bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Anatomy of the Deep Lateral Orbital Wall
Authors: Beden U. , Edizer M. , Elmali M. , Icten N. , Gungor I. , Sullu Y. , Erkan D. 
Published: January 2018

Purpose. To determine the exact anatomic location and volume of the thickest section of the greater wing of the sphenoid bone (trigone), which is removed during deep lateral orbital wall decompression. Methods. Eighteen dried skulls were used to determine the exact anatomic location and computed tomography (CT) images of 20 patients (10 male, 10 female) were used for volumetric calculations. Results. Mean values were 14.5 mm for the orbital rim to inferior orbital fissure distance, 23.3 mm for rim to trigone distance, 13.0 mm for width of the trigone base, 5.8 mm for trigone to orbital apex distance, and 12.3 mm for trigone height. The width of the narrowest section of the trigone was 5.2 mm. The trigone was found to have a lower segment (0.92 cc) neighboring the inferior orbital fissure, and an upper segment (0.32 cc) adjoining the thick substance of frontal bone. The narrowest part between these two segments was located just at the superior border of the lateral rectus muscle. Conclusions. The authors recommend avoiding the thin rectangular portion located in the interfissural area adjacent to the superior orbital fissure. A high intersubject variability underscores the need for individualized preoperative analysis by imaging studies
Optimal Dosage of Cyclopentolate 1% for Complete Cycloplegia: A Randomized Clinical Trial
Authors: Bagheri A. , Givrad S. , Yazdani S. , Mohebbi M. Reza 
Published: January 2018

Purpose. To determine the optimal dosage of cyclopentolate for adequate cycloplegia with minimal side effects. Methods. A prospective randomized clinical trial of patients 3.5 to 20 years of age referred to a strabismus clinic during a 1-year period. Eligible patients were randomly divided into three groups. In Group 1, the cycloplegic effect of one drop of cyclopentolate was compared with two drops; in Group 2, the effect of two drops was compared with three drops; and in Group 3, the effect of one drop was compared with three drops. Results. This study includes 192 eyes of 96 patients with a mean age of 11.0±5.7 years. Strabismus was present in 43 patients (44.8%). A total of 146 patients (76%) were hyperopic, 33 (17.2%) were myopic, and 13 (6.8%) were slightly hyperopic or myopic at the two stages of the study. Overall, only 16 eyes, including 9 eyes in Group 1 (16.4%), 2 eyes in Group 2 (3.2%), and 5 eyes in Group 3 (8.6%), had ≥0.5 D difference in spherical equivalent refractive error at two stages of the study; however, intergroup differences were not statistically significant (p=0.16, chi-square test). Within each group, the percentage of eyes with <0.5 D difference was significantly greater than those with ≥0.5 D difference (p<0.001 in all three groups, binomial test). Side effects were more prevalent using more frequent drops. Conclusions. A single drop of cyclopentolate 1% suffices for cycloplegic refraction. There were less frequent side effects using one drop of cyclopentolate, compared to two or three drops.
Factors Affecting Changes in Astigmatism before and after Suture Removal following Penetrating Keratoplasty
Authors: Yilmaz S. , Ozdil M. Ali , Maden A. 
Published: January 2018

Purpose. To analyze the factors related to changes in astigmatism before and after suture removal in patients who underwent penetrating keratoplasty (PK). Methods. The study group consisted of 171 consecutive PKs in 171 patients. Keratometric astigmatism was measured before and after suture removal in all patients. The vectorial difference for each eye was calculated between the examination before suture removal and the first year after suture removal. The vectorial difference values were compared with the possible factors affecting astigmatic change such as age of the patient, donor-recipient trephine diameter difference, preoperative diagnosis, and time of suture removal. All sutures were removed completely in one session. The vectorial difference values of all groups were compared with each other statistically. Results. Before suture removal, the mean cylinder was 4.40±3.24 D; it was 3.96±2.19 D at 1 year after suture removal. The net difference of astigmatism was −0.27±3.50. The mean value of vectorial difference for all patients was 4.93±4.02 D. There was a statistically significant negative correlation between the trephine diameter difference and the vectorial difference (r=-0.582, p<0.01). There was a significant change in vectorial difference values in patients with high pre-suture removal astigmatism. Patients with keratoconus had a positive correlation between the pre-suture removal astigmatism and the vectorial difference (r=0.615, p=0.038). Conclusions. After suture removal following PK, unexpected high levels of astigmatic change could be encountered due to donor-recipient trephine diameter difference and underlying primary diagnosis such as keratoconus. In particular, high level astigmatism before suture removal has a greater risk of increased astigmatic change after suture removal.
Comparison of Divide and Conquer and Phaco-Chop Techniques during Fluid-Based Phacoemulsification
Authors: Tsorbatzoglou A. , Módis L. , Kertész K. , Németh G. , Berta A. 
Published: January 2018

Purpose. To determine whether, similar to ultrasound phacoemulsification, applied energy and surgery time decrease using phaco-chop nucleus fragmentation method compared to divide and conquer technique using the fluid-based system. Methods. This prospective, comparative, randomized clinical study included patients with cataract who were randomly assigned to use either standard divide and conquer technique (25 eyes of 25 patients, Group 1) or Nagahara phaco-chop maneuver (25 eyes of 25 patients, Group 2) during fluid-based phacoemulsification. Surgical parameters were recorded and patients were examined 1 day, 10 days, and 1 month after surgery. Statistical analyses were performed using the paired test of Wilcoxon. Results. Fluid-based time, mean fluid-based magnitude, effective fluid-based time, and the number of pulses were significantly less using phaco-chop technique compared to divide and conquer method (p<0.001). Surgery time was similar using the two nucleofractis techniques (p=0.97). Visual acuities showed no statistical differences between the two groups (p>0.05). Conclusions. Nuclear fragmentation can be performed with Nagahara phaco-chop technique using the fluid-based system as well. The applied fluid-based energy decreases compared to divide and conquer method. However, surgery time is not reduced due to the difficulties reaching the full occlusion necessary to hold the nucleus during the chop maneuver
A Comparison of Higher Order Aberrations in Eyes Implanted with AcrySof IQ SN60WF and AcrySof SN60AT Intraocular Lenses
Authors: Awwad S.T. , Lehmann J.D. , Mcculley J.P. , Bowman R.W. 
Published: January 2018

Purpose. To evaluate the efficacy of AcrySof SN60WF aspheric intraocular lens (IOL) in decreasing spherical aberration and total higher order aberrations (HOAs) after cataract surgery compared to the spherical SN60AT lens. Methods. Wavefront analysis was conducted on 28 eyes of 28 patients that underwent uncomplicated phacoemulsification with implantation of either SN60WF (15 eyes) or SN60AT lenses (13 eyes). Eyes with a history of uveitis, retinal diseases, and previous surgery were excluded. Results. SN60WF eyes had less mean absolute spherical aberration than SN60AT eyes both at 4 mm (0.04±0.03 vs 0.11±0.03 RMS, p<0.0001) and 6 mm pupils (0.09±0.04 vs 0.43±0.12 RMS, p<0.0001). Mean total HOAs was lower in the SN60WF group at 6 mm pupils (0.44±0.14 vs 0.56±0.13 RMS, p=0.0274), while no difference was seen at 4 mm pupils (0.20±0.10 vs 0.25±0.08 RMS, p=0.160). There were no clinically significant differences between the SN60WF and SN60AT IOLs both at 4 and 6 mm pupils in terms of coma (0.16±0.07 vs 0.18±0.09 RMS, p=0.514 and 0.25±0.12 vs 0.23±0.12 RMS, p=0.664) and trefoil (0.14±0.09 vs 0.10±0.05 RMS, p=0.167 and 0.28±0.12 vs 0.23±0.07 RMS, p=0.199). There were no differences between groups in mean age, axial length, postoperative spherical equivalent, IOL power, or corneal curvature. Conclusions. An aspheric posterior optic IOL design with thinner center effectively reduces the positive ocular spherical aberration observed in the pseudophakic and elderly eyes, especially at larger pupillary diameters (6 mm), with no notable increase in coma. However, reduction in total ocular HOAs was only significant at 6 mm pupils.
Comparison of Anterior Chamber Depth Measurements using Orbscan II and IOLMaster
Authors: Frisch I.B. , Rabsilber T. M. , Becker K.A. , Reuland A.J. , Auffarth G.U. 
Published: January 2018

Purpose. To To evaluate and compare anterior chamber depth (ACD) measurements using Orbscan II (Bausch & Lomb, Rochester, NY) and IOLMaster (Carl Zeiss Meditec AG, Jena, Germany). Methods. In this prospective clinical study, the authors measured ACD of 145 phakic eyes of 30 healthy volunteers and 115 patients using Orbscan II and IOLMaster. Average patient age was 52.9±19.4 (range 16 to 87) years. ACD was evaluated from corneal epithelium to anterior lens surface. Additionally, axial length (AL) was measured using the Zeiss IOLMaster to calculate the regression coefficient between AL and ACD. Results. Mean ACD was 3.35±0.43 mm (range 2.01 mm to 4.37 mm) using Orbscan II and 3.36±0.41 mm (range 2.09 mm to 4.24 mm) using IOLMaster. Mean total axial length was 24.04 mm ± 2.1 mm (range 20.7 mm to 31.41 mm). The linear regression coefficient of ACD between both methods was R=0.95. ACD and AL correlated only slightly (R=0.57). The Spearman coefficients of rank correlation were 0.94 and 0.61, respectively. A p value less than 0.01 (paired Wilcoxon test) was considered statistically significant. However, a significant difference was not calculated comparing ACD measurements using both systems and the Bland-Altman-Plot showed 95% of the differences ranging between 0.25 and −0.27 mm. Conclusions. Regarding clinical application, both systems seem to be equally good and interchangeable in clinical practice in terms of ACD evaluation.
Impact of Intraocular Pressure after Filtration Surgery on Visual Field Progression in Primary Open-Angle Glaucoma
Authors: Lazaro C. , Garcia-Feijoo J. , Castillo A. , Perea J. , Martinez-Casa J.M. , Garcia-Sanchez J. 
Published: January 2018

Purpose. To compare visual field progression after trabeculectomy in eyes showing a postoperative intraocular pressure (IOP) less than or equal to 16 mmHg and eyes with an IOP of 17 to 21 mmHg. Methods. A retrospective cohort study design was used. A total of 101 eyes of 101 consecutive patients undergoing trabeculectomy for primary open-angle glaucoma (POAG) with a postoperative IOP less than or equal to 21 mmHg were divided into two groups: Group 1 included eyes showing a postoperative IOP less than or equal to 16 mmHg at all visits and Group 2 included eyes with a postoperative IOP between 17 and 21mmHg. In turn, each of these groups was divided into two subgroups according to whether treatment was required for IOP control. Glaucomatous visual field control during follow-up was compared between the subject groups. Results. Kaplan-Meier analysis revealed glaucomatous visual field control in 98.53% of the eyes in Group 1 and 89.06% of those in Group 2 at 5 years, the difference between the groups being significant. Conclusions. Glaucomatous disease progression is less frequent when IOP is less than or equal to 16 mmHg in all the follow-up visits after trabeculectomy. The results indicate a definite benefit of low IOP in visual field control.
Penetration of Betaxolol HCL Ionic Suspension 0.25% and Betaxolol HCL Solution 0.50% into the Aqueous Humor
Authors: Yalvac I. Sagdic , Basci N.E. , Dulger B. , Duman S. 
Published: January 2018

Purpose. To determine the intraocular penetration of topical drops of betaxolol HCl 0.25% suspension and betaxolol HCl 0.50% solution into the aqueous humor. Methods. Fifteen patients were randomly assigned to receive topical betaxolol HCl 0.25% suspension (n=7) or topical betaxolol HCl 0.50% solution (n=8) the day before cataract surgery. Aqueous samples were collected 2 hours after the administration of the morning dose during cataract surgery. Drug concentrations were determined by high-performance liquid chromatography with fluorescence detection. Results. The mean aqueous humor concentration of topical betaxolol HCl 0.25% suspension was 275.1±168.8 μg/mL (range 570–70 μg/mL) and the mean aqueous humor concentration of topical betaxolol HCl 0.50% solution was 195.4±102.4 μg/mL (range 334–50 μg/mL) (p=0.281). Conclusions. The mean aqueous humor concentration of betaxolol 0.25% suspension was higher than betaxolol 0.50% solution; however, the difference was not statistically significant. With twofold reduced concentration and similar anterior chamber penetration, betaxolol 0.25% suspension could be first choice for β1 selective blocker therapy when considered for patients with glaucoma.
Optic Nerve Alterations in P27Kip1 Knockout Mice
Authors: Lopez-Sanchez E. , Frances-Muñoz E. , Chaques V. , Sanchez-Benavent M.L. , Menezo J.L. 
Published: January 2018

Purpose. To study the morphologic characteristics of the optic nerve (ON) by using an experimental model of knockout mice for the expression of the P27Kip1 gene, mainly involved in cell cycle arrest, apoptosis control, and retinoblastoma protein phosphorylation. Methods. Eyeballs with the retrobulbar ON attached were obtained from 26-week-old mice. By using morphologic and morphometric techniques, light and electron transmission microscopy, the ON characteristics were determined in two groups of mice: 1) wild type mice as the control group (n=15), 2) homozygous knockout mice (-/-) for the P27Kip1 gene as the knockout group (n=15). Glial fibrillary acidic protein (GFAP) and myelin basic protein (MBP) were studied using Western blot and immunoblotting approaches. Results. The ON cross-sectional area was significantly larger in the P27Kip1 knockout mice group than in the control group (p<0.001). The axon sizes in knockout animals were much larger than in wild-type mice (p<0.001). Higher number of axons forming the ON, intra-axonal degeneration, myelin sheath, and axoplasm density alterations were found in P27Kip1 knockout mice when compared with control group (p<0.001). Analysis of lysates of optic nerves by Western blot showed less expression of myelin basic protein and GFAP in P27Kip1 knockout mice as compared to wild type mice (p<0.005, p<0.01, respectively). Conclusions. The morphologic and morphometric results suggest that homozygous P27Kip1 knockout mice had hypertrophic, hyperplastic, and dystrophic ON.
Biometric Indices Evaluation in Central Retinal Vein Occlusion using Partial Coherence Laser Interferometry
Authors: Moghimi S. , Mirshahi A. , Lasheie A. , Maghsoudipour M. , Beheshtnejaad A. 
Published: January 2018

Purpose. To evaluate the association of axial length and posterior segment length with central retinal vein occlusion (CRVO) using optical coherence interferometry. Methods. The study group consisted of 29 patients (13 female and 16 male) with unilateral CRVO who were referred to Farabi Eye Hospital. Patients with macular edema were excluded. The mean keratometry (mean K), axial lengths (AL), anterior chamber depths (ACD), and posterior segment lengths (PSL, defined by AL - ACD) of affected and fellow eyes were measured using optical coherence interferometry. Results. Age range was 45 to 74 years (mean 59.2 ± 7.5 years). The mean K of affected eyes was not statistically significantly lower than that of unaffected eyes in the CRVO group. This was also true for ACD. Although affected eyes had shorter axial length (23.26 mm vs 23.33 mm), the difference was not significant. There was a statistically significant difference in PSL affected and unaffected eyes (20.15 mm vs 20.26 mm) (p=0.008). Conclusions. Posterior segment length of eyes with CRVO may be shorter than unaffected eyes. This may predispose them to more crowding of central retinal vein and artery in lamina cribrosa, and developing CRVO.
Phakic Intraocular Lenses after Scleral Buckling for Retinal Detachment
Authors: Leccisotti A. 
Published: January 2018

Purpose. To assess efficacy and safety of angle-supported phakic intraocular lenses (PIOL) implanted after scleral buckling for retinal detachment. Setting. Private practice in Siena, Italy. Methods. Retrospective, noncomparative consecutive case series. Inclusion criteria for retrospective evaluation were previous uncomplicated external retinal detachment surgery (scleral buckling), and a complete follow-up superior to 3 years from PIOL implantation. Results. Nine eyes of seven patients were included. Mean time interval between retinal detachment surgery and PIOL implantation was 3.2 years ± 4.5 (range 1 to 15). Mean spherical equivalent (SE) before PIOL implantation was −16.36 D ± 3.98; range: −11.75 to −23. PIOL surgery was uneventful in all cases. Mean SE after PIOL implantation was −0.99±0.51 (95% confidence interval for the mean: −0.59 to −1.39). Mean follow-up after PIOL implantation was 4.2 years ± 0.8 (range 3 to 5). Complications were pupil ovalization (inferior to 1 mm) in two eyes, and worsening of floaters in both eyes of one patient. No recurrences of retinal detachment were observed. Conclusions. In selected eyes with no anterior chamber abnormalities, the implantation of angle supported PIOL after scleral buckling for retinal detachment is associated with good refractive results and minor complications.
Serum Prolactin Levels and Behçet Disease
Authors: Proença H. , Ferreira C. , Miranda M. , Castanheira-Dinis A. , Monteiro-Grillo M. 
Published: January 2018

Purpose. To evaluate serum prolactin levels in Behçet disease (BD) and correlate with phenotypic expression of the disease. Methods. This was a prospective, nonrandomized comparative trial. Twenty-two patients fulfilling BD Research Committee criteria and 21 healthy control subjects were included. Patients were classified in complete-type or incomplete-type BD subgroups according to clinical characteristics such as recurrent oral ulcers, genital ulcers, skin lesions, and ocular disease. Age, sex, HLA phenotyping, and therapy were recorded for comparative analysis between groups. Serum prolactin levels were determined by electrochemiluminescence immunoassay on a Modular Analytics E170 analyzer. Results. Prolactinemia was significantly higher (mean=19.34 ng/mL) in BD patients vs controls (mean=9.83 ng/mL) (p=0.009). This value was also statistically higher in complete-type BD subgroup vs controls (p=0.02). Younger patients (<30 y) required corticosteroids plus immunosuppressives more often (75%), suggesting an association between age and disease severity, although not statistically significant. Conclusions. Results suggest the role of prolactin in BD pathogenesis and its association with disease expression, especially in complete-type BD.
Triaging and Coding Ophthalmic Emergency - the Rome Eye Scoring System for Urgency and Emergency (RESCUE): A Pilot Study of 1000 Eye-Dedicated Emergency Room Patients
Authors: Rossi T. , Boccassini B. , Iossa M. , Mutolo M.G. , Lesnoni G. , Mutolo P.A. 
Published: January 2018

Purpose. Ophthalmic emergency (OE) triage is essential for prompt recognition of urgent cases. To date, no formal eye-dedicated triaging system has been widely accepted. The purpose of the present study is to propose a fast, accurate, and reproducible coding scale called the Rome Eye System for Scoring Urgency and Emergency (Rescue). Methods. Phase 1 of the study is a retrospective analysis of electronic medical records (EMR); phase 2 is a prospective consecutive series. Phase 1 included 160,936 patients. Phase 2 included 1000 consecutive patients referred to the emergency department (ED) of our institution. In phase 1, the authors retrospectively analyzed EMRs of patients presenting to the ED, listing signs and symptoms most frequently associated with hospitalization. Redness, pain, loss of vision, and the risk for an open eye were identified and assigned a score ranging from 0 to 12. Color coding was assigned based on increasing scoring: 0–3 white, 4–7 green, 8–12 yellow code. In phase 2, 1000 consecutive ED patients were enrolled and prospectively coded according to RESCUE. After diagnosis and proper treatment, EMRs were retrospectively reviewed by a masked physician and patients recoded (Retro coding) according to clinical course. Correlation between Rescue and Retro coding was calculated. Main outcome measures: Prospective and retrospective ED color coding correlation. Results. A total of 160,936 EMR were retrospectively analyzed; 2407 (1.4%) patients required hospitalization. Loss of vision (90%), redness (76%), and pain (47%) were the most frequent complaints. Rescue significantly correlated to Retro coding (p<0.01): 841/1000 patients coded exactly the same color, 45/1000 were overestimated by one color class, none by two, 107/1000 underestimated by one, and 6/1000 by two classes. The 32/1000 hospitalized patients in the prospective cohort had a Rescue score significantly higher than non-admitted patients (p<0.01) and color coding among admitted and dismissed patients was significantly different as well (p<0.01). Conclusions. The Rescue system seems promising in terms of usefulness and ease of implementation. The high correlation between Rescue code assigned prospectively and the post-diagnosis coding, as well as the prompt discrimination of cases that eventually required hospitalization, may lead to a wider use of the Rescue system. Further testing on larger samples and different institutions is warranted.
Magnitude and Causes of Unilateral Absolute Blindness in a Region of Oman: A Hospital-Based Study
Authors: Bansal R.K. , Khandekar R. , Nagendra P. , Kurup P. 
Published: January 2018

Purpose. To report the magnitude and causes of unilateral absolute blindness (no light perception) and barriers faced by persons with unilateral blindness in the South Batinah region of Oman. Methods. Between January and June 2002, 12,000 patients were evaluated for visual acuity, ocular pressure, anterior ocular biomicroscopic examination, and posterior segment indirect ophthalmoscopy examination by ophthalmologists at Al Rustaq hospital in Oman. Patients having no perception of light in at least one eye were included in the cohort. A closed-ended questionnaire was used to collect data on the personal profile, history of blindness, barriers perceived as the cause of blindness, and participants’ attitude towards eye care and quality of life following visual disability. Results. In the 12,000 patients studied, absolute unilateral blindness (no perception of light) was present in 122 persons, a rate of 1.0% in our series. The onset of blindness was gradual in 78 (63.9%) persons and 64 (54.9%) persons had unilateral blindness for more than 10 years. The main causes of blindness were phthisis/absent/disorganized blind eye, which was present in 64 (52.5%) persons; glaucoma, seen in 49 (40.2%) participants; and corneal opacity, seen in 8 (6.5%) persons. Eighty (14.8%) persons had <3/60 vision in the fellow eye. Thirty (24.6%) persons had cataract and 19 (15.6%) persons had glaucoma in the fellow eye. Forty-eight (39.3%) persons had undergone cataract surgeries while 2 (1.6%) persons were operated for glaucoma in the fellow eye. Lack of access to ophthalmic services and use of traditional medicines during the onset of blindness were reported by nearly half of the cohort. The attitude towards blindness was negative in two thirds of subjects. Conclusions. Cataract and glaucoma were important determinants of visual impairment in the fellow eyes of this cohort. These patients are at higher risk of developing bilateral impairment and need special care to prevent/treat visual disabilities in the fellow eyes. Using appropriate services, one can attempt attitudinal changes, rehabilitate them, and create a positive attitude towards life.