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Biomedical subjects

I Karel

Publications and source records attributed to I Karel.

At least 37 records · Page 2Linked to original sources
PubMed2000

[Serum copper levels in patients with acute and chronic types of ischemic heart disease and its relation to lipoprotein levels and extent of coronary atherosclerosis].

The authors assessed serum copper and lipoprotein concentrations in a group of 67 patients hospitalized successively at the cardiological department. During hospitalization they were subjected to selective coronarography with assessment of the angiographic score. In 35 patients the angiographic examination was made during the chronic stage of IHD (group A), in 32 patients it was indicated on account of acute coronary syndrome (group B). The authors found that serum copper concentrations are significantly higher in patients with acute forms of IHD (group B, p < 0.001). Serum copper concentrations do not correlate significantly with lipoprotein concentrations nor with the extent of coronary atheroclerosis (angiographic score).

Aged↗
PubMed1999

[Vitrectomy and autologous thrombocyte concentrate in the treatment of idiopathic macular holes].

OBJECTIVE: To evaluate the results of surgery of idiopathic macular holes (IMH) using or not using autologous thrombocyte concentrates (ATC). METHOD: Fifty eyes with IMH, stage 2-4, were divided into two groups. Group 1 comprised 27 eyes with an average persistence of complaints of 12 months where pars plana vitrectomy (PPV) and tamponade with 16% C3F8 were combined with the use of ATC. Group 2 comprised 23 eyes with a mean duration of complaints of 14 months which were treated by PPV and 16% C3F8 without ATC. In all IMH stage 2 and 3 the posterior vitreous membrane was detached from the retina. The epimacular membrane was removed, if present. The mean follow-up period in group 1 was 17.2 months and in group 2 12.3 months. RESULTS: In group 1 anatomical success was achieved in 21 eyes (78%), visual acuity improved by two lines and more in 16 eyes (59%). In group 2 anatomical success was recorded in 15 eyes (69%) (p = 0.326) and visual acuity improved in 10 eyes (44%) (p = 0.265). Nine eyes were reoperated with ATC. Reoperations improved the anatomical success in the whole series to 90% and the functional success to 62%. The visual acuity improved in 70% operated eyes within 12 months from the onset of complaints and in 47% eyes with a longer case-history (p = 0.1182). Complications included retinal tears in 5 eyes (10%), detachment of the retina in one eye (2%), minor facete-like defects in the pigmented epithelium in 22 eyes (44%), disciform maculopathy in 5 eyes (10%) and atrophy of the optic disc in 3 eyes (6%). CONCLUSIONS: PPV is beneficial in IMH in the majority of patients. ATC can improve anatomical and functional results. Functional success is more likely after surgery in the early stage of the disease. The results of surgery are jeopardized by various complications. It is important to inform patients on the limitations and risk of surgery.

Adult↗
PubMed1999

[Vitrectomy in optic nerve disc pit with maculopathy].

There is described a rare case of a congenital optic disc pit of the 20-years old man that was accompanied by a cyst-like change in the macula with serous retinal detachment. Visual impairment in his right eye was treated with pars-plana-vitrectomy with surgical posterior vitreous detachment and gas tamponade. After temporary pneumatic displacement of the subretinal fluid inferiorly the corrected visual acuity improved to 6/9. Schisislike changes persisted in the macular area. Our findings could support the view on the two-layer structure of optic disk pit maculopathy and an important role of tangential vitreous traction in the pathogenesis of the central retinal detachment.

Adult↗
PubMed1999

[Retinal detachment with retinal tears--clinical characteristics and surgical results].

The authors evaluate a group of 53 eyes of 52 patients operated on account of retinal detachment with an oral dialysis. The mean follow-up period was 35 months. There were 37 (70%) traumatic dialyses. They were in the temporal lower quadrant in 58%, in the nasal upper quadrant in 16%, temporal upper quadrant in 13% and in the nasal lower quadrant in 13%. There were 16 (30%) idiopathic dialyses, all with one exception in the temporal upper quadrant, they were in the lower temporal quadrant. 52 eyes were operated primarily cryosurgically, one eye by pars plana vitrectomy. After primary surgery the retina adhered completely in 94% eyes. On account of relapses of detachment 9.4% eyes were reoperated. At the end of the follow up the retina adhered completely in 94% eyes. Functional improvement or stabilization of vision was achieved in 78% eyes with traumatic tears and in 87% eyes with idiopathic tears. The authors confirmed the existence of two different clinical entities--traumatic and idiopathic oral dialysis which differ as to site and to a certain extent also the prognosis of the disease.

Adolescent↗
PubMed1998

Results of penetrating keratoplasty in bullous silicone oil keratopathy.

BACKGROUND: To evaluate the results of penetrating keratoplasty (PK) in bullous silicone oil keratopathy (BSK). MATERIAL AND METHODS: PK for BSK was performed in 13 patients, aged from 31 to 82 years. In all patients, pars plana vitrectomy (PPV) with silicone oil implantation (SOI) had been previously performed as the definitive surgery: for complicated retinal detachment with advanced proliferative vitreoretinopathy in 12 eyes and for diabetic traction detachment in one eye. Seven patients were monocular. All 13 eyes were aphakic and there was a long-lasting contact of silicone oil with the corneal endothelium. Before keratoplasty, each eye underwent between two and five operations, on average three, for retinal detachment or late complications of SOI. The interval between SOI and PK was from 11 to 79 months. The patients were followed up for 12-52 months. RESULTS: At the last follow-up examination, a clear graft was found in 6 out of 13 eyes (46%). The six clear grafts were found in the ten eyes where silicone oil had been removed before keratoplasty. The graft became opaque in all three eyes in which silicone oil had not been removed. Six out of seven eyes with failed grafts atrophied. Visual acuity improved in all six eyes with the clear graft from had movement preoperatively to 0.05-0.25. The decreased visual acuity was caused by irreparable damage to the macula, which resulted from high myopia, proliferative vitreoretinopathy or long-lasting detachment of the macula. CONCLUSIONS: PK in BSK was successful only in those eyes in which the attached retina enabled the removal of the silicone oil before the PK. The reattached retina and useful visual acuity before the development of BSK were the preconditions for functional success of the PK.

Adult↗
PubMed1997

Poly (triethylenglycol monomethacrylate) and poly (glycerol monomethacrylate) cross-linked gel as potential viscoelastics for intraoperative use.

BACKGROUND: The highly swelling poly (glycerol monomethacrylate) gel (polyGLYMA) and hydrophilic polymer poly (triethylenglycol monomethacrylate (polyTEGMA) were tested as potential viscoelastics for intraoperative use in anterior segment surgery. METHODS: PolyGLYMA was implanted into the anterior chamber in 5 rabbits, and 40% polyTEGMA in 16 rabbits. The eyes were enucleated 1 week to 3 months after the operation. The corneal endothelium was examined with specular microscopy, and then the whole eye histopathologically. RESULTS: In all eyes of the polyGLYMA group, the clinical findings were characterized by a marked ciliary injection and severe secondary glaucoma, and the histologic ones by a marked inflammatory infiltration and thickening of Descemet's membrane in the anterior chamber angle. Specular microscopy revealed a decrease in the endothelial cell density and polymorphism of the endothelial cells. In the polyTEGMA group, the anterior segment and the fundus were physiologic all the time, and specular microscopy and histologic findings showed no degenerative and/or inflammatory changes. CONCLUSIONS: PolyGLYMA proved unsuitable for intracameral application in rabbits. The new polymer polyTEGMA is characterized by high biologic tolerance after its implantation into the anterior chamber of rabbits. PolyTEGMA 40% might be considered as a potential viscoelastic material in humans.

Animals↗
PubMed1997

Retinal detachment in Marfan's syndrome. Characteristics and surgical results.

BACKGROUND: The presence of a rhegmatogenous retinal detachment in a patient with Marfan's syndrome is manifested by narrow pupils, dislocated lenses, and a spectrum of pathology ranging from simple holes to giant tears with or without proliferative vitreoretinopathy. PATIENTS AND METHODS: Thirteen patients (18 eyes) with Marfan's syndrome underwent surgery for retinal detachment. Characteristic findings were a retinal detachment in three or more quadrants (12 eyes), a single tear smaller than 30 degrees (eight eyes), a tear between 80 degrees and 120 degrees (five eyes), equatorial and postequatorial tears (11 eyes), and advanced proliferative vitreoretinopathy (seven eyes). Nine uncomplicated retinal detachments were managed with scleral buckling, and nine complicated retinal detachments were managed with pars plana vitrectomy, scleral buckling, and retinal tamponade, mostly with silicon oil. RESULTS: The results of surgery varied, depending on the nature of the retinal tear and the presence of proliferative vitreoretinopathy. Complete retinal reattachment was achieved in 89% of uncomplicated retinal detachments and in 56% of complicated retinal detachments. Additional partial anatomic success was achieved in two eyes with complicated retinal detachments where the macula was attached. Visual acuity improved significantly in five eyes with uncomplicated retinal detachments (median final vision, 20/80) and in six eyes with complicated retinal detachments (median final vision, 20/200). CONCLUSION: The results of surgical treatment for retinal detachments in patients with Marfan's syndrome were comparable with those in patients without Marfan's syndrome. In seven cases of retinal detachment in patients with Marfan's syndrome, we were able to reattach the retina without removing the dislocated intraocular lens.

Adolescent↗
PubMed1997

[Long-term results of pars plana vitrectomy and silicone oil in large retinal tears in children].

Pars plana vitrectomy (PPV) with implantation of silicone oil (ISO) was performed giant tears (GT) in 24 eyes of 22 children aged 6-15 years. In 15 eyes of 13 children idiopathic GT were involved (71%), in 9 eyes (29%) the GT was preceded by an injury-contusion in 5 eyes and a perforating injury in 4 eyes. The patients were followed up for 24-132 months after operation, on average for 55 months. The final anatomical success with an attached macula and functional success with a visual acuity of 0.02 or better were achieved in 18 eyes (75%). The results did not depend on the size of the GT and were better in post-traumatic than in idiopathic GT. The success of the operation declined from 82% after two years and 79% after 3 years to 45% after 5 and more years. The silicone oil was removed in 13 years (46%). Of those in 4 eyes (31%) the detachment relapsed and in two eyes (15%) the relapse was the cause of the final failure. PPV with ISO was a very effective operation in GT. Proliferative vitreoretinopathy was the main cause of surgical failures and a frequent obstacle for removal of silicone oil from the eye. Dispensarization, prophylactic cryopexy and early diagnosis of GT are the main prerequisites of a better prognosis and results in GT in children.

Adolescent↗
PubMed1996

[Vitreous surgery in complicated retinal detachment].

Vitreous surgery in complicated retinal detachment has three main objectives: 1. elimination of traction and mobilization of the retina, 2. inner tamponade of the retina, 3. retinopexy. Pars plana vitrectomy with inner tamponade is indicated: 1. In rhegmatogenous retinal detachment, where vitreous hemorrhage or exsudate make the finding and localization of the retinal break impossible. 2. In rhegmatogenous retinal detachments, where the localization of the break in the posterior eye pole or the size of a giant tear prevent to close the retinal break by means of a cryosurgical procedure with episcleral plombage. 3. In retinal detachment complicated by advanced proliferative vitreoretinopathy: in idiopathic rhegmatogenous detachment, tractional detachment after perforating injury, and in diabetic retinopathy. Vitreous surgery increased the limits of operability in complicated retinal detachments.

Humans↗
PubMed1996

[Pars plana vitrectomy in retinal detachment with a macular hole].

The long-term results of pars plana vitrectomy (PPV) for retinal detachment due to a macular hole were evaluated in 40 eyes of 40 patients. The patients were followed up for 6 to 72 months. In 9 eyes, subtotal PPV with expansive gases was used: in 5 of them, in addition, the macular hole was treated with laser endocoagulation. The operation was successful in 4 out of 5 eyes treated with laser barrage. In the remaining 5 eyes, the operation failed and reattachment was obtained after secondary silicone oil implantation (SOI). In 31 eyes, PPV was combined with a primary SOI. Twenty of them suffered from serious myopic degenerative changes of the posterior eye pole, and in 11 posterior stafyloma. Reattachment of the retina was achieved in 28 eyes (90.3%), visual acuity 1/24 (0.04) or better in 13 eyes (41.9%). Silicone oil was removed in 13 eyes (41.9%), in all these without complications. PPV with expansive gases and laser coagulation proved to be effective in macular holes with the well-preserved pigment epithelium. Silicone oil proved competent in macular holes associated with serious chorioretinal degeneration and posterior stafyloma.

Adult↗
PubMed1995

[Pars plana vitrectomy in Terson's syndrome].

Pars plana vitrectomy (PPV) was the operation of choice in haemorrhage (Terson's syndrome) in 7 eyes of 5 patients aged 32 to 47 years. The interval between intracranial haemorrhage and PPV varied from 2 to 10 months. Patients after PPV were followed up for 12 to 84 months. The postoperative course was complicated by successfully operated retinal detachment in two eyes where PPV was not safeguarded by cerclage. The final visual acuity 0.7-1.0 was achieved in 6 of 7 eyes (87%); visual acuity of 0.1 in one eye was due to a lamellar defect of the macula. PPV is the treatment of choice in Terson's syndrome with bilateral haemorrhage into the vitreous body and in massive unilateral extravasation with inadequate spontaneous resorption. Cerclage in PPV in TS is according to the authors essential prevention of iatrogenic retinal detachment.

Adult↗
PubMed1995

[Retinal detachment in pseudophakia].

The author evaluates the prevalence and results of surgical treatment of retinal detachment (RD) after implantation of intraocular lenses in a group of 10,185 eyes operated at the First and Second Ophthalmological Clinic from 1988 to the end of 1993. Retinal detachment was observed in 0.4% of artephakic eyes. A striking risk factor for the development of RD was in particular loss of the vitreous body during cataract operation, a previous injury, myopia and YAG capsulotomy. The presence of an intraocular lens did not influence in a substantial way the selection of the surgical procedure. In cases with a complicated finding in the anterior segment and the retina the authors selected more frequently pars plana vitrectomy (PPV) with internal tamponade with an expansive gas or silicone oil (in 44.3% eyes). The retina became attached in 90.4% of the eyes, while in patients operated by cryosurgery anatomical success was achieved in 82.1% of the eyes and in the group operated by PPV with internal tamponade in 100% of the eyes. Functional improvement, as compared with the condition before surgery of RD, was achieved in 48.9% of successfully operated eyes. In the PPV group the authors observed, however, substantially poorer functional results as compared with cryosurgery. In complicated artephakic RD PPV with internal tamponade contributed to a striking improvement of anatomical results but the poorer functional results after PPV in complicated RD provide evidence of a poorer prognosis of artephakic RD, as compared with aphakic ones.

Adult↗
PubMed1994

[Relaxing retinectomy: anatomic and functional results].

The author analyzed the results of relaxing retinectomy (RR) combined with internal tamponade of the retina by silicone oil in 50 patients. The causes of tractional detachment and shortening of the retina were: proliferative vitretinopathy complicating idiopathic rhegmatogenic detachment of the retina in 25 eyes, proliferative diabetic retinopathy in 12 eyes, post-traumatic proliferation in seven eyes, intraocular inflammation in four eyes and the cicatricial stage of retinopathy of the premature in two eyes. During an observation period of 6-75 months, mean 17 months, the authors recorded complete adherence of the retina in 60%, partial anatomical success with defined retinal detachment and adherent macula in 24% and functional success with visual acuity of 0.02 or better in 66%. The poorest functional results were obtained in proliferative diabetic retinopathy (success in 30%). Functional success declined with the observation period from 66% 6 months after RR to 38% after 36 months following RR. The extent of RR did not have a substantial effect on the anatomical and functional results. Sufficiently extensive RR with internal tamponade of the retina with silicone oil is the operation of choice in complicated retinal detachment where radical membranectomy does not release the retinal traction. Reproliferation after RR were the frequent causes of relapses of retinal detachment and an impediment for removal of silicone oil from the eye.

Adolescent↗
PubMed1994

[Personal experience with expanding gases in pars plana vitrectomy].

At the Second Ophthalmological Clinic in Prague the authors operated between January 1991 and November 1993 50 patients, 33 men and 17 women. The mean age of the patients was 43.6 years, the minimum observation period 5 months. In all patients pars plana vitrectomy was performed (PPV) and at the end of the operation or subsequently into the vitreous space the expansive gas SF6 (hexafluorosulphide) or C3F8 (perfluoropropane) was insufflated. In all instances the authors indicated the expansive gas for treatment or prevention of retinal detachment and with regard to this they divided the patients into two groups: 1. From the total number of 50 patients the authors operated in the first group 31 patients with complicated retinal detachment (RD). In 17 patient RD with large postequatorial tears and traces of blood in the vitreous space were involved. In 7 patients the cause of RD was a severe eye injury. In five patients the authors found a macular opening, in one patient a large postequatorial tear in the temporal half and in one patient a circumscribed tractional RD associated with diabetic proliferative retinopathy was involved. 2. In the second group of 19 patients the gas was used as prevention of RD. In 5 patients after transvitreal extraction of a foreign intraocular body with suspected or obvious retinal defect. In two patients after extraction of a posterior lenticular luxation following severe contusion of the eye. In the remaining 12 patients the expansive gas was used after removal of silicone oil (SO) and the gas was used at the same time to prevent hypotonia of the eye. Anatomical results of surgery. 1. In the group of 31 patients with complicated RD after PPV and gas insufflation the retina adhered anatomically in 23 patients (74%). In the group with PVR C1-C3 in 13 patients after gas insufflation the retina became attached in 10 patients (76.9%). In one of these patients after three months accentuated cerclage was performed because of a new fissure. 2. In the group of 19 patients where gas was used for preventive reasons the retina became detached only after removal of SO in 5 of 12 patients (42%). Functional results of operation. To assess final vision the authors evaluated in the first group a total of 39 patients only after gas insufflation and in the second group another 11 patients after reoperation with implantation of SO.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1993

[Is restriction of physical activity indicated in the prevention of retinal detachment?].

The author evaluates the importance of different vitreoretinal factors and the role of indirect injury in the pathogenesis of detachment of the retina/DR/and holds the following view as regards subjects inclined to pursue physical activity. Numerous and frequent vitreoretinal risk factors are a forecast of DR only in a small fraction of patients. Indirect injury is not recognized as a cause of DR. Risk factors incl. medium-grade and high-grade myopia are not an indication for restriction of physical activity nor for Caesarean section in pregnant women. Restriction of physical activity acts as a psychic trauma and does not prevent the development of DR.

Exercise↗
PubMed1993

[Pars plana vitrectomy in epimacular membranes].

Epimacular membranes /EMM/ reduce markedly visual acuity and the only treatment is pars plana vitrectomy /PPV/ and removal of the EMM. The authors analyzed the results of PPV in 30 eyes with EMM of different aetiology. The group comprised 4 idiopathic EMM and 26 secondary EMM after operations of a detached retina, injury, intraocular inflammation, occlusion of the retinal vein and retinopathies of the premature. The operation markedly improved the visual acuity in 20 eyes /67%/ and the best results were obtained in idiopathic EMM. The prognosis did not depend on the preoperative visual acuity and duration of the disease and was determined by the state of the macula beneath EMM which in dense secondary EMM is difficult to assess before operation. The poorest functional results were obtained in postinflammatory and post-traumatic EMM.

Adolescent↗
PubMed1993

[Liquid perfluorocarbons in surgery for lens subluxation].

Liquid perfluocarbons (PFC) with a high specific weight and low viscosity were used to remove dislocated lenses from the vitreous body cavity in four patients. In three patients dislocation of the lens with the firm nucleus into the vitreous body cavity occurred following severe contusion, in one female patient luxation of a posterior chamber lens occurred after implantation. After pars plana vitrectomy the liquid PFC lifted the dislocated lens from the bottom of the eye beyond the pupil and from there the lens was removed by means of a cryoprobe and the posterior chamber artificial lens was removed by means of forceps. Liquid PFC are a simple and sparing tool for removal of lenses with a firm nucleus and of implanted lenses from the vitreous body cavity. They reduce manipulation with instruments inside the vitreous body cavity to a minimum. Their use is the operation of choice. The high price of PFC is outweighed by the minimal risk of surgical and postoperative retinal complications.

Adult↗