Gauge Transconjunctival Sutureless Vitrectomy in Eyes with Posteriorly Dislocated Intraocular Lens

Pur po se: To evaluate the efficacy and safety of 23-gauge (23G) pars plana vitrectomy (PPV) in dislocated intraocular lens (IOL) cases: In early- and late-term follow-up. Ma te ri al and Met hod: In this retrospective study, the medical records of 17 patients who underwent 23 G PPV treatment for dislocated IOL between January 2009 and June 2011 were analyzed. Detailed ophthalmologic examination was performed in all patients; intraoperative and postoperative complications were recorded. Re sults: In this study, mean follow-up time was 9.0 (4-22) months and mean age was 60.8 (8-82) years. Mean time after cataract surgery was variable (mean of 28.3 (0-80) months). Four patients had trauma history, five patients had pseudoexfoliation syndrome, and two patients had pathologic myopia. Dislocated IOL was placed into the sulcus in nine patients (52.9%). In two cases (11.7%), the IOLs were removed, and the patients were left aphakic. In two cases out of other 6 (11.7%), the dislocated IOL was changed with scleral fixation lens, whereas in the other four cases (23.5%), IOL was changed with iris claw lens. One patient (5.8%) remained at the same level of vision, while twelve (70.5%) cases increased two or more lines in BCVA. The vision was decreased in two cases. Intraocular pressure elevation controlled by medication was observed in one case. For two days, hypotony was observed in one patient. Dis cus si on: 23 G PPV technique is an effective and safe method for removing and repositioning of dislocated IOL in the vitreous. (Turk J Ophthalmol 2013; 43: 99-102

The Factors Affecting Success of Pneumatic Retinopexy in Treatment of Retinal Detachment

Objective: To present the factors that influence the suc­cess rate of pneumatic retinopexy on rhegmatogenous retinal detachment treatment. Methods: Ninety eyes of 29 female and 61 male patient were included to the study. The patient’s age, sex, du­ration of symptoms, the best corrected visual acuities (BCVA) on the time of application, lens status, preopera­tive retinal tear number and location, retinal detachment size, macular involvement, tamponade type, coexisting complications, and anatomic success rates were record­ed at preoperative, postoperative 3rd months and final examination. Results: Only one treatment session success number was 55 over 90 (61.1%) patients. Median preoperative, postoperative 3rd month and final examination Log­MAR BCVA values were 1.3, 0.5 and 0.5 respectively.(p=0.0001) Preoperative and postoperative other param­eters was not revealed significant differences with one treatment session. However there was a significant posi­tive correlation between the detachment size and ana­tomical success. (p=0.03, r=0.324) Conclusion: Pneumatic retinopexy is an alternative treat­ment option for the anatomical and functional success in retinal detachment at suitable patients. In our study the success rate was higher in patients with less than 3 clock dial retinal detachment patients

Prophylactic Selective Laser Trabeculoplasty in the Prevention of Intraocular Pressure Elevation After Intravitreal Triamcinolone Acetonide Injection

Demirok, Ahmet/0000-0001-8197-2458WOS: 000297714900011PubMed: 21861972PURPOSE: To evaluate the prophylactic efficacy of selective laser trabeculoplasty for preventing an increase in intraocular pressure (IOP) after intravitreal triamcinolone acetonide injection. DESIGN: Prospective, comparative, interventional case series. METHODS: We studied 31 eyes with a baseline TOP of 21 mm Hg or more of 31 patients for which intravitreal triamcinolone acetonide injection was planned for diabetic macular edema. The patients were divided into 2 groups, a study group and control group. The study group comprised 15 eyes of 15 patients that underwent selective laser trabeculoplasty a mean of 8.3 +/- 4.1 days before intravitreal triamcinolone acetonide injection. The control group comprised 16 eyes of 16 patients who underwent only intravitreal triamcinolone acetonide injection. Main outcomes measures were mean IOP and number of patients requiring antiglaucomatous therapy. RESULTS: Mean baseline IOP was 21.6 +/- 0.9 ram Hg in the study group and 21.5 +/- 0.8 mm Hg in the control group (P = .98). Mean IOP at 1 day after injection was 17.0 +/- 2.0 mm Hg in the study group and 19.5 +/- 4.3 mm Hg in the control group (P = .23). Mean IOP at 1 week after injection was 16.9 +/- 1.7 mm Hg and 18.4 +/- 4.0 mm Hg, respectively (P = .49); mean IOP at 1 month after injection was 16.4 +/- 1.5 mm Hg and 20.8 +/- 5.6 mm Hg, respectively (P = .003); mean IOP at 3 months after injection was 15.8 +/- 2.5 mm Hg and 18.3 +/- 5.5 mm Hg, respectively (P = .01); and mean IOP at 6 months after injection was 15.7 +/- 1.4 mm Hg and 17.1 +/- 1.5 mm Hg, respectively (P = .03). The number of patients requiring antiglaucomatous therapy during follow-up was 0 of 15 eyes in the study group and 8 of 16 eyes in the control group (P = .001). CONCLUSIONS: The IOP elevation after intravitreal triamcinolone acetonide injection may be prevented by performing selective laser trabeculoplasty before intravitreal triamcinolone acetonide injection, especially in cases with a baseline IOP of 21 mm Hg or more. (Am J Ophthalmol 2011;152:976-981. (C) 2011 by Elsevier Inc. All rights reserved.

Measurements of anterior segment parameters using three different non-contact optical devices in keratoconus patients

<b>AIM:</b> To evaluate the measurements of anterior segment parameters using three different non-contact optical devices in keratoconus patients.<b>METHODS:</b>A hundred and one eyes of 55 keratoconus patients were enrolled in this study. The mean age was 26.2±8.9 years. The inclusion criteria were keratoconus stage I to III according to the Amsler-Krumeich keratoconus classification. All the measurements were done by the same operator, under the mesopic light condition and repeated with three different optical methods; Visante , Orbscan and Pentacam. The evaluated anterior segment parameters were anterior chamber depth (ACD), central and thinnest corneal thickness (CCT and TCT) and pupil diameter (PD).<b>RESULTS:</b> The mean CCT measured by Visante, Orbscan and Pentacam were as follows:462.0±48.1µm, 463.9±60.9µm, 476.5±45.3µm, respectively (<i>P</i>=0.873). The mean ACD values were 3.34±0.33mm, 3.26±0.33mm, 3.49±0.40mm, respectively (<i>P</i>=0.118). The mean PD measurements were 5.11±1.14mm, 4.80±0.85mm, 3.80±1.38mm, respectively (<i>P</i><0.001). The mean TCT measurements of Visante, Orbscan and Pentacam were 437.9±48.2µm, 447.6±60.6µm and 459.9±44.0µm, respectively (<i>P</i>=0.214). The Visante and Orbscan measured CCT similarly, while Pentacam measured CCT thicker than the other two. The Visante measured TCT thinner than the other two devices. In ACD measurements, Orbscan was the one giving the lowest values. PD was measured differently by the devices.<b>CONCLUSION:</b> Although TCT, CCT and ACD measurements acquired by Visante, Orbscan and Pentacam in keratoconus patients are similar, PD measurements show large differences among the devices

Intravitreal Ranibizumab Therapy in Wet Type Macular Degeneration

Objectives: To evaluate the efficacy and safety of intravitreal ranibizumab treatment in all types of choroidal neovascularization that developed secondary to age-related macular degeneration. Materials and Methods: We enrolled ninety-four eyes of 92 patients with previously untreated neovascular age-related macular degeneration who underwent intravitreal ranibizumab injection and were followed for at least 12 months. All of the patients underwent a complete examination, including best-corrected visual acuity (BCVA) (Snellen), biomicroscopy, and dilated fundus examination at preoperatively and postoperative follow-up visits. Number of injections and frequency of follow-up visits per year were evaluated. Size, location, and type of the lesions were evaluated by fluorescein angiography (FA). Pre- and postoperative changes in lesion size, central macular and foveal thickness measured by OCT were compared. Results: A total of 92 patients (36 women and 56 men) with a mean age of 69.1±11.0 years were evaluated. Mean follow-up time was 14.6±3.44 (12-25) months, and mean number of injections was 4.9±1.81 (3-12). The average annual number of follow-up visits was 9.2±1.02 (8-12). Patients’ mean best-corrected visual acuity increased by 12.1 letters. The lesion size was 3.27±0.95 µm at pre-treatment period and improved to 2.72±1.15 µm in post-treatment period measured by FA (p=0.006). Leakage was still detected in ten patients at final follow-up visit. Statistically significant decrease in macular and foveal thickness was recorded in all post-treatment measurements compared to pre-treatment ones. Conclusion: Intravitreal ranibizumab treatment is efficient and safe in all types of choroidal neovascularization that develops secondary to age-related macular degeneration. Flexible dosing interval increases the patient compliance and anatomical and functional success rate. (Turk J Ophthalmol 2014; 44: 356-60

Melatonin reduces oxidative stress in the rat lens due to radiation-induced oxidative injury

TAYSI, Seyithan/0000-0003-1251-3148; KOC, MEHMET/0000-0003-1504-2900; yilmaz, adnan/0000-0001-9769-9791WOS: 000260573400003PubMed: 18979314Purpose: The aim of this study was to evaluate the antioxidant role of melatonin against radiation-induced cataract in the rat lens after total cranial irradiation with a single 5 Gray (Gy) dose of gamma irradiation. Materials and methods: Twenty-eight Sprague-Dawley rats were used for the experiment.The rats were randomly divided into four equal groups. The control group did not receive melatonin or irradiation but received both 0.1ml physiological saline intraperitoneally and sham irradiation. The irradiation (IR) group received 5 Gy gamma irradiation to the total cranium as a single dose plus 0.1ml physiological saline intraperitoneally. The melatonin plus IR group received irradiation to the total cranium plus 5mg/kg/day melatonin intraperitoneally. The melatonin group received only 5mg/kg/day melatonin plus sham-irradiation. Biochemical parameters measured in murine lenses were carried out using spectrophotometric techniques. Results: Lens antioxidant capacity, as measured by levels of total superoxide scavenger activity (TSSA), non-enzymatic superoxide scavenger activity (NSSA) and glutathione reductase (GRD) activity, significantly increased in melatonin, control and melatonin plus IR groups when compared with the IR group. Lens glutathione-S-transferase (GST) activity significantly increased in control and melatonin groups when compared with the IR group. Lens malondialdehyde (MDA) levels significantly increased in the IR group when compared with control, melatonin and melatonin plus IR groups. Lens TSSA and NSSA activities significantly decreased in control and melatonin plus IR groups when compared with the melatonin group. Lens GST activity significantly increased in the control group when compared with melatonin plus IR group. Lens GRD activity significantly increased in melatonin and melatonin plus IR groups when compared with control group. Conclusions: Melatonin reduces oxidative stress markers and augments anti-oxidant capacity in the rat lens

The Efficacy of Intravitreal Bevacizumab in Vitreous Hemorrhage of Diabetic Subjects

Objectives: To evaluate the efficacy of intravitreal bevacizumab (IVB) in the resolution of vitreous hemorrhage (VH) secondary to proliferative diabetic retinopathy (PDR). Materials and Methods: Seventy eyes of 70 patients (43 male, mean age 55.6±12.2 years) diagnosed with VH secondary to PDR were evaluated retrospectively. Demographic characteristics of the patients, baseline and final clinical results, and the interventions the patients were subject to were recorded. The patients who received IVB injections (group 1, n=29) were compared to those who did not receive injections (group 2, n=41) in terms of VH clearance time and surgery rates. Results: The mean follow-up time was 14.5±6.1 months in group 1 and 18.4±9.6 months in group 2 (p=0.185). The mean visual acuity was similar between the groups at baseline and at the last visit (for all p>0.05). Panretinal photocoagulation could be applied in 86% of subjects in group 1 and in 58% in group 2 within the first month (p=0.016). VH clearance time was not different between the groups (2.3±2.1 months in group 1 and 3.4±2.6 months in group 2, p=0.146). The number of subjects requiring surgery was 7 (24%) in group 1 and 20 (48.8%) in group 2 (p=0.048). Conclusion: IVB was found effective in cases with VH secondary to PDR in terms of reducing the need for surgery and increasing the rate of subjects to whom panretinal photocoagulation could be applied in the early period, although there was no impact on final visual acuity