Ewa Langwińska-Wośko

Publications of Ewa Langwińska-Wośko

• A clinical case study of a Wolfram syndrome-affected family: pattern-reversal visual evoked potentials and electroretinography analysis.

  Authors: Ewa Langwińska-Wośko, Karina Broniek-Kowalik, Kamil Szulborski

  Documenta ophthalmologica. Advances in ophthalmology. 02/2012; 124(2):133-41.

  Wolfram syndrome (WFS), or DIDMOAD, is a rare (1/100 000 to 1/770 000), progressive neurodegenerative disorder. In its early stages, it is characterized by insulin-dependent diabetes mellitus, opticWolfram syndrome (WFS), or DIDMOAD, is a rare (1/100 000 to 1/770 000), progressive neurodegenerative disorder. In its early stages, it is characterized by insulin-dependent diabetes mellitus, optic atrophy and loss of sensorineural hearing-this is followed by diabetes insipidus, progressive neurological abnormalities and other endocrine abnormalities, which occur in later years. The aim of this study was to report on the clinical and electrophysiological findings from a family with the WFS1 mutation. The five family members were subjected to a complete ophthalmic examination, which included a flash full-field electroretinogram and pattern-reversal visual evoked potentials (PVEPs) performed according to ISCEV standards. Optic atrophy was confirmed in two homozygotic patients, where P100 latencies were significantly delayed-up to 146 ms in PVEP. P100 latencies were normal in the three heterozygotic patients we examined. Curve morphology abnormalities were observed in all five patients we examined. No literature describing the morphology of PVEP in Wolfram syndrome patients was found. In flash electroretinography, scotopic and photopic responses appeared in normal morphology and value. Diabetic retinopathy was not observed in the diabetes mellitus patients.

• The impact of capsulorhexis diameter, localization and shape on posterior capsule opacification.

  Authors: Ewa Langwińska-Wośko, Karina Broniek-Kowalik, Kamil Szulborski

  Medical science monitor : international medical journal of experimental and clinical research. 10/2011; 17(10):CR577-82.

  The aim of this study was to evaluate the impact of capsulorhexis diameter, localization and shape on posterior capsule opacification (PCO) development after cataract extraction withThe aim of this study was to evaluate the impact of capsulorhexis diameter, localization and shape on posterior capsule opacification (PCO) development after cataract extraction with phacoemulsification. We retrospectively analyzed of 297 patients who underwent phacoemulsification and AcrySof SA60AT implantation. In a first group of 97 patients, 53 received small capsulorhexis (3.9 to 4.9 mm in diameter) and 44 patients received large capsulorhexis (5.0 to 5.9 mm in diameter). Another group of 99 patients was split into subgroups--66 patients whose capsulorhexis were centrally located and 33 patients whose capsulorhexis were paracentral. A third group of 101 patients was split into subgroups--a subgroup of 59 patients were classified as having a regularly rimmed capsulorhexis and a subgroup of 42 patients as having an irregularly rimmed capsulorhexis. At 6 months follow-up, PCO was classified as none, mild, moderate, or severe, depending on the number of quadrants involved. 86.79% of the patients with a small capsulorhexis had no or mild PCO (p<0.001), whereas, 68.18% of the patients with a large capsulorhexis experienced moderate or severe PCO; 89.4% of the patients with a central capsulorhexis had no or mild PCO (p<0.001), whereas, 75.75% of the patients with a paracentral capsulorhexis had moderate or severe PCO; 86.44% of the patients with a regularly rimmed anterior capsulorhexis had no or mild PCO (p<0.001); and 69.04% of the patients with an irregular capsulorhexis rim had moderate or severe PCO. A small capsulorhexis diameter, its central localization and regular shape result in less PCO following phacoemulsification.

• A retrospective analysis of the intraocular lens power calculation in cases of sulcus fixation.

  Authors: Ewa Langwińska-Wośko, Piotr Skopiński, Wojciech Kołodziejczyk, Kamil Szulborski, Anna Wójcik-Gryciuk

  Klinika oczna. 01/2011; 113(1-3):13-5.

  To evaluate the refractive results in patients with intraocular lenses fixated in the sulcus of posterior chamber. Sulcus fixation causes a more anterior position of IOL than had been intended duringTo evaluate the refractive results in patients with intraocular lenses fixated in the sulcus of posterior chamber. Sulcus fixation causes a more anterior position of IOL than had been intended during the preoperative power calculation. A lack of correction of the IOL's power results in a myopic shift. 27 patients (27 eyes) who underwent cataract surgery by phacoemulsification and foldable IOL MA60BM sulcus fixation due to a posterior capsule rupture at the Department of Ophthalmology, Medical University of Warsaw. The position of the IOL was confirmed by ultrabiomicroscopy. The study included patients with axial lengths ranging from 22 to 25 mm. Patients who suffered from a corneal astigmatism of > 1,00 Dcyl prior to the surgery were excluded from the study. The study also excluded patients with vitreous loss as this causes the anterior chamber to become deeper after vitrectomy, and consequently the IOL might sit in a more posterior position. The difference between the predicted and the postoperative refraction was evaluated. The mean visual acuity was significantly better after cataract surgery. The best corrected visual acuity (BCVA) was 1.0, which occurred in 19 cases (70%). The myopic shift, which was assessed as a mean difference between the predicted and the postoperative refraction after sulcus fixation, was 1.25 D. In order to avoid a myopic shift in the case of sulcus fixation, the IOL power calculation should be adjusted accordingly. The authors recommend that the IOL power should be reduced by approximately 1.25 to 1.50 D in emetropic eyes.

• The complications during phacoemulsification in patients with posterior polar cataract.

  Authors: Ewa Langwińska-Wośko, Kamil Szulborski, Karina Broniek-Kowalik

  Klinika oczna. 01/2011; 113(1-3):16-8.

  The aim of the study was to evaluate the intraoperative complications during phacoemulsification of a posterior polar cataract, especially the risk of posterior capsule rupture. The retrospectiveThe aim of the study was to evaluate the intraoperative complications during phacoemulsification of a posterior polar cataract, especially the risk of posterior capsule rupture. The retrospective evaluation of complications during phacoemulsification of a posterior polar cataract in patients in the Department of Ophthalmology, Medical University of Warsaw from January 2001 to June 2007. The surgical procedures, as well as the implanted IOL type and intraoperative and postoperative complications were evaluated in every case in 2 years' observations. Best-corrected visual acuity before and 3 months after surgery was evaluated using the standard Snellen chart. The study group consisted of 16 individuals, 6 women and 10 men in age 21-55 (mean 32.7). 22 eyes were operated on, all using the phacoemulsification method through corneal incision (10 individuals--1 eye, 6 individuals--both eyes). In all cases, phacoemulsification was performed using a hydrodissection free technique by corneal incision. A posterior capsule rupture was observed in 4 eyes (18%), localized in the central region and caused by changes in the capsula. The mean visual acuity was significantly better after cataract surgery. The best corrected visual acuity (BCVA) was 6/6 in 8 eyes (36%). A BCVA of less than 1.0 was caused by either amblyopia or nystagmus. Phacoemulsification in patients with posterior polar cataract is associated with a high risk of posterior capsule rupture and potential vitreous loss, which is why this procedure should be performed carefully by senior surgeons using an appropriate, hydrodissection free technique.

• Late onset cone dystrophy.

  Authors: Ewa Langwińska-Wośko, Kamil Szulborski, Karina Broniek-Kowalik

  Documenta ophthalmologica. Advances in ophthalmology. 06/2010; 120(3):215-8.

  Cone dystrophies are a hereditary, progressive and heterogeneous group of retinal diseases with cone system degeneration. They lead to reduced visual acuity, colour vision impairment and photophobia.Cone dystrophies are a hereditary, progressive and heterogeneous group of retinal diseases with cone system degeneration. They lead to reduced visual acuity, colour vision impairment and photophobia. Full-field electroretinogram (ERG) reveals severe cone function impairment, with normal rod responses or slightly depressed in advanced stages in some cases. The purpose of the study was to present a case of late onset cone dystrophy in 47-year-old male and the proper diagnostic procedure. A 47-year-old patient presented with progressive visual loss for several years and mild photophobia, which he observed recently. The patient underwent fundus photography, fluorescein angiography, colour vision testing, Goldmann visual field testing, full-field electroretinogram (ERG) and multifocal electroretinogram (mfERG). Symptoms and signs of late onset cone dystrophy may be unclear and establishing the proper diagnosis may be difficult in these cases. Patients may be misdiagnosed as having other diseases, especially in case of absence or subtle changes in the macula. The electrophysiological testing is essential in these cases, and ERG is the most useful clinical test in early and differential diagnosis of retinal dystrophies.

• [Analysis of patients, reasons attendance to emergency service carried out by the Department of Ophthalmology Medical University of Warsaw]

  Authors: Ewa Langwińska-Wośko, Izabella Wójcicka, Sebastian Gajda

  Klinika oczna. 02/2009; 111(4-6):122-4.

  The aim of this study was to assess the percentage of purposeful attendance to ophthalmology emergency service and to analyse the main reasons of attendance. The authors analysed a group of over 40The aim of this study was to assess the percentage of purposeful attendance to ophthalmology emergency service and to analyse the main reasons of attendance. The authors analysed a group of over 40 thousand patients, and came to the conclusion that at least, one third of them should not have sought help in emergency service since their status did not justify that.

• [Comparison of postoperative refractive outcome in phacotrabeculectomy and phacoemulsification]

  Authors: Ewa Langwińska-Wośko, Piotr Skopiński, Marzena Gabrysiak-Wasowska, Karina Broniek-Kowalik

  Klinika oczna. 02/2008; 110(1-3):18-21.

  PURPOSE: The aim of this study is to compare the postoperative refractive oucomes following phacotrabeculectomy and phacoemulsification with posterior chamber intraocular lens implantation. MATERIALSPURPOSE: The aim of this study is to compare the postoperative refractive oucomes following phacotrabeculectomy and phacoemulsification with posterior chamber intraocular lens implantation. MATERIALS AND METHODS: The study involved the patients who underwent surgical pocedures: phacotrabeculectomy and phacoemulsification with posterior chamber intraocular lens implantation in Department of Ophthalmology Medical University of Warsaw since June 2005 to June 2006. A retrospective randomised review of postoperative refractive outcomes of 126 eyes (110 patients): 52 eyes (49 patients) that underwent phacotrabeculectomy and 74 eyes (61 patients) that underwent phacoemulsification in the same time was done. Sex and mean age was simillar in both groups of patients. We analysed the difference between preoperative predicted refractive outcome and the actual postoperative refraction. All surgery procedures were performed by two qualified optical surgeons and biometry measurements were performed by two qualified doctors. RESULTS AND CONCLUSIONS: No significant difference was found between predicted errors following phacotrabeculectomy and phacoemulsification.

• [Deep non-penetrating sclerectomy with implant versus trabeculectomy m. Cairns four years of experience]

  Authors: Jerzy Szaflik, Ewa Langwińska-Wośko, Zbigniew Kiciak, Mariusz Rowiński

  Klinika oczna. 02/2004; 106(4-5):585-7.

  The aim of this study is to present four years of experience with new surgery technique--deep sklerectomy with implant.

• [Evaluation of corneal endothelium following cataract surgery in diabetic patients]

  Authors: Ewa Langwińska-Wośko, Anna Chociszewska-Nitka, Edyta Zielińska, Adam Hapunik

  Klinika oczna. 02/2004; 106(1-2):28-30.

  PURPOSE: The aim of this study was to evaluate the influence of cataract surgery on the condition of corneal endothelium, in diabetic patients. MATERIAL AND METHODS: We examined 103 patients (103PURPOSE: The aim of this study was to evaluate the influence of cataract surgery on the condition of corneal endothelium, in diabetic patients. MATERIAL AND METHODS: We examined 103 patients (103 eyes) after cataract surgery (64 women and 39 men), at the age between 49 and 89. In our study we didn't involve any patients with intra or post-surgery complications. Using Specular Microscope SP-1000 corneal endothelium was examined before cataract surgery and in the long-term follow-up: 7, 30 and 90 days after surgery. The patients were divided into two groups: suffering from diabetes (54) and matched control group--non-diabetic patients with cataract (49). The same patients were also divided depending on the type of surgical technique: phacoemulsification (42) or extracapsular cataract extraction (61). RESULTS: The mean percent loss of corneal endothelium cells, due to surgery in diabetic patients was: 11.31% after 7 days, 13.99% after 30 and 15.38% after 90 days. In the control group: 5.45% after 7 days, 8.66% after 30 and 11.33% after 90 days. The mean percent loss of corneal endothelium cells after phacoemulsification was: 10.10% after 7 days, 13.21% after 30 and 15.87% after 90 days; after extra-capsular cataract extraction: 6.84% after 7 days, 9.71% after 30 and 11.48% after 90 days. Differences between mean value of corneal endothelial cells in diabetic patients compared with control group, were statistically essential 7 and 30 days after cataract surgery, and near such assessment 90 days after surgery. There were no statistically essential differences between endothelial cells density in both operated groups, in relation to type of operation (phacoemulsification and extra-capsular cataract extraction). CONCLUSIONS: Above results are the evidence, that cataract surgery is a big trauma for cornea, especially for its endothelium. The operation is mainly dangerous for patients suffering from diabetes. The surgeon should be aware of the above threat during cataract surgery in diabetic patients, and therefore should express high level of caution, irrespective of the technique of operation.

• [Transcleral fixation as lens surgery method]

  Authors: Jerzy Szaflik, Ewa Langwińska-Wośko, Mariusz Rowiński, Anna Maria Ambroziak

  Klinika oczna. 02/2003; 105(1-2):31-5.

  PURPOSE: The aim of study is the presentation and retrospective analysis of our experience in implantations of posterior chamber lenses with transcleral fixation. MATERIAL AND METHODS: 172 eyes werePURPOSE: The aim of study is the presentation and retrospective analysis of our experience in implantations of posterior chamber lenses with transcleral fixation. MATERIAL AND METHODS: 172 eyes were analysed after implantations of posterior chamber lenses with transcleral fixation. We analysed operative technique, complications and results. RESULTS: 127 eyes obtained usable visual acuity. CONCLUSIONS: On the basis of our own observations we can say, that implantations of posterior chamber lenses with transcleral fixation is an effective and safe method in lens surgery.