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Purpose: This paper describes complications due to the posterior polymorphous corneal dystrophy in one patient., Material and Methods: Medical history of misdiagnosis and subsequent wrong procedures, to which patient with binocular posterior polymorphous corneal dystrophy was exposed, where presented. The eye misdiagnosed with profound keratitis was initially treated with high doses of steroids, what could possibly lead to extensive fungal corneal ulceration and complicated cataract., Results: Thanks to the detailed examination of the fellow eye in the slit lamp and specular microscope, correct diagnosis was made., Conclusions: Since posterior polymorphous corneal dystrophy is one of the rare conditions, especially with coexisting eye irritation, wrong diagnosis of this disorder is possible to be made. Therefore, extremely important in every day ophthalmological practice precise examination of the both eyes and special care during steroid treatment is essential.

Purpose: Evaluation of the usefulness of corneal scanning topography performed with Orbscan for the localization of corneal graft due to keratoconus., Material and Methods: We examined 33 eyes in 33 individuals (23 men 10 women) during one year 2000/2001. Corneal topography was performed with Orbscan apparatus before the transplantation of the cornea due to the keratoconus. Trepanning depended of the thickness of peripheral cornea. Visual acuity without correction was compared with the control group of 33 eyes, after corneal transplantation done due to the corneal cone between 1998-1999, without consideration of scanning topography., Results: Significant differences in the post-surgical visual acuity in favor of the examined group in the range from 5/5 to 5/7 and from 5/25 to 5/50 were observed., Conclusions: Scanning corneal topography will probably facilitate proper qualification for the transplantation and better postoperative visual acuity.

The purpose of this study was to compare grafts performed because of keratoconus in our clinic in years 1990-1999. These years were chosen for analysis because in this time some methods of grafting were changed, particularly: material for transplantation, graft's size, method of trephination and graft suturing, also management after operation. The study included 51 patients (17 females, 34 males) with keratoconus, aged 16 to 46 (mean age 31.3), which have had penetrating keratoplasty done in years 1990-1999. The amount of surgery, sex of patients, preoperative preparation, kind of graft material, technique of operation, methods of graft suturing, postoperative procedure, the time of patients hospitalization, time of suture removing, postoperative visual acuity and complication were compared.

Purpose: To check post penetrating keratoplasty (PK) corneal wound healing characteristics after epidermal growth factor (EGF) application and to compare it with controls., Material and Methods: The PK was performed in the group of 72 young, healthy New Zealand rabbits (36 females and 36 males). Slit-lamp examination, tonometry and corneal topography by Tomey's corneal modeling system (TMS-1) were carried out before and after surgery. The PK was performed in both eyes. Half of animals were used as a bilateral donor for the other half, with a rule: right eye cornea to the right eye and left eye cornea to the left eye. As a result, after completed surgery 36 rabbits had bilateral grafts. The animals were divided into 3 equal groups (12 in each). Two drops of the human recombined EGF dissolved in the saline solution with concentration varied from 500 to 1500 ng in each drop were applied to the right eye according to schedule. The left eye was used as a control and did not receive EGF. Time of observation varied from 24 hours to 6 months. The tensinometry and the histopathologic study--light and electron microscopy were performed to determine corneal scarring., Results: The wound healing pattern after PK was characteristic and constant in each group. The corneal wound healing significantly accelerated in the EGF treated group of rabbits compared with the controls (p < 0.05). In the group of rabbits receiving 1000 ng of hrEGF 3 times/day, after two weeks of application we noted increase of the wound strength up to 600 folds, comparing with controls. Well-organized scar was histologically seen on the 21st post-surgery day. The post-operative corneal astigmatism was less expressed in the eyes treated with EGF comparing to controls., Conclusions: These preliminary results of our experimental study indicated accelerated effect on the corneal wound healing after PK with topical, low dose hrEGF application. Clinical observation of utilization of similar low doses of the hrEGF after PK--is in progress.

A case of 21 year old woman with corneal degeneration similar to Salzmann's degeneration and binocular cataract is presented. A successful corneal transplantation combined with extracapsular cataract extraction followed by posterior chamber lens implantation was performed. Patient is undergoing a treatment in endocrinology ward. A rare idiopathic hypoparathyroidism with Fahr syndrome was ascertained.

In the period of 1985-1992 we performed in our centres 34 operations of a double procedure and 12 operations of a triple procedure. During the observation--from 2 months to 7 years--we obtained favourable results encouraging to connect the corneal grafting with cataract extraction in high myopia and with extracapsular cataract extraction with implantation of an artificial lens in emmetropic eyes. Presented is the appropriate technique of operation and the results obtained.

The discussion on this topic was considered as advisable because of frequent diagnostic faults and an incorrect treatment of keratoconus. The authors presents the diagnosis, foundations of the general and topical treatment of keratoconus.

One of the main problems of corneal transplantation is the postoperative astigmatism. In the last period the intraoperative application of the kerato-scope, new type of needles and threads in stitching the corneal patch created a chance for solving this problem. The authors present the methods used for stitching of the corneal patch, their advantages and the defects with consideration of differences resulting from the thickness and kind of the thread, from the length and form of the needle. Basing on personal experience and data from the literature they propose the technique of the suture which they are using.

Eleven re-transplantations of the cornea were performed between October 1988 and October 1991. Utilized was the material selected according to a partial compatibility of the HLA factor in 11 men with opacified transplants performed previously without antigen selection in high risk leukoma (in 10 cases after severe eye burns). In 3 patients the transplant was the fifth one, in 1 patient the fourth, in two--the third and in 5 the second one. Favourable results (transparent and semi-transparent grafts) were obtained in 8 patients (72.7 p.c.).

The study presents conditions mostly described as co-existing with the keratoconus in 7 patients (from among 300 examined) born from an uni-ovular twin pregnancy. Only one pair of twins showed keratoconus of both eyes and developing identically in both eyes.

On examining about 300 patients with keratoconus in the period of 20 years the authors detected in a number of cases variations of the intraocular pressure. By means of a pneumo-tonometer Digilab 30R periodic variations of the IOP were measured in 76 patients and daily variations in 42. The statistical analysis showed that the application of Timolol and reduction of the IOP variations has a decisive influence on the improvement of objective changes and the visual acuity without correction. Presently in our Department Timolol is used successfully in 160 patients. There was no deterioration in either patient at that time and many patients showed an improvement of the condition of keratoconus.

Fifteen corneal grafts were performed in 15 men with high risk leukoma (5+) in the period October 1988--November 1990. The age of the patients oscillated between 11 and 76 years. In 5 patients the grafting was done in only eye. The period of observation after surgery amounted 4-29 months. The favourable results (transparent and ++semi-transparent grafts) were obtained in 9 eyes (60 p.c.) and partly opacified grafts in 6 (40 p.c.). Neither of the grafts opacified. In the preceding years--without taking into account the antigenic selection of the donor--favourable results in similar leukoma cases were achieved in ca. 42 p.c. of cases.

Ten corneae from donors selected in respect of partial compatibility of the HLA antigens were transplanted in the period October 1988--October 1989. The grafting was performed in 10 patients with leukomas included in the group of maximal risk (5+). In 9 patients the leukomas were due to ocular burns (chemical in 8 patients and thermal in 1 patient). In 1 patient, a 74 years old man the grafting was performed in the single eye with Salzman's corneal dystrophy with a simultaneous cataract extraction. During observation, which lasted 2 to 12 months 6 grafts remained transparent, 1--partly opacified. Not any transplant did totally opacify.