Optic Nerve Head Parameters Measured with Spectral-Domain Optical Coherence Tomography in Healthy Turkish Children: Normal Values, Repeatability, and Interocular Symmetry.

To determine normal values, repeatability, and interocular symmetry of optic nerve head measurements, three spectral-domain optical coherence tomography (SD-OCT) scans were obtained from 128 healthy Turkish children aged 5-17 years consecutively and prospectively. The mean disc area, rim area, cup volume, cup to disc area ratio, and vertical and horizontal cup to disc ratios were 2.30 ± 0.42 mm2, 1.84 ± 0.45 mm2, 0.09 ± 0.10 mm3, 0.20 ± 0.13, 0.37 ± 0.17, and 0.45 ± 0.20, respectively. The intraclass correlation coefficients were >0.9 for repeatability and >0.75 for interocular correlation. Interocular differences were not statistically significant (p > 0.05). Normal paediatric SD-OCT measurements of the optic nerve head are presented, which showed excellent repeatability and no interocular difference.

Early clinical outcome with a new monofocal microincision intraocular lens.

The purpose of this study was to evaluate the early visual and refractive outcomes of a new aspheric monofocal microincision intraocular lens (IOL). This retrospective case series included eyes of patients who underwent implantation of a microincision IOL following 1.8 mm manual coaxial microincision cataract surgery and who attended regular postoperative follow-up visits on the first week and first, third, and sixth months. The postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refraction and predictability, intraoperative and postoperative complications, posterior capsule opacification (PCO), IOL centration, and surgically induced astigmatism (SIA) were evaluated. Sixty-three eyes of 38 patients ranging in age from 51 to 86 were included in the study. The mean preoperative BCVA was 0.52 ± 0.42 logMAR. At the postoperative sixth month, the mean postoperative UCVA and BCVA were 0.12 ± 0.11 and 0.01 ± 0.03 logMAR, respectively. The mean postoperative spherical equivalent refraction (SER) was -0.30 ± 0.49 D. The SER was within ± 1.00 D of the attempted correction in 95.2 % of the eyes. The mean SIA measured with vector analysis was 0.45 ± 0.28 D. Mild PCO was observed in 9 eyes (14.7 %) with none requiring Nd:Yag laser capsulotomy. On centration analysis, the IOL was found to be 0.26 mm on average to the supero-nasal position. The aspheric microincision IOL was safely implanted and provided satisfactory visual and refractive outcomes in the early postoperative period.

Spontaneous Haptic Flexion and Misalignment of a New Microincisional Aspheric Intraocular Lens in the Early Postoperative Period in Two Patients.

PURPOSE: To present two cases of spontaneous haptic flexion and misalignment of a new single-piece microincisional aspheric intraocular lens (IOL) following uneventful microincisional phacoemulsification surgery and IOL implantation. METHODS: Case reports. RESULTS: Both patients had decreased visual acuity and significant myopia and astigmatism in their operated eye at the postoperative first month visit. On dilated biomicroscopic examination, flexion of one haptic was observed in both cases. In one of the cases, the misaligned IOL was explanted and a different posterior chamber IOL was implanted. In the other case, the misaligned IOL was repositioned. CONCLUSIONS: Cataract surgeons should be aware of the risk for haptic flexion and misalignment of this new IOL, causing decreased visual acuity and significant refractive error in the early postoperative period. Satisfactory results can be achieved by either IOL exchange or repositioning the IOL.

Clinical outcomes of a new diffractive multifocal intraocular lens.

AIM: To evaluate clinical outcomes after implantation of a new diffractive aspheric multifocal intraocular lens (IOL) with +3.00 addition power. METHODS: This is a retrospective, consecutive case series of cataract patients who underwent bilateral implantation of the Optiflex MO/HF D012 (Moss Vision Inc. Ltd, London, UK) multifocal IOL. Patients followed for 6mo were included in the study. Data on distance, intermediate and near visual acuity, refractive error [manifest spherical equivalent (MSE)], contrast sensitivity, adverse events, subjective symptoms, spectacle independence and patient satisfaction [visual function questionnaire (VFQ)-25 questionnaire] were retrieved from electronic medical records and analyzed. RESULTS: Forty eyes of 20 patients with a mean age of 66.7±8.5y (range: 53-82) were included in the study. Mean uncorrected distance, near and intermediate visual acuity remained stable through postoperative visits and was 0.19±0.19 logMAR, Jaeger 4 and Jaeger 3 respectively at the 6mo visit. At the end of postoperative 6mo, MSE was -0.14±0.42 diopters (D) and 98% of the eyes were within 1.00 D of target refraction. Postoperative low contrast (10%) visual acuity remained stable (P=0.54) through follow up visits with a mean of 0.35±0.17 logMAR at the 6mo visit. There were no reported adverse events. None of the patients reported subjective symptoms of halo or glare. Spectacle independence rate was 90%. Mean VFQ-25 questionnaire score was 93.5±6.12. CONCLUSION: The Optiflex MO/HF-DO12 IOL was safely implanted and successfully restored distance, intermediate and near visual acuity without impairing contrast sensitivity. High levels of spectacle independence were achieved at all distances including intermediate distance.

Central corneal thickness in type II diabetes mellitus: is it related to the severity of diabetic retinopathy?

BACKGROUND/AIM: To compare the central corneal thickness (CCT) of type II diabetes mellitus patients with age- and sex-matched healthy subjects and to determine the association of the severity of diabetic retinopathy and CCT. MATERIALS AND METHODS: Type II diabetes mellitus patients without retinopathy, with nonproliferative retinopathy, and with proliferative retinopathy were organized as the three subgroups of the study group, and an age- and sex-matched control group was formed. All subjects underwent full ophthalmological examination and CCT measurement with ultrasonographic pachymetry. CCT values were compared between diabetic and healthy subjects and between the three diabetic subgroups. Correlation analysis was performed to determine any relationship between CCT and intraocular pressure. RESULTS: The average CCT was significantly higher in diabetic patients than in the control group (P = 0.04). CCT in diabetic patients without retinopathy did not significantly differ from that of patients with retinopathy (P = 0.64). Similarly, there was no significant difference in CCT between nonproliferative and proliferative diabetic retinopathy patients (P = 0.47). In the whole study population, CCT was significantly correlated with intraocular pressure (P < 0.01). CONCLUSION: CCT is significantly increased in type II diabetes mellitus patients with respect to controls. Retinal disease severity does not seem to have an effect on corneal thickness.

Thiemann disease.

Thiemann disease is a rare genetic disorder that is considered to be a form of avascular necrosis of the proximal interphalangeal joints of the fingers and toes. The clinical symptoms usually appear in adolescence or puberty and may be confused with juvenile rheumatoid arthritis. The characteristic symmetrical, firm, relatively painless deformity and x-ray findings of the epiphysical irregularities should suggest the diagnosis. As rheumatologists become more familiar with the disease, it may be more frequently and promptly diagnosed.