Comparison of Biomicroscopy and Light Microscopy Findings in Demodex Diagnosis in Patients With Chronic Blepharitis.

OBJECTIVES: We aimed to compare the results of biomicroscopic examination and light microscopy in the diagnosis of Demodex infestation in chronic blepharitis cases. METHODS: The study was performed with retrospective data and included patients with chronic blepharitis and who were admitted to the Medipol University Ophthalmology Outpatient Clinic. Biomicroscopic evaluation was performed intentionally under 40x magnification to investigate the presence of Demodex ectoparasites. Three or four pieces of eyelashes were obtained from all cases with epilation technique, and Demodex parasites were examined under ×100 and ×400 magnifications with light microscopy. The presence of one or more Demodex parasites in the examined area under light microscopy was considered to be positive for infestation. We calculated sensitivity, specificity, false-positive rate, false-negative rate, and positive and negative predictive values of biomicroscopic examination compared with those of positive light microscopy. RESULTS: Of the 255 subjects included in the study, 134 (52.5%) were men and 121 (47.5%) were women. The mean age was 43.9±11.9 years. Of the 255 chronic blepharitis cases, 130 (51%) presented Demodex infestation on light microscopy. We calculated the sensitivity, specificity, false-positive rate, false-negative rate, positive predictive value, and negative predictive value and were found to be 83.07%, 90.4%, 9.6%, 16.9%, 90%, and 83.7%, respectively, for the biomicroscopic examination. CONCLUSIONS: Careful biomicroscopic examination can be time-efficient and cost-effective, and the need for more advanced and invasive procedures for the identification of Demodex in patients with chronic blepharitis can be reduced.

Comparison of rebound tonometry and non-contact airpuff tonometry to Goldmann applanation tonometry.

PURPOSE: The aim of this study was to compare the intraocular pressure measurements obtained from healthy subjects with the rebound tonometry, non-contact airpuff tonometry, and Goldmann applanation tonometry in different age groups. METHODS: A total of 180 eyes of 90 healthy subjects were included in the study. According to the subjects' ages, the eyes were categorized into three groups: group 1 (age: 7-17 years), group 2 (age: 18-40 years), and group 3 (age: 41-75 years). Intraocular pressure was measured on each subject always in the same order: rebound tonometry, non-contact airpuff tonometry, and Goldmann applanation tonometry. Central corneal thickness values were obtained using ultrasonic pachymetry. One-way repeated-measures analysis of variance, Pearson's correlation coefficient, and Bland-Altman analysis were used for the statistical assessment. RESULTS: The mean corneal thickness was found to be 604 ± 13 µm, 546 ± 15 µm, and 547 ± 15 µm in group 1, group 2, and group 3, respectively. Non-contact airpuff tonometry was significantly higher than both Goldmann applanation tonometry and rebound tonometry measurements in all groups (p < 0.001, for all). No statistical difference between Goldmann applanation tonometry and rebound tonometry measurements was found in group 1 (p = 0.248), group 2 (p = 0.63), and group 3 (p = 0.126). There was a significant positive correlation in the meaning of intraocular pressure measurements between rebound tonometry and non-contact airpuff tonometry; non-contact airpuff tonometry and Goldmann applanation tonometry; and Goldmann applanation tonometry and rebound tonometry in all groups. CONCLUSION: As a result, without need for topical anesthesia, fast measurement and ease-of-use rebound tonometry is a reliable alternative to Goldmann applanation tonometry in different age groups.

Investigation of Demodex Parasite Existence in Treatment-Resistant Chronic Blepharitis Cases.

OBJECTIVE: Demodex acari is an obligate ectoparasite, and it is usually located in the human hair follicles, eyelash roots, and sebaceous glands. The aim of this study was to investigate the presence of Demodex infestation in chronic blepharitis cases that are resistant to therapy. METHODS: Patients who were admitted at the Istanbul Medipol University School of Medicine Hospital with a diagnosis of chronic blepharitis were included. All cases received conventional therapy at least three times. Three or four eyelash samples from patients with blepharitis were collected and examined under light microscopy. For the diagnosis, the presence of one or more Demodex parasites at 10× and 40× magnification by a light microscope was considered as positive for infestation. RESULTS: Overall, 153 cases were included in the study. Of the cases, 79 (51.6%) were males and 74 (48.4%) were females. The mean age was 43.1±9.7 years. The presence of D. acari in the follicles of the eyelashes in patients with chronic blepharitis was found in 69 (45.1%) cases. CONCLUSION: D. acari should be considered in patients with chronic blepharitis, especially in treatment-resistant cases. We believe that it would be useful to search for the parasite in patients with blepharitis prior to treatment on a routine basis.

Comparison of Central Corneal Thickness with Ultrasound Pachymetry, Noncontact Specular Microscopy and Spectral Domain Optical Coherence Tomography.

BACKGROUND: To determine the agreement of central corneal thickness (CCT) measurements taken with ultrasonic pachymetry (USP), spectral domain optical coherence tomography (SD-OCT) and noncontact specular microscopy (NSM). METHODS: A prospective, observational, cross-sectional study was performed in the outpatient ophthalmology clinic. CCT was measured in a total of 147 eyes of 147 consecutive healthy patients with USP, NSM, and SD-OCT. Same examiner performed all examinations. Bland-Altman plots were used to evaluate the agreement between instruments. RESULTS: The average CCT values obtained by USP, NSM, and SD-OCT were 555 ± 37 µm, 554 ± 34 µm, and 546 ± 34 µm, respectively. There was a strong correlation between instruments: USP with SD-OCT (r = 0.937, p < 0.01), USP with NSM (r = 0.943, p < 0.01) SD-OCT with NSM (r = 0.975, p < 0.01) for CCT. The mean differences (lower/upper limit of agreement) for CCT measurements were -10 ± 12.9 µm (15.28/-35.28) between SD-OCT and USP, -8.1 ± 7.7 µm (7/-23.2) between SD-OCT and NSM, and 1.8 ± 12.3 µm (25.9/-22.3) between USP and NSM. CONCLUSIONS: USP and NSM were found to have comparable CCT measurements and these two methods can be used correspondingly. However, CCT measurements by SD-OCT were lower when compared to other methods.

Dry Eye Assessment in Patients With Vitamin D Deficiency.

OBJECTIVES: The aim of this study was to evaluate tear film function in patients with vitamin D deficiency. METHODS: In a single center, 60 eyes of 30 patients with vitamin D deficiency (group 1), and 60 eyes of 30 healthy individuals (group 2) were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear break-up time (TBUT), scoring of ocular surface fluorescein staining using a modified Oxford scale, and tear osmolarity. RESULTS: Tear osmolarity values, OSDI, and Oxford scale scores were significantly higher in group 1 (309±9 mOsm/L, 35.78±21.44 and 1.3±0.9, respectively) compared with group 2 (295±10 mOsm/L, 18.69±17.21 and 0.4±0.8, respectively) (P<0.001 for all). Schirmer I test and TBUT results in group 1 (8.5±3.7 mm and 8.7±0.6 sec, respectively) were significantly lower compared with group 2 (16.6±2.4 and 18.1±0.5, respectively) (P<0.001 for all). CONCLUSIONS: This study demonstrates that vitamin D deficiency is associated with tear hyperosmolarity and tear film dysfunction. Patients with vitamin D deficiency may be prone to dry eye.

A CASE OF CONE DYSTROPHY ASSOCIATED WITH CHOROIDAL NEOVASCULARIZATION.

PURPOSE: To report a case of choroidal neovascularization (CNV) in a patient with cone dystrophy (CD). METHODS: Case report. RESULTS: A 20-year-old woman presented with diminished vision in her right eye. Fundus examination showed perifoveal retinal pigment epithelial changes and retinal hemorrhage consistent with subretinal CNV in the right eye, and mild retinal pigment epithelial changes with a dull foveal reflex in the left eye. Optical coherence tomography analysis and fundus fluorescein angiography also confirmed the subfoveal CNV in the right eye. Electroretinography showed decreased amplitudes in photopic and 30-Hz flicker tests in both eyes, which confirmed cone dystrophy. A single intravitreal ranibizumab injection resolved the edema and stabilized the CNV during the follow-up of 6 months. CONCLUSION: Cone dystrophy is an inherited ocular disorder characterized by loss of cone photoreceptors. Association of CNV has been reported in patients with fundus flavimaculatus, best dystrophy, gyrate atrophy, choroideremia, retinitis pigmentosa, adult-onset foveomacular vitelliform dystrophy, Sorsby macular dystrophy, Bietti crystalline dystrophy, and myotonic dystrophy-related macular dystrophy. We report a case of a patient with CD in whom CNV developed in one eye and responded to a single ranibizumab injection.

Tear osmolarity and ocular surface parameters in patients with psoriasis.

PURPOSE:: The aim of this study was to evaluate tear osmolarity, tear film function, and ocular surface changes in patients with psoriasis. METHODS:: At a single center, 30 eyes of 30 patients with psoriasis (group 1) and 30 eyes of 30 healthy individuals (group 2) were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear film break-up time (TBUT) test, scoring of ocular surface fluorescein staining using a modified Oxford scale, and tear osmolarity measurement. RESULTS:: Tear osmolarity values, OSDI, and Oxford scale scores were significantly higher in group 1 (309.8 ± 9.4 mOsm, 38.9 ± 1.1, and 0.7 ± 1.1, respectively) than in group 2 (292.7 ± 7.7 mOsm, 4.2 ± 0.3, and 0.1 ± 0.3, respectively; p<0.01 for all). TBUT was significantly lower in group 1 (8.7 ± 3.6 s) than in group 2 (18.1 ± 2.8 s; p<0.001). No significant differences were detected in Schirmer I test values between the groups (16.2 ± 2.5 mm in group 1 and 16.6 ± 2.3 mm in group 2; p=0.629). CONCLUSIONS:: The results of this study showed that psoriasis may influence tear osmolarity and tear film function. Patients with psoriasis showed tear hyperosmolarity and tear film dysfunction.

The Relationship between Metabolic Syndrome, Its Components, and Dry Eye: A Cross-Sectional Study.

PURPOSE: The aim of this study was to evaluate tear osmolarity and tear film function and ocular surface changes in patients with metabolic syndrome. METHODS: 108 eyes of 64 patients with metabolic syndrome (group 1) and 110 eyes of 55 healthy individuals (group 2) were included in this cross-sectional study. All participants were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear film break-up time (TBUT), and tear osmolarity. Main outcome measures were Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear film break-up time (TBUT), and tear osmolarity values. RESULTS: Tear osmolarity values and OSDI scores were significantly higher in group 1 (314.4 ± 19.1 mOsm and 38.9 ± 1.1, respectively) compared with group 2 (295 ± 14.3 mOsm and 18.69 ± 17.2, respectively) (p = 0.01 for both). The Schirmer test values and TBUT in group 1 (10 ± 3.7 mm and 14.8 ± 3.6 sec, respectively) were significantly lower compared with group 2 (16.8 ± 2.6 mm and 18.1 ± 0.5 sec, respectively) (p < 0.001 for both). There was significant correlation between tear osmolarity versus waist circumference and fasting blood glucose in the study group (r = 0.364, p = 0.04; and r = 0.542, p ≤ 0.001, respectively). CONCLUSIONS: This study showed that metabolic syndrome can influence tear osmolarity and tear film function. Patients with metabolic syndrome showed tear hyperosmolarity and tear film dysfunction.

Tear osmolarity and ocular surface parameters in patients with psoriasis / Parâmetros de osmolaridade lacrimal e da superfície ocular em pacientes com psoríase

ABSTRACT Purpose: The aim of this study was to evaluate tear osmolarity, tear film function, and ocular surface changes in patients with psoriasis. Methods: At a single center, 30 eyes of 30 patients with psoriasis (group 1) and 30 eyes of 30 healthy individuals (group 2) were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear film break-up time (TBUT) test, scoring of ocular surface fluorescein staining using a modified Oxford scale, and tear osmolarity measurement. Results: Tear osmolarity values, OSDI, and Oxford scale scores were significantly higher in group 1 (309.8 ± 9.4 mOsm, 38.9 ± 1.1, and 0.7 ± 1.1, respectively) than in group 2 (292.7 ± 7.7 mOsm, 4.2 ± 0.3, and 0.1 ± 0.3, respectively; p<0.01 for all). TBUT was significantly lower in group 1 (8.7 ± 3.6 s) than in group 2 (18.1 ± 2.8 s; p<0.001). No significant differences were detected in Schirmer I test values between the groups (16.2 ± 2.5 mm in group 1 and 16.6 ± 2.3 mm in group 2; p=0.629). Conclusions: The results of this study showed that psoriasis may influence tear osmolarity and tear film function. Patients with psoriasis showed tear hyperosmolarity and tear film dysfunction.

RESUMO Objetivo: O objetivo deste estudo foi avaliar a osmolaridade da lágrima, função do filme lacrimal e alterações da superfície ocular em pacientes com psoríase. Método: Em um único centro, 30 olhos de 30 pacientes com psoríase (grupo 1) e 30 olhos de 30 indivíduos saudáveis (grupo 2) foram avaliados pelo questionário do Índice de Doença da Superfície Ocular (OSDI), teste de Schirmer tipo I, tempo de ruptura do filme lacrimal (TBUT), coloração por fluoresceína da superfície ocular utilizando a escala de Oxford modificada e osmolaridade lacrimal. Resultados: Os valores de osmolaridade lacrimal, OSDI e escores da escala de Oxford foram significativamente maiores no grupo 1 (309,8 ± 9,4 mOsm, 38,9 ± 1,1 e 0,7 ± 1,1, respectivamente) em comparação com o grupo 2 (292,7 ± 7,7 mOsm, 4,2 ± 0,3 e 0,1 ± 0,3, respectivamente) (p<0,01 para todos). TBUT no grupo 1 (8,7 ± 3,6 s) foi significativamente menor em comparação com o grupo 2 (18,1 ± 2,8 s) (p<0,001). Não foram detectadas diferenças significativas nos valores de teste de Schirmer (16,2 ± 2,5 mm no grupo 1 e 16,6 ± 2,3 mm no grupo 2, p=0,629). Conclusões: Este estudo mostrou que a psoríase pode influenciar osmolaridade lágrima e função do filme lacrimal. Os pacientes com psoríase apresentaram hiperosmolaridade lágrima e disfunção do filme lacrimal.

Efficacy of adjunctive mitomycin C in transcanalicular diode laser dacryocystorhinostomy.

The objective of the study was to compare the success rate of transcanalicular laser dacryocystorhinostomy (TCL-DCR) with or without the use of adjunctive mitomycin C (MMC) in cases with primary nasolacrimal duct obstruction (NLDO). This retrospective study was comprised of 68 patients with uncomplicated primary NLDO. There were two groups in the study: the Group 1 (n = 35) patients underwent TCL-DCR surgery with MMC and the Group 2 (n = 33) patients underwent TCL-DCR surgery without MMC. All patients had bicanalicular silicone tube intubation. The main outcome measures were patent osteotomy as visualized endoscopically and patent nasolacrimal irrigation. The follow-up period was 12 months. All patients had unilateral TCL-DCR with silicone tube intubation. Six months following surgery, the silicone tubes were removed. At the final evaluation, success rates were 80 % in Group 1 and 78.8 % in Group 2. There was no statistically significant difference between the two groups (p = 0.52). No complications related to MMC usage were recorded during the study period. Intraoperative use of MMC has no beneficial effect on the success rate in TCL-DCR.

Changes in Anterior Chamber Depth after Combined Phacovitrectomy.

OBJECTIVES: To evaluate changes in anterior chamber depth (ACD) and postoperative refractive outcomes after combined phacovitrectomy. MATERIALS AND METHODS: This study included 10 eyes of 10 patients that underwent combined phacovitrectomy (study group) and 14 eyes of 14 patients that underwent phacoemulsification surgery (control group) at Istanbul Medipol University Ophthalmology Department. Preoperative and 3-month postoperative best corrected visual acuity (BCVA), ACD, change in ACD and refractive outcomes were compared between the two groups. RESULTS: Preoperative ACD, postoperative ACD at 3 months and change in ACD were similar between two groups (p=0.403, p=0.886, p=0.841). Postoperative mean refractive outcomes were 0.22±0.51 diopter in the phacovitrectomy group and -0.39±0.53 diopter in the phacoemulsification group (p=0.019). BCVA was increased in both groups (p=0.001). CONCLUSION: Postoperative refractive outcomes in eyes that underwent combined phacovitrectomy are different from those in eyes that underwent only phacoemulsification surgery. This is important in determining preoperative intraocular lens power before combined phacovitrectomy.

Tear Osmolarity and Tear Film Parameters in Patients With Ocular Rosacea.

OBJECTIVES: The aim of this study was to evaluate tear osmolarity and tear film parameters in patients with ocular rosacea. METHODS: In a single center, 25 eyes of 25 patients with ocular rosacea (group 1), 25 eyes of 25 patients with rosacea without ocular involvement (group 2), and 20 eyes of 20 healthy individuals (group 3) were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I test, tear film break-up time (TBUT), scoring of ocular surface fluorescein staining using modified Oxford scale, and tear osmolarity. RESULTS: Tear osmolarity values, OSDI and Oxford scale scores were significantly higher in group 1 than in groups 2 and 3 (P<0.001 for all). Schirmer I test and TBUT in group 1 were significantly lower than in groups 2 and 3 (P<0.001 for all). There were no significant differences in OSDI, Schirmer I test, TBUT, Oxford scores, or tear osmolarity between groups 2 and 3 (P=0.629, P=0.175, P=0.713, P=865, and P=0.388, respectively). CONCLUSIONS: This study showed that ocular rosacea is associated with tear hyperosmolarity and tear film dysfunction.

Anterior segment optical coherence tomography evaluation of corneal epithelium healing time after 2 different surface ablation methods.

OBJECTIVES: To compare epithelial healing time following laser epithelial keratomileusis (LASEK) and photorefractive keratectomy (PRK) with anterior segment optic coherence tomography (AS-OCT). METHODS: This prospective interventional case series study comprised 56 eyes of 28 patients that underwent laser refractive surgery in the Department of Ophthalmology, Medipol University Medical Faculty, Istanbul, Turkey, between March 2014 and May 2014. Each patient was randomized to have one eye operated on with PRK, and the other with LASEK. Patients were examined daily for 5 days, and epithelial healing time was assessed by using AS-OCT without removing therapeutic contact lens (TCL). Average discomfort scores were calculated from ratings obtained from questions regarding pain, photophobia, and lacrimation according to a scale of 0 (none) to 5. RESULTS: The mean re-epithelialization time assessed with AS-OCT was 3.07±0.64 days in the PRK group, 3.55±0.54 days in the LASEK group, and the difference was statistically significant (p=0.03). Mean subjective discomfort score was 4.42±0.50 in the PRK eyes, and 2.85±0.44 in the LASEK eyes on the first exam day (p=0.001). The score obtained on the second (p=0.024), and third day (p=0.03) were also statistically significant. The fourth (p=0.069), and fifth days scores (p=0.1) showed no statistically significant difference between groups. CONCLUSION: The PRK showed a statistically significant shorter epithelial healing time, but had a statistically significant higher discomfort score until the postoperative fourth day compared with LASEK.

Ocular surface and tear parameters in patients with chronic hepatitis C at initial stages of hepatic fibrosis.

PURPOSE: The aim of this study was to evaluate changes in ocular surface and tear function parameters in chronic hepatitis C at initial stages of hepatic fibrosis. METHODS: Thirty-one patients with biopsy-proven chronic hepatitis C and 31 age- and sex-matched healthy control subjects without systemic hepatitis C infection were examined with the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I, tear film break-up time, and scoring of ocular surface fluorescein and Rose Bengal staining using modified Oxford and van Bijsterveld scoring systems, respectively. RESULTS: All ocular surface parameters, except OSDI and corneal staining scores, were significantly worse in hepatitis C group. The control group had greater OSDI scores than the hepatitis C group, but there was no statistically important difference. In subgroup analysis, progression of hepatic fibrosis was found to be correlated strongly with decreased Schirmer test I, increased OSDI, lid parallel conjunctival folds, conjunctival, and corneal staining scores. CONCLUSION: Patients with chronic hepatitis C were more likely to exhibit severe ocular surface damage and signs of dry eye.

Anterior segment optical coherence tomography measurement after neodymium-yttrium-aluminum-garnet laser capsulotomy.

PURPOSE: To evaluate changes in anterior chamber depth (ACD) and angle width after neodymium-yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy. DESIGN: Prospective interventional case series. METHODS: In a single institution, 43 eyes of 43 consecutive pseudophakic patients with symptomatic posterior capsule opacification (PCO) underwent Nd:YAG laser capsulotomy. Anterior chamber depth and angle width in pseudophakic eyes with posterior capsule opacification were measured with anterior segment optical coherence tomography (AS-OCT) before and 3 days after Nd:YAG laser capsulotomy. Preoperative and postoperative measurements of anterior chamber depth and angle width included the angle opening distance, measured as the perpendicular distance from the trabecular meshwork at 500 µm and 750 µm anterior to the scleral spur to the anterior iris surface (AOD500 and AOD750, respectively), and anterior chamber angle (ACA) in the nasal and temporal quadrants. Main outcome measures were the changes in ACD and angle width parameters. RESULTS: The mean patient age was 63.4 ± 3.6 years. Before Nd:YAG laser capsulotomy, mean ACD, AOD500, AOD750, and ACA (nasal and temporal) measurements were 3.71 ± 0.11 mm, 0.61 ± 0.054 mm, 0.67 ± 0.063 mm, and 34.5 ± 1.67 degrees and 34.8 ± 1.55 degrees, respectively. Three days after Nd:YAG laser capsulotomy, mean ACD, AOD500, AOD750, and ACA (nasal and temporal) measurements were 3.77 ± 0.1 mm, 0.69 ± 0.06 mm, 0.73 ± 0.06 mm, and 35.51 ± 1.64 degrees and 36.17 ± 1.51 degrees, respectively (P < .01 for all). CONCLUSIONS: The depth and width of the ACA in pseudophakic eyes with PCO increased significantly after Nd:YAG laser capsulotomy, as shown by AS-OCT, a reliable and noncontact method for measuring anterior ocular structures. Our study shows that the different angle parameters such as ACD, AOD500, AOD750, and ACA measurements seem highly correlated.

Comparison of photorefraction, autorefractometry and retinoscopy in children.

Photorefractive devices have been evaluated for their effectiveness in detecting anisometropia, hyperopia, myopia, and astigmatism. We investigated the reliability of Plusoptix S08, the newest photoscreener, and Topcon autorefractometer by comparing them with cycloplegic retinoscopy. Plusoptix S08, cycloplegic retinoscopy, and cycloplegic autorefractometer measurements for 235 eyes of 118 children (59 female, 59 male) with a mean age of 4.9 ± 2.6 and median age of 5 years (range 1-12) were conducted. The Plusoptix S08 produced the following mean (± SD) results--spherical 0.27 ± 1.64, cylindrical power -0.81 ± 0.71, axis 89.73 ± 61.18, and spherical equivalent -0.05 ± 1.61. The cycloplegic retinoscopy produced the following mean (± SD) results--spherical 0.12 ± 1.35, cylindrical power -0.89 ± 0.71, axis 92.18 ± 68.39, and spherical equivalent -0.15 ± 1.31. The cycloplegic autorefractometer produced the following mean (± SD) results--spherical 0.16 ± 1.44, cylindrical power -0.88 ± 0.72, axis 90.86 ± 68.21, and spherical equivalent -0.12 ± 1.41. This study has shown that cycloplegic autorefractometer and retinoscopy results are similar and Plusoptix S08 is a very safe, easy-to-use and reliable screening method of refraction, especially for ophthalmologists unskilled in retinoscopy. Plusoptix S08 is a useful tool for estimating refraction in patients for whom conventional autorefraction is not an option.

Effect of air bubble on inflammation after cataract surgery in rabbit eyes.

PURPOSE: Intense inflammation after cataract surgery can cause cystoid macular edema, posterior synechia and posterior capsule opacification. This experimental study was performed to investigate the effect of air bubble on inflammation when given to anterior chamber of rabbit eyes after cataract surgery. MATERIALS AND METHODS: 30 eyes of 15 rabbits were enrolled in the study. One of the two eyes was in the study group and the other eye was in the control group. After surgery air bubble was given to the anterior chamber of the study group eye and balanced salt solution (BSS; Alcon) was left in the anterior chamber of control eye. RESULTS: On the first, second, fourth and fifth days, anterior chamber inflammations of the eyes were examined by biomicroscopy. On the sixth day anterior chamber fluid samples were taken for evaluation of nitric oxide levels as an inflammation marker. When the two groups were compared, in the air bubble group there was statistically less inflammation was seen. (1, 2, 4. days P = 0,001, and 5. day P = 0,009). CONCLUSIONS: These results have shown that when air bubble is left in anterior chamber of rabbits' eyes after cataract surgery, it reduced inflammation. We believe that, air bubble in the anterior chamber may be more beneficial in the cataract surgery of especially pediatric age group, uveitis patients and diabetics where we see higher inflammation. However, greater and long termed experimental and clinical studies are necessary for more accurate findings.

Intravitreal bevacizumab may increase diabetic macular edema in eyes with attached posterior vitreous.

PURPOSE: To report 2 eyes of a patient which developed vitreomacular traction (VMT) 1 month after intravitreal bevacizumab (IVB) injection. MATERIALS AND METHODS: A 45-year-old female with bilateral diffuse diabetic macular edema (DME) received bilateral IVB. RESULTS: Her initial visual acuity (VA) was 0.15 and 0.2 in OD and OS, respectively. Central foveal thickness (CFT) was 568 and 662 µm in OD and OS, respectively, without any sign of VMT. Both eyes responded well initially but developed VMT at 1 month. This time, intravitreal triamcinolone (IVTA) injection was performed. One month after IVTA injection, VMT was released and CFT decreased to 163 and 181 µm in OD and OS, respectively. Six months after IVTA injection, CFT was 163 and 153 µm, and VA was 0.7 and 0.9 in OD and OS, respectively. CONCLUSION: In eyes with DME and attached posterior vitreous, VMT may develop after IVB injection and increase edema. IVTA injection might be an option to release VMT before considering vitrectomy.