Effect of surgical skill on surgically-induced astigmatism in cataract surgery

AIM:To evaluate the effect of surgical experience on surgically-induced astigmatism(SIA)in patients with uncomplicated phacoemulsification surgery.<p>METHODS:Fifty-three eyes of fifty patients, mean age 64.5±10.8y, were randomly divided into two groups(23 eyes and 30 eyes). First group was underwent surgery by cataract specialists and the second was by residents. At baseline all the patients were underwent a complete opthalmological examination including keratometry and autorefractometer measurements. Vector analysis programme including the Alpins' method was used for the calculation of SIA. All the measurements were repeated postoperative first day, first month and second month and changes were recorded. Shapiro Wilk and Mann-Whitney tests were applied for determining the statistical differences between the SIA with two groups.<p>RESULTS:There were no significant differences in demographic data of the groups. Intergroup analysis showed, first group was more effective results in SIA postoperative first day(<i>P</i>=0.002), first month(<i>P</i>=0.004)and the second month(<i>P</i>=0.001). For the first group, SIA were 0.79±0.41 diopter(D)at the first postoperative day, 0.54±0.41 D at the first postoperative month and 0.47±0.37 D at the second postoperative month. Second one was 1.27±0.66 D, 0.98±0.56 D and 0.94±0.54 D, respectively.<p>CONCLUSION:According to the results, surgical experience was one of the factors that affects SIA. Residents would perform more phacoemilcification surgery to obtain more surgical experience

Arginine-Restricted Therapy Resistant Bilateral Macular Edema Associated with Gyrate Atrophy

Introduction. Gyrate atrophy is a rare genetical metabolic disorder affecting vision. Here, we report a 9-year-old boy with gyrate atrophy associated with bilateral macular edema at the time of diagnosis and the effect of long term metabolic control on macular edema. Case Presentation. A 9-year-old boy presented with a complaint of low visual acuity (best corrected visual acuity: 20/80 in both eyes, refractive error: −12.00 D). Dilated fundus examination revealed multiple bilateral, sharply defined, and scalloped chorioretinal atrophy areas in the midperipheral and peripheral zone. Spectral-domain optical coherence tomography revealed bilateral cystoid macular edema in both eyes. Serum ornithine level was high (622 μmol/L). An arginine-restricted diet reduced serum ornithine level (55 μmol/L). However, visual findings including macular edema remained unchanged in 2 years of follow-up. Conclusion. Arginine-restricted diet did not improve macular edema in our patient with gyrate atrophy. A more comprehensive understanding of the underlying factors for macular edema will lead to the development of effective therapies

Canaliculitis Awareness

Objectives: To evaluate the demographic characteristics, treatment, and results of patients with canaliculitis. Materials and Methods: Medical records including the demographic characteristics, clinical findings, and treatment outcomes of patients diagnosed and treated for canaliculitis between September 2009 and March 2014 were analyzed retrospectively. Results: The median age of the 7 canaliculitis patients consisting of 4 women and 3 men was 49 (range 8-58) years. All patients had unilateral canaliculitis (on the right side in 2 and left side in 5 patients) and the inferior canaliculus was involved more frequently (71.4%). Epiphora, chronic conjunctivitis, a palpable and thickened canaliculus, and yellow discharge from the punctum were present in all cases. Actinomyces spp. was the most frequently cultured microorganism (75%). Dacryolith was observed in 6 patients. Canaliculotomy and dacryolith removal with canalicular curettage were performed, followed by medical treatment (topical penicillin 100,000 U/ml and oral ampicillin/sulbactam) for 10 days. Patients were followed up for a mean duration of 17.0 +/- 15.2 (range 3-46) months. Signs and symptoms resolved completely within a month. Epiphora recurred in the 36th month in a single patient and was treated with daily canalicular irrigation with antibiotics and there were no further symptoms during 10 months of follow-up after the recurrence. Conclusion: Canaliculitis is often overlooked and can be misdiagnosed. Every patient with chronic conjunctivitis and lacrimal infection should be examined carefully for canaliculitis

Could Platelet Indices and Neutrophil to Lymphocyte Ratio Be New Biomarkers for Differentiation of Arteritic Anterior Ischemic Neuropathy from Non-Arteritic Type?

The aim of this study was to assess the possible relationship between AAION (arteritic anterior ischemic optic neuropathy) and NAION (non-arteritic anterior ischemic optic neuropathy) with blood platelet parameters and NLR (neutrophil-to-lymphocyte ratio). The medical records of 12 patients with AAION, 33 patients with NAION, and 35 healthy subjects were examined. MPV, PDW, and PCT values showed marked elevation in AAION and NAION groups compared with control group. The mean NLR was statistically significantly higher only in AAION group compared to the NAION and control groups, suggesting that platelet function plays an important role in AIONs and NLR might be used to differentiate AAION from NAION

Full Thickness Retinal Hole Formation after Nd:YAG Laser Hyaloidotomy in a Case with Valsalva Retinopathy

A 27-year-old male was presented with a sudden onset of visual loss in his right eye. A secondary care center referred the patient with fundus photographs which were screened 4 days before and after the Nd: YAG laser hyaloidotomy treatment. Snellen acuity was 10/10 in both eyes. Fundus examinations revealed a retinal pigment epithelium (RPE) alteration at the margin of the inferior temporal arterial vascular arcade in the right eye and resolved preretinal and subretinal hemorrhages were seen in the macula. A diagnosis of Valsalva retinopathy was made based on the history and the treatment photographs of Nd:YAG laser hyaloidotomy. At 1st month examination all hemorrhages were resolved but RPE alterations were still at the margin of the inferior temporal arterial vascular arcade. The optical coherence tomography angiography (OCTA) images revealed 2 lesions. On en face OCT angiogram of OCTA full thickness retinal hole formation and ellipsoid zone damage at the superior and inferior margin of the inferior temporal arterial vascular arcade were seen. Superficial vascular plexus was also damaged at that region. The projection of the evacuation of blood from subhyaloid space and the full thickness retinal hole formation were the same, indicating that the partial and full thickness retinal holes were created by the laser treatment