bluuebunny/crossref_metadata_2025_split huggingface dataset:
Toxic corneal ulcer: a frequent and sight-threatening disease
Authors: Sacchetti Marta , Lambiase Alessandro , Coassin Marco , Bonini Sergio , Bonini Stefano 
Published: March 2018

Purpose Overtreatment with topical ophthalmic preparations can lead to toxic corneal ulcer development. This study aimed to investigate the clinical and visual impact of toxic corneal ulcers and the management and risk factors for their development and outcomes. Methods Clinical records of 226 consecutive patients with corneal ulcers referred to our tertiary care center were retrospectively evaluated. Frequency, clinical features, and management of toxic corneal ulcers are described. The relationship between clinical severity and outcomes (healing time, corneal transparency, and visual acuity) of toxic corneal ulcers and the number and classes of topical drugs, the number of daily instillations, and the duration of treatment were statistically evaluated. Results Toxic corneal ulcer was diagnosed in 9% (21/226) of all patients. After topical treatment discontinuation, the cornea spontaneously healed in all patients in 2 to 21 days. A longer healing time was related to a greater number of topical drugs used (p=0.029), a greater frequency of daily instillations (p=0.042), and a longer duration of treatment (p=0.048). The specific drugs used did not significantly influence healing time. After resolution, 16 out of 21 patients showed corneal scarring and impairment of visual function. The severity of corneal haze was related to the number of drugs used (p=0.023), to the frequency of daily instillations (p=0.031), and to the healing time (p=0.008). Conclusions Toxic corneal ulcer is a frequent disease that can potentially lead to permanent visual impairment. A high-dose regimen is the major risk factor for corneal toxic ulcer development and poor visual outcomes.
Photoablation centration on the corneal optical center in myopic LASIK using AOV excimer laser
Authors: Wu Liangcheng , Zhou Xingtao , Chu Renyuan , Wang Qing 
Published: March 2018

Purpose To evaluate the clinical efficacy of laser-assisted in situ keratomileusis (LASIK) with ablation centration on the corneal optical center with standard sphero-cylindrical ablation model. Methods A total of 119 eyes (60 patients) underwent primary myopic LASIK with standard sphero-cylindrical ablation model using AOV Excimer laser, and they were divided into 2 groups according to the ablation centration. The experimental group had 60 eyes (30 patients) with ablation centered on the corneal optical center and in the control group of 59 eyes (30 patients) ablation was centered on the pupil center. Patients' basic characteristics were evenly matched. The distance between ablation center and corneal vertex normal (DAV) was measured to describe the match of ablated tissue and virgin cornea. The uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refraction, and higher-order aberrations (HOAs) for a 6-mm pupil area between the 2 groups were compared. Results Mean DVA was 0.35±0.15 mm in the experimental group versus 0.69±0.23 mm in the controls, and the difference between the two groups was significant (p<0.05). No significant difference was found in postoperative UCVA and BSCVA between the 2 groups (p>0.05). A total of 90% of eyes in the experimental group had residual astigmatism within 0.5 D versus 72.88% eyes in the control group, and the difference was significant (p<0.01). The increase of root mean square of HOAs was smaller in the experimental group (p<0.01), as compared to the control group. Conclusions The corneal optical center serving as the ablation center in LASIK with standard sphero-cylindrical ablation model may be superior to the entrance pupil center.
Influential factors on the survival of endothelial cells after penetrating keratoplasty
Authors: Lee Hyun Soo , Kim Man Soo 
Published: March 2018

Purpose To evaluate the factors that influence the survival of corneal endothelial cells after penetrating keratoplasty. Methods We retrospectively reviewed the medical records of 83 eyes of 83 patients who had undergone penetrating keratoplasty and whose corneal endothelial cell density was more than 2000 cells/mm2 at postoperative 1 month. The patients were divided into 3 groups: keratoconus (Group 1), bullous keratopathy (Group 2), and herpetic keratitis with uveitis (Group 3), based on the underlying disease and the recipient's corneal endothelial state. We analyzed the difference of endothelial cell loss among the 3 groups and some risk factors such as preoperative glaucoma, postoperative increased intraocular pressure, graft rejection, peripheral corneal disease, and the donor trephine size. Results The corneal endothelium cell loss was significantly higher in Groups 2 and 3 than in Group 1 after 2 years. There were statistically significant differences of the rate of corneal endothelium cell loss for the eyes with preoperative glaucoma, postoperative glaucoma medication with more than 2 agents, graft rejection, and peripheral corneal disease, but the donor trephine size was not a significant factor for corneal endothelium cell loss. Conclusions For the eyes with bullous keratopathy and herpetic keratitis with uveitis, the survival rate of the endothelium was lower than that for the eyes with keratoconus. We should carefully manage patients who have risk factors such as graft rejection, peripheral corneal disease, and perioperative glaucoma to minimize the loss of corneal endothelium and to reduce graft failure after penetrating keratoplasty.
Comparison of IOP measurement by ocular response analyzer, dynamic contour, Goldmann applanation, and noncontact tonometry
Authors: Oncel Banu , Dinc Umut Asli , Orge Faruk , Yalvaç Belkis Ilgaz 
Published: March 2018

Purpose To assess the agreement among ocular response analyzer (ORA), dynamic contour tonometry (DCT), Goldmann applanation tonometry (GAT), and noncontact tonometry (NCT), and to determine the effects of central corneal thickness (CCT) and corneal hysteresis (CH) on intraocular pressure (IOP) measurements with these devices. Methods Sixty healthy volunteers were recruited. The average of ORA (corneal compensated IOP [IOP-ORAcc] and Goldmann-correlated IOP [IOP-ORAg]), DCT, GAT, and NCT levels were compared and the devices were examined with respect to CCT and CH. One-way analysis of variance and Pearson correlation tests were used for statistical analysis. Results Mean CCT was 543.28±36.2 μm and mean CH was 10.87±1.27 mmHg. Mean IOP obtained using DCT was 16.4±2.9 mmHg, whereas those provided by ORA were 15.8±2.9 mmHg for IOP-ORAcc and 15.1±2.8 mmHg for IOP-ORAg. The mean IOPs obtained using GAT and NCT were 14.8±3.1 mmHg and 14.7±2.8 mmHg. The differences between the measurements of DCT and GAT, NCT, and IOP-ORAg were statistically significant (p=0.002, p=0.002, and p=0.015, respectively), but not between DCT and IOP-ORAcc (p=0.263). We did not detect a significant correlation between DCT and CCT, and IOP-ORAcc and CCT (p=0.081 and p=0.093). No correlation was observed between IOP-ORAg and CCT (p=0.067). We found a significant correlation between GAT and CCT, and NCT and CCT (p=0.004 and p=0.001). CH was detected to be correlated only to IOP-ORAcc (p=0.017). Conclusions IOP readings detected by DCT and IOP-ORAcc were not found to be clinically interchangeable with GAT and NCT readings. IOP-ORAcc and DCT readings may be regarded as comparable and independent of CCT, in the range of the normal IOP.
Study of the effects of ocular hypotensive drugs on number of neurons in the retinal ganglion layer in a rat experimental glaucoma
Authors: Villena Alicia , Díaz Florentina , Vidal Lourdes , Moreno Mercedes , Garcĺa-Campos Jose , De Vargas Ignacio Pérez 
Published: March 2018

Purpose We investigated the effects of antiglaucomatous drugs on neurons in the retinal ganglion layer (RGL) in an experimental model of elevated intraocular pressure (IOP). Methods Three episcleral veins of rats with normal IOP were cauterized. Three months later, we examined the effects on the number of neurons in the RGL as well as in rats submitted to treatment with timolol, latanoprost, or brimonidine. The IOP was measured using a calibrated Tono-Pen XL tonometer before and immediately after cauterization and every 2 weeks for the following 3 months as well as immediately before perfusion. Results The IOP was 14.85±0.65 mmHg in the control group, whereas it was 1.25-fold higher (33.5±1.06 mmHg) in the experimental group. After treatment, the IOP returned to baseline levels. The mean number of neurons per mm2 in the RGL was 33% lower in the experimental group (283±10 cells/mm2) compared with the control group (423±11 cells/mm2). In the groups treated with timolol, latanoprost, or brimonidine, the neuronal loss was less (331±10, 360±15, and 333±3 cells/mm2, respectively), although values did not return to baseline levels. Conclusions This experimental model provokes an immediate, constant, and prolonged increase in IOP and the application of hypotensive agents affords a certain degree of protection to neurons in the RGL.
Comparison of conventional and torsional mode (OZil) phacoemulsification: randomized prospective clinical study
Authors: Bozkurt Ercüment , Bayraktar Sukru , Yazgan Serpil , Cakir Mehmet , Cekiç Osman , Erdogan Havva , Yilmaz Omer F. 
Published: March 2018

Purpose To compare the amount of intraoperative energy used during conventional and torsional phacoemulsification surgery and investigate the changes in corneal endothelial cell density. Methods In this study, a total of 100 eyes in patients with age-related cataract (mean age 68.9 years) were included. Patients were randomly allocated into conventional (group 1) or torsional (OZil, group 2) phacoemulsification. Mean nuclear grade made according to Lens Opacities Classification System II was not different in the 2 groups. Total ultrasound time (USTT), cumulative dissipated energy (CDE), and the percent of total equivalent power in position 3 (%USTEPiP3) were compared between the 2 groups. Results There were 47 eyes in group 1 and 53 eyes in group 2. Patient age and sex were matched between the 2 groups (p=0.49, p=0.08). Mean USTT was 1.6±1.1 minutes (m) in group 1 and 1.5 ± 0.9 m in group 2 (p=0.55). Average CDE was 29.9±16.9 in group 1 and 25.2±19.1 in group 2 (p=0.20). Mean %USTEPiP3 was 27.0%±8.5% in group 1; however, it was 22.4%±6.6% in group 2 (p=0.003). At the first postoperative day, mean corneal edema was graded as 0.25±0.5 in group 1 and 0.18 ± 0.4 in group 2 (p=0.47). At the first postoperative week, it was found to be 0.02±0.15 in group 1 and 0.03±0.27 in group 2 (p=0.71). ECD loss was 6.7%±3.3% in group 1 and 4.2%±5.7% in group 2 (p=0.56). Conclusions No statistically significant difference was found between conventional and torsional phacoemulsification with respect to USTT and CDE. Torsional mode led to a significant reduction in US power in footswitch position 3. Torsional mode also appears to be associated with less loss of ECD
Optical coherence tomography of macular thickness after biaxial vs coaxial microincision clear corneal cataract surgery
Authors: Kurz Sabine , Krummenauer Frank , Thieme Hagen , Dick H. Burkhard 
Published: March 2018

Purpose To evaluate macular thickness changes after biaxial microincision versus coaxial small incision cataract surgery using optical coherence tomography (OCT). Methods This prospective, randomized, marked study comprised 70 patients (70 eyes) undergoing biaxial microincision surgery or conventional coaxial phacoemulsification. Patients were evaluated by Stratus OCT preoperatively and 1 day, 4 weeks, and 8 weeks postoperatively. Best-corrected visual acuity (BCVA), phacoemulsification power, and effective phacoemulsification time (EPT) were evaluated. Results In the biaxial group, median foveal thickness changed from 160 μm preoperatively to 168 μm 8 weeks postoperatively (p=0.018), while median macular volume increased from 2.43 mm3 to 2.57 mm3 (p<0.001). In the coaxial group, median foveal thickness increased from 164 μm preoperatively to 170 μm 8 weeks postoperatively (p=0.082), while median macular volume changed from 2.45 mm3 to 2.55 mm3 (p<0.001). No significant differences in the intraindividual increase of foveal thickness and macular volume were found between groups at 8 weeks. A statistically significant difference between groups was found in median foveal thickness at day 1 postoperatively (p=0.027). No significant differences between groups in median macular volume were found at day 1 or at 4 and 8 weeks postoperatively. Median phacoemulsification power was 7.1% and EPT 2.4 seconds in the biaxial group versus 10.6% and 3.2 seconds in the coaxial group (p<0.001 and p=0.078). Conclusions No clinically relevant differences in foveal thickness or macular volume were observed after biaxial microincision and coaxial small incision clear corneal cataract surgery. The blood–retinal barrier did not seem to be influenced by either procedure.
Conversion from nonischemic to ischemic retinal vein occlusion: prediction by venous velocity on color Doppler imaging
Authors: Arsene Sophie , Vierron Emilie , Le Lez Marie Laure , Herault Beatrice , Gruel Yves , Pisella Pierre-Jean , Giraudeau Bruno , Tranquart François 
Published: March 2018

Purpose To identify color Doppler imaging (CDI) parameters and other prognostic factors of a conversion from nonischemic to ischemic retinal vein occlusion (RVO) in a large population with a long follow-up. Methods This was a retrospective observational study. Data were collected for patients who had been admitted to the ophthalmologic department of the Hospital of Tours because of nonischemic central RVO (CRVO) or branch RVO (BRVO). We analyzed the relation between time until conversion into ischemic RVO and several prognostic factors of conversion, mainly vein velocities as measured by CDI. Results Analyses involved 162 patients. One year after inclusion, conversion into ischemic RVO occurred in 25.0% of the 113 CRVO and in 28.6% of the 49 BRVO cases. For CRVO, an increase of the minimal central retinal venous velocity (CRV), measured by CDI before and after treatment by hemodilution, diminished the risk of conversion into an ischemic form (p=0.048). For BRVO, an elevated maximal CRV on diagnosis was a protector (p=0.004). Age was associated with a high risk of ischemic evolution for CRVO (p=0.023) but not BRVO. Initial visual acuity was not associated with the conversion, for BRVO or CRVO. Increased retinal hemorrhages highly increased the risk of conversion both for CRVO (p<0.0001) and BRVO (p=0.010). Conclusions Risk of ischemic evolution for BRVO and CRVO treated by isovolemic hemodilution was associated with central venous velocities. CDI might be useful for identifying risk of ischemic conversion and individualizing the follow-up of patients.
Is multifocal ERG a reliable index of macular function after triamcinolone acetonide injection in diffuse diabetic macular edema?
Authors: Durukan Ali Hakan , Memisoglu Serdar , Gundogan Fatih Cakir 
Published: March 2018

Purpose To investigate the changes and the reliability of multifocal electroretinogram (mfERG) after intravitreal triamcinolone acetonide (IVTA) injection in diffuse diabetic macular edema (DDME). Methods Twenty-four eyes with DDME were treated with an intravitreal injection of 4 mg of triamcinolone acetonide. Visual acuity (VA), central macular thickness (CMT), mfERG, and intraocular pressures (IOP) were evaluated in the preinjection period and the 15th day, third month, and sixth month after IVTA injection. Results Age and gender of the patients were not significantly correlated to logMAR VA (p=0.888 for age, p=0.192 for gender), CMT (p=0.282 for age, p=0.625 for gender), or P1/N1 amplitudes/implicit times in mfERG at baseline (p>0.05 for age and gender). The correlation between logMAR VA and CMT at baseline also was not significant (r=0.069, p=0.750). The VA increased significantly at the 15th day (p<0.001). The VA increase persisted until the third month and decreased to preinjection values at the sixth month (p=0.324). CMT decrease was significant at the 15th day (p=0.012) but insignificant at the third and sixth months (p=1.000 for both). Correlations between logMAR VA change/CMT change at the 15th day were not significant (r=–0.043, p=0.843). Moreover, the correlation of CMT change with P1/N1 amplitude/implicit time changes was not significant (p>0.05 for all). Conclusions The positive effect of IVTA injection in DDME is reversible until the sixth month. Monitoring of the improvement in visual function by mfERG is violated possibly by irreversible macular dysfunction due to long duration of macular edema and primary neurophysiologic effects of diabetes on the retina.
Intravitreal bevacizumab combined with panretinal photocoagulation in the treatment of open angle neovascular glaucoma
Authors: Ciftci Suleyman , Sakalar Yildirim Bayezit , Unlu Kaan , Keklikci Ugur , Caca Ihsan , Dogan Eyup 
Published: March 2018

Purpose To evaluate the clinical efficacy of intravitreal bevacizumab (IVB) combined with panretinal photocoagulation in patients with open angle neovascular glaucoma (NVG). Methods Nine patients (9 eyes) with NVG participated in this study. Patients received IVB (1.25 mg) as the initial treatment for NVG and were followed up for at least 4 months. IVB was offered as the first treatment of choice to patients with NVG. Panretinal photocoagulation was performed as soon as feasible after the second week and completed in all patients the fourth week after IVB. The main outcome measures are resolution of INV, inhibition of peripheral anterior synechia (PAS), and controllability of intraocular pressure (IOP). Results The mean follow-up period was 5.6±1.4 months (range, 4–9 months). The mean IOP before treatment was 35.1±9.7 mmHg (range, 24–56) under medication before IVB treatment. After IVB and after combined treatment, the mean IOP was reduced to 22.8±8.1 mmHg (range, 9–33) and 13.0±4.0 mmHg (range, 7–20), respectively. The mean referral INV was 3.6±0.4 grade (range, 3–4) and reduced to 1.6±0.4 (range 1–2) grade after IVB and 0.6±0.8 (range 0–2) grade after combined therapy. By IVB, combined panretinal photocoagulation recurrence of INV was not observed. Conclusions In NVG, IVB treatment can reduce iris and angle neovascularization and inhibits further PAS formation temporarily. Panretinal photocoagulation inhibits neovascularization constantly. Therefore, management of open angle NVG is more feasible with bevacizumab combined with panretinal photocoagulation.
Retinal nerve fiber layer thickness in chronic renal failure without diabetes mellitus
Authors: Demir M. Necati , Ekşioğlu Ümit , Altay Mustafa , Tök Özlem , Yilmaz F. Gül , Acar Mehmet A. , Duranay Murat , Duman Sunay 
Published: March 2018

Purpose To evaluate the retinal nerve fiber layer (RNFL) thickness in patients with chronic renal failure (CRF) without diabetes mellitus by using optical coherence tomography (OCT). Methods Sixty-six eyes of 33 patients with CRF were evaluated. Eighteen patients have been treated with hemodialysis (group 1) and 15 patients have been treated with peritoneal dialysis (group 2). The RNFL thicknesses were assessed before and after the hemodialysis in group 1. None of these patients had diabetes mellitus. Forty eyes of 20 age-matched normal control subjects were assessed in group 3. An RNFL thickness protocol was used to acquire circular scans of 3.4 mm in diameter around the optic nerve. For each eye, RNFL thicknesses were evaluated in 4 quadrants. All of the measurements were automatically calculated by the existing OCT software. All normal subjects and CRF patients underwent comprehensive ophthalmologic examination. The mean and quadrantal RNFL thickness values in patients with CRF were compared with the control group. Results The mean RNFL thickness values in patients with CRF were statistically significantly lower than the control group. Differences between the RNFL thickness values in group 1 and group 2 and the predialysis and postdialysis measurements were not statistically significant. Conclusions The RNFL thickness in CRF without DM, which was measured by OCT-3, was found to be significantly decreased. The presence of CRF can be a source of false positive results and lead to overestimation of glaucomatous optic neuropathy.
Pars plana vitrectomy for vitreoretinal complications of ocular toxoplasmosis
Authors: Adán Alfredo , Giralt Joan , Alvarez Guifré , Alforja Socorro , Burés-Jesltrup Anniken , Casaroli-Marano Ricardo P. , Corcóstegui Borja 
Published: March 2018

Purpose Ocular toxoplasmosis is associated with vitreoretinal complications that can potentially cause severe visual loss. The aim of this study is to report the preoperative, intraoperative, and postoperative outcomes of vitreous surgery in eyes with vitreoretinal complications secondary to ocular toxoplasmosis. Methods This retrospective study included 15 eyes of 15 patients (8 men, 7 women; mean age at surgery, 37.2 years, range 18–57 years) who had undergone vitreoretinal surgery for vitreoretinal complications secondary to ocular toxoplasmosis. Visual acuity was compared between the last preoperative visit and the most recent follow-up visit. Intraoperative and postoperative complications were also analyzed. Results Indications for surgery were retinal detachment in 8 eyes (53.3%), epiretinal membrane in 2 eyes (13.3%), persistent vitreous opacities in 2 eyes (13.3%), choroidal neovascularization in 1 eye (6.6%), vitreous hemorrhage secondary to vasoproliferative retinal tumor in 1 eye (6.6%), and hemorrhagic vasculitis with premacular hemorrhage in 1 eye (6.6%). At last examination, visual acuity improved in 11 eyes (73.3%) by 2 lines or more. Postoperative events that might be related to the surgery included 1 localized retinal detachment, 2 cataracts, and 1 glaucoma. Conclusions Pars plana vitrectomy for treatment of vitreoretinal complications secondary to ocular toxoplasmosis can be safely performed and may result in improved visual acuity.
Endophthalmitis after vitrectomy and vitrectomy combined with phacoemulsification: incidence and visual outcomes
Authors: Wani Vivek B. , Sabti Khalid Al , Kumar Niranjan , Mathew Sebastian , Kandari Jamal Al , Raizada Seemant 
Published: March 2018

Purpose To study the incidence of endophthalmitis after vitrectomy and after combined vitrectomy and phacoemulsification surgery and to report the results of treatment in such cases. Methods This is a retrospective, noncomparative, interventional study based at a tertiary ophthalmology center in Kuwait. Cases of vitrectomy only and combined vitrectomy with phacoemulsification surgery performed during the period from January 1, 1997, to December 31, 2007, were included. Patients undergoing vitrectomy for traumatic etiologies and endophthalmitis were excluded. Patients who developed endophthalmitis after vitrectomy were identified and their records were analyzed. Results Six patients developed endophthalmitis among 2965 cases of all vitrectomy procedures, resulting in an incidence of 0.20%. The incidence of endophthalmitis was 0.12% for cases undergoing vitrectomy (3 out of 2564 cases) and 0.75% for cases undergoing combined vitrectomy and phacoemulsification surgery (3 out of 401 cases), respectively. Three cases were culture positive. Four cases ended up with final visual acuity of perception of hand movements or worse. Conclusions Incidence of endophthalmitis in our series was higher than in other studies. The visual results were poor in 4 out of 6 cases. Earlier diagnosis and more aggressive approach may be needed to improve the results of treatment in these cases.