Biomedical subjects

Wojciech Omulecki

Publications and source records attributed to Wojciech Omulecki.

18 recordsLinked to original sources

PubMed2005

[Retinal capillary blood flow in nonexudative age-related macular degeneration].

PURPOSE: The purpose of this study was to evaluate retinal capillary blood flow in patients with nonexudative age-related macular degeneration. MATERIAL AND METHODS: Twenty five patients with nonexudative age-related macular degeneration and twenty five age-matched control subjects were enrolled into the study. Full ophthalmological examination and fluorescein angiography were performed. Retinal blood flow was evaluated with the Heidelberg Retina Flowmeter. Total mean flow and mean velocity were calculated using the technique of automatic full field perfusion image analysis RESULTS: Patients with nonexudative age-related macular degeneration revealed statistically significant lower retinal blood flow than control subjects. In AMD group total mean flow values were 266.89 / 272.21 AU, while in control group were: 1.498 / 1.509 AU. Mean velocity values were: 1.315 / 1.329 AU in AMD patients and: 1.498 / 1.509 AU in controls. CONCLUSIONS: The study results showed reduced capillary retinal blood flow in patients with age-related macular degeneration compared to normal subjects. This retinal microcirculation impairment suggests more generalized perfusion defect involving both, choroidal and retinal blood flow.

Blood Flow Velocity↗

PubMed2005

[Color Doppler imaging of the retrobulbar circulation in non-exudative and exudative age-related macular degeneration].

PURPOSE: To study ocular perfusion in the ophthalmic artery, central retinal artery, nasal and temporal posterior ciliary : arteries in non-exudative and exudative age-related macular degeneration. MATERIAL AND METHODS: Twenty five subjects with non-exudative age-related macular degeneration were compared to twenty five subjects with exudative age-related macular degeneration and to twenty five age-matched control subjects. Color Doppler imaging measured peak systolic velocity (PSV) and end diastolic velocity (EDV) in the ophthalmic artery, central retinal artery, nasal and temporal posterior ciliary arteries of one eye. The resistivity index (RI) and the pulsatility index (PI) were calculated. RESULTS: There were statistically significant differences between: subjects with non-exudative age-related macular degeneration and subjects with exudative age-related macular degeneration in EDV, RI and PI in the ophthalmic artery and PSV in the temporal posterior ciliary artery, subjects with non-exudative age-related macular degeneration and control subjects in RI in central retinal artery, subjects with non-exudative age-related macular degeneration and control subjects in RI and PI in nasal posterior ciliary artery, subjects with exudative age-related macular degeneration and control subjects in PI in nasal posterior ciliary artery. CONCLUSIONS: The study results showed reduced ocular blood flow in patients with non-exudative age-related macular degeneration compared to patients with exudative age-related macular degeneration and to control subjects. The higher RI in central retinal artery in non-exudative age-related macular degeneration compared to control subjects, suggest there may be a more generalized perfusion abnormality beyond the choroid.

Case-Control Studies↗

PubMed2004

[Long-term results of trabeculectomy in patients with open angle and angle-closure glaucoma].

PURPOSE: To provide data on the long-term results of trabeculectomy performed in open angle and in chronic angle-closure glaucoma. MATERIAL AND METHODS: Fifty nine eyes of 51 patients, underwent trabeculectomy from 1992 to 1994 in the Department of Ophthalmology, Medical University of Lodz. The follow up was minimum 10 years. Such pre- and postoperative measurements, as: visual acuity, intraocular pressure (IOP), visual field and the use of hypotensive medications, were evaluated. RESULTS: Successful IOP control was obtained in 91%. After 10-years follow-up the average IOP was 15 mmHg. The decrease in visual acuity was found in 25% of eyes, caused mainly by cataract. In 71% of eyes (10 years after surgery) additional topical medication was required. CONCLUSIONS: Trabeculectomy is effective and very often performed surgery in glaucoma.

Aged↗

PubMed2004

[Intraocular pressure in early postoperative period after cataract phacoemulsification].

PURPOSE: The purpose of this study was to investigate the pattern of intraocular pressure (IOP) change after phacoemulsification and its bearing on timing of postoperative review. MATERIAL AND METHODS: 31 eyes of 31 consecutive patients having uneventful phacoemulsification were included in this study. The IOP was measured by Goldmann applanation tonometry preoperatively and 1-3 hours, 1 day and 1 week postoperatively. The relationship between these measurements' readings were examined. RESULTS: 31 patients completed the study. The IOP checked next day was significantly correlated with the IOP preoperatively. CONCLUSION: After phacoemulsification with OIL implantation the decrease in IOP was observed in first three postoperative hours in comparison with preoperative values and it was followed by an increase on the first postoperative day. It decreased again after a week reaching values lower than preoperatively. Only in few cases (10%) a transient intraocular hypertension (23-26 mmHg) appeared on the first postoperative day.

Aged↗

PubMed2004

[Analysis of the causes of enucleations performed at the Department of Ophthalmology of the Medical University of Lódź].

PURPOSE: To gather and analyse the data about causes of enucleations, which were performed in the Department of Ophthalmology, Medical University of Lódź. MATERIAL AND METHODS: The data were based on case histories. The whole examined group consisted of 57 patients, who had an enucleation surgery done in the period from June 1999 to June 2003. The analyzed data included: clinical diagnosis, visual acuity, intraocular pressure, results of histopathology examination and results of diagnostic imaging examinations. RESULTS: The most frequent causes of enucleations were: intraocular tumors (fraction 0.51 of the whole group), painful blind eyes (fraction 0.33), endophthalmitis (fraction 0.12) and ocular traumas (fraction 0.04). CONCLUSIONS: Despite significant advances in ophthalmology in recent years, enucleation remains a method of treatment. The main indications for this type of surgery are: intraocular tumors, painful blind eyes, severe endophthalmitis and some cases of ocular trauma.

Adult↗

PubMed2004

[Multifocal electroretinogram].

The paper presents current state of knowledge regarding multifocal electroretinography (mfERG). The theoretical basis of this technique, procedure, methods and examples of use in clinical diagnostics are presented.

Electroretinography↗

PubMed2004

[Epidemiology of cataract in clinical material of Department of Ophthalmology, Medical University of Lódź].

PURPOSE: Analysis of some epidemiological features of patients operated for senile and presenile cataract at our department in years: 1992, 1994, 1997, 2000 and 2002. MATERIAL AND METHODS: In the analyzed years 4385 patients (1594 males and 2791 females) aged from 36 to 97 years were operated. The age of patients, sex, duration of cataract symptoms before surgery, preoperative visual acuity, type of cataract, place of living and coexistence of diabetes or high myopia, were taken into consideration. RESULTS: The mean age of patients was 70.4. A statistically significant difference between mean age in 1997 (69.7), and 2000 (71.6) and 2002 (71.4) was found. Women tended to be operated on 2 years later than men (mean age for women--71.1, mean age for men--69.1). 16% of patients suffered from diabetes, and 6.7% had high myopia. Senile cataract affected people with high myopia at earlier age (mean--67.3 years). 67.5% of patients were of big town origin, 13% came from small towns and 19% were from the country. Patients from big towns were operated in higher age (mean--72.4 years) than patients from small cities (mean--69.9 years), and from country (mean--70.2 years) and had better visual acuity (mean--0.20) than patients from small towns (mean--0.16) and from country (mean--0.13). Preoperative visual acuity in the range 0.4-1.0 was found in 0.4% of patients in 1992, and in 28% in 2002. The visual acuity <0.1 was found in 77.5% of patients in 1992 and in 45% of patients in 2002. CONCLUSIONS: Mean age of patients operated for cataract is increasing and there is a tendency of performing operations in cases with better visual acuity. Women suffer from cataract later than men. People of country origin were operated at earlier age with worse visual acuity comparing to patients coming from towns. Senile cataract affects people with high myopia at earlier age.

Adult↗

PubMed2004

[Using a botuline toxin diagnostic test in a case of bilateral stilling--Türk--Duane (STD) syndrome found during preparation for cataract surgery].

PURPOSE: The presentation of complex procedures in preoperative diagnosis, allowing the evaluation of reaction of a patient with bilateral STD syndrome, to a potential change in the long-lasting ocular motility disturbances and corrective head position. MATERIAL AND METHODS: The botuline toxin was injected into the medial rectus muscle of the eye with greater motility disturbance in convergent strabismus. It was discovered during preparation for cataract surgery in a 45 years old female with STD Syndrome I type. Due to reduced visual acuity the diagnosis of binocular vision were performed after bilateral cataract surgery. We were afraid that the fixed sensory status of the patient would change, and therefore we performed botuline injections. Strabismus angle, ocular motility and diplopia were assessed and compared. RESULTS: The reduction of strabismus angle was achieved with no diplopia. The patient no longer needed the corrective head position, with binocular vision present while looking straight ahead. Also, a slight improvement was obtained in the abduction motility of the eye to which botuline toxin was injected. CONCLUSION: Preoperative diagnostic botuline toxin injection into the rectus medial muscle of the eye with greater motility disturbance, gives an effect of strabismus reduction. This allows for further decisions of whether, and what type of surgical treatment should be performed.

Abducens Nerve↗

PubMed2004

[The influence of viscoelastic's maintenance in the anterior chamber on early results and complications after trabeculectomy].

PURPOSE: The evaluation of intraocular pressure and number of complications in the early postoperative period in patients after trabeculectomy with viscoelastic agent used to recreate the anterior chamber at the end of procedure. MATERIAL AND METHODS: Between November 2001 and February 2002, in 56 patients (58 eyes) with primary open-angle glaucoma trabeculectomy was performed. Patients were divided into two groups. Trabeculectomy was performed with leaving the viscoelastic agent (Provisc) in the anterior chamber at the end of surgery in 29 eyes of 28 patients (Group A), while in 28 patients (29 eyes) the anterior chamber was filled with Ringer solution (Group B). Preoperative IOP in group A ranged from 19 to 48 mmHg, mean--28.41 mmHg. In group B it ranged between 19 and 41 mmHg, mean--25.07 mmHg. The follow-up time was 1 month in every case. RESULTS: The mean IOP on the first, fifth, 14th and 30th day after surgery was 14.0 mmHg, 13.2 mmHg, 12.03 mmHg and 11.76 mmHg respectively in group A, while in group B corresponding values were: 9.0 mmHg, 8.97 mmHg, 8.83 mmHg and 8.9 mmHg. The shallowing of anterior chamber and choroidal detachment were observed in 4 eyes (13.8%) in group A and in 8 eyes (27.6%) in group B postoperatively. The increased IOP during first days after surgery was observed in 3 cases (10.3%) in group A. CONCLUSIONS: The viscoelastic agent left in the anterior chamber at the end of trabeculectomy significantly decreases the frequency of anterior chamber shallowing and choroidal detachment and reduces number of cases with hypotony.

Adjuvants, Immunologic↗

PubMed2004

[Surgically induced astigmatism after cataract phacoemulsification].

PURPOSE: To evaluate the astigmatic effect after phacoemulsification depending on size and location of incision. MATERIAL AND METHODS: Three groups of 30 patients each: In 1st group with scleral tunnel incision enlarged to 6 mm with continuous cross-like suture at 12 o'clock; In 2nd group with 3.2 mm scleral incision without suture at 12 o'clock; In 3rd group with 3.2 mm superotemporal incision in clear cornea, no suture. Postoperative astigmatism was examined by keratometry after 1 day, 1 week and 1 and 3 months post surgery. Surgically induced astigmatism was calculated by polar values method. RESULTS: After 3 months observation the lowest mean postoperative corneal astigmatism was achieved in group III. The SIA was 0.71 in group III, 1.08 in group I and 0.95 in group II. The differences between group III and groups I, II were statistically significant. CONCLUSIONS: Surgically induced astigmatism can be minimized with incision in clear cornea and no suture.

Adult↗

PubMed2003

[Advancements in diagnosis and surgical treatment of strabismus in adolescent and adults].

PURPOSE: To present complete process of pre-operative strabismus diagnosis, which can be used for prediction of post-operative diplopia in adolescents and adults. MATERIAL AND METHODS: The study involved three patients, who were qualified for the surgical treatment of strabismus. Complete pre-operative diagnosis predicting potential post-operative diplopia was performed in all patients. The prismatic test for diplopia, hyperfunctional muscle botuline toxin injection, and prism correction were performed RESULTS: Regarding the results of tests, two patients were qualified for surgical treatment. None of them suffered from diplopia after this treatment. The third patient in pre-operative tests showed unacceptably high risk of intolerable diplopia. CONCLUSIONS: Post-operative diplopia in adolescents and adults represents a serious problem, especially in susceptible patients. Accurate and complete pre-operative diagnosis allows for risk reduction in post-operative diplopia. The predictive test for post-operative diplopia, botuline toxin injection and prism correction in isolation are not always able, to give a reliable indication, as to the sensory status following strabismus surgery. A combination of the three above mentioned techniques give more reliable diagnosis. For patients, who can possibly suffer from post-operative diplopia, the adjustable suture technique should be applied.

Adolescent↗

PubMed2002

[Treatment of dislocated lenses in patients with Marfan's syndrome using vitrectomy and intraocular lenses].

PURPOSE: To evaluate results of surgical complex treatment of lens dislocation in Marfan syndrome cases. MATERIAL AND METHODS: Nineteen eyes of 13 patients were operatively treated for lens dislocation. Pars plana vitrectomy was done in all eyes. Dislocated lenses were removed by lensectomy in 5 eyes and with an intracapsular method in 14 eyes. The scleral fixation technique was used for primary posterior chamber intraocular lens implantation in 18 eyes, and one eye remained aphakic. Time of observation ranged between 6 and 71 months (mean 3.5 years). RESULTS: All eyes achieved improvement in visual acuity or good preoperative visual acuity was maintained. The vision between 6/6 and 6/8 was achieved in 14 patients. There were no serious intraoperative or early postoperative complications. Retinal detachment appeared in two eyes in a long observation time and it was successfully operatively treated. The not good visual results were due to amblyopia (n = 2), complications of retinal detachment surgery (n = 2) and glaucomatous optic disc atrophy coexisting with macular degeneration (n = 1). CONCLUSIONS: Pars plana vitrectomy and primary scleral-fixated IOL implantation gives quick and good visual rehabilitation in adult patients with Marfan's syndrome. The described surgical method is complex and need a prolonged operative time, but gives very good functional results and very few complications.

Adult↗

PubMed2002

[Simultaneous bilateral cataract surgery with PC IOL implantation].

PURPOSE: To evaluate results of simultaneous bilateral extracapsular cataract extraction with PC IOL implantation and to discuss indications for such treatment. MATERIAL AND METHODS: Simultaneous bilateral cataract surgery was performed in 3 patients: 56-year-old woman with Little's syndrome, 75-year-old woman with Parkinson's disease and 29-year-old mentally handicapped man. All patients required general anesthesia because of the general state of health. All patients were treated topically with broad-spectrum antibiotic drops before the surgery. Simultaneous bilateral surgery was performed as two separate operations. After successful completion of surgery of the first eye, the gloves, drapes and gowns were changed and the new set of instruments and irrigation solution was used. RESULTS: The visual acuity improved in all eyes after surgery, and it was 6/6 in both eyes in patients 1 and 3, whereas it was 6/8 and 6/60 in patient 2, due to glaucomatous optic nerve atrophy. There were no intra- or postoperative complications. CONCLUSIONS: Simultaneous bilateral cataract surgery is a safe procedure if all special conditions are fulfilled. It is specially indicated in patients requiring general anesthesia. Patients are not at risk of the second general anesthesia and achieve earlier visual binocular rehabilitation. Extracapsular cataract extraction with PC IOL implantation was performed in all eyes. The excision of fibrotic anterior lens capsule was necessary before the aspiration of cortical material in 2 eyes with congenital cataracts. The corneal incision and plastic surgery of the iris was done in the eye, which had undergone iridencleisis. In the other eye of the same women cutting and suturing of the iris was performed because of posterior synechiae and very narrow pupil.

Adult↗

PubMed2002

[Massive choroidal hemorrhage as a late trabeculectomy complication ].

The purpose of this paper was to present the case of an unusual late complication of filtering glaucoma surgery. A massive choroidal hemorrhage occurred 5 years after trabeculectomy and extracapsular cataract extraction. The diagnosis was confirmed by MRI examination. Improvement in choroidal status and in visual acuity (from hand motions to 6/12 with aphakic correction of 12 diopters) was observed during three weeks of medication. The retina and the choroid remained attached during two years of observation.

Aged↗

PubMed2002

[Refraction changes after cataract extraction with IOL implantation in the eyes with previous performed vitrectomy].

PURPOSE: To determine differences between the predicted and postoperative refraction after cataract extraction with intraocular lens implantation in the eyes, which previous underwent vitrectomy. MATERIAL AND METHODS: Fifty three eyes of 52 patients underwent the analysis: twenty five in group I, nineteen in group II and nine eyes with previous scleral buckling in group III. All the eyes had ECCE and IOL with PMMA implantation after vitrectomy. In groups II and. III silicone oil tamponade was used and removed before cataract extraction. Thirty eyes of the control group K underwent cataract surgery and IOL implantation alone. The IOL power calculation was performed with SRK II formula. The predicted and postoperative refractions were compared. The follow-up was minimum 4 months (on average 15 +/- 12.71 months). RESULTS: The postoperative refractions were significantly shifted toward myopia than it was predicted--1.41 +/- 1.21 D in group I, -0.81 +/- 2.11 D in group II and -3.03 +/- 1.49 D in group III. In the control group K the difference was--0.07 +/- 0.91. CONCLUSIONS: Myopic shift of postoperative refraction after cataract surgery should be considered, when calculating the IOL power in the eye after vitreoretinal procedures.

Adult↗

PubMed2002

[A study of human lens epithelial cells by light and electron microscopy and by immunohistochemistry in different types of cataracts].

PURPOSE: To evaluate the characteristics of cataract changes in lens epithelial cells (LECs), in different types of human cataract. MATERIAL AND METHODS: Anterior capsules for the study were obtained from patients with different types of cataracts during extracapsular cataract extraction, or phacoemulsification using continuous curvilinear capsulorhexis. LECs attached to the anterior capsules were analyzed for morphological changes by light and electron microscopy, and for cellular characteristics by immunohistochemistry. The reactivity to cytokeratins 5,6,8,17 and 19 (arker for epithelial cells) and to vimentin (arker for mesenchymal cells) was determined. RESULTS: The consecutive degenerative changes were observed in most of the cells: multilayered cells, nuclei of abnormal diameters and shapes, vacuolation of nuclei and cytoplasm. LECs were immunohistochemically positive for cytokeratin and vimentin, or only for vimentin in all types of cataract. Some of LECs showed morphological and immunohistochemical characteristics of mesenchymal cells. CONCLUSIONS: Lens epithelial cells show similar degenerative changes in different types of cataract and may have the ability to transdifferentiate into mesenchymal cells.

Adult↗

PubMed2002

[Removal of luxated crystalline lenses by intravitreal phaco-emulsification].

PURPOSE: To present the complex surgical technique used for the management of luxated crystalline lenses and to evaluate results of this treatment. MATERIAL AND METHODS: Between May 2001 and February 2002, ten patients (ten eyes) were treated for crystalline lens luxation. There were 4 females and 6 males in this group, their age ranged between 46 and 78 years (average 63 years). In all cases, the surgical technique comprised pars plana vitrectomy, perfluorocarbon liquid injection and crystalline lens phacoemulsification in the vitreous cavity. Simultaneously, anterior chamber IOLs were implanted in 8 eyes, and scleral-fixation, posterior chamber IOLs in 2 eyes. The follow-up ranged between 1 and 9 months (mean 2.7 months). RESULTS: All dislocated lenses were successfully removed. No complications occurred during phacofragmentation. We achieved improvement in visual acuity in 5 cases, while good pre-operative visual acuity (with aphakic correction) did not change postoperatively in remaining 5 eyes. The mean preoperative visual acuity was 0.52 (0.1-1.0), and it was 0.75 (0.2-1.0) postoperatively. In 9 cases very good visual acuity (6/6-6/12) was achieved. There were no serious complications. In the first postoperative days transient hypotonia and Descemet's membrane folds were observed in 8 eyes, fibrinous reaction in the anterior chamber in one eye, and dispersed blood in the vitreous cavity in 2 eyes. CONCLUSION: The management of luxated lenses using the described method is safe. Very good functional results and lack of severe complications are very encouraging. Additional cases with a longer follow-up study are necessary to support our opinion.

Aged↗

PubMedDate not supplied

Pars plana vitrectomy and transscleral fixation of black diaphragm intraocular lens for the management of traumatic aniridia.

BACKGROUND AND OBJECTIVES: Partial or complete aniridia occurring after severe ocular trauma is a difficult therapeutic problem. Diaphragm intraocular lenses were developed for the correction of aniridia, but the safety and efficacy of implanting such lenses are not well established in traumatic cases because of very few reports, and the small number of cases studied. PATIENTS AND METHODS: Six patients, 4 men and 2 women with a mean age of 44 years, were treated for traumatic aniridia using pars plana vitrectomy and transscleral fixation of a black diaphragm intraocular lens. Total aniridia was observed in 3 eyes and partial aniridia in 3 eyes. Four eyes were aphakic and severe lens subluxation was seen in 2 eyes. Vitreous hemorrhage coexisted in 2 patients and bacterial endophthalmitis was present in 1 patient. Follow-up time ranged between 4 and 39 months (mean, 23 months). RESULTS: Best-corrected visual acuity improved in 5 patients and 1 remained unchanged. Good visual acuity (20/20 - 20/40) was achieved in all cases and all lenses were well-centered. No severe complications were noted. Three of 6 patients required glaucoma topical medications pre- and postoperatively achieving good intraocular pressure control. CONCLUSION: The management of traumatic aniridia using pars plana vitrectomy and implantation of scleral fixation black diaphragm intraocular lenses seem to be safe. Very good functional results and lack of severe complications are encouraging. Additional cases with a longer follow-up study are necessary to support our opinion.

Adult↗