[The sutureless technic in cataract surgery].
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Biomedical subjects
Publications and source records attributed to P Kuchynka.
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The authors followed the collection of 77 eyes with glaucoma (54 eyes with POAG, 16 eyes with PACG and 7 eyes with CG) after ECCE or phacoemulsification with implantation of IOL. The patients were operated in 1990-1991 at the Ophthalmological Clinic FNKV and 3rd Medical Faculty in Prague. The authors evaluated IOP, therapy and visual acuity 6 weeks and 6 months after operation. After 6 months period IOP was decreased in average about 3 mmHg; in POAG the reduction was 1.9 mmHg and in PACG the reduction was 4.7 mmHg. In this time the authors also registered decreasing antiglaucomatous therapy at 38 eyes (i.e. 49.3% operated eyes). The reducing therapy represents 50% eyes with POAG and 69% eyes with PACG. The visual acuity is in 70% 6/6-6/12. Patients with PACG have more expressive postoperative effect. The authors draw the attention to late diagnosis CG, after successful operation the visual acuity is reduced on account of advanced changes of the optic disc.
The authors report on 80 patients subjected to a cataract operation performed by phacoemulsification with implantation of silicone lenses Nordan-Varifocal manufactured by Iovision Co. In the methodical part the authors describe briefly the operation and implantation of the lens. They discuss also peroperative and postoperative complications, results of visual acuity and astigmatism during the six-month period following operation.
The author gives an account of different therapeutic possibilities as regards treatment of malignant melanomas of the uvea. She describes factors which influence the selection of therapy and indications of different methods.
The job and results of International Eye Bank of Prague in 1993 are described. The experience from the work of Eye Bank and some results of statistical processing of basic information about donors and recipients are presented. The necessity of close cooperation between Eye Bank and ophthalmological clinics and particularly between Eye Bank and various units from hospitals cooperating in the search for suitable donors is stressed in conclusion.
Complications and problems in the first 300 patients operated on by phacoemulsification technique are described. In the first 100 cases the procedure began with the creation of the corneoscleral incision and the anterior capsule was opened in a "can opener" fashion. In the second group of 200 patients we preferred the scleral incision, and the anterior capsule was opened mainly by capsulorhexis. The phacoemulsification was predominantly performed in the capsular bag or in the iris plane. The wound was closed with interrupted sutures. The most common and the most serious complication as well in the first 100 cases was posterior capsule rupture (11%). Then the percentage of this most common complication was diminished significantly with increasing experience of the surgeon (2.5% in 200 cases). The same problems which the authors had in their first operations appeared again, though in a smaller amount as soon as they started to work with phacoemulsification as a method of choice of cataract surgery.
In a group of 300 patients with a posterior chamber lens in 19% its decentration was found, in 2.3% the iris capture syndrome. The author discusses possible causes of decentration of the implanted lens, possibilities of its therapy.
In 194 patients aged 32-81 years 200 retropupillary lenses were administered. 129 lenses were implanted into the sulcus ciliaris, 71 lenses into the lenticular capsule. The surgical technique was the same in both groups. The authors divide inflammatory postoperative complications they encountered into two major groups: cellular reactions on the anterior surface of the lens and fibrinoid reactions with the formation of membranes or synechiae. The authors discuss possible reasons for the development of these complications and possibilities of therapy.
In four cases of retinoblastoma examined with the method of Golgi we have only found vessels and glial elements at different stages of differentiation. Moreover, in the areas containing typical rosettes, Golgi method revealed some isolately impregnated elements resembling photoreceptors in evolution. Within the retina abuting on the tumor were found only normal retinal nervous elements. Some nervous elements were found also in areas where the tumor tissue intermingled with infiltrated neighbouring retina.
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The authors present a detailed report on the histological findings in the anterior and posterior segments in Wegener's granulomatosis. Histopathologically the granuloma is nonspecific, usually consisting of histiocytes and lymphocytes. There were no giant cells in the cellular infiltrations. The granulomas were mainly located perivascularly; in some locations they had central necrosis.
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