How to Convert the Obliquely Crossed to Non-Crossed Astigmatism? A Simple Method Using Vector Analysis

The authors discussed about the problem of special form in astigmatism classification. This special type of astigmatism is the form of obliquely crossed astigmatism. In which the meridians, major and minor, are not right angles. In this astigmatism is not possible to prescribing for cylindrical (toric) spectacle lens. Authors describe the Thompson formula for oblique crossed cylinder and observe that this formula is to complicate for calculation new cylinder power. In this reason, the authors create the new formula and simple procedure for this calculation. This simple formula based on vector analysis and read: DM3 = DM2 ´ cos2 b

Resolution of Pseudophakic Cystoid Macular Edema with Combination Therapy of Topical Corticosteroids and Nonsteroidal Anti-inflammatory Drugs

A 69 years old women underwent uneventful cataract surgery of her left eye with phacoemulsification and posterior chamber intraocular lens implantation in topical anesteshia. Patinet was postoperatively treated with combination of antibiotic and steroid in decreasing dosages during five weeks: one drop five times a day the first week, three times a day second to forth week and one time a day the fifth week. In each checkup, performed first postoperative day, 7 days, 5 weeks and 12 weeks after the operation, visual acuity with and without correction, tonometry, corneal transparency, biomicroscopy of posterior pole and measure of macular thickness by optical coherence tomography (OCT) were performed. At first day follow-up visit, the patient’s visual acuity was 20/25 but 6 weeks after the operation, the patient’s vision had worsened to 20/60 after a slow steroid tapper. At that time OCT showed foveal thickening and cystic changes specific for cystoid macular edema (CME). Combination of corticosteroid and non-steroidal anti-inflammatory drug four times daily was included in therapy. The dose was tapered off over the ensuing 8 weeks. The total treatment duration was 12 weeks. At the patient’s 2-month follow-up visit, vision has improved to 20/20 and the fovea appeared flat. OCT showed complete resolution of foveal thickening and cystic changes. Combination of corticosteroid and NSAID is effective and safe therapy for treating pseudophakic CME. Patient showed significant improvement in visual acuity and retinal thickness at 2 months post treatment. Abbreviations: OCT – optical coherence tomography, CME – cystoid macular edema, NSAID – non-steroidal anti-inflammatory drug

Therapeutic Effect of Amniotic Membrane in Persistent Epithelial Defects and Corneal Ulcers in Herpetic Keratitis

Amniotic membrane transplantation (AMT) promotes rapid epithelialization and reduces stromal inflammation and ulceration in HSV-1 keratitis. 18 patients with non-healing epithelial defect or corneal ulcer caused by herpetic keratitis were included in the study. All patients were treated by AMT. Corneal epithelial cells in patients suffering from herpetic keratitis secreted 5 ± 4.8 pg/ml of IL-1a and 0.16 ± 0.47 pg/ml of IL-1b (mean ± SD). IL-1a level was significantly higher as compared to controls (p<0.005). Amniotic membranes that were used to treat investigated patients contained 339.87 ± 105 pg/ml of IL-1ra. In herpetic keratitis pro-inflammatory cytokine IL-1a is secreted from corneal epithelial cells in significantly higher level then in controls. Beneficial effect of the AMT in such patients could be explained by the fact that AM secretes its natural antagonist IL-1ra

Comparison of Diffractive and Refractive Multifocal Intraocular Lenses in Presbyopia Treatment

Multifocal intraocular lenses (MFIOL) enable good near and far vision after cataract surgery. Excellent results with cataract patients encouraged ophthalmologists to implant MFIOL after clear lens extraction (CLE). There are two types of MFIOL: diffractive and refractive. In our prospective study we compared clinical outcomes after CLE and bilateral implantation of diffractive (Tecnis Multifocal), (N = 100 eyes, 50 patients) and refractive (ReZoom), (N = 100 eyes, 50 patients) MFIOL to patients with presbyopia and hyperopia. Near and distant uncorrected visual acuity (UCVA), spectacle dependency, subjective satisfaction and visual disturbances were measured and compared between two groups. Patients achieved good near and distant UCVA in both groups. »Tecnis« group had better near UCVA (statistically not significant) and less night time visual disturbances. »ReZoom« group reported less problems with intermediate vision. Diffractive and refractive MFIOL enable high rate of spectacle independency to presbyopic hyperopic patients with low rate of side-effects. Refractive MFIOL provide better intermediate vision and diffractive slightly better near vision and less haloes and glare