Evaluation of retinal light scattering, visual acuity, refraction and subjective satisfaction in patients after Acrysof IQ PanOptix intraocular lens implantation.

AIM: To evaluate the retinal light scattering, visual acuity, refraction and subjective satisfaction in patients after implantation of Acrysof IQ PanOptix intraocular lens. METHODS: Our group included 32 eyes of 21 patients who underwent cataract surgery or refractive lensectomy with Acrysof IQ PanOptix multifocal intraocular lens implantation at the Ophthalmology Clinic of Faculty Hospital Hradec Králové during the time from September 2015 to December 2017. The observed parameters were visual acuity, subjective refraction, retinal light scattering and patient subjective satisfaction. Preoperative refractive values and visual acuity values were compared with results obtained on day 1, 1 month and at an average of 27 months postoperatively. Subjective satisfaction and degree of light scattering on the retina were evaluated at the end of the follow-up period. RESULTS: Preoperative, uncorrected distant visual acuity improved from an average of 0,51 ± 0,29 (expressed in decimal values) to 0,94 ± 0,10 at the end of the follow-up period. Preoperative best-corrected distance visual acuity improved from an average of 0,95 ± 0,19 to 1,00 ± 0,09 at the end of the follow-up period. The mean value of preoperative uncorrected near visual acuity was 8,29 ± 4,93 of Jaeger charts, the mean value of uncorrected near visual acuity at the end of the follow-up period was 1,00 ± 0 of Jaeger charts. Subjective satisfaction was assessed using a standardized VF-14 questionnaire at least 1 year after surgery (mean follow-up of 27 months). Retinal light scattering was examined using an Oculus C-Quant instrument. The retinal light scattering value in our sample was 1,12 ± 0,19. In only 6 eyes of 4 patients, the resulting value was outside the physiological range used for eyes with lens crystallina Conclusion: The value of light scattering on the retina is a factor affecting the degree of sensitivity to glare after implantation of multifocal intraocular lenses. In our group, we observed a deviation from the physiological range of retinal light scattering in only 6 eyes of 4 patients, but this did not lead to a deterioration in subjective postoperative satisfaction.

Pilot Results of Implantation of the New Hydrophobic Intraocular Lens Zeiss LUCIA 611P in the Czech Republic.

BACKGROUND: Cataract surgery is one of the most common procedures performed by the ophthalmic surgeon. In this paper, we evaluate of postoperative results of the hydrophobic intraocular lens CT LUCIA 611 in patients undergoing routine cataract surgery. METHODS: The study included 23 patients (29 eyes), average age of 69.0 + 9.2 years (span 53 to 86 years) with uncomplicated senile cataract. After phacoemulsification, CT LUCIA 611 intraocular lenses were implanted. Patients were examined 3 months and 6 months after surgery. Uncorrected visual acuity (UVA), best-corrected visual acuity (BCVA), refraction, occurrence of opacities of the posterior capsule, and subjective contentment of patients according to the questionnaire VF-14 (visual functioning) were examined. RESULTS: 3 months after surgery, the average UVA was 0.68 ± 0.4, and BCVA 0.92 ± 0.3. Half-a-year after surgery, UVA was 0.82 ± 0.1 and BCVA 0.94 ± 0.2. Good uncorrected visual acuity and a minimal occurrence of opacities of the posterior capsule corresponded with a high degree of contentment of patients. CONCLUSIONS: On the basis of the authors present experience it can be concluded that the Zeiss CT LUCIA 611 intraocular lens exhibits good and stable postoperative results. Key words: intraocular lens CT LUCIA 611; posterior capsule opacity; phacoemulsification.

Correction of Myopia and Myopic Astigmatism by Implantation of a Phakic Posterior Chamber Implantable Collamer Lens.

AIM: We analysed two years results in patients with correction of moderate-to-high myopia or myopic astigmatism by implantation of posterior chamber phakic intraocular Impantable Collamer Lens (ICL). METHODS: To the retrospective study were included 63 eyes of 32 patients (3 men, 29 women), who underwent implantation of ICL between 2007 - 2016 in the outpatient Department of Ophthalmology clinic, University Hospital in Hradec Králové, to correction moderate-to-high myopia or myopic astigmatism. We assess uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA), subjective refraction, intraocular pressure (IOP), endothelial cell density (ECD) and the incidence of complications in the two years follow-up period. RESULTS: At the time of implantation was the mean patients age 28,14 ± 5,35 years (range 21 to 36 years). In 16 eyes was implanted ICM V4 model, in 23 eyes VICMO, in 2 eyes TICM V4, in 13 eyes VTICMO and in 9 eyes VTICM. The mean preoperative subjective refraction improved from -7,8 ± 2,7 D sf (range -14 to -3,25 D sf) and -0,65 ± 0,8 D cyl (range -3,25 to 0 D cyl) to -0,01 ± 0,1 D sf (range -0,75 to 0 D sf) and -0,05 ± 0,16 D cyl (range -0,55 až 0 D cyl). The mean ECD value was 3270,5 ± 454,7 cells/mm2 (range 2155 to 4201 cells/mm2) compared to 2803,4 ± 441,8 cells/mm2 (range 2079 to 4184 cells/mm2) at the end of our follow-up period. The percentage loss of ECD two years after the surgery was 13,5%. The mean preoperative value of intraocular pressure (IOP) was 15,0 ± 2,9 mmHg (range 10 to 20 mmHg) and 15,2 ± 2,5 mmHg (range 10 to 20 mmHg) at the end of follow-up period. We observed the elevation of IOP over 21 mmHg 1 month postoperatively in 11 eyes. In 9 eyes was IOP until 35 mmHg (27,7 ± 3,74, range 22 to 34 mmHg), in a one case (both eyes of the same patient) over 50 mmHg. Postoperatively we observed following complications: IOP elevation (11 eyes), decentration of ICL with development of subcapsular opacity in the crystallin lens periphery (1 eye), pigment dispersion without elevation of IOP (1 eye) and incidence of optical phenomenon (4 patients). The explantation of ICL was indicated in one patient bilaterally. CONCLUSIONS: According to our experience is the correction of moderate-to-high myopia or myopic astigmatism by implanation of ICL an effective, relative safe and predictable method. It has an important place in the modern refractive surgery, especially in patients, who are not able to undergo the photorefractive corneal surgery to correct their refractive errors. Key words: Implantable Collamer Lens, phakic intraocular lens, myopia, myopic astigmatism.

Successful rituximab treatment of granulomatous/lymphocytic interstitial lung disease in common variable immunodeficiency.

Successful rituximab treatment of granulomatous/lymphocytic interstitial lung disease in common variable immunodeficiency Common variable immunodeficiency, a heterogeneous group of diseases, represents a clinically relevant form of antibody immunodeficiency. Granulomatous/lymphocytic interstitial lung disease is among the most serious complications. A case report is presented of a young women with granulomatous/lymphocytic interstitial lung disease and splenomegaly accompanied by pancytopenia. Intravenous rituximab treatment in monotherapy (at a weekly dose of 375 mg/m2 for four consecutive weeks, repeated six months later) not only led to a significant improvement in clinical symptoms but also to positive morphological and functional lung changes, mitigation of pancytopenia, considerable reduction of alkaline phosphatase level, and disappearance of splenic granulomas. The treatment was well tolerated without any side effects. The case report presented suggests possible efficacy and safety of rituximab monotherapy in patients with a complicated form of common variable immunodeficiency. KEYWORDS Rituximab - antibody immunodeficiency - lung disease - treatment Epidemiol. Mikrobiol. Imunol., 67, 2018, c. 3, s. 142-148.

[Treatment of Keratoconus by Accelerated Cross-linking]. / Lécba keratokonu metodou akcelerovaného cross-linkingu.

This study evaluates the efficacy of treatment of progressive keratoconus using Accelerated Corneal Collagen cross-linking (ACXL) method. Patients underwent ACXL at the Dept. of Ophthalmology of University Hospital in Hradec Králové between 2012 - 2013. Uncorrected distance visual acuity, best corrected distance visual acuity, keratometry (K1, K2, Kmax), corneal astigmatism and corneal pachymetry were measured preoperatively and in 6 months, 1year, 2 and 3 years after the surgery. The results were statistically analysed by non-parametric Wilcoxon test. There were found statistically significant changes in K2 values and values of corneal thickness postoperatively.Key words: keratoconus, ectasia, accelerated corneal cross-linking.

[Objective Assessment of Postoperative Results of Intraocular Lenses]. / Objektivizace pooperacních výsledku nitroocních cocek.

PURPOSE: To prospectively compare postoperative results of two premium intraocular lenses EnVISTA (Bausch and Lomb) and AcrySof IQ (Alcon), focussing on glistenings and posterior capsule opacification. The evaluation of glistenings was done using Image J software and posterior capsule opacifications were quantified with OSCA system. METHODS: Twenty patients (7 men and 13 women) with bilateral cataract were included. EnVista intraocular lens (IOL) was implanted in one eye and AcrySof IQ IOL in the second eye of each patient. Objective evaluation methods were used for assessment. Glistenings was quantified with ImageJ software and PCO using the Open-Access Systematic Capsule Assessment (OSCA) system (Devised by Aslam TM, Edinburgh, United Kingdom). Complete ophthtalmological evaluation including evaluation after pupil dilatation was done and digital images of intraocular lenses were obtained. The results of 2-, 4-, 6- and 12-month follow-up were compared. RESULTS: Twenty patients were analyzed 2 months, 16 patients 4 months, 14 patients 6 months and 13 patients 12 months after cataract surgery. There was only minimal difference in best corrected visual acuity between EnVista and AcrySof group. The glistenings in the EnVista IOLs was objectively lower than in the AcrySof IOLs during whole follow-up period. In contrast to PCO, in eyes with AcrySof IOL was lower PCO score. CONCLUSION: Development of new materials and techniques of cataract surgery is the topic of ophthtalmologists worldwide. Reduction of glistenings and PCO is one of the main aims, objective measurements is important part of assessment of postoperative results after cataract surgery. KEY WORDS: glistenings, posterior capsule opacification, EnVista, AcrySof IQ, Image J software, OSCA system.

[Evaluation of the Clinical Results of Implantation the Hydrophobic Intraocular Lens CT LUCIA 601P]. / Hodnocení klinických výsledku implantace hydrofobní nitroocní cocky CT LUCIA 601P.

PURPOSE: To evaluate the properties and clinical outcomes after implantation the new hydrophobic intraocular lens CT LUCIA 601P in patients undergoing routine cataract surgery. MATERIAL AND METHODS: The study included 38 patients (43 eyes), mean age 70±8 years (range 56-91 years) with senile cataract. After phacoemulsification intraocular lens CT LUCIA 601P was implanted. Patients were evaluated at 4 months after surgery. We assessed uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refraction, keratometry and the incidence of posterior capsule opacification (PCO--Posterior capsule opacification). RESULTS: Before surgery the mean UCVA was 0.3±0.18 and four months after surgery was 0.7±0.15. The mean BCVA before surgery was 0.58±0.21 and after surgery was 0.94±0.08. PCO value was 0.199±0.05, that means minimal incidence of PCO. CONCLUSION: The new hydrophobic intraocular lens CT LUCIA 601P could be easily implanted and after surgery shows a high degree of biocompatibility in patients undergoing routine cataract surgery.

[Cytomegalovirus infection (CMV) in patients with acquired immunodeficiency syndrome]. / Cytomegalovirová retinitida u pacienta se syndromem získané imunodeficience.

Cytomegalovirus infection (CMV) in patients with acquired immunodeficiency syndrome (Acquired Immune Deficiency Syndrome, AIDS) is the most common opportunistic infection. This infection is harmless for healthy individuals, but for weakened individuals cause disease. The most common form of CMV-infection in patients with AIDS is cytomegalovirus retinitis, which occurs in 15% to 40% of cases. We report the case of aman twenty-five year old, treated for CMV retinitis and retinal vasculitis vessels. Prescribed Valcyte 900mg tbl. twice daily for 21 days with agood therapeutic effect. In patients with AIDS and decreased visual acuity is need be primarily thinking about the possible presence of CMV-infection and in time to start treatment.Key words: Cytomegalovirus (CMV) retinitis, AIDS, valganciklovir.

[Long term results of phakic 6 refractive implantation for myopia correction]. / Dlouhodobé výsledky implantace Phakic 6 Refractive pri korekci krátkozrakosti.

OBJECTIVE: To evaluate the safety and the long term results of anterior chamber phakic lens, Phakic 6 Refractive, for myopia correction. METHODS: In this retrospective study we reviewed the charts of 35 myopic patients (62 eyes) who had implantation of anterior chamber phakic lenses (Phakic 6 Refractive, Ophthalmic Innovations International, California, USA) for correction of myopia. The mean age of patients was 26 years (18 to 45 years). The mean spherical refraction was -9.9 (-4 to -18 D). The best corrected distant visual acuity (BCDVA) was 0.92 (1.2 to 0.3) before surgery. The mean follow-up was 8 years (4 to 10). The mean endothelial cell count was 2481 cells/mm2 and the mean pachymetry was 540 µm before surgery. In those patients who needed a second surgical intervention (explantation or lens reposition) the last follow-up visit is the visit before the lens explantation or reposition. The same surgeon (P. R.) performed all surgeries and used the same technique in each surgery. RESULTS: On the final follow up visit the BCDVA was in the mean 1.02 (1.5 to 0.5). The spherical refraction was in the mean - 0.53 D (-3.0 to +1.0). We noticed a 16% decrease in the mean number of corneal endothelial cells, and no change in the pachymetry values. We had to explant the lenses in 7 eyes (12 %) because of the decreased endothelial cells count. 2 eyes (3.0 %, 1 patient) had to receive treatment for glaucoma, 4 eyes (6.5 %) had to have the artificial lens repositioned, 1 patient had to have photocoagulation therapy for a retinal tear. 93 % of the study eyes had stable refraction during the study period. There was a 10 % increase in the average BCDVA, and there was a 95 % improvement of the original refractive error. CONCLUSIONS: In selected cases, the implantation of Phakic 6 Refractive anterior chamber lens is a viable option despite it is currently largely abandoned. Key words: Phakic 6 Refractive implantation, myopia correction.

[Acute posterior multifocal placoid pigment epitheliopathy - case report]. / Akutní zadní multifokální plakoidní pigmentová epiteliopatie.

Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) affects individuals between 20 to 30 years of age and ocular manifestations are often preceded by flu-like illness. Symptoms of the disease include acute vision decrease associated with central and paracentral scotoma. Impairment of vision is usually bilateral, but may be asymmetric. We report the case of a man at the age of twenty-one, who was treated for APMPPE. Due to the involvement of the macula, low visual acuity and related immunogenetic predisposition (HLA-B27 positivity) was recommended corticosteroid therapy with a good therapeutic effect. Key words: acute posterior multifocal placoid pigment epitheliopathy (APMPPE), white dot syndromes, macular edema.

[Internal limiting membrane peeling as prophylaxis of epimacular membrane formation in eyes undergoing vitrectomy for rhegmatogenous retinal detachement]. / Peeling vnitrní limitující membrány na odchlípené makule jako prevence rozvoje epimakulární membrány po pars plana vitrektomii pro rhegmatogenní amoci sítnice.

PURPOSE: Rhegmatogenous retinal detachment is a serious condition that can significantly impair visual function, even after a successful surgery. One of the complications that can significantly impair visual acuity in the postoperative period is a development of the epimacular membrane (ERM). The aim of this work is to monitor the effect of peeling of the internal limiting membrane (ILM) in the macula at the anatomical and functional results in the postoperative period, especially with regard to the development of ERM. METHODS: Prospective study of 21 eyes, which underwent peeling of ILM during pars plana vitrectomy for rhegmatogenous retinal detachment (on detached macula). The ILM peeling was done without using decalin during this procedure. We tested best corrected visual acuity (BCVA) and followed fundus biomicroscopic findings. Proliferative vitreoretinopathy (PVR) was evaluated according to the recommendations of the Retina Society Terminology Committee. To exclude the development of ERM in the macula optical coherence tomography (OCT) was performed at the end of the 18-month follow-up period. RESULTS: In total, the results of 21 eyes of 21 patients who underwent PPV for rhegmatogenous retinal detachment were evaluated. In all of them was during PPV performed ILM peeling on detached macula, these are followed prospectively. ILM peeling without using decalin was sufficient in all eyes. All eyes with ILM peeling did not develop ERM at the end of the follow-up period. CONCLUSIONS: ILM peeling during PPV for rhegmatogenous retinal detachment reduces the risk of developing secondary ERM.

[Surgical treatment of severe degree of ptosis of the upper eyelid using a Fronto-tarsal sling of biocompatible PVC]. / Operacní resení tezkého stupne ptózy horního vícka pomocí fronto-tarzálního závesu trubickou z biokompatibilního PVC.

PURPOSE: ptosis is anomalous drop of the upper eyelid. Depending on the cause of the state and especially according to the results of clinical findings (dominated significance of elevation of the upper eyelid) we can be perform various surgical procedures. Operation under Fasanella-Servat is suitable for the easiest cases - function of the upper eye-lid levator muscle (levator) is at least 10 mm and a maximum of 2 mm ptosis. Aponeurosis advancement has good results in all types of involutional origin. Eyelid levator resection is performed when the levator function is better than 5 mm. Eye-lid sling to brow lift mechanism is designed for the toughest conditions, when the levator function is worse than 4 mm. The authors present the results of surgery for ptosis with biocompatible PVC tube fronto-tarsal sling. METHODS: case-reports of 4 eyes in 3 adult patients were prospectively monitored. It was a one man and two women with different etiologies of ptosis. The principle of operation is suspension the upper eyelid to eyebrow-levators using PVC tubes in the subcutaneous tissue. Monitored parameters were: best corrected visual acuity, clinical finding of the front segment (with an emphasis on lagophthalmos in the postoperative period), eye-fissure height and levator function in millimeters (mm). RESULTS: there was the most severe degree of ptosis in all cases. In terms of functional and cosmetic effect treatment were surgeries successful in all patients. One half of the cases (2 of 4 eyes) had transient postoperative lagophtalmos, which in one case was solved with moisture chamber. None of exposure keratopathy developed. In one case, it was after 9 months after the operation, we had to extract one implant due to extruzion of the tube. CONCLUSIONS: The fronto-tarsal tubing with biocompatible PVC is effective and relatively safe technique in cases of severe degree of ptosis of the upper eyelid. The material appears to be well tolerated by the surrounding tissue.

[Scleral buckling for Rhegmatogenous retinal detachment]. / Operace rhegmatogenního odchlípení sítnice zevním postupem.

Rhegmatogenous retinal detachment (RRD) is the separation of the sensory retina from the pigment epithelium (RPE). RRD is caused by a retinal tear in the periphery and the vitreoretinal (VR) traction, which allows access of the vitreous fluid to the subretinal space. Treatment of symptomatic retinal detachment is currently surgical only. Surgical options are intraocular and extraocular. This is the retrospective evaluation of the group of 17 eyes of 17 patients with RRD, which were operated by scleral buckling. Patients were 9 men and 8 women, age range 19-61 (median 46) years. The observation period is 1-13 months (median 7). The possible types of external interventions procedure were used only two: the radial plombage (in one case double) and cerclage. 15 patients (88 %) were phakic, and 2 were pseudophakic. In 12 eyes (71 %) were the quadrant RRDs, 2 eyes had dialysis in periphery of the retina, 1x it was the top half and 1x bottom half, and 1 patient had a subtotal RRD. In 9 (53 %) cases were used type of operation cryocoagulation with radial buckle and in 8 cases cryocoagulation with the cerclage. In four cases, was injected the gas tamponade into the vitreous at the end of the surgery. Primary attaching the retina occurred in 16 cases (94 %) and the retina remained flat in 14 eyes (82.4% ), in 2 cases occurred re-detachment (11.7 %). Preoperative best corrected visual acuity (BCVA) ranged from hand movement to 20/20 (average Snellen equivalent 20/63) and postoperative BCVA was 1/50 - 20/20 (average 20/50). Improving BCVA was statistically significant (Wilcoxon p=0.01). We consider the cryosurgical procedure for phakic eyes as the gold standard of the surgical treatment of uncomplicated rhegmatogenous retinal detachment. The main reason for the eventual failure of this technique is persistent vitreous traction and proliferative vitreoretinopathy (PVR).

[Scleral buckling for rhegmatogenous retinal detachment]. / Operace rhegmatogenního odchlípení sítnice zevním postupem.

Rhegmatogenous retinal detachment (RRD) is the separation of the sensory retina from the pigment epithelium (RPE). RRD is caused by a retinal tear in the periphery and the vitreoretinal (VR) traction, which allows access of the vitreous fluid to the subretinal space. Treatment of symptomatic retinal detachment is currently surgical only. Surgical options are intraocular and extraocular. This is the retrospective evaluation of the group of 17 eyes of 17 patients with RRD, which were operated by scleral buckling. Patients were 9 men and 8 women, age range 19-61 (median 46) years. The observation period is 1-13 months (median 7). The possible types of external interventions procedure were used only two: the radial plombage (in one case double) and cerclage. 15 patients (88 %) were phakic, and 2 were pseudophakic. In 12 eyes (71 %) were the quadrant RRDs, 2 eyes had dialysis in periphery of the retina, 1x it was the top half and 1x bottom half, and 1 patient had a subtotal RRD. In 9 (53 %) cases were used type of operation cryocoagulation with radial buckle and in 8 cases cryocoagulation with the cerclage. In four cases, was injected the gas tamponade into the vitreous at the end of the surgery. Primary attaching the retina occurred in 16 cases (94 %) and the retina remained flat in 14 eyes (82.4% ), in 2 cases occurred re-detachment (11.7 %). Preoperative best corrected visual acuity (BCVA) ranged from hand movement to 20/20 (average Snellen equivalent 20/63) and postoperative BCVA was 1/50 - 20/20 (average 20/50). Improving BCVA was statistically significant (Wilcoxon p=0.01). We consider the cryosurgical procedure for phakic eyes as the gold standard of the surgical treatment of uncomplicated rhegmatogenous retinal detachment. The main reason for the eventual failure of this technique is persistent vitreous traction and proliferative vitreoretinopathy (PVR).

[Oculars disturbances as first sign of decompensated arterial hypertension]. / Ocní obtíze jako první známka dekompenzované arteriální hypertenze.

Arterial hypertension is a serious health problem. Decompensation of blood pressure may cause many ocular complications. We present three case reports of men with decompensated blood pressure and associated ocular complications. Successful compensation of blood pressure leads to objective improvement of fundus changes and vision.

Rheohaemapheresis in the treatment of nonvascular age-related macular degeneration.

PURPOSE: To evaluate the experience with rheohaemapheresis (RH) in the treatment of age-related macular degeneration (AMD). METHODS: Thirty-eight patients were each treated with 8 procedures of RH (14 males, 24 females). The control group consisted of 34 random patients (30 females, 4 males) with the dry form of AMD but not treated by RH. Our modification of the cascade method (named rheohaemapheresis) was used for plasma separation. After plasma separation (blood cell separator, Cobe Spectra, Denver, CO, USA), the separated plasma was pumped through a rheofilter (Evaflux 4A, Kuraray, Osaka, Japan) to remove lipoproteins and other high-molecular-weight rheologic factors. RESULTS: In treated patients, best-corrected visual acuity (BCVA) increased significantly from 0.61 (0.06-1.00) to 0.68 (0.35-1.00) after 2.5 years (p = 0.035). We found no significant changes or differences in scotopic activity, whereas cone response and paramacular activity in the more peripheral region between 14° and 22° of eccentricity were significantly higher in treated patients after 2.5 years. CONCLUSION: RH therapy favourably influenced BCVA. During 2.5 years after the therapy, no progression of dry to wet AMD was observed in our patients. RH reduced the area of drusenoid retinal pigment epithelium detachment (which increased during the natural course of dry form AMD). RH influenced rheological markers and probably improved metabolism in the affected retinal areas which lead to the aforementioned positive results.

[Evaluation of the clinical results of implantation the hydrophobic-hydrophilic intraocular lens ERIFLEX 877 FAB]. / Hodnocení klinických výsledku implantace hydrofobne-hydrofilní nitroocní cocky EriFlex 877 FAB.

PURPOSE: To evaluate the properties of intraocular lens ERIFLEX 877 FAB, the manipulation during implantation and clinical outcomes after implantation of the new hydrophobic-hydrophilic intraocular lens in patients undergoing routine cataract surgery. MATERIAL AND METHODS: The study included 30 patients (38 eyes), mean age 71 ± 8 years (range 53-89 years) with senile cataract. After phacoemulsification intraocular lens ERIFLEX 877 FAB was implanted. Patients were evaluated at 3 months after surgery. We assessed the uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA), refraction, keratometry and the incidence of posterior capsule opacification (PCO - Posterior capsule opacification). Individual patients and surgeons satisfaction was also documented including manipulation during surgery. RESULTS: Three months after surgery, the mean UCVA was 0.7 ± 0.2 and BCVA was 0.97 ± 0.16. PCO value was 0.15 ± 0.09, that means minimal incidence of PCO. Good UCVA and a minimal incidence of PCO have resulted in a high degree satisfaction of patients. CONCLUSION: The new hydrophobic-hydrophilic intraocular lens ERIFLEX 877 FAB could be easily implanted and after surgery shows a high degree of biocompatibility in patients undergoing routine cataract surgery.

[Surgical treatment of very advanced rhegmatogenous retinal detachment]. / Operacní resení u velmi pokrocilých rhegmatogenních amocí

Rhegmatogenous retinal detachment is a serious ocular pathology. Therapeutic options are surgical only. Surgery is in advanced stages technically and financially demanding. In this paper, we consider the results operated detachments, which were for their advancement, with respect to the technical possibilities of the present intraocular surgery, on the border of the surgical possibilities. The group consisted of 37 eyes of 37 patients who were followed prospectively and had in the affected eye very advanced (old) rhegmatogenous retinal detachment. As a method to confirtm any visual functions were used visual evoked potentials in flash monocular stimulation (F-VEP). All patients had a cerclage performed 12 mm from the limbus, 20G pars plana vitrectomy (PPV), in 2 was also performed cataract surgery (phacoemulsification with implantation of an artificial intraocular lens to the bag). Surgery was done in 23 of 37 patients (62 % of the whole group), with the remaining 14 eyes was not due to the severity of finding highly advanced retinal detachment. Attached retina at the end of the observation period had 14 eyes (61% of the patients, 38% of the whole group). In 5 eyes was due to local re-detachment in the periphery only stabilized finding (22% of operated eyes, 14% of all). The values ​​of visual acuity in the subgroup of operated eyes were statistically significantly increased after surgery (Wilcoxon p = 0.036). The values ​​of F-VEP were not statistically significantly different between operated and non-operated patients and was not found any statistically significant correlation between the vision (and even after surgery) and F-VEP in operated eyes. Anatomical success of surgical treatment of advanced retinal detachment is possible. But the correlation was not found in visual acuity and F-VEP or the severity of preoperative disturbed visual function, even in the improvement in the postoperative period. F-VEP is not a suitable marker for determining the indication for the procedure, or to the prognostics and therefore we can not use this technique to distinguish between operable and inoperable findings. Based on our clinical experience, we recommend carefully consider the suitability of surgical treatment of rhegmatogenous retinal detachment with low vision than the hand movement with the correct projection of light, when the duration is longer than three months and the anatomic findings is contractile anterior proliferative vitreoretinopathy.

[Vision loss after uncomplicated pars plana vitrectomy]. / Ztráta zraku po nekomplikované pars plana vitrektomii.

Every eye surgery has its pitfalls and possible complications. Even after properly and noncomplicated orbital or intraocular surgery there can develop a loss of visual acuity or visual field. In the perioperative period was on the operated eye for epimacular membrane (23G pars plana vitrectomy) retinal arterial occlusion with fatal consequences for visual function. Entrance visual acuity decreased from 20/63 to counting fingers. Risk factors for age-related and underlying diseases were accompanied by systemic hypotension and mild anemia. Commonly available topical and general therapy did not lead to any significant improvement.

[Wet form age-related macular degeneration two years treatment results using anti VEGF drugs]. / Dvouleté výsledky lécby vlhké formy vekem podmínené makulární degenerace s pouzitím léku proti vaskulárnímu endotelovému rustovému faktoru.

AIM: The aim of the study was to establish the efficacy of anti VEGF (Vascular Endothelial Growing Factor) drugs in the treatment of wet form ARMD (Age-Related Macular Degeneration) in everyday clinical practice in the Department of Ophthalmology, Faculty Hospital, Hradec Králové, Czech Republic, E.U., in patients registered in the Czech national registry AMADEUS. MATERIAL AND METHODS: Retrospective study with 24 months follow-up period. In the group were evaluated 143 eyes of 140 patients, out of them were 77 women (65.8 %), of average age 73.09 (71.69 - 74.48) years, and 40 men (34.2 %) of average age 74 (58 - 85) years. All of the patients were completely examined before the beginning of the treatment; during the treatment were, except the standardized eye examination, in patients treated with ranibizumab the color fundus photography and Optical Coherence Tomography (OCT) with measuring of the central retinal thickness performed every three months at least. The patients treated by pegaptanib were examined every six weeks before the drug application. The fluorescence angiography (FA) was performed at the beginning of the treatment to establish the type and extension of the choroidal neovascularization and during the treatment in case of necessity to establish the activity of the choroidal neovascular membrane (CNV). The treatment by ranibizumab was in the regimen PRN (pro re nata), and pegaptanib was applied every six months during the first year with the follow-up evaluation of the findings. The treatment evaluations were performed at 12 and 24 months. RESULTS: During the two years follow - up period, the authors noticed in patients treated with ranibizumab loss of 5.12 letters of ETDRS optotypes in case of mostly classical CNV, in occult CNV loss of 5.45 letters, and in minimally classical CNV loss of 2.83 letters. In three evaluated eyes with classical CNV in patients treated with pegaptanib we noticed after 2 years loss of 6.67 letters, in eleven eyes with occult CNV we established loss of 9.91 letters, and in two eyes with minimally classical CNV the average best-corrected visual acuity (BCVA) remained unchanged. The pegaptanib treatment results may be influenced by small number of evaluated patients. The visual acuity changes during the two years treatment were not statistically significant. We noticed the decrease of average CRT (central retinal thickness) in all types of CNV treated both with ranibizumab and pegaptanib after the two years follow up. To reach these results, an average of 5.51 applications of ranibizumab and 9 applications of pegaptanib during the two years were used. CONCLUSION: In the followed-up group we found, comparing to the natural course of neovascular form of ARMD, retarding of the BCVA decrease during the two years treatment with VEGF inhibitors in everyday clinical practice. Better results were achieved with ranibizumab treatment, however the differences were not statistically significant. Key words: age related macular degeneration, AMADEUS Czech national registry, ranibizumab, pegaptanib.