Biomedical subjects

Edward Wylegała

Publications and source records attributed to Edward Wylegała.

10 recordsLinked to original sources

PubMed2006

[Results of posterior lamellar keratoplasty].

PURPOSE: Posterior lamellar keratoplasty (PLK) in patients with pseudophakic corneal oedema. PARTICIPANTS AND METHODS: The PLK have been performed in our department since November 2004. The studied group consisted of 8 patients (7 female and 1 male), 65 to 82 years of age (mean age: 71.5 years). Visual acuity before the surgery ranged from 0.01 to fingers counting. All the patients suffered from pseudophakic corneal oedema. Endothelial keratoplasty was performed using Melles technique: a deep stromal pocket was created across the cornea through a 5-mm scleral access incision. Endothelium was prepared from whole eyeballs collected according to the EEBA guidelines. Donor disc containing healthy endothelium was folded during the implantation procedure. Average donor endothelial cell density was 2800 cells/mm2. All surgeries were performed by one surgeon (EW). RESULTS: In two eyes conversion to PKP was necessary. Best corrected visual acuity (BCVA) ranged from 0.4 to 1.0 (mean 0.6 +/- 0.12). Postoperative astigmatism ranged from 0.75 to 2.5 D (mean 1.8 D +/- 0.34). Postoperative endothelial cell density ranged from 1700 do 2300 cells/mm2 (mean 2200 cells/mm2 +/- 150). Mean Postoperative endothelial cell loss came to 29%. CONCLUSIONS: Posterior lamellar keratoplasty is a feasible surgery to manage corneal endothelial disorders. Automation of procedures by the use of laser preparation of donor tissue and adaptation automatic microkeratomes will increase the afterrepeating of procedures.

Aged↗

PubMed2005

[A clinical study of the Ahmed glaucoma valve implant in refractory glaucoma].

OBJECTIVE: To assess clinical outcomes of the Ahmed glaucoma valve implant in patients with refractory glaucoma. PARTICIPANTS: 15 patients (16 eyes), including 7 women and 8 men; patients with glaucoma: phakic- 10 eyes, pseudophakic - 4 eyes, and aphakic - 2 eyes, average age: 47.2 (18-72 years old), average IOP before the intervention: 47 mmHg (32-71 mmHg), average number of medications taken before the intervention: 3.0. MAIN OUTCOME MEASURES: Success was defined as IOP less than or equal to 21 mmHg and no need to perform another surgical intervention. Average period of observation was 23.2 months (6-42 months). RESULTS: Intervention was successful in 12 out of 16 eyes. Average number of medicaments taken after the intervention decreased to 1.2. 4 out of 16 patients had a hypertensive phase. Cumulative probabilities of success at 1 and 2 years were 88% and 72% respectively. COMPLICATIONS: hyphema - 4 eyes (25%), tube exposure - 1 eye (6.25%), corneal graft failure - 4 eyes (25%), hypertensive phase - 4 eyes (25%) anterior chamber shallowing - 2 eyes (12.5%) CONCLUSIONS: The Ahmed glaucoma valve implant is an effective way of treating the patients with refractory glaucoma.

Adult↗

PubMed2005

[Indications for keratoplasty in District Railway Hospital in Katowice].

PURPOSE: The retrospective analysis of indications for keratoplasty. MATERIAL AND METHODS: The study of 517 keratoplasties between May 2000 and December 2004. RESULTS: The indications were: corneal oedema--24,5%, keratoconus--18,1%, corneal leucoma--15,0%, limbus insufficiency--10,2%, Fuchs endothelial dystrophy--9,0%, graft decompensation--8,1%, other acquired keratopaties--5,9%, corneal perforation--5,8%, anterior and stromal dystrophies--2,3%, Peters' syndrome--0,38%, choristoma--0,19%. CONCLUSION: Main indication for keratoplasty are corneal oedema and keratoconus.

Corneal Diseases↗

PubMed2004

[Macular corneal dystrophy including histologic and ultrastructural changes].

PURPOSE: The study reports the results of a histological and ultrastructural examination of the corneal button, obtained during penetrating keratoplasty from patient with clinically recognized macular corneal dystrophy. MATERIAL AND METHODS: 34-year-old male patient suffering from macular corneal dystrophy (MCD) has been treated on corneal epithelium defect and photophobia since his early childhood. Visual acuity was decreased on the Snellen test chart to 0.02. Slit-lamp examination, and ultrasonographical measurement of the cornea's thickness were performed. Removed during penetrating keratoplasty corneal button was divided into two pieces. One of them was prepared in standard procedure for histological examination in the light microscopy after having been stained with hematoxylin and eosin, alcian blue and paS-method. From the other part, slides for ultrastructural examination in the transmission electron microscopy were prepared with the use of standard method. The family history from the patient was also taken, and available relatives have undergone examination in search of typical MCD symptoms. RESULTS: Slit-lamp examination findings revealed diffuse, from limbus to limbus, stromal opacification. In measurement by pachymeter cornea's thickness was reduced. In the light microscopy, in typical stained slides, delaminations within stroma and deficit of endothelial cells were observed. After being stained with alcian blue, dark blue deposits in the places of delamination became visible. By transmission electron microscopic examination, intracellular and extracellular deposits were detected in the stroma, Descemet membrane and endothelium. Distended keratocytes with enormous vacuoles containing abnormal material were found. Pedigree was typical for autosomal recessive inherited disease. CONCLUSIONS: Histological and ultrastructural diagnosis is a basis of recognition of macular corneal dystrophy. Analysis of the pedigree as well as ultrasonographical measurement of the cornea's thickness is very helpful to establish the right diagnosis.

Adult↗

PubMed2004

[Partial coherent interferometry--an alternative method for intraocular lens power calculation performed by ultrasonography].

PURPOSE: To compare axial length estimated by means of Zeiss IOLMaster and A-scan ultrasonography and anticipate postoperative refraction after IOL implantation with refraction measured after operation. MATERIAL AND METHODS: 26 patients were analyzed. Measurement of axial length was performed by Zeiss IOLMaster and A-scan ultrasonography. Preoperative refraction was determined by both methods based on SRK/T calculation formula and 119.0 and 120.5 A-constant for IOL. Postoperative refraction was expressed as a spherical equivalent and was obtained by autokeratorefraktometry in the first day after cataract surgery. RESULTS: Mean axial length measured by IOLMaster was longer by 0.06 mm in compared to ultrasound estimation (p < 0.001). The correlation between pre-operative refraction values determined by IOLMaster and post-operative measurements was statistically significant (p = 0.03). CONCLUSIONS: Measurement of axial length performed by IOLMaster is longer than by ultrasonography. IOLMaster seems to be more reliable method than ultrasonography in intraocular artificial lens calculation in cataract surgery.

Aged↗

PubMed2004

[Donor matching for corneal limbal stem cell transplantation from living related donors based on compatibility typing of HLA class I].

The cornea is an immune privileged site, but failure of corneal limbal stem cells is the cause of vascularisation, increasing the risk of immune response activity. The outcome after conjuctival limbal stem cells transplantation depends mainly on HLA system compatibility. HLA class I typing is one of the important factors considered in donor/recipient par matching. The aim of our study was the analysis of post transplant period in 16 related donor/recipient pars after limbal stem cells transplantation. We conclude that HLA class I and other immunogenetic factors compatibility (inside and out of the HLA region), may play the role in effective treatment.

Adult↗

PubMed2003

[Foreign bodies in the orbit misdiagnosed as fracture of the orbital lateral wall].

54 years old male presented with an injury to the face. As a result of this incident, some pieces of glass were penetrating into the left orbit. Total ophthalmoplegia and hematoma with exophthalmus in the left orbit were observed. The difficulties of radiology and clinical diagnosis was described. The circumstances of accident were wrong reported by the patient. Radiograms and computed tomography (CT) were misdiagnosed. As a result of theses, it was necessary to perform two times operation. The best useful but not ideally in diagnostic was NMR. Consultation and collaboration with oculist, radiologist, neurologist and maxillofacial surgeon is often useful.

Diagnosis, Differential↗

PubMed2003

[Applying deep lamellar keratoplasty in corneal disorders without endothelial abnormalities].

PURPOSE: To present own experiences in the surgery of deep lamellar keratoplasty. MATERIALS AND METHODS: 25 eye of 25 patients suffering from various corneal pathologies with preserved endothelium: 22 with keratoconus eyes, 2 with post-inflammatory scar and one eye with leucoma in Stevens-Johnson syndrome. Mean follow-up was 25.5 months (from 6 to 32). Main outcome measures were Non-Corrected and Best Corrected Visual Acuity (NCVA, BCVA), astigmatism, refractive error, IOP and corneal transparency. The surgery was performed in general anesthesia. In majority of cases the recipient stroma was trephined to a depth of 70% with 7.5 mm diameter vacuum trephine. In cases of intraoperative perforation of Descemet membrane with shallow anterior chamber we converted the procedure into penetrating keratoplasty. The donor lenticule was trephined in the artificial chamber with the 0.5 mm oversized manual trephine to a depth of 90%. In two cases after DLK was finished, limbal stem cell grafting was additionally performed. RESULTS: Postoperative NCVA ranged from 0.01 to 0.8 and BCVA from 0.1 to 0.8. Astigmatism ranged from 0.5 to 10.0 D. Refractive error ranged from -8.0 to +1.0 D. In follow-up period all grafts maintained transparent. The complications were mainly intraoperative perforations of Descemet membrane (9 cases): in 7 cases we convert the procedure into penetrating keratoplasty. In 2 cases the double chamber-forming was observed: in one case on 7 day following surgery the penetrating keratoplasty was performed, in other a spontaneous attachment was observed. We also observed loose sutures in 2 cases, inflammatory infiltrates in one case. Two cases of ocular hypertension was successfully treated by medication. CONCLUSIONS: Deep lamellar keratoplasty is an effective procedure for treating various diseases of corneal stroma with unaffected endothelium.

Adult↗

PubMed2003

[Surgical techniques in limbal stem cell transplantation].

Limbal stem cells (LSC) deficiency is one among the causes of corneal transparency loss. The only effective management is LSC transplantation. In available techniques the source of donor tissue containing LSC can be healthy fellow eye (CLAU, EVELAU), living-related (lr-CLAL, lr-EVELAL) or cadaveric donor (c-CLAL). From among them, the most efficient and the safest procedure is transplantation of cultured stem cells. Preoperative diagnosis and ocular surface condition determine the choice, of which procedure is the best. The surgical restoration of ocular surface is the sequence of procedures and the penetrating keratoplasty is the ultimate rehabilitative step in this process.

Cell Culture Techniques↗

PubMed2003

[Limbal stem cell transplantation from HLA-compatible living donors. Long term observation].

PURPOSE: The assessment of clinical outcome in patients after Ir-CLAL procedure. MATERIALS AND METHODS: Retrospective, interventional case series including 11 patients (12 eyes), all with non-ambulatory visual acuity (from light perception to hand movements). Mean age was 39.4 years (ranging from 18 to 76 years). In 7 eyes Limbal Stem Cells Deficiency (LSCD) resulted from chemical burn, in 2 eyes from ocular cicatricial pemphigoid, in one eye from Stevens-Johnson syndrome (SJS). In one eye congenital LSCD was diagnosed and in another one post-inflammatory LSCD. Mean follow-up was 16.2 months (from 10 to 32). Among donors prospective class I HLA matching was performed. Maximal two mismatches were accepted. General immunosuppressive therapy was switched-on in all subjects. Surgical excision of corneal pannus with clearing of limbal area was performed. Five clock hours stem cells tissue grafts from living related donors were harvested and transplanted to the recipient eye. Three penetrating keratoplasty, one deep lamellar keratoplasty and seven amniotic membrane transplantations were additionally performed. Main outcome measures were graft survival as a restoration of corneal epithelium, visual acuity improvement and complication in donors and recipients. Kaplan-Meyer survival curve and generalized Peto test were used for comparison. RESULTS: The graft survival was 83.6% in mean 20.3 months follow-up (from 10 to 32 months). Two cases of graft failure concern eye with SJS and eye with PKP regrafting after chemical burn. Visual improvement in 7 cases (58.3%), the same visual acuity in 4 cases (33.3%) and deterioration one case (8.3%) were noted. Ambulatory vision in 50% of patients was achieved. Graft rejection syndrome in four eyes was noticed also when ideal matching and CsA serum level 220 ng/ml. Two cases were treated with success and another two grafts failed. No complications in donors eyes were noticed. Impression cytology in eyes with successful grafts not related to pathological changes. CONCLUSIONS: Lr-CLAL are effective in ocular surface restoration. Living-related donors are suitable source of stem cells for cultivation in vitro. The prognosis for stem cells grafting is definitely worse when eyelid anomaly and adhesions exist.

Adult↗