Near-infrared and short-wavelength autofluorescence imaging in central serous chorioretinopathy.

AIMS: The aim of the study was to compare the results of short-wavelength (SW) and near-infrared (NIR) autofluorescence (AF) in acute central serous chorioretinopathy (CSC). METHODS: Twenty-six eyes of the 26 patients diagnosed with CSC (mean age 37.4 years) were included in this retrospective study. AF images were evaluated and compared with angiographic and ophthalmoscopic findings. Fluorescein angiography and AF imaging were performed using a confocal scanning laser ophthalmoscope. RESULTS: Focally decreased AF at the leakage site was seen in most of the cases with acute CSC (20 of 26 eyes in SW-AF; 20 of 20 eyes in NIR-AF). Twenty-four of the 26 cases had decreased SW-AF corresponding to the area of the serous retinal detachment, while 19 of the available 20 cases had decreased NIR-AF corresponding to the area of the serous retinal detachment. Increased granular AF corresponding to the extent of the former retinal detachment was seen earlier with SW-AF imaging, but disappeared later in the course of disease with NIR-AF imaging. CONCLUSIONS: AF imaging in CSC demonstrates different patterns according to the course of the disease, reflecting RPE and outer retinal changes. Combining two different methods of AF imaging could predict recent or former CSC episodes and may be a non-invasive technique for monitoring CSC and performing differential diagnosis.

[Effectiveness of topical ciclosporin A treatment after excision of primary pterygium and limbal conjunctival autograft]. / Efficacité du traitement topique de ciclosporine A après excision du ptérygion primaire et autogreffe conjonctivo-limbique.

AIM: To study the efficacy and safety of topical ciclosporin A (CsA) as an adjunctive therapy after surgical treatment of primary pterygium including excision and limbal conjunctival autograft (LCA) with respect to postoperative pain and complications. PATIENTS AND METHOD: A prospective randomized clinical study was conducted in 60 consecutive patients with primary pterygium. Sixty eyes were operated on using the same surgical technique including excision and LCA. Thirty eyes were randomly treated with topical 0.05% CsA for 3 months after the surgery as a supplement to the standard topical therapy. All patients were followed for postoperative pain using the visual analog scale (VAS) for 1 week after surgery and for complications including recurrences for a period of 1 year. RESULTS: The average VAS was significantly lower in the CsA group (p=0.034). There was only one recurrence (3.4%) in the CsA group (n=28) and five recurrences (17.9%) in the control group (n=29). The other complications were substantial graft scarring (one in the CsA group, three in the control group), Tenon's granuloma (0/2), and fibrovascular proliferation (1/3). The ratio of the cases with no complications was statistically significantly higher in the CsA group (p=0.017). CONCLUSION: This study shows that topical CsA therapy after pterygium surgery may reduce postoperative pain and also decreases complications including recurrences.

Excitation-time-dependent increment in the luminescence of fundus autofluorescence.

AIM: To investigate the excitation-time-dependent increment in luminescence of fundus autofluorescence. METHODS: Fundus autofluorescence (FAF) images were obtained with a confocal scanning laser ophthalmoscope. Consecutive 60 images of each eye were taken at 1 s time intervals immediately after the beginning of argon laser excitation. Twenty-one eyes of 21 normal subjects were enrolled in the study. To analyse the luminescence of fundus autofluorescence, an 80 x 80 pixel square selection was placed in a relatively avascular fundus area of each consecutive image. Individual grey-scale values of the selected areas were recorded, and the time slope was plotted. RESULTS: The time-dependent increment of the autofluorescence was observed in all subjects. The average luminosity value of subjects at the beginning was calculated as 32.5 mean grey value (MGV), and luminosity reached its maximum (45.4 MGV) between 25 and 30 s. CONCLUSION: The excitation-time-dependent increment in FAF luminosity should be taken into account while acquiring FAF images for quantitative, comparative and longitudinal studies.

The effect of hyperbaric oxygen on intraocular pressure.

The effects of hyperoxia on intraocular pressure (IOP) have been studied in experiments on human beings and animals. The changes occurring in IOP in patients during routine HBO2 therapy are unknown. In this study we investigated IOP changes arising during the HBO2 therapy at 2.5 ATA. Fifty-six patients receiving HBO2 therapy for various reasons were included in the study. Bilateral IOPs of patients measured with the Tono-pen XL (Medtronic, Solan, USA) tonometer before, during and after HBO2 therapy. Average IOPs were 14.85 +/- 3.17 mmHg (range, 10-24), 13.00 +/- 2.97 mmHg (range, 9-21) and 14.74 +/- 3.12 mmHg (range, 10-22), respectively. IOP was reduced significantly during HBO2 therapy and returned its pre- HBO2 levels after therapy. Our data indicated a statistically significant decrease in IOPs during therapy at 2.5 ATA. This decrease was of minor physiological significance in these patients whose baseline IOP values were within the normal range.

Review of sterile, postoperative, anterior segment inflammation following cataract extraction and intraocular lens implantation.

PURPOSE: To evaluate unexpected, acute intraocular anterior segment inflammation following uneventful cataract extraction by phacoemulsification and foldable posterior chamber intraocular lens (PCIOL) implantation. METHODS: This retrospective study evaluated five cases of postoperative inflammation that occurred after cataract extraction with foldable PCIOL implantation. Medical records were reviewed to analyze the unexplained postoperative inflammation. RESULTS: The five patients who developed inflammatory activity during the postoperative period responded well to corticosteroid treatment. Toxic maculopathy developed in one patient after aggressive antibacterial therapy. Vitrectomy was performed for one patient with prolonged vitreal inflammatory activity. CONCLUSIONS: Noninfectious endophthalmitis developing upon surgery may be caused by a multifactorial process or an interindividual variable response to a common factor as a hypersensitivity reaction. It should be remembered in inflammatory cases after surgery in order to prevent the toxic, irreversible side effects of bacterial endophthalmitis treatment.

The effects of three-piece or single-piece acrylic intraocular lens implantation on posterior capsule opacification.

PURPOSE: To evaluate the development of posterior capsule opacification (PCO) in patients implanted with 5.5 mm optics, single-piece or three-piece acrylic intraocular lens (IOL) in cataract surgery prospectively. METHODS: This study was carried out on 267 eyes of 249 patients implanted with three-piece, 5.5 mm optics, acrylic IOL and 252 eyes of 244 patients implanted with single-piece, 5.5 mm optics, acrylic IOL by phacoemulsification technique between September 2001 and February 2003. A total of 519 eyes of 493 patients were prospectively evaluated for PCO development during the 25-month period. All the patients were analyzed periodically with anterior segment retroillumination photography. The data provided were analyzed with chi-square method. RESULTS: The results between the two groups for PCO development were not statistically significant. However, there was a prominent opacification of the posterior capsule where the optic and haptic junction of IOL was positioned in some patients implanted with single-piece IOL. During the follow-up period, no patients implanted with either three-piece or single-piece acrylic IOL required Nd:YAG laser capsulotomy. CONCLUSIONS: Biocompatibility and reduced rate of PCO development are among the leading features of new generation IOLs. The intracapsular implantation of 5.5 mm optics acrylic IOLs resulted in decreased incidence of PCO and therefore greater patient satisfaction. Further studies investigating the effects of IOL optics, haptic structure and length, capsulorrhexis size, and IOL material and design features on PCO development will clarify the subject.

The effects of three-piece or single-piece acrylic intraocular lens (IOL) implantation on posterior capsule opacification.

PURPOSE: To evaluate the development of posterior capsule opacification (PCO) in patients implanted with 5.5 mm optics, single-piece or three-piece acrylic intraocular lens (IOL) in cataract surgery prospectively. METHODS: This study was carried out on 267 eyes of 249 patients implanted with three-piece, 5.5 mm optics, acrylic IOL and 252 eyes of 244 patients implanted with single-piece, 5.5 mm optics, acrylic IOL by phacoemulsification technique between September 2001 and February 2003. A total of 519 eyes of 493 patients were prospectively evaluated for PCO development during the 25-month period. All the patients were analyzed periodically with anterior segment retroillumination photography. The data provided were analyzed with chi-square method. RESULTS: The results between the two groups for PCO development were not statistically significant. However, there was a prominent opacification of the posterior capsule where the optic and haptic junction of IOL was positioned in some patients implanted with single-piece IOL. During the follow-up period, no patients implanted with either three-piece or single-piece acrylic IOL required Nd:YAG laser capsulotomy. CONCLUSIONS: Biocompatibility and reduced rate of PCO development are among the leading features of new generation IOLs. The intracapsular implantation of 5.5 mm optics acrylic IOLs resulted in decreased incidence of PCO and therefore greater patient satisfaction. Further studies investigating the effects of IOL optics, haptic structure and length, capsulorrhexis size, and IOL material and design features on PCO development will clarify the subject. (Eur J Ophthalmol 2004; 14: #-80).

The effect of capsulorhexis size on development of posterior capsule opacification: small (4.5 to 5.0 mm) versus large (6.0 to 7.0 mm).

PURPOSE: The most common surgically related cause of reduced vision after extracapsular cataract extraction is posterior capsule opacification (PCO), which occurs in up to 50% of eyes following cataract extraction. This study examined whether small capsulorhexes of 4.5 to 5.0 mm, which lie completely on the 5.5 mm intraocular lens (IOL), and large capsulorhexes of 6.0 to 7.0 mm, which lie completely off the lens optic, are effective in preventing PCO development. METHODS: In this prospective study, 496 eyes of 367 patients underwent standardized phacoemulsification with capsulorhexis and capsular bag foldable acrylic IOL implantation. The patients were randomly assigned to receive either a small capsulorhexis of 4.5 to 5 mm to lie completely on the IOL optic or a large capsulorhexis of 6 to 7 mm to lie completely off the lens optic. Retroillumination photographs were taken at 6 months and then yearly. RESULTS: Throughout the follow-up, there was less PCO in the small capsulorhexis group than in the large capsulorhexis group. CONCLUSIONS.:Small capsulorhexes were associated with less wrinkling of the posterior capsule and less PCO than were large capsulorhexes. PCO after IOL implantation has a multifactored pathogenesis. Small (4.5 to 5.0 mm) capsulorhexis and capsular bag implantation of 5.5 mm acrylic IOL are likely to reduce the PCO incidence when compared with the 6.0 to 7.0 mm capsulorhexis. The significance of the IOL optic diameter in association with the capsulorhexis size should also be documented by further studies.

The role of capsulotomy and intraocular lens type on tilt and decentration of polymethylmethacrylate and foldable acrylic lenses.

The purpose of this study is to determine the effects of different anterior capsulotomy techniques and intraocular lens (IOL) types on IOL tilt and decentration. For this purpose the device using Purkinje reflections and photographic documentation were evaluated. A total of 107 cataractous eyes undergoing IOL implant surgery were divided into four groups based on the type of IOL and capsulotomy: group 1, single-piece polymethylmethacrylate (PMMA) IOL with a haptic distance of 13.50 mm; group 2, single-piece PMMA IOL with 12. 0 mm overall length; group 3, three-piece foldable acrylic IOL with 13.00 mm PMMA haptic distance; group 4, the same IOL as group 1. While continuous circular capsulorhexis was the type of capsulotomy in the first three groups, envelope capsulotomy was used in group 4. Mean tilt and decentration were significantly less when capsulorhexis technique was used in comparison with envelope capsulotomy. Mean tilt of group 1 (2.83+/-0.89 degrees) and mean decentration of group 2 (0.28+/-0.14 mm) were higher within the first three groups. The differences regarding both the IOL decentration and tilt between the first three groups were statistically significant. This study shows that if the IOLs were placed properly in the capsular bag after continuous circular capsulorhexis, foldable acrylic IOLs with PMMA haptics are superior in terms of tilt and decentration.

Improvement of visual field following trabeculectomy for open angle glaucoma.

Trabeculectomy was performed in 24 eyes affected by primary open angle glaucoma. Visual fields were measured using automated perimetry preoperatively and in the first, third, sixth and twelfth months after surgery. Significant improvement in visual field occurred in 96% of cases.