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Biomedical subjects

M Holousová

Publications and source records attributed to M Holousová.

9 recordsLinked to original sources

[Cryotherapy and photocoagulation in the treatment of retinopathy of prematurity].

In a retrospective clinical trial is compared efficacy of transscleral cryotherapy versus diode laser photocoagulation in the treatment of threshold stage 3 retinopathy of prematurity (ROP) in zone II-III. 40 eyes were treated with cryotherapy and 32 eyes were treated with diode laser photocoagulation. All children have been followed up for 5 to 9 years after treatment. The long-term best-corrected visual acuity (BCVA) and refractive errors were evaluated. BCVA from 6/6 to 6/18 in last examination had 53% of eyes with cryotherapy and 56% of eyes with photocoagulation. The difference was not statistically significant (P = 0.094). Myopia over -6.0 D were at 32.5% of eyes with cryotherapy and at 22% of eyes with photocoagulation. This difference was statistically significant (P < 0.05). In the second part of this study is evaluated the long-term visual acuity and structural outcome in Zone 1 ROP (Very posterior Zone 1 disease, rush disease). 20 eyes with cryotherapy and 24 eyes with photocoagulation of this severe form ROP were followed up for 5 to 11 years. BCVA of 6/36 and better had 30% eyes of cryotherapy and 37.5% eyes of laser photocoagulation (P < 0.05). Unfavourable structural fundus outcomes had 55% eyes of cryotherapy and 33% eyes of photocoagulation (P < 0.05). These differences were statistically significant. Our results support the long-term efficacy and safety of cryotherapy and diode laser photocoagulation in the treatment of threshold 3 stage ROP. Visual acuity results suggest that diode laser photocoagulation is as effective as cryotherapy in treatment of this ROP stage. In the group of posterior Zone 1 ROP was achieved better visual acuity results and reduced unfavourable structural outcomes with diode laser photocoagulation as compared to cryotherapy.

Child↗

[Phototherapeutic keratectomy in the treatment of corneal surface disorders in children].

Retrospective clinical trial evaluated efficacy and safety of phototherapeutic keratectomy (PTK) within 35 children (35 eyes) aged 8 to 18 years (mean 12.6 years). All children had a long time postoperative follow-up ranged from 2 to 5 years (mean 3.2 years). Indications for PTK in children were: recurrent corneal epithelial erosion syndrome, superficial scars after keratitis "e lagophthalmo", dry spots and mucous plaques after atopic- vernal eye disease, band keratopathy, anterior corneal dystrophies, corneal scars secondary to post-infectious keratitis (post-herpes simplex corneal scarring) and following trauma. The aim of treatment were to improve visual acuity and to reduce or eliminate subjective ocular discomfort-pain, lacrimation and photophobia. Fully informed parents consent was done at all cases. There was increased the best spectacle corrected visual acuity (BSCVA) in all Children, and episodes of ocular pain, lacrimation and photophobia diminished. The mean preoperative BSCVA 6/36 (ranged from 6/9 to 1/60) improved to mean value 6/12 (ranged from 6/6 to 6/60) as 2-5 years follow-up postoperatively. Seven children had 5 or more Snellen's lines gain of the BSCVA, ten children gained 4 lines, eight children gained 3 lines and five children gained 2 lines postoperatively in comparison to their preoperative values. At four cases were evaluated only 1 line gain of BSCVA, one eye unchanged, and no eye had BSCVA worsened after PTK. Phototherapeutic keratectomy in children seems to be an effective and safety procedure in the management of suitable anterior corneal disorders. Our clinical results suggest the most suitable diagnoses for treatment include recurrent corneal epithelial erosions, band keratopathy, dry spots, mucous plaques, anterior corneal dystrophies, and anterior post-keratitis and post-traumatic scars.

Adolescent↗

[Photorefractive keratectomy in high myopic anisometropia in children].

The authors evaluate the results of photorefractive keratectomy in children with high myopic anisometropia proved by intolerance of a contact lens and intolerance of full correction by glasses. The objective was to maintain or improve the already achieved binocular vision without or with feasible correction by glasses. The group is formed by 13 children, mean age 11.5 years at the time of surgery (range 7-15 years). The mean preoperative value of myopia was -8.9 dpt (SE), within the range of -7.0 to -11.75 dpt (SE) on the operated eye. The preprequisite condition for surgery was confirmed intolerance of a contact lens, intolerance of complete correction by glasses and previous systematic pleoptic treatment with training of binocular functions. The operation was always implemented during hospitalization. The follow-up after surgery in all children of the group is more than 2 years. The mean value of the refraction defect two years after surgery is -1.12 dpt (SE). The mean non-corrected visual acuity improved from 0.021 before surgery to 0.48 two years after surgery and the mean best corrected visual acuity improved from 0.51 before surgery to 0.61 two years after surgery. The authors compare results of binocular functions before and after operation. Two years after surgery all children had superposition and a normal Bagolini test, 12 children had fusion I, 9 children fusion II, and 6 children fusion III and stereopsis. Based on the results of the trial PRK appears to be an effective and safe method for correction of high myopic anisometropia in intolerance of contact lenses or complete correction by glasses. This operation thus makes it possible to preserve further the degree of binocular vision practised in advance or to improve it. This is the first group, though small, of thus treated children published in our professional literature.

Adolescent↗

[Photorefractive excimer laser keratectomy in myopia and astigmatism with a 2-year follow-up after surgery].

In a group of 1037 operated eyes the effectiveness, predictive value, stability and safety of photorefraction keratectomy by means of an excimer laser was tested in myopia (PRK) and astigmatism (PARK) with a two-year follow-up period after operation. The range of the preoperative refraction defect was -1.75 to -2.10 dpt (SE). The maximal value of the corrected cylinder in astigmatism was -6.0 cyl dpt. In the PRK group 459 operations were evaluated, in the PARK group 578 operations. Both groups are classified according to the spherical equivalent of the refractory defect into three groups. Group A is formed by myopia up to -6.0 dpt, group B myopia -6.25 to -10.0 dpt and group C above -10.25 dpt. Non-corrected visual acuity 6/12 and better was recorded in the 20th month after operation in group A in 93.4-97.6% (PARK-PRK) operated eyes, in group B 88.7-91.5% and in group C 61.2-68.4% of operated eyes. The achieved final refraction (SE) in an interval +(-1.0) dpt from the originally planned one was recorded during the 20th month after operation in group A in 92.8-96.5% (PARK-PRK) operated eyes, in group B 73.5-78.9% and in group C 59.7-63.5% operated eyes. The best corrected visual acuity (NKZO) in the whole group 20 months after operation was unaltered or better by 1 line of projected optotypes as compared with NKZO before operation in group A in 97.6%, in group B in 94.3% and in group C in 89.7% operated eyes. The analysis of results in PRK and PARK in the group with a two-year follow-up period after operation permits to evaluate the method as sufficiently effective and safe for correction of myopia up to -10.0 dpt but less predictive in myopia above -10.0 dpt.

Adult↗

[Optimization of therapy in lacrimal duct obstruction in neonates and infants].

The authors present an account on experience with the diagnosis and treatment of obstruction of the lacrimal pathways in neonates and infants. They analyze the three-year period from 1994-1996 during which they treated 892 confirmed cases of symptomatic obstructions. The method of early and aimed probing proved successful in 890 children, i.e. in 99.78% of the group. During the same period the authors investigated also the need of cannulation of lacrimal pathways in children. The application of this procedure was called for in particular in injuries of the lacrimal pathways, when the silicone cannulas were used much more frequently than in congenital lacrimal obstructions. The authors emphasize the importance of the doctor's experience, perfect knowledge and respecting of the anatomy of the lacrimal pathways and the necessity of perfect immobilization of the child during treatment.

Humans↗

[Excimer laser photorefractive keratectomy in myopia and astigmatism--1 year experience].

The authors evaluate the results of photorefractive keratectomy by means of an excimer laser myopia and astigmatism in 343 eyes with a minimal follow-up period of 9 months. The value of the preoperative refractive error expressed in spherical equivalents was -1,75 to -18,5 d. In astigmatism the maximal value was -5 cyl. d. The group was divided into four sub-groups: A) -1,75 to -3,0 d., B) -3,25 to -6,0 d., C) -6,25 to -10,0 d., D) more than -10,25 d. The spherical equivalent of the refractive error 9 month after operation was -0,28 d. in group A, -0,37 d. in group B, -0,67 d. in group C and -1,82 d. in group D. Uncorrected vision, 6/12 or better, 9 mons after operation was recorded in group A in 98,1% patients, group B 95,6% group C 91,2% and in group D in 72,5% patients. The authors proved a high effectiveness, safety predictability and stability of photorefractive keratectomy by means of an excimer laser in myopia up to -10 d. Photorefractive keratectomy is a promising method which extends the possibilities of correcting myopia and astigmatism in sufficiently positively motivated and indicated patients.

Adult↗

[Histiocytosis X and the orbit in children].

Histiocytosis X, a clinical entity which was not defined and classified exactly so far, is manifested by a varied range of clinical manifestations. In rare instances the affection of the orbit is the only and first symptom of the disease. The authors present an account of three children. In one isolated affection of the orbit with a non-inflammatory swelling of the external portion of the upper eyelid was the first symptom of the disease. In the other two patients with the acute multifocal form of histiocytosis X exophthalmos developed only 3 and 7 months resp. after establishment of the diagnosis. In the discussion of symptoms, the prognosis and treatment the authors are inclined to believe that at present the prognosis of multifocal form of the disease is not always adverse. In the frequently difficult differential diagnosis of orbital lesions histiocytosis X should be considered as one of the possible causes of affections of the orbit in children.

Child, Preschool↗

[Mesodermal dysgenesis].

The authors present an account on a 12-year-old girl with ectomesodermal dysgenesis of the Rieger type syndrome. The disease was manifested at the age of nine months by transient diffuse corneal opacity, while the intraocular pressure was normal. In addition to typical corneal changes and changes in the angle of the chamber other associated somatic symptoms included megalocornea, high myoptic astigmatism, cleft soft palate, hypoplasia of the upper jaw, partial anodontia, marked thoracic kyphosis, scoliosis, generalized hypermobility and taxicity of the joints and torticollis. Examination revealed an uncommon pathological karyotype 46, XX, t/1,4 (p36, q23). Cytogenetic examination of the parents and siblings of the proband did not disclose any numerical or structural aberrations. The authors reflect on possible causes of the development of the disease and on the differential diagnosis.

Abnormalities, Multiple↗