Analiza opinii polskich specjalistów ochrony wzroku dotyczących osadów na soczewkach kontaktowych

Miękkie soczewki kontaktowe służące do korekcji ametropii są powszechnie używane na całym świecie. Jako wyrób medyczny powinny być dopasowywane i systematycznie oceniane na oku pacjenta przez specjalistów ochrony wzroku. Badanie kontrolne powinno obejmować ocenę osadów na soczewkach. Powszechne stosowanie soczewek silikonowo-hydrożelowych (Si-Hy) i ich tendencja do odkładania się złogów lipidowych wskazują, że specjaliści ochrony wzroku powinni zwracać szczególną uwagę na ten rodzaj osadów. Celem niniejszej pracy jest analiza opinii polskich specjalistów ochrony wzroku w zakresie osadów na soczewkach kontaktowych, ze szczególnym uwzględnieniem lipidów i soczewek Si-Hy. Dane zebrano od 103 polskich specjalistów ochrony wzroku poprzez ankietę internetową. Respondenci wskazali, że osady lipidowe najczęściej występują na soczewkach Si-Hy, a osady białkowe na soczewkach hydrożelowych. Niemal wszyscy ankietowani deklarują, że oceniają osady na soczewkach kontaktowych podczas wizyt kontrolnych, co pozwala wnioskować, iż jest to dla nich istotna część procesu doboru soczewek. Respondenci uważają, że poszczególne soczewki i płyny do ich pielęgnacji różnią się w kontekście ich interakcji z osadami lipidowymi. Parametry te powinny być brane pod uwagę w momencie wyboru produktu dla pacjenta. Specjaliści ochrony wzroku oczekują opisów odporności soczewek na powstawanie osadów lipidowych oraz skuteczności płynów pielęgnacyjnych w redukcji osadów lipidowych.

Forum ophthalmicum – how to take control over accumulation of diagnostic data from macular OCT with benefit for both doctor and patient?

Wet age-related macular degeneration (wet AMD) is a disease which requires regular diagnostic tests such as macular optical coherent tomography which is extremely important both in diagnosis and disease monitoring. With constant aging of the population, we are dealing with an increasing incidence rate of AMD, which makes it even more important to have a tool allowing for quick and precise analysis of anatomical changes in macular region, particularly in the current complicated epidemiological situation when diagnostic time should be used most efficiently to plan the follow-up treatment. Forum® software allows for the precise analysis of many tests performed in a single patient and combining it with treatment effectiveness assessment which substantially accelerates the diagnostics.

Extended depth of focus intraocular lenses – the present and future in cataract surgery

The purpose of this article is to evaluate the technology behind intraocular lenses with extended depth of focus, explain how they work, assess their benefits for patients, and summarize our own early experience.

Current and new indications for corneal cross-linking in the therapy of corneal diseases

Corneal collagen cross-linking, a technique used in ophthalmology, involves the creation of new bonds between collagen fibers, thus leading to stabilization and corneal stiffening. The most common indication for corneal collagen cross-linking procedures is to prevent the progression of corneal ectasia,\ i.e., keratoconus, pellucid marginal degeneration, and ectasia after corneal refractive surgery. Clinical data also indicate that it is effective in the treatment of bacterial corneal infections and bullous keratopathy. Corneal collagen cross-linking was shown to inhibit the progression of corneal ectasia, and the treatment commonly leads to the improvement in visual acuity, decreases the maximum keratometry values, and improves the corneal topography image. In addition, it is possible to avoid or postpone the need for more complex and invasive surgery.

Diagnosis of type 3 macular neovascularization

Type 3 macular neovascularization is characterized by a complex of pathological vessels located in the sensory retina. Fundus oculi examination reveals intraretinal hemorrhages, macular edema, hard exudates and pigment epithelial detachments. Indocyanine and fluorescein angiography, OCT and angio-OCT are used for diagnosis and treatment monitoring. The treatment efficacy depends on the disease severity and the therapy applied.

The role of epithelial thickness mapping in corneal refractive surgery

Refractive surgery has stimulated significant progress in anterior segment imaging. Knowledge of epithelial thickness profile considerably increases the efficacy and safety of refractive procedures. This review aims to present new technologies evaluating corneal epithelial thickness and the most important clinical applications in the field of corneal refractive surgery.

The issue of preservatives in light of evidence based medicine

Glaucoma is the leading cause of irreversible blindness worldwide. Most patients will require drug therapy for the rest of their lives. Preservatives play a key role in the development of topical medications whose primary role is to provide antimicrobial activity to maintain sterility. The most common preservative is benzalkonium chloride, which has antibacterial, antifungal, and antiviral properties. This article was written based on the latest research in MEDLINE and other major bibliographic databases for studies published in English by August 1st, 2021. Our meta-analyses confirm that eye drops side effects are not caused solely by the presence of preservatives, and the effectiveness of anti-glaucoma drugs containing benzalkonium chloride and those without preservatives is comparable. During the COVID-19 pandemic, studies showed the protective effect of preservatives against SARS-CoV-2.

Conjunctival herpetic ulcer in an immunosuppressed patient with birdshot chorioretinopathy

Introduction: Herpes Simplex Virus (HSV) is a human herpesvirus responsible for systemic infections. Ocular involvement spans all ocular tissues. Corneal lesions, such as dendritic or geographic ulcers, are frequently found in HSV keratitis while conjunctival lesions have been described as infrequent. Clinical case: A 62-year-old man diagnosed with Birdshot chorioretinopathy presented a stye in his eyelid that was treated with oxytetracycline-hydrocortisone ointment. One week later he returned presenting several small dendritic corneal ulcers in both eyes and a conjunctival ulcer in one of them. All lesions healed completely after treatment with topical acyclovir ophthalmic ointment at 3%. Conclusions: We should pay attention to the conjunctiva and not merely focus on the cornea when examining patients with herpetic eye disease, especially if being treated with inmunosupressors.

Switching Between Aflibercept and Ranibizumab in the Treatment of Refractory Exudative Age-related Macular Degeneration

Introduction: Aflibercept and ranibizumab have become the most used drugs in the treatment of wet age-related macular degeneration. Some patients; however, do not respond to aflibercept and ranibizumab treatment. Our aim was to determine whether the switch from aflibercept to ranibizumab, and then switchback, is effective in a group of patients poorly responding to aflibercept. We assessed best corrected visual acuity, central retinal thickness, and the presence of intra- and subretinal fluid (respectively). Material and methods: We conducted a retrospective comparative case series study. Twenty eyes of 20 patients, who had no inhibition of disease activity after at least one year of treatment with aflibercept, were included in the study. If after switch to ranibizumab the response to the drug was again inadequate, we returned to aflibercept. We divided the study population into two groups: treatment- naïve and patients who had received injections before entering the Drug Program for the Treatment of Age-Related Exudative Macular Degeneration. Results: We observed an improvement in both best corrected visual acuity and central retinal thickness parameters, but only in the treatment-naïve group. We did not observe any statistically credible effects for sub- and intraretinal fluid in the studied groups. Conclusions: Drug conversion may be beneficial for patients poorly responding to primary therapy. Greater improvement is seen in previously untreated patients.

SMILE – charakterystyka zabiegu i jakość życia pacjentów

Zabieg laserowej korekcji wad wzroku ReLEx® SMILE jest stosunkowo nowym, bezpłatkowym zabiegiem refrakcyjnym, wykonywanym tylko przy użyciu lasera femtosekundowego. Zyskał on uznanie zarówno wśród okulistów, jak i pacjentów, stanowiąc alternatywę dla zabiegu LASIK, uważanego dotąd za złoty standard w korekcji krótkowzroczności i astygmatyzmu krótkowzrocznego. W niniejszym artykule przedstawiono charakterystykę zabiegu ReLEx® SMILE w porównaniu z innymi zabiegami laserowej korekcji wad wzroku oraz jego wpływ na jakość życia pacjentów po zabiegu.