Biomedical subjects

I Karel

Publications and source records attributed to I Karel.

At least 19 recordsLinked to original sources

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

[Pars plana vitrectomy in proliferative diabetic retinopathy. Long-term results and prognostic parameters in diabetics with surgery 1983-1989].

The authors evaluated the long-term results and prognostic parameters of pars plana vitrectomy (PPV) in complications of proliferative diabetic retinopathy in 235 eyes of 187 diabetics operated between Jan. 1 1983 and June 30 1989. In 117 eyes PPV was combined with implantation of silicon oil. During an average observation period of 27 months PPV improved markedly the visual acuity of 125 eyes (53.2%), however a visual acuity of 0.1 or better acuity was recorded only in 53 eyes (22.6%). The number of successfully operated eyes declined with the length of the observation period from 67.7% after three months to 50% after 60 months. Active vascular proliferation, iatrogenic fissures of the retina, implantation of silicone oil and postoperative development of rubeosis were statistically significant adverse factors from the prognostic aspect. With the development of new surgical procedures the importance of different prognostic factors changes partly.

Adult↗

PubMed1991

[Ultrastructural changes in the vitreous body in diabetic retinopathy].

The authors investigated by transmission electron microscopy bioptic specimens obtained during pars plana vitrectomy. In the findings phagocytozing cells predominate. Due to cell damage accurate typing is difficult. The authors discuss the causes and extent of cellular damage. From morphological findings the conclusion can be drawn that in the histological picture macrophages, hyalocytes and damaged collagen fibrils predominate.

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↗

PubMed1991

[Use of Tissucol, a tissue glue, in reconstructive surgery of large scleral defects].

In a 14-year-old female patient the postoperative course of myectomy of the musculus rectus oculi externus on account of concomittant strabism was complicated by necrosis of the sclera (diameter 9 mm) at the site of intrascleral stitches and exudation into the anterior chamber and the vitreous body. For fixation of the transplant from lyophilized sclera the tissue glue Tissucol Kit was used. Tissucol rapidly and firmly joined the wound areas, its direct contact with uveal tissue did not produce an inflammatory reaction and the exudate from the anterior chamber and vitreous body was absorbed rapidly and completely.

Adolescent↗

PubMed1990

[Long-term results after implantation of silicone orbital implants].

In 1980-1988 at the Second Ophthalmological Clinic 78 enucleations of the bulbs with a orbital silicon implant were performed. The tolerance of the implant and the cosmetic result of the operation was evaluated in 53 adults and 5 children. The observation period varied between 6 months and 7 years. From the total number of 53 adults a very good cosmetic effect was achieved in 9 (17.1%), a good effect in 25 (47.1%), a satisfactory effect in 12 (22.6%) a poor effect in 2 (1.8%) patients. The implant was rejected in 5 (9.4%) of the cases, 4 implants within one month and one two years after enucleation. A very good cosmetic effect was observed in one (20%) child and a good effect also in one (20%). The implant was rejected in 3 (60%) children, 1, 4 and 20 months after operation. Rejection after 20 months was preceded by an inflammatory reaction in the area of the implant. Rejection of orbital silicon implants in adults was as a rule due to surgical complications or incorrect surgical technique. In the rejection of implants in young children the increased biological reaction of the child organism may be involved.

Adolescent↗

PubMed1989

Specular and scanning electron microscopy in diffuse silicone keratopathy.

In a 50-year-old man, penetrating keratoplasty was carried out to treat a diffuse silicone keratopathy that developed 2 years after a pars plana vitrectomy combined with an intravitreal silicone injection for a complicated retinal detachment in the only aphakic eye. At 2 weeks after the intravitreal silicone injection, specular microscopy revealed a mild pleomorphism in the corneal endothelium and an endothelial cell loss of 26%. After 5 months, a small silicone drop floated in the anterior chamber and the first signs of diffuse keratopathy were observed. At the same time, specular microscopy revealed severe damage to the endothelial cells and a cell loss of 69%. After the keratoplasty, scanning electron microscopy of the corneal button showed a filamentous structure of the posterior surface of the cornea, with fibroblast-like cells; the endothelial cells were absent.

Anterior Chamber↗

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↗

PubMed1989

[Indications for pars plana vitrectomy].

The main indications of pars plana vitrectomy are opacities of the vitreous without tendency to be absorbed, proliferating retinopathies, complicated retina detachment, heavy ocular injuries and states after the injuries, infective endopthalmitis and epimacular membranes. There is paid attention also to the indication for the inner tamponade using gases and silicone oil. Author emphasizes the cooperation between the all ophthalmologists with specialized vitreoretinal surgical units, because this is extremely needed for the repair of the urgent cases where early performance of PPV is operation of choice.

Humans↗

PubMed1989

[Problems in pars plana vitrectomy in complicated diabetic retinopathy].

Introduction summarizes basal indications for pars plana vitrectomy (PPV) in complicated diabetic retinopathy (DR) and indications for urgently performed PPV are accentuated. Further there are explained various peculiarities of PPV in DR, various components forming the solution for infusion, advantages of the cerclage, some problems with surgery of the complicated cataracts, contribution and indications of the use of the silicone oil for the inner tamponade. Special attention was paid to the postoperative complications affecting the cornea, rubeosis iridis, iatrogenic tears of the retina and recurring intravitreal hemorrhages. Thereafter author concludes this review evaluating prognosis and long-term results of PPV and DR. He emphasizes the technical difficulties of this operation and recommends to concentrate the performance of this operation into the centres specialized for vitreoretinal surgery.

Diabetic Retinopathy↗

PubMed1989

[Is the prognosis of pars plana vitrectomy in diabetic retinopathy dependent on the general status of the diabetic?].

Results of pars plana vitrectomy (PPV) were compared in two groups of patients. The first group was formed from 105 eyes of 87 diabetics without clinical signs of the diabetic nephropathy or nephropathy without decrease of renal functions. The other group was formed from 64 eyes of 50 diabetics suffering from diabetic nephropathy in the stage of the renal insufficiency. In the first group PPV was successful during the mean observatory period of 26 months, in 59 from 105 eyes (56%) and the mean visual acuity was 0.12. In the second group PPV was successful, during the mean observatory period of 18 months, in 34 from 64 eyes (53%) and the mean visual acuity was 0.09. Number of the successfully treated PPV was steadily decreasing according to the prolonged period of the further observations, in both mentioned groups: from 85 (81%) after 3 months on 62 (41%) after the interval of 3 years. The mean visual acuity in both followed groups was, with respect to the length of observation, moderately increased. Diabetic nephropathy in the stage of the renal insufficiency was without negative effect on the prognosis of PPV in complicated diabetic retinopathy. The more advanced organ complications of diabetes were not evaluated as contraindications of PPV and the operation may significantly improve the quality of the life of an otherwise heavily ill diabetic patient.

Adult↗

PubMed1988