[Optical coherence tomography in monitoring of choroidal folds after surgical excision of ethmoidal myxoma]. / Zastosowanie optycznej tomografii komputerowej w monitorowaniu faldów naczyniówki po chirurgicznym usunieciu sluzaka sitowia.

PURPOSE: We describe a case of choroidal folds coexisting with ethmoidal myxoma and the evolution of folds after tumor excision. Choroidal folds can occure in the case of intraorbital pathology. Optical coherence tomography is usefull in diagnosis and monitoring of these folds. MATERIAL AND METHODS: 45 years old woman was reffered to our clinic because of visal disturbances in her right eye. Visual acuity of right eye was 0.5, of the left eye 1.0. Intraocular pressure of both eyes was within normal limits. Biomicroscopic evaluation of the right eye revealed no changes in anterior segment but choroidal folds in posterior segment were evident. The left eye was normal. Computer tomography of the orbit documented the presence of tumor within the right ethmoid. The tumor was excised surgically and its myxoidal nature was confirmed. RESULTS: 3 months after that intervention retinal profile in posterior pole in optical coherence tomography was normal and visual acuity of right eye improved by 1 line in Snellen chart. CONCLUSIONS: Choroidal folds caused by ethmoidal myxoma can disapper after surgical excison of tumor. Optical coherence tomography is very useful in documentation of these changes.

[Results of tectonic epikeratoplasty in the management of corneal perforations]. / Wyniki epikeratoplastyki tektonicznej w leczeniu perforacji rogówki.

PURPOSE: To present therapeutic application of tectonic epikeratoplasty as logical patch in severe ocular surface disorders. MATERIAL AND METHODS: Full thickness corneo-scleral transplants, 14 mm in diameter were used in 67 operations of 41 patients with corneal perforation or descemetocele. (14 women and 27 men), in the period 1998-2008. The mean age of patients was 55.2 +/- 17.7 years (range 15-82). The transplants were sutured over the limbus or the scleral rim and was implanted under the conjunctiva after 360 degrees peritomy. Donor tissue unsuitable for penetrating keratoplasty because of poor endothelium or corneal scarring, was obtained from Lublin Eye Bank. RESULTS: We observed closing of the perforation in all cases. Healing of the ulceration with scar formation and new vessels ingrowth was noted. In some eyes repeated epikeratoplasties were performed. CONCLUSIONS: Tectonic epikeratoplasty is a safe and simple method of treatment of corneal perforations. It provides a biological patch stimulating the healing of corneal defects. It gives time for systemic treatment before further ocular surface reconstructive procedures can be performed.

[Fungal infections of the cornea--diagnostics and management]. / Diagnostyka i postepowanie w grzybiczych zakazeniach rogówki.

Fungal keratitis, an important cause of corneal infectious disease, is one of the most challenging types of microbial keratitis to diagnose, isolate the etiologic fungal organism and treat successfully. Aspergillus spp. are most commonly responsible for fungal keratitis worldwide. Most cases occur in hot, humid climates. Fungi invade the ocular surface only when it is compromised and gain access into the corneal stroma through a defect in the epithelial barrier. Pathogens multiply then, and cause inflammatory reaction together with tissue necrosis. Symptoms of fungal keratitis typically are not as acute as those of other forms of microbial keratitis. On examination, both signs seen in other forms of microbial keratitis and specific features of fungal keratitis are observed. In all cases with suspected fungal keratitis, corneal smears and cultures should be performed as soon as possible. Antifungal therapy should be restricted to those cases with fungus-positive laboratory results. The use of topical corticosteroids in the treatment of fungal keratitis is contraindicated. In about one-third of patients pharmacological therapy is not successful. In those cases, surgical intervention is essential. The main goal of surgical intervention is to control infection and maintain the integrity of the globe. The most commonly performed surgery in fungal keratitis is therapeutic penetrating keratoplasty. The use of topical corticosteroids is contraindicated in early postoperative period.

[Analysis of 24 viral keratitis cases treated by corneal graft from 1998-2000]. / Analiza 24 przypadków wirusowego zapalenia rogówki leczonych metoda przeszczepu rogówki w latach 1998-2000.

PURPOSE: To determine the clinical character of patients with keratoplasty after viral keratitis and comparison of pre- and postoperative visual acuity. MATERIAL AND METHODS: The study involved 24 patients treated using corneal graft after viral keratitis complications. Sex, age, permanent residence, duration of disease, previous pharmacological treatment, indications to corneal graft and postoperative functional results were evaluated. RESULTS: In 24 cases 16 (66.7%) were males in age 38-75 years old. Eight (33.3%) of the 24 cases were females in age 12-78 years old. Visual acuity improvement after corneal graft was observed in 23 patients. There was no visual acuity improvement in one case with considerable degree of optic nerve lesion. CONCLUSIONS: The results of these examinations showed, that keratoplasty after viral keratitis complications were more frequent in males, especially in 40-59 age range, professionally engaged. Statistical analysis of these cases showed good prognosis of visual acuity improvement after surgical treatment.