bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Bubble Modification of the Big Bubble Technique for Deep Anterior Lamellar Keratoplasty
Authors: Hosny Mohammed H. , Shalaby Ahmad M.M. , El Din Nashwa Badr 
Published: January 2018

Purpose. We modified the deep anterior lamellar keratoplasty big bubble technique to improve safety and ease of performance. Methods. We describe a modification of the big bubble technique that involves injecting the air bubble through a peripheral corneal incision 1 mm from the limbus. The incision is made with a limbal relaxing incision knife. This is done before trephination of the recipient cornea, hence the name “early bubble.” The goal of this technique is to reduce the risk of intraoperative corneal perforation and to obtain a large air bubble between Descemet membrane and the corneal stroma. We report outcomes of this technique in 21 eyes. Results. At 6 months, 16 eyes showed a best-corrected visual acuity of 20/50; the remaining eyes had a best-corrected visual acuity of 20/80 or better. The postoperative corneal astigmatism was 3.6±0.9 diopters at 3 months and 3.15±0.67 diopters at 6 months. The rate of conversion to penetrating keratoplasty was 14%. Conclusions. We found that the “early bubble” technique improved the ease of performance, safety, and predictability of deep anterior lamellar keratoplasty.
Effect of Amniotic Membrane Transplantation on Corneal Healing and Proteoglycan Expression in an Experimental Model of Limbal Deficiency in Rabbits
Authors: Andrade Alexandre L. , Campos Mauro Q. , Gomes José A. P. , Berto Alessandra G. A. , Michelacci Yara M. 
Published: January 2018

Purpose. Amniotic membrane transplantation (AMT) has been used as a graft or as a dressing in ocular surface reconstruction, facilitating epithelization, maintaining normal epithelial phenotype, and reducing inflammation, vascularization, and scarring. The corneal transparency is due, at least in part, to the arrangement in orthogonal lamellae of collagen fibrils, surrounded by proteoglycans (PGs). These PGs regulate fibrilogenesis, the matrix assembly, and ultimately the corneal transparency. The purpose of the present study was to investigate the effects of AMT upon the corneal PGs after severe limbal injury. Methods. Experiments were performed on the right corneas of 22 New Zealand female albino rabbits, and their left corneas were used as matched controls. These animals were divided into 3 groups: G1 (n=10): total peritomy and keratolimbectomy followed by application of 0.5 M NaOH; G2 (n=10): submitted to the same trauma as G1, and treated by AMT; G3: no trauma, only AMT (n=2). The right corneas of G2 and G3 were covered by DMSO4 cryopreserved human amniotic membrane, fixed by interrupted 9-0 mononylon sutures, with its stromal face toward the ocular surface. After 7 or 30 days, the corneas were removed and PGs were extracted. Results. Normal corneas contained approximately 9 mg of PGs per gram of dry tissue. AMT on intact cornea (G3) did not cause any changes in the concentration of PGs. In contrast, injured corneas contained much less PGs, both on the seventh and on the 30th day posttrauma. The PG concentration was even lower in injured corneas treated by AMT This decrease was due almost exclusively to dermatan sulfate PGs, and the structure of dermatan sulfate was also modified, indicating changes in the biosynthesis patterns. Conclusions. Although beneficial effects have been observed on clinical observation and concentration of soluble proteins after AMT, the normal PG composition of cornea was not attained, even 30 days postinjury indicating that the normal ocular surface reconstruction, if possible, is a long-term process.
Broader Corneal Characterization with PulseESPI Applied to Elasticity Measurements
Authors: Gualini Muddassir M.S. , Iqbal Salman , Sixt Willibald , Khan Wajid A. , Zulfiqar Khurram 
Published: January 2018

Purpose. A novel application of pulsed electronic speckle pattern interferometry (PulseESPI) techniques in important corneal elasticity measurements is presented in this pilot study. For laser-ablative procedures like laser-assisted in situ keratomileusis, it has been found that elastic properties of the cornea have a role in the outcome of corneal refractive surgery, while for optimal ablative laser power calculations this measurement method may possibly be helpful. It may also help in earlier diagnosis of degenerative corneal disorders such as keratoconus. Methods. The approach of this study is to observe dynamic behavior of cornea against stresses as mapped with PulseESPI. For this purpose, strain was induced to the cornea using a fine rod with a mechanical vibrator. Results. It was found that cornea has a response pattern to the dynamic stressing. Its surface exhibits a resonance frequency which can be measured with PulseESPI. This information of resonance frequency can be characteristic to the cornea. Conclusions. PulseESPI may help in important corneal elasticity measurements used for complication-free optimized ophthalmic surgery. It seems to be a promising method to conduct stress-related investigations on biological samples. To our knowledge, this is the first time that PulseESPI has been used for such ophthalmic measurements.
Quantitative Evaluation of Anterior Chamber Changes after Iridotomy Using Pentacam Anterior Segment Analyzer
Authors: López-Caballero Cristina , Puerto-Hernández Beatriz , Muñoz-Negrete Francisco J. , Rebolleda Gema , Contreras Inés , Cabarga Carmen , Corral Angeles 
Published: January 2018

Purpose. To evaluate changes in anterior chamber morphology with the Pentacam anterior segment analyzer and gonioscopy after laser peripheral iridotomy (LPI) in patients with primary angle closure glaucoma and narrow angle and to compare central corneal thickness measurements performed with Pentacam and ultrasound pachymetry Methods. Twenty eyes of 20 patients were enrolled in this prospective interventional study. Before and after LPI, volume, angle, and central and peripheral depth of anterior chamber was quantified with Pentacam. Central corneal thickness was measured with Pentacam and ultrasound pachymetry. Results. Mean central corneal thickness as measured with Pentacam pachymetry was slightly lower than the measurements provided by ultrasonic pachymetry (551.9 μm, range 509–659, versus 556.8 μm, range 520–644) (p=0.93) with an intraclass correlation coefficient of 0.92. Anterior chamber angle increased from 20.32 (standard deviation [SD] 4.2) to 22.31 degrees (SD 3.9). Anterior chamber central depth increased significantly from 1.79 mm (SD 0.22) to 1.85 mm (SD 0.21) and volume changed from 72.18 mm (SD 16.82) to 89.12 mm (SD 12.3), p=0.001. Gonioscopy showed that Shaffer angle widened significantly in all quadrants. Mean intraocular pressure changed from 20.8 mmHg to 18.3 mmHg after LPI (p<0.05). Conclusions. In patients with primary angle closure glaucoma and narrow angles, anterior chamber volume, angle, and central and peripheral depth, measured with Pentacam, increase significantly after LPI.
Comparison of Burst, Pulse, and Linear Modes Used in Phacoemulsification Surgery
Authors: Özkurt Yelda B. , Evciman Tufan , Sengor Tomris , Haboglu Melih , Bas Gokcen , Kurna Sevda , Aki Suat 
Published: January 2018

Purpose. To compare different ultrasound modes used in phacoemulsification surgery in terms of their efficacy and outcomes during and after surgery. Methods. A total of 86 patients with cataract diagnosis who underwent phacoemulsification surgery in Fatih Sultan Mehmet Education and Research Hospital Eye Diseases Clinic between November 2006 and February 2008 were included in the study and were prospectively analyzed. Patients were randomized into 3 groups based on the phacoemulsification mode to be used (burst, pulse, and linear mode). Results. Mean phacoemulsification time was 40.32±33.14 seconds, ultrasound time was 19.94±9.10 seconds, and effective ultrasound time was 20.16±16.57 seconds in Group I; mean phaco time was 79.90±65.52 seconds, ultrasound time was 15.30±5.74 seconds, and effective ultrasound time was 39.95±32.76 seconds in Group II; and mean phaco time was 75.75±50.56 seconds, ultrasound time was 11.65±2.91 seconds, and effective ultrasound time was 37.87±22.89 seconds in Group III. Central corneal thickness measurements with pachymetry were 586.61±46.86 μm on day 1,555.54±39.31 μm at week 1,543.29±33.88 μm at month 1, and 543.29±33.88 μm at month 3 in Group I; 549.83±49.18 μm on day 1,530.03±46.42 μm at week 1,524.32±45.76 μm at month 1, and 521.32±45.26 μm at month 3 in Group III; and 572.91±39.12 μm on day 1,545.91±32.67 μm at week 1,537.70±29.77 μm at month 1, and 534.04±28.64 μm at month 3 in Group III. Conclusions. Phacoemulsification power should be kept at minimum in order to induce minimal trauma and to achieve early rehabilitation.
Optical Coherence Tomography Findings in Pseudoxanthoma Elasticum
Authors: Yaylali Sevil Ari , Akcakaya Aylin Ardagil , Erbil Hasan Hasbi , Salar Senem , Karakurt Yücel 
Published: January 2018

Purpose To describe optical coherence tomography (OCT) findings of ocular lesions in pseudoxanthoma elasticum (PXE). Methods. Sixteen eyes of 8 patients with PXE and 20 eyes of 10 age-matched healthy volunteers were included in the study. All patients in the study and control group underwent a complete ophthalmologic examination and OCT. Fluorescein angiography was performed on the patients with PXE. Results. In the areas of peau de orange mottling, OCT demonstrated increased reflectivity on the level of retinal pigment epithelium (RPE), Bruch membrane, and choriocapillaris complex. OCT scans of crystalline body showed a hyperreflective shell and an isoreflective or hyporeflective core. OCT scans of the angioid streaks demonstrated thinning in RPE-Bruch membrane-choriocapillaris complex. Conclusions. Disturbances on the level of RPE, choroid, and Bruch membrane may be responsible for the ocular lesions in PXE. OCT may give clues to the pathophysiology of the retinal lesions. Spectral domain OCT could provide more details and information. Further studies using this new technology should be performed.
Torsional Diplopia after Orbital Decompression and Strabismus Surgery
Authors: Serafino Massimiliano , Fogagnolo Paolo , Trivedi Rupal H. , Saunders Richard A. , Nucci Paolo 
Published: January 2018

Purpose. To investigate diplopia after orbital decompression in patients with thyroid-related orbitopathy. Methods. We retrospectively analyzed medical records of 45 consecutive patients who had undergone orbital decompression surgery (DS) and a subgroup of 10/45 patients who underwent disinsertion of the inferior oblique (IO) muscle during DS. Diplopia was assessed before DS and 1 and 3 months after DS. Residual strabismus defects were treated surgically approximately 3 months after DS with follow-up visits 1 week, 3 months, and 6 months postoperatively. Patients with horizontal or vertical diplopia were evaluated using the alternate prism-and-cover test and torsional diplopia (TD) using a double Maddox rod test to quantitate their strabismus. Results. Strabismus surgery was effective in treating the horizontal and vertical diplopia (13/40 cases with residual deviations required prism glasses), but did not resolve the TD. None of the patients with IO disinsertion during DS complained of TD before strabismus surgery. However, after strabismus surgery, TD occurred in all IO patients with IO disinsertion vs 8/30 patients without IO disinsertion (p<0.001, Fisher exact test). Overall, TD was induced in 18/45 (40%) of the DS cohort. Conclusions. Patients with IO disinsertion during DS may be at increased risk of developing TD postoperatively. We recommend sparing or reattaching the IO muscle during DS when possible to reduce the risk of developing untreatable TD.
Epidemiology of Open-Globe Trauma in the Southeast of Spain
Authors: Larque-Daza Ana Belen , Peralta-Calvo Jesus , Lopez-Andrade Jesus 
Published: January 2018

Purpose. To describe epidemiologic and clinical findings of open-globe trauma (OGT) in the southeast area of Spain. Methods. A retrospective descriptive study of 94 eyes with OGT evaluated between 1999 and 2007, in a primary referral hospital. Results. The incidence of OGT in our area was 6.76 per 100,000 inhabitants/year. The majority of patients were male (89%) and young (80% of patients < 50 years old), with an average age of 37 ± 20 years (mean ± SD). The most common causes and location of injury were wire-induced trauma (50%) and accidents at work (56%), respectively. The types of injury encountered were ruptures, intraocular foreign bodies, perforating injury, penetrating injury, and mixed injury. Sixty-six percent of these injuries were penetrating in zone I (55%). The injuries found were vitreous hemorrhage (33%), cataracts (47%), vitreous prolapse (30%), retinal detachment (8%), endophthalmitis (2%), and associated with a facial trauma (7%). Eighty percent of surgery was carried out under general anesthesia. Fifty-one percent of the eyes underwent one operation only (5% were enucleated). Sixty-one percent of the eyes resulted in visual acuity of less than 50%. Conclusions. The incidence of OGT in the southeast of Spain is very high, being in most cases produced by accidents while using wire in greenhouses. This provokes severe monocular visual loss among the young population.
Spectral OCT Analysis in Bietti Crystalline Dystrophy
Authors: Gaucher David , Saleh Maher , Sauer Arnaud , Bourcier Tristan , Speeg-Schatz Claude 
Published: January 2018

Purpose. To report the analysis of the cornea and the macular retina using both time domain (TD-OCT) and Fourier domain optical coherence tomography (FD-OCT) in a case of Bietti crystalline dystrophy (BCD). Methods. This is a case study of a 32-year-old woman who presented with moderate visual loss in both eyes with nyctalopia. She had a complete ophthalmologic examination including fundus examination. She also underwent fluoroangiography Goldmann perimetry, electroretinography/electrooculography and both TD-OCT and FD-OCT examinations. Results. Large atrophy of retinal pigment epithelium and choroidal sclerosis were observed on both funduscopy and angiography. Microcrystals deposits were observed in the cornea and in the retina. Visual fields were constricted and electrophysiology was greatly impaired. BCD was diagnosed. TD-OCT examination was normal whereas FD-OCT revealed modifications of the outer retina and the presence of numerous lesions corresponding to microcrystals deposits in all retinal layers. The diameter of the deposits was comprised between 18 and 100 μm. Conclusions. FD-OCT was superior to TD-OCT in detecting and localizing microcrystals in BCD. FD-OCT might be useful in the understanding and the follow-up of this rare disease.
Clinical evaluation of the Canon TX-10 noncontact tonometer in healthy eyes
Authors: García-Resúa Carlos , Fernández María Jesús Giráldez , Yebra-Pimentel Eva , García-Montero Silvia 
Published: January 2018

Purpose. To assess the accuracy and repeatability of intraocular pressure (IOP) measurements obtained with the Canon TX-10™ noncontact tonometer (NCT), using the Goldmann applanation tonometer (GAT) as the gold standard. Methods. Seventy-three young healthy subjects were enrolled in the study. Central corneal thickness (CCT) was obtained with Orbscan™ Topography System and then repeated IOP measurements were obtained with both tonometers. Canon TX-10™ NCT was performed first, followed by GAT. Another study sample of 32 young healthy subjects was used to test the repeatability with both tonometers. Two sets of data were acquired separated by 1 week. Plotting the difference between the methods against the mean was done to compare the tonometers and the intersession variability. The hypothesis of zero bias was examined by a paired t test. The 95% limits of agreement (LoA) were also calculated. Results. NO statistically significant differences were found when comparing the Canon TX-10™ NCT with GAT, displaying close level of agreement with GAT as seen by the 95% LoA (-4.78 mmHg to +4.00 mmHg). CCT ranged from 419 νm to 585 μm and no relationship was found between CCT and IOP measurements. The coefficients of repeatability were 3.70 mmHg and 3.41 mmHg for GAT and TX-10 tonometers, respectively. Conclusions. There was a good agreement between Canon TX-10™ and GAT in healthy subjects. From the results obtained here, CCT appears to not affect IOP measurements when CCT is thinner than 570 μm.
Comparing the Measurement of Diurnal Fluctuations in Intraocular Pressure in the Same Day versus over Different Days in Glaucoma
Authors: Magacho Leopoldo , Toscano Daniela A. , Freire Gislene , Shetty Rajesh K. , Ávila Marcos P. 
Published: January 2018

Purpose. To compare the measurement of diurnal fluctuations in intraocular pressure (IOP) in the same day versus over different days in primary open-angle glaucoma. Methods. Twenty-five eyes from 25 patients with primary open-angle glaucoma were submitted to a diurnal curve on the same day, 5 measurements, 2.5 hours apart, from 8:00 AM to 6:00 PM. For the measurements on different days, we randomly selected one time point from the diurnal curve for each patient. All patients were then instructed to return every 3–7 days to complete all 5 measurements. The maximum, minimum, and IOP fluctuation were compared between the 2 methods. Results. The IOP fluctuation (maximum-minimum) was similar when we measured the IOP on different days (5.0±2.6 mmHg vs 4.0±1.2 mmHg, p=0.08). There was no difference regarding the minimum or maximum IOP assessed in the diurnal curve or over different days. There was a high correlation for the maximum IOP (r=0.863, p<0.001) and the minimum IOP (r=0.708, p<0.001) by either method of measuring during the same day or different days, as well as for all measurements (8:00 AM: r=0.718, p<0.001; 10:30 AM: r=0.479, p=0.01; 1:00 PM: r=0.628, p=0.001; 3:30 PM: r=0.757, p<0.001; and 6:00 PM: r=0.910, p<0.001). Conclusions. IOP fluctuation in primary open-angle glaucoma can be assessed using IOP measures on different days, at different time points, which strongly correlate to a diurnal curve.
Adjustable Superior Oblique Tendon Spacer with Application of Nonabsorbable Suture for Treatment of Isolated Inferior Oblique Paresis
Authors: Fard Masoud A. , Ameri Ahmad , Anvari Faramaz , Jafari Alireza K. , Yazdian Ziaeddin 
Published: January 2018

Purpose To evaluate and report the outcomes of a superior oblique tendon spacer procedure using nonabsorbable adjustable sutures in patients with inferior oblique (IO) paresis. Methods This interventional case series included 6 eyes of 6 patients with IO paresis. All met Bielschowsky/Parks Three-step Test criteria to identify an isolated IO paresis. In all patients, the superior oblique tendon was exposed; 2 nonabsorbable polyester sutures were placed 3 mm apart, and the tendon was cut. With the use of a slipknot, the cut ends of the tendon were separated 5 to 7 mm. Tendon separation was adjusted intraoperatively according to the fundus torsion and exaggerated traction test. Results The mean duration of follow-up was 8.1 months (range, 5-12 months). Four patients had congenital IO paresis and 2 had iatrogenic IO paresis following denervation/myectomy of IO. Mean primary position hypotropia improved from 15.2 prism diopters (PD) before surgery to 2.7 PD in congenital IO paresis and from 11.5 PD to 2.5 PD in iatrogenic IO paresis. In congenital IO paresis, mean preoperative superior oblique overaction and IO underaction was +2 and −2, which decreased to 0 and −1.25 respectively; fundus incyclotorsion resolved in all patients. Superior oblique overaction and IO underaction improved in iatrogenic IO paresis as well. In no patient did an overcorrection develop. Conclusions The adjustable superior oblique tendon suture spacer procedure is an effective and safe option for correcting IO paresis without developing iatrogenic superior oblique paresis.
Evaluation of the Effect of Topical Cyclosporine a with Impression Cytology in Dry Eye Patients
Authors: Yüksel Bora , Bozdağ Berkant , Acar Memed , TopaloğLu Engin 
Published: January 2018

Purpose. This study evaluated the efficacy of topical cyclosporine A 0.05% treatment with impression cytology in dry eye patients. Methods. Forty eyes of 40 patients with dry eye were included. Schirmer, tear break-up time, and Ocular Surface Disease Index (OSDI) scores and goblet cell densities were noted before and after 6 months of topical cyclosporine A treatment. Patients were graded clinically and biomicroscopically as follows: grade 1, 12 patients; grade 2, 18; and grade 3, 10 patients. Results. Mean age was 57.1±11.8 (23.0–80.0) years. A total of 36 (90%) of the patients were female and 4 (10%) were male. Mean Schirmer test value was 3.2±1.6 (0.0–8.0) mm in the beginning and was 8.4±4.3 (1.0–19.0) mm after 6 months of cyclosporine A topical treatment (p=0.00). At the first visit, mean tear break-up time was 4.4±1.8 (2.0–8.0) seconds. It increased to 11.8±4.8 (2.0–20.0) seconds at the end of the sixth month (p=0.00). Mean clinical grading was 1.9±0.8 (1.0–3.0) and this value regressed to 0.8±1.2 (0.0–3.0) after the treatment (p=0.00). Mean OSDI score was 30.0±11.7 (9.0–50.0) before the treatment and 21.3±11.0 (4.0–47.0) after the treatment (p=0.00). Mean goblet cell density of all cases was 12.3±8.7 before the treatment (2.0–28.0). It increased to 33.0±25.4 (6–70) after the treatment (p=0.04). Conclusions. Topical cyclosporine A treatment is effective in grade 1 and grade 2 dry eye patients but results are poor in grade 3 patients.
Serum Lycopene Levels in Patients with Diabetic Retinopathy
Authors: Li Zhen-Zuo , Lu Xiu-Zhen , Ma Chi-Cheng , Chen Li 
Published: January 2018

Purpose. Accumulating evidence indicates that oxidative stress may play an important role in the pathogenesis of type 2 diabetes and its complications. Lycopene, a very potent antioxidant of carotenoids, has received considerable scientific interest in recent years for its potential role in the prevention of oxidative stress-related chronic diseases. This study was undertaken to investigate whether the serum levels of lycopene are altered between type 2 diabetic patients with and without diabetic retinopathy. Methods. A total of 71 patients with type 2 diabetes were analyzed and compared with 23 nondiabetic healthy controls. Serum lycopene concentrations were assayed using high-performance liquid chromatography. Results. Lycopene level was found to be significantly lower in diabetic patients than in controls (p=0.021). In the diabetic group, subjects with proliferative diabetic retinopathy had significantly lower lycopene levels than subjects without diabetic retinopathy or with nonproliferative diabetic retinopathy. In the analysis of correlations, hemoglobin A1c were negatively correlated with lycopene (r=–0.345, p=0.007) after multivariate adjustment. A stepwise linear multiple regression model revealed that age and hemoglobin A1c were significant determinants of lycopene. Conclusions. Our findings show that measuring serum lycopene is a novel convenient method for evaluating oxidative damage. Diabetic patients, especially those with advanced diabetic retinopathy, had significantly lower serum lycopene levels; this suggests that lycopene may be helpful for the diagnosis, severity, and therapeutic evaluation of diabetic retinopathy.