Zdravko Mandić

Comparative Study of Pterygium Surgery

The aim of this study was the comparison of recurrence rates of pterygia following different surgical methods. Twenty-one patients were operated by the bare sclera technique, with the application of mitomycin C (0.25 mg/ml for 2 min). Twenty-seven patients were operated by limbal stem cell transplantation. The third group contained 13 patients who were operated by amniotic membrane transplantation. Five recurrences of pterygia were noted in the mitomycin C group and 2 each in the limbal stem cell transplantation group and the amniotic membrane group. The mean time to recurrence was 5.4 ± 4.12 months in the mitomycin C group versus 10.5 ± 3.5 months in the group of patients with limbal transplantation. In the third group, both recurrences were evident 4 months after the operation.

Azithromycin vs doxycycline in the treatment of inclusion conjunctivitis.

PURPOSEnThe aim of the study was to compare the efficacy and safety of azithromycin and doxycycline in the treatment of chlamydial conjunctivitis in adults.nnnDESIGNnAn open, randomized clinical trial.nnnMETHODSnSeventy-eight adult patients with incluson conjunctivitis were enrolled in this multicenter clinical study. Patients with chlamydial conjunctivitis as indicated by a positive direct fluorescent antibody (DFA) test or cell culture were randomized to receive a single 1-g dose of azithromycin or doxycycline, 100 mg twice daily for 10 days. A conjuctival swab for cell culture was obtained from all patients immediately before the treatment for subsequent confirmation of the presence of chlamydial infection in the central laboratory. Control examinations were performed 10 to 12 days and 4 to 6 weeks after the treatment initiation. Clinical and bacteriological responses to the treatment were evaluated at the last visit. The occurrence and frequency of adverse events were analyzed as well.nnnRESULTSnOf 78 patients enrolled, 51 completed the study and were evaluated for efficacy. The main reasons for withdrawal were lack of confirmation of the presence of chlamydial infection by the central laboratory and failure to attend the follow-up visit. Eradication of C. trachomatis was achieved in 23 of 25 (92%) patients treated with azithromycin and in 25 of 26 (96%) patients treated with doxycycline. Clinical cure was observed in 15 (60%) and 18 (69%) patients treated with azithromycin and doxycycline, respectively. Both drugs were equally well tolerated.nnnCONCLUSIONSnA single 1-g azithromycin therapy was as effective as standard 10-day treatment with doxycycline (100 mg twice daily) in the treatment of adult inclusion conjunctivitis.

Pseudophakic dysphotopsia associated with the implantation of intraocular lenses

Purpose: To determine the incidence of unwanted light images after cataract surgery and the relationship between various intraocular lens (IOL) types. n n n nMethods: Prospective study included 50 patients who filled up a written questionnaire where reported on incidence of glare, light sensitivity and unwanted images. Patients were included in the study only if they had uneventful cataract surgery and no additional ocular pathology. They were excluded if they had refractive errors which could cause similar phenomena. The study was performed in three month postoperative period. n n n nResults: A significant number of patients reported symptoms. Patients with acrylic IOL were at increased risk. At last control more than 1/3 of symptoms resolved spontaneously. No one reported negative dysphotopsia and there was no IOL exchange. n n n nConclusions: Intraocular lenses can introduce stray light artifacts into the eye. While positive dysphotopsia has been largely attributed to edge effects of the implant, negative dysphotopsia appears to be more related to the patients anatomical structure than to specific lens designs or materials.

Treatment of patients with late complications after filtering surgery

Purpose: Demonstrate the possibilities of successful surgical treatment of patients with late n n n ncomplications after filtering surgery. n n n nMethods: This study shows patients who have developed a cystically dilated or leaking filtering bleb in the late post-surgical period after filtering surgery. Excision of the indadequate filtering bleb has been performed in the patient with a cystic bleb. After the failure of less invasive methods of treatment, we have proceeded to bleb revision with a scleral patch graft in the patient with a leaking bleb. n n n nResults: Patients treated with either bleb excision or scleral patch graft showed no signs of neither hypotonia nor secretion during the six-months post-surgical period. During that period, complicated cataracts developed. After cataract surgery the function of the filtering bleb was preserved. n n n nConclusions: During the several months of patients follow-up, reconstructive methods of treatment have shown to be successful in high-risk patients who have developed post-surgical complications n n n nin the form of leaking or inadequate filtering bleb.

Transplantation von Amnionmembran bei symptomatischer bullöser Keratopathie

ZusammenfassungFragestellungStellenwert der Transplantation von Amnionmembran zur Rekonstruktion der Oberfläche bei Augen mit bullöser Keratopathie.Patienten und Methode16 Augen von 16 Patienten mit ätiologisch unterschiedlicher bullöser Keratopathie wurden prospektiv untersucht. Bei allen Patienten wurde eine Amnionmembran appliziert.ErgebnisseAlle bis auf 2 Augen zeigten eine rasche Epithelalisation und hatten keine Schmerzen. In einem durchschnittlichen Nachbeobachtungszeitraum von 11 Monaten erzielten 14 Augen eine fast vollständige Reduktion von Schmerzen und Lichtscheu. Dabei wurde eine gute Deckung des Transplantates mit vollständigem Epithelverschluss beobachtet.SchlussfolgerungAus den Ergebnissen unserer prospektiven Studie geht ein positiver Effekt der Transplantation von Amnionmembran bei Augen mit bullöser Keratopathie und schlechter visueller Prognose hervor.SummaryPurposeTo determine weather amniotic membrane transplantation can bee used to reconstruct the surface of the eyes with bullous keratopathy.Patients and methods16 eyes in 16 patients with different aetiology of bullous keratopathy have been analysed. At all patients amniotic membrane was applied.ResultsIn all patients except two the quickly restitution of epithel without pain was noticed. During the mean follow-up period of 11 months 14 eyes became pain and photophobia free. We have find out complete disappearance of epithelial defects.ConclusionAccording to our results amniotic membrane transplantation has shown good results in the treatment of eyes with bullous keratopathy and poor visual potential.