Purpose:To evaluate the efficacy of α-lipoic acid (ALA) in reducing scarring after trabeculectomy.Materials and Methods:Eighteen adult New Zealand white rabbits underwent trabeculectomy. During trabeculectomy, thin sponges were placed between the sclera and Tenon’s capsule for 3 minutes, saline solution, mitomycin-C (MMC) and ALA was applied to the control group (CG) (n=6 eyes), MMC group (MMCG) (n=6 eyes), and ALA group (ALAG) (n=6 eyes), respectively. After surgery, topical saline and ALA was applied for 28 days to the control and ALAGs, respectively. Filtrating bleb patency was evaluated by using 0.1% trepan blue. Hematoxylin and eosin and Masson trichrome staining for toxicity, total cellularity, and collagen organization; α-smooth muscle actin immunohistochemistry staining performed for myofibroblast phenotype identification.Results:Clinical evaluation showed that all 6 blebs (100%) of the CG had failed, whereas there were only 2 failures (33%) in the ALAG and no failures in the MMCG on day 28. Histologic evaluation showed significantly lower inflammatory cell infiltration in the ALAGs and CGs than the MMCG. Toxicity change was more significant in the MMCG than the control and ALAGs. Collagen was better organized in the ALAG than control and MMCGs. In immunohistochemistry evaluation, ALA significantly reduced the population of cells expressing α-smooth muscle action.Conclusions:ΑLA prevents and/or reduces fibrosis by inhibition of inflammation pathways, revascularization, and accumulation of extracellular matrix. It can be used as an agent for delaying tissue regeneration and for providing a more functional-permanent fistula.

BackgroundThe aim of this study was to compare the effect of W-shaped skin (WS) and linear skin (LS) incisions on cutaneous scar tissue formation in patients who have undergone bilateral external dacryocystorhinostomy.MethodsSixteen patients (14 females and two males) with acquired bilateral nasolacrimal duct obstruction were included in this prospective, interventional comparative study. LS incision was applied to one side and WS skin incision to the other side. The skin incisions were assessed 6 months after each procedure by the patients themselves and by two ophthalmologists who were unaware of the skin incision shape and side. Scar tissue that was not recognized under the same light conditions and in the same room from a 100 cm distance was recorded as grade 1. Minimally visible scar tissue was assessed as grade 2, moderately visible scar tissue as grade 3, and easily visible scar tissue as grade 4.ResultsThe mean scar assessment scores recorded by the first ophthalmologist were 2.50±0.82 for the LS group and 1.25±0.45 for the WS group (P<0.001). The second ophthalmologist’s assessment scores were 2.25±0.86 for the LS group and 1.25±0.45 for the WS group (P<0.001). The mean patient self-assessment score for the incision scars was 2.44±1.03 for the LS group and 1.56±0.73 for the WS group (P<0.001).ConclusionCompared with LS incision, WS incision resulted in less cutaneous scar tissue formation in patients who have undergone bilateral external dacryocystorhinostomy.

Skin scar tissue was found to be significantly reduced with a "W incision" in external DCR operations.

Objectives:To investigate the correlation of visual field (VF), pattern electroretinography (PERG) and Fourier domain optical coherence tomography (FD-OCT) results in patients with ocular hypertension (OHT) and early primary open-angle glaucoma (POAG).Materials and Methods:The study included 72 eyes of 37 patients with early POAG, 76 eyes of 38 patients with OHT, and 60 eyes of 30 controls. All subjects underwent full ophthalmologic examination, VF assessment with 24-2 Humphrey standard automated perimetry (Swedish Interactive Thresholding Algorithm (SITA)-Standard), retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness measurement with FD-OCT, and PERG P50 and N95 wave latency and amplitude measurements with electroretinography (Nihon Kohden).Results:With the exception of the nasal quadrant, all GCC parameters and RNFL results were significantly lower in the POAG group compared to the OHT and control groups. There was no statistically significant difference between the OHT and control group. PERG amplitudes were lower in the POAG and OHT groups than in the control group. Reduction in N95 amplitude was greater than that of P50 amplitude. No difference was detected in PERG latencies among groups. GCC was significantly correlated with VF and RNFL in the POAG group. Conclusion:Significant thinning of the GCC and RNFL occurs in addition to VF pathologies in patients with early POAG, and these examinations should be concomitantly evaluated. During diagnostic assessment of patients with early POAG, GCC and RNFL analysis by FD-OCT are highly effective. GCC is as reliable as RNLF in the early diagnosis of glaucoma and there is a highly significant correlation between them. Dysfunction of ganglion cells in patients with OHT may be detected earlier using PERG amplitude analysis.

Polypropylene suture as a frontalis suspension material in ptosis patients with poor levator function maintained satisfactory results at follow-up. This material allows easy and repeatable eyelid height adjustment and does not obviate future eyelid procedures.

BACKGROUND:The aim of this study was to evaluate the clinical and epidemiological features of 132 patients with orbital wall fracture who were treated at Şişli Etfal Teaching and Research Hospital, Istanbul, between 2005-2012.

We report the use of anterior segment optical coherence tomography (ASOCT) in Descemet's membrane detachment (DMD). A patient who developed DMD after uneventful cataract surgery with posterior chamber lens implantation is presented in this case report. At the follow-up examination after cataract surgery, slit-lamp evaluation showed stromal striae, but it was impossible to diagnose the DMD due to the corneal edema. ASOCT imaging of the cornea revealed a DMD, and the patient underwent intracameral air injection to the anterior chamber through the site which was identified as intact by ASOCT. Follow-up ASOCT imaging revealed the reattachment of the Descemet's membrane and reduced corneal thickness. If DMD is suspected in any cases, ASOCT can be useful to document and follow the postsurgical detachment of DMD and also to determine the site, configuration, and extent of the DMD, thus guiding the treatment method and monitoring the treatment outcome.

The purpose of this study was to evaluate the effects of the use of the subconjunctival injection of ranibizumab (Lucentis) on angiogenesis in the rabbit cornea. Corneas of 12 New Zealand Rabbits were cauterized with silver nitrate crystal. Animals were divided in two groups: control group (GC) that received 0.02 ml of 0.9% saline solution; group ranibizumab (GR) that received 0.5 mg of ranibizumab subconjunctivally at the 24th h after the lesion was formed. Animals corneas were extracted on the 14th day under general anesthesia. The newly formed vessels digital photographs were obtained and analyzed in a computerized system (google sketch-up program). In the control group, neovascularization covered 64.66%±20.81 (mean±standard deviation [SD]) of the corneal surface, compared with 34.17%±4.53 (mean±SD) in the GR group. When vascular density is compared between treated groups, statistical differences were observed (P<0.002). The results showed an inhibition of angiogenesis when the control group was compared with ranibizumab treated groups. These results suggest that subconjunctival injection of ranibizumab is able to inhibit corneal angiogenesis. Kornea Neovaskülarizasyonunun Ranibizumab (Lucentis) ile Baskılanması: Tavşan Korneasında Deneysel Çalışma Özet Bu çalışma, tavşan kornea anjiogenezisi üzerine ranibizumab'ın (Lucentis) subkonjonktival enjeksiyon kullanımının etkilerini değerlendirmek amacıyla yapıldı. Araştırmada 12 Yeni Zelanda tavşanı kullanılarak korneaları gümüş nitrat kristal ile koterize edildi. Hayvanlar iki gruba ayrıldı. Lezyon oluşturulduktan sonraki 24. saatte kontrol grubuna (GK) 0.02 ml %0.9 tuz solüsyonu, ranibizumab grubuna (GR) ise 0.5 mg ranibizumab subkonjonktival olarak enjekte edildi. Hayvanlar 14. günde korneaları genel anestezi altında alındı. Yeni oluşan damarların dijital fotoğrafları alınarak bilgisayar sistemi ile (google sketch-up programı) incelenmesi yapıldı. Kontrol grubunda neovaskülarizasyonun 64.66%±20.81 (ortalama±standart sapma [SD]) korneal yüzeyi kaplaması, GR grubundaki 34.17%±4.53 (ortalama±standart sapma [SD]) neovaskülarizasyonun korneal yüzeyi kaplaması ile kıyaslandı. Damar yoğunluğu tedavi grupları arasında karşılaştırıldığında, istatistiksel olarak farklılık (P<0.002) belirlendi. Sonuç olarak, kontrol grubu ve ranibizumab ile tedavi edilen grup karşılaştırıldığında anjiyogenezin inhibe edildiği saptandı. Bu sonuçlar ranibizumabın subkonjonktival enjeksiyonu ile kornea anjiogenezisinin inhibe edilmesinin mümkün olduğunu göstermektedir.