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Biomedical subjects

E Rakowska

Publications and source records attributed to E Rakowska.

14 recordsLinked to original sources
PubMed2001

[Zinsser-Engman-Cole syndrome (dyskeratosis congenita) with severe sicca syndrome, panuveitis and corneal perforation--a case report].

BACKGROUND: Zinsser-Engman-Cole syndrome (Z.E.C.) is a very rare type of ectodermal dysplasia, inherited in X-linked recessive manner and characterised by poikiloderma, nail dystrophy, lingual leucoplakia, bone marrow hypoplasia, hyperkeratosis and hyperhidrosis of planta and palms, dental anomalies and caries, premature grey hair. PATIENT AND METHODS: We report on a 46-year-old man who presented with occlusion of lacrimal puncta, trichiasis, severe dry eye, recurrent corneal ulceration and perforation, uveitis. HLA typing, flow cytometry of peripheral lymphocytes, bone marrow biopsy, conjunctival biopsy and extensive laboratory evaluation towards autoimmune and infectious diseases were performed. RESULTS: CD4+ T cells fraction was decreased, CD8+ and CD3+ HLA DR+ elevated. The patient was HLA-B27 positive. Laboratory studies revealed increased erythrocyte sedimentation rate and C-reactive protein level, hypochromic and hypoplastic anaemia, negative serum titers of antibodies to Epstein-Barr virus, HIV, HTLV-I, toxoplasma gondii and treponema pallidum, repeated titers to cytomegalovirus, herpes simplex and herpes zoster viruses--IgM negative, IgG positive. Corneal perforation was treated with amniotic membrane transplantation and corneal transplantation. CONCLUSION: The defect in cell-mediated immune mechanisms in Z.E.C. syndrome explains the corneal perforation, sicca syndrome and uveitis, first reported in this syndrome.

Autoimmune Diseases↗
PubMed1999

[Capsule contraction syndrome].

AIM: To analyse the occurrence of the anterior capsule contraction following cataract surgery. Capsule contraction syndrome (CCS) is defined as an extreme reduction in diameter of anterior capsulectomy, capsular bag diameter and, occasionally, displacement of the IOL after extracapsular cataract extraction. It is relatively frequent in pseudoexfoliation, advanced age, in association with uveitis, pars planitis and myotonic muscular dystrophy. MATERIALS AND METHODS: 5965 eyes of patients were operated on cataract between 1.01.1994 and 31.12.1997 in Tadeusz Krwawicz Chair of Ophthalmology and 1st Eye Hospital, Medical School in Lublin. Two types of surgical procedures were performed: "divide and conquer" phacoemulsification with 4.5-8 mm continuous curvilinear capsulorhexis (3385 eyes) and extracapsular cataract extraction with "can opener" capsulotomy (2580 eyes). RESULTS: 20 cases of clinically apparent CCS were referred to the Department: in the course of intensive postoperative inflammation--5, in patients over 80--4, in pseudoexfoliation syndrome--2, myotonic dystrophy--1, ectopia lentis--2, other causes--6. In order to improve visual acuity in 4 cases surgical removal of the distorted and opaque anterior capsule was performed, in 3 cases relaxing radial tears were done, in 3 cases secondary anterior capsulotomy was performed using Q-switched Nd:YAG laser. CONCLUSIONS: In cases where the occurrence of CCS is especially high large diameter capsulorhexis should be performed and IOL designed to provide maximal peripheral capsular bag expansion should be implanted.

Adult↗
PubMed1999

[Application of amniotic membrane transplantation in severe corneal diseases].

PURPOSE: To present our experience with the amniotic membrane transplantation in severe corneal diseases. MATERIAL AND METHODS: In 1998 amniotic membrane transplantation was applied in 18 eyes (17 patients) with severe and persistent corneal diseases. The indications were as follows: perforated corneal ulcer--9 eyes, persistent non-perforated corneal ulcer--4 cases, recurrent transplant disease--2 eyes, 1 patient with Sjögren syndrome and 1 with keratolysis in the course of ulcerative colitis. Amniotic membrane was prepared in the International Eye Bank of Lublin from human placenta after elective caesarean section according to the standard protocol. RESULTS: In 7 eyes with perforated ulcers and 4 eyes with non-perforated ulcers prompt healing was observed. In 4 cases markedly improved visual acuity resulted from corneal clarification. In 1 eye perforation persisted in spite of amniotic membrane transplantation and keratoplasty was performed afterwards. In the case of keratolysis, amniotic membrane transplantation did not prevent corneal perforation which was closed successfully with autologous conjunctival flap. In 2 eyes with recurrent transplant disease amniotic membrane dissolved quickly after transplantation. In one case the state of the cornea improved. The second eye required retransplantation of the membrane. We observed that amniotic membrane dissolved more quickly in a vascularized bed. CONCLUSION: Amniotic membrane transplantation may be considered a good alternative method for treating severe corneal disorders that are refractory to conventional treatment.

Adult↗
PubMed1997

[Corneal astigmatism after trabeculectomy].

PURPOSE: The aim of the present study was to investigate the effect of conventional and mitomycin trabeculectomy on the corneal astigmatism. SUBJECT AND METHODS: Measurements with the use of computer-assisted videokeratography (Eye-Sys) were performed in 34 glaucoma patients who underwent trabeculectomy. Color-coded topography maps were analyzed to obtain astigmatic data. RESULTS: The mean surgically-induced astigmatism in conventional trabeculectomy group was 2.2 D and in the mitomycin group 4.0 D, 1 day post-op, 1.3 D and 3.0 D after 10 days and 0.4 D and 1.1 D after 3 months, respectively. CONCLUSION: There was an apparent correlation between the amount of induced astigmatism and the use of mitomycin. This may be related to the impaired healing process of trabeculectomy wound and lower intraocular pressure in the mitomycin group.

Astigmatism↗
PubMed1996

[The value of bacteriologic examination in cataract surgery].

The purpose of our study was to compare the incidence of intrabulbar infections following cataract extraction and its correlation with the results of preoperative bacterial cultures. We examined 2344 patients who were operated on from 1st January 1993 to 31st December 1994 in our hospital. Patients were divided into 3 groups. In the first group surgery, was performed only in cases where preoperative cultures were negative, in the second group conjunctival cultures were prepared just before surgery. In the third group no preoperative cultures were prepared. Additionally in the second and the third group one drop of 5% Betadine solution was administered to the conjunctival sack just before surgery. We conclude that negative preoperative conjunctival cultures did not prevent from postoperative infections of the eye. After resigning of preoperative bacterial cultures the incidence of intrabulbar infections following cataract surgery did not increase in our study.

Cataract Extraction↗
PubMed1996

[Use of the laser-flare meter for early diagnosis of corneal graft rejection and for monitoring therapy].

AIM: The purpose of this study was to noninvasively quantify, with the use of a laser-flare meter, the alterations of the blood-aqueous barrier following penetrating keratoplasty. This could objectively indicate the disruption of this barrier in eyes with early allograft rejection, possibly even before the manifestation of the clinical signs, and would help to monitor the efficacy of the treatment. MATERIAL AND METHODS: We used the laser flare-meter (Kowa FM-500) to investigate alterations of the blood-aqueous barrier following uncomplicated penetrating keratoplasty (PK) and in corneal allograft rejection. Examination was performed in 53 eyes of 50 patients after uncomplicated PK (7 days to 12 months after PK), in 20 normal control eyes and in 8 patients with acute allograft rejection before and during the treatment. The treatment consisted of systemic and topical administration of steroids and in some cases additionally topical immunosuppressants. RESULTS: Mean flare values in the control eyes were 3.9 +/- 1.0 photon counts/ms. During the first two weeks after uncomplicated keratoplasty they were significantly increased (18.2 +/- 5.8) but were postoperatively slowly decreasing in time, nearly reaching the control values within 6-12 months. They were considerably higher in eyes with acute allograft rejection (34.0 +/- 13.1), but gradually diminished to 8.1 +/- 1.2 after successful treatment. CONCLUSIONS: The application of laser flaremetry is useful in the follow-up of patients after perforating keratoplasty, especially after high risk grafts. The method helps to detect quantitatively early allograft rejection and is beneficial in monitoring the effectiveness of the treatment.

Adult↗
PubMed1994

[Acanthamoeba keratitis].

Acanthamoeba keratitis has become a clinical problem together with the widespread use of soft and rigid contact lenses. The number of cases with this kind of infection is growing, but many of cases are diagnosed too late or misdiagnosed. The authors presented, for the first time in Polish literature, a case of acanthamoeba keratitis concerning a 62 aged man. The disease was diagnosed in the right aphakic eye after a 5-year use of soft contact lens, just after cataract operation performed in the clinic in the left eye.

Acanthamoeba Keratitis↗
PubMedDate not supplied

A simplified technique for non-penetrating deep sclerectomy.

PURPOSE: To present a modified technique for non-penetrating deep sclerotomy (NPDS) with limited use of sharp instruments. MATERIALS AND METHODS: A special fine spatula is used to separate the Descemet membrane from stromal tissue afterpreparing superficial and deep scleral flaps and opening the Schlemm's canal. Another specially designed spatula is used to protect the membrane when excising the overlying trabecular and stromal tissue. The other steps of the surgery are identical with the original Kozlov method. The modified surgery was performed by one surgeon experienced in NPDS, and three others starting their transition to this technique under the guidance of the first. Sixty-six patients (66 eyes) with primary open-angle glaucoma (51) or pseudo-exfoliature glaucoma (15) were treated with NPDS. RESULTS: Two microperforations (3%) of the Descemet membrane were the only intraoperative complications. They did not require iridotomy or any special treatment. In the early postoperative period one 2-mm hyphema was observed, and in five cases there was transient hypotony. In one other case there was a choroidal detachment, which resolved spontaneously in less than two weeks. IOP the day after surgery ranged from 5 to 13 mmHg (mean 9.6) and after one year from 10 to 22 mmHg (mean 14.6). Late complications and IOP control were similar to conventional NPDS. CONCLUSIONS: These procedures performed by one experienced and three inexperienced surgeons gave satisfactory results and the modified method can be recommended for surgeons beginning nonpenetrating glaucoma surgery, and should shorten their learning curve.

Adult↗