Biomedical subjects

K Vavrová

Publications and source records attributed to K Vavrová.

9 recordsLinked to original sources

PubMed2001

[Microsurgical treatment of posterior capsule opacification].

PURPOSE: To evaluate irrigation/aspiration and posterior capsulectomy in the treatment of the posterior capsule opacification (PCO). SETTING: Department of Ophthalmology, School of Medicine, Comenius University, Bratislava, Slovakia. MATERIAL AND METHODS: Between 1.1.1999 and 31.7.2000 we treated 75 patients (79 eyes) for PCO. Cataract surgery was performed in the years 1990-1999. The artificial intraocular lens (IOL) was implanted in 62 eyes. The interval between cataract surgery and PCO surgery ranged from 4 m.-10 y. The regenerative type of PCO was present in 41, fibrotic in 23 and combined in 15 eyes. Irrigation/aspiration (I/A) was performed in 44 eyes. Capsulectomy with a vitrectomy probe was performed in 35 eyes. I/A procedure was 42x performed with a bimanual system. Capsulectomy was performed in combinations of various insertions of the infusion line (without, anterior chamber maintainer-AChM, pars plana) and capsulectomy (limbal or pars plana approach). It was evaluated: occurrence of peri- and postoperative complications; achieved best corrected visual acuity. RESULTS: Complications during I/A: posterior capsule tearing with vitreous prolaps 4x, IOL subluxation 3x, partial zonular dialysis 2x-1x with vitreous prolaps. During capsulectomy performed through the limbus was observed vitreous prolaps in two eyes. After capsulectomy, performed through pars plana without infusion line, was observed the chronical corneal oedema in one eye. The best corrected visual acuity improved for 2 and more lines in 79.5% of eyes after I/A procedure and in 74.3% of eyes after capsulectomy. The achieved visual acuity lower then 6/60 was caused by changes not related to the cataract and PCO surgery. After testing of various combinations, the most suitable capsulectomy procedure seems to be: infusion line through the limbus, capsulectomy through the radial scleral tunnel incision. In this fashion it is possible to perform the procedure as no-stitch surgery. CONCLUSIONS: Instead of possibility of occurrence of various peri- and postoperative complication after I/A and capsulectomy used for treatment of PCO these procedures complete possibilities in the treatment of PCO. For the regenerative type of PCO is suitable I/A procedure. For the fibrotic type of PCO is suitable capsulectomy through pars plana with AChM. By this procedure it is possible to remove also nearly all vitreous opacities.

Adult↗

PubMed2000

[Intraocular foreign bodies in the posterior eye segment].

BACKGROUND: A penetrating eye injury due to an intraocular foreign body (IOFB) may result in a poor vision and even in loss of the eye. A proper analysis of the cause of injury and of the injured eye enables a correct decision to be made concerning timing and method to be used not only for foreign body removal but also concerning of all sight saving surgical procedures. PATIENTS AND METHODS: Over the years 1989-1993, 51 patients with an IOFB in the posterior segment of the eye were treated at the Department of Ophthalmology of the Comenius University in Bratislava. One patient was lost from the long-term observation and in two patients was an intraocular foreign body not removed. We evaluate results in 48 patients. The operative techniques used by foreign body removal and by reoperations are mentioned. The occurrence of peroperative and postoperative complications and the final anatomical and functional results are evaluated. An average follow-up period was 40.7 months. The value of the following prognostic factors was considered in relation to the final visual acuity: size and location of the laceration of the eye, size of IOFB and time of IOFB removal. The statistical significance was tested by Chí-square. Fischer's coefficient for tetrachoric tables was used for the calculation of power of dependence. RESULTS: The foreign body was removed from 64.6% of the eyes after pars-plana vitrectomy. Foreign body caused serious damage of the intraocular structures in 37.5% of the eyes. The poor anatomical result was achieved in 18 (37.5%) and good in 30 eyes (62.5%). In twelve eyes (25%) was implanted an IOL. The final visual acuity of 6/9-6/6 was achieved in 18 (37.5%) and visual acuity lower than 2/60 was recorded in 21 (43.7%) of the eyes. The prediction of bad visual acuity (lower than 2/60) was significant related to: all lacerations except of corneal wounds smaller than 4 mm, IOFB size exceeding 3 x 2 mm. CONCLUSIONS: Management of retained intraocular foreign bodies should be individual and is dependent on the extent of the initial injury and the characteristics and location of the IOFB. The final outcome depends mostly on the extent of the primary injury and of the occurrence of the peroperative and postoperative complications.

Adolescent↗

PubMed2000

[Problems in diagnosis of intraocular foreign bodies in the posterior eye segment].

BACKGROUND: To evaluate the application of the available diagnostic procedures in intraocular foreign bodies impacted in the posterior segment of the eye. MATERIALS AND METHODS: Between 1989-1993 were treated 51 patients and between 1994-1998 were treated 74 patients with intraocular foreign bodies in the posterior eye segment at the Department of Ophthalmology, Medical faculty of the Comenius University in Bratislava. It was evaluated: time of the first medical examination, cause of the injury, time of the right diagnostic and used ancillary testings. In the second period (prospective study) was evaluated also foreign body trajectory in the posterior segment of the eye. The influence on the final visual acuity was evaluated in no proper diagnosed patients. RESULTS: 50.9% of patients in the first period and 55.9% of patients in the second period were injured while at work. Foreign body was metallic in 96% and 94.7% respectively. In the first period 12 patients were injured by various explosions and in the second period 16 patients were injured by working with some circulating tools. The most common ancillary testing was plain film testing and Comberg localisation. In the second period was intraocular foreign body trajectory defined as indirect in 24 eyes (32%). The foreign body achieved its final intraocular position after simple or double contact with the retina. Foreign body was unproperly diagnosed in 14 patients. The final visual acuity was negative influenced by this fact in 8 patients. CONCLUSIONS: A history and ocular examinationare are still most important in diagnosis of the penetrating eye injury with intraocular foreign body. The basic ancilary testing is simple plain film. Ultrasonography is helpful in diagnosis of other intraocular pathological changes. In justified cases is also possible to perform computed tomography. The peroperative intraocular diagnostics is very important for treatment of the all injured intraocular structures.

Adult↗

PubMed1998

[Endophthalmitis after lens surgery].

At the University Eye Clinic Bratislava we performed a retrospective study on the occurrence of endophthalmitis after lens operations. Over the years 1993-1995 we performed 2374 lens operations. Endophthalmitis occurred in 20 eyes (0.84%). Endophthalmitis occurred after uncomplicated as well as after surgical procedures with various perioperative complications. All patients were treated with antibiotics locally and parenterally. Nine patients were treated with steroids. In these patients we did not performed pars plana vitrectomy. Owing to endophthalmitis one eye was eviscerated. In one eye after previous vitrectomy for proliferative diabetic retinopathy developed later inoperable retinal detachment. In one eye was present an old retinal detachment before the cosmetic cataract extraction was performed. Without any complications were cured nine eyes. In eight eyes are remained iris synechiae and vitreous opacities. Two eyes lost light perception and one eye was without light perception already before cataract extraction. The final visual acuity was better than 2/60 in 70% of the eyes and better than 6/36 in 50% of the eyes.

Cataract Extraction↗

PubMed1998

[5-years' experience with transvitreal extraction of subretinal neovascular membranes].

Over the period between June 1992 and November 1997, 15 subretinal neovascular membranes were removed in the Department of Ophthalmology of the Comenius University in Bratislava. The age of patients ranged between 57 and 72 years. In 13 patients the membrane was caused by age-related macular degeneration, in one patient the cause was choroiditis of unclear etiology and in one patient the membrane was caused probably by age related changes combined with myopic changes in the macular region. In three eyes only subretinal membrane was present. In all other eyes were also subretinal haemorrhages, hemophthalmus, or retinal detachment present. The visual acuity ranged between light perception and 1/50. After membrane removal the retina was tamponated by silicone oil in 10 eyes and by expanding gases in four eyes. In one eye peroperatively occurred profuse bleeding from choroidal vessels and this procedure was interrupted. The follow-up period ranged form 5-52 months. During this period in nine patients were performed additional 12 surgical procedures. The visual acuity achieved is 0 in three eyes and in other eyes it ranged between hand movement and 5/50. Two eye atrophied. In one eye retinal detachment is present. Three eyes are still filled with silicone oil. In two of them the tamponade will be probably permanent. In nine eyes large areas of retinal pigment epithelium atrophy are present and in two eyes also subretinal fibrous membranes are present.

Aged↗

PubMed1997

[Endophthalmitis after intraocular interventions].

BACKGROUND: Endophthalmitis is serious complication of intraocular surgery. At the University Eye Clinic Bratislava we performed a retrospective study on the occurrence of endophthalmitis after various intraocular procedures. MATERIAL AND METHODS: Over the years 1993-1995 we performed 2374 cataract extractions, 305 anti-glaucoma operations, 106 perforating keratoplasties and 926 pars plana vitrectomies. The charts of all patients were reviewed. The occurrence of endophthalmitis, type of surgery, perioperative complications, elapsed time between surgery and start of endophthalmitis, results of preoperative conjunctival smear cultures, final anatomical and functional results were evaluated. RESULTS: The frequency of endophthalmitis after cataract extraction was 0.84%, after antiglaucoma surgery 1.31% and 0.97% after pars plana vitrectomy. No endophthalmitis was found after penetrating keratoplasties. In most cases endophthalmitis began in the first three days after surgery. Endophthalmitis occurred after uncomplicated as well as after surgical procedures with various perioperative complications. The preoperative conjunctival smear cultures were sterile in 22 patients. Staphylococcus epidermidis was the most commonly cultured germ. All patients were treated with antibiotics parenterally and locally. Pars plana vitrectomy and intravitreal application of antibiotics was performed only exceptionally. Enucleation was required in two eyes and two other eyes become phthitical. 22 eyes recovered without serious complications. Five eyes were blind and in 11 eyes the final visual acuity was better than 6/36. CONCLUSIONS: Pre-, peri-, and postoperative measures must be improved to prevent postoperative endophthalmitis. In cases of endophthalmitis all therapeutical options have to be performed as soon as possible to save the patient's eye and sight.

Adult↗

PubMed1995

[Use of the DK-Line OPSIA liquid perfluorocarbon].

Since May 1993 to February 1995 we have used "DK-LINE" OPSIA in 137 patients in whom were 161 procedures on 141 eyes performed. It was used in 116 retinal detachments, 29 of them were posttraumatic. 28x in the eyes with proliferative diabetic retinopathy, 8x by injuries of the posterior segment of the eye, 5x in dislocated lenses and 3x by the removal of subretinal membranes. At the end of retinal detachment surgery was retina attached in 94.2%. Peroperatively we recorded subretinal migration of PFCL in 16 cases. 13x was removed peroperatively and 3x later by the reoperations. In three aphakic eyes we recorded postoperatively small bubble of PFCL at the bottom of the anterior chamber. From two of them was fully removed by paracenthesis and from the third by the reoperation. Only 1x we used an internal tamponade in duration of 5 day. We recorded serious sero-fibrinous exudation in the anterior chamber and in the vitreous cavity over the level of PFCL.

Fluorocarbons↗

PubMed1994

[Effective extraction of intraocular foreign bodies].

In 39 patients was removed an intraocular foreign body in the years 1989-1991. 12 of them in the anterior segment of the eye, 14 in the vitreous body, 11 in the retina and 2 in the posterior part of the sclera. From the anterior segment were all bodies removed with forceps. From the vitreous body and the retina were foreign bodies removed mostly by forceps after previous vitrectomy. Functionally the worst results were achieved in foreign bodies where pre-, or peroperatively retinal detachment was present. Visual acuity under hand movement was present in 12 eyes.

Adolescent↗

PubMed1993

[Ostensible ultrasonic changes after internal tamponade of the retina with silicone oil].

Echographic control after pars plana vitrectomy (PPV) and internal tamponade of the retina with silikon oil (SO) is necessary in case of opaque optical media (bulous keratopathy, bleeding and exsudation within anterior chamber, complicated cataract). In interpretation of echographic image some difficulties or errors may be caused by physical properties of SO, as for example reduced speed of propagation of ultrasound in this media, ultrasound absorption coefficient, acoustic impedance and reflection coefficient.

Eye↗