Biomedical subjects

D Dotrelová

Publications and source records attributed to D Dotrelová.

At least 19 recordsLinked to original sources

PubMed1994

[Personal experience with expanding gases in pars plana vitrectomy].

At the Second Ophthalmological Clinic in Prague the authors operated between January 1991 and November 1993 50 patients, 33 men and 17 women. The mean age of the patients was 43.6 years, the minimum observation period 5 months. In all patients pars plana vitrectomy was performed (PPV) and at the end of the operation or subsequently into the vitreous space the expansive gas SF6 (hexafluorosulphide) or C3F8 (perfluoropropane) was insufflated. In all instances the authors indicated the expansive gas for treatment or prevention of retinal detachment and with regard to this they divided the patients into two groups: 1. From the total number of 50 patients the authors operated in the first group 31 patients with complicated retinal detachment (RD). In 17 patient RD with large postequatorial tears and traces of blood in the vitreous space were involved. In 7 patients the cause of RD was a severe eye injury. In five patients the authors found a macular opening, in one patient a large postequatorial tear in the temporal half and in one patient a circumscribed tractional RD associated with diabetic proliferative retinopathy was involved. 2. In the second group of 19 patients the gas was used as prevention of RD. In 5 patients after transvitreal extraction of a foreign intraocular body with suspected or obvious retinal defect. In two patients after extraction of a posterior lenticular luxation following severe contusion of the eye. In the remaining 12 patients the expansive gas was used after removal of silicone oil (SO) and the gas was used at the same time to prevent hypotonia of the eye. Anatomical results of surgery. 1. In the group of 31 patients with complicated RD after PPV and gas insufflation the retina adhered anatomically in 23 patients (74%). In the group with PVR C1-C3 in 13 patients after gas insufflation the retina became attached in 10 patients (76.9%). In one of these patients after three months accentuated cerclage was performed because of a new fissure. 2. In the group of 19 patients where gas was used for preventive reasons the retina became detached only after removal of SO in 5 of 12 patients (42%). Functional results of operation. To assess final vision the authors evaluated in the first group a total of 39 patients only after gas insufflation and in the second group another 11 patients after reoperation with implantation of SO.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

PubMed1993

[Bilateral retinal detachment].

In 1977-1990 a total of 2,554 patients with rhegmatogenic retinal detachment were operated by the cryosurgical method, using silicone episcleral implants. The total number of patients comprosed 36 (1.4%) where the authors detected during the preoperative examination retinal detachment, usually in an initial stage, on the other eye. In 30 patients the authors operated bilateral detachment of the retina simultaneously and in the remaining six during the same hospitalization. The poorer eye was characterized by 1. more extensive retinal detachment, 2. a higher grade of proliferative vitreoretiopathy (PVR). As to the preoperative findings, the authors consider the following points important: 1. Almost 70% of the patients did not report subjective complaints of the better eye. 2. With regard o the pathogenesis the patients were divided into three groups: lattice degenerations in 61.1%, idiopathic oral dialysis 11.1%, other factors 27.8% of the patients. 3. Symmetry of the retinal defect up to 90 in two-thirds of the patients. 4. Type of operation. On the poorer eye the authors performed segmental plombage in 12 eyes (33.3%), cerclage in 5 eyes (139%) and reinforced cerclage in 19 eyes (52.8%). For the better eye the authors indicated segmental plombage in 12 eyes (77.8%), cerclage in 4 eyes (11.1%) and reinforced cerclage in 4 eyes (11.1%). Subretinal fluid was punctured on the poorer eye in 19 eyes (52.7%) and on the better eye in 7 eyes (19.4%). After an average observation period of 40 months the retina became anatomically attached in 86.0% on the poorer eye, and in 100% on the better eye. Bilateral retinal detachment in our group can be considered a model situation of retinal detachment which developed roughly at the same time and under equal endogenous conditions of the given organism. It may be thus assumed that a different extent of detachment and grade or proliferative vitreoretinopathy before operation was determined above all by the period of retinal detachment.

Adolescent↗

PubMed1993

[Liquid perfluorocarbons in surgery for lens subluxation].

Liquid perfluocarbons (PFC) with a high specific weight and low viscosity were used to remove dislocated lenses from the vitreous body cavity in four patients. In three patients dislocation of the lens with the firm nucleus into the vitreous body cavity occurred following severe contusion, in one female patient luxation of a posterior chamber lens occurred after implantation. After pars plana vitrectomy the liquid PFC lifted the dislocated lens from the bottom of the eye beyond the pupil and from there the lens was removed by means of a cryoprobe and the posterior chamber artificial lens was removed by means of forceps. Liquid PFC are a simple and sparing tool for removal of lenses with a firm nucleus and of implanted lenses from the vitreous body cavity. They reduce manipulation with instruments inside the vitreous body cavity to a minimum. Their use is the operation of choice. The high price of PFC is outweighed by the minimal risk of surgical and postoperative retinal complications.

Adult↗

PubMed1991

[New views on treatment of intraocular foreign bodies].

The authors evaluated the results of surgery in 130 patients operated at the Second Ophthalmological Clinic in 1983-1989 on account of intraocular foreign bodies. Extraction of the body was successful in 126 patients (96%), the function of the eye was preserved in 102 of 126 extracted foreign bodies (81%), a visual acuity of 0.5 to 1.0 was recorded in 78 eyes (60%). The authors investigated the relationship of functional results on the type, size and site of the intraocular foreign body, the way of extraction, interval between the injury and operation and previous attempted extractions. Analysis of results revealed the advantages of extraction of intraocular foreign bodies under visual control in the majority of foreign bodies. Intraocular foreign bodies are not an indication for immediate but for early operation. After careful treatment of the wound where the foreign body penetrated extraction may be delayed for several days before optimal conditions for surgery are created.

Adolescent↗

PubMed1991

[Retinal detachment after perforating eye injuries. IV. Anatomic and functional results of cryosurgical procedures].

In the course of ten years the authors operated 69 patients with detachment of the retina (DR) after perforating eye injuries, using cryosurgical methods with silicone episcleral implants. In 37 patients DR developed after simple perforation (group A) and in 32 patients after perforation of the eye with an intraocular foreign body (group B). In all patients the perforation affected the vitreous space. From the total number of patients anatomical apposition of the retina was achieved in 62.3%. A significant difference is the poorer anatomical result of the operation in the group with simple perforations without a foreign body 54.0%, as compared with the group after perforation with a foreign body, 71.9%. The anatomical results were evaluated with regard to the period of DR, aphakia, the characteristic of the retinal defect, the type of LR and the extent of the operation. From the total number of successfully operated patients we recorded the same or better vision in 44.2% and in 51.2% poorer vision, as compared with that after the perforating injury of the eye. Deterioration was caused by the duration of DR, detachment of the macular region, an extensive operation and complications.

Adolescent↗

PubMed1991

[Retinal detachment after perforating injuries of the eye. I. Analysis of anamnestic data related to the injury, analysis of deficiencies in the primary care of the eye injury and principles of prevention of post-traumatic retinal detachment].

In 1977-1987 the authors operated by the cryosurgical method 69 patients on account of detachment of the retina. The detachment occurred in 37 patients after simple perforation of the eye and in 32 patients after perforation with a foreign intraocular body. In all patients the perforation penetrated as far as the vitreous body. In the first part of the paper the authors analyze in detail anamnestic data related to the injury: age, mechanism of injury, rapidity and method of surgical treatment, chemical nature of foreign body and its size, rapidity and method of extraction of the foreign body. In the subsequent part the authors define the principles of prevention of post-traumatic detachment of the retina during surgical treatment of the injury. Finally the basic shortcomings of primary treatment of the injury from the aspect of detachment of the retina are outlined, as recorded in the group treated by the authors.

Adolescent↗

PubMed1991

[Retinal detachment after perforating eye injuries. II. The interval between injury and retinal detachment and factors which may have contributed to the development of retinal detachment].

The authors operated in 1977-1987 by the cryosurgical method 69 patients after injuries on account of detachment of the retina. Detachment developed in 37 patients after simple perforation of the eye and in 32 patients after perforation of the eye with a foreign intraocular body. In all patients the perforation reached as far as the vitreous body. The interval injury--detachment was assessed retrospectively. The authors found that for the development of post-traumatic detachment of the retina a period of two years after the injury is decisive--within this period detachment of the retina occurred in 55% of the cases. Another 31.9% of the cases occurred during the late post-traumatic period, i.e. 6-40 years after injury. In 21.7% patients anamnestic data were found which were, no doubt, associated with the detachment of the retina: surgical trauma in 8.7%, direct contusion of the eye in 10.1% and lifting a heavy burden in 2.9%.

Adolescent↗

PubMed1991

[Retinal detachment after perforating eye injuries. III. Analysis of retinal detachment after perforating eye injuries and determination of the characteristics of the retinal detachment after perforating eye injuries].

In 1977-1987 the authors operated, using the cryosurgical method post-traumatic retinal detachment in 69 patients. Retinal detachment developed in 37 patients after simple perforation of the eye by a foreign intraocular body. In all patients the perforation penetrated as far as the vitreous space. In patients with retinal detachment the authors investigated the following: the patient's age, refraction, period of retinal detachment, extent of retinal detachment, the state of the macula, the characteristics of the retinal defect (site, size and number), type of retinal detachment and associated adverse factors. In the characteristics of retinal detachment after perforating eye injuries the first place was held by prognostically adverse vitreous traction in 73.9%.

Adolescent↗

PubMed1991

[Pars plana vitrectomy in the treatment of exogenous suppurative endophthalmitis].

The authors evaluate the results of pars plana vitrectomy (PPV) in 12 patients with exogenous suppurative endophthalmitis (EHE). EHE developed after operation of cataract in eight patients and after perforating injury of the sclera in four patients. The shape, size and appearance of the eye was preserved in 11 eyes, the function of the eye with a visual acuity of 0.5-1.0 was saved in six eyes (50%), in one eye with bacteriologically confirmed mycotic enophthalmitis and in five eyes where bacterial infection was assumed. Inoperable detachment of the retina characterized the ophthalmoscopic finding in all eyes with loss of function. Close cooperation of ophthalmological departments with vitreoretinal centres and early performance of urgent surgery are the basic prerequisites of better functional results of PPV in EHE.

Adult↗

PubMed1991

[Pars palana vitrectomy in chronic uveitis].

The authors evaluated the results of pars plana vitrectomy (PPV) on account of chronic uveitis in 10 eyes of nine patients. In one patient where both eyes were operated on the cause of uveitis was spondylitis ankylopoietica, in the remainder the cause of uveitis was not revealed. All eyes tolerated PPV well. PPV markedly improved the visual acuity in 7 eyes (70%), a visual acuity of 1.0-0.7 was recorded in three eyes, an acuity of 0.4-0.1 also in three eyes and an acuity of 0.04 in one eye. The cause of failure in all instances was detachment of the retina. PPV is an obvious asset in the treatment of chronic uveitis associated with thick exudation into the vitreous body.

Adolescent↗

PubMed1989

[Pars plana vitrectomy with implantation of silicone oil in surgery forvery large retinal tears].

The authors evaluate the results of pars plana vitrectomy (PPV) with intravitreal implantation of silicon oil (ISO) in 19 eyes of 17 patients with gigantic tears of the retina. During the mean observation period of 22 months the operation was successful in 15 of 19 eyes (78%). The retina adhered on the entire surface in 12 eyes (65%), in three eyes (15%) there remained a defined flat elevation of the retina in the periphery of the lower half of the fundus which did not go as far as the macula. In successfully operated eyes the visual acuity was 0.4 in two eyes, visual acuity of 0.3-0.1 in 7 eyes and visual acuity less than 0.1, making spatial orientation possible, in six eyes. The cause of reduced visual acuity of successfully operated eyes were macular abnormalities which were associated with the fundamental disease, degenerative myopia, injury, impaired nurture of the macula during prolonged detachment, a membrane-forming process. As to late complications of ISO, the most frequent were glaucoma in 42% and complicated cataract u 78% phakic eyes. Extraction of a cataract with iridectomy VI and supplementation of silicon oil into the intravitreal space did not cause in any of the patients a relapse of detachment of the retina. The final evaluation of PPV with ISO in the surgery of gigantic lesions of the retina will be possible only after the long-term follow up of larger groups of patients.

Adolescent↗

PubMed1988