Immediate evaluation of the flaps created by femtosecond laser using anterior segment optical coherence tomography.

BACKGROUND AND OBJECTIVE: To demonstrate the practical and functional evaluation of flaps created intraoperatively by femtosecond laser using anterior segment optical coherence tomography (AS-OCT). PATIENTS AND METHODS: The study prospectively examined 11 eyes of 6 patients who underwent uneventful LASIK surgery with the aid of the IntraLase femtosecond laser (IntraLase Corp., Irvine, CA). During the waiting period between femtosecond laser and excimer laser, all eyes were evaluated by AS-OCT to image each flap immediately before flap lifting and laser ablation. Flap thickness and residual stromal bed thickness were calculated automatically using the software's flap tool. RESULTS: A uniform flap was created by femtosecond laser not only in the central cornea, but also in all quadrants. CONCLUSION: The qualitative and quantitative evaluation of the corneal flap created by a femtosecond laser using AS-OCT before lifting the flap confirms that the femtosecond laser is a practical intraoperative approach that offers a safer surgery.

Corneal biomechanical properties and intraocular pressure changes after phacoemulsification and intraocular lens implantation.

PURPOSE: To evaluate corneal viscoelastic and intraocular pressure (IOP) changes measured by an ocular response analyzer (ORA) after phacoemulsification and intraocular lens (IOL) implantation. SETTING: Yeditepe University Department of Ophthalmology, Istanbul, Turkey. METHODS: Fifty-one eyes scheduled for cataract surgery were included in the study. Corneal hysteresis (CH), corneal resistance factor (CRF), corneal-compensated intraocular pressure (IOPcc), and Goldmann-correlated IOP (IOPg) were measured by ORA preoperatively and 1 week and 1 and 3 months postoperatively. Central corneal thickness (CCT) was measured using the ORA's integrated handheld ultrasonic pachymeter. RESULTS: The mean preoperative CCT (537 microm+/-46 [SD]) did not change significantly by the end of 1 month postoperatively. The mean preoperative IOPcc (17.2+/-3.0 mm Hg) decreased significantly by 3 months postoperatively (15.2+/-3.7 mm Hg) (P= .018). The mean CH decreased from 10.36+/-1.48 mm Hg preoperatively to 9.64+/-1.26 mm Hg at 1 week (P= .028); it increased to preoperative values at the end of 1 month (10.20+/-1.70) and 3 months (10.74+/-1.54) (P>.05). The mean CRF decreased from 10.94+/-2.54 mm Hg preoperatively to 9.99+/-1.77 at 1 week (P= .026); it increased to preoperative values at 1 month (10.26+/-1.59) and 3 months (10.35+/-1.46) (P>.05). CONCLUSIONS: Although CH and the CRF decreased in the early postoperative period, the parameters increased and reached preoperative values by 3 months postoperatively, showing that corneal biomechanical properties are influenced by phacoemulsification and IOL implantation.

Anterior segment optical coherence tomography measurement of anterior chamber depth and angle changes after phacoemulsification and intraocular lens implantation.

PURPOSE: To use anterior segment optical coherence tomography (AS-OCT) to evaluate anterior chamber depth (ACD) and angle after phacoemulsification and intraocular lens (IOL) implantation. SETTING: Department of Ophthalmology, Yeditepe University, Istanbul, Turkey. METHODS: Forty-seven eyes (37 patients) had uneventful phacoemulsification and IOL implantation through a clear corneal incision. Anterior segment OCT was performed preoperatively and 1 week and 1 month postoperatively. The angle-referenced (ACD(1)), pupil-referenced (ACD(2)), and lens-referenced (ACD(3)) ACDs, crystalline lens rise (CLR), pseudophakic posterior chamber depth (PPCD), and nasal and temporal iridocorneal angles were measured. Statistical analysis was by a 1-way analysis of variance and Pearson correlation analysis. RESULTS: The mean age of patients was 70 years+/-10.17 (SD). The mean ACD(1) (mean increase) was 3.06+/-0.25 mm preoperatively, 3.16+/-0.22 mm at 1 week (0.1 mm), and 3.16+/-0.19 mm at 1 month (0.1 mm); the mean ACD(2), 2.76+/-0.47 mm preoperatively, 3.62+/-0.24 mm at 1 week (0.86 mm), and 3.63+/-0.20 mm (0.87 mm) at 1 month; and the mean ACD(3), 2.54+/-0.46 mm preoperatively, 3.97+/-0.28 mm at 1 week (1.43 mm), and 3.91+/-0.25 mm at 1 month (1.37 mm). The mean CLR was 0.497+/-0.363 mm and the mean PPCD, 0.322+/-0.150 mm. The increase in nasal and temporal iridocorneal angles was statistically significant at both postoperative examinations (P<.01). CONCLUSION: Deepening of the anterior chamber and widening of the nasal and temporal angles after cataract extraction was shown on AS-OCT.

Fluorescein angiographic findings in cases with intermediate uveitis in the inactive phase.

BACKGROUND: To determine fundus fluorescein angiography (FA) findings in cases with intermediate uveitis in the inactive phase. METHODS: This prospective study included all eligible cases with a diagnosis of intermediate uveitis that were treated at the uvea unit of Trakya University ophthalmology department between January 2002 and January 2004. Study criteria included patients in the inactive phase who had no complaints, no biomicroscopic or ophthalmoscopic inflammatory findings in the anterior and posterior segments, and no period of inflammation that had occurred within the previous 6 months. Cases receiving immunosuppressive treatment were not excluded. FA was performed in all cases, which were evaluated by 2 independent observers. RESULTS: A total of 21 eyes from 21 cases with intermediate uveitis were included in the study. FAs of the cases were taken approximately 8.8 (SD 5.4) months (range 6-23 months) after the last activation. In these FAs, no pathological findings were identified in 5 eyes (23.8%); optic disc hyperfluorescence was observed in 14 eyes (66.7%); large vein staining was observed in 2 eyes (9.5%); peripheral venous leakage was observed in 6 eyes (28.6%); and cystoid macular edema was observed in 5 eyes (23.8%). INTERPRETATION: These findings indicate that retinal vascular inflammatory changes persist in cases with intermediate uveitis even if the clinical manifestations have been treated.