22 research outputs found
Multifokalne intraokularne leÄe za korekciju prezbiopije nakon operacije katarakte
Monofocal intraocular lenses are effective in improving vision after cataract surgery but the loss of accommodation is not restored by implantation of these intraocular lenses. Because multifocal intraocular lenses may improve uncorrected distance and near vision, we compared clinical outcome and patient satisfaction after implantation of multifocal intraocular lenses. The study included eight patients who underwent cataract surgery using phacoemulsification and implantation of multifocal intraocular lenses (ReStor,Tecnis). Intraocular power calculation was measured by standard immersion A-scan ultrasonography using Holladay 2 formula, with target hyperopia +0.50 Dpt. Assessments were made preoperatively, and at 1 and 3 months postoperatively, whereas outcome was evaluated by interview. Satisfaction related to preoperative expectations was similar in all study patients. Visual acuity was 0.9 1.0 in 92% of the patients. All patients were satisfied with near vision without glasses. The perceived quality of corrected near vision showed highest correlation with patient satisfaction. Study results suggested that the patients were satisfied with their intraocular lens performance, and most would have the multifocal intraocular lens implanted again. The frequency of spectacle wear was greatly reduced for both distance and near vision.Monofokalne intraokularne leÄe su uÄinkovite u poboljÅ”anju vidne oÅ”trine nakon operacije katarakte, ali se gubitak akomodacije ne može vratiti ugraÄivanjem ovih leÄa. BuduÄi da multifokalne intraokularne leÄe poboljÅ”avaju vidnu oÅ”trinu na daljinu i blizinu, usporedili smo kliniÄke rezultate i zadovoljstvo bolesnika nakon ugradnje multifokalnih intraokularnih leÄa. U istraživanje je bilo ukljuÄeno osmoro bolesnika operiranih metodom fakoemulzifikacije, kod kojih je ugraÄena multifokalna intraokularna leÄa (ReStor, Tecnis). Aksijalna duljina je mjerena imerzijskom tehnikom A-scan uz primjenu formule Holladay 2, a željena poslijeoperacijska refrakcija je bila do +0,50 Dpt. Bolesnici su pregledani prijeoperacijski, te 1. i 3. mjeseca poslijeoperacijski, ukljuÄujuÄi intervjue. Zadovoljstvo u odnosu na prijeoperacijska oÄekivanja bilo je sliÄno kod svih bolesnika. Vidna oÅ”trina bez korekcije bila je 0.9-1.0 kod 92% bolesnika i nisu bile potrebne dodatne korekcije na blizinu. Zabilježena kvaliteta vida na blizu kod bolesnika s multifokalnom intraokularnom leÄom bila je usko povezana sa zadovoljstvom nakon operacije katarakte. Ova studija je pokazala izrazito zadovoljstvo bolesnika s multifokalnom intraokularnom leÄom, te bi oni opet izabrali istu kod ponovne operacije katarakte. Potreba za noÅ”enjem korekcije za daljinu i blizinu je smanjena
Obostrani neuritis oÄnoga živca kao poÄetna pojavnost neurosifilisa kod bolesnika pozitivnog na HIV
Syphilis, a disease which used to be terminal up to the 1950s, has become curable with the discovery of penicillin. In the last few years, an increase in its incidence has been recorded in the world as well as in Croatia, primarily with the human immunodeficiency virus (HIV) co-infection. We present a 40-year-old male patient who complained of a sudden decrease of visual acuity on both eyes, accompanied by dizziness. Clinical examination revealed low visual acuity and blurred edges of the optical nerve head without prominence. Pulse corticosteroid therapy failed to produce any recovery of visual acuity. Additional tests were done including Treponema pallidum hemagglutination assay (TPHA), which confirmed the infection with Treponema pallidum. The patient was administered Extencillin therapy. As a reaction to therapy administered, the patient.s visual acuity gradually fully recovered. In the medical literature available, there is no report of optical neuritis as the first and only manifestation of HIV and syphilis co-infection.Sifilis, bolest koja je do pedesetih godina proÅ”loga stoljeÄa bila smrtonosna, otkriÄem penicilina postala je izljeÄivom. U posljednjih nekoliko godina bilježi se porast incidencije kako u svijetu tako i kod nas, osobito uz suinfekciju virusom humane imunodeficijencije (HIV). Prikazujemo sluÄaj 40-godiÅ”njeg muÅ”karca koji se javio zbog naglog pada vidne oÅ”trine na oba oka praÄenog vrtoglavicom. Pri kliniÄkom pregledu utvrÄena je niska vidna oÅ”trina te glava vidnog živca nejasnih brisanih granica bez prominencije. Propisana pulsna kortikosteroidna terapija nije dovela do oÄekivanog oporavka vidne oÅ”trine, pa su uÄinjene dodatne pretrage, meÄu kojima i test hemaglutinacijske reaktivnosti Treponema pallidum (TPHA), kojim se dokazala infekcija bakterijom Treponema pallidum. Bolesniku je propisana terapija Extencillinom. Ova terapija je dovela do potpunog oporavka vidne oÅ”trine. U dostupnoj medicinskoj literaturi, prema naÅ”im saznanjima, dosad nije opisan sluÄaj optiÄkog neuritisa kao prve i jedine manifestacije suinfekcije HIV i sifilisa
Limbalna relaksirajuÄa incizija tijekom operacije katarakte
Limbal relaxing incisions are one of the more commonly performed procedures with phacoemulsification to correct preexisting astigmatism during cataract surgery. The aim of the study was to evaluate the effect and stability of limbal relaxing incisions in reducing preexisting astigmatism at the time of phacoemulsification. The study included 10 eyes in 12 patients who underwent limbal relaxing incisions during cataract surgery, with preexisting astigmatism of 1-2 diopter (D). Assessments were made preoperatively, and 1 and 3 months postoperatively. Outcome measures included uncorrected distance visual acuity, best corrected distance visual acuity and keratometric astigmatism measures. The mean preoperative and postoperative refractive astigmatism was 1.50 D (Ā±0.75D) and 0.25 D (Ā±0.25 D), respectively. There were no serious postoperative complications. Limbal relaxing incisions provide a viable option for correcting preexisting astigmatism at the time of cataract surgery with mild complications.Limbalna relaksirajuÄa incizija je jedna od Äestih metoda koja se primjenjuje za korekciju astigmatizma za vrijeme operacije katarakte metodom fakoemulzifikacije. Svrha ovoga rada bila je analizirati uÄinak i stabilnost limbalne relaksirajuÄe incizije u smanjenju prijeoperacijskog astigmatizma. Analiza je obuhvatila deset oÄiju u dvanaest bolesnika kod kojih je uÄinjena limbalna relaksirajuÄa incizija za vrijeme operacije katarakte s prijeoperacijskim astigmatizmom od 1-2 dioptrije (D). Analizirani su prije operacije te l-2 mjeseca poslijeoperacijski ukljuÄujuÄi nekorigiranu i najbolje korigiranu vidnu oÅ”trinu na daljinu te keratometrijske vrijednosti. Srednji prijeoperacijski i poslijeoperacijski astigmatizam bio je 1,50 D (Ā±0,75) odnosno 0,25 D (Ā±0,25). Ozbiljne poslijeoperacijske komplikacije nisu naÄene. Limbalna relaksirajuÄa incizija omoguÄuje održiv izbor za korekciju prijeoperacijskog astigmatizma za vrijeme operacije katarakte s blagim komplikacijama
Konzervans u oÄnim kapima kao uzrok pojasaste keratopaije rožnice kod dugotrajne terapije pilokarpin hidrokloridom
The aim is to present a patient with severe bilateral corneal complications after long-term antiglaucoma treatment with 1% pilocarpine hydrochloride (Pilokarpin, Pliva, Zagreb, Croatia) and its management. A patient with narrow-angle glaucoma treated with 1% topical pilocarpine hydrochloride eye drops for the last twenty years complained of impaired vision, intermittent visual haloes and eye redness. Ophthalmologic examination showed bilateral band keratopathy, peripheral laser iridotomy, medicamentous myosis, brown nuclear cataract, and synchysis scintillans of his right eye. Band keratopathy was thought to have resulted from the presence of the preservative phenylmercuric nitrate in the pilocarpine hydrochloride eye drops. Treatment of the patient consisted of two separate procedures for both eyes, i.e. phaco trabeculectomy and six months later corneal procedure including abrasion of corneal epithelium followed by removal of the superficial stromal calcium deposits by means of a 3.75% ethylenediaminetetraacetic (EDTA) solution. After phaco trabeculectomy, visual acuity was 0.8 on both eyes. Bilateral visual improvement with visual acuity 1.0 was recorded after corneal treatment with EDTA. In conclusion, one must be aware of preservative complications in long-term topical use, such as band keratopathy that can be visually incapacitating. Surgical treatment using EDTA is safe and effective treatment for band keratopathy.Cilj je prikazati sluÄaj nastanka rožniÄnih komplikacija uzrokovanih konzervansima pri dugotrajnoj upotrebi kapi 1%- tnog pilokarpin hidroklorida (Pilokarpin, Pliva, Zagreb, Hrvatska) i njihovo lijeÄenje. Bolesnik s glaukomom zatvorenog kuta koji se unazad dvadeset godina lijeÄio antiglaukomskim kapima 1%-tnog pilokarpin hidroklorida tri puta na dan žalio se na slabiji vid, haloe i povremeno crvenilo oÄiju. OftalmoloÅ”kim pregledom naÄene su obostrane pojasaste degeneracije rožnice, periferne laserske iriditomije, zjenice u medikamentnoj miozi, tamna nuklearna bilateralna katarakta i scintilirajuÄa sinhiza desnog oka. Konzervans živin nitrat smatra se uzrokom pojasaste degeneracije rožnice kod ovoga bolesnika. LijeÄenje bolesnika sastojalo se od dva postupka za oba oka: prvi je bio kombinirani zahvat fakoemulzifikacije katarakte s trabekulektomijom, a nakon Å”est mjeseci lijeÄenje koje je ukljuÄivalo abraziju kornealnog epitela i uklanjanje stromalnih kalcijskih depozita pomoÄu 3,75%-tne otopine etilendiamintetraoctene kiseline (EDTA). Vidna oÅ”trina nakon fakotrabekulektomije bila je 0,8 na oba oka. Obostrano poboljÅ”anje vida do vidne oÅ”trine 1,0 postiglo se nakon uklanjanja rožniÄnih depozita pomoÄu EDTA. ZakljuÄuje se kako se prilikom dugotrajne upotrebe lijekova s konzervansima mogu oÄekivati nuspojave kao Å”to je pojasasta degeneracija rožnice koja može doprinijeti znatnom smanjenju vidne oÅ”trine. KirurÅ”ko lijeÄenje pomoÄu EDTA je sigurna i uÄinkovita metoda lijeÄenja pojasaste degeneracije rožnice
MetaboliÄki Äimbenici rizika, suoÄavanje sa stresom i psiholoÅ”ko zdravlje u bolesnika sa senilnom makularnom degeneracijom
The aim of this study was to determine the relationship between the risk factors (age, obesity, hypertension, hyperlipidemia, smoking, consumption of alchohol and drugs, positive family history, and exposure to sunlight), coping with stress, psychological well-being and age-related macular degeneration (ARMD). Forty patients with ARMD (case group) and 63 presbyopes (control group) participated in the study. Patient data were collected through general information questionnaire including patient habits, the COPE questionnaire that showed the way the patients handling stress, and the GHQ that analyzed the psychological aspects of their quality of life. These questionnaires were administered to the patients during ophthalmologic examination. The study involved 46 (44.66%) men and 57 (55.33%) women. Statistical analysis showed that the major risks for the development of ARMD were elevated cholesterol, triglycerides and LDL cholesterol in plasma. A significantly higher number of ARMD patients had a positive family history when compared with presbyopes. This study showed presbyopes to cope with emotional problems significantly better and to have a lower level of social dysfunction when compared with ARMD patients. However, it is necessary to conduct further studies in a large number of patients to determine more accurately the pathophysiological mechanisms of metabolic factors as well as the impact of the disease on the quality of life in patients with ARMD.Cilj ovoga istraživanja bio je utvrditi povezanost izmeÄu riziÄnih Äimbenika (dob, pretilost, hipertenzija, hiperlipidemija, puÅ”enje, konzumacija alkohola i lijekova, pozitivna obiteljska anamneza, izloženost sunÄevom zraÄenju), suoÄavanja sa stresom, psiholoÅ”kog aspekta kvalitete života i senilne makularne degeneracije (SMD). U istraživanje su bili ukljuÄeni bolesnici oboljeli od SMD (n=40) koji su Äinili ispitivanu skupinu i prezbiopi (n=63) koji su Äinili kontrolnu skupinu. Podatci su se prikupili ispunjavanjem upitnika kojim su se dobili opÄi podatci i opisale navike bolesnika, upitnika COPE kojim su se ispitali naÄini reagiranja na stres te upitnika GHQ kojim se analizirao psiholoÅ”ki aspekt kvalitete života. Navedeni upitnici bili su osobno uruÄeni ispitanicima prilikom oftalmoloÅ”kog pregleda. U istraživanje je bilo ukljuÄeno 46 (44,66%) muÅ”karaca i 57 (55,33%) žena. StatistiÄka obradba pokazala je da najveÄi rizik za obolijevanje od SMD predstavljaju poviÅ”ene razine kolesterola, triglicerida i LDL kolesterola u krvi. ZnaÄajno veÄi broj bolesnika u ispitivanoj skupini imao je pozitivnu obiteljsku anamnezu u odnosu na kontrolnu skupinu. Ovo istraživanje pokazalo je da prezbiopi znaÄajno bolje reagiraju u osjeÄajima usmjerenom suoÄavanju te da imaju niži stupanj socijalne disfunkcije u odnosu na bolesnike oboljele od SMD. MeÄutim, potrebno je provesti daljnja istraživanja na velikom broju bolesnika kako bi se toÄnije utvrdili patofizioloÅ”ki mehanizmi metaboliÄkih Äimbenika, kao i utjecaj bolesti na kvalitetu života u bolesnika sa SMD