[Updates in corneal transplantation]. / Nouvelles approches des greffes de cornée.

Corneal transplantation or keratoplasty has rapidly developed over the last 10 years. Penetrating keratoplasty, a well-known operation consisting of full thickness replacement of the cornea, has remained the dominant procedure for a long time. It allows appropriate therapy of most causes of corneal blindness. However, this technique is currently evolving toward slamellar keratoplasties which selectively treat the specific affected layers: deep anterior lamellar keratoplasty replaces the diseased corneal stromal layers; endothelial keratoplasty replace the affected endothelium. This article will present these techniques, and briefly discuss their advantages.

[Clinical case of the month. Sudden orbital cellulitis in the emergency unit]. / Le cas clinique du mois. Exophtalmie aiguë au service des urgences.

We report a case of infectious orbital cellulitis complicating a frontal sinusitis in a seventy-three-year-old patient. The onset of this orbital complication was sudden. A clinical examination and an orbital CT-scan allowed an early diagnosis. Despite an appropriate surgical and medical treatment, the patient retains an altered visual function. We consider the clinical causes and consequences of orbital cellulitis as well as their surgical indications.

[Combined therapy in the exsudative age-related macular degeneration (photodynamic therapy and intravitreally-applied ranibizumab)]. / Kombinovaná lécba u vlhké formy VPMD (fotodynamická terapie a intravitreálne podávaný ranibizumab).

The choroidal neovascularization (CNV) is the leading cause of blindness in industrial countries. CNV in age-related macular degeneration (AMRD) is dynamic, multifactor process, which cause wasn't revealed until now. It is obvious that in multifactorial disease no single treatment is optimal, and that the monotherapy can't cover all factors leading to the CVN development. The contemporary modern and variably effective treatment techniques have common characteristic--the treatment is very expensive and it is necessary to repeat it to obtain the treatment effect. The authors refer about 18 months lasting period of follow-up of the group of 25 patients (9 men and 16 women, average age was 68 years, range, 59-76 years of age) who underwent the photodynamic therapy followed by ranibizumab intravitreal injections due to an active CNV. Mostly classical membranes were diagnosed in 18 cases (72%), minimally classical membranes in 5 cases (20%) and occult CNV in 2 patients (8%). The average best corrected visual acuity before the treatment was 46 letters of EDTRS chart, and after the treatment it was 50 letters. From the total number of 25 patients, in 20 (80%) of them the stabilization or improvement (+/- 15 letters of EDTRS chart) was achieved, in two patients the improvement was better than 15 letters (8%). Three patients' visual acuity decreased by more than 15 letters (12%). On average, to stabilize the CNV (after the PDT), 3.16 applications of ranibizumab were needed.