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Biomedical subjects

S Rusnák

Publications and source records attributed to S Rusnák.

4 recordsLinked to original sources
PubMed2004

[Is it possible to sucessfully treat severe penetrating injuries?].

The number of serious devastating eye injuries caused by violent crimes or transport accidents is growing. The patients are mostly young men and the preserving of the eye, especially its function is often difficult. From June 2000 to March 2003, 4 eyes of 3 men (aged 16-23 years) with extraordinary serious devastating penetrating injuries were treated in the Department of Ophthalmology in Pilsen. One eye was enucleated because of serious laceration of the whole globe and eyelids at the initial treatment. In three eyes, a pars plana vitrectomy (PPV) with inner silicone tamponade was performed after the initial treatment of the penetrating and eventually exiting site. In all vitrectomized eyes a pars plana lensectomy (PPL) was performed, at the time of PPV in one eye, and in two eyes subsequently. When the eyes were stabilized, and the retina was attached, the silicone oil was removed in two eyes. The visual acuity before the surgery decreased to uncertain light projection, and in two eyes of one patient, we were not able to detect the visual acuity because of the unconsciousness of the patient. The follow-up period was 3 months to 2 years; all three eyes are aphakic, and the central visual acuity improved in two eyes to 6/6-9 (20/20-30 or 1.0-0.66) with the aphakic correction or with the contact lens, in one eye with the silicone eye remained the visual acuity is 6/60 (20/200 or 0.1). Even as the prognosis in such patients is unfavorable, in some cases good functional results may be obtained. The basic precondition for successful reconstruction of the seriously injured eye is meticulous primary treatment. For salvage of visual functions, there are often necessary repeated surgeries on the anterior as well as posterior segment of the eye. Their good timing and adequate technique may rapidly decrease the risk of complications after the injury and/or after the surgery respectively.

Adolescent↗
PubMed2004

[Macular translocation--first experience].

The age related macular degeneration (ARMD) is the most common cause of the central visual acuity loss in persons of age more than 60 years in the well developed countries. Rotation of the macula is nowadays a progressive method of choice of treatment of the exsudative form of ARMD. The aim of this surgical technique is to relocate the neuroretinal epithelium of the central region of the retina to a position situated outside the border of the subfoveolar lesion. Three eyes of three patients (2 woman and one man) were operated on during the period between March and May 2001 at the Department of Ophthalmology of the School of Medicine, Charles University in Pilsen. The method used was the scleral imbrication, which belongs to methods designated as "limited translocation". The mean age of the patients was 62 years and the follow up period was 2 years. After the surgery the relocation of the fovea was observed in all three eyes. In two eyes, the postoperative period was complicated by tractional retinal detachment that occurred three weeks after the surgery as a consequence of progressive proliferative vitreoretinopathy (PVR). Both eyes with the retinal detachment were re-operated. In both of them, the repeated pars plana vitrectomy, epiretinal membranes removal with relaxing retinectomy was performed and after maximal mobilization of the retina, the silicone oil implantation followed. In the second patient, the postoperative period was complicated by elevation of the intraocular pressure and a radial retinal fold running from the encircling buckle indentation up to the macula. Slightly improved function was noticed only in the first patient after following cataract surgery with intraocular lens implantation. In the two other eyes, as noticed at the last follow up check, the postoperative complications caused severe decrease of the central visual acuity although the retina remained attached. Macular translocation procedure is in stage of development and its surgical techniques are being further modified. The risk of postoperative complications with profound loss of central visual acuity corresponds to the level of the technical difficulty and extent of surgical intervention.

Aged↗
PubMed2001

[Penetrating intraocular injuries caused by foreign bodies of organic origin] ].

OBJECTIVE: To demonstrate two eyes of two patients with a penetrating injury by an organic intraocular foreign body (CNT), to outline the course of treatment and to evaluate anatomical and functional results. MATERIAL AND METHODS: During the period between May and July 1999 the authors treated at their department an 11-year-old girl and a 17-year old boy with a penetrating CNT injury of organic origin. In the girl they extracted a CNT which pierced the sclera and protruded into the vitreous body. The foreign body was extracted by means of a forceps, the site of perforation was treated by a cryosurgical procedure with a radial Silastic filling. The man was shot into the OL by a grain of pepper from an air-gun. The organic body in the vitreous body caused a violent inflammatory reaction in the vitreous body and retina. Early extraction of the CNT could not be made because of an adverse corneal finding which made surgery impossible. The progressing proliferative vitreoretinopathy (PVR) led to repeated formation of epiretinal, subretinal and cyclitic membranes which caused relapsing detachment of the retina (OS). The foreign body was extracted during pars plana vitrectomy (PPV) by the transvitreal route using a forceps. Definite adherence of the retina was achieved during the third PPV, membranectomy and implantation of silicone oil (SO). Final functional success was achieved by eliminating SO and by partial perforating keratoplasty. RESULTS: The CNT in the girl was histologically and parasitologically identified as a fibre of animal origin (animal hair or human eyelash). The follow up period is six months, VOP-5/5 nat., NOT 17 torr, bulbus undisturbed. In the second patient the cultivation finding from the vitreous body was negative. Extensive PVR developed as a result of breakdown products of the organic CNT and led to relapsing OS. Three months after the last operation the bulbus is at rest, the corneal disc clear, the retina attached, VOL-3/60 s + 8.0 D steop., NOT 12 torr. CONCLUSIONS: The final results of treatment of severe devastating penetrating injuries by a CNT is determined by the preoperative condition of the ocular tissues. CNT of organic origin damage intraocular tissues by their breakdown products as well as by more frequent contamination with pathological microorganisms. Our experience provided evidence that penetrating injuries by non-infected CNT of organic origin have a favourable prognosis. But even relapsing and prolonged OS after extraction of the CNT of organic origin and endophthalmitis need not lead to loss of the eye or its function.

Adolescent↗