Capsular tension ring implantation in cataract patients with pseudoexfoliation

Purpose: To investigate the influence of capsular tensionring (CTR) on prevention of intraoperative complicationsdue to zonular weakness and increased capsular fragilityduring phacoemulsification of cataracts with pseudoexfoliation.Materials and methods: 148 eyes of 148 patients whohad cataract with pseudoexfoliation underwent phacoemulsificationsurgery included. 74 eyes of the firstgroup (study group) were implanted with CTR after hydrodissection,while CTR was not performed in 74 eyesof control group (Group 2). In both groups, intraoperativecomplications such as zonular dialysis, conversion to extracapsularcataract extraction (ECCE) or intracapsularcataract extraction (ICCE), posterior capsular rupture,vitreus loss, and early postoperative complications wererecorded and compared between two groups.Results: In group 1, no complication occurred in 64 eyes(86.5%) and intraocular lens (IOL) implanted in the bag.In 10 eyes (13.5%) posterior capsule rupture occurred,in 4 of them converted to ECCE, IOL implanted in foureyes. In other 6 eyes, phacoemulsification completed underlayviscoelastic. In group 2, no complication occuredin 42 eyes and IOL implanted in the bag. In 10 patients(13.5%) zonular dialysis occurred, in 4 of them IOL implantedin the bag and in 6 of them converted to ICCE andIOL implanted in anterior chamber. Posterior capsule ruptureoccurred in 20 eyes (27.0%), all of them converted toECCE and IOL was implanted. In 2 eyes capsullorrhexisoccurred and converted to ECCE, IOL was implanted insulcus.Conclusion: In patients with pseudoexfoliation, CTR implantationin phacoemulsification simplified the surgery,increased the rate of IOL implanted in the bag and preventedcomplications like IOL desantralization after surgery

Does the type of suturing technique used affect astigmatism after deep anterior lamellar keratoplasty in keratoconus patients?

Banu Torun Acar, Ece Turan Vural, Suphi AcarHaydarpasa Numune Education and Research Hospital, Ophthalmology Clinic, Istanbul, TurkeyPurpose: To compare the effect of three different suturing techniques on astigmatism after deep anterior lamellar keratoplasty (DALK) in patients with keratoconus.Methods: In this retrospective study, 54 eyes of 54 patients with advanced keratoconus underwent DALK with three suturing techniques: single running, interrupted running, and combined interrupted and running. Postkeratoplasty astigmatism was evaluated during examinations 1, 3, and 6 months postoperatively and 2 months after completing suture removal.Results: Twenty-four eyes had single running sutures, 16 eyes had interrupted sutures, and in 14 eyes the suturing technique used was combined interrupted and running sutures. Mean age was 25.6 ± 5.9 years, 27.3 ± 6.8 years, and 26.5 ± 5.7 years (P = 0.422), and postoperative astigmatism 1 month after surgery was 3.79 ± 1.19 D, 5.56 ± 1.78 D, and 4.21 ± 1.55 D in the three groups, respectively (P = 0.012). However, 2 months after completing the suture removal, final postoperative astigmatism was 3.43 ± 1.44 D, 3.87 ± 1.38 D, and 3.71 ± 1.46 D (P = 0.846). Final astigmatism less than 4 D was seen in 18 cases (75%) in the single running group, nine cases (56.2%) in the interrupted running group, and nine cases (64.2%) in the combined interrupted and running group (P = 0.08).Conclusion: Postkeratoplasty astigmatism is comparable with three different suturing techniques used in patients with keratoconus after completing suture removal in DALK. Due to earlier suture removal in DALK, the type of suturing technique used is not considerably important.Keywords: astigmatism, deep anterior lamellar keratoplasty, suturing techniqu

Effect of Cap-Lenticule Diameter Difference on the Visual Outcome and Higher-Order Aberrations in SMILE: 0.4 mm versus 1.0 mm

Purpose. To evaluate the effect of cap-lenticule diameter difference (CLDD) on the visual outcome and higher-order aberrations (HOAs) of small-incision lenticule extraction (SMILE). Methods. A total of 132 patients who had bilateral SMILE for myopia or myopic astigmatism were included. The CLDD was 0.4 mm in 54 patients (group 1) and 1.0 mm in 78 patients (group 2). The refractive parameters, uncorrected (UDVA) and corrected distance visual acuity (CDVA), and HOAs were determined preoperatively and during six months follow-up. Results. Group 1 had better CDVA (in logMAR) compared to group 2 at day 1 (−0.07 ± 0.07 versus 0.04 ± 0.07, resp.; p<0.001) and week 1 (−0.07 ± 0.07 versus –0.04 ± 0.07, resp.; p=0.001). The visual acuity improved more in group 1 than in group 2. The UDVA (in logMAR) was 0.07 ± 0.07 and 0.29 ± 0.09 at day 1 (p<0.001) and −0.08 ± 0.07 and −0.06 ± 0.06 at six months (p=0.038) in group 1 and group 2, respectively. Group 1 was associated with significantly less induction of HOAs (0.24 ± 0.08 μm and 0.32 ± 0.26 μm, resp.; p=0.002). Conclusions. In SMILE, 0.4 mm CLDD is associated with better visual outcome and less induction of HOAs than 1.0 mm. Narrow CLDD should be considered in SMILE to increase the visual acuity particularly in the early postoperative period

Development of storage facility model for spent fuels of vver-1200 nuclear reactor and cost analysis

Nükleer güç santrallerinin kullanılmış yakıtlarının yönetiminde izlenebilecek iki yöntem mevcuttur. Kullanılmış yakıt yeniden işlenebilir veya jeolojik yapılarda bertaraf edilebilir. Ancak, günümüzde jeolojik bertaraf henüz gerçekleştirilemediği için kullanılmış yakıtlar uzun süreli depolanmaktadır. Bu çalışmada, dört adet VVER-1200 tipi reaktör ünitesi içeren bir nükleer güç santralinin işletilmesi sırasında oluşacak kullanılmış yakıtlar için depolama tesisi modeli geliştirilmiş ve iki farklı depolama senaryosunun uygulanması durumunda tesisin yaşam döngüsü maliyeti analiz edilmiştir. Çalışmanın ilk bölümünde, işletme ömrü boyunca santralden çıkarılacak kullanılmış yakıt miktarı belirlenmiştir. Daha sonra, hesaplanan kullanılmış yakıt envanterinin depolanması için bir depolama tesisi modeli geliştirilmiş ve depolama varilinin tipi, malzemesi, depolama alanı büyüklüğü gibi tesisin temel özellikleri belirlenmiştir. Son olarak, iki farklı depolama senaryosunun uygulanması durumunda “net şimdiki değer” ve “seviyelendirilmiş birim maliyet” yöntemleri kullanılarak tesis için yaşam döngüsü maliyet analizi yapılmıştır.There are two methods to be applied in the management of spent fuels of nuclear power plants. Spent fuel can be reprocessed or disposed of in geological formations. However, since the geological disposal has not been realized yet, spent fuels are stored for a long time. In this study, a storage facility model has been developed for spent fuels of a nuclear power plant containing four VVER-1200 units and life cycle cost analysis of the facility has been performed for two storage scenarios. In the first part of the study, the amount of spent fuel to be discharged from the plant during its operational life is determined. Then, a storage facility model is developed for the storage of estimated spent fuel inventory and basic characteristics of the facility such as storage cask type, material, storage area is determined. Finally, life cycle cost analysis of the facility is performed for two storage scenarios by using “net present value” and “levelised unit cost” methods

Usher syndrome associated with Fuchs’ heterochromic uveitis: a case report

We report a case of Usher syndrome in association with unilateral Fuchs’ heterochromic uveitis

Calprotectin levels in patients with rheumatoid arthritis to assess and association with exercise treatment

Rheumatoid arthritis (RA) is a chronic, inflammatory, and autoimmune disease that can cause permanent joint damage. In our study, we aim to analyze the change in calprotectin levels following the low-density exercise levels applied to the patients with RA. Twenty-eight patients with RA and 30 healthy controls were included in this study. To evaluate the activity of disease in RA, scores of disease activity that has increased (DAS-28) are figured. Calprotectin, nitric oxide (NO), white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and rheumatoid factor (RF) levels are tested as the laboratory evaluation. Calprotectin, NO, CRP, ESR, WBC, and RF levels were significantly higher in the patient group compared to the control group (p < 0.01, p < 0.001, p < 0.01, p < 0.01, p < 0.01, and p < 0.05, respectively). In correlation analysis applied to the patient group with RA, there has been determined a positive relation with calprotectin, and DAS-28, CRP, NO, RF, and WBC (p < 0.001, p < 0.05, p < 0.001, p < 0.05, and p < 0.05, respectively). In result of the low-density exercise treatment applied to patients with RA for 8 weeks, there has been determined a significant decrease in calprotectin, DAS-28, NO, CRP, ESR, and RF levels (p < 0.05, p < 0.001, p < 0.01, p < 0.05, p < 0.05, and p < 0.05, respectively). As a result, a significant relation is found between RA disease activity and calprotectin levels and other inflammatory parameters. At the same time, it shows that calprotectin which is a significant indicator of local inflammation can be used as a good identifier in following up exercise treatment

Children with Behçet Disease-associated Thrombosis: A Single-Center Experience

Behçet disease (BD) is a systemic vasculitis that can be complicated with thrombosis, which is an important cause of mortality and morbidity. The course of BD is more severe, and the diagnosis is usually delayed. In children, thrombosis associated with BD is very rare. In this study, we aimed to evaluate the characteristics of children with BD complicated with thrombosis. Forty-six patients with BD who were followed-up at a pediatric rheumatology department between January 2012 and September 2019 were evaluated retrospectively. Thrombosis was detected in 10 patients (21.7%), and it was the first sign of BD in 7 patients. Four patients had cerebral sinus venous thrombosis, 4 patients had deep-vein thrombosis, 1 patient had renal vein thrombosis, 1 had pulmonary artery thrombosis, and 1 had intracardiac thrombosis. None of the patients had arterial thrombosis. All patients had received anticoagulant therapy with immunosuppressive treatment. Any complication due to anticoagulant therapy was not detected. One patient had recurrent thrombosis, and none of the patients died during follow-up. Vasculitic diseases such as BD may cause a predisposition to thrombosis, and thrombosis might be the first sign of BD. Therefore, in children presenting with unprovoked thrombosis, BD should also be investigated. © 2021 Lippincott Williams and Wilkins. All rights reserved