Svrha je ovoga članka pružiti osnovni pregled dosadašnje obrade i percepcije redovnika glazbenika Franjevačke provincije Presvetoga Otkupitelja iz 18. stoljeća u domaćoj i stranoj (ponajviše u ...talijanskoj) literaturi, u rasponu od napisa iz 1846. do posve recentnih priloga. Prateći njihov diskurs, kroz istraživanja i poglede raznih kulturnih djelatnika i znanstvenika (napose muzikologa), u smislu rasvjetljivanja imena, biografija, djelovanja i doprinosa glazbenika članova dotične franjevačke pokrajine tijekom baroka i (pret)klasicizma – a djelomično onda i onih starije njezine provincije-majke, Bosne Srebrene – uočljivi su različiti pristupi te postupno povećavanje uvida u broj i dostignuća odnosnih protagonista. Imena don Petra (bivšega fra Pavla OFM) Nakića i fra Petra Kneževića OFM, iako su se u literaturi navodila još u drugoj polovici 19. stoljeća, kao najpoznatija među njima (uz neke druge, manje zastupnike sličnih glazbenih htijenja) trebala su ponešto pričekati da ih se prepozna i pravilno (tj. pravilnije) shvati u odnosu na glazbene prethodnike, suvremenike i nasljednike. Pritom ih recentni(ji) radovi, bilo članci i specijalizirana (čak i popularna) izdanja, bilo povijesne sinteze/pregledi i ostali napisi, nipošto ne mogu više ispuštati iz vida; dapače, u nekoliko su navrata Nakić i Knežević bili i glavnim predmetom višeautorskih/zborničkih izdanja. I buduća istraživanja, koja itekako valja poticati (te intenzivirati postojeća), zacijelo će dati odgovore na dio zasad još uvijek otvorenih pitanja, otkriti možda i neka nova imena te omogućiti izoštreniju sliku već poznatih činjenica.
The tuck-and-pull technique was developed for practical and safe explantations of posterior chamber phakic intraocular lenses (PCPIOLs). In this technique, after the creation of a side port, ...viscoelastic (or OVD ophthalmic viscosurgical device) is initially injected behind the PCPIOL to widen the space between PCPIOL and the crystalline lens. The old incisions can be used after recent implantations rendering the enlargement of the main incision unnecessary. After additional OVD over and under the PCPIOL, the haptic is tucked by a chopper and pulled through the main incision with a single maneuver. The haptic is grasped by two suture forceps and explanted with a "hand-to-hand" maneuver. The tuck-and-pull technique provided high protection of the corneal endothelium, crystalline lens, anterior chamber structures, and the PCPIOL itself. This technique is a practical, easy, and safe approach for explantations of all PCPIOL types, whatever the reason for its explantation may be.
To evaluate the safety, efficacy, and predictability of IntraLase (Abbott Medical Optics) femtosecond laser-assisted compared to microkeratome-assisted myopic LASIK.
A comprehensive literature search ...of Cochrane Library, PubMed, and EMBASE was conducted to identify relevant trials comparing LASIK with IntraLase femtosecond laser to LASIK with microkeratomes for the correction of myopia. Meta-analyses were performed on the primary outcomes (loss of ≥2 lines of corrected distance visual acuity CDVA, uncorrected distance visual acuity UDVA 20/20 or better, manifest refraction spherical equivalent MRSE within ±0.50 diopters D, final refractive SE, and astigmatism), and secondary outcomes (flap thickness predictability, changes in higher order aberrations HOAs, and complications).
Fifteen articles describing a total of 3679 eyes were identified. No significant differences were identified between the two groups in regards to a loss of ≥2 lines of CDVA (P=.44), patients achieving UDVA 20/20 or better (P=.24), final UDVA (P=.12), final mean refractive SE (P=.74), final astigmatism (P=.27), or changes in HOAs. The IntraLase group had more patients who were within ±0.50 D of target refraction (P=.05) compared to the microkeratome group, and flap thickness was more predictable in the IntraLase group (P<.0001). The microkeratome group had more epithelial defects (P=.04), whereas the IntraLase group had more cases of diffuse lamellar keratitis (P=.01).
According to the available data, LASIK with the IntraLase femtosecond laser offers no significant benefits over LASIK with microkeratomes in regards to safety and efficacy, but has potential advantages in predictability.
We report a case of acute corneal hydrops followed by corneal perforation five years after corneal cross-linking for keratoconus. A healthy 24-year-old female patient underwent Dresden protocol ...cross-linking in her left eye due to advanced keratoconus. After five years of a stable cornea, she returned with epiphora, blurred vision, and a soft left eye. Acute hydrops and corneal perforation were diagnosed. There was no history of pregnancy, atopy, eye rubbing, trauma, or contact lens use. Local antibiotic and eye patching were applied. Three months after the resolution of the acute episode, she retained useful visual acuity with no need for further surgery. Although cross-linking efficiently halts keratoconus, progression can occur, leading to corneal hydrops and perforation, even in the absence of any risk factors.
Background/Aim. Blue light might be harmful to the retina. The nano-material based on fullerene C60 and polymethyl methacrylate (PMMA) transforms the light into harmonized light and absorbs violet, ...blue, and ultraviolet (UV) wavelength. The aim of the study was to evaluate the subjective and objective impact of the spectacles on daily activities. Methods. Twenty-five healthy participants were sub-mitted to contrast sensitivity (CS) and visual field (VF) testing and a questionnaire about the influence of spectacles on daily activities: two spectacles with different concentrations of fullerene C60 vs. two commercially available blue-blocking spectacles. Results. There was no statistical difference in CS (p = 0.83), in VF parameters: mean deviation (MD) (p = 0.36), pattern standard deviation (PSD) (p = 0.25), number of relative scotomas (p = 0.31), while the number of absolute scotomas showed a statistically significant decrease (p < 0.05). Spectacles B (with a lower concentration of fullerene ? 0.025%) had the best overall comfort mean score (p < 0.00001): four-fifths of participants performed better only during the day, while two-thirds performed better both during the day and night. Spectacles B were also superior in overall satisfaction regarding all combined daily activities (4.04 ? 1.1) (p = 0.0008). Conclusion. Blue-blocking filters with fullerene C60 increase the overall comfort of daily tasks during and after their use. These filters might be an effective mechanism that can protect us from ocular pathologies while providing better comfort in daily activities.
To compare 2 sequences of combined intrastromal corneal ring segment (ICRS) implantation and ultraviolet/riboflavin-mediated corneal collagen crosslinking (CXL) in progressive keratoconus.
Dunya Eye ...Hospital, Istanbul, Turkey.
In this prospective comparative randomized consecutive study, CXL was followed by ICRS implantation (Group 1) or ICRS implantation was followed by CXL (Group 2). Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, spherical equivalent (SE), manifest cylinder (cylinder), and mean keratometry (K) were compared preoperatively and postoperatively.
The mean interval between treatments was 7 months +/- 2 (SD) (mean follow-up, 13 +/- 1 months). The mean UDVA and CDVA improved in both groups (UDVA: 0.07 +/- 0.09 to 0.25 +/- 0.12, Group 1, and 0.11 +/- 0.09 to 0.32 +/- 0.21, Group 2; CDVA: 0.24 +/- 0.11 to 0.41 +/- 0.20 and 0.22 +/- 0.16 to 0.55 +/- 0.2, respectively). The mean SE, cylinder, and mean K values decreased in both groups (SE: -7.13 +/- 3.34 D to -2.98 +/- 2.33 D, Group 1, and -7.05 +/- 5.54 D to -2.81 +/- 4.08 D, Group 2; cylinder: -4.38 +/- 2.03 D to -2.62 +/- 1.93 D and -4.68 +/- 2.60 D to -2.20 +/- 1.67 D, respectively; mean K: 52.47 +/- 4.01 D to 48.31 +/- 3.65 D and 52.06 +/- 4.93 D to 48.08 +/- 4.13 D, respectively). Overall, there was more improvement in CDVA, SE, and mean K in Group 2 than in Group 1.
Implantation of ICRS followed by CXL resulted in greater improvement of keratoconus.
To present the results of topography-guided transepithelial photorefractive keratectomy (PRK) after intracorneal ring segments implantation followed by corneal collagen cross-linking (CXL) for ...keratoconus.
In this prospective case series, 10 patients (16 eyes) with progressive keratoconus were included. All patients underwent topography-guided transepithelial PRK after Keraring intracorneal ring segments (Mediphacos Ltda) implantation, followed by CXL treatment. The follow-up period was 6 months after the last procedure for all patients. Time interval between both intracorneal ring segments implantation and CXL and between CXL and topography-guided transepithelial PRK was 6 months.
LogMAR mean uncorrected distance visual acuity and mean corrected distance visual acuity were significantly improved (P<.05) from 1.14±0.36 and 0.75±0.24 preoperatively to 0.25±0.13 and 0.13±0.06 after the completion of the three-step procedure, respectively. Mean spherical equivalent refraction was significantly reduced (P<.05) from -5.66±5.63 diopters (D) preoperatively to -0.98±2.21 D after the three-step procedure. Mean steep and flat keratometry values were significantly reduced (P<.05) from 54.65±5.80 D and 47.80±3.97 D preoperatively to 45.99±3.12 D and 44.69±3.19 D after the three-step procedure, respectively.
Combined topography-guided transepithelial PRK with intracorneal ring segments implantation and CXL in a three-step procedure seems to be an effective, promising treatment sequence offering patients a functional visual acuity and ceasing progression of the ectatic disorder. A longer follow-up and larger case series are necessary to thoroughly evaluate safety, stability, and efficacy of this innovative procedure.
To study central corneal pachymetric variations during corneal collagen cross-linking (CXL) treatment with the use of riboflavin and ultraviolet A irradiation (UVA).
Prospective, noncomparative, ...interventional clinical study.
Fifteen keratoconic patients (19 eyes) were enrolled.
All patients underwent riboflavin-UVA-induced corneal CXL. Intraoperative central corneal thickness (CCT) measurements using ultrasound pachymetry were performed during the procedure. Measurements were obtained after epithelial removal, after riboflavin drop instillation, and every 5 minutes (6 interval times) during UVA irradiation (30 minutes).
Central corneal thickness measurements.
Mean patient age was 26.9+/-6.5 years (range, 17-40 years). Ten were male and 5 were female. Mean preoperative CCT was 458.5+/-21.5 microm (range, 427-494 microm; 95% confidence interval CI, 448-467 microm) and 415.7+/-20.6 microm (range, 400-468 microm; 95% CI, 406-426 microm) before and after epithelial removal, respectively. There was a statistically significant decrease (mean, 75 microm) of CCT between the epithelial removal interval (415.7+/-20.6 microm; range, 400-468 microm) and at the end of riboflavin solution instillation (340.7+/-22.9 microm; range, 292-386 microm; P<0.001). There was no statistically significant change in CCT during irradiation (P>0.05). There was no statistically significant difference between preoperative and 1-month postoperative endothelial cell count (preoperative, 2780+/-197 to 1-month postoperative, 2713+/-116; P = 0.14). No intraoperative, early postoperative, or late postoperative complications were observed in this patient series.
During corneal CXL with the use of riboflavin and UVA irradiation, a statistically significant decrease of CCT was demonstrated.
To evaluate staged combined treatment for keratoconus with intrastromal corneal ring segment (ICRS) implantation followed by corneal collagen crosslinking (CXL) with riboflavin-ultraviolet-A (UVA) ...and then toric implantable collagen copolymer phakic intraocular lens (pIOL) implantation.
Large private ophthalmic hospital system.
Case series.
Eyes with progressive keratoconus had ICRS implantation, then CXL, and then pIOL implantation (minimum 6 months between procedures).
The study enrolled 14 eyes (9 patients). After the combined treatments, the mean decimal uncorrected distance visual acuity (UDVA) and mean decimal corrected distance visual acuity (CDVA) were significantly improved from 0.01 and 0.14, respectively, preoperatively to 0.44 and 0.57, respectively (P<.0001). The mean manifest refraction spherical equivalent decreased from -16.40 diopters (D) ± 3.56 (SD) (range -11.50 to -22.50 D) to -0.80 ± 1.02 D (range -2.00 to +2.00 D) after the combined treatments (P<.0001). The mean refractive astigmatism decreased from -4.73 ± 1.32 D (range -3.00 to -7.00 D) to -0.96 ± 0.35 D (range -0.50 to -1.50 D) (P<.0001). The mean steep and mean flat keratometry values reduced from 60.57 D and 56.16 D, respectively, to 54.48 D and 53.57 D (P<.0001), respectively. No intraoperative or postoperative complications occurred.
A combined 3-stage-approach keratoconus treatment comprising ICRS implantation followed by CXL and then toric pIOL implantation was effective in improving functional vision and reducing disease progression. Longer term studies are required for further evaluation and comparison with other methods.
Purpose To report the results of intrastromal corneal ring segment ICRS (KeraRing; Mediphacos, Belo Horizonte, Brazil) implantation using a femtosecond laser (IntraLase Corp, Irvine, California, USA) ...in keratoconic patients. Design Retrospective, noncomparative, interventional study. Methods Thirty-two keratoconic patients (50 eyes) who underwent ICRS insertion using a femtosecond laser for channel creation and completed at least one year of follow-up were included in this study. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refraction, topographic findings, and adverse events were assessed. Results No intraoperative complications were demonstrated in this series of patients. At the first postoperative day, segment migration to the incision site was seen in three eyes (6%; early postoperative complication). To avoid melting, we repositioned the migrated segment away from the incision site. Serious second migration was not seen and we did not need to reposition any segment again. At the last postoperative examination, there was a statistically significant reduction in the spherical equivalent refractive error compared with that observed at the examination before implantation (mean ± standard deviation, −5.62 ± 4.15 diopters D; range, −23.62 to 0.50 D to −2.49 ± 2.68 D range, −11.12 to 3.5 D; P < .001). The UCVA before implantation was 20/40 or worse in 47 eyes (94%; range, counting fingers to 20/30), whereas at the last follow-up examination, 14 (28%) of 50 eyes had a UCVA of 20/40 or better (range, counting fingers to 20/25). Nine eyes (18%) maintained the preimplantation BSCVA, whereas 39 eyes (68%) experienced a BSCVA gain of one to four lines at the last follow-up examination. Only in two eyes (4%; two patients) with advanced keratoconus (stage III) was there a decrease of up to two lines. Despite this deterioration in BSCVA, the patients did not want to remove the ICRSs, because there was an increase of UCVA. No late postoperative complications were observed during the follow-up period. Conclusions ICRS (KeraRing) implantation using femtosecond laser for tunnel creation is a minimally invasive procedure for improving visual acuity (both UCVA and BSCVA) in keratoconic patients.
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