Vitreous IL-8 and VEGF levels in diabetic macular edema with or without subretinal fluid.

PURPOSE: To determine the cytokine levels in vitreous samples of diabetic macular edema (DME) patients in comparison with nondiabetic patients, and to evaluate the effect of subretinal fluid on the cytokine levels of vitreous samples. METHODS: In this prospective case-control study, 11 eyes of 11 patients with DME and subretinal fluid, 11 eyes of 11 patients with DME without subretinal fluid, and 14 eyes of 14 patients who had undergone vitreoretinal surgery for the epiretinal membrane or a macular hole (control group) were evaluated. The blood glycated hemoglobin (HbA1c) level, vitreous vascular endothelial growth factor (VEGF), and interleukin-8 (IL-8) levels were determined. RESULTS: The vitreous VEGF level of patients in DME groups was significantly higher than the control group (p < 0.001) without significant difference between DME patients with and without subretinal fluid (p = 0.796). The vitreous IL-8 level of DME patients with subretinal fluid was significantly higher than both control (p = 0.002) and DME without subretinal fluid groups (p = 0.019). The blood HbA1c level was significantly higher in DME group with subretinal fluid than those without subretinal fluid (8.7 ± 1.32 and 7.1 ± 1.13%, respectively, p = 0.010). The only significant correlation was between vitreous VEGF level and blood HbA1c level in DME patients without subretinal fluid (r = 0.813, p = 0.002). CONCLUSIONS: IL-8 level in vitreous samples was higher in DME patients with subretinal fluid than those without subretinal fluid, suggesting that inflammation is an important factor in the progression of DME leading to the subretinal fluid formation in diabetic patients.

A novel iridoplasty suture technique to repair iris defects and traumatic mydriasis.

A new iridoplasty method is described, which uses the U-suture technique to repair traumatic mydriasis and large iris defects. Two 0.9 mm opposing corneal incisions were made. The needle was inserted through the first incision, passed through the iris leaflets, and removed through the second incision. The needle was reinserted through the second incision and removed through the first incision by re-passing the needle through the iris leaflets to form a U-shaped suture. The modified Siepser technique was applied to fix the suture. Thus, with a single knot, the iris leaflets were brought closer (shrinking like a pack), fewer sutures were used and fewer gaps were left. Satisfactory aesthetic and functional results were obtained in all cases in which the technique was applied. There was no suture erosion, hypotonia, iris atrophy, or chronic inflammation during the follow-up.

Survey of Intravitreal Injection Preferences for the Treatment of Age-Related Macular Degeneration and Macular Edema Among Members of the Turkish Ophthalmological Association.

Objectives: To analyze the current preferences of ophthalmologists for the treatment of macular edema and age-related macular degeneration (AMD) and to evaluate off-label use of bevacizumab in Turkey. Materials and Methods: All members of the Turkish Ophthalmological Association were contacted by e-mail to complete an anonymous, 47-question internet-based survey. The second part of the survey (questions 36-47) was evaluated. Results: When current legal regulations were considered, ophthalmologists used bevacizumab as the first-line agent in patients with diabetic macular edema (DME), AMD, and retinal vein occlusion (RVO) (58.25%, 55.89%, and 52.29%, respectively). When economic and legal constraints were disregarded, the participants' preference for bevacizumab in the treatment of DME, AMD, and RVO decreased (11.64%, 10.58%, and 10.93%, respectively). Approximately three-quarters (75.75%) of ophthalmologists stated that dispensing multiple syringes from a single bevacizumab bottle could increase the risk of endophthalmitis. Most participants (93.68%) did not feel legally safe from harm caused by off-label bevacizumab use. However, 66.43% of ophthalmologists stated that bevacizumab is as effective as other anti-vascular endothelial growth factor (anti-VEGF) drugs. Conclusion: Bevacizumab is widely used as a first-line treatment for all indications of anti-VEGF use in the current reimbursement conditions, which preclude the right of ophthalmologists to treat according to their own preferences.

Management of optic disc pit-associated maculopathy: A case series from a tertiary referral center.

PURPOSE: To report outcomes of pars plana vitrectomy (PPV) combined with internal limiting membrane (ILM) stuffing technique in patients with optic disc pit associated maculopathy (ODP-M). METHODS: Data including best-corrected visual acuity (BCVA), central macular thickness (CMT), foveal center point thickness (FCP), and maximum height of fluid (max_fluid) (intraretinal or subretinal) were collected from the medical records of the patients. RESULTS: Six eyes of six patients with a mean age of 28.0 ± 17.68 years (range: 9-53 year) underwent PPV + ILM plug surgery. The mean follow-up duration was 25.62 ± 26.11 months (range: 11.80-78.00 month) duration. The mean BCVA increased from 1.25 ± 1.04 logMAR (20/355, Snellen equivalent) to 0.86 ± 1.09 logMAR (20/144, Snellen equivalent) at last follow-up (p = 0.043). Compared to baseline, CMT, FCP, and max_fluid significantly decreased at all visits after the surgery (p < 0.05 for all visits). At last follow-up, 66.6% of the eyes (four eyes) showed complete resolution of fluid at a mean of 5.25 ± 4.99 months (range: 1-12 months) after the surgery. CONCLUSION: PPV with ILM plug seemed to be an effective surgical technique in ODP-M. Studies with longer follow-up and higher number of patients are needed to confirm our results.

Evaluation of retinal inflammatory biomarkers after intravitreal steroid implant and Ranibizumab injection in diabetic macular edema.

PURPOSE: To compare the efficacy of intravitreal (IV) ranibizumab (IVR) injection with IV dexamethasone implant (IVDEX) in treatment naive diabetic macular edema (DME) patients with inflammatory component. MATERIALS AND METHODS: Treatment naive DME eyes with subfoveal neurosensorial detachment (SND) and hyperreflective spots (HRS) were treated either three loading doses of IVR (18 eyes) or one dose of IVDEX (19 eyes). Central macular thickness (CMT), height of SND, the number of HRSs scattered on the individual retinal layers and photoreceptor integrity were assessed using spectral domain- optical coherence tomography scans over 3-months follow-up. RESULTS: The mean change in best-corrected visual acuity (BCVA) was -0.11 ± 0.08 logMAR in IVDEX group and -0.04 ± 0.06 logMAR in IVR group at 1-month (p = 0.011). IVDEX group showed statistically significant more increase in BCVA compared to those receiving IVR injections at 2-months (p = 0.004) and 3-months (p = 0.017) visits. Compared to baseline, the number of total HRSs and the number of HRSs at each individual inner retinal layer significantly decreased in both groups at all follow-up visits. However, IVDEX group showed more decrease in the total number of HRSs at 2- and 3-months (p < 0.001 at 2-months, and p = 0.006 at 3-months) and in the mean number of HRSs located at inner nuclear layer-outer plexiform layer level (p = 0.016 at 1-month, p < 0.001 at 2-months, and p < 0.001 at 3-months). After treatment, the number of HRSs on the outer nuclear layer showed some non-significant increase in both groups. CONCLUSION: HRSs tended to migrate from inner retina to the outer retina in DME eyes by treatment. Dexamethasone seemed to be more effective option in such cases with inflammatory component.

Survey of Intravitreal Injection Techniques and Treatment Protocols Among Members of the Turkish Ophthalmological Association.

OBJECTIVES: To describe the intravitreal injection (IVI) techniques, practices, and treatment protocols of ophthalmologists in Turkey from May 20, 2020 to June 4, 2020. MATERIALS AND METHODS: All members of the Turkish Ophthalmological Association were contacted by e-mail to complete an anonymous, 47-question internet-based survey. RESULTS: Thirteen percent of the participants prescribed prophylactic antibiotics pre-injection, 63.8% (406/636) used antibiotic drops immediately after injection, and 91.8% prescribed topical antibiotics. The majority of IVI procedures were performed in an operating room (65.3%) or clean room (33.6%). Most surgeons used sterile gloves, masks, sterile drape, sterile fenestrated cover, and sterile eyelid speculum. Multispecialists (M) preferred to wear sterile gloves more than retina specialists (RS) (99.0% vs. 95.3%; p=0.004). Also, M prescribed antibiotics more than RS (93.7% vs. 88.8%; p=0.029). RS dilated the pupil more frequently than M (48.3% vs. 39.0%) (p=0.020). RS were more familiar to use different quadrants (right p=0.012; left p=0.001). Most surgeons (82.8%) did not perform injections in both eyes on the same day. CONCLUSION: Ophthalmologists in Turkey employ a wide range of techniques in care before, during, and after IVI. In addition, IVI techniques and treatment protocols differed between RS and M. Further research is needed to elucidate best practice patterns.

Bilateral Sequential Paracentral Acute Middle Maculopathy.

We aim to present a case with bilateral sequential paracentral acute middle maculopathy (PAMM). A 57-year-old man presented with paracentral scotoma in the left eye. The patient's multimodal imaging findings were consistent with PAMM in the left eye. Extensive systemic work-up revealed hypertension and a history of cerebrovascular event. One year after initial presentation, the patient had a subsequent decrease in visual acuity in the right eye and developed optical coherence tomography findings consistent with PAMM, whereas the left eye showed resolved PAMM findings. Although rare, PAMM can occur bilaterally. Clinicians should monitor unilateral PAMM patients with systemic vasculopathy for involvement in the fellow eye.

Surgical closure of giant traumatic macular hole with retinal graft.

AIM: To present a case with a large traumatic macular hole that we repaired with a retinal graft. CASE DESCRIPTION: A 24-year-old male patient presented with corneal penetration and an intraocular foreign body caused by a work accident. Vitrectomy and intraocular foreign body removal were performed. One month after the surgery, the patient had macula on retinal detachment in the nasal and superior quadrant. In addition, a giant macular hole was formed. However, the macula was atrophic because of the trauma, and we could not repair the hole with classic macular hole surgery techniques. For this reason, we used a retinal graft to cover the macular hole, and we observed that the hole was closed in follow-up visits. CONCLUSION: Retinal grafts can be used in patients with giant macular holes. They may be useful especially in patients with atrophic macula in trauma cases.

Late in-the-bag spontaneous IOL dislocation: risk factors and surgical outcomes.

AIM: To evaluate the possible predisposing risk factors for late in-the-bag spontaneous IOL dislocations and to study the early surgical and visual outcomes of repositioning and exchange surgeries. METHODS: Medical and surgical records of 39 eyes of 39 patients who underwent IOL repositioning or exchange surgery for dislocation between 2010 and 2018 were reviewed. Possible predisposing risk factors and some characteristics of late in-the-bag spontaneous IOL dislocations; outcomes of IOL repositioning and exchange surgeries, including visual acuity, refractive status before and after surgery and postoperative complications were evaluated. RESULTS: The predisposing factors for late in-the-bag spontaneous IOL dislocations were pseudoexfoliation [PEX; 12/39 (30.8%)], previous vitreoretinal surgery [7/39 (17.9%)], axial myopia [3/39 (7.7%)], both PEX and axial myopia [1/39 (2.6%)], both previous vitreoretinal surgery and axial myopia [2/39 (5.1%)] and uveitis [1/39 (2.6%)]. The mean interval between cataract and dislocation surgery was 7.23y, greater in PEX positive group (8.63y). The mean best corrected visual acuity (BCVA) improved significantly after dislocation surgery (P<0.001) and also improved significantly after exchange surgery (P=0.001). The mean value of spherical equivalant decreased significantly after dislocation surgery (P=0.011), whereas corneal astigmatism increased but this difference was not significant after dislocation surgery and exchange surgery (P=0.191, P=0.074, respectively). CONCLUSION: The most prevelant risk factors for late in-the-bag spontaneous IOL dislocations are PEX, previous vitreoretinal surgery and axial myopia. In the management of IOL dislocations, exchange surgery with small corneal incision seemed effective with improved BCVA and safety with low postoperative complications.

Foveal thickness after phacoemulsification in patients with pseudoexfoliation syndrome, pseudoexfoliation glaucoma, or primary open-angle glaucoma.

PURPOSE: To use optical coherence tomography (OCT) to assess changes in foveal thickness after uneventful phacoemulsification in eyes with pseudoexfoliation syndrome (PXF), pseudoexfoliation glaucoma (PXG), or primary open-angle glaucoma (POAG). SETTING: Department of Ophthalmology, University of Kocaeli, Kocaeli, Turkey. METHODS: This prospective observational case series comprised 87 eyes (87 patients) that had phacoemulsification. Thirty-three were control eyes with cataract and no ocular disease, 15 eyes had POAG, 22 eyes had PXF, and 17 eyes had PXG. Foveal thickness was measured by OCT preoperatively and 1, 2, 4, and 8 weeks postoperatively. Intraocular pressure was recorded preoperatively and 8 weeks postoperatively. RESULTS: In all groups, the mean foveal thickness was statistically significantly greater at all postoperative visits than preoperatively. The mean change in foveal thickness was higher in the POAG group than in the PXF and control groups at 2 and 8 weeks. The mean increase in foveal thickness was greater in the PXG group than in the control group and the PXF group at 2 and 4 weeks. Three patients (1 patient in each group except PXF) developed clinically significant cystoid macular edema (CME); the incidence of CME was not statistically significant. CONCLUSION: Foveal thickness measured by OCT increased in patients with POAG and PXG and was higher than in the control group and the PXF group after uneventful phacoemulsification.

Tissue plasminogen activator-assisted vitrectomy for submacular hemorrhage due to age-related macular degeneration.

PURPOSE: The purpose of this study was to evaluate the treatment efficacy of vitrectomy combined with subretinal recombinant tissue plasminogen activator (r-tPA) and factors affecting visual improvement in patients with submacular hemorrhage (SMH) due to neovascular age-related macular degeneration (nAMD). MATERIALS AND METHODS: Medical records of 17 consecutive patients diagnosed with SMH secondary to nAMD were retrospectively reviewed. The initial surgical procedure involved a 23-gauge transconjunctival vitrectomy, subretinal r-tPA application through a self-sealing inferior retinotomy, and sulfur hexafluoride gas for tamponade in all patients. The duration, size, and thickness of the hemorrhage and the pre- and post-operative visual acuity (VA) using a Snellen chart were recorded. VA was converted to logMAR for statistical analysis. RESULTS: The average duration and size of the SMH were 12.8 ± 18.2 days and 8.6 ± 5.3 disc areas, respectively. The mean follow-up time was 16.9 ± 4.7 months. A statistically significant visual improvement was found when comparing initial VA with postoperative best-corrected VA (BCVA) and final BCVA (Wilcoxon rank test, P ≤ 0.01). There was no significant correlation between the size of the hemorrhage and postoperative BCVA and final BCVA (Spearman's rho test). There was no statistically significant correlation between the initial VA and postoperative BCVA and final BCVA (Spearman's rho test). There was no significant correlation between the duration of hemorrhage and postoperative BCVA and final BCVA (Spearman's rho test). The preoperative thickness of hemorrhage (747.5 ± 30 µm) was not correlated with postoperative BCVA or final BCVA (Pearson's test). CONCLUSIONS: Vitrectomy combined with subretinal r-tPA injection and gas tamponade is an effective surgical intervention to preserve VA in selected patients with apparent SMH.

Effect of vancomycin, teicoplanin, and cefuroxime on Staphylococcus epidermidis adherence to intraocular lenses.

PURPOSE: To compare the adherence of Staphylococcus epidermidis on AcrySof (Alcon) and poly(methyl methacrylate) (PMMA) intraocular lenses (IOLs) treated with vancomycin, teicoplanin, and cefuroxime. SETTING: Kocaeli University, School of Medicine, Kocaeli, Turkey. METHODS: The lenses were contaminated with S epidermidis solutions containing 10(8) colony-forming units. Intraocular lenses were placed in sterile triptic soy broth after being held in antibiotic solutions for 15 minutes. After that, sonication and vortex procedures were performed to remove all the attached bacteria that could not be removed by antibiotics. Ten microliters from each broth were taken and inoculated into sheep blood agar. The colonies were counted overnight. The statistical analyses were made using Mann-Whitney U and Kruskal-Wallis tests, and a P value less than 0.05 was considered statistically significant. RESULTS: Regarding the inhibitory effect of antibiotics on bacterial adhesion, there was no statistically significant difference between AcrySof and PMMA lenses. In the cefuroxime group, the mean numbers of colony-forming units on AcrySof and PMMA lenses were 35.2 +/- 6.94 and 30.8 +/- 18.69, respectively (P>.05). In the teicoplanin group, the mean number of colony-forming units on AcrySof lenses was 100.1 +/- 20.97 and 70.6 +/- 43.75 on the PMMA lenses. The adherence in the vancomycin group was 245 +/- 273.74 colony-forming units for AcrySof lenses and 159.8 +/- 101.94 for PMMA lenses (P>.05). Regarding the inhibitory effect of antibiotics, cefuroxime was the most effective, followed by teicoplanin and vancomycin, respectively. Overall, the mean numbers of colony-forming units on the lenses that were held in cefuroxime, teicoplanin, and vancomycin solutions were 33.0 +/- 13.90, 85.35 +/- 36.66, and 202.4 +/- 205.74, respectively (P = .000). CONCLUSIONS: The results suggest that cefuroxime, teicoplanin, and vancomycin significantly inhibit bacterial adherence to IOLs. The effect of cefuroxime on adherence inhibition was significantly higher than that of teicoplanin and vancomycin. Bacterial adherence is an important factor in bacterial virulence. Antibiotics, especially cefuroxime, can successfully inhibit bacterial adherence.

Evaluation of intranasal midazolam in refraction and fundus examination of young children with strabismus.

PURPOSE: To determine the clinical sedative effect and dosage of intranasal midazolam in refraction and fundus examination of children with strabismus. PATIENTS AND METHODS: Refraction and fundus examination with (n = 28) and without (n = 24) sedation were performed in 52 children with strabismus whose ages ranged from 7 to 26 months. We delivered a 5-mg/mL solution of midazolam via a syringe for 60 seconds to provide a dose of 0.2 mg/kg. We repeated the dose to a maximum of 0.3 mg/kg if there was no clinical sedative response after 10 to 15 minutes. The ease of examination and sedation for each patient was scored by a blinded observer. The groups were evaluated for ease of examination and the time needed to complete it. RESULTS: We obtained clinically adequate sedation at a mean (+/- standard deviation) of 15 minutes (+/- 2.69 minutes). Sedation was achieved with a mean dose of 2.64 mg/kg (+/- 0.66 mg/kg). Children receiving midazolam had significantly calmer examination scores. The time needed to complete the examination was statistically significantly shorter for these children than for children not receiving sedation (P < .05). CONCLUSIONS: Intranasal midazolam is a beneficial drug and method of delivery for the sedation of anxious children with strabismus undergoing refraction and fundus examination. Sedation prior to examination is effective in reducing the anxiety and time associated with ophthalmologic examination of children with strabismus.

Comparison of two anesthetic methods for intravitreal ozurdex injection.

Purpose. To determine whether subconjunctival lidocaine injection maintains additional anesthetic effect during intravitreal Ozurdex injection. Methods. 63 patients who were diagnosed as central or branch retinal vein occlusion and planned to receive Ozurdex injection for macular edema were prospectively included in the study. The patients were randomized into one of the two anesthetic groups. The first group received topical proparacaine drop and lidocaine applied pledget. The second group received subconjunctival lidocaine injection in addition to the anesthetics in group 1. Results. Mean pain score was 1.90 ± 2.39 in group 1 and 1.71 ± 2.09 in group 2 (p = 0.746). Mean subconjunctival hemorrhage grade was 1.67 ± 0.17 in group 1 and 0.90 ± 0.14 in group 2 (p = 0.001). There was no relationship between the amount of subconjunctival hemorrhage and pain score of the patients. Conclusions. There was no difference in pain scores between the two anesthetic methods. The addition of subconjunctival lidocaine injection offered no advantage in pain relief compared to lidocaine-applied pledgets.

Evaluation of choroidal thickness via enhanced depth-imaging optical coherence tomography in patients with systemic hypertension.

PURPOSE: The purpose was to evaluate choroidal thickness via spectral domain optical coherence tomography (SD-OCT) and to compare the data with those of 24-h blood pressure monitoring, elastic features of the aorta, and left ventricle systolic functions, in patients with systemic hypertension. MATERIALS AND METHODS: This was a case-control, cross-sectional prospective study. A total of 116 patients with systemic hypertension, and 116 healthy controls over 45 years of age, were included. Subfoveal choroidal thickness (SFCT) was measured using a Heidelberg SD-OCT platform operating in the enhanced depth imaging mode. Patients were also subjected to 24-h ambulatory blood pressure monitoring (ABPM) and standard transthoracic echocardiography (STTE). Patients were divided into dippers and nondippers using ABPM data and those with or without left ventricular hypertrophy (LVH+ and LVH-) based on STTE data. The elastic parameters of the aorta, thus aortic strain (AoS), the beta index (BI), aortic distensibility (AoD), and the left ventricular mass index (LVMI), were calculated from STTE data. RESULTS: No significant difference in SFCT was evident between patients and controls (P ≤ 0.611). However, a significant negative correlation was evident between age and SFCT in both groups (r = -0.66/-0.56, P ≤ 0.00). No significant SFCT difference was evident between the dipper and nondipper groups (P ≤ 0.67), or the LVH (+) and LVH (-) groups (P ≤ 0.84). No significant correlation was evident between SFCT and any of AoS, BI, AoD, or LVMI. DISCUSSION: The choroid is affected by atrophic changes associated with aging. Even in the presence of comorbid risk factors including LVH and arterial stiffness, systemic hypertension did not affect SFCT.

Progressive indocyanine green toxicity.

PURPOSE: To report a case of progressive indocyanine green (ICG) toxicity that occurred after pars plana vitrectomy for an epiretinal membrane. METHODS: The patient underwent pars plana vitrectomy for an epiretinal membrane. After fluid--air exchange, ICG was spread only on the macular area, and air-fluid exchange was performed immediately. The epiretinal membrane was removed with serrated forceps. RESULTS: Although the preoperative visual acuity was 0.6, it was 0.2 in the first postoperative month, and fundus fluorescein angiography revealed retinal pigment epithelium atrophy in the macula that matched the area of ICG application. Visual acuity in the fourth postoperative month was 0.1, and there was optic atrophy. During the sixth postoperative month, visual acuity was hand movements, and there were multiple retinal holes in the macula and sclerosis of the arteries. CONCLUSION: This study demonstrates that intravitreal use of ICG might have toxic effects on the retina. Unnecessary use of ICG should be avoided, and care must be taken when using intravitreal ICG.

Evaluation of choroidal thickness via enhanced depth‑imaging optical coherence tomography in patients with systemic hypertension.

Purpose: The purpose was to evaluate choroidal thickness via spectral domain optical coherence tomography (SD‑OCT) and to compare the data with those of 24‑h blood pressure monitoring, elastic features of the aorta, and left ventricle systolic functions, in patients with systemic hypertension. Materials and Methods: This was a case–control, cross‑sectional prospective study. A total of 116 patients with systemic hypertension, and 116 healthy controls over 45 years of age, were included. Subfoveal choroidal thickness (SFCT) was measured using a Heidelberg SD‑OCT platform operating in the enhanced depth imaging mode. Patients were also subjected to 24‑h ambulatory blood pressure monitoring (ABPM) and standard transthoracic echocardiography (STTE). Patients were divided into dippers and nondippers using ABPM data and those with or without left ventricular hypertrophy (LVH+ and LVH–) based on STTE data. The elastic parameters of the aorta, thus aortic strain (AoS), the beta index (BI), aortic distensibility (AoD), and the left ventricular mass index (LVMI), were calculated from STTE data. Results: No significant difference in SFCT was evident between patients and controls (P ≤ 0.611). However, a significant negative correlation was evident between age and SFCT in both groups (r = −0.66/−0.56, P ≤ 0.00). No significant SFCT difference was evident between the dipper and nondipper groups (P ≤ 0.67), or the LVH (+) and LVH (–) groups (P ≤ 0.84). No significant correlation was evident between SFCT and any of AoS, BI, AoD, or LVMI. Discussion: The choroid is affected by atrophic changes associated with aging. Even in the presence of comorbid risk factors including LVH and arterial stiffness, systemic hypertension did not affect SFCT.

Effect of cefuroxime and moxifloxacin on Staphylococcus epidermidis adherence to intraocular lenses.

OBJECTIVE: To investigate and compare the effect of cefuroxime and moxifloxacin on adhesion of Staphylococcus epidermidis to intraocular lenses (IOLs). DESIGN: Experimental study. METHODS: The 3-pieced hydrophobic acrylic lenses were contaminated with S. epidermidis (American Type Culture Collection 35983) solutions containing 108 colony-forming units. IOLs were inoculated into test tubes containing tryptic soy broth after being held in antibiotic solutions for 15 minutes. Sonication and vortex procedures were performed in order to remove all the remaining bacteria. From each tube 10 microL and 100 microL was taken and inoculated into sheep blood agar. The colonies were counted overnight. The statistical analyses were made using one-way ANOVA, Turkey Honestly Significant Differences test (HSD) and independent t tests, and a p value less than 0.05 was considered statistically significant. RESULTS: Overall, the mean numbers of colony-forming units on the lenses that were held in control, cefuroxime, moxifloxacin 0.5 mg/0.1 mL and moxifloxacin 0.1 mg/0.1 mL solutions were 1398 (SE 10.01 x 10(3)), 29.9 (SE 1.16 x 10(3)), 0.23 (SD 0.04 x 10(3)), and 0.41 (SD 0.05 x 10(3)), respectively. The evaluation using one-way ANOVA and Turkey HSD tests revealed significant statistical differences among the groups (p = 0.000). The evaluation using independent t tests revealed significant statistical differences between the 2 moxifloxacin groups (p < 0.05). CONCLUSION: Our results suggest that moxifloxacin and cefuroxime significantly inhibit bacterial adherence to IOLs. The effect of moxifloxacin on inhibition of bacterial adherence was significantly greater than that of cefuroxime. For this reason moxifloxacin might be considered as a better prophylactic agent.

Serous retinal detachment in the macula related to latanoprost use.

A 67-year-old woman referred to our clinic complaining of decrease in vision and metamorphopsia for 1 month after initiating latanoprost therapy. Fundus examination and optical coherence tomography (OCT) revealed serous detachment in the macula. The macular thickness measured by OCT was 532 microm. Latanoprost was discontinued. At follow-up, a progressive decrease in macular thickness and increase in visual acuity was observed. Four months later, serous detachment was completely resolved, and macular thickness measured by OCT was 186 mum. Latanoprost may lead a serous retinal detachment in the posterior pole. Clinicians should keep in mind that decreased visual acuity in patients using latanoprost might be related with this complication.