Piotr Jurowski

Publications of Piotr Jurowski

• Pulsatile ocular blood flow in subjects with sleep apnoea syndrome.

  Authors: Michal S Nowak, Piotr Jurowski, Roman Gos, Marek E Prost, Janusz Smigielski

  Archives of medical science : AMS. 04/2011; 7(2):332-6.

  The aim of the study was to determine the correlation between pulsatile ocular blood flow (POBF) and sleep apnoea syndrome (SAS). Patients were recruited from those who underwent polysomnography inThe aim of the study was to determine the correlation between pulsatile ocular blood flow (POBF) and sleep apnoea syndrome (SAS). Patients were recruited from those who underwent polysomnography in the "Sleep Unit" of the physiology department (Medical University, Lodz, Poland). A total of 52 Caucasian patients, 34 with SAS and 18 age- and gender-matched controls, were included in the study. Comprehensive ophthalmic examination included the pulsatile ocular blood flow (POBF) measurements, disc analysis with Heidelberg Retina Tomograph II and Oculus Centerfield computerized perimetry as well as the best visual acuity, a slit lamp and indirect ophthalmoscopic evaluation of anterior and posterior segments and applanation tonometry. The observed prevalence of glaucoma in SAS patients was 5.9% (2 of 34). The mean values of POBF were 1069.21 ±235.94 µl/min in the SAS group and 1061.78 ±174.63 µl/min in the control group. The study revealed that the differences of mean POBF between the SAS patients and the control group were not statistically significant: Mann-Whitney U-test p > 0.05. No correlations were found between sleep apnoea syndrome and mean intraocular pressure (IOP), mean retinal nerve fibre layer (RNFL) thickness and visual field mean defect (MD). No correlation was found between pulsatile ocular blood flow and sleep apnoea syndrome. Although some previous studies found an association between IOP, MD, RNFL thickness and sleep apnoea syndrome, our study did not confirm that. However, a high prevalence of glaucoma was found among SAS patients in Poland.

• [Cutaneous eyelid tuberculosis--a case report].

  Authors: Anna Wyrwicka, Radosław Minias, Piotr Jurowski

  Klinika oczna. 01/2011; 113(4-6):172-4.

  Tuberculosis is a bacterial infection caused by a germ called Mycobacterium tuberculosis. The bacteria usually attacks the lungs, but it can also affects other human organs or tissues. LocalizationTuberculosis is a bacterial infection caused by a germ called Mycobacterium tuberculosis. The bacteria usually attacks the lungs, but it can also affects other human organs or tissues. Localization of tuberculosis out of respiratory system is very rare and sometimes difficult to establish. Our patient finally diagnosed as lid tuberculosis with negative tuberculin reaction and clinical presentation as basal cell carcinoma of the lids, is a strong argument for that.

• [Serpiginous choroidopathy--spectrum of fundus changes in 3 years of follow up].

  Authors: Anna Wyrwicka, Piotr Jurowski

  Klinika oczna. 01/2010; 112(1-3):53-6.

  Serpiginous choroidopathy (SC) is classified as idiopathic chorioretinal disease. Atrophy of external retina comprising foveolar area and/or submacular neovascularisation is a leading cause of visualSerpiginous choroidopathy (SC) is classified as idiopathic chorioretinal disease. Atrophy of external retina comprising foveolar area and/or submacular neovascularisation is a leading cause of visual acuity deterioration. A case report shows progression of fundus lesion in the course of SC during 3 years of follow up.

• Ocular findings among young men: a 12-year prevalence study of military service in Poland.

  Authors: Michal S Nowak, Piotr Jurowski, Roman Gos, Janusz Smigielski

  Acta ophthalmologica. 06/2009;

  Abstract. Purpose: To determine the prevalence of ocular diseases among young men and to assess the main ocular causes reflecting discharge from military service in Poland. Methods: A retrospectiveAbstract. Purpose: To determine the prevalence of ocular diseases among young men and to assess the main ocular causes reflecting discharge from military service in Poland. Methods: A retrospective review of the medical records of 105 017 men undergoing a preliminary examination for military service during the period 1993-2004. Sample size for the study was calculated with 99% confidence within an error margin of 5%. All of the study participants were White men of European origin, most of whom live or lived in Poland. Data regarding the vision status were assessed in 1938 eyes of 969 participants. Two groups were distinguished based on the age of the participants: group I aged 18-24 years, and group II aged 25-34 years. Results: Presented visual impairment [visual acuity (VA) < 20/40)] followed by colour vision defects were the most common ocular disorders, accounting for 13.2%. There were statistically significant differences in uncorrected VA as well as in the rates of particular refractive errors in between the age groups (p < 0.05). The prevalence of glaucoma and ocular hypertension was significantly higher in older participants. Six hundred and sixty-seven (68.8%) participants examined medically in the study period were accepted for military service. However, 302 (31.2%) failed their examination and were temporarily or permanently discharged from duty. Fifty-two of them (17.2%) were discharged because of various ocular disorders. The most common causes were high refractive errors, which accounted for 38.5% of all the ocular discharges, followed by chronic and recurrent diseases of the posterior segment of the eye, which accounted for 19.2%. Conclusion: The prevalence of ocular disorders among young men in an unselected military population was closer to the results obtained in other population-based studies comprising both men and women in the same age group. High refractive errors followed by chronic and recurrent diseases of the posterior segment of the eye are important causes of medical discharges from military service in Poland.

• Correctable and non-correctable visual impairment among young males: a 12-year prevalence study of the Military Service in Poland.

  Authors: Michal S Nowak, Roman Gos, Piotr Jurowski, Janusz Smigielski

  Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists). 03/2009;

  Purpose: To evaluate the prevalence of correctable and non-correctable visual impairment in a representative sample of young males commissioned for Military Service in Poland. Material and methods:Purpose: To evaluate the prevalence of correctable and non-correctable visual impairment in a representative sample of young males commissioned for Military Service in Poland. Material and methods: Data concerning vision status was retrospectively reviewed in 969 subjects of European Caucasian origin, most of whom live and have lived in Poland. They were selected from the original database comprising 105017 subjects examined in the period 1993-2004. Based on the age of subjects they were divided into two groups; group I aged 18-24 and group II aged 25-34 years. Visual impairment was defined as distance visual acuity of <20/40 in one or both eyes. Non-correctable impairment was defined as that which was not eliminated by refractive correction. Results: A total of 1938 eyes of 969 white males were examined. There was statistically significant association between rates of visual impairment and increasing age (p < 0.001). Visual impairment was found in 128 (13.2%) subjects in at least one eye. Non-correctable visual impairment was found in 12 (1.2%) subjects. Amblyopia was the main cause, accounting for eight cases (66.67%). Correctable visual impairment was found in the remaining 116 (12.0%) patients. Among them myopia was the most common refractive error and accounted for 75.8%. Differences between age-specific rates of refractive errors were statistically significant (p = 0.003). Conclusions: Appropriate refractive correction improves visual acuity in most subjects presenting with visual impairment. There was a relatively low prevalence of non-correctable visual impairment in a population of young adults in Poland, and this was mainly due to amblyopia.

• [Phacosclerothalamotomy--new surgical procedure in the treatment of coexisted cataract with glaucoma. Essence of technique surgery]

  Authors: Piotr Jurowski, Roman Goś

  Klinika oczna. 02/2007; 109(7-9):276-9.

  PURPOSE: To present some relevant stages of phacosclerothalamotomy procedure. MATERIAL AND METHODS: Surgery comprised: superior clear corneal phacoemulsification with in the bag IOL implantationPURPOSE: To present some relevant stages of phacosclerothalamotomy procedure. MATERIAL AND METHODS: Surgery comprised: superior clear corneal phacoemulsification with in the bag IOL implantation combined with 4 ab interno sclerostomy with high frequency diathermic probe. The position of the probe was checked under gonioscopic view and microscopic or endoillumination light. Six patients (6 eyes) were enrolled. In 5 patients there was POAG and POCG in 1. RESULTS: Phacoemulsification were performed uneventfully. During sclerothalamotomy bleeding within trabecular meshwork and shallowing of anterior chamber were observed. The value of IOP was lower in each case postoperatively. Antiglaucoma medications ratio was decreased. CONCLUSIONS: Phacosclerothalamotomy links up some advantages of small incision cataract surgery with surgical bypass between anterior chamber and Schlemm's canal as well as deep sclerostomy (thalamotomy) performed ab interno with diathermic probe. This technique allows to avoid some complications of filtration surgery.

• Quantitative thermographic analysis of viscoelastic substances in an experimental study in rabbits.

  Authors: Piotr Jurowski, Roman Goś, Jarosław Kuśmierczyk, Grzegorz Owczarek, Grzegorz Gralewicz

  Journal of cataract and refractive surgery. 01/2006; 32(1):137-40.

  PURPOSE: To measure the temperature parameters on the corneal surface during the delivery of standardized ultrasound energy assisted with ophthalmic viscosurgical devices (OVDs) or differentPURPOSE: To measure the temperature parameters on the corneal surface during the delivery of standardized ultrasound energy assisted with ophthalmic viscosurgical devices (OVDs) or different temperatures of irrigating solutions in an experimental animal model. SETTING: Department of Ophthalmology and Visual Rehabilitation, Medical University of Lodz, and Central Institute for Labor Protection, National Research Institute, Warsaw, Poland. METHODS: Thirty rabbits (60 eyes) were randomly divided into 6 groups in which different OVD or balanced salt solutions (BSS) were used: group 1: Viscoat (sodium hyaluronate 3%-chondroitin sulfate); group 2: Provisc (sodium hyaluronate 1%); group 3: soft-shell technique; group 4: Celoftal (hydroxypropyl methylcellulose 2%); group 5: BSS 22 degrees C; and group 6: BSS 4 degrees C. After the nucleus and lens cortex were removed, the anterior chamber was filled with OVD or BSS and a phaco tip was introduced into the pupillary plane and switched on. The same phaco tip parameters were used in all groups. For thermographic measurements (ie, maximal temperature [MT], dynamic rise in temperature [DRT], and time when the maximal level of temperature [TMLT] was achieved), a thermocamera was used. RESULTS: Mean preoperative temperature on the rabbit corneal surface was 22.76 degrees C +/- 1.48 degrees C (SD). Working with a phaco tip increased the temperature in each group. A significantly higher MT was observed in group 5 (27.85 degrees C +/- 0.52 degrees C), followed by group 2 (27.75 degrees C +/- 0.54 degrees C), group 3 (27.74 degrees C +/- 0.46 degrees C), and group 4 (27.25 degrees C +/- 0.60 degrees C), than in group 6 (26.81 degrees C +/- 0.34 degrees C) and group 1 (26.52 degrees C +/- 0.48 degrees C) (P<.05). Significantly higher values of DRT and shorter TMLT values were observed in group 5 (1.16 degrees C/s +/- 0.42 degrees C/s, 4 seconds) and group 6 (0.91 degrees C/s +/- 0.13 degrees C/s, 5 seconds) than in groups 2, 3, 1, and 4 (0.09 degrees C/s +/- 0.07 degrees C/s, 30 seconds; 0.08 degrees C/s +/- 0.04 degrees C/s, 40 seconds; 0.07 degrees C/s +/- 0.03 degrees C/s, 45 seconds; 0.06 degrees C/s +/- 0.02 degrees C/s, 50 seconds, respectively) (P<.0001). CONCLUSIONS: Currently used OVDs potentially offer different levels of protection against the increase in temperature that occurs during phacoemulsification. Therefore, the surgeon should consider this aspect when choosing an OVD, particularly in difficult cases (ie, hard nucleus, shallow anterior chamber, endothelial abnormalities).

• [Phacoemulsification of intumescent cataract, IOL implantation and reconstruction of congenital iris coloboma through one anterior chamber superior opening. Case report]

  Authors: Piotr Jurowski

  Klinika oczna. 02/2005; 107(1-3):110-2.

  PURPOSE: To report a phacoemulsification of intumescens cataract and repair of congenital iris coloboma through one superior incision. MATERIAL AND METHODS: Retrospective case report. RESULTS:PURPOSE: To report a phacoemulsification of intumescens cataract and repair of congenital iris coloboma through one superior incision. MATERIAL AND METHODS: Retrospective case report. RESULTS: Postoperative repair resulted in adequate pupil restoration, exact IOL position that allowed good visual rehabilitation. CONCLUSIONS: Cataract surgery in most cases is performed through superior incision. Congenital iris coloboma repair using the same incision is difficult but provides good cosmetic and functional results.

• [Capsule contraction as a cause of in-the-bag intraocular lens subluxation and simplified technique of IOL reposition]

  Authors: Piotr Jurowski

  Klinika oczna. 02/2005; 107(10-12):684-6.

  Presentation of the case of the pseudophakic patient in whom 3 months after uncomplicated phacoemulsification severe capsule contraction syndrome, followed by equatorial capsule fibrosis, 240 degreePresentation of the case of the pseudophakic patient in whom 3 months after uncomplicated phacoemulsification severe capsule contraction syndrome, followed by equatorial capsule fibrosis, 240 degree zonular dialysis, and spontaneous in-the-bag intraocular lens subluxation, were observed. Consecutive surgical intervention consisting of simplified transscleral "free haptic" through the capsule fixation and additional plastic of phimotic capsulorrhexis allowed to restore the best corrected visual acuity to 20/25.

• [The role of retinal oxygen metabolism in origin of age-related macular degeneration (AMD)]

  Authors: Michał Nowak, Witold Gnitecki, Piotr Jurowski

  Klinika oczna. 02/2005; 107(10-12):715-8.

  Age-related macular degeneration (AMD) is the leading cause of visual loss in individuals over 60 years old, in developed countries. This article provides the latest information about the role ofAge-related macular degeneration (AMD) is the leading cause of visual loss in individuals over 60 years old, in developed countries. This article provides the latest information about the role of retinal oxygen metabolism in origin of that disease. It is considered that reactive oxygen species (ROS), including free radicals are responsible for apoptotic cell death and developing of pathological changes in AMD. Exposure to visible light induces dysfunction of retinal pigment epithelial cells, accumulation of lipoprotein aggregates in Bruch's membrane, formation of drusen, and final results are damage to photosensitive retina, which leads to AMD. There are many of antioxidant systems in retina, which protect tissue from ROS. In this review we focus on their actions in terms of mechanisms of preventing oxidative damage and their potential role in therapy of AMD. There is strong evidence suggesting the supporting role of the nutritional antioxidant supplementation and protection from exposure to the visible light in the prevention and treatment of age-related macular degeneration.

• [Broken part of IOL haptic as a cause of bullous keratopathy. Case report]

  Authors: Piotr Jurowski

  Klinika oczna. 02/2005; 107(10-12):687-9.

  Presentation of the case of the patient in whom 1 year after penetrating keratoplasty a broken, free moving haptic part of the IOL within anterior chamber was found. In accordance to increases ofPresentation of the case of the patient in whom 1 year after penetrating keratoplasty a broken, free moving haptic part of the IOL within anterior chamber was found. In accordance to increases of pain and high likelihood of donor corneal flap damage decision about surgical removal of free haptic was undertaken. Finding of the broken part of IOL throw light on the cause of bullous keratopathy in this case.

• Comparative analysis of the eye function and complications after removal of complicated cataract due to uveitis and senile cataract.

  Authors: Piotr Jurowski, Roman Goś, Katarzyna Kaszuba-Bartkowiak, Alicja Zeman-Miecznik

  Klinika oczna. 02/2005; 107(7-9):421-5.

  PURPOSE: retrospective, comparative analysis of the effectiveness of the results among patients who underwent removal of complicated cataract due to uveitis and senile cataract. MATERIAL AND METHODS:PURPOSE: retrospective, comparative analysis of the effectiveness of the results among patients who underwent removal of complicated cataract due to uveitis and senile cataract. MATERIAL AND METHODS: Patients with cataract enrolled in this study were divided into two groups. Group 1 comprised 30 eyes with complicated cataract due to uveitis. The main causes of uveitis were: rheumatoid arthritis in 8 eyes, ankylosing spondylitis in 7, Reiter syndrome in 3, psoriatic arthritis in 3, systemic sarcoidosis in 2, post-traumatic uveitis in 1. In 6 patients (6 eyes) the etiology of uveitis was unknown. Group 2 comprised 30 eyes with senile cataract. In 5 patients in each group there were coexisting glaucoma. In both groups phacoemulsification or phacoaspiration and foldable three piece IOL implantation were performed. The follow-up period was 12 months. Best corrected visual acuity and intra and postoperative complications were taken into consideration. RESULTS: There were no differences in gender and cataract hardness between the two groups. Significantly younger patients were in group 1 p< 0.01. Mean preop./ postop. visual acuity was better in group 2 as compared with group 1: 0.4/ 0.8 and 0.2/ 0.5, respectively, p < 0.01. In both groups however, the preoperative visual acuity was significantly lowest in patients with coexisting glaucoma: group 1, 0.1 p < 0.01 and in group 2: 0.25 p < 0.001. Significantly more frequent intraoperative complications were observed in group 1 as compared with group 2 e.g., corneal burn 10% and 6.6%, local sphincter damage 10% and 0%, zonular rupture 10% and 3.3% respectively. Similarly, in the late postoperative period more frequent complications were observed in group 1 than in group 2 e.g.: secondary cataract 50% and 13.3%, IOL decentration 40% and 6.6%, capsule contraction 80% and 10%, glaucoma 10% and 3.3% respectively. Recurrence of uveitis was observed in 30% of eyes in group 1. CONCLUSIONS: Although the modern microsurgical technology and IOL implantation have led to more effective treatment of senile cataract, the surgery of complicated cataract due to uveitis is still not free from complications. Future surgical strategy of complicated cataract owing to uveitis has to comprise the most adequate qualification criteria e.g. choice of the optimal period for surgery and the most convenient surgical technique as well as the most effective perioperative anti-inflammatory treatment.

• [Effectiveness of the combined surgical treatment for glaucoma and cataract]

  Authors: Piotr Jurowski, Roman Goś

  Klinika oczna. 02/2005; 107(4-6):212-6.

  PURPOSE: There are currently some techniques of combined cataract and glaucoma treatment. They have been under debate for many years. We present efficacy of different techniques of combined cataractPURPOSE: There are currently some techniques of combined cataract and glaucoma treatment. They have been under debate for many years. We present efficacy of different techniques of combined cataract and glaucoma surgery MATERIAL AND METHODS: 50 patients (60 eyes, 21 male and 29 female), mean age 64.9+/-5.6 years enrolled in the study were divided into 3 groups in which the combined surgery were performed. Group 1: phacotrabeculectomy (20 patients, 27 eyes) (FT), group 2: phacoemulsification combined with deep nonperforative sclerectomy (20 patients, 23 eyes) (FS) and group 3: phacoemulsification combined with iridocleisis (10 patients, 10 eyes) (FW). Measure outcomes during 6 months of follow up were: value of postoperative intraocular pressure, visual acuity, pre and postoperative antiglaucoma medications ratio, intra and postoperative complications. RESULTS: There were not differences in preoperative intraocular pressure (IOP) among group 1 and 2 Significantly higher IOP was assessed in group 3. Preoperative antiglaucoma medications ratio was the highest in group 3 (3.5 +/- 1.5) as compared with group 1 and 2, (2.0 +/- 1.5). Postoperatively mean value of IOP was significantly lower as compared with the value in preoperative period in each group. After 3 months of follow up the IOP lower than 20 mmHg was achieved in 81.5% eyes in group 1, 73.9% eyes in group 2 and in 40 % of eyes in group 3. Six months postoperatively the target IOP was decreased to 62.9% in group 1 and 65.2% in group 2 and slightly increased to 50% in group 3. Postoperative antiglaucoma medications ratio was higher in group 3 (2.0 +/- 1.0), as compared with group 1 and 2, (1.5 +/- 1.0). The best visual acuity after 6 month of follow up was achieved in group 2, (0.8 +/- 0.2). More severe intraoperative complications such as: anterior chamber bleeding as well as postoperative complications eg.: hypotension, inflammation were noticed particularly in group 1 and 3 and choroidal effusion only in group 1. CONCLUSIONS: Efficacy in lowering of IOP after FT and FS is the highest within first 3 months postoperatively. In the late postoperative period the efficacy of these methods is significantly decreasing and additional conservative treatment has to be introduced. Interestingly, the efficacy of IOP normalization after FW in the late postoperative period increases. Most of intra and postoperative complications are link up on FT and FW techniques. Our results suggest that further investigations and preparing more adequate indications for surgical strategy among patients with combined cataract and glaucoma are needed.

• [Color of human eye. Morphologic correlates and conditions that affect iridial pigmentation]

  Authors: Piotr Jurowski

  Klinika oczna. 02/2005; 107(4-6):340-3.

  Iris color is still considered as relevant and not exactly understandable clinical problem. This problem seems to be especially important if we considered that iris color can changed with age, someIris color is still considered as relevant and not exactly understandable clinical problem. This problem seems to be especially important if we considered that iris color can changed with age, some general and local disorders and application of different medications. This publication draw attention to past and contemporary opinions of morphologic correlations and some conditions that affect iris color.

• [Eye surface temperature after different techniques of local anesthesia--preliminary report]

  Authors: Piotr Jurowski, Roman Goś, Grzegorz Owczarek

  Klinika oczna. 02/2004; 106(4-5):557-60.

  PURPOSE: To assess temperature on the eye surface after local anesthesia due to phacoemulsyfication. MATERIAL AND METHODS: 15 patients treated with local anesthesia: peribulbar - 5, retrobulbar - 5PURPOSE: To assess temperature on the eye surface after local anesthesia due to phacoemulsyfication. MATERIAL AND METHODS: 15 patients treated with local anesthesia: peribulbar - 5, retrobulbar - 5 and sub Tenon anesthesia. Mean temperature on both eye surface was assessed with termovision camera (Inframetrics 760) before surgery, 20 minutes and 1 hour after anesthesia. RESULTS: In all examined groups changes in temperature values in anesthetized and contralateral eye were observed. Significant decrease of temperature was observed after sub Tenon anesthesia. CONCLUSIONS: Eye surface temperature and its changes can be considered as indirect indicator of blood supply and blood supply disturbances after local anesthesia.

• [Keratolimbal allografts and multilayer amniotic membrane transplantation in the treatment of ocular surface disease due to chemical burns]

  Authors: Piotr Jurowski, Iroman Goś

  Klinika oczna. 02/2004; 106(4-5):648-52.

  PURPOSE: To analyze the functional effect and to present the technique of keratolimbal allograft and multilayer amniotic membranetransplantation for the treatment of ocular surface disease afterPURPOSE: To analyze the functional effect and to present the technique of keratolimbal allograft and multilayer amniotic membranetransplantation for the treatment of ocular surface disease after heavy chemical burn. MATERIAL AND METHODS: Treatment comprised 3 eyes of 2 patients suffering form ocular surface deficiency after chemical (acid) burn. Surgeries were provided under local anesthesia. After circumferential peritomy and removal of fibrovascular layer, stem cells in the fashion of keratolimball crescent allograft, following by multilayer amniotic membrane transplantation were performed. RESULTS: 3 months after surgery the corneal surface was covered with fully differentiated epithelium in all patients. In two of three patients, improvement of the visual acuity was also observed. However, in one eye despite good epithelium maintenance the stroma was still not transparent. CONCLUSION: Keratolimbal allograft with multilayer amniotic transplantation is interesting method of ocular surface reconstruction. Combined procedure with use of two different tissues seems to be relevant among patients with bilateral ocular surface dysfunction with complete destruction of stem cells after chemical burn.

• [Secondary glaucoma due to progressive iris atrophy--a century after the first description. Case report]

  Authors: Piotr Jurowski, Roman Goś, Andrzej Kapica, Małgorzata Zdzieszyńska

  Klinika oczna. 02/2004; 106(1-2):80-2.

  The iridocorneal endothelial syndrome (ICE) consists of some disorders, like: progressive essential iris atrophy, Chandler disease and the iris nevus syndrome that are characterized by cornealThe iridocorneal endothelial syndrome (ICE) consists of some disorders, like: progressive essential iris atrophy, Chandler disease and the iris nevus syndrome that are characterized by corneal endothelium proliferation and migration, iris atrophy, corneal oedema and/or pigmentary iris nevi. Secondary, refractory glaucoma affects about 50% of patients with progressive essential iris atrophy. Medication of glaucoma is only initially effective. Some conventional filtering surgeries, to control glaucoma are often unsuccessful. Presented case of our patient with primary essential iris atrophy, with secondary glaucoma shows surgical problems. Multiple filtration surgery with or without antiproliferative agents turn out not to be sufficient. In conclusion, intraocular pressure was effectively lowered with iridocleisis technique.

• [Reasons of postoperative astigmatism]

  Authors: Piotr Jurowski

  Klinika oczna. 02/2003; 105(1-2):82-5.

  At present, cataract extraction offers great improvement for uncorrected and best corrected visual acuity and rapid postoperative rehabilitation. Cataract surgery is now treated as refractiveAt present, cataract extraction offers great improvement for uncorrected and best corrected visual acuity and rapid postoperative rehabilitation. Cataract surgery is now treated as refractive surgery. Postoperative astigmatism has remained the only obstacle to the achievement of good, uncorrected visual acuity after cataract surgery. Postoperative astigmatism is a very complex clinical problem. The main influence on its appearance has preoperative astigmatism as well as shape and length of anterior chamber opening, suturing technique and wound healing.

• [Evaluation of early postoperative astigmatism with respect to anterior chamber opening]

  Authors: Piotr Jurowski

  Klinika oczna. 02/2003; 105(1-2):27-30.

  The study evaluates amount and direction of postoperative astigmatism after usually performed techniques of cataract surgery. MATERIAL AND METHODS: 90 consecutive patients (120 eyes) mean aged 74.5The study evaluates amount and direction of postoperative astigmatism after usually performed techniques of cataract surgery. MATERIAL AND METHODS: 90 consecutive patients (120 eyes) mean aged 74.5 years, who underwent cataract surgery with clear corneal superior (Group 1) or temporal incision (Group 2), sclero-corneal tunnel sutureless incision (Group 3) or limbal ECCE incision with x sutures (Group 4), were examined with respect to postoperative astigmatism. Anterior chamber opening was determined by primary astigmatism and nucleus hardness. All measurements were performed based on keratometry. RESULTS: The highest mean value of with the rule astigmatism was assessed in Group 4. From the other hand, the least value were determined in group 2--95% with the rule and 5% oblique and in group 1--40% with the rule, 40% against the rule 20% oblique. In group 3, the value of postoperative astigmatism was higher, as compared with Group 1 and 2. It was assessed with similar proportion as in Group 1. CONCLUSIONS: At present cataract surgery techniques are not free of induced astigmatism. Study demonstrates significance of preoperative primary astigmatism assessment, with respect to surgery technique, to avoid postoperative astigmatism.

• Nitric oxide levels in aqueous humor after lens extraction and poly(methyl methacrylate) and foldable acrylic intraocular lens implantation in rabbit eyes.

  Authors: Piotr Jurowski, Roman Goś, Grazyna Piasecka

  Journal of cataract and refractive surgery. 12/2002; 28(12):2188-92.

  PURPOSE: To measure the nitric oxide (NO) level in the aqueous humor of rabbit eyes after common cataract surgery techniques. SETTING: Department of Ophthalmology, Military Medical University, andPURPOSE: To measure the nitric oxide (NO) level in the aqueous humor of rabbit eyes after common cataract surgery techniques. SETTING: Department of Ophthalmology, Military Medical University, and Department of Immunology and Immunotoxicology of Respiratory System, Clinic of Pneumonology and Allergology, Medical University of Łódź, Łódź, Poland. METHODS: Thirty rabbits were randomly divided into 4 groups, and surgery was performed as follows: Group 1, extracapsular cataract extraction (ECCE) and poly(methyl methacrylate) (PMMA) intraocular lens (IOL) implantation; Group 2, ECCE; Group 3, phacoemulsification and foldable acrylic IOL implantation; Group 4, phacoemulsification. The aqueous humor specimens were collected on days 1, 3, and 5. Nitric oxide measurements were performed indirectly with a spectrophotometer. The NO level in the aqueous humor collected before surgery served as a control group. RESULTS: In the physiological condition, the concentration of NO was 26.52 nm/dL +/- 4.86 (SD). Postoperatively, the highest NO level in each groups was as follows: Group 1, 46.26 +/- 5.23 nm/dL on day 3; Group 2, 72.46 +/- 6.94 nm/dL on day 1; Group 3, 41.04 +/- 7.31 nm/dL on day 1; and Group 4, 32.67 +/- 2.84 nm/dL on day 3. Significantly higher levels of NO (P <.05) were observed in Groups 1 and 2 at each follow-up day; in Group 3, on days 1 and 3; and in Group 4, on day 3. CONCLUSIONS: Techniques of cataract extraction caused the NO level to increase; however, phacoemulsification with a foldable IOL caused the smallest release of NO. Rapid postoperative NO changes may theoretically contribute to blood-aqueous barrier breakdown secondary to cataract surgery.