The efficacy of different anti-vascular endothelial growth factor agents, and dexamethasone implant therapy in patients with serous retinal detachment caused by Irvine-Gass syndrome.

PURPOSE: The aim of this study is to compare the efficacy of intravitreal aflibercept (IVA), bevacizumab (IVB), ranibizumab (IVR), and dexamethasone implant (IVDI) in the treatment of serous retinal detachment (SRD) caused by Irvine-Gass syndrome (IGS). DESIGN: Retrospective cohort, comparative study. METHODS AND MATERIALS: The medical records of 128 eyes with no previous history of intravitreal agents in 128 IGS patients with SRD that received IVA, IVB, IVR, and IVDI monotherapy were retrospectively reviewed. The patients were divided into 4 groups, according to treatment. Patients with recurrence and/or were unresponsive following a course of topical steroids and non-steroidal anti-inflammatory drugs (NSAIDs) were included in the study. Best corrected visual acuity (BCVA), central macular thickness (CMT), subfoveal choroidal thickness (SFCT), and SRD were compared between the 4 treatment groups at baseline, at follow-up months 1, 3, 6, and 12, and at the final follow-up visit. RESULTS: Serous retinal detachment completely resolved in 74%, 45.7%, 66.4%, and 40.8% of the eyes at month 1 (P = 0.042), 87%, 50.9%, 75.8%, and 80.9% at month 3 (p = 0.031), 88.9%, 50.4%, 75.7%, 80.2% at month 6 (p = 0.028), 81.7%, 72.8%, 68.7%, 80.1% at month 12 (p = 0.580), and 100%, 66.4%, 87.9%, 93.2% (p = 0.478) at final follow-up visit in the IVA, IVB, IVR, and IVDI groups, respectively. BCVA was significantly better in the IVA group at all follow-up time points (month 1: p < 0.001; month 3: p < 0.001; month 6: p = 0.002; month 12: p = 0.009, final follow-up visit: p < 0.001). CMT was significantly lower in the IVA group at months 3 (p = 0.008), 6 (p = 0.011), and 12 (p = 0.010), and at the final follow-up visit (p < 0.001). Recurrence was observed after a longer period of time and fewer injections were needed in the IVDI and IVA groups (p < 0.05). Resolution of CME was most rapid in the IVA group (p = 0.032). CONCLUSION: All intravitreal agents were effective in terms of visual results in the SRD patients; however, eyes treated with IVA and IVDI required fewer injections, as compared to the eyes treated with IVB and IVR. Furthermore, SRD entirely resolved in all eyes in the IVA group at the final follow-up visit.

Efficacy of topical dexamethasone eye drops in preventing ocular inflammation and cystoid macular edema following uncomplicated cataract surgery with or without injection of a single dose perioperative subtenon triamcinolone acetonide.

PURPOSE: To evaluate the efficacy and safety of topical dexamethasone (DEX) eye drops in combination with a single perioperative subtenon triamcinolone acetonide (sTA) injection versus conventional topical DEX eye drops in the prevention of ocular inflammation and cystoid macular edema following cataract surgery. MATERIALS AND METHODS: Medical records of 245 eyes of 245 patients who underwent uncomplicated cataract surgery were analyzed in this retrospective controlled clinical study. Topical DEX eye drops were administered to 128 eyes routinely postoperatively, and 117 eyes were given a single dose of sTA (40 mg/ml) together with topical DEX eye drops for postoperative care. Postoperative topical antibiotic prophylaxis was applied to all eyes. The primary outcomes were anterior chamber (AC) cells and flare, central macular thickness (CMT), best corrected visual acuity (BCVA), and intraocular pressure (IOP) measurements on day 7, day 30, day 90, and day 180 following surgery. RESULTS: Although CMT increased in the DEX group, no increment was observed in the DEX + sTA treated group for all follow-up periods (on day 7 (+1.3 ± 18.6 and -8.7 ± 21.9 µm, p = 0.038), on day 30 (+20.5 ± 58.4 and -4.1 ± 25.2 µm, p = 0.009), on day 90 (+7.2 ± 19.9 and -5.7 ± 30.6 µm, p = 0.029), and on day 180 (+8.2 ± 22.6 and -6.4 ± 32.9 µm, p = 0.032)). There was no significant difference in terms of AC cells and flare between the two groups during the entire follow-up period (p > 0.05). Significant improvement in BCVA was observed in the DEX + sTA group at day 30 (p = 0.008). IOP differences were comparable, and both groups had high ocular tolerance. There were no severe adverse effects recorded. CONCLUSIONS: Topical DEX eye drops in combination with single dose perioperative injection of sTA have robust efficacy in preventing ocular inflammation and the development of cystoid macular edema following uncomplicated cataract surgery.

Long term results of three anti-vascular endothelial growth factor agents in pachychoroid neovasculopathy.

PURPOSE: To assess morphological changes and visual results in eyes with pachychoroid neovasculopathy (PNV) that underwent different intravitreal anti-vascular endothelial growth factor (VEGF) agents. MATERIALS AND METHODS: This is a retrospective, observational, comparative study that included 76 PNV eyes in 76 patients that were allocated to three groups according to the monotherapy injection procedure, as follows: the intravitreal bevacizumab (IVB) group, intravitreal ranibizumab (IVR) group, and intravitreal aflibercept (IVA) group. Central macular thickness (CMT), best-corrected visual acuity (BCVA), and subfoveal choroidal thickness (SFCT) were measured at baseline, after treatment 1st month, 3rd month, 6th month, and 12th month, and at the final post-treatment examination. RESULTS: Mean age of the patients was 57.31 ± 5.91 years (range: 34-67 years). The mean duration of follow-up was 31.50 ± 12.91 months (range: 13-60 months). The IVB group included 30 eyes, the IVR group included 22 eyes, and the IVA group included 24 eyes. There weren't any significant differences in BCVA changes between the groups at any post-baseline measurement time point. Although CMT did not change significantly in the IVB group from baseline to the final follow-up visit (baseline: 376.33 ± 86.31 µm; final visit: 340.80 ± 122.70 µm) (p = 0.172), CMT did change significantly in the IVA group (baseline: 383.41 ± 131.83 µm; final visit: 297.33 ± 103.81 µm) (p = 0.029) and IVR group (baseline: 379.18 ± 97.93 µm; final visit: 335.72 ± 111.45 µm) (p = 0.041). SFCT decreased significantly in the IVR and IVA groups (p = 0.015 and p < 0.001, respectively). The mean number of injections was 12.06 ± 4.72 (range: 6-20) in the IVB group, 11.81 ± 3.31(range: 7-17) in the IVR group, and 7.16 ± 3.15 (range: 4-13) in the IVA group (p = 0.004). CONCLUSION: All three anti-VEGFs were effective in terms of visual results in patients with PNV. Patients treated with IVA required fewer injections than those treated with IVB or IVR. Furthermore, IVR and IVA treatment significantly decreased SFCT, whereas IVB did not.

The efficacy of different anti-vascular endothelial growth factor agents and prognostic biomarkers in monitoring of the treatment for myopic choroidal neovascularization.

PURPOSE: To evaluate anatomical and visual results of eyes with naive myopic choroidal neovascularization (mCNV) in patients treated with intravitreal anti-vascular endothelial growth factor (VEGF) therapies. MATERIAL AND METHODS: This is a retrospective, non-randomized, comperative, intervetional study. One hundred fourteen eyes of 114 patients with mCNV who underwent intravitreal bevacizumab (IVB), intravitreal ranibizumab (IVR) or intravitreal aflibercept (IVA) monotherapy injections were enrolled into the study. The best corrected visual acuity (BCVA), central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) were compared among the groups during the follow-up periods at the beginning, months 1, 3, 6, 12, and the final visit. RESULTS: The mean age of the patients was 47.76 ± 10.57 years (range, 33-72 years) and the mean follow-up period was 23.34 ± 6.81 months (range, 13-38 months). The mean BCVA denoted a significantly improve at each group (p < 0.05). In terms of an inter-group analysis of all 3 groups, at months 1, 6, and 12 and final visit, the BCVA were statistically significantly better in the IVA group when compared to both IVB and IVR groups (p = 0.021, p = 0.032, p = 0.024, p = 0.012). There was a significant decrease in CMT following IVB (236.49 ± 40.91 µm-190.74 ± 50.12 µm), IVA (232.91 ± 46.29 µm-193.73 ± 46.81 µm) and IVR (234.78 ± 45.37 µm-192.21 ± 37.27 µm) between baseline and final visit (p = 0.018, p = 0.002, p < 0.001, respectively). There was a statistically significant decrease in SFCT values between baseline and final examination only in the IVA group (p < 0.001). The mean number of injections were 9.18 ± 3.18 (range; 3 to 13) in IVB, 6.46 ± 2.93 (range; 3-11) in IVR and 4.45 ± 1.42 (range; 2-7) in IVA (p = 0.028). CONCLUSION: All three anti-VEGFs were found to be effective in terms of visual results in patients with mCNV. However, we demonstrated that IVA reduces the need for anti-VEGF when compared to patients who received both IVB and IVR. Furthermore, IVA induced a prominent reduction in SFCT, whereas IVR and IVB did not have a significant action on SFCT.

Predictive value of ectopic inner foveal layer without internal limiting membrane peeling for idiopathic epiretinal membrane surgery.

PURPOSE: To investigate the clinical importance of ectopic inner foveal layer (EIFL) grading (mild to severe) in patients diagnosed with idiopathic epiretinal membrane (iERM) and had pars plana vitrectomy (PPV) with solely ERM peeling. MATERIALS AND METHODS: Patients diagnosed with iERMs who had undergone PPV including only ERM peeling were enrolled in the study, and follow-up findings were recorded at baseline, and at 3, 6, 12 months and final examinations. EIFL was categorized into four grades, from mild to severe. Pre- and postoperative anatomical changes were measured using spectral domain optical coherence tomography (SD-OCT) imaging. The association between EIFL and other SD-OCT parameters with best-corrected visual acuity (BCVA) was assessed before and after PPV surgery. RESULTS: One-hundred thirty-eight eyes of 106 patients with mild to severe EIFL were included in the study. Higher EIFL thickness was significantly correlated with lower baseline (r = 0.575, p = 0.020) and final BCVA (r = 0.748, p = 0.001). Although EIFLs continued in advanced-stage cases (stage 3 and 4) (64 eyes [82%]) at the final visit, it was observed in 8 eyes (23%) in the early stage (stage 2) of iERMs. A strong positive correlation was found between EIFL thickness and recurrence rate of ERM (r = 0.876, p < 0.001). Recurrence of ERM was detected in 27 eyes; 2 (7%) at stage 1, 3 (9%) at stage 2, 10 (23%) in stage 3, and 12 (33%) in stage 4 (p < 0.001). CONCLUSION: A negative association was found between the severity of EIFL and postoperative anatomical and visual recovery. In terms of surgical timing, early stages (stages 1 and 2) may be preferred for providing good anatomical and visual recovery and a low recurrence rate following surgery.

Hyperbaric Oxygen Therapy for Central Retinal Artery Occlusion: Patient Selection and Perspectives.

The central retinal artery occlusion (CRAO) is a rare ophthalmological emergency that can occur in the eye. CRAO can affect persons of any age, however it is most common in people over the age of 60. CRAO is associated with a number of risk factors, including giant cell arteritis, carotid artery atherosclerosis, cardiogenic emboli, hypertension, smoking, diabetes, and thromboembolic disease. The chance of each of these etiologies being present is assessed during the course of the investigation. Hyperbaric oxygen treatment (HBOT) is classified by the American Heart Association for CRAO at level IIb. In accordance with that, HBOT might be considered for the treatment of such a severe condition. HBOT can maintain retinal oxygenation during ischemic events by allowing oxygen to diffuse through choroidal capillaries that have been exposed to elevated partial pressures of oxygen. As a result, ischemia-related damage is reversed if applied within proper time frame. The amount of time that has passed prior to initiation of HBOT is considered to be the most critical factor in determining the best visual prognosis. According to the Undersea and Hyperbaric Medical Society, patients who are identified with CRAO after the onset of symptoms should be evaluated for HBOT within 24 hours. HBOT has the advantage of having a low risk profile, and it can be utilized to improve visual outcomes in proper patients.

An efficacy comparison of combination of different anti-vascular endothelial growth factors and photodynamic therapy in patients with pachychoroid neovasculopathy.

PURPOSE: To evaluate anatomical and visual outcomes in patients who received intravitreal anti-vascular endothelial growth factor (VEGF) agents in combination with full-dose photodynamic therapy (PDT) on eyes with choroidal neovascularization (CNV) secondary to naive pachychoroid neovasculopathy (PNV). MATERIALS AND METHODS: Medical records on 19 eyes of 19 patients whom intravitreal bevacizumab (IVB), intravitreal ranibizumab (IVR), and intravitreal aflibercept (IVA) injections were administered for CNV caused by PNV were enrolled into the study. The central macular thickness (CMT), best-corrected visual acuity (BCVA), and subfoveal choroidal thickness (SFCT) were recorded at the baseline, months 1, 3, 6, 12, and final control visit following treatment. RESULTS: The age average was 53.84 ± 5.23 years (range, 46-62 years), and mean follow-up time was 33.42 ± 9.43 months (range, 16-49 months). The change in BCVA was found statistically significant in the IVA group only during follow-up visits (p = 0.007). Although there was no statistically significant change in CMT following IVR (360.60 ± 75.64-252 ± 75.04 µm) (p = 0.077), significant changes were observed in IVB (397.14 ± 122.59-275.28 ± 63.82 µm) (p = 0.004) and IVA (385.85 ± 43.82-244.42 ± 51.57 µm) (p = 0.005) between the baseline and the final visit. SFCT significantly decreased following both IVR and IVA treatments (p = 0.016, p = 0.039, respectively). In consideration of the number of injections, significantly fewer injections were needed in the IVA group than the others (p = 0.018). CONCLUSIONS: Anti-VEGF agents with full-dose PDT were well tolerated for the first 3 months and were highly effective treatment option in order to naive PNV patients. However, in long-term follow-ups, the effectiveness of IVA was superior to other anti-VEGFs.

Evaluation of the effect of combined intravitreal ranibizumab injection and sub-tenon steroid injection in the treatment of resistant diabetic macular edema.

PURPOSE: To compare sub-tenon steroid plus anti-VEGF injection with anti-VEGF injection solely in the treatment of resistant diabetic macular edema (DME). METHOD: Patients who exhibited insufficient anatomic [over 350 µm central macular thickness (CMT)] and less than 3 lines of visual gain at least six anti-VEGF injections, were randomly divided into two groups. In group I, the anti-VEGF injection was performed 10 days after the sub-tenon steroid injection [Triamcinolone acetonide (Sinakort-A®)]. And anti-VEGF was performed when needed during the follow-up period. In group II, treatment was continued with anti-VEGF only. All patients' visual acuity and CMT were followed up for 6 months. RESULTS: The baseline BCVA in group I and group II was 0.51 ± 0.667 logMAR and 0.47 ± 0.60 logMAR, respectively (p = 0.52). In group I and II, at the end of 6-month follow-up, BCVA improved to 0.38 ± 0.60 logMAR (p < 0.001) and 0.43 ± 0.60 logMAR (p = 0.20), respectively. The baseline CMT in group I and group II was 494 ± 118.32 and 438.20 ± 90.99 µm, respectively (p = 0.029). In group I and II, at the end of 6 months, CMT decreased to 302.57 ± 69.89 µm (p < 0.001) and 439.20 ± 107.6 µm (p = 0.96), respectively. CONCLUSION: Adding steroid to routine anti-VEGF treatment is an effective way of treatment method for resistant DME.

The Effect of Smoking on Corneal Biomechanics.

PURPOSE: To determine the effect of smoking on corneal biomechanical behavior. MATERIALS AND METHODS: The medical records of consecutive patients that presented to the ophthalmology department were reviewed. History of smoking and ophthalmological examination findings were recorded. The smoking group met the following criteria: a clear history of and present smoking habit, negative history of corneal disease and surgery, ocular response analyzer measurement at the time of examination, and a waveform score ≥3.7. Nonsmokers (never smoked or quit smoking ≥6 months earlier) that met the same criteria constituted the control group. Corneal biomechanical parameters were measured using ocular response analyzer. Data were analyzed using Pearson's χ2 test, Mann-Whitney U test, and Spearman's correlation coefficient. RESULTS: The smoking group included 166 eyes of 166 patients with a mean age of 38.7 ± 11.95 years, and the control group consisted of 170 eyes of 170 patients with a mean age of 38.40 ± 12.2 years. Mean cumulative smoking dose in the smoking group was 9.59 ± 11.87 pack-years (0.04- 75.00). There was no significant correlation between cumulative smoking dose and corneal hysteresis and corneal resistance factor (P = 0.382 and 0.074, respectively). There were no significant differences in corneal hysteresis or the corneal resistance factor between the two groups (P > 0.05). There was no significant difference in corneal hysteresis between those in the smoking group aged 18-44 years and those aged 45-64 years (P = 0.258), whereas in the control group mean corneal hysteresis was significantly lower in the 45-64 year olds than in the 18-44 year olds (P = 0.034). CONCLUSIONS: Although there was no significant difference in corneal biomechanics between smoking and control groups, the decrease in corneal hysteresis with aging was less apparent in the smoking group, which may be due to the potential changes in the cornea's microstructure induced by smoking during aging and the effect of smoking in aged corneal tissue viscosity.

Evaluation of the 'Hedgehog' signaling pathways in squamous and basal cell carcinomas of the eyelids and conjunctiva.

The purpose of the present study was to assess the role of hedgehog signaling pathway in the carcinogenesis of eyelid skin and conjunctival epithelial malignant tumors. The study was conducted on specimens from 41 patients with cutaneous eyelid basal cell carcinoma, 22 with bulbar conjunctival squamous cell carcinoma, 12 with bulbar conjunctival intraepithelial neoplasia. Major molecules of Hedgehog signaling pathway (Sonic Hedgehog [Shh] and Patched-1 [Ptch-1] and Glioma-associated oncogene [Gli-1]) were evaluated in paraffin-embedded tissue specimens using immunohistochemical staining. For each specimen, the percentage (<10%, 10-50%, >50%) and the intensity of the immunohistochemical staining (graded from 0 to 3) were calculated and the scores obtained by multiplication of two values were analyzed using the Kruskall-Wallis test. Shh and Ptch-1 expression levels were statistically significantly lower in the basal cell carcinoma group compared with the squamous cell carcinoma group (P=0.043 for Shh; P=0.030 for Ptch-1). In the conjunctival squamous cell carcinoma group, the Ptch-1 score was 0 in ~25% of specimens and the Gli-1 score was ≤2 in ~45% of cases. In the conjunctival intraepithelial neoplasia group, the Ptch-1 score was ≥2 in 66% of specimens, the Gli-1 score was ≤2 in ~92% of cases. Ptch-1 mutations contribute to the development of cutaneous eyelid basal cell carcinoma. The present study provides evidence that alterations in hedgehog signaling pathways may lead to transformation of the conjunctival intraepithelial neoplasia into invasive squamous cell carcinoma.

A rare case of tick infestation of the eyelid: case report and literature review / Um caso raro de infestação de carrapatos da pálpebra: relato de caso e revisão da literatura

ABSTRACT This article presents a case of tick infestation of the lower eyelid by a previously unreported species. A 71-year-old male presented with a tick attached to the lower eyelid. The tick was identified morphologically, and then molecularly via polymerase chain reaction (PCR) and sequencing of its DNA. In addition, a review of the literature relevant to the genera of ticks associated with infestation of the human eye is provided. The tick, which was in the nymphal developmental stage, was first identified according to taxonomic keys as Dermacentor sp. For complete species identification, 16s rDNA gene PCR and sequencing were performed, which showed that the tick was D. marginatus. Systematizing tick species could assist physicians in determining the potential for transmission of tick-borne human diseases.

RESUMO Este artigo apresenta um caso de infestação por carrapatos da pálpebra inferior por uma espécie previamente não declarada. Um homem de 71 anos de idade apresentou-se com um carrapato grudado na pálpebra inferior. O carrapato foi identificado morfologicamente, e, em seguida, uma estrutura molecular através de reacção em cadeia da polimerase (PCR) e a sequenciação do seu DNA. Além disso, uma análise da literatura pertinente aos gêneros de carrapatos associados à infestação do olho humano é fornecido. O carrapato, que estava em fase de desenvolvimento das ninfas, foi identificado pela primeira vez de acordo com chaves taxonômicas com o Dermacentor sp. Para identificação de espécies completa, gene 16S rDNA PCR e sequenciamento foram realizadas, que mostrou que o carrapato foi D. marginatus. Sistematizando espécie de carrapato poderia ajudar os médicos a determinar o potencial de transmissão de doenças humanas transmitidas por carrapatos.

Iris metastasis of gastric adenocarcinoma.

BACKGROUND: Iris metastasis in patients with gastric cancer is extremely rare. Herein, it is aimed to report on a patient with gastric adenocarcinoma and iris metastasis. CASE PRESENTATION: A 65-year-old patient with the history of gastric cancer was admitted for eye pain and eye redness on his left eye. There was ciliary injection, severe +4 cells with hypopyon in the anterior chamber and a solitary, friable, yellow-white, fleshy-creamy vascularized 2 mm × 4 mm mass on the upper nasal part of the iris within the left eye. The presented patient's mass lesion in the iris fulfilled the criteria of the metastatic iris lesion's appearance. The ocular metastasis occurred during chemotherapy. CONCLUSIONS: Iris metastasis can masquerade as iridocyclitis with pseudohypopyon or glaucoma. In patients with a history of gastric cancer that present with an iris mass, uveitis, and high intraocular pressure, ocular metastasis of gastric cancer should be a consideration.

The role of mast cells in vascularized recurrent pterygium / O papel dos mastócitos no pterígio recidivado vascularizado

Objective: To determine and compare the mast cell count in primary and recurrent vascularized pterygium, and in normal bulbar conjunctiva. Methods: The study included 22 patients with primary pterygium (PP group) and 28 patients with vascularized recurrent pterygium (VRP group) that underwent excision via the limbal conjunctival autograft technique. Normal conjunctiva samples were collected from the superotemporal bulbar conjunctival region, just temporal to the site from which the autograft conjunctival tissue was harvested. The total number of mast cells in the pterygium (primary and recurrent) and control tissue samples was calculated microscopically using 1% toluidine blue stain under 400× magnification. Results: The mean mast cell count in primary and vascularized recurrent pterygium tissue was 7.45 ± 2.06 mm–2 and 16.11 ± 4.33 mm–2, respectively, and the difference was significant (independent samples t-test, P<0.001). The mean mast cell count in pterygium tissue was significantly higher than that in normal conjunctiva tissue in both groups (Student's t-test, P<0.001). Conclusion: An increase in the number of mast cells might play a role in the pathogenesis of recurrent pterygium. Determination of a mast cell count cut-off value could be of diagnostic significance for recurrent pterygium. .

Objetivo: Determinar e comparar o número de mastócitos em pterígio primário e recidivado vascularizado, assim como em conjuntiva bulbar normal. Métodos: O estudo incluiu 22 pacientes com pterígio primário (grupo PP) e 28 pacientes com pterígio recidivado vascularizado (grupo VRP), submetidos à exérese por meio da técnica de transplante de conjuntiva autólogo de limbo. Amostras de conjuntivas normais foram coletadas da região bulbar superotemporal, próximas do local a partir do qual o tecido autólogo de conjuntiva foi colhido. O número total de mastócitos em amostras de tecido dos pterígios (primários e recidivados) assim como dos controles foi calculado microscopicamente utilizando azul de toluidina a 1% sob magnificação de 400×. Resultados: O número de mastócitos médio no tecido pterígio primário e recidivado vascularizado foi de 7,45 ± 2,06 mm-2 e 16,11 ± 4,33 mm-2, respectivamente, e a diferença foi significativa (amostras independentes t-test, P<0,001). A contagem média de mastócitos no tecido pterígio foi significativamente mais elevada do que no tecido conjuntivo normal em ambos os grupos (teste t de Student, P<0,001). Conclusão: Um aumento no número de mastócitos pode desempenhar um papel na patogênese do pterígio recidivado. A determinação de um valor de corte na contagem de mastócitos pode ser importante para o diagnóstico de pterígio recidivado. .

Differentiation of true anophthalmia from clinical anophthalmia using neuroradiological imaging.

Anophthalmia is a condition of the absence of an eye and the presence of a small eye within the orbit. It is associated with many known syndromes. Clinical findings, as well as imaging modalities and genetic analysis, are important in making the diagnosis. Imaging modalities are crucial scanning methods. Cryptophthalmos, cyclopia, synophthalmia and congenital cystic eye should be considered in differential diagnoses. We report two clinical anophthalmic siblings, emphasizing the importance of neuroradiological and orbital imaging findings in distinguishing true congenital anophthalmia from clinical anophthalmia.

The relationship between age and the intraoperative complication rate during phacoemulsification surgery.

AIM: The aim of this study was to determine if aging is a factor that increases the intraoperative complication rate during phacoemulsification surgery. MATERIALS AND METHODS: Patients who underwent phacoemulsification surgery were divided into three age groups according to World Health Organization classification, as follows: ≤ 59, 60-74, and ≥ 75 years. The intraoperative complications which occurred during the operation were recorded. Binary logistics regression analysis, Pearson's correlation analysis, and Duncan's (multiple range) test were used for statistical analysis. RESULTS: In total, 789 patients who underwent phacoemulsification surgery at Nigde State Hospital, Ophthalmology Clinic between 01 July 2010 and 31 October 2012 were retrospectively reviewed, and intraoperative complications that occurred during surgery were recorded. Mean age of the patients was 68.98 years (range 38­93 years). In all, 132 (16.7 %) patients were aged ≤ 59 years, 406 (51.5 %) were aged 60 - 74 years, and 251 (31.8 %) were aged ≥ 75 years. The complication rates were 3.78 % in the ≤ 59-year-old age group, 5.17 % in the 60- to 74-year-old age group, and 5.30 % in the ≥ 75-year-old age group. Age did not have a significant effect on intraoperative complication rates during phacoemulsification surgery, according to binary logistic regression analysis (P = 0.58) and Pearson's correlation analysis (P = 0.076). The incidence and risk of intraoperative complications in the age groups did not differ statistically (Duncan's test, P = 0.18). CONCLUSION: Age has no effect on the rate of intraoperative complications during phacoemulsification surgery.