[Clinical evaluation of isopropyl unoprostone (Rescula), in the adjunctive treatment of primary open angle glaucoma]. / Ocena kliniczna izopropylo-unoprostonu (Rescula) w terapii skojarzonej jaskry prostej otwartego kata.

AIM: To investigate the clinical characteristics of docosanoid derivative, isopropyl unoprostone in the treatment of primary open angle glaucoma (POAG). MATERIAL AND METHODS: In 17 patients (22 eyes) with POAG we analysed prospectively the effect of Rescula upon intraocular pressure, aqueous flare, pupil size, ocular signs and symptoms. Patients were followed up every 2 weeks for at least 8 weeks with complete ocular examination. Concomitant topical therapeutics were used in the study: 0.5% Timolol--group I (16 eyes), and 0.5% Timolol + 2% Dorzolamide--group II (6 eyes). RESULTS: Mean (+/- SD) pretreatment pressure was 24.7 +/- 4.3 mm Hg in group I and it was reduced by 3.7 mm Hg (13.5%) (p < 0.05) at the end of the follow up. In group I Rescula was very effective (delta T% > 25%) in 6/16 eyes (37.5%) and it was ineffective (delta T% < 10%) in the same number of eyes. In group II pretreatment pressure was 24.8 +/- 2.6 mm Hg and it was reduced by 2.6 mm Hg (10.6%) (p = 0.1). Rescula induced no elevation of the aqueous flare during the treatment. No effect on pupil size was observed, either. Eye stinging/conjunctival hyperaemia was noted in 2/17 patients and punctate epitheliopathy in 1 patient (5.9%) that caused discontinuation of drops. CONCLUSIONS: Unoprostone produced significant additive effect to Timolol. Thus, it may be a valuable option for adjunctive therapy. However, interindividual differences need to be considered, as in some patients the response was insignificant.

[Postoperative ptosis after cataract extraction: own material]. / Opadniecie powieki górnej po operacji zacmy--material wlasny.

PURPOSE: To determine the incidence of postoperative ptosis in patients after cataract extraction and whether the type of local anaesthesia has any influence on the occurrence of this complication. MATERIAL AND METHODS: This study comprised 72 patients who had phakoemulsification of cataract. In group I 36 patients received 2-point peribulbar anaesthesia and in group II 36 patients received retrobulbar anaesthesia and the lid block. No bridle suture was used in both groups. To evaluate the ptosis the distance between the upper lid margin and central corneal reflex was measured before and 3 days after the operation. RESULTS: The ptosis of 2 mm occurred in one patient. There was no statistical difference between two groups referring to the incidence of ptosis. CONCLUSION: This relatively low incidence may be due to not using bridle suture. The technique of anaesthesia seemed to have no influence on the incidence of postoperative ptosis in our study.

[Secondary glaucoma in the course of arterio-cavernous fistula: a case report]. / Jaskra wtórna w przebiegu przetoki tetniczo-jamistej--opis przypadku.

PURPOSE: To present a case of 59-year-old woman with the symptoms of redness, proptosis of her left eye and temporary bruit in her head. METHODS: Basic ophthalmological examination, measurement of proptosis, tonometry, visual field examination (Humphrey 30-2 threshold) CT, MRI and carotid angiography were performed. CLINICAL SIGNS: Proptosis of the left eye, dilatation of the episcleral vessels, fundus examination--optic disc normal, enlarged and engorged venous vessels, intraretinal haemorrhages in posterior pole. Tonometry--13 mm Hg--right eye, 24 mm Hg--left eye. Perimetry--general reduction of sensitivity. CT scan--abnormal structure (0.9 x 0.4 cm) in the medial part of the left orbit, without enhancement after applying contrast. MRI examination--enlargement of extraocular muscles of the left eye. Carotid artery angiography revealed indirect carotid--cavernous fistula. CONCLUSION: Special investigations like CT and MRI showed different picture, final diagnosis could be based upon the clinical picture and confirmed by angiography.

[Diode laser trans-scleral cyclo-photo-coagulation]. / Przeztwardówkowa cyklofotokoagulacja laserem diodowym.

The purpose of this study is to present the results of treatment of refractory glaucoma with diode laser transscleral cyclophotocoagulation (DLCT). 88 patients (from 10 to 91 years old) were treated with diode laser. The follow up was 6 months. Mean intraocular pressure (IOP) before treatment was 38.2 mm Hg, 1 week after treatment--23.8 mm Hg, 1 month after treatment--21.3 mm Hg, after 6 months--19.0 mm Hg. We repeated treatment in 5 patients (5.6%). In 2 patients we observed hypotony--about 2 mm Hg. Diode laser cycloablation is a relatively safe and effective method in treatment of advanced refractory glaucoma.

[Solar retinopathy]. / Retinopatia sloneczna.

The purpose of this study is the present clinical evaluation of 21 patients (number of affected eyes--33), who watched eclipse of the sun on 12 October 1996. All patients had general ophthalmic examination with emphasis on visual acuity, visual field, Amsler test, fluorescein angiography and fundus appearance. Eleven out of 21 patients had at least one follow up examination (number of affected eyes--17). None of the patient received any treatment. All patients revealed tiny, central scotomata--positive Amsler test and decreased visual acuity on the first visit; reading Snellen chart could be improved in all patients by adequate head tilt or eye movement (improvement up to 3 Snellen chart lines). No signs of retinopathy were observed in two eyes with uncorrected refractive error and one amblyopic eye. After 7-8 weeks the visual acuity was decreased to 5/30 in two eyes and to 5/10 in ten eyes. In all those eyes persisted a tiny, central scotoma. Looking at the eclipse of the sun in spite of using primitive eye protection may cause irreversible retinal damage. Return of visual acuity to 5/5 does not always imply complete recovery because of persistent central scotoma.

[Intraretinal foreign bodies]. / Wewnatrzsiatkówkowe ciala obce.

PURPOSE: To present our experience with the removal of intraretinal foreign bodies. MATERIAL AND METHODS: 9 intraretinal foreign bodies were removed by pars plana vitrectomy. Laser photocoagulation of the retina surrounding the foreign body was performed either before surgery or intraoperatively (endolaser). Pars plana vitrectomy with foreign body removal through the sclerotomy site with endomagnet and/or forceps was performed. In some cases fluid-gas exchange was done. RESULTS: The average follow-up period was 6.2 months. Seven of nine foreign bodies were magnetic and two were nonmagnetic. Five of seven magnetic foreign bodies had negative magnetic traction as the first surgical procedure. In these 9 eyes, final visual acuity was below 1/50 in 2 eyes and over 5/50 in 7 eyes. CONCLUSION: Pars plana vitrectomy should be the method of choice in removal of intraretinal foreign bodies.