bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distribution of Axial, Corneal, and Combined Ametropia in a Refractive Surgery Unit
Authors: Barcsay Gy. , Nagy Z.Zs. , NÉmeth J. 
Published: January 2018

Purpose To group eyes in our refractive surgery unit on the basis of the origin of their ametropia and to assess the percentage of eyes in the different groups. Methods Refractive parameters and the axial eye length (AL) of 131 eyes of 131 persons with different refraction were measured. The eyes were initially classified into five groups on the basis of the grade of their ametropia: hypermetropic (>+0.5 D, n=35), emmetropic (between ±0.5 D, n=24), low myopic (between –0.75 and –4.0 D, n=24), medium myopic (between –4.25 and –8.0 D, n=24), and high myopic (over-8.0 D, n=24). Then a classification scheme was made to group the origin of the ametropia on the basis of AL and corneal refractive power. Results In the hypermetropic group pure corneal origin was found in 8.6%, pure axial origin in 62.8%, and combined origin in 28.6% of the eyes. In the low myopic group these values were 20.9%, 29.2%, and 45.8%, respectively In the medium and high myopic groups no pure corneal myopia was found, while axial myopia was found in 16.7% and combined myopia in 83.3% of the eyes. Conclusions With the help of the classification scheme, an objective decision could be made as to whether the ametropia of a particular eye had axial, corneal, or mixed origin. The most interesting result was that in 83% of medium and high myopic eyes not only AL but also corneal refractive power contributed to the refractive error instead of the eyes being purely axially myopic.
Improvement of Human Corneal Endothelium in Culture after Prolonged Hypothermic Storage
Authors: Camposampiero D. , Tiso R. , Zanetti E. , Ruzza A. , Bruni A. , Ponzin D. 
Published: January 2018

Purpose To evaluate whether the organ culture method for human cornea preservation may be applied to corneas stored for several days at 4°C. Methods The cell density, viability, and morphology of corneal endothelium were examined in 140 human corneas stored at 4°C for the minimal time required for transport to the bank and for the preliminary controls of cornea status (1.6±1.1 days) and in 46 corneas preserved at 4°C for 6.1±1.9 days in Optisol-GS. The evaluation was repeated after 19.7±9.1 days of incubation at 31°C in a culture medium containing 2% newborn calf serum. Results After the hypothermic storage the corneal endothelium had a mean density of 2475±159 cells/mm2 without significant difference between the short and the long term incubation. Several corneas of the two groups showed signs of endothelium degeneration and were positive to trypan blue test. After the incubation at 31 °C, the corneas with endothelial degeneration decreased by 52.2% and those positive to trypan blue decreased by 21.7%. Polymorphism (enlarged endothelial cells) increased from 9.6% to 14.5% of the coneas. The remodeling of the endothelium led to a 6.7% decrease in cell density. These results were similar after short-term and long-term storage at 4°C. Conclusions Organ culture was effective in improving corneal endothelium when the hypothermic storage was prolonged to the upper temporal limit for this procedure (7–10 days). These results may encourage the possibility of an eye bank to allocate the available conea pool, thus decreasing the risk of discarding precious material.
The Effect of Anterior Chamber Maintainer on Anterior Chamber Contamination
Authors: Baykara M. , Özakin C. , doğru M. , Ertürk H. , Heper Y. , Özçetin H. 
Published: January 2018

Purpose To evaluate the effect of anterior chamber continuous infusion maintainer system on the contamination of anterior chamber in phacoemulsification surgery. Methods Clear corneal phacoemulsification surgery was performed in 132 eyes of 132 randomly selected patients with cataract who were divided into two groups of 66 eyes according to the use of an anterior chamber maintainer (ACM) system. The fluid specimens were taken from anterior chamber in the beginning and at the end of the surgery. They were transferred under anaerobic conditions and investigated by culturing onto blood agar and thiogluconate broth media. Differences between the two groups with respect to contamination of the specimens were investigated. Results The mean age of the group undergoing surgery without a maintainer system (Group A) was 63±10 years (min = 41, max = 80) versus 59±10 years (min = 33, max = 80) in the other group (Group B) in which the maintainer was used during surgery. In the postoperative specimen, Micrococcus species were isolated from one eye (1.5%) in Group A and S. pyogenes in one eye (1.5%) from Group B. Mean follow-up interval was 12±6 (min = 4, max = 28) months. Conclusions The use of ACM system in clear corneal phacoemulsification surgery carries no additional risks as far as contamination is concerned.
Glare Disability in Patients with Hydrophilic and Hydrophobic Acrylic Intraocular Lens Implants
Authors: Akman A , Bozbeyoglu S. , Akova Y.A. 
Published: January 2018

Purpose To compare glare disability test results in patients with hydrophilic and hydrophobic acrylic intraocular lenses (IOL). METHODS Sixty eyes of 60 patients were studied in three groups of 20. Each eye in Group 1 had a single-piece hydrophilic acrylic (Bioacryl, Biotech, France) IOL implant, and each eye in Group 2 had a three-piece hydrophobic acrylic (AcrySof, Alcon, USA) IOL implant. Group 3 was the control group, and consisted of eyes without cataracts. Glare disability was tested using the Ophthimus glare sensitivity test (Ophthimus, Sweden). For each eye, we determined log contrast sensitivity values without exposure to glare source and with exposure to glare source. The difference between these values was recorded as the threshold contrast increase. An infrared camera was used to measure pupil diameter during glare disability testing, and pupil diameter greater than 4 mm was used as an exclusion criterion to eliminate edge design as a potential contributor to glare disability. Results The respective mean log contrast sensitivity scores for Groups 1, 2, and 3 in the absence of the glare source were 0.80±0.03, 0.81±0.04, and 0.79±0.08. The corresponding findings with glare source were 0.84±0.07, 0.89±0.07, and 0.84±0.03. The threshold contrast increase in Group 2 (0.070±0.035) was significantly higher than that in both Group 1 (0.043±0.040) and the control group (0.045±0.026) (p<0.05 for both comparisons). There were no significant differences between Group 1 and the control group regarding log contrast sensitivity values with glare source and threshold contrast increase (p>0.05 for both comparisons). CONCLUSIONS The eyes with hydrophilic acrylic IOL showed better glare disability results than those with hydrophobic acrylic IOL. The superior performance of the hydrophilic acrylic IOL could be related to their lower refractive index and equi-convex design.
Nonpenetrating Deep Sclerectomy: A 6-Year Retrospective Study
Authors: Lachkar Y. , Neverauskiene J. , Jeanteur-lunel M.-N. , Gracies H. , Berkani M. , Ecoffet M. , Ko pel J. , Kretz G. , Lavat P. , Lehrer M. , Valtot F. , Demailly P. 
Published: January 2018

Purpose Nonpenetrating trabeculectomy, also called nonpenetrating deep sclerectomy (NPDS), is a filtering surgery where the internal wall of Schlemm's canal is excised, allowing sub-conjunctival filtration without actually entering the anterior chamber. This technique was developed to minimize the complications of trabeculectomy. The authors investigated its safety and efficacy in a retrospective noncomparative study. METHODS A total of 258 eyes (179 patients, mean age 61.4±11.56 years) with uncontrolled open angle glaucoma with prior medical therapy were treated. NPDS with a biocompatible collagen device (157 eyes) sutured to deep scleral bed or with the use of a 5-fluorouracil sponge (90 eyes) were analyzed. The main outcome measure was postoperative intraocular pressure (IOP) with an average follow-up of 54.4±17.07 months (range 1–85). Efficacy was determined 1 month, 3 months, and every 6 months after the procedure for 6 years. Results Mean preoperative IOP was 24.47±5.92 mmHg. Mean postoperative IOP was 14.44±5.31 mmHg (average lowering of the IOP was 38.94±23.81%) at 1 month, 15.16±4.57 mmHg (35.73±21.35%) at 3 months, 15.87±4.24 mmHg (32.45 ±20.52%) at 6 months, 16.32±4.53 mmHg (29.96±23.69%) at 12 months, 17.12±4.45 mmHg (26.51±23.93%) at 18 months, 16.77±4.44 mmHg (28.18±21.73%) at 24 months, 16.43±4.15 mmHg (28.89±23.69%) at 30 months, 16.34±4.12 mmHg (30.05±21.61%) at 36 months, 16.16±4.01 mmHg (30.06±22.55%) at 42 months, 15.71±3.74 mmHg (32.49±19.08%) at 48 months, 15.61±3.48 mmHg (31.26±21.01%) after 5 years, and 15.81 ±3.79 mmHg (33.73±20.9%) after 6 years. YAG goniopuncture was performed in 47.3% of cases with a mean follow-up of 12±13 months. These goniopunctures were effective in lowering IOP after a long-term follow-up (24 months). Additional 5-fluorouracil injections were used in 7% of cases. Visual field (Octopus or Humphrey mean defect and corrected loss variance or loss variance) was not modified (p<0.01). Number of preoperative glaucoma medications was 2.01±0.58 and number of postoperative glaucoma medications was 0.85±0.92. Complications were peroperative microperforations in 27 eyes (10.5%), shallow anterior chamber in 2 eyes, hyphema in 2 eyes (0.8%), cataract in 5 eyes (2%), and dellen in 1 eye (0.4%). No cases of endophthalmitis or choroidal detachment were found. After surgery, 23 eyes (8.9%) required a new filtering surgical procedure, and diode laser cyclophotocoagulation was necessary in 2 eyes (0.8%). The probability success rate, defined as an IOP lower than 21 mmHg, was 66.46% (Kaplan Meier) at 60 months off all glaucoma medications and 80.32% with medical or new surgical treatment. CONCLUSIONS NPDS appears to be an effective and safe filtering procedure for lowering IOP and could be an alternative to trabeculectomy in open angle glaucoma with the advantage of having fewer complications.
Air-Guided Manual Deep Lamellar Keratoplasty
Authors: Caporossi A , Simi C. , Licignano R. , Traversi C. , Balestrazzi A. 
Published: January 2018

Purpose To evaluate the efficacy of a new modified technique of deep lamellar keratoplasty (DLK). METHODS Nine eyes of eight patients with keratoconus of moderate degree were included. All patients underwent DLK with manual dissection from a limbal side port after an air bubble injection in the anterior chamber. The patients underwent a complete ophthalmologic examinations months after the suture removal, evaluating best-corrected visual acuity, corneal thickness, endothelial cell count, and topographic astigmatism. Results One case (11.1%) was converted to penetrating keratoplasty because of micro-perforation. In the eight successful cases, 7 eyes (77.8%) achieved 20/30 or better visual acuity 6 months after suture removal. Mean postoperative pachymetry was 604.76μm (SD 46.76). Specular microscopy 6 months after suture removal revealed average endothelial cell count of 2273/mm2 (SD 229). CONCLUSIONS This modified DLK technique is a safe and effective procedure and could facilitate, after a short learning curve, this kind of surgery with a low risk of conversion to penetrating keratoplasty.
Involution of Retinochoroidal Shunt Vessel after Radiotherapy for Optic Nerve Sheath Meningioma
Authors: Mashayekhi A. , Shields J.A. , Shields C.L. 
Published: January 2018

Purpose To illustrate the development and involution of retinochoroidal shunt vessel of the optic disc in a patient with primary optic nerve sheath meningioma. CASE REPORT A 38-year-old woman presented with gradual onset of blurred vision in her right eye. Examination revealed a right relative afferent pupillary defect and mild edema of the right optic disc. Computed tomography (CT) showed changes consistent with a primary optic nerve sheath meningioma affecting the orbital portion of the right optic nerve. Patient was observed without treatment and subsequently developed a retinochoroidal shunt vessel on her right optic disc. With progression of the meningioma towards the optic chiasm, treatment with stereotactic radiosurgery was done. Following treatment, the optic disc gradually became pale and the retinochoroidal shunt vessel decreased in caliber with complete involution three years after radiotherapy.
Indocyanine Green Dye-Enhanced Micropulsed Diode Laser: A Novel Approach to Subthreshold RPE Treatment in a Case of Central Serous Chorioretinopathy
Authors: Ricci F. , Missiroli F. , Cerulli L. 
Published: January 2018

Purpose To present a case of central serous chorioretinopathy (CSC) treated with indocyanine green (ICG) dye-enhanced subthreshold micropulsed diode laser photocoagulation. METHODS CASE REPORT A 35-year-old man presenting with recurrent CSC with persistent serous detachment of the sensory retina in his left eye who declined treatment with a 532 nm laser. Subthreshold treatment, with no visible endpoint, was performed with an 810 nm diode laser 15 minutes after the injection of 25 mg ICG in 2 cc of 5% glucose solution. The laser energy was delivered over the active leakage sites with a sequence of repeated 500 ms “envelopes” each containing a train of 250 micropulses with 500 mW peak power at 10% duty cycle (200 μs ON and 1,800 μs OFF) and each separated by 500 ms intra-envelopes relaxation time. Due to the absence of visible laser-induced lesions, post treatment ICG digital angiographic images were taken without further dye injection to verify that the hypofluorescent spots resulting from the subthreshold laser applications coincided with the points of leakage. Results After 7 days, the patient presented with a less hyperopic refraction, improved visual acuity, and reduction of serous neuroepithelial detachment. No signs of laser treatment were visible at fluorescein angiography. After 8 weeks, the serous neuroepithelial detachment was almost completely resolved. CONCLUSIONS ICG dye-enhanced subthreshold micropulsed diode laser photocoagulation appears to be a safe and effective treatment and tepresents a possible approach for the management of chronic CSC with persistent central serous neuroepithelial detachment. Immediate post treatment ICG angiography, without ICG reinjection, allows documenting the actual number and location of the delivered subthreshold laser applications.
Scleral Fixation of a Posterior Chamber Intraocular Lens in a Patient with Two Dislocated Lens Implants
Authors: Cavallini G.M. , Pagliani L. , Campi L. , Lugli N. , Saccarola P. , Volante V. 
Published: January 2018

Purpose To report the clinical findings and management of a case of two consecutive intraocular lenses (IOLs) dislocated into the vitreous cavity after complicated cataract surgery. METHODS. Review of clinical findings and treatment. Results A 69-year-old man sought treatment for posterior chamber IOL dislocation. The patient reported a significant loss of visual acuity in the right eye for 4 months (best-corrected visual acuity (BCVA) 20/200 in the affected eye). In the vitreous cavity two dislocated IOLs were found, complicated by a cystoid macula edema. Surgery was planned and the two IOLs were removed from the vitreous cavity. Aphakia was then corrected by means of a scleral fixated posterior chamber lens. Three months after surgery, BCVA was 20/40. CONCLUSIONS In the absence of randomized controlled clinical trials evaluating treatment options, preoperative patient work-up should be as accurate as possible in order to reduce the risk of intraoperative and postoperative complications. In this patient, removing the two IOLs and placing a sutured-fixated posterior chamber IOL allowed resolution of the cystoid macular edema.
The Prevalence of Blindness and Low Vision in Older Onset Diabetes Mellitus and Associated Factors: A Community-Based Study
Authors: Idil A. , Caliskan D. , Ocaktan E. 
Published: January 2018

Purpose This community-based study was conducted to assess the prevalence and related factors of low vision and legal blindness in older onset diabetic patients (diagnosed at age 30 and older). Methods All known diabetic patients who live in the four primary health care center region Abidinpaşa Ankara, Turkey (total population: 96,348) were included in this cross-sectional study. The prevalence of known diabetes mellitus is 2.2%, of which 96.6% are older onset and 3.4% are younger onset. Results In the older onset diabetes group (1289 cases), 10.8% of the population had low vision and only 2.7% had legal blindness. Diabetic retinopathy (DR) was observed in 23.6% of the patients with low vision (42% proliferative DR) and in 62.9% of the patients with legal blindness (90.1% proliferative DR). Conclusions In older onset diabetic patients with low vision, nonproliferative retinopathy was a more frequent cause of impaired vision than proliferative retinopathy. Low vision and legal blindness caused by retinopathy were significantly associated with sex, age at examination, age at diagnosis, duration of diabetes, type of diabetes treatment, and hypertension in univariate analysis. However, in logistic regression analysis, low vision and legal blindness caused by retinopathy were found to be associated with longer duration of diabetes (≥15 years), use of insulin, and hypertension.
Progesterone Administration Fails to Protect Albino Male Rats against Photostress-Induced Retinal Degeneration
Authors: Káldi I. , Berta A. 
Published: January 2018

Purpose Female patients show better recover y after brain injury and lower incidence of vascular diseases before menopause. The aim of this study was to test the protective effect of female sexual hormones against photostress-induced photoreceptor apoptosis. Methods Five week old male albino Sprague-Dawley rats were injected intraperitoneally with progesterone (60 mg/kg body weight) for 4 days. The control group was injected with the vehicle only (benzyl alcohol). Both groups were halved and one was stressed with light (2700 lux for 24 hours) and the other remained under the original dim cyclic light condition. For functional evaluation, baseline electroretinograms (ERGs) were recorded 7 days before light stress, with follow-up ERGs 5 days after the cessation of light exposure. Animals were sacrificed and their eyes enucleated for histology. Results Light exposure caused pronounced decrease in the ERG a- and b-wave amplitudes compared to controls. However, in the light-stressed group, the difference in retinal function between progesterone-treated and nontreated animals was not statistically significant. The thickness of the outer nuclear layer and the length of rod outer and inner segments were significantly reduced in the light-stressed group, indicating loss of rod photoreceptor cells. Progesterone had no neuroprotective effect on rod cell structure. Conclusions The administration of progesterone did not prove to be protective against excessive light-caused retinal degeneration on male albino rats. The role of other sexual steroids and their interaction need to be clarified.
Choroidal Detachment following Retinal Detachment Surgery: An Analysis and a New Hypothesis to Minimize Its Occurrence in High-Risk Cases
Authors: Verma L. , Venkatesh P. , Chawla R. , Tewari H.K. 
Published: January 2018

Purpose To determine factors predisposing to the development of choroidal detachment following conventional retinal detachment surgery, to evaluate its clinical course, and to identify possible measures to reduce its occurrence. Methods Analysis of 25 consecutive cases of choroidal detachment following retinal detachment surgery out of a total of 510 cases undertaken at a tertiary care referral eye center over a period of 15 months. Results The incidence of developing choroidal detachment was 4.9%. The mean age was 61 years (range 28 to 76 years) and there was no sex predilection. Hypertension was present in 16% (n=4). A total of 44% (n=11) of patients had myopia and with respect to the lens status, 44% (n=11) were phakic, 36% (n=9) were pseudophakic, and 20% (n=5) were aphakic. Redetachment of the retina was observed in 12% (n=3) of cases. Elevated intraocular pressure developed in 12% (n=3). In one patient with an anterior chamber intraocular lens and “kissing” choroidal detachment, drainage of the choroidals was undertaken to prevent corneo-lenticular touch and corneal decompensation. In two patients with redetachment, anatomic settlement of the retina was achieved only following vitreoretinal surgery. Conclusions The following preoperative and intraoperative factors are associated with a significantly increased risk of choroidal detachment following retinal detachment: higher age, myopia, posteriorly placed explants even if its extent is less, anteriorly placed explants whenever its extent is large, drainage of subretinal fluid, and intraoperative hypotony. Choroidal detachment may also occur in patients with only a radial sponge. Designing a notch intraoperatively in the region of the explants overlying the vortex veins may help to reduce the risk of choroidal detachment following conventional retinal detachment surgery.
Intraocular Pressure Lowering Efficacy of Travoprost
Authors: Przydryga J.T. , Egloff C. ,   Swiss Start Study Group
Published: January 2018

Purpose To assess the intraocular pressure lowering effect of travoprost 0.004% in patients previously treated with another topical medication, and in previously untreated patients. Methods This 12-week, open-label trial in 1590 patients was conducted at 219 sites in Switzerland. Primary open-angle glaucoma and ocular hypertension patients discontinued prior medications, and instilled 1 drop of travoprost in each affected eye at 8 pm. Untreated patients were subdivided into 2 groups: baseline IOP of ≥ 21 mmHg, and baseline IOP of ≤ 20 mmHg. Patients returned for follow-up visits at 1 and 3 months. The primary outcome was mean IOP change from baseline to follow-up. Results Of 626 patients previously on monotherapy, and 525 previously untreated or newly-diagnosed patients, 479 and 423, respectively, completed 3 months of therapy. The mean changes from baseline at 1 month (mmHg ± SD), by prior treatment group were: beta blocker, −4.9 (±3.6); latanoprost, −2.3 (± 2.8); alpha-agonist, −4.0 (± 3.7); dorzolamide/timolol fixed combination, −3.4 (± 3.9); topical CAI, −4.4 (± 3.1); new IOP ≥ 21 mmHg, −8.6 (± 4.4); new IOP ≤ 20 mmHg, −4.4 (± 3.0). (All changes from baseline were statistically significant (p < 0.0001). Conclusions In patients previously treated with a single drug, travoprost decreased IOP to pressures below those achieved on prior therapy. In all groups, travoprost reduced mean IOP below 18 mmHg within 1 month of starting therapy, and control was maintained for at least 3 months. Overall, travoprost was safe and well-tolerated.