[Show abstract][Hide abstract] ABSTRACT: Purpose::
To evaluate the choroidal thickness (CT) in pseudoexfoliative (PEX) glaucoma and age-matched healthy subjects using spectral optical coherence tomography (SD-OCT).
Patients and methods::
In this prospective study, 32 eyes of 32 PEX glaucoma patients and 30 eyes of 30 age-matched healthy subjects were enrolled. The CT is measured perpendicularly (from the outer edge of the hyperreflective retinal pigment epithelium to the inner sclera) at the fovea, and 1.5 mm temporal, 3.0 mm temporal, 1.5 mm nasal, and 3.0 mm nasal to the fovea using SD-OCT (RTVue-100).
The groups were similar regarding the mean age and axial length values (both, P>0.05). The CT measurements were 182.12±39.88 and 201.56±32.00 μm at 1.5 mm nasal to the fovea (P=0.039), and 126.47±32.12 and 146.60±31.37 μm at 3.0 mm nasal to the fovea (P=0.015) in the PEX glaucoma and control groups, respectively. There were no significant differences in the subfoveal and temporal CT measurements among the 2 groups (all, P>0.05).
The findings of this study indicate that PEX glaucoma causes significant thinning in the nasal choroid. Thus, measuring the CT with SD-OCT may be the way of better clarification of the relationship between PEX and glaucomatous optic neuropathy.
No preview · Article · Aug 2014 · Journal of Glaucoma
[Show abstract][Hide abstract] ABSTRACT: To compare the RTVue spectral optical coherence tomography (SD-OCT), Sirius Scheimpflug-Placido topographer, Lenstar optical low coherence reflectometry (OLCR) and ultrasound pachymetry (USP) devices in terms of their agreement and repeatability of measuring central corneal thickness (CCT).
In this prospective study, 50 eyes of 50 patients were included. Three repeated measures were obtained using SD-OCT, Scheimpflug-Placido topographer and USP and five measurements were determined with the OLCR. Bland-Altman plots were used to assess agreement among the instruments, and 95% limits of agreement (LoA) for each comparison were calculated. Intra-examiner repeatability was assessed using intraclass correlation coefficients (ICCs).
The mean CCT by SD-OCT, Scheimpflug-Placido topographer, OLCR, and USP were 525.90±34.08 µm, 525.92±34.10 µm, 530.30±35.62 µm, and 543.50±37.11 µm respectively. All 4 modalities of CCT measurements correlated closely with each other, with Pearson correlation coefficients ranging from 0.977 to 0.995. The mean differences (and upper/lower LoA) for CCT measurements were -0.05±6.77 µm (13.3/-13.3) between SD-OCT and Scheimpflug-Placido topographer, 4.38±3.79 µm (11.8/-3.1) between OLCR and SD-OCT, 4.38±6.03 µm (16.2/-7.5) between OLCR and Scheimpflug-Placido topographer, 13.20±6.46 µm (25.9/0.5) between USP and OLCR, 17.59±6.76 µm (30.8/4.3) between USP and SD-OCT, and 17.58±8.13 µm (33.5/1.6) between USP and Scheimpflug-Placido topographer. Intra-examiner repeatability was excellent for all devices with ICCs>0.98.
For most practical purposes, CCT measurements with the RTVue, Sirius and Lenstar can be used interchangeably. Although highly correlated, CCT measurement differences between USP and these 3 optical instruments can be significant depending on the clinical situation.
No preview · Article · Apr 2014 · International Journal of Ophthalmology
[Show abstract][Hide abstract] ABSTRACT: Purpose: To assess the effects of artificial tears on corneal higher order aberrations in dry eye patients. Materials and Methods: 30 right eyes of 30 newly diagnosed dry eye patients were evaluated in this prospective study. After routine ophthalmological examination, Schirmer test and tear break-up time (TBUT) test were performed in all patients. Anterior corneal aberrations were derived from conversion of the corneal elevation profile into corneal wavefront data with 6.0 mm pupil diameter using Zernike polynomails by corneal topography before and 5 minutes after instillation of artificial tear (Eyestil®). Corneal optical aberrations were compared before and after instillation of eyedrop. Results: The study included 17 women and 13 men; the average age of the patients was 44.36±13.22 years. Mean TBUT was 4.78±2.78 seconds and mean Schirmer value was 3.58±2.45 mm/5 minutes. After instillation of artificial tear, significant reductions in corneal total aberration from 1.120±0.35 μm to 0.960±0.34 μm, higher order aberration from 0.674±0.26 μm to 0.464±0.18 μm, coma-like aberration from 0.283±0.10 μm to 0.238±0.09 μm, and spherical-like aberration from 0.254±0.11 μm to 0.221±0.08 μm were detected (all, p<0.001). After eyedrop instillation, statistically significant increment was observed in Strehl ratio (p<0.001). Conclusion: As well as reducing the dry eye symptoms, artificial tears also cause increment in optical quality of the eye. Benefits of artificial tears on visual quality can be evaluated objectively via corneal wavefront aberrations.
[Show abstract][Hide abstract] ABSTRACT: To evaluate the repeatability of the anterior and posterior corneal wavefront aberrations using the Sirius Scheimpflug-Placido topographer in normal eyes and keratoconus eyes.
Bozok University Faculty of Medicine, Yozgat, Turkey.
Evaluation of diagnostic test.
In eyes of healthy subjects and eyes of keratoconus patients, 3 repeated measurements were obtained using the Scheimpflug-Placido topographer. Repeatability of the corneal aberrometric data using a 7th-order Zernike expansion (6.0 mm pupil) and central corneal power (3.0 mm zone) in the anterior and posterior corneal surfaces were analyzed. The within-subject standard deviation (Sw) and the intraclass correlation coefficient (ICC) were calculated.
For all modal pairs, the Sw was 0.08 μm or less for anterior and posterior corneal aberrations in both groups. The ICC of the anterior corneal surface ranged from 0.607 (pentafoil) to 0.988 (primary coma) in keratoconus eyes (n = 41) and from 0.568 (quadrifoil) to 0.856 (primary coma) in normal eyes (n = 30). The ICCs for posterior corneal surface aberrometry were 0.656 to 0.873 and 0.592 to 0.824, respectively. For anterior and posterior corneal curvatures, the Sw was 0.12 or lower and the ICC values were more than 0.93 in all cases except the posterior corneal surface reading at the 3.0 mm corneal area in keratoconus eyes (ICC 0.875).
The intraexaminer repeatability of most anterior corneal aberrations with the Scheimpflug-Placido system was moderate to high in normal eyes and keratoconus eyes. The system showed moderate repeatability for the posterior corneal surface.
No author has a financial or proprietary interest in any material or method mentioned.
No preview · Article · Dec 2013 · Journal of Cataract and Refractive Surgery
[Show abstract][Hide abstract] ABSTRACT: Purpose: To evaluate the correlation between clinical tests, patient symptoms and spectral optical coherence tomography (OCT; RTVue, Optovue)-derived lower tear meniscus (TM) parameters and to verify sensitivity and specificity of TM parameters in the diagnosis of dry eye disease. Material and Method: 38 eyes of 38 patients (22 dry eye patients, 16 healthy subjects) were examined in this prospective study. After routine ophthalmologic examination, anterior segment OCT-derived TM height (TMH), TM depth (TMD), and TM area (TMA) were measured, and tear break-up time (TBUT) and Schirmer test with anesthesia were assessed in all patients. For evaluation of symptoms, the participants completed ocular surface disease index (OSDI) questionnaire. Correlation between tests was assessed using Pearson's correlation coefficient (r). Results: There was a significant positive correlation between Schirmer test results and TMH, TMA and TMD (r=0.79, 0.58, 0.58, respectively). TBUT was positively correlated with TMH, however, it was not correlated with TMA and TMD (r=0.63, 0.14 and 0.10, respectively). There was no significant correlation between OSDI score and 3 parameters of TM. TM measurements were significantly lower in dry eyes than in controls. Sensitivity and specificity for dry eye diagnosis were 81.5% and 86.8% for TMH, 78.9% and 76.3% for TMA, and 76.3%, and 52.6% for TMD, respectively. Discussion: OCT-derived TM parameters were correlated with Schirmer test, but there was no correlation between TM parameters and patient symptoms. TM measurements have high sensitivity and specificity for the diagnosis of dry eye.
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to evaluate tear osmolarity and ocular comfort with two different types of hydrogel daily disposable lenses. The right eyes of 15 first-time contact lens users were included in this prospective study. All eyes wore hilafilcon B silicone hydrogel contact lenses for 8 h (group 1). After 1 week without contact lenses, all eyes wore narafilcon A silicone hydrogel contact lenses for 8 h (group 2). Tear osmolarity measurement was performed before and after 4 and 8 h of each contact lens wear. Ocular comfort was assessed after 4 and 8 h of each contact lens wear. In group 1, the mean baseline, 4- and 8-h tear osmolarity values were 293 ± 10.57, 303.00 ± 10.5 mOsm/L (p = 0.023), and 295.0 ± 1.4 mOsm/L (p > 0.05), respectively. In group 2, the mean baseline, 4- and 8-h tear osmolarity values were 294 ± 13.65, 300.9 ± 11.3 mOsm/L (p = 0.007), and 298.80 ± 7.2 mOsm/L (p > 0.05), respectively. In group 1, the mean comfort score was 7.20 ± 0.45 and 8.60 ± 0.45 at 4 and 8 h, respectively (p = 0.038). In group 2, the mean comfort score significantly decreased from 9.80 ± 0.45 to 7.80 ± 0.84 at 4 h (p = 0.039). Both hydrogel and silicone hydrogel daily disposable contact lenses elevated tear osmolarity during 8 h of contact lens wear. The increase in tear osmolarity with both contact lenses was below the cut-off value for dry eye and was not associated with ocular comfort.
No preview · Article · Apr 2012 · International Ophthalmology
[Show abstract][Hide abstract] ABSTRACT: To assess the efficacy of quantitative analysis of the optic nerve head and peripapillary retinal nerve fiber layer (RNFL) with the spectral-domain optical coherence tomography (SD-OCT) in differentiating optic disc edema (ODE) from optic nerve head drusen (ONHD).
Prospective clinical study. Twenty-five eyes of 25 ODE patients (group 1), 25 eyes of 25 ONHD patients (group 2), and 25 eyes of 25 healthy subjects were included. The thickness of the peripapillary RNFL, the thickness of the subretinal hyporeflective space (SHYPS), the area of the SHYPS, the horizontal length of the optic nerve head, and the angle between the temporal RNFL and the optic nerve head (α-angle) were evaluated with SD-OCT.
The mean RNFL thickness was significantly greater in group 1 when compared with group 2 and control group (P < 0.001). The receiver operating characteristic curve areas for temporal and nasal RNFL thicknesses in differentiating group 1 and group 2 were 0.819 and 0.851, respectively (for temporal RNFL thickness >101.5 μm: sensitivity 92%, specificity 65%; for nasal RNFL thickness >74.5 μm: sensitivity 92%, specificity 47%). The mean SHYPS thickness, SHYPS area, and degree of the α-angle were greater in group 1 when compared with group 2 (P < 0.05). For the SHYPS thickness >464 μm: 85% sensitivity and 60% specificity; for the SHYPS area >811 μm: 85% sensitivity and 89% specificity; and for the α-angle >141°: 77% sensitivity and 95% specificity were obtained.
The quantitative analysis of the optic nerve head and peripapillary RNFL with SD-OCT can provide useful data in differentiating ODE from ONHD.
No preview · Article · Mar 2012 · Journal of neuro-ophthalmology: the official journal of the North American Neuro-Ophthalmology Society
[Show abstract][Hide abstract] ABSTRACT: Purpose: To evaluate the effects of silicone hydrogel contact lenses (SHCL) on central corneal thickness (CCT), corneal endothelial cell morphology, and tear functions. Material and Method: Fifty-five eyes of 28 SHCL wearers (Group 1) and 52 eyes of 26 healthy subjects (Group 2) were included in this study'. According to their contact lens wearing time, the contact lens wearing subjects were divided into 2 groups: Group 1a - wearing time less than 1 year and Group 1b - wearing time more than 1 year. CCT, epithelial thickness, corneal endothelial cell morphology, ocular surface disease index score (OSDI), and tear break-up time (TBUT) were evaluated. Results: In Group 1 and Group 2, the mean CCT was 561.85±39.98 μm and 537.25±27.12 μm, respectively (p: 0.001).The epithelial thickness was 50.38±5.41 μm and 55.64±5.32 μm, respectively (p: 0.001). In Group 1a and Group1 b, the mean CCT was 573.39±33.86 μm and 546.96±42.98 μm (p: 0.014) and the epithelial thickness was 49.51±4.78 μm and 51.50±6.04 μm (p>0.05), respectively. In Group 1, the percentage of endothelial cells larger than 700μ was low, while the percentage of endothelial cells between 200 and 400μ was high (p<0,05). Discussion: With SHCL wear, the corneal morphology is more affected in the short-term period. During long-term contact lens wear, the cornea enters an adaptation period and shows near-normal morphology. Tear functions are not affected by short- or long-term SHCL wear.
[Show abstract][Hide abstract] ABSTRACT: Objective: This study aims at the evaluation of factors influencing the outcome of intermittent exotropia surgery. Material and Methods: Sixty-seven patients with intermittent exotropia were included. The patient files were retrospectively evaluated for the factors influencing the postoperative outcome. Among these evaluated factors are age, the age at onset of strabismus, type of deviation (convergence insufficiency, divergence excess or simple exotropia), age at operation, amount of preoperative misalignment, the time between the age of onset of deviation and age at operation, the refraction defect, presence of anisometropia or amblyopia and A-V pattern, hyperfunction of oblique muscles, binocular single vision and amount resection and recession. The outcome was assigned as successful operation (ortophoric or residual deviation below 10 pd) and unsuccessful operation (residual deviation above 10 pd). Results: Mean age of onset of deviation was 4.46±3.94 (min:0, max:15) and mean age at operation was 21.14±12.13 (min:2, max:47). At the last visit of their follow-up 42 patients (62.7%) were assigned as successful operation whereas 25 patients (37.3%) were as unsuccessful. There was no significant relation between the age at onset of strabismus, type of deviation, age at operation, the time between the age of onset of deviation and age at operation, the refraction defect, presence of amblyopia and A-V pattern, oblique muscle dysfunction and binocular single vision with postoperative outcome (p=0.121). Operational success was better for the patients without anisometropia (p=0.042). There was a negative relation between the exchanged muscle amount and the success (p=0.012). The success rate was lower as the amount of exchanged muscles elevated. Conclusion: It has been found that the most important factors influencing the outcome of strabismus surgery are the presence of anisometropia and the amount of preoperative deviation.
[Show abstract][Hide abstract] ABSTRACT: To evaluate and compare the clinical results of 2 diffractive multifocal small-incision intraocular lenses (IOLs) implanted after biaxial microincision cataract surgery (MICS).
Atatürk Training and Research Hospital, 2nd Ophthalmology Department, Ankara, Turkey.
Comparative case series.
Eyes that had biaxial MICS with implantation of an Acri.Lisa 366D IOL (Group 1) or Acriva Reviol MFM 611 IOL (Group 2) were followed for at least 6 months postoperatively. Uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuities; corrected distance visual acuity; distance-corrected intermediate and near visual acuities; and contrast sensitivity measurements with and without glare were determined. Early and late complications and subjective complaints were recorded and evaluated.
The study enrolled 60 eyes of 32 patients. The preoperative and intraoperative data were comparable in the 2 IOL groups. There were no statistically significant postoperative differences in the mean spherical equivalent (Group 1, -0.30 diopter (D) ± 0.30 [SD]; Group 2, -0.26 ± 0.28 D; P=.584), mean UDVA (0.80 ± 0.14 and 0.86 ± 0.17, respectively; P=.158), and mean Jaeger UNVA (1.46 ± 0.73 and J 1.23 ± 0.50, respectively; P=.155). However, there was a significant difference in mean Jaeger UIVA (3.06 ± 0.90 and 2.23 ± 0.72, respectively; P=.000). Mesopic contrast sensitivity and the incidence of complications and dysphotopsia symptoms were not significantly different between the 2 IOL groups.
Both IOLs provided excellent distance and near visual acuity and contrast sensitivity. The Group 2 IOL gave better intermediate distance results.
No preview · Article · Nov 2011 · Journal of Cataract and Refractive Surgery
[Show abstract][Hide abstract] ABSTRACT: To measure the lower tear meniscus dynamics with Fourier domain-optical coherence tomography (FD-OCT) in keratoconus patients without dry eye findings to evaluate the effects of the corneal ectasia on lower tear meniscus parameters, and to determine the most affected meniscus variable from the corneal ectasia in keratoconus.
Prospective, clinical study. Forty-one eyes of 25 keratoconus patients without dry eye and 40 eyes of 20 healthy subjects were included. The lower tear meniscus analysis with FD-OCT, and corneal topography, keratometry, and pachymetry measurements were performed in all eyes. The main outcomes, including the lower tear meniscus height (TMH), depth (TMD), area (TMA), and angle between cornea and the tear meniscus (α-angle), were assessed. The results were compared between the patients and the control subjects.
The average keratometric power was 53.94 ± 5.76 D (between 44.46 to 63.75 D) in keratoconic eyes. It was 43 ± 0.8 D (between 40.50 to 45.94 D) in the controls. The average TMH, TMD, and TMA values did not show any statistically significant difference between the patients and the controls (p = 0.39, p = 0.824, p = 0.516, respectively). However, the average value of the α-angle was significantly higher in keratoconic eyes when compared to controls (p = 0.031). It was positively correlated with the keratometric power (r = 0.577, p = 0.001).
The TMH, TMD, and TMA did not show any change with the corneal protrusion; however, the α-angle had positive correlation with the keratometric power in keratoconic eyes.
No preview · Article · Jun 2011 · Current eye research
[Show abstract][Hide abstract] ABSTRACT: To use Fourier-domain anterior segment optical coherence tomography (AS-OCT)) to evaluate the main clear corneal incisions (CCIs) in microcoaxial and biaxial cataract surgery, the effects of incision enlargement, and the probable reasons for problematic healing.
Atatürk Training and Research Hospital, 2nd Ophthalmology Department, Ankara, Turkey.
Eyes that had microcoaxial cataract surgery through a 1.8 mm CCI or biaxial cataract surgery through a 1.2 to 1.4 mm trapezoidal CCI were divided into 2 equal subgroups based on incision enlargement. All surgeries were completed by stromal hydration. Incisions were evaluated 1, 8, and 30 days postoperatively.
The CCIs in the microcoaxial group were longer, thinner, and more slanted than those in the biaxial group, with no statistical difference. The microcoaxial incisions had significantly more arcuate configuration at 1 day (P=.003); however, the configuration became linear in the following days in both groups. The endothelial gap rates were less and Descemet membrane detachment rates greater than reported in the literature. In eyes with enlarged CCIs, the endothelial gap rate was higher in the microcoaxial group and the Descemet membrane detachment rate was higher in the biaxial group (both P=.05). At 1 day, the intraocular pressure (IOP) was significantly lower in Descemet membrane detachment and endothelial gap cases (P=.006 and P<.001, respectively).
Although closure was reliable in both groups, the microcoaxial group had slightly fewer undesirable effects on the incision site. Low postoperative IOP seemed to be a significant factor in problematic healing.
No preview · Article · Mar 2011 · Journal of Cataract and Refractive Surgery
[Show abstract][Hide abstract] ABSTRACT: To evaluate the tear function tests and the ocular surface damage in Graves' disease (GD) patients either with or without thyroid associated orbitopathy (TAO).
Forty-two eyes of 21 randomly selected patients with GD, and 30 eyes of 15 healthy subjects were included in this prospective study. The presence of TAO was evaluated clinically. The palpebral fissure height, degree of proptosis, ocular surface disease index (OSDI), Schirmer tear test, tear break-up time (TBUT), and conjunctival impression cytology were assessed. The results were first compared between the patient and the control groups. Results were then compared between the patients with TAO (group I) and without TAO (group II).
The mean OSDI score in the patient group was 44.79 ± 11.83 and it was 21.17 ± 9.89 in the control group (p = 0.001). The mean Schirmer tear test score was 14.4 ± 8.32 mm and 24.9 ± 3.57 mm in the patient and control group, respectively (p = 0.001). The mean TBUT in the patient group was 7.1 sec. In the control group it was significantly increased to 10 sec (p = 0.003). The mean proptosis and interpalpebral distance did not show any difference between the GD patients and controls (p > 0.05). The patients with GD showed significant ocular surface damage in which 75.71% had grade 2-3 squamous metaplasia in temporal interpalpebral conjunctiva. Twenty-four (57%) eyes composed group I. There were no differences in the mean OSDI score, Schirmer tear test score, TBUT, and the amount of ocular surface damage between group I and group II (p > 0.05).
Dry eye findings and the ocular surface damage in GD were most likely associated with the ocular surface inflammation. Before the development of the classic findings of TAO, ocular surface inflammation can be the only presenting clinical sign in GD.
No preview · Article · Jan 2011 · Current eye research
[Show abstract][Hide abstract] ABSTRACT: Purpose: To evaluate the relationship between peripapillary atrophy and optic disc parameters measured by Heidelberg Retina Tomography (HRT) and visual field findings in eyes with primary open-angle glaucoma. Methods: Thirty eyes of 30 patients with primary open-angle glaucoma were included in this study. In addition to routine ophthalmic examination, optic disc parameters were evaluated with HRT and visual field was evaluated with Humphrey Visual Field Analyzer. Peripapillary atrophy area was measured by drawing contour of the border of the peripapillary atrophy (Beta zone: chorioretinal atrophy area in which sclera and big choroid blood vessels were seen) in HRT. The relationship between this atrophy area and both visual field findings and optic disc parameters was evaluated. Pearson's correlation coefficient and statistical significance were calculated. Results'he mean age of the patients was 61.4±8.9 years. Measured beta zone area was 0.65±0.40 mm 2. Mean deviation measured with Humphrey Visual Field Analyzer was -8.6±8.2 dB and pattern standard deviation was 6.4±4.6. Statistically significant correlation between peripapillary atrophy area and age (PC=0.495, p=0.005), mean deviation (PC=-0.554, p=0.001), cup area (PC=0.382, p=0.037), cup/disc area ratio (PC=0.562, p=0.001), linear cup/disc area ratio (PC=0.422, p=0.020) and mean retinal nerve fiber layer thickness (PC=-0.360, p=0.047) was found. There was not a significant relationship between other optic disc parameters and peripapillary atrophy area (p>0.05). Conclusion: Significant correlation was seen between peripapillary beta zone atrophy area and some important optic disk parameters in primary open-angle glaucoma patients. More meaningful information would have been obtained if sectoral investigation of the optic disc was performed.
[Show abstract][Hide abstract] ABSTRACT: To report a case of a patient with periorbital necrotizing fasciitis caused by community-associated methicillin-resistant Staphylococcus aureus (MRSA).
Case report. A previously healthy 33-year-old man was presented with pain and rapidly progressive swelling of the right upper eyelid following a minor trauma. Computed tomography scanning revealed soft tissue swelling and fracture of the anterior wall of the right frontal sinus. Oral amoxicillin + klavulanat 1 g, twice daily was started. Over the next 24 hours periorbital necrotizing fasciitis was developed. A wound swab was taken and sent for microscopic evaluation, culture, and antibiotic sensitivity. The patient was started on intravenous crystallized penicillin, third-generation cephalosporin, and metronidazol treatment. An urgent extensive necrotic tissue debridement and frontal sinus curettage were performed.
Wound culture yielded MRSA which showed sensitivity to the given antibiotics. The patient responded to the treatment which was continued for 14 days.
Monomicrobial MRSA should be considered in the etiology of periorbital necrotizing fasciitis. Early diagnosis and prompt surgical and medical therapy are essential in the management of periorbital necrotizing fasciitis.
No preview · Article · Dec 2010 · Orbit (Amsterdam, Netherlands)
[Show abstract][Hide abstract] ABSTRACT: To evaluate the efficacy and reliability of a microincision intraocular lens (IOL) and its use in biaxial microincision cataract surgery (MICS).
Atatürk Training and Research Hospital, Ankara, Turkey.
Prospective clinical study.
A microincision IOL (Akreos MI60) was implanted after cataract extraction by the biaxial MICS technique. Over a postoperative follow-up of 12 months or more, visual acuity, contrast sensitivity, surgically induced astigmatism (SIA), corneal and ocular aberrations, and early and late complications were recorded.
The IOLs were implanted in the capsular bag in all 100 eyes. The mean final incision size was 1.82 mm ± 0.09 (SD). Postoperatively, the mean corrected distance visual acuity was 0.06 ± 0.10 logMAR; the mean spherical equivalent, -0.48 ± 0.91 diopter (D); and the mean calculated SIA, 0.20 ± 0.22 D. Contrast sensitivity with and without glare was within normal limits. There was no statistically significant difference in the root mean square of total corneal aberrations between preoperatively and postoperatively. Ocular wavefront analysis 3 months postoperatively showed mean values of 0.15 ± 0.2 μm for spherical aberration, 0.38 ± 0.16 μm for higher-order aberrations, 0.18 ± 0.14 μm for coma, and 0.14 ± 0.08 μm for trefoil. The 4 cases (4.0%) of membranous anterior chamber reaction resolved with treatment. None of the 20 eyes (20.0%) with posterior capsule opacification required neodymium:YAG capsulotomy. All IOLs remained well centered.
The aspheric microincision IOL was safely implanted through a 1.8 mm or smaller incision during biaxial MICS and gave good postoperative outcomes.
No preview · Article · Nov 2010 · Journal of Cataract and Refractive Surgery
[Show abstract][Hide abstract] ABSTRACT: To evaluate the effects of topical cyclosporine A (CsA) 0.05% (Restasis) on the signs and symptoms of dry eye, on apoptosis, and on MMP-9 expression in conjunctiva epithelial cells in thyroid orbitopathy (TO)-related dry eye patients.
Prospective, clinical study. Twenty-four eyes of 12 consecutive TO patients with dry eye findings instilled CsA twice daily for 2 months. Ocular surface disease index, Schirmer tear test, tear breakup time (TBUT), conjunctival apoptosis index, and conjunctival MMP-9 expression were evaluated before and after 2 months treatment. Conjunctival biopsies were harvested from all eyes at baseline and after 2 months treatment. Apoptosis was detected by the terminal deoxynucleotidyl transferase-mediated dUTP-nick end labeling (TUNEL) assay. MMP-9 expression was determined by immunohistochemistry.
After 2 months of topical CsA treatment, the mean OSDI score was significantly decreased from 58.08 +/- 6.28 to 36.41 +/- 11.75 (P = 0.001). At baseline, the mean Schirmer tear test score was 8.92 +/- 5.52 mm. It was increased to 11.25 +/- 4.71 mm after treatment (P > 0.05). The mean TBUT increased significantly from 3.92 +/- 2.18 sec to 9.16 +/- 3.34 sec (P = 0.001). The mean percentage of apoptosis index at baseline was 72.10 +/- 35.82%. This was significantly decreased to 53.29 +/- 34.46% after treatment (P = 0.008). The mean percentage of MMP-9 expression of the conjunctival epithelial cells was significantly decreased from 48.12 +/- 28.58% to 26.66 +/- 25.13% following treatment (P = 0.005).
Topical CsA treatment appears to improve the signs and symptoms of dry eye and inhibits apoptosis and MMP-9 expression in conjunctival epithelial cells in TO-related dry eye patients after 2 months of treatment.
No preview · Article · Sep 2010 · Current eye research
[Show abstract][Hide abstract] ABSTRACT: Many nucleofractis techniques introduced to date have both advantages and disadvantages. Therefore, the search for the most effective, functional, and safest technique continues. The half-moon supracapsular phacoemulsification technique, which the authors define as a new method, is a hybrid technique derived from both chopping and supracapsular techniques. This technique allows the endonucleus to partially prolapse out of the capsulorhexis rim into the anterior chamber during hydrodissection, to be chopped under direct vision, and to continue the quadrant-removal stage endocapsularly after sending the heminuclei back into the capsular bag. The nucleus-splitting stage is performed in the anterior chamber, and the quadrant-removal stage continues in the capsular bag away from the corneal endothelium, which is again the safest place. The half-moon supracapsular phacoemulsification technique achieves the two stages of nucleus removal in the safest location with the most effective method and therefore may provide some advantages in terms of efficacy, safety, and functionality.
No preview · Article · May 2010 · Ophthalmic Surgery Lasers and Imaging