Spontaneous Resolution of an Orbital Mass After Delivery: A Diagnostic Challenge.

The authors report a 35-year-old woman who presented 1 month after delivery with the complaint of pain behind her left eye which started during her pregnancy. The patient described increased fullness with dependent head position and pain on left gaze but she had no proptosis and her ocular examination was normal. Magnetic resonance imaging (MRI) revealed an intraconal mass with inhomogeneous contrast enhancement. As the authors did not suspect malignity and her ocular examination was normal without any signs of inflammation, the authors followed the patient closely. Repeat MRI obtained 6 months after delivery revealed complete resolution of the mass. Upon disappearance of the lesion, the authors reviewed the case thoroughly and decided that orbital venous anomaly with intralesional hemorrhage/thrombosis was the most probable diagnosis. As hemorrhage or thrombosis occurring in orbital vascular anomalies may be a diagnostic challenge because of the localized lesion and distinct borders, careful interpretation of clinical characteristics and MRI findings and close follow-up is important in interpretation of orbital mass lesions, especially in pregnant or puerperal women.

Klestadt Cyst: Magnetic Resonance Imaging.

The Klestadt cyst, also known as nasoalveolar cyst, is an uncommon nonodontogenic tumor located in the maxillofacial soft tissue, on the region corresponding to the nasolabial furrow. Following its first description by Zuckerkandl in 1882, <300 patients have been reported in the literature. Magnetic resonance imaging (MRI) is the preferred modality for diagnosis and management of Klestadt cyst. Magnetic resonance imaging is superior to computed tomography in demonstration of the relationship with surrounding soft tissues and bones, and also showing the accurate localization of the lesion. The aim of this report is to describe 2 patients with rarely seen Klestadt cyst and to discuss the MRI findings of this condition. Klestadt cyst must be remembered in patients suffering from nasolabial sulcus deformity and/or nasal obstruction. Its correct diagnosis is important for the management of this uncommon cyst.

Serum Vitamin D Levels in Patients with Acute Anterior Uveitis.

PURPOSE: To evaluate serum 25-hydroxyvitamin D levels in patients with acute anterior uveitis (AAU). METHODS: This observational case-control study involved 20 patients with AAU, and 20 consecutive, age and sex-matched healthy subjects without any ocular or systemic diseases. Serum 25-hydroxyvitamin D was quantified with electrochemiluminescence technique. RESULTS: No significant differences were found between the groups with respect to age (p = 0.185) and sex (p = 0.465). Serum vitamin D levels of the subjects with AAU (mean 5.75 ± 4.50 ng/mL, median 4.00 ng/mL, range: 3.00-19.00 ng/mL) were significantly lower than the control group (mean 12.96 ± 5.89 ng/mL, median 11.00 ng/mL, range: 5.20-25.92 ng/mL) (p<0.001). CONCLUSIONS: We found significantly low serum levels of vitamin D in patients with AAU, which suggest that vitamin D deficiency may play a role in the pathogenesis of anterior uveitis. Further studies are necessary to demonstrate the efficacy of vitamin D supplementation in the management of patients with anterior uveitis.

The association between ocular dominance and physiological palpebral fissure asymmetry.

Physiological palpebral fissure asymmetry is a common observation in a physician's everyday practice. The goal of this study was to examine the relationship between palpebral fissure height (PFH) and ocular dominance. Sixty-nine healthy volunteers (42 female, 27 male) were included in this research, and ocular dominance was determined using hole-in-the-card and pointing-a-finger tests. Those volunteers with inconsistent test results were excluded. Standard photographs were taken of all of the subjects in the primary position with a consistent background and photographic equipment. The PFHs were measured using an ImageJ analyser, and a mixed ANOVA was used for the statistical analysis. Overall, 87% of the participants showed small differences in their PFHs, with their dominant eyes being significantly wider than their non-dominant eyes (10.51 ± 0.97 vs. 10.32 ± 1.03; p = .001). This study revealed that ocular dominance has a significant effect on the PFH. Further research is required to understand the importance of this association in daily practice.

Phacoemulsification in posterior polar cataract.

PURPOSE: To evaluate the results and complications of phacoemulsification surgery in eyes with posterior polar cataracts and compare the techniques of viscodissection and hydrodissection. METHODS: The medical records of 29 consecutive patients (16 males, 13 females) with posterior polar cataracts (44 eyes) who had undergone cataract surgery were retrospectively reviewed. Patients were divided into two groups according to the technique used; viscodissection was applied to the experimental group (group 1) and hydrodissection to the control group (group 2). RESULTS: The postoperative best corrected visual acuity (BCVA) was 0.19 ± 0.22 logMAR (mean ± standard deviation) (range 0.00-0.70) in group 1 and 0.25 ± 0.18 logMAR (range 0.00-0.70) in group 2. Although the mean postoperative BCVA in group 1 was greater than that in group 2, the difference was not statistically significant (p=0.165). The mean postoperative BCVA was significantly greater than the mean preoperative BCVA in both groups (p=0.00). Intraoperatively, posterior capsular rupture occurred during the removal of the cortex in three eyes (13%) of group 1 patients, with vitreous loss and anterior vitrectomy in one eye only. In group 2, six eyes (28.5%) presented posterior capsular rupture, and anterior vitrectomy was performed because of vitreous loss in three eyes. Although the percentage of posterior capsular rupture was greater in group 2, the difference was not statistically significant (p=0.207). CONCLUSIONS: Complications in posterior polar cataract surgeries can be overcome by being careful throughout the surgery and using proper techniques. Viscodissection may be better for avoiding posterior capsular rupture than hydrodissection.

Evaluation of the effectiveness of biodegradable electrospun caprolactoneand poly(lactic acid-ε-caprolactone) nerve conduits for peripheral nerveregenerations in a rat sciatic nerve defect model.

BACKGROUND/AIM: The aim of this study was to compare electrospun caprolactone (EC) and poly(lactic acid-ε-caprolactone) (PLCL) nerve conduits with nerve graft in a rat sciatic nerve defect model. MATERIALS AND METHODS: A total of 32 male Wistar albino rats were divided into 4 groups, with 8 rats in each group. A nerve defect of 1 cm was constructed in the left sciatic nerve of the rats. These defects were left denuded in the sham group, and reconstructed with nerve grafts, PLCL, and EC nerve conduits in the other groups. After 3 months, nerve regenerations were evaluated macroscopically, microscopically, and electrophysiologically. The numbers of myelinated axons in the cross-sections of the nerves were compared between the groups. RESULTS: Macroscopically, all nerve coaptations were intact and biodegradation was detected in nerve conduits. Electromyographic assessment and count of myelinated axons in the cross-sections of the nerves displayed the best regeneration in the nerve graft group (P < 0.001) and similar results were obtained in the PLCL and EC nerve conduit groups (P = 0.79). Light and electron microscopy studies demonstrated nerve regeneration in both nerve conduit groups. CONCLUSION: EC nerve conduits and PLCL nerve conduits yielded similar results and may be alternatives to nerve grafts as they biodegrade.

Phacoemulsification in posterior polar cataract / Facoemulsificação na catarata polar posterior

ABSTRACT Purpose: To evaluate the results and complications of phacoemulsification surgery in eyes with posterior polar cataracts and compare the techniques of viscodissection and hydrodissection. Methods: The medical records of 29 consecutive patients (16 males, 13 females) with posterior polar cataracts (44 eyes) who had undergone cataract surgery were retrospectively reviewed. Patients were divided into two groups according to the technique used; viscodissection was applied to the experimental group (group 1) and hydrodissection to the control group (group 2). Results: The postoperative best corrected visual acuity (BCVA) was 0.19 ± 0.22 logMAR (mean ± standard deviation) (range 0.00-0.70) in group 1 and 0.25 ± 0.18 logMAR (range 0.00-0.70) in group 2. Although the mean postoperative BCVA in group 1 was greater than that in group 2, the difference was not statistically significant (p=0.165). The mean postoperative BCVA was significantly greater than the mean preoperative BCVA in both groups (p=0.00). Intraoperatively, posterior capsular rupture occurred during the removal of the cortex in three eyes (13%) of group 1 patients, with vitreous loss and anterior vitrectomy in one eye only. In group 2, six eyes (28.5%) presented posterior capsular rupture, and anterior vitrectomy was performed because of vitreous loss in three eyes. Although the percentage of posterior capsular rupture was greater in group 2, the difference was not statistically significant (p=0.207). Conclusions: Complications in posterior polar cataract surgeries can be overcome by being careful throughout the surgery and using proper techniques. Viscodissection may be better for avoiding posterior capsular rupture than hydrodissection.

RESUMO Objetivo: Avaliar os resultados e complicações da cirurgia de facoemulsificação em olhos com catarata polar posterior e comparar as técnicas de viscodissecção e hidrodissecção. Métodos: Os prontuários de 29 pacientes consecutivos (16 homens, 13 mulheres) com posterior cataratas polares (44 olhos), que haviam sido submetidos a cirurgia de catarata foram analisados retrospectivamente. Os pacientes foram divididos em dois grupos de acordo com a técnica utilizada; viscodissecção foi aplicada ao grupo experimental (grupo 1) e hidrodissecção para o grupo de controle (grupo 2). Resultados: No pós-operatório, a melhor acuidade visual corrigida (BCVA) foi 0,19 ± 0,22 logMAR (média ± desvio padrão) (variação 0,00-0,70) no grupo 1 e 0,25 ± 0,18 (0,00-0,70) logMAR no grupo 2. Embora a média da BCVA pós-operatória do grupo 1 tenha sido maior do que a do grupo 2, a diferença não foi estatisticamente significativa (p=0,165). A melhor acuidade visual corrigida pós-operatória foi significativamente melhor do que no pré-operatório, em ambos os grupos (p=0,00). No grupo 1, houve ruptura capsular posterior durante a remoção do córtex em três olhos (13%); houve perda vítrea e necessidade de vitrectomia anterior mas apenas em destes olhos. No grupo 2, a ruptura da cápsula posterior ocorreu em seis olhos (28,5%); vitrectomia anterior foi necessária após a perda vítrea em três destes olhos. Embora a porcentagem de ruptura da cápsula posterior tenha sido maior no grupo 2, a diferença não foi estatisticamente significativa (p=0,207). Conclusões: As complicações em cirurgias de catarata polar posterior podem ser superadas com cautela durante toda a cirurgia e usando técnicas adequadas. Viscodissecção é melhor para evitar a posterior ruptura capsular do que hidrodissecção.

Prevalence of allergic rhinitis symptoms and positive skin-prick test results in patients with dry eye.

BACKGROUND: Dry eye is characterized by decreased tear production and/or increased evaporation rates of the tear film barrier. Allergic rhinitis is an inflammatory disease that develops through immunoglobulin E in the rhino-ocular mucosa due to allergens. To investigate the prevalence of allergic rhinitis symptoms and positive skin-prick test results in patients with dry eye. METHODS: This is a case-control study. The study included 57 patients with dry eye and 48 healthy subjects. The prevalence of allergic symptoms and skin-prick test results were assessed and compared with the control group. RESULTS: With regard to positive reactions to allergens in skin-prick tests, Dermatophagoides pteronyssinus allergy (p = 0.0003), Dermatophagoides farinae allergy (p = 0.0003), grass-mix allergy (p = 0.049), Salicaces allergy (p = 0.006), and Compositae allergy (p = 0.019) were significantly observed to be higher in the group with dry eye. Nasal obstruction (p = 0.027), discharge (p = 0.0001), sneeze (p = 0.0003), itching (p = 0.0001), and postnasal drainage (p = 0.001) symptoms were observed to be significantly higher in the group with dry eye. CONCLUSIONS: Our study revealed that there was a significant association between dry eye and allergic rhinitis with positive skin-prick test results. There may be a possible link between dry eye and allergy.

Pain Perception in Phacoemulsification with Topical Anesthesia and Evaluation of Factors Related with Pain.

OBJECTIVES: Evaluation of pain during and after phacoemulsification with topical anesthesia in patients with senile cataract and investigation of factors related with pain. MATERIALS AND METHODS: Ninety-two adult patients scheduled for routine clear corneal phacoemulsification with topical anesthesia who had no previous cataract surgery in their fellow eyes were included in the study. Verbal pain scale and visual analog scale were used to measure pain intensity. Demographic characteristics, concomitant systemic diseases, drug consumption, need of additional anesthesia during surgery, surgical complications, duration of surgery and surgeon comfort were also evaluated for each patient. RESULTS: Seventy-two patients (78.3%) reported pain during surgery and 68 patients (73.9%) reported pain in the period after the surgery. When the intensity of pain during the surgery was evaluated, the percentage of patients reporting mild, moderate and intense pain was 35.9%, 25.0% and 17.4%, respectively. The average verbal pain score during the surgery was 1.4±1.0 (0-3). Reported pain level was not associated with age or gender (p>0.05). Diabetic patients and patients who consumed nonsteroidal anti-inflammatory drugs in the morning before operation reported less pain during and after the surgery (p<0.05). There were no complications except posterior capsule rupture in one patient. Duration of surgery was longer in patients who reported pain during surgery (p<0.05). There was no significant difference between pain reported during surgery and surgeon comfort (p>0.05). CONCLUSION: Patients frequently experience pain during phacoemulsification with topical anesthesia. Although pain perception does not affect surgical success, preoperative administration of analgesics in suitable patients or giving additional anesthesia to patients reporting severe pain during surgery may increase patient comfort.

Oxidative stress parameters and serum magnesium levels in patients with seasonal allergic conjunctivitis.

OBJECTIVE: To evaluate oxidative stress parameters and serum magnesium (Mg) levels in patients with seasonal allergic conjunctivitis (SAC) during the pollen season. METHODS: This observational cross-sectional study involved 35 patients with SAC without any other ocular and systemic diseases, and 38 consecutive, age- and sex-matched healthy subjects. Serum malondialdehyde (MDA), adjusted ischemia modified albumin (IMA), and Mg levels were quantified, and the results were compared between the groups. RESULTS: No significant differences were found between the groups with respect to age (p = 0.416) and sex (p = 0.362). Serum MDA and adjusted IMA levels of the subjects with SAC (69.54 ± 7.71 µM and 0.74 ± 0.39 ABSU) were significantly higher than the control group (64.61 ± 5.89 µM and 0.57 ± 0.19 ABSU) (p = 0.002 and p = 0.025, respectively). There was no significant difference for serum Mg levels between the groups (p = 0.177). CONCLUSION: We demonstrated higher levels of oxidative stress parameters in patients with SAC compared to the control group, which imply a possible role of oxidative stress in the pathogenesis of SAC.

Evaluation of the peripapillary retinal nerve fiber layer and ganglion cell-inner plexiform layer measurements in patients with iron deficiency anemia with optical coherence tomography.

OBJECTIVE: To evaluate the thickness of the peripapillary retinal fiber layer (RNFL) and macula ganglion cell-inner plexiform layer (GCL+) using optical coherence tomography (OCT) in patients with iron deficiency (ID) anemia. METHODS: This study included 73 eyes of 39 patients with ID anemia and 68 eyes of 34 age- and sex-matched healthy subjects. The measurements included the peripapillary RNFL thicknesses as average, 4 quadrant and 12 clock-hour (CH) based and macula GCL+ thicknesses as average and 6 quadrant based. All measurements were completed with Cirrus HD-OCT and the results were compared between the groups. RESULTS: A total of 73 eyes of 39 patients with ID anemia and 68 eyes of 34 healthy subjects were included to the study. Regarding peripapillary RNFL thicknesses of the study and control patients, the values of average and quadrants revealed no significant differences between the groups. In CH sectors comparison, peripapillary RNFL thicknesses were significantly decreased only in CH4 (68.7 ± 14.5 µm in study versus 72.0 ± 13.4 µm in control patients, p = 0.049) and CH5 (93.4 ± 20.0µm in study versus 102.2 ± 20.1 µm in control patients, p = 0.01) sectors. All measured quadrants were statistically similar, when macula GCL+ thicknesses were compared between the groups. When the correlations between peripapillary RNFL and macula GCL+ thicknesses and serum hemoglobin and ferritin levels of study and control patients were calculated, the only statistically significant parameter was the correlation of peripapillary RNFL thickness in CH10 sector with serum ferritin level (p = 0.032, Spearman correlation coefficient: 0.369). CONCLUSION: The study revealed that peripapillary RNFL is thinner in nasal-inferior quadrant in patients with ID anemia. The measurements of macula GCL+ thicknesses were similar between the groups. Analyzing the retinal layers using OCT may provide valuable information in neurodegenerative events.

Phacoemulsification in eyes with cataract and pseudoexfoliation syndrome / 国际眼科杂志(Guoji Yanke Zazhi)

? AIM: To evaluate the visual outcomes and intraoperative and postoperative complications of phacoemulsification surgery in patients with cataract and pseudoexfoliation syndrome ( PEX ) and the usage of proper surgical techniques and appropriate devices intraoperatively.?METHODS: Sixty-seven eyes of 53 patients with PEX and cataract who had undergone phacoemulsification and intraocular lens ( IOL ) implantation surgery were evaluated retrospectively. The mean age was 71. 68 ± 9. 96 (53-89)y, and there were 24 (45%) males and 29 (55%) females. Nuclear, cortical, posterior subcapsular, and mature cataracts were all represented.? RESULTS: Nuclear cataract was significantly more common than other types ( P = 0. 00 ). The mean preoperative best corrected visual acuity ( BCVA) was 0. 99 ± 0. 30 ( SD ) ( 0. 40 - 1. 50 ) logMAR, and the mean postoperative BCVA was 0. 32±0. 31 (SD) (0. 00-1. 00) logMAR (P=0. 00). Iris retractors were used in 12 (18%) eyes. Capsular tension ring ( CTR) implantation was used in 15 ( 22%) eyes, it was planned in 8 ( 12%) and unplanned in 7 (10%). Posterior capsule rupture occurred in 4 ( 6%) eyes, and vitreous loss occurred in 2 ( 3%) eyes. Anterior vitrectomy was performed in these 2 eyes. Conversion to extracapsular cataract extraction ( ECCE ) was needed in these 2 ( 3%) eyes due to large posterior capsular rupture. Persistent corneal edema was observed in 4 (6%) eyes, and anterior chamber reaction in 5 (7%) eyes. IOL dislocation occurred in 4 ( 6%) eyes, but repositioning was only needed in 1 (1. 5%) eye. Posterior capsule opacification ( PCO ) requiring Nd: YAG laser capsulotomy developed in 13 (20%) eyes.?CONCLUSION: Postoperative visual acuities of patients with cataract and PEX are satisfactory. However, intraoperative and postoperative complications like posterior capsule rupture, vitreous loss, conversion to ECCE, persistent corneal edema, anterior chamber reaction and IOL dislocation may be observed. To avoid these complications, proper surgical techniques and the use of appropriate devices intraoperatively are essential.

The effect of phacoemulsification surgery on intraocular pressure and anterior segment anatomy of the patients with cataract and ocular hypertension.

We evaluated the effect of phacoemulsification surgery on intraocular pressure (IOP), anterior chamber depth (ACD), iridocorneal angle (ICA), and central corneal thickness (CCT) of the patients with cataract and ocular hypertension. The decrease in IO P values of the 1 st week, 1 st month, 3 rd month, 6 th month, and 1 st year was statistically significant, but that of the 2 nd year was not significant. The increase in ACD and ICA values of the 1 st week, 1 st month, 3 rd month, 6 th month, and 1 st year was statistically significant, but that of the 2 nd year was not significant. The increase in CCT values of 1 st week and 1 st month was statistically significant, but those of 3 rd month, 6 th month, 1 st year, and 2 nd year were not significant. In conclusion, phacoemulsification surgery decreases IOP and increases ACD and ICA in the short-term. However, in the long-term it does not cause any significant changes.

Phacoemulsification in eyes with cataract and high myopia.

PURPOSE: To evaluate the outcomes and complications following phacoemulsification surgery in eyes with cataract and high myopia. METHODS: We retrospectively evaluated the data of 43 eyes of 28 consecutive patients (12 males, 16 females) with cataract and high myopia who had undergone phacoemulsification and intraocular lens (IOL) implantation. The mean [± standard deviation (range)] age of the patients was 59.20 ± 11.08 (39-77) years. RESULTS: The frequency of nuclear cataract was significantly higher than that of other cataract types (P=0.003). The mean axial length was 28.97 ± 1.99 (26-33) mm and the mean IOL power was 5.09 ± 4.78 (-3.0 to +14.0) diopters (D). The mean preoperative spherical equivalent (SE) was -16.48 ± 5.23 (-8.00 to -25.00) D and the mean postoperative SE was -1.46 ± 0.93 (0.00 to -3.00) D (P=0.00). The mean preoperative best-corrected visual acuity (BCVA) was 0.91 ± 0.37 (0.30 to -1.50) logMAR and the mean postoperative BCVA was 0.29 ± 0.25 (0.00-1.00) logMAR (P=0.00). Twenty-two eyes (51.2%) achieved the target postoperative refraction (±1.0 D). The eyes were divided into 3 groups according to the axial length. The mean biometric error was significantly higher in the group with the greatest axial length than in the other groups (P=0.007). Preoperative argon laser photocoagulation was performed in 7 eyes (16%) on account of retinal tears, retinal holes, or lattice degeneration. Postoperatively, retinal tears developed in 2 eyes (4%) and were treated with photocoagulation. One eye (2%) developed retinal detachment postoperatively, with the patient consequently referred for retinal surgery. Postoperatively, posterior capsule opacities developed in 11 eyes (25%), with all cases treated by laser capsulotomy. CONCLUSIONS: Good postoperative outcomes following phacoemulsification surgery were observed in patients with cataract and high myopia. However, clinicians should be aware of the risk of postoperative retinal tears and rhegmatogenous retinal detachment. Preoperative prophylactic argon laser photocoagulation treatment should be considered where necessary.

Phacoemulsificatıon in eyes wıth cataract and high myopia / Facoemulsificação em olhos com catarata e alta miopia

ABSTRACTPurpose:To evaluate the outcomes and complications following phacoemulsification surgery in eyes with cataract and high myopia.Methods:We retrospectively evaluated the data of 43 eyes of 28 consecutive patients (12 males, 16 females) with cataract and high myopia who had undergone phacoemulsification and intraocular lens (IOL) implantation. The mean [± standard deviation (range)] age of the patients was 59.20 ± 11.08 (39-77) years.Results:The frequency of nuclear cataract was significantly higher than that of other cataract types (P=0.003). The mean axial length was 28.97 ± 1.99 (26-33) mm and the mean IOL power was 5.09 ± 4.78 (-3.0 to +14.0) diopters (D). The mean preoperative spherical equivalent (SE) was -16.48 ± 5.23 (-8.00 to -25.00) D and the mean postoperative SE was -1.46 ± 0.93 (0.00 to -3.00) D (P=0.00). The mean preoperative best-corrected visual acuity (BCVA) was 0.91 ± 0.37 (0.30 to -1.50) logMAR and the mean postoperative BCVA was 0.29 ± 0.25 (0.00-1.00) logMAR (P=0.00). Twenty-two eyes (51.2%) achieved the target postoperative refraction (±1.0 D). The eyes were divided into 3 groups according to the axial length. The mean biometric error was significantly higher in the group with the greatest axial length than in the other groups (P=0.007). Preoperative argon laser photocoagulation was performed in 7 eyes (16%) on account of retinal tears, retinal holes, or lattice degeneration. Postoperatively, retinal tears developed in 2 eyes (4%) and were treated with photocoagulation. One eye (2%) developed retinal detachment postoperatively, with the patient consequently referred for retinal surgery. Postoperatively, posterior capsule opacities developed in 11 eyes (25%), with all cases treated by laser capsulotomy.Conclusions:Good postoperative outcomes following phacoemulsification surgery were observed in patients with cataract and high myopia. However, clinicians should be aware of the risk of postoperative retinal tears and rhegmatogenous retinal detachment. Preoperative prophylactic argon laser photocoagulation treatment should be considered where necessary.

RESUMOObjetivo:Avaliação dos resultados e complicações associadas à cirurgia de facoemulsificação em olhos com catarata e miopia alta.Método:Quarenta e três olhos de 28 pacientes (12 homens, 16 mulheres) consecutivos com catarata e alta miopia, que haviam sido submetidos a facoemulsificação e implante de lentes intraoculares (LIO), foram avaliados retrospectivamente. A idade foi de 59,20 ± 11,08, (39-77) anos [média ± desvio padrão, (variação)].Resultados:A frequência de catarata nuclear foi significativamente maior do que os outros tipos (p=0,003). O comprimento axial foi 28,97 ± 1,99, (26-33) mm e o poder da LIO foi 5,09 ± 4,78, (-3,0 a 14,0) dioptrias (D). O equivalente esférico pré-operatório (SE) foi de -16,48 ± 5,23, (-25,00 a -8,00) D e o SE pós-operatório foi -1,46 ± 0,93, (0,00 a -3,00) D, (P=0,00). A melhor acuidade visual corrigida pré-operatória (BCVA) foi de 0,91 ± 0,37, (0,30 -1,50) logMAR e a BCVA pós-operatória foi de 0,29 ± 0,25, (0,00-1,00) logMAR, (P=0,00). Vinte e dois olhos (51,2%) estavam dentro de refração alvo pós-operatória (± 1,0 D). Os olhos foram divididos em três grupos, de acordo com o comprimento axial. O erro biométrico foi significativamente maior no terceiro grupo, em comparação com os outros grupos (p=0,007). Fotocoagulação pré-operatória por laser de argônio foi realizada em 7 olhos (16%) devido a roturas retinianas, buracos de retina ou degeneração látice. No pós-operatório, as roturas da retina ocorreram em dois olhos (4%); tratados com fotocoagulação. Um olho (2%) desenvolveu descolamento de retina no pós-operatório e foi encaminhado para cirurgia de retina. No pós-operatório, opacidades da cápsula posterior ocorreram em 11 olhos (25%) e estes foram tratados com capsulotomia a laser.Conclusões:A cirurgia de facoemulsificação permite bons resultados em pacientes com catarata e miopia alta. No entanto, devemos estar atentos para a possibilidade de roturas da retina pós-operatórias e para o descolamento de retina regmatogênico. Se necessário, devemos usar o tratamento profilático de fotocoagulação a laser antes da cirurgia.

The influence of size and shape of Nd:YAG capsulotomy on visual acuity and refraction.

PURPOSE: To evaluate the influence of size and shape of neodymium:yttrium aluminum- Garnet (Nd:YAG) laser capsulotomy on visual acuity and refraction. METHODS: We retrospectively evaluated 85 eyes of 67 patients treated with Nd:YAG laser posterior capsulotomy for posterior capsule opacification (PCO). The mean age of included patients was 57.57 ± 9.26 (mean ± standard deviation, 38-75 years). The mean interval between surgery and Nd:YAG laser capsulotomy was 26.09 ± 7.08 (10-38) months. Patients were divided into four groups according to the shape and size of capsulotomy. Groups comprised patients with cruciate shape capsulotomies with openings of less than or equal to 3.5 mm (Group 1) or greater (Group 2) and patients with circular shape capsulotomies with openings of less than or equal to 3.5 mm (Group 3) or greater (Group 4). RESULTS: The mean number and energy of laser firings were significantly higher in Group 4 (p=0.00), and significantly lower in Group 1 (p=0.00), compared with that in other groups. Pre-procedural and post-procedural mean spherical equivalent (SE) values were significantly higher in Group 1 (p=0.026 and p=0.011, respectively). No statistical difference in best-corrected visual acuities (BCVA) or intraocular pressures (IOP) were observed between groups before (p=0.44 and p=0.452, respectively) or after capsulotomy (p=0.108 and p=0.125, respectively). A significantly higher number of patients in Group 4 (p=0.001), and a significantly lower number of patients in Group 1 (p=0.001), reported floating bodies compared with that in other groups. No significant changes in SE or intraocular pressure were observed after capsulotomy in any group (p=0.074 and p=0.856, respectively). Best-corrected visual acuity was significantly improved following capsulotomy in all groups (p<0.01). CONCLUSION: Cruciate shape capsulotomy with an opening of 3.5 mm or less provides the greatest improvement in visual function with minimal complications.

The influence of size and shape of Nd:YAG capsulotomy on visual acuity and refraction / A influência do tamanho e forma da capsulotomia por laser de Nd:YAG sobre a acuidade visual e refração

ABSTRACTPurpose:To evaluate the influence of size and shape of neodymium:yttrium aluminum- Garnet (Nd:YAG) laser capsulotomy on visual acuity and refraction.Methods:We retrospectively evaluated 85 eyes of 67 patients treated with Nd:YAG laser posterior capsulotomy for posterior capsule opacification (PCO). The mean age of included patients was 57.57 ± 9.26 (mean ± standard deviation, 38-75 years). The mean interval between surgery and Nd:YAG laser capsulotomy was 26.09 ± 7.08 (10-38) months. Patients were divided into four groups according to the shape and size of capsulotomy. Groups comprised patients with cruciate shape capsulotomies with openings of less than or equal to 3.5 mm (Group 1) or greater (Group 2) and patients with circular shape capsulotomies with openings of less than or equal to 3.5 mm (Group 3) or greater (Group 4).Results:The mean number and energy of laser firings were significantly higher in Group 4 (p=0.00), and significantly lower in Group 1 (p=0.00), compared with that in other groups. Pre-procedural and post-procedural mean spherical equivalent (SE) values were significantly higher in Group 1 (p=0.026 and p=0.011, respectively). No statistical difference in best-corrected visual acuities (BCVA) or intraocular pressures (IOP) were observed between groups before (p=0.44 and p=0.452, respectively) or after capsulotomy (p=0.108 and p=0.125, respectively). A significantly higher number of patients in Group 4 (p=0.001), and a significantly lower number of patients in Group 1 (p=0.001), reported floating bodies compared with that in other groups. No significant changes in SE or intraocular pressure were observed after capsulotomy in any group (p=0.074 and p=0.856, respectively). Best-corrected visual acuity was significantly improved following capsulotomy in all groups (p<0.01).Conclusion:Cruciate shape capsulotomy with an opening of 3.5 mm or less provides the greatest improvement in visual function with minimal complications.

RESUMOObjetivo:Avaliar a influência do tamanho e forma da capsulotomia a laser de Neodímio: Ítrio-Alumínio-Granada (Nd:YAG) na acuidade visual e refração.Métodos:Oitenta e cinco olhos de 67 pacientes, com opacificação de cápsula posterior (PCO), que tinham sido submetidos a capsulotomia por laser de Nd:YAG, foram avaliadas retrospectivamente. A idade foi 57,57 ± 9,26 (média ± desvio padrão), variação 38-75 anos. O intervalo médio entre a cirurgia e a capsulotomia a laser de Nd:YAG foi 26,09 ± 7,08 (variação 10-38) meses. Os pacientes foram divididos em 4 grupos de acordo com a forma e o tamanho da capsulotomia. O grupo 1 incluiu pacientes com forma cruzada e tamanho igual ou menor do que 3,5 mm de abertura capsulotomia, Grupo 2, forma cruzada e tamanho maior do que 3,5 mm, Grupo 3, forma circular e tamanho igual ou menor do que 3,5 mm e Grupo 4, forma circular e tamanho superior a 3,5 mm.Resultados:A quantidade média de energia utilizada e tiros aplicadas foram significativamente maiores no Grupo 4 (p=0,00) e significativamente menores no grupo 1 (p=0,00). O equivalente esférico (SE), antes e após o procedimento, foi significativamente mais elevado no Grupo 1 (p=0,026, p=0,011). Não houve diferença estatística entre os grupos em relação à acuidade visual melhor corrigida (BCVA) e pressão intraocular (IOP) antes do procedimento (p=0,44, p=0,452) e após o procedimento (p=0,108, p=0,125). O número de pacientes com sintomas de moscas volantes foi significativamente maior no grupo 4 (P=0,001) e significativamente inferior no grupo 1 (p=0,001). SE e IOP após o procedimento não foram estatisticamente diferentes daqueles antes do procedimento (p=0,074, p=0,856, respectivamente) em todos os grupos. BCVA após o procedimento foi significativamente melhor do que antes do procedimento (p=0,00) em todos os grupos.Conclusões:Em conclusão, para complicações mínimas e máximas funções visuais, o tamanho ótimo capsulotomia deve ser igual a ou menor do que 3,5 mm e deve ser em forma cruzada.

The course of dry eye after phacoemulsification surgery.

BACKGROUND: The aim of this retrospective study was to evaluate the course of dry eye syndrome after phacoemulsification surgery. METHODS: One hundred and ninety-two eyes of 96 patients (30 males, 66 females) with chronic dry eye syndrome and cataract, who had undergone phacoemulsification surgery were enrolled in this study. RESULTS: Their mean age was 68.46 ± 8.14 standard deviation (SD) (range 56-83) years . Thirty of them (31 %) were males and 66 (69 %) were females. Ocular Surface Disease Index (OSDI) questionnaire scores increased postoperatively, but arrived preoperative levels at the end of 3rd month following the surgery. Fluorescein staining patterns according to Oxford Schema got worse postoperatively, however after postoperative 3rd month they got better and resembled preoperative patterns. The mean postoperative 1st day, 1st week and 1st month Break-up Time (BUT) values were significantly lower than preoperative BUT value (P < 0.001, P < 0.001, P < 0.001), however 3rd month, 6th month, 1st year and 2nd year values were not significantly different from preoperative value (P = 0.441, P = 0.078, P = 0.145, P = 0.125). The mean postoperative 1st day, 1st week and 1st month Schirmer Test 1 (ST1) values were significantly lower than preoperative ST1 value (P < 0.001, P < 0.001, P < 0.001), however 3rd month, 6th month, 1st year and 2nd year values were not significantly different from preoperative value (P = 0.748, P = 0.439, P = 0.091, P = 0.214). CONCLUSION: Phacoemulsification surgery may aggravate the signs and symptoms of dry eye and affect dry eye test values in chronic dry eye patients in short-term. However, in long-term, signs and symptoms of dry eye decrease and dry eye test values return to preoperative values.