Procedure for keratoconus detection according to the Rabinowitz-Rasheed method--personal experience

PURPOSE: The purpose of this study was to investigate sensitivity of KISA% index to compare with Klyce-Maeda and Smolek-Klyce methods in detection of early or suspected keratoconus by using AutoTopographer TMS-3 (Tomey). MATERIAL AND METHODS: At the First Department and Clinique of Ophthalmology, Silesian Medical School in Katowice, 69 eyes underwent ophthalmological examinations in patients, who did not wear contact lenses at least for 6 weeks before examination. The procedure was performed with the TMS-3 AutoTopographer (Tomey). During the study we investigated index definitions included in Keratoconus Screening Program. RESULTS: The examination showed the false negative results in 29% patients with early or suspected keratoconus. Using KISA% index we detected false negative results in 5.8% patients with early or suspected keratoconus. CONCLUSION: To sum up, we can say that the KISA% index is highly sensitive and specific for diagnosing keratoconus, more useful than Klyce-Maeda and Smolek-Klyce methods. This method can be used by users of all types of videokeratoscopes.     

Cataract surgery in adults and children with chronic uveitis

PURPOSE: To present preoperative strategies and results of cataract surgery in patients with different types of uveitis. PATIENTS AND METHODS: The results of 18 cases of extracapsular cataract extraction with or without intraocular lens implantation were retrospectively analysed. Age of patients ranged from 10 to 71 years (mean age: 35 years). Etiology of uveitis was determined in 10 cases (63%). Preoperative management was determined by the diagnosis of uveitis. The postoperative observation time ranged from 3 years to 6 months (mean: 25 months). RESULTS: Visual acuity improved postoperatively in 17 eyes (96%), and was better than 0.5 in 10 eyes (63%). The reasons for lower visual acuity were: cystoid macular edema in 6 cases (33%), band keratopathy, amblyopia and floaters in the vitreous. CONCLUSIONS: Establishing the diagnosis and controlling the inflammation pre- and postoperatively are the basic conditions for the surgical outcomes in cataract surgery in patients with history of uveitis.     

Cataract extraction and lens implantation in glaucomatous eyes after trabeculectomy

PURPOSE: Presentation of problems connected with an implantation of eye lens after trabeculectomy with changed anatomic conditions. PATIENTS AND METHODS: In 51 cases of patients with cataract and glaucoma, following a trabeculectomy operation, ECCE was made by corneal incision and lens implantation into posterior chamber. In the analysis, the following were taken into consideration: state of the eye before cataract operation, intrasurgical difficulties with necessary application of additional surgical actions, evaluation of postoperative course. RESULTS: In 41.1% of patients, surgical operations followed a non-typical way and the below procedures were necessary: loosening of adhesions, mechanical pupillary dilation, tearing off fibrous or stained membrane, iridorrhaphy and pupil reconstruction. Posterior chamber lens was implanted in 96% of patients and the following acuity was achieved: 0.5-1.0 in 25 eyes, 0.3-0.4 in 13 eyes, 0.02-0.2 in 10 eyes. There was no acuity improvement in 3 eyes only. CONCLUSIONS: Operation posterior chamber lens implantation after trabeculectomy can proceed in a non-typical way because of changed anatomic conditions. Postoperative functional results depend on the degree of nerve lesion (injury), but they are often better than preoperative prognoses indicate.     

Use of a diode laser for glaucoma in children and adolescents

OBJECTIVE: To present the results of the use of diode laser in the treatment of secondary glaucoma in children. MATERIAL AND METHODS: The study was performed on 15 eyes in 14 children (7 males and 7 females) with glaucoma resistant to pharmacotherapy. Transscleral contact cyclophotocoagulation (TSCPC) was performed using SLx diode laser (Iris Medical Instrument). The number of photocoagulations performed within the circumference of 270 degrees ranged from 18 to 30 and the energy depended on "pop sound". RESULTS: In one child visual acuity decreased from 0.5/50 to light perception, while in the remaining children it did not change. Prior to coagulation, the mean intraocular pressure was 37.67 +/- 3.2 mm Hg, and 6 months after coagulation it was 22 +/- 3.74 mm Hg. CONCLUSIONS: TSPC is a well tolerated method of treatment in children with pharmacotherapy-resistant glaucoma. In order to assess the late outcomes of the therapy, prolonged observation of the patients is required.     

Determination of oxymetazoline hydrochloride and decomposition products by high-performance liquid chromatography

An HPLC method for the separation of the oxymetazoline hydrochloride and the products of its decomposition was developed and validated. The determination was performed with a LiChrospher RP-18 column, mobile phase of methanol-H2O-triethylamine-sodium acetate (1 mol l(-1))-acetic acid (1.06 kg l(-1)) (130:60:6:2:1). UV detector set at 280 nm and antazoline methanesulfonate as an internal standard.     

Energetic metabolism of the placenta and vascular blood flow as criteria for the choice of drugs in risk pregnancy--results of our investigations

Object of this paper was to estimate the vascular resistances of the placenta and the lactate/pyruvate-quotient influenced by 8 and 40 mu/min orciprenaline and 320 micrograms/min papaverine. 38 placentas were tested in extraorganic circulation. The content of lactic acid and pyruvic acid was determined in the perfusion solution flowing out of the umbilical vein. Pressure was registered with cymograph. Infusion of 8 micrograms/min orciprenaline diminishes the lactate/pyruvate-quotient and the vascular resistances. 40 micrograms/min orciprenaline causes spasm of placental vessels in the terminal phase of examination. In this group the processes of oxygenation were limited by the oxygen content in the perfusion solution. Papaverine turned the metabolism of the placenta to an anaerob way and the antispasmodic effect was shortlasting.--Therefore the drug effect results out of a metabolic and a spasmolytic component. In risk pregnancy there has to be considered in addition to the spasmolytic the metabolic effects, too.     

Molecular modeling of buspirone-serotonin receptor interactions

Modern concepts of buspirone activity as an anxiolytic drug are reviewed. Particular attention is focused on the molecular aspects of buspirone interactions in the phases that simulate cellular environment. Three-dimensional models of buspirone-serotonin receptor complexes are discussed as well.