[Intraocular correction of aphakia after cataract extraction for uveitis in adolescents]

PURPOSE

To demonstrate 3 cases with pediatric pseudophakia after cataract extraction as a complication of unilateral uveitis.

MATERIAL AND METHODS

The boys were at the age of 8, 11 and 15 years at the moment of surgery. Uveitis was monocular, the etiology unknown and clinically significant cataract was diagnosed after several months from the beginning of inflammation. The last recurrence of uveitis was observed 1 to 6 months before operation. There were intermediate uveitis (2 cases) and anterior uveitis (1 cases). In 2 eyes PMMA implant was placed in-the-bag and in one eye in the ciliary sulcus. During surgery we did not observe any complications except greater tendency to bleeding. Follow-up after operation ranged from 1.5 to 2.5 years.

RESULTS

Visual acuity before cataract extraction was 0.01; 0.04 and 0.02 and during last visit after surgery it was 0.9, 0.6 and 0.4 respectively. Postoperative near distance visual acuity was 0.5, 0.75 and 1.25. We observed cystoid macular oedema in the latter case. Two months after PC-IOL implantation the symptoms of mild inflammation in the eye of 15-year-old boy with anterior uveitis occurred. Intraocular pressure before and after operation ranged from 12 to 17 mm Hg. Corneal central endothelial cell density was from 2850/mm2 to 3100/mm2 before and from 2469/mm2 to 2979/mm2 during last visit.

CONCLUSION

Cases of posterior pseudophakia during uveitis in children showing good functional and anatomical state of eyes in the long term observation after IOL implantation recommend the intraocular correction in carefully selected uveitic pediatric patients.

[Trabeculectomy as the initial procedure in primary congenital glaucoma]

PURPOSE

To estimate the effectiveness of trabeculectomy performed in buphthalmic eyes.

MATERIAL AND METHODS

42 eyes of 24 children, 14 boys and 10 girls. There were 18 children (32 eyes) operated on at the age from 7 days to 12 months (group I) and 6 patients (10 eyes) at the age from 3 to 7 years (group II) with primary congenital glaucoma. Corneal diameter ranged from 11.5 to 15 mm in infants, in 10 eyes of 6 children elder than 2 years it was from 13 to 15 mm. The axial length of eyeballs was from 19 to 23.5 mm. Forty five trabeculectomies were performed, in 3 cases they were repeated two and six years after the first procedure. Follow up was from 1 year to 22 years, mean 82 months, 7 years of group I, 6 years of group II.

RESULTS

29 of 42 eyes (64.2%) with intraocular pressure varied between 8 and 21 mm Hg, other eyes required additional local antiglaucoma treatment. Normal IOP was obtained in 95.2% of eyes. Trabeculectomy normalized IOP in 68.9% eyes of infants (group I), whereas in elder children the percentage came up to 50 (group II). In other eyes pharmacological agents decreased IOL to values below 21 mm Hg, in the group I in 97% of eyes and in the group II in 90% of cases.

CONCLUSION

Trabeculectomy performed as a first procedure in primary congenital glaucoma is effective in infants and older children with buphthalmos in long-term follow-up. The necessity to perform this operation in very small children and even neonates does not always mean poor prognosis, and intraocular pressure can be stabilized at safe level for many years.

[The case of a large orbital foreign body evacuated by lateral orbitotomy using the Kronlein-Reese-Berk method]

The authors describe a case of patient with orbital large foreign body (glass) treated using Kronlein lateral orbitotomy.

[Pharmacotherapy of congenital glaucoma in young children]

The aim of congenital glaucoma treatment is to preserve visual function of children's eyes. There are three forms of congenital glaucoma: primary congenital glaucoma of infants, children and the youth, glaucoma in dysgenesis of anterior segment of the eyeballs and glaucoma in congenital systemic diseases. Pharmacotherapy is indicated during preparation for surgical treatment, as an adjunct following surgical procedures and as a protection of retinal and optic nerve function. Carbonic anhydrase inhibitors, hyperosmotic agents, sympathomimetic drugs, parasympathomimetic drugs, prostaglandins may be used. Dopamine antagonists, calcium channel blockers, serotonin antagonists are indicated as a protection of retinal cells and optic nerve function. The most widely used are carbonic anhydrase inhibitors and beta-blocker: betaxolol. Antiglaucoma drugs have proven to be efficacious in treating children with congenital glaucoma but they have several serious side effects. Therefore, pharmacotherapy may be used only periodically. The main treatment of congenital glaucoma is surgical treatment.

[Scanning laser tomography in the diagnosis of juvenile glaucoma]

The aim of our research was to evaluate the optic nerve head parameters of children with juvenile glaucoma with the scanning laser ophthalmoscope from Laser Diagnostic Technologies Inc. The material consisted of 46 eyes of 25 children aged from 7 to 18 years. There were 18 glaucomatous eyes (I group) and 28 eyes without glaucoma (II group) as a control group. The three examinations were repeated every three months. Mean values of Vol. B in the glaucomatous group were -0.327 +/- 0.098, first visit; -0.390 +/- 0.130, second visit; 0.344 +/- 0.096 mm3, third visit. These values in the control group were--0.234 +/- 0.73; -0.224 +/- 0.071; -0.252 +/- 0.069 mm3. The difference was statistically significant. Mean values of Volume A were significantly lower in the I group: 0.216 +/- 0.034, 0.207 +/- 0.033, 0.203 +/- 0.030 mm3 than in the II group: 0.269 +/- 0.039, 0.283 +/- 0.032, 0.271 +/- 0.042 mm3. CD ratio was higher in the glaucomatous eyes: 0.447 +/- 0.080; 0.491 +/- 0.069; 0.484 +/- 0.074 in comparison with the control group: 0.376 +/- 0.060; 0.368 +/- 0.067; 0.399 +/- 0.056. It was significant difference. More changes of biomorphometric parameters of the optic nerve head were observed in the glaucomatous group during follow-up period. The role of laser scanning ophthalmoscopic tomography is very important in the diagnosis of early forms of juvenile glaucoma in the youth.

[Therapeutic contact lenses in infant corneal ulcerations]

PURPOSE

We present our own results of treatment in corneal ulcerations with therapeutic contact lenses in 4 infants aged between 3 days to 5 weeks.

MATERIAL AND METHODS

Four patients (5 eyes) with deep corneal ulcerations of various origin were treated with soft contact lenses at the Clinic of Pediatric Ophthalmology in Katowice. All eyes received one type of the therapeutic lens. Contact lenses were worn between 8 and 21 days. After application of contact lenses pharmacological therapy was used individually for each patient, according to the result of microbiological tests.

RESULTS

All patients were successfully cured. A scar of cornea was observed only in one infant because the contact lens had been used too late. Four infants had no corneal haze after the treatment.

CONCLUSION

The best results were obtained using the contact lenses early, during the first days of treatment. Contact lenses caused decreasing of pain and reduced application of medicines. They were a good protection for injured cornea.

[Cataract in uveitis in children]

PURPOSE

To evaluate the anatomical and functional state of eyeballs after cataract extraction in uveitis in children and to analyze the factors affecting visual outcome.

MATERIAL AND METHODS

Among 182 examined eyes with uveitis we have observed cataract in 22 eyeballs of 17 children (12%). Before operation in 72.7% cases visual acuity was less or equal 0.02, in the others it was not more than 0.2. The age of patients ranged between 2 and 18 years, the mean age 8 years. The cause of uveitis was: chronic tonsillitis or sinusitis in 6 patients, juvenile rheumatoid arthritis in 2 patients, heterochromic Fuchs iridocyclitis in 2 children, in the others the cause was unknown. In 4 eyeballs (18%) we have observed increased intraocular pressure before operation. Follow-up ranged from 6 months to 15 years, the mean was 5 years.

RESULTS

We have obtained normal visual acuity in 31.8% cases and better than 0.1 in 68.2% od eyes. In children with juvenile rheumatoid arthritis, 2 eyeballs lost light perception as a result of corpus vitreous fibrosis and in one case we have observed only light perception. Optic nerve glaucomatous neuropathy was the cause of poor functional result in 2 eyes (0.02 and 0.04). Another causes of not satisfactory visual acuity were: corneal dystrophy (2 eyes), cystoid macular oedema (2 eyes) and amblyopia ex anopsia (2 eyes).

CONCLUSIONS

We have obtained normal or good visual acuity in majority of the operated eyes. The causes of poor vision were the anatomical changes after uveitis before the cataract extraction.

[Laser scanning laser ophthalmoscopy in diagnosis of juvenile glaucoma cases with myopia]

The diagnosis of the open angle glaucoma in myopic eyes remains one of the major problems, as the changes of the optic head in myopia may be similar to glaucomatous changes. The aim of the study was to analyse biomorphometric parameters of the optic nerve head in myopic eyes with glaucoma with scanning laser ophthalmoscope from Laser Diagnostic Technologies Inc. There was 29 children examined and among them 12 children with glaucoma and myopia as a study group (I) and 17 children with myopia as a control group (II).

RESULTS

TCA means values; group I: 1.994 +/- 0.158, group II:2.028 +/- 0.200 CD means values; group I; 0.315 +/- 0.072, group II: 0.247 +/- 0.057 Rim means values; group I: 1.366 +/- 0.164, group II: 1.511 +/- 0.136 Vol. A mean values; group I: +0.205 +/- 0.03, group II: +0.83 +/- 0.03 Vol. B mean values; group I: -0.159 +/- 1.608, group II: -0.117 +/- 0.08. Average values of the biomorphometric parameters of the optic nerve head were worse in group I than in group II, but there was not statistical significance between the differences. Scanning laser ophthalmoscopy may be used as very important additional examination in juvenile glaucoma cases with myopia.

[The computer as an assistant to the physician]

BACKGROUND

The possibilities of using computer in physician's research work are presented as an example of statistical analysis of axial eyeball length in relation to the age in myopic children with low birthweight.

MATERIAL AND METHODS

The study group consisted of 100 children aged from 3 to 15 years, with birthweight from 580 to 2450 g, where in 180 eyes myopia ranging from -1.5 to -22.0 Dsph and axial length of the eye from 20.0 to 30.9 mm were present. The dynamics of eyeball's axial length increase was compared between two groups: one-in which no symptoms of retinopathy of prematurity were present (no-RROP), and the second--in which signs of regressed retinopathy of prematurity were observed (RROP).

RESULTS

The results of the analysis are shown in analytical and graphical modes. Statistically significant differences were shown between axial lengths of eyeball's in the analysed groups of mean 9-year-old premature children (no-RROP: 25.19 mm and RROP: 24.33 mm). It was shown that the use of a computer reduces the time of performing statistical analysis of large amount of data.

[The significance of myopia and birth weight in prematurity]

AIM

The relation between myopia and birth weight of premature newborns was assessed in this study.

MATERIAL AND METHODS

There were 90 children (180 eyes) involved in the study, their birth weight ranged between 580 and 2450 g (mean 1698), and myopia ranged from -1.5 to -22.5 D (mean -9.8 D). Children were divided into two groups: group I: 38 children (76 eyes) with birth weight from 580 to 1500 g (mean 1158 g), group II: 52 children (104 eyes) with birth weight from 1501 to 2450 g (mean 2093 g). Mean value of myopia in group I was -10.4 D and -9.4 D in group II.

RESULTS

The results were assessed with Statgraphics software. The analysis of mean values regression showed no relation between myopia and birth weight in group I (regression coefficient b = 0.003, p = 0.24) and no relation in group II (regression coefficient b = 0.008, p = 0.016) at significance level alpha = 0.01.

[Hypoplasia of the optic disc in children]

PURPOSE

Analysis of etiological factors and functional assessment of the eyes.

MATERIAL AND METHODS

Optic disc hypoplasia was diagnosed in 43 children, aged 12 months--12 years, unilateral in 9 (20.9%). The follow-up ranged from 8 months to 9 years, the mean age of patients during the last examination was 10.4 years.

RESULTS

The following presumed etiological factors were stated in anamnesis: abose of alcohol by the mothers during pregnancy, syphilis, influenza, herpes and severe anemia. Visual acuity ranged from light perception with false localization to 5/50; in 58% of cases it was not above 1/50 but in 1/5 of the eyes visual acuity for short distance was sufficient for school needs. Concentric contraction and nasal scotoma were revealed in visual field. Hypermetropia was found in 28 eyes. In 3 cases mental dificiency was observed, in 1 of them with atrophy of a temporal cerebral cortex and epilepsia occurred in 1 child.

[Condition of the posterior capsule in pseudophakia in children]

PURPOSE

Evaluation of the posterior capsule transparency in children after congenital cataract surgery with posterior intraocular lens implantation.

MATERIAL AND METHODS

Examination comprised 41 eyes of 29 patients with posterior IOLS, aged 5-17 years (mean 10.3). In all cases, posterior capsule was unimpaired during surgery.

RESULTS

During follow-up, (mean 27 months), 36.6% the eyes showed posterior capsule opacity of various degree. Neodymium YAG laser capsulotomy was performed in 13 cases and instrumental capsulotomy in 2. Opacity of the posterior capsule caused a decrease of visual acuity below 0.4. It improved after capsulotomy in all cases. No serious complications were observed.

[Optic neuritis in children and adolescents]

The aim of the study was to analyse the cause, course and results of treatment in cases of optic nerve inflammation, including frequency of recurrencies. One hundred and ten children aged 2-18 years treated in our clinic from 1989 to 1994 were examined. Mean age was 13 years. Bilateral inflammation was found in 60% of cases, 176 eyes were assessed. The disease was more frequent in autumn, winter. In children below 14 (62%) inflammation concerned the intraocular part of the nerve while in older children it was mainly retrobulbar. Recurrence of the disease was observed in 1/3 of cases. In younger patients, the cause of the inflammation was usually viral infectious disease or chronic focal infection. In older children, the main causes were trauma or underlying neurological diseases. The treatment administered resulted in a normalisation of the visual field in more than half of the cases and visual acuity improvement in 73.5% of cases after retrobulbar inflammation, and in 75% of cases after intra-bulbar inflammation. During an average follow-up of 3 years, full visual acuity was achieved in 56% of eyes after retrobulbar inflammation and 46% of eyes after intra-bulbar inflammation. Signs of post-inflammatory neuropathy were present in 46% of eyes. Full recovery of visual function was achieved especially in those cases where it was not deeply decreased during the disease.

[Eyeball axis changes in children's myopia]

The aim of study was to assess changes in eyeball axial length in myopic children depending on age in comparison with hyperopic and emmetropic groups. The study group consisted of 200 children (100 girls and 100 boys), from 3 to 17 years old (mean 9.8). Myopia was diagnosed in 376 eyes (-4.0 D to -24.0 D, mean -9.64 D) with axial length from 21.0 to 30.95 mm (mean 26.05 mm). Control group consisted of 334 eyes (167 children) with mean refraction +0.53 D and axial length from 20.0 to 23.9 mm (mean 22.36 mm). We have used the Statgraphics program for statistical analysis. A statistically significant difference was found between mean eyeball axial length within myopic group of girls (mean 25.77 mm) and boys (mean 26.31 mm) with p = 0.321 and significance level alpha = 0.05. The axial length increases irregularly over time. The axis of the eyeball in myopic children aged between 3 and 17 increases more than in emmetropic and hyperopic (up to 1.0 D) children.

[Surgical results using the Friedenwald-Guyton method for congenital ptosis in children]

The studies comprised 96 children with congenital ptosis, aged 10 months to 12 years, operated on in the years 1987-1992. Cosmetic and functional results, as well as the complications of the surgery were evaluated. A stable widening of a interpalpebral fissure with uncovering of the pupil was achieved in 96.6% of cases. The author concluded that the Friedenwald-Guyton's method is especially recommended in children with levator muscle dysfunction. The method is highly efficient, technically easy, causes little surgical trauma and rare complications.

[Primary intraocular implants in congenital cataract]

Analysis of 47 eyes in 31 patients, aged 5-17 years with posterior or anterior IOL's implantation performed during cataract surgery was done. Visual acuity examined 7 days after surgery was 0.02-0.4 in the cases with cataract in one eye and 0.2-1.0 in those with cataract in both eyes. After the mean period of 2.5 years, visual acuity of at least 0.5 was achieved in all cases with binocular pseudophakia and in 20% of those with one pseudophakic eye. Uveitis was the most frequent complication in early postoperative period (25.5% of eyes) and posterior capsule opacities were observed later (31.9% of eyes).

[Occurrence of glaucoma in phakomatosis]

Our clinical material of the last 10 years comprised 8 cases of phakomatosis with glaucoma: 6 children with Sturge-Weber-Krabbe's syndrome and 2 with Recklinghausen's disease. The age of the children was 15 months to 16 years. In 5 children with Sturge-Weber-Krabbe's syndrome glaucoma was found in one eye, in all cases with Recklinghausen disease it was bilateral. The following surgical methods of treatment were applied: trabeculectomy, trabeculectomy with cataract aspiration, cyclo-cryo-application and perforative cyclo-diathermy. The normalisation of the intraocular pressure was achieved in 88.9% of cases.

[Binocular single vision in children with pseudophakia]

The studies comprised 45 patients, aged 5-17 years with IOL implantations performed during primary cataract surgery or secondarily some time after traumatic or congenital cataract and dislocated lens extraction. Simultaneous perception was achieved in 58% cases after primary and in 44.4% after secondary IOL implantations. Fusion was found only in primary IOL implantations in 38.4% of patients. The results of binocular single vision are better after primary as compared to secondary IOL implantations in children after traumatic cataract.

[Ocular changes in Down's syndrome]

The authors analyzed the kind of ocular changes and methods of therapy in 34 children, aged 5 months to 14 years, treated in the clinic in the years 1982-1992. The most frequent change was congenital cataract. The other signs observed were: Brushfield's spots, alternate esotropia, nystagmus, partial optic atrophy, retinal detachment, congenital glaucoma, ectropion and keratoconus. Occurrence of several anomalies were frequent. The adequate surgical treatment was applied depending on the kind of changes. Cataract extraction was made by aspiration method. Visual acuity improved in 58.8% of eyes.

[Incidence of ocular congenital anomalies in clinical material]

The aim of the study was to analyse, basing on the clinical material of the years 1987-1992, the congenital ocular anomalies and to compare the results with the observations made 20 years ago. Among the total clinical material of 7333 examined patients in the age from 3 days to 18 years congenital anomalies, including high myopia, were found in 3882 cases (group A). There were 2201 boys and 1681 girls. Group B, without high myopia, comprised 2639 cases of congenital anomalies, 1539 boys and 1100 girls. It was established that the incidences of congenital retinal degenerations and optic nerve atrophy were now higher than in the 1970-s years. About 1/3 of cases with congenital anomalies were those with high myopia.

[Ultrasonographic imaging of retinal detachment in retinopathy of prematurity]

The authors presented results of ultrasonographic examinations of 89 eyes of newborns, aged 2-12 months, in the stadium V of ROP. Analysis of the configuration of detached retina in A and B scan was done. In 48.3% of cases the funnel was narrow both anterior and posterior and only in 7.8% it was open in both parts. In vitreous fibrous proliferations and dense opacities were observed. In the majority of cases ultrasonography revealed subretinal densities and proliferations, and in 17% of the eyes calcifications.

[Behavior of intraocular pressure after internal tamponade with SF6]

The clinical material comprised 22 cases of traumatic retinal detachment, in children aged 5-18 years, in whom after circumferential buckle a mixture of air and SF6 was injected into the vitreous cavity. Intraocular pressure was measured with applanation tonometer before surgery, after gas injection and on consecutive 7 days. On the first day after operation intraocular pressure showed changes, however no increase was recorded in the later period.

[Myopia as a complication of retinopathy of prematurity]

Studies were carried out on a total of 103 children, aged 3-15 years, with birth weight 580-2450 g (mean 1710 g), with myopia of various degree. Relationships between axial length of the eye, birth weight, gestational age, duration of oxygen exposure and the degree of myopia were evaluated. Analyses of vascular and retinal changes in the fundus of the eye typical of regressed retinopathy of prematurity were performed. The values of myopia ranged from 1.5 D to 22.0 D (mean (9.78 D) and axial length from 20.36 to 30.9 mm (mean 25.08). The studies revealed that myopia in retinopathy of prematurity is not associated with the axial elongation of the eyeball. No relationship between the degree of myopia and other examined parameters was found.

[Tumors of the eye in childhood]

Cases of benign and malignant tumors treated in Children's Ophthalmological Clinic of Silesian Medical Academy in Katowice in the years 1982-1991 were presented. The clinical material comprises 135 eyes in 129 children. The benign tumors occurred in 83 children (64.3%) and malignant tumors in 46 children (35.7%). The most often observed benign tumor was naevus pigmentosus (23.7%) and the malignant tumor was mainly retinoblastoma (34.8%).

[Glaucoma after congenital cataract extraction in children]

The clinical material comprised 45 eyes in 33 children aged from 5 months to 8 years. In the period of 5 days to 7 years after congenital cataract surgery, an increased intraocular pressure has been observed. Antiinflammatory treatment, optic, cyclocryotherapy, synechia-lysis, anterior vitrectomy, YAG-laser and trabeculectomy were applied, depending on the mechanisms that caused the increase of intraocular pressure. In 1-5 years follow-up, the control of intraocular pressure, using the pharmacological treatment and/or surgery, was obtained in 88.4% of the cases. On admission, the enlargement of the eyeball was observed in 26.6% of children, whereas in every fifth of them the cupping of the optic disc was recorded.

[Diagnostic and therapeutic problems of juvenile glaucoma]

The material comprised 27 patients, aged 6-15 years, treated for juvenile glaucoma. Non-typical first symptoms, good visual acuity in the majority of the cases, the lack of anatomical changes of anterior segment of the eye and the elongation of the anatomic axis, difficulties in the evaluation of optic disc changes, especially in myopic eyes, and the lack of correlation of these changes with the results of visual field examination, little reliable in children, and also very often the normal intraocular pressure values, delay the diagnosis and make it much more difficult. The repetition of tests and the indication of the C factor make the diagnosis much easier. During the follow-up, intraocular pressure was well-controlled in 87% of the cases, 10% of them with additional optic treatment.

[Retinopathy of prematurity and retinal detachment]

The authors examined 60 children (91 eyes), aged 5 months to 17 years, with retinal detachment in the ROP course; 19 eyes were selected for the surgery, 5 eyes with the active ROP phase and 14 myopic eyes with the vitreo-retinal changes resulting from ROP. The segmental or encircling scleral buckling was performed in 19 eyes, in 4 eyes the vitrectomy and the endo-tamponade was used. In 12 eyes (63%) the retinal attachment was achieved, in 2 eyes in the active phase (40%) and 10 eyes (71.3%) with regressed ROP.

[Examination of corneal endothelium after cataract extraction in children]

Examined were 39 eyes (23 children) after extraction of congenital cataract or a subluxated lens as well as after implantation of an anterior chamber lens; evaluated were changes of density of the corneal endothelial cells. The operation the least damaging the corneal endothelium showed to be the lensectomy through the pars plana of the ciliary body.

[Eye burns in children and adolescents]

The authors present a material of 91 eyes in 66 children aged 2 days to 16 years, who sustained burns of the eyes. Fifty one eyes (1st group) was burned by thermal or chemical means, mainly by lime; 40 eyes (2d group) sustained chemico-mechanical injuries caused by explosions of petards or miner's detonators. Bilaterality of the injuries was seen in 50 p.c. of cases of the 1st group and in 25 p.c. of cases of the second group. Reduction of the visual acuity down to light perception was observed in 19.7 p.c. of cases of the 1st group and in 22.5 p.c. of cases in the 2d one; at the same time 2 cases of this group became blind. The cause of deterioration of the visual acuity in the group of chemico-thermal trauma were the corneal opacities, in the group of mixed injuries--changes in the posterior segment of the eye.

[Pathological conditions of the vitreous body in children after eye injuries]

The material consists of 142 eyes in 138 children aged 2-17 years who sustained contusions and perforating injuries. Pathological changes of the vitreous have been observed in 75 p.c. of cases: haemorrhages, opacities, destructive and fibrous changes and even a total fibrosis of the vitreous with shortening of the anatomical axis of the eye. Vitrectomy was performed in 23 cases with extraction of the foreign body in 11. In eyes with a destruction of the vitreous and with vitreoretinal proliferation a laser photocoagulation of the retina or transscleral cryopexy was performed. It is considered that the prophylactical treatment is indicated in all eyes exhibiting structural changes in the vitreous.

[Surgical treatment of retinal detachment with ora serrata dialysis in children]

The clinical material comprises 38 eyes in 36 children aged 5-17 years. The goal of this work was a presentation of the efficacy of retinal detachment surgery in cases of ora serrata dialysis. Apposition of the retina after surgery was achieved in 97 p.c. of cases. The visual acuity higher than 0.1 was observed in 67.5 p.c. of cases. Cerclage of the eye performed in a large group of patients did not influence the functional results in comparison with the results obtained by other methods.

[Phaco-aspiration and phaco-emulsification of cataract--personal experience]

The authors present material collected in the course of 10 years of applying the surgical technique of cataract extraction by means of a Cavitron-Kelman model 8000 V. The age of the patients oscillated between 4 months and 80 years. Phacoaspiration was performed in 4416 eyes and phacoemulsification in 2195 eyes. Following intraoperative complications were observed during surgery; rupture of the posterior lens capsule occurred in 9.75 p.c. of eyes in the course of the phacoaspiration and in 12.4 p.c. of phacoemulsification. The endothelial corneal degeneration occurred after phacoaspiration in 0.13 p.c., after phacoemulsification in 3 p.c. of cases; cystic macular oedema after phacoemulsification in 0.95 p.c. of cases. Visual acuity 5/25 to 5/10 was attained in 47.1 p.c. and visual acuity of 5/10-5/5 in 37.3 p.c. of the eyes. A larger number of complications after phacoemulsification--in spite of the time of application of the ultrasound considered as a safe one--caused a reduction in application of this method.

[The role of ocular symptoms in the diagnosis of neoplasms of the central nervous system]

Eighty four patients with a diagnosis of a neoplasm of the central nervous system were examined; full ophthalmological examination was performed in all of them. They showed pathological signs in the ocular adnexa, abnormal positioning and motility of the eyes, nystagmus, poor visual acuity, defects of the visual field, pathological changes in the anterior and posterior segment of the eye. In general--abnormal signs in the visual system were seen in 84.5 p.c. of cases comprising all of the children. In a part of cases ocular signs and symptoms were the only ones which drew attention from the side of the patient.

[Surgery of post-traumatic cysts in the iris of children]

The authors describe 7 cases of implanted iris cysts which appeared after perforating corneal injuries in children aged 3 to 14 years. All the cysts have been excised by sector iridectomy performed in the healthy iris. Described is the technique of the intervention. Attention is called to the possibility of preservation of a round pupil by leaving intact the pupillary border or by a simultaneous plastic operation of the iris.

[Treatment of glaucoma in children in congenital pathologic syndromes]

Presented are the results of surgical treatment glaucoma in congenital aniridia (10 eyes), in the syndrome of closed anterior chamber (7 eyes), in Sturge-Weber's syndrome (7 eyes) in marfan's disease (2 eyes), in Lowe's disease (2 eyes) and Recklinghausen's disease (1 eye). Trabeculectomy was performed in this majority of cases; in cleavage syndrome it was connected with cataract extraction. In Marfan's disease with lensectomy of a luxated lens. Cyclocryopexy and cyclodiathermy were applied as secondary surgical interventions. In general--44 operations were performed obtaining normalization of the intraocular pressure in 82% of eyes.

[Surgical treatment of secondary glaucoma]

Results of surgical treatment of secondary glaucoma (caused by uveitis, aphakia, injury) in adults and children are presented. Topical and general corticosteroids were applied immediately after trabeculectomy (deep sclerectomy). A favourable percentage of normalization of the IOP was observed together with a small amount of early and late postoperative complications.