Three year outcomes of intravitreal ranibizumab and aflibercept treatment of patients with diabetic macular edema: A comparative study.

Background: Diabetic macular edema (DME) is the most common cause of visual deterioration in patients with diabetes mellitus. Various treatment options have been used for DME, including intravitreal injection of steroids and anti-vascular endothelial growth factors. Objectives: To evaluate and compare the functional and anatomical outcomes of intravitreal ranibizumab (IVR) and intravitreal aflibercept (IVA) treatments in patients with DME. Design: Retrospective study. Methods: Four hundred three eyes of 235 naïve patients who underwent IVR or IVA treatment for DME followed up to 36 months included in the study. Best corrected visual acuity (BCVA) and central macular thickness (CMT) were measured at baseline, year 1, 2 and 3. Primary endpoint of the study was the change in BCVA and CMT each year from baseline and requirement of additional treatment (laser/steroid injection). Results: There were 198 eyes in IVR group and 205 eyes in IVA group. The changes in mean BCVA were 0.09 ± 0.32 versus 0.17 ± 0.41 Logarithm of the minimum angle of resolution (logMAR) (p = 0.042) at year 1, 0.09 ± 0.37 versus 0.12 ± 0.45 logMAR (p = 0.512) at year 2 and 0.13 ± 0.36 versus 0.15 ± 0.48 logMAR (p = 0.824) at year 3 in IVA and IVR groups, respectively. The baseline mean BCVA were lower (p = 0.004) in IVA group. The mean total number of injections was 7.93 ± 3.38 versus 7.42 ± 3.05 (p = 0.112). Conclusion: At year 1, change in mean BCVA was statistically significantly higher in IVA group; however this difference did not persist at years 2 and 3. Although the mean total number of injections was similar between groups, the requirement for adjuvant steroid treatment was significantly higher in ranibizumab group, which may affect the number of visits and treatment costs. Both ranibizumab and aflibercept treatments achieved a good long-term visual and anatomical response in DME patients.

Phototherapeutic keratectomy: current approaches and changing trends in a tertiary eye clinic / Ceratectomia fototerapêutica: abordagens atuais e tendências de mudança em uma clínica oftalmológica terciária

ABSTRACT Purpose: To examine the efficacy of phototherapeutic keratectomy as a treatment for variable pathologies with anterior corneal opacities and evaluate the distribution of phototherapeutic keratectomy indications over the past 10 years. Methods: The records of 334 eyes from 276 patients who underwent phototherapeutic keratectomy between March 2010 and 2020 were retrospectively reviewed. Etiologies of the patients who underwent phototherapeutic keratectomy were noted, and their changes were examined. Refractive and visual acuity results before and after the operation were recorded and analyzed according to etiology. Results: The mean age of the patients was 40.7 ± 16.2 years (range: 19-84). The mean follow-up was 25.5 ± 19.1 months (range: 3-96). Phototherapeutic keratectomy was most frequently applied for corneal stromal dystrophies (44%, 151 eyes from 111 patients), and granular dystrophy was the most common phototherapeutic keratectomy indication among corneal dystrophies. Unlike other indications, there has been an increase in the application of phototherapeutic keratectomy for persistent subepithelial opacities due to adenoviral conjunctivitis in the past 10 years. There was a significant increase in visual acuity in all groups except for the recurrent epithelial defect group (p<0.05). The greatest improvement in visual acuity was detected for stromal dystrophies in the granular dystrophy subgroup. Conclusion: Despite changing indication trends, phototherapeutic keratectomy remains an effective and reliable treatment for anterior corneal lesions.

RESUMO Objetivo: Examinar a eficácia da ceratectomia fo­toterapêutica para o tratamento de patologias variáveis que apresentarem opacidades anteriores da córnea, e avaliar a distribuição das indicações de ceratectomia fototerapêutica nos últimos 10 anos. Métodos: Foram revisados retrospectivamente os prontuários de 276 pacientes, com 334 olhos tratados com ceratectomia fototerapêutica entre março de 2010 e o ano de 2020. As etiologias dos pacientes submetidos à ceratectomia fototerapêutica foram anotadas e suas alterações foram examinadas. Os resultados refrativos e de acuidade visual antes e após a operação foram registrados e analisados de acordo com a etiologia. Resultados: A idade média dos pacientes foi de 40,7 ± 16,2 anos (faixa: 19-84). O tempo médio de acompanhamento foi de 25,5 ± 19,1 meses (faixa: 3-96). A ceratectomia fototerapêutica foi aplicada com mais frequência para distrofias estromais corneanas (44%, 151 olhos de 111 pacientes); entre as distrofias corneanas como um todo, a distrofia granular foi a indicação terapêutica mais comum desse procedimento. Ao contrário de outras indicações, nos últimos 10 anos houve um aumento na aplicação de ceratectomia fototerapêutica em casos de opacidade subepitelial persistente causada por conjuntivite adenoviral. Houve um aumento significativo na acuidade visual em todos os grupos, exceto para o grupo com defeito epitelial recorrente (p<0,05). A maior melhora na acuidade visual foi detectada em casos de distrofia estromal, no subgrupo das distrofias granulares. Conclusão: Apesar das mudanças nas tendências de indicação, a ceratectomia fototerapêutica continua sendo uma abordagem terapêutica eficaz e confiável para tratar lesões da córnea anterior.

The effect of anterior segment parameters on surgical success of Descemet membrane endothelial keratoplasty: a prospective study.

PURPOSE: To investigate how anterior segment parameters affect the success of Descemet membrane endothelial keratoplasty (DMEK) in patients with endothelial insufficiency without stromal opacities and to identify factors predisposing them to repeat keratoplasty. METHODS: Our prospective observational study included patients who underwent primary DMEK for Fuchs' endothelial dystrophy and pseudophakic bullous keratopathy between March 2019 and March 2020. After a detailed ophthalmologic examination, corneal topographic analysis, anterior segment optical coherence tomography (AS-OCT) scans, endothelial cell density (ECD) and axial length (AL) measurements were performed. Surgical success was defined as no endothelial dysfunction during follow-up. Changes in the parameters and how preoperative parameters affect surgical success were investigated. RESULTS: In 43 eyes of 43 patients (mean age: 68.58 ± 8.51 years), mean visual acuity was 1.73 ± 0.74 LogMAR before DMEK and 0.31 ± 0.29 LogMAR in the final visit. Central corneal thickness (CCT, p = 0.026) and mean anterior chamber depth (ACD, p = 0.001) affected surgical success. Preoperative CCT values greater than 770 µm increased the risk of repeat keratoplasty by 8.75-fold, whereas preoperative ACD values less than 2.5 mm increased the risk by 2.92-fold. CONCLUSION: Preoperative higher CCT and lower ACD values were associated with surgical failure after DMEK. Early surgery may be considered for more successful results. TRIAL REGISTRATION: This prospective study has been registered on the ClinicalTrials.gov system with the registration number NCT04420429 on 06/06/2020.

Phototherapeutic keratectomy: current approaches and changing trends in a tertiary eye clinic.

PURPOSE: To examine the efficacy of phototherapeutic keratectomy as a treatment for variable pathologies with anterior corneal opacities and evaluate the distribution of phototherapeutic keratectomy indications over the past 10 years. METHODS: The records of 334 eyes from 276 patients who underwent phototherapeutic keratectomy between March 2010 and 2020 were retrospectively reviewed. Etiologies of the patients who underwent phototherapeutic keratectomy were noted, and their changes were examined. Refractive and visual acuity results before and after the operation were recorded and analyzed according to etiology. RESULTS: The mean age of the patients was 40.7 ± 16.2 years (range: 19-84). The mean follow-up was 25.5 ± 19.1 months (range: 3-96). Phototherapeutic keratectomy was most frequently applied for corneal stromal dystrophies (44%, 151 eyes from 111 patients), and granular dystrophy was the most common phototherapeutic keratectomy indication among corneal dystrophies. Unlike other indications, there has been an increase in the application of phototherapeutic keratectomy for persistent subepithelial opacities due to adenoviral conjunctivitis in the past 10 years. There was a significant increase in visual acuity in all groups except for the recurrent epithelial defect group (p<0.05). The greatest improvement in visual acuity was detected for stromal dystrophies in the granular dystrophy subgroup. CONCLUSION: Despite changing indication trends, phototherapeutic keratectomy remains an effective and reliable treatment for anterior corneal lesions.

Comparison of Intraocular Pressure Measurements With Goldmann Applanation Tonometry, Tonopen XL, and Pascal Dynamic Contour Tonometry in Patients With Descemet Membrane Endothelial Keratoplasty.

PRCIS: IOP measured with Tonopen and DCT was higher than GAT in eyes that underwent DMEK. PURPOSE/AIM OF THE STUDY: To compare intraocular pressure (IOP) measurements measured based on Goldmann applanation tonometry (GAT), Tonopen XL, and Pascal Dynamic Contour Tonometry (DCT) in patients who had undergone descemet membrane endothelial keratoplasty (DMEK) and to appraise the influence of central corneal thickness (CCT) on IOP measurements. MATERIALS AND METHODS: Thirty-four eyes (from 34 patients) who underwent DMEK at least 1 month before the study were included. We performed Tonopen XL, GAT, and DCT IOP measurements at 10 min intervals. Bland-Altman plots were used to assess agreement between GAT, Tonopen XL, and DCT. Spearman rank correlation was used to calculate the deviation from GAT readings by each device and correlate the readings with the CCT variable. RESULTS: The mean IOP values with GAT, Tonopen XL, and DCT were 14.9±5.8, 16.2±5.5, and 19.2±5.0, respectively. Statistically significant differences between GAT and Tonopen XL and between GAT and DCT were noted ( r =0.942 [0.885-0.971]; P =0.0001 and r =0.942 [0.885-0.971]; P =0.0001, respectively). DCT tended to return a higher IOP relative to GAT and Tonopen XL. CCT and IOP readings obtained by GAT, Tonopen XL, and DCT did not show a statistically significant correlation with each other. CONCLUSION: IOP as measured with both Tonopen and DCT was found to be higher than GAT in eyes that underwent DMEK surgery although the techniques showed a good correlation. After DMEK surgery, all 3 measurement techniques can be practical in routine postoperative examinations, however it is recommended to measure IOP with the same device during patient follow-up.

Graft survival and clinical outcomes of Descemet membrane endothelial keratoplasty: long-term results.

PURPOSE: The aim is to report long-term graft survival rates and clinical outcomes of Descemet membrane endothelial keratoplasty (DMEK). METHODS: In this study 150 eyes that underwent DMEK whether for Fuchs endothelial corneal dystrophy (FECD) or for bullous keratopathy (BK) surveilled for 7 years at 6 time points to evaluate graft survival rates and clinical outcomes of post-corneal transplantation. RESULTS: Overall, the estimated survival probability of 95% confidence interval at 7 years of post-DMEK was 0.58 (0.72-0.77), and the survival probabilities of eyes operated for FECD (0.53) were higher than eyes operated for BK (0.42) (log rank 26.87, [p = 0.197]). Post-transplant eyes with FECD achieved better visual acuity levels than eyes with BK (p = 0.006). Primary graft failure occurred in 11.3% eyes. Secondary graft failure rate was 9.3%, and allograft rejection rate was 4.7%. CONCLUSION: Although DMEK is effective and safe in long term, visual results and graft survival rates are better in cases with FECD.

Assessment of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and mean platelet volume in patients with idiopathic epiretinal membrane.

PURPOSE: To assess the role of inflammation in the pathogenesis of idiopathic epiretinal membrane (iERM) using the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) as indicators of inflammation and to compare these parameter levels between iERM and control subjects. METHODS: We retrospectively analyzed the medical records of 36 patients who underwent vitrectomy-ERM peeling and 39 patients who had cataract surgery. We obtained blood samples from all individuals who participated in the study to investigate these parameters. RESULTS: Seventy-five subjects were included in this study: 36 in the iERM group and 39 in the control group. The mean neutrophil and MPV levels were significantly higher in iERM subjects than in control subjects. The mean lymphocyte level was lower in the iERM group. The mean NLR, PLR, and MPV levels were higher in iERM subjects than in control subjects. CONCLUSION: The higher NLR, PLR, and MPV levels found in patients with iERM may indicate that subclinical systemic inflammation may associate with iERM.

Evaluation of Diplopia Secondary to Seton Implantation Surgery: Ahmed Glaucoma Valve and Diplopia.

Objectives: To determine and evaluate the rate of diplopia after Ahmed glaucoma valve (AGV) implantation surgery. Materials and Methods: The records of patients who underwent AGV implantation in our hospital between the years of 2010 and 2017 were retrospectively reviewed. Patients who were referred to our strabismus department due to binocular diplopia after AGV implantation surgery were included. The details of postoperative day 1, day 7, day 15, and 1 month examinations were recorded. In the postoperative period, the onset time of diplopia complaints, diplopia type, and the presence of diplopia at distance and near fixation were noted. Ocular motility examination and deviation measurements were evaluated. Results: Ten (47%) of 211 patients who underwent AGV implantation in our hospital between 2010 and 2017 met the study inclusion criteria. Six of the 10 patients were men (60%) and 4 were women (40%). The mean age of the patients was 44.5 (34-63) years. Complaints of diplopia developed at a mean of 14.5±12.3 (1-30) days after AGV implantation. The prism measurements of the patients were found to be 8.4±1.4 prism diopters (PD) exotropia and 7.1±8.8 PD hypotropia. While 8 patients had diplopia only at near distance, 2 patients had diplopia at both distance and near. Three patients were treated with prismatic glasses, and their complaints of diplopia recovered spontaneously in 5.11±4.10 months. The other 7 patients were followed up without treatment, and their diplopia complaints resolved spontaneously in 6.11±4.40 months. Conclusion: Although most of the diplopia that develops after AGV implant surgery resolves without treatment, prismatic glasses might be considered as a treatment option in patients whose diplopia affects their daily lives.

Comparative study of small-incision lenticule extraction and phakic intraocular lens implantation for the correction of high myopia: 6-year results.

PURPOSE: To compare the long-term safety, efficacy, and complications of small-incision lenticule extraction (SMILE) and flexible iris-fixated anterior chamber phakic intraocular lens (pIOL) implantation for the treatment of high myopia. SETTING: University of Health Science Turkey, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey. DESIGN: Retrospective comparative case series. METHODS: Data of patients who underwent SMILE or pIOL (Artiflex) implantation for myopia were retrospectively reviewed. Only patients with preoperative manifest refraction spherical equivalent from -6.00 to -10.00 diopters (D) were included in the study. RESULTS: There were 47 eyes of 32 patients in the SMILE group and 52 eyes of 29 patients in the pIOL group. The mean postoperative follow-up was 63.75 ± 18.40 months in the SMILE group and 65.38 ± 16.22 months in the p-IOL group (P = .71). At 6 years postoperatively, refractive predictability was slightly better in the pIOL group, and the percentages of eyes within ±0.50 D of the attempted correction were 77% and 83% in the SMILE and pIOL groups, respectively. Although mean uncorrected distance visual acuity was comparable (SMILE, 0.12 ± 0.06 logarithm of the minimum angle of resolution [logMAR]; p-IOL, 0.09 ± 0.05 logMAR), the safety indices (1.08 ± 0.22 vs 1.11 ± 0.20; P = .02) and the efficacy indices (0.92 ± 0.24 vs 1.11 ± 0.22; P = .03) were statistically significantly higher after pIOL implantation. Despite a mean of 11.09% of the endothelial cell being lost at 6 years after pIOL implantation, no pIOL was explanted due to endothelial cell loss. CONCLUSIONS: In this comparative and long-term study, iris-fixated anterior chamber pIOL implantation for high myopic correction showed slightly better safety and efficacy profiles but with statistically significant endothelial cell loss.

Anterior Segment Surgery Performed During the COVID-19 Pandemic.

OBJECTIVES: This study evaluated anterior segment surgeries performed during the coronavirus 2019 (COVID-19) pandemic. Prevention of virus transmission is a critical consideration for surgeons, and includes assessment of etiology, the referral region, demographic characteristics, and the surgery to be performed. METHODS: The data of 144 patients who underwent anterior segment surgery between March 19, 2020 and June 1, 2020 were retrospectively reviewed. The patient demographic data and details of ophthalmological examination findings, the region patients were referred from, and the type of surgery performed were recorded and analyzed. RESULTS: A total of 144 patients, 49 women (34%) and 95 men (66%), were included in this study. The mean age of the patients was 31.30±25.88 years (range: 1-86 years). The presenting complaint was in the right eye in 43.7% of the cases, in the left eye in 52.8%, and in both eyes in 3.5% of the cases. While 94.4% of the applications were from Istanbul, the remaining 5.6% were from outside the province. Though 43.7% of the cases were patients seen previously at the study hospital in Istanbul, 56.3% presented for the first time. This hospital was the first referral center in only 39.6% of the cases. Evaluation of etiology indicated that corneal perforation (18.1%) was the most common, followed by keratitis (13.2%). The most common surgical intervention applied was amnion membrane transplantation (19.4%), followed by perforation repair (16.7%). CONCLUSION: Ophthalmological surgeries continue to be performed during the ongoing COVID-19 pandemic, however, special algorithms must be used to reduce the risk of COVID-19 transmission and to ensure continuity of healthcare for ophthalmology patients.

Effect of phacoemulsification surgery on intraocular pressure and function of bleb after trabeculectomy.

PURPOSE: To evaluate the effect of phacoemulsification (PE) surgery on intraocular pressure (IOP) control and morphology of filtering bleb in eyes that have previously had trabeculectomy in the long-term. METHODS: This retrospective study included 98 eyes of 93 patients who had undergone trabeculectomy first and then PE surgery. The IOP, morphology of bleb, the number of glaucoma medication of each patient before PE, and 1 day, 1 month, 3 months, 1 year, 2 years after PE, and at the last visit were recorded. The need for additional glaucoma medication or glaucoma surgery were noted. Surgical success was defined as 6 mmHg ≤ IOP ≤ 21 mm Hg at the 3rd month, 1st year, and 2nd year follow-up visit, without additional medication or surgery. RESULTS: Before PE the IOP was ≤ 21 mmHg in all of the eyes. At the last visit, the IOP was ≤ 21 mmHg in 6 eyes with fewer glaucoma medication, in 24 eyes with the same number, and in 36 eyes with more. There was an increase in the number of glaucoma medications on each visit (p < 0.05). There was a statistically significant difference in bleb morphologies between before PE and each visit after PE (p < 0.001). Surgical success after PE was obtained in 52 eyes, additional glaucoma medication was needed in 36 eyes, and additional surgical procedures were required in 14 eyes. CONCLUSION: Phacoemulsification surgery may increase the number of glaucoma medications and the mean IOP and also may reduce the function of bleb in eyes that underwent trabeculectomy.

Complications of accelerated corneal collagen cross-linking: review of 2025 eyes.

PURPOSE: To evaluate the early- and late-stage complications of accelerated cross-linking (A-CXL) in a large case series and investigate the relationship of A-CXL complications with ocular and systemic conditions accompanying keratoconus. METHODS: Retrospectively, records of 2025 eyes of 1184 patients diagnosed with keratoconus between March 2013 and 2020 who underwent A-CXL (18 mW/cm2 for 5 min) treatment were reviewed. Comorbid ocular and systemic diseases other than keratoconus were recorded. In the postoperative follow-up, early and late complications and their association with accompanying diseases were examined. RESULTS: The mean age of patients was 26.16 ± 6.05 (range 18-42), and the mean follow-up time was 3.40 ± 1.63 years (range 1-8 years). Vernal keratoconjunctivitis (3.7%) was the most common disease accompanying keratoconus. Less frequently, systemic allergic diseases (2.9%) and Down syndrome (2.3%) were observed. The most common complication in the early postoperative period was haze formation (9.1%), while failure of the treatment (4.2%) occurred in the late period. Other common complications were loss of two or more Snellen lines (2.4%) and delayed epithelial healing (1.8%). There was a significant relationship between vernal keratoconjunctivitis and delayed epithelial healing (p = 0.011). Statistically significant relationships were found between Down syndrome and haze formation (p < 0.001) and sterile infiltrate formation (p = 0.041). CONCLUSION: Although A-CXL complication rates are low, vernal keratoconjunctivitis following A-CXL might increase the risk of delayed epithelial healing, and similarly corneal haze and sterile infiltrates might be observed more frequently in patients with Down syndrome.

Comparison of the lamina cribrosa parameters in eyes with exfoliation syndrome, exfoliation glaucoma and healthy subjects.

PURPOSE: This study aimed to compare lamina cribrosa (LC) parameters obtained by spectral-domain optical coherence tomography (SD-OCT) of eyes with exfoliation syndrome (PXS), exfoliation glaucoma (PXG) and healthy subjects. METHODS: In this cross-sectional comparative study, 206 eyes of 206 subjects were included. The Bruch's membrane opening distance (BMOd), the anterior and posterior borders of the LC (LC thickness) and the anterior laminar depth (ALD) were imaged using the enhanced depth imaging (EDI) mode of SD-OCT. RESULTS: There were 96 eyes in the PXG group, 55 eyes in the PXS group, and 55 eyes in the control group. The LC thickness was the thinnest in the PXG group (151.10 ± 51.18 µm), followed in the PXS group (158.76 ± 49.62 µm), and the thickest in the control group (181.00 ± 39.10 µm) (p = 0.002). In PXG cases where LC was observed in the deepest location, the ALD value was highest (423.92 ± 111.75 µm) in the PXG group, followed by the control group (403.08 ± 63.56 µm), and PXS group (357.43 ± 80.87 µm) (p < 0.001). The BMOd values were largest in the PXG group (1542.43 ± 152.99 µm), followed by the control group (1506.52 ± 169.09 µm) and PXS group (1435.74 ± 141.06 µm) (p < 0.001). In the PXG group, peripapillary retinal nerve fiber layer (pRNFL) thickness, BCVA, and cup to disc (C/D) ratio were also statistically different from the other groups (p < 0.001). CONCLUSION: We found thinner LC thickness in PXG and PXS cases relative to the control group. Although its severity is associated with the diagnosis and severity of glaucoma, LC thinning can be encountered as an isolated condition in the presence of exfoliation.

The Effect of Topical Cyclopentolate on Anterior Segment Parameters in Patients with Keratoconus

Objectives: To investigate the effect of cycloplegia on anterior segment structures in keratoconus and forme fruste keratoconus patients using corneal topography. Materials and Methods: In this study, 40 patients with keratoconus (group 1), 40 patients with forme fruste keratoconus (group 2), and 40 healthy subjects (group 3) were evaluated prospectively. Flat keratometry (K) value (K1), steep K value (K2), mean K value (Kmean), maximum K value (Kmax), corneal astigmatism value, anterior chamber depth (ACD), symmetry index front, symmetry index back, thinnest corneal thickness, central corneal thickness and corneal volume were measured using Sirius topography before and after cycloplegia. Results were compared with one way ANOVA test. Results: The mean age of the participants was 24.4±6.2 years for group 1, 26.3±4.3 years for group 2 and 26.5±6.1 years for group 3. There was no difference between the groups with respect to mean age and gender (p>0.05). Mean K1 value was 45.54±2.43 diopters (D) before cycloplegia and 45.46±2.48 D after cycloplegia for group 1 (p=0.044). K1 value didn't change significantly after cycloplegia for group 2 and 3 (p=0.275, p=0.371). There was no significant difference in K2 and Kmean values after cycloplegia for all groups (p>0.05). Kmax value decreased significantly after cycloplegia in group 1 (p=0.001), but the difference was not significant for group 2 and 3 (p=0.087, p=0.241). ACD increased significantly after cycloplegia in all groups (p=0.001). Conclusion: Cycloplegia causes corneal flattening only in manifest keratoconus patients, leading to an increase in ACD in all groups.

Comparison of the Lamina Cribrosa Measurements Obtained by Spectral-Domain and Swept-Source Optical Coherence Tomography.

Purpose/Aim of the study: The aim of this study was to compare the lamina cribrosa (LC) measurements obtained by Spectral-Domain Optical Coherence Tomography (SD-OCT) and Swept-Source Optical Coherence Tomography (SS-OCT) in the same eye and we also investigate how the differences in measurement will change in the presence of pseudoexfoliation glaucoma (PEG). Materials and Methods: A total of 30 patients from one institution have accepted. Detailed medical case histories and clinical examination, optic nerve head imaging using the SD-OCT (Heidelberg Engineering, Heidelberg, Germany) and SS-OCT (Triton; Topcon Medical Systems, Tokyo, Japan) for patients with pseudoexfoliation glaucoma and healthy volunteer. Results: Fifty-three eyes of the 30 patients (13 female, 17 male) were included in the study. Twenty-nine of eyes were healthy and 24 of eyes had pseudoexfoliation glaucoma. The mean age was 62 ± 7.3 years (range, 50-86 years). The difference between the mean Bruch's membrane opening distance measured by SD-OCT (1504.7 ± 154.2 µm) and by SS-OCT (1568.6 ± 193.3 µm) was statistically significant (p = .009). The difference between LC depth and LC thickness measurements between two OCT devices were not statistically significant. There was a negative correlation between the difference of two devices Bruch's membrane opening distance measurements and the cup/disc ratio (p = .007). Conclusion: Generally accepted belief is that lamina cribrosa visibility would be worse in healthy subjects who have thick prelaminar tissues, and better in individuals with glaucoma who had suffered the loss of prelaminar tissue. The difference between Bruch's membrane opening distance measurements taken with two devices was greater in normal eyes, and this difference was decreasing in glaucomatous eyes in our study. The Lamina Cribrosa measurement values shall not be directly compared between SD-OCT and SS-OCT.

Manual Intracorneal Silicone Oil Insertion for Symptomatic Treatment of Bullous Keratopathy in a Patient with Corneal Scarring.

Bullous keratopathy is a result of endothelial loss and the failure of the remaining corneal epithelium to pump leaking water molecules away from the corneal tissue, causing overhydration. In eyes with good visual potential, keratoplasty is the primary treatment. There are also several other approaches to provide temporary improvement until a permanent solution with keratoplasty can be achieved. These alternatives include hypertonic topical sodium chloride (5%) drops, bandage contact lenses, anterior stromal puncture, phototherapeutic keratectomy, amniotic membrane transplantation, conjunctival flaps, and collagen crosslinking. This case report is a description of a different surgical technique using manual lamellar corneal dissection and intrastromal silicone oil insertion to provide symptomatic treatment of bullous keratopathy in an eye with no light perception and significant corneal scarring.