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Biomedical subjects

P Kuchynka

Publications and source records attributed to P Kuchynka.

At least 19 recordsLinked to original sources
PubMed2004

[Congenital cataract--the growth of the eyeball after the PC IOL implantation].

The authors followed the influence of PC IOL (posterior chamber intraocular lens) implantation in congenital cataract to the growth of the eyeball (six bilateral cataracts and 6 monolateral cataracts). The development of the eye growth was compared to the 6 healthy eyes of patients of this group. The intraocular lens implantation was performed at the age of 1 to 5.5 year, in average at the age of 3 years. The follow up period was 4 to 7 years, mean 6 years. In operated, as well as in non-operated eyes, an equal average growth of the eyeball 0.2 mm per year was detected. All operated eyes were slightly hypermetropized according to the physiological values of growth of healthy eyes. The absolute mean deviation from emmetropia was 1.8 diopters. The author established the suitability of intraocular lens implantation in small children because of positive influence to the growth as well as to the final visual acuity, which ranged from 0.05 to 1.0, mean 0.4.

Cataract↗
PubMed2003

[Angiolymphoid hyperplasia with eosinophilia or Kimura disease?].

Angiolymphoid hyperplasia with eosinophilia (ALHE) and Kimur's disease are two rarely occurring and mutually very similar, yet independent nosological units. For the frequency of similar features these diseases were long considered to be modifications of one disease. In the last years most authors considered these diseases to be independent entities with certain specific clinical and morphological features. The case of a 76-year white man, suffering from occurrence of subcutaneous tumor formations in various part of the body for the period of six years, is described. Six years after the first signs of the disease, swelling of eyelids on the right eye with palpable resistance under the upper temporal margin of eye socket developed. A similar finding also developed on the left side eight months later. The tumors were removed by surgery and subjected to histological examination. One year later a unilateral relapse developed to be again subjected to surgical treatment and histological examination. In the first two orbital excisions the tumor infiltrate was in topical connection with structure of the tear gland, the third excision did not contain such structures. The histological diagnosis was established as ALHE in spite of some common features with the Kimur's disease. The diagnosis of ALHE was especially supported by absence of the formation of lymphatic follicles, absent fibrotization in the infiltrate and epithelium-like or even histiocyte-like appearance of proliferating endothelia, which formed minute vascular lumina. A substantial exceptionality in the occurrence of the Kimur's disease in white Europeans further supported the diagnosis of ALHE. Our own experience indicates that both units mutually overlap even in features considered to be of distinctly different character. A question arises, whether the strict division of these two nosological units is really possible in practice with unequivocal certainty.

Aged↗
PubMed2003

[Indications for refractive procedures in adult patients with strabismus and results of the subsequent therapeutic procedures].

The authors estimated the contribution of the refraction intervention and a possible evolution in the position of eyes in 102 adult individuals considering a refraction intervention. The indications for this intervention were a disorder in eye position or amblyopia in those who were interested in this operation and were examined in the years 1996 to 2002. The basic refraction examination was always supplemented by a detailed orthoptic analysis. Based on this examination the intervention was not recommended in 14 examined subjects (14%). ARK represented the contraindication of the refraction intervention in 9 patients, since subsequent changes in the size of the deviation or operation adjustment of strabismus could result in diplopia. An excessive convergence with a high AC/A in hyperopia was also considered as an unsuitable indication, since a lasting cosmetic and functional significant convergent deviation into near distances could not be excluded. Five patients declined from the refraction intervention on the basis of this explanation. The paper is mainly dealing with an analysis of the development of position of the eyes and binocular functions in 46 adult patients, who decided to undergo a refraction intervention and further orthoptic care after a complex stroboscopic and refraction examination. The adjustment of refractive error was made by the LASIK methods (Laser in Situ Keratomileusis) on 69 eyes (80%) and CLE (Cleans Lens Extraction) on 17 eyes (20%). The orthoptic analyses before and the refraction intervention revealed that in all 29 even only partially accommodating esotropia, the deviation was diminished after the refraction intervention on the average by +11.2 degrees (in the rage of +2 degrees to +30 degrees) to 5.4 degrees (in the range of parallel position to +20 degrees) in the predominantly represented hyperopia, but also in 6 myopias. The improved position of the bulbs was not directly associated with the degree of hyperopia with the original deviation. The deviation after the refraction intervention in 23 patients (79%) with esotropia was not higher than degrees. The cosmetic position of the eyes was completely satisfactory and did not therefore represent even indication for the operation. The 9 patients (35%) with esotropia and hyperopia there were an improvement of binocular functions. It could be theoretically due to the newly developed emetropia making permanent optimal sensory information possible. In all 17 exotropias there were not any significant changes in the size of deviation and the binocular functions were not reestablished, if they were not retained before. The position of eyes was solved surgically in 12 patients, while exotropia predominated in two thirds of them. The weakening or strengthening interventions on horizontal straight muscles were selected according to character of strabismus in 11 patients. Recession of the lower oblique muscle was indicated one case only for the simultaneously present torticollis with exotropia. The residual deviation was not greater than 5 degrees immediately after the operation or during the following months. Binocular functions were not reestablished in any patients. A alternate suppression or suppression of perception on one eye were proved.

Adult↗
PubMed2002

[Implantation of the AcrySof MA30BA lens using the Monarch system].

The authors describe experiences with implantation of the intraocular lens AcrySof MA30BA by the Monarch IOL delivery system. They consider the facility of Monarch's system completion, the location of the lens in the cartridge and its folding, lens passage through the cartridge and its expansion intraocculary. The authors evaluate the width of incision necessary for the conduction of injector, preoperative and postoperative course, final visual acuity and inducted astigmatism. The results of the work show that implantation of the lens AcrySof MA30BA by the IOL Monarch delivery system is easy and safe. The width of incision after implantation performs criterion of the no stitch technique and corresponds contemporary requirements of the modern cataract surgery of small incision.

Adult↗
PubMed2002

[Spontaneous reduction and absorption of cataracts in childhood].

The authors give an account on spontaneous reduction and absorption of cataracts in nine children. The initial symptom where leukocoria predominated was as a rule detected already in infant age. In one case the affection was bilateral and was manifested by partial pseudoaphakia. The observation comprised also classical secondary aphakia in a 4-year-old girl. Resorption of lenticular masses of cataracts into the shape of membranous discs or reduced masses of a fibrous character took on average 18 months on seven eyes and this process was associated with vascular activity in four lenses. In two of these patients during resorption panuveitis was observed with a hyperergic response in humoral and cellular immunity without obvious general antigenic action which caused atrophy of the optic nerve. Surgical solution of cataract was used in four eyes, PC IOL was implanted in one patient which had a favourable effect on visual function. Histological examination was successful of the extracted reduced lens only in one case. Inside the lenticular capsule was a mixture of the original fibrotically altered cataract masses with ingrowing vascular tissue.

Aphakia↗
PubMed2001

Causes of severe visual impairment and blindness in children attending schools for the visually handicapped in the Czech Republic.

AIMS: To describe the causes of severe visual impairment and blindness in children in schools for the visually handicapped in the Czech Republic in 1998. METHODS: Pupils attending all 10 primary schools for the visually handicapped were examined. A modified WHO/PBL eye examination record for children with blindness and low vision was used. RESULTS: 229 children (146 males and 83 females) aged 6-15 years were included in the study: 47 children had severe visual impairment (20.5%) (visual acuity in their better eye less than 6/60), and 159 were blind (69.5%) (visual acuity in their better eye less than 3/60). Anatomically, the most affected parts of the eye were the retina (124, 54.2%), optic nerve (35, 15.3%), whole globe (25, 10.9%), lens (20, 8.7%), and uvea (12, 5.2%). Aetiologically (timing of insult leading to visual loss), the major cause of visual impairment was retinopathy of prematurity (ROP) (96, 41.9 %), followed by abnormalities of unknown timing of insult (97, 42.4%), and hereditary disease (21, 9.2%). In 90 children (40%), additional disabilities were present: mental disability (36, 16%), physical handicap (16, 7%), and/or a combination of both (19, 8%). It was estimated that 127 children (56%) suffer from visual impairment caused by potentially preventable and/or treatable conditions (for example, ROP, cataract, glaucoma). CONCLUSIONS: Establishing a study group for comprehensive evaluation of causes of visual handicap in children in the Czech Republic, as well as for detailed analysis of present practice of screening for ROP was recommended.

Adolescent↗
PubMed2001

[Treatment of intermediate hypermetropia using laser in situ keratomileusis--retrospective study (1995-1999)].

In this study, the authors present their findings concerning the usage of the LASIK method in 225 cases of hyperopia. This method has been used in our ELAS refractive centre from 1995 in the treatment of hyperopia up to +7.0 D. The average preoperative spherical equivalent in this group was +4.91 D, and in cycloplegic refraction 20 D (+/- 1.94 D). The postoperative average spherical equivalent was 0.53 D (+/- 0.58 D). Uncorrected visual acuity is used as the main criterion in assessing the effectiveness of the refractive procedure. The average uncorrected visual acuity was improved from a preoperative value of 0.4 (+/- 0.27) to a postoperative one of 0.8 (+/- 0.24). The average value of the best correct visual acuity worsened from 0.98 (+/- 0.31) preoperatively to 0.88 (+/- 0.23) postoperatively. This was perhaps caused by the side-effects of laser ablation (glare), which occurred in using LASIK with cases of hyperopia of over 0 D. For this reason, the choice of the LASIK method for correction of middle hyperopia should be made with caution.

Astigmatism↗
PubMed2001

[Retrospective study of histologically confirmed intraocular tumors at the Eye Clinic of the Vinohrady Faculty Hospital in Prague].

The authors evaluated statistically in a retrospective study the histological findings of a total of 182 intraocular tumours assembled at the Ophthalmological Clinic, Vinohrady Faculty Hospital Prague in 1992-2000. The histological material was obtained from 147 patients by enucleation of the bulbus and in 35 patients by surgical resection. In 97.2% the authors proved the malignant character of the tumour. In 95% an uveal melanoma was involved. In malignant melanomas of the choroid the following parameters were investigated: site, size, histological type, state of Bruch's membrane and extrascleral propagation of tumour. In 67% the melanoma was in the choroid, in 21% in the ciliary body and in 12% in the iris. As to size, large and extremely large melanomas predominated (66%). Histologically melanomas of the mixed and spindle-cell type were most frequent (93%). Bruch's membrane was damaged in 48% melanomas. Transscleral extension of the tumour was present in 9% malignant choroid melanomas.

Eye Neoplasms↗
PubMed2000

[Frequency of secondary cataracts in patients with AcrySof MA30BA and MA60BM lenses].

The authors present an account on the incidence of secondary cataract in AcrySof lenses MA30BA and MA60BM in a group of 65 eyes. The authors selected as criterium for evaluation of secondary cataract the transparency of the posterior capsule in correlation with deterioration of visual acuity and the number of performed Nd:YAG posterior capsulotomies. The follow-up period was 6 to 32 months. The incidence of secondary cataract in AcrySof lenses was 13.8%, the number of performed capsulotomies was 0. These results were compared with the incidence of secondary cataract in PMMA and silicone lenses. The incidence of secondary cataract in eyes with PMMA lenses was recorded in 58.5% and in eyes with a silicone lens in 46.2%. In eyes with a PMMA lens Nd:YAG posterior capsulotomy was performed in 32% and in eyes with a silicone lens in 26%.

Adolescent↗
PubMed2000

[Laser in situ keratomileusis in the treatment of myopia (retrospective study 1995-1996].

In this article, the authors present their findings concerning the usage of the LASIK method in 1,602 cases of myopia. The LASIK procedure is shown to be a very effective and safe method in a high percentage of cases. All operations were performed under topical anesthesia with Oxybuprocain 0.4% and Lidocain 2.0%. Uncorrected visual acuity is used as the main criterion in assessing the effectiveness of refractive procedures, and our average values of improvement were from 0.08 pre-operatively to 1.01 post-operatively. The average spherical equivalent was improved from a pre-operative value of -5.74 D to a post-operative one of 0.26 D. Emetropy was achieved in 89% of cases, 8.5% of cases were undercorrected and 2.5% overcorrected.

Humans↗
PubMed1999

[Aging and color discrimination after IOL implantation].

Colour discrimination was tested by FM 100-hue test in 106 patients (43 women and 63 men) after implantation PMMA IOL to the posterior chamber. Examined group of patients aged from 41-70 years was represented by 132 eyes. As a control were groups of healthy people (without hypertension and diabetes) of the same age categories with physiological eye findings and still clear crystalline lens. After IOL implantation the resulting total score of the test in examined patients of all decades was similar to the control group of healthy people. Even in healthy patients with IOL the colour discrimination is better beginning with 61 years (P < 0.05). Colour discrimination for red, green and blue colour has improved in comparison with the control groups and getting better with ageing. Clearly better sensitivity was in the area of green colour, it was observed in the age group starting with 61 years (P < 0.05) and for blue colour already since 51 years (P < 0.05). The improvement of colour discrimination in pseudophakic eyes in comparison with healthy population is slightly improving with increasing age.

Adult↗
PubMed1998

[Comparison of the occurrence of secondary cataracts in silicone and PMMA lenses].

The authors compared the frequency of secondary cataract after implantation of silicone and polymethylmetacrylate lenses (PMMA) in a group of 130 eyes of 100 patients within 12-30 months after surgery of cataract with primary implantation of a IOL. For evaluation of secondary cataract two criteria were used: 1. opacification of the posterior capsule in correlation with deterioration of eyesight after other causes of deterioration were ruled out, 2. the number of performed Nd:YAG posterior capsulotomies (so-called "capsulotomy rate") in the investigated patients. The authors provided evidence of a lower incidence of secondary cataracts in silicone lenses i.e. a lower incidence of opacification of the posterior capsule (46% as compared with 58.5% in PMMA lenses) as well as a lower rate of Nd:YAG capsulotomies (26% as compared with 32% in PMMA lenses). The longer time interval of capsulotomy after implantation (on average by five months) is also in favour of silicone plate-haptic IOL.

Aged↗
PubMed1998

[Chronic postoperative endophthalmitis caused by Propionibacterium acnes].

There is a report of three cases of chronic postoperative endophthalmitis following cataract operations. In two patients there was proven Propionibacterium acnes. There is presented a technique to obtain specimens for microbiological examination and an overview of clinical experience in treatment of the mentioned less common types of endophthalmitis. Early surgical treatment as well as intraocular injection of vancomycin can help to restore a good visual acuity despite of longlasting inflammation.

Aged↗
PubMed1998

[Echographic findings in orbital varices].

An orbital varix is a rare venous affection, its main symptom being intermittent exophthalmus. For the diagnosis of an orbital varix ultrasonic examination of the orbit is a useful examination method. The authors present the ultrasonic finding of three patients with the diagnosis of an orbital varix. The correct diagnosis of an orbital varix can be as a rule established already from the typical clinical picture and echographic finding.

Adolescent↗
PubMed1998

[Echography of carotid-cavernous fistulae].

Arteriovenous shunts belong to less frequent vascular disorders affecting the orbit primarily or secondarily. They comprise in particular arteriovenous malformations, carotidocavernous fistulae and dural arteriovenous fistulae. Most frequently secondary affections of the orbital veins are encountered during the development of a carotidocavernous fistula. In addition to the typical symptomatology a carotidocavernous fistula has also a typical angiographic and echographic finding. The authors present the echographic finding of a dilated superior ophthalmic vein, discuss also other echographic signs in the orbit during the development of a carotidocavernous fistula.

Arteriovenous Fistula↗
PubMed1997

[Induced astigmatism after implantation of Acrysof MA 60 BM and Hydroview H 60 M intraocular lenses].

The purpose was to find an induced corneal astigmatism after cataract surgery. Change in the keratometric cylinder was examined in two ways by the vector analysis according to Jaffe/Clayman and according to Cravy. In the majority of cases we examined excellent visual acuity in only the first week after surgery. Concerning the mean actual keratometric cylinder values for the first eight postoperative months, in both groups induced astigmatism and rotation of cylinder axis was absolutely minimalized.

Astigmatism↗
PubMed1995

[ProVisc--a new viscoelastic material for surgery of the anterior segment. A multicenter clinical study].

Within the framework of a multicentric clinical study which was implemented at nine selected departments a new viscoelastic material ProVisc of Alcon company was tested during extracapsular extraction of cataract with implantation of posterior chamber intraocular lenses. A total of 100 eyes of 100 patients were operated and all pre- and postoperative data were recorded in uniform protocols. The selection of suitable patients and the type of surgical procedure was within the responsibility of the surgeon. The type and frequency of surgical and postoperative complications was similar as when other viscoelastic material ProVisc can be recommended as safe and effective in modern surgery of cataract.

Anterior Eye Segment↗