Impression Cytology in Different Types of Contact Lens Users

This study compared tear function tests and cytologic changes on the conjunctival surface in asymptomatic patients wearing contact lens of different materials. Included in this study were 40 eyes wearing daily wear 4 week replacement hydrogel (H) lenses, 32 eyes wearing silicone hydrogel (SiH) lenses, 18 eyes wearing rigid gas-permeable (RGP) lenses, and 21 healthy eyes (no lenses) as the control group. Epithelial morphology of the conjunctival surface was evaluated, based on Nelson classification with conjunctival impression cytology (CIC), after the tear break-up time (TBUT) and Schirmer test were performed. The mean values of the Schirmer and TBUT tests were significantly higher in the control group than in the other lens groups (p < 0.001). Grade 0 was the most frequent CIC in the control group (66.7%) and least frequent in the SiH lens group (40.6%); grade I was least frequent in the control and RGP groups (33.3%) and most frequent in the SiH lens group (40.6%). Moreover, grade 2 was most frequent in the SiH lens group (18.8%). There was no statistically significant difference in goblet cell densities between the groups (p = 0.462). In addition to the different Schirmer and TBUT test results between contact lens wearers and healthy non-wearers, some cytologic changes may occur on the ocular surface with direct mechanical effects of contact lenses. This simple and noninvasive technique may be used to evaluate the ocular surface with regard to intolerance to contact lenses

Effects of 1% cyclopentolate hydrochloride on anterior segment parameters obtained with Pentacam in young adults

Purpose: To investigate the effects of topically applied 1% cyclopentolate hydrochloride on anterior segment parameters obtained with a Pentacam rotating Scheimpflug camera in healthy young adults. Methods: Anterior segment analyses of 25 eyes from 25 young adults (Group 1), before and after 45 min of 1% cyclopentolate hydrochloride application, were performed. For a control group (cycloplegia-free, Group 2), 24 eyes of 24 age- and sex-matched healthy cases were evaluated twice at 45 min intervals. The results obtained from the groups were compared statistically. Results: The mean ages of the groups were 23.04 ± 3.42 (range, 18-29) and 22.4 ± 2.05 (range, 18-27) years for Groups 1 and 2, respectively (p=0.259). In Group 1, measurements between the two analyses were significantly different for the values of anterior chamber depth (ACD), anterior chamber angle (ACA), and anterior chamber volume (ACV) (p<0.05), whereas no statistical difference was found for the central corneal thickness (CCT) and keratometry (K1, K2) measurements. In Group 2, none of these parameters were statistically different between the two analyses. Conclusions: Topically applied 1% cyclopentolate hydrochloride caused an increase in the ACD and ACV values, and a decrease in the ACA value. However, it had no significant effect on the CCT and keratometry measurements. It is important to consider these effects when using the Pentacam device on young adults with cycloplegia and when applying it for various reasons

Surgical Treatment Options According to Inferior Oblique Hyperfunction in Superior Oblique Palsy

Objective: To evaluate comparatively the outcomes of different types of operations performed according to clinical examination and distinct clinical types of the patients who were diagnosed as superior oblique palsy (SOP). Material and Methods: A total of 32 patients who were followed up in Strabismus Section of Cerrahpasa Medical Faculty Department of Ophtalmology were enrolled in the study and evaluated prospectively. Subjects were divided into four groups according to surgical techniques. The first group (n=12): Patients whose inferior oblique hyperfunction (IOH) was +++ underwent anterior transposition of the inferior oblique (ATIO). The second group (n=9): Patients whose IOH was + underwent 8 mm of inferior oblique recession (IOR), ++ underwent 10 mm of inferior oblique recession (IOR). The third group (n=6): Patients whose IOH was ++++ underwent inferior oblique myectomy (IOM). The fourth group (n=5): Patients who had superior oblique (SO) hypofunction without IOH and patients whose SO tendon was detected to be loose in forced duction test underwent 6-12 mm of SO tucking. Results: Of the subjects, 17 were males and 15 were females. Mean age was 16.41 +/- 11.91. The right eye was involved in 15 cases, the left eye was involved in 15 cases and two cases were involved bilaterally. Of the SOP cases, 24 were congenital and eight were acquired in origin. Six of the acquired SOP cases were related to trauma and two were related to intracranial tumor. A statistically significant decrease was detected in IOH in the first three groups compared to preoperative status (p<0.05). Abnormal head position decreased in four groups postoperatively but a statistically significant decrease was only seen in TOR group (p=0,031), however a statistically significant difference was not found in stereopsis (p=0.076). Conclusion: ATIO and IOM methods were found to have similar effectiveness in terms of IOH correction. Surgical treatment was found to be effective in eliminating abnormal head position in SOP however a significant difference was not found in stereopsis postoperatively. It was concluded that presence of < 12 prism dioptry horizontal strabismus accompany with SOP did not constitute a definite indication for performing surgery to the horizontal muscle in the first session that surgery was done on the vertical muscle

Late-term topical tacrolimus for subepithelial infiltrates resistant to topical steroids and ciclosporin secondary to adenoviral keratoconjunctivitis

Purpose Investigation of the efficacy and safety of 12 months of topical tacrolimus 0.03% ointment treatment against the subepithelial infiltrates (SEIs) due to adenoviral keratoconjunctivitis (AKC) resisting at least 2 years was aimed. Methods This case series included consecutive patients with SEIs secondary to AKC who were resistant to topical steroid and ciclosporin-A (CSA) treatment and treated with topical 0.03% tacrolimus (Protopic; Fujisawa Healthcare, Teva, Deerfield, Illinois, USA) for 12 months, at least 2 years after AKC. For the evaluation of treatment efficacy, best-corrected visual acuity (BCVA), Fantes score, corneal subepithelial infiltrate score (CSIS), Oxford score, Schirmer and tear breakup time results were evaluated. Intraocular pressure and complaints of the patients were followed for evaluating the safety profile of the treatment. The patients were followed after the baseline visit at the 1st, 3rd, 6th and 12th month. Results 15 eyes of 11 patients with SEIs and 16 eyes of 16 healthy controls were included in this study. 1 patient (9.1%) could not tolerate the treatment. Significant improvements in BCVA, CSIS, Fantes score and Schirmer results were observed in the study group starting from the 3rd-month visit, and the improvements persisted until the end of 12 months of treatment. Conclusion Topical 0.03% tacrolimus might show efficacy against the SEIs persisting at least 2 years despite corticosteroid and/or CSA treatment without any prominent side effect. While at least a period of 3 months was necessary for a significant improvement in the BCVA, SEIs and Schirmer results, a period of 6 months was necessary for a decrease in Oxford score

Peripapillary serous retinal detachment preceding complete posterior vitreous detachment

Purpose To report on a case of peripapillary serous detachment due to vitreopapillary traction during the development of posterior vitreous detachment