[Implementation of a psychological support program for children with cancer in Poland. Preliminary report]. / Wdrazanie programu wsparcia psychologicznego u dzieci leczonych w Polsce z powodu choroby nowotworowej doniesienie wstepne.

Intensive chemotherapy programme in children with cancer may result in psychological mal adjustment. Treatment facilities as well as psychological support are of great importance to minimize these side effects. In 1998 the programme of psychological support was introduced in 7 Polish paediatric haematology / oncology centres. Psychological adjustment of patients treated in each centre was examined 5 yrs after the termination of therapy. At the same time children with new diagnosis of cancer were monitored psychologically along with the psychological support programme. Psychological status of each patient was examined with the following tests: Cattell's questionnaires (CPQ, HSPQ), Manifest Anxiety Scale, Spielberger's inventories (STAI, STAIC), Wechsler Intelligence Scale. The programme of psychological support was based on guidelines of SIOP Psychosocial Committee and included such elements as informing about diagnosis and treatment, explaining any doubt, maintaining an open communication, educational care in the periods of treatment, encouraging to activity even during periods of discomfort. The analysis showed that most of the participating centres could only provide some elements of the support programme. The main problem was to convince medical staff to inform children on diagnosis and treatment plans. Preliminary results of the study indicate that full psychological support for children with cancer and their families from the beginning of therapy can result in improvement in psychological adjustment. During the ensuing period, patients and their parents appreciate the possibilities to contact a psychologist.

[Comparative evaluation of visual acuity after cataract extraction with monofocal, bifocal or progressive lenses implantation]. / Ocena porównawcza ostrosci wzroku po operacji zacmy z wszczepem soczewek tylnokomorowych jednoogniskowych, dwuogniskowych i progresywnych.

PURPOSE: Evaluation which of the lenses: monofocal, bifocal or progressive, assure the best visual acuity in patients. MATERIAL AND METHODS: 86 patients aged from 21 to 84 years were operated. Monofocal lenses were implanted in 30 cases, bifocal in 32 and progressive in 24 cases. RESULTS: In 90% of patients with monofocal lenses and over 90% of patients in the remaining groups full uncorrected or corrected distance visual acuity was achieved. In groups with bifocal and progressive lenses full near visual acuity without correction, or with the same correction as for distance, was achieved by respectively 65.5% and 75% of patients. CONCLUSIONS: In all three groups very good distance visual acuity was achieved. The best near visual acuity is assured by progressive lenses, in lower degree by bifocal lenses.

[Comparative evaluation of corneal endothelial cells after extracapsular cataract extraction with PMMA and heparin-surface modified lens implantation]. / Ocena porównawcza komórek sródblonka rogówki po zewnatrztorebkowym usunieciu zacmy z wszczepem soczewek z PMMA i heparynizowanych.

PURPOSE: Comparison of endothelial cells density in eyes after PMMA and heparin-surface-modified lenses (HSfM1) implantation. MATERIAL AND METHODS: 58 patients (26 male and 32 female) aged from 36 to 89 years. In 30 patients PMMA lenses produced by Pharmacia, Storz and Alcon and in 28 HSM (Pharmacia) lenses were implanted, after ECCE. RESULTS: Percentage loss of endothelial cells in eyes with PMMA lenses was 8.61% after month and 13.56% 6 months post-operatively. In eyes with HSM lenses endothelial cell loss was 8.44% and 13.55% respectively. CONCLUSION: Loss of corneal endothelial cells in eyes with PMMA lenses is almost the same in eyes with HSM lenses.

[Evaluation of 200 extracapsular cataract extractions using the envelope technique]. / Ocena 200 operacji zewnatrztorebkowego wydobycia zacmy wykonanych technika koperty.

PURPOSE: To present own results of extracapsular cataract extraction with the use of the envelope technique. MATERIAL: 200 patients (110 male, 87 female and 3 children) aged from 7 to 86 years operated in the Department of Ophthalmology in Bydgoszcz from December 1992 to May 1996, including patients with congenital, senile, presenile cataract or with diabetes. RESULTS: In 187 patients (93.5%) final distance visual acuity was 0.7-1.0. Visual acuity less than 0.7 wasn't related with surgical procedure itself. In 8 patients corneal edema, lasting for a few days, was observed postoperatively. After treatment with systemic steroids all the symptoms resolved-not effecting final visual acuity. CONCLUSION: Cataract extraction with the use of an envelope technique allows for stable IOL placement in the lens capsule and decreases postoperative corneal reaction to minimum.

[Methods of coping with the disease and treatment in children with neoplastic blood diseases]. / Sposoby radzenia sobie z choroba i leczeniem podejmowane przez dzieci z nowotworowymi chorobami krwi.

Neoplastic disease and the employed therapeutic management may cause strong anxiety in children. The authors analyzed factors affecting anxiety level. The analysis included the reaction of children to hospitalization and methods of coping with diseases and therapy by children in various age groups.

[Corneal endothelium after radical keratotomy]. / Sródblonek rogówki po keratotomii radialnej.

Corneal endothelium was examined in 37 patients with a contact endothelial specular microscope before and after radial keratotomy. The mean percent of cell loss was 0.9% one month and 2.5% six months after surgery.

[Corneal endothelium after cataract surgery]. / Sródblonek rogówki po operacjach zacmy.

Corneal endothelium was examined in 95 patients with a contact endothelial specular microscope before endothelium was examined in 95 patients before and after extracapsular cataract extraction with IOL implantation. The patients were divided into four groups, depending on the surgical techniques: I--traditional can opener capsulectomy with lens implanted in ciliary sulcus, II--envelope technique, III--envelope technique preceded by laser anterior capsulotomy, IV--phacoemulsification. In the last 3 groups the IOL was placed in the lens capsule. Studies of the endothelium cells density were performed 1 and 3 months after surgery. The mean percent age of cell loss was following: in group I 10.8% after 1 month and 14.6% after 3 months, in group II 12% and 15%, in group III 11% and 14.8%, in group IV 13% and 18% respectively.

[Artificial intraocular lenses in patients with cataracts and glaucoma]. / Sztuczne soczewki wewnatrzgalkowe u chorych z zacma i jaskra.

The authors evaluated 52 glaucomatous eyes in which, after the extracapsular cataract extraction, artificial posterior lens has been implanted. In 32 patients glaucoma has been treated for 2-6 years. In 7 patients of this group, it was not possible to control the intraocular pressure before surgery and in these cases simultaneous trabeculectomy, extracapsular cataract extraction and the implantation of artificial posterior lens were performed. In 13 patients, anti-glaucomatous surgery had been performed before, and in 7 cases, glaucoma was diagnosed in the preoperative period. We considered our results as satisfactory since in 67% visual acuity was over 0.5; 29% of the patients did not require anti-glaucomatous treatment, whereas 71% took anti-glaucomatous drugs in reduced doses. In our opinion, glaucoma is not a contraindication for artificial lens implantation, although surgery can be technically more difficult.

[Use of transconjunctival cryoapplication in chronic pars planitis with involvement of peripheral retina and choroid]. / Zastosowanie krioaplikacji przezspojówkowej w przewleklych zapaleniach czesci plaskiej ciala rzeskowego z zajeciem obwodu siatkówki i naczyniówki.

The transconjunctival cryoapplication was performed in 8 patients (13 eyes) with the recurrent pars planitis and the simultaneous involvement of peripheral retina and choroid. Before the surgery, the peripheral fundus of the eye was examined with the Goldmann three-mirror lens and afterwards, the cryoapplication of lesions was performed. The topical treatment, dexamethasone and indomethacin drops, followed the surgery only. In all cases the inflammation disappeared but the macular edema and vitreal exudation regressed slowly. The considerable improvement of visual acuity was achieved in 8 eyes (61%). So far, the results of the observations are satisfactory and they entitle the authors to carry on the application of the treatment mentioned above.

[Late results of the treatment of eye burns]. / Odlegla ocena wyników leczenia oparzen oczu.

An analysis of patients treated in the Ophthalmic Department in Bydgoszcz for eye burns in the 10 years period from 1980 till 1990. Taken into account were the causes of burns, the treatment installed in the early period and in cases of late complications. All the patients were asked to call in for a control examination in order to compare the condition of the eyes at the date of discharge and in the long-lasting time. Among 118 eyes in 91 the visual acuity amounted 0.5-1.0, in the remaining 25 it was only hand movements--0.4. The main causes of low visual acuity were: corneal leucoma, secondary glaucoma, complicated cataract. The eye was enucleated in 2 patients because a painful ocular atrophy developed in the course of the pathological process. These were the cases of thermal burns combined with a mechanical injury. The obtained results were evaluated as sufficiently favourable and comparable to the data of other authors.

[Critical evaluation of the treatment of diabetic retinopathy based on personal experience]. / Krytyczna ocena leczenia retinopatii cukrzycowej w oparciu o material wlasny.

The authors present the results of analysis of the treatment of 184 patients (360 eyes) with diabetic retinopathy; it comprises as well the out-patients as the in-patients divided into 4 groups in dependence on the changes and the treatment applied (laser focused photocoagulation, panretinal photocoagulation, cryopexy) the majority of patients reported to the hospital with an advanced proliferative diabetic retinopathy and this allowed only the performance of a panretinal photocoagulation and in a part of cases only cryopexy. The attention is called to the necessity of an early detection of pathological changes and of an early treatment.

[Preoperative anterior capsulotomy using YAG laser in cataract extraction by the envelope method. Preliminary report]. / Przedoperacyjne rozciecie torebki przedniei soczewki laserem YAG w usunieciu zacmy technika koperty. Doniesienie wstepne.

The envelope technique was used in 50 patients with cataract. In 25 patients anterior capsulotomy was performed by YAG laser before surgery (in 5 persons 1 day, in the remaining 20 1 hour before operation). The sole complications connected with laser capsulotomy was the raise in the intraocular pressure in 2 patients. In these woman-patients the laser surgery was performed a day before operation. In all the patients in whom the cataract operation was preceded by laser capsulotomy the removal of the anterior capsule did not produce any difficulty. The experience obtained during the study enable to state that laser capsulotomy simplifies considerably the operation and in connection with the envelope technique diminishes to a minimum the possibility of postoperative complications.

[Study of the fundus oculi periphery in patients with posterior- chamber lenses]. / Badanie obwodu dna oka u osób z soczewka tylnokomorowa.

Evaluation of the eye fundus after an extracapsular cataract extraction with posterior chamber lens implantation was performed in 50 patients 1 month after surgery and in 50 another patients 2 years after surgery. In the earlier period a very good inspection was possible in 88 p.c. of cases, 2 years after cataract extraction in 78 p.c. The usefulness of bilateral ophthalmoscopy was emphasized.

[Intraocular lenses in patients with diabetes mellitus]. / Soczewki wewnatrzgalkowe u chorych z cukrzyca.

Presented are personal experiences concerning the application of artificial intraocular lenses in patients with diabetes and cataract. Operated were patients aged 50-76 years in whom implantation of an artificial lens of Alcon or Cilco was performed either to the anterior or posterior chamber. During the qualification for surgery eliminated were patients with proliferating retinopathy, with rubeosis iridis (with or without secondary glaucoma) and with juvenile diabetes. In 16 patients the obtained visual acuity was 0.8-1.0, in one female patient 0.5; in the remaining 2 persons the visual acuity amounted 0.2 and 0.3. These patients exhibited a simple exudative retinopathy with a macular oedema and after surgery they were subjected to a laser therapy. Observation of our material showed that qualifying diabetic patients for cataract extraction and taking into consideration the over mentioned contraindications one can obtain good results similar as in other patients with cataract.