Szemészet, 2006 (143. évfolyam, 1-4. szám)

2006-12-01 / 4. szám

143. évfolyam (2006) Supplementum I.

33

Review of the main characteristics of vitreous haemorrhage patients accepted in our Clinic between 2000 and 2004

Rózsa Dégi, Anita Cseh, Agnes Szabó, Lajos Kolozsvári

University of Szeged Faculty of Medicine, Department of Ophthalmology

We retrospectively analysed the data of patients with vitreous haemorrhage accepted in the Szeged University Department of Ophthalmology between 1 January 2000 and 31 December 2004. Among the 526 cases, in 64% (54.9% male, 45.1% female) the reason for the haemorrhage was proliferative retinopathy as a complication of diabetes mellitus. In the remaining 34% of cases, trauma affecting the bulbus, and retinal tear resulting in retinal detachment, were the causes.

69% of the patients had hypertonia accompanying diabetes mellitus. The average age of the diabetic group (250 patients) was 60.4 years. 171 of these patients were receiving insulin therapy, while 79 were treated with oral antidiabetic medications. As our main conclusion, we may state that vitreous bleeding appeared at a significantly earlier age in male patients. It was most frequent among 51-60 year-old insulin-treated male patients, with a 3 times greater incidence than observed in women. The latter are mainly affected by vitreous bleeding in the age-groups 61-70 and 71-80 years. We found similar results in the non insulin-treated group.

In 69.9% of the cases we performed vitrectomy, while the remaining patients were treated with conservative therapy. After vitrectomy, visual acuity increased in 60.5%, remained unchanged in 28%, and decreased in 11.5% of patients.

Our data suggest that vitreous haemorrhage as a complication of diabetes mellitus occurs most commonly among males of working age. We emphasise the importance of early screening and proper diabetic care.

Cataract formation and surgery after penetrating keratoplasty

Iva Dekaris,1 Nikica Gabric,2 Damir Bosnar,1 Jurica Predovic,1 Edita Kondza Krstonijevic,1 Zeuka Karaman Martinovic,1 Ante Barisic,1 Igor Knezovic1

University Department of Ophthalmology, General Hospital “Sveti Duh”, Zagreb (Croatia)

2Eye Clinic “Svjetlost”, Zagreb

Purpose: to assess the incidence of cataract formation and the results of phaco surgery in eyes that had previously undergone penetrating keratoplasty.

Methods: Out of 242 patients who underwent penetrating keratoplasty (PK) in our setting between January 2002 and December 2005, 119 (49.2%) were phakic. 62.5% of patients were 50 years of age or over. Patients were prospectively followed-up (for 14-40 months) for the development of cataract. Where this was the case, the cataract was removed by phacoemulsification and a PCIOL was implanted. Also, when possible, residual post-PK astigmatism was corrected during the surgery. Main outcome measures studied were: incidence of cataract formation in different age groups, incidence of complications during cataract surgery, visual acuity achieved, and effect of cataract removal on graft survival.

Results: Frequency of cataract formation after penetrating keratoplasty was 15% (18 of 119 eyes). It was significantly higher (p= 0.049) in patients aged >50. Mean time for cataract development was 15.6 months (range 8-40 months). The likelihood of cataract formation was higher for female patients (75%) and for those with early preoperative lens opacity. No complications were recorded during phacoemulsification. Visual acuity at last follow up was 0.5 or better in 9 eyes (50% of the sub-group) that underwent cataract extraction. Graft survival rate in phaco-operated patients was 87.5%, which was comparable to that in patients without cataract.

Conclusion: Cataract surgery after penetrating keratoplasty has no influence on graft survival rate. If modern cataract surgery is performed on a separate occasion then, thanks to the possibility of correct IOL power calculation and the opportunity for intraoperative correction of residual post-PK astigmatism, visual results are better then in case of cataract removal at the time of PK.