[Phacoemulsification of subluxated opacified lens in pseudoexfoliation glaucoma patients, performed with the use of a capsular tension ring and iris retractors]

PURPOSE

To evaluate results of phacoemulsification of subluxated lens in patients suffering from pseudoexfoliation-related cataract and glaucoma, performed with the use of a capsular tension ring (CTR) and iris retractors and implantation of artificial intracapsular lens.

PATIENTS AND METHODS

The retrospective covered 15 patients (15 eyes) at the average age of 75 years, with a subluxated, cloudy lens and pseudoexfoliation glaucoma with IV PEX. Due to poor mydriasis resulting from the course of the pseudoexfoliation syndrome, it was necessary with all the patients to apply iris retractors in order to enlarge the pupil. The opacified lens were removed by means of phacoemulsification. In order to provide additional peripheral support and to maintain the artificial lens in the central position after the surgery, a tension ring was implanted into the lenticular capsule. A foldable intraocular lens was implanted inside the capsule.

RESULTS

The observation period was 12 months. The average visual acuity prior the surgery was 0.18+/-0.2, while after a year after the surgery it was 0.56+/-0.32 (p<0.001). Besides, the intraocular pressure was observed to decrease from 18.2+/-5.02 mm Hg before the surgery to 15.8+/-0.84 mmHg (p<0.001) after the surgery. The anti-glaucoma medication ratio was also reduced from 2.1 to 1.3 in the post-surgery period. Inflammatory reaction of the anterior chamber was observed in 7 eyes.

CONCLUSIONS

Application of a CTR and iris retractors during a surgery of cataract in patients with subluxated opacified lens considerably facilitates the implantation procedure of an artificial lens into the capsule, and it allows to improve the visual acuity and stabilize the intraocular pressure while reducing the quantity of the applied anti-glaucoma drugs.

[Evaluation stereometric parameters of the optic nerve head in the III and IV stage of pseudoexfoliation syndrome]

PURPOSE

Pseudoexfoliation syndrome (PEX) often coexists with glaucomatous optic nerve head damage. Confocal scanning laser tomography Heidelberg Retina Tomograph (HRT) is the most competent and accurate technique of monitoring of glaucomatous optic nerve head damage. Our aim was to determine correlation between stage of PEX and glaucomatous optic nerve head damage, by using HRT system.

MATERIAL AND METHODS

Two groups of patients underwent examination. The examined PEX-group with 35 eyes with III stage and 35 eyes with IV stage of PEX. The control group (POAG patients) of 44 eyes. Stereometric parameters Disc Area, Cup Area, Cup/Disc Area Ratio, Rim Area, Height Variation Contour, Cup Volume, Rim Volume, Mean Cup Depth, Max Cup Depth, Cup Shape Measure, Mean RNFL Thickness, RNFL Cross Section Area were obtained by HRT.

RESULTS

No statistical differences were noted between III and IV stage of PEX for DA, HVC, RV, Mean RNFL Thickness and RNFL Cross Section Area parameters. Between III stage of PEX and control group no statistical differences were confirmed for HVC. Between IV stage of PEX and control group no statistical differences have respect to: CSM, Mean RNFL Thickness and RNFL Cross Section Area stereometric parameters.

CONCLUSIONS

IV stage of PEX syndrome is the serious risk for glaucomatous neuropathy and requires precise monitoring.

[Frequency doubling perimetry in diagnosis of early glaucomatous optic nerve fiber damage]

PURPOSE

The comparative evaluation results of frequency doubling technology (FDT) in healthy subjects, in patients with glaucoma suspected and glaucoma, as well as analysis influences of selected risk factors onset, and progression of glaucoma (age, gender, intraocular pressure, refractive errors, circulation system disease, diabetes mellitus, vasospastic vascular disease) on FDT-parameters.

MATERIAL AND METHODS

Sixty four patients (128 eyes), in age between 13-80, with refraction error from -14.5 to +6.5 D sph and average intraocular pressure 19.8 +/- SEM were included in this study. All patients were previously diagnosed towards glaucoma. The visual field testing with help of FDT Visual Field Instrument were made at least triple at all patients, with capitalize on the THR N-30 threshold program. Global indices: mean deviation (MD) and pattern standard deviation (PSD) and numerical value of mean retinal sensitivity for central visual field 5 degree sector (mean sensitivity to central 5 degrees--MS 5 degrees) come in comparative analysis. All data were analyzed by chi2 and Kruskal-Wallis tests.

RESULTS

Comparative analysis examined groups of healthy persons, patients with glaucoma suspect and glaucoma, it proves statistically significant difference between MD, PSD and MS 5 degrees. Statistically no significant difference between PSD and MS 5 degrees at groups of healthy and glaucoma suspect patients was detected. In glaucoma group there did not reveal an influence on selected risk factors on FDT parameters. However, in glaucoma suspect group revealed an influence on most risk factors on perimetry parameters.

CONCLUSIONS

FDT is useful for detection of glaucomatous nerve fiber damage. There should be taken precautions of interpretation FDT results at glaucoma suspect patients.

[Phacotrabeculectomy in patients with cataract and chronic open angle glaucoma, and patients with cataract and pseudoexfoliation glaucoma]

PURPOSE

To compare the results obtained after phacotrabeculectomy followed by implantation of an intracapsular lens in patients with cataract and chronic open angle glaucoma, and patients with cataract and pseudoexfoliation open angle glaucoma.

MATERIAL AND METHODS

The retrospective study covered 55 eyes with cataract and glaucoma. In 28 eyes, chronic open angle glaucoma was diagnosed, and in 27--pseudoexfoliation glaucoma. In all cases, phacoemulsification of the opacified lens was carried out, a foldable intraocular lens was implanted in the capsule, and the trabeculum was removed by means of a punch. Visual acuity, intraocular pressure and the ratio of applied anti-glaucoma drugs were subject to the assessment.

RESULTS

The observation period was 12 months. Within the COAG patient group, the average visual acuity prior to the surgery was 0.2+/-0.24, and after one year from the surgery it increased to 0.82+/-0.22. For PEX glaucoma patients, the values were respectively 0.3+/-0.25 before the surgery and 0.75+/-0.29 a year after it. Considerable reduction of the intraocular pressure was also achieved: in the COAG patients--from 19.51+/-3.8 mm Hg to 16.6+/-1.6 mm Hg, and in PEX glaucoma patients--from 22.28+/-5.18 mm Hg to 17.6+/-2.33 mm Hg one year after the surgery. Also, the quantity of anti-glaucoma drugs applied in the study groups was significantly reduced. The anti-glaucoma drug ratio in the COAG patients dropped from 1.8 to 0 after the surgery, and in the PEX glaucoma patients--from 2.3 to 0.3.

CONCLUSIONS

Phacotrabeculectomy is an efficient and safe surgical method, to be recommended for patients both with primary open angle glaucoma and with pseudoexfoliation glaucoma.

[Phacoemulsification in patients with cataract and pseudoexfoliation syndrome--own experience]

The aim of the study was the assesment of effectivness of phacoemulsification procedure in patients with cataract and pseudoexfoliation syndrome. Analysed group consisted of 72 eyes (8 patients), age 53 - 93 years with PEX and 50 eyes (50 patients), age 49-82 without PEX. All cases have performed the phacoemulsification with implantation of artificial posterior chamber lens using small incision procedure. In more than 50% of patients marked postoperative improvement of visual acuity up to 0,6. Year after operation significant decrease of intrabulbar pressure was observed. We conclude that phacoemulsification in cataract treatment is an efficient and save procedure with improvement of patient's visual acuity and with low number of postoperative complications.

[Implantation of Ahmed-type valve in the treatment of glaucoma, following penetrating keratoplasty]

PURPOSE

To evaluate the outcomes of Ahmed glaucoma valve implantation for therapy of glaucoma after penetrating keratoplasty.

MATERIAL AND METHODS

17 Ahmed glaucoma valve implants were placed in 17 eyes with glaucoma after penetrating keratoplasty. The follow up was 1 year. V.A., IOP and index medication were observed before and 1 year after surgery.

RESULTS

The mean preoperative IOP was 29.1 mmHg (+/-6.5) with average medication 2.65 +/- 0.5, 1 year after surgery the mean IOP decreased to 18.4 mmHg +/- 4.7 with 0.7 +/- 0.8 medication. The tube implant successfully controlled glaucoma in 13 eyes (73.5%) at 1 year. The corneal grafts remain clear in 11 eyes (64.7%).

CONCLUSIONS

Implantation of Ahmed glaucoma valve successfully controlled IOP in difficult cases of glaucoma after penetrating keratoplasty.

[Confocal laser scanning tomography (HRT) in diagnosis and monitoring glaucomatous optic nerve damage in primary open angle glaucoma]

PURPOSE

The aim of this study was to estimate HRT usefulness in quantitative evaluation of structural glaucomatous optic nerve head damage and in monitoring this atrophy in POAG patients and normal subjects, during 18-monthly follow up.

MATERIAL AND METHODS

130 eyes of 84 patients with primary open angle glaucoma, 52 women (79 eyes) and 32 men (51 eyes) in age 45-70 (mean = 54.69 yrs) and 96 eyes of 48 normal subjects, 33 women (66 eyes) and 15 men (30 eyes) in age 40-70 (mean=51.90 yrs). The ONH-stereometric parameters were examined using confocal laser scanning tomography--HRT (version 2.01).

RESULTS

All of ONH stereometric parameters (except: HVC) statistically significant distinguish glaucoma and normal eyes. The most marked of ONH-parameters are: C/D area ratio, CA, CSM, RA, RV, Mean cup depth, CV, Max cup depth, Mean RNFL thickness, RNFL-csa and DA. Statistically significant changes of all ONH stereometric parameters in primary open angle glaucoma were found during follow up (except: HVC, CV and CSM).

CONCLUSIONS

HRT is precise method for ONH-parameters evaluation. All of ONH-stereometric parameters (except HVC) are good markers of quantitative ONH-glaucomatous damage. HRT is valuable and precise method of quantitative monitoring progression of glaucomatous neuropathy.

[The estimation of efficacy of the phacotrabeculectomy procedure in patient with cataract and pseudoexfoliation glaucoma]

PURPOSE

The aim of the study was the estimation of phacotrabeculectomy effectiveness in patient with pseudoexfoliation syndrome.

MATERIAL AND METHODS

The analyzed group consisted of 72 eyes of 65 patients in the range of 61-92 years old. 32 patients have phacoemulsification procedure (gr. I) and 40 patients have performed the procedure of the phacotrabeculectomy (gr. II).

RESULTS

In 60% of the eyes marked postoperative improvement of visual acuity to more than 0.6 was observed. We noticed significant decrease of mean intraocular pressure (from 22.45 mmHg-17.88 mmHg), only in group II.

CONCLUSIONS

We have concluded that the polyprocedular operation of phacotrabeculectomy in cataract with pseudoexfolation syndrome is an efficient procedure lowering mean intraocular pressure and improving visual acuity.

[Non-proliferative diabetic retinopathy and red blood cell aggregation]

The pathogenesis of diabetic retinopathy is not clear, but it is generally agreed, that in addition to vascular components hemorheological disturbances can play a role in the impairment of microvascular flow. The aim of this study was to correlate the severity of retinopathy in diabetic patients with red blood aggregation and some parameters of aggregation. The study was carried out on 52 patients suffering from type 2 diabetes mellitus with non-proliferative retinopathy--25 men and 27 women (mean age 63.8 +/- 6.5 years) and 43 healthy--20 men and 23 women (mean age 55.5 +/- 9.6 years). The fundus appearance of patients showed non-proliferative diabetic retinopathy. Red blood cell aggregation was determined by LORCA aggregometer. Aggregation index (AI), disaggregation shear rate (gamma(p)), time to the half of the disaggregation (t1/2), time constant of fast component in syllectogram (T1), time constant of slow component (T2) and amplitude (total extent of aggregation Am) were measured. In diabetics with non-proliferative retinopathy we observed the increase of AI (66.5 +/- 7.2 vs 59.4 +/- 5.8; p < 0.001), decrease of Am (19.8 +/- 3.3 vs 21.2 +/- 2.7; p < 0.05), decrease of T1 (2.4 +/- 0.5 vs 2.75 +/- 0.42; p < 0.005), increase of T2 (27.6 +/- 4.7 vs 25.75 +/- 4.11; p < 0.05), decrease of t1/2 (1.98 +/- 0.72 vs 2.7 +/- 0.77; p < 0.001) and increase of gamma(p) (215.6 +/- 23.3 vs 98.1 +/- 8.7; p < 0.001). The parameters of erythrocytes aggregation were correlated with intensification of diabetic retinopathy symptoms. Our results show the importance of red blood cell aggregation parameters in the development of diabetic microangiopathy.

Correlations between the severity of retinopathy in diabetic patients and whole blood and plasma viscosity

The aim of this study was to correlate the severity of retinopathy in diabetic patients with the whole blood and plasma viscosity. The studies were performed on 52 patients suffering from type II diabetes mellitus with non-proliferative retinopathy (25 men and 27 females, mean age of patients 64+/-6.5 years). The mean duration of diabetes treatment was 13.7 years. The control group consisted of 43 healthy persons (20 men and 23 women, the mean age of controls was 55.9+/-9.2 years). Blood samples were taken from patients immediately after ophthalmological examination from anticubital vein and anticoagulated with K2EDTA. The symptoms of retinopathy were: macular edemas, microaneurysms, hard and soft exudates and hemorrhagic focuses. The severity of particular signs of retinopathy was expressed in a three point scale. The total number of rank points was correlated with blood and plasma viscosity, moreover with eyes acuity. Blood viscosity measurements were performed with the use of cone-plate Brookfield's viscometer at shear rate 150 s(-1), and plasma viscosity with capillary Ubbelohd's viscometer. Besides the viscometric examinations hematocrit, fibrinogen, blood morphology, total cholesterol concentration, LDL-cholesterol, HDL-cholesterol, triglycerides, blood glucose concentration and glycosylated hemoglobin were examined. The whole blood viscosity, the corrected blood viscosity adjusted to 45% of hematocrit were significantly higher in diabetics (p<0.001). The whole blood relative viscosity was also significantly elevated in diabetic patients (p<0.002). The correlation between visual acuity and rank point of retinopathy severity was negative (r= -0.91, p<0.001). The retinopathy severity was positively correlated with whole blood and plasma viscosity (r=0.51; p<0.001 and r=0.4; p<0.005, respectively).

CONCLUSION

Elevated blood and plasma viscosity may play an additional and significant role in the development of diabetic retinopathy.

A unique case of primary corneal melanoma

PURPOSE

To report a unique case of primary corneal melanoma.

METHODS

A 59-year-old white woman underwent keratectomy to remove a pigmented rapidly enlarging growth on the corner of her left eye. The specimen was submitted for histopathologic examination.

RESULTS

Ophthalmic examination disclosed no association with limbal or conjunctival melanocytic abnormalities. Histopathologic studies demonstrated nodular malignant melanoma.

CONCLUSION

Possible development of primary corneal melanoma should be considered in diagnosing all cases with a past history of corneal melanin pigmentation.

[Surgical correction of astigmatism after wedge resection keratoplasty]

PURPOSE

To analyse the results of astigmatism correction after keratoplasty using wedge resection technique.

MATERIAL AND METHODS

Eleven patients underwent a wedge resection for postkeratoplasty astigmatism. The average postoperative astigmatism was 13.9 diopters (range 11.0 to 17.0 D). Among the patients there were 5 women and 6 men, aged 25 to 70 years. All of the grafts were in static phase, after suture removal. The indications for keratoplasty were: keratoconus--8, pseudophakic and aphakic corneal edema--3. The follow-up period after wedge resection was 6 to 24 months. The astigmatism was evaluated by videokeratometer (ORC Masterviue Ultra).

RESULTS

Postoperatively, the average astigmatism was 7.25 D by 6 months, 8.1 D by 12 months, 8.45 D by 24 months. The visual acuity corrected with spectacles was 0.2 to 1.0. 8 patients (72.7%) gained better visual acuity. Complications included: 1) growing vessels through the wound, 2) delay of epithelization.

CONCLUSION

Wedge resection is an effective technique for managing postkeratoplasty high astigmatism.

[A grid pattern type of photocoagulation in treatment of diabetic maculopathy--personal experience]

PURPOSE

The aim of the present study was the evaluation of visual outcome of 425 eyes in 283 patients treated by focal and grid pattern photocoagulation for clinically significant macular edema according to the recommendations of the Early Treatment Diabetic Retinopathy Study (ETDRS).

MATERIAL AND METHODS

On the basis of baseline status of macula, eyes were classified into three groups: group I--eyes treated by focal photocoagulation (39 eyes), group II--eyes treated by focal photocoagulation and/or modified grid (84 eyes), group III--eyes treated by focal photocoagulation and/or grid pattern (302 eyes). Eligibility criteria for this retrospective study included a diagnosis of clinically significant macular edema according to the ETDRS scale. The baseline examination for all patients presented in this review included: the best corrected visual acuity (VA), slit lamp with contact lens indirect ophthalmoscopy, fundus color photography and fluorescein angiography. All patients were treated with argon green by grid with Nidek 2300 laser. Modified grid or focal photocoagulation according to the ETDRS recommendations were performed. Patients with proliferative diabetic retinopathy (PDR) were transferred to panretinal photocoagulation (PRP) after treatment of maculopathy. Development of VA from the baseline to last checkup in treated eyes was reported and compared. Follow-up ranged widely from 6 to 45 months.

RESULTS

General stabilization was achieved in 51.3%, improvement in 10.1% and deterioration in 38.6% of eyes. The best results were achieved after selective and focal and/or modified grid treatment: in the Ist group stabilization of VA was achieved in 43.6% and improvement in 41% of eyes; in the IInd group: stabilization in 60.7% and improvement in 21.4% were stated; in the IIIrd group: stabilization in 49.7% and improvement only in 3.0%. In 164 (38.6%) cases supplemental treatment was administered.

CONCLUSION

Photocoagulation has proved effective in the treatment of diabetic clinically significant macular edema.

[Valve implants of glaucoma pressure regulator for refractory glaucoma: own experience]

PURPOSE

To present our experiences in valve implantation for refractory glaucoma.

MATERIAL AND METHODS

From October 1993 to December 1996 implantations of Glaucoma Pressure Regulator Optimed were performed in 7 eyes of 7 patients. There were 4 men and 3 women aged from 32 to 65 years. There were 3 eyes with neovascular glaucoma due to diabetes mellitus, 2 eyes with posttraumatic glaucoma, including 1 case after keratoplasty, 1 eye with postkeratoplasty glaucoma and 1 eye with aphakic glaucoma. Preoperative IOPs ranged from 33 to 61 mm Hg (mean 37.6 +/- 7.2 mm Hg).

RESULTS

Success was considered an IOP of less than 22 mm Hg without medication (complete success) or with medication (qualified success) without additional filtering surgery. Postoperative success was obtained in 4 out of 7 eyes after follow-up period of 37.4 +/- 17.08 months (range 16-39 months). Early complications were hyphema (1 patient, 14.3%), blockage of intracameral portion of the tube (1 patient, 14.3%), hypertony (1 patient, 14.3%). Late complications were: external conjunctival bleb failure (2 patients, 28.6%), blockage of intracameral portion of tube by fibrovascular tissue (1 patient, 14.3%).

CONCLUSION

Our experiences confirm that the valve implant is still today an alternative surgical procedure for controlling IOP in eyes with refractory glaucoma that have visual potential.

[Polymorphism of the chymase gene and development of retinopathy in type 2 diabetic patients]

Diabetic retinopathy is one of the major causes of blindness in developed countries. Among the factors involved in development of retinopathy genetic factors related to the generation of angiotensin II are mentioned. Recently was described that tissue chymase enzyme is the alternative trait for angiotensin II formulation. The aim of the study was assessment of association of CMA/B hCC polymorphism of chymase gene with the development and progression of diabetic retinopathy. The study was conduced in 587 type 2 diabetic patients with diabetes duration longer than 10 years. Mean age 62.8 +/- 8.58, mean duration 16.7 +/- 5.66, HbA1c 8.23 +/- 1.71, BMI 29.1 +/- 4.91. Ophthalmological examination was performed to determine the presence of retinopathy. Next polymorphism CMA/B hCC chymase gene by PCR method was assessed. Gene distribution was estimated by chi-square test. In the whole examined group no significant changes of gene distribution was found. However, in female group without retinopathy the tendency to lower incidence of GG genotype was observed (p = 0.06). When assessed the female group without retinopathy despite 15 years duration of diabetes frequency decrease of GG genotype was significant (p = 0.04). According to the results we conclude that CMA/B hCC chymase gene polymorphism is associated with the presence of diabetic retinopathy. Association is expressed by decreased frequency of GG genotype in female group without retinopathy.

[The evaluation of the usefulness of phacotrabeculectomy as the only surgery for glaucoma and cataract patients]

PURPOSE

To evaluate IOP changes after phacotrabeculectomy.

MATERIAL AND METHODS

24 glaucoma patients (27 eyes) with coexistence of cataract. Age: 56-79 years. Mean IOP level before surgery: 23.2 +/- 2.4 mm Hg. In all cases phacotrabeculectomy was performed. Follow-up ranged from 3 to 12 months.

RESULTS

IOP decrease after surgery was achieved: mean decrease 7.1 +/- 2.3 mm Hg after 3 months and 5.5 +/- 2.4 mm Hg, and 4.1 +/- 2.1 mm Hg after 6 and 12 months, respectively.

CONCLUSION

Phacotrabeculectomy combines all advantages of phacoemulsification and creates perspective for IOP normalization.

[Keratectomy for a malignant melanoma of the cornea]

PURPOSE

To present the possibility of malignant melanoma treatment of the cornea using keratectomy.

MATERIAL AND METHODS

A 59-year old woman with a primary malignant melanoma of the cornea. Visual acuity before surgery 0.2. Malignant melanoma was removed using keratectomy. Follow-up 18 months.

RESULTS

Satisfactory cosmetic result and visual acuity 1.0 was obtained. In 18 months follow-up no local or general symptoms of tumor recurrence are observed.

CONCLUSION

Keratectomy should be considered as an alternative treatment for primary malignant melanoma of the cornea.

[Glaucoma after penetrating keratoplasty in the material of the ocular department of the Mountain Hospital in Sosnowiec]

PURPOSE

To evaluate the necessity of antiglaucoma therapy in patients after penetrating keratoplasty (PK).

MATERIAL AND METHODS

An analysis of 537 penetrating keratoplasties performed in our department was undertaken. Incidence of glaucoma after penetrating keratoplasty procedure, necessity of pharmacological antiglaucoma treatment as well as the kind of surgical procedure and its influence on the graft transparency were estimated.

RESULTS

The incidence of post keratoplasty glaucoma was 11.2% (60/537). 42 patients required pharmacological treatment (42/60) and the remaining 18 required surgery. 12 trabeculectomies, 6 drainage devices procedures and 1 cyclokrytherapy were performed and stabilization of intraocular pressure was obtained. 14 of the grafts treated surgically lost their transparency.

CONCLUSIONS

Multiple surgical treatment of post-penetrating keratoplasty glaucoma, despite the stabilisation of the intraocular pressure, may lead to loss of graft transparency in most cases.

[Trans-sclerally fixated PC-IOLs: six year of investigations]

PURPOSE

To present the results of PC IOLs transscleral fixation to the ciliary sulcus in six years follow-up.

MATERIAL AND METHODS

152 eyes in 3 groups: 15 eyes with primary fixations of PC IOLs, 92 eyes with secondary fixations of PC IOLs and 45 eyes with secondary fixations of PC IOLs combined with penetrating keratoplasty.

RESULTS

Postoperative corrected visual acuity was 0.5 or better in 32.2% of cases, the most common complications in our material was CME (9.9%), lens tilt (4.6%) and increase of IOP (3.95%).

CONCLUSION

Transscleral fixation of PC IOLs offers good visual outcome with relatively low rate of complications and is recommended in cases with inadequate posterior capsule support.

[Diagnostic-therapeutic procedures in ocular sarcoidosis]

The authors present diagnostic and therapeutic procedure in patients with ocular sarcoidosis.

[Symptomatic eye changes during the course of sarcoidosis]

The authors present ocular changes observed in sarcoidosis. The most frequent features are: symptoms of dry eye and uveitis. Frequency of ocular manifestations leads to the conclusion that ophthalmic examinations ought to be routine procedure at sarcoid patients.

[Evaluation of the usefulness of the laryngeal mask for general anesthesia in eye microsurgery--preliminary results]

PURPOSE

This prospective study was designed to compare intraocular pressure changes and haemodynamic response to insertion of either a laryngeal mask or an orotracheal tube during general anaesthesia for cataract surgery.

MATERIAL AND METHODS

The effect of techniques (tracheal tube-TT, laryngeal mask airway-LMA) securing a clear upper airway on the heart rate changes (HR), arterial pressure (SAP, DAP), oxygen saturation (SpO2), end-tidal carbon-dioxide pressure (Et-CO2), intraocular pressure (IOP) and the incidence of coughing, stridor and sore throat was analysed in 60 patients undergoing cataract surgery during general anaesthesia.

RESULTS

The mean values for HR, SAP, DAP and IOP measured before and after induction of anaesthesia were not different in both groups. After securing a clear airway, mean HR increased in TT group to 95.5/min and decreased to 75.7/min in LMA group. SAP increased in TT group to 131 mmHg, DAP to 82.6 mmHg, whilst in LMA group both values decreased to 98.6 mmHG and 66.3 mmHg, respectively. The significant difference in IOP values was observed after intubation or using laryngeal mask. In TT group, intraocular pressure increased to 15 mmHg in healthy eye and to 13.6 mmHg in ill eye whilst there was a decrease in LMA group to 5.5 and 7.43 mmHg, respectively. Furthermore, a greater incidence of such complications as coughing, stridor and sore throat in TT group was observed.

CONCLUSION

The results show that using LMA in microsurgery during general anaesthesia is more advantageous and safer for patients in comparison with tracheal intubation.

[Treatment of idiopathic blepharospasm with botulinum toxin A]

The preparations of botulinum toxin A--Botox and Porton were injected into the orbicular muscle of eye in 18 patients with idiopathic blepharospasm or Meige's syndrome. Improvement was achieved in 17 patients; in 10 injections should be repeated after about 8 weeks. Minor side effects declined after several days. Injection of botulinum toxin could be effective in this disease, otherwise hard to cure.

[Methods of preventing opacification in the posterior lens capsule after extracapsular cataract extraction]

The methods of extracapsular cataract extraction generated some problems connected with postoperative opacification of the posterior capsule. The authors present clinical and experimental methods applied nowadays, intended to prevent these opacifications from forming.

[Changes of the retinal pigmented layer in familial polyposis of the colon]

Ophthalmoscopic examinations were performed in 96 patients with polyps or another disturbances of the colon, among them 3 cases suffered a histopathologically confirmed familial polyposis of the colon. All 3 cases of the familial polyposis exhibited in the ophthalmological examination pathological changes of the retinal pigment epithelium of both eyes.