Iris and ciliary body cysts and phakic intraocular lenses.

Phakic intraocular lenses are used to correct refractive errors. The procedure is predictable and potentially reversible. The procedure is not free of complications though. The occurrence of iris cyst after implantation of a phakic intraocular lens was not described previously in the literature. We describe two cases of iris cysts in the presence of a phakic intraocular lens; the first case describes a cyst which was not present prior to the anterior chamber phakic intraocular lens implantation. The second case describes a hidden iris cyst that affected the posterior chamber phakic intraocular lens position and lead to glaucoma.

[The glaucoma pharmacological treatment and biomechanical properties of the cornea]. / Medikamentózní lécba glaukomu a biomechanické vlastnosti rohovky.

PURPOSE: To evaluate and compare the impact of long-term use of intraocular pressure lowering medication on the biomechanical properties of the cornea. MATERIAL AND METHODS: Group of 305 eyes of 154 patients newly diagnosed with primary open angle glaucoma (POAG, n = 68) or ocular hypertension (OH, n = 6) was enrolled in prospective cohort study. The control group was established of 80 untreated eyes of 40 patients with ocular hypertension and 80 eyes of 40 patients with no ocular pathology. Following parameters were evaluated: intraocular pressure (IOPg,IOPcc), hysteresis (CH), corneal resistance factor (CRF) and central corneal thickness (CCT). The parameters were evaluated at baseline (untreated) and in follow up periods of 3, 6, 9 and 12 months. The same schedule was used for eyes in the control group. Eyes with POAG or OH were sorted into two groups depending on the type of applied medication: prostaglandin analogues, carboanhydrase inhibitors alone or combined with betablockers. RESULTS: We did not prove any statistically significant difference in hysteresis in patients with newly diagnosed POAG (yet untreated) in comparison with normal eyes in control group (p = 0.238). We proved significantly higher values of CRF (p = 0.032) and CCT (p = 0.013) in the control group of untreated patients with ocular hypertension. This result confirms higher number of patients with stiffer and thicker corneas. Statistically significant difference of CH and CRF was proved (p < 0.0001) in eyes treated by prostaglandin analogues during follow up period. In these eyes we also demonstrated reduction of CCT (p < 0.001). We did not record any other statistically significant change in remaining followed parameters. CONCLUSION: Increase of CH and CRF can show change of biomechanical properties of the cornea after long-term use of prostaglandin analogues. The biomechanical properties of the cornea were not impacted by carboanhydrase inhibitors. Further studies are required to establish the effect of long-term use prostaglandin analogues on accuracy of IOP measurements.

The efficacy and safety of timolol maleate versus brinzolamide each given twice daily added to travoprost in patients with ocular hypertension or primary open-angle glaucoma.

PURPOSE: To compare the efficacy and safety of timolol maleate 0.5% versus brinzolamide 1% when added to travoprost 0.004% in patients with ocular hypertension or primary open-angle glaucoma. DESIGN: A prospective, double-masked, randomized, active-controlled, parallel comparison. METHODS: Qualified patients at Visit 1 were placed on travoprost dosed every evening for 4 weeks and then were randomized at baseline (Visit 2) to the addition of timolol maleate or brinzolamide each given twice daily. Patients returned to clinic at Week 4 (Visit 3) for a safety visit and Week 12 (Visit 4) for an efficacy visit. At Visits 2 and 4 the intraocular pressure (IOP) was measured at 08:00, 12:00, and 16:00 hours. RESULTS: Ninety-seven patients on brinzolamide had a baseline diurnal IOP of 21.5+/-2.2 mmHg and 95 on timolol maleate had 21.3+/-2.5 mmHg, each added to travoprost. The diurnal mean IOP at Week 12 was 18.1+/-2.7 mmHg for brinzolamide and 18.1+/-3.0 mmHg for timolol maleate (p=0.96). There was no statistical difference found between treatment groups in the absolute level of pressure, or in the reduction in IOP from baseline, at each time point or for the diurnal curve (p>0.05). There was no significant difference for any adverse event between groups (p>0.05), with the most common side effect being conjunctival hyperemia in 15/97 (16%) brinzolamide and 6/95 (6%) timolol treated patients (p=0.06). CONCLUSIONS: This study showed that brinzolamide provides similar safety and efficacy compared to timolol maleate when added to travoprost.

[Initial experience with the use of mitomycin C in anti-glaucoma filtering surgery]. / První zkusenosti s aplikací mitomycinu C pri antiglaukomových filtrujících operacích.

The authors report on their initial experience with the use of peroperative administration of mitomycin C (0.5 mg/ml for a period of 5 mins.) in complicated cases of glaucoma. In 14 eyes of 15 with a mean observation period of 8 months compensation of the intraocular pressure was achieved. In one eye 5 months after a filtering operation transplantation of the cornea was performed with secondary implantation of the posterior-chamber intraocular lens, decompensation of the intraocular pressure was treated 11 months after the filtering operation by cyclocryotherapy. Mitomycin C is a promising substance which improves substantially the prognosis of complicated cases of glaucoma.

[Microbiologic study of anterior chamber contents after cataract surgery]. / Mikrobiologické zhodnocení obsahu prední komory na konci operace katarakty.

The authors present an account of the results of cultivation of the contents of the anterior chamber at the end of cataract operations. Data assembled during 50 operations are evaluated. The material was cultivated on solid and liquid media. The assembled results indicate that only cultivation from the surgical wound or eye contents at the end of the operation can provide a reliable picture of the microbial population in case of inflammatory complications.

[Implantation of intraocular lenses in patients with glaucoma]. / Implantace nitroocní cocky u pacientu s glaukomem.

The authors evaluate the results of operations of cataract with implantation of an intraocular lens in glaucoma patients operated in 1989-1991 at the ophthalmological clinic of the Masaryk Hospital in Ustí n. Labem. The group comprised 57 patients, 64 eyes were operated. In 56 eyes ECCE with implantation of IOL was performed, in seven eyes a combined operation with trabeculectomy and in one instance a secondary implantation. The most frequent complication of operations was rupture of the posterior capsule 5 times (7.8%), possibly with loss of the vitreous body 5 times (7.8%). The most frequent early postoperative complication was a fibrinous reaction in the anterior chamber (31.2%). Vision in all patients before operation was 6/60 or poorer. On discharge it was in 48.4% 0.33 or better, 6 months after operation it was in 68.8% eyes 6/18 or better. The intraocular pressure was compensated before operation in 47 eyes (73.4%), decompensated in 7 eyes (10.9%) which corresponds to the number of combined operations. Antiglaucomatous medication after surgery -3 eyes (4.7%) had more medication, 11 eyes (17.2%) had less medication, 39 eyes (60.9%) had the same amount of medication and 11 eyes (17.2%) were without therapy.

[Analysis of the first 1000 implants of intraocular lenses]. / Rozbor prvních 1000 implantovaných nitroocních cocek.

The authors give an account of the development of implantology and extracapsular extraction in their department. In 1987 they performed 342 operations of cataract, an intraocular lens was implanted in 13.2%, extracapsular extraction was performed in 12.9%. In the first half of 1991 354 operations of cataract were performed, an intraocular lens was implanted in 82.5%, and extracapsular extraction was performed in 96.9%. The most frequent peroperative complication was rupture of the posterior capsule--from 14.0% to 20.1%. The most frequent postoperative complication (306 implantations in the first half of 1991)--keratopathia striata 179, fibrinous exudate--79, elevated intraocular pressure--50. The time spent in hospital in the first half of 1991 was on average 2 days in 156 operated patients who did not develop any or only one postoperative complication. The most frequent postoperative complication was posterior capsule opacification--11%. The most serious late complication during the entire follow-up period was endo-ophthalmitis in 8 eyes which in 5 patients after an interval up to 12 months following operation ended by evisceration of the bulbus--in all instances Russian lenses which were sterilized by ourselves were involved. The visual acuity on admission was below 6/60 in 72.3%, on discharge 6/12 or better in 32.8% and 6 months after operation 6/12 or better in 73.9%, incl. 651 eyes (88%) without supplementary correction. Despite the difficult conditions extracapsular extraction with implantation of an intraocular lens has become a routine method in our department, with a short period of hospitalization and minimal contraindications.

[Use of 5-fluorouracil in complicated cases of glaucoma--personal experience]. / Pouzití 5-fluorouracilu u komplikovaných prípadu glaukomu--vlastní zkusenosti.

The authors give an account of the results of trabeculectomy with the use of 5-fluorouracil in a group of 8 patients with complicated glaucoma. Treatment was successful in 5 patients, in three patients it failed. The use of 5-fluorouracil in specific cases of glaucoma gives greater hope of successful surgery.

[Clinical index for prediction of visual acuity after cataract surgery--personal experience]. / Klinický index k predpovedi zrakové ostrosti po operaci katarakty--valastní zkusenosti.

The authors are giving an account of their own experience with the clinical index for prediction of the visual acuity after cataract surgery. The index uses the following data - age, visual acuity before operation, number of regularly taken drugs and frequency of reading before operation. In 171 eyes of patients operated on account of cataract by different techniques (the patients were not specially selected and some suffered from other eye diseases), the authors found a close agreement between the vision predicted by means of the clinical index and the final visual acuity after operation. Agreement was recorded in 68%. The authors recommend the clinical index for more extensive clinical tests.