Cases of toxic anterior segment syndrome after primary pterygium surgery.

PURPOSE: Toxic anterior segment syndrome (TASS) is an acute, sterile, inflammatory reaction of the anterior segment after intraocular surgeries. We aimed to report an outbreak of TASS which occurred following pterygium surgeries. METHODS: A case series. RESULTS: Four eyes of four patients developed TASS associated with formaldehyde after uneventful primary pterygium surgery with conjunctival autograft. No patients reported pain; all patients demonstrated diffuse corneal edema, epithelial defects, and anterior chamber inflammation without hypopyon, fibrin formation, and vitreous involvement on the first postoperative day. TASS diagnosis was made based on clinical findings. All patients were treated with hourly topical 1% prednisolone acetate (Pred Forte, Allergan, CA), moxifloxacin 0.5% (Vigamox, Alcon, TX), and 0.24% of hyaluronic acid (Artelac complete, Bausch & Lomb). Oral steroid (prednisolone 1 mg/kg) was added on the first week and gradually tapered over weeks. None of the affected corneas improved spontaneously. Best-corrected visual acuity ranged from 20/25000 to 20/200 in the second month after surgery. Keratoplasty was scheduled for all patients. CONCLUSIONS: This is the first study to present TASS cases after pterygium surgery. Clinicians should be aware of TASS that can emerge after an extraocular surgery. In our analysis, since 2% formaldehyde was used by the operating room personnel for cleaning and sterilizing reusable ocular instruments, it was thought that formaldehyde was the most likely cause.

The Effect of Secondary Intraocular Lens Implantation Time on Visual Prognosis in Aphakia Cases after Open Globe Injury.

PURPOSE: We investigated the effect of the time of secondary intraocular lens (IOL) implantation on final visual acuity and other causes affecting visual prognosis in cases left aphakic after open globe injury. METHODS: The study included 62 eyes of 62 patients left aphakic after the repair of open globe injury between 2012 and 2019. Demographic characteristics, trauma zone, ocular trauma score, type of injury, time of secondary IOL implantation, final best-corrected visual acuity (BCVA), and complications were recorded for each patient. RESULTS: The mean follow-up time of 62 patients was 25.05 ± 12.59 months. The preoperative BCVA was found to be 2.40 ± 0.86 logarithm of the minimum angle of resolution (logMAR), while the postoperative final BCVA was found to be 0.53 ± 0.70 logMAR (p < 0.01). The mean interval timing of secondary sulcus foldable IOL implantation was determined to be 3.79 ± 4.04 months. No correlation was observed between secondary IOL implantation time and final BCVA (r = 0.140, p = 0.319). Furthermore, when only pediatric patients were taken, an excellent positive correlation was found between the secondary IOL implantation time and final BCVA logMAR (r = 0.895, p < 0.01). Multiple linear regression on final BCVA with age, revealed a significant model explaining 48.0% of the variability with younger age and better final BCVA with as significant coefficients (p = 0.007). CONCLUSIONS: Although time interval between primary repair and secondary IOL implantation to correct aphakia does not effect final BCVA in adult patients, earlier surgery should be considered for amblyopia management in pediatric patients.

Efficacy and safety of iris-supported phakic lenses (Verisyse) for the treatment of high myopia: 5-year results.

PURPOSE: Evaluating efficacy and safety of iris-supported phakic lenses (Verisyse) for high myopia treatment. METHODS: Patients treated with Verisyse (Abbott Medical Optics, Santa Ana, CA, USA) intraocular lens (IOL) implants were evaluated retrospectively. Patients with follow-up periods of more than 5 years were included in the study. Pre- and postoperative fifth-year spheric equivalent (SE) of manifest refraction values, uncorrected and corrected distance visual acuities (UDVA and CDVA, respectively), and endothelial cell density (ECD) values were recorded. Complications were evaluated. RESULTS: Forty-seven eyes of 31 patients were included in the study. Pre- and postoperative fifth year mean SE was - 12.50 ± 3.51D and - 0.72 ± 0.40D, respectively. Pre- and postoperative fifth-year UDVA was 1.56 ± 0.22 and 0.33 ± 0.18 logMAR (p < 0.001), respectively. The safety index (pre- and postoperative CDVA) was 1.39 ± 0.63 at the 5-year follow-up (p > 0,05). The efficacy index (ratio of mean postoperative UDVA to mean preoperative CDVA) of the patients was 1.14 ± 0.60. The mean postoperative endothelial cell loss at 5 years was -7.42%. None of the patients had lost 25% of their preoperative endothelial cells at 5-year follow-up. The mean postoperative endothelial cell loss was -3.05% at 1 year, -1.23% between years one and three, -1.02% between the third and fifth years. CONCLUSION: Verisyse IOL implantation is an effective and safe for high myopia surgical treatment. However, the 5-year follow-up period is not sufficient to evaluate the safety profiles in terms of endothelial cells.

Treatment of intravitreal bevacizumab combined with focal laser photocoagulation in the case of macular telangiectasia type 2 with retinal arterial macroaneurysm.

Macular telangiectasia type 2 (Mac Tel 2) is a bilateral disease of unknown cause with characteristic changes of the retinal vasculature. To the best of our knowledge, we could not find any reported cases of Mac Tel 2 with retinal arterial macroaneurysm (RAM). Our aim is to report a case of Mac Tel 2 with RAM.

Treatment of intravitreal bevacizumab combined with focal laser photocoagulation in the case of macular telangiectasia type 2 with retinal arterial macroaneurysm.

Macular telangiectasia type 2 (Mac Tel 2) is a bilateral disease of unknown cause with characteristic changes of the retinal vasculature. To the best of our knowledge, we could not find any reported cases of Mac Tel 2 with retinal arterial macroaneurysm (RAM). Our aim is to report a case of Mac Tel 2 with RAM.