Miro Kalauz

Cataract Surgery in Eyes with Pseudoexfoliation (PEX) Syndrome

Pseudoexfoliation (PEX) syndrome is a common age-related systemic disorder characterized by a huge production and deposition of fibrillogranular amyloid-like extracellular material within many ocular tissues. Pseudoexfoliation is a risk factor for glaucoma and also correlated to an increased incidence of cataract formation. Cataract surgery in eyes with pseudoexfoliation is connected with many complications and presents challenges that require careful preoperative planning and intraoperative care to ensure safe surgery and successful postoperative outcome. Zonular weakness and poor pupillary dilation are two major risk factors for surgical complications and poor visual acuity after surgery. With proper preparation and use of specialized adjunctive devices, phacoemulsification (PHACO) is the preferred procedure of cataract extraction in this group of patients. Postoperatively pseudoexfoliation patients require frequent and detailed follow-up to monitor for complications such as intraocular pressure rise, inflammation and intraocular lens dislocation. In conclusion, with appropriate preoperative, intraoperative and postoperative care the risks of complications can be minimized and favourable outcomes can be achieved in cataract surgery in eyes with pseudoexfoliation syndrome.

Posterior Capsule Opacification and Nd:YAG Rates with Two Acrylic Intraocular Lenses after Age-Related Cataract Treatment: Three-year Results.

ABSTRACT Objective: To compare the incidence and intensity of posterior capsule opacification (PCO) between two intraocular lenses (IOLs) over three years. Methods: Eighty-three patients underwent cataract surgery with implantation of Acreos Adapt AO or Acrysof SA60AT. PCO values were assessed using a photographic image analysis system (EPCO 2000) and the amount of PCO at the slit lamp. Results: Mean PCO score was 2.78 ± 1.55 for the Acreos Adapt AO and 2.32 ± 1.20 for the Acrysof SA60AT (P=.229). There were no significant differences in the median EPCO values in the entire IOL optics area (0.60 ± 0.26 vs 0.58 ± 0.23; P=.745) and in the central 3-mm zone (0.28 ± 0.13 vs 0.27 ± 0.12; P=.638). Neodymium:YAG capsulotomy was performed in 28% of eyes with Acreos Adapt AO and 23.33% with Acrysof SA60AT (P=.692). Conclusion: Both IOLs had comparable PCO and Nd:YAG rates three years postoperatively.

Usporedba debljine kompleksa ganglijskih stanica i živčanih vlakana mrežnice u dijagnostici glaukoma

The aim was to compare retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thicknesses in patients with primary open angle glaucoma (POAG), ocular hypertension (OH) and healthy subjects, and to investigate the role of GCC parameters in glaucoma diagnosis. Eighty-one patients were divided into four groups according to Hodapp-Parrish-Anderson classification: 26 OH, 22 early POAG, 10 moderate to advanced POAG, and 23 healthy subjects. All patients underwent RNFL and GCC thickness measurement using SOCT Copernicus HR. All RNFL and GCC parameters were significantly lower in POAG than in OH and healthy subjects, especially Average RNFL, RNFL Superior and Inferior, GCC Average, and GGC Inferior. Of all RNFL parameters, the highest area under the receiver operating characteristic curve (AUC) was recorded for Average RNFL, 0.906. GCC Average, and GCC Superior and Inferior had the overall highest AUCs (0.957, 0.955 and 0.946, respectively) with 100% specificity. The RNFL Average and Inferior and GCC Average, Superior and Inferior were identified as the main predictors for development of glaucoma (p=0.015 and p=0.014 vs. p=0.002, p=0.002 and p=0.003, respectively). In conclusion, GCC parameters showed a slightly better glaucoma discriminating ability and were found to be better predictors for development of glaucoma as compared with RNFL.