Results at 7years after cross-linking procedure in keratoconic patients.

PURPOSE: Long-term evaluation of functional results based on visual acuity, keratometry, spherical equivalent and refractive cylinder in patients with progressive keratoconus treated with corneal collagen cross-linking (CXL). MATERIALS AND METHODS: We studied a group of 114 eyes of 91 consecutive patients treated from 2006 to 2009 by "Epi-off type" CXL. In the preoperative period, all patients had a complete ophthalmologic examination. The inclusion criteria were: patients aged 15 to 54years, with various stages of keratoconus, with a corneal thickness of at least 400µm at the thinnest point. The exclusion criteria were: patients with a corneal thickness of less than 400µm at the thinnest point, with Vogt's striae or herpetic keratitis, dry eye syndrome or aphakia. The patients were then followed at 1, 3 and 6months, and then every year between 1 and 7years postoperatively. RESULTS: There was a decrease in the minimum K and maximum K, respectively 1.6 and 2.0, at 7years postop. (P<0.05). The cylinder decreased from -4.45 D to -3.50 D at 7 years postop (P<0.05). The spherical equivalent decreased by 1.66 D at 7 years (P<0.05). Uncorrected visual acuity increased from an average of 0.78 to 0.679 log MAR (P<0.05) at 7 years postop. The best-corrected visual acuity increased from a mean of 0.64 to 0.52 log Mar (P<0.05) at 7 years postop. CONCLUSIONS: The results of CXL were stable at 7 years in all patients, consisting of reduction of keratometric values and refraction, and improvement in visual acuity.

Corneal collagen cross-linking in keratoconus -- long-term prospective study.

PURPOSE: To determine the refractometric, keratometric and functional results 3 years after cross-linking therapy in patients with keratoconus. PATIENTS AND METHODS: Eighty-one patients in various stages of keratoconus were studied, all meeting eligibility criteria for the cross-linking technique. RESULTS: The results showed a decrease both in the K-values, of about 1.5 D, and in the refraction. Visual acuity improved by 1, 2 or 3 Snellen lines in 70% of the cases. CONCLUSIONS: The cross-linking technique is a modern method for stopping the progression of keratoconus.

Adsorption of heavy metal cations by Na-clinoptilolite: equilibrium and selectivity studies.

This paper summarizes the conclusions of experiments conducted on the adsorption of Cd(2+), Co(2+), Cu(2+), Mn(2+), Ni(2+), Pb(2+) and Zn(2+) onto zeolite. The focus of the experiments was to establish the influence of the initial pH of the contact solution as well as the selectivity of zeolite on the efficiency of the adsorption process. To this end, experimental adsorption isotherms were established for the pH values ranging from 1 to 4 by using the Na-form of clinoptilolite (particle size range 0.5-1 mm) as an adsorbent. Langmuir, Freundlich and Dubinin-Raduschkevich isotherm models were used to validate the experimental data and the Gibbs free energy was calculated based on the distribution coefficient. From the Langmuir model, correlations between the maximum adsorption capacity and selected physical-chemical parameters of the cations studied were established. The results of the experiments suggest that the selectivity of zeolite is strongly influenced by the pH of the contact solution, dehydration energy of cations, diffusion coefficient and the pH at which the precipitation of hydroxides occurs.

[Correlations between ocular biometry and post-surgical refraction]. / Corelatii între biometria oculara si refractia postoperatorie.

PURPOSE: To show the importance of ocular biometry in establishing the power of intraocular lens. MATERIAL AND METHOD: We studied 212 eyes operated in the University Eye Hospital from Cluj-Napoca by planned extracapsular extraction with intraocular lens implantation. Before operation there was performed ocular biometry, using SRK II formulas for calculation of intraocular lens. At 6 weeks after operation, we checked the ocular refraction by dioptronometry and we established the optical correction of the patients. RESULTS: The standard error was statistically significantly in all cases. In 84.19% of cases it was performed visual acuity with optimal correction over 0.7. CONCLUSION: The ocular biometry represents significant factor in obtaining a very good visual acuity after cataract operation.

[The Faden operation in strabismus surgery]. / Faden--operatia în chirurgia strabismului.

PURPOSE: Is to evaluate the indications of Faden operation and the postoperative results. MATERIAL AND METHOD: We studied a number of 32 patients with convergent strabismus operated in the Universitary Eye Hospital from Cluj, during 1998-2000 at whom we performed Faden operation with conventional surgery on the medial rectus. The anAestesia was with ketamine i.v. RESULTS: The majority of patients where females (62.50%) with ages between 0-14 years. We performed surgery in cases of convergent strabismus with spasm of fixation. The postoperative results were promising; in 23 cases we obtained ortHophory, in 8 cases a remaining deviation angle (5-10 D P), and in 1 case a deviation angle above 5-10 D P. CONCLUSIONS: 1. Faden operations is indicated to correct the spatical component of the deviation angle. 2. The postoperative good results are depending on the aSsociations of Faden operation with conventional surgery. 3. Under or above correction of the strabismus is linked with a deficiency of the conventional surgery associated.

[The explantation and implantation of artificial crystalline lenses]. / Explantarea si înlocuirea cristalinelor artificiale.

UNLABELLED: THE PURPOSE of the study is to evaluate the causes of explantation and replacement of different types of intraocular lenses. MATERIAL AND METHOD: We performed a study of 1060 eyes operated for cataract in the University Eye Hospital between 1992-1996, following the number of explantation and replacement of intraocular lenses (IOL), the types of IOL and the causes of explantation. RESULTS: We performed 8 explantation of IOL (0.75 g) for pseudophakic bullous keratopathy (1 case), chronic uveitis (3 cases), secondary glaucoma (2 cases), suppurative uveitis (1 case), cystoid macular oedema (1 case). From the 8 explantation of IOL, 3 were anterior chamber intraocular lenses (AC-IOL) and 5 posterior chamber intraocular lenses (PC-IOL). We performed reposition in 4 cases of IOL. The most frequent cause of explantation was chronic uveitis and secondary glaucoma. CONCLUSION: Explantation is indicated in certain cases of IOL complications without response on medical treatment.

[Etiopathogenic consideration in the development of retinal detachment in aphakic and pseudoaphakic eye]. / Consideratii etiopatogenetice în aparitia dezlipirii de retina pe ochi afak si pseudofak.

PURPOSE: Is to evaluate the risk factors implicated in the development of retinal detachment in aphakic and pseudophakic eyes. MATERIAL AND METHOD: We studied 46 cases operated for cataract by planned extracapsular cataract extraction with or without intraocular lens, wich developed after the operation retinal detachments. RESULTS: Retinal detachment appeared in 2.98% cases of EEC with AC-IOL and in 0.56% in EEC with PC-IOL. We performed Yag laser capsulotomy in 4 cases. Retinal detachment appeared in 12 cases between 6-12 months. The most frequent breaks causing retinal detachment where "horse shoe tears" in 23.4% of cases and tears in 14.89% cases. CONCLUSIONS: 1. High myopia and peripheral retinal degenerations are risk factors in the development of retinal detachment after the cataract operation. 2. Vitreous loss facilitates the appearing of vitreo-retinal tractions followed by retinal detachment. 3. PC-IOL reduces the frequency of retinal detachment by the stabilisation of the eye and limiting the ophthalmodonesis.

[Postoperative induced astigmatism]. / Astigmatismul indus operator.

PURPOSE: Is to evaluate the astigmatism induced by cataract surgery, ethiological factors and ways of prophilaxies and treatment. MATERIAL AND METHOD: We followed a number of 211 eyes operated for cataract by planned extracapsular extraction with intraocular lens implantation, in Ophthalmological Clinic from Cluj-Napoca. All the pacients had limbal incision and the suture was performed with 9.0 suture, after the operation the treatment consisted in local drops with steroids. REZULTS: The astigmatism induced by the surgery was direct in 53.08% of cases and indirect in 46.92%. The position of the axes was 0-900 in 72.51% and oblique in 27.48%. The optical correction of astigmatism was with combined spherocylinder glases in 57.34% and only with cilinder in 42.65% of cases. CONCLUSIONS: 1. The induced astigmatism by cataract surgery is in relation with the incision, suture and IOL. 2. Correction of astigmatism is possible with optical correction, repearing the suture or with refractive surgery. 3. The prevention of astigmatism over 1.5 D is by using Troutmann keratometer and to evidence the congenital astigmatism.

[The therapeutic aspects in intermittent divergent strabismus]. / Consideratii terapeutice în strabismele divergente intermitente.

PURPOSE: Is to evaluate the possibilities of treatment in intermittent divergent squint at children and young adults. MATERIALS AND METHOD: We studied an group of 66 patients treated in the University Clinic of Ophthalmology from Cluj-Napoca. RESULTS: The most frequent type of intermiTtent divergent squint (IDS) is the type of excess of divergency (25.76%). In 46.9% the onset was between 2-6 years. In 69.7% visual acuities were equal and stereopsis was present in 74.24%. Hyperopia +/- astigmatism was present in 69.7%. The treatment of intermittent exodeviation was conservative in 51.5% and surgical for first intention in 39.3%. CONCLUSIONS: 1. The most frequent type of intermittent exodeviation is by excess of divergency. 2. The treatment of exodeviation is an optical, orthoptic and surgical treatment. 3. The surgical technique depends on the type of intermittent exodeviation.

[A clinical case of functional recovery after an extensive, perforating corneoscleral wound with partial evisceration of the membranes and crystalline lens]. / Caz clinic de recuperare functionala dupa plaga corneo-sclerala perforanta, întinsa, cu evacuare partiala de membrane si cristalin.

The article presents a clinical case of functional recuperation after perforated corneo-scleral wound with partial evisceration of the eye and lens. The authors describe the possibilities of evolution and the surgical modalities for correction of aphakia.

[YAG laser capsulotomy in secondary cataract]. / Capsulotomia laser YAG în cataracta secundara.

UNLABELLED: The purpose of the study is to evaluate the modern possibilities of performed by laser YAG in secondary cataract. MATERIAL AND METHOD: We performed a study on 200 eyes with secondary cataract operated in the University Eye Hospital from Cluj-Napoca during 1991-1997. RESULTS: We had 95 male and 105 female, with age between 30-90 years old. The capsular fibrosis was present in 86% of the cases. Secondary cataract was present in 13.33% of the cases with PC-IOL. Functional results showed a visual acuity between 0.7-1 in cases from the 50 cases review after 1 week after YAG Laser. CONCLUSIONS: 1. Secondary cataract is the most frequent complications of PC-IOL which influence the visual acuity. 2. YAG laser capsulotomy is a modem, efficient and non-invasive method to solve the secondary cataract.

[The posterior chamber artificial crystalline lens implant in the diabetic patient]. / Implantul de cristalin artificial de camera posterioara la bolnavul diabetic.

UNLABELLED: The purpose of this study is to display the influence of diabetes on the course of the operation, postoperative complications and functional results in operated primary cataract. MATERIAL AND METHODS: We performed a study on 72 eyes with cataract and diabetes operated in the University Eye Hospital from Cluj-Napoca during 1992-1997. RESULTS: From the 72 cases, 58 had diabetes noninsuline dependent. Background diabetic retinopathy was present in only 18 cases. In 71 cases it was performed EEC + IOL-CP and 1 case with open angle glaucoma we made the triple procedure (EEC + CP-IOL + trabeculectomy). In 43 cases it was striate keratitis, in 30 eyes pigmentary migration and in 4 cases uveitis. As late postoperative complication we had 10 secondary cataract and i retinal detachment. Functional results were in majority cases between 0.1-0.3. CONCLUSIONS: Diabetes do not influence the course of planned extracapsular extraction with PC-IOL, which is the best choice for the patients with cataract and diabetes. Functional results depends on the presence of diabetic retinopathy.

[Surgical treatment in strabismus with a vertical component]. / Tratamentul chirurgical în strabismele cu componenta verticala.

In the paper we studied 87 patients with vertical or combined deviations treated in Eye Clinic from Cluj-Napoca between 1994-1998. The most patients show vertical deviation due to inferior muscle overaction (70 patients). 17 patients had a vertical deviation due to another causes (superior oblique paresis, III-nerve paresis and dissociated vertical deviations). We treated vertical deviation due to superior oblique muscle overaction only when was an important deviation in the primary position of gate. In superior muscle paresis we did a superior oblique muscle resection or weaken of inferior oblique muscle secondary overacting. In III-nerve paresis with contralateral superior rectus muscle overaction we did recession of this muscle. The results are favourable: the deviation disappear in the primary position of the gaze and decrease or disappear in the lateral gaze.

[The functional prognosis of traumatic cataracts operated on for an artificial lens implant]. / Prognosticul functional al cataractei traumatice operate cu implant de cristalin artificial.

The authors shows the modern possibilities of rehabilitation of the vision in traumatic cataract on a group of 57 cases hospitalised and operated in the Department of Ophthalmology of the University of Medicine from Cluj-Napoca. The study includes the repartition of cases on age, sex, profession, the type of traumatic cataract, different techniques of surgery and the functional results. In all cases it were used intraocular lenses (pupillary, anterior chamber and posterior chamber).

[Complications specific to posterior chamber lens implantation]. / Complicatii specifice implantelor de cristalin de camera posterioara.

The purpose of the study is to evaluate posterior chamber intraocular lenses complication, causes and their prevention.

[The conservative treatment and evolution of intermittent divergent strabismus]. / Tratamentul conservator si evolutia strabismelor divergente intermitente.

We study 43 children with intermittent exotropia treated in Eye Clinic, Cluj. 83.7% shows excess divergence exotropia and only 16.3% convergence insufficiency exotropia. The children are treated with optical correction, prisms and orthoptics.

[The functional results in primary surgical cataract associated with diabetes mellitus]. / Rezultate functionale în cataracta primitiva operata, asociata cu diabet zaharat.

UNLABELLED: The purpose of this study is to display the influence of diabetes on the course of the operation, postoperative complications and functional results in operated primary cataract. MATERIAL AND METHODS: We performed a study on 42 eyes with cataract and diabetes operated in the University Eye Hospital from Cluj-Napoca during 1992-1996. RESULTS: From the 42 cases, 32 had diabetes non-insulin-dependent. Background diabetic retinopathy was present in only 16 cases (38%). In 33 cases it was performed EEC + PC - IOL. Postoperative, in 38 cases it was striate keratitis, in 21 eyes pigmentary migration and in 3 cases uveitis. As late postoperative complications we had 5 secondary cataract and 1 retinal detachment. Functional results were in majority cases between 0.1-0.3. CONCLUSIONS: Diabetes do not influence the course of planned extracapsular extraction with PC-IOL, which is the best choice for the patients with cataract and diabetes. Functional results depends on the presence of diabetic retinopathy.

[The results and complications of artificial lens implantation in the anterior chamber]. / Rezultate si complicatii ale implantului de cristalin artificial de camera anterioara.

UNLABELLED: The purpose of the study is to make a comparison in the evolution of AC-IOL per primam and per secundam. MATERIAL AND METHOD: We reviewed 50 cases operated in the University Clinic of Ophthalmology from Cluj-Napoca since 1995-1996, 35 managed with primary and 15 with secondary AC-IOLs. RESULTS: Early and late postoperative complications are frequently present at the primary AC-IOLs. Explanation was performed in 2 cases. The functional results were superior at secondary AC-IOLs. CONCLUSIONS: AC-IOL is the solution to be chosen in case of intraoperative complication (loss of vitreous). Secondary AC-IOL is to be preferred because the postoperative complications are fewer and the functional results are better.

[The posterior chamber implant per secundam]. / Implantul de camera posterioara per secundam.

UNLABELLED: The purpose of the study is to show the efficacy and advantages secondary implant of PC-IOL in certain conditions. MATERIAL AND METHOD: We studied 8 aphakic eyes which had been operated on in the past for senile and traumatic cataract and who desired an secondary implantation of IOL. In 3 causes it was performed Yag laser capsulotomy for secondary cataract. The functional results in all cases were between 0.7-1 with optimal correction. CONCLUSION: Secondary implantation of PC-IOL is a good solution in aphakic eyes, in certain ocular conditions.

[Postoperative uveitis in cataract surgery]. / Uveita postoperatorie în chirurgia cataractei.

Postoperative uveitis is a complication of cataract surgery; this complication may compromise the functional outcome and sometimes loss of the eye ball. Between 1995-1996 in Ophthalmological Clinic from Cluj five hundred patients underwent one surgical procedure for cataract; from these in fifteen cases occurred postoperative uveitis. At thirty cases from them was practised the implant by posterior chamber and by anterior chamber at two cases. The debut and the clinical aspect shows the exogenic character in two cases and the endogenic character in thirty cases. The postoperative uveitis frequency in the cataract surgery was 0.4 per cent. In two cases the outcome was the functional loss of the eyeball. The endogenous uveitis answered favorable at the treat with topic and general corticotherapy. In none of the cases was the implant explantation effected.