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Biomedical subjects

J Lesták

Publications and source records attributed to J Lesták.

14 recordsLinked to original sources
PubMed1999

[Initial clinical experience with deep sclerectomy in ambulatory surgery in glaucoma].

Deep sclerectomy is a non-perforating filtering operation used in surgical treatment of open angle glaucomas. The advantage of the operation is the creation of gradual filtration due to the thin trabecular Descement membrane which reduces markedly the risk of development of postoperative complications typical for perforating antiglaucomatous operations. The authors operated at the out-patient department 10 eyes of 8 patients (age 46-81 years). Indications for deep sclerectomy was seven times primary open angle glaucoma (POAG), once capsular glaucoma and twice normotensive glaucoma (NTG). In all eyes deep sclerectomy was indicated because of decompensation of the intraocular pressure with maximum tolerated therapy before surgery. None of the eyes were operated previously. The mean value of intraocular pressure before surgery was 25.1 +/- 6.5 mm Hg. From the results ensues that in nine operated eyes the intraocular pressure at the end of the 6-month follow-up period was compensated without supplementary therapy, only in one eye beta-blockers were prescribed one month after surgery. The cause of failure of filtration was the development of superficial adherence at the site of microperforatiion of the trabecular Descemet membrane which developed during operation. The mean intraocular pressure values at the end of the investigation period were 14.3 +/- 2.8 mm Hg. In two eyes haemorrhage into the anterior chamber was observed on the first day after surgery, the blood was absorbed within 24 hours. Hypotonia in two eyes was only transient and was not associated with a change in the depth of the anterior chamber or other complications. In none of the patients a decline of visual acuity was observed. In three operated eyes a change of refraction was necessary due to discontinuation of miotics after surgery. Deep sclerectomy is a delicate microsurgical technique which calls for experience and skill of the surgeon. The most complicated task is to prevent perforation of the trabecular Descemet membrane during surgery. Provided the surgical technique is perfect, it burdens the patient less than commonly performed perforating antiglaucomatous operations and it can be implemented in the out-patient department.

Adult↗
PubMed1995

[Compression lesions of the chiasmal area from the viewpoint of the ophthalmologist].

The authors evaluate 100 tumour of the chiasmal region (80 pituitary adenomas, 8 meningiomas, 7 craniopharyngiomas, 5 other tumours) and present their neuroophthalmological findings. In comparison with the findings in pituitary adenomas of the last decade the number of bilateral blindness was lower by 2.4%, the number of the optic atrophy was lower by 48.1% and the number of patients with a vision worse then 1.0 by 60.6%. Before the operation 91.2% patients had defects in the visual fields (monolateral in 5% and bilateral in 86.2%). The authors point out a relatively long period between the first compressive symptoms and the operation, especially in nonsecreting pituitary adenomas (2.1 years). An early diagnosis and an appropriate therapy of the patients suffering from the compressive lesions of the chiasmal region decreases the risk of permanent vision defects.

Adenoma↗
PubMed1993

[Suture technic in perforating keratoplasty and postoperative astigmatism].

The authors evaluate postoperative vision, value of astigmatism and keratometry in 25 patients operated in 1992 by perforating keratoplasty, incl. 11 where the disc was fixed by interrupted stitches and 14 by continuous diagonal stitches. After evaluation of the influence of interrupted stitches and continuous diagonal stitches on postoperative astigmatism in perforating keratoplasty the authors recommend the use of diagonal suture. The reason is in the first place the uniform spreading and good adaptation of the transplanted cornea, as well as slighter traumatization and easier removal of stitches. An important role is played also by the larger number of measurable radii of the corneal curvature with regard to possible postoperative correction of astigmatism either by added stitches or differentiated adjustment of the tension of the continuous stitch.

Adult↗
PubMed1990

[Diplopia in fractures of the orbital floor].

Based on their own experience with surgical treatment of 43 patients with fractures of the orbital floor, the authors discuss the problem of early operation in relation to the development of residual diplopia. They evaluate the functional result by the size of the visual field where diplopia occurred. In confirmed fractures of the orbit they recommend operation as early as possible after the injury. All patients were operated by the method of transantral reposition of the orbital floor. Satisfactory functional results were achieved in all operated patients. None of them had diplopia in the primary position of the eyes. The best results were achieved in patients operated early (residual diplopia in 10%), where none of the patients had diplopia in the visual field beneath 30 degrees.

Adult↗
PubMed1990

[Revascularization of the choroid in patients with pigmented retinal dystrophy].

The authors describe an analysis of visual functions and subjective changes in 44 eyes of 22 patients with pigmentary dystrophy of the retina followed up for a period of 2 to 55 months. They performed the operation of choroid revascularization according to their own method on 37 eyes. The est results were achieved in relatively early stages of the disease and where the operation was performed beneath both horizontal muscles. They did not observe per- or postoperative complications during the observation period. They recommend the operation as part of comprehensive treatment of a disease as serious as pigmentary retinal dystrophy.

Adolescent↗