Eyelash in the anterior chamber.

We present the case of a patient who had surgery for cataract extraction by phacoemulsification method and that the first day after surgery one lash was found in the anterior chamber of the eye. The lash was removed the same day, the postoperative refraction being 1.0. Starting from this case, therapeutic attitude is presented in different intracameral foreign bodies.

A comparison of accommodation amplitudes in pseudophakic eyes measured with three different methods.

PURPOSE: To compare the accommodative amplitudes with three different methods in pseudophakic eyes with different types of intraocular lenses (IOLs). METHODS: Fifty-one pseudophakic eyes of 44 patients (age: 72.02+/-8.53 years) were studied. One of two different types of IOL were implanted (N=30, three-piece Alcon Acrysof MA60AC and N=21, one-piece Alcon Acrysof SA60AT) in-the-bag after standard phacoemulsification. The time of the examinations was 13.85+/-7.35 months postoperatively. We measured the amplitude of accommodation with three different methods: (1) subjective minus-lenses-to-blur method; (2) a new optical device (ACMaster, Carl Zeiss, Jena, Germany) using partial coherence interference (PCI) technique under physiological stimulus; and (3) objective anterior chamber depth measuring with a standard A-scan ultrasonic device (Ultrascan Imaging System, Alcon Laboratories, Forth Worth, TX, USA) before and after pharmacological relaxation of ciliary muscle. RESULTS: We measured -0.83+/-0.63 D amplitude of accommodation with subjective minus-lenses-to-blur method. The IOL position did not change significantly during physiological accommodation effort measured with PCI method (-0.026+/-0.134 mm). The change in the IOLs position between near fixating and after ciliary muscle relaxation was -0.18+/-0.28 mm measured with ultrasound. There were no significant differences between values of one-piece and three-piece IOL groups. CONCLUSION: The amplitude of accommodation measured by subjective and objective methods are different and are not comparable with each other. We did not observe any difference between values of examined two types of IOLs.

Demonstration of increasing standard pH value of lacrimal fluid with increase of flow rate.

PURPOSE: To test the hypothesis that pH value of human tears is affected by flow rate. METHODS: After stimulation with a drop of 70% alcohol into the ipsilateral nasal cavity tears from the left eyes of 30 healthy volunteers were collected with glass capillaries while flow rate of tear secretion was registered. The pCO(2), actual and standard pH were determined in the collected samples with the Astrup method: Standard pH is defined as the pH of the sample that has been equilibrated at 37 degrees C with a gas mixture having pCO(2)=40 mmHg. RESULTS: The flow rate correlated positively and significantly with both the standard pH value (r=0.503, p<0.01) and the pCO(2) (r=0.517, p<0.01) while there was no correlation between the actual pH and the flow rate. CONCLUSION: Loss of CO(2) from the sample is a cause of serious uncertainty in tear pH determination. A positive flow rate-pH relationship was found for human tears when the uncertainty was removed by determination of the standard pH.

Comparison of different keratometers with the EyeSys videokeratoscope.

We compared the accuracy and the reproducibility of the measurements using a Haag-Streit, a Shin-Nippon, and a Carl Zeiss keratometer and an EyeSys videokeratoscope. Two investigators performed 20 measurements on 3 calibrated steel balls and 5 measurements on 22 normal corneas with all instruments. Calculating the accuracy of the measurements the limits of the 95% confidence intervals of the bias were determined. The accuracy was better than +/-0.1D for the keratometers, whereas it was better than +/-0.25D for the EyeSys videokeratoscope. The coefficient of reproducibility (1.96 x standard deviation) on test balls and corneas was smaller than 0.25D in the case of the Shin-Nippon and Carl Zeiss keratometers and the EyeSys videokeratoscope whereas it was between 0.25-0.5D in the case of the Haag-Streit keratometer. The Carl Zeiss keratometer was the best with respect to the accuracy and reproducibility of the measurements. Paired t-test was used to find possible significant differences between the results of the two investigators, but only clinically insignificant differences were found.

Changing concept and modern techniques in cataract surgery.

Until the middle of the 80-ies the routine method of cataract surgery was intracapsular extraction (ICCE). Approximately 10 years ago the so called extracapsular cataract extraction (ECCE) started to become more and more widely used. After extracapsular cataract extraction had come into general use, it became possible to implant the IOL behind the iris, into the left in place capsular bag of the original lens. We usually perform extracapsular cataract extraction with posterior chamber lens (PCL) implantation as a routine procedure. In the last few years phacoemulsification started to gain acceptance. During this operation one breaks the nucleus of the lens into pieces with the help of ultrasound, and this way it is possible to remove both the nucleus and the cortex of the lens through a small wound. The first step in learning phacoemulsification is to be able to create a perfectly round hole on the anterior capsule (capsulorhexis). Besides using various manual techniques we introduced diathermal capsulotomy for capsulorhexis. This latter procedure is becoming more and more popular as it is safe, easy to perform, and gives excellent result.

Different opening techniques in cataract surgery.

A retrospective study on the different opening techniques in cataract surgery at our Department in 1996 was carried out. In our everyday practice fornix based conjunctival flap and sclerocorneal oblique or vertical-oblique approach with a center at 12 o'clock was performed. In the case of hemorrhagic diathesis and secondary ACL implantation the corneal approach was preferred. After glaucomatous filtration surgery the incision was made temporally in some cases.

[A new method for semi-quantitative alpha 1-antitrypsin determination in human tear fluid]. / Eine neue Methode zur semiquantitativen Alpha-1-Antitrypsinbestimmung in der menschlichen Tränenflüssigkeit.

We developed a simple and rapid semiquantitative method for the determination of alpha-1-antitrypsin (alpha-1-AT) in human tears. It is a modification of Endre's method (1974) which was originally developed for the determination of serum alpha-1-AT. A filter paper disc saturated with trypsin was placed on the light-sensitive side of a color slide that had been developed unexposed. The trypsin digested the gelatine layers containing different stains and the film under the filter paper showed various colors depending on the trypsin content of the filter paper and the duration of digestion. If the filter paper discs saturated with trypsin had been treated with 5 microliters of tears before film digestion, the trypsin inhibitors in the tears partially or totally inhibited the digestion of the layers with different stains. Four grades of tear trypsin inhibitor capacity were differentiated on the basis of the inhibition of film digestion. These grades correspond to four alpha-1-AT concentration ranges: I greater than 150 micrograms/ml; II = 50-150 micrograms/ml; III = 15-50 micrograms/ml; IV less than 15 micrograms/ml. The concentration ranges were determined by radial immune diffusion. Alpha-1-AT was determined in the tears of 14 normal and 36 pathological eyes using the film digestion method. This method has been found to be suitable for rapid clinical and screening examinations and for the diagnosis of different types of keratitis.