Corneal Thickness and Topography Indices after Collagen Cross-linking for Keratoconus: 18 Months Follow-up and Literature Review

Objective: To evaluate the changes in corneal topography indices and corneal thickness after cross-linking treatment for keratoconus. Study Design: Retrospective Observational Study Patients and Methods: The data of patients who underwent corneal collagen cross-linking treatment for keratoconus were retrieved. Central corneal thickness (CCT), maximum and mean keratometry (Kmax, Kmean) values and topography indices: index of surface variance (ISV), index of vertical asymmetry (IVA), keratoconus index (KI), central keratoconus index (CKI), minimum radius of curvature (Rmin), index of height asymmetry (IHA), and index of height decentration (IHD) were obtained from Pentacam and Wavelight-Allegretto Wave Topolyzer outputs. Follow-up was 18 months. Results: The study comprised of 15 eyes of 10 patients with keratoconus. Central corneal thickness had decreased significantly 1 month after the procedure (p=0.003) but there were no statistically significant changes between the baseline values and last visits (p>0.05). Kmax and Kmean values were not statistically different from the preoperative values and at the last visits (p>0.05). Almost all of the corneal topography indices improved significantly after postoperative 6th month (p<0.05). Conclusion: There were improvements in topography indices during 18-month follow-up period, suggesting that the cornea becomes more optically regular and symmetrical after cross-linking

Endonasal Dacryocystorhinostomy; The Learning Curve and Our Experience

Aim: It was aimed to give an insight on the learning curve adopted by an ophthalmic surgeon while performing endonasal dacryocystorhinostomy under the supervision of an otolaryngologist with the results experienced during this survey. Materials and Methods: In this retrospective study, consecutive cases with endonasal dacryocystorhinostomy (DCR) surgery were performed by a single ophthalmic surgeon while a second otolaryngologist was overlooking the procedures. A total of 29 surgeries were performed on 23 patients. Patients that were diagnosed with complete nasolacrimal duct obstruction were then evaluated and proceeded to the surgery. The intraoperative video was recorded in all surgical cases and recording time was noted for each case. All of the complications that occurred during or at the postoperative stages were noted. Results: The mean age of the 23 patients was 55.25±18.6 years (15 y-80 y), of which 20 cases (87%) were female. The left side was involved in 69% (20/29) of cases. At the final follow-up of the mean of 12,4 months, the anatomical and functional success was achieved in 89% (26/29) cases. The mean time spent in the operating theatre was 84±17.2 minutes (range, 40–110 min). It was found that the only 3 failed surgeries were in the first 5 surgeries performed with no surgical failure in the remaining 24 eyes. Conclusions: Endonasal dacryocystorhinostomy is a safe, effective and cosmetically pleasing surgery for the treatment of nasolacrimal duct obstruction. Although it has a somewhat longer learning curve than some surgeries, once handling of the endoscope has been mastered and familiarity with the surgical field is improved, the duration of the surgery will decrease significantly. We believe multidisciplinary coordination plays an important role in decreasing potential complication rates and also in perfecting the technique

Horner’s Syndrome Following Herpes Zoster Ophthalmicus

A 60-year-old woman presented with the complaint of left upper eyelid ptosis. Eight weeks earlier she was treated with antiviral agents for herpes zoster ophthalmicus. Neuro-ophthalmic examination revealed pitozis and miyozis in her left eye. Based on aprac- lonidine and hydroxyamphetamine test results the patient was diagnosed as postganglionic Horner’s syndrome. The rarity of Hor- ner’s syndrome following herpes zoster ophthalmicus and the importance of topical agents in its diagnosis are emphasize

Comparison of 3d reformat computed tomography images using different softwares: do they have an incremental value in 3D imaging?

Three dimensional (3D) imaging gained an important diagnostic role because of providing the precise diagnosis in computed tomography (CT) studies. Various 3D softwares such as; VitreaWorkstation - Toshiba, Japan; OsiriX-Switzerland; Volume Viewer-General Electric, USA have been manufactured to improve its diagnostic ability. Providing the deep sense and dimensional perception, the aim of this prospective study is to compare the native 3D (N3D) CT images with 2 anaglyph images by using different softwares and delineate their contribution to 3D CT imaging

Clinical Performance of Samfilcon A Contact Lenses in Intensive Digital Device Users: A Multicenter, Prospective Clinical Study

Introduction To evaluate patient satisfaction with samfilcon A contact lenses (CLs) in intensive digital device users with myopia and to compare patient satisfaction with samfilcon A lenses to prior experience with senofilcon A or lotrafilcon B CLs. Methods This was a comparative, prospective, national study conducted at 14 centers in Turkey. Subjects were adults aged 18 and 45 years with myopia (range -0.25 D to -6.00 D) who spend a minimum of 3 hours viewing digital devices (e.g., computer, smartphone). A subgroup of patients were habitual lens wearers (senofilcon A or lotrafilcon B lens wear for at least 6 months prior to enrollment). The primary assessment was patient satisfaction with samfilcon A lenses (0-100 Likert scale). Secondary assessments included patient satisfaction with samfilcon A lenses compared to patients' habitual lenses, investigator satisfaction with samfilcon A lenses and investigator-evaluated slit lamp examination findings. Results Samfilcon A lenses were given high overall ratings from both patients and investigators, with a low incidence of ocular symptoms. Overall, patients were highly satisfied with samfilcon A lenses for comfort, vision and overall performance, and stated that they would consider wearing these lenses in the future. Among habitual senofilcon A or lotrafilcon B lens wearers, samfilcon A lenses were rated significantly better than the habitual lenses in regard to comfort, vision and overall performance. Investigator assessments were also highly favorable, both at initial fit and after 4 weeks of follow-up, with no significant findings noted on slit lamp examination. Conclusion Samfilcon A lenses were rated highly by investigators in regard to fit, handling and slit lamp findings, and by novice and habitual lens wearers in regard to comfort, vision and overall performance. These results support the use of samfilcon A lenses among digital device users who seek day-long comfort and good visual acuity