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Biomedical subjects

P Rozsíval

Publications and source records attributed to P Rozsíval.

At least 19 recordsLinked to original sources
PubMed2006

[Correction of the astigmatism with the Artisan phakic toric lens].

The implantation of the intraocular anterior chamber phakic toric lens (PTIOL) Artisan, a product of the Ophtec company, is one of the most up-to-date methods of the correction of higher degree of myopic as well as hyperopic astigmatism. The authors refer about the results of PTIOL Artisan implantation in 6 patients (10 eyes). The major indication was the hyperopic astigmatism--in 5 patients (8 eyes); in one patient the indication was myopic astigmatism. In the followed up group of patients, there is the preponderance of men (5), and one woman only. The patients were divided into two subgroups: one with myopic astigmatism (1 patient, 2 eyes) and other with hyperopic astigmatism (5 patients, 8 eyes). The average age of the whole group at the time of the surgery was 27.7 +/- 2.8 years (range 23-38 years) and the average follow up period was 13.0 +/- 6.9 months (range 6-22 months). In the group the patients with follow up period shorter than 6 months were not included. The average preoperative spherical refractive error was +4.8 +/- 2.25 dioptres (D) and the average astigmatic error was -5.15 +/- 2.82 cylinders (Dcyl). In one case of myopia, the preoperative refractive error in both eyes was -7.0 D and -3.5 Dcyl. The target refraction was emetropia +/- 1.0 D. The authors evaluate the final uncorrected and best-corrected visual acuity (UCVA, BCVA), final postoperative refractive error, presence of intra- as well as postoperative complications, and changes of endothelial cells' density over time. The average final postoperative error in patients with hyperopic astigmatism was +0.72 +/- 0.93 D and -1.08 +/- 0.60 Dcyl. In the only patient with myopic astigmatism the final postoperative error of both eyes was +0.5 D and -0.5 Dcyl. The advantage of the PTIOL implantation is fast visual recovery, potential reversibility of the procedure, maintaining of the accommodation, and stability of the postoperative refraction.

Adult↗
PubMed2006

[Vernal keratoconjunctivitis and possibilities its treatment].

The authors present a case of vernal keratoconjunctivitis (VKC) in 5 years old boy. Despite intensive topical pharmacological therapy (mast-cell stabilizers, antihistamines, steroids in acute exacerbations) unsatisfied reduction of the symptoms was observed and cornea became involved in the left eye (LE). Repeated surgical abrasion of the papillary hypertrophy was performed with temporaly relief. We decided to provide a cryocoagulation of the papillary hypertrophy in the LE. We did not see any pre and post operative complications, significant improvement was observed and the patient is now (13 months after the surgery) in a good condition, on mast cell stabilizers only.

Child, Preschool↗
PubMed2006

[Surgical treatment of submacular hemorrhage combined with tissue plasminogen activator (a case report)].

Authors present the possibilities of extensive submacular hemorrhage surgery in a patient after serious eye injury with bleeding into the vitreous and underneath the retina. The combination of vitrectomy with tissue plasminogen activator application into the subretinal space allows better to dissolve the coagulated blood and facilitates its removal. This procedure with correct operation technique decreases the damage of the retinal tissue and consequently preserves the photoreceptors' function. In this report, a result of surgical treatment in a 22-year-old man is presented. In the presence of intravitreal bleeding and submacular hemorrhage, during the vitrectomy the tissue plasminogen activator was used, which during few minutes dissolved the already coagulated hemorrhage and facilitated its whole removal from the subretinal space.

Adult↗
PubMed2006

[The use of accommodative lenses for surgical correction of the presbyopia using the Prelex method].

The authors refer about their experience with the surgical correction of the presbyopia by means of the Prelex (presbyopic lens exchange) method. Patients, who underwent this type of refractive surgery procedure to decrease their dependency on glasses correction for far as well as for near vision (12 patients, 23 eyes) and 1 young female patient (2 eyes) with juvenile cataract and high hyperopia, were included in the study. The average age at the time of the surgery was 51.0 +/- 5.5 years (range, 19-77 years). The average follow up period of the whole group of patients is 9.8 months (range, 1-13 months). Depending on the type of the lens implanted, the group was divided into subgroup A with the accommodative lens 1 CU produced by Human Optics Company implanted, and subgroup B with the accommodative lens Kellan TetraFlex KH 3500 produced by LensTec Company implanted. The subgroup A consists of 8 patients (15 eyes) with the average preoperative refractive error +2.35 +/- 3.45 diopters. The average uncorrected visual acuity of this group was 0.24 +/- 0.18, and the average best-corrected visual acuity was 0.77 +/- 0.22 at the time before the surgery. The average glasses correction for near was +4.1 dioptres, and the uncorrected vision for near was Jaeger's table Nr. (J) 13. The B subgroup consists of 5 patients (10 eyes). The average preoperative refractive error was +2.23 +/- 0.93 diopters. The average value of the uncorrected visual acuity before the surgery was 0.43 +/- 0.28, and the average corrected visual acuity was 0.82 +/- 0.25. The average value of the glasses correction for near was +5.25 and uncorrected vision for near J 13. The final average postoperative error at the time of the last visit was in the A subgroup +0.06 +/- 1.17 dioptres. The average uncorrected visual acuity was 0.69 +/- 0.24, and the average best-corrected visual acuity 0.96 +/- 0.12. The average vision of the patients of this subgroup for near was J 3. In the B subgroup we found at the last visit the average final value of the postoperative refractive error -0.2 +/- 0.72 dioptres. The average uncorrected visual acuity 0.57 +/- 0.22 and the average corrected visual acuity 0.95 +/- 0.12. Average uncorrected vision for near was J 5. We did not notice any serious per- or postoperative complication of this procedure.

Accommodation, Ocular↗
PubMed2005

[Trabeculectomy--long term results].

Goal of this paper was to analyze retrospectively and partially also prospectively the results of trabeculectomies (TE) performed at the Department of Ophthalmology of the University Hospital in Hradec Králové (Königgrätz), Czech Republic, EU, during the 1990-2000 period using the database program GLAUCOM Access 97. The authors did statistical analysis of 538 trabeculectomies performed as the first surgery for lowering the intraocular pressure (IOP) on the followed eye without peroperative use of antimetabolites or cytostatics with follow up period 1-10 years. The baseline criteria for the evaluation were changes of the IOP, visual acuity, and pharmacological treatment after the operation. The average age at the time of the surgery was 61.28 +/- 14.58 years. Surgeries were performed by 11 surgeons. During the follow-up period the IOP lowering effect of the surgery was demonstrated by lowering the average IOP values from 28.42 +/- 8.98 mm Hg to 16.53 +/- 5.93 mm Hg. In the first half of the follow-up period a slight improvement of the visual acuity was noticed, in the second one the visual acuity decreased. Pre-operative average visual acuity was 0.59 +/- 0.34, and at the end of the follow-up period it was 0.59 +/- 0.33. The surgery in glaucoma patients effectively lowered the average number of prescribed antiglaucomatics after TE from 1.92 +/- 0.83 to 0.89 +/- 0.80 drugs. Our evaluations clearly showed trabeculectomy is even in the presence of existence non-perforating surgeries the basic and relatively easy-to-perform IOP lowering technique with broad variety of indications, and with relatively low number of complications.

Female↗
PubMed2005

[Spontaneous late subluxation of capsule, intraocular lens and capsular ring in patient with pseudoexfoliation syndrome--a case report].

The authors present a case of spontaneous late subluxation of capsule, intraocular lens and capsular ring in patient with pseudoexfoliation syndrome. A 78-year old woman was operated (phacoemulsification, implantation of capsular tension ring and intraocular lens) in the left eye in June 2001 and the same procedure was performed in the right eye in September 2001. No early postoperative complicantions were encountered. The patient was referred with vision reduction in the left eye in May 2004. Biomicroscopy revealed inferior dislocation of the capsular bag, capsular ring, and intraocular lens. Explantation of the whole complex and secondary anterior chamber lens was provided. The postoperative course was uneventful, and visual functions improved.

Aged↗
PubMed2005

[Electroretinoraphic findings in age-related macular degeneration (ARMD) before and after radiotherapy].

Standard ERG examinations were performed in 61 patients with ARMD before and after radiotherapy. Before the radiotherapy, a significant decrease in the cone b- wave amplitude and a significant reduction of the sum of oscillatory potentials (OP1-OP4) were found. At 24 months after the first dose of radiotherapy, a significant decrease in the rod response and 30-Hz flicker response were described. A possible explanation for the findings is an influence of radiotherapy onto primary circulatory disturbances in the whole retina in ARMD.

Aged↗
PubMed2005

[Results of cataract surgery in patients aged 80 years and older].

BACKGROUND: The authors evaluate the benefits of the cataract surgery in old patients. METHODS AND RESULTS: Best corrected visual acuity (BCVA) before operation, on the first postoperative day and 6 months after surgery were assessed as well as changes in the quality of life using the modified test VF-8. The positive effect of the cataract surgery was proved in patients in this age group. Not only recovery of the visual functions, but also improvement of the orientation and of the quality of life was reported by those patients. CONCLUSIONS: Based on our results we consider the cataract surgery indicated for old patients even with systemic morbidities.

Aged, 80 and over↗
PubMed2004

[Implantation of multifocal intraocular lenses].

The authors refer to the first experience in implantation of multifocal intraocular lens (MIOL) AMO ARRAY (model SA 40 N) produced by Allergan to a group of 35 patients (69 eyes). The proportion of men in the group was 42.9%, women being 57.1%. The mean age of the group was 50.9 +/- 4.3 year, range 36-71 years. The implantation of this type of intraocular lens was made due to a refractory intervention on a clear lens in 84.0% eyes and operation on cataract in 16.0%. The study was aimed at evaluation of the results of visual acuity for short and long distances, resulting refraction after the operation, the occurrence of side visual phenomena and their tolerance by the patient, necessary supplementary eyeglass correction especially in patients after refraction lensectomy. Uncorrected visual acuity for long distances 0.7 or better was in 75.9% of patients. Sixty one % of patients with MIOL in both eyes do not require glasses for vision into short distances (No 1-3).

Adult↗
PubMed2004

[Photorefractive keratectomy in hypermetropia].

AIM: To evaluate the results in patients with hypermetropia having undergone photoreactive keratectomy (PRK). GROUP AND METHODS: The authors present a retrospective analysis of the results in 40 eyes operated on PRK in the period of September 1997 to November 2002 at the Eye Clinic of the Faculty Hospital in Hradec Králové. The mean preoperation spherical refraction was 2.90 +/- 0.98 dioptry (D), the mean astigmatism being -0.82 +/- 0.78 D, visual uncorrected visual acuity (NZO) 0.37 +/- 0.37, the mean corrected visual acuity (KZO) 1.28 +/- 0.27). RESULTS: One year after the operation on 31 eyes, the resulting mean spherical refraction was 0.76 +/- 1.10 D, the mean astigmatism being -1.01 +/- 0.80 D, NZO 0.77 +/- 0.18, KZO 0.99 +/- 0.21, NZO 6/12 and better was detected in 94% of surgically treated eyes. CONCLUSION: The PRK method has been found sufficiently effective for the correction of low and medium hypermetropia.

Female↗
PubMed2004

[Effect of adjustment of corneal running sutures on cylindrical refraction after perforating keratoplasty].

Authors refer about the effect of adjusting (adjustment of the suture tension) of the running corneal suture on the final cylindrical refraction in patients who underwent penetrating keratoplasty due to keratoconus. In our article we evaluate two groups of patients. The group I consists 76 patients (76 eyes) who regularly visited our department of ophthalmology. There were 52.6% of females and 47.4% of males. The average age at the time of surgery was 33.5 +/- 5.2 years (range, 18-52 years). In this group of patients, the adjusting was performed during the surgery. In the group II 35 patients (40 eyes) underwent the adjusting procedure of the running corneal suture in the early postoperative period. There were 19 (54.0%) women and 16 (46.0%) men. The average age of the whole group at the time of surgery was 34.6 +/- 3.8 years (range, 18-50 years). The indication to carry out the adjusting was topographically verified astigmatism of more then 3.5 cylindrical diopters (D cyl). The purpose of this study was to find the ultimate surgery technique to get not only the clearness and good healing of the corneal graft, but first of all to prevent extensive ametropia already during the surgery. In the early stage after the surgery we are trying to reduce emerged refractive error and to get faster recovery of good visual acuity of the operated eye. In the sense of the least final postoperative astigmatism, the best results we have reached in cases where the donor corneal graft was 0.25 mm larger in diameter and the suture was adjusted during the surgery using light circles according to Serdarevic. In this group of patients the average final cylindrical refractive error after the surgery was 2.00 +/- 0.81 D cyl. When adjusting the corneal suture in postoperative period, the mean final refractive error decreased of about 3.09 +/- 1.62 D cyl.

Adolescent↗
PubMed2004

[Selective laser trabeculoplasty].

The prospective clinical study of the selective laser trabeculoplasty (SLT) by means the Coherent Selecta 7000 laser (wave length 532 nm) was conducted. Totally 108.7 +/- 18.3 laser non-overlapping spots (mean energy level 1.04 +/- 0.22 mJ) along the whole circle of the trabecular meshwork in the anterior chamber angle were applied. The study included 258 eyes of 146 patients (50 of them were men) with glaucoma. The mean age of the whole group was 55.9 +/- 13.7 years. The group of unsuccessfully treated patients (30 patients, 41 eyes) in whom the intraocular pressure (IOP) elevated from 23.2 +/- 3.7 mm Hg in 4.7% (measured 493 +/- 474 days after the treatment) during the follow up, was removed from the study. In the group with good response to the SLT, 116 patients (217 eyes) were evaluated 650 +/- 405 days after treatment. Before treatment, in this group the IOP was 23.9 +/- 3.0 mm Hg, at the end of the study the IOP was lowered by 4.5 +/- 2.9 mm Hg, in total by 18.6%. IOP decrease was more pronounced in patients with higher level of IOP at the beginning. Immediately after SLT, no significant rising of the IOP level was recorded. Selective laser trabeculoplasty preserves the integrity of the trabecular meshwork of the anterior chamber angle, and is a safe and clinically effective method of treatment of different forms of glaucoma and ocular hypertension.

Adolescent↗
PubMed2004

[European Cataract Outcome Study--results of five years of participation].

GOAL: To inform about European Cataract Outcome Study and to publish results from the Department of Ophthalmology, Faculty Hospital in Hradec Králové achieved during the five years' participation. METHOD, GROUPS: European Cataract Outcome Study is an international multicentric study pursuing quality of cataract surgery in individual departments of European countries. Its goal is to monitor the development of new trends and to be helpful in setting standards using the collected data. The Study evaluates results of all surgeries performed during one month. Our department participated in it in the years 1998-2002. In the first part of the trial the basic demographic data as well as the course of the surgeries were followed, in the second part results of examination during the first six months after the surgery were collected. RESULTS: Operations are mostly performed by means of the facoemulsification method in local anesthesia (subconjunctival or parabulbar), the stay in hospital varies in individual years between 35.1% and 56%, the percentage of implanted foldable (soft) intraocular lenses rises every year, in 2002 up to 61.5% (average of the whole study was 78.2% in 2002), the percentage of posterior lens capsule rupture during the procedure during the five year period in our department descends (range 3.7% to 1.2%). In the referred groups, 40.4% to 50.5% of eyes suffered from still another disease. The best corrected visual acuity 0.6 or better after the surgery achieved in individual years 64% to 78%. The deviation from planed refraction is between 0.69 to 0.88 diopters. The induced postoperative astigmatism varied in followed periods from 0.49 to 0.69 cylindrical diopters. CONCLUSION: The results of the study shows that the quality of surgeries performed in the department is on the high level and is fully comparable with contemporary European standard.

Aged↗
PubMed2004

[Evidence based medicine and cost-effectiveness analysis in ophthalmology].

GOAL: To make the reader familiar with the term evidence based medicine (EBM), to explain the principle of cost-effectiveness analysis (price-profit), and to show its usefulness to compare the effectiveness of different medical procedures. METHOD: Based on few examples, in this article the relevance and calculation of important parameters of cost-effectiveness analysis (CE), as utility value (UV), quality adjusted life years (QALY) is explained. In addition, calculation of UV and QALY for the cataract surgery, including its complications, is provided. RESULTS: According to this method, laser photocoagulation and cryocoagulation of the early stages of retinopathy of prematurity, treatment of amblyopia, cataract surgery of one or both eyes, from the vitreoretinal procedures the early vitrectomy in cases of hemophtalmus in proliferative diabetic retinopathy or grid laser photocoagulation in diabetic macular edema or worsening of the visual acuity due to the branch retinal vein occlusion belong to highly effective procedures. On the other hand, to the procedures with low cost effectiveness belongs the treating of the central retinal artery occlusion with anterior chamber paracentesis, as well as with CO2 inhalation, or photodynamic therapy in choroidal neovascularization in age-related macular degeneration with visual acuity of the better eye 20/200. CONCLUSION: Cost-effectiveness analysis is a new perspective method evaluating successfulness of medical procedure comparing the final effect with the financial costs. In evaluation of effectiveness of individual procedures, three main aspects are considered: subjective feeling of influence of the disease on the patient's life, objective results of clinical examination and financial costs of the procedure. According to this method, the cataract surgery, as well as procedures in the pediatric ophthalmology belong to the most effective surgical methods.

Cataract Extraction↗
PubMed2004

[Visual functions in optic neuritis].

The authors present results of retrospective study of 25 patients with the first attack of acute optic neuritis followed at the Department of Ophthalmology, University Hospital Hradec Králové. Visual functions were deteriorated in all patients. Visual acuity was in range between 0.8 to hand movement. Central scotoma was present in 12 patients, other visual field patterns were seen in 13 patients. Complete recovery of visual functions was observed in 24 patients during the six months. Patients were examined for signs of multiple sclerosis (MS). In the group without MS (15 patients) were three treated with steroids (2 received intravenous methylprednisolone and 1 oral prednisone before referral to us), vitamins were administered to the others. The patients with proved MS were managed at the Department of Neurology, University Hospital, Hradec Králové.

Acute Disease↗
PubMed2003

[Corneal surface analysis].

Fourier analysis is a powerful method of evaluating the surface of the cornea. In 50 patients after photorefractive keratectomy included in our study we measured spherical equivalent, regular astigmatism, irregular astigmatism and decentration retrospectively acquired by Fourier series analysis of corneal topography data 1, 3, 6 and 12 months after operation. Postoperative decentration increased significantly from a mean preoperative value. The preoperative and postoperative values are not significantly different. The Fourier spherical equivalent and the values of keratometric spherical (equivalent) are highly correlated. Correlation among decentration, irregular astigmatism and best corrected visual acuity is important for clinical practice. Due to Fourier analysis we obtain information, which could explain worse results of some surgeries.

Astigmatism↗