Effect of Systemic Infliximab Therapy in Patients with Sjögren’s Syndrome

Objectives: To investigate the effect of systemic infliximab therapy on tear function tests and the ocular surface in patients with Sjögren’s syndrome secondary to various autoimmune diseases. Materials and Methods: This prospective study included 22 eyes of 22 patients with Sjögren’s syndrome who began treatment with systemic infliximab. Tear film break-up time (TBUT), anesthetized Schirmer’s 1 test, fluorescein staining test, and Ocular Surface Disease Index (OSDI) scores were recorded before treatment and in the 3rd and 6th months of treatment. Results: In the 3rd month of infliximab therapy, no significant changes were observed in Schirmer’s values, TBUT, fluorescein staining, or OSDI scores (p=0.260, p=0.357, p=0.190 and p=0.07, respectively). In the 6th month of infliximab therapy, no significant changes were observed in TBUT, fluorescein staining, Schirmer’s value or OSDI scores (p=0.510, p=0.320, p=0.220 and p=0.344, respectively). Conclusion: Infliximab therapy, which is commonly used in systemic autoimmune diseases such as rheumatoid arthritis, Crohn’s disease, ulcerative colitis, and ankylosing spondylitis, did not show a positive effect on ocular surface and tear function tests. (Turk J Ophthalmol 2015; 45: 138-141

The Effects of Nd: YAG Laser Capsulotomy on Visual Acuity, Macular Thickness, and Intraocular Pressure in Diabetic Patients

Objectives: To compare macular thickness, best-corrected visual acuity (BCVA), and intraocular pressure (IOP) changes after Nd: YAG laser capsulotomy for posterior capsule opacification (PCO) in diabetic and non-diabetic eyes. Materials and Methods: Thirty-six eyes of 25 diabetic patients and 40 eyes of 25 non-diabetic patients were included. All patients was treated with Nd: YAG laser capsulotomy. Macular thickness measured by optical coherence tomography (OCT), IOP, and BCVA were evaluated before and 1 week, 1 month, and 3 months after the procedure. Results: There was no difference between the two groups in age, gender, and applied laser technique. The time interval between cataract surgery and laser capsulotomy was shorter in the group of diabetic patients (p=0.009). In both groups, BCVA was significantly increased 1 week after laser capsulotomy (respectively, p=0.023, p=0.016). However, there was no statistically significant difference between the two groups. There was no significant difference in macular thickness before and after the procedure between the two groups (p>0.05). However, in group 1, cystoid macular edema was observed in 2 eyes during follow-up. Despite prophylactic treatment, IOP remained around 21-30 mmHg in 3 patients in group 1 and 4 patients in group 2 at first day and at the end of the 1st week. IOP was controlled except in one glaucoma patient. In the two groups, IOP values before and after laser capsulotomy were not statistically significantly different (p>0.05). At first day, +2 cells in the anterior chamber were detected in 3 patients in group 1 and in 2 patients in group 2; at 1 week after routine topical steroid treatment, anterior chamber reaction was not observed. Conclusion: It is known that there is a breakdown in the blood-aqueous and inner blood-retinal barriers in diabetes, however, no difference was determined in visual improvement, macular thickness, and IOP when comparing diabetic to non-diabetic eyes. We observed that Nd: YAG laser capsulotomy is a safe and effective method for posterior capsular opacification in diabetic and non-diabetic patients. (Turk J Ophthalmol 2015; 45: 47-51

Canine Tooth Syndrome

After radiological imaging analysis, a mass extending into the orbit was detected in a 10-year-old girl with complaints of swelling and protrusion in the right eye. The mass was excised by the neurosurgery department through transcranial approach and found to be ossifying fibroma in histopathological examination. The case, presenting with head position and diplopia as well as trochlear swelling in physical examination in the postoperative first week, was diagnosed with canine tooth syndrome developing after surgical trauma. (Turk J Ophthalmol 2012; 42: 163-

Outcomes of Phacoemulsification with Anterior Chamber Maintainer in Vitrectomized Eyes

Pur po se: To evaluate the outcomes of phacoemulsification with anterior chamber maintainer in vitrectomized eyes with complicated cataract. Ma te ri al and Met hod: Twenty eyes of 20 patients who developed complicated cataract after pars plana vitrectomy (PPV) were included in the study. Phacoemulsification with clear corneal incision and foldable intraocular lens implantation was performed. In group 1, anterior chamber maintainer (ACM) was used during phacoemusification and in group 2, ACM was not used. Pre- and postoperative visual acuities as well as per- and postoperative complications were reviewed retrospectively. Re sults: Anterior chamber maintainer was used during the surgery in 12 (60%) cases and was not used in 8 (40%) cases. Phacoemulsification was performed 16.5±9.2 (4-40) months after PPV. Best-corrected visual acuities were between hand motions and 0.4 preoperatively and between counting fingers from 1 meter and 1.0 postoperatively in group 1. Best-corrected visual acuities were between hand motions and 0.1 preoperatively and between counting fingers from 1 meter and 0.8 postoperatively in group 2. Posterior capsule was ruptured in 1 eye peroperatively in group 1. In group 2, phacoemulsification was more difficult due to deep anterior chamber in 8 eyes and intraoperative complications were iris sphincter rupture in 1 eye and posterior capsule rupture in 1 eye. Mild corneal edema in 7 (58.3%) eyes, fibrin reaction in 2 (16.6%), intraocular lens decentralization in 1 (8.3%) and posterior capsule opacification in 4 (33.3%) eyes were the postoperative complications in group 1. Mild corneal edema in 5 (62.5%) eyes, fibrin reaction in 1 (12.5%) and posterior capsule opacification in 2 (25%) eyes were the postoperative complications in group 2. Dis cus si on: Complicated cataracts which may develop after PPV can be treated safely with phacoemulsification. Continuous irrigation during the surgery may provide a stable anterior chamber and prevents surgical complications. (Turk J Ophthalmol 2012; 42: 253-6

Marginal Zone B-Cell Lymphoma of the Lacrimal Gland Secondary to Sjogren’s Syndrome

Sjogren’s syndrome is a chronic, autoimmune, inflammatory disease which can affect all exocrine glands, particularly the salivary and lacrimal glands, causing dryness of the mouth and eyes. The most serious complication is the development of lymphoma. In this article, we aimed to present a very rare case of marginal zone B-cell lymphoma in the lacrimal gland secondary to Sjogren’s syndrome. (Turk J Ophthalmol 2014; 44: 322-4

Yag Laser hyaloidotomy and pars plana vitrectomy in tersons syndrome

Kafa içi kanamalar (subaraknoid/subdural) ve yüksek kafa içi basıncına ikincil gelişen göz içi kanamalar (vitre içi/retinal/ preretinal) Terson sendromu olarak tanımlanmaktadır. Bu çalışmada, subdural kanamaya ikincil subhyaloid hemoraji gelişen ve Nd:YAG lazer hyaloidotomi ile tedavi edilen bir olgu ile; subaraknoid kanamaya ikincil yoğun vitre içi hemora- jisi olan ve pars plana vitrektomi uygulanan bir olgu sunulmaktadır. Tedavi öncesi her iki olgunun görme keskinliği de el hareketleri düzeyinde iken; tedavi sonrasında 0.9 düzeyindeydi. Girişimler sırasında ya da sonrası takiplerinde herhangi bir komplikasyon gözlenmedi.Tersons syndrome is an intraocular hemorrhage (intravitreal/retinal/preretinal) that occurs after intracranial hemorrhages (subdural/subarachnoid). In this study, a case of subhyaloid hemorrhage secondary to subdural hemorrhage treated by Nd:YAG laser hyaloidotomy and a case of dense intravitreal hemorrhage secondary to subarachnoid hemorrhage treated by vitrectomy are presented. Visual acuities were hand motions before treatment; and 0.9 after treatment for both of two cases. There was no complication during the procedures and at postoperative follow-up

Cerrahisi Phacoemulsification in Eyes with Cataract and Corneal Opacity

Amaç: Kataraktı ve beraberinde kornea opasitesi olan gözlerde fakoemülsifikasyon (FE) cerrahisinin intraoperatif zorluklarını ve postoperatif sonuçlarını değerlendirmek. Gereç ve Yöntem: Ocak 2010-Ocak 2013 tarihleri arasında kataraktı ve beraberinde korneal opasitesi olan, kliniğimizde FE cerrahisi uygulanmış 22 olgunun 22 gözü geriye dönük olarak incelendi. Olgular yaş, cinsiyet, korneal opasite etyolojisi, preoperatif ve postoperatif en iyi düzeltilmiş görme keskinlikleri, cerrahi sırasında ve sonrasında oluşan komplikasyonlar açısından değerlendirildi. Bulgular: Olguların 8sı (%36.3) kadın, 14ü (%63.7) erkek olup yaş ortalaması 81.3±5.6 yıl (66-89) idi. Ameliyat sonrası ortalama takip süresi 9 (5-12) aydı. Kornea opasitesi 12 (%54.5) gözde keratite, 5 gözde (%22.7) travmaya, 5 gözde (%22.7) geçirilmiş pterjium cerrahisine ikincil olarak gelişmişti. Ameliyat sırasında 12 gözde kapsüloreksis öncesi %0.1lik tripan mavisi kullanıldı ve tüm olgularda kapsüloreksis başarıyla tamamlandı. Ameliyat sonrası olguların 17 sinde (%77.2) kornea ödemi, 6sında (%27.2) medikal tedaviye yanıt veren geçici göz içi basınç artışı gelişti. Olguların ameliyat öncesi görme keskinliği 3.10-0.70 LogMAR arasında iken, ameliyat sonrası en son kontrolde 1.51-0.30 LogMAR idi. Ortalama görme keskinliği düzeyleri ameliyat öncesi 1.38±0.76 LogMAR iken, en son kontrolde 0.74±0.58 LogMAR idi. Görme keskinliği cerrahi sonrası 4 gözde (%18.2) değişim göstermezken, 18 gözde (%81.8) artış gösterdi. Sonuç: Kataraktı ve beraberinde kornea opasitesi olan gözlerde sadece FE cerrahisi ile bile işlevsel görsel sonuçlar elde edilebilir.Purpose: To evaluate the intraoperative difficulties and postoperative outcome following phacoemulsification surgery in eyes with cataract and corneal opacity. Material and Methods: Records of 22 eyes of 22 patients who underwent phacoemulsification surgery for cataract and corneal opacity between January 2010-2013 were reviewed retrospectively. Age, gender, etiology of corneal opacities, preoperative and postoperative best corrected visual acuity, intraoperative and postoperative complications were evaluated. Results: The mean age of the patients (14 male, 8 female) was 81.3±5.6 (66-89) years. Mean follow-up time was 9 (5-12) months postoperatively. The corneal opacity was a result of healed keratitis in 12 (54.5%) eyes, trauma in 5 (22.7%) eyes, and pterygium surgery in 5 (22.7%) eyes. Trypan blue (0.1%) was used in 12 eyes during the surgery and capsulorhexis was completed succesfully in all eyes. Corneal edema in 17 (77.2%) eyes and transient intraocular pressure increase in 6 eyes (27.2%) were noted as postoperative complications. Pre- and postoperative mean best corrected visual acuities were 1.38±0.76 LogMAR and 0.74±0.58 LogMAR respectively. Visual acuity improved in 18 eyes (81.8%) and remained same in 4 eyes (18.2%). Conclusion: Ambulatory and useful vision can be achieved by phacoemulsification surgery in eyes with cataract and corneal opacit