Low-dose ranibizumab administration in retinopathy of prematurity.

PURPOSE: To evaluate the efficiency of low-dose intravitreal ranibizumab therapy in the treatment of aggressive retinopathy of prematurity (A-ROP). METHODS: A total of 124 eyes of 62 patients who underwent intravitreal ranibizumab after an A-ROP diagnosis between January 2015 and January 2021 were evaluated retrospectively. After receiving family-approved informed consent, low-dose intravitreal ranibizumab was administered, and regular follow-ups were performed. RESULTS: Patients included in the study had a mean birth week of 26.6 (23-33 weeks), a mean birth weight of 905 (450-1970) grams, and an average injection postnatal time of 9.1 (4-19) weeks. The mean follow-up period was 63 (24-250) weeks. In all eyes, ROP regressed in the first week after injection, and no asymmetrical response was observed in the eyes of any baby. A total of 58 eyes recovered with a single dose of intravitreal injection therapy, and peripheral retinal vascularization was completed. A second injection was required in 38 eyes. Rescue treatment was applied in addition to intravitreal ranibizumab treatment in 22 eyes of 11 babies. None of the patients had any ocular or systemic side effects. CONCLUSION: Low-dose intravitreal ranibizumab injection with close follow-up and appropriate timing is an effective treatment modality in A-ROP. Even among patients undergoing rescue laser treatment, the treatment can be completed with a wide visual field.

The effectiveness of the dacryocystorhinostomy operation with physiodispenser in nasolacrimal duct obstruction.

PURPOSE: To evaluate the effectiveness of the dacryocystorhinostomy (DCR) operation with physiodispenser in nasolacrimal duct obstruction. METHODS: Two hundred and twelve eyes from 150 patients with chronic dacryocystitis who had undergone external DCR operation with Kerrison punch were included in Group 1. Two hundred and fourteen eyes from 150 patients with chronic dacryocystitis who had undergone external DCR operation with physiodispenser were included in Group 2. RESULTS: There were no significant differences between the two groups in terms of age and sex (p > .05). Excessive bleeding requiring cauterization was observed in 41 (19%) patients in Group 1 and 8 (3%) patients in Group 2 (p < .05) during surgery. The mean operation duration was 32.36 ± 5.46 (26-42) minutes in the first group and 20.41 ± 4.98 (15-28) minutes in the second group (p < .05). Functional success rate at the end of the second postoperative year was 90.2% in the first group and 92.4% in the second (p > .05). Anatomical success rate at the end of second postoperative year was 95.8% in the first group and 98.1% in the second (p > .05). CONCLUSION: DCR operation with physiodispenser shortens the operation duration, reduces excessive bleeding, and has high functional and anatomical success rates.

Facilitated Tenon-Free Conjunctival Autograft Preparation and Limited Tenon Removal Technique in Pterygium Surgery.

BACKGROUND: The main complication of primary pterygium surgery is the recurrence of the pterygium. In the present study, we aimed to compare a classical technique and facilitated tenon-free conjunctival autograft preparation and a limited tenon removal technique in pterygium surgery in terms of recurrence rate, complications, and operation duration. MATERIAL AND METHODS: This is a retrospective, comparative, observational study. Group 1 comprised 120 eyes of 115 patients who underwent pterygium excision with a new facilitated tenon-free conjunctival-limbal autograft preparation and limited tenon removal technique between May 2017 and October 2019. Group 2 comprised 117 eyes of 113 patients who underwent pterygium excision with a conventional conjunctival-limbal autograft technique between January 2016 and May 2017. RESULTS: The mean follow-up time after surgery was 18.2 ± 5.8 months in group 1 and 19.1 ± 6.3 months in group 2 (p = 0.25). The mean operation duration was 5.54 ± 1.22 (4 - 7) minutes in group 1 and 8.23 ± 1.26 (8 - 10) minutes in group 2 (p = 0.02). Flap edema was present in 33 eyes (28.2%) in group 2 and in 11 eyes (9.16%) in group 1. Flap edema was significantly higher in group 2 (p < 0.001). At the end of the 1-year follow-up of the patients, we observed recurrence in only one (0.83%) eye in group 1 and 14 (11.96%) eyes in group 2. The recurrence rate of group 1 was significantly less than that of group 2 (p < 0.001). CONCLUSIONS: The simplified technique of tenon-free conjunctival autograft preparation and limited tenon removal yielded better clinical outcomes without serious complications. Additionally, this technique shortened the surgical time and reduced surgeon-dependent factors.

The effects of trypan blue use on the corneal endothelium during cataract surgery in patients with pseudoexfoliation syndrome (PEX).

PURPOSE: In the present clinical study, it was aimed to investigate the possible effects of Trypan blue (TB) use on the corneal endothelium during cataract surgery in eyes with pseudoexfoliation syndrome (PEX) during a three-month follow-up period using the contralateral eye control design. METHODS: This prospective, randomised controlled, individual cohort study included 92 eyes of 46 patients with bilateral PEX and cataracts. While 1% TB was applied to one eye of the patients before capsulorhexis (study group), it was not applied to the other eye (control group). Both groups were compared preoperatively and postoperatively in terms of endothelial cell density (ECD), endothelial cell loss (%), pleomorphism, polymegathism and central corneal thickness (CCT) using specular microscopy. RESULTS: Preoperative corneal ECD was measured as 2362.56 ± 253.27 in the study group, 2380.84 ± 220.54 in the control group, and 2145.58 ± 221.71 in the study group and 2184.97 ± 200.94 cells/mm2 in the control group in the postoperative 3rd-month follow-up (p = 0.71 and = 0.37, respectively). In addition, there were no significant differences between the two groups in terms of the percentage of hexagonal cells, coefficient of variation (CV), and CCT both preoperatively and postoperatively 3 months later (p = 0.78, =0.39, =0.95 preoperatively and p = 0.31, =0.26, =0.83 postoperatively, respectively). CONCLUSION: This study demonstrated that the injection of 1% TB into the anterior chamber for staining the anterior capsule during cataract surgery did not cause significant corneal endothelial changes at postoperative 3rd months, despite the increased fragility of corneal endothelial cells in patients with PEX.

The Youngest Patient with Bilateral Keratoconus Secondary to Chronic Persistent Eye Rubbing.

We present the case of a four-year-old girl with bilateral keratoconus secondary to chronic persistent eye rubbing. She was referred to our clinic with intractable ocular itching and low vision. According to her family, she was generally rubbing her eyes. On slit-lamp biomicroscopic examination, bilateral papillary reactions were seen on the upper tarsal conjunctiva. Clinical examination and corneal topography were compatible with keratoconus. The patient's visual acuity was not evaluated because of cooperation difficulties. Systemic examination was normal. In fact, trauma may be the common underlying factor in eye rubbing and may cause development of keratoconus, even in the early years. To the best of our knowledge, this is the youngest patient with bilateral keratoconus secondary to chronic persistent eye rubbing in the literature. Keratoconus should be kept in mind in patients with severe ocular itching, even in small children.