In this study we evaluated the frequency of pseudoexfoliation syndrome, the percentages of glaucoma and senile cataract in patients with and without pseudoexfoliation syndrome, and the percentages of pseudoexfoliation syndrome in patients with glaucoma and senile cataract in the Eastern Mediterranean area of Turkey. We examined 1356 persons over 40 years of age. Frequency of pseudoexfoliation syndrome in the greater than or equal to 50 years old age band was 7.2%, and there was a statistically significant difference between the sexes. Over 60 years of age, the frequency of pseudoexfoliation syndrome was 11.2%, the percentage of glaucoma in patients with pseudoexfoliation syndrome was 34.3%, the percentage of pseudoexfoliation syndrome in patients with glaucoma was 46.9%, the percentage of cataract in persons with pseudoexfoliation syndrome was 88.1%, and the percentage of pseudoexfoliation syndrome in persons with cataract was 17.7%. The differences between the percentage of glaucoma and cataract in patients with and without pseudoexfoliation syndrome, were both statistically significant (p less than 0.001).

In the present study, the records of 242 children, aged 1-14 years, admitted with perforating ocular injury were reviewed retrospectively over a 5-year period. There were 175 boys and 67 girls in the study group. The patients were divided into 3 groups according to their ages. Perforating injuries occurred most frequently in the street in all groups. The second most common place of the injury was at home in the 1-9 year-olds and in the fields in the 10-14 year-olds. The cause of the perforation was a metallic substance in 32.6%, wood in 15.3%, stone in 12.0%, glass in 12.3%, pellets in 12%, and injection needles in 8.3%. Most of the perforations occurred during unsupervised play, while all perforations with glass occurred during traffic accidents. Surgery was performed in 234 patients, while 8 patients in whom spontaneous closure had already occurred during admission received only medical treatment. In 28.9% the visual acuity was undetermined, in 25.7% the visual acuity was 0.1 or more, in 22.7% the visual acuity was between 0.06 and light perception, and in 22.7% there was no light perception on final evaluation. It is emphasized that educative and legislative measures such as informing the parents, teachers and children about the causative factors and potential hazards of perforating ocular injuries and restricting the availability of dangerous items to children, should be taken into consideration in order to prevent perforating ocular injuries in children.

Patients suspected of CL should be evaluated and treated early in the course of their disease to prevent any permanent ocular or periocular deformities.

PURPOSE. To evaluate the effects of antiproliferative agents on the fibrous tissue responsible for the failure of external dacryocystorhinostomy at the site of surgical rhinostomy. METHODS. The study group consisted of 60 cases. Patients with primary acquired idiopathic nasolacrimal duct obstruction were divided into three groups according to the agent used. Each group consisted of 20 patients. Mitomycin C was applied to the first group (0.5 mg/ml to 10, 1 mg/ml to 10 cases) and 5-flourouracil to the second group (2.5 mg/ml to 10, 5 mg/ml to 10 cases). The third group consisted of 20 control cases. The mean follow-up period was 15.3 +/- 2.60 (12-18) months. The tissues obtained during the revision of the cases with failure were evaluated by light and electron microscopic examination. RESULTS. External dacryocystorhinostomy failed in four cases. Of these, one was in the first group (0.5 mg/ml mitomycin C), one in the second group (2.5 mg/ml 5-flourouracil), and two were in the control group. Light microscopic examination of the tissues revealed an increase in fibroblastic activity in the control group whereas hypo- and acellular areas were found to be dominant in the groups given antifibroblastic agents. The control group revealed more active fibroblasts with cytoplasms containing numerous organelles in electron microscopic examination. Electron microscopic examination of the cases given antifibroblastic agents revealed fibroblastic cells with nuclear fragmentation, necrosis or pyknosis, while some others had scanty cytoplasms poor in organelles. CONCLUSION. We can conclude that intraoperative antiproliferative agents improve the success rate of external dacryocystorhinostomy.

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Purpose: To evaluate the efficacy of the Ritleng lacrimal intubation system in the treatment of congenital nasolacrimal duct obstruction. Methods: Twenty-six patients (29 eyes) with congenital nasolacrimal duct obstruction, who ranged in age from 2 to 12 years (mean, 4.85 ± 2.9 years), underwent silicone intubation with the Ritleng lacrimal intubation system. The Ritleng lacrimal intubation system is composed of a Ritleng probe, a monofilament guide thread and a silicone tube. The prolene tip was removed from the inferior meatus with nasal endoscopy in 26 eyes, whereas this was done by using a Ritleng hook in 3. Clinical success was defined by the relief from symptoms and signs of obstruction. The tubes were left in place for an average of 6 months. The patients were followed up between 6 and 25 months (mean, 8.3 months). Results: All cases were successfully intubated with the Ritleng system. Two cases underwent reintubation because of tube dislocation during the first week. Granuloma developed at the edge of the inferior punctum in 1 case. We observed relief from symptoms in all cases. Conclusion: The Ritleng lacrimal intubation system is an easy, effective and nontraumatizing procedure for the treatment of congenital nasolacrimal duct obstruction.

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