Kamil Szulborski

Publications of Kamil Szulborski

• 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.