[Phacoemulsification and pseudoexfoliative syndrome]. / Facoemulsificarea în sindromul pseudoexfoliativ.

PURPOSE: To compare the results and the complications of cataract surgery by phacoemulsification in eyes with pseudoexfoliation syndrome (PEX) and without pseudoexfoliation syndrome. METHODS: A retrospective clinical study (January 2001 - January 2004; mean follow-up 21.5 months) of 116 cases divided in two groups: group A (55 eyes) with senile cataract and pseudoexfoliation syndrome and group B (61 eyes) with senile cataract but without pseudoexfoliation syndrome. The eyes were without another associated ophthalmological diseases and the phacoemulsifications were performed by the same surgeon. Intraoperative observations included anterior chamber depth, pupil size after maximal mydriasis, zonular dehiscence, capsule tear, vitreous loss and postoperatively: best corrected visual acuity, intraocular pressure (IOP), aqueous flare response and IOL stability were evaluated at 1 day, 1 week, 1 month and until 3 years. The Student-t test was used for statistical analyses. RESULTS: There were determined significant correlations between pupil size, anterior chamber depth and the rate of complications in the group A. The visual acuities were similar in both groups. IOP reduction was superior in the eyes with PEX as compared with control group, but without statistically significantly difference. In group A, there were a non-statistically significantly percentage of IOL dislocation as compared with group B. In the eyes with PEX, it is necessary to utilize IOLs with bigger optic size. CONCLUSIONS: Phacoemulsification represents a safe method in cataract surgery in eyes with pseudoexfoliation syndrome in the presence of careful surgical technique: maximal mydriasis, circular continuous curvilinear capsulorhexis, adequate hydrodissection. On the long run, the postoperative results were comparable between eyes with PEX and the control group (without PEX).

[Visual fields defects in cerebral hemorrhagic vascular accident]. / Modificarile câmpului vizual în accidentele vasculare cerebrale caz clinic.

Interpretation of the fields of vision forms a key part of ophthalmic and neurologic examinations. The homonymous hemianopa is a hallmark of a retrochiasmal lesion. Postchiasmal lesions that interrupt the visual pathway may have multiple causes which the circulatory disturbances is one of the most important. The authors present the case of a woman who has an isolated homonymous hemianopa produced by a vascular accident of occipital lobe, dwell upon the only manifestation of the cerebral acute hemorrhagic vascular accident was represented by an visual field defect.

[Conjunctival changes related to topical treatment and effectiveness of surgery in glaucoma]. / Modificarile conjunctivale legate de tratamentul topic si eficienta chirurgiei filtrante în glaucom.

PURPOSE: The topical treatment for a long run in glaucoma rises histopathological changes of conjunctiva. The study is aimed at assessing the correlations between conjunctival changes bound of the type and duration of medical glaucoma therapy and the efficiency of subsequent filtering surgery. METHOD: For this purpose, we carried out a three years clinical prospective study (01.05.2000-30.04.2003), with a mean follow-up period of 18.5 months, enrolling 22 cases (38 eyes) operated by trabeculectomy for primary open angle glaucoma (POAG), with the same technique and the same surgeon. There were excluded both the patients with previous ophthalmic surgical interventions and ocular/systemic chronic inflammatory disease. The cases were divided according to type and duration of topical treatment. There were recorded the conjunctival changes (by histological exam and immunohistochemistry), dynamic evolution of intraocular pressure (IOP) and the morphological aspects of filtering blebs. Statistical analysis was performed by Wilcoxon test. RESULTS: In all groups, the efficiency of filtering surgery was correlated with the duration of topical medication; the survey presents the correlations between topical treatment, conjunctival changes and postoperative evolution. CONCLUSIONS: These results suggest that exhaustive topical treatment in POAG, for a long period, with many drugs may represent a negative prognostic factor for the subsequent filtering surgery. Therefore it is necessary an individual approach for the first line therapy in POAG.