Background/Aim. Phacoemulsification is a modern surgical technique for
cataract operations. Through minimal corneal wound (2.2-2.7 mm) lens nucleus
is emulsificated and arteficial lens is implanted ...in capsular bag.
Complications during operations are possible, and can vary from minor to very
serious one, with consecutive visual loss. One of possible complications is
rupture of posterior lens capsule, which could happen in any stage of
operation. The aim of this study was to evaluate results of monoblock
arteficial lens implantation in sulcus on the remains of anterior capsule and
capsulorhexis after posterior capsule rupture during phacoemulsification.
Methods. This prospective, non-comparative study included 19 patients with
rupture of posterior capsule as a result of cataract operation with
phacoemulsification method. Average monitoring time was 14 months (1-18). We
analysed best corrected visual acuity, intraocular pressure, fundus findings,
and implanted lens position with wawelight allegro oculizer (Scheimpflug
camera). Results. Preoperative visual acuity was from L+P+ to 0.5. On first
postoperative day visual acuity 0.02-0.08 was noted in 8 patients, from
0.1-0.4 also in 8 patients and 0.5 and more in 3 patients. After 12 months
from the operation 15 patients had visual acuity better than 0.5. Among early
complications corneal edema was noted in 6 cases, anterior chamber reaction
with or without fibrin reaction in 8 cases and rise of intraocular pressure
in 3 cases. All complications were reversibile. Conclusion. Posterior capsule
rupture/break is a serious complication of phacoemulsification, hardly to
prevent. Regarding size of posterior rupture, foldable monoblock arteficial
lens can be implanted into the sulcus on the remains of anterior capsule in
most of the cases, keeping the advantages of small corneal incision: smaller
astigmatism, better postoperative visual acuity, faster wound healing and
earlier visual rehabilitation.
Uvod/Cilj. Fakoemulzifikacija je savremena, suverena metoda operacije
katarakte. Kroz minimalni rez (2,2-2,75 mm) na roznjaci vrsi se
emulzifikacija nukleusa sociva pomocu ultrazvucnih talasa, a zatim i
implantacija vestackog sociva u socivnu vrecicu. Komplikacije tokom izvodjenja
fakoemulzifikacije su moguce kao i kod svake hirurgije i mogu varirati od
bezazlenih pa do najtezih, sa posledicnim gubitkom vida. Jedna od mogucih
komplikacija je i ruptura zadnje kapsule sociva, koja moze nastati u bilo kom
stadijumu operacije. Cilj ove studije bio je da se ocene rezultati
implantacije monoblok sociva u sulkus sa osloncem na prednju kapsulu sa
ocuvanom kapsuloreksom posle rupture zadnje kapsule tokom fakoemulzifikacije.
Metode. Sprovedena je prospektivna, nekomparativna studija u kojoj je praceno
19 bolesnika kod kojih se, tokom operacije katarakte metodom
fakoemulzifikacije, javila ruptura zadnje kapsule kao intraoperativna
komplikacija. Prosecno vreme pracenja bilo je 14 (1-18) meseci. Posmatrana je
najbolja korigovana vidna ostrina, intraokularni pritisak, nalaz na fundusu,
kao i polozaj implantiranog sociva wavelight allegro okulajzerom (Scheimpflug
kamera). Rezultati. Preoperativna vidna ostrina kretala se od osecaja svetla
sa tacnom projekcijom (L+P+) do 0,5. Prvog postoperativnog dana zabelezena je
vidna ostrina od 0,02 do 0,08 kod osam bolesnika, od 0,1 do 0,4, kod, takodje,
osam bolesnika, od 0,5 i vise kod tri bolesnik. Posle 12 meseci od operacije
kod 15 bolesnika vidna ostrina bila je > 0,5. Od ranih postoperativnih
komplikacija, edem roznjace javio se kod sest bolesnika, pojacana reakcija u
prednjoj komori sa ili bez fibrinske reakcije kod osam bolesnika i povecanje
intraokularnog pritiska kod tri bolesnika. Sve promene bile su reverzibilnog
karaktera. Zakljucak. Ruptura zadnje kapsule jedna je od cescih i ozbiljnijih
komplikacija fakoemulzifikacije koju je tesko prevenirati. U zavisnosti od
velicine rupture, moguce je izvrsiti implantaciju monoblok savitljivih sociva
u sulkus sa osloncem na prednju kapsulu sa ocuvanom kapsuloreksom kod
najveceg broja bolesnika, cime se zadrzavaju prednosti malog reza: manji
astigmatizam, bolja postoperativna vidna ostrina, ubrzano zarastanje rane, te
ranija vidna i radna rehabilitacija.
To evaluate the participation of proinflammatory cytokines in the acute phase of corneal wound-healing response after excimer laser treatment.
The study included 68 myopic eyes up to -3.0 diopters ...divided into two groups: 1) eyes treated with laser in situ keratomileusis (LASIK) (n=31) and 2) eyes treated with photorefractive keratectomy (PRK) (n=37). Each group was then divided into three subgroups based on tear sampling times: before (0 hours), 1 hour after, and 24 hours after treatment. The tear fluid was sampled from lower lateral tear meniscus using a cellulose microsurgical sponge. The levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6, and IL-8 in tear fluid were determined by flow cytometry method.
Statistical significance was observed in the concentrations of TNF-α (P=0.0421) and IL-1β (P=0.0225) between samples collected 1 and 24 hours after PRK treatment in favor of samples collected 1 hour after treatment. IL-6 concentration changes showed a significant increase in the PRK group in both time intervals following treatment compared to pretreatment (0 hour/1 hour, P=0.0031; 0 hour/24 hours, P=0.0059). For IL-8 concentrations, significant differences were observed between control and experimental groups in samples collected 1 hour after LASIK and 1 hour after PRK treatment (P<0.001 for both groups), and IL-8 concentrations between control and experimental groups in samples collected 24 hours after LASIK and 24 hours after PRK treatment were greater after PRK treatment (P=0.0005). Comparison of average concentration values of proinflammatory cytokines in all the tested samples between LASIK and PRK groups showed significantly higher levels of IL-1β in the LASIK group 24 hours after treatment (P=0.0134), and of IL-6 in the PRK group 24 hours after treatment (P=0.0031).
The acute phase of corneal wound healing after excimer laser treatment is defined by an intensive inflammatory response. After PRK treatment, there were increased concentrations of TNF-α and IL-1β in tear samples 1 hour after treatment, IL-6, 1 and 24 hours after treatment, and IL-8, 1 and 24 hours after treatment. After LASIK treatment, there were increased concentrations of IL-8 in tear samples 1 hour after treatment and IL-1β, 24 hours after treatment. Both PRK and LASIK methods are characterized with a significant inflammatory response. However, tear findings following PRK method showed more intensive inflammatory response than the findings after LASIK method.
Abstract Cataract represents the reduction of the transparency of the crystalline lens. Cataract surgery is the most commonly performed surgical procedure worldwide. One of the most common ...postoperative complication of successfully performed cataract surgery is a development of posterior capsule opacification (PCO). In the postoperative period, lens epithelial cells (LECs) undergo proliferation, migration and differentiation, which is clinically manifested by the development of PCO. Inflammation has a central role in these processes. Cytokines, such as transforming growth factor β, fibroblast growth factor, interleukin 1, interleukin 6, matrix metalloproteinases have a huge effect on the activity of LECs. Understanding these processes can find a great usage in clinical practice. By prescribing anti-inflammatory therapy in the early postoperative period, the incidence of PCO can be significantly reduced.
Phacoemulsification is a modern surgical technique for cataract operations. Through minimal corneal wound (2.2-2.7 mm) lens nucleus is emulsificated and arteficial lens is implanted in capsular bag. ...Complications during operations are possible, and can vary from minor to very serious one, with consecutive visual loss. One of possible complications is rupture of posterior lens capsule, which could happen in any stage of operation. The aim of this study was to evaluate results of monoblock arteficial lens implantation in sulcus on the remains of anterior capsule and capsulorhexis after posterior capsule rupture during phacoemulsification.
This prospective, non-comparative study included 19 patients with rupture of posterior capsule as a result of cataract operation with phacoemulsification method. Average monitoring time was 14 months (1-18). We analysed best corrected visual acuity, intraocular pressure, fundus findings, and implanted lens position with wawelight allegro oculizer (Scheimpflug camera).
Preoperative visual acuity was from L+P+ to 0.5. On first postoperative day visual acuity 0.02-0.08 was noted in 8 patients, from 0.1-0.4 also in 8 patients and 0.5 and more in 3 patients. After 12 months from the operation 15 patients had visual acuity better than 0.5. Among early complications corneal edema was noted in 6 cases, anterior chamber reaction with or without fibrin reaction in 8 cases and rise of intraocular pressure in 3 cases. All complications were reversibile.
Posterior capsule rupture/break is a serious complication of phacoemulsification, hardly to prevent. Regarding size of posterior rupture, foldable monoblock arteficial lens can be implanted into the sulcus on the remains of anterior capsule in most of the cases, keeping the advantages of small corneal incision: smaller astigmatism, better postoperative visual acuity, faster wound healing and earlier visual rehabilitation.
Metabolic syndrome denotes a common cluster of naturally connected risk factors including obesity, elevated blood pressure, insulin resistance, dyslipidemia, proinflammatory state and prothrombotic ...state. Anterior ischemic optic neuropathy is an acute ischaemic disorder of the optic nerve head and may lead to severe visual loss.
We considered three patients with moderate degree of diabetic retinopathy and anterior ischemic optic neuropathy. They were submitted to endocrinological examination and the diagnosis of metabolic syndrome was established.
Cardiological examination revealed that blood pressure control was not optimal. The signs of left ventricular hypertrophy and diastolic dysfunction were confirmed by echocardiography. They are possible markers of preclinical cardiovascular disease.
We observed that a variety of well-known risk factors in metabolic syndrome may be involved in serious eye and cardiological complications. The early diagnosis and treatment of these patients can not only improve visual function but also prevent cardiovascular complications.
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