Objectives:The aim was to examine efficacy and safety after Implantable Collamer Lens (ICL) implantation for correction of myopia et myopic astigmatism.Methods:This prospective clinical study included 28 eyes of 16 patients which underwent implantation of ICL for correction of myopia up to -18,00 diopters (D) and myopic astigmatism up to -6,00 D in the Eye Clinic Svjetlost Sarajevo, from January 2013 to January 2016. Uncorrected distance visual acuity (UDVA), spherical equivalent (SE), corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell (EC) density were evaluated at one, six and twelve months. For statistical analysis SPSS for Windows and Microsoft Excel were used.Results:Out of 16 patients, with mean age of 28,21 ± 4,06 years, 12 of them had binocular and 4 of them had monocular procedure. After 12 months mean UDVA was 0,76 ± 0,16 compared to UDVA 0,04 ± 0,03 preoperatively. Mean SE preoperatively was -0,21 ± 0,27 D compared to -9,52 ± 3,69 D preoperatively. At 12 months one eye (3,57%) lost 2 Snellen lines. In this study 8 eyes (28,57%) gained 1 line, 5 eyes gained (17,56%) 2 lines, and 3 eyes (10,72%) gained 3 lines. EC loss was 5,50±4.71% after 12 months. There was no significant change of IOP by the end of 12 months follow up period. One haptic crack was reported as the only intraoperative complication. Three postoperative complications were: two lens rotations and one retinal detachment.Conclusion:Implantation of ICL is an effective and safe method for reducing or correcting myopia and myopic astigmatism.
Introduction: In the field of ophthalmology, laser technology is used in many basic and clinical disciplines and specialities. It has played an important role in promoting the development of ophthalmology. Aim: This article is designed to review the evolution of laser technology in refractive surgeries in ophthalmology, mainly focusing on the characteristics of the excimer laser applied in corneal refractive surgery. Methods: This article was performed based on a literature review and Internet search through scientific databases such as PubMed, Scopus, Web of Science and Google Scholar. Result: The literature on excimer laser technology addresses the technical and physical aspects of excimer lasers including types, characteristics and commercially available lasers on the market. Conclusion: The conclusion on this forum aims to help understand the benefits of excimer laser use in ophthalmology, with focus on correction of refractive errors.
Introduction:Marcus Gunn syndrome is a rare phenomenon with very less number of cases reported in literature. It may be congenital or acquired.Aim:The aim of this case report was to report the clinical characteristics of Marcus Gunn patient from our Clinic.Case report:A comprehensive opthalmologic examination, CDVA (corrected distance visual acuity), fundus examination and photography, was conducted in Marcus Gunn patient. Clinical findings of patient presented as - chin positioned slightly upwards, extraocular motility normal on both eyes, cover test with normal findings, pupillary examination normal on both eyes. Left upper eyelid was in a lower position than the right one. On right eye, rima interpalpebrarum was 9 mm with upgaze of 13mm. On the left eye, rima interpalpebrarum was 5 mm with upgaze of 6 mm, and with open mouth, left rima interpalpebrarum was 10 mm. Visual acuity on both eyes was 1.0. Cycloplegic refraction on both eyes was +0,75 diopters (D), and Lang test was normal. In the differential diagnosis of patients with ptosis, Marcus Gunn jaw winking syndrome should be considered especially if it improves during feeding, sucking, chewing, smiling or any kind of mouth movement. In case of ptosis always do the jaw test. Have the infant bottle-feed. An older child can chew gum. Have the patient open the mouth, move the jaw from side to side, or protrude the jaw forward.Conclusion:Address first to treatment of any amblyopia if present - eyeglasses, patching etc., or strabismus. Think twice before deciding to operate.
Aim: To evaluate safety and efficacy of Laser in situ Keratomileusis (LASIK) procedure for the correction of high hypermetropia. Methods: Retrospective study of 160 patients (266 eyes) who underwent LASIK procedure for the correction of hypermetropia between +3.00 and +7.00 diopters(D) and cylinder up to 2.00D from January 2013 and August 2015. All ablations were performed with Wavelight Allegretto Eye-Q400Hzexcimer laser (Alcon, Forth Worth, TX, USA) with aberration free module and were centered on a corneal vertex. All flaps were made with Moria M2 (Moria, Antony, France) mechanical microkeratome (90μm head). Preoperative and postoperative uncorrected and corrected distant visual acuity (UDVA, CDVA), spherical equivalent (SE) and a berrometry for 5mm pupil were measured. Measurements were taken at 1 week, 1,3,6 and 12 months after the surgery. Wilcoxon Signed Ranks Test was used for statistical analysis. Results: Postoperative UDVA was lower than preoperative CDVA at 1 week( p =0.001), at 1 month there was no difference ( p =0.099), and at 3,6 and 12 months UDVA was better ( p <0.0001). Preoperative SE was 4.69±1.20D (+3.75 to +7.50D). At 1 week SE was 0.03±0.67D (-0.50 to +0.63D), while at 1 year regressed to 0.58±0.56D (+0.25 to +0.88D). Sphere shifted from negative values targeted in treatment planning to compensate for regression to positive values. There was significant difference in SE at every time point ( p <0.0005). There was a significant increase in coma ( p <0.0001), trefoil ( p <0.0001, p =0.0006) and spherical aberration ( p =0.022, p =0.0052) at 1 week and 1 month postoperatively, without change throughout the rest of follow up. Conclusion: LASIK for high hypermetropia showed satisfactory results in postoperative refraction with reasonable regression without significant loss of lines of visual acuity. However, more test are necessary to asses optical quality.
Introduction: Diabetic retinopathy (DR) is an important cause of blindness, and occurs as a result of long-term accumulated damage to the small blood vessels in the retina. 2.6% of global blindness can be attributed to diabetes. Disease severity was most often classified by the Early Treatment Diabetic Retinopathy Study (ETDRS) classification for DR severity. Patients are usually categorized based on the severity of DR as having mild nonproliferative diabetic retinopathy (NPDR), moderate NPDR, severe NPDR, or proliferative diabetic retinopathy (PDR). Aim: To evaluate DR status among patients at Eye Clinic Svjetlost Sarajevo , both, type 1 and type 2 DM patients who presented in our clinic at 2 years period-from June 2016 to June 2018. This is single center study. Methods: Retrospective analysis of 753 diabetic patients that came for the first check up in our institution during those two years, 363 patients were male and 390 were female. Patients were divided in 3 groups (based on DR changes): a) No changes, b) Nonproliferative DR (with and without Diabetic macular edema-DME), c) Prolipherative DR (with and without DME + Advanced PDR). Results: There were 35% of patients with no ocular changes, 41.2% had NPDR and 24% had PDR. Prevalence of DR in our study was 65.32%. Distribution of NPDR was 66.27%, and PDR was 33.73%. DME was present in 33.70% cases. In NPDR, DME was presented in 51% of the cases, while in PDR was presented in 49% of the cases. In state of advanced PDR, PDR was presented in 30.52% cases, tractional detachment and haemophtalmus in 50.20% of cases and neovascular glaucoma in 19.28%. Sixty-three patients ended up with vitroretinal surgery (8.4%) while in other studies that number is up to 3%. Out of that number 9 patients were patient with virgin eyes (14.28%). Neovascular glaucoma occurred in 19.28% of diabetics with proliferative retinopathy and 4.60% in all of diabetics. Conclusion: Diabetic retinopathy status of patients presenting at Eye clinic Svjetlost Sarajevo, Bosnia and Herzegovina is quite poor. There is a big need for early DR screening measures, good prevention and management of DR risk factors. Adequate and ON TIME management of DM and its vision threatening complications is of major importance.
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