Cationic nanoemulsion vs. 0.15% sodium hyaluronate artificial tears in the healing process following modern surface keratorefractive surgery.

PURPOSE: The aim of this study was to investigate the influence of artificial tears containing either cationic nanoemulsion (CCN) or sodium hyaluronate artificial tears (SH) on early postoperative healing after modern surface refractive surgery. MATERIALS AND METHODS: In this multicenter, prospective, double-masked, parallel-group (1:1), comparative study, 129 patients (n = 255 eyes) were randomized to receive CCN (n = 128) or SH (n = 127) as an adjuvant treatment after either transepithelial photorefractive keratectomy (transPRK) or Epi-Bowman keratectomy (EBK). The patients' perspectives were gathered using the Ocular Surface Disease Index (OSDI) questionnaire, and uncorrected (UCVA), and corrected (BCVA) visual acuity were assessed before and one week and one month after the procedure. In addition, corneal epithelization and subjective assessment of visual blur and eye irritation on drop instillation were assessed at one week postoperatively. RESULTS: No statistically significant differences were found between two groups in age, spherical equivalent refractive error, UCVA, BCVA or OSDI scores before the procedure. There was also no difference between groups in UCVA one week and one month after the procedure. However, statistically significantly lower OSDI scores were found one week and one month after the procedure in the CCN group. Moreover, blurred vision after use of the eye drops was observed less frequently in the CCN group than in the SH group. CONCLUSIONS: The CCN and SH groups had similar postoperative UCVA. However the significantly lower OSDI scores and less frequently blurred vision after application of the eye drops in the CCN group suggest better subjective outcomes in this group.

Single-Step Transepithelial PRK vs Alcohol-Assisted PRK in Myopia and Compound Myopic Astigmatism Correction.

Transepithelial photorefractive keratectomy (tPRK), where both the epithelium and stroma are removed in a single-step, is a relatively new procedure of laser refractive error correction. This study compares the 3-month results of myopia and compound myopic astigmatism correction by tPRK or conventional alcohol-assisted PRK (aaPRK).This prospective, nonrandomized, case-control study recruited 148 consecutive patients; 93 underwent tPRK (173 eyes) and 55 aaPRK (103 eyes). Refractive results, predictability, safety, and efficacy were evaluated during the 3-month follow-up. The main outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and mean refractive spherical equivalent (MRSE).Mean preoperative MRSE was -4.30 ±â€Š1.72 D and -4.33 ±â€Š1.96 D, respectively (P = 0.87). The 3-month follow-up rate was 82.1% in the tPRK group (n = 145) and 86.4% in aaPRK group (n = 90), P = 0.81. Postoperative UDVA was 20/20 or better in 97% and 94% of eyes, respectively (P = 0.45). In the tPRK and aaPRK groups, respectively, 13% and 21% of eyes lost 1 line of CDVA, and 30% and 31% gained 1 or 2 lines (P = 0.48). Mean postoperative MRSE was -0.14 ±â€Š0.26 D in the tPRK group and -0.12 ±â€Š0.20 D in the aaPRK group (P = 0.9). The correlation between attempted versus achieved MRSE was equally high in both groups.Single-step transepithelial PRK and conventional PRK provide very similar results 3 months postoperatively. These procedures are predictable, effective, and safe for correction of myopia and compound myopic astigmatism.

[Visual and anatomical outcomes of three intravitreal aflibercept injections in eyes with neovascular form of age-related macular degeneration]. / Anatomiczne i czynnosciowe wyniki podania trzech doszklistkowych iniekcji afliberceptu w oczach z neowaskularna postacia zwyrodnienia plamki zwiazanego z wiekiem.

PURPOSE: To evaluate results of treatment of choroidal neovascularization due to age-related macular degeneration with aflibercept in a group of patients representative for Polish population. MATERIAL AND METHODS: Three intravitreal injections of 2.0 mg of aflibercept were administrated to 48 eyes with active choroidal neovascularization at the four week intervals. In the evaluated population there were 19 eyes previously treated with other anti-VEGF drugs and 29 treatment naive eyes. RESULTS: The mean best corrected visual acuity at baseline in the entire group was 0.47. During the follow-up exam after the first injection, the best corrected visual acuity increased to 0.58. After the second and third injection, it reached the level of 0.62 and 0.63, respectively. Such improvement in visual acuity was accompanied by the reduction of central retinal thickness. Eyes with intraretinal fluid presence confirmed in baseline spectral domain optical coherence tomography had significantly lower best corrected visual acuity throughout the entire follow up. CONCLUSION: Three intravitreal aflibercept injections in eyes with neovascular age-related macular degeneration resulted in significant improvement of best corrected visual acuity and reduction of central retinal thickness both in eyes previously treated using other anti-VEGF drugs and newly diagnosed ones. aflibercept, neovascular age-related macular degeneration, choroidal neovascularization, anti-VEGF treatment, optical coherence tomography.

[Dural metastatic infiltration in prostate cancer--case report]. / Przerzuty raka gruczolu krokowego do opon mózgowych--opis przypadku.

Metastatic changes secondary to prostate cancer usually occur in bones, less commonly in pelvic lymph nodes, liver, lungs, urinary balder and brain. Less common localization includes skin, testis and other structures. The current paper reports a rare case of metastatic infiltration of the dura mater in patient with prostate cancer (Gleason 8 (4+4)) with disseminated bone metastasis. Magnetic resonance imaging revealed an advance infiltration of dura mater of anterior and posterior cranial fossa without any neoplasmatic-related changes in brain. Along optic nerves it penetrated to the optic canal and right orbit.

Solid-pseudopapillary neoplasm of the pancreas - comparisons between magnetic resonance and histological findings.

Solid-pseudopapillary neoplasm is a rare pancreatic tumor typically observed in young adults. A new case of the tumor was diagnosed in a 22-year-old woman. An abnormal mass connected with the pancreatic body was found on ultrasound and computed tomography. Magnetic resonance revealed weak homogeneous contrast enhancement and a low ADC value (0.824 mm/s2; b1000). Primary radiological diagnosis suggested a solid pancreatic neoplasm, which was confirmed during histopathological assessment after resection of the pancreatic body with preservation of the spleen and normal drainage through the main pancreatic duct. Histological appearance of the solid-pseudopapillary neoplasm corresponded with its radiological morphology.

[Uveal effusion syndrome complicated by anterior ischemic optic neuropathy and cystoid macular edema]. / Zespól wysiekowy naczyniówki powiklany przednia niedokrwienna neuropatia nerwu wzrokowego oraz torbielowatym obrzekiem plamki.

The current paper presents a case of unique presentation of idiopathic uveal effusion syndrome. The 28 years old patient with combined bilateral choroidal and retinal detachment, recurrent in the left eye, underwent surgical procedures. He was treated with lamellar sclerectomy under the scleral flap in both eyes and another sclerectomy in the left eye later on. The apposition of the retina was achieved in both eyes and visual acuity improved significantly. Three months later, the patient developed anterior ischemic optic neuropathy in the right eye. In left eye after cataract phacoemulsification, persisted cystoid macular edema appeared.

Long-term outcomes of prostaglandin analog versus timolol maleate in ocular hypertensive or primary open-angle glaucoma patients in Europe.

PURPOSE: To determine the direct costs of therapy over 5 years of a European monotherapy cohort begun on a prostaglandin (PTG) versus timolol in patients with primary open-angle glaucoma or ocular hypertension. METHODS: A retrospective, multicenter, active-controlled, observational study. Data were abstracted for European patients treated as initial monotherapy in 1996 or afterward, with 5 years of available records. RESULTS: This study included 271 patients (166 on a PTG and 105 on timolol at baseline). The average cost/month/patient over 5 years was $45.47±12.61 for PTG and $31.50±15.47 for timolol (P<0.001, based on German prices). After 5 years, although there was no difference in number of glaucoma medicines prescribed between groups (1.0 PTGs and 1.1 timolol, P=0.41), the timolol group demonstrated a higher intraocular pressure (17.7±2.9 vs. 16.5±3.0 mm Hg, P<0.001), more medication changes (P=0.01), greater incidence of glaucomatous progression (P=0.04), and less patients persistent on original monotherapy (P<0.001) than the PTG cohort. CONCLUSIONS: Patients originally on timolol monotherapy have a lower cost of care over 5 years than those started on a PTG. However, timolol patients during follow-up may demonstrate a higher intraocular pressure, more progression, more medication changes, and lower persistency of the original monotherapy.

[Refractive changes in children with pseudophakia]. / Zmiany refrakcji u dzieci pseudofakia.

PURPOSE: To report refractive changes after cataract surgery and intraocular lens implantation in children. MATERIAL AND METHODS: 104 patients (123 eyes) operated between January 1987 and December 1997 with congenital or traumatic cataract. Refractive power in both operated and non operated eyes, were measured. RESULTS: The operated eyes tended to become myopic. Children, who underwent surgery in the first 6 years of life had a greater myopic shift than older children. The mean myopic shift ranged from -2.33 D to -0.51 D in operated eyes and from -1.05 D to -0.49 D in non operated eyes. CONCLUSIONS: Pseudophakia in children is predicted to result in a large quantity of myopic shift, particularly in very young children. This natural myopic shift is magnified by the optical effect of a high-power IOL.

[Axial length and corneal curvature in pseudophakia in children]. / Dlugosc osiowa galki ocznej i promien krzywizny rogówki w pseudofakii u dzieci.

PURPOSE: To assess changes in axial length, corneal curvature in pseudophakia in children. MATERIAL AND METHODS: 104 patients (123 eyes) operated between January 1987 and December 1997 with congenital or traumatic cataract. Serial measurements were made of axial length and corneal curvature. RESULTS: The follow up time ranged from 2 to 10 years. The ranges of axial length changes were from 0,16 to 0,93 mm. Eyes in the first 6 years of life (group I) experienced more elongation than eyes in the older years (group II and III). The corneal curvature changes ranged from 0,02 to 0,05 mm. There was no significant difference between preoperative and postoperative corneal curvature. CONCLUSIONS: The pattern of axial elongation and corneal flattening was similar in the congenital and traumatic cataract groups to that observed in normal eyes. No significant retardation or acceleration of axial growth was found in the eyes implanted with IOLs, compared with normal eyes.