Comparison of pascal dynamic contor tonometry and goldmann aplanation tonometry and effect of central corneal thicness on intraocular pressure measurements

Amaç: Bu çalışmadaki amacımız, primer açık açılı glokom (PAAG), oküler hipertansiyon (OHT) ve kontrol grubu olgularında Goldmann aplanasyon tonometrisi (GAT) ve Pascal dinamik kontur tonometre (DKT) yöntemlerini karşılaştırmak, santral kornea kalınlığı (SKK) ve diğer kornea özelliklerinin ölçümlere etkisini değerlendirmektir. Hastalar ve Yöntem: PAAG'lu 50 olgu, OHT'lu 43 olgu ve 50 kontrol grubu olgusunun GİB, GAT ve DKT yöntemleriyle ölçüldü. Tüm olguların SKK, ultrasonik pakimetri ile belirlendi. Olguların korneal kurvatür ve astigmatizma değerleri tespit edildi. Tüm gruplarda sağ ve sol gözlerde GAT ve DKT yöntemleri karşılaştırıldı. SKK ve diğer kornea özelliklerinin GİB ölçüm yöntemlerine etkisi incelendi. Bulgular: Tüm gruplarda GAT ve DKT yöntemleri ile yapılan ölçümler birbiri ile korelasyon gösterdi. DKT ile yapılan ölçümler PAAG ve kontrol grubunda GAT'a göre anlamlı derecede yüksekti. OHT grubunda DKT ve GAT ölçüm değerleri arasında anlamlı fark yoktu. DKT ve GAT arasındaki GİB değeri farkı, düşük GİB değerlerinde daha fazla iken yüksek GİB değerlerinde farkın azaldığı tespit edildi. SKK, OHT grubundaki olgularda PAAG ve kontrol grubundaki olgulara göre anlamlı derecede kalındı. GAT ve DKT değerlerinin SKK ile korelasyon gösterdiği görüldü fakat GAT ve SKK arasındaki korelasyon GAT ve DKT arasındaki korelasyona göre daha fazlaydı. DKT ile GAT arasındaki GİB değeri farkı ince kornealarda kalın kornealara göre daha fazla idi. GAT ve DKT yöntemlerinin, korneal kurvatür, korneal astigmatizma ve yaş faktörleri ile ilişkili olmadığı belirlendi. Sonuç: GAT'a göre SKK'ından daha az ekilenen DKT yöntemi, günlük pratikte kullanılabilecek bir yöntemdir. Glokom teşhisinde DKT yöntemi için yeni eşik GİB değerleri belirlenmelidir. Anahtar Kelimeler: Pascal dinamik kontur tonometre, Goldmann aplanasyon tonometrisi, primer açık açılı glokom, oküler hipertansiyon, santral kornea kalınlığı Purpose: To compare the Pascal dynamic contor tonometry (DCT) and Goldmann aplanation tonometry (GAT) in cases with primary open angle glaucoma (POAG), ocular hypertension (OHT) and control group and to evalute the effect of central corneal thickness (CCT) and other corneal parameters on the measurements of intraocular pressure (IOP). Patients and Methods: The IOP of fifty cases with POAG, 43 cases with OHT and 50 cases of control group were measured with GAT and DCT. The CCT of the cases were measured by ultrasound pachimetry. The corneal curvature and astigmatism levels of the cases were determined. GAT and DCT were compared in right and left eyes of the cases. The effect of CCT and other corneal parameters on GAT and DCT was detected. Results: GAT and DCT measurements were correlated in all groups. The meuserements with DCT were significantly higher than GAT measurements in POAG and control group. There was no significant difference between GAT and DCT in OHT group. The difference between DCT and GAT was higher in cases with low IOP levels whereas the difference was smaller in high IOP levels. The CCT in the group with OHT was significantly higher than in controls and cases with POAG. GAT and DCT were correlated with CCT but the correlation between GAT and CCT was higher than the correlation between DCT and CCT. Difference in IOP measurements between DCT and GAT was higher in cases with lower CCT. GAT and DCT measurements were not effected by age, corneal curvature and astigmatism. Conclusion: This study suggest that, DCT seems to be reliable method for intraocular pressure mesurement, which is influnced by CCT lower than GAT. New threshold levels in glaucoma diagnosis should be determined for DCT. Key words: Pascal dynamic contour tonometry, Goldmann aplanation tonometry, primary open angle glaucoma, ocular hypertension, central corneal thicknes

A simple method for scleral buckling procedure in a patient with extreme scleral thinning Aşırı skleral incelmesi olan bir hastada skleral çökertme için basit bir yöntem

© 2015 Gazi Eye Foundation. All Rights Reserved.Rupture of the sclera is a rare but serious complication of retinal detachment surgery. Pre-existing scleral pathology is a major risk factor for globe rupture during scleral buckling procedures. In this case report, we performed a wide silicone tire to cover the scleral thinning area which unexpectedly encountered intraoperatively, so the retinal detachment surgery completed successfully without any complication

Comparison Between Scleral Buckling Surgery with and without use of Operating Microscope in Cases of Rhegmatogenous Retinal Detachment

Objectives: To compare the results of scleral buckling surgery with and without use of operating microscope for primary rhegmatogenous retinal detachment (RRD). Materials and Methods: This comparative study consisted of 74 eyes of 74 patients who underwent scleral buckling for primary RRD. Group 1 consisted of 35 patients (17 male and 18 female) who were operated using operating microscope and Group 2 consisted of 39 patients (19 male and 20 female) who were operated without operating microscope. Patients with post-equatorial breaks, retinal breaks greater than 90°, proliferative vitreoretinopathy (≥C2), and those with follow-up period of less than sıx months were excluded from the study. The two groups were compared based on age, sex, etiology, anatomic success, and surgical complications (scleral perforation, iatrogenic retinal breaks, vitreous hemorrhage, buckle malposition, and vortex vein damage). Results: Mean age was 64.11±7.91 years (range, 55-79 years) in Group 1 and 65.20±6.15 years (range, 56-80 years,) in Group 2. Mean age and gender were not statistically significantly different between the groups (p=0.508 and p=0.990, respectively). Etiological causes were revealed as myopia, peripheral retinal degeneration, pseudophakia, aphakia, trauma, and idiopathic. Etiological causes were not significantly different between the two groups (p>0.05, for all). Surgical complication rates were higher in Group 2, however, the differences were not statistically significant (p>0.05, for all). Anatomical success rates was similar between the two groups (80% in Group 1 and 79.5% in Group 2, p=0.956). Conclusion: The results of scleral buckling surgery with and without use of operating microscope were not significantly different; However, operating microscope should be used especially in presence of risk factors for scleral complications. (Turk J Ophthalmol 2014; 44: 175-8

Fakoemülsifikasyon parametreleri ile ikinci gözde artmış ağrı şikayeti arasında herhangi bir ilişki var mı?

WOS: 000445208200001Objective: To evaluate the relation between pain complaints after cataract surgery and phacoemulsification parameters. Materials and Methods: This prospective study was based on studies of 94 eyes across 47 patients, who underwent cataract surgery at 15 day intervals. The mean values of nucleus grade, total duration of surgery, U/S total time, U/S total equivalent power in foot position 3, cumulative dissipated energy, phacoemulsification time, average phacoemulsification power and average phacoemulsification power in foot position 3 were recorded. Patients were asked to score their pain on the first day, after the first week and after the first month following surgery on each eye. Results: The mean nucleus grade, cumulative dissipated energy, and U/S total time were found significantly higher in the first eye compared with the second eye (p= 0.01, 0.016, and 0.03, respectively). There was no statistically significant difference in mean operation time, phacoemulsification time, U/S total equivalent power position 3, average phacoemulsification power and average phacoemulsification power position 3 between the first and second eyes. Although there was no statistically significant difference in pain scores between first and second eyes on the first postoperative day and first month, there was a significant difference at one week (p=0.080, 0.269 and 0.004, respectively). There was no correlation between phacoemulsification parameters and pain scores after both surgeries. Conclusion: This study showed no correlation between the phacoemulsification parameters and postoperative pain scores after both first and second surgeries. In addition, there was a significant difference between the pain scores of the first and that of the second surgery at the first postoperative week.Amaç: Katarakt ameliyatı sonrası ağrı şikayeti ile fakoemülsifikasyon parametreleri arasındaki ilişkiyi değerlendirmek. Gereç ve Yöntem: Bu prospektif çalışmaya, 15 gün arayla katarakt ameliyatı yapılan 47 hastanın 94 gözü dahil edildi. Ortalama nukleus sertliği, ameliyat süresi, total ultrason (U/S) zamanı, total enerji (U/S total equivalent power in foot position 3), kümülatif yayılan enerji, fakoemülsifikasyon zamanı, ortalama fakoemülsifikasyon enerjisi ve ayak pedalı 3. pozisyonda iken kullanılan ortalama fakoemülsifikasyon enerjisi kaydedildi. Hastalardan ağrılarını postoperatif birinci gün, birinci hafta ve birinci ay kontrollerinde skorlamaları istendi. Bulgular: Ortalama nukleus sertliği, kümülatif yayılan enerji, total U/S zamanı ilk gözde ikinci göze göre anlamlı olarak artmış bulundu. (sırasıyla p= 0.01, 0.016, ve 0.03). İlk göz ve ikinci göz arasında ortalama ameliyat süresi, fakoemülsifikasyon zamanı, total enerji, ortalama fakoemülsifikasyon enerjisi ve ayak pedalı 3. pozisyonda iken kullanılan ortalama fakoemülsifikasyon enerjisi arasında anlamlı fark yoktu. Postoperatif birinci gün ve birinci ayda ağrı skorunda birinci ve ikinci göz arasında istatistiksel olarak bir fark bulunmamasına rağmen, birinci hafta skorlarında anlamlı farklılık vardı. (sırasıyla p=0.080, 0.269 ve 0.004). Her iki ameliyattan sonra da fakoemülsifikasyon parametreleri ile ağrı skorları arasında herhangi bir korelasyon yoktu. Sonuç: Bu çalışma, hem birinci hem de ikinci ameliyatlardan sonra fakoemülsifikasyon parametreleri ile postoperatif ağrı skorları arasında korelasyon olmadığını gösterdi. Ek olarak, posoperatif birinci haftada ilk ameliyatın ağrı skorları ile ikinci ameliyatın ağrı skorları arasında anlamlı fark vardı

Haemorrhagic Conjunctival Retention Cyst

Forty-eight–year-old male presented with a complaint of mild stinging in the right eye. Best-corrected visual acuity was 1.0 in both eyes. Slit lamp examination revealed retention cysts in the lower temporal and lower nasal bulbar conjunctiva and also nasal pinguecula in the right eye. Both cysts contained multiple lobules. Inferior lobules appeared hemorrhagic, and hemorrhage was horizontally extended above the level of liquid contained a transparent view. the patient was re-examined 5 months later. the findings were similar with the findings of the first examination. in this case report, we presented a patient with retention cysts with leveled hemorrhagic lobules and optical coherence tomographic findings