Assessment of efficacy of topical azithromycin 1.5 per cent ophthalmic solution for the treatment of meibomian gland dysfunction

WOS: 000417934000004PubMed ID: 28677153BackgroundThe aim was to evaluate the clinical efficacy of topical azithromycin 1.5 per cent ophthalmic solution in treatment of the clinical signs and symptoms associated with meibomian gland dysfunction (MGD). MethodsIn this retrospective study, 35 patients with MGD were treated with topical azithromycin 1.5 per cent ophthalmic solution for 30 days. Topical azithromycin 1.5 per cent ophthalmic solution was prescribed twice daily for two days and then once daily for a total of 30 days. Daily lid hygiene with dilute baby shampoo was instructed for all patients. Patient total symptom score, meibomian gland grading score, Schirmer score with anaesthetic, tear film break-up time (TFBUT) and corneal fluorescein staining score were evaluated at baseline and after one and three months. ResultsPatient total symptom score, meibomian gland grading score, Schirmer score with anaesthetic, TFBUT and corneal staining score reduced significantly from the baseline to the first month (p 0.05, for each). ConclusionThese results demonstrate that topical azithromycin 1.5 per cent ophthalmic solution appears effective in the short-term treatment of the clinical signs and symptoms associated with MGD

Fonksiyonel endoskopik sinüs cerrahisinin oftalmik komplikasyonlarının tedavisi

Orbital complications of functional endoscopic sinus surgery (FESS) may cause irreversible damage to the orbital structures, including optic nerve, extraocular muscles, and lacrimal drainage system. The clinical diagnosis and management of these patients may be extremely difficult because of the complexity and severity of the injuries. We describe a patient with ocular motility disturbances, anisocoria, and optic neuropathy in the right eye secondary to FESS. Early medical and surgical intervention resulted in symptom resolution.Fonksiyonel endoskopik sinüs cerrahisi (FESS), optik sinir, göz dışı kasları ve gözyaşı drenaj sistemini de içeren orbita yapılarında geriye dönüşümsüz hasara yol açabilir. Bu hasarın karmaşıklığı ve ciddiyeti nedeniyle klinik tanı ve tedavi son derece zor olabilir. Bu makalede kronik sinüzit için FESS uygulanan ve erken post-operatif dönemde çift görme şikayeti ve sağ gözde anizokori, optik nöropati tespit edilen hastanin erken tıbbi ve cerrahi müdahale ile belirtilerinin düzelmesi anlatılmaktadır

Effect of air bubble on inflammation after cataract surgery in rabbit eyes

Purpose: Intense inflammation after cataract surgery can cause cystoid macular edema, posterior synechia and posterior capsule opacification. This experimental study was performed to investigate the effect of air bubble on inflammation when given to anterior chamber of rabbit eyes after cataract surgery. Materials and Methods: 30 eyes of 15 rabbits were enrolled in the study. One of the two eyes was in the study group and the other eye was in the control group. After surgery air bubble was given to the anterior chamber of the study group eye and balanced salt solution (BSS; Alcon) was left in the anterior chamber of control eye. Results: On the first, second, fourth and fifth days, anterior chamber inflammations of the eyes were examined by biomicroscopy. On the sixth day anterior chamber fluid samples were taken for evaluation of nitric oxide levels as an inflammation marker. When the two groups were compared, in the air bubble group there was statistically less inflammation was seen. (1, 2, 4. days P = 0,001, and 5. day P = 0,009). Conclusions: These results have shown that when air bubble is left in anterior chamber of rabbits’ eyes after cataract surgery, it reduced inflammation. We believe that, air bubble in the anterior chamber may be more beneficial in the cataract surgery of especially pediatric age group, uveitis patients and diabetics where we see higher inflammation. However, greater and long termed experimental and clinical studies are necessary for more accurate finding

Bilateral vitreomacular traction syndrome secondary to an aromatase inhibitor usage

Selektif üçüncü kuşak aromataz inhibitörleri (anastrozol, letrozol ve eksemestan) on yılı aşkın bir süredir menopoz sonrası dönmede olan, hormon reseptörü pozitif (HR+) meme kanserli olguların tedavisinde kullanılmaktadır. İlacın meme kanseri üzerinde olan etkinliği genel olarak kabul görse de yan etkilerinin tipleri ve sayısı oldukça değişkenlik gösterebilmektedir. Aromataz inhibitörü kullanan hastaların Optik Kohorens Tomografi (OKT) ile yapılan retinal kalınlık analizlerinde vitrues ile retina arasındaki traksiyonel kuvvetin arttığı ve bunun görmeyi tehdit edebileceği ortaya konmuştur. Bu sunumda meme kanserinin nüksünü azaltmak için iki yılı aşkın süredir anastrozol kullanan ve bunun neticesinde her iki gözünde vitreomaküler traksiyon sendromu tespit edilen 56 yaşındaki bir bayan hastayı literatür eşliğinde sunmak istedik.The selective third-generation aromatase inhibitors (anastrozole, letrozole, and exemestane ) have been used for more than ten years in worldwide for the standard of therapy for hormone-receptor-positive breast cancer in postmenopausal women. The authors are in agreement on the effectiveness of this drug in breast cancer, but the type and number of side effects have been quite variable. Based on analysis of OCT retinal thickness data, it is likely that aromatase inhibitors increases the tractional force between the vitreous and retina, and this might be at increased risk for traction-related vision loss. We report a 56- years-old woman with bilateral vitreomacular traction sydrome treated with anastrozole more than two years to decrease recurrence of breast cancer

Anterior segment optical coherence tomography measurement after neodymium-yttrium-aluminum-garnet laser capsulotomy

Purpose: To evaluate changes in anterior chamber depth (ACD) and angle width after neodymium- yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy.Design: Prospective interventional case series.Methods: In a single institution, 43 eyes of 43 consecutive pseudophakic patients with symptomatic posterior capsule opacification (PCO) underwent Nd:YAG laser capsulotomy. Anterior chamber depth and angle width in pseudophakic eyes with posterior capsule opacification were measured with anterior segment optical coherence tomography (AS-OCT) before and 3 days after Nd:YAG laser capsulotomy. Preoperative and postoperative measurements of anterior chamber depth and angle width included the angle opening distance, measured as the perpendicular distance from the trabecular meshwork at 500 mm and 750 mm anterior to the scleral spur to the anterior iris surface (AOD500 and AOD750, respectively), and anterior chamber angle (ACA) in the nasal and temporal quadrants. Main outcome measures were the changes in ACD and angle width parameters.Results: The mean patient age was 63.4 ± 3.6 years. Before Nd:YAG laser capsulotomy, mean ACD, AOD500, AOD750, and ACA (nasal and temporal) measurementswere 3.71 ± 0.11mm, 0.61 ± 0.054mm, 0.67 ± 0.063 mm, and 34.5 ± 1.67 degrees and 34.8 ± 1.55 degrees, respectively. Three days after Nd:YAG laser capsulotomy, mean ACD, AOD500, AOD750, and ACA (nasal and temporal) measurements were 3.77 ± 0.1 mm, 0.69 ± 0.06 mm, 0.73 ± 0.06 mm, and 35.51 ± 1.64 degrees and 36.17 ± 1.51 degrees, respectively (P <.01 for all).Conclusion: The depth and width of the ACA in pseudophakic eyes with PCO increased significantly after Nd:YAG laser capsulotomy, as shown by AS-OCT, a reliable and noncontact method for measuring anterior ocular structures. Our study shows that the different angle parameters such as ACD, AOD500, AOD750, and ACA measurements seem highly correlated

Intraoperative and early postoperative flap-related complications of laser in situ keratomileusis using two types of Moria microkeratomes

WOS: 000341838700012PubMed ID: 24531872The purpose of this study is to describe the incidence, management, and visual outcomes of intraoperative and early postoperative flap-related complications of laser in situ keratomileusis (LASIK) surgery using two types of Moria M2 microkeratomes. This retrospective analysis was performed on 806 primary LASIK cases. The intraoperative and early postoperative flap-related complications were identified and categorized according to type of Moria microkeratome. There were 52 intraoperative and early postoperative complications-one case of partial flap (0.124 %), one case of free flap (0.124 %), one case of small flap (0.124 %), 13 cases of epithelial defect (1.61 %), 12 cases of flap striae (1.49 %), 10 cases of diffuse lamellar keratitis (1.24 %), 10 cases of interface debris (1.24 %), three cases of epithelial ingrowth (0.37 %), and one case of microbial infection (0.124 %). The overall incidence of flap complications was 6.45 %. There were 27 right eye (6.73 %) and 25 left eye (6.17 %) complications. The incidence of complications with the Moria automated metallic head 130 microkeratome was 4.22 % and with the Moria single-use head 90 microkeratome was 2.23 %. We observed one culture-negative interface abscess which was cured with surgical cleaning and intensive medical treatment. The most common complication encountered was epithelial defects, followed by flap striae. Our study showed that LASIK with a microkeratome has a relatively low incidence of intraoperative and early postoperative flap complications. The authors have no financial interest in any of the issues contained in this article and have no proprietary interest in the development of marketing of or materials used in this study

Effects of dorzolamide/timolol fixed combination on retrobulbar hemodynamics in pseudoexfoliative glaucoma

WOS: 000369596300007PubMed ID: 26853174In our study we aimed to evaluate the short-term effects of dorzolamide/timolol on ocular perfusion pressure and retrobulbar blood flow in patients with pseudoexfoliative glaucoma (PXG). This prospective observational cross-sectional study enrolled 22 eyes of 22 newly-diagnosed patients with PXG in a single center. All of the patients received a fixed combination of dorzolamide/timolol. Besides routine ophthalmologic examination, the retrobulbar hemodynamic parameters in the ophthalmic artery, central retinal artery, and short posterior ciliary arteries were measured in all participants at baseline and the 3rd month using color Doppler imaging. The mean intraocular pressure (IOP) was 22.3 +/- 2.1 mmHg at baseline and reduced to 17.4 +/- 2.3 mmHg at the 3rd month (p < 0.05). None of the retrobulbar parameters, except peak systolic velocity and resistive index in temporal short posterior ciliary arteries, changed significantly on therapy with dorzolamide/timolol fixed combination when the results were analyzed at Month 3. The drug significantly decreased the peak systolic velocity (p = 0.044) and reduced the resistive index in 0.04 units, 95% confidence interval 0.03-0.05, (p < 0.001) in the temporal short posterior ciliary arteries. This study reports that the retrobulbar hemodynamics might be affected less than expected by dorzolamide/timolol fixed combination in patients with PXG although the reduction of IOP was statistically significant

Transcanalicular revision surgery for failed dacryocystorhinostomy

WOS: 000329935000007PubMed ID: 24424227Aim. To evaluate the effectiveness of transcanalicular multi diode laser in revision dacryocystorhinostomy and to determine the outcomes. Materials and Methods. Fifty-three consecutive patients (19 males, 44 females) who were referred for recurrent dacryostenosis with epiphora after a failed primary dacryocystorhinostomy (DCR) operation were included in the study. Patients were assigned to two separate groups on the basis of primary DCR operation: either endonasal dacryocystorhinostomy (END-DCR) or transcanalicular multi diode laser dacryocystorhinostomy (TC-MDL DCR). TC-MDL DCR technique was used for revision surgeries in both groups. The mean age of the patients was 46.5 +/- 13.1 (Range, 15 -71) and the average follow-up duration was 12 months. Results. The success rate was 62% (18/29) in the primarily TC-MDL DCR operated group, and 85.2% (29/34) in the primarily END-DCR operated group respectively. The occlusion of internal ostium with granulation tissue was the leading etiology of unsuccessful surgical outcome in both group 1 and group 2 (42.8% and 28.5% respectively). Conclusions. TC-MDL DCR is a minimally invasive surgical method with relatively high success and low complication rates in patients with failed primary DCR requiring revision

Anterior segment optical coherence tomography evaluation of corneal epithelium healing time after 2 different surface ablation methods

WOS: 000349405000011PubMed ID: 25630007Objectives: To compare epithelial healing time following laser epithelial keratomileusis (LASEK) and photorefractive keratectomy (PRK) with anterior segment optic coherence tomography (AS-OCT). Methods: This prospective interventional case series study comprised 56 eyes of 28 patients that underwent laser refractive surgery in the Department of Ophthalmology, Medipol University Medical Faculty, Istanbul, Turkey, between March 2014 and May 2014. Each patient was randomized to have one eye operated on with PRK, and the other with LASEK. Patients were examined daily for 5 days, and epithelial healing time was assessed by using AS-OCT without removing therapeutic contact lens (TCL). Average discomfort scores were calculated from ratings obtained from questions regarding pain, photophobia, and lacrimation according to a scale of 0 (none) to 5. Results: The mean re-epithelialization time assessed with AS-OCT was 3.07 +/- 0.64 days in the PRK group, 3.55 +/- 0.54 days in the LASEK group, and the difference was statistically significant (p=0.03). Mean subjective discomfort score was 4.42 +/- 0.50 in the PRK eyes, and 2.85 +/- 0.44 in the LASEK eyes on the first exam day (p=0.001). The score obtained on the second (p=0.024), and third day (p=0.03) were also statistically significant. The fourth (p=0.069), and fifth days scores (p=0.1) showed no statistically significant difference between groups. Conclusion: The PRK showed a statistically significant shorter epithelial healing time, but had a statistically significant higher discomfort score until the postoperative fourth day compared with LASEK.الطريقة: هذه الدراسة التداخلية املرتقبة للحاالت املسلسلة تتضمن 56 ً عينا من 28 ً مريضا الذين تلقوا جراحة الليزر االنكسارية في قسم أمراض العيون في مستشفى كلية الطب جامعة ميدي بول، اسطنبول، تركيا، في الفترة ما بني مارس 2014م مايو 2014م. كل مريض خضع للعملية ألحدى عينيه بطريقة )الالزيك( والعني االخرى بطريقة )بي آر كي(. مت االختيار بني العينني بطريقة عشوائية. مت فحص كل مريض بعد العملية بشكل دوري وملدة خمسة أيام، ومت حساب الزمن املستغرق لشفاء الغشاء الظهاري للقرنية باستخدام الـ ) أي اس- أو سي تي( بدون ازالة العدسات الالصقة املداوية. مت حساب معدل درجات االنزعاج عن طريق سؤال املريض عن األلم، رهاب الضوء و تدمع العني بنقاط من الصفر )مبعنى ال يوجد( الى 5. النتائج: املتوسط الزمني لعودة التظهرن املقاس بطريقة الـ ) أي اس- أو سي تي( كانت: 64.0±07.3 يوم في مجموعة الـ)بي آر كي( و 54.0±55.3 في مجموعة الـ )الالزيك( والفرق بني املجموعتني كان ً واضحا ً إحصائيا )بي= 03.0 .)املتوسط االنزعاجي الغير املوضوعي كان 50.0±42.4 في العيون التي خضعت للـ )بي آر كي( و 44.0±85.2 في العيون التي خضعت للـ )الالزيك( في اليوم األول للفحص. املعدالت التي مت احلصول عليها لدرجة االنزعاج في اليومني الثاني والثالث كانت ً أيضا ً واضحة احصائيا، )بي= 024.0 و بي=03.0 على التوالي(. ً اليومني الرابع واخلامس لم يظهر درجات واضحة احصائيا بني املجموعتني )بي=069.0 و بي=1.0 )على التوالي. اخلامتة: أظهرت طريقة الـ )بي آر كي( زمنا أقصر اللتئام الغشاء الظهاري ً الذي كان واضحا ً إحصائيا ولكنه في الوقت نفسه أظهرت درجة انزعاج أكثر حتى اليوم الثالث بعد العملية

Longitudinal assessment of intraocular pressure in premature infants

Purpose: To investigate the longitudinal change in intraocular pressure (IOP) in premature infants and to establish a normative IOP value. Methods: Forty premature infants with a gestational age (GA) of 26 weeks were enrolled in this longitudinal study. Measurements were taken initially at 28 weeks postconceptional age (PCA) and at 2-week intervals up to 40 weeks PCA. Intraocular pressure was measured with a hand-held tonometer (Tono-Pen XL; Reichert Inc.). Results: From 40 (22 male, 18 female) premature Caucasian infants, seven (for each eye) IOP measurements were obtained. Mean GA was 26 weeks and mean birthweight was 820 ± 112 grams. The mean IOP was 15.1 ± 1.2 mm Hg and 14.9 ± 1.1 mm Hg for the right and left eyes, respectively. The mean IOP in both eyes for all measurements was 15.0 ± 1.1 mm Hg. At 28 weeks PCA, 9 (22.5%) preterm infants had IOP values greater than 20 mm Hg. The mean IOPs at 28 weeks, 30 weeks, 32 weeks, 34 weeks, 36 weeks, 38 weeks, and 40 weeks PCA were 18.7 ± 1.1 mm Hg, 16.9 ± 0.9 mm Hg, 15.3 ± 0.9 mm Hg, 14.1 ± 1.3 mm Hg, 13.7 ± 1.3 mm Hg, 13.4 ± 1.4 mm Hg, and 13.1 ± 1.3 mm Hg, respectively. A significant decrease in IOP measurements was found up to 34 weeks PCA, with no significant decline in IOP measurements after that point (F = 109.7, p<0.01). There was a negative correlation between IOP and PCA (r = −0.712, p<0.01). Conclusions: The mean IOP of premature infants was 15.0 ± 1.1 mm Hg and IOP values decreased significantly up to 34 weeks PCA, indicating a decline trend approaching the term period