Segmental Analysis of Macular Layers in Patients With Rhegmatogenous Retinal Detachment Treated With Perfluoropropane or Silicon Oil.

BACKGROUND AND OBJECTIVE: To determine possible changes in thickness profiles of retinal layers in patients with rhegmatogenous retinal detachment (RRD) treated with perfluoropropane (C3F8) or silicon oil (SiO). PATIENTS AND METHODS: Seventy-two eyes of 36 patients were enrolled in this retrospective comparative study. Patients were divided into two groups according to intraocular tamponade: C3F8 or SiO. All study eyes were compared with fellow eyes via spectral-domain optical coherence tomography segment analysis at 6 months postoperatively. Macular layer thicknesses including retinal nerve fiber layer, ganglion cell layer, inner plexiform layer, inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), and retinal pigment epithelium were analyzed. RESULTS: There was a statistically significant difference between eyes in terms of INL thickness (P = .044) in C3F8 group. Otherwise there was a statistically significant difference between eyes in terms of INL, OPL, and ONL thicknesses (P = .006, P = .048, and P = .004, respectively) in the SiO group. CONCLUSION: The findings of the present study show that the tamponade used in RRD surgery can affect the retinal layers differently. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:41-47.].

Relationship between Peeled Internal Limiting Membrane Area and Anatomic Outcomes following Macular Hole Surgery: A Quantitative Analysis.

Purpose. To quantitatively evaluate the effects of peeled internal limiting membrane (ILM) area and anatomic outcomes following macular hole surgery using spectral domain optical coherence tomography (SD-OCT). Methods. Forty-one eyes in 37 consecutive patients with idiopathic, Gass stage 3-4 macular hole (MH) were enrolled in this retrospective comparative study. All patients were divided into 2 groups according to anatomic success or failure. Basal MH diameter, peeled ILM area, and MH height were calculated using SD-OCT. Other prognostic parameters, including age, stage, preoperative BCVA, and symptom duration were also assessed. Results. Thirty-two cases were classified as anatomic success, and 9 cases were classified as anatomic failure. Peeled ILM area was significantly wider and MH basal diameter was significantly less in the anatomic success group (p = 0.024 and 0.032, resp.). Other parameters did not demonstrate statistical significance. Conclusion. The findings of the present study show that the peeled ILM area can affect the anatomic outcomes of MH surgery.

Choroidal Thickness, Photoreceptor Thickness, and Retinal Vascular Caliber Alterations in Dark Adaptation.

PURPOSE: Our aim was to evaluate the alterations of subfoveal choroidal thickness (SFCT), photoreceptor layer thickness (PRT), and retinal vessel diameter in the dark and light adaptation. METHODS: Twenty-four eyes of 24 healthy volunteers (12 males, 12 females) were included in this cross-sectional and observational study. The SFCT, PRT, retinal arteriole, and venule caliber measurements were performed with spectral domain optical coherence tomography in the dark (0.0 cd/m2) and under light (80 cd/m2) adapted conditions. RESULTS: The mean age of the participants was 30.4 ± 4.4 years (range: 22-42). The SFCT increased statistically significantly in dark adaptation (p < 0.001), then returned to baseline values following light adaptation. The PRT, retinal arteriole, and venule caliber measurements were similar in the dark and light (p > 0.05). CONCLUSIONS: While SFCT increased, PRT, and retinal vessel diameter did not change following transition from light to dark.

SILICONE OIL BARRIER SUTURES IN APHAKIC EYES WITH IRIS DEFECTS.

PURPOSE: To evaluate the efficacy and safety of silicone oil barrier sutures in aphakic eyes with iris defects. METHODS: Sixteen aphakic and iris-defective eyes of 16 patients who underwent a pars plana vitrectomy procedure with silicone oil tamponade because of retinal detachment were included in this retrospective study. Silicone oil barrier sutures were placed as a grid pattern within the plane of the previous iris after vitrectomy and before silicone oil injection. RESULTS: The mean follow-up time after silicone oil barrier suture operations was 12.0 ± 6.8 months. Silicone oil was present in the anterior chamber in five eyes (31%) at the last visit. These eyes also had hypotony, band keratopathy, and anterior proliferative vitreoretinopathy. CONCLUSION: In this study, silicone oil barrier sutures were proven to be safe and effective in preventing silicone oil-corneal endothelium touch in aphakic eyes with iris defects, unless hypotony was present because of anterior proliferative vitreoretinopathy.

23 gauge pars plana vitrectomy for the removal of retained intraocular foreign bodies.

BACKGROUND: To evaluate the morpho-functional outcomes and safety of transconjuctival 23-gauge pars plana vitrectomy(PPV) for removal of intraocular foreign bodies (IOFBs). METHODS: A retrospective study of 36 consecutive cases (mean age; 34,2 ± 10,9 years (between 15 and 60), 27 M,9 F) of 23-G PPV for the removal of IOFBs during the period of April 2009 and December 2011 and followed 9,4 ± 6,4(2-27) months were conducted. Visual outcomes, slit lamp biomicroscopy, intraocular pressure (IOP), and posterior segment visualization by indirect ophthalmoscopy, A-B mode ultrasonography, and computed orbital tomography were performed for all cases. Main outcomes including anatomic and visual outcomes, and both intraoperative and postoperative complications were recorded. RESULTS: Of the 36 cases available for the study, the IOFBs (size range, 3 to 12 mm) could be removed in all eyes. Mean preoperative LogMAR BCVA was 1.44 ± 138 (range, 1.00 to 0.00) and mean postoperative LogMAR BCVA at final visit was 0,78 ± 0,98 (range, 1.00 to 0.00). (P = 0,007) Anatomic success was obtained in 97.2 % of eyes. 16 patients needed primary wound repair due to the leakage in insertion sites before the PPV, however remaining 20 cases were not. Fibrin reaction was seen in 8 (22.2 %) patients in early postoperative period, intraocular pressure elevation was detected in 12 (33.3 %) patients in which the silicone oil was used as an intravitreal tamponade, one patient with silicone oil tamponade developed band keratopathy and phthisis bulbi. CONCLUSIONS: 23-Gauge PPV is a feasible, effective approach in the surgical management of the patients with posterior segment intraocular foreign bodies.

Can perifoveal pseudocyst area be a prognostic factor in macular hole surgery?: A prospective study with quantitative data.

To evaluate the effect of perifoveal pseudocysts on the anatomical outcomes of the idiopathic macular hole surgery as a prognostic factor. Twenty-one eyes of 20 consecutive patients with a Gass stage 3 or 4 idiopathic macular hole were enrolled in this prospective study between March 2012 and May 2013. Demographic data, medical history, and ocular examinations were recorded preoperatively and on postoperative day 1, week 1, and month 1, 3, and 6. Five spectral domain optical coherence tomography (SD-OCT) parameters were analyzed: macular hole (MH) basal diameter, MH minimum diameter, MH height, macular hole index, and a new parameter, the area of macular pseudocysts via the software of SD-OCT device at the widest cross section of the MH formation. The mean preoperative best-corrected visual acuity was 0.86±0.29 logarithm of the minimum angle of resolution (LogMAR) (between 0.4 and 1.3) and improved to 0.64±0.28 LogMAR (between 0.22 and 1.23) postoperatively (P=0.004). There was a statistical significant difference between both MH basal diameter and MH pseudocyst area with anatomical success, respectively (P=0.016 for MH basal diameter, P=0.004 for MH pseudocyst area). The anatomical closure was correlated with MH basal diameter and MH pseudocyst area (P=0.01 and P=0.001, respectively). Spearman correlation rank coefficient between with MH basal diameter and MH pseudocyst area was r=0.493 and statistically significant (P=0.02). Perifoveal pseudocysts seem to be associated with anatomic failure and may be used as a prognostic factor in MH surgery.

Comparison of conjunctival graft thickness after primary and recurrent pterygium surgery: anterior segment optical coherence tomography study.

OBJECTIVE: The objective of the following study is to compare the conjunctival graft thickness measured with anterior segment optical coherence tomography (OCT) after primary and recurrent pterygium excision. DESIGN: Prospective, interventional and comparative study. PARTICIPANTS: A total of 20 eyes of 20 patients with primary pterygium (primary group) and 20 eyes of 20 patients with recurrent pterygium (recurrent group) were enrolled. MATERIALS AND METHODS: All patients underwent pterygium excision with conjunctival autograft transplantation. Conjunctival graft thickness was measured at 1 week, 1 month and 3 months after surgery using the Visante-OCT (Carl-Zeiss Meditec, Dublin, CA, USA). Main outcome measure was the mean conjunctival thickness determined as the mean of three measurements at 1, 2 and 3 mm posterior to the scleral spur. RESULTS: There were no statistically significant differences in age, sex, or laterality between the groups. Mean thickness of the graft in primary and recurrent groups, respectively, was 430 ± 127 µm and 461 ± 178 µm at 1 week after surgery (P = 0.587), 114 ± 19 µm and 162 ± 48 µm at 1 month after surgery (P = 0.001) and 109 ± 15 µm and 107 ± 18 µm at 3 months after surgery (P = 0.726). CONCLUSION: The findings revealed that conjunctival thickness after primary or recurrent pterygium excision was greatest at 1 week after surgery and continued to decrease for up to 3 months. Mean graft thickness differed significantly between the two groups only at 1 month after surgery.

Comparison of intravitreal bevacizumab treatment between phakic and pseudophakic neovascular age-related macular degeneration.

INTRODUCTION: Before the era of intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment, only prevention for visual loss might have been achieved in a limited number of neovascular age-related macular generation (nAMD) patients with different treatment options. OBJECTIVE: To compare the efficacy of intravitreal bevacizumab (IVB) for the treatment of nAMD between phakic and pseudophakic eyes. MATERIALS AND METHODS: The newly diagnosed nAMD patients were included in this retrospective study. The patients were divided into the phakic and pseudophakic groups. Initially, the patients received three consecutive, monthly, IVB injections, and then the treatment was continued on an as-needed regimen. The patients were examined monthly, and the data at the baseline, at 3, 6, 9, and 12 months and at the last follow-up were evaluated. The changes in the visual acuity (VA), central retinal thickness (CRT) and the number of injections were compared between the two groups. RESULTS: The study included 62 eyes of 62 patients (39 phakic, and 23 pseudophakic patients). The mean follow-up time was 19.7 and 17.2 months in the phakic and pseudophakic groups, respectively (p=0.06). The mean Log MAR VA at the baseline, 12 months and the last follow-up was 0.82, 0.72 and 0.75 in the phakic group and 0.77, 0.67, and 0.68 in the pseudophakic group, respectively. The change in the mean BCVA from the baseline to 12 months and at the last follow-up was not statistically different between the two groups (p=0.9 and p=0.7, respectively). The mean injection number at 12 months was 4.5 and 4.9 in the phakic and pseudophakic group, respectively (p=0.2). CONCLUSION: The beneficial effect of IVB is equal in both the phakic and pseudophakic group of nAMD patients. The functional and anatomical outcomes of the treatment and the number of injections were similar in the two groups.

Comparison of the efficacy and safety of selective laser trabeculoplasty in cases with primary open-angle glaucoma and pseudoexfoliative glaucoma.

The purpose of this study was to compare the efficacy and safety of selective laser trabeculoplasty (SLT) for patients with primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PXG). In this retrospective case series, 85 eyes (48 POAG, 37 PXG) of 85 patients were investigated. The medical records of patients who underwent SLT for POAG or PXG were reviewed. The main outcome measures included intraocular pressure (IOP)-lowering effect and ocular side effects. The mean decrease in IOP differed significantly (p < 0.001) between eyes with POAG (-4.4 ± 2.1 mmHg) and eyes with PXG (-6.1 ± 3.6 mmHg) at a mean follow-up period of 1 year. The rate of side effects, such as early IOP spike and uveitis, did not significantly differ between the two groups. In conclusion, SLT has a greater IOP-lowering effect in PXG compared with POAG.

Photorefractive keratectomy in the correction of astigmatism using Schwind Amaris 750s laser.

AIM: To evaluate the results of three photorefractive keratectomy (PRK) procedures in the treatment of astigmatism. METHODS: In this retrospective comparative case series, 89 eyes of 50 patients who underwent PRK treatment for astigmatism were enrolled. The patients were divided into 3 groups based on the PRK procedure: Group 1: PRK without mitomycin-C (MMC) application, Group 2: PRK with MMC application, and Group 3: Trans-Photorefractive Keratectomy (T-PRK). The efficacy, safety, predictability, and complications of treatment were assessed at 1, 3 and 6 months after the treatment. RESULTS: At postoperative 6 months, the percentage of postoperative uncorrected visual acuity (UCVA) of 20/20 or better was 55.6% (20 eyes) in group 1, 75% (15 eyes) in group 2, and 75.8% (25 eyes) in group 3 (P=0.144). The percentage of postoperative best corrected visual acuity (BCVA) of unchanged or gained ≥1 lines was 80.6% (29 eyes) in group 1, 70% (14 eyes) in group 2, and 90.9% (30 eyes) in group 3 (P=0.151). The percentage of postoperative BCVA of lost ≥2 lines was 11.1% (4 eyes) in group 1, 20% (4 eyes) in group 2, and 6.1% (2 eyes) in group 3. The mean manifest refractive spherical equivalent (MRSE) and mean cylindrical refraction were not significantly different among the each groups (P>0.05). At postoperative 6 months, the percentage of MRSE of within ±0.50 D was 100% (36 eyes) in Group 1, 100% (20 eyes) in Group 2, and 93.9% (31 eyes) in Group 3. At the each follow-up period, there was no significant difference in number of eyes with haze and mean haze score(P>0.05). CONCLUSION: The study showed that PRK without MMC, PRK with MMC and T-PRK appears to have similar effectiveness, safety and predictability in the treatment of astigmatism. The incidence of haze was also similar between the three groups.

Can intravitreal ranibizumab alter retrobulbar circulation in eyes with age-related macular degeneration?

PURPOSE: To determine the effect of a single intravitreal ranibizumab injection on retrobulbar circulation in cases with neovascular age-related macular degeneration (AMD). METHODS: In this prospective and interventional study, 32 patients with neovascular AMD were enrolled. A single intravitreal ranibizumab dose was in only 1 eye per patient. Peak systolic velocity, end-diastolic velocity, resistive index and pulsatility index values in the common carotid artery, ophthalmic artery, central retinal artery, nasal posterior ciliary artery, and temporal posterior ciliary artery in both injected and uninjected healthy fellow eyes were measured using color Doppler ultrasonography at baseline and 1 week and 1 month after the injection of ranibizumab. RESULTS: All measurements revealed no statistically significant difference among baseline, first week, and first month after injection measurements for all parameters measured in all arteries in both the injected and uninjected healthy fellow eyes. CONCLUSION: A single intravitreal injection of ranibizumab does not significantly affect on retrobulbar circulation of either the injected or the uninjected healthy fellow eyes with neovascular AMD.

Changes in anterior segment morphology after intravitreal injection of bevacizumab and bevacizumab-triamcinolone acetate combination.

PURPOSE: To evaluate the effects of 2 different amounts of commonly used intravitreal agents on anterior segment morphology in conjunction with intraocular pressure (IOP) changes. METHODS: Two groups of 46 patients who received intravitreal injection of bevacizumab (group 1, 0.05 mL) or bevacizumab-triamcinolone acetate (TA) combination (group 2, 0.1 mL) were included in this prospective study. All patients underwent anterior segment optical coherence tomography (AS-OCT) imaging with Visante OCT and IOP measurement before and at 5 minutes, 1 hour, and 3 hours after injection. Anterior chamber depth (ACD), angle-opening distance (AOD 500-750), trabecular-iris space area (TISA 500-750), and anterior chamber angle (ACA) were measured. Results were compared between groups and measurement time points. RESULTS: The mean change in IOP showed significant difference between baseline and first measurements after the injection in group 1 and group 2 (p = 0.012, p = 0.008, respectively). There was a statistically significant difference from baseline in ACD at the first and second measurements in group 2 (p = 0.005, p = 0.018, respectively). All angle parameters showed insignificant decrease from baseline at all measurement time points in both groups (p>0.05 for each). The difference of angle parameters after injection was not statistically significant between the groups (p>0.05 for each). CONCLUSION: Intravitreal injection of bevacizumab (0.05 mL) or bevacizumab-TA combination (0.1 mL) caused a change in anterior segment configuration determined by AS-OCT. The changes in anterior chamber parameters returned to baseline values with the normalization of IOP values after the first few minutes of injection.

Single injection of triamcinolone versus three repeated injections of bevacizumab for treatment of diabetic macular edema.

To compare the effect of a single intravitreal injection of triamcinolone acetonide versus three consecutive monthly intravitreal injections of bevacizumab for the treatment of diabetic macular edema (DME). Forty patients treated with a single intravitreal injection of 4 mg triamcinolone acetonide (triamcinolone group) were compared with 40 patients treated with three consecutive monthly intravitreal injections of 1.25 mg bevacizumab (bevacizumab group). The triamcinolone group showed a significant decrease in mean central retinal thickness (CRT) from 472.5 µm ± 120.35 to 374.0 µm ± 152.31 after 3 months (p < 0.001). The bevacizumab group also showed a significant reduction in CRT from 464.5 µm ± 115.3 to 370.0 µm ± 142.31 (p < 0.001). The triamcinolone group displayed an increase in best-corrected visual acuity (BCVA) following a single intravitreal triamcinolone acetonide injection from a mean of +0.70 ± 0.17 logMAR to a mean of +0.54 ± 0.38 logMAR after 3 months (p < 0.05). The bevacizumab group also showed an increase in BCVA following three injections of bevacizumab from a mean of +0.73 ± 0.28 logMAR to a mean of +0.57 ± 0.33 logMAR (p < 0.05). Statistical analysis showed no significant difference between both groups at 3 months. Our study showed that a single intravitreal injection of triamcinolone is as effective as three consecutive monthly intravitreal injections of bevacizumab for treatment of DME with regard to BCVA and CRT measured by optical coherence tomography. Despite the recent popularity of bevacizumab, three injections are no more effective than a single injection of triamcinolone for the treatment of DME.

Topical application of bevacizumab as an adjunct to recurrent pterygium surgery.

PURPOSE: To evaluate the clinical outcomes of topical bevacizumab as adjunctive to the surgical excision for treatment of recurrent pterygium. METHODS: The 44 patients who underwent recurrent pterygium excision with conjunctival autograft transplantation were enrolled in this prospective and interventional study. The patients were randomized in 2 groups: study group, 1 month after surgery, 22 patients received only topical bevacizumab (5 mg/mL) 4 times daily for 2 months; control group, 1 month after surgery, 22 patients were administered only an artificial tear 4 times daily for 2 months. Patients were prospectively followed for 6 months after pterygium surgery. The main outcome measures were pterygium recurrence, corneal neovascularization, and other postoperative complications. RESULTS: No statistically significant differences were observed between the 2 groups in terms of age, gender distributions, laterality, length of pterygium, and number of recurrence. A pterygium recurrence was not noted in any patients in the study group but was noted in 2 of 22 eyes (9%) in the control group during the follow-up after surgery (P = 0.244). Although none of the patients developed corneal neovascularization in the study group, 5 of 22 eyes (22.7%) developed this condition in the control group during the follow-up after surgery (P = 0.024). No serious complications were observed during the follow-up period in both the groups. CONCLUSIONS: Topical bevacizumab therapy 1 month after surgical excision of recurrent pterygium is well tolerated and effective to prevent neovascularization. Although the recurrence rate is lower in the study group without significant difference, further studies are required to support this result.

Comparing the effects of three different intravitreal injection techniques on vitreous reflux and intraocular pressure.

PURPOSE: To compare the effects of straight, oblique, and double-plane tunnel scleral intravitreal injection techniques, on short-term intraocular pressure (IOP) changes, occurrence of vitreous reflux (VR), and/or other complications. METHODS: A total of 105 patients were included in this prospective study. Patients were assigned randomly to one of the straight injection group (SI; n=35), oblique injection group (OI; n=35), or double-plane tunnel injection group (DPTI; n=35). The occurrence of VR and preinjection and postinjection IOP at 2 and 6 h were compared between groups, and complications were assessed. RESULTS: The mean patient age was 71.1±6.6 years (range 58 to 86 years; 50 women and 55 men). In the SI, OI, and DPTI groups, VR occurred in 18 (51.4%), 12 (34.3%), and 6 patients (17.1%), respectively. Mean preinjection IOPs were 15.4, 14.8, and 15.6 mmHg, and changed to 17.3, 18.0, and 20.0 mmHg at the second hour, and 15.7, 16.2, and 16.1 mmHg at the sixth hour, respectively. No significant differences among the groups were found in terms of complications such as transient mild uveitis or subconjunctival hemorrhage. CONCLUSION: Double-plane tunnel injection prevents VR from the injection site and has no additional complications than other techniques.

Evaluation of corneal morphologic and functional parameters after use of topical cyclosporine-a 0.05% in dry eye.

PURPOSE: To report the effect of topical Cyclosporine-A (CsA) 0.05% on corneal morphologic and functional parameters in patients with dry eye. METHOD: In this prospective and observational study 30 eyes of 30 patients who received topical CsA 0.05% for treatment of dry eye were evaluated. Each clinical examination included a routine Schirmer I test and tear film break-up time (TBUT) was performed at baseline and after 1, 2, 3, and 6 months of treatment. All participants also underwent central corneal thickness (CCT) measurements with ultrasound pachymetry, endothelial cell density (ECD) with specular microscopy, corneal topographical evaluation with Orbscan II, and corneal biomechanical parameters with Ocular Response Analyzer measurements at baseline and after treatment. RESULTS: The Schirmer I test and TBUT were significantly improved after treatment (for both; P<0.01). The CCT, topographical findings, ECD, and corneal biomechanical parameters were not significantly different at baseline and follow-up visits (P>0.05). No serious adverse effects were seen at follow up visits. CONCLUSION: The study showed that Topical CsA 0.05% caused no changes on corneal morphology and function.

Effects of posterior capsular opacification on the evaluation of retinal nerve fiber layer as measured by Stratus optical coherence tomography.

OBJECTIVE: To evaluate the effects of posterior capsular opacification (PCO) and Nd:YAG laser capsulotomy on the evaluation of peripapillary retinal nerve fibre layer (RNFL) as measured by Stratus (Carl Zeiss Meditec, Dublin, CA) optical coherence tomography (OCT). DESIGN: Prospective interventional case series. PARTICIPANTS: We studied 98 eyes of 89 patients experiencing PCO. METHODS: We performed a complete ophthalmologic examination and evaluation of RNFL as measured by Stratus OCT before and after Nd:YAG capsulotomy. The patients were classified on the basis of PCO score or signal strength (SS) obtained by prelaser OCT scans. RESULTS: The preoperative and postoperative peripapillary RNFL thicknesses were 90.24 ± 15.9 µm and 98.27 ± 14.1 µm, respectively (p < 0.001). The mean preoperative SSs were 5.4 ± 1.6, and they improved to 9.5 ± 0.5 postoperatively (p < 0.001). Prelaser and postlaser RNFL thicknesses differed significantly in eyes with preoperative SSs less than 7 (p < 0.05). Also, in patients with preoperative PCO grades higher than 2, there were significant increases in RNFL thickness after laser capsulotomy (p < 0.05). CONCLUSION: RNFL thickness measured by the Stratus OCT is affected by PCO. RFNL thickness may be underestimated in eyes with preoperative PCO grades higher than 2 and in eyes with preoperative SSs lower than 7.

Corneal biomechanical properties and intraocular pressure measurement in Marfan patients.

PURPOSE: To compare the biomechanical properties of the cornea and intraocular pressure (IOP) between patients with Marfan syndrome and age-matched controls. SETTING: Departments of Ophthalmology and Genetics, Bakirkoy Maternity and Children Diseases Hospital, and Beyoglu Eye Education and Research Hospital, Istanbul, Turkey. DESIGN: Cross-sectional study. METHODS: This study comprised patients with Marfan syndrome (study group) and healthy individuals (control group). The study group was subdivided into patients with ectopia lentis and patients without ectopia lentis. In the right eye of each patient, the corneal hysteresis (CH), corneal resistance factor (CRF), Goldman-correlated IOP, and corneal-compensated IOP were recorded. RESULTS: Overall, the mean CH, CRF, Goldman-correlated IOP, and corneal-compensated IOP were not significantly different between the study group and the control group. The mean CH was 9.9 mm Hg ± 1.2 (SD) in study eyes with ectopia lentis and 11.2 ± 1.5 mm Hg in study eyes without ectopia lentis (P=.016); the mean CRF was 8.2 ± 1.8 mm Hg and 11.3 ± 1.9 mm Hg, respectively (P<.001). The mean Goldman-correlated IOP was 11.7 ± 2.7 mm Hg in study eyes with ectopia lentis and 16.2 ± 4.3 in study eyes without ectopia lentis (P=.003); the mean corneal-compensated IOP was 13.5 ± 4.1 mm Hg and 15.6 ± 3.8 mm Hg, respectively (P=.07). CONCLUSION: The CH, CRF, and Goldman-correlated IOP were significantly lower in the Marfan syndrome eyes with ectopia lentis than in the Marfan syndrome eyes without ectopia lentis.

Prophylactic selective laser trabeculoplasty in the prevention of intraocular pressure elevation after intravitreal triamcinolone acetonide injection.

PURPOSE: To evaluate the prophylactic efficacy of selective laser trabeculoplasty for preventing an increase in intraocular pressure (IOP) after intravitreal triamcinolone acetonide injection. DESIGN: Prospective, comparative, interventional case series. METHODS: We studied 31 eyes with a baseline IOP of 21 mm Hg or more of 31 patients for which intravitreal triamcinolone acetonide injection was planned for diabetic macular edema. The patients were divided into 2 groups, a study group and control group. The study group comprised 15 eyes of 15 patients that underwent selective laser trabeculoplasty a mean of 8.3 ± 4.1 days before intravitreal triamcinolone acetonide injection. The control group comprised 16 eyes of 16 patients who underwent only intravitreal triamcinolone acetonide injection. Main outcomes measures were mean IOP and number of patients requiring antiglaucomatous therapy. RESULTS: Mean baseline IOP was 21.6 ± 0.9 mm Hg in the study group and 21.5 ± 0.8 mm Hg in the control group (P = .98). Mean IOP at 1 day after injection was 17.0 ± 2.0 mm Hg in the study group and 19.5 ± 4.3 mm Hg in the control group (P = .23). Mean IOP at 1 week after injection was 16.9 ± 1.7 mm Hg and 18.4 ± 4.0 mm Hg, respectively (P = .49); mean IOP at 1 month after injection was 16.4 ± 1.5 mm Hg and 20.8 ± 5.6 mm Hg, respectively (P = .003); mean IOP at 3 months after injection was 15.8 ± 2.5 mm Hg and 18.3 ± 5.5 mm Hg, respectively (P = .01); and mean IOP at 6 months after injection was 15.7 ± 1.4 mm Hg and 17.1 ± 1.5 mm Hg, respectively (P = .03). The number of patients requiring antiglaucomatous therapy during follow-up was 0 of 15 eyes in the study group and 8 of 16 eyes in the control group (P = .001). CONCLUSIONS: The IOP elevation after intravitreal triamcinolone acetonide injection may be prevented by performing selective laser trabeculoplasty before intravitreal triamcinolone acetonide injection, especially in cases with a baseline IOP of 21 mm Hg or more.