Background/Aims: To evaluate the correlation between visual acuity (VA) and photoreceptor integrity in eyes with resolved diabetic macular edema (DME) after pars plana vitrectomy (PPV). Methods: Eleven eyes with resolved macular edema following PPV with internal limiting membrane removal for DME were included in this retrospective study. The integrity of the external limiting membrane (ELM) and inner and outer segments (IS/OS) of the photoreceptor junction was evaluated by spectral domain optical coherence tomography. The main outcome measures were percentage of disrupted ELM and IS/OS lines, and correlation between VA and photoreceptor integrity. Results: The mean time after PPV was 78 ± 17 months. The mean lengths of the disrupted ELM and IS/OS lines were 223 ± 167 µm (63%) and 189 ± 175 µm (54%) in the foveola, and 900 ± 522 µm (60%) and 835 ± 582 µm (55%) in the fovea, respectively. Intact ELM and IS/OS lines were positively correlated with VA in both the fovea (p = 0.09 and p = 0.02, respectively) and foveola (p = 0.004 and p = 0.03, respectively). Linear regression analysis showed a statistically significant association of intact ELM and IS/OS lines with VA in the fovea. Disrupted ELM and IS/OS lines had a strong correlation with each other in both the fovea (r = –0.71, p = 0.013) and foveola (r = 0.81, p = 0.02). Conclusions: The integrity of the ELM and IS/OS lines was positively correlated with VA in eyes with resolved DME after PPV.
Purpose. To evaluate the relationship between internal carotid artery (ICA) stenosis and subfoveal choroidal thickness (SFCT) in the elderly population. Methods. A total of 42 eyes of 21 patients with more than 70% ICA stenosis (Group 1) on one side and less than 70% stenosis (Group 2) on the other side were recruited for this study. ICA stenosis was diagnosed using both the B-mode and Doppler ultrasound. The two groups were compared in terms of the percentage of stenosis, SFCT measurements, intraocular pressure, ocular perfusion pressure, refractive error, and peak systolic velocity. Eyes were examined with the RTVue-100 OCT device by the EDI-OCT technique. Results. The mean age of the patients was 71.9 ± 10.8 years. The mean percentage of ICA stenosis was 74 ± 4.9% in Group 1 and 47.5 ± 7.7% in Group 2. The mean SFCT was 231.9 ± 44.6 μm in Group 1 and 216.2 ± 46.8 μm in Group 2, which was significantly lower (P = 0.028). A statistically significant positive correlation was found between the percentage of internal carotid artery stenosis and SFCT (r = 0896, P = 0.001). Conclusions. Compensatory SFCT increase can be seen in ipsilateral internal carotid artery stenosis greater than 70%.
Twenty-three-gauge transconjunctival sutureless vitrectomy was observed to be effective and safe in patients with retained lens fragments after complicated cataract surgery. In cases with hard nucleus, 23-G vitrectomy probe may not be adequate to remove the lens fragments.
To evaluate the topographic changes of cornea after pars plana vitrectomy (PPV) with the 23-gauge- (23-G) transconjunctival sutureless vitrectomy (TSV) system within the first postoperative month. In this prospective study, corneal topographic changes were evaluated in 24 eyes of 24 patients who underwent PPV with the 23-G TSV system. All eyes underwent computer-assisted videokeratography using NAVIS (Nidek Advanced Vision Information System) software preoperatively and at the first day, first week, and first month postoperatively. The topographic parameters that were analyzed statistically were the average corneal power (ACP), corneal surface cylinder (CSC), surface asymmetry index (SAI), and surface regularity index (SRI). Mean induced astigmatism was estimated by vector analysis software. The Wilcoxon test was used for statistical analysis. Mean ACP was 43.12±1.16 diopters (D) preoperatively and 42.88±1.44 D at first day (P=0.301), 43.04±1.14 D at first week (P=0.796), and 43.32±1.17 D at first month postoperatively (P=0.187). Mean CSC was 0.61±0.32 D preoperatively and 0.71±0.48 D at first day (P=0.918), 0.60±0.25 D at first week (P=0.826), and 0.70±0.33 D at first month postoperatively (P=0.414). Mean SAI was 0.12±0.05 preoperatively and 0.21±0.16 at first day (P=0.070), 0.15±0.06 at first week (P=0.176), and 0.16±0.09 at first month postoperatively (P=0.198). Mean SRI was 0.41±0.37 preoperatively and 1.05±0.41 at first day (P=0.001), 0.54±0.42 at first week (P=0.211), and 0.41±0.5 at first month postoperatively (P=0.861). Mean surgically induced astigmatism was 0.67±0.7 D at first day, 0.36±0.2 D at first week, and 0.33±0.17 D at first month postoperatively. Corneal surface and astigmatic changes were observed to be insignificant in the early postoperative period after PPV with the 23-G TSV system.
Amaç: Komplikasyonlu fakoemülsifikasyon (FAKO) cerrahisi sonrasında sekonder ön kamara (ÖK) ve sekonder skleral fiksasyonlu (SF) göziçi lenslerini (GİL) görsel prognoz ve ameliyat sonrası komplikasyonlar açısından karşılaştırmak. Gereç ve Yöntem: Bu çalışmada, geriye dönük olarak incelenen 30 hastanın 30 gözü incelenmiştir. Ön kamara GİL implantasyonu yapılan olgular birinci grubu (n=15), SF GİL implantasyonu yapılan olgular ikinci grubu (n=15) oluşturdu. Tüm olgulara ameliyat öncesinde Snellen eşeli ile düzeltilmiş en iyi görme keskinliği ölçümü, biyomikroskopik muayene, aplanasyon tonometrisi, Goldmann'ın üç aynalı lensi ile gonyoskopi ve fundus muayenesi yapıldı. Bulgular: Gruplara göre ameliyat sonrası görme keskinliği düzeyleri arasında istatistiksel olarak anlamlı bir fark bulunmamaktadır (p=0,492). Ameliyat sonrası başarı (görme keskinliğinin artması ve/veya aynı kalması) açısından iki grup arasında anlamlı fark bulunmamıştır (p=0,598), bu oran birinci grupta %80 iken ikinci grupta %93,7 olarak bulunmuştur. Ameliyat sonrası silindirik değerlere göre gruplar arasında yine istatistiksel olarak anlamlı bir fark bulunmamaktadır (p=0,220). Birinci grupta gelişen ameliyat sonrası komplikasyonlar; beş olguda geçici kornea ödemi, iki olguda geçici göziçi basıncı (GİB) artışı, bir olguda ÖK'de fibrin reaksiyonu, bir olguda geç ikincil glokom, bir olguda hifema, bir olguda kistoid maküla ödemi, bir olguda ÖK'ye vitreus prolapsusu, bir olguda GİL malpozisyonu idi. İkinci grupta gelişen ameliyat sonrası komplikasyonlar; üç olguda geçici kornea ödemi, iki olguda ÖK'ye vitreus prolapsusu, iki olguda GİL malpozisyonu, bir olguda geçici GİB artışı ve bir olguda retina dekolmanı idi. Sonuç: Bu çalışmada komplikasyonlu katarakt cerrahisi sonrasında yeterli kapsül desteği olmayan olgularda her iki GİL tipinin de tercih edilebilir olduğu gözlendi. Ancak, kapsül desteği yetersiz olan gözlerde en uygun GİL seçeneğinin saptanması için daha çok sayıda olgu içeren çalışmalara ihtiyaç vardır. (Turk J Ophthalmol 2014; 44: 102-7) Anahtar Kelimeler: Fakoemülsifikasyon, sekonder göziçi lensi implantasyonu, ön kamara göziçi lensi, skleral fiksasyonlu göziçi lensi Objectives: To compare the visual prognosis and postoperative complication rates of secondary anterior chamber (AC IOL) and scleralfixated (SF) intraocular lenses (IOL) after complicated phacoemulsification surgery. Materials and Methods: Thirty eyes of thirty patients were reviewed for this retrospective study. The patients with secondary AC IOL implantation formed group 1 (n=15), and the patients with secondary SF IOL implantation formed group 2 (n=15). Best-corrected visual acuity (BCVA) with Snellen chart, biomicroscopic examination, intraocular pressure (IOP) measurement with applanation tonometer, gonioscopy performed by Goldmann's 3-mirror contact lens, and fundus examination were performed preoperatively in all patients. Results: There was no statistically significant difference in postoperative BCVA (p=0.492) and postoperative success (BCVA not changed or better postop...
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