Iridociliary melanoma - Clinical case.

Iris and ciliary body melanoma is an aggressive tumor, which, unfortunately, presents symptoms only in advanced stages and is often discovered accidentally during a routine eye examination. There are several treatment options, ranging from in time monitorization in order to observe the tumor's evolution to more aggressive methods such as radiotherapy and enucleation. We present a case of iridociliary melanoma, who underwent conservative surgery, iridocyclectomy under scleral flap, with good results, and maintenance of the function and integrity of the eyeball.

[The significance of imaging in a case of intraorbital cystic tumor]. / Influenta investigatiilor imagistice într-un caz de tumora chistica intraorbitara.

Conjunctival inclusion cyst represents a congenital or, in most cases, an acquired disorder. The most frequent cause of an acquired conjunctival cyst is the implantation of conjunctival epithelium after surgical interventions or ocular trauma. Usually, these cysts are located supero-medially, with a stationary evolution, without a progression in dimension, but in some cases can evolve into enormous translucent cysts. Histologically, they are lined by stratified, nonkeratinized, squamous epithelium and contain desquamated cellular debris, chronic inflammatory cells and mucus, when goblet cells are present. Most cysts can be treated adequately by complete excision with marsupialization of the entire epithelial lining to prevent fluid reaccumulation.

Use of amniotic membrane in bullous keratopathy palliative care.

BACKGROUND: Assessment of efficiency of amniotic membrane covering in the improvement of bullous keratopathy symptoms. MATERIAL AND METHOD: The paper represents a clinical prospective study, which includes 42 patients diagnosed with bullous keratopathy and operated between January 2009 and November 2013 in the Department of Clinical Ophthalmology from "Dr. Carol Davila" Central Military Emergency Hospital. Follow up between 6 and 48 months, with an average of 22 months. Subject to research: corneal re-epithelisation, epithelial bullae, pain and photophobia relapse. RESULTS: In 37 cases, the symptoms improved, in 8 cases the minimum symptoms persisted and in 29 cases the symptoms completely disappeared. In 5 cases, there were no significant improvements, symptoms reappeared briefly after membrane resorption. CONCLUSIONS: Amniotic membrane covering represents an efficient palliative care means in oedematous keratopathy.

Tobacco-alcohol optic neuropathy--clinical challenges in diagnosis.

Part of the large group of nutritional and toxic optic neuropathies, tobacco-alcohol optic neuropathy is a disease often underdiagnosed or detected at a stage when the full recovery of vision is not possible. This article summarizes its signs and symptoms, describes the pathophysiological processes involved and provides the necessary information for diagnosis and treatment of the entity previously known as tobacco-alcohol amblyopia, reporting in the end, a challenging case along with its findings.

[Alternative therapeutic excision of intraepithelial conjunctival carcinoma with corneal extension]. / Alternative terapeutice la excizia unui carcinom intraepitelial conjunctival cu extensie corneeana.

Surgical treatment for conjunctival neoplasms, with wide local excision, with or without supplemental cryotherapy to the surgical margins represents the treatment of choice for this pathology. In some cases, these neoplasms can be diffuse or multifocal, with borders that are difficult to detect clinically, such that topical therapies offer a more efficient method for treating the entire ocular surface, delivering high drug concentrations at this level, with negligible systemic side effects. Beginning from the clinical case of a patient diagnosed with conjunctival intraepithelial neoplasia, we try to present other therapeutical alternatives, although in this case the therapeutical approach was the classic one.

[Computer-assisted phacoemulsification for hard cataracts]. / Intelligent phaco în cataractele dure.

PURPOSE: to evaluate the efficiency of new torsional phacoemulsification software (Ozil IP system) in hard nucleus cataract extraction. METHODS: 45 eyes with hard senile cataract (degree III and IV) underwent phacoemulsification performed by the same surgeon, using the same technique (stop and chop). Infiniti (Alcon) platform was used, with Ozil IP software and Kelman phaco tip miniflared, 45 degrees. The nucleus was split into two and after that the first half was phacoemulsificated with IP-on (group 1) and the second half with IP-off (group 2). For every group we measured: cumulative dissipated energy (CDE), numbers of tip closure that needed manual desobstruction the amount of BSS used. RESULTS: The mean CDE was the same in group 1 and in group 2 (between 6.2 and 14.9). The incidence of occlusion that needed manual desobstruction was lower in group 1 (5 times) than in group 2 (13 times). Group 2 used more BSS compared to group 1. CONCLUSION: The new torsional software (IP system) significantly decreased occlusion time and balanced salt solution use over standard torsional software, particularly with denser cataracts.

[Intelligent phaco--always necessary?]. / Intelligent phaco--întotdeauna necesar?

PURPOSE: To assess the need of /P system use in soft cataract METHODS: prospective study--40 eyes with soft cataract (+/++); surgery with Infinity system, Ozil handpiece; in 20 eyes we used low levels (max 70%) of torsional ultrasound power and IP system; in 20 eyes we used higher levels of torsional ultrasound power without IP system; we assessed: the CME value and the presence of cornela edema. RESULTS: In cases with tosional ultrasound only: average value of CME--2.4; maxim value of CME--4.3; all corneas without edema. In cases with torsional ultrasound and IP system; average value of CME--3.6; maxim value of CME--7.2; 4 eyes with decemetic folds in central cornea. CONCLUSIONS: In soft cataracts is better to not use IP system

[Pituitary adenoma--clinical case]. / Adenom hipofizar--caz clinic.

This is a case report of pituitary adenoma diagnosed by a deep ophthalmological examination. We identified a serious neurosurgical and endocrinological condition, potentially lethal, starting from an ocular symptom. The patient did not pay attention to the hormonal changes as they were developing slowly. Visual acuity was the only reason why the patient decided to seek medical attention.

[Intravitreal triamcinolone acetonide treatment in diabetic macular edema]. / Triamcinolonul intravitreean în tratamentul edemului macular diabetic.

PURPOSE: To assess the efficacy and safety of intravitreal triamcinolone acetonide in diabetic macular oedema. METHODS: prospective study; 76 patients, 102 eyes; preoperative assessment: visual acuity, intraocular pressure, fundus biomicroscopy fluoresceine angiography, sometimes OCT; postoperative assessment: visual acuity, intraocular pressure, fundus biomicroscopy, fluoresceine angiography, sometimes OCT. RESULTS: Visual acuity improvement in 42% cases; subjective improvement of visual acuity in 72% of cases CONCLUSIONS: Triamcinolon acetonide may play a role in treatment of diabetic macular oedema.

[The secret of red eyes]. / Secretul ochilor rosii.

"Red eye" is a sign and the same time a symptom frequently met in the ophthalmological practice. The "red eye" is not always the clinical manifestation of a common conjunctivitis. We will present a case report of a patient who accused conjunctival hyperemia, lacrimation, foreign--body sensation; she was also describing recurrent conjunctivitis for the past year. After an detailed ophthalmologic examination and interdisciplinary consultations. She was diagnosed with Basedow Disease and paraselar meningioma with invasion in the pterigoid fossa. The authors are suggesting that there is an indirect left carotid - cavernous fistula.

[Refractive stability of artificial crystallins--acrysof TORIC]. / Stabilitatea refractiva a cristalinelor artificiale acrysof TORIC.

PURPOSE: To evaluate the results of AcrySof Toric intraocular lens (Alcon) implantation to correct pre-existing astigmatism and rotational stability in patients having cataract surgery or not. METHODS: Retrospective study three surgical teams, between February 2009-August 2010, included 37 eyes with more than 1 diopter (D) of preexisting corneal astigmatism having or not cataract surgery. RESULTS: Rotation at 6 M post-op: 32 patients (87%)--> rotation between aprox. 0-5 degrees, 4 patients (11%)--> rotation between A 5-10 degrees, 1 patient (2%) rotation of A 20 degrees. The mean refractive cylinder decreased significantly after surgery: 34 (91.90%) of cases between 0.25-0.75 D--2 (5.40%) of cases 1.5 D--1 (2.70%) of cases > 1.5 D. CONCLUSIONS: In conclusion the results indicate that TheAcrySof Toric IOL is a viable option of preoperative corneal astigmatism in carefully selected cases. The Toric IOL showed good rotational stability The most frequent cause of turnover is the: viscoelastic left in the capsular bag (early rotation); fibrosis of the bag (late rotation).

[Glomus tumor with diplopia]. / Diplopie prin tumora glomica--caz clinic.

This paper highlights the case of a 46-year-old female patient who seeks ophthalmic medical advice for her complaint about double vision on right gaze. Patient's medical history reveals several symptoms like headaches, progressive hearing loss on right side and dysphonia for which all investigations proved irrelevant. Thourough clinical examination, lab exams and imaging techniques revealed the cause for this symptoms i.e. glomic tumour with middle ear extention. We find this case to be exceptional as ocular symptoms led to the diagnose of a non-ocular serious, possible life threatening condition, bearing in mind that previously occured non-ocular symptoms couldn't elucidate the cause.

[Corneal transplantation in Romania]. / Transplantul de cornee in Romania--actualitati, perspective.

The paper shows the activity of corneal transplantation in Romania. The author discuss about the aspects involved in this activity. The laws about donation, prelevation and surgery. Juridical aspects about activity of tissues banks. Human resources. Material resources. The author tries to find some solutions for improvement of this activity.

[Treatment of thyroid ophthalmopathy--a clinical case]. / Tratamentul oftalmopatiei tiroidiene pornind de la un caz clinic.

Thyroid ophthalmopathy is a relatively frequent pathology. Usually it is a self-limited affection but same cases develop visual-threatening complication. The management of thyroid disorders necessitates both treatment of the systemic thyroid disease and management of the thyroid eye disease in order to alleviate the ocular discomfort, to prevent disfigurement and to avoid the visual threatening complications.

[Posttraumatic hyphema?]. / Hifema posttraumatica?

The authors present the case of a patient with ocular pain and visual impairment after an ocular trauma. The ophthalmologic exam and the complementary exams show atypical aspects of the traumatic ocular pathology.

[Palliative treatment in bullous keratopathy]. / Tratamentul paliativ in keratopatia edematoasa.

The article is a review of the possibilities of palliative treatment for bullous keratopathy, medical methods (hypotensor and hyperosmotic agents) and surgical methods (conjunctival flap, annular keratotomy, anterior stromal puncture, therapeutic photo-keratectomy and amniotic membrane use), each of them with indications, results, advantages and disadvantages.

[Toxic anterior segment syndrome]. / Sindromul toxic al segmentului anterior (TASS).

The authors present two cases of TASS which occurred consequent upon anterior chamber administration of cefuroxime(Axetin). The ESCRS guidelines on prevention, investigation and management of postoperative endophthalmitis recommends intracameral injection of an antibiotic agent (cephalosporin) at the conclusion of surgery. In our group of patients TASS occurred. Elements of diagnosis and treatment in TASS are discussed. As a conclusion to our study we decided to discontinue cefuroxime administration.

[Amniotic membrane transplantation in palliative treatment of bullous keratopathy]. / Acoperirea cu membrana amniotica in tratamentul paliativ al keratopatiei edematoase.

PURPOSE: To assess the efficacy of amniotic membrane transplantation for the improvement of symptoms in bullous keratopathy. MATERIAL AND METHOD: Prospective study. 14 patients were operated between 01.02.2003 - 01.02.2006. the follow-up period: between 6 and 42 months with an average of 18 months. The following parameters were evaluated: corneal re-epithelialisation appearance of epithelial bullae, pain, photophobia. RESULTS: In 11 cases there was an improvement of the symptomatology: complete in 8 cases and partial in 3 cases. CONCLUSIONS: Amniotic membrane transplantation is an efficient palliative treatment for bullous keratopathy.