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ABSTRACT: To assess the aortic root function in patients with pseudoexfoliation syndrome (PEXS).
In this case- controlled observational study, aortic root function in 31 PEXS patients (mean age 71±9 years) and 29 controls of similar ages (mean age 69±9 years) were evaluated by M-mode transthoracic echocardiography. Aortic cross-sectional compliance (CSC), Peterson's elastic modulus (index beta), aortic stiffness index (ASI) and aortic root distensibility (ARD) were calculated by M-mode echocardiography to evaluate the aortic root function. The findings of two groups of patients were compared by Mann-Whitney U test.
The CSC and ARD were significantly decreased in patients with PEXS. The CSC was 12.2±6.3 cm2/mmHg in patients with PEXS and 17.5±11.6 cm2/mmHg in the control group (p=0.015). The ARD was 1.56±0.80 cm2/dyne in patients with PEXS and 2.23±1.48 cm2/dyne in the control group (p=0.021). The other two indices of aortic root function were not significantly different between the two groups.
Aortic root function decreases in patients with PEXS. PEXS may be regarded as a risk factor for cardiovascular and cerebrovascular events.
Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 06/2012; 12(6):483-7. · 0.44 Impact Factor
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ABSTRACT: To report a case of necrotizing scleritis after pterygium surgery with conjunctival autografting (CA) and intraoperative Mitomycin C (MMC) and its treatment with amniotic membrane transplantation (AMT) and systemic steroid.
A 41-year-old woman who had recurrent nasal pterygium underwent pterygium excision with CA and intraoperative MMC. Two weeks after surgery, graft necrosis and necrotizing scleritis associated with severe pain and irritation were observed on her operated eye.
Pulse steroid treatment (intravenous 1 g methylprednisolone for 3 days) was initiated and AMT was performed for ocular surface reconstruction. Over the next 2 weeks, the graft vascularization was complete and there was no complication which required further treatment.
Necrotizing scleritis is a rare complication of CA with MMC. Systemic steroid therapy is necessary for subsiding ocular inflammation and AMT can be performed for ocular surface reconstruction.
Orbit (Amsterdam, Netherlands) 04/2010; 29(2):88-90.
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ABSTRACT: To evaluate the clinical findings, tear film functions and ocular surface changes in patients with seborrhoeic dermatitis.
This prospective study involved 63 patients with seborrhoeic dermatitis (Group 1) and 65 control subjects (Group 2). Best-corrected visual acuity measurement, slit-lamp examination, Schirmer I test, tear film break-up time (BUT), Rose Bengal staining and conjunctival impression cytology were performed in all patients. Subjective ocular complaints were scored using an Ocular Surface Disease Index (OSDI) questionnaire. Results between the two groups were compared.
In group 1, meibomitis, blepharitis and conjunctival hyperemia were seen significantly more frequently than in group 2 (p < 0.001). Impression cytology revealed grade 0 changes in 25 (39.6%) eyes, grade 1 changes in 22 (34.9%) eyes, grade 2 changes in 13 (20.6%) eyes and grade 3 changes in 3 (4.7%) eyes in group 1, whereas grade 0 changes in 48 (73.8%) eyes, grade 1 changes in 11 (16.9%) eyes and grade 2 changes in 6 (9.2%) eyes were seen in group 2 (p = 0.032). Mean goblet cell density was 795 ± 55 cells/mm(2) in group 1 and 1820 ± 100 cells/mm(2) in group 2 (p < 0.001). Mean Schirmer I and mean BUT results were statistically lower in group 1 than in group 2 (p = 0.043 and p < 0.001, respectively). Mean Rose Bengal scores and mean OSDI scores were statistically higher in group 1 than in group 2 (p = 0.002 and p < 0.001, respectively).
Our data show that patient with seborrhoeic dermatitis has decreased tear production, tear film instability and significant degeneration of the ocular surface epithelium, compared with normal subjects.
Acta ophthalmologica 11/2009; 89(2):e137-41. · 2.44 Impact Factor
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Acta ophthalmologica 10/2009; · 2.44 Impact Factor
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ABSTRACT: We aimed to compare the clinical efficacy and ocular surface variables of olopatadine, ketotifen fumarate, epinastine, emedastine and fluorometholone acetate ophthalmic solutions in preventing the signs and symptoms of seasonal allergic conjunctivitis (SAC).
This was a prospective, randomized, double-blinded and placebo-controlled study. A total of 100 patients with SAC were randomly assigned to one of five groups, in which they were administered olopatadine, ketotifen fumarate, epinastine, emedastine or fluorometholone acetate, instilled twice daily for 2 weeks. One eye of each patient was treated with the study drug and the other was treated with a placebo. Signs and symptoms of allergic conjunctivitis (itching, redness, tearing, chemosis and eyelid swelling) were scored on a 4-point scale. Each symptom was assessed at baseline and then again after 1 and 2 weeks of treatment. Ocular surface variables were assessed by conjunctival impression cytology.
At weeks 1 and 2, all antiallergic agents were significantly more effective than placebo in alleviating itching, redness, tearing, chemosis and eyelid swelling. Fluorometholone acetate was significantly less effective than the other agents in reducing itching and redness at all control visits. Ocular surface findings by impression cytology improved significantly after all treatments compared with placebo.
In patients with SAC, olopatadine, ketotifen, epinastine and emedastine are more efficacious than fluorometholone acetate in preventing itching and redness. All the antiallergic agents gave similar results in terms of reducing tearing, chemosis and eyelid swelling. Our data showed that impression cytology parameters improved after treatment with antiallergic agents in patients with SAC.
Acta ophthalmologica 08/2009; 87(5):549-54. · 2.44 Impact Factor
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ABSTRACT: To investigate levels of vascular endothelial growth factor (VEGF) and nitric oxide (NO) in the aqueous humor and plasma of patients with pseudoexfoliation syndrome (PXS) and pseudoexfoliation glaucoma (PXG), compared with controls.
This prospective study involved 37 patients with PXS, 15 with PXG, and 32 control subjects in whom cataract surgery was indicated. Aqueous humor and plasma VEGF and NO levels were measured with enzyme-linked immunosorbent assay and chemiluminescence methods, respectively.
Aqueous humor and plasma VEGF concentrations were higher in patients with PXS and PXG than in controls (P<0.001). Aqueous humor NO concentrations were higher in patients with PXS and PXG than in controls (P<0.05 and P=0.001, respectively). Plasma NO concentrations did not differ between the 3 groups. Aqueous humor and plasma VEGF and NO levels were not significantly different in patients with PXS versus PXG. VEGF and NO levels showed no significant correlation among the 3 groups (P>0.05).
Elevated aqueous humor VEGF and NO levels and plasma VEGF concentrations in eyes with PXS and PXG can be explained by the ischemic nature of these disorders. The lack of correlation between VEGF and NO levels may indicate impaired downregulation, which may have a role in the progression to PXG.
Journal of glaucoma 07/2009; 19(3):207-11. · 1.74 Impact Factor
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ABSTRACT: To determine and compare the amount of apoptosis and changes in rabbit corneal endothelial cell morphology after intracameral administration of different anesthetic agents.
Department of Ophthalmology, Baskent University Medical Faculty, Ankara, Turkey.
Right eyes of 64 Vienna white rabbits were injected intracamerally with preservative-free lidocaine hydrochloride 2%, ropivacaine 1%, levobupivacaine 0.75%, or fortified balanced salt solution (BSS Plus) (control). Animals were humanely killed 1 day or 7 days later. Terminal deoxynucleotidyl transferase deoxy-UTP-nick end labeling was used to detect apoptosis. Corneal endothelial cells and apoptotic cells were counted by light microscopy. The morphologic appearance was determined by transmission electron microscopy (TEM).
Apoptotic cell density was high in the anesthetic groups on day 1 (P<.01); there was no significant difference between groups at 7 days. Apoptotic cell density declined significantly between 1 day and 7 days in the anesthetic groups (P<.05) but not in the control group. There was no difference in endothelial cell density between the 4 groups at 1 or 7 days. All anesthetic groups showed degenerative changes on TEM, with the least change in the preservative-free lidocaine hydrochloride 2% group.
Intracameral injections of preservative-free lidocaine, ropivacaine, and levobupivacaine induced significantly more apoptotic endothelial cell loss than BSS Plus and led to morphologic changes in the corneal endothelial cells in the early period. This effect was temporary, with recovery by 7 days. Considering the limited proliferative capacity in human eyes, the induced apoptosis might result in the permanent cell loss and enlargement in human corneal endothelium.
Journal of cataract and refractive surgery 05/2009; 35(4):753-8. · 2.75 Impact Factor
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The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 04/2009; 22(4):368-70. · 1.36 Impact Factor
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ABSTRACT: To evaluate the ocular surface changes and tear-film functions in patients with familial Mediterranean fever (FMF).
This prospective case-control clinical study examined 35 patients with FMF (group 1) and 35 controls (group 2). All patients underwent a full ophthalmological examination. Ocular surface changes were evaluated by determining cell content of surface conjunctival epithelium using conjunctival impression cytology and tear-film functions using Schirmer-I, break-up time (BUT), corneal fluorescein and Rose Bengal tests. Subjective ocular complaints were scored with a four-point scale. Between-group results were compared.
In group 1, impression cytology revealed grade 0 changes in 15 eyes, grade 1 changes in 11 eyes and grade 2 changes in nine eyes in group 1; in group 2, it revealed grade 0 changes in 27 eyes, grade 1 changes in five eyes and grade 2 changes in three eyes (p = 0.013). Mean goblet cell density was 765 +/- 45 cells/mm(2) in group 1 and 1730 +/- 100 cells/mm(2) in group 2 (P < 0.001). Mean results on the Schirmer-I test results were 17.36 +/- 3.18 mm in group 1 and 19.60 +/- 4.17 mm in group 2 (p = 0.364). Mean BUT was 8.20 +/- 1.60 seconds in group 1 and 9.93 +/- 2.33 seconds in group 2 (p = 0.001). Mean corneal fluorescein and Rose Bengal staining scores were 3.26 +/- 1.67 and 0.96 +/- 0.71 in group 1 and 1.37 +/- 0.34 and 0.40 +/- 0.49 in group 2 (p = 0.037, p = 0.005). The presence of subjective ocular complaints was more frequent in group 1 than in group 2.
Despite normal tear production, the ocular surface and tear-film functions of FMF patients differ from those of healthy individuals. These changes may be related to the chronic inflammatory nature of FMF.
Acta ophthalmologica 01/2009; 87(1):39-43. · 2.44 Impact Factor
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ABSTRACT: To evaluate the ocular surface changes and tear-film functions in patients treated with systemic isotretinoin.
Fifty subjects treated with 0.8 mg/kg oral isotretinoin were enrolled in this prospective clinical trial. All patients underwent a full ophthalmoscopic examination before, during, and after treatment with isotretinoin. Ocular surface changes of the cell content of the surface conjunctival epithelium were evaluated by conjunctival impression cytology and tear-film functions using the Schirmer test, anesthetized Schirmer test, tear breakup time, and rose bengal staining. Subjective ocular complaints were scored with an Ocular Surface Disease Index questionnaire.
There were no significant differences observed in average Schirmer test scores for patients before, during, or after isotretinoin treatment. Mean anesthetized Schirmer test scores and tear breakup time decreased significantly during treatment (P < 0.001). Mean impression cytology scores, Ocular Surface Disease Index scores, and rose bengal staining scores increased significantly during treatment (P < 0.05, P < 0.001 and P < 0.001, respectively). Blepharitis was seen in 36% of patients. All abnormal findings disappeared 1 month after the cessation of treatment.
Conjunctival epithelial cells, tear basal secretion, and tear quality are markedly affected in patients during systemic treatment with isotretinoin (0.8 mg/kg). Ocular adverse effects of isotretinoin are generally not serious and are reversible after discontinuation.
Cornea 01/2009; 28(1):46-50. · 1.73 Impact Factor
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ABSTRACT: To compare the use of fibrin glue versus sutures for fixating conjunctival autografts in patients undergoing pterygium excision.
Fifty patients (50 eyes) with primary pterygium were randomised to undergo pterygium surgery using either fibrin glue (25 eyes) or 8-0 Vicryl sutures (25 eyes) to attach the conjunctival autograft. The patients were followed up for 12 months. Outcome measures were postoperative patient comfort, duration of surgery and recurrence of pterygium.
In the fibrin glue group, the mean operation time was 15.7 (SD 2.4) min (range 12-18 min) and in the suture group (p<0.001) it was 32.5 (6.7) min (range 25-40 min). The intensity of the postoperative pain, foreign-body sensation, irritation and epiphora were significantly lower in the fibrin glue group than in the suture group (p<0.001). The intensity of itchy sensation at the first two postoperative visits was lower among patients in the fibrin glue group (five patients, 20%) than in the suture group (12 patients, 48%) (p<0.05). Two patients in the fibrin glue group had partial graft dehiscence; these grafts were successfully reattached with fibrin glue. At the end of follow-up, pterygium recurrence was observed in one eye (4%) in the fibrin glue group and in three eyes (12%) in the suture group (p<0.05).
The use of fibrin glue in pterygium surgery with conjunctival autografting significantly reduces surgery time, improves postoperative patient comfort and results in a lower recurrence rate compared with suturing.
The British journal of ophthalmology 07/2008; 92(9):1206-10. · 2.92 Impact Factor
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ABSTRACT: To explore the efficacy, safety and tolerability of 1 mg intracameral triamcinolone acetonide (TA) in controlling ocular inflammation in patients undergoing cataract surgery.
Sixty eyes of 60 patients undergoing cataract extraction with phacoemulsification at the Department of Ophthalmology, Baskent University School of Medicine were randomized into two groups. After surgery, eyes in group A were injected with 1 mg/0.1 ml TA into the anterior chamber, but eyes in group B were not. Postoperatively; in group B, topical prednisolone acetate 1% eyedrops were administered six times per day for 7 days, then four times per day for 15 days, to control postoperative inflammation. In group A, topical corticosteroids were not used. To evaluate the efficacy of intracameral TA, anterior chamber cells, anterior chamber flare and conjunctival hyperaemia were measured on postoperative days 1, 7 and 30 by slit-lamp biomicroscopy. The safety of intracameral TA was evaluated by visual acuity measurements, intraocular pressure values and fundus examination. Tolerance variables were assessed by the degree of burning, stinging and blurred vision.
Both treatments were equally effective in controlling postoperative inflammation following phacoemulsification. No statistically significant differences between groups were observed for the efficacy, safety and tolerance variables, and no serious adverse events were observed.
Intracameral TA of 1 mg can effectively be used to control postoperative inflammation after uncomplicated cataract surgery with phacoemulsification. This makes it possible to decrease the dosage and duration of topical prednisolone acetate.
Acta ophthalmologica 04/2008; 86(2):183-7. · 2.44 Impact Factor
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ABSTRACT: To compare a bupivacaine and lidocaine mixture with levobupivacaine and ropivacaine in terms of safety, efficacy and blocking quality in peribulbar anaesthesia for phacoemulsification.
A total of 105 patients scheduled for cataract surgery with peribulbar anaesthesia were randomly allocated into three groups of 35 patients each, to receive 5 ml of, respectively, a 1 : 1 mixture of bupivacaine 0.5% and lidocaine 2% (group 1), levobupivacaine 0.75% (group 2), or ropivacaine 1% (group 3). Ocular movement scores were evaluated at 2, 4, 6, 8 and 10 mins after injection. Intraoperative and postoperative analgesia were evaluated by verbal pain scores. Duration of surgery, need for supplementary anaesthesia, haemodynamic parameters and the incidence of perioperative complications were recorded.
The ocular movement score in min 2 was significantly lower in group 1. There was no significant difference between groups 2 and 3. Ocular movement scores at mins 4 and 6 were significantly decreased in group 1 and 2 compared with group 3. There was no significant difference among the groups in ocular movement scores at mins 8 and 10. Verbal pain scores in postoperative hour 4 were highest in group 3, but scores for the intraoperative period and postoperative hours 1 and 2 were similar among the groups. Duration of surgery and haemodynamic parameters did not differ among the groups.
All agents were considered to be convenient for clinical use in cataract surgery with peribulbar anaesthesia. Although the ocular movement scores in the ropivacaine group were higher than in the other groups at mins 4 and 6, this did not imply any clinical significance.
Acta Ophthalmologica Scandinavica 01/2008; 85(8):844-7. · 1.85 Impact Factor
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ABSTRACT: To compare the effectiveness of brinzolamide 1%, brimonidine 0.2%, acetazolamide 250 mg, intracameral acetylcholine, and timolol 0.5% in preventing intraocular pressure (IOP) peaks during the early period after phacoemulsification in which sodium chondroitin sulfate 4%-sodium hyaluronate 3% (Viscoat) was used as the ophthalmic viscosurgical device (OVD).
Department of Ophthalmology, Baskent University Medical Faculty, Ankara, Turkey.
This prospective randomized study comprised 185 eyes of 185 patients with uncomplicated cataract scheduled for phacoemulsification using Viscoat as the OVD. Patients were randomly assigned to 1 of 6 groups: postoperative application of topical brinzolamide 1%, brimonidine 0.2%, oral acetazolamide 250 mg, intracameral acetylcholine, timolol 0.5%, or no ocular hypotensive agent (control group). The IOP was measured at baseline (preoperatively) as well as 6 hours, 20 to 24 hours, and 1 week after surgery.
The mean preoperative IOP values were not significantly different between the groups. Six hours and 20 to 24 hours postoperatively, the mean IOP was significantly lower in all groups receiving an ocular hypotensive agent than in the control group (P<.01). Six hours after surgery, the mean IOP significantly increased in all groups but was higher in the control group. At 20 to 24 hours, the mean IOP decreased significantly in all ocular hypotensive agent groups but remained significantly high in the control group. One week after surgery, there were no significant differences between the groups.
Brinzolamide, brimonidine, acetazolamide, intracameral acetylcholine, and timolol had similar effects in reducing IOP increases after phacoemulsification performed using Viscoat.
Journal of Cataract [?] Refractive Surgery 11/2007; 33(11):1941-5. · 2.26 Impact Factor
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ABSTRACT: To investigate if resveratrol can prevent sodium selenite-induced experimental cataract model in rats.
Forty-eight Spraque-Dawley rat pups were divided into 3 treatment groups: (1) normal saline-% 5 ethanol injected i.p. on postpatum day 10; (2) Na selenite (30 nmol/g body wt) injected s.c on day 10; (3) Na selenite s.c on day 10+resveratrol (40 mg/kg) i.p on days 10-13. On day 21, cataract development was graded by slit-lamp examination and photography. Encapsulated lenses and erythrocytes were analyzed for reduced glutathione (GSH) and malondialdehyde (MDA), a marker of lipid peroxidation. Lenses were also analyzed for total nitrite (TN).
All control lenses in group 1 were clear. In group 2, all rats developed cataracts (grade 3-grade 6), whereas in group 3, only 9 of 16 rats developed cataracts (grade 2-grade 3). The difference of cataract frequency between groups 2 and 3 was statistically significant (p<0.05). Group 3 lenses and erythrocytes had higher mean GSH and lower mean MDA levels than those in group 2 (p<0.05). TN was highest in group 3 and lowest in group 1 (p<0.05).
Resveratrol suppressed selenite-induced oxidative stress and cataract formation in rats. This protective effect was supported by higher GSH and lower MDA in lens and erythrocytes. The presence of oxidative stress in selenite cataract development and its prevention by resveratrol support the possibility that high natural consumption of resveratrol in food can help prevent human senile cataract.
Current Eye Research 03/2006; 31(2):147-53. · 1.28 Impact Factor
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ABSTRACT: To investigate the antiinflammatory effects of adding heparin sodium to the irrigating solution to prevent fibrinoid reaction and related long-term complications after pediatric cataract surgery.
Department of Ophthalmology, Inonu University, Turgut Ozal Medical Center, Malatya, Turkey.
Thirty eyes of 18 children who had cataract or other ocular surgery were included in the study. Bilateral cataract surgery was performed in 20 eyes of 10 children and bilateral secondary intraocular lens (IOL) implantation in 4 eyes of 2 children (Group 1). Four eyes of 4 children had unilateral cataract surgery and 2 eyes of 2 children with previous perforating eye injury had synechiotomy and pupilloplasty (Group 2). Heparin sodium was added to the irrigating solution during surgery in 12 left eyes of children with bilateral surgery (Group 1a) and in all eyes in Group 2. Heparin sodium was not added during surgery in 12 right eyes of children having bilateral surgery (Group 1b, control). Early and late postoperative intraocular reactions were recorded and compared.
In Group 1a (heparin added), 6 eyes had less fibrinoid reaction and fewer related complications such as posterior synechias, pupil irregularity, and intraocular lens (IOL) decentration than the fellow right eyes. No eye in Group 1a having primary cataract surgery had hyphema or intraocular bleeding. Hyphema occurred on the first postoperative day in 1 eye in Group 1a that had secondary IOL implantation.
Adding heparin sodium to the irrigating solution decreased postoperative inflammatory and fibrinoid reactions and related complications such as synechias, pupil irregularity, and IOL decentration in pediatric cataract surgery. However, the use of heparin during surgery can be risky in eyes with a defective blood-aqueous barrier such as after previous ocular surgery.
Journal of Cataract [?] Refractive Surgery 11/2004; 30(10):2163-9. · 2.26 Impact Factor
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ABSTRACT: To investigate whether caffeic acid phenethyl ester (CAPE) and cortisone prevent proliferative vitreoretinopathy (PVR).
Twenty pigmented rabbits were used in this study. All rabbits except controls received an intravitreal injection of 0.15 ml (75,000 U) of platelet-rich plasma into their left eye. The animals were divided into four groups: group I was treated with intraperitoneal injection of 0.5 ml (15 micromol/kg) of CAPE for 3 days, group II received 0.15 ml (4 mg/kg) of intravitreal cortisone, group III received nothing (blank group), and group IV (control group) received only 1 ml of 1% ethanol intraperitoneally daily for 3 days. Proliferative changes were graded in a masked fashion by indirect ophthalmoscopy for a 15-day follow-up period. The malondialdehyde (MDA), reduced glutathione (GSH) and total nitrite (NO) levels were measured in the vitreous humor.
The grades of PVR were B-C in group I, and C-D in group II. The PVR grade in the control group was C-D. The mean MDA level in group I (4.0+/-0.8 micromol/l) was significantly lower than in the blank group (6.0 micromol/l) (p < 0.05). The mean GSH level in group I (71.0+/-11.2 micromol/l) was significantly different than in the blank group (p < 0.05). The MDA and GSH levels in group II were 4.7+/-0.6 micromol/l and 53.8+/-7.8 micromol/l, respectively. Both these levels were not significantly different from the blank group (p > 0.05). The NO levels in both treatment groups were significantly lower than in the blank group (p < 0.001).
These findings suggest an inhibitory effect of CAPE on PVR. The inhibitory effect was supported by lower MDA and NO with higher GSH levels in treatment groups than in the blank group. There was no detected significant effect of cortisone for preventing PVR experimentally.
Mediators of Inflammation 05/2004; 13(2):127-30. · 3.26 Impact Factor
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ABSTRACT: To evaluate the effect of limbal relaxing incisions (LRIs) in the treatment of primary mixed astigmatism and mixed astigmatism after cataract surgery.
Department of Ophthalmology, Inönü University, Malatya, Turkey.
Limbal relaxing incisions were performed to correct astigmatism in 37 eyes of 26 patients with mixed astigmatism. Twenty-four eyes had primary astigmatism, and 13 eyes had astigmatism after cataract surgery. The length, number, and depth of the incisions were determined using the Gills and Gayton nomogram. The manifest refractive astigmatism was measured preoperatively and 1 day, 1 week, and 1, 3, 6, and 12 months postoperatively. Surgically induced astigmatism using the vector method, preoperative and postoperative uncorrected visual acuity (UCVA), and best spectacle-corrected visual acuity (BSCVA) were evaluated. Follow-up was at least 6 months in all cases.
The mean preoperative and postoperative refractive astigmatism was 3.31 diopters (D) +/- 1.50 (SD) and 1.59 +/- 1.28 D, respectively (P <.001). The mean absolute change in refractive astigmatism was 1.72 +/- 0.81 D. No patient lost lines of UCVA or BSCVA. The safety index was 1.21 and the efficacy index, 0.88. The mean preoperative and postoperative UCVA was 0.29 +/- 0.22 and 0.54 +/- 0.31, respectively (P =.0001) and the mean BSCVA, 0.61 +/- 0.30 and 0.74 +/- 0.30, respectively (P =.0001). The mean vectorial magnitude was 2.32 +/- 1.36 D at the last follow-up. There were no serious postoperative complications.
Limbal relaxing incisions are a simple, safe, and effective method to correct primary mixed astigmatism and mixed astigmatism after cataract surgery.
Journal of Cataract [?] Refractive Surgery 05/2003; 29(4):723-8. · 2.26 Impact Factor
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ABSTRACT: To analyze and compare the outcomes and complication rates of secondary implantation of flexible, open-loop, anterior chamber intraocular lenses (AC IOLs) and single-piece, scleral-fixated, posterior chamber IOLs (PC IOLs).
Departments of Ophthalmology, Gaziantep University Medical Faculty, Research Hospital, Gaziantep, and Inönü University Medical Faculty, Research Hospital, Malatya, Turkey.
This study comprised 124 eyes of 113 aphakic patients (61 men, 52 women) with insufficient capsule support who had secondary IOL implantation from January 1997 to June 2001. In Group 1 (n = 73 eyes), a flexible, open-loop AC IOL was implanted and in Group 2 (n = 51 eyes), a single-piece, scleral-fixated PC IOL. The mean follow-up was 34 months (range 6 to 53 months) and took place at several different clinical settings. The mean interval between the initial cataract operation and secondary IOL implantation was 63 months (range 6 months to 12 years). The postoperative outcomes, safety, efficacy, and complication rates were analyzed, and the preoperative and postoperative best spectacle-corrected visual acuities (BSCVAs) were compared.
The postoperative mean BSCVA was 20/34.8 +/- 45.2 (SD) in Group 1 and 20/32.1 +/- 33.7 in Group 2; the difference was not significant (P =.718). A BSCVA of 20/40 or better was achieved in 62 eyes (84.9%) in Group 1 and 45 eyes (88.2%) in Group 2. A BSCVA of 20/25 or better was achieved in 40 eyes (54.8%) and 33 eyes (64.7%), respectively. The difference between the 2 groups was not significant (P =.472). Complications occurred in 25 eyes (34.2%) in Group 1 and 13 eyes (25.5%) in Group 2 (P >.05). The most frequent complications in Group 1 were early transient corneal edema, intraocular pressure elevation, cystoid macular edema, hyphema, secondary glaucoma, and iris capture or pupil decentration and in Group 2, suture erosion, a tilted or decentered IOL, fibrin reaction, and vitreous prolapse into the anterior chamber.
The AC IOLs and PC IOLs were safe and effective for secondary implantation to correct aphakia. Secondary implantation of the scleral-fixated PC IOL seemed to provide a more favorable outcome and a lower complication rate than the open-loop AC IOL in complicated cataract cases with inadequate capsule and zonular support. As scleral-fixated PC IOL implantation is technically more difficult than AC IOL implantation, the decisive factor in choosing a secondary IOL is surgical experience. Long-term comparison of both techniques is required.
Journal of Cataract [?] Refractive Surgery 02/2003; 29(2):301-8. · 2.26 Impact Factor
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ABSTRACT: Aim: To establish a new clinical index to evaluate the presence of hypo-hypertelorism with greater accuracy. Material and Methods: After screening a wide range of population, 310 elementary school children (185 boys, 125 girls) aged 7–15 years were included in this study. For this cross-sectional study, a millimetre ruler was used. The anatomical interpupillary distance was measured by a modified Viktorin's method. In addition, inner and outer intercanthal distances were obtained. The data were analyzed by Student's t -test for two independent samples using SPSS for Windows. There were children with clinical hypertelorism (n=92, group 1), children with large fronto-occipital circumference (FOC) (n=101, group 2), and age- and sex-matched normal controls (n=117, group 3). Due to variations in FOC among healthy subjects, we introduced a new practical concept for evaluation of interpupillary distance, namely the interpupillary index, the simple product obtained by dividing the interpupillary distance by the FOC, multiplied by 100. Results: The overall idiopathic benign macrocephalic children (group 2) had significantly (p<0.001) larger interpupillary distances (6.13±0.36 cm) and FOCs (56.99±1.46 cm) than those of normal controls (5.70±0.26 cm and 52.82±1.22 cm, respectively). But, the difference between the combined product of interpupillary distance and FOC, the interpupillary index, was not significant (10.76±0.50 and 10.79±0.35, respectively) (p>0.05). On the other hand, the children with hypertelorism had significantly (p<0.001) larger interpupillary distances (6.47±0.29 cm) and FOCs (54.90±2.18 cm) when compared with the controls. In addition, the interpupillary index was significantly (p<0.001) higher (11.80±0.45) than both macrocephalic children (10.76±0.50) and controls (10.79±0.35). Intercanthal distances and intercanthal index of hyperteloric children were also significantly (p<0.001) larger than both macrocephalic children and controls. Conclusion: This new index offers a new concept for more accurate evaluation of the presence of ocular hypo-hypertelorism.
Journal of Cranio-Maxillofacial Surgery 08/2001; · 1.64 Impact Factor
