Aging lens undergoes the changes in the amount of water soluble lens proteins and their redistribution from low molecular weight to high. This results in the development of high molecular weight aggregates, which change the lens transparency, increase light scattering and contribute to the hardening of the lens. All these disturbances cause changes in ultrasound attenuation. Hardness of the cataractous lens is one of the major factors influencing the suitability of a patient for fhacoemulsification. Age and nuclear color have been shown to be good clinical markers of lens hardness, but there is a need of more quantitative and objective examination method. In this work a new methodics of assessement of eye lens hardness in vitro was developed, the hardness of dogs and human eye lenses was assessed experimentally, the investigation of ultrasound attenuation coefficient, the amount of water soluble lens proteins and their distribution to the fractions of different molecular weight was performed. A strong correlation between lens hardness and ultrasound attenuation was investigated. The results enable to evaluate lens hardness pre-operatively and non invasively and help surgeons when choosing patients to the phacoemulsification method of cataract extraction. The performed investigation confirmed that the opacification of the lens is due to the changes in the amount of water soluble lens proteins and the presence of high molecular weight compounds, which disturb the light... [to full text]

The hereditary cataract is one of the most common eye disease in dogs. The expansion of this disease in the Staffordshire bullterrier breed has been so massive that in the Czech Republic was introduced the rule of mandatory testing of at least one of a breeding pair. This is a degenerative disease of the lens causing total blindness of the affected animal within three years. Since some time ago there are no more dogs affected by the disease in the Czech Republic, there are however still hidden carriers which need to be discovered to the complete extinction of the disease in the genome. The goal of this study was to test simple ways of collecting biological samples, try them in practice and to verify whether they are suitable for the DNA isolation and also to test an alternative method of molecular detection of this disease. In total there have been 23 buccal swabs collected from male and female Staffordshire Bullterrier examples. The detection of the hidden carriers of the hereditary cataract was carried out by PCR analysis with specific primers. The obtained amplicons were detected by both gel and chip electrophoresis and by using fragment analysis. This detection of the carriers was based on the presence of two amplicons (heterozygotes). I came to conclusion that to detect hidden carriers it is neccessary to use the fragment analysis because of the difference of only one base in the reference section of DNA. Neither gel nor chip electrophoresis does provide sufficiently high resolution and it is not possible to detect two fragments that differ only by one bp. As the most appropriate sampling method I have chosen the buccal smear by cytological brush followed by isolating the DNA by Chelex with purification of the sample subsequently.

This diploma thesis is focused on cost analysis of cataract treatment.The aim of the diploma thesis is to evaluate the effectiveness and efficiency of cataract surgery and treatment in terms of the costs and benefits of treatment in two possible ways from the perspective of the patient and the health care facility.

Lietuvoje pirmą kartą nagrinėjama daugiažidinių intraokulinių lęšių (DIOL) implantacija. Atliktas tyrimas leidžia detaliau vertinti regėjimo funkcijas po DIOL implantacijos. Keturi skirtingi DIOL lyginami pagal tą pačią meto¬diką ir pateikiami ilgos pooperacinės stebėsenos duomenys. Pirmą kartą aprašomos paciento pasitenkinimo po DIOL implantacijos ir Didžiojo penketo asmenybės dimensijų sąsajos. Darbo tikslas - įvertinti regėjimo kokybę ir pacientų pasitenkinimo rezultatais sąsajas su asmenybės bruožais po skirtingų modelių daugiažidinių intraokulinių lęšių implantacijos. Uždaviniai: 1) įvertinti regėjimo aštrumą implantavus skirtingus DIOL modelius; 2) įvertinti kontrastinį jautrumą implantavus skirtingus DIOL mo¬de¬lius; 3) įvertinti paciento poreikį papildomai korekcijai akiniais po DIOL implantacijos; 4) įvertinti pašalinių optinių fenomenų pasireiškimą su DIOL; 5) įvertinti pacientų pasitenkinimo regėjimo rezultatais dažnumą ir sąsajas su asmenybės bruožais po DIOL implantacijos. / In this study, postoperative follow-up data that cover a rather long period after the multifocal intraocular lens (MIOL) implantation are presented. It is the first time that the same methodology was used to compare four different types of MIOL. The influence of personality traits on the visual function has been defined. The aim of the study - to assess the influence of different MIOL on the quality of vision and the links between the satisfaction of patients with the results and their personality traits after the implanting of different MIOL models. The objectives of the study: 1) to compare the visual acuity between different MIOLs models; 2) to compare the contrast sensitivity between different MIOLs models; 3) to establish the need of patients for additional correction with glasses after the implanting of MIOLs; 4) to assess the occurrence of photic phenomena after the implanting of MIOLs; 5) to assess the level of visual function and the influence of personality traits on patients’ satisfaction with the visual function following the MIOL implantation.

<p>Katarakta i glaukom su po svom toku hronične i progresivne bolesti koji predstavljaju dva vodeća uzroka slepila u svetu. Obe bolesti su karakteristične za stariju životnu dob i često se sreću zajedno kod iste osobe. Katarakta podrazumeva hirur&scaron;ko lečenja, dok se lečenje glaukoma zasniva na snižavanju visine intraokularnog pritiska (IOP), medikamentoznim i hirur&scaron;kim sredstvima. Cilj ovog istraživanja bio je da se utvrdi da li i u kojoj meri dolazi promene IOP-a i dubine prednje komore oka (ACD) nakon operacije katarakte, da li su preoperativne vrednosti IOP-a i ACD povezane sa postoperativnom visinom IOP-a i da li postoje razlike u ovim pojavama kod osoba operisanih od katarakte sa i bez prisutnog primarnog glaukoma otvorenog ugla (POAG). Rezultati ove studije pokazuju da postoji statistički značajno sniženje IOP-a 6 meseci nakon operacije katarakte. U poređenju sa preoperativnim vrednostima, ono iznosi prosečno 1,2 mmHg (7,5%) u grupi pacijenata bez POAG i 1,24 mmHg (6,49%) u grupi pacijenata sa POAG. Između dve grupe pacijenata nije postojala razlika u stepenu sniženja (p&gt;0,05). Ustanovljen je statistički značajano veći (p&lt;0,05) porast dubine ACD u grupi pacijenata sa POAG (1,03 mm; 34,8%) u odnosu pacijente bez glaukomske bolesti (0,92 mm; 30,37%). Rezultati korelacione analize, kao i regresionih univarijantih i multivarijantnih modela, pokazali su da statistički značajna povezanost postoji između preoperativne visine IOP-a i njegovog sniženja nakon operacije katarakte. Povezanost je bila pozitivnog smera i nije se uočena značajna razlika između obe grupe pacijenata. Ustanovljena je i pozitiva korelacija, bez statistički značajne razlike u obe grupe pacijenata, između PD indeksa (odnos preoperativnog IOP-a i ACD) i promene IOP-a nakon operacije katarakte. Preoperativna dubina prednje komore oka nije ispoljila povezanost sa postoperativnom promenom IOP-a. Na&scaron;a studija je pokazala statistički značajno postoperativno sniženje IOP-a i povećanje dubine ACD nakon operacije katarakte, koja se održava &scaron;est meseci nakon operacije katarakte. Nije ustanovljena razlika u redukciji IOP-a između pacijenata sa i bez POAG. Ustanovljena je pozitivna korelacija preoperativne visine IOP-a i PD indeksa sa postoperativnom promenom IOP-a, &scaron;to može biti od koristi prilikom odluke o optimalnom lečenju katarakte kod pacijenata sa POAG.</p> / <p>Cataract and glaucoma are chronic and progressive diseases and they are two of the leading causes of blindness wold wide. Both diseases are typical for an older age and often coincide within the same person. Treatment of cataract is surgical, while glaucoma treatment is based on lowering the level of intraocular pressure (IOP) with various medical and surgical options. The aims of this research were to determine whether there is a change in IOP and in the depth of anterior chamber of the eye (ACD) after cataract surgery, whether preoperative values of IOP and ACD are related to postoperative IOP values and to determine if there are differences in these events between people operated from cataract with or without primary open angle glaucoma (POAG). Results of this study show that there is a statistically significant decrease of IOP six months after cataract surgery. Comparing with preoperative values, it was found to be 1.2 mmHg (7.5%) in group of patients without POAG, and 1.24 mmHg (6.49%) in patients with POAG. There was no statistically significant difference found between two groups of patients (p&lt;0.05). Group of patients with POAG had significantly higher (p&lt;0.05) deepening of ACD (1.03 mm; 34.8%), in comparison with patients with no glaucoma (0.92 mm; 30.37%). Results of correlation analysis, as well as univariate and multivariate regression models, have shown significant correlation of preoperative IOP and its reduction after cataract surgery. Correlation was of positive direction with no statistically significant differences among two groups of patients. There was a positive correlation found, with no statistically significant differences in both groups of patients, between PD index (ratio of preoperative IOP and ACD) and IOP change after cataract surgery. Preoperative anterior chamber depth has shown no correlation with postoperativeIOP change. Our study showed statisticallysignificant postoperative reduction ofIOP and deepening of ACD, lasting for six months aftercataract surgery. No difference inpostoperativeIOP decrease has been detected betweenpatients with or without POAG. A positivecorrelation of preoperativeIOP height and PDindex with postoperativeIOP change has beenestablished, which mayprove usefulfordecision of optimal treatmentof cataract among POAG patients.</p>

Lens development and differentiation are strictly regulated processes. Various disturbances of these processes can lead to vision-limiting pathologies. The vertebrate lens is composed of epithelial cells and terminally differentiated fiber cells. Differentiation of fiber cells is connected with expression of fiber cell specific proteins (such as crystallins), cell cycle exit, and finally with the degradation of cell nucleus and organelles. Wnt/β-catenin signaling plays important roles during early eye development as well as later during the lens differentiation. To investigate the consequences of constitutive activation of Wnt/β-catenin signaling in lens fiber cells transgenic mouse strain, called CLEF, was created. Constitutive activation of Wnt/β-catenin signaling in fiber cells of CLEF mouse is achieved by transgenic protein CLEF that contains C-terminal activation domain of β-catenin fused to the amino terminus of full-length protein Lef1. The expression of CLEF transgene is under the control of αA-crystallin promoter. As a result of constitutive activation of Wnt/β-catenin signaling in fiber cells, adult CLEF mice develop cataracts and microphthalmia, and the morphology of adult mutant lenses is disrupted. Transgenic CLEF mRNA is expressed starting from E13.5 and by E16.5 transgenic CLEF protein is...

Current state: Congenital cataract is an ophthalmic disorder where the clouding of the lens causes defect in its transparency and light dispersion. The child experiences a visual impairment that can be examinated depending on the age and mental state of the child. The treatment is removal of the clouded lens, subsequent correction of dioptric defects and subsequent training and monitoring of amblyopia. Purpose: of this study was to describe the roles of paediatric nurse in nursing care of children with congenital cataract and the specifics in nursing care in this condition, based on reviewed material. The following research problems were explored: What are the roles of paediatric nurse in nursing care of children with congenital cataract? What are the specifics in nursing care of children with congenital cataract? Methods: In order to reach the goal set by this study we used qualitative data and study analysis. This study implements data sources from National Medical Library in Prague, the Academic Library of University of South Bohemia in České Budějovice, the library of 2. LF UK and FN Motol in Prague and the library of National center of nursing and non-medical health providers in Brno. Moreover the study reviewed the material from bibliographic databases (Cochrane Library, Ebscohost, Medscape, ProQuest, PubMed, ScienceDirect, Scopus) and online databases of medical associations of ophthalmology (The American Academy of Ophthalmology, The Royal College of Ophthalmologists). Results: The goal of this study is to provide a comprehensive view on nursing care of children with congenital cataract. Conclusion: Even though the role of paediatric nurse in nursing care of children with congenital cataract is rather neglected in current literature, it is crucial in all forms of healthcare. In conclusion we define the role of paediatric nurse in nursing care of children with congenital cataract and description of the specifics of this care.