Sensitivity and specificity of spectral OCT in patients with early glaucoma.

This work deals with sensitivity and specificity in spectral OCT in detection of early glaucoma. Our goal was to evaluate data from RNFL analysis and compare them with resulted diagnosis of glaucoma neuropathy based on visual field changes. This retrospective study contains 31 subjects who undergone OCT examination in our department between years 2008 and 2017. Test statistic showed RNFL OCT sensitivity 63.64 % and specificity 90 %. Test ROC (receiver operating characteristic curve) showed AUC (area under curve) 0.734, which was statistically significant (p = 0.0097). We found that spectral OCT SLO with RNFL analysis is useful and effective instrument in analysis of glaucoma.

[Quantitative Color Vision Defect Evaluation - Lanthony Test and its Modified Interpretation]. / Kvantitativní vyhodnocení defektu barvocitu - Lanthonyho test a jeho modifikovaná interpretace.

UNLABELLED: Our aim was to develop quick and exact instrument for examination of color vision defects (CVD). We used Lanthony saturated and desaturated test. Data were evaluated according the Vingrys and King-Smith study. We had together 123 eyes of 86 patients. From all subjects we received these average values: AA 44.32 (min -87.13, max 80.64), TES 13.36 (min 8.84, max 30.30), SI 1.97 (min 1.22, max 5.69) and CI 1.66 (min 1.0, max 3.94). At the base of counting algorithm and average values form saturated and desaturated test we revealed 25 (29 %) patients with CVD. Twelve patients (14 %) classified as CVD+ had dichromacy and all had inborn CVD. Eight patients (9 %) from this group had deutranopia and four patient (5 %) protanopia. Anomaly trichromacy we revealed in thirteen patients (15 %). Eight (9 %) of these patients had inborn CVD. Six (7 %) of these patients had protanomalia, one (1 %) had deuteranomalia and one tritanomalia. We established and specified TES, CI and SI critical values, which was used to dividing patients into specific groups. KEY WORDS: Lanthony test, color vision defect, index of selectivity, index of confusion, total error score.

[Disorders of Simple Binocular Vision in Heterophoria and their Spectacle Correction]. / Poruchy jednoduchého binokulárního videní u heteroforií a jejich resení brýlovou korekcí.

This study deals with evaluation of binocular vision in group of young subjects without eye pathology. We examined at whole 68 subjects with average age 26 years, median 24 years. The sample was divided into two main groups. Group A contains subjects with far and near ortophoria (at whole 26 subjects = 38 %). Group B contains subjects with binocular vision disorder (at whole 42 subjects). One subject had strabismus. The most frequent non-strabismus disorder of binocular vision was convergence insufficiency (13 subjects = 19 %), simple esophoria (12 subjects = 17 %) and simple exophoria (8 subjects = 12 %). We decreased average distance heterophoria value (from 1.02 to 0.36 cm/m esophoria) and near heterophoria value (from 0.60 to 0.31 cm/m exophoria) after proper sphere-cylindrical correction. Result of our study shows that adequate and actual sphere-cylindrical correction can reduce disorder of simple binocular vision.Key words: simple binocular vision, heterophoria, spectacle lenses, convergence insufficiency.

[Stereo Vision Deterioration by Artificially Induced Aniseikonia]. / Zhorsení prostorového videní umele navozenou aniseikonií.

UNLABELLED: Main purpose of this study was to evaluate effect of aniseikonia on the stereo vision. We had together 90 subjects without eye pathology with or without habitual correction. Five of them were excluded due to important anisometropia or bad visual acuity (V < 0.5 on worse eye). All 85 subjects every in 4 cases (without size lens, with size lens on OD 1, 3 and 5 %) undergone measuring of their stereoscopy parallax. This was evaluated by Random dot stereo test. The level for stereoscopy vision was set bellow 60 arc seconds. This criterion was not achieved naturally by 6 subjects, so final number of all cases was 316 (100 %). As a whole 48 subjects (15.2 %) fail after using the test with size lens on OD 1, 3 or 5 %. All 268 cases (84.8 %) had not impaired stereoscopy parallax with size lens over chosen critical level. KEY WORDS: size lens, anisometropia, aniseikonia, heterophoria, stereoscopy vision.

[First Results and Experience with the iTrace Aberometer]. / První výsledky a zkusenosti s aberometrem iTrace.

PURPOSE: To evaluate obtained data by using a relatively novel devices and their results which are important eg. in refractive and cataract surgery. MATERIAL AND METHODS: The study included 66 eyes (n = 66). Subjects were represented by 32 women and 1 man whose age was 22.5 years ± 1.2 years (min. 21, max. 26 years) without any signs of potential eye disease. Duration of the study was 3 months. Results were compared with the measurements using the auto-refract-keratro-tono-pachymeter (TRK 1P, Topcon, Japan), Keratograph 5M (Oculus, Germany) and aberrometer iTRACE (Hoya, Japan). RESULTS: After 3 months were statistically compared keratometry values of ​​ corneal anterior surface detected by all devices. They provided to be comparable. Furthermore the values ​​of objective refraction and pachymetry were detected. CONCLUSION: Results of this study show a statistically significant correlation values ​​of objective refraction using devices TRK and iTRACE (r = 0.66 at p = 0.05) and showed a significant relationship between the keratometric data for all the devices. All used methods and devices are possible to reliably and use for valid evaluation parameters of the eye. KEY WORDS: aberrometry, low and high orders abberations, keratometry, topography, pachymetry.

[Microperimetry in the wet form of age - related macular degeneration (ARMD)]. / Mikroperimetrie u vlhké formy vekem podmínené makulární degenerace.

UNLABELLED: Aim of the paper is to introduce and evaluate the microperimetry as a support technique in the evaluation of the ARMD wet form bevacizumab (Avastin) treatment efficacy. METHODS: Twenty-one patients (21 eyes) with ARMD wet form were included in the study; they were examined by means by OCT/SLO (optic coherence tomography / scanning laser ophthalmoscope) machine whose part is the microperimetric test. In each patient, there were two microperimetric examinations performed - the first one was done one day before the application of the treatment and the second one one month after the application. The values of retinal sensitivity and possible absolute scotomas were recorded by the microperimeter. The best-corrected visual acuity measurement was recorded as well. RESULTS: The measurements were performed in the group of 21 eyes of 8 men and 13 women (age 50 - 86 years). There were the differences between the genders evaluated (at the selected level of significance of 0.05) in the following categories: age, retinal sensitivity, absolute scotoma extent, and visual acuity. Differences among men and women were found in retinal sensitivity, before the treatment and after it as well. The influence of the gender we may exclude, except the category of retinal sensitivity. In the categories age, visual acuity, and even absolute scotoma extent, no differences between genders were found. The retinal sensitivity (in case of fixation up to 4 degrees) improved in the men group from 14.49 dB ± 2.44 dB to 15.65 dB ± 2.61 dB, in the women group from 10.47 dB ± 3.11 dB to 12.05 dB ± 3.10 dB. The visual acuity in the whole group (men + women) increased from 0.48 ± 0.17 to 0.60 ± 0.18, so improved by 12 %. Statistically significant is also the result of the treatment in the absolute scotoma. CONCLUSION: Microperimetry is a suitable method to evaluate the function of macular region of the retina. The study confirms, that the treatment of wet form ARMD by means of intravitreal bevacizumab injections significantly increases the retinal sensitivity (in dB), decreases of the extent of absolute scotoma and improves the visual acuity by 12 %.

[Simple binocular vision evaluation on healthy adult subjects with synoptophore]. / Evaluace parametru jednoduchého binokulárního videní na synoptoforu u zdravé dospelé populace.

PURPOSE: The main goal of our study was to determine the database of parameters of simple binocular vision (SBV) in healthy adult population. Next goal was to verify current data of particular parameters of SBV. Recent public data (e.g. Divisova, Hromadkova) were determined without proper specification of examination (size of fusion object), or are too diffused (e.g. from 15 to 25 prismatic diopters = pD). At last we want to prove, if there are some other factors, which could influence parameters of SBV. METHODS: We had 74 subjects (64 women, 10 men) without significant eye pathology with average age of 24.82 years (max. 28 years, min. 22 years, SD 2.5 years). Particular parameters of SBV were examined without corrective lenses by emetropes, but with habitual correction by ametropes all on Sbisa synoptophore. We measured minimally 16 parameters of SBV, which were note in centimeters (pupillary distance) and in prismatic dioptres (deviation, fusion range and so on). These data were than statistically processed with program MS Excel and with Statitstika version 10. Level of statistical significance was set on p = 0.05. RESULTS: We got, thanks our study, these significant average results: Subjective deviation for far of all 74 subjects was count to 2.78 ± 3.65 pD, of women was 2.90 ± 3.69 and only for men was 2.00 ± 3.49. This result probably shows inadequate elimination of proximal convergence with the instrument. According our measurement of positive fusion range of all subjects is 25.10 ± 12.77 pD and negative fusion range -6.45 ± 4.18 dD, accommodation convergence to accommodation ration (AC/A) is 3.41 ± 1.47 pD a subjective deviation by accommodation on 33 cm (with minus 3 D) is 13.02 ± 5.23 pD. Further we proved statistical significant correlation between these parameters of SBV: Age and AC/A, SU-3 and AC/A, SU0 and SU-3, SU-3 and FS0 and FS-3. We didnt find any statistical significant differences, when we compared SBV parameters between emetropes, hypermetropes and myopes. The same results we got (except of pupillary distance), when we compared data divided according to gender. CONCLUSION: In our study we set the normative average data of SBV parameters, which were measured on healthy adult emetropes and ametropes with habitual correction. We also find how parameters influence each other. All SBV parameters differ on statistical significant level, when we compared them with respect to refractive state and gender. Knowledge of basic SBV parameters is important not only for ophthalmologist but also for optometrists. They can influence these in that way, which can bring comfortable SBV. The most frequent optometric methods are proper sphere-cylindrical correction, prismatic correction and visual training. accommodation ration, pupillary distance.

[Repeatability and reliability of the visual acuity examination on logMAR ETDRS and Snellen chart]. / Opakovatelnost a spolehlivost vysetrení zrakové ostrosti na optotypových tabulích logMAR ETDRS a Snellen.

PURPOSE: The main goal of our study was to prove the statistical significant correlation between repeated measurements and test-retest variability TRV expressed with confidence interval CI according to Bland-Altman's method on 95% level of statistical confidence. The methods are threshold interpolation logMAR method on ETDRS chart, whole-line method on Snellen chart and modified threshold interpolation method on Snellen chart with Sloan letters. METHODS: We had 468 measurements measured with threshold interpolation log MAR method on ETDRS chart, whole-line method on Snellen chart and modified threshold interpolation method on Snellen chart with Sloan letters. The average value of the first sequence of measurements measured with whole-line method on Snellen chart was -0.043 logMAR (min. 1, max. -0.30. SD 0.25) and of the second sequence of measurements was -0.045 logMAR (min. 1, max. -0.30. SD 0.23). The average value of the first sequence of measurements measured with interpolation method on Snellen chart was -0.018 logMAR (min. 0.98, max. -0.30. SD 0.29) and of the second sequence of measurements was -0.024 logMAR (min. 1, max. -0.80. SD 0.29). The average value of the first sequence of measurements measured with interpolation method on ETDRS chart was -0.0612 logMAR (min. 0.72, max. -0.30. SD 0.21) and of the second sequence of measurements was -0.0610 log MAR (min. 0.8, max. -0.28, SD 0.21). RESULTS: We have proved that all methods do not have statistical significant difference between repeated measurements (Wilcoxon paired test, whole-line method on Snellen chart p = 0.74, interpolation method on Snellen chart p = 0.33 and interpolation method on ETDRS p = 0.95) and they also have statistical significant correlations (Spearman correlation coefficient, whole-line method on Snellen chart r = 0.91, p < 0.0001, interpolation method on Snellen chart r = 0.89, p < 0.0001 and interpolation method on ETDRS chart r = 0.89, p < 0.0001). TRV expressed with CI on 95% statistical significance level according to method of Bland-Altman was with whole-line method on Snellen chart +/- 0.11 (i.e., 5 letters), with interpolation method on Snellen chart +/- 0.20 (i.e., 10 letters) and with interpolation method on ETDRS +/- 0.08 (i.e., 4 letters). CONCLUSION: In our study we proved that there is no statistical significant difference between repeated measurements with all three methods. After that we proved statistical significant correlations between repeated measurements with all three methods. The biggest clinical importance has determination and confirmation of the CI value of TRV. With interpolation method on ETDRS it was CI +/- 0.08 (i.e., +/- 4 letters), with whole-line method on Snellen it was CI +/- 0.11 (i.e., +/- 5 letters) and with interpolation method on Snellen it was CI +/- 0.20 (i.e., +/- 10 letters). Our recommendation based on results of our study is that is not clinically appropriate to convert measured values from Snellen optotype to logMAR and perform interpolation method on Snellen chart.

[Incidence of refractive errors with corrective aids subsequent selection]. / Výskyt refrakcních vad s následnou volbou korekcní pomucky.

UNLABELLED: This study follows the occurrence of refractive errors in population and the possible selection of the appropriate type of corrective aids. Objective measurement and subsequent determination of the subjective refraction of the eye is on essential act in opotmetric practice. The file represented by 615 patients (1230 eyes) is divided according to the refractive error of myopia, hyperopia and as a control group are listed emetropic clients. The results of objective and subjective values of refraction are compared and statistically processed. METHODS: The study included 615 respondents. To determine the objective refraction the autorefraktokeratometer with Placido disc was used and the values of spherical and astigmatic correction components, including the axis were recorded. These measurements were subsequently verified and tested subjectively using the trial lenses and the projection optotype to the normal investigative distance of 5 meters. After this the appropriate corrective aids were then recommended. RESULTS: Group I consists of 123 men and 195 women with myopia (n = 635) of clients with an average age 39 +/- 18,9 years. Objective refraction - sphere: -2,57 +/- 2,46 D, cylinder: -1,1 +/- 1,01 D, axis of: 100 degrees +/- 53,16 degrees. Subjective results are as follows--the value of sphere: -2,28 +/- 2,33 D, cylinder -0,63 +/- 0,80 D, axis of: 99,8 degrees +/- 56,64 degrees. Group II is represented hyperopic clients and consists of 67 men and 107 women (n = 348). The average age is 58,84 +/- 16,73 years. Objective refraction has values - sphere: +2,81 +/- 2,21 D, cylinder: -1,0 +/- 0,94 D; axis 95 degree +/- 45,4 degrees. Subsequent determination of subjective refraction has the following results - sphere: +2,28 +/- 2,06 D; cylinder: -0,49 +/- 0,85 D, axis of: 95,9 degrees +/- 46,4 degrees. Group III consists from emetropes whose final minimum viasual acuity was Vmin = 1,0 (5/5) or better. Overall, this control group is represented 52 males and 71 females (n = 247). The average age was 43 +/- 18,73 years. Objective refraction - sphere: +0,32 +/- 0,45 D; cylinder: -0,51 +/- 0,28 D, axis of: 94,7 degrees +/- 57,5 degrees. DISCUSSION: Values of objective refraction take higher values than the subsequent execution of the subjective examination of the refractive error and recommendation of the appropriate type of corrective aids. This all is in examined groups and in the individual components of refractive errors. It also confirmed the hypothesis that the population outweighs with-the-rule astigmatism, the deployment of resources according to the literature ranges from 90 degrees +/- 10 degrees. CONCLUSION: The values observed correction of refractive errors are then derived also offer the most common prescription ranges and products for the correction of given ametropia. In the selection and design corrective aids, we are often limited. Our task is then to manufacture high quality, functional and aesthetic corrective aids, you need to connect knowledge from the fields of optics, optometry and ophthalmology. Faster visual rehabilitation simplifies clients' rapid return to everyday life.

[Comparison of keratometric values and corneal eccentricity of myopia, hyperopia and emmetropia]. / Porovnání keratometrických hodnot a excentricit rohovek u myopie, hypermetropie a emetropie.

PURPOSE: The aim of this work is to compare the findings of keratometric values and their differences at various ametropias. The eccentricity of the cornea in the sense compared to the possible influence of refraction of the eye is topographically observed. Groups of myopia, hyperopia and emmetropia are always represented 100 subjects, i.e. 600 eyes. The results of these measurements are mutually compared and statistically processed. METHODS: The studied cohort a total of 300 clients enrolled. To measure the steepest (r1) and flattest meridian (r2) and to determine corneal eccentricity was used autorefraktokeratometer with Placido disc (KR 8100P, Topcon, Japan). The obtained data were processed with appropriate software and statistically evaluated. RESULTS: Group A consisted of 100 myopes (n = 200), 35 men and 65 women, average age 37.3 +/- 18.7 years (min. 10 years, max. 87 years). Objective refractive error - sphere: - 2.9 +/- 2.27 D (min.-0.25 D, -14.5 D max), cylinder: -0.88 +/- 0.75 D (min. -0.25 D, up to -5.0 D). Keratametry in this group is as follows: radius of curvature of the cornea in the front area of the steepest meridian 7.62 +/- 0.28 mm (min. 6.96 mm, max. 8.44 mm) and the flattest meridian is 7.76 +/- 0.3 mm (min. 7.08 mm, max 8.75 mm). The mean eccentricity was 0.37 +/- 0.12 (min 0.00, max. 0.79). Group B consisting of 100 hyperopic subjects (n = 200), 40 men and 60 women, average age 61.6 +/- 15 years (min. 21 years, max 88 years). Objective refraction in this group -sphere: +2.71 +/- 1.6 D (at least +0.25 D, up to +9.0 D), cylinder: -1.0 +/- 0.9 D (min. -0.25 D, max. -5.75 D).Corneal surface curvature in two main sections according keratometric measurement looks as follows: the steepest meridian is 7.67 +/- 0.29 mm (min. 6.99 mm, max. 8.62 mm), the flattest meridian then 7.81 +/- 0.29 mm (min. 7.10 mm, max. 8.70 mm). The value of the median eccentricity for these hundred hyperopes is 0.37 +/- 0.14 (min. 0.00; max 0.86). The third group C consists of 100 emetropic subjects (n = 200), then clients without refractive errors who achieve without corrective aids Vmin = 1.0. This group is composed of 42 men and 58 women, mean age 41.4 +/- 17.8 years (min. 3 years, max. 82 years). Measured values of objective refraction - sphere: +0.32 +/- 0.47 D (at least -1.75 D, up to +1.5 D), cylinder: -0.28 +/- 0.45 D (min. -1.25 D, up to +1.25 D). Keratometry values measured at the corneal surface in two perpendicular cross-section are: steepest meridian corresponds to the radius of curvature of 7.72 +/- 0.26 mm (min. 6.91 mm, max. 8.32 mm), the flattest meridian reaches values 7.83 +/- 0.25 mm (min. 7.10 mm, max. 8.53 mm). The median eccentricity is represented by the observed values of 0.36 +/- 0.11 (min 0.00; max. 0.57). Due to the validity of the results from the groups as unsuitable respondents with corneal astigmatism greater than -1.0 D were subsequently eliminated. CONCLUSION: Keratometry as well as topography is one of the fundamental methods of measuring corneal front surface. Their proportions are essential for the proper parameters selection, especially with contact lenses as one of the possible means intended to correct refractive errors. The study subjects were not included in any load condition cornea, purulent conjunctivitis, blepharitis, after refractive surgery or other eye symptoms.

[Long term results of laser refractive operations--methods Epi-LASIK or LASEK]. / Dlhodobé výsledky laserových refrakcných operácií--metóda LASEK alebo Epi-LASIK.

PURPOSE: To compare and evaluate postoperative results of two methods of refractive laser surgery, Epi-LASIK and LASEK, performed at the Department of Ophthalmology and Optometry of St. Anne's University Hospital Brno, Czech Republic. METHODS: 128 eyes operation were performed on patients with myopia, 102 with the Epi-LASIK method and 26 with the LASEK method. The preoperative mean spherical equivalent was -4.8 +/- 2.6 D (range -2.3 to -7.5) in the Epi-LASIK eyes and -3.5 +/- 3.1 D (range -1.6 to -7.8) in the LASEK eyes. The average preoperative uncorrected visual acuity (UCVA) was 0,129 (from 0.02 to 0.8) with the Epi-LASIK method and 0,246 (from 0.02 to 0.8) with the LASEK method. The best average corrected visual acuity was 1,139 (from 0.63 to 1.6) with the Epi-LASIK method and 1.115 (from 0.25 to 1.25) with the LASEK method. The average cylindrical refraction of the Epi-LASIK patients before the operation was -1.52 +/- 0.80 D (range -1.0 to -3.5) and the LASEK patients was -1.55 +/- 0.89 D (range -1.0 to -3.0), except of those who have astigmatism up to +/- 0.75D. In both methods was used the excimer laser Mel 80 Meditec-Zeiss with 193 nm wavelength and the frequency of 250 Hz and active eye-tracking system. RESULTS: The postoperative mean spherical equivalent was 0 +/- 0.5 D (range -0.6 to 0.6) in the Epi-LASIK eyes and 0.3 +/- 0.4 D (range -0.3 to 0.7) in the LASEK eyes. The average uncorrected visual acuity was 0.745 with Epi-LASIK and 0.687 with LASEK after first week, 0.996 and 1,083 after month, 1.068 and 1.063 after 3 months, 1.147 and 1,082 after 6 months, 1.090 and 1.031 after one year. The average cylindrical refraction after the operation was -0.82 +/- 0.69 D (range 0 to -1.7) with Epi-LASIK and -0.59 +/- 0.55 D (range 0 to -1.5) with LASEK. Average "haze", evaluated by the Gartry's scale, was 0.39 with Epi-LASIK and 0.46 with LASEK after week, 0.21 and 0.06 after one year. CONCLUSIONS: The Epi-LASIK and LASEK methods have comparable postoperative results of visual acuity, astigmatism, "haze". They are effective too in worse form of the myopia.

[Diabetics in population of patients treated by pars plana vitrectomy]. / Diabetici v populácii pacientov liecených pars plana vitrektómiou.

The purpose of this study is to evaluate visual and anatomic outcomes following pars plana vitrectomy (PPV) for complications of diabetic retinopathy (DR), and to assess risk factors that might influence the visual outcome after successful PPV. The medical records of 35 diabetic patients of both types 1 and 2 of diabetes, who underwent vitrectomy for complications of proliferative diabetic retinopathy (PDR) between 2004 and 2005, were analyzed retrospectively. Certain preoperative systemic and ophthalmic variables, intraoperative variables and postoperative complications with negative influence on visual outcome after PPV were recorded. The postoperative follow-up time was 6 months. The collected data as well as visual outcomes after PPV were statistically analyzed. Statistically significant visual improvement was achieved in 51.4 % of the patients; visual acuity (VA) deteriorated in 25.7% of the patients and remained unchanged in 22.9 % of the patients. Preoperative median of VA was 0.0167, changed to 0.1 postoperatively and remained stable on 0.1 level during the 6 months follow-up. VA > or = 0.1 was achieved in 60 % of the patients 6 months after PPV. Some of the followed variables associated with deteriorated or unchanged postoperative VA can be considered as risk factors of an unfavorable prognosis. Evaluated risk factors include preoperative VA worse than 0.1, presence of systemic complications of DM accompanying ocular complications, postoperative occurrence of iris neovascularization and neovascular glaucoma. In conclusion, anatomically successful PPV in diabetic patients is not always followed by an improvement of VA. The optimal timing of vitrectomy is very important not only in order to obtain good visual acuity but also to maintain good visual function for long time. We suppose that an adequate control of DM, sufficient screening for DR and timely laser intervention of DR might decrease the progression of DR and onset of sight threatening complications of PDR as well as decrease the prevalence of blindness at diabetic patients in the future.

[Transmissing electron microscopy of the vitreo-macular border in clinically significant diabetic macular edema]. / Transmisní elektronová mikroskopie vitreomakulárniho rozhraní u klinicky signifikantního diabetického makulárního edému.

The authors examined samples of the epimacular tissue in clinically significant macular edema by means of the transmissing electron microscopy. They did not found morphological differences between samples from patients already treated by means of laser photocoagulation before the pars plana vitrectomy and those without the laser treatment. Findings may be divided into three groups: (1) the inner limiting membrane (ILM) covered with collagen vitreous fibers, (2) cells' elements of the fibroblasts category, and (3) fibrous astrocytes in the vitreous cortex constituting one- or multilayer cellular membranes.

[Macular edema after cataract surgery in diabetic patients without retinopathy]. / Makulární edém po operaci katarakty u diabetiku bez diabetické retinopatie.

PURPOSE: To study the effect of phacoemulsification on the development of macular edema and diabetic retinopathy in diabetic patients without preoperative retinopathy. PATIENTS AND METHODS: This study comprised 86 patients; 26 diabetics, who had no clinically detectable diabetic retinopathy preoperatively, formed a study group and 60 non-diabetics were included into the control group. Diabetes mellitus duration, preoperative hemoglobin A1c level, and diabetes treatment method were recorded in diabetics. Monocular cataract surgery was performed in all patients. The patients were clinically assessed with OCT examination preoperatively, and postoperatively on day 1, in week 1, and in months 1, 2, 3 and 6 respectively. Foveal, inner macular, outer macular thickness, and macular volume were analyzed. RESULTS: The increase of the retinal thickness after the cataract surgery reached maximum in both groups in months 1 and 2. Since month 3 on, there was a progressive decrease in abnormal retinal thickness. There was a significant major increase in retinal thickness in diabetics in all examined areas in month 2 (p < 0.05 for fovea and inner macula; p = 0.001 for outer macula and p = 0.005 for macular volume changes). Trend toward major increase in retinal thickness in diabetics was still evident even three months after the surgery. In no case did a diabetic eye develop clinically detectable diabetic retinopathy during the follow-up period. The correlation between hemoglobin A1c level and retinal thickness changes in diabetics was not significant. There was also no significant difference in final visual acuity between diabetics and non-diabetics. CONCLUSION: We can expect similar induced retinal thickness changes in diabetics without retinopathy as in non-diabetics after uneventful cataract surgery, though there was a trend toward major increase in retinal thickness in diabetics.

[Bilateral Terrien's degeneration treated by corneoscleral graft transplantation]. / Oboustranná Terrienova degenerace osetrená transplantací korneosklerálního stepu.

Authors operated on a patient with bilateral corneal involvement in Terrien's marginal degeneration and spontaneous corneal perforation. The surgery was performed in both eyes at the same time and a free sclerocorneal graft was used. The postoperative cosmetical and functional results as well were very good. It is advisable to follow up the patients with Terrien's marginal dystrophy. The surgery on right time removes the defect of the cornea and accompanying high corneal astigmatism.

[Transmission electronic microscopy of the inner limiting membrane and epiretinal tissue in idiopathic macular hole]. / Transmisní elektronová mikroskopie vnitrní limitující membrány a epiretinální tkáne u idiopatické makulární díry.

The authors examined samples of epimacular tissue obtained during the surgeries of the idiopathic macular hole in different stages of the disease by means of transmission electronic microscopy. In the early stages of the disease only the inner limiting membrane with isolated cells on the vitreous side was present, in later ones of the disease the connective tissue membrane was attached. In rare cases of the later stages of the disease they found the presence of the retinal pigment epithelium (RPE). They suppose the RPE plays an important role in the regeneration of the defects of the retina.

[Effect of viscoelastic substances on postoperative intraocular pressure in phacoemulsification]. / Vliv viskoelastického materiálu na pooperacní nitroocní tlak u fakoemulzifikace.

The Influence of the Type of Viscoelastic Substances on the Level of Intraocular Pressure after Phacoemulsification The aim of study was to asses the influence of the type of viscoelastic substances on the level of intraocular pressure (IOP) after cataract surgery and intraocular lens (IOL) implantation. In the study group of 100 patients Viscoat was used at 32 operated eyes, Provisc at 14 eyes and Duovisc in 54 eyes during phacoemulsification and IOL implantation. IOP was measured before surgery, one day after surgery and one week after surgery. Mean IOP level 1. day postoperatively was 24.94 mmHg in the Viscoat group of eyes, 24.65 mmHg in the Provisc group and 21.09 mmHg in the Duovisc group. The type of viscoelastic substance used during the surgery significantly influenced the level of IOP in the first postoperative day. The level of IOP was significantly lower in the Duovisc group comparing to Viscoat and Provisc. The level of IOP did not differ significantly between the Viscoat and Provisc group. One week after surgery the level of IOP was not significantly different between all types of viscoelastic device. Duovisc was the most profitable viscoleastic substance in the point of view of the course of phacoemulsification, IOL implantation and postoperative level of IOP.

[The cases of penetrating eye injuries with large intraocular foreign body]. / Prípady poranení oka s velkým cizím nitroocním telesem.

AIM: Three consecutive cases of penetrating eye injuries complicated with large (size 9-12 mm) intraocular foreign body are presented as such. PATIENTS AND METHODS: The initial findings, management, surgical procedures and final anatomical and functional outcomes of each particular case are given. Corneal entrance laceration was seen in all three patients. Second scleral full-thickness eye wall laceration was found just posterior to the horizontal muscle insertions in two eyes. Full-thickness exit posterior eye wall laceration obturated with foreign body was diagnosed in one case. This metallic foreign body projected into posterior orbit. Two eyes were injured with metallic radio opaque foreign body. Glass fragment was removed from posterior segment of the eye in one patient. Following primary wound closure pars plana vitrectomy was performed to remove all posterior segment intraocular foreign bodies. RESULTS: Silicone oil was used to fill the vitreous cavity at the end of the surgery in two eyes. Gas bubble (perfluoropropane, C3F8) was injected into the vitreous space at the end of the vitrectomy in one eye. The authors observed following complications: vitreous cavity haemorrhage, traumatic cataract formation, cystoid macular oedema and peripheral stationary traction retinal detachment. CONCLUSION: Good anatomical results and restoration of good visual functions of injured eye were achieved in all patients despite some inferior initial prognostic factors.

[Ultrastructure of the iris pigmentary epithelium]. / Ultrastruktura duhovkového pigmentového epitelu.

The iris pigmentary epithelium has identical structure as the retinal epithelium has. The peripheral iridectomy makes it possible to obtain sufficient amount of tissue to be used for the multiplication of the pigmentary epithelium cells in tissue culture, or, for direct implantation into the subretinal space. The technique of the peripheral iridectomy is regardful enough; in none of the specimens mechanically damaged cells were found.

[Comparison of ultrasound and optic biometry with respect to ocular refraction after cataract surgery]. / Srovnání ultrazvukové a optické biometrie s ohledem na refrakci ocí po operaci katarakty.

In the prospective study of 56 patients with cataract (67 eyes) the authors compared axial length biometry) regarding to postoperative refraction of the eyes. Dioptric power of the intraocular lens (IOL) was determined by SRK II. formula. The difference between predicted and actual postoperative refraction in the spherical equivalent were compared 3 months postoperatively. Axial length measured by ultrasound differed significantly from the axial length measured by optical biometry (p = 0.016). Dioptric power of IOL calculated according to the axial length measured by ultrasound was significantly different from the dioptric power of IOL calculated according to the axial length measured by optical biometry (p = 0.003). The difference between predicted and actual postoperative refraction was not statistically significant (p = 0.384) even if we considered both type of measurement. In conclusion, we found partial coherence interferometry was an accurate and reproducible method for measurement of axial length of the eye before cataract surgery. In the cases of advanced dense cataracts backup of ultrasonic biometry is still necessary.