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Background: The crucial elements for optimal suturing result are good tissue approximation, handling the problem of tension and security of knots. We propose a use of secure locking knot, which could allow optimal suturing result. The proposed initial secure locking knot is kept in first position without danger of slipping, before finishing it by additional knot of two loops. Methods: Sharing of experience. Result: The secure locking knot is not bulky, it has strength and it is easy to master. The completed knot may fail by breaking, but never by slippage. Conclusion: The proposed secure locking knot allows optimal tissue approximation and it could have application in ophthalmology.

Isolated intraocular histiocytosis is a rare disease that may manifest by recurrent uveitis and solid subretinal masses. The course, diagnosis and treatment of isolated intraocular histiocytosis in a 12-year-old girl are presented. As extensive diagnosis and therapy with corticosteroids and tuberculostatics failed to produce satisfactory results, diagnostic- therapeutic vitrectomy was performed. The intraoperatively obtained material was examined by the methods of histopathology, cytology and immunocytochemistry, along with herpes and cytomegalovirus polymerase chain reaction. The vitreous inflammatory exudate and subretinal masses were operatively removed. Analysis of the intraoperatively obtained material pointed to histiocytosis, whereas additional examinations revealed no systemic manifestations of the disease. Chronic uveitides that respond poorly to classic immunosuppressive therapy require multidisciplinary analysis of intraocular material. Pars plana vitrectomy is an appropriate diagnostic-therapeutic operative procedure.

Changes in the eye axial diameter were studied to assess the eye globe impact of conventional operation for retinal detachment. The study included 69 eyes in 69 patients operated on for rhegmatogenous retinal detachment. There were 46.4% of men and 53.6% of women, mean age 52.7 (+/- 15.21) years. Results of preoperative and postoperative ultrasonographic measurement of axial diameter are presented. The mean preoperative and postoperative eye axial diameter was 23.69 (+/- 1.84) mm and 24.43 (+/- 1.91) mm, respectively. Postoperative results showed the axial eye length to increase by a mean of 0.74 (+/- 0.44) mm, yielding a statistically significant difference from the preoperative measurement (p0.001). The mean myopia induced by this eyeball elongation was 1.77 D. The encircling band with and without segmental buckling used in surgical repair of retinal detachment creates circular and segmental indentation of the eyeball, thus increasing its axial length. The myopia induced by elongation of the eyeball results in considerable myopia, which requires appropriate correction in the early postoperative period to achieve favorable vision rehabilitation.

Quality assessment of clinical health care with the programme of quality standard is a method of health management, through which better efficiency and safety of health outcomes can be achieved. In the period from 2002 to 2004, a pilot program of quality has been carried out on the Department of Ophthalmology, University Hospital Center in Zagreb. Seven internal audit teams of hospital commission and teams of hospital departments were evaluating introducing practice for quality standards every three months. In the period of two years improvement in all standards of quality has been noticed (expressed in percent of progress towards the ideal result of 100%): personnel 20%, patient rights 15%, medical equipment 40%, quality of emergency service 60%, implementation of clinical guidelines and criteria for elective admission 55%, quality of risk prevention 70%, quality of medical records 60%. The two-years-improvement dynamics of about 46%, first year 24%.

Makularna rupa je potpuni defekt neuroretine okružen okruglim ograničenim odljepljenjem mrežnice. Makularne rupe nastaju kao rezultat anteroposteriorne i tangencijalne trakcije stražneg vitreusa na makularno područje. Mogu biti posljedica različitih bolesti, ali su najčešće povezane sa starenjem te ih nazivamo idiopatskim. Prema Gassu se dijele u četiri stupnja. Simptomi, metamorfopsija, ispad u vidnom polju i gubitak vidne oštrine su proporcionalni stupnju makularne rupe. Shvaćanje uloge staklovine u nastanku i razvoju makularih rupa dovelo je do spoznaje da će pars plana vitrektomija dovesti do zatvaranja makularne rupe i anatomskog i funkcionalnog poboljšanja.