Comparison of Hybrid Contact Lenses and Rigid Gas-Permeable Contact Lenses in Moderate and Advanced Keratoconus

Objectives:We aimed to compare the clinical results and topographic data of the new generation hybrid contact lens (HCL) and rigid gaspermeable contact lens (RGPCL) in patients with moderate and advanced keratoconus.Materials and Methods:In this prospective study, HCL users comprised group 1 and RGPCL users comprised group 2. Snellen uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and lens-corrected visual acuity (LCVA); manifest spherical-cylindrical values; corneal topography measurements (flat keratometry [K1], vertical keratometry [K2], mean K, maximum K [Kmax], central corneal thickness [CCT], and thinnest corneal thickness [TCT]); and cone location were recorded.Results:The study included 83 eyes of 51 patients in group 1 and 61 eyes of 40 patients in group 2. The groups were similar in age and gender (p>0.05). Mean LCVA (logMAR) was significantly lower than BCVA in both groups (p0.05). There was also no significant difference between the two groups in terms of keratoconus stages, mean Kmax, CCT, TCT, or cone location (p>0.05), while mean UCVA (logMAR) and mean K were higher in group 2 (p<0.05). In both groups, the visual gain with lenses was higher in eyes with central cones, and there was significantly greater visual increase in group 2 (p=0.039).Conclusion:In moderate and advanced keratoconus, HCLs improved vision as much as RGPCLs and both lenses were more effective for central cones. Nevertheless, longer term of follow-up and larger numbers of patients are needed for long term follow-up results of HCL

Abnormal foot angles has an association with ingrown toenail

Background: Onychocryptosis, frequently termed ‘‘ingrown toenail’’ is a common foot problem in routine dermatology and orthopaedic clinical practice which leads to pain and disability. Although the aetiology of ingrown toenail is not well understood various associated risk factors have been identified with the pathogenesis. Material and methods: This study was a retrospective investigation of 170 patients with hallux valgus and lateral border ingrown toenail of all stages. The patients were compared with a control group. The radiologic assessment in both groups included right hallux valgus angle, left hallux valgus angle, right first and second intermetatarsal angle, and left first and second intermetatarsal angle. Results: There were 121 female and 49 male patients in the case group and 68 female and 32 male in the control group. The mean age of the case group was 41.1 years and 41.1 years in the control group. A statistically significant difference was found between the case and the control groups in terms of the right hallux valgus angle variable. Conclusion: The abnormal hallux valgus angle and the abnormal intermetatarsal angle plays an important role in ingrown toenail aetiology. The X-rays of the feet should be performed to determine the susceptibility of the patients who are admitted to the hospital for ingrown toenail in order to prevent other toes ingrown toenail and for planning the treatment of the patients with an ingrown toenail

Diplopia Associated with Interferon-b1a Treatment: Report of a Case

A 25-year-old male with relapsing-remitting multiple sclerosis (RRMS) presented with three transient episodes of horizontal diplopia after the last three administrations of interferon (IFN)-b1a. The episodes of diplopia occurred one day after the administration of IFN-b1a and all lasted for three days. The patient had been taking IFN-b1a treatment weekly for one year, and denied any diplopia previously. Its development after IFN-b1a injection and transient nature suggest the diplopia was an adverse effect of IFN-b1a. To the author’s knowledge, this is the first case to be reported with diplopia associated with IFN-b1a treatment in RRMS

Torus Düğümleri Ve Kontakt Ameliyatlar

A closed curve homeomorphic to the unit circle in a 3-manifold is called a knot. In particularly, a knot that can be drawn on a torus without intersecting itself is called a torus knot. In this thesis, we study torus knots and their topological properties, invariants and polynomials. We study Dehn surgery on torus knots in topological 3 manifolds. Then, we study contact 3-manifolds. We study a special class of Legendrian knots which have topological knot type as torus knots. The aim of this thesis is to study lens spaces by using contact surgery techniques. For this purpose, obtaining lens spaces L(4m+3,4) by Legendrian surgery along the negative torus knots T(2,−(2m+1)) where m ≥ 1 are studied in detail.3-manifoldlar içerisinde kendi kendisini kesmeyen kapalı eğrilere düğüm denir. Özel olarak, 2-boyutlu torus üzerinde kendi kendisini kesmeyecek şekilde çizilebilen düğüm tiplerine torus düğümleri denir. Bu tezde topolojik 3-manifoldlar içerisindeki torus düğümlerinin yanı sıra kontakt 3-manifoldlar içerisindeki Legendre torus düğümleri çalışılacaktır. Torus düğümlerinin topolojik özellikleri, değişmezleri ve polinomları çalışılıp hesaplanacaktır. Torus düğümlerine yapılan topolojik Dehn ameliyatları ve Legendre düğümlerine yapılan kontakt ameliyatlar çalışılacaktır. Bu tezde Legendre torus düğümleri de çalışılmıştır. Bu tezin amacı lens uzaylarını kontakt ameliyat tekniklerini kullanarak çalışmaktır. Bu amaçla, m ≥ 1 olmak üzere L(4m + 3,4) lens uzaylarının T(2,−(2m+1)) negatif torus düğümlerine Legendre kontakt ameliyat yapılarak elde edilme tekniği detaylı olarak incelenmiştir

Thyroid Orbitopathy and Dry Eye

Thyroid orbitopathy (TO) is an inflammatory autoimmune disease of the orbital and periorbital tissues that is characterized by the presence of autoantibodies against thyroid-stimulating hormone receptor (TSH-R). Hyperthyroidism and less commonly hypothyroidism or euthyroidism can be associated with this disorder. The orbital fibroblasts activated with T cells and the secreted cytokines are the key cells in the etiology. Dry eye can be seen in 80% of TO patients. The main factor for the development of dry eye in these patients is the inflammation of the lacrimal gland and the ocular surface. The second factor is the hyperosmolarity of the tear film caused by the evaporation of the tear film due to exophthalmos and the increased interpalpebral distance. In the treatment of TO, the usage of topical anti-inflammatory agents along with artificial tears is important because of the role of inflammation in the etiology. (Turk J Oph thal mol 2011; 41: 348-50

Evaluation of Tear Function Tests and Lower Tear Meniscus Height in Keratoconus Patients

Pur po se: To assess the tear function tests and the lower tear meniscus height (LTMH) in keratoconus patients and to evaluate the relationship of these parameters with the progression of keratoconus. Ma te ri al and Met hod: Thirty-eight eyes (group 1) of 21 keratoconus patients and 36 eyes (group 2) of 18 healthy subjects were included in this prospective study. Both groups underwent corneal topographic and keratometric measurements, tear break-up time (T-BUT) and Schirmer tests as well as measurement of the LTMH with anterior segment optic coherence tomography (OCT) after the ophthalmologic examination. The values obtained from both groups were compared and evaluated for statistical significance and reliability. Re sults: There was no statistically significant difference between the two groups in terms of age and gender (p>0.05). The mean Schirmer test values were 14.87±8.9 mm and 16.77±8.1 mm in group 1 and group 2, respectively (p=0.367). There was not any correlation between the keratometric power and the Schirmer test in group 1 and group 2 (group 1: r=0.114, p=0.548, group 2: r=0.151, p=0.972). The mean TBUT value was 12.83±7.3 sec in group 1, and 18.25±8.5 sec in group 2 (p=0.018). There was a negative correlation between keratometric power and TBUT in group 1, while there was no correlation in group 2 (group 1: r=0.717, p=0.001, group 2: r=0.235, p=0.212). The mean LTMH was 265.30±112 µm in group 1 and 313.29±167 µm in group 2 (p=0.151). There was no correlation between keratometric power and LTMH in both groups (group 1: r=0.001, p=0.997, group 2: r=0.318, p=0.130). Dis cus si on: In this study, it was shown that keratoconus patients have normal tear volume but reduced tear film stability compared to healthy individuals and this reduction is relate to the progression of keratoconus. (Turk J Ophthalmol 2012; 42: 249-52

Ocular Manifestations of Bilateral Ethmoidal Sinus Mucopyocele: Case Report

Mucoceles of the paranasal sinuses are slowly growing, epithelium-lined cystic lesions with sterile content. When the mucocele content becomes infected with a bacterial super-infection, the lesion is defined as mucopyocele. Mucoceles or mucopyoceles are commonly located in the frontal and anterior ethmoidal sinuses and can manifest with ocular signs and symptoms, mostly proptosis. In this report, we demonstrate a case of bilateral ethmoidal mucopyocele in a 53-year-old female who presented with reduced vision, diplopia, and proptosis. Computed tomography (CT) scanning of the paranasal sinuses revealed cystic lesions filling the maxillary sinuses and anterior ethmoidal cells bilaterally and causing erosion in the walls of the sinuses. After marsupialization of the mucopyoceles was performed by endoscopic sinus surgery, the symptoms of the patient recovered rapidly. (Turk J Ophthalmol 2011; 41: 354-6

Comparison of Electrocoagulation and Conventional Medical Drops for Treatment of Conjunctivochalasis: Short-Term Results

Objectives: To compare the effectiveness of electrocoagulation and conventional medical drops for treatment of conjunctivochalasis using anterior segment-optical coherence tomography (AS-OCT). Materials and Methods: Forty eyes of 20 patients with bilateral conjunctivochalasis were included in this prospective study. Twenty eyes of 10 patients were assigned to Group 1 and underwent electrocoagulation. The other 20 eyes of 10 patients were assigned to Group 2 and received conventional medical treatment consisting of non-steroidal antiinflammatory drop (topical 0.5% ketorolac tromethamine) 4 times a day and artificial tears (0.15% sodium hyaluronate) 6 times a day for 4 weeks. Before and 4 weeks after treatment, all patients were evaluated by slit-lamp biomicroscopy, tear film break-up time (TBUT) test, and ocular surface disease index (OSDI) questionnaire. Tear meniscus height (TMH), tear meniscus area (TMA), and conjunctivochalasis area (CCA) were measured with AS-OCT. Results: In Group 1, posttreatment values of TMH, TMA, and TBUT were significantly higher (p0.05 for all values). Conclusion: Electrocoagulation is an effective modality for treatment of conjunctivochalasi

Long-Term Results of Punctal Plug Applied to Dry Eye Patients

Purpose: The evaluation of long-term results of punctal plugs applied to dry eye patients and the potential problems they may bring about. Material and Method: In this study, we retrospectively assessed 30 eyes of 15 patients with moderate to advanced dry eyes who were applied punctal plug (5 mm) for treatment purpose and were observed for 12 months. The patients’ Ocular Surface Disease Index (OSDI ) scoring, Schimer-1 test (without topical anesthesia), tear film break-up time (TBUT) and ocular surface staining with fluorescein results were evaluated and compared before and after 6- and 12-month use of punctal plug. The patients were started on topical antiinflammatory treatment and artificial tears two months before the application of the punctum plug. Results: The patients’ average age was 56.4±2.3 (range: 36-70) years, and the average follow-up period was 15 (12-30) months. The average OSDI score was statistically significantly decreased at 6 and 12 months when compared to the initial value (p<0.05). The average Schirmer-1 test values measured at 6 and 12 months were also statistically significantly increased compared with the initial value (p<0.05). The average Schirmer-1 test value at 12 months was considerably increased when compared with the 6th month’s value (p<0.05). The average TBUT was statistically significantly increased when compared to the values at 6 and 12 months (p<0.05). When the outcomes of ocular surface staining with fluorescein were evaluated, a significant decrease was seen at 6 and 12 months when compared to the initial value (p<0.05). Discussion: The punctal plug treatment associated with topical anti-inflammatory treatment for moderate and advanced dry eye patients is a reliable method. It decreases the dry eye symptoms and findings in the long term. (Turk J Ophthalmol 2011; 41: 225-9

The Long-Term Effects of Silicone Hydrogel Contact Lenses on the Ocular Surface and Tear Function Tests

Objectives: To evaluate the effects of three different silicone hydrogel contact lenses, i.e. Balafilcon A (Pure Vision, Bausch & Lomb), Senofilcon A (Acuvue Oasys, Johnson & Johnson), and Confilcon A (Biofinity, CooperVision), on ocular surface after one, three, and sıx months of wear. Materials and Methods: Silicone hydrogel contact lenses (SHCL) were fitted to 58 patients (Balafilcon A to 40 eyes: Group 1, Senofilcon A to 42 eyes: Group 2, and Confilcon A to 34 eyes: Group 3) who have not used any contact lenses before. All groups were graded according to the Cornea and Contact Lens Research Unit’s grading score, and were performed ocular surface disease index scoring (OSDI), tear break-up time (BUT), and Schirmer 1 test. Results: The mean age was 22.45±5.96, 20.76±3.70, 21.00±3.84 years in Groups 1,2, and 3, respectively (p>0.05). While the increase in papillary hypertrophy as well as palpebral and bulbar hyperemia at 1st month in Group 1 and at 6th month at Group 2 were significant, there were no change in Group 3 with the use of SHCL (p<0.05). The mean OSDI, BUT did not show any difference in and between the groups (p>0.05). In Group 3, the Schirmer test was lower than in Groups 1 and 2, which was statistically significant (p=0.048, p=0.003). Conclusion: Factors like lens material, modulus, the presence of an internal wetting agent, and water content play an important role in the effects of SHCL on the ocular surface. In this study, it is demonstrated that SHCL does not cause clinically significant dry eye. (Turk J Ophthalmol 2014; 44: 201-6