Late-Onset Glaucoma-Filtrating Bleb Leak in a Penetrating Keratoplasty Patient: A Case Report

Introduction. Late-onset bleb leaks occur more frequently after the use of adjunctive antimetabolites and require surgical management to seal and preserve filtrating bleb. Case Presentation. A 48-year-old female presented with decreased visual acuity for five days in her left eye. She had a left penetrating keratoplasty one year earlier and two trabeculectomies 7 years earlier. Visual acuity was hand motions, intraocular pressure was 3 mmHg, corneal graft was clear, mature cataract was present, and axial length was 30.48 mm. The conjunctiva covering the superotemporal sclerotomy was avascular, flat, and partially lost. After heavily painting the bleb with a fluorescein, late-onset point leak was revealed. Overlying conjunctiva was excised. The atrophic, irregular, and partially absent scleral flap was covered by a processed human pericardium graft and conjunctival advancement. Postoperatively, intraocular pressure stabilized around 16 mmHg. After four months, phacoemulsification and intraocular lens implantation were performed. Visual acuity did not exceed 0.1 (in decimal notation) due to degenerative myopia-related macular atrophy. Corneal graft remained clear at her 6-month followup period. Conclusion. Surgical bleb revision using a pericardium graft and conjunctival advancement seems to be an effective method for treating late bleb leaks. However, careful follow-up is required for detecting recurrent leaks and elevated intraocular pressure

Changing indications and techniques for corneal transplantations at a tertiary referral center in Turkey, from 1995 to 2014

BACKGROUND: Indications for corneal transplantation in developed and developing nations differ according to the different spectrum of corneal disease in each country. OBJECTIVE: The purpose of this study is to analyze the changing indications and surgical techniques for corneal transplantation over the past 20 years at a tertiary referral center in Turkey. METHODS: We retrospectively reviewed the records of patients who underwent keratoplasty from January 1995 to December 2014 (between 1995 and 2004, period 1, and between 2005 and 2014, period 2). Patients’ demographic data, indications for corneal transplantation, and the type of surgery were recorded. RESULTS: The number of keratoplasties performed ranged from 548 in period 1 to 782 in period 2. Between 1995 and 2004, the leading indications were keratoconus (34.1%), bullous keratopathy (17%), and non-herpetic corneal scar (13.3%), and between 2005 and 2014, they were keratoconus (33.8%), corneal stromal dystrophy (14.2%), and bullous keratopathy (12.7%). All the keratoplasties performed in the 1995–2004 period were penetrating keratoplasty (PKP). During the period 2005–2014, PKP accounted for 93%, automated lamellar keratoplasty 5.8%, and deep anterior lamellar keratoplasty 1.2% of all corneal transplantations. CONCLUSION: Keratoconus was the leading indication for keratoplasty in both periods. In the 2005–2014 period, corneal stromal dystrophy increased significantly. All the keratoplasties performed in period 1 and 93% of all keratoplasties performed in period 2 were PKP

Pattern Visual Evoked Potential Changes in Diabetic Patients without Retinopathy

Purpose. To assess the different check sizes of pattern visual evoked potential (PVEP) in diabetic patients without retinopathy according to HbA1c levels and diabetes duration. Methods. Fifty-eight eligible patients with type 2 diabetes mellitus and 26 age- and sex-matched healthy controls were included in the study. Only the right eye of each patient was analyzed. All of the patients underwent a comprehensive ophthalmic examination, and the PVEPs were recorded. Results. There was a statistically significant difference in P100 latency in 1-degree check size and in N135 latency in 2-degree check size between controls and patient groups which have different HbA1c levels. There were statistically significant, positive, and weak correlations with diabetes duration and P100 latency in 7-minute and 15-minute check sizes and N135 latency in 15-minute check size. Conclusions. It was showed that there were prolongations in P100 latency only in 1-degree check size and in N135 only in 2-degree check size in diabetic patients without retinopathy. There was statistically significant correlation between diabetes duration and P100 and N135 latencies in different check sizes

The outcomes of 326 external dacryocystorhinostomy operations in children with dacryostenosis - 30-year experience of an oculoplastic surgeon

ABSTRACT Purpose: To report demographic features and surgical outcomes of 320 children undergoing external dacryocystorhinostomy for dacryostenosis. Methods: We performed a retrospective evaluation of the records of patients aged <16 years who underwent external dacryocystorhinostomy. Patient demographic features and success rates of the operations were analyzed from the data records. Children with <12-month follow-up were not enrolled in the study. Results: We identified 326 operative records of 320 children (162 [50.6%] girls and 158 [49.4%] boys) who underwent external dacryocystorhinostomy with a mean follow-up of 26.03 ± 11.11 months. Overall, we evaluated 116 (35.6%) cases of congenital nasolacrimal duct obstruction. Our series demonstrated a 99.4% success rate for external dacryocystorhinostomy. Conclusions: External dacryocystorhinostomy in children has a high success rate if performed by an experienced oculoplastic surgeon

Review of 306 evisceration surgeries performed between 2005 and 2013

Background/aim: The purpose of the present study was to evaluate the reasons for eye evisceration surgeries performed from 2005 to 2013 in our clinic