Nd: YAG laser posterior capsulotomy rates in myopic eyes after implantation of capsular tension ring.

BACKGROUND: The aim f this study was to evaluate the effect of capsular tension ring implantation during cataract surgery on the incidence of neodymium: YAG (Nd: YAG) laser posterior capsulotomy in myopic (axial length [AL] ≥25.00 mm) eyes. MATERIAL/METHODS In this retrospective study, the records of the cases of 117 myopic patients who underwent cataract surgery between January 2004 and January 2011 were reviewed. A total of 153 eyes with an axial length of 25 mm or higher were included in the study with consideration of exclusion criteria mentioned below. Eyes were grouped by presence or lack of capsular tension ring (CTR+ and CTR-, respectively). RESULTS: The study included 153 eyes from 107 myopic patients. Hydrophilic acrylic IOL and capsular tension ring (CTR) were implanted in 78 eyes (CTR+ group), and 75 eyes received only the hydrophilic acrylic IOL (CTR- group). Six eyes (7.6%) in CTR+ and 16 eyes (21.3%) in CTR- required Nd: YAG laser capsulotomy within 7 years. The difference between the 2 groups was statistically significant (p=0.021). CONCLUSIONS: Because CTRs significantly decrease subsequent need for Nd: YAG laser posterior capsulotomy in myopic patients, are very inexpensive, and provide other benefits, our data suggest that the use of CTRs in myopic eyes undergoing cataract surgery with an hydrophilic acrylic IOL implantation is advantageous and should be standard practice.

Toxic effects of chronic mercury exposure on the retinal nerve fiber layer and macular and choroidal thickness in industrial mercury battery workers.

BACKGROUND: The aim of this study was to evaluate the toxic effects of mercury on retinal nerve fiber layer thickness (RNFLT), macular thickness (MT), and choroidal thickness (CT) by using spectral-domain optical coherence tomography (SD-OCT) in battery industry workers who had been chronically exposed to mercury. MATERIAL/METHODS: Battery factory workers (n=31) and healthy non-factory employee controls (n=15) participated in the study. Participants were divided into 3 groups: Group 1 (n=15) was factory workers who had worked for more than 5 years in a mercury battery factory; Group 2 (n=16) was factory worker who had worked for less than 5 years in a mercury battery factory; and Group 3 (n=15) was healthy non-employees. Systemic symptoms were recorded. Ophthalmic examination included best-corrected visual acuity test, color vision test, full ophthalmologic examination, and SD-OCT of the RNLF, macula, and choroid. To determine mercury exposure, venous blood samples were collected and mercury levels were assessed. RESULTS: In our study group the most common systemic symptoms were insomnia (67.7%) and fatigue (67.7%). There were no significant differences between Group 1 and Group 2, but there were significant differences between Group 3 and both Group 1 and Group 2 in best-corrected visual acuity values (1=2<3), color vision scores, blood mercury levels, and duration (mean ±SD, range) of mercury exposure(1>2>3). OCT values of RNFLTs, MTs, and CTs of all 3 groups were statistically different from each another (1<2<3). CONCLUSIONS: SD-OCT can be useful for evaluating the toxic effects of chronic exposure to mercury.

Topical anesthesia for cataract surgery: the patients' perspective.

Purpose. To evaluate the analgesic efficacy of 0.5% propacaine hydrochloride as topical anesthesia during phacoemulsification surgery. Methods. Intraoperative pain intensity was assessed using a 5-category verbal rating scale during each of three surgical stages. Pain scores from each surgical stage and total pain scores were compared for the factors of patient age, gender, cataract laterality, and type. Results. In comparison of cataract type subgroups, the mean total pain scores and mean stage 2 pain scores in both white mature cataract (WMC) and corticonuclear plus posterior subcapsular cataract (CN + PSC) groups were significantly higher than in the PSC-only (PSC) group (P < 0.05). Conclusion. Phacoemulsification with topical anesthesia is not a completely painless procedure. Pain intensity varies with cataract type and stage of surgery.

Traumatic wound dehiscence after penetrating keratoplasty.

BACKGROUND: We aimed to evaluate the risk factors, clinical features and outcomes of surgery for traumatic wound dehiscence (TWD) following penetrating keratoplasty (PK). METHODS: Twenty-six patients with TWD following PK were evaluated retrospectively in terms of factors related to the trauma, types of reconstructive surgery, final graft clarity, and visual acuity. RESULTS: There were 26 patients with a mean age of 40.7±19.6 years. In 12 (46.1%) patients, the better eye was affected by the trauma. The most frequent type of trauma was blunt trauma by various objects (9). In all cases, the dehiscence was at the graft host junction. The mean extent of detachment was 135.4°±57.6°. Crystalline or intraocular lens damage was present in 42.3% of cases. Median follow-up time after the reconstructive surgery was 36 months. The graft remained clear in 13 (50%) patients, whereas graft insufficiency/graft rejection developed in 13 (50%) patients. Final visual acuity was over 20/200 in 13 (50%) patients. CONCLUSION: TWD may occur at any time after PK, most frequently within the first postoperative year. Low visual acuity in the other eye seems to be a major risk factor. In patients without major complications such as posterior segment damage, visual outcomes and graft survival can be favorable.

The use of polypropylene suture as a frontalis suspension material in all age groups of ptosis patients.

PURPOSE/AIM: To evaluate the use of 2-0 polypropylene suture for frontal suspension in ptosis patients with poor levator function. MATERIALS AND METHODS: This retrospective study included 20 eyelids of 16 patients (5 female, 11 male) with 4 mm or less levator function. The operation was considered successful when the difference between the two upper lids was ≤ 1 mm, and the upper lid covered the upper limbus by <3 mm. RESULTS: Median patient age was 22.94 years (2 to 59). Mean follow-up time was 18.06 months (12-29). A successful result was obtained in 14 patients (87.5%). Ptosis recurrence was observed in two patients (12.5%). Lagophthalmos with punctate epithelial keratitis and subsequent spontaneous recovery occurred during the first postoperative week in six patients (37.5%). Two patients with hypocorrection underwent revision surgery in the first postoperative week. Granuloma and material exposition at the forehead incision site observed in one patient at the postoperative fifth month were repaired by excision of the granuloma and suture reposition. CONCLUSIONS: Polypropylene suture as a frontalis suspension material in ptosis patients with poor levator function maintained satisfactory results at follow-up. This material allows easy and repeatable eyelid height adjustment and does not obviate future eyelid procedures.