Clinical Performance and Patient Satisfaction of Hybrid Contact Lenses in Patients with Keratoconus

Objectives:The aim of the study was to evaluate the fitting process, clinical performance, and patient satisfaction of hybrid contact lenses (HCL) in patients with keratoconus (KC).Materials and Methods:Sixty-eight KC patients (35 female, 33 male) who were prescribed HCL were included in the study. Corneal topographic parameters, best corrected visual acuity (BCVA) with eyeglasses, the number of HCL trials, prescribed HCL base curve (BC), and visual acuity with HCL were recorded from hospital records. A contact lens satisfaction survey was sent to the patients via email or WhatsApp and the data was statistically analyzed using IBM SPSS Statistics version 22.0.Results:The study included 110 eyes of 68 patients with a mean age of 27.34±8 years (range: 12-48 years). According to the Amsler-Krumeich classification, 35.5% of the eyes were stage 1, 50.9% were stage 2, and 13.5% were stage 3 or 4. Mean K1, K2, and Kmean values were 7.14±0.50 mm (range 5.72-8.30 mm), 6.63±0.49 mm (range 5.07-7.84 mm), and 6.89±0.48 mm (range 5.39-8.06 mm), respectively. The average number of lens trials was 1.59±0.82 (range 1-4). The mean BC of the prescribed HCL was 6.84±0.50 mm (range 5.60-8.00 mm). BCVA with glasses was 0.36±0.2 (range 0.05-0.8), and 0.80±0.14 (range 0.3-1.0) with HCL (pmean value and in most of the patients, fitting was successful with the first or second CL trial. The overall satisfaction score was moderate to good and the disadvantages were low comfort compared to soft CL, difficulty with insertion and removal, short lens life, and high cost

Characteristics of the Anterior Segment Biometry and Corneal Endothelium in Eyes with Pseudoexfoliation Syndrome and Senile Cataract

Objectives: To evaluate the anterior segment biometric features and corneal endothelial changes in eyes with pseudoexfoliation (PEX) syndrome and senile cataract. Materials and Methods: The central corneal thickness, anterior chamber depth (ACD), pupil diameter, lens thickness, endothelial cell density (ECD), and percentages of polymegathism and pleomorphism of 52 subjects with PEX and cataract were compared with 51 age- and gender-matched control subjects with cataract using optical low-coherence reflectometry (OLCR, Lenstar LS 900; Haag Streit AG, Switzerland) and in-vivo confocal microscopy (Confo Scan 4, Nidek Co. Ltd, Osaka, Japan). Nineteen subjects with PEX syndrome had glaucoma and were using anti-glaucoma medications. Only one eye of the subjects was used in statistical analysis and a p value less than 0.05 was considered statistically significant. Results: None of the OLCR parameters reached statistically significant differences among the 3 groups (ANOVA p>0.05). The percentage of eyes with ACD <2.5 mm was 13.7% in the control group, 24.2% in PEX eyes without glaucoma and 21.1% in PEX eyes with glaucoma, with no statistically significant differences (p=0.45). There was a significant difference in mean ECD among the 3 groups (ANOVA p=0.02), whereas no differences could be found in respect to polymegathism and pleomorphism (p>0.05). Mean ECD was significantly lower in the PEX glaucoma group (2,199.5±176.8 cells/mm2) than the control group (2,363±229.3 cells/mm2) (p=0.02), whereas no difference was found in mean ECD of PEX eyes without glaucoma and the control group (p=0.42). ECD was less than 2,000 cells/mm2 in 15.8% of PEX subjects with glaucoma, 9.8% of control subjects and 6.1% of PEX eyes without glaucoma, with no statistically significant difference (p=0.52). Conclusion: As eyes with both PEX glaucoma and cataract seem to be associated with decreased endothelial cell number, specular or confocal microscopy screening should be done for the patients scheduled for intraocular surgery. (Turk J Ophthalmol 2015; 45: 188-192

Bir Olgu Sebebiyle Tek Taraflı Optik Atrofi Etiyolojisinde Hipofiz Adenomlarının Yeri

Hipofiz adenomları gerçek kapsül ihtiva etmeyen adenohipofizyel hücrelerden oluşan metastaz yapmayan neoplazilerdir. Hipofiz adenomları intrakraniyel kitlelerin %10-15'ini oluştururlar. En sık 3-6. dekadlarda görülürken, çocuklarda nadirdir. Hipofiz adenomları boyut olarak 1 cm’den küçük ise mikroadenom, 1 cm’den büyük ise makroadenom olarak sınıflandırılır. Mikroadenomların aksine makroadenomlar görsel semptomlara, görme alanı defektine ve hipofiz yetmezliğine sebep olabilir. Hipofiz makroadenomları, benign tümöral olgular olarak kabul edilseler de nörovasküler bası ve hipopituitarizm yoluyla klinik tabloyu kötüleştirebilirler. Optik sinire bası yapan tümor patofizyolojik olarak desendan optik atrofiye yol açabilir. Optik diskin atrofik görünümü hastanın görme keskinliğini ve görme kalitesini önemli derecede düşüren, bir takım klinik olaylar zincirinin son basamağı olarak karşımıza çıkan bir tablodur. Bu nedenle takip ve tedavide fikir sahibi olabilmek için optik atrofi ile karşılaşıldığında ayırıcı tanı yapmak, hasta için önem arz etmektedir. Biz bu olguda tek taraflı optik disk atrofisinden yola çıkılarak yapılan görüntüleme sayesinde tanı konulan makroadenom hastasını sunmayı amaçladı

Spectral domain optical coherence tomography findings in posterior microphthalmia

Bu olgu sunumunda iki posterior mikroftalmi olgusunun retinal spectral domain optik koherens tomografi (SD-OKT) bulguları sunulmaktadır. Bu amaçla uzağı net görememe şikayeti ile kliniğimize başvuran, yüksek hipermetropi saptanan beş ve yedi yaşlarındaki iki kardeşin bulguları incelendi. Posterior mikroftalmi tanısı konulan her iki olgunun biyomikroskopik ön segment muayenesi ve gonyoskopi bulguları doğal olarak saptandı ve aksiyel uzunlukları 17 mmden kısa olarak ölçüldü. Fundus muayenelerinde gözlenen papillomaküler katlantıların SD-OKT ile yapılan değerlendirmesinde katlantılara yalnız nörosensoriyel retinanın katıldığı izlendi. Katlantı altında intraretinal alanda yalnız birinci olguda bilateral kistler; subretinal alanda ise her iki olguda apeksi katlantı apeksi ile örtüşen üçgen şeklinde hiporeflektif alan gözlendi. SD-OKT posterior mikroftalmi olgularında tanı ve eşlik eden dejeneratif değişikliklerin takibinde yardımcı bir görüntüleme cihazıdır. Bu değişiklikler görme prognozu açısından da önemli olabilmektedir. (Turk J Ophthalmol 2014; 44: 240-2)The retinal spectral domain optical coherence tomography (SD-OCT) findings of two posterior microphthalmia cases are presented in this case report. For this purpose, the findings of two siblings aged five and seven years who presented to our clinic with the complain of far-sightedness and high hypermetropia were evaluated. Both cases diagnosed to have posterior microphthalmia demonstrated normabiomicroscopic anterior segment examination and gonioscopy findings and the axial lengths were measured to be shorter than 17mmThe SD-OCT analysis of papillomacular folds detected in fundus examination revealed contribution of only neurosensorial retinaBeneath the retinal fold, we observed bilateral cysts in the intraretinal area in one of the cases and a triangle-shaped hyporeflective spacwith an apex corresponding to that of the retinal fold in the subretinal area in both cases. SD-OCT is an adjunctive imaging tool for diagnosis and follow-up of degenerative changes in posterior microphthalmia. These changemay be also important for visual prognosis. (Turk J Ophthalmol 2014; 44: 240-2

Diurnal Variation of Anterior Chamber Flare

Objectives: To investigate the ideal time and reproducibility of anterior chamber flare measurements. Materials and Methods: Anterior chamber flare measurements were performed with laser flaremetre device at 8 am to 45 volunteers and these measurements were repeated on the same day at 12 pm and 4 pm. Results: Twenty-five (55.5%) of the volunteers were women and 20 (44.5%) were men; mean age was 28.67±7.40 (18-49) years. The mean anterior chamber flare measurements taken following the ophthalmologic examination were 5.94±1.41 foton/msn at 8 am, 5.65±1.45 foton/msn at 12 pm, and 5.79±1.20 foton/msn at 4 pm. No statistical difference was found between the measurements (p=0.08). Subgroup analysis according to eye color, revealed no significant difference between flare measurements in brown, hazel, and green eyes (p=0.21). Correlation analysis demonstrated association between age and all flare measurements within the day (r=0.24, p=0.03; r=0.41, p=0.01, r=0.27, p=0.01). Conclusion: No significant diurnal change was detected in the flare measurements of our study subjects but positive correlation with age was observed. Hence, all flare measurements within a day are reliable and have high repeatability in healthy subjects. (Turk J Ophthalmol 2015; 45: 52-5

Diurnal variation of anterior chamber flare

Amaç: Laser flaremetre cihazı ile yapılan ön kamara bulanıklık ölçümlerin ideal zamanı ve tekrarlanabilirliğinin araştırılması. Gereç ve Yöntem: Kırk beş gönüllünün sabah saat 8.00da laser flaremetre cihazı ile ön kamara bulanıklık ölçümleri yapılmış ve bu ölçümler aynı gün saat 12.00 ve saat 16.00da tekrarlanmıştır. Bulgular: Gönüllülerin 25i (%55,5) kadın ve 20si (%44,5) erkekti ve ortalama yaşları 28,677,40 yıldı. Olguların oftalmolojik muayenelerini takiben alınan ortalama ön kamara bulanıklık ölçümleri sabah saat 8:00da 5,941,41 foton/msn, saat 12de 5,651,45 foton/msn, saat 16.00da 5,791,20 foton/msn idi. Ölçümler arasında anlamlı bir farklılık saptanmadı (p0,08). Katılımcıların göz rengine göre yapılan alt grup analizinde de kahverengi, ela ve yeşil göz renkler arasında anlamlı bir farklılık bulunmamıştır (p0,21). Korelasyon analizinde gün içinde alınan üç ölçümün de yaşla korele olduğu görülmüştür (r0,24, p0,03; r0,41, p0,01, r0,27 p0,01). Sonuç: Ön kamara bulanıklık ölçümlerinde sağlıklı bireylerde gün içerisinde anlamlı bir değişiklik saptanmamıştır ancak yaşla pozitif korelasyon göstermektedir. Bu nedenle gün içindeki tüm ölçümler güvenilirdir ve tekrarlanabilirliği yüksektir. (Turk J Ophthalmol 2015; 45: 52-5)Objectives: To investigate the ideal time and reproducibility of anterior chamber flare measurements. Ma&shy;te&shy;ri&shy;als and Met&shy;hods: Anterior chamber flare measurements were performed with laser flaremetre device at 8 am to 45 volunteers and these measurements were repeated on the same day at 12 pm and 4 pm. Re&shy;sults: Twenty-five (55.5%) of the volunteers were women and 20 (44.5%) were men; mean age was 28.67±7.40 (18-49) years. The mean anterior chamber flare measurements taken following the ophthalmologic examination were 5.94±1.41 foton/msn at 8 am, 5.65±1.45 foton/msn at 12 pm, and 5.79±1.20 foton/msn at 4 pm. No statistical difference was found between the measurements (p0.08). Subgroup analysis according to eye color, revealed no significant difference between flare measurements in brown, hazel, and green eyes (p0.21). Correlation analysis demonstrated association between age and all flare measurements within the day (r0.24, p0.03; r0.41, p0.01, r0.27, p0.01). Conclusion: No significant diurnal change was detected in the flare measurements of our study subjects but positive correlation with age was observed. Hence, all flare measurements within a day are reliable and have high repeatability in healthy subjects. (Turk J Ophthalmol 2015; 45: 52-5