Retrospective evaluation of traction time for impacted dilacerated maxillary central incisors in mixed dentition.

PURPOSES: This study aimed to contribute to understanding the factors affecting the time of traction treatment of impacted dilacerated maxillary central incisors. METHODS: This retrospective study included children aged 8 - 11 years with a history of trauma, who applied to the pediatric dentistry clinics of Marmara University, School of Dentistry, between December 2013 and December 2019, and were treated for unilateral impacted dilacerated maxillary upper central incisors. Children's age, sex, digital panoramic radiographs, cone-beam computed tomography, and intraoral photographs were retrieved from electronic dental health records. The effects of children's age, sex, the direction of impacted teeth, distance of the teeth to the top of the alveolar crest, and root dilaceration level on traction time were analyzed by Mann-Whitney U test and Spearman's rank correlation coefficient test. RESULTS: The inverse position of the incisors significantly increased the traction time (P = 0.012). However, the traction time did not differ according to the sex of the children (P = 0.707) or the level of root dilaceration (P = 0.429). No correlation was observed between the traction time and the age of children (P = 0.644) or the distance of the incisors from the top of the alveolar crest (P = 0.397). CONCLUSIONS: In cases of the forced eruption of for the impacted dilacerated maxillary central incisors, the direction of the teeth should be evaluated when deciding on the treatment plan, as it may affect the treatment time.

Effect of Topical Antibiotic Prophylaxis on Conjunctival Flora and Antibiotic Resistance Following Intravitreal Injections in Patients with Type 2 Diabetes.

PURPOSE: We sought to determine changes in the conjunctival bacterial flora and antibiotic resistance after topical antibiotic drops for infection prophylaxis were administered following intravitreal injections in patients with type 2 diabetes. METHODS: This prospective and nonrandomized cohort study included 116 eyes of 116 treatment-naive patients with type 2 diabetes who received six serial intravitreal anti-vascular endothelial growth factor injections for macular edema. Three conjunctival cultures were obtained from each eye over the course of the study (Culture 1, baseline; Culture 2, 1 month after the third injection; and Culture 3, 1 month after the sixth injection). The study subjects were given topical moxifloxacin hydrochloride for 4 days after each monthly intravitreal injection. The growth patterns of conjunctival bacterial flora and the antibiotic resistance to several commonly used antibiotics were examined. RESULTS: The rate of culture positivity increased significantly during the observation period (Culture 1, n = 47, 40.5%; Culture 2, n = 58, 50%; Culture 3, n = 76, 65.5%, p < 0.001). The bacterium with the highest baseline culture positivity was Staphylococcus epidermidis (n = 45, 38.8%), which increased significantly during the observation period (p < 0.001). No significant increase was noted in the culture positivity of the other bacteria with baseline culture positivity (p > 0.05). Regarding antibiotic susceptibility, significant increases in resistance to the fluoroquinolone group of drugs were noted (p < 0.001). No significant changes in sensitivity were detected in the other 11 investigated antibiotics that are commonly used in clinical practice (p > 0.05). CONCLUSIONS: The use of topical moxifloxacin after each intravitreal injection significantly increases the fluoroquinolone resistance of the ocular surface flora and the culture-positivity rate of S. epidermidis in patients with type 2 diabetes.

The Use of Autologous Serum Eye Drops after Epithelium-off Corneal Collagen Crosslinking.

SIGNIFICANCE: After epithelium-off crosslinking (CXL), epithelial closure time and post-operative pain are an important issue in terms of possible complications and patient comfort. We report a prospective randomized study about the use of autologous serum eye drops after CXL. PURPOSE: This study aims to evaluate the effect of autologous serum eye drops on epithelial healing and post-operative pain after CXL. METHODS: Sixty patients diagnosed as having progressive keratoconus and treated with accelerated CXL (9 mW/cm for 10 minutes) randomly received 20% autologous serum eye drops (autologous serum group, n = 30) or artificial tears (control group, n = 30). Patients were evaluated every day after the surgery, and the day of epithelial closure was recorded. All patients were asked to report the maximum pain level using the Wong-Baker FACES Pain Rating Scale at the end of each day until the epithelial closure was completed. The change in topographic parameters and haze were recorded at 6 months. RESULTS: The mean epithelial closure time was significantly lower in the autologous serum group than in the control group (2.37 ± 0.49 and 2.67 ± 0.47 days, respectively; P = .02). There was a statistically significant difference between the pain scores in the first and second days of surgery between the two groups (first-day autologous serum autologous serum group: 2.80 ± 0.66 and control group: 3.50 ± 0.82, P = .01; second-day autologous serum group: 1.73 ± 0.69 and control group: 2.20 ± 0.76, P = .02). Pre-operative and post-operative topographic parameters and haze at 6 months were similar between the two groups (P > .05 for all). CONCLUSIONS: Use of autologous serum eye drops after CXL accelerates epithelial healing and reduces post-operative pain. Shortening the duration of epithelial closure would be beneficial in reducing possible complications and increasing patient comfort.

Comparison of outcomes of conventional transcanalicular laser dacryocystorhinostomy and modified transcanalicular laser dacryocystorhinostomy.

INTRODUCTION: Transcanalicular laser DCR (TL-DCR) approaches have been developed for the formation of a fistula between the nasal cavity and the lacrimal sac to ensure the continuity of the lacrimal drainage system over the years. However, the success rate of TL-DCR has varied widely. AIM: To evaluate and compare the success rates of conventional transcanalicular multidiode laser dacryocystorhinostomy and modified transcanalicular multidiode laser dacryocystorhinostomy. MATERIAL AND METHODS: Ninety-one eyes of 91 adult patients admitted with epiphora and diagnosed with chronic dacryocystitis were included in the study. The participants were divided into two groups. Group 1 consisted of 55 patients who were treated with conventional transcanalicular laser dacryocystorhinostomy. Group 2 consisted of 36 patients to whom the same surgical procedure was applied with the difference of nasal mucosa excision prior to laser osteotomy. The groups' intraoperative surgical ostium size, perioperative and postoperative complications, operative times and success rates were compared. RESULTS: The mean follow-up periods for each group were 8.88 ±2.99 months and 10.28 ±4.47 months, respectively (p = 0.077). Intraoperative mean surgical ostium sizes were 31.85 ±14.98 mm2 and 42.25 ±18.09 mm2, respectively (p = 0.004). The mean operation time in group 1 was significantly shorter compared to group 2 (18.55 ±4.05 min and 24.44 ±3.18 min, respectively, p = 0.0001). The overall success rate was 65.45% in group 1 and 75.00% in group 2 (p = 0.335). CONCLUSIONS: Although the surgical ostium area was significantly greater in group 2, there was no significant difference in surgical success and patient satisfaction rates between the two groups.

Elevated serum fetuin-A levels are associated with grades of retinopathy in type 2 diabetic patients.

PURPOSE: Fetuin-A is a physiological inhibitor of insulin receptor tyrosine kinase and thus associated with insulin resistance, metabolic syndrome, and an increased risk for type 2 diabetes mellitus (T2DM). This study aims to investigate the possible relation between the serum fetuin-A levels and the stages of diabetic retinopathy (DR) in patients with T2DM. METHODS: This prospective study included 82 patients with T2DM and 19 age- and gender-matched healthy controls (HCs) (group 1). Diabetic patients were subclassified into three groups according to ocular findings: without DR (group 2; n = 26); non-proliferative DR (group 3; n = 29), and proliferative DR (group 4; n = 27). Serum fetuin-A levels were determined by a spectrophotometric technique using an immulite chemiluminescent immunometric assay. The data were analyzed using a Mann-Whitney U test, and the results were expressed as mean ± standard deviation. RESULTS: Mean fetuin-A values were 256.4 ± 21.3 µg/ml in group 1, 263.5 ± 24.2 µg/ml in group 2, 282.2 ± 31.1 µg/ml in group 3, and 296.3 ± 26.2 µg/ml in group 4. Group 2 had higher mean fetuin-A level compared with group 1, but the difference was not statistically significant (p > 0.05). Serum fetuin-A levels were significantly higher in groups 3 and 4 compared with HCs (both p < 0.05). Compared with group 2, both DR groups had higher fetuin-A levels with a significant difference (both p < 0.05); and patients with proliferative DR had significantly higher serum fetuin-A levels compared with non-proliferative DR (p < 0.05). The mean serum fetuin-A levels increased with the stage of DR, and the highest levels were found in patients with proliferative DR. CONCLUSION: Our findings suggest an association between fetuin-A levels and DR stage. In diabetic patients, the risk of retinopathy development increases with higher fetuin-A values. Fetuin-A may play an important role in the pathophysiology and progression of DR.

Long-term changes in subfoveal choroidal thickness and central macula thickness after Nd:YAG laser capsulotomy.

PURPOSE: To evaluate changes in central macula thickness (CMT), subfoveal choroid thickness (SCT), and intraocular pressure (IOP) before and after neodymium:yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy. METHODS: 42 eyes of 42 patients who underwent Nd:YAG laser capsulotomy were included in this prospective study. CMT, SCT, and IOP were evaluated preoperatively and at postoperative week 1 and postoperative months 1, 3, 6, and 12. RESULTS: CMT was 238.1 ± 27.6 µm (mean ± SD) preoperatively, then 239.7 ± 29.8, 241.3 ± 28.7, 242.7 ± 27.2, 238.8 ± 23.7, and 238.3 ± 21.7 µm at postoperative week 1 and months 1, 3, 6, and 12, respectively. SCT was 263.3 ± 21.6 µm preoperatively, and 265.5 ± 24.8, 266.2 ± 25.7, 267.1 ± 26.3, 269.1 ± 24.2, and 269.9 ± 21.4 µm at postoperative week 1 and months 1, 3, 6, and 12, respectively. There were no significant differences between preoperative and postoperative results for CMT, SCT, or IOP (all p > 0.05). CONCLUSION: Although there were slight changes in choroid thickness in the long term, treatment of posterior capsule opacification with a low-energy Nd:YAG laser is a safe procedure that increases visual acuity without creating a significant increase in IOP, CMT, and SCT.

Relationship between Altered Platelet Morphological Parameters and Retinopathy in Patients with Type 2 Diabetes Mellitus.

Purpose. To investigate whether platelet morphology or function is altered in patients with diabetic retinopathy (DR). Methods. This prospective study enrolled 85 healthy controls (HCs) (group 1) and 262 patients with Type 2 diabetes mellitus (T2DM). Patients were subclassified into three groups according to ocular findings: no DR (group 2; n = 88); nonproliferative DR (group 3; n = 88), and proliferative DR (group 4; n = 86). Mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (PLCR), plateletcrit (PCT) values, and platelet count were measured in the studied groups. Results. MPV, PDW, and PLCR levels were significantly altered in groups 2-4 compared with HCs (p < 0.05, p < 0.05, p < 0.05). Compared with group 2, both DR groups had higher MPV and PDW levels, with a significant difference between groups 2 and 4 for both MPV (p = 0.036) and PDW (p = 0.006). PLCR correlated with retinopathy stage, but no significant difference was found between the DR groups. Platelet count and PCT values were not significantly different between the groups (p > 0.05). Conclusion. Our findings suggest an association between mean platelet indices (MPI) (i.e., MPV, PDW, and PLCR) and DR stage. Therefore, MPI could be a beneficial prognostic marker of DR in patients with T2DM.

Long-Term Changes in Subfoveal Choroidal Thickness After Cataract Surgery.

BACKGROUND Cataract surgery is associated with the development of late-onset age-related macular degeneration (AMD). The pathogenic mechanism is still not fully established. The purpose of this study was to evaluate the possible changes in central macula thickness (CMT) and subfoveal choroid thickness (SCT) after uneventful cataract surgery. MATERIAL AND METHODS A total of 65 eyes of 65 patients who underwent phacoemulsification and intracapsular lens implantation were included in this prospective study. Patients had not undergone previous ocular surgery and had no other ocular abnormality. CMT and SCT were measured at baseline and postoperatively at week 1 and months 1, 3, 6 and 12 via spectral domain optical cohorence tomography (SD-OCT). RESULTS CMT was 252.4±27.6 µm (mean ±SD) preoperatively, then 253.5±29.8, 256.1±28.7, 257.4±27.2, 253.18±23.7, and 252.8±21.7 µm at postoperative week 1 and postoperative months 1, 3, 6, and 12, respectively. There were insignificant changes in CMT, and it returned to baseline at six months after surgery (all p>0.05). SCT was 237.4±21.6 µm preoperatively, and 240.5±24.8, 241.2±25.7, 242.7±26.3, 243.1±24.2, and 244.2±21.4 µm at postoperative week 1 and postoperative months 1, 3, 6, and 12, respectively. Although there was an increase in SCT during follow-up, the difference between preoperative and postoperative values was not significant (p>0.05). CONCLUSIONS Uncomplicated phacoemulsification induces subclinical changes in CMT, probably due to the inflammatory insult of surgery, and CMT returns to baseline value. There were slight, insignificant increases in choroid thickness during follow-up, and this did not return to baseline during follow-up. Changes in the choroid after cataract surgery may provide clues to the development of late-onset AMD.