[Show abstract][Hide abstract] ABSTRACT: Objective
We aimed to compare intraocular pressure (IOP) measurements via three different tonometers: the Goldmann applanation tonometer (GAT), the Tono-Pen® XL (TPXL), and a non-contact airpuff tonometer (NCT).
This was a cross-sectional study of 200 eyes from 200 patients. Right eyes of all patients were included in this study. IOP was measured via GAT, NCT, and TPXL by three physicians. Each physician used one of the tonometers. Measurements via the three devices were compared.
The mean IOP was 15.5±2.2 mmHg (range 10–22) with the GAT, 16.1±3.0 (range 9–25) with the TPXL, and 16.1±2.8 (range 10–26) with the NCT. Bland–Altman analysis showed that the mean difference between measurements from the NCT and the GAT was 0.6±2.3 mmHg. The mean difference between the TPXL and GAT measurements was 0.7±2.5 mmHg. The mean difference between the NCT and TPXL measurements was −0.02±3.0 mmHg. There was no significant difference between the groups according to a one-way analysis of variance (ANOVA) test. P-values were 0.998 for NCT–TPXL, 0.067 for NCT–GAT, and 0.059 for TPXL–GAT.
The NCT and TPXL provide IOP measurements comparable to those of the gold standard GAT in normotensive eyes.
[Show abstract][Hide abstract] ABSTRACT: To evaluate the results of three photorefractive keratectomy (PRK) procedures in the treatment of astigmatism.
In this retrospective comparative case series, 89 eyes of 50 patients who underwent PRK treatment for astigmatism were enrolled. The patients were divided into 3 groups based on the PRK procedure: Group 1: PRK without mitomycin-C (MMC) application, Group 2: PRK with MMC application, and Group 3: Trans-Photorefractive Keratectomy (T-PRK). The efficacy, safety, predictability, and complications of treatment were assessed at 1, 3 and 6 months after the treatment.
At postoperative 6 months, the percentage of postoperative uncorrected visual acuity (UCVA) of 20/20 or better was 55.6% (20 eyes) in group 1, 75% (15 eyes) in group 2, and 75.8% (25 eyes) in group 3 (P=0.144). The percentage of postoperative best corrected visual acuity (BCVA) of unchanged or gained ≥1 lines was 80.6% (29 eyes) in group 1, 70% (14 eyes) in group 2, and 90.9% (30 eyes) in group 3 (P=0.151). The percentage of postoperative BCVA of lost ≥2 lines was 11.1% (4 eyes) in group 1, 20% (4 eyes) in group 2, and 6.1% (2 eyes) in group 3. The mean manifest refractive spherical equivalent (MRSE) and mean cylindrical refraction were not significantly different among the each groups (P>0.05). At postoperative 6 months, the percentage of MRSE of within ±0.50 D was 100% (36 eyes) in Group 1, 100% (20 eyes) in Group 2, and 93.9% (31 eyes) in Group 3. At the each follow-up period, there was no significant difference in number of eyes with haze and mean haze score(P>0.05).
The study showed that PRK without MMC, PRK with MMC and T-PRK appears to have similar effectiveness, safety and predictability in the treatment of astigmatism. The incidence of haze was also similar between the three groups.
Full-text · Article · Jun 2013 · International Journal of Ophthalmology
[Show abstract][Hide abstract] ABSTRACT: To evaluate the increase in corrected distance visual acuity (CDVA) after laser in situ keratomileusis (LASIK) in adults with anisometropic amblyopia.
The medical records of consecutive patients diagnosed with anisometropic amblyopia at the time of refractive evaluation who underwent LASIK were retrospectively reviewed. Patients with at least a two-line difference of visual acuity (VA) between the eyes with a spherical refractive error difference of at least 3.00 diopters (D) or an astigmatic difference of at least 2.00D were included. Patients with any other possible reason for amblyopia other than anisometropia or those who had undergone previous amblyopia treatment were excluded. Amblyopic eyes with myopia or myopic astigmatism were considered as group 1, hypermetropia or hypermetropic astigmatism constituted group 2, and mixed astigmatism patients comprised group 3. Uncorrected distance visual acuity (UDVA), subjective manifest refraction, and CDVA were analyzed at 1 week and 1 month, 3, and 6 months.
The study included 57 eyes of 57 patients. There were 33 eyes in group 1, 12 eyes in group 2, and 12 eyes in group 3. The preoperative mean values for spherical equivalent of subjective manifest refraction (SE) in groups 1, 2, and 3 were (-4.66±1.97)D, (4.40±1.00)D, and (0.15±1.05)D, respectively. Mean CDVA improved 0.1 log units (1 line LogMAR) at 6 months (P<0.05). Sixteen eyes (28%) exhibited an improvement in CDVA in week 1. Fourteen eyes (25%) experienced two or more lines of CDVA improvement at month 6. There were no statistically significant differences among the groups in terms of CDVA (P>0.05). Moreover, age, the amount of preoperative refractive error, and the levels of preoperative corrected and UDVA had no effect on postoperative CDVA improvement (P>0.05).
Correction of refractive errors with LASIK produced significant CDVA improvement in adult patients with anisometropic amblyopia and no previous amblyopia treatment.
No preview · Article · Jun 2013 · International Journal of Ophthalmology
[Show abstract][Hide abstract] ABSTRACT: PurposeTo investigate the changes in choroidal thickness (CT), axial length (AL), and ocular perfusion pressure (OPP) accompanying intraocular pressure (IOP) reduction after trabeculectomy.Methods
Thirty-nine eyes of 39 patients with primary open-angle glaucoma uncontrolled by medical therapy were included in this prospective and interventional study. All patients underwent a fornix-based trabeculectomy. The CT was measured by enhanced depth imaging-optical coherence tomography. IOP, AL, and systolic/diastolic blood pressure were also measured, and OPP was calculated. All measurements were performed at baseline and 1 month after surgery.ResultsThe mean IOP was 25.0±5.8 mm Hg at baseline and 11.7±2.6 mm Hg after trabeculectomy (P<0.001), and the mean subfoveal CT was 295±84 mm Hg at baseline and 331±82 mm Hg after trabeculectomy (P<0.001). The mean AL was 23.64±0.98 mm at baseline and 23.54±0.96 mm after trabeculectomy (P<0.001), whereas the mean OPP was 38.8±6.2 mm Hg preoperatively, and 51.1±7.3 mm Hg postoperatively (P<0.001). The change in CT negatively correlated with the change in IOP (r=-0.785, P<0.001) and AL (r=-0.693, P<0.001), whereas it positively correlated with the change in OPP (r=0.418, P=0.008).Conclusion
These results suggest that the large IOP decrease following trabeculectomy causes choroidal thickening. In addition, CT changes are associated with IOP and AL reduction as well as OPP increase.Eye advance online publication, 7 June 2013; doi:10.1038/eye.2013.116.
Full-text · Article · Jun 2013 · Eye (London, England)
[Show abstract][Hide abstract] ABSTRACT: Purpose:
To quantitatively assess the parameters of anterior chamber and angle dimensions by anterior segment optical coherence tomography (AS-OCT) in nanophthalmos.
In this prospective, cross-sectional and comparative study, 34 eyes of 34 healthy individuals (control group) and 37 eyes of 37 patients with nanophthalmos (study group) were enrolled. A single experienced ophthalmologist imaged and measured the right eye with the Visante AS-OCT. The anterior chamber angle (ACA), angle opening distance (AOD) at 500 and 750 µm from the scleral spur, and trabecular-iris space area (TISA) at 500 and 750 µm at the nasal and temporal angles were measured.
Mean nasal/temporal ACA was 44.90 ± 9.09/47.07 ± 8.69° in the control group and 32.15 ± 10.30/29.77 ± 10.57° in the study group (p < 0.001). Mean nasal/temporal AOD500 and AOD750 was 0.52 ± 0.18/0.53 ± 0.15 mm and 0.71 ± 0.26/0.71 ± 0.23 mm in the control group. The mean nasal/temporal AOD500 and AOD750 were 0.33 ± 0.12/0.31 ± 0.15 mm and 0.48 ± 0.16/0.47 ± 0.22 mm in the study group. Mean nasal/temporal TISA500 and TISA750 were 0.16 ± 0.06/0.17 ± 0.05 mm(2) and 0.31 ± 0.11/0.33 ± 0.09 mm(2) in the control group. Mean nasal/temporal TISA500 and TISA750 were 0.11 ± 0.04/0.09 ± 0.05 mm(2) and 0.20 ± 0.07/0.20 ± 0.10 mm(2) in the study group. All values were significantly lower in the study group compared with the control group.
Determination of angle parameters using AS-OCT is a rapid noncontact method that is useful in patients with nanophthalmos. The findings demonstrated that nanophthalmic eyes had lower ACA parameters including ACA, AOD500, AOD750, TISA500 and TISA750 at the nasal and temporal angles.
No preview · Article · Mar 2013 · Current eye research
[Show abstract][Hide abstract] ABSTRACT: Purpose: To evaluate the results of bleb needling of encapsulated blebs with 1% mitomycine-C (Mtm-C) after trabeculectomy surgery. Ma te ri al and Met hod: 98 eyes of 90 glaucoma patients who had undergone trabeculectomy between July 2009 and September 2011 were evaluated retrospectively. Twenty-five eyes of 24 patients who developed encapsulated bleb with at least 3-month follow-up were enrolled in the study. These patients had undergone bleb needling with 1% Mtm-C (16 eyes) since medications were not efficient for IOP control. The preand post-needling intraocular pressures (IOP) were compared with IOPs being controlled with anti-glaucoma medications (9 eyes). Re sults: Encapsulated bleb was seen in 25 (25.6%) eyes of 24 patients out of 98 eyes of 90 patients who had trabeculectomy. The mean age was 62.6±13.6 (23-83) years and the mean follow-up time was 5.7±4.4 (3-20) months. The mean time that encapsulated blebs were diagnosed was 4.1±1.5 (2.5-8) weeks after the trabeculectomy. The number of eyes with IOP controlled with medication only was 9 (36%) with 5.7±4.0 (3-14) months mean follow-up time. Mtm-C 1% bleb needling was performed at mean 9.1±3.2 (3-15) weeks after trabeculectomy in 16 eyes (64%) which had uncontrolled IOP with medical treatment. The IOPs before surgery and at postoperative 1st week, 1st, 3rd, and 6th months were 26.5±8.6 mmHg, 11.9±2.6 (5-18) mmHg, 14.5±3.8 (11-20) mmHg, 15.2±5.6 (8-20) mmHg, and 14.8±1.4 (8-28) mmHg, respectively (p<0,01). The numbers of anti-glaucoma medication before surgery and at postoperative 1st week, 1st, 3rd, and 6th months of needling were 2.1±0.7, 0.3±1.2, 1.1±1.4, 0.7±1.2, and 1.3± 0.8, respectively (p<0.05). Dis cus si on: One of the complications which compromises the IOP reduction after filtrating glaucoma surgery is formation of encapsulated bleb. Needling of encapsulated bleb with 1% Mtm-C is a safe and efficient surgical treatment in patients who have inadequate IOP reduction with anti-glaucoma medications.
[Show abstract][Hide abstract] ABSTRACT: Purpose:
To compare the biomechanical properties of the cornea between topographically normal relatives of patients with keratoconus and age-matched controls.
Thirty healthy individuals (control group) and 30 topographically normal relatives of patients with keratoconus (study group) were enrolled in this prospective, cross-sectional comparative study. Topographical measurements including pachymetric values, keratometry values, irregularity, and inferior-superior dioptric asymmetry difference values in the right eye of each participant were obtained using Orbscan II (Bausch & Lomb Laboratories, Inc, Rochester, NY). Corneal hysteresis (CH), corneal resistance factor (CRF), corneal compensated intraocular pressure, and Goldmann-related intraocular pressure were also measured using the Reichert Ocular Response Analyzer (ORA).
Topographic parameters were not significantly different between both groups (P > 0.05). Mean CH was 9.9 ± 1.6 mm Hg in the study group and 11.3 ± 1.0 mm Hg in the control group (P = 0.001); mean CRF was 9.8 ± 1.6 mm Hg and 11.2 ± 2.1 mm Hg in the study and control groups, respectively (P = 0.013). Mean Goldmann-related intraocular pressure was 15.0 ± 4.3 mm Hg in the study group and 15.8 ± 6.7 mm Hg in the control group (P = 0.603); mean corneal compensated intraocular pressure was 16.2 ± 4.7 mm Hg in the study group and 15.4 ± 5.8 mm Hg in the control group (P = 0.595).
The CH and CRF values were significantly lower in the relatives of patients with keratoconus than in the controls. Future studies including monitoring of these participants with topographical and biomechanical measurements may indicate the role of this study in detection of early corneal changes in relatives of patients with keratoconus.
[Show abstract][Hide abstract] ABSTRACT: To compare the biomechanical properties of the cornea and intraocular pressure (IOP) between patients with nanophthalmos and age-matched controls.
In this prospective, cross-sectional and comparative study, 27 eyes of 27 healthy individuals (control group) and 27 eyes of 27 patients with nanophthalmos (study group) were enrolled. Corneal hysteresis (CH), corneal resistance factor (CRF), corneal compensated intraocular pressure (IOPcc) and Goldmann correlated intraocular pressure (IOPg) were recorded for the right eye of each participant using Reichert Ocular Response Analyser measurements. Also, all participants in this study underwent a standardised ocular examination including IOP measurement with Goldmann applanation tonometry (IOP(GAT)), central corneal thickness and axial length (AL) assessments.
Mean CH in the nanophthalmic eyes and in the control eyes were 13.3 ± 2.4 mm Hg and 11.6 ± 1.7 mm Hg, respectively (p=0.003); mean CRF values in the nanophthalmic and the control eyes were 13.2 ± 1.8 mm Hg and 11.4 ± 1.9 mm Hg, respectively (p=0.001). Mean IOP(GAT) was 15.2 ± 3.3 mm Hg in the nanophthalmic eyes and 13.4 ± 2.7 mm Hg in the control group (p=0.031); mean IOPg values for the nanophthalmic and the control groups were 17.1 ± 5.3 mm Hg and 14.7 ± 3.5 mm Hg, respectively (p=0.042). Mean IOPcc values in the nanophthalmic and the control group were 13.6 ± 6.1 mm Hg and 14.8 ± 3.2 mm Hg, respectively (p=0.365).
The CH, CRF, IOPg and IOP(GAT) were significantly higher in the nanophthalmic eyes, whereas no significant differences in IOPcc were observed. These findings may be taken into account when measuring IOP values in patients with nanophthalmos.
No preview · Article · Mar 2012 · The British journal of ophthalmology
[Show abstract][Hide abstract] ABSTRACT: To compare the biomechanical properties of the cornea and intraocular pressure (IOP) between patients with Marfan syndrome and age-matched controls.
Departments of Ophthalmology and Genetics, Bakirkoy Maternity and Children Diseases Hospital, and Beyoglu Eye Education and Research Hospital, Istanbul, Turkey.
This study comprised patients with Marfan syndrome (study group) and healthy individuals (control group). The study group was subdivided into patients with ectopia lentis and patients without ectopia lentis. In the right eye of each patient, the corneal hysteresis (CH), corneal resistance factor (CRF), Goldman-correlated IOP, and corneal-compensated IOP were recorded.
Overall, the mean CH, CRF, Goldman-correlated IOP, and corneal-compensated IOP were not significantly different between the study group and the control group. The mean CH was 9.9 mm Hg ± 1.2 (SD) in study eyes with ectopia lentis and 11.2 ± 1.5 mm Hg in study eyes without ectopia lentis (P=.016); the mean CRF was 8.2 ± 1.8 mm Hg and 11.3 ± 1.9 mm Hg, respectively (P<.001). The mean Goldman-correlated IOP was 11.7 ± 2.7 mm Hg in study eyes with ectopia lentis and 16.2 ± 4.3 in study eyes without ectopia lentis (P=.003); the mean corneal-compensated IOP was 13.5 ± 4.1 mm Hg and 15.6 ± 3.8 mm Hg, respectively (P=.07).
The CH, CRF, and Goldman-correlated IOP were significantly lower in the Marfan syndrome eyes with ectopia lentis than in the Marfan syndrome eyes without ectopia lentis.
No preview · Article · Dec 2011 · Journal of Cataract and Refractive Surgery
[Show abstract][Hide abstract] ABSTRACT: PUPOSE: The purpose of this study was to compare the biomechanical properties of the cornea and intraocular pressure (IOP) between patients with systemic lupus erythematosis (SLE) and age-matched controls.
In this prospective study, 30 healthy individuals (control group) and 30 patients with SLE (study group) underwent Reichert ocular response analyzer (ORA) measurements. In the right eye of each participant, the corneal hysteresis (CH), corneal resistance factor (CRF), and Goldman-related IOP (IOPg) were recorded using the ORA.
Mean CH, CRF, IOPg were significantly different between groups. Mean CH was 10.2 ± 0.6 mm Hg in the study group and 11.3 ± 1.3 in the control group (P=0.02); mean CRF was 9.7 ± 1.1 mm Hg and 11.9 ± 1.5 mm Hg, respectively (P=0.001). Mean IOP(g) was 13.9 ± 2.9 mm Hg in the study group and 16.9 ± 2.6 mm Hg in the control group (P=0.001).
The biomechanical properties of the cornea are altered in patients with SLE compared with normal controls. These findings should be taken into account when measuring IOP values in patients with SLE as IOP readings may be underestimated in SLE eyes.
Full-text · Article · May 2011 · Eye (London, England)