BACKGROUND: To evaluate corneal topographic parameters in patients with psoriasis. METHODS: This prospective, cross-sectional study included 50 right eyes of 50 patients with psoriasis and 50 right eyes of 50 age- and sex-matched healthy individuals. Detailed dermatological and ophthalmological examinations were performed in all cases. Noninvasive tear break-up time (NIBUT), meibography, keratometry values, and high-order corneal aberrations (HOAs) were obtained using corneal topography and compared to healthy subjects. These values were also evaluated according to anti-tumor necrosis factor alpha (anti-TNF-α) use, the Psoriasis Area and Severity Index (PASI) score, psoriasis duration, and patient age. The chi-square test, Mann-Whitney U test, and Pearson correlation test were used for statistical assessment. RESULTS: Lower NIBUT and higher meibomian gland loss (MGL) were detected in psoriasis patients compared to healthy controls. There were no significant differences between the groups in terms of corneal HOAs. Higher MGL was detected in patients using anti-TNF-α than in patients not using it. A positive correlation was found among topographic parameters, especially between PASI score and the patient's age. No correlations were found between the disease duration and the other parameters. CONCLUSION: NIBUT and MGL are more common in psoriasis patients than in healthy subjects. The relationship between anti-TNF-α use, PASI score, patient age, and corneal parameters should be considered in the follow-up and treatment of ocular findings in psoriasis patients.
Photochemotherapy , Psoriasis , Humans , Corneal Topography , Cross-Sectional Studies , Prospective Studies , Tumor Necrosis Factor Inhibitors/therapeutic use , Photochemotherapy/methods , Photosensitizing Agents/therapeutic use , Tumor Necrosis Factor-alpha , Psoriasis/drug therapy
PURPOSE: This study aimed to compare the clinical outcomes following deep anterior lamellar keratoplasty and penetrating keratoplasty in contralateral eyes of the same patients. METHODS: In this retrospective, comparative case series, clinical outcome data included best-corrected visual acuity, refractive spherical equivalent, refractive astigmatism, endothelial cell density, endothelial cell loss, central corneal thickness, and intraocular pressure, which were evaluated at 6, 12, 24, and 36 months after deep anterior lamellar keratoplasty and penetrating keratoplasty. Additionally, complications were assessed. RESULTS: Fifty-two eyes (26 patients) were included, of which 19 patients had keratoconus, 6 had stromal dystrophy, and 1 had post-laser-assisted in situ keratomileusis ectasia. The mean follow-up was 44.1 ± 10.5 months in the deep anterior lamellar keratoplasty Group and 47.9 ± 11.9 months in the penetrating keratoplasty Group. No significant differences were observed in the mean best-corrected visual acuity, refractive spherical equivalent, refractive astigmatism, and central corneal thickness between the deep anterior lamellar keratoplasty and penetrating keratoplasty Groups during follow-up. The endothelial cell density was significantly higher in the deep anterior lamellar keratoplasty Group than in the penetrating keratoplasty Group at 24 and 36 months postoperatively (p=0.022 and 0.013, respectively). Endothelial cell loss was significantly lower in the deep anterior lamellar keratoplasty Group than in the penetrating keratoplasty Group at 24 and 36 months postoperatively (p=0.025 and 0.001, respectively). Intraocular pressure was significantly lower in the deep anterior lamellar keratoplasty Group than in the penetrating keratoplasty Grroup at 6 months postoperatively (p=0.015). Microperforation occurred in 4 eyes (15%) during deep anterior lamellar keratoplasty surgery; however, penetrating keratoplasty was not required. No endothelial rejection occurred in the penetrating keratoplasty Group during follow-up. CONCLUSIONS: Over the 3-year follow-up, endothelial cell loss and intraocular pressure in the deep anterior lamellar keratoplasty Group were significantly lower than those in the penetrating keratoplasty Group, while visual and refractive results were similar.
PURPOSE: Ocular burns are ophthalmic emergencies that can cause devastating injuries. This study aimed to analyze the epidemiology, complications, and management of ocular-periocular burns. METHODS: A total of 193 patients with ocular-periocular burns were admitted to our tertiary hospital from January 2018 to December 2020. The demographic characteristics of the patients, injury variables, complications, and treatments were evaluated. RESULTS: There were 142 male (73.6%) and 51 female (26.4%) patients with a mean age of 32.53±17.75 years. The average total body surface area was 12% (range, 1-80%). Injuries were most common at work (52.3%) and home (36.3%). Thermal burns were the most common injuries (74.6%), followed by chemical (14.5%) and electrical burns (10.9%). Alkaline agents (75.0%), mainly sodium hydroxide and lime, were common in chemical burns. Superficial lid burns were significantly higher in the thermal group (p < 0.001), and grade III-IV corneal burns were significantly higher in the chemical group (p < 0.001). Various complications were developed in 50 (13%) eyes. Medical treatment only was performed in 318 (82.4%) eyes, and additional surgical treatment was performed in 64 (17.6%) eyes; however, 54 (14.0%) underwent more than one surgery. The most common complications were corneal scars (7.3%), limbal deficiency (4.1%), and ectropion (3.9%). The most frequent procedures performed were amniotic membrane transplantation (AMT) (11.9%) and tarsorrhaphy (6.7%). CONCLUSION: Chemical burns, limbal and conjunctival ischemia, and full-thickness eyelid defects had a poor prognosis. The degree of limbal deficiency and injury of intraocular structures were found to have a great influence on the outcome of their visual acuity.
Burns, Chemical , Corneal Injuries , Eye Burns , Humans , Male , Female , Adolescent , Young Adult , Adult , Middle Aged , Eye Burns/epidemiology , Eye Burns/etiology , Eye Burns/therapy , Burns, Chemical/epidemiology , Burns, Chemical/etiology , Burns, Chemical/therapy , Tertiary Care Centers , Conjunctiva
ABSTRACT Purpose: To evaluate the clinical course and management of infectious interface keratitis after Descemet membrane endothelial keratoplasty. Methods: A total of 352 cases that had undergone Descemet membrane endothelial keratoplasty were retrospectively reviewed. Patients with infectious interface keratitis during follow-up were analyzed. The microbiological analyses, time to infection onset, clinical findings, follow-up duration, treatment, and post-treatment corrected distance visual acuity were recorded. Results: IIK was detected in eight eyes of eight cases. Three fungal and three bacterial pathogens were identified in all cases. All patients received medical treatment according to culture sensitivity. Antifungal treatment was initiated in two cases with no growth on culture, with a preliminary diagnosis of fungal interface keratitis. Intrastromal antifungal injections were performed in all patients with fungal infections. The median time to infection onset was 164 days (range: 2-282 days). The postoperative infectious interface keratitis developed in the early period in two cases. The mean follow-up duration was 13.4 ± 6.2 months (range: 6-26 months). Re-Descemet membrane endothelial keratoplasty was performed in two patients (25%) and therapeutic penetrating keratoplasty in four patients (50%) who did not recover with medical treatment. The final corrected distance visual acuity was 20/40 or better in five patients (62.5%). Conclusion: The diagnosis and treatment of infectious interface keratitis following Descemet membrane endothelial keratoplasty are challenging. Early surgical intervention should be preferred in the absence of response to medical treatment. Better graft survival and visual acuity can be achieved with therapeutic penetrating keratoplasty and re-Descemet membrane endothelial keratoplasty in patients with infectious interface keratitis.
RESUMO Objetivo: Avaliar o curso clínico e o manejo da ceratite infecciosa de interface após ceratoplastia endotelial da membrana de Descemet. Métodos: Um total de 352 casos submetidos a ceratoplastia endotelial da membrana de Descemet foram revisados retrospectivamente. Pacientes com ceratite infecciosa de interface foram analisados durante o acompanhamento. As análises microbiológicas, o tempo até o início da infecção, os achados clínicos, a duração do acompanhamento, o tratamento e a acuidade visual para longe corrigida pós-tratamento foram registrados. Resultados: Ceratite infecciosa de interface foi detectada em 8 olhos de 8 casos. Três patógenos fúngicos e três bacterianos foram identificados em todos os casos e receberam tratamento médico de acordo com a sensibilidade da cultura. O tratamento antifúngico foi iniciado em dois casos sem crescimento em cultura, com diagnóstico preliminar de ceratite infecciosa fúngica. Injeções antifúngicas intraestromais foram usadas em todos os casos com infecções fúngicas. O tempo médio para o início da infecção foi de 164 dias (variação: 2-282 dias). A ceratite infecciosa de interface pós-operatória desenvolveu-se no período inicial em dois casos. A duração média do acompanhamento foi de 13,4 ± 6,2 meses (variação: 6-26 meses). A ceratoplastia endotelial de membrana de Descemet foi realizada em dois casos (25%) e ceratoplastia penetrante terapêutica em quatro casos (50%) que não se recuperaram com tratamento médico. A acuidade visual para longe corrigida final foi de 20/40 ou melhor em 5/8 (62,5%) dos pacientes. Conclusões: O diagnóstico e o tratamento da ceratite infecciosa de interface após ceratoplastia endotelial da membrana de Descemet são difíceis. A intervenção cirúrgica precoce deve ser o procedimento preferido se não houver resposta ao tratamento médico. Melhor sobrevida do enxerto e melhor acuidade visual podem ser alcançadas com ceratoplastia penetrante terapêutica e ceratoplastia endotelial da membrana de Descemet em pacientes com ceratite infecciosa de interface
BACKGROUND: This study aimed to evaluate the factors influencing final visual acuity in pediatric traumatic cataracts. METHODS: Data of patients who presented with traumatic cataracts were reviewed retrospectively. We evaluated age at trauma; gender, trauma type, cause, and zone; duration between the time of trauma and cataract surgery; surgical method used; time, location, and type of intraocular lens (IOL) implantation; initial and final best corrected visual acuity (BCVA); amblyopia rate; and complications. RESULTS: In all, 61 eyes of 59 patients aged < 16 years with cataracts after trauma were included. The mean age of the children was 7.2 ± 3.9 years. Primary IOL implantation was performed in 70.9% of eyes. The BCVA was 0.7 LogMAR or better in 5.9% of the 49 eyes in which the visual acuity could be measured at the time of trauma and in 69.1% of 55 eyes in which it could be measured after treatment. Evaluation of factors potentially influencing the final visual acuity revealed that eyes that had undergone posterior capsulotomy (PC) and anterior vitrectomy (AV) during cataract surgery had significantly better final visual acuity compared with eyes that did not undergo these procedures. CONCLUSIONS: In children with posttraumatic cataracts, final visual acuity was not affected by patient age and gender; trauma type, cause, and zone; duration between the time of trauma and cataract surgery; surgical method used; and time, location, and type of intraocular lens (IOL) implantation. Improvements in the final BCVA could be seen only by PC + AV combined with lens aspiration with or without IOL implantation. However, this approach of amblyopia treatment needs to be confirmed by more comprehensive and prospective studies.
Amblyopia , Cataract , Eye Injuries , Amblyopia/complications , Cataract/complications , Child , Child, Preschool , Eye Injuries/complications , Eye Injuries/surgery , Humans , Prospective Studies , Retrospective Studies , Tertiary Care Centers
PURPOSE: To evaluate the clinical course and management of infectious interface keratitis after Descemet membrane endothelial keratoplasty. METHODS: A total of 352 cases that had undergone Descemet membrane endothelial keratoplasty were retrospectively reviewed. Patients with infectious interface keratitis during follow-up were analyzed. The microbiological analyses, time to infection onset, clinical findings, follow-up duration, treatment, and post-treatment corrected distance visual acuity were recorded. RESULTS: IIK was detected in eight eyes of eight cases. Three fungal and three bacterial pathogens were identified in all cases. All patients received medical treatment according to culture sensitivity. Antifungal treatment was initiated in two cases with no growth on culture, with a preliminary diagnosis of fungal interface keratitis. Intrastromal antifungal injections were performed in all patients with fungal infections. The median time to infection onset was 164 days (range: 2-282 days). The postoperative infectious interface keratitis developed in the early period in two cases. The mean follow-up duration was 13.4 ± 6.2 months (range: 6-26 months). Re-Descemet membrane endothelial keratoplasty was performed in two patients (25%) and therapeutic penetrating keratoplasty in four patients (50%) who did not recover with medical treatment. The final corrected distance visual acuity was 20/40 or better in five patients (62.5%). CONCLUSION: The diagnosis and treatment of infectious interface keratitis following Descemet membrane endothelial keratoplasty are challenging. Early surgical intervention should be preferred in the absence of response to medical treatment. Better graft survival and visual acuity can be achieved with therapeutic penetrating keratoplasty and re-Descemet membrane endothelial keratoplasty in patients with infectious interface keratitis.
Corneal Ulcer , Descemet Stripping Endothelial Keratoplasty , Eye Infections, Fungal , Keratitis , Humans , Descemet Membrane/surgery , Descemet Stripping Endothelial Keratoplasty/adverse effects , Antifungal Agents/therapeutic use , Retrospective Studies , Keratitis/etiology , Keratitis/microbiology , Keratoplasty, Penetrating/adverse effects , Eye Infections, Fungal/etiology , Eye Infections, Fungal/microbiology , Corneal Ulcer/drug therapy
AIM: To report a critical case series of six patients with posterior microphthalmos (PM). METHOD: Complete ophthalmologic examinations of all patients were performed using best-corrected visual acuity (BCVA), cycloplegic refraction, applanation tonometry, slit lamp biomicroscopy of the anterior segment, fundoscopy, A and B mode ultrasonography (USG), keratometry, and optic coherence tomography (OCT). RESULTS: The most significant clinical characteristics of male patients aged 10-25â¯years was the presence of shorter posterior segments (mean: 15.27-18.91â¯mm) accompanying high hyperopia (mean +9.00 - +18.50 diopter) despite the normal anterior segment findings. The BCVA ranged between 20/320 and 40/100. Retinal folds were detected bilaterally on the papillomacular band in all patients. Although neurosensory retina was included in the fold in OCT images, retinal pigment epithelium, choroid, and sclera were not included in the fold. Pigmentary retinopathy was detected in one patient. CONCLUSION: Despite normal anterior segment, posterior microphthalmos is characterized with high hyperopia, and shorter axial length and bilateral papillomacular retinal fold. Refractive amblyopia, uveal effusion syndrome, retinal detachment and macular hole are complications that can be corrected. Posterior microphthalmos must be kept in mind in patients with a normal anterior segment, and high hyperopia.
BACKGROUND: The purpose of this study is to investigate whether oral colchicine has an effect on peripapillary retinal nerve fiber layer (pRNFL) thickness of familial Mediterranean fever (FMF) patients. METHODS: We conducted a cross sectional study by comparing pRNFL thickness of FMF patients on colchicine (treated group), newly diagnosed colchicine naïve FMF patients (untreated group) and healthy controls. The study included 66 FMF patients and 32 healthy control subjects. Treated FMF patients were grouped according to colchicine use, duration of use and dosage. pRNFL thickness of the patients and controls were measured by using optical coherence tomography and the measurements were compared. RESULTS: No statistically significant difference was found between the pRNFL thickness in untreated group, treated group and the healthy control group (all p > 0.05). No statistically significant difference was found between pRNFL thickness in the healthy control group and FMF patients grouped according to duration or dosage of colchicine use (all p > 0.05). CONCLUSIONS: According to our study, FMF and oral colchicine use had no statistically significant effect on pRNFL thickness.
Colchicine/therapeutic use , Familial Mediterranean Fever/drug therapy , Nerve Fibers/drug effects , Retinal Ganglion Cells/drug effects , Tubulin Modulators/therapeutic use , Administration, Oral , Adult , Cross-Sectional Studies , Female , Humans , Intraocular Pressure , Male , Middle Aged , Nerve Fibers/pathology , Optic Disk , Retinal Ganglion Cells/pathology , Tomography, Optical Coherence
A toric intraocular Collamer lens (ICL) was used to correct myopic astigmatism after penetrating keratoplasty. The patient's manifest refraction improved from -8.0 -1.75 x 170 preoperatively, with an uncorrected distance visual acuity (UDVA) of 0.15 and a corrected distance visual acuity (CDVA) of 0.4, to +0.75 -0.50 x 130 postoperatively, with a UDVA of 0.8 and a CDVA of 1.0. No serious complications or refractive changes occurred during the 1-year follow-up. Implantation of a myopic toric ICL in phakic eyes is an option to correct postkeratoplasty anisometropia and astigmatism.
Astigmatism/surgery , Keratoplasty, Penetrating/adverse effects , Lens Implantation, Intraocular , Myopia/surgery , Phakic Intraocular Lenses , Adult , Astigmatism/etiology , Astigmatism/physiopathology , Cell Count , Corneal Topography , Endothelium, Corneal/pathology , Humans , Male , Myopia/etiology , Myopia/physiopathology , Postoperative Complications , Visual Acuity/physiology
