Clinical Study The Role of Epiretinal Membrane on Treatment of Neovascular Age-Related Macular Degeneration with Intravitreal Bevacizumab

. Purpose. To determine the effect of epiretinal membranes (ERM) on the treatment response and the number of intravitreal bevacizumab injections (IVB) in patients with neovascular age-related macular degeneration (nAMD). Methods. A retrospective chart review was performed on 63 eyes of 63 patients. The patients were divided into AMD group ( = 35) and AMD/ERM group ( = 28). Best corrected visual acuity (BCVA) and central retinal thickness (CRT), as well as the number of injections, were evaluated. Results. There was a significant improvement in BCVA at 3 months for the AMD and AMD/ERM groups ( = 0.02, = 0.03, resp.). At 6, 12, and 18 months, BCVA did not change significantly in either of the groups compared to baseline ( > 0.05 for all). At 3, 6, 12, and 24 months, the AMD group had an improvement in BCVA (logMAR) of 0.09, 0.06, 0.06, and 0.03 versus 0.08, 0.07, 0.05, and 0.03 for the AMD/ERM group ( = 0.29, = 0.88, = 0.74, = 0.85, resp.). A significant decrease in CRT occurred in both groups for all time points ( < 0.001 for all). The change in CRT was not statistically different between the two groups at all time points ( > 0.05 for all). The mean number of injections over 24 months was 8.8 in the AMD group and 9.2 in the AMD/ERM group ( = 0.76). Conclusion. During 24 months, visual and anatomical outcomes of IVB in nAMD patients were comparable with those in nAMD patients with ERM with similar injection numbers

The effect of anterior segment parameters on surgical success of Descemet membrane endothelial keratoplasty: a prospective study

Purpose To investigate how anterior segment parameters affect the success of Descemet membrane endothelial keratoplasty (DMEK) in patients with endothelial insufficiency without stromal opacities and to identify factors predisposing them to repeat keratoplasty. Methods Our prospective observational study included patients who underwent primary DMEK for Fuchs' endothelial dystrophy and pseudophakic bullous keratopathy between March 2019 and March 2020. After a detailed ophthalmologic examination, corneal topographic analysis, anterior segment optical coherence tomography (AS-OCT) scans, endothelial cell density (ECD) and axial length (AL) measurements were performed. Surgical success was defined as no endothelial dysfunction during follow-up. Changes in the parameters and how preoperative parameters affect surgical success were investigated. Results In 43 eyes of 43 patients (mean age: 68.58 +/- 8.51 years), mean visual acuity was 1.73 +/- 0.74 LogMAR before DMEK and 0.31 +/- 0.29 LogMAR in the final visit. Central corneal thickness (CCT, p = 0.026) and mean anterior chamber depth (ACD, p = 0.001) affected surgical success. Preoperative CCT values greater than 770 mu m increased the risk of repeat keratoplasty by 8.75-fold, whereas preoperative ACD values less than 2.5 mm increased the risk by 2.92-fold. Conclusion Preoperative higher CCT and lower ACD values were associated with surgical failure after DMEK. Early surgery may be considered for more successful results

Effect of Fluorometholone/Tetrahydrozoline Fixed Combination on Conjunctival Autograft Morphology after Primary Pterygium Excision

Purpose. To evaluate the effect of a fluorometholone/tetrahydrozoline fixed combination on conjunctival graft morphology after primary pterygium excision. Methods. The patients who underwent pterygium excision with conjunctival autograft transplantation were randomized into three groups based on postoperative medications as the fluorometholone/tetrahydrozoline group, fluorometholone group, and dexamethasone group. Conjunctival graft thickness was measured with anterior segment optical coherence tomography. The conjunctival graft hyperemia was evaluated using a high definition external camera. Results. The mean graft thickness was significantly lower in the fluorometholone/tetrahydrozoline group compared with fluorometholone and dexamethasone groups at 2 weeks (P=0.002 and P=0.012, resp.) and at 1 month after surgery (P=0.003 and P=0.013, resp.). The conjunctival hyperemia score was significantly lower in the fluorometholone/tetrahydrozoline group compared with fluorometholone and dexamethasone groups at 2 weeks (P=0.000 and P=0.000, resp.) and at 1 month (P=0.039 and P=0.040, resp.). The graft thickness and conjunctival hyperemia score were similar among the groups at 1 week and 3 months (P>0.05). Conclusion. The findings of the present study revealed that treatment with the fluorometholone/tetrahydrozoline fixed combination may be helpful to decrease graft edema and to achieve better cosmetic appearance at 2 weeks and 1 month after pterygium excision

Evaluation of Corneal Topography and Biomechanical Parameters after Use of Systemic Isotretinoin in Acne Vulgaris

Purpose. We report the effect of isotretinoin on corneal topography, corneal thickness, and biomechanical parameters in patients with acne vulgaris. Method. Fifty-four eyes of 54 patients who received oral isotretinoin for treatment of acne vulgaris were evaluated. All patients underwent a corneal topographical evaluation with a Scheimpflug camera combined with Placido-disk (Sirius), ultrasonic pachymetry measurements, and corneal biomechanical evaluation with an ocular response analyzer at baseline, in the 1st, 3rd, and 6th months of treatment, and 6 months after isotretinoin discontinuation. Results. The thinnest corneal thickness measured with Sirius differed significantly in the 1st, 3rd, and 6th months compared with the baseline measurement; there was no significant change in ultrasonic central corneal thickness measurements and biomechanical parameters (corneal hysteresis and corneal resistance factor) throughout the study. Average simulated keratometry and surface asymmetry index increased significantly only in the first month of treatment according to the baseline. All changes disappeared 6 months after the end of treatment. Conclusion. Basal tear secretion and corneal morphologic properties were significantly influenced during the systemic isotretinoin treatment and the changes were reversible after discontinuation. No statistical important biomechanical differences were found to be induced by isotretinoin

Topographic and Biomechanical Evaluation of Corneas in Patients With Ocular Rosacea

Purpose: To compare the topographic and biomechanical properties of corneas in the eyes of patients with ocular rosacea (OR) with those of healthy individuals

Evaluation of Corneal Topography and Biomechanical Parameters after Use of Systemic Isotretinoin in Acne Vulgaris

Purpose. We report the effect of isotretinoin on corneal topography, corneal thickness, and biomechanical parameters in patients with acne vulgaris. Method. Fifty-four eyes of 54 patients who received oral isotretinoin for treatment of acne vulgaris were evaluated. All patients underwent a corneal topographical evaluation with a Scheimpflug camera combined with Placido-disk (Sirius), ultrasonic pachymetry measurements, and corneal biomechanical evaluation with an ocular response analyzer at baseline, in the 1st, 3rd, and 6th months of treatment, and 6 months after isotretinoin discontinuation. Results. The thinnest corneal thickness measured with Sirius differed significantly in the 1st, 3rd, and 6th months compared with the baseline measurement; there was no significant change in ultrasonic central corneal thickness measurements and biomechanical parameters (corneal hysteresis and corneal resistance factor) throughout the study. Average simulated keratometry and surface asymmetry index increased significantly only in the first month of treatment according to the baseline. All changes disappeared 6 months after the end of treatment. Conclusion. Basal tear secretion and corneal morphologic properties were significantly influenced during the systemic isotretinoin treatment and the changes were reversible after discontinuation. No statistical important biomechanical differences were found to be induced by isotretinoin

Photorefractive keratectomy in the correction of astigmatism using Schwind Amaris 750s laser

AIM: To evaluate the results of three photorefractive keratectomy (PRK) procedures in the treatment of astigmatism.METHODS: In this retrospective comparative case series, 89 eyes of 50 patients who underwent PRK treatment for astigmatism were enrolled. The patients were divided into 3 groups based on the PRK procedure: Group 1: PRK without mitomycin-C (MMC) application, Group 2: PRK with MMC application, and Group 3: Trans-Photorefractive Keratectomy (T-PRK). The efficacy, safety, predictability, and complications of treatment were assessed at 1, 3 and 6 months after the treatment.RESULTS: At postoperative 6 months, the percentage of postoperative uncorrected visual acuity (UCVA) of 20/20 or better was 55.6% (20 eyes) in group 1, 75% (15 eyes) in group 2, and 75.8% (25 eyes) in group 3 (P=0.144). The percentage of postoperative best corrected visual acuity (BCVA) of unchanged or gained ≥1 lines was 80.6% (29 eyes) in group 1, 70% (14 eyes) in group 2, and 90.9% (30 eyes) in group 3 (P=0.151). The percentage of postoperative BCVA of lost ≥2 lines was 11.1% (4 eyes) in group 1, 20% (4 eyes) in group 2, and 6.1% (2 eyes) in group 3. The mean manifest refractive spherical equivalent (MRSE) and mean cylindrical refraction were not significantly different among the each groups (P>0.05). At postoperative 6 months, the percentage of MRSE of within ±0.50 D was 100% (36 eyes) in Group 1, 100% (20 eyes) in Group 2, and 93.9% (31 eyes) in Group 3. At the each follow-up period, there was no significant difference in number of eyes with haze and mean haze score(P>0.05).CONCLUSION: The study showed that PRK without MMC, PRK with MMC and T-PRK appears to have similar effectiveness, safety and predictability in the treatment of astigmatism. The incidence of haze was also similar between the three groups