The cornea is a transparent, avascular and abundantly innervated tissue through which light rays are transmitted to the retina. The innermost layer of the cornea, also known as the endothelium, consists of a single layer of polygonal endothelial cells that serve an important role in preserving corneal transparency and hydration. The average corneal endothelial cell density (ECD) is the highest at birth (~3,000 cells/mm 2 ), which then decrease to ~2,500 cells/mm 2 at adulthood. These endothelial cells have limited regenerative potential and the minimum (critical) ECD required to maintain the pumping function of the endothelium is 400-500 cells/mm 2 . ECD < the critical value can result in decreased corneal transparency, development of corneal edema and reduced visual acuity. The condition of the corneal endothelium can be influenced by a number of factors, including systemic diseases, such as diabetes or atherosclerosis, eye diseases, such as uveitis or dry eye disease (DED) and therapeutic ophthalmological interventions. The aim of the present article is to review the impact of the most common systemic disorders (pseudoexfoliation syndrome, diabetes mellitus, cardiovascular disease), eye diseases (DED, uveitis, glaucoma, intraocular lens dislocation) and widely performed ophthalmic interventions (cataract surgery, intraocular pressure-lowering surgeries) on corneal ECD.

UGH syndrome can be induced by unstable in-the-bag IOL due to zonular laxity. Depending on the severity of the syndrome, this condition can be fought by applying a minimally invasive approach-IOL suturing to the iris with direct observation under the surgical microscope precisely in the anticipated location with no or minimal pupil deformation. Symptoms of UGH did not recur due to increased stability of the IOL and, as a result of this, declined irritation of the uveal tissue.

No abstract

Purpose. To evaluate the in vivo changes in Schlemm's canal (SC) and the trabecular meshwork (TM) in patients with primary open-angle glaucoma (POAG) after phacocanaloplasty using anterior segment optical coherence tomography (AS-OCT). Methods. Ten eyes of nine patients with POAG (6 men and 3 women) who underwent phacocanaloplasty. Preoperative and postoperative visual acuity (VA), intraocular pressure (IOP), and use of glaucoma medications were evaluated. The main outcome measures were the area of SC and TM thickness assessed using AS-OCT before and 12 months after surgery. Results. We found statistically significant reduction in IOP (from 26.4 (8.6) mmHg to 12.9 (2.5) (p < 0.05) mmHg), increase in VA from 0.7 (0.4) to 0.9 (0.2), and decrease in glaucoma medication from 2.6 (1.2) to 1.1 (1.3) at 12 months postoperatively. There was a significant increase in the SC area (3081.7 (842.8) μm2 versus 5098.8 (1190.5) μm2, p < 0.001) and a decrease in mean TM thickness (91.2 (18.6) μm versus 81.3 (15.1) μm, p = 0.001) after surgery. We found negative correlations between SC area and IOP before surgery (r = −0.67, p = 0.03) and also between SC area before and IOP reduction 12 months after the phacocanaloplasty (r = −0.80, p = 0.005). Conclusions. Our results showed statistically significant dilation of SC area and reduction of TM thickness after phacocanaloplasty in POAG patients. The degree of SC expansion was related to the IOP decrease.

No abstract

A larger number of defined visible superficial connections to collectors after injection of fluorescein into SC is related to a more pronounced IOP decrease after non-penetrating glaucoma surgery.

Reikšminiai žodžiai: Štargardto geltonosios dėmės distrofija, klinika, genetika, gydymo galimybės. Štargardto geltonosios dėmės distrofija pirmą kartą aprašyta 1909 metais vokiečių oftalmologo Karlo Stargardto. Tai dažniausia autosominiu recesyviniu būdu paveldima geltonosios dėmės distrofija, kurios paplitimas yra 1:10 000. Daugelis autorių apjungia Štargardto geltonosios dėmės distrofiją su geltondėmiu dugnu, nes abiejų ligų atveju nustatyta tame pačiame gene esanti mutacija. Liga dažniausiai pasireiškia centrinio matymo netekimu ir tinklainės pigmentinio epitelio atrofija. Štargardto geltonosios dėmės distrofijos klinikinė eiga priklauso nuo geografinės ir etninės kilmės, paciento amžiaus diagnozės nustatymo metu. Ligai būdingas kintantis fenotipiškumas, įvairus pacientų amžius simptomų pasireiškimo metu, skirtingas ligos sunkumo laipsnis, akių dugno vaizdas. Dažniausiai šią ligą sąlygoja ABCA4 geno mutacija. Liga dažniausiai pažeidžia abi akis. Štargardto geltonosios dėmės distrofija dažniausiai pasireiškia dešimties–dvidešimties metų amžiuje, abipusiu laipsniniu centrinio matymo sutrikimu, ne visada proporcingu geltonosios dėmės pažeidimui, nors kai kurie pacientai simptomus gali pajusti sulaukę tik 30–40 metų. Šiame straipsnyje aptariame Štargardto geltonosios dėmės distrofijos kliniką, histopatologinius pakitimus, genetines mutacijas ir gydymo galimybes.

Purpose: To assess the ability of a noncontact optical coherence tomography to evaluate the morphological features of filtering blebs one year after glaucoma surgery.Design: Prospective study.Methods: Eighteen patients (18 eyes) with diagnosed primary open-angle glaucoma (POAG) assigned for trabeculectomy were included in the 12-month study carried out in the Eye clinic of the Lithuanian University of Health Sciences. All participants underwent trabeculectomy with 5-fluorouracil (5-FU). Bleb function was considered to be successful if the intraocular pressure (IOP) was ≤ 18 mmHg without glaucoma medications and a limited success if: 18 < IOP ≤ 21 mmHg with or without glaucoma medications at 12 months after surgery. The filtering blebs were imaged by anterior segment optical coherence tomography (AS-OCT) to evaluate the bleb wall reflectivity and measured bleb structures 12 months after trabeculectomy. Level of significance: p < 0.05 was considered significant.Results: The mean preoperative IOP was 25.7 (6.5) mmHg and the mean number of topical glaucoma medications was 3.0 (1.2). After surgery the mean IOP was 13.8 (3.4) mmHg and glaucoma medication was 0.3 (1.0) (Wilcoxon test, p < 0.001). Analyzing bleb morphology and bleb function it was found that with uniform wall reflectivity 0 out of 3 eyes (0%) had successful bleb function and with multiform wall reflectivity 14 out of 15 eyes (93.3%) had successful bleb function 12 months after surgery (p = 0.005).We found positive correlation between IOP changes and bleb wall thickness, height of internal fluid-filled cavity (bleb height) and total bleb height (r = 0.875, 0.897, 0.939, p < 0.001).Conclusion: AS-OCT is a useful device to assess the structure of the filtering bleb. Larger internal fluid-filled cavity, total bleb height, bigger bleb wall thickness and multiform bleb wall reflectivity were found to be good indicators of bleb function.