Evaluation of the effect of prostate diameters on erectile dysfunction in patients who underwent low-anterior resection.

OBJECTIVE: Male erectile dysfunction is an important complication of rectal surgery. In this research, the effect of prostate dimensions on the development of postoperative erectile dysfunction in patients diagnosed with mid-rectum adenocarcinoma who underwent low anterior resection (LAR) is examined. PATIENTS AND METHODS: Thirty-one male patients diagnosed as mid-rectal adenocancer were included. The International Index of Erectile Function (IIEF) questionnaire was used to determine the patients' pre and postoperative erectile dysfunction levels, and the level of relationship between the change in these IIEF scores and prostate measurements determined by computed tomography were evaluated. RESULTS: There were statistically significant differences between IIEF index score and anterior posterior (AP) and transverse (TR) measurements (p≤0.001; p≤0.001), but no statistically significant difference was found between craniocaudal (CC) measurement values (p=0.169). CONCLUSIONS: The risk of nerve injury will be higher in those with a small prostate transverse diameter. Intraoperative nerve monitoring should be recommended primarily in younger patient groups.

Investigation of long-term COVID-19 patients' quality of life and affecting factors: Data from single COVID-19 follow-up center.

Background: Patients with COVID-19 experienced changes in their quality of life. However, far less is known about how quality of life changes in long-term COVID-19 follow-ups. Aim: This article aims to explore the relationship between quality of life change and long-term COVID-19 patient status in the COVID-19 follow-up center. Patients and Methods: This study was designed retrospectively with patients admitted to the COVID-19 follow-up center between January and May 2021. The single group consisted of 125 patients. Their status and 36-Item Short-Form Health Survey (SF-36) variables were compared at two different time intervals. The first admission indicates the first 3 months, and the second admission covers 3-6 months after being diagnosed with COVID-19. Results: Cough and chest pain increased in the second admission (P < 0.001). No significant differences were found in SF-36 change according to age. The general health subgroup scores were lower in females than males (P = 0.004). The SF-36 Form's subgroups for physical function, physical role, emotional role, bodily pain, energy, mental health, general health, and social function showed improvement (P = 0.001, P = 0.001, P = 0.026 P < 0.001, P = 0.007, P = 0.031, P <0.001, P <0.001, respectively). In addition, comparing with the SF-36 subgroups in terms of treatment places, a significant result was found between the inpatient and intensive care unit (ICU) in the general health subgroup (P = 0.044). Conclusions: The results show that quality of life may worsen during follow-up for COVID-19. In summary, these findings have significant implications for understanding long-term COVID-19 patients with a multidisciplinary approach and the necessity of follow-up centers to detect the unpredictable results of long-term COVID-19.

Tannic acid exhibits anti-inflammatory effects on formalin-induced paw edema model of inflammation in rats.

The aim of the study was to determine the relationship between anti-inflammatory effects of the natural polyphenolic compound tannic acid (CAS number: 1401-55-4) and myeloperoxidase (MPO) enzyme activity in paw edema model. Thirty-five female rats were divided into five groups. The paws of rats were injected subcutaneously in the plantar surface with formalin except for the control group. Indomethacin and tannic acid were intraperitoneally administered 1 h after formalin injection. The paws volume was measured by using vernier caliper. MPO enzyme activity was determined using 4-aminoantipyrine-phenol solution as the substrate for MPO-mediated oxidation by H2O2. About 17% and 13% edema inhibition has detected in the indomethacin-applied group, at the measurements run every other hour right after the treatment. An inhibition of 16% was found at the group treated with 25 mg/kg tannic acid. However, in the group treated with 50 mg/kg tannic acid, 15% and 7% of the edema inhibition was observed. Serum and paw tissue MPO activities were decreased in treated groups with indomethacin and tannic acid according to formalin control group. Our study results suggest that tannic acid may contribute to the treatment of inflammation by decreasing MPO enzyme activity, but the molecular mechanism is still not clear.

The first case of fungal endophthalmitis caused by Emericella nidulans after cataract surgery.

Emericella nidulans is a species that has only rarely been implicated in human disease after cataract surgery. Here, we report the first postoperative case in the literature, as far as we know. The patient was a 50-year-old patient presented with mild anterior uveitis one week after cataract surgery, and hypopion developed over the next two days. First microbiological evaluation and the results of direct microscopy and cultures of the anterior chamber and vitreous samples were found to be negative. Despite vigorous topical and intravitreal (vancomycin and amikacin) therapy, the endophthalmitis did not improve. Anterior chamber paracentesis, vitreous tap and finally complete vitrectomy with removal of the capsular bag including the intraocular lens (IOL) were performed. The anterior chamber, vitreous fluid samples and IOL were submitted to the microbiology laboratory: the culture yielded E. nidulans growth. Ocular inflammation resolved and vision improved on intravenous, subconjunctival and long-term oral voriconazole treatment. E. nidulans can be an important cause of ocular fungal infections including endophthalmitis, and voriconazole seems to be effective for the treatment of E. nidulans endophthalmitis.

Intraocular Pressure Changes During Oral Glucose Tolerance Tests in Diabetic and Non-diabetic Individuals.

BACKGROUND: Hyperglycaemia in diabetic patients may lead to elevated intraocular pressure. Different reasons have been suggested in previous studies to explain the increase in intraocular pressure. The purpose of the present study was to investigate the change in intraocular pressure during oral glucose tolerance tests in diabetic and non-diabetic subjects. PATIENTS AND METHODS: 51 individuals who fulfilled the inclusion criteria of the study and were scheduled for oral glucose tolerances tests based on the recommendations of World Health Organization (WHO) underwent clinical examinations. Biochemical parameters associated with metabolic syndrome, insulin resistance (HOMA-IR) and systolic and diastolic blood pressure were also measured. A complete ophthalmologic examination was performed before the test. During the test, intraocular pressure was measured twice in the fasting state and at the first and second hours after oral glucose administration using rebound tonometry (ICARE). RESULTS: The mean age of the 51 patients was 46.19±9.13 years. The participants were categorized as non-diabetic (n: 24) and diabetic (n: 27). The baseline glucose levels were higher in the diabetic patients (p<0.001). The first-hour intraocular pressures (IOP1-0) changes in the right eye were significant in the diabetic and non-diabetic participants, and the first-hour intraocular pressure changes in the left eye (IOP1-0l) in the diabetic group were significant (p=0.017, p=0.017, p<0.001, respectively). CONCLUSION: The relation between diabetes mellitus and glaucoma has been addressed in many studies, but no clear underlying mechanisms have been identified. In our study of diabetic and non-diabetic individuals, hyperglycaemia during an oral glucose tolerance test was found to be positively related to intraocular pressure, which suggests that hyperglycaemia may represent a possible mechanism by which elevated IOP occurs.

Evaluation of the effect of nasal dorsal skin cooling on nasal mucosa by acoustic rhinometry.

BACKGROUND: The use of cold nasal packs on the nose and nape of the neck is currently recommended for patients with epistaxis as this is thought to induce reflex nasal vasoconstriction, which decreases the bleeding. There have been a few investigations on the effect of cold compress application to the nose, but none of these focused specifically on nasal cooling of the skin of the nose. METHODS: Acoustic rhinometry was performed to obtain baseline measurements. Nasal dorsal skin was then cooled with two ice packs that were held on the left and right side of the nose for a total of 10 minutes by the subjects. The rhinometry measurements were taken at the time of initial application (baseline), and after 5 and 10 minutes of ice pack application. RESULTS: Comparisons of the first and second minimal cross-sectional area values, and total nasal cavity volume measurements revealed no statistical differences. CONCLUSION: The results of this study indicate that one should be sceptical about the efficiency of cold compress application, which is frequently used in clinical practice in cases with epistaxis.

The role of flow cytometry in the diagnosis of non- Hodgkin's lymphoma, Hodgkin's lymphoma, granulomatous inflammation and reactive lymph node specimens.

PURPOSE: In this study we aimed to compare the flow cytometry (FC) results of patients with B cell lymphoma, T cell lymphoma, Hodgkin's lymphoma, granulomatous inflammation and reactive lymph node and investigate the role of FC in malignant or non malignant conditions. METHODS: Ninety patients were divided into 5 groups according to histopathology results. Patients were compared according to cytokeratin and positivity percentage of the following surface markers: CD45, CD19, CD5, CD19-CD5, CD4, CD8, CD3,CD16-CD56, CD10, CD10-CD19, CD23, CD20, CD4-CD8, CD3-CD16-56, CD30, CD38, kappa and lambda light chains, CD20-CD23. Patients were also compared according to the intensity of the expression (exp) of same markers. ROC curve analysis was performed for CD19+ cell percentage, CD38 exp, kappa/lambda and lambda/kappa ratios. RESULTS: 1) Kappa/lambda and lambda/kappa ratios can distinguish B cell lymphoma from T cell lymphoma, Hodgkin's lymphoma, granulomatous inflammation and reactive lymph node; 2) CD19+ cell percentage can distinguish T cell lymphoma from Hodgkin's lymphoma, granulomatous inflammation and reactive lymph node; 3) CD38 exp can partly distinguish B cell lymphoma from T cell lymphoma, Hodgkin's lymphoma, granulomatous inflammation and reactive lymph node and T cell lymphoma from granulomatous inflammation, T cell lymphoma from reactive lymph node, Hodgkin's lymphoma from reactive lymph node. CONCLUSION: Flow cytometry has a role in distinguishing lymphomas from non malignant lesions.

Comparison of blood brain barrier permeability in normal and ovariectomized female rats that demonstrate right or left paw preference.

We explored the relations among paw preference, cerebral asymmetry and asymmetrical disruption of blood-brain barrier (BBB) permeability in normal and ovariectomized female rats with known paw preference. A high dose of pentylenetetrazol was used to disrupt the BBB and induce acute hypertension. To determine the areas of macroscopic infarct, samples were stained with 2,3,5-triphenyltetrazolium chloride. Histological staining techniques were used to show the areas of infarct microscopically on paraffin sections. Sixty-two percent of the rats demonstrated right paw preference, 24% demonstrated left paw preference and 14% were ambidextrous. Areas of infarct, which indicated destruction of the BBB, were determined microscopically and macroscopically in rats that demonstrated right and left paw preference. We found a relation between permeability of the BBB and paw preference. There may be a relation between paw preference, cerebral asymmetry and asymmetrical destruction of the BBB in rats. Asymmetrical destruction of the BBB in experimental rats was similar to the control group, which had asymmetrically disrupted BBB with respect to paw preference. Like the control rats, asymmetrical areas of infarct consistent with cerebral asymmetry were observed in ovariectomized rats.

Prediction of suboptimal cytoreduction of epithelial ovarian carcinoma by preoperative computed tomography.

In an aim to evaluate the diagnostic efficacy of preoperative abdominal-pelvic CT for the prediction of suboptimal cytoreduction of epithelial ovarian carcinoma (EOC) at primary surgery, CT scans of 48 patients who underwent primary surgery for EOC were retrospectively analyzed. The presence of at least one of the following CT findings: multiple implants > 1 cm in maximum diameter in the mesenteria of the small or large intestines, porta hepatis or intersegmental fissure or on the hepatic surface, diaphragmatic peritoneum, gastrohepatic or gastrosplenic ligaments or the extension of tumor infiltration > 2 cm on the omentum towards the spleen or stomach or the intestines encased by the tumor > 2 cm, diffuse peritoneal thickening or invasion of the lateral pelvic wall > 1 cm or multiple lymph nodes > 1 cm at the cardiophrenic and suprarenal levels were accepted as the critical markers for predicting suboptimal cytoreduction. Suboptimal surgery, defined as leaving a residual tumor mass > 1 cm, was determined in 18 (37.5%) patients. CT predicted suboptimal cytoreduction with 83.3% (15/18) sensitivity, 90% (27/30) specificity and 87.5% (42/48) accuracy. PPV and NPV values were 83.3% (15/18) and 90% (27/30), respectively. These results suggested that preoperative CT could successfully predict suboptimal surgery in patients with EOC.

Cytokine and immune cell levels in peritoneal fluid and peripheral blood of women with early- and late-staged endometriosis.

OBJECTIVE: To investigate the level of cytokines and immune cells in the peripheral blood (PB) and peritoneal fluid (PF) of different stages of endometriosis. METHODS: A prospective study was conducted to include 97 women with (n 60) and without (n 37) histopathologically confirmed endometriosis. Based on rASRM classification, stage I/II and stage III/IV were categorized as early-and late-staged endometriosis. Prior to surgery, 10 ml of blood was withdrawn from antecubital vein and serum was obtained. Aliquots were made and stored at -70 degrees C until assayed for cytokines. PF was aspirated from the pouch of Douglas. Peripheral and PF samples were analyzed by ELISA in terms of IL-2, IL-4, IL-10 and IFN-gamma. Determinations of T helper, T suppressor, NK, and B cells were assessed by using cluster determinant-3 (CD-3), CD4, CD8, CD25, CD28, CD45, CD16, CD23 and antibodies against early T cell activation antigens such as CD45RA/CD45RO, CD-69 and late activation antigens such as HLA-DR. A multiparameter flow cytometry was applied to detect the cell activation antigen expression. RESULTS: In terms of cytokine levels in PB and PF's of control group and early- and late-staged endometriosis cases, no significant difference was depicted in the cytokine levels (p > 0.05). Levels of immune cells did not differ between three groups (p > 0.05). CONCLUSIONS: The result of this study did not show any significant difference in PB and PF cytokine and lymphocyte subgroups between normal and early- and late-staged endometriosis.

Apoptosis patterns in eutopic and ectopic endometrium, adhesions and normal-looking peritoneum from women with or without endometriosis.

OBJECTIVE: To assess the apoptosis rate in eutopic and ectopic endometrial stromal and glandular cells, normal peritoneum and adhesions in women with endometriosis. METHODS: A total number of 97 women with (n:60) and without (n:37) histopathologically confirmed endometriosis who underwent laparoscopy or laparotomy in the early follicular phase of the menstrual cycles for pain and infertility were included in this study. Stage I/II and stage III/IV were categorized as early staged and late-staged endometriosis. The endometrial samples were obtained with a Novack cannula from the corpus of the uterus. Normal-looking peritoneum, peritoneal implants and adhesions were sampled and fixed in formaldehyde for immunohistochemical staining with Bcl-2 and Bax. Tissue samples were fixed in formaldehyde for the assessment of apoptosis via terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) and M30 cytoDEATH antibody. RESULTS: The intensity of Bax staining of normal-looking peritoneum in early staged endometriosis was higher, compared to women with late-staged and women without endometriosis (P = 0.03). However, degree of Bcl-2 staining did not differ among early and late-staged endometriosis and women without endometriosis (P = 0.1). In terms of Bcl-2 and Bax staining in the stromal and glandular parts of the eutopic endometria, no significant differences were detected among three groups. In cases with early- and late-staged endometriosis the intensity of Bax and Bcl-2 stainings did not differ in both stromal and glandular parts of ectopic endometria. Number of cells with positive apoptotic signals assessed via TUNEL (P = 1.0) and M30 cytoDEATH antibody (P = 0.59) in normal-looking peritoneum did not differ between three groups. In addition, no difference in term of numbers of apoptotic cells obtained from adhesions was observed between three groups (for TUNEL, P = 0.29, for M30, P = 0.19). CONCLUSIONS: Apoptosis patterns did not differ in the eutopic and ectopic endometria as well as adhesions of women with or without endometriosis.

Clustering of invasive Aspergillus ustus eye infections in a tertiary care hospital: a molecular epidemiologic study of an uncommon species.

Aspergillus infections are being increasingly recognized as an important cause of morbidity and blindness. We report here the first cluster of Aspergillus ustus endophthalmitis cases which occurred in a large tertiary care hospital during the period October 2003 to June 2004. In three of the cases, the patients required enucleation following cataract surgery, while the fourth involved a fatal infection in a pediatric patient hospitalized for osteopetrosis. Patient charts from the four cases were reviewed retrospectively and indicated that postoperative signs of fungal endophthalmitis developed in the patients 1-11 weeks after surgery. The molecular characterization of the isolates and their epidemiological relatedness were evaluated by Random Amplification of Polymorphic DNA (RAPD). A source investigation of this mini outbreak was performed by environmental sampling, but no isolates of A. ustus were recovered from these studies. All A. ustus strains isolated from three patients with fungal endophthalmitis had the same RAPD pattern suggesting a common source. The strain from the pediatric patient differed from the ophthalmic isolates in five electrophoretic loci. The latter was included solely as an outbreak, unrelated control to evaluate the discriminatory power of the molecular typing method employed in the analysis of the ophthalmic strains. These cases illustrate the potential for uncommon species like A. ustus to cause high morbidity and mortality in some clinical settings. Aspergillus ustus endophthalmitis is a serious and devastating complication of ocular surgery. It is unknown whether ongoing hospital construction may have contributed to this cluster of cases. Random amplification of polymorphic DNA may give valuable clues about the clonality of A. ustus strains.

Effect of smoking on semen parameters of men attending an infertility clinic.

OBJECTIVE: To assess the effects of smoking on total sperm count, progressive sperm motility and sperm morphology among couples attending an infertility clinic. METHODS: A total of 223 sperm samples (126 smokers and 97 nonsmokers) from men attending an infertility clinic for routine infertility workup were compared on the basis of standard semen analysis. RESULTS: Cigarette smoking is negatively correlated with progressive motile sperm count (r = -0.1464, p = 0.042), but not with sperm concentration (p = 0.961), total motile sperm count (p = 0.890) and sperm morphology (p = 0.838). Furthermore, packages/ year (cumulative dose of cigarettes) did not correlate with any of the sperm parameters including sperm density (p = 0.976), total (p = 0.559) and progressive (p = 0.406) motile sperm count and sperm morphology (p = 0.449). CONCLUSIONS: Although the effect of smoking on male infertility remains inconclusive, smoking had an adverse effect on the progressive sperm motility, irrespective of total amount of cigarettes smoked per day.

Possible factors affecting the age at menopause among women in the central anatolian region of Turkey.

OBJECTIVE: We aimed to investigate the age at menopause and possible related factors in a Turkish population. STUDY DESIGN: In a three-year period, a retrospective analysis of 541 spontaneous menopause cases were evaluated. All postmenopausal women with spontaneous cessation of menses for > or = 12 months and serum FSH levels > 40 IU/l were included in the study. Sociodemographic status, reproductive and medical history, menopausal symptoms, and previous contraceptive and hormonal therapy use were assessed based on an interview using a standardized information system. Age at menarche, parity, menopausal age of mother and sister, history of lactation, physical activity, cigarette smoking, oral contraceptive use and body mass index (BMI) were assessed. RESULTS: Menopausal age of the enrolled cases was positively correlated with mothers and sisters' ages at menopause. Postmenopausal smokers had an earlier age at menopause compared to non-smokers. CONCLUSION: Cigarette smoking results in earlier menopause in the Turkish population. Menopausal ages of mothers and sisters clearly correlated with the age at menopause.

Terror-related open-globe injuries: a 10-year review.

PURPOSE: To describe mechanisms and injury characteristics influencing visual outcomes in eyes with open-globe injuries sustained in terrorist acts. DESIGN: Retrospective, interventional case series. METHODS: The charts of 260 consecutive patients (285 eyes) who had open-globe injury caused by terrorist attack and admitted to the tertiary referral center for military in Turkey between March 1991 and April 2001 were reviewed, and 50 patients (56 eyes) with complete data were evaluated for predicting visual outcome according to the Ocular Trauma Classification System (OTCS). RESULTS: The mean age of patients was 22.6 years, and the mean follow-up was 5.8 months. Seventeen patients (6.54%) had traumatic amputation in the extremities. Forty-eight eyes (16.84%) were enucleated. Type A, grade V, zone III, and RAPD-positive injuries were associated with unfavorable visual outcome. Land mine and hand grenade injuries had the worst outcome. CONCLUSIONS: In terror-related open-globe injuries, unusual presentations and devastating visual results are common, and OTCS seems to predict visual outcomes.

Hyperbaric oxygen therapy for mitomycin C-induced scleral necrosis.

Intraoperative or postoperative use of mitomycin C is one of the treatment options to reduce the recurrence of pterygia. Scleral necrosis, a potentially blinding complication after mitomycin C use, has been among great concern in ophthalmic practice. A patient is presented in whom scleral necrosis developed 20 days after a pterygiectomy with bare sclera technique was performed, followed by the application of 0.4 mg/mL of topical mitomycin C eye drops for 3 weeks. After conjunctival flap failures the patient was treated with hyperbaric oxygen therapy. The sclera revascularized and returned to near normal thickness after 24 sessions of hyperbaric oxygen therapy. This case demonstrates that it is an effective, novel treatment. [Ophthalmic

Endophthalmitis after deadly-weapon-related open-globe injuries: risk factors, value of prophylactic antibiotics, and visual outcomes.

PURPOSE: To identify clinical and microbiologic factors influencing the prevalence and visual outcomes in endophthalmitis after deadly-weapon-related open-globe injuries. METHODS: In a retrospective study of 228 eyes of 212 patients with deadly-weapon-related open-globe injuries, clinical and microbiologic factors influencing the prevalence and visual outcome in endophthalmitis were analyzed in detail. RESULTS: Twenty-nine eyes enucleated for irreparable damages at presentation were excluded. Nineteen eyes (18 patients) of 199 (186 patients) were associated with culture-proven endophthalmitis. Presence of grade 4 injury, a variable of Ocular Trauma Classification System, and lens disruption at presentation were the significant risk factors for development of endophthalmitis (P =.001; odds ratio = 15.9 [2.0 to 122.1]), and ([P <.001; odds ratio = 17.7 [2.3 to 136.3]), respectively. Favorable outcome (visual acuity of 5/200 or better) was achieved in only four eyes (21%). Five eyes (26.3%) were phthisical, and five eyes (26.3%) were enucleated or eviscerated. All eyes were under the coverage of prophylactic intravenous antibiotics when culture positivity was obtained. Except two eyes with Acinetobactersp., all were infected by gram-positive micro-organisms (89.5%), the most common of which (42%) was Staphylococcus epidermidis. None of the clinical characteristics and treatment modalities affected final visual outcome. Favorable outcome was associated with infection by the less virulent micro-organism S. epidermidis (P =.018; odds ratio = 0.50 [0.25 to 1.00]). CONCLUSIONS: Endophthalmitis after deadly-weapon-related open-globe injuries has a dismal visual prognosis. Severity of injury and lens disruption are significant risk factors for development of endophthalmitis. Infection with a less virulent microbe is the only factor associated with favorable outcome.

Deadly weapon-related open-globe injuries: outcome assessment by the ocular trauma classification system.

PURPOSE: To describe mechanisms and injury characteristics influencing visual outcomes in eyes with open-globe injuries caused by deadly weapons and to apply the classification system introduced by the Ocular Trauma Classification Group. METHODS: Two-hundred-twenty-eight eyes of 212 consecutive patients, who were mostly injured in military confrontation, were analyzed. Mechanism and injury characteristics were evaluated for predicting visual outcome according to the recently studied classification system as well as other variables pertinent to this specific clinical setting of severe eye trauma. Final visual acuities were defined as favorable (5/200 or better) or unfavorable (less than 5/200, including enucleation). RESULTS: The mean age of patients was 23 years, and the mean follow-up was 5.7 months. The predictors for favorable visual outcome were type B, grade 1, zone I, and relative afferent pupillary defect-negative injuries. The predictors for unfavorable outcome were type A, grade 5, zone III, and relative afferent pupillary defect-positive injuries. Land mine and hand grenade injuries had the worst outcome among causative agents. Proliferative vitreoretinopathy, comprising 30.4% of postoperative failures, was the most common complication. CONCLUSION: Deadly weapon-related open-globe injuries, especially those associated with land mines and hand grenades, have devastating visual results. Evaluation of trauma mechanism and injury characteristics according to the Ocular Trauma Classification System seems to predict visual outcomes in this series of severe open-globe injuries.

Assessment of central and peripheral fusion and near and distance stereoacuity in intermittent exotropic patients before and after strabismus surgery.

PURPOSE: To determine whether central fusion and distance stereoacuity are useful as objective measures in assessing the need for and success of surgery for intermittent exotropia (X[T]). METHODS: A prospective, institutional, clinical trial was conducted of 26 consecutive patients with X(T) who were undergoing strabismus surgery in whom fusion (central and peripheral) and stereoacuity (at near and distance) were assessed preoperatively and postoperatively, as well as in 112 normal subjects. To obtain accurate measurements with sensory tests, the lower age was limited to 5 years for inclusion. A successful surgical alignment was defined as an exotropia of 10 prism diopters or less at 6 m. Sensory and motor outcome measures were determined 1 year after surgery. RESULTS: The successful surgical alignment rate was 69%. All patients with X(T) demonstrated peripheral fusion, whereas 35% demonstrated central suppression preoperatively and postoperatively. Central fusion was not predictive of surgical outcome (P = .078); however, there was a trend toward less surgical success in patients with central suppression. Patients with X(T) exhibited good near stereoacuity before and after surgery. Distance stereoacuity in patients with X(T) preoperatively was significantly diminished compared with normal subjects (P < .001) and was improved in 58% postoperatively. Patients who achieved successful surgical alignment had a greater likelihood of demonstrating distance stereoacuity improvement postoperatively than patients who failed to achieve successful surgical alignment (P = .003). Patients with central suppression were unlikely to improve their distance stereoacuity postoperatively (P = .014). CONCLUSIONS: Successful surgery may improve distance stereoacuity. Better distance stereoacuity and central fusion are frequently associated with better surgical success in X(T).

A comparative study of recurrent pterygium surgery: limbal conjunctival autograft transplantation versus mitomycin C with conjunctival flap.

OBJECTIVE: To compare the recurrence rate following treatment of recurrent pterygia using one of two techniques-limbal conjunctival autograft transplantation versus low-dose intraoperative mitomycin C (0.2 mg/ml) combined with conjunctival flap closure. DESIGN: Randomized clinical trial. PARTICIPANTS: Eighty-one patients with recurrent pterygia treated by limbal conjunctival autograft transplantation (n= 41) or mitomycin C combined with conjunctival flap (n= 40) participated. INTERVENTION: Limbal conjunctival autograft transplantation or low-dose intraoperative mitomycin C application with conjunctival flap technique was performed on recurrent pterygium cases. MAIN OUTCOME MEASURES: Recurrence of pterygium and postoperative complications. RESULTS: During mean follow-up periods of 16+/-1.9 and 15.5+/-1.5 months, six recurrences (14.6%) in the limbal conjunctival autograft transplantation group and five recurrences (12.5%) in the mitomycin C group were observed (P=0.77). The difference between the mean ages of recurrent (26.4+/-8.0 years) and nonrecurrent (35.8+/-11.9 years) cases for all patients was statistically significant (P=0.014). Technically, limbal conjunctival autograft transplantation seemed to be more difficult. The most frequent complication in limbal conjunctival autograft transplantation was graft edema, whereas that in the mitomycin C group was superficial keratitis. CONCLUSION: Both techniques showed similar recurrence rates in the treatment of recurrent pterygia. Although technically easier to perform, further follow-up is necessary to determine the long-term safety of low-dose intraoperative mitomycin C with conjunctival flap closure. The surgeon's familiarity with either procedure should determine the method of choice.