Effect of Periodontitis on Dry Eye Disease Signs and Symptoms: A Cross-sectional Study.

PURPOSE: Gingivitis and periodontitis are oral disorders characterised by chronic inflammation, impacting the supportive structures around teeth due to bacterial accumulation. While the role of inflammation in both periodontitis and dry eye disease (DED) has been established individually, their potential association remains unclear. This study aimed to investigate the association between periodontitis and the manifestation of signs and symptoms related to DED in patients aged 18-40. MATERIALS AND METHODS: A cross-sectional study was conducted involving healthy controls, DED patients with or without periodontitis, and patients with periodontitis without DED. Ophthalmic and oral examinations were performed, and demographic, ocular, and systemic disease data were collected. Statistical analysis was conducted using ANOVA and chi-squared tests. RESULTS: A total of 684 participants were included in the study. Significant elevations in tear osmolarity levels, increased Ocular Surface Disease Index scores (OSDI), and decreased tear break-up time (TBUT) and Schirmer (ST-I) values were observed in DED patients with periodontitis compared to individuals with DED but without periodontitis, as well as control and periodontitis groups. Furthermore, higher neutrophil-to-lymphocyte ratios (NLR) were found in DED patients with periodontitis. CONCLUSION: The findings suggest an association between periodontitis and the severity of signs and symptoms related to DED. The study highlights the importance of interdisciplinary approaches in understanding the systemic implications of periodontal disease and its potential impact on ocular health.

Clarifying the effect of refractive errors and stereopsis on traumatic dental injuries in childhood.

BACKGROUND/AIM: Visual acuity and stereopsis both play an important role in developing posture and balance in children. The aim of this study was to investigate whether children with traumatic dental injuries (TDI) have abnormal stereopsis, due to a reduction in visual acuity, compared to children with good dental health. MATERIAL AND METHODS: A total of 140 participants (75 with traumatic dental injuries resulting from falls and crashes, and 65 age-matched controls without dental trauma) were enrolled in this prospective, cross-sectional study. The participants underwent complete dental and ophthalmologic examinations. After the ophthalmologic examination, the stereo acuities were assessed by a Titmus stereo test at 40 cm. RESULTS: Titmus test scores were significantly worse in the TDI group (mean score 252.46 ± 629.12 seconds of arc) compared to the control group (mean score 56 ± 27.39 seconds of arc) (P < .05). The percentage of subjects with abnormal Titmus test scores was higher in the TDI group (28%) than in the control group (3.1%). The mean anisometropia value was 3.03 ± 2.37 D and 0.55 ± 0.41 D in the TDI group and the control group, respectively (P < .001). The severity of anisometropia correlated with the degree of stereopsis (r = .83, P < .01). CONCLUSIONS: The presence of abnormal stereopsis may lead to postural instability which can lead to traumatic dental injuries. The prevalence of abnormal stereopsis in children with TDI was higher than in children with good binocular vision and stereopsis.

Evaluation of corneal thickness with spectral-domain optical coherence tomography following keraring implantation for keratoconus: five year follow-up.

To evaluate the change in the position of intrastromal corneal ring segments (ICRS) implanted in keratoconus patients within five years of implantation. Participants in this study included keratoconus patients who received Keraring 10 ICRS implantation and had a follow-up time of at least 5 years. The distances from apex to anterior corneal surface (AA), from outer basal corner to posterior corneal surface (BP), and from inner basal corner to posterior corneal surface (CP) were measured at every postoperative visit (6 months, 1 year, 3 years, and 5 years) and compared to each other. Thirty eyes of 22 patients were included. The CP showed a statistically significant decrease at all 15 time points (p < .001); however, no statistically significant difference was found at 5 years regarding AA or BP (p > .05 for all). Triangular ICRS implanted in keratoconus patients remained stable for five years without any complications, which is an extremely important aspect of ICRS surgery. The only difference was a slight posterior movement of the inner basal corner, although without anterior chamber perforation.

Different accelerated corneal collagen cross-linking treatment modalities in progressive keratoconus.

BACKGROUND: To compare the outcomes of two different protocols of accelerated corneal crosslinking (CXL) on visual, corneal high order aberrations (HOA) and topographic parameters in patients with progressive keratoconus. METHODS: In this prospective comparative study, sixty-six eyes of 66 patients with progressive keratoconus were divided into two groups; 37 eyes in Group 1 received 18 mW/cm2 for five minutes, and 29 eyes in Group 2 were treated with 9 mW/cm2 for 10 min. The uncorrected distant visual acuity (UCVA), best-corrected distant visual acuity (BCVA), corneal HOAs and topography parameters were measured preoperatively and postoperatively at the end of 12 months. The data for the two groups were compared statistically. RESULTS: The mean UCVA and BCVA were significantly improved at the postoperative 12 months compared with the preoperative values in both groups (P < 0.05 for all). A significant improvement in corneal HOAs was observed in both groups (P < 0.05 for all). The change in corneal coma value was significantly higher in Group 2 (P < 0.05). The change in keratometric values K1, K2, AvgK and maximum keratometry (AKf) were significantly higher in Group 2 (P < 0.05 for all). The regression model showed that the most important factor predicting the change in AKf was the type of CXL (ß = - 0.482, P = 0.005). CONCLUSIONS: Accelerated CXL using 10 min of UVA irradiance at 9 mW/cm2 showed better topographic improvements and coma values than five minutes of UVA irradiance at 18 mW/cm2 independent of keratoconus severity.

The Impact of Vitamin D Deficiency on Retinopathy and Hearing Loss among Type 2 Diabetic Patients.

AIM: The current study was aiming to investigate the relation between vitamin D, retinopathy, and hearing loss among type 2 diabetes mellitus (T2DM) patients. METHODS: Cross-sectional study carried on 638 subjects aged between 20 and 60 years who visited the Endocrinology, Ophthalmology, and ENT Outpatient Clinics of the Medipol Hospital during the period from March 2016 to May 2017. Two audiometers Grason Stadler GSI 61 and Interacoustics AC40 Clinical audiometer were used to evaluate the hearing loss. Risk factors for diabetic retinopathy were evaluated, including age, sex, diabetes duration, glycated hemoglobin (HbA1c), hypertension, and lipid profiles. RESULTS: The mean age (± SD, in years) for retinopathy with hearing loss versus normal subjects was 47.7 ±10.2 versus 48.5±9.1. The associated risk factors were significantly higher in T2DM with hearing loss, hypertension (32.6% versus 15.7%), tinnitus (40.0% versus 18.0%), vertigo (59.7% versus 26.8%), and headache (54.9% versus 45.3%), than in normal hearing diabetes. There were statistically significant differences between hearing impairment versus normal hearing for vitamin D [19.40±9.71 ng/ml versus 22.67±9.28 ng/ml; p<0.001], calcium, magnesium, phosphorous, cholesterol, HDL-C, LDL-C, albumin, systolic blood pressure [131.70±9.25 Hg versus 127.73±11.98 Hg], diastolic blood pressure [82.20±8.60 mm Hg versus 79.80±8.20 mm Hg], and microalbuminuria. Multivariate logistic regression analysis revealed that variables such as vertigo, duration of DM, mobile/I pad phone, vitamin D deficiency, sleeping disturbance, headache, frequently TV watching, tinnitus, cigarette smokers, and hypertension were considered at higher risk as a predictors of retinopathy with hearing loss among diabetic patients. CONCLUSION: Vitamin D deficiency is considered as a risk factor for diabetic retinopathy and hearing loss among diabetic patients. Meanwhile, hyperglycemia could be considered as a modifiable risk factor for diabetic retinopathy; tight glycemic control may be the most effective and important therapy for improving quality of life and substantially reducing the incidence of retinopathy and in T2DM patients.

A CASE OF CONE DYSTROPHY ASSOCIATED WITH CHOROIDAL NEOVASCULARIZATION.

PURPOSE: To report a case of choroidal neovascularization (CNV) in a patient with cone dystrophy (CD). METHODS: Case report. RESULTS: A 20-year-old woman presented with diminished vision in her right eye. Fundus examination showed perifoveal retinal pigment epithelial changes and retinal hemorrhage consistent with subretinal CNV in the right eye, and mild retinal pigment epithelial changes with a dull foveal reflex in the left eye. Optical coherence tomography analysis and fundus fluorescein angiography also confirmed the subfoveal CNV in the right eye. Electroretinography showed decreased amplitudes in photopic and 30-Hz flicker tests in both eyes, which confirmed cone dystrophy. A single intravitreal ranibizumab injection resolved the edema and stabilized the CNV during the follow-up of 6 months. CONCLUSION: Cone dystrophy is an inherited ocular disorder characterized by loss of cone photoreceptors. Association of CNV has been reported in patients with fundus flavimaculatus, best dystrophy, gyrate atrophy, choroideremia, retinitis pigmentosa, adult-onset foveomacular vitelliform dystrophy, Sorsby macular dystrophy, Bietti crystalline dystrophy, and myotonic dystrophy-related macular dystrophy. We report a case of a patient with CD in whom CNV developed in one eye and responded to a single ranibizumab injection.

Dry Eye Assessment in Patients With Vitamin D Deficiency.

OBJECTIVES: The aim of this study was to evaluate tear film function in patients with vitamin D deficiency. METHODS: In a single center, 60 eyes of 30 patients with vitamin D deficiency (group 1), and 60 eyes of 30 healthy individuals (group 2) were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear break-up time (TBUT), scoring of ocular surface fluorescein staining using a modified Oxford scale, and tear osmolarity. RESULTS: Tear osmolarity values, OSDI, and Oxford scale scores were significantly higher in group 1 (309±9 mOsm/L, 35.78±21.44 and 1.3±0.9, respectively) compared with group 2 (295±10 mOsm/L, 18.69±17.21 and 0.4±0.8, respectively) (P<0.001 for all). Schirmer I test and TBUT results in group 1 (8.5±3.7 mm and 8.7±0.6 sec, respectively) were significantly lower compared with group 2 (16.6±2.4 and 18.1±0.5, respectively) (P<0.001 for all). CONCLUSIONS: This study demonstrates that vitamin D deficiency is associated with tear hyperosmolarity and tear film dysfunction. Patients with vitamin D deficiency may be prone to dry eye.

Predicting the refractive outcome and accuracy of IOL power calculation after phacoemulsification using the SRK/T formula with ultrasound biometry in medium axial lengths.

PURPOSE: To evaluate the accuracy of the SRK/T formula using ultrasound (US) biometry in predicting a target postoperative refraction of ±1.00D in eyes with medium axial length (AL) that underwent phacoemulsification. METHODS: The present study was a retrospective analysis, which included 538 eyes with an AL from 22.0 to 24.60 mm that underwent phacoemulsification and foldable intraocular lens (IOL) implantation (six different IOLs) in the bag. Preoperative AL was measured by US biometry and IOL power (IOLp) was calculated with the SRK/T formula. Patients had a complete ophthalmic examination, preoperatively and 1, 7, and 30 days after surgery. The achieved spherical equivalent (SE) and the prediction error (PE) were calculated. The prediction error was defined as the difference between attempted predicted target refraction and the achieved postoperative SE refraction. Statistical analysis was performed with SPSS V21. RESULTS: The mean age of the patients was 66.96±9.67 years, the mean AL was 23.29±0.62 mm, the mean K1 was 43.62±1.49D, the mean K2 was 43.69±1.53D, the mean IOL power was 21.066±1.464D, the mean attempted (predicted) SE was -0.178±0.266D, and the mean achieved SE was -0.252±0.562D. The mean PE (difference between predicted and achieved SE) showed a relatively hyperopic shift (mean ± standard deviation: 0.074±0.542D, ranging from -1.855 to 2.170D, P=0.001). A total of 93.87% of eyes were within ±1.00D of the PE and 92.75% of eyes within ±1.00D of achieved postoperative refraction. A total of 39 eyes (7.25%) had a refractive surprise. A total of 32 of 39 eyes were more myopic than -1.00D and 7 of them were more hypermetropic than +1.00D. There was no correlation between the mean PE and IOL type, AL, K1, K2, and IOLp. There were a positive statistically significant correlation between PE and age (r=0.095; P=0.028) and a negative statistically significant correlation between achieved SE and AL (Spearman's r=-0.125; P=0.04), and age (r=-0.141; P=0.01). CONCLUSION: The IOLp calculation using the SRK/T formula with US biometry may demonstrate very good postoperative refractive outcomes in medium eyes with a few refractive surprises.

Tear osmolarity and ocular surface parameters in patients with psoriasis.

PURPOSE:: The aim of this study was to evaluate tear osmolarity, tear film function, and ocular surface changes in patients with psoriasis. METHODS:: At a single center, 30 eyes of 30 patients with psoriasis (group 1) and 30 eyes of 30 healthy individuals (group 2) were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear film break-up time (TBUT) test, scoring of ocular surface fluorescein staining using a modified Oxford scale, and tear osmolarity measurement. RESULTS:: Tear osmolarity values, OSDI, and Oxford scale scores were significantly higher in group 1 (309.8 ± 9.4 mOsm, 38.9 ± 1.1, and 0.7 ± 1.1, respectively) than in group 2 (292.7 ± 7.7 mOsm, 4.2 ± 0.3, and 0.1 ± 0.3, respectively; p<0.01 for all). TBUT was significantly lower in group 1 (8.7 ± 3.6 s) than in group 2 (18.1 ± 2.8 s; p<0.001). No significant differences were detected in Schirmer I test values between the groups (16.2 ± 2.5 mm in group 1 and 16.6 ± 2.3 mm in group 2; p=0.629). CONCLUSIONS:: The results of this study showed that psoriasis may influence tear osmolarity and tear film function. Patients with psoriasis showed tear hyperosmolarity and tear film dysfunction.

The Relationship between Metabolic Syndrome, Its Components, and Dry Eye: A Cross-Sectional Study.

PURPOSE: The aim of this study was to evaluate tear osmolarity and tear film function and ocular surface changes in patients with metabolic syndrome. METHODS: 108 eyes of 64 patients with metabolic syndrome (group 1) and 110 eyes of 55 healthy individuals (group 2) were included in this cross-sectional study. All participants were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear film break-up time (TBUT), and tear osmolarity. Main outcome measures were Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear film break-up time (TBUT), and tear osmolarity values. RESULTS: Tear osmolarity values and OSDI scores were significantly higher in group 1 (314.4 ± 19.1 mOsm and 38.9 ± 1.1, respectively) compared with group 2 (295 ± 14.3 mOsm and 18.69 ± 17.2, respectively) (p = 0.01 for both). The Schirmer test values and TBUT in group 1 (10 ± 3.7 mm and 14.8 ± 3.6 sec, respectively) were significantly lower compared with group 2 (16.8 ± 2.6 mm and 18.1 ± 0.5 sec, respectively) (p < 0.001 for both). There was significant correlation between tear osmolarity versus waist circumference and fasting blood glucose in the study group (r = 0.364, p = 0.04; and r = 0.542, p ≤ 0.001, respectively). CONCLUSIONS: This study showed that metabolic syndrome can influence tear osmolarity and tear film function. Patients with metabolic syndrome showed tear hyperosmolarity and tear film dysfunction.

Tear osmolarity and ocular surface parameters in patients with psoriasis / Parâmetros de osmolaridade lacrimal e da superfície ocular em pacientes com psoríase

ABSTRACT Purpose: The aim of this study was to evaluate tear osmolarity, tear film function, and ocular surface changes in patients with psoriasis. Methods: At a single center, 30 eyes of 30 patients with psoriasis (group 1) and 30 eyes of 30 healthy individuals (group 2) were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear film break-up time (TBUT) test, scoring of ocular surface fluorescein staining using a modified Oxford scale, and tear osmolarity measurement. Results: Tear osmolarity values, OSDI, and Oxford scale scores were significantly higher in group 1 (309.8 ± 9.4 mOsm, 38.9 ± 1.1, and 0.7 ± 1.1, respectively) than in group 2 (292.7 ± 7.7 mOsm, 4.2 ± 0.3, and 0.1 ± 0.3, respectively; p<0.01 for all). TBUT was significantly lower in group 1 (8.7 ± 3.6 s) than in group 2 (18.1 ± 2.8 s; p<0.001). No significant differences were detected in Schirmer I test values between the groups (16.2 ± 2.5 mm in group 1 and 16.6 ± 2.3 mm in group 2; p=0.629). Conclusions: The results of this study showed that psoriasis may influence tear osmolarity and tear film function. Patients with psoriasis showed tear hyperosmolarity and tear film dysfunction.

RESUMO Objetivo: O objetivo deste estudo foi avaliar a osmolaridade da lágrima, função do filme lacrimal e alterações da superfície ocular em pacientes com psoríase. Método: Em um único centro, 30 olhos de 30 pacientes com psoríase (grupo 1) e 30 olhos de 30 indivíduos saudáveis (grupo 2) foram avaliados pelo questionário do Índice de Doença da Superfície Ocular (OSDI), teste de Schirmer tipo I, tempo de ruptura do filme lacrimal (TBUT), coloração por fluoresceína da superfície ocular utilizando a escala de Oxford modificada e osmolaridade lacrimal. Resultados: Os valores de osmolaridade lacrimal, OSDI e escores da escala de Oxford foram significativamente maiores no grupo 1 (309,8 ± 9,4 mOsm, 38,9 ± 1,1 e 0,7 ± 1,1, respectivamente) em comparação com o grupo 2 (292,7 ± 7,7 mOsm, 4,2 ± 0,3 e 0,1 ± 0,3, respectivamente) (p<0,01 para todos). TBUT no grupo 1 (8,7 ± 3,6 s) foi significativamente menor em comparação com o grupo 2 (18,1 ± 2,8 s) (p<0,001). Não foram detectadas diferenças significativas nos valores de teste de Schirmer (16,2 ± 2,5 mm no grupo 1 e 16,6 ± 2,3 mm no grupo 2, p=0,629). Conclusões: Este estudo mostrou que a psoríase pode influenciar osmolaridade lágrima e função do filme lacrimal. Os pacientes com psoríase apresentaram hiperosmolaridade lágrima e disfunção do filme lacrimal.

Is children's Body Mass Index associated with their parents' personality? A prospective controlled trial.

BACKGROUND: The aim of this study was to elucidate the effect of the personal characteristics and psychological status of parents on their children's Body Mass Index (BMI) by using validated questionnaires. METHODS: Obese and healthy control group was assessed with The Parental Attitude Research Instrument (PARI) for the evaluation of parental attitudes towards their children. Additionally, Depression Anxiety and Stress Scale (DASS) were used to assess the relationships between parental depression, anxiety, stress and childhood obesity. RESULTS: A total of 105 children and their parents were divided into two groups. The study group consisted of 58 children with a BMI of higher than 85th percentile whereas 47 children with normal BMI (<85th percentile) were included as the control group. In both groups, the BMI of mothers which is between 25-and 30 kg/m2 and >30 kg/m2 had significant impact on the risk of children's obesity status 1.12-fold and 3.68-fold respectively. The PARI results provided that the children who had disciplined, over-protective parents and those in the parental incompatibility group had higher risk of being obese. Analysis of the DASS Test results showed that children having depressed parents had significantly higher risk of obesity than children whose parents were not depressed (P<0.05). CONCLUSIONS: Our results provided that, the parent's status such as obesity, depression and strict personal behaviors have negative impact on their children's weight which is resulting with obesity.

Performance of the SRK/T formula using A-Scan ultrasound biometry after phacoemulsification in eyes with short and long axial lengths.

BACKGROUND: The SRK/T formula is one of the third generation IOL calculation formulas. The purpose of this study was to evaluate the performance of the SRK/T formula in predicting a target refraction ±1.0D in short and long eyes using ultrasound biometry after phacoemulsification. METHODS: The present study was a retrospective analysis, which included 38 eyes with an AL < 22.0 mm (short AL), and 62 eyes ≥24.6 mm (long AL) that underwent uncomplicated phacoemulsification. Preoperative AL was measured by ultrasound biometry and SRK/T formula was used for IOL calculation. Three different IOLs were implanted in the capsular bag. The prediction error was defined as the difference between the achieved postoperative refraction, and attempted predicted target refraction. Statistical analysis was performed with SPSS V21. RESULTS: In short ALs, the mean age was 65.13 ± 9.49 year, the mean AL was 21.55 ± 0.45 mm, the mean K1 and K2 were 45.76 ± 1.77D and 46.09 ± 1.61D, the mean IOL power was 23.96 ± 1.92D, the mean attempted (predicted) value was 0.07 ± 0.26D, the mean achieved value was 0.07 ± 0.63 D, the mean PE was 0.01 ± 0.60D, and the MAE was 0.51 ± 0.31D. A significant positive relationship with AL and K1, K2, IOL power and a strong negative relationship with PE and achieved postoperative was found. In long ALs, the mean age was 64.05 ± 7.31 year, the mean AL was 25.77 ± 1.64 mm, the mean K1 and K2 were 42.20 ± 1.57D and 42.17 ± 1.68D, the mean IOL power was 15.79 ± 5.17D, the mean attempted value was -0.434 ± 0.315D, the mean achieved value was -0.42 ± 0.96D, the mean PE was -0.004 ± 0.93D, the MAE was 0.68 ± 0.62D. A significant positive relationship with AL and K1, K2 and a significant positive relationship with PE and achieved value, otherwise a negative relationship with AL and IOL power was found. There was a little tendency towards hyperopic for short ALs and myopic for long ALs. The majority of eyes (94.74 %) for short ALs and (70.97 %) for long ALs were within ±1 D of the predicted refractive error. No significant relationship with PE and IOL types, AL, K1, K2, IOL power, and attempted value, besides with MAE and AL, K1, K2, age, attempted, achieved value were found in both groups. CONCLUSION: The SRK/T formula performs well and shows good predictability in eyes with short and long axial lengths.

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

In 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 3(rd) 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 3(rd) 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.

Changes in Anterior Chamber Depth after Combined Phacovitrectomy.

OBJECTIVES: To evaluate changes in anterior chamber depth (ACD) and postoperative refractive outcomes after combined phacovitrectomy. MATERIALS AND METHODS: This study included 10 eyes of 10 patients that underwent combined phacovitrectomy (study group) and 14 eyes of 14 patients that underwent phacoemulsification surgery (control group) at Istanbul Medipol University Ophthalmology Department. Preoperative and 3-month postoperative best corrected visual acuity (BCVA), ACD, change in ACD and refractive outcomes were compared between the two groups. RESULTS: Preoperative ACD, postoperative ACD at 3 months and change in ACD were similar between two groups (p=0.403, p=0.886, p=0.841). Postoperative mean refractive outcomes were 0.22±0.51 diopter in the phacovitrectomy group and -0.39±0.53 diopter in the phacoemulsification group (p=0.019). BCVA was increased in both groups (p=0.001). CONCLUSION: Postoperative refractive outcomes in eyes that underwent combined phacovitrectomy are different from those in eyes that underwent only phacoemulsification surgery. This is important in determining preoperative intraocular lens power before combined phacovitrectomy.

Tear Osmolarity and Tear Film Parameters in Patients With Ocular Rosacea.

OBJECTIVES: The aim of this study was to evaluate tear osmolarity and tear film parameters in patients with ocular rosacea. METHODS: In a single center, 25 eyes of 25 patients with ocular rosacea (group 1), 25 eyes of 25 patients with rosacea without ocular involvement (group 2), and 20 eyes of 20 healthy individuals (group 3) were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear film break-up time (TBUT), scoring of ocular surface fluorescein staining using modified Oxford scale, and tear osmolarity. RESULTS: Tear osmolarity values, OSDI and Oxford scale scores were significantly higher in group 1 than in groups 2 and 3 (P<0.001 for all). Schirmer I test and TBUT in group 1 were significantly lower than in groups 2 and 3 (P<0.001 for all). There were no significant differences in OSDI, Schirmer I test, TBUT, Oxford scores, or tear osmolarity between groups 2 and 3 (P=0.629, P=0.175, P=0.713, P=865, and P=0.388, respectively). CONCLUSIONS: This study showed that ocular rosacea is associated with tear hyperosmolarity and tear film dysfunction.

Anterior Segment Optical Coherence Tomography Assessment After Laser Capsulotomy in Pseudophakic Eyes With Pseudoexfoliation.

PURPOSE: To assess changes in anterior-chamber depth (ACD) and angle width after neodymium:yttrium aluminum garnet (Nd:YAG) laser capsulotomy pseudophakia in eyes with pseudoexfoliation (PEX). METHODS: This prospective and interventional case series study included 25 pseudophakic eyes of 25 patients with PEX and 26 pseudophakic eyes of 26 patients without PEX scheduled for Nd:YAG laser capsulotomy in a single institution. Anterior-chamber depth and angle width were measured with anterior segment optical coherence tomography before and three days after Nd:YAG laser capsulotomy. Preoperative and postoperative measurements of ACD and angle width included the angle opening distance (AOD), measured as the perpendicular distance from the trabecular meshwork at 500 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 ACD, AOD500, AOD750, and ACA (nasal and temporal) measurements were 3.67±0.12 mm, 0.63±0.05 mm and 0.65±0.05 mm, 0.67±0.06 mm and 0.77±0.04 mm, 35.25±1.69° and 35.37±1.68° in eyes with PEX and 3.73±0.11 mm, 0.6±0.05 mm and 0.63±0.05 mm, 0.66±0.06 mm and 0.74±0.06 mm, 34.24±1.6° and 34.6±1.47° in control eyes, respectively (P>0.05 for all). After Nd:YAG laser capsulotomy, mean ACD, AOD500, AOD750, and ACA (nasal and temporal) measurements were 3.76±0.09 mm, 0.73±0.05 mm and 0.76±0.05 mm, 0.75±0.06 mm and 0.87±0.04 mm, 36.82±1.46° and 35.06±1.52° in eyes with PEX and 3.77±0.1 mm, 0.68±0.06 mm and 0.72±0.06 mm, 0.72±0.05 mm and 0.84±0.06 mm, 34.95±1.4° and 35.79±1.36° in control eyes, respectively (P=0.811, P=0.019, P=0.021, P=0.109, P=0.126, P=0.001, and P=0.01, respectively). CONCLUSIONS: The depth and width of the anterior chamber in eyes with PEX and in control eyes increased significantly after Nd:YAG laser capsulotomy. The change in the width of the anterior chamber in eyes PEX was statistically significant comparing control eyes.

Anterior uveitis following eyebrow epilation with alexandrite laser.

Ocular tissues are known to be sensitive to damage from exposure to laser emissions. This study reports the case of a female patient with acute unilateral anterior uveitis caused by alexandrite laser-assisted hair removal of the eyebrows. We report a 38-year-old female who presented with unilateral eye pain, redness, and photophobia after receiving alexandrite (755 nm) laser epilation of both eyebrows. Best corrected visual acuity was 20/20 in both eyes. Right eye examination was normal. Left eye examination showed conjunctival injection and 2+/3+ cells in the anterior chamber. Intraocular pressure and fundus examination were normal. Topical steroids and cycloplegic drops were prescribed for 3 weeks. At the end of the 3-week follow-up, best corrected visual acuity was 20/20, and intraocular pressure and fundus examination were normal in both eyes. The left eye was white, and the anterior chamber was clear. The patient continues to be monitored. In conclusion, without adequate protective eyewear, laser hair removal of the eyebrows with alexandrite laser can lead to ocular damage.

Evaluation of the effects of serum iron levels on lacrimal gland secretion.

In our study we aimed to demonstrate the relationship between the serum iron levels, and tears quality and quantity in term newborns. This study was conducted at a single institution between March 2013 and May 2013. A total of 46 newborns were prospectively enrolled. Serum iron levels were measured via the umbilical cord blood. Infants were divided into two groups according to their serum iron levels. Group A, serum iron level ≤70 µg/dL (n = 27) and Group B, serum iron level > 70 µg/dL (n = 19). The evaluation of the osmolarity was tested by using the TearLab Osmolarity System (TearLab Co, San Diego, CA, USA). The assessment of quantity was performed by using Schirmer I test. Osmolarity testing and Schirmer I test (with/without anesthesia) were performed bilaterally on the 1(st) day of life by an ophthalmologist. The outcomes of Schirmer I and tear osmolarity showed no statistically significant difference between right and left eyes of any infant in the groups. Moreover, there was no statistical difference between sexes in these two groups. Osmolarity was found to have a moderate negative correlation coefficient with serum iron level (r = -0.4, p < 0.01). Furthermore, there was a high positive correlation between Schirmer I with anesthesia and serum iron levels (r = 0.7, p < 0.01). We observed that the quality and quantity of the tears was lower in term newborns with lower serum iron levels than healthy newborns. These results indicate that low serum iron level could affect lacrimal gland functions.