The impact of prism adaptation test on surgical outcomes in patients with primary exotropia

WOS: 000354400400006PubMed ID: 25476463BackgroundWe aimed to determine the impact of the preoperative prism adaptation test (PAT) on surgical outcomes in patients with primary exotropia. MethodsThirty-eight consecutive patients with primary exotropia were enrolled. Pre-operative PAT was performed in 18 randomly selected patients (Group 1). Surgery was based on the angle of deviation at distance measured after PAT. The remaining 20 patients in whom PAT was not performed comprised Group 2. Surgery was based on the angle of deviation at distance in these patients. Surgical success was defined as ocular alignment within eight prism dioptres (PD) of orthophoria. ResultsSatisfactory motor alignment ( 8 PD) was achieved in 16 Group 1 patients (88.9 per cent) and 16 Group 2 patients (80 per cent) one year after surgery (p = 0.6; chi-square test). There were no statistically significant differences in demographic parameters, pre-operative and post-operative angle of deviation between the two groups (p > 0.05; Mann-Whitney U and chi-square tests). Nine patients in Group 1 (50 per cent) and two patients in Group 2 (10 per cent) had increased binocular vision one year post-operatively. A statistically significant difference was determined in terms of change in binocular single vision between the two groups (p = 0.01; chi-square test). ConclusionAlthough the prism adaptation test did not lead to a significant increment in motor success, it may be helpful in achieving a more favourable functional surgical outcome in patients with primary exotropia

Impact of prolonged face mask wearing on tear break-up time and dry eye symptoms in health care professionals

Purpose To evaluate the impact of prolonged surgical face mask wearing on dry eye symptoms and tear film break-up time (T-BUT) in health care professionals. Materials and methods A total of 33 health care professionals were included in the present cross sectional prospective study. In addition to a complete ophthalmological examination T-BUT measurements were performed twice for all participants in the morning (8 am) and in the afternoon (5 pm). The subjects also filled-in the ocular surface disease index (OSDI) questionnaire twice, before and after wearing the face mask, on the same day. Results Sixty-six eyes of 33 participants (17 female and 16 male) were evaluated. The mean age was 33.6 +/- 7.55 (24-48) years and mean total duration with mask on between the two evaluations was 514 +/- 12.5 (495-526) minutes. The mean T-BUT was 9.3 +/- 1.0 (3-16) seconds at 8 am and 8.3 +/- 1.5 (3-14) seconds at 5 pm (p = 0.01). The mean OSDI score was 20.1 +/- 8.3 (0-68.75) at 8 am and 27.4 +/- 10.4 (0-81.25) at 5 pm (p 0.01). Conclusion Use of a surgical mask for the entire work-day was seen to worsen T-BUT and increase dry eye symptoms in healthy individuals. Ophthalmologists should be aware of the possibility of worsening of dry eye symptoms with the prolonged use of surgical face masks and consider modifications if necessary

Bilateral acute iris transillumination: Case report

WOS: 000383720500009PubMed ID: 27330389Bilateral acute iris transillumination (BAIT) is a recently defined disease characterized with bilateral acute, severe pigment dispersion of iris and pupil sphincter paralysis. The etiopathogenesis of the disease is unknown, but antibiotics such as moxifloxacin, clarithromycin, viral infections, and fumigation therapies were considered as probable etiologic factors. A 33-year-old female was referred to our clinic for acute iridocyclitis refractory to azathioprine, colchicum and corticosteroid treatments. Ophthalmic examination revealed bilateral pigment dispersion, significant iris transillumination, heavy pigment deposition in iridocorneal angle, and elevated intraocular pressure. Upon systemic evaluation she was found to have bacterial urinary tract infection. BAIT is an important cause of pigment dispersion and clinicians must be vigilant for this condition to avoid unnecessary diagnostic tests and treatment

Comparison of central corneal thickness and endothelial cell measurements by Scheimpflug camera system and two noncontact specular microscopes

WOS: 000439166500029PubMed ID: 28674859To investigate the correlation of Scheimpflug camera system and two noncontact specular microscopes in terms of central corneal thickness (CCT) and corneal endothelial cell morphology measurements. One hundred eyes of 50 healthy subjects were examined by Pentacam Scheimpflug Analyzer, CEM-530 (Nidek Co, Ltd, Gamagori, Japan) and CellChek XL (Konan Medical, California, USA) via fully automated image analysis with no corrections made. Measurement differences and agreement between instruments were determined by intraclass correlation analysis. The mean age of the subjects was 36.74 +/- 8.59 (range 22-57). CCTs were well correlated among all devices, with having CEM-530 the thinnest and CellChek XL the thickest measurements (intraclass correlation coefficient (ICC) = 0.83; p < 0.001 and ICC = 0.78; p < 0.001, respectively). Mean endothelial cell density (ECD) given by CEM-530 was lower than CellChek XL (2613.17 +/- 228.62 and 2862.72 +/- 170.42 cells/mm(2), respectively; ICC = 0.43; p < 0.001). Mean value for coefficient of variation (CV) was 28.57 +/- 3.61 in CEM-530 and 30.30 +/- 3.53 in CellChek XL. Cell hexagonality (HEX) with CEM-530 was higher than with CellChek XL (68.70 +/- 4.16% and 45.19 +/- 6.58%, respectively). ECDs with CellChek XL and CEM-530 have good correlation, but the values obtained by CellChek XL are higher than CEM-530. Measurements for HEX and CV differ significantly and show weak correlation. Thus, we do not recommend interchangeable use of CellChek XL and CEM-530. In terms of CCTs, Pentacam, CEM-530 and CellChek XL specular microscopy instruments are reliable devices

Evaluation of Ex-PRESS mini glaucoma shunt implantation with preoperative intracameral bevacizumab injection in refractory neovascular glaucoma

WOS: 000393691000022PubMed ID: 26951529Purpose: To evaluate the efficacy and safety of Ex-PRESS mini glaucoma shunt implantation with preoperative intracameral bevacizumab injection in eyes with refractory neovascular glaucoma. Methods: A retrospective chart review of patients with medically uncontrolled neovascular glaucoma who had received 50-mu L intracameral bevacizumab (1.25 mg) before undergoing Ex-PRESS mini glaucoma shunt implantation was performed. Success was defined as a postoperative intraocular pressure (IOP) between 5 and 21 mm Hg without (complete success) or with or without (qualified success) glaucoma medications and no additional glaucoma surgery, or loss of light perception. Results: In total, 33 eyes of 33 patients (15 female, 18 male) were enrolled in the study. The mean age of the study population was 61.2 years (range 36-78). The mean IOP decreased from 41.0 mm Hg (range 24-72) to 17.6 mm Hg (range 8-28) over a mean follow-up of 20.9 months (range 6-60) (p<0.001; Wilcoxon signed-rank test). Complete and qualified success rates were 36.4% and 66.7%, respectively. The average number of antiglaucoma medications decreased from 3.5 (range 2-4) preoperatively to 1.8 (range 1-4) postoperatively (p<0.001; Wilcoxon signed rank test). In 81.8% of cases, the decrease in IOP was 30% or more postoperatively. Conclusions: Ex-PRESS mini glaucoma shunt implantation with preoperative bevacizumab injection may be an effective alternative procedure for refractory neovascular glaucoma

Embolization of Dural Carotid-Cavernous Fistulas via the Thrombosed Superior Ophthalmic Vein

WOS: 000321698400015PubMed ID: 23715515Purpose: To present the authors' experience treating dural carotid-cavernous sinus fistulas (CCF) with retrograde embolization via the thrombosed superior ophthalmic vein (SOV). Methods: The medical records of 4 patients with dural CCFs treated via the thrombosed SOV were reviewed. All procedures were performed unilaterally in the interventional radiology unit with the administration of general anesthesia. The SOV was exposed via an eyelid crease incision, and then an angiocatheter was inserted in the vein and advanced through the segment with thrombosis to the cavernous sinus, where embolizing agents were deposited. After the procedure, the patients were followed up and evaluated clinically. Results: Three patients had unilateral CCFs, and 1 had a bilateral CCF (3 women and 1 man; age range, 58-68 years). The CCFs were Barrow type B (n = 2) and Barrow type D (n = 2). All patients had severe venous congestive orbital symptoms, chorioretinopathy, increased intraocular pressure, and visual loss. In all cases, the SOV appeared as a pale, thin, tortuous vessel adherent to the surrounding tissues during the surgical procedure. In 3 patients, the cavernous sinus was successfully embolized, and all symptoms were completely resolved without recurrence during follow up (3, 15, and 24 months). In the patient in whom the SOV could not be catheterized, the symptoms regressed slowly, but visual acuity remained unchanged during follow up (64 months). Conclusions: Dural CCFs can be successfully treated through the SOV, even when the vein is thrombosed. Identification and catheterization of the thrombosed SOV may be difficult because of the tiny and fibrotic structure of the vein

Evaluation of ocular surface and meibomian glands in patients with uveitis related to oligoarticular juvenile idiopathic arthritis

WOS: 000544253500029PubMed: 32270334Purpose To evaluate ocular surface changes and meibomian gland scores in patients with oligoarticular juvenile idiopathic arthritis. Materials and methods This prospective study was conducted at Ege University School of Medicine, Department of Ophthalmology. A total of 34 eyes of 17 patients with oligoarticular juvenile idiopathic arthritis and 30 right eyes of 30 age and gender-matched healthy subjects were included. Besides ophthalmic examination Schirmer 1 test, tear film break up time, Oxford staining scale and meibography were performed. Results There was no statistically significant differences between groups in terms of age, mean intraocular pressure, mean Schirmer 1 test value, tear film break up time and Oxford staining score. the median upper and lower eyelid meiboscore were 1 +/- 0.60 (IQR = 1), and 0 +/- 0.34 (IQR = 0) in Group 1, and they were 1 +/- 0.56 (IQR = 0), 1 +/- 0.12 (IQR = 1) in Group 2. Also, mean upper and lower meiboscores were statistically similar (pvalues 0.068 and 0.545, respectively). However, the median total meiboscore was 1 +/- 0.42 (IQR = 1) in Group 1 and 1 +/- 0.66 (IQR = 1) in Group 2. the difference was statistically significant (p = 0.041). Conclusion Aqueous-deficient dry eye is a well-known condition in patients with rheumatologic diseases. However, evaporative dry eye and meibomian glands were not studied earlier. the current study demonstrated that total meiboscores of oligoarticular juvenile idiopathic arthritis patients are higher than normal subjects, which indicates a possible evaporative dry eye tendency in this entity