Transcanalicular multidiode laser versus external dacryocystorhinostomy in the treatment of acquired nasolacrimal duct obstruction

Objectives: This study was a comparison of the outcomes of transcanalicular multidiode laser dacryocystorhinostomy (TCLDCR) and external dacryocystorhinostomy (EXDCR) treatment for patients with acquired nasolacrimal duct obstruction. Methods: Thirty-one consecutive patients who underwent TCLDCR (TCLDCR group) and 68 consecutive patients who underwent EXDCR (EXDCR group) due to acquired nasolacrimal duct obstruction were enrolled in the study. Follow-up visits were performed on the first day, and at the first week, first month, third month, sixth month, and every six months thereafter. Surgical success was defined as achievement of a patent osteotomy and a successful bicanalicular silicone intubation during the procedure. Anatomical success was defined by observation of a patent osteotomy on lacrimal irrigation, regardless of epiphora. The surgery time and intra- and postoperative complications were noted for each patient. Results: The TCLDCR group had a significantly shorter mean surgery time (27.9±5.5 minutes) compared with the EXDCR group (58.5±12.0 minutes) (p<0.001). However, the mean anatomical and functional rates of TCLDCR (58.0% and 54.8%, respectively) were significantly lower than those of the EXDCR group (94.1% and 91.1%, respectively) (both p<0.001). Two patients had "cheese wiring" damage of the lower canaliculus and 1 patient in the TCLDCR group had a full-thickness skin defect in the medial canthal region. No serious intra- or postoperative complication occurred in the EXDCR group. Conclusion: Although a TCLDCR procedure decreased the surgical time, it had a significantly lower success rate in the treatment of acquired nasolacrimal duct obstruction compared to EXDCR. The decision of the type of surgery should be made based on the cosmetic and success expectations of the patients and the presence of systemic problems

Comparison of subconjunctivally injected bevacizumab, ranibizumab, and pegaptanib for inhibition of corneal neovascularization in a rat model

WOS: 000317873300005PubMed: 23638411AIM: To compare the efficacies of subconjunctival bevacizumab, ranibizumab, and pegaptanib sodium injections for the inhibition of corneal neovascularization in an experimental rat model. METHODS: Sixteen corneas of 16 rats were chemically cauterized and randomized into four groups: bevacizumab group that treated with 0.05mL/1.25mg bevacizumab, ranibizumab group that treated with 0.05mL/0.5mg ranibizumab, pegaptanib group that treated with 0.05mL/0.15mg pegaptanib sodium, and control group that treated with 0.05mL saline solution. Digital photographs of the corneas were taken and analyzed using an image analysis software program. All corneas were excised and examined histologically on the 15th day. RESULTS: Each treatment group had significantly less neovascularized corneal areas and fewer blood vessels than the control group (all P 0.05). CONCLUSION: Subconjunctival bevacizumab, ranibizumab, and pegaptanib sodium were effective with no corneal epitheliopathy for inhibiting corneal neovascularization after corneal burn in rats. Bevacizumab was more effective than ranibizumab and pegaptanib sodium

Effect of Pterygium Surgery on Tear Osmolarity

Purpose. To investigate changes of dry eye test results in patients who underwent pterygium surgery. Methods. Seventy-four patients who underwent primary pterygium surgery were enrolled in this study. At the baseline, 3-, 12-, and 18-month visits, measurements of tear osmolarity, BUT, and Schirmer test were performed. The patients were divided into 2 groups: Group 1, which consisted of patients in whom pterygium did not recur, and Group 2, which consisted of patients in whom pterygium recurred after surgery. Results. The patients in Group 1 had lower tear osmolarity levels after surgery than those at baseline (all P0.05). Conclusions. Anormal tear film function associated with pterygium. Pterygium excision improved tear osmolarity and tear film function. However, tear osmolarity deteriorated again with the recurrence of pterygium

Serum YKL-40 levels as a novel marker of inflammation and endothelial dysfunction in patients with pseudoexfoliation syndrome

WOS: 000321700800013PubMed: 23661157Purpose To evaluate serum levels of YKL-40 in patients with pseudoexfoliation syndrome (PEX) in comparison with those of age-and sex-matched healthy subjects. Methods Forty patients with PEX (PEX group) and 40 age- and sex-matched control subjects (control group) were enrolled in the study. An enzyme immunoassay method using the commercially available test MicroVue YKL-40 was used to measure serum YKL-40 concentration. Systolic and diastolic blood pressures, serum levels of high sensitivity C-reactive protein (hsCRP), total cholesterol, low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), and triglycerides were also examined. Results the mean age was 54.4 +/- 7.6 (ranging 41-65) years in each group. the mean serum YKL-40 level of the PEX group was significantly higher than that of the control group (P<0.001). in addition, the mean serum HsCRP, total cholesterol, LDL, and triglycerides levels were significantly higher, and mean serum HDL level was significantly lower in the PEX group than in the control group (all P<0.001, excluding both P = 0.002 for triglycerides and HDL levels). Further, the mean systolic and diastolic blood pressures were significantly higher in the PEX group than in the control group (P-1 = 0.001 and P-2 = 0.01, respectively). Conclusion We have shown a relationship between PEX and elevated serum levels of YKL-40. We imply that a better understanding of the role of YKL-40 in the pathogenesis of endothelial dysfunction and atherosclerosis is necessary to develop new therapies for preventing or treating PEX. Further studies are warranted to clarify the clinical relevance of these findings

Topikal ve subkonjonktival bevacizumab (avastin) uygulamasının deneysel korneal neovaskülarizasyon modelindeki inhibitör etkisinin araştırılması ve karşılaştırılması

Bu çalısma yüksek ve düsük doz topikal ve subkonjonktival bevacizumab (Avastin, Genentech Inc., San Fransisco, Ca, USA) uygulamasının sıçan modelinde korneal neovaskülarizasyondaki inhibitör etkilerinin arastırılması ve karsılastırılması amacıyla yapılmıstır. Sprague-Dawley türü, 20 erkek sıçanın korneaları gümüs nitrat çubukları kullanılarak kimyasal olarak koterize edildi. Sıçanlar 4 gruba ayrıldı: düsük doz (grup 1) ve yüksek doz (grup 2) topikal bevacizumab (Avastin) gruplarına sırasıyla günde 2 defa 4 mg/ml ve 12.5 mg/ml topikal bevacizumab (Avastin), subkonjonktival enjeksiyon grubuna (grup 3) 1. 3. 5. ve 7. günlerde 0.05 ml/1.25 mg subkonjonktival bevacizumab ve kontrol grubuna (grup 4) günde 2 defa topikal suni gözyası uygulandı. Dijital fotoğraflar çekildi ve bir bilgisayar programı (Pixcavator Image Analyzer, Intelligent Perception,WV, USA) kullanılarak incelendi. Onuncu günde bütün sıçanlar sakrifiye edilerek gözleri enüklee edildi. Korneal kesitler alınarak histopatolojik değisiklikler incelendi. Ortalama neovasküler korneal alan kontrol grubunda % 63.32 ± 13.10 (ortalama ± SS), grup 3’te (subkonjonktival injeksiyon) % 50.22 ± 15.73 , grup 1’de (düsük doz topikal bevacizumab) % 26.76 ± 10.23 ve grup 2’de (yüksek doz topikal bevacizumab ) % 25.52 ± 12.45 olarak bulundu. Kontrol grubu ile grup 1 (düsük doz topikal bevacizumab) ve grup 2 (yüksek doz topikal bevacizumab) arasındaki fark istatistiksel olarak anlamlı bulundu (p1,p2<0.01). Fakat grup 3 (subkonjonktival enjeksiyon grubu) ile kontrol grubu arasındaki fark istatistiksel olarak anlamlı bulunmadı (p>0.05). Korneal kesitlerin histopatolojik incelemesinde düsük ve yüksek doz topikal bevacizumab ile tedavi edilen gözlerde kontrol grubuna göre daha az neovasküler korneal alan ve korneada daha az sayıda eritrosit içeren damar olduğu görüldü.Topikal bevacizumab (Avastin) uygulaması deneysel korneal neovaskülarizasyonu azaltmaktadır ancak subkonjonktival bevacizumab (Avastin) enjeksiyonunun bu konudaki etkisi yetersiz görünmektedir. Sonuçlar topikal bevacizumab uygulamasının doz arttırılmasına gerek kalmadan ( 4 mg/ml veya 12.5 mg/ml) korneal anjiyojenezi inhibe ettiğini göstermektedir. Topikal bevacizumab (Avastin), klinik kullanımda korneal neovaskülarizasyon tedavisine katkı sağlayabilir. This study was carried out to evaluate and compare the inhibitory effects of topical high dose, low-dose and subconjunctival bevacizumab (Avastin, Genentech Inc., San Francisco, Ca, USA) on corneal vascularization in a rat model. Corneas of 20 Sprague-Dawley male rats were chemically cauterized with silver nitrate sticks. Animals were divided in four groups: low-dose (group 1) and high-dose (group 2) topical bevacizumab groups that received twice daily instillation of 4 mg/ml and 12.5 mg/ml bevacizumab, subconjunctival injection group (group 3) that received 0.05 ml (1.25mg) of bevacizumab on day 1, 3, 5 and 7; control group (group 4) that received only topical artificial tear drops twice daily, respectively. Digital photographs of the corneas were taken and analyzed using an image analysis software (Pixcavator Image Analyzer, Intelligent Perception,WV, USA). On day 10, all animals were sacrificed and the eyes were enucleated. Corneas were excised and examined for changes in histology. The mean percentage of neovascularized corneal area in the control group was 63.32 % ± 13.10 (mean ± SD), 50.22 % ± 15.73 in group 3 (subconjunctival injection), 26.76 % ± 10.23 in group 1 (low dose topical bevacizumab) and 25.52 % ± 12.45 in group 2 (high dose topical bevacizumab). The differences between control group and group 1 (low dose topical bevacizumab) and group 2 (high dose bevacizumab) were found to be statistically significant (p1,p2 < 0.01). However, there was no statistically significant difference of mean percentage values between group 3 ( subconjunctival injection ) and control group (p > 0.05). In histopathological examination of the excised corneas, treated eyes with low and high dose bevacizumab (Avastin) showed significantly less neovascular area and number of vessels than the control group.Topical application of bevacizumab (Avastin) reduces experimental corneal vascularization compared with the control group, but the effect of subconjunctival injection of bevacizumab (Avastin) seems to be insufficient. These results suggest that topical bevacizumab is able to inhibit corneal angiogenesis, without increasing the dosage (4mg/ml or 12.5mg/ml for topical form). Clinical use of topical bevacizumab may have an additional effect in the treatment for corneal neovascularization

The surgical outcomes of transcanalicular multidiod laser dacryocystorhinostomy treatment in acquired nasolacrimal duct obstruction

Amaç: Edinilmiş primer nazolakrimal kanal tıkanıklığı tedavisinde transkanaliküler multidiod lazer dakriyosistorinostomi ameliyat sonuçlarının değerlendirilmesi.Gereç ve Yöntem: Bu retrospektif çalışmaya, epifora şikayeti ile başvuran ve muayenede ortak kanalikülün distalinde tıkanıklık tespit edilerek transkanaliküler multidiod lazer dakriyosistorinostomi cerrahisi ve bikanaliküler silikon tüp yerleştirilmesi ameliyatı uygulanan hastalar dahil edildi. Postoperatif dönemde yapılan kontrollerde pasajın açık olup olmadığı nazolakrimal kanal lavajı ile kontrol edilip semptom ve bulgulardaki değişiklikler sorgulandı. Tüplerin çıkarılma süreleri ayrıca kaydedildi.Bulgular: Transkanaliküler multidiod lazer dakriyosistorinostomi uygulanan toplam 49 hastanın 35’i kadın 14’ü erkekti. 49 hastanın 50 gözüne transkanaliküler multidiod lazer dakriyosistorinostomi cerrahisi ve bilateral silikon tüp entübasyonu yapıldı. Hastaların yaş ortalaması 50.00±14.299 yıl idi. Ortalama takip süresi 14.08±7.042 ay idi. Slikon tüplerin çıkarılma süreleri ortalama 3.42±0.906 ay idi.Takip sonrası 49 hastada başarı oranı %56 (28/50) olarak saptandı.Sonuç: Transkanaliküler multidiod lazer dakriyosistorinostomi ameliyatı estetikliği, kolaylığı, hızlı ve tekrarlanabilirliği yönü ile cazip görünse de cerrahi başarı oranı istenilen düzeyde çıkmamıştır.Objective: To evaluate the surgical outcomes of transcanalicular multidiod laser dacryocystorhinostomy treatment in acquired nasolacrimal duct obstruction. Material and Method: In this retrospective study, we included patients with epiphora complaints due to obstruction at the distal part of the joint canalicule who underwent transcanalicular multidiod laser dacryocystorhinostomy surgery and placement of bicanalicular silicone tube. In the postoperative period we performed nasolacrimal duct lavage to control the patency of the passage. We noted changes in symptoms and signs. Results: Transcanalicular multidiod laser dacryocystorhinostomy was applied to 49 patients (35 female and 14 male). Fifty eyes of 49 patients underwent transcanalicular multidiod laser dacryocystorhinostomy surgery and silicone tube intubation. The mean age of the patients was 50.00±14,299 years. Mean follow-up was 14.08±7042 months. The average removal time of the silicone tube was 3.42± 0.906 months. The success rate was 56% (28/50). Conclusion: Although transcanalicular multidiod laser dacryocystorhinostomy surgery seems aesthetic, safe, rapid and repeatable but it’s surgical success rates were inefficien

Megalokornealı bir hastada fakoemülsifikasyon ve göz içi lens yerleştirilmesi

Bu makalede fakoemulsifikasyon cerrahisi yapılan nadir görülen iki taraflı megalokornea ve katarakt hastası anlatılmıştır. Sol göze tek parçalı akrilik göz içi lensi (GİL) ve sağ göze üç parçalı akrilik GİL yerleştirildi. Göz içi lensleri desantralize olmasına rağmen cerrahi sonuç Kabul edilebilir düzeydeydi.We report an unusual case of bilateral megalocornea and cataract in a patient who underwent phacoemulsification surgery. A 1-piece acrylic IOL and a 3-piece acrylic IOL with polymethyl methacrylate haptics were implanted into the capsular bag in the left and right eye respectively. Despite decentered IOLs, the outcomes of the surgeries were acceptable. Using the Holladay II Formula for calculating IOL power provided satisfying results as well

Associations between choroidal thickness, axial length and spherical equivalent in a paediatric population

WOS: 000379963700009PubMed: 27151380BackgroundThe aim was to compare the choroidal thickness (ChT) of myopic children's eyes with that of emmetropes to determine whether there are associations between ChT, axial length and spherical equivalent (SE) in a paediatric population. MethodsA total of 117 eyes of 117 children including 53 myopic eyes (myopic group) and 64 emmetropic eyes (emmetropic group) were enrolled in this cross-sectional comparative study. ChT was analysed by using the HD 5 Line Raster scan protocol of spectral domain enhanced depth imaging optical coherence tomography. Subfoveal ChT was measured manually as the distance between the retinal pigment epithelium and the chorioscleral border and three additional measurements were carried out every 750 m temporal (T1, T2 and T3) and nasal (N1, N2 and N3) to the fovea. ResultsThe mean age was 11.7 2.7 years (range five to 17 years) in the myopic group and 10.9 +/- 3.4 years (range 5 to 17 years) in the emmetropic group. There were no significant differences between the groups concerning age and sex (both p > 0.05). the myopic eyes had significantly thinner subfoveal, T1, T2, T3, N1, N2, N3 and average choroid than the emmetropic eyes (all p < 0.05). in addition, correlation analyses among all the study subjects showed that all subfoveal, T1, T2, T3, N1, N2, N3 and average ChT had negative correlations with axial length and positive correlations with the SE. ConclusionThe present study showed that the myopic children's eyes had significantly thinner subfoveal choroid than the emmetropic control eyes. Further, ChT was negatively correlated with axial length and positively correlated with SE in the population that included myopic and emmetropic children

Effect of pathological myopia on biomechanical properties: a study by ocular response analyzer

AIM: To evaluate the ocular response analyzer (ORA) measurements of patients with pathological myopia in comparison with those of emmetropic control subjects, and to investigate the correlation between these ORA measurements and spherical equivalent (SE). METHODS: Measurements of 53 eyes of 53 subjects with pathological myopia (SE>-6.00 D) were compared with those of 60 eyes of 60 emmetropic controls. Corneal hysteresis (CH), corneal resistance factor (CRF), noncontact tonometer intraocular pressure (IOPg), and corneal-compensated IOP (IOPcc) were obtained for each subject. The refractive error value was determined as SE via a cycloplegic refraction test. RESULTS: The mean age was 54.1±18.9y (ranging from 5 to 88) in the pathological myopic group and 56.2±19.0y (ranging from 6 to 89) in the control group. There were no significant differences between the groups concerning age and sex. CH and CRF were significantly lower in the pathological myopic group than in the control group (P<0.001, P=0.005, respectively). IOPcc and IOPg were significantly higher in the pathological myopic group than in the control group (P<0.001, P=0.009, respectively). There were significantly positive correlations between CH and SE (r=0.565, P<0.001) and between CRF and SE (r=0.364, P=0.007). There were significantly negative correlations between IOPcc and SE (r=-0.432, P=0.001) and between IOPg and SE (r=-0.401, P=0.003). CONCLUSION: The present study displayed that pathological myopia affected biomechanical properties measured by ORA. The results of corneal biomechanical properties measured by ORA may need to be appreciated by taking refraction into account. Further, pathological myopia might be related with the increased IOP

Evaluation of corneal biomechanical properties in patients with rheumatoid arthritis: a study by ocular response analyzer

WOS: 000336428300011PubMed: 24131046Purpose: To compare the corneal biomechanical properties of rheumatoid arthritis (RA) patients with those of healthy controls. Methods: Measurements of 39 eyes of 39 RA patients (patient group) were compared with those of 55 eyes of 55 healthy controls (control group). Corneal hysteresis (CH), corneal resistance factor (CRF), intraocular pressure (IOP), and corneal-compensated IOP (IOPcc) were obtained for each subject by the ocular response analyzer (ORA). Corneal thickness (CCT) was measured by ultrasonic pachymeter. Results: CH and CRF were significantly lower in the patient group than in the control group (p1 = 0.002, p2 = 0.019, respectively). the patient group had significantly higher IOPcc values than the control group (p = 0.024). There was no significant differences between the groups concerning CCT and IOP. Conclusions: RA patients had lower CH and CRF, but higher IOPcc values than healthy controls. RA should be considered when the corneal biomechanical properties measured by the ORA are used for diagnoses or therapies