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Biomedical subjects

B Kalvodová

Publications and source records attributed to B Kalvodová.

At least 19 recordsLinked to original sources
PubMed2006

[Sympathetic ophthalmia].

PURPOSE: To evaluate the efficacy of treatment on prevention of disease development and protection of visual outcomes in patients suffering from sympathetic ophthalmia. METHODS: Retrospective case. RESULTS: Four patients with sympathetic ophthalmia were treated in our department from 1999 to 2004. All patients were men with the mean age 27.5 years (15-49 years). In two patients, there was a history of penetrating eye injury prior to the onset of sympathetic ophthalmia, in other two patients sympathetic ophthalmia occurred after eye surgery (pars plana vitrectomy), with no previous ocular trauma. Two patients were treated with monotherapy of corticosteroids; other two patients were commenced on combined immunosuppression. In all these cases, the therapy was effective. CONCLUSION: Sympathetic ophthalmia is a rare, sight-threatening eye disease. Among the triggering factors dominates penetrating eye injury, however, there is currently an increase in the number of cases with sympathetic ophthalmia following eye surgery, mainly pars plana vitrectomy. Early introduction of immunosuppressive treatment can get the disease under control, prevent the development of intraocular inflammation and improve visual outcomes.

Adolescent↗
PubMed2003

[Pars plana vitrectomy and primary implantation of silicone oil in the treatment of acute exogenous endophthalmitis in eyes without retinal detachment].

UNLABELLED: Acute exogenous endophthalmitis (AEE) is the most serious post-traumatic or postoperative complication which without immediate treatment leads to amaurosis or anatomical loss of the eye. If comprehensive antibiotic treatment fails immediate pars plana vitrectomy (PPV) is indicated. Empirically and later also by laboratory methods the antiinflammatory effect of silicone oil (SO) was revealed. The objective of the present retrospective study is to demonstrate anatomical and functional results of PPV with implantation of SO for AEE on eyes without detachment of the retina. In 1990-2000 the authors operated a total of 22 eyes of 22 patients with AEE. The mean age of the patients was 59.6 years, the mean observation period 35.5 months. In 17 eyes postoperative and in 5 eyes post-traumatic AEE was involved. The mean interval between the original operation and PPV was 20.8 days and between the injury and PPV 5.4 days. In all patients we took at the beginning of PPV specimens of the vitreous body for cultivatin which gave in 63.6% a positive result. The intraocular lens was explanted in 81.8% eyes. After subtotal resection of the vitreous body we implanted SO and in all aphakic eyes we performed iridectomy in no. 6. PPV was completed by administration of vancomycin and ceftazidime into the vitreous space. In 95.4% of the eyes we preserved anatomically the bulbus, in one instance we eviscerated the bulbus three days after failure of PPV (4.6%). In 86.4% the retina remained anatomically attached and in the remaining 9% eyes beneath the SO traction detachment of the retina developed. Visual acuity improved in 72.7% eyes, it remained unchanged in 9.1% eyes and deteriorated in 18.2% eyes. Silicone oil was explanted in 40.9% eyes after a mean interval of 4.6 months following PPV. In the remaining patients we did not indicate explantation of SO, in particular because of the patients' advanced age, CONCLUSION: We recommend PPV and implantation of SO in AEE on eyes without detachment of the retina as the method of choice.

Acute Disease↗
PubMed2003

[Primary pars plana vitrectomy in the treatment of penetrating eye injuries involving intraocular foreign bodies in the vitreous body ].

The method of choice in the treatment of penetrating eye injuries affecting the vitreous body with an intraocular foreign body is in the majority of patients primary pars plana vitrectomy with transvitreal extraction of the foreign body (FB). During the period from April 1999 till September 2000 the authors treated thus at the Ophthalmological Clinic of the General Faculty Hospital and 1st Medical Faculty Charles University Prague 26 eyes of 26 young men with an average age of 34 years. The mean interval between the injury and primary PPV was 8.5 days. The patients were followed up on average for 23.5 months. The entrance of the penetrating injury was in 17 eyes in the cornea or limbus, in 9 eyes in the sclera. In two eyes posttraumatic endophthalmitis developed. The intraocular FB was 6 mm2 in size in 16 eyes and 6-20 mm2 in 10 eyes. In primary PPV we indicated in 14 eyes internal tamponade with gas or silicone oil. On account of late retinal complications which developed as a result of proliferative vitreoretinopathy we indicated in eight eyes PPV reoperation. At the end of the investigation period in 3 eyes inoperable detachment of the retina developed. As the main negative prognostic factor for final visual acuity the authors evaluated a size of the FB greater than 6 mm2, other negative prognostic factors are the scleral entrance injury, complications of the entrance injury (prolapse of the iris, vitreous body, haemophthalmus) and the development of posttraumatic exogenous endophthalmitis.

Adult↗
PubMed2002

[Screening for diabetic maculopathy].

Diabetic maculopathy (DMP) is an important but curable of eyesight losses in diabetic with type 1 and 2 diabetic mellitus (DM). In the submitted work the author investigates the pathogenesis of diabetic macular oedema (DME). Classification, diagnosis and standard of treatment of DMP, incl. the different therapeutic procedure used in concurrent DMP and proliferative diabetic retinopathy in DM type 1 and 2.

Diabetic Retinopathy↗
PubMed2002

[Screening for diabetic retinopathy in the Czech Republic--guideline].

Diabetic retinopathy (DR) and diabetic maculopathy (DMP) are the most frequent and most serious complications of diabetes mellitus (DM). At present the adverse development of these microvascular complications of DM can be very successfully delayed by available therapeutic methods. The success of the therapeutic procedure depends in particular on early treatment of DR and DMP by laser coagulation and/or pars plana vitrectomy, which presumes detection of early stages of the disease. The authors evaluate the priorities of DR screening, the final effect of which is a decline of blindness caused by DM. Conditions for screening of diabetic eye disease are the diagnosis of DR by simple and safe procedures, classification of DR on the basis of the dynamics of retinal changes and standards of treatment. An integral part of the ophthalmological screening programme is professional collaboration of ophthalmologists, diabetologists, general practitioners and specialists in internist medicine. Successful screening of DR makes it possible to involve the subject in preventive and therapeutic care, education of the patient, regular lifelong follow up and early treatment of DR and DMP. By the method of screening of DR we reduce the risk of a decline of visual acuity and prevent severe functional losses as a result of diabetic ophthalmological complications.

Blindness↗
PubMed2002

[Results of vitrectomy in cystoid diabetic macular edema detected by optical coherence tomography].

PURPOSE: To evaluate the surgical results of the pars plana vitrectomy (PPV) with separation of the posterior hyaloid (PH) with the cystoid diabetic macular edema (DME) using optical coherence tomography (OCT). METHODS: PPV with removing of the PH was performed in 10 eyes of 10 patients with cystoid DME. The macular structure, the vitreoretinal interface and the foveal thickness before and after PPV was evaluated using OCT and was correlated with a slit lamp biomicroscope. All 10 eyes had undergone panretinal and macular photocoagulation. RESULTS: OCT demonstrated postoperatively in all 10 eyes the regression of cystoid DME and the presence of foveal depression. Visual acuity (VA) has improved by 2 and more Snellen lines in 6 eyes with preoperative decrease of VA not longer than 5 months. CONCLUSIONS: PPV with separation of PH is efficient method in treatment of cystoid DME. Duration of cystoid DME is a significant factor for determination of functional prognosis. OCT facilitates the follow-up of the dynamics of regression of the structure and thickness of the fovea.

Adult↗
PubMed2001

[Changes in microcirculation and selected laboratory parameters in the early stages of diabetic microangiopathy].

BACKGROUND: Early stages of diabetic microangiopathy are accompanied with dysfunction, manifested by changes of some biochemical parameters. Parallel changes were observed in microcirculation. The aim of this study was to compare microcirculation in the skin of a forearm evaluated by laser Doppler with selected laboratory markers of endothelial dysfunction in Type 1 diabetes mellitus without microangiopathy or with incipient microangiopathy. METHODS AND RESULTS: Group of 43 Type 1 diabetic patients was examined in this study. 20 of them had no signs of microangiopathy and in 23 patients a simple diabetic retinopathy (background retinopathy) was diagnosed. Control group consisted of 25 healthy persons of comparable age, sex, and body mass index. All persons involved in this study were examined by laser Doppler and by biochemical examination and the results were compared. In comparison with control group, in diabetic patients the arm occlusion significantly lowered the increase of perfusion (29 +/- 12 vs. 41 +/- 18 perfusion units (PU) p < 0.01). Similarly the perfusion velocity increase was significantly lower in diabetic patients than in healthy controls (p < 0.01). Also the velocity of the perfusion increase after the warming up was lower in the diabetic than in non-diabetic persons (p < 0.01). Such changes of perfusion or those of velocity of perfusion increase were significantly lower in diabetic patients with microangiopathy than in those without this complication. Perfusion increases after both stimuli highly correlated (r = 0.86, p < 0.001). In diabetic patients with microangiopathy significantly higher N-acetyl-beta-glucosaminidase (NAG) activities in serum and E-selection or ICAM-1 concentrations were found as compared with patients without microangiopathy, whereas plasma concentrations of tissue plasminogen activator (tPA) or inhibitor (PAI-1) were comparable with those in the control group. NAG activity inversely correlated with velocity of the perfusion increase after both the occlusion (r = -0.41, p < 0.01) and the warming (r = -0.38, p < 0.05). Similar relationship was found between tPA or E-selectin and the velocity of the perfusion increase after the occlusion (r = -0.48, p < 0.01). CONCLUSIONS: Our results confirm that biochemical parameters and microcirculation are impaired in the early stage of microangiopathy in Type 1 diabetic patients. Detailed analysis showed that both types of examination offer slightly different information on the vascular status. A long prospective study in diabetic patients without incipient vascular changes will be necessary to evaluate if biochemical or microcirculatory changes can bring an earlier information on the developing angiopathy.

Acetylglucosaminidase↗
PubMed2001

[Cataract surgery in eyes treated with vitrectomy for idiopathic macular holes].

The authors evaluated the final functional results in 30 eyes where on account of nuclear and cortical cataract an intraocular lens was implanted. The operation was preceded by pars plana vitrectomy (PPV) with internal gas tamponade on account of an idiopathic macular hole (IMD). The cataract the development of which was recorded in 57 eyes was the manifestation of a late postoperative complication from a total number of 84 phakic eyes (67.9%) which were operated on account of IMD between April 1996 and June 1999. After cataract surgery the corrected visual acuity improved in 23.3% eyes. The investigation confirmed improvement and stabilization of the final corrected visual acuity in 24 eyes (80%) and confirmed the importance of these surgical procedures.

Aged↗
PubMed2000

[Glaucoma after surgery for idiopathic macular holes].

UNLABELLED: The objective of the prospective randomized study is to evaluate the effect of surgery of an idiopathic macular hole (IMH) on intraocular pressure (IOP). The study comprised 60 primary pars plana vitrectomies (PPV) on account of IMH using 16% perfluoropropane (C3F8). Stage III according to Gass predominated in 65% and stage IV in 28.3%. Furthermore the authors enlisted in the study 15 secondary PPV on account of a patent IMH. A total of 75 primary and secondary PPV were performed. In 43 PPV an autologous thrombocyte concentrate (ATC) was used. With regard to the IOP after PPV the patients were subdivided into the following groups. Group A: IOP under 24 mm Hg was recorded throughout the investigation period in 24 of 75 PPV (32%). The total mean value of IOP in group A was 17.4 mm Hg. Group B: Early increase of IOP during the first week after surgery was recorded in 51 of 75 PPV (68.0%) This group was divided into two sub-groups according to the maximum postoperative deviation of IOP during that period. Sub-group B1 comprised a total of 34 PPV (45.3%) where the maximum postoperative deviation of IOP was between 25-35 mm Hg. The total mean value of IOP in sub-group B1 was 23.5 mm Hg. In sub-group B2 there was a total of 17 PPV (22.7%) and the maximum postoperative deviation of IOP was above 35 mm Hg. The total mean value of IOP in sub-group B2 was 28.6 mm Hg. Moreover the authors investigated the effect of ATC administration on the IOP after primary and secondary PPV. They did not reveal a significant relationship between administration of ATC and postoperative glaucoma. CONCLUSION: 1. Glaucoma after PPV in IMH can in individual cases cause deterioration of the functional results of the operation. PPV in IMH has an increased risk: a) in a monoculus, b) in advanced primary glaucoma with an open angle, c) in primary glaucoma with a narrow angle.

Adult↗
PubMed2000

[Ultrastructural analysis of tissue removed during surgery of idiopathic macular holes].

AIM: To analyze the ultrastructural features of epimacular tissue removed during idiopathic macular hole (IMH) surgery and to compare them with those of idiopathic epimacular membranes. METHODS: Three consecutive patients with unilateral stage 3 IMH underwent pars plana vitrectomy with surgical removal of delicate gelatinous membranous epimacular tissue. One patient was previously treated with laser photocoagulation. The excised material was investigated by means of light and transmission electron microscopy. Results were compared with the findings of the excised material in two idiopathic epimacular membranes. RESULTS: The excised material included variable proportions of cellular and membranous material. Glial cells (Müller cells, fibrous astrocytes) and fibroblast-like cells dominated in the cellular component both in the specimens from IHM eyes and in the comparative material. Neural elements were revealed in two of three specimens from IMH eyes. Membraneous material was formed by fragments of internal limiting membrane. CONCLUSIONS: Dominance of the glial cells in the cellular component of epimacular formations may reflect the important role of these cells both in formation and in healing process of IMH. The presence of neural elements in the removed epimacular tissue suggests that, at least in some cases, IMH surgery with peeling of an epimacular membrane can be associated with some injury of the macula.

Aged↗
PubMed1999

[Vitrectomy and autologous thrombocyte concentrate in the treatment of idiopathic macular holes].

OBJECTIVE: To evaluate the results of surgery of idiopathic macular holes (IMH) using or not using autologous thrombocyte concentrates (ATC). METHOD: Fifty eyes with IMH, stage 2-4, were divided into two groups. Group 1 comprised 27 eyes with an average persistence of complaints of 12 months where pars plana vitrectomy (PPV) and tamponade with 16% C3F8 were combined with the use of ATC. Group 2 comprised 23 eyes with a mean duration of complaints of 14 months which were treated by PPV and 16% C3F8 without ATC. In all IMH stage 2 and 3 the posterior vitreous membrane was detached from the retina. The epimacular membrane was removed, if present. The mean follow-up period in group 1 was 17.2 months and in group 2 12.3 months. RESULTS: In group 1 anatomical success was achieved in 21 eyes (78%), visual acuity improved by two lines and more in 16 eyes (59%). In group 2 anatomical success was recorded in 15 eyes (69%) (p = 0.326) and visual acuity improved in 10 eyes (44%) (p = 0.265). Nine eyes were reoperated with ATC. Reoperations improved the anatomical success in the whole series to 90% and the functional success to 62%. The visual acuity improved in 70% operated eyes within 12 months from the onset of complaints and in 47% eyes with a longer case-history (p = 0.1182). Complications included retinal tears in 5 eyes (10%), detachment of the retina in one eye (2%), minor facete-like defects in the pigmented epithelium in 22 eyes (44%), disciform maculopathy in 5 eyes (10%) and atrophy of the optic disc in 3 eyes (6%). CONCLUSIONS: PPV is beneficial in IMH in the majority of patients. ATC can improve anatomical and functional results. Functional success is more likely after surgery in the early stage of the disease. The results of surgery are jeopardized by various complications. It is important to inform patients on the limitations and risk of surgery.

Adult↗
PubMed1999

[Vitrectomy in optic nerve disc pit with maculopathy].

There is described a rare case of a congenital optic disc pit of the 20-years old man that was accompanied by a cyst-like change in the macula with serous retinal detachment. Visual impairment in his right eye was treated with pars-plana-vitrectomy with surgical posterior vitreous detachment and gas tamponade. After temporary pneumatic displacement of the subretinal fluid inferiorly the corrected visual acuity improved to 6/9. Schisislike changes persisted in the macular area. Our findings could support the view on the two-layer structure of optic disk pit maculopathy and an important role of tangential vitreous traction in the pathogenesis of the central retinal detachment.

Adult↗
PubMed1998

Results of penetrating keratoplasty in bullous silicone oil keratopathy.

BACKGROUND: To evaluate the results of penetrating keratoplasty (PK) in bullous silicone oil keratopathy (BSK). MATERIAL AND METHODS: PK for BSK was performed in 13 patients, aged from 31 to 82 years. In all patients, pars plana vitrectomy (PPV) with silicone oil implantation (SOI) had been previously performed as the definitive surgery: for complicated retinal detachment with advanced proliferative vitreoretinopathy in 12 eyes and for diabetic traction detachment in one eye. Seven patients were monocular. All 13 eyes were aphakic and there was a long-lasting contact of silicone oil with the corneal endothelium. Before keratoplasty, each eye underwent between two and five operations, on average three, for retinal detachment or late complications of SOI. The interval between SOI and PK was from 11 to 79 months. The patients were followed up for 12-52 months. RESULTS: At the last follow-up examination, a clear graft was found in 6 out of 13 eyes (46%). The six clear grafts were found in the ten eyes where silicone oil had been removed before keratoplasty. The graft became opaque in all three eyes in which silicone oil had not been removed. Six out of seven eyes with failed grafts atrophied. Visual acuity improved in all six eyes with the clear graft from had movement preoperatively to 0.05-0.25. The decreased visual acuity was caused by irreparable damage to the macula, which resulted from high myopia, proliferative vitreoretinopathy or long-lasting detachment of the macula. CONCLUSIONS: PK in BSK was successful only in those eyes in which the attached retina enabled the removal of the silicone oil before the PK. The reattached retina and useful visual acuity before the development of BSK were the preconditions for functional success of the PK.

Adult↗
PubMed1997

Poly (triethylenglycol monomethacrylate) and poly (glycerol monomethacrylate) cross-linked gel as potential viscoelastics for intraoperative use.

BACKGROUND: The highly swelling poly (glycerol monomethacrylate) gel (polyGLYMA) and hydrophilic polymer poly (triethylenglycol monomethacrylate (polyTEGMA) were tested as potential viscoelastics for intraoperative use in anterior segment surgery. METHODS: PolyGLYMA was implanted into the anterior chamber in 5 rabbits, and 40% polyTEGMA in 16 rabbits. The eyes were enucleated 1 week to 3 months after the operation. The corneal endothelium was examined with specular microscopy, and then the whole eye histopathologically. RESULTS: In all eyes of the polyGLYMA group, the clinical findings were characterized by a marked ciliary injection and severe secondary glaucoma, and the histologic ones by a marked inflammatory infiltration and thickening of Descemet's membrane in the anterior chamber angle. Specular microscopy revealed a decrease in the endothelial cell density and polymorphism of the endothelial cells. In the polyTEGMA group, the anterior segment and the fundus were physiologic all the time, and specular microscopy and histologic findings showed no degenerative and/or inflammatory changes. CONCLUSIONS: PolyGLYMA proved unsuitable for intracameral application in rabbits. The new polymer polyTEGMA is characterized by high biologic tolerance after its implantation into the anterior chamber of rabbits. PolyTEGMA 40% might be considered as a potential viscoelastic material in humans.

Animals↗
PubMed1996

[Pars plana vitrectomy in retinal detachment with a macular hole].

The long-term results of pars plana vitrectomy (PPV) for retinal detachment due to a macular hole were evaluated in 40 eyes of 40 patients. The patients were followed up for 6 to 72 months. In 9 eyes, subtotal PPV with expansive gases was used: in 5 of them, in addition, the macular hole was treated with laser endocoagulation. The operation was successful in 4 out of 5 eyes treated with laser barrage. In the remaining 5 eyes, the operation failed and reattachment was obtained after secondary silicone oil implantation (SOI). In 31 eyes, PPV was combined with a primary SOI. Twenty of them suffered from serious myopic degenerative changes of the posterior eye pole, and in 11 posterior stafyloma. Reattachment of the retina was achieved in 28 eyes (90.3%), visual acuity 1/24 (0.04) or better in 13 eyes (41.9%). Silicone oil was removed in 13 eyes (41.9%), in all these without complications. PPV with expansive gases and laser coagulation proved to be effective in macular holes with the well-preserved pigment epithelium. Silicone oil proved competent in macular holes associated with serious chorioretinal degeneration and posterior stafyloma.

Adult↗