Combined Procedure of Phacoemulsififi cation and Implantation of Ex-PRESS Miniature Glaucoma Shunt

Glaucoma patients not responding to maximum medical therapy with coexistent cataract are candidates for combined cataract and glaucoma therapy. There are different therapy models. The choice of therapy depends on numerous patient and surgeon related factors. Ex-PRESS mini glaucoma shunt is a modifi ed trabeculectomy and can be combined with cataract surgery when indicated. In this paper we presented our experience with this combined procedure. Our results showed good intraocular pressure control and visual acuity improvement, comparable to other therapy choices

Ex-PRESS Miniature Glaucoma Shunt in Treatment of Refractory Glaucoma

Refractory glaucoma in a complicated type of glaucoma of different ethyologies with one same characteristic – intraocular pressure of great resistance to therapy. There are different methods of treatment in such glaucomas, primary surgical options. Ex-PRESS miniature glaucoma shunt implantation was our treatment of choice. In our group of patients we achieved stabile intraocular pressure values in 4 month period of time with no serious or unexpected complications

Capsular Tension Ring in Damaged Zonules

Capsular tension ring (CTR) is endocapsular support device important during cataract surgery in eyes with weak zonular apparatus. It was presented our experience, advantages and limitations of CTR in phacoemulsifi cation cataract surgery with damaged zonules. Phacoemulsifi cation surgery was performed by clear corneal technique using topical anesthesia. Capsular ring was implanted to stabilize the capsular bag before implantation of intraocular lens. CTR has become increasingly important in the management of zonular weakness during cataract extraction. It lowers the incidence of capsule contraction, stabilizes the capsular bag and enhances IOL centration

Aktivna okularna toksoplazmoza pacijenata dijagnosticiranih i liječenih u Općoj bolnici Zadar

Toxoplasma gondii is responsible for the 20-60% of all the cases of chorioretinitis. Causes of permanently reduced vision (found in about 25% of the patients) include macular active lesions and macular oedema, optic nerve involvement, vascular occlusion, retinal detachment, and late secondary choroidal neovascularization. A retrospective, non-consecutive chart review was performed on 11 patients with active ocular toxoplasmosis. At examination, all patients had central active lesions on retina. Preexisting chorioretinal scars were found in seven patients (63.6%). Eight patients (72.7%) had vitritis, while three patients (27,3%) had iridocyclitis. Six patients (54.6 %) had macular inflammatory lesions, four (36,37%) of them had active lesions out of vascular arcades, and one (9.1%) had active lesions inside vascular arcades, while macula was not affected. The mean value of visual acuity at first visit of the patients was 0,5. The mean value of visual acuity was 0.9 after the healing process. All the patients were treated with oral antibiotics. Seven patients also received oral corticosteriods, and seven of them were also treated with pyrimethamine. All patients with signs of iridocyclitis were also treated with topical corticosteroids. Although toxoplasmosis chorioretinitis is usually a self-limited infection and generally resolves spontaneously, unrecognised cases can result in severe visual impairments.Toxoplasma gondii je uzročnik 20-60 % svih slučajeva korioretinitisa. Uzroci trajno smanjenog vida (slučaj kod otprilike 25% pacijenata) uključuju aktivne lezije u makuli, makularni edem, lezije optičkog živca, vaskularne okluzije, ablacije mrežnice i kasne koroidalne neovaskularizacije. Prilikom pregleda, svi su pacijenti imali aktivne lezije na mrežnici. Raniji korioretinalni ožiljci pronađeni su u sedam pacijenata (63,6%). Osam pacijenata je imalo vitritis (72,7%), dok su tri pacijenta imala iridociklitis (27,3%). Šest pacijenata (54,6 %) imalo je upalne lezije u makuli, četvero (36,37%) je imalo aktivne lezije izvan krvožilnih arkada, a jedan (9,1%) je imao aktivne lezije unutar krvožilnih arkada, dok makula nije bila zahvaćena. Srednja vrijednost vidne oštrine prilikom prvog pregleda bila je 0,5. Poslije izlječenja srednja vrijednost vidne oštrine bila je 0,9. Svi pacijenti liječeni su peroralnim antibioticima. Sedam pacijenata je, također, primilo peroralne kortikosteroide, a sedam pirimetamin. Svi pacijenti s iridociklitisom su, također, primili topičke kortikosteroide. Iako je korioretinitis uzrokovan toksoplazmom uobičajeno samolimitirajuća bolest koja se može spontano izliječiti, nedijagnosticirani slučajevi mogu rezultirati ozbiljnim oštećenjima vida

Comparison of IOL – Master and Ultrasound Biometry in Preoperative Intra Ocular Lens (IOL) Power Calculation

Postoperative refractive outcome largely depends on the accuracy of calculating power of implanted IOL. Lens power calculation can be done by conventional ultrasound biometry and partial coherence laser interferometry (IOL Master). The aim was to compare the accuracy of IOL power calculations using conventional ultrasound biometry and partial coherence laser interferometry.40 eyes were included in this prospective randomized trial. Twenty eyes underwent IOL master and 20 eyes had aplanation ultrasound biometry. There were included only eyes with age-related cataract and postoperative natural visual acuity (VA) 0.7. Visual acuity was performed 6 weeks after cataract surgery. After 6 weeks best natural visual acuity were 0.9 (±0.1) in IOL-Master group and 0.85 (±0.15) in ultrasound biometry. The postoperative mean absolute refractive error was 0.75 (±0.5) D for ultrasound biometry and 0.50 (±0.50) D for IOL-Master. Optical biometry with the IOL-Master proved to be slightly more accurate than ultrasound biometry for IOL power calculation

Ocular Surface Changes in Glaucoma Patients Related to Topical Medications

Topical glaucoma therapy is a long termed, usually lifelong. Antiglaucomatous drugs have toxic effects on ocular surface, due to preservative toxicitiy or the drug itself. Adding a lubricant eyedrops to antiglaucomatous therapy, especially if considering the preservative used, can have protective effect. The purpose of this study was to evaluate the stability of precorneal tear fi lm in glaucoma patient prior and after administration of lubricant eye drops with different tipe of preservatives. The study showed the protective role of ocular surface lubrication especially when using drugs with less harmful preservatives

FEAR OF BLINDNESS IN PATIENTS UNDERGOING CATARACT SURGERY

Background: Fear is a negative emotion induced by the threat of danger, pain and harm. Cataract surgery is one of the most performed surgeries in the world. The aim of this study was to investigate and analyze the predominant fears in patients undergoing cataract surgery. Subjects and methods: In this cross-sectional study 152 patients were examined. Self-designed questionnaires to examine emotions of the fear, anxiety, nervousness frequency gratitude was used and insecurity immediately before cataract surgery. We also examined what the greatest fear during the cataract surgery was. The fear of blindness was compared with other life fears such as cancer, memory loss, AIDS, stroke and heart attack. The presence of fear was compared in patients having had previous cataract surgery with those undergoing their first cataract surgery. Including criteria were adults with senile cataract. Excluding criteria was ocular co-morbidity, psychiatric disorders, inability to read, deafness and surgery under general anesthesia. Completed questionnaires were analyzed. Pearson\u27s chi-squared test was used. Results: Fear was the most frequent emotion before cataract surgery, present in 60.5% patients. Fear of blindness was the greatest fear during cataract surgery in 55.3% of patients. There was no statistically significant difference in fear in patients having undergone their first cataract surgery and patients before their second cataract surgery (p<0.05). Conclusion: Fear is the predominant emotion before cataract surgery which is in correlation to the leading life fear - fear of blindness. Good preoperative preparation and a trusting doctor-patient relationship are important for reducing the fear of the procedure

Ocular Surface Changes in Glaucoma Patients Related to Topical Medications

Topical glaucoma therapy is a long termed, usually lifelong. Antiglaucomatous drugs have toxic effects on ocular surface, due to preservative toxicitiy or the drug itself. Adding a lubricant eyedrops to antiglaucomatous therapy, especially if considering the preservative used, can have protective effect. The purpose of this study was to evaluate the stability of precorneal tear fi lm in glaucoma patient prior and after administration of lubricant eye drops with different tipe of preservatives. The study showed the protective role of ocular surface lubrication especially when using drugs with less harmful preservatives