bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of Vitreous Loss during Cataract Surgery under Topical Anesthesia with Transconjunctival Vitrectomy System
Authors: Shah V.A. , Gupta S.K. , Chalam K.V. 
Published: January 2018

Purpose A new technique to manage posterior capsular rupture with vitreous prolapse into the anterior chamber during phacoemulsification under topical anesthesia using the sutureless self-sealing 25-gauge transconjuctival vitrectomy system. Method In the event of vitreous prolapse into the anterior chamber, the corneal wound is sutured and cleared of vitreous. A trans conjunctival 25-gauge sclerotomy through the pars plana is made. The high speed 25-guage trans-conjunctival vitrectomy system (TVS-25) under topical anesthesia is introduced and vitrectomy is performed to clear the anterior chamber of vitreous. An anterior vitrectomy is also done. A foldable intraocular lens is subsequently inserted. Results The vitrectomy is performed in a closed chamber maintaining normal intraocular pressure. The high-speed cutter exerts minimal traction on the vitreous. The accessibility to vitreous improves through the pars plana route ensuring more complete removal of the vitreous and restoration of normal anatomy. Topical anesthesia avoids the risks of globe perforation, retrobulbar hemorrhage, and prolonged postoperative akinesia of the eye. Conclusions The 25-gauge pars plana incision is small and self-sealing. This makes the procedure fast, effective, painless and safe.
Unilateral Giant Coloboma of the Upper Eyelid Associated with Other Congenital Anomalies (33 Years Follow-Up of Surgical Repair)
Authors: Scassellati-Sforzolini G. , Scassellati-Sforzolini B. 
Published: January 2018

Purpose To describe a case of congenital unilateral giant coloboma and its successful surgical repair with 33 years of follow-up. Case Report A 6-year-old boy presented with a congenital unilateral giant coloboma of the right upper eyelid associated with madarosis of the eyebrows, microphthalmos, dystopia of the hair, and coloboma of the apex of the nose. The patient underwent surgical repair of the multiple anomalies in different steps. Discussion A multiple-step, two-layer technique for the reconstruction of the right upper eyelid was performed in a 6-year-old boy with congenital unilateral giant coloboma associated with multiple ocular and facial anomalies. After 33 years of follow-up, the cosmetic results are excellent, although it has not been possible to preserve the visual function of the right eye, which had to be enucleated.
Open-Sky Capsulorrhexis in Triple Procedure: With or without Trypan Blue?
Authors: Özkiriş A. , Arslan O. , Cicik E. , KÖylüoglu N. , Evereklioglu C. 
Published: January 2018

Purpose To establish the beneficial effects of trypan blue 0.1% capsule staining in open-sky capsulorrhexis during triple procedure. Methods Patients who underwent penetrating keratoplasty (PK) with phacoemulsification and intraocular lens (IOL) implantation were divided into two groups. Group 1 consisted of 31 eyes of 26 patients with a mean age 64.4 ± 6.9 years and anterior lens capsule was stained with trypan blue 0.1% to perform open-sky capsulorrhexis. In Group 2, capsulorhexis was performed without staining of the anterior capsule in 19 eyes of 17 patients with a mean age 60.6 ± 5.3 years. The rates of complete capsulorrhexis and intra- and postoperative capsule-related complications were compared between the groups. Results The most common diagnosis before PK was corneal opacification in both groups. Open-sky capsulorrhexis was not completed in 3 eyes (9.6%) in Group 1 and in 9 eyes (47.3%) in Group 2. The rates of incomplete capsulorrhexis, posterior capsule tear, and transscleral fixation IOL implantation were higher in Group 2 (for each, p<0.05). The diameters of capsulorrhexis were smaller than 4.5 mm in one eye in Group 1 and in two eyes in Group 2, and larger than 6.5 mm in two eyes in Group 1 and in three eyes in Group 2. Malposition of IOL, zonular dialysis, retinal detachment, and pupil capture were only observed in eyes in Group 2. In the follow-up period, there were no adverse reactions due to application of trypan blue in Group 1. Conclusions Trypan blue staining of the anterior capsule during triple procedure helps the surgeon perform open-sky capsulorrhexis more easily and safely and in proper dimensions, provides positive effects on the other steps of the surgery, and decreases the rate of posterior capsule tear formation.
Clonazepam Associated Retinopathy
Authors: Gatzonis Sta. , Karadimas P. , Gatzonis Sty. , Bouzas E.A. 
Published: January 2018

Purpose To report a case of retinopathy associated with the longterm intake of the antiepileptic drug clonazepam. Methods Case report. Results A 36-year-old woman, with a history of long-term use of the antiepileptic drug clonazepam developed subtle visual disturbances. Funduscopy revealed areas of mild depigmentation of the retinal pigment epithelium throughout the posterior pole bilaterally corresponding to transmission hyperfluorescence on fluorescein angiography. There was no history of any inherited retinal degenerative disease and no other known agent responsible for retinal toxicity had been used. Conclusions The longstanding intake of the antiepileptic drug clonazepam may be associated with the development of toxic retinopathy.
Acute Commotio Retinae Determined by Cross-Sectional Optical Coherence Tomography
Authors: Meyer C.H. , Rodrigues E.B. , Mennel S. 
Published: January 2018

Purpose To demostrate the cross-sectional anatomy in acute commotio retinae. Methods A 27-year-old male with unilateral decreased vision after acute blunt ocular trauma, was examined by optical coherence tomography (OCT). Results Visual acuity was 20/20 OD and 20/50 OS. Fundus examination OS demostrated a mild edema in the papillomacular and foveal area. OCT confirmed a separation of the neurosensory retina and the retinal pigment epithelium (RPE). The thickness of the retina was normal and the contour of the foveola intact. The uncommon hyperreflective band at the outer retina may present the traumatic disruption of photoreceptors. Conclusions In vivo investigations by OCT confirmed previous histological studies, a commotio retinae consists a disruption and fragmentation at the level of the foveal photoreceptor segments and RPE.
Small Incision Clear Lens Extraction for Correction of High Myopia
Authors: Kubaloğlu A , Yazicioğlu T. , Tacer S. 
Published: January 2018

Purpose To evaluate the effectiveness, predictability, and safety of clear lens extraction in the correction of high myopia. SETTING Kartal Education and Research Hospital, Istanbul, Turkey. METHODS This retrospective study comprised 56 eyes of 30 patients who had clear lens extraction to correct myopia of 12.00 diopters (D) or more. Small incision clear lens extraction using an anterior chamber maintainer was performed and low-power posterior chamber intraocular lens (IOL) was implanted. The mean postoperative follow-up was 40.2±11.9 months. Results Uncorrected visual acuity improved in 94.6% of eyes. Best-corrected visual acuity (BCVA) improved in 37 eyes (66 %); 27 (48.2 %) gained two or more lines. The percentage of eyes achieving a BCVA of 20/40 or better increased from 26.7% preoperatively to 58.9% postoperatively. Of the eyes, 38 (67.8%) were within ±1.00 D of targeted refractive error and 52 (92.8%) were within ±2.00 D. Posterior capsule tear with vitreous loss occurred in one eye (1.7%). During the follow-up, retinal detachment (RD) occurred in 2 eyes (3.5%). CONCLUSIONS Clear lens extraction and IOL implantation was effective and had an acceptable predictability and a low morbidity in correcting high myopia. Regular retinal examination is necessary to prevent postoperative RD.
Optic Disc Pit Maculopathy after Blunt Ocular Trauma
Authors: Meyer C.H. , Rodrigues E.B. 
Published: January 2018

Purpose To present a symptomatic optic pit 3 months after a blunt ocular trauma. METHODS A 16-year-old male with unilateral decreased vision was examined with multiple cross-sectional scans using optical coherence tomography (OCT) and kinetic ultrasound at the optic disc and macula. Results Visual acuity was 20/30 OD and 20/20 OS. Fundus examination OD demonstrated an optic pit with a corresponding serous macular detachment. OCT disclosed a schisis-like separation of the inner retinal layer emanating from the optic disc and an outer layer detachment of the retina. B-scan ultrasound disclosed attached Choquet's canal at the optic pit. CONCLUSIONS Patients with optic pit and firm adherent posterior vitreous may develop schisis-like retinal detachments after blunt ocular trauma.
Refractive Outcome of Single Running Suture Adjustment in Penetrating Keratoplasty
Authors: Küçükerdönmez C. , Akova Y.A. , Dursun D. 
Published: January 2018

Purpose To evaluate the effectiveness of single running suture adjustment in reducing postoperative astigmatism and improving visual acuity in patients who have undergone penetrating keratoplasty. METHODS Eighteen eyes of 18 patients who underwent penetrating keratoplasty at the Department of Ophthalmology, Başkent University between May 1997 and December 2000 and who had an astigmatism over 2 diopters (D) at the fourth postoperative week were included. All eyes underwent suture adjustment at the fourth week and eight eyes with residual astigmatism above 3 D underwent a second adjustment at the eighth week. Final astigmatism and visual acuity findings were evaluated 28 weeks postoperatively. Results The mean postoperative keratometric and refractive astigmatism were 5.76±0.88 D (range=4.50–7.76) and 5.22±0.78 D (range=4.0–7.0) at the fourth week, which were decreased to 2.82±0.99 D (range=1.25–4.62, p=0.0001) and 2.61 ± 1.01 D (range=1.0–4.5, p=0.0001) after suture adjustment, respectively. In eight eyes at the eighth week, a second suture adjustment reduced the average keratometric and refractive astigmatism from 3.86±0.65 D (range=2.75–4.62) and 3.81±0.44 D (range=3.25–4.50) to 2.33±0.91 D (range=0.87–3.50, p=0.012) and 2.06±0.68 D (range=1.0–2.75, p=0.011), respectively. At the 28th week, the average keratometric and refractive astigmatism levels for the entire cohort, which were 2.39±1.06 D (range=1.0–3.50) and 2.25±0.96 D (range=1.0–3.25), respectively, showed a statistically significant decrease when compared with the levels before the first suture adjustment (p=0.0001 for both data). The mean best-corrected visual acuity was 20/25 on the Snellen chart at the 28th week. CONCLUSIONS Postoperative adjustment of single running suture is a safe and effective way of reducing postkeratoplasty astigmatism.
Nitric Oxide Levels of Aqueous Humor after Photorefractive Keratectomy
Authors: Adiguzel U. , Bilgihan K. , Ozdek S.C. , Sancak B. , Hasanreisoglu B. 
Published: January 2018

Purpose To measure the nitric oxide (NO) levels of aqueous humor in rabbits after photorefractive keratectomy (PRK) and to evaluate the alterations of NO levels according to the PRK surgery steps, ablation depth, and time. METHODS Fifty eyes of 25 New Zealand white rabbits were included in the study. One eye was later randomly excluded from the study in order to equalize the number of eyes in groups. Eyes were divided into seven groups, each comprising seven eyes: unwounded control (Group 1), epithelial scrape (Group 2; aqueous humor samples taken at the 4th hour), superficial PRK (Group 3; samples taken at the 4th hour), deep PRK (Group 4; samples taken at the 4th hour), epithelial scrape (Group 5; samples taken at the 24th hour), superficial PRK (Group 6; samples taken at the 24th hour), and deep PRK (Group 7; samples taken at the 24th hour). The corneal epithelium was mechanically removed in surgical groups. The authors performed superficial corneal ablation (59 μm) in Groups 3 and 6 and deep corneal ablation (99 μm) in Groups 4 and 7. Aqueous humor samples were taken at the 4th hour (Groups 2–4) or 24th hour (Groups 5–7) after corneal surgeries. NO measurements were performed indirectly by using the Griess reaction with a spectrophotometer. Results Aqueous humor NO levels 4 hours after corneal surgery were statistically significantly lower than the control group (p<0.05). However, there was no difference among the surgical groups at the 4th hour (p>0.05). At the 24th hour, the deep PRK group had significantly lower NO levels than both the control group and Groups 5 and 6 (p<0.05). NO levels were normalized at the 24th hour in epithelial scrape and superficial PRK groups (p>0.05) but remained stable at lower levels in deep PRK groups (p<0.05). CONCLUSIONS Corneal surgery caused low NO levels in aqueous humor 4 hours after surgery. However, 24 hours after surgery, NO levels normalized following epithelial scrape and superficial PRK and were stable at lower levels in the deep PRK group. Complications of deep PRK application are possibly induced by low NO existence in the aqueous humor.
Effect of Cataract Surgery and Foldable Intraocular Lens Implantation on Retinal Nerve Fiber Layer as Measured by Scanning Laser Polarimetry with Variable Corneal Compensator
Authors: Vetrugno M. , Trabucco T. , Sisto D. , Sborgia C. 
Published: January 2018

Purpose Scanning laser polarimetry (SLP) enables the measurement of retinal nerve fiber layer (RNFL) thickness in vivo. As SLP measurements can be influenced by several conditions such as corneal birefringence, the new version GDx Access is implemented by the variable corneal compensator (VCC). The aim of this study was to evaluate the influence of cataract extraction and foldable intraocular lens (IOL) implantation on SLP parameters measured by GDx Access. METHODS Sixty-eight eyes of 68 patients undergoing phacoemulsification with foldable IOL implantation (silicone and acrylic) were examined by SLP before and after surgery. SLP was performed using GDx Access (with VCC). Mean values for SLP parameters were compaied before and after 30 days from surgery with paired two-tailed Student's t-test. Results No statistically significant differences were found between SLP parameters before and after cataract surgery, and regardless of the type of IOL implanted. CONCLUSIONS Phacoemulsification and foldable IOL implantation do not influence RNFL parameters, as measured by GDx Access.
Subretinal Choroidal Neovascularization Associated with Choroidal Nevus
Authors: Zografos L. , Mantel I. , Schalenbourg A. 
Published: January 2018

Purpose Evaluation of a large series of choroidal nevi inducing the formation of a neovascular membrane in order to more clearly define the clinical presentation and to evaluate the efficacy of various treatment options. METHOD Retrospective study of 22 clinical cases. Results All nevi were situated in the posterior choroid. They had a mean diameter of 3.8 mm and a mean thickness of 1.4 mm. Neovascular membranes were classic in all cases, extrafoveal in 13 cases (59%), and subfoveal in 9 cases (41%). A serous retinal detachment was present in every case, hemorrhages were present in 13 cases (59%), and lipid deposits were present in 16 cases (73%). All extrafoveal neovascular membranes were successfully treated by thermal laser photocoagulation. Initial visual acuity was 0.1 in three cases, 0.2–0.4 in five cases, 0.5–0.8 in four cases, and 1.0 or more in two cases. Final visual acuity was 0.1 in one case, 0.2–0.4 in one case, 0.5–0.8 in four cases, and 1.0 or more in seven cases. Five subfoveal neovascular membranes were treated either by thermal laser, photodynamic therapy, or irradiation. No treatment was applied in four cases and in one of these cases, spontaneous resolution of the neovascular membrane was observed. No growth of the pigmented tumor was observed with a mean follow-up of 4.8 years. CONCLUSIONS Proliferation of a neovascular membrane on the surface of a pigmented choroidal tumor is a rare complication and is considered to be a relative indicator of a benign nature of the lesion. In the authors' experience, neovascular membranes are extrafoveal in more than half of cases and are accessible to laser photocoagulation. In contrast, the various modalities used to treat subfoveal neovascular membrane were ineffective and functional prognosis was unfavorable in these cases.
Choroidal Effusion and Hypotony Caused by Severe Anterior Lens Capsule Contraction following Cataract Surgery
Authors: Musa F. , Aralikatti A. K.V. , Prasad S. 
Published: January 2018

Purpose To describe a case of severe anterior capsular contraction associated with choroidal effusion in a 81 year old female with primary open angle glaucoma undergoing routine phacoemulsification cataract surgery. CASE REPORT Eight weeks following surgery the anterior capsule opening had reduced to 3 mm in size. Intraocular pressure was found to be 4 mmHg and B scan ultrasound revealed a large choroidal effusion. Anterior capsulotomy with Nd:YAG laser was performed. At review, two weeks later, the choroidal effusion had resolved and visual acuity had recovered. CONCLUSIONS The Nd:YAG laser radial relaxing capsulotomies helped relieve the capsular contraction and associated traction on the ciliary body.
Repeated Probing Results in the Treatment of Congenital Nasolacrimal Duct Obstruction
Authors: Singh Bhinder G. , Singh Bhinder H. 
Published: January 2018

Purpose To assess the results of our protocol of repeated probing for the treatment of congenital nasolacrimal duct obstruction in various presentations. METHODS A total of 1600 patients (1748 eyes) with congenital dacryocystitis (850 boys, 750 girls; age range, 1 month to 48 months [mean 16.54 ± 12.21 months]) were included. Diagnosis was confirmed by history of tearing, crusting of lids, and a boggy swelling over inner canthal region, which on pressure ejected mucopurulent discharge through punctum. Antibiotic eye drops were instilled five times a day for a week in affected eyes after the mother pressed the sac area and cleaned the discharge. The cases that were not relieved were subjected to sequential probing dilating with an increasing diameter probe repeated in failed cases second and third times at 1-week interval. Results Medical treatment was effective in only 60 eyes (3.43%). Probing and syringing achieved successful results in 790 eyes (100%) aged 1 month to 12 months; 330 eyes (99.40%) aged 12 months to 18 months; 200 eyes (98%) aged 18 months to 24 months; 150 eyes (95.24%) aged 24 months to 36 months; and 158 eyes (89.87%) aged 36 months to 48 months. The cure rate with first probing was 98.10%, second probing was 99.64%, and third probing was 100%. CONCLUSIONS Our protocol of medical regime and early probing repeated two to three times was very effective in the treatment of nasolacrimal duct obstruction at all ages. A second and third probing was recommended after 1 week of the first probing with successful results if first probing failed.
Disease-Specific Assessment of Quality of Life after Decompression Surgery for Graves' Ophthalmopathy
Authors: Tehrani M. , Krummenauer F. , Mann W.J. , Pitz S. , Dick H.B. , Kahaly G.J. 
Published: January 2018

Purpose Graves' ophthalmopathy (GO) is an organ-specific autoimmune disease. Hydrophily of accumulated acidic mucopolysaccharides into bulbar adipose tissue leads to swelling of the eye muscles. Orbital surgical decompression is performed in severe cases of compressive optic neuropathy and severe corneal exposure or failure of steroid therapy. The study was designed to evaluate decompression surgery with respect to the clinical benefit and the patient's satisfaction by means of a disease-specific questionnaire. METHODS The 90-item study questionnaire was distributed to 105 patients with GO who underwent orbital decompression surgery at the authors' institution. Results A total of 88% of patients stated that decompression had helped them, 80% of the interviewees would undergo decompression again, 78% were content with their eye symptoms, and 71% were satisfied with the cosmetic result of decompression. Furthermore, analysis showed a clinically relevant increase in quality of life after surgery. The correlation between the clinical endpoint proptosis at last examination and the quality of life score proved to be significant (p=0.05). CONCLUSIONS The large majority of interviewees were satisfied with the result of the orbital decompression. These results confirmed that disfiguring proptosis is an important indication for decompression surgery.
Giant Chalazia in the Hyperimmunoglobulinemia E (Hyper-Ige) Syndrome
Authors: Crama N. , Toolens A.P.M. , Van der meer J.W.M. , Cruysberg J.R.M. 
Published: January 2018

Purpose To report the occurrence of recurrent multiple giant chalazia in the hyperimmunoglobulin E syndrome (hyper-IgE syndrome or Job syndrome). METHODS Two patients with hyperimmunoglobulinemia E (>500 IU/ml) had ophthalmologic examination and surgical treatment for chalazia of the eyelids. Results The hyper-IgE syndrome is a rare immunodeficiency and multisystem disorder characterized by recurrent skin and pulmonary abscesses, connective tissue abnormalities, and elevated levels of serum IgE. In two patients with the hyper-IgE syndrome, multiple giant chalazia were seen in upper and lower eyelids. Despite surgical incision new giant chalazia arose. CONCLUSIONS Recurrent multiple giant chalazia may occur as an ophthalmic feature of the hyper-IgE syndrome.
Polypoidal Choroidal Vasculopathy Associated with Doyne'S Familial Choroiditis: Treatment with Thermal Laser
Authors: Ladas I.D. , Karagiannis D.A. , Georgalas I. , Rouvas A.A. , Moschos M.M. , Apostolopoulos M. 
Published: January 2018

Purpose To report the unusual occurrence of polypoidal choroidal vasculopathy (PCV) in a patient with Doyne's familial honeycomb choroiditis (DFHC) and its course after laser treatment. DESIGN Interventional case report. METHODS Indocyanine green (ICG) angiography guided laser was performed on active polypoidal lesions. Results A 45-year-old man with a 15-year history of bilateral DFCH and a scarred macular choroidal neovascularization in the right eye (RE) was referred to us with exudative maculopathy in the left eye (LE). His best-corrected visual acuity (BCVA) was 20/800 in the RE and 20/40 in the LE. ICG angiography revealed a picture that was characteristic for PCV in both eyes. ICG guided argon green laser was performed on the active parapapillary and perifoveal polypoidal lesions of the LE. Eight months after the laser photocoagulation treatment, the macular exudative lesions had subsided and the BCVA improved to 20/20. The favorable anatomic and functional results have remained stable over 3 years. CONCLUSIONS This is, to our knowledge, the first case of a PCV that occurred secondary to DFHC.
Vitreoretinal Surgery of Retinal Detachment and Macular Hole Associated with Optic Nerve Pit: An Optical Coherence Tomography Study
Authors: Sengün A. , Batioğlu F. , Akbatur H. , Atmaca L. 
Published: January 2018

Purpose To describe the course of a case of macular elevation and a full-thickness macular hole associated with optic nerve pit. Methods Case report. A 28-year-old woman who had laser-assisted in situ keratomileusis surgery 2.5 years ago presented with decreased vision, full-thickness macular hole, and macular detachment in association with optic nerve pit. Complete ophthalmic examination was done and optical coherence tomography (OCT) was performed before and after vitreoretinal surgery. Results OCT showed that the macular elevation consisted of both separation of the inner and outer retinal layers with neurosensory retinal detachment. There was a full-thickness macular hole. After vitreous surgery and intraocular gas tamponade, the macular elevation completely resolved, and OCT showed the flattening of the outer and inner retinal layers but the macular hole was not closed. Conclusions OCT is a reliable technique to study macular elevation with a hole associated with optic nerve pit before and after vitrectomy and gas tamponade.