Basic parameters of thrombophilia in ocular Behçet disease with posterior segment involvement.

AIM: To assess basic thrombophilic parameters in both active and inactive periods of the ocular Behçet disease (BD) with posterior segment involvement in comparison with those in healthy adults as controls. METHOD: Thirty patients within the active period of the ocular BD with posterior segment involvement, 30 patients within the inactive period of the ocular BD with posterior segment involvement and 30 age-and sex-matched healthy controls were included in the study. Plasma protein C, free protein S, antithrombin III and activated protein C resistance were measured in the studied groups. RESULTS: Activated protein C resistance and antithrombin III levels were significantly altered in both active and inactive ocular BD patients when compared with those in the controls (p<0.05), whereas protein C and free protein S levels were not significantly changed within both groups (p>0.05). There was no difference among the active and inactive groups of BD for all of the studied blood tests (p>0.05). CONCLUSION: Activated protein C resistance together with increased antithrombin III plasma levels are associated with the posterior segment involvement in ocular BD based on the assessment of basic thrombophilic tests.

Cataract surgery in previously vitrectomized eyes.

PURPOSE: To evaluate the results of extracapsular cataract extraction (ECCE) and phacoemulsification (PHACO) performed in previously vitrectomized eyes. MATERIAL AND METHOD: In this retrospective study, 56 vitrectomized eyes that had ECCE and 60 vitrectomized eyes that had PHACO were included in the study group while 65 eyes that had PHACO in the control group. The evaluated parameters were the incidence of intra-operative and postoperative complications (IPC) and visual outcomes. Chi-squared, independent samples and paired samples tests were used for comparing the results. RESULTS: Deep anterior chamber (AC) was significantly more common in the PHACO group of vitrectomized eyes (PGVE) and observed in eyes that had undergone extensive vitreous removal (p < 0.05). Except for this there were no significant differences in the rate of IPC between the ECCE group and the PGVE (p > 0.05). Some of the intra-operative conditions such as posterior synechiae, primary posterior capsular opacification (PCO) and postoperative complications such as retinal detachment (RD), PCO were significantly more common in vitrectomized eyes than the controls (p < 0.05). There was no significant difference in the visual acuity gain between the ECCE group and the PGVE (p > 0.05). CONCLUSION: Deep AC is more common in eyes with extensive vitreous removal during PHACO than ECCE. Decreasing the bottle height is advised in this case. Except for this, the results of ECCE and PHACO are similar in previously vitrectomized eyes. Posterior synechiaes, primary and postoperative PCO and RD are more common in vitrectomized eyes than the controls.

Long-term outcomes of heavy silicone oil tamponade for complicated retinal detachment.

PURPOSE: To assess the long-term success rates and complications of heavy silicone oil tamponade (Oxane HD) in the management of complicated retinal detachment with proliferative vitreoretinopathy (PVR). METHODS: Twenty-one eyes of 21 patients with complicated retinal detachment and PVR were included in this study. Vitreoretinal surgery with heavy silicone oil (Oxane HD) tamponade was performed in all patients. Heavy silicone oil was injected by perfluorocarbon liquid-air-silicone oil exchange, and was removed after 3 months. The main outcomes of the surgery including the success and complication rates were evaluated during the mean follow-up period of 11.4+/-0.88 months. Wilcoxon signed ranks test was used for statistical analysis of visual acuity changes. The outcomes of our study were compared with those of the previous studies. RESULTS: All eyes had complicated retinal detachment with PVR Grade C3 or worse. Retinal detachment was rhegmatogenous in 6 eyes, secondary to previous detachment surgery in 11 eyes, secondary to proliferative diabetic retinopathy in 3 eyes, and secondary to perforating eye injury in 1 eye. The overall anatomic success rate was 80.9% at the end of the follow-up period. The overall visual success rate was 42.8%, with no statistically significant difference from baseline (p>0.05). Postoperative complications included severe reproliferation (4 eyes), intraocular pressure rise (3 eyes), anterior dislocation of silicone oil (2 eyes), posterior subcapsular cataract formation (4 eyes), vitreous hemorrhage (1 eye), rubeosis iridis (3 eyes), optic atrophy (1 eye), and ocular pain and photophobia (21 eyes). CONCLUSIONS: According to the results of this study, vitreoretinal surgery with temporary heavy silicone oil tamponade appears to increase the anatomic success rates with minimal complication rate in cases with complicated retinal detachment and PVR.

A possible link between the pseudoexfoliation syndrome and coronary artery disease.

PURPOSE: This is a collaborative case-control study from Ophthalmology and Cardiology departments of a tertiary care hospital, designed to explore the relationship between coronary artery disease (CAD) and pseudoexfoliation syndrome (PEX). METHOD: In all, 50 patients with CAD proven by coronary angiography, and 50 controls with normal coronary angiographic findings were compared in terms of PEX, other vascular diseases, and retinal vascular findings. chi2-test and Student's t-test were used for statistical analysis. RESULTS: The number of patients with PEX among CAD (+) patients was substantially larger than controls. In all, 28 of 50 CAD (+) patients and only 12 of 50 CAD (-) patients had PEX. PEX was significantly associated with CAD (P=0.001). When all patients were regrouped according to the presence of PEX, patients with PEX did not differ from patients without PEX in terms of age (P=0.360) and sex (P=0.507), but the prevalence of CAD was higher (P=0.001) and fundoscopic findings of vascular diseases were significantly more prominent (P=0.0001) in PEX (+) patients. DISCUSSION: We demonstrated statistically significant difference in the prevalence of PEX in CAD patients, and also in the prevalence of CAD in PEX (+) individuals. These were striking differences. We should consider the possibility of the presence of PEX in CAD patients; and the predisposition of PEX (+) persons for CAD, which necessitates a fundus examination for findings of systemic vascular diseases.

Comparison of subretinal fluid levels of two 0.3% ciprofloxacin-containing eye drops.

PURPOSE: Two ophthalmic solutions of 0.3% ciprofloxacin eye drops are available in Turkey: Ciloxan and Siprogut. A previous study by the same authors was the first to report vitreous penetration of ciprofloxacin-containing eye drops. The aim of the present study was to compare the levels of drug found in the subretinal fluid by the two products following local administration. METHODS: Forty-three patients undergoing conventional retinal detachment surgery received either Ciloxan (22 patients) or Siprogut (21 patients). Beginning 6 h before surgery, two drops of solution were instilled onto the operative eye every 30 min for the first 3 h and then hourly for the next 3 h. Subretinal fluid samples were collected 30 min after administration of the last dose and were assayed for ciprofloxacin levels using a method involving high-performance liquid chromatography with fluorometric detection. RESULTS: The minimum and maximum subretinal fluid concentrations measured were 0.11 microg/mL and 0.65 microg/mL, respectively, with Ciloxan, and 0.08 microg/mL and 0.62 microg/mL, respectively wth Siprogut. There was no statistical difference between the subretinal fluid ciprofloxacin levels of the two products. The subretinal fluid drug evels attained by both products were below the minimum inhibitory concentrations of common ocular pathogens. CONCLUSIONS: Ciloxan and Siprogut can penetrate subretinal fluid. The ocular bioavailability of ciprofloxacin after local administration is equivalent for both pharmaceutical products.

Subretinal fluid levels of topical, oral, and combined administered ciprofloxacin in humans.

AIMS: To investigate the subretinal fluid (SRF) penetration of ciprofloxacin following topical, oral, and combined administration. METHODS: 34 patients undergoing conventional retinal reattachment surgery were randomly assigned to three groups. Twelve patients received topical ciprofloxacin, 11 patients received oral ciprofloxacin, and the other 11 patients received combined drug administration. SRF drug level was measured by using high performance liquid chromatography method. RESULTS: The highest drug concentrations of all tested modes were attained following combined administration and lowest following topical administration (p<0.001). The SRF drug concentration following oral administration was also significantly higher than that of topical administration (p<0.001). Concentrations after oral and combined administration did not differ significantly (p = 0.217). CONCLUSIONS: Topical ciprofloxacin can penetrate SRF. Ocular bioavailability of ciprofloxacin in SRF after oral and combined administration is equivalent.

Combined phacoemulsification, vitrectomy, foreign-body extraction, and intraocular lens implantation.

PURPOSE: To assess the outcome of simultaneous phacoemulsification, pars plana vitrectomy, intraocular foreign-body extraction, and intraocular lens (IOL) implantation. SETTING: SSK Ankara Eye Hospital, Department of Vitreoretinal Surgery, Ankara, Turkey. METHODS: Seventeen patients with corneal perforation, intraocular foreign body, vitreous hemorrhage, and lens opacity had simultaneous clear corneal phacoemulsification, pars plana vitrectomy, intraocular foreign-body extraction, and IOL implantation. RESULTS: Postoperative complications included massive retinal fibrosis in 2 patients, retinal detachment in 1, and cilioretinal artery occlusion in 1. At a mean follow-up of 15.2 months, best corrected visual acuity improved in the remaining 13 eyes (76%). The IOL was stable in all cases. CONCLUSION: Combined phacoemulsification with IOL implantation and vitreoretinal surgery was safe in selected cases of penetrating ocular trauma resulting from an intraocular foreign body.

Penetration of topical, oral, and combined administered ofloxacin into the subretinal fluid.

AIMS: To assess the subretinal fluid (SRF) levels of ofloxacin following topical, oral or combined administration. METHODS: 31 patients undergoing conventional retinal reattachment surgery were randomly assigned to three groups. Nine patients received topical ofloxacin, 11 patients received oral ofloxacin, and the other 11 patients received combined administration. Collected SRF samples were analysed for drug level by using high performance liquid chromatography. RESULTS: SRF drug levels after oral and combined administration were significantly higher than that after topical administration (p=0.0002 and p=0.0002, respectively) while there was no significant difference between oral and combined administration (p=0.0844). CONCLUSIONS: Ocular bioavailability of ofloxacin in SRF after oral and combined administration is equivalent. The addition of oral ofloxacin to topical therapy increased drug SRF penetration sixfold.

Aqueous humour levels of topically applied ciprofloxacin and ofloxacin in the same subjects.

PURPOSE: To evaluate aqueous humour levels of topical 0.3% ciprofloxacin and 0.3% ofloxacin in the same subjects. METHODS: Thirty-two bilateral cataractous patients received topical 0.3% ciprofloxacin in one eye and 0.3% ofloxacin in the other eye before each cataract extraction. Eyedrops were repetitively instilled for 6 h. Aqueous humour samples were collected and assayed for drug concentrations by a method described originally by us using high-performance liquid chromatography. RESULTS: Mean aqueous ciprofloxacin and ofloxacin levels were 0.33 +/- 0.04 microgram/ml (mean +/- SEM) and 1.34 +/- 0.14 micrograms/ml respectively (p < 0.0001). CONCLUSION: Ofloxacin level in the aqueous humour is 4 times higher than that of ciprofloxacin in the same subjects.

Changes in anterior chamber depth and intraocular pressure after phacoemulsification and posterior chamber intraocular lens implantation.

BACKGROUND AND OBJECTIVE: To determine anterior chamber depth (ACD) and intraocular pressure (IOP) following uncomplicated cataract extraction with phacoemulsification and posterior chamber intraocular lens (IOL) implantation. PATIENTS AND METHODS: The ACDs and IOPs of 56 patients were prospectively evaluated after phacoemulsification and IOL implantation. Measurements of ACD were performed using ultrasonography and measurements of IOP were performed using a Goldmann applanation tonometer preoperatively and at 1 week and 1, 3, 6, and 9 months postoperatively. RESULTS: The mean IOP had decreased and the mean ACD had increased significantly by 1 month postoperatively (P < .03 and P < .01, respectively). Between 1 and 3 months, a significant increase in ACD (P < .05) and decrease in IOP (P < .01) was also observed. The ACD peaked (3.51 +/- 0.45 mm) and the IOP reached its lowest value (10.05 +/- 2.23 mm Hg) at 3 months postoperatively. The reduction in IOP and increase in ACD remained significant during the follow-up period, compared with the preoperative values. CONCLUSION: These results suggest that increases in ACD and decreases in IOP occur in selected patients after uncomplicated cataract extraction by phacoemulsification with IOL implantation.