Anterior chamber flare and choroidal vascular index as inflammatory markers after uncomplicated phacoemulsification surgery.

PURPOSE: To determine the effect of phacoemulsification surgery, which is one of the types of cataract surgery by using ultrasonic power to break up the crystalline lens and clean it with vacuum, on anterior chamber flare (ACF) and choroidal vascular index (CVI). METHODS: For this cross-sectional study, patients were included if they had cataract with nucleus hardness grade 2 or 3, no systemic inflammatory disease, and not use of anti-inflammatory drugs/prostaglandins preoperatively. ACF using a laser flare meter and CVI in patients underwent uncomplicated phacoemulsification was recorded preoperatively, on the postoperative 1st day, 1st week, and 1st month. RESULTS: Fifty-six eyes were included. ACF was 9.00 ± 2.90 ph/ms preoperatively. Although ACF increased significantly on postoperative day-1 (39.38 ± 23.31ph/ms) and decreased gradually until the 1st month (14.03 ± 6.03ph/ms) after the operation, it was still significantly higher at the 1st month (p < 0.001). Macular and peripapillary CVI increased significantly on postoperative day-1 (0.64 ± 0.03/0.63 ± 0.05) and week-1 (0.64 ± 0.04/0.62 ± 0.04) (p = 0.01, p < 0.001); the postoperative 1st month was similar to the preoperative one (0.59 ± 0.06/0.58 ± 0.06). The relationship between the change in ACF and the change in CVI was not significant. CONCLUSION: Phacoemulsification causes raises in ACF and CVI due to increased intraocular inflammation. The fact that ACF was significantly higher in postoperative month-1 and CVI returned to its preoperative value suggests that the effect of uncomplicated phacoemulsification surgery on the increase in inflammation in the anterior segment lasts longer than in the posterior segment. These results suggest that ACF and CVI follow-up may be clinically important in the follow-up of postoperative inflammation.

Optical coherence tomography angiography findings in optic disc drusen and idiopathic intracranial hypertension.

PURPOSE: To evaluate the changes in peripapillary microvascularity in idiopathic intracranial hypertension (IIH) and optic disc drusen (ODD) patients, by comparing them with those in healthy individuals, via optical coherence tomography angiography (OCTA). METHODS: Sixty-two eyes of 33 patients with ODD, 58 eyes of 30 patients with IIH, and 70 eyes of 70 healthy people were imaged for 6 × 6-mm optic disc scans on a spectral-domain OCTA. Vascular densities in superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC) of ODD, IIH, and healthy eyes were compared with a one-way analysis of variance. Post-hoc analysis was performed with the Gabriel test. RESULTS: There was a significant decrease in peripapillary vessel density in SCP, DCP, and CC in patients with IIH compared to the control group (p < 0.05). In ODD patients, especially peripapillary vessel density in DCP was significantly reduced compared to the control group (p < 0.05). Peripapillary vessel density in DCP was significantly lower in the IIH group than ODD group (p < 0.05). CONCLUSIONS: Peripapillary vascular density may be affected during the course of the disease in both IIH and ODD. Compared to healthy individuals, the decrease in vascular density in these patients and the consequent decrease in perfusion in the peripapillary region may guide the pathogenesis of the complications in the course of these two diseases. Although vascular density in DCP and CC differs significantly between IIH and ODD, case-controlled studies are needed to evaluate the role of OCTA in the differential diagnosis of IHH and ODD.

Seven-Year clinical outcomes after implantation of Eyecryl posterior chamber phakic intraocular lenses for high myopia.

PURPOSE: To evaluate the long-term clinical outcomes, safety and efficacy of Eyecryl posterior-chamber phakic intraocular lens implantation (pIOL) implantation in patients with high myopia. METHODS: Patients with myopia between -6.00 and -20.00 dioptres and with endothelial cell density (ECD) was ≥2300 cells/mm2 were included. Preoperative and postoperative first, fourth, and seventh years of refraction, uncorrected/corrected distance visual acuity (UDVA/CDVA), ECD, central vault were detected. RESULTS: Thirty-six eyes were analyzed. The mean UDVA and CDVA in postoperative seventh years were 0.25 ± 0.31 and 0.13 ± 0.24 logMAR, respectively. The safety and efficacy indices were 1.55 ± 0.54 and 1.24 ± 0.53, respectively. The mean cumulative ECD loss was 6.96% (p < 0.001). The central vault at the 1st and the 7th year were 0.52 ± 0.14 and 0.49 ± 0.14 mm, respectively (p = 0.25). CONCLUSIONS: These findings supported the long-term stability, efficacy, safety of the Eyecryl pIOL for high myopia. Eyecryl posterior chamber pIOL is one of the effective refractive options in correcting high myopia.

Efficacy of gonioscopy-assisted transluminal trabeculotomy and trabeculectomy in patients with primary open-angle glaucoma and pseudoexfoliative glaucoma: A single surgeon's experience.

PURPOSE: To compare the intraocular pressure (IOP)-lowering efficiency of gonioscopy-assisted transluminal trabeculotomy (GATT) and trabeculectomy (TRAB) with mitomycin C in patients with primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PEXG). METHODS: In this retrospective comparative study, consecutive patients with POAG or PEXG who underwent GATT or TRAB by a single surgeon and with a follow-up period of at least 1 year were included. Surgical success rates, change in best-corrected visual acuity, IOP, the need for antiglaucoma medication, surgical complications, and the need for additional glaucoma surgery were compared. Surgical success was defined as an IOP reduction of ≥30% or an IOP of ≤18 mmHg. Complete success was defined as without medication. Qualified success was defined as with or without topical medication. RESULTS: The mean baseline IOP was 27.4 ± 8.3 and 24.6 ± 7.6 mmHg (P = 0.13) with the mean number of medications being 3.7 ± 1.0 and 3.7 ± 1.1 (P = 0.98) in TRAB and GATT, respectively. At 12 months, the mean IOP was 15.3 ± 3.5 and 12.5 ± 4.6 mmHg (P = 0.24) with the mean number of medications being 0.9 ± 1.2 and 0.8 ± 1.4 (P = 0.76) after GATT and TRAB, respectively. IOP was lowered from baseline by 52.7% ± 17.5% after TRAB and 45.7% ±18.6% after GATT (P = 0.12). There was no decrease in best-corrected visual acuity in either group. The qualified surgical success rate was 94.4% in the GATT group and 94.9% in the TRAB group (P = 0.75). Percentage of complete success was 64.1% and 52.8% (P = 0.22) after TRAB and GATT, respectively. CONCLUSION: In patients with POAG and PEXG, GATT was as effective and safe as TRAB in lowering IOP and reducing the number of antiglaucomatous drugs.

Histopathological View of Benign Essential Blepharospasm: Orbicularis Oculi Hormone Receptor Levels.

Objectives: Benign essential blepharospasm (BEB) is a focal dystonia characterized by involuntary contractions of the orbicularis oculi and periocular muscles. We aimed to investigate the effects of muscle receptor levels on the etiopathogenesis of blepharospasm by evaluating the orbicularis oculi estrogen receptor (ER) and androgen receptor (AR) levels. Methods: Four blepharospasm patients (2 females and 2 males) who underwent upper lid blepharoplasty and/or orbicularis myomectomy and 4 healthy cases (2 females, 2 males) that had upper lid blepharoplasty were included. The pretarsal, preseptal, and orbital parts of the orbicularis muscles of the patients who underwent orbicularis myomectomy and the waste muscle tissue materials taken from the preseptal orbicularis muscles of the patients who had only upper blepharoplasty were analyzed. Immunohistochemical staining was performed with estrogen alpha and androgen. Results: In healthy men, the orbicularis oculi muscle was stained with ER at a moderate intensity and with AR at a high intensity. In men with blepharospasm, the orbicularis oculi were not stained with ER at all, but at a high intensity with AR. In healthy women, the orbicularis oculi were stained with ER and AR at a high intensity (>50%). In women with blepharospasm, the staining intensities of both receptors were moderate. Conclusion: We determined a decrease in ER and AR in females and almost the absence of ER in males with BEB. This decrease in ER may be associated with a functional abnormality in mitochondria and the decrease in hormonal receptors may be associated with sarcopenia in orbicularis oculi muscle fibers.