[Comparison of topic mydriasis and mydriasis achieved by soaked cellulose in the conjunctival sac]. / Porovnanie topickej mydriázy a mydriázy pomocou nasiaknutej celulózy vo fornixe.

AIM: To compare mydriasis before the cataract surgery after the local application of mydriatics in to the conjunctival sac with mydriasis achieved using the mydriatic solution in soaked piece of cellulose applied in to the lower fornix. The same mydriatics (tropicamide 0.5 %, phenylephrine 10%, and homatropine 4 %) were used. METHODS: In a prospective, non-randomized study the authors measured maximal artificial mydriasis in 100 patients (60 women, 40 men) in 100 eyes before the cataract surgery. The mean age of the patients was 70.17 years (range, 42 - 91 years). The patients were divided into two groups (A, B), each of 50 persons: In the group A, during the 10 - 15 minutes period, the mydriatics, tropicamide 0.5%, phenylephrine 10%, and homatropine 4%, were topically applied three times. In the patients of the B group, the conjunctival sac was anesthetized by oxybuprocaine 0.4%; and afterwards, a cut piece of cellulose (Kettenbach) soaked in to the mydriatics solution was applied for 30 - 40 minutes in to the conjunctival sac and the eyelids were taped together. The mydriatic solution was mixed by tropicamide 0.5%, phenylephrine 10%, and homatropine 4%, of equal doses. On the surgery table, before the operation, th soaked cellulose was removed, and thereafter the achieved preoperative horizontal size of the pupil was measured with caliper under the operation microscope. The achieved preoperative pupillary width in the group A and B were compared. The authors noticed also subjective symptoms and objective signs in both groups of patients. For statistical comparison of the average mydriasis between the A and B group of patients, the unpaired Student t test was used. As statistically significant we considered p < 0.05. RESULTS: The average mydriasis in the A group (mydriatic drops topically) was 7.84 +/- 0.99 mm. In the B group of patients (cut piece of cellulose soaked in to the mydriatics solution), the average mydriasis was 7.94 +/- 1.03 mm. The authors did not found significant difference in the diameters between the A and the B group of patients (p = 0.622; p > 0.05). In the B group of patients, subjective symptoms as well as objective signs appeared (burning sensation, sticking, pain, and corneal epithelium erosion); these problems were caused by the triangle shape and the size of the cut cellulose piece. CONCLUSION: Artificial preoperative mydriasis in patients in both our groups was very good. Topic classically introduced preoperative mydriasis has its stable place also in contemporary modern cataract surgery; the mydriasis achieved by soaked cellulose may save the nurses' time.

[Pigmentary glaucoma after implantation of the iris claw intraocular lens]. / Pigmentový glaukóm po negatívnej iris claw VOS.

The authors refer about a female patient with pigmentary glaucoma after implantation of iris claw intraocular negative dioptric power lens. Because of high myopia, eight years ago, a phakic iris claw intraocular negative dioptric power lens was implanted in the right eye and a photorefractive keratectomy (PRK) was performed in the left eye in a 32 years old woman. During the postoperative examinations the patient complained about headaches, and in the right eye elevated intraocular pressure was detected. On the intraocular lens surface, as well as in the anterior chamber angle, a dispersion of pigmented cells was detected and the perimetric examination revealed visual field defects characteristic for glaucoma. Findings in the left eye were normal. In the literature, reports about secondary glaucoma in eye with implanted iris claw lens and functional iridectomy are not so common. With growing number of implanted phakic iris claw intraocular lenses, the long-term follow up of those patients will be useful.

[Etiopathogenesis of age-related macular degeneration and present possibilities of treatment]. / Etiopatogenéza vekom podmienenej makulárnej degenerácie a súcasné moznosti jej liecby.

Age-related macular degeneration is the frequent cause of central visual acuity loss in the elderly patients group. The authors analyze in detail the pathogenesis of the process. The explanation of pathogenesis enables therapeutical intervention even though its possibilities are limited. Photodynamic therapy induces pharmacological thrombosis without any damage to the retina in the macular area. Pilot studies have demonstrated complete occlusion new vessels without any alteration of the photoreceptor layer. Age-related macular degeneration still remain a challenge for ophthalmologist and it also poses a serious social problem.

[Use of computer-assisted corneal topography in ophthalmology]. / Vyuzitie pocítacovej rohovkovej topografie v oftalmológii.

The authors give an account of the possible application of corneal computer topography in some diseases of the cornea and in particular in refraction surgery.

[Bimanual irrigation/aspiration]. / Bimanuálna irigácia/aspirácia.

Bimanual irrigation/aspiration is a safe method for the removal of lenticular mass from the eye and can be used in some complicated cases. As it is a perfectly closed system, oscillation of the posterior capsule does not occur and this prevents prolapse of the vitreous body. If the pupil is narrow, the margin of the pupil can be shifted by means of the irrigation cannula and thus suction of the lenticular mass up to the equator is made possible. In subluxed lenses by gently pushing back the lenticular capsule its adherence to the aspiration cannula is prevented. It is relatively easy to clean the anterior lenticular capsule from epithelial cells by bimanual I/A.

[Comparison of corneal endothelial cells after ECCE and phacoemulsification of the lens]. / Porovnanie nálezu endoteliálnych buniek rohovky po ECCE a fakoemulzifikácii sosovky.

The authors evaluate the finding on the corneal endothelium before and after operation of cataract. For examination of the endothelium they used a specular microscope SP 1.000 of Topcon Co. The group comprised 64 eyes of 64 patients. The patients were divided at random into two groups. The first group comprised 26 patients, where ECCE was performed. The second group comprised 38 patients and the opaque lens was removed by phacoemulsification. The mean age in the first group was 69.3 years and in the second group 70.7 years. The same viscoelastic material (methylcellulose) was used and the same synthetic lens from PMMA material was implanted into the capsule. The endothelium was examined one day after operation and on the 7th to 10th day after operation. The following parameters were evaluated: density of the endothelial cells in the centre, mean cell size, polymegethism, coefficient of variation, pleomorphism. In the group of patients who had ECCE the loss of endothelial cells was 18.53%, in the group with phacoemulsification of the nucleus the loss was 16.43%. This difference is not statistically significant. After operation in both groups enlargement of the minimal, maximal as well as mean cell size was observed, the coefficient of variation increased while the grade of cell hexagonality decreased. However these differences in endothelial cells were not statistically significant. After operation of cataract not only endothelial cells are lost but also significant changes in cell morphology occur.

[Treatment of recurrent pterygia]. / Liecba recidivujúceho pterýgia.

The author's work confirmed that a single administration of 0.02% mitomycin C with exposure for 3.5 minutes during surgical excision of a pterygium is an effective treatment, which reduces the percentage of recurrences of pterygium and does not induce negative effects of mitomycin C.