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Publications (6)0 Total impact

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    ABSTRACT: To compare the course of surgery and operative outcomes in patients with different stages of nuclear hardness. The study comprises 36 patients with hard nucleus cataract (III and IV degree in LOCS scale)--group II and 45 patients with softer types of cataract (I and II degree in LOCS scale)--group I. All patients underwent clear corneal phacoemulsification and foldable intraocular lens implantation. In both groups intraoperative course was assessed and energy with effective phaco time were measured. Visual acuity, intraocular pressure, central corneal thickness and endothelial cell density were estimated preoperatively and one week postoperatively. Energy and effective phaco time were significantly higher in group II. Mean visual acuity in both groups was 0.8 +/- 0.2. Intraocular pressure, central corneal thickness and endothelium cell loss were not significantly different in both groups. Endothelium cell loss were not significantly correlated with increase of energy or duration of phacoemulsification in any of groups. Cataracts with higher stage of nuclear hardness required more energy and effective phaco time to be employed, but it did not influenced significantly postoperative visual acuity, intraocular pressure, central corneal thickness change and loss of endothelial cells.
    Klinika oczna 01/2008; 110(4-6):172-5.
  • Agata Wesołek-Czernik, Wojciech Omulecki, Ewa Chrul, Aleksandra Synder
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    ABSTRACT: Estimation of long-term results and complications of complex surgical technique, used for the management of luxated crystalline lenses. This prospective study involved 29 consecutive patients (31 eyes) with the mean age of 62 years. The applied surgical technique comprised pars plana vitrectomy, perfluorocarbon liquid injection and crystalline lens phacofragmentation in the vitreous cavity. Simultaneously, anterior chamber intraocular lenses (IOLs) were implanted in 13 eyes, and scleral-fixated, posterior chamber IOLs in 17 eyes. In one patient with high myopia the lens was not implanted. The follow-up ranged between 9 and 38 months (mean 22.8 months). No complications were observed during phacofragmentation. Improvement in visual acuity was achieved in 18 cases one week after operation and in 23 patients at last examination. We achieved visual acuity of 4/50--hand movements in 4 cases, 5/16-5/50 in 3 eyes, 5/8-5/12 in 7 and 5/5-5/7 in 17 cases, in last examination. There were no intra-operative complications. Low visual acuity in some cases was due to the presence of postoperative complications or coexisting eye diseases, such as secondary glaucoma, atonic pupil, age related macular degeneration, retinal detachment and macular hole. Phacofragmentation with perfluorocarbon liquid and IOL implantation for the management of luxated crystalline lenses is safe and effective method, providing very good long-term functional results.
    Klinika oczna 02/2007; 109(4-6):191-3.
  • Agata Wesołek-Czernik, Joanna Bartela, Ewa Zamojska, Wojciech Omulecki
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    ABSTRACT: To evaluate the influence of diabetes mellitus and type of hipoglicemic therapy on corneal endothelium cell morphology. In 68 diabetic patients' eyes with non proliferative diabetic retinopathy (29 males and 39 females), corneal endothelium was studied. Patients age was between 50 and 82 years (mean 63.28). As age-matched control group we analyzed 58 eyes of non diabetic patients. Corneal endothelium density, percentage of corneal endothelium hexagonal cells, average size of corneal endothelium cells and corneal thickness were imaged by non-contact specular microscope TOPCON SP-2000P. The mean corneal endothelium cell density was: 2467 cells/mm2 in diabetic patients, and 2573 cells/mm2 in control group. The mean percentage of corneal endothelium hexagonal cells was: 55.3% in diabetic patients treated with insulin and 52.9% in diabetic patients treated with oral antidiabetic drugs, and 54.4% in the control group. The mean size of corneal endothelium cells was: 414.6 microm2 in diabetic patients, and 395.9 microm2 in the control group. The mean corneal thickness was: 0.556 mm in diabetic patients and 0.545 mm in the control group. Corneal endothelium was thicker in diabetic patients than in non diabetic patients. The duration of diabetes mellitus had no influence on corneal endothelium cell morphology. Diabetic patients treated with oral antidiabetic drugs had larger percentage of hexagonal cells than those treated with insulin.
    Klinika oczna 02/2007; 109(10-12):410-2.
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    ABSTRACT: To evaluate the astigmatic effect after phacoemulsification depending on size and location of incision. 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. 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. Surgically induced astigmatism can be minimized with incision in clear cornea and no suture.
    Klinika oczna 02/2004; 106(6):756-9.
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    ABSTRACT: 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. 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. 31 patients completed the study. The IOP checked next day was significantly correlated with the IOP preoperatively. 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.
    Klinika oczna 01/2004; 106(1-2 Suppl):194-5.
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    ABSTRACT: To determine blood-flow parameters in extraocular vessels in patients with primary open-angle glaucoma before and after trabeculectomy. Between November and December 2002 in 18 patients (12 women and 6 men) with primary open-angle glaucoma trabeculectomy was performed. In preoperative period, 10 days after and between third and sixth month after trabeculectomy, patients were subjected to complete ocular examination and evaluation of blood flow velocity (mean, systolic, diastolic) and pulsation indexes in posterior ciliary arteries with Doppler focused pulsating ultrasonography. Based on the results of the last examination patients were divided in two groups before the treatment. Group A included 9 patients (4 men and 5 women), age ranged from 46 to 77 (mean 63.67). Preoperative IOP in this group ranged from 14.6 mmHg to 34.5 mmHg (mean 25.6 mmHg). Blood-flow velocities were lowered in 9 patients for 20% below the norm. Pulsation indexes ranged from 1.0 to 1.3 in 7 patients and from 1.3 to 1.5 in 2 patients. Group B included 9 patients (6 women and 3 men) age ranged from 58 to 88 (mean 73.5). Preoperative IOP in this group ranged from 14 to 44 mmHg (mean 27.24 mmHg). Blood-flow velocities were lowered in 9 patients for 30-50% below the norm and pulsation indexes were higher then 1.2. Three of the 9 described patients had no velocities in diastolic phase and pulsation indexes were higher than 2.0. Postoperative IOP in group A ranged from 7.1 to 17.3 mmHg (mean 11.0 mmHg). Four of the 7 described patients had velocities higher for 20-30% than preoperatively and were normal. Pulsation indexes lowered to 1.0-1.2. In 3 patients velocity increase was observed later (after 6 months). In group B postoperative IOP ranged from 4.9 to 14.6 mmHg (mean 8.6 mmHg). Velocity increase was observed and it reached the lower limit of the norm or were higher. Pulsation indexes lowered to 1.0-1.2. The parameters of blood-flow in posterior ciliary arteries improved in all cases after trabeculectomy.
    Klinika oczna 01/2004; 106(1-2 Suppl):206-8.