Evaluation of corneal topographic parameters in patients with psoriasis.

BACKGROUND: To evaluate corneal topographic parameters in patients with psoriasis. METHODS: This prospective, cross-sectional study included 50 right eyes of 50 patients with psoriasis and 50 right eyes of 50 age- and sex-matched healthy individuals. Detailed dermatological and ophthalmological examinations were performed in all cases. Noninvasive tear break-up time (NIBUT), meibography, keratometry values, and high-order corneal aberrations (HOAs) were obtained using corneal topography and compared to healthy subjects. These values were also evaluated according to anti-tumor necrosis factor alpha (anti-TNF-α) use, the Psoriasis Area and Severity Index (PASI) score, psoriasis duration, and patient age. The chi-square test, Mann-Whitney U test, and Pearson correlation test were used for statistical assessment. RESULTS: Lower NIBUT and higher meibomian gland loss (MGL) were detected in psoriasis patients compared to healthy controls. There were no significant differences between the groups in terms of corneal HOAs. Higher MGL was detected in patients using anti-TNF-α than in patients not using it. A positive correlation was found among topographic parameters, especially between PASI score and the patient's age. No correlations were found between the disease duration and the other parameters. CONCLUSION: NIBUT and MGL are more common in psoriasis patients than in healthy subjects. The relationship between anti-TNF-α use, PASI score, patient age, and corneal parameters should be considered in the follow-up and treatment of ocular findings in psoriasis patients.

Two-year results of a novel sutureless scleral fixation surgery with the haptic hook technique.

PURPOSE: In this study, we evaluated the visual results and complication rates of the novel technique of sutureless scleral fixated intraocular lens (SFIOL) surgery in patients without capsular support. METHODS: In this retrospective study, patients who did not have adequate capsular support and who underwent sutureless SFIOL between 2013 and 2017 at the University of Health Science Dr. Lütfi Kirdar Kartal Training and Research Hospital's Eye Clinic were included. Preoperative and postoperative best corrected visual acuity (BCVA), perioperative and postoperative complications, surgical indications, previous surgeries, and surgical procedures were evaluated. RESULTS: The study included 131 eyes of 162 patients who underwent sutureless SFIOL surgery. Thirty-one patients were excluded from the study because of missing data. The mean age of the patients was 61.5 ± 23.2 years, 72 of whom were female, and the mean follow-up period was 24.3 ± 11.4 months. When all the patients were evaluated together, the preoperative mean BCVA was 1.11 ± 1.01, 0.86 ± 0.76 in the first month, 0.71 ± 0.69 in the third month, and 0.60 ± 0.50 in the second year after surgery according to logMAR. CONCLUSION: The 2-year results of our study demonstrate that the haptic hook technique for sutureless SFIOL surgery is effective and safe in aphakia rehabilitation. However, haptic hooks and their associated future complications must be monitored for a longer period of time to reach a definite conclusion.

Does Storage Time Affect the Outcomes of Split Corneal Transplantation to Reduce Corneal Donor Shortage? A Retrospective Study.

Split cornea transplantation can reduce the shortage of donor corneas. Therefore, this study aimed to evaluate the effect of split graft storage time on the outcomes of split corneal transplantation through Descemet membrane endothelial keratoplasty (DMEK) and deep anterior lamellar keratoplasty (DALK) surgeries. Split corneal transplantation was performed in 80 eyes using 41 donor corneas. The mean before and after splitting storage times and total storage times were recorded. Donor corneal buttons and split grafts were stored in short-term solution at 4°C. In both surgeries (DMEK and DALK), donor corneas were divided into groups depending on their storage times. Mean postoperative 12th month best corrected visual acuity (BCVA), endothelial cell density (ECD), endothelial cell loss (ECL), central corneal thickness (CCT), refractive spherical equivalent (RSE), refractive astigmatism, and complication rates were compared among the groups. Correlation between storage times and 1-year BCVA, ECL, and complication rates were assessed. Clinical outcomes of the groups 1 year after the surgeries were also compared. DALK and DMEK were performed in 41 and 39 eyes, respectively. Storage times were not correlated with 1-year DMEK outcomes and only weakly correlated with post-DALK ECD, ECL, and RSE values. Except for CCT in those that underwent DALK, the outcomes of DMEK and DALK surgeries with stored and non-stored split grafts were not significantly different (P = .02). The storage times of donor corneas and split grafts do not have any impact on outcomes.

Sutureless Scleral-Fixated Intraocular Lens Implantation in the Treatment of Congenital Lens Subluxation Related to Marfan Syndrome.

PURPOSE: To evaluate the efficacy and safety of bimanual capsulorhexis combined with sutureless scleral-fixated intraocular lens (IOL) implantation in children diagnosed as having Marfan syndrome. METHODS: The study included 14 eyes with subluxated lenses of 7 children who were diagnosed as having Marfan syndrome and underwent bimanual capsulorhexis combined with sutureless scleral-fixated IOL implantation by the same surgeon between 2015 and 2019 at the University of Health Sciences, Kartal Dr. Lütfi Kirdar City Hospital's Eye Department. RESULTS: The mean preoperative and postoperative uncorrected visual acuity was 1.47 ± 0.41 and 0.42 ± 0.15 logarithm of the minimum angle of resolution (logMAR), respectively (P = .001). The preoperative best corrected visual acuity (BCVA) ranged from 1.30 to 0.40 logMAR with a mean value of 0.81 ± 0.30 logMAR. Postoperatively, all patients had an increase in the BCVA with a mean value of 0.20 ± 0.11 logMAR, which was statistically significant (P = .001). The mean preoperative and postoperative spherical equivalent was -9.69 ± 4.59 and -0.27 ± 1.21 diopters, respectively. CONCLUSIONS: Despite the small number of patients in this study, good visual results and a low complication rate were obtained in patients with ectopic lens. The long-term IOL status in patients who have undergone sutureless scleral-fixated IOL implantation will make it possible to better evaluate the safety and applicability of the technique. [J Pediatr Ophthalmol Strabismus. 2021;58(6):401-406.].

Peripapillary retinal nerve fiber layer and ganglion cell-inner plexiform layer changes on optical coherence tomography in patients with unilateral hypertensive cytomegalovirus anterior uveitis.

PURPOSE: To investigate whether peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thinning are present in patients with unilateral hypertensive Cytomegalovirus anterior uveitis (hCMV AU). METHODS: We included 19 eyes with unilateral hCMV AU and their unaffected fellow eyes as the control group in this study. Peripapillary RNFL and macular GCIPL changes were determined using spectral-domain (SD) - optical coherence tomography (OCT). RESULTS: The overall calculated mean pRNFL thickness was significantly lower in the effected eyes with hCMV AU than in the uneffected fellow eyes (p = 0.012). The mean macular GCIPL thickness in the affected eyes was also significantly lower than in the normal eyes (p < 0.001). CONCLUSION: Measurement of pRNFL and macular GCIPL thickness with OCT may detect signs of damage before the visual field changes in patients with hypertensive CMV AU. Early aggressive treatment in these patients may prevent further glaucomatous damage.

Comparison of the Success Rate of Two Different Marking Techniques (F-Mark and Asymmetric Triangular Mark) to Orient the Donor Graft During Descemet Membrane Endothelial Keratoplasty.

OBJECTIVES: We evaluated the effects of various graft-marking techniques on surgical results in patients undergoing Descemet membrane endothelial keratoplasty. MATERIALS AND METHODS: In this single-center retrospective study, 65 eyes from 55 patients that had received various types of marking or no marking and that had been used for Descemet membrane endothelial keratoplasty endothelial graft preparation were included. Patients were divided into 3 groups according to the marking technique used: group I (F-marked graft; 17 eyes), group II (asymmetric triangle-marked graft; 12 eyes), and group III (unmarked graft; 36 eyes). The main outcome measurements were best-corrected visual acuity, endothelial cell density, central corneal thickness, postoperative complications, rebubbling, and secondary keratoplasty rates. RESULTS: In groups I, II, and III, rates of patients with 6-month best-corrected visual acuity ≥ 20/32 were 35.7%, 77.8%, and 71.9%, respectively (P = .04). The mean 6-month endothelial cell density decrease for each group was 43.3%, 48.8%, and 46.4%, respectively (P = .589), whereas the mean 6-month central corneal thickness decrease for each group was 7.7%, 15.8%, and 34.0%, respectively (P = .001). Rates of primary graft failure for groups I, II, and III were 35.3%, 8.3%, and 13.9%, respectively. Rebubbling was performed in 21.5% of eyes, and secondary keratoplasty was required in 29.2% of eyes. CONCLUSIONS: Although graft-marking techniques for Descemet membrane endothelial keratoplasty greatly facilitate graft positioning during surgery, both the potential toxic effects of alcohol on the endothelium when marking with gentian violet dye and the risk of graft detachment with asymmetric marking must be considered.

Epidemiological Characteristics of Corneal Donors at a Tertiary Referral Center in Turkey: An Eye Bank Study.

OBJECTIVES: The aim of this study was to evaluate the demographic features of corneal donors and available data of corneas in our eye bank during a 14-year period. MATERIALS AND METHODS: The demographic features of the corneal donors, the causes of death, the death-to-excision interval, serology results, the mean endothelial cell density, and the reasons for discarding the corneas were retrospectively evaluated. RESULTS: During the study period, 6524 corneas were retrieved from 3326 donors (76.1% male, 23.9% female). Mean donor age was 43.7 ± 16.0 years (range, 4-75 years; median 45.0 years). The most common cause of death was cardiovascular disease (n = 1467; 44.1%). The most common reason for discarding corneas was positive serology (n = 509; 78.6%). The mean endothelial cell density was 3030.1 ± 484.3 cells/mm². There was a weak negative statistically significant correlation between age and endothelial cell density (Pearson correlation coefficient r = -0.187, P < .001). Multiorgan donations made up 1.5% of the whole group (n = 50). CONCLUSIONS: We believe that preoperative detailed evaluations of graft quality in addition to review of donor-related medical records and data from previous surgeries, after collecting them in a single system, will have a positive effect on postoperative corneal survival.

Bilateral Serous Macular Detachment After Attempted Suicide with Pregabalin.

A 24-year-old female presented with bilateral vision loss following attempted suicide with pregabalin. Her best-corrected visual acuity (BCVA) was 20/40 in the right eye and 20/50 in the left eye. The bilateral visual disturbance was associated with serous macular detachment. Fundus examination of both eyes showed foveal serous retinal detachment, which was confirmed by optical coherence tomography. Topical nepafenac 0.1% eye drops were started as single drop every 8 hours for 4 weeks. One month later, the serous macular detachment had regressed and BCVA increased to 20/20 in both eyes. To the best of our knowledge, this is the first reported case of bilateral serous macular detachment presumably caused by pregabalin intoxication.

Effect of oral Colchicine on Peripapillary retinal nerve fiber layer thickness in patients with familial Mediterranean fever.

BACKGROUND: The purpose of this study is to investigate whether oral colchicine has an effect on peripapillary retinal nerve fiber layer (pRNFL) thickness of familial Mediterranean fever (FMF) patients. METHODS: We conducted a cross sectional study by comparing pRNFL thickness of FMF patients on colchicine (treated group), newly diagnosed colchicine naïve FMF patients (untreated group) and healthy controls. The study included 66 FMF patients and 32 healthy control subjects. Treated FMF patients were grouped according to colchicine use, duration of use and dosage. pRNFL thickness of the patients and controls were measured by using optical coherence tomography and the measurements were compared. RESULTS: No statistically significant difference was found between the pRNFL thickness in untreated group, treated group and the healthy control group (all p > 0.05). No statistically significant difference was found between pRNFL thickness in the healthy control group and FMF patients grouped according to duration or dosage of colchicine use (all p > 0.05). CONCLUSIONS: According to our study, FMF and oral colchicine use had no statistically significant effect on pRNFL thickness.

Use of an Intravitreal Dexamethasone Implant (Ozurdex) in a Case with Accidental Foveal Photocoagulation by Alexandrite Laser.

Alexandrite laser is one of the most common methods of hair removal. Its utilization is gradually increasing due to easy accessibility and high effectiveness. However, the disuse of protective goggles during the application of this laser is a serious problem. In this case report, we presented a 35-year-old male patient who had foveal injury by alexandrite laser. The inflammatory process secondary to the foveal injury and subsequent macular edema were treated with Ozurdex because of its potent antiedematous effect.