Application of amniotic membrane in ocular surface diseases: Clinical features and treatment outcomes [Oküler yüzey rekonstrüksiyonunda amniyon zarı uygulamaları: Klinik özellikler ve tedavi sonuçları]

Purpose: To investigate the effectiveness of amniotic membrane transplantation in cases with corneal thinning, desmatocele and refractive corneal ulcer. Material and Method: Fifty-four eyes of 54 patients who were applied amniotic membrane transplantation for various ocular surface disease between January 2004 and February 2009 in Çukurova University Ophthalmology Department were included in the study. A complete ophthalmologic examination was performed. Corneal culture and corneal cytology samples were collected from the patients with the diagnosis of corneal ulcers. The patients were informed about the surgical procedure and the possible complications and informed consent was obtained. The amniotic membranes that were prepared under optimal conditions and protected in frozen forms were used in the operations. Follow-up examinations were done at postoperative 1st day, 1st week, 1st month, 3rd month, 6th month and then once in a year. Results: Of 54 patients, 26 (48.1%) were men and 28 (51.8%) were women. The mean age of patients was 52.53±19.75 (2-87) years. The cases were separated into 2 groups according to the etiology: group 1 - eyes with corneal ulcer (n:26) and group 2 - eyes with corneal stromal thinning, persistent epithelial defects and desmatocel (n:28). The transplantations were performed using cover technique in 17 eyes (31.4%), graft technique in 37 eyes (68.5%) and graft technique with corneal patch in 2 eyes (3.7%). Partial penetrating keratoplasty was required in 38 of 54 eyes (70.3%). One eye was enucleated. Discussion: The amniotic membrane transplantation has advantages like: it can be prepared easily and is cost-effective. It is a safe and effective procedure in ocular surface disease

An unexpected delayed complication of cataract surgery: Retinal detachment secondary to capsular tension ring dislocation

We aim to present a case of retinal detachment secondary to capsular tension ring dislocation following cataract surgery. A 45-year-old man who underwent cataract surgery 2 years previously presented with decreased vision in his left eye. The patient's posterior capsule was intact with a well-located posterior chamber intraocular lens. Fundus examination revealed retinal detachment with retinal tears, and a capsular tension ring located around the tear was noticed during pars plana vitrectomy; it was removed through the sclerotomy site. In conclusion, dislocation of the capsular tension ring is a rare and unexpected complication of cataract surgery. Although the integrity of the posterior lens capsule is partially preserved, the ring may shift through a small tear in the bag even during its placement, and may cause retinal tears, retinal detachment or just remain silently suspended in the vitreous. Copyright © 2012 S. Karger AG, Basel

The correlation of clinical findings and macular changes detected by optical coherence tomography in patients with uveitis [Üveitlerde optik koherens tomografide tespit edilen maküler degişikliklerin klinik bulgular ile i·lişkisi]

Purpose: To evaluate the optical coherence tomography (OCT) changes in uveitis patients with macular involvement and to investigate the correlation between clinical activation and tomographic features. Material and Method: Patients who have been followed for uveitis in Uvea-Behçet department were enrolled in the study. Patients having any kind of media opacity (cataract, condensation of vitreous, corneal opacity) were excluded. Main outcome measures were visual acuity, macular thickness, and the integrity of the photoreceptor inner and outer segment junction during active and inactive period of the disease. Results: Twenty-six eyes of 19 (7 females, 12 males) patients were included. The patients were classified as having anterior uveitis (2 patients), posterior uveitis (10 patients) and panuveitis (7 patients). The mean macular thickness was 335.38±113.88 µm in active stage and 235.96±48.38 µm in remission phase. This difference was statistically significant (p=0.025). The integrity of photoreceptor inner and outer segment junction was disturbed in 65% of patients with active disease, while in 30.8%, the integrity of this layer was regained during remission. Discussion: OCT provides clinically important information about the changes induced by acute inflammatory episodes. These findings were observed to correlate with clinical features. OCT is a non-invasive technique which may be used for follow-up and for evaluation of the response to treatment of patients with uveitis