Longitudinal evaluation of retinal thickness and OCTA parameters before and following silicone oil removal in eyes with macula-on and macula-off retinal detachments.

BACKGROUND: To investigate the longitudinal retinal vascular and structural alterations by using OCTA following successful repair of retinal detachment (RD) by using silicone oil (SO) endotamponade. METHODS: A prospective cohort study was performed on 24 eyes of 24 subjects; 17 of them with macula-off and seven with macula-on RD. At least four OCTA scans were generated for each study eye; two before and two after SO removal (SOR). At each session, retinal thickness (RT), vascular density (VD) in the superficial (SCP) and deep capillary plexuses (DCP) and foveal avascular zone(FAZ) size were measured within the fovea, parafovea and whole macular image. The changes in repeated measures of the same parameters especially before and after SOR were performed and compared within macula-on and macula-off groups and between fellow eyes. RESULTS: "In the macula-off eyes, RT measurements within the whole macula, fovea and parafovea reduced as compared with their fellow eyes(p < 0.0001, p = 0.001 and p < 0.0001, respectively) and did not improve after SOR. Additionally, all of the whole macular, foveal, and parafoveal VD measurements at SCP and foveal VD at DCP were less than their fellow eyes after SOR (p = 0.026, p = 0.023 p = 0.026, and p = 0.002, respectively). In macula-on eyes, RT measurements decreased within the parafovea and whole macular area before SOR (p = 0.018 and p = 0.011, respectively) but improved after SOR. Also, VD measurements did not change during follow-up and were not statistically different than their fellow eyes (p > 0.05). FAZ enlargement was found in eyes with macular-off RD after SOR, whereas it was not observed with macular-on RD (p = 0.038and p = 0.237, respectively). CONCLUSIONS: Treatment of macula-off RD with SO tamponade has been associated with vascular retinal abnormalities which did not improve following SOR. On the contrary, successful treatment of RD with SO tamponade in macula-on eyes VD measurements of SCP and DCP were not statistically different than their fellow eyes.

Optical coherence tomography-signal strength index following trifocal and monofocal intraocular lens implantation.

PURPOSE: To evaluate the influence of trifocal and monofocal intraocular lens implantation on the optical coherence tomography-signal strength index values obtained during macular and peripapillary scanning. METHOD: Study group included 60 eyes of 60 patients with intraocular lens (Acriva BB UD 613 monofocal in 30 eyes and Acriva Trinova UD trifocal in 30 eyes) implantation after uneventful phacoemulsification. Thirty eyes of 30 healthy subjects without any intraocular surgery were selected as the control group. Eyes with best corrected visual acuity less than 20/20 due to any media opacity, high refractive errors excluded. Macular and retinal nerve fiber layer scans were generated by optical coherence tomography after pupillary dilation. Intergroup comparisons of signal strength index values of the macular and peripapillary scans were performed between eyes implanted with two different intraocular lenses and control group. RESULTS: The mean signal strength index of the peripapillary and macular scans obtained in the eyes implanted with both monofocal and trifocal intraocular lenses were statistically less than the control group (p < 0.05, for all). SSI's of macular and peripapillary scans recorded from the eyes implanted with either monofocal or trifocal intraocular lenses were not statistically different from each other (p = 0.957 and p = 0.877, respectively). CONCLUSION: In the present study despite different intraocular lenses properties, the image quality values were not found to be lower in eyes with trifocal sinusoidal intraocular lenses implantation compared to monofocal intraocular lenses during macular and peripapillary optical coherence tomography scans.

Assessment of lens autofluorescence in patients with well-controlled essential hypertension and those with renal failure secondary to hypertension undergoing hemodialysis.

PURPOSE: To compare the lens autofluorescence (AF) levels among patients with end-stage renal failure and undergoing hemodialysis secondary to hypertension, patients with well-controlled hypertension, and healthy controls. METHOD: This study was a prospective, cross-sectional, comparative study conducted between February and April 2018. Two groups of patients and a group of healthy individuals were included in the study. The first group of patients included individuals with a renal insufficiency due to essential hypertension who underwent regular hemodialysis treatment (dialysis group). The second group included patients with well-controlled essential hypertension (hypertension group). Lens autofluorescence was measured via a scanning confocal lens fluorescence biomicroscope optical system for all participants. The measurement of fluorescence ratio is given as a numerical data. The AF results were compared in all groups. RESULTS: The study included 87 individuals. There were 29 individuals (33.3 %) in the dialysis group, 30 (34.5 %) in the hypertension group, and 28 (32.2 %) in the healthy group. The mean fluorescence ratio(FR) was 0.20 ± 0.06, 0.20 ± 0.04, and 0.17 ± 0.04 in the dialysis, hypertension, and healthy groups respectively. There was a significant difference in the mean FR measurements between the three groups (p = .004). As a result of a binary comparison, mean FR values for patients in the dialysis group were higher (0.20 ± 0.06) than for healthy individuals (0.17 ± 0.04), which was statistically significant (p = .025). Mean FR measurements of hypertensive patients were higher (0.20 ± 0.04) than healthy individuals (0.17 ± 0.04), which was also statistically significant (p = .02). However, there was no statistically significant difference among the mean FR measurements between the hypertension and dialysis groups (p = .63). CONCLUSION: We demonstrated that lens autofluorescence increased in patients with renal failure undergoing hemodialysis and those with well-controlled hypertension. The mean lens autofluorescence levels were significantly higher in both patient groups than the healthy control group.

Inter-Ocular Symmetry of Vascular Density and Retinal Thickness in Unilateral Anisometropic Amblyopia.

BACKGROUND: Inter-ocular symmetry of macular vascular anatomy in healthy subjects has been well documented in previous optical coherence tomography angiography (OCTA) studies. In our present study, we have demonstrated that the presence of anisometropic amblyopia in one eye does not alter this unique feature significantly. We investigated whether the presence of unilateral anisometropic amblyopia due to moderate amounts of hyperopia and/or astigmatism would have any significant influence on measurements of retinal thickness (RT) and superficial vessel density (SVD) in adult subjects. SUBJECTS AND METHODS: In the study group, both eyes of 21 adult subjects with unilateral anisometropic amblyopia were enrolled. Only one eye of an age-matched control group including 33 subjects was randomly selected. RT and SVD were measured in foveal and parafoveal retinal areas and compared in amblyopic eyes, their fellow eyes and in the control group. Inter-ocular symmetry of RT and SVD in amblyopic and fellow eyes were investigated by using correlation analysis. RESULTS: There were statistically significant inter-ocular correlations of foveal and parafoveal RT in amblyopic and fellow eyes (P < 0.0001, for both). Foveal and parafoveal RT of the control group were not statistically different from amblyopic eyes (P = 0.072 and P = 0.46, respectively). There was no difference between foveal SVD of amblyopic eyes and control group (P = 0.10) and a significant inter-ocular correlation was found between amblyopic and fellow eyes (P = 0.029). CONCLUSION: For our adult subjects, none of the investigated OCTA parameters of the amblyopic eyes were found to be statistically different from those of age-matched controls. The preservation of inter-ocular symmetry in the amblyopic and fellow eyes implies that the influence of anisometropic amblyopia in one eye would be relatively small and negligible on routine OCTA examination.

The correlation between glaucomatous visual field loss and vision-related quality of life.

PURPOSE: To evaluate the vision-related quality of life (QoL) of glaucoma patients in terms of the correlation between visual field (VF) loss and National Eye Institute Visual Functioning Questionnaire-39 (NEI VFQ-39) survey. MATERIALS AND METHODS: A total of 244 glaucoma patients were examined with monocular Humphrey 24-2 central full threshold and Esterman binocular VF tests. Patients were grouped according to their monocular VFs done by Advanced Glaucoma Intervention Study (AGIS) classification and Esterman binocular VF efficiency scores. NEI VFQ-39 was applied for the evaluation of vision-related QoL. RESULTS: NEI VFQ-39 subscales and total scores were evaluated and the highest mean average values were in "color vision" (92.00±16.59) and "social functioning" (90.74±15.98). The lowest mean average values were in "general health" (54.76±18.86) and "general vision" (66.03±17.59). All the subscales except "general health" and "ocular pain" showed positive correlations with the monocular and Esterman binocular VF groupings. Pearson correlation analysis between NEI VFQ-39 subscales and the AGIS VF classification-based groups indicated that the subscales had statistically significant negative correlations except the "general health" (r=-0.151, P=0.018) and "ocular pain" (r=-0.048, P=0.455). The highest correlation with AGIS VF classification was in "driving" (r=-0.477, P=0.001) and "general vision" (r=-0.446, P=0.000) subscales. There was statistically significant correlation between NEI VFQ-39 subscales and Esterman binocular VF groups except "general health" (r=-0.064, P=0.318) and "ocular pain" (r=-0.062, P=0.337). The highest negative correlation was in "distant activities" (r=-0.522, P=0.000) and the lowest negative correlation was in "color vision" (r=-0.416, P=0.000) subscales. The highest correlation between binocular distant and binocular near-visual acuities was in "distant activities" and the lowest correlation was in "role difficulties" subscales. CONCLUSIONS: There is statistically significant correlation between the glaucoma patients' VF loss and the vision-related QoL. The evaluation of self-reported vision status in glaucoma patients may be a guide for the rehabilitation of their disabilities in vision-related daily activities.

Does the use of preoperative antiglaucoma medications influence trabeculectomy success?

PURPOSE: To investigate the influence of preoperative antiglaucoma medications on trabeculectomy outcome. METHODS: Two hundred fifteen eyes, which underwent primary trabeculectomy, were retrospectively analyzed. The average follow-up was 39.8±30.3 months. The only cases of primary open-angle glaucoma, with or without pseudoexfoliation (PXF), were included. "Complete success" was defined as intraocular pressure (IOP) <18 mmHg without glaucoma medications, whereas relative success was defined as the same IOP target with medications. The influence of the preoperatively used glaucoma medications on surgical success was analyzed by univariate Pearson correlation and multivariate (ordinal) regression analysis. RESULTS: There were 118 male (54.9%) and 97 female (45.1%) patients with a mean age of 66.9±9.3 years. PXF glaucoma (PXFG) was present in 93 eyes (43.3%). In 33 patients (15.3%), diabetes mellitus (DM) was present. Complete success was achieved in 116 eyes (54%), relative success in 81 eyes (37.6%), and failure in 18 eyes (8.4%). Neither the total number nor the duration of glaucoma medications used before trabeculectomy was found to have any statistically significant influence on surgical success. In statistical analysis, a combination of topical beta-blocker and carbonic anhydrase inhibitor (BB+CAI) used before surgery was found to be associated with statistically better outcome, whereas the preoperative use of topical beta-blockers alone could have a negative influence on success. PXF was shown to be independently associated with trabeculectomy outcome on multivariate regression analysis. CONCLUSION: The glaucoma medications used preoperatively were not found to have any statistically significant negative influence on the trabeculectomy outcome and use of the combined BB+CAI preparation could have a positive influence, whereas the use of topical beta-blockers alone could have a negative influence on success, although not statistically significant. The presence of PXF was independently associated with a better surgical outcome.

Surgical Management of Pseudophakic Malignant Glaucoma via Anterior Segment-Peripheral Iridectomy Capsulo-Hyaloidectomy and Anterior Vitrectomy.

Purpose. To describe our surgical technique in the management of pseudophakic malignant glaucoma refractory to conventional treatment. Methods. Two pseudophakic eyes with malignant glaucoma underwent peripheral iridectomy, lens capsulectomy, hyaloidectomy, and anterior vitrectomy through a clear corneal incision by using a vitreous cutter. Results. Prompt resolution of malignant glaucoma was achieved in both cases and no recurrence was observed during postoperative followup of five months. Conclusions. An anterior segment surgeon can treat pseudophakic malignant glaucoma successfully by using a vitreous cutter inserted through a corneal incision and performing peripheral iridectomy, capsulo-hyaloidectomy, and anterior vitrectomy.

Phacoemulsification in high myopia.

OBJECTIVE: To analyze the visual results of phacoemulsification in highly myopic eyes, to investigate the risk factors for poor postoperative visual acuity and to assess postoperative complications. METHODS: This retrospective study reviewed the records of 209 eyes of 150 patients with high myopia who underwent phacoemulsification and foldable intraocular lens (IOL) implantation between January 1998 and July 2008 at Beyoglu Education and Research Eye Hospital, Istanbul, Turkey. RESULTS: Postoperative best-corrected visual acuity (BCVA) was 0.5 or better in 63.2% of eyes. One hundred forty-seven (70.3%) eyes were within ±1.0 diopter (D) of the intended target refraction. In multiple regressions, only pre-existing myopic chorioretinal macular degeneration was found to be associated with poor BCVA (p=0.000). Nor patient age nor axial length (AL) had any correlation with postoperative BCVA. Retinal detachment (RD) occurred in one eye (0.5%) during mean follow-up (18.7+/-8.9 months). CONCLUSION: Most of the eyes with high myopia achieved satisfactory improvement in BCVA with few complications. Myopic retinal degenerative changes were the single independent factor limiting visual potential. Our lower incidence of postoperative RD could be attributed partially to our lower neodymium:yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy rates and our surgical modification involving the implementation of primary posterior capsulorhexis in all patients younger than 40.

Comparison of conventional and torsional mode (OZil) phacoemulsification: randomized prospective clinical study.

PURPOSE: To compare the amount of intraoperative energy used during conventional and torsional phacoemulsification surgery and investigate the changes in corneal endothelial cell density. METHODS: In this study, a total of 100 eyes in patients with age-related cataract (mean age 68.9 years) were included. Patients were randomly allocated into conventional (group 1) or torsional (OZil, group 2) phacoemulsification. Mean nuclear grade made according to Lens Opacities Classification System II was not different in the 2 groups. Total ultrasound time (USTT), cumulative dissipated energy (CDE), and the percent of total equivalent power in position 3 (%USTEPiP3) were compared between the 2 groups. RESULTS: There were 47 eyes in group 1 and 53 eyes in group 2. Patient age and sex were matched between the 2 groups (p=0.49, p=0.08). Mean USTT was 1.6+/-1.1 minutes (m) in group 1 and 1.5 +/- 0.9 m in group 2 (p=0.55). Average CDE was 29.9+/-16.9 in group 1 and 25.2+/-19.1 in group 2 (p=0.20).Mean %USTEPiP3 was 27.0%+/-8.5% in group 1; however, it was 22.4%+/-6.6% in group 2 (p=0.003). At the first postoperative day, mean corneal edema was graded as 0.25+/-0.5 in group 1 and 0.18 +/- 0.4 in group 2 (p=0.47). At the first postoperative week, it was found to be 0.02+/-0.15 in group 1 and 0.03+/-0.27 in group 2 (p=0.71). ECD loss was 6.7%+/-3.3% in group 1 and 4.2%+/-5.7% in group 2 (p=0.56). CONCLUSION: No statistically significant difference was found between conventional and torsional phacoemulsification with respect to USTT and CDE. Torsional mode led to a significant reduction in US power in footswitch position 3. Torsional mode also appears to be associated with less loss of ECD.

Intracorneal inlay for the surgical correction of presbyopia.

PURPOSE: To evaluate the clinical safety and efficacy of the ACI-7000 intracorneal inlay in increasing the depth of field in emmetropic presbyopic patients. SETTING: Beyoglu Eye Research and Education Hospital, Istanbul, Turkey. METHODS: This prospective unmasked study comprised 39 presbyopic patients; 12 were naturally emmetropic and 27 had emmetropia resulting from previous hyperopic laser in situ keratomileusis. The intracorneal inlay was placed over the pupil in the patient's nondominant eye after flap lift or creation of a conventional flap using a microkeratome. The inlay was centered on the visual axis. Postoperative follow-up was 1 year. RESULTS: Of the 39 inlays implanted, 3 were explanted during the study. At 1 year, the mean uncorrected near visual acuity improved from J6 (preoperatively) to J1+. All eyes with an inlay had an uncorrected near acuity of J3 or better and 85.3%, of J1 or better. Binocularly, the mean uncorrected near acuity remained J1 or better throughout the study. The mean uncorrected distance visual acuity in eyes with an inlay did not change significantly from preoperatively and remained 20/20 throughout the study period. All 3 eyes with inlay explantation returned to within +/-1.00 diopter of the preoperative refractive state for near and distance vision, with no loss of best corrected distance visual acuity. CONCLUSION: The ACI-7000 intracorneal inlay showed the potential to provide safe, effective, and reversible treatment of presbyopia.

Efficacy of intravitreal triamcinolone for the treatment of macular edema secondary to branch retinal vein occlusion in eyes with or without grid laser photocoagulation.

PURPOSE: To evaluate the efficacy of primary and secondary (following grid laser photocoagulation) intravitreal triamcinolone acetonide (IVTA) injection for the treatment of macular edema associated with branch retinal vein occlusion (BRVO). METHODS: Eyes with macular edema secondary to BRVO and best-corrected visual acuity (BCVA) worse than 20/40 were included. Eyes eligible for Branch Retinal Vein Occlusion Study (BVOS) guidelines received grid laser treatment first. Those that were not improved at least two lines following grid laser or that did not meet those guidelines received 4 mg IVTA injection. The efficacy of IVTA treatment was assessed by analyzing the change in BCVA and reduction in central macular thickness (CMT) measured by optical coherence tomography. Intraocular pressure (IOP) spikes and other complications were recorded. RESULTS: The data from 37 eyes were included; in 12 of them IVTA injection was given after grid laser while 25 of them received IVTA as a primary treatment. Mean follow-up was 9.6 +/- 4.5 months. BCVA was 0.06 +/- 0.30 and 0.17 +/- 0.50 in the primary and secondary IVTA injection groups, respectively. In the primary injection group, there was a statistically significant gain in BCVA throughout the follow-up (P < 0.05), while a small increase in BCVA was noted only at the third month visit in the secondary IVTA injection group (P = 0.04). Average CMT were 434.8 +/- 122.1microm and 389.0 +/- 171.9 microm before IVTA injection in the two groups, respectively. In the primary IVTA injection group, CMT decreased at 1 month following IVTA injection and remained statistically significant until the sixth month visit (P < 0.05). In the secondary IVTA injection group, a slight reduction in CMT was noted only in the first month visit (P = 0.02). Pre-IVTA BCVA was found to be the single statistically significant predictor of BCVA gain following IVTA injection. In 8 patients (21.6%), the IOP increased above 25 mmHg postoperatively, and was successfully managed by medical treatment. Endophthalmitis did not develop in any of the patients. CONCLUSION: IVTA injection produced a significant reduction of macular edema in eyes with BRVO either with or without prior grid laser treatment. Reduction of CMT increased the BCVA in most of the eyes receiving IVTA primarily, while only a slight improvement of BCVA was found in eyes with prior grid laser. The IVTA effect was transient. Larger studies are necessary to find the best approach (either grid laser or IVTA) to patients with macular edema associated with BRVO.

Intravitreal bevacizumab treatment of retinal telangiectasis complicated by subretinal neovascularization.

BACKGROUND: Idiopathic perifoveal telangiectasia (IPT) is a disorder characterized by focal parafoveal capillary dilatation of unknown cause. Photodynamic therapy (PDT) was reported to be efficacious in the treatment of subretinal neovascularization (SRN) associated with idiopathic juxtafoveal retinal telangiectasis. However, visual improvement is limited. METHODS: We describe the clinical, angiographic, and optical coherence tomography findings for a patient with IPT complicated with SRN and treated with PDT and bevacizumab. RESULTS: The patient underwent 2 sessions of PDT; however, metamorphopsia persisted, and visual acuity further decreased to 20/100 after the second PDT. Two injections of intravitreal bevacizumab (1.25 mg) were administered after PDT. Visual acuity increased dramatically from 20/100 to 20/25 after the injections. Four months after the second injection, there was no recurrence, and the patient was asymptomatic. CONCLUSION: Intravitreal bevacizumab treatment should be considered for patients with SRN associated with perifoveal telangiectasis, especially after insufficient therapeutic response to PDT.

Central retinal vein occlusion in a young adult during risperidone therapy.

BACKGROUND: Various articles in the literature point out the higher risk of venous thrombosis in patients taking antipsychotic drugs. However, to our knowledge, an association with central retinal vein occlusion (CRVO) has not been reported before. METHODS: We describe the clinical and angiographic findings of a patient with CRVO that may have been related to his antipsychotic medication. RESULTS: A 19-year-old patient had been taking risperidone and fluoxetine for the last 7 months. He presented with atypical nonischemic CRVO with atypical deep intraretinal hemorrhages, a swollen optic disk, dilatation and engorgement of retinal veins, and optic disk capillaries. Despite a detailed workup, no systemic or ocular risk factors for a thromboembolic event were found. He had hyperprolactinemia resulting from his medication. CONCLUSION: The use of risperidone may be a risk factor for CRVO.

Spontaneous separation of epiretinal membrane in a child with Stargardt macular dystrophy.

We demonstrate optical coherence tomography findings of spontaneous separation of an epiretinal membrane associated with Stargardt macular dystrophy in a child. A period of observation seems appropriate in eyes with an epiretinal membrane associated with Stargardt's disease, as the membrane may show spontaneous release and the macular area may improve.

ZB5M anterior chamber and Fyodorov's posterior chamber phakic intraocular lenses: long-term follow-up.

PURPOSE: To compare the long-term complications of two outdated phakic intraocular lenses (PIOL) implanted in eyes with high myopia to aid development of better PIOL designs. METHODS: Sixty-two eyes of 37 patients implanted with the ZB5M anterior chamber PIOL (anterior chamber group) and 22 eyes of 14 patients implanted with Fyodorov's posterior chamber PIOL (posterior chamber group) were examined. Complications were compared after a mean follow-up of 71.15 +/- 32.17 months (range: 24 to 145 months) in the anterior chamber group and 84.14 +/- 26.43 months (range: 24 to 132 months) in the posterior chamber group (P = .07). RESULTS: At last follow-up, pupil ovalization was present in 32 (51.6%) eyes in the anterior chamber group and 1 (4.5%) eye in the posterior chamber group (P < .001), and cataract in 5 (8.1%) eyes in the anterior chamber group and 7 (31.8%) eyes in the posterior chamber group (P = .007). Phakic intraocular lens decentration, glaucoma, retinal detachment, corneal decomposition, and monocular diplopia were additional complications encountered in both groups, with no statistically significant difference. CONCLUSIONS: Proper understanding of these outdated PIOLs may be helpful in developing better PIOL designs.

Intraocular pressure control after clear corneal phacoemulsification in eyes with previous trabeculectomy: a controlled study.

PURPOSE: To compare intraocular pressure (IOP) control in eyes with or without clear corneal phacoemulsification following trabeculectomy. METHODS: The study group included 30 eyes that underwent uneventful clear corneal phacoemulsification and foldable intraocular lens implantation following trabeculectomy without antimetabolites. Thirty eyes that had undergone filtering surgery without cataract extraction were selected as controls. Case and control groups were matched with respect to age, gender, IOP, number of glaucoma medications, glaucoma type (primary open-angle glaucoma/pseudoexfoliative glaucoma), trabeculectomy time and follow-up. Comparisons between the study and control groups (intergroup) and within the same group at different time-points (intragroup) were performed for IOP, glaucoma medications and bleb morphology. Success rates were investigated by Kaplan-Meier survival analysis and the factors influencing final success by logistic regression. RESULTS: Intraocular pressure (p = 0.04) and glaucoma medications (p = 0.001) increased during an average follow-up of 26.1 +/- 9.9 months in both groups. Intragroup differences became statistically significant after the 6-month visit, but intergroup differences remained insignificant. Bleb height decreased significantly following phacoemulsification in the study group (p = 0.017). Success rates decreased with time in both groups, with no intergroup difference (p = 0.46). The final success rate was negatively correlated with IOP and number of glaucoma medications used at the study entry, while there was a positive correlation between the baseline and final success rates. CONCLUSION: Trabeculectomy success decreased in a time-dependent manner in eyes with and without subsequent phacoemulsification. Uncomplicated clear corneal phacoemulsification was not found to have any additional unfavorable influence on IOP control in eyes with filtering blebs.

Delayed-onset streptococcus pyogenes endophthalmitis following Ahmed glaucoma valve implantation.

BACKGROUND: To report a case of delayed-onset Streptococcus pyogenes endophthalmitis following implantation of an Ahmed glaucoma valve. CASE: A 10-year-old patient presented with acute endophthalmitis 1 year after Ahmed glaucoma valve implantation. OBSERVATIONS: The conjunctiva and Tenon's capsule over the valve plate had been penetrated by one of the polypropylene fixation sutures. The valve was removed, and pars plana vitrectomy was performed. Vitreous specimens and removal of the discharge over the plate revealed Streptococcus pyogenes. CONCLUSIONS: This is the first documented case of Streptococcus pyogenes endophthalmitis following Ahmed glaucoma valve implantation. We think the conjunctival buttonhole caused by the polypropylene suture provided an entry site for the infection.

Anterior chamber depth, iridocorneal angle width, and intraocular pressure changes after uneventful phacoemulsification in eyes without glaucoma and with open iridocorneal angles.

PURPOSE: To investigate the influence of uneventful phacoemulsification on anterior chamber depth (ACD), iridocorneal angle (ICA) width, and intraocular pressure (IOP) in nonglaucomatous eyes with open ICA preoperatively. SETTING: Beyoglu Eye Education and Research Hospital, Istanbul, Turkey. METHODS: Fifty-three eyes of 49 patients were evaluated for 6 months postoperatively. The nonparametric Wilcoxon signed rank test was used to compare preoperative and postoperative IOP, ACD, and ICA width. Univariate and multivariate regression analyses were used to evaluate the relationships between IOP, ACD, and ICA width and between preoperative patient characteristics. RESULTS: The mean preoperative IOP of 15.1 mm Hg +/- 2.8 (SD) dropped postoperatively to 13.4 +/- 3.4 mm Hg at 1 day, 13.3 +/- 2.6 mm Hg at 1 week, 13.2 +/- 3.1 mm Hg at 1 month, 13.3 +/- 2.7 mm Hg at 3 months, and 14.1 +/- 2.5 mm Hg at 6 months (P<.05). The mean preoperative ICA grade of 2.97 +/- 0.72 increased to 3.55 +/- 0.48 at 1 week and 3.68 +/- 0.45 at 1 month (P<.05). The mean preoperative ACD of 3.06 +/- 0.49 mm increased to 3.57 +/- 0.47 mm at 4 weeks, 3.69 +/- 0.32 mm at 1 month, and 3.70 +/- 0.36 mm at 3 months (P<.05). The IOP decrease was not correlated with the changes in ICA width or ACD. Multiple regression analysis showed preoperative IOP was the single predictor of the postoperative IOP drop (P<.001). CONCLUSIONS: In nonglaucomatous eyes with an open ICA preoperatively, uneventful phacoemulsification reduced IOP, increased ACD, and widened the ICA. The changes were statistically significant over 6 months.