Evaluation of changes in retinal and choroidal thickness using spectral domain optical coherence tomography in unilateral non granulomatous acute anterior uveitis.

PURPOSE: To assess retinal and choroidal thickness changes in eyes with a first episode of unilateral non granulomatous acute anterior uveitis (AU). METHODS: Thirty-one patients with acute unilateral non granulomatous AU who had undergone spectral domain optical coherence tomography (SD-OCT) of both eyes were included in this retrospective study. Retinal thickness (RT) as defined by the Early Treatment Diabetic Retinopathy Study (ETDRS) and subfoveal choroidal thickness (SFCT) obtained by SD-OCT were recorded. Healthy fellow eyes of the patients served as the control. RESULTS: A significant thickening in 1mm of ETDRS subfield and in subfoveal choroid was observed in eyes with acute AU when compared with the unaffected fellow eyes (P=0.005 and P<0.00001, respectively). RT and SFCT of affected eyes did not show a significant difference in terms of HLA-B27 antigen presence or absence (P>0.05, for all). CONCLUSIONS: Significant posterior segment changes were detected in eyes with acute unilateral non granulomatous AU.

Efficacy and safety of pneumatic trabeculoplasty versus timolol added to latanoprost in primary open angle glaucoma.

BACKGROUND: To compare the safety and short-term additive hypotensive effect of pneumatic trabeculoplasty (PNT) versus timolol among patients receiving topical latanoprost for primary open angle glaucoma (POAG). PATIENTS AND METHODS: This study prospectively evaluated 30 eyes of 30 patients with POAG receiving latanoprost monotherapy. We randomly assigned 15 eyes to PNT plus latanoprost (Group A), and 15 eyes to latanoprost/timolol fixed combination therapy (Group B). PNT treatment was performed at days 0, 7, and 90. Follow-up visits occurred at day 1, week 1, and months 1 and 3. RESULTS: Compared to baseline values, both treatments significantly lowered IOP (p ≤ 0.001).The mean IOP for Group A was 21.13 ± 1.6 mmHg at baseline and 18.7 ± 1.5 mmHg at three months (p ≤ 0.001). For Group B, mean IOP was 20.8 ± 1.9 mmHg at baseline and 18.9 ± 0.8 mmHg at three months (p ≤ 0.001). Transient conjunctival hyperaemia, the only adverse effect occurring after PNT, was observed in all patients in Group A. CONCLUSION: The additive IOP-lowering effect of PNT was similar to timolol in patients with POAG receiving latanoprost.

Transcanalicular revision surgery for failed dacryocystorhinostomy.

AIM: To evaluate the effectiveness of transcanalicular multi diode laser in revision dacryocystorhinostomy and to determine the outcomes. MATERIALS AND METHODS: Fifty-three consecutive patients (19 males, 44 females) who were referred for recurrent dacryostenosis with epiphora after a failed primary dacryocystorhinostomy (DCR) operation were included in the study. Patients were assigned to two separate groups on the basis of primary DCR operation: either endonasal dacryocystorhinostomy (END-DCR) or transcanalicular multi diode laser dacryocystorhinostomy (TC-MDL DCR). TC-MDL DCR technique was used for revision surgeries in both groups. The mean age of the patients was 46.5 ± 13.1 (Range, 15 -71) and the average follow-up duration was 12 months. RESULTS: The success rate was 62% (18/29) in the primarily TC-MDL DCR operated group, and 85.2% (29/34) in the primarily END-DCR operated group respectively. The occlusion of internal ostium with granulation tissue was the leading etiology of unsuccessful surgical outcome in both group 1 and group 2 (42.8% and 28.5% respectively). CONCLUSIONS: TC-MDL DCR is a minimally invasive surgical method with relatively high success and low complication rates in patients with failed primary DCR requiring revision.

Subconjunctival bevacizumab injection in the surgery of primary pterygium: comparison with intraoperative mitomycin-C.

PURPOSE: To assess the efficacy of subconjunctival bevacizumab injection as adjuvant therapy in the prevention of recurrence following the surgical treatment of pterygium by comparison with intraoperative mitomycin-C application. METHODS: This prospective comparative study included thirty consecutive patients with primary nasal pterygium that were surgically treated with simple excision. In addition to surgical excision, subconjunctival bevacizumab was injected in 15 eyes (group A), and, in the remaining 15 eyes, topical mitomycin-C 0.2 mg/mL was applied for 2 minutes (group B). The postoperative outcome was followed clinically for a minimum of 12 months. The main outcome criteria were recurrence rate and postoperative complications. RESULTS: A significantly higher recurrence rate was found in bevacizumab group (66.7%) compared to MMC group (26.7%) (P= 0.028). In group A, conjunctival wound separation was observed in 3 of 15 eyes; however, no conjunctival separation was observed in Group B and no other serious complications were observed in either group. CONCLUSION: The intraoperative use of subconjunctival bevacizumab does not seem to be effective in reducing the rate of pterygium recurrence following excision when compared with intraoperative mitomycin-C application.

Comparison of sulcus implantation of single-piece hydrophilic foldable acrylic and polymethylmethacrylate intraocular lenses in eyes with posterior capsule tear during phacoemulsification surgery.

PURPOSE: To compare the results of sulcus implantation of acrylic and poly(methylmethacrylate) (PMMA) intraocular lens (IOL) in eyes with posterior capsule tear during phacoemulsification surgery. METHODS: In all eyes a posterior capsule tear developed during phacoemulsification surgery and an IOL to the ciliary sulcus was implanted primarily. A total of 89 eyes of 88 patients received hydrophilic foldable acrylic IOL (acrylic group). A total of 72 eyes of 72 patients received PMMA IOL (PMMA group). The mean age was 67.1 years and 68.1 years and postoperative follow-up period was 19.2 months and 17.9 months in acrylic and PMMA groups, respectively. RESULTS: Temporary corneal edema appeared in 33 eyes and 26 eyes, elevation of intraocular pressure in 17 eyes and 12 eyes, anterior chamber inflammatory reaction in 5 eyes and 5 eyes, clinical cystoid macular edema in 7 eyes and 12 eyes, and decentered IOL in 4 eyes and 3 eyes in acrylic and PMMA groups, respectively. Late postoperative endophthalmitis developed in two eyes of the PMMA group. Rhegmatogenous retinal detachment developed in one eye in each group. Final best-corrected visual acuities were 5/10 and above in 73 eyes (82.02%) in the acrylic group and 5/10 and above in 42 eyes (58.33%) in the PMMA group. Postoperative final induced astigmatism was 0.5+/-0.5 D (SD) in the acrylic group and 1.11+/-0.65 D (SD) in the PMMA group (p=0.0001) (independent samples t-test). CONCLUSIONS: Increased astigmatism is more frequently seen in the PMMA group. The implantation of foldable acrylic IOL in the sulcus after posterior capsule tear maintains the advantages of small incision surgery.