77.42%) had 1 dioptre error or less, 58 eyes (93.55%) had 2 dioptres error or less and 4 eyes (6.45%) had an error of more than 2 dioptres.