Bilateral Macular Hole Following Myopic Photorefractive Keratectomy

A 42-year-old man was admitted to our clinic complaining of visual distortion in his left eye two months after bilateral myopic photorefractive keratectomy (PRK). Macular optical coherence tomography (OCT) showed a stage II macular hole in the left eye. Simultaneous OCT in the right eye showed vitreous traction and distortion of the outer retina. One month later, the patient underwent vitrectomy for the left eye, and the macular hole was closed. Two months after that, the patient complained of visual distortion in the right eye, and OCT revealed increased traction and accentuated outer retinal distortion indicating a stage IB macular hole. Traction attenuated later without any intervention. The short interval between PRK and hole formation, bilateral involvement, and the moderate refractive error in this case highlight the possible role of PRK in aggravating vitreoretinal interface abnormalities. We recommend the addition of PRK to the list of procedures that may be associated with the formation of a macular hole.

Evaluation of sterile uveitis after iris-fixated phakic intraocular lens implantation

To evaluate the clinical features, and visual outcomes of sterile uveitis after iris-fixated phakic intraocular lens implantation [pIOLs] [Artisan-Artiflex and Verisyse-Veriflex]. Material and Methods: In this retrospective non-comparative case series, the medical records of 117 eyes implanted with Artisan-Artiflex [Ophtec BV, Groningen, Netherlands] and Verisyse-Veriflex [AMO, Santa Ana, CA] iris claw phakic IOLs were analyzed for postimplantation sterile uveitis. The mean age of the 87 patients included in the study was 27.2 +/- 7.4 years. Of these patients, 56 [64.3%] were men and 31 [35.6%] were women. Patient age, gender, IOL brand type, refractive error, optic diameter, unilateral vs bilateral implantation, and anterior chamber depth were analyzed. Features of uveitis, uncorrected and best corrected visual acuity [VA] at presentation and at follow-up visits were examined. The mean follow-up time was 14.6 months [range: 6-37 months]. Clinically significant uveitis was observed in 12 of 117 eyes [10.3%] in a total of ten patients. Of these ten patients, four [40%] were women and six [60%] were men, and the mean age was 25.1 +/- 5.3 years [range: 18-36 years]. Among those with bilateral implantation, 6.9% of patients developed bilateral uveitis, while 13.8% [4 of the 29 implanted bilaterally] developed unilateral uveitis. Foldable pIOL implantation was the only variable associated with the development of uveitis [P=.03]. Although the prognosis is usually benign, sterile uveitis occurred in 10.3% of patients after iris-fixated pIOL implantation. The implantation of a foldable pIOL was the only variable associated with sterile uveitis. Appropriate medical management can be effective treatment, without the need for pIOL replacement

effects of riboflavin/ultraviolet: a corneal cross-linking on the signs and symptoms of bullous keratopathy

To evaluate the effectiveness of corneal cross-linking in improving the signs and symptoms of bullous keratopathy. This prospective non-randomized case series evaluated 20 eyes with bullous ketratopathy that underwent corneal cross-linking [C3R] with riboflavin and ultraviolet-A [UVA, 370 nm, 3 mW/cm 2]. C3R was performed for 30 min in a routine procedure after removal of epithelium. Central corneal thickness [CCT], corneal haze, visual acuity [VA], and the presence of irritating symptoms were recorded before the procedure, and at 1 week, 1 month, 3 months, and 6 months after the procedure. The mean CCT was 872 +/- 162 micro m [range: 665-1180 micro m] before the procedure. Following the procedure, CCT was 855 +/- 175 micro m after 1 week, 839 +/- 210 micro m after 1 month, 866 +/- 185 micro m after 3 months, and 863 +/- 177 micro m after 6 months [P>0.05, all visits]. There was no significant improvement in VA or corneal clarity after 6 months. Improvement of the following symptoms: burning, pain, and foreign body sensation were reported after 6 months by 83.3%, 75.0%, and 66.7% of patients, respectively. Persistent epithelial defect occurred in five patients [25%] resolved with frequent lubrication and bandage contact lenses. The outcomes of this study indicate corneal cross-linking is not an effective treatment for bullous keratopathy with respect to VA and CCT, although it can improve irritation and discomfort

Comparing the effects of normal saline and 0.05 betadine on bacterial culture results obtained from conjunctiva before and after irrigation during cataract surgery

To compare the effects of normal saline and 0.05 betadine on bacterial cultures obtained from eye conjunctiva before and after irrigation during cataract surgery. It was a Randomized Control Trial [RCT] in patients with cataract. Culture samples were obtained from the inferior fornix prior to periocular prep and after preparation. Subsequently, inside the eyes and fornices were irrigated with 10 cc normal saline or 4 cc 5% betadine for 3 minutes. Once the data were fed into SPSS software, they were analyzed using ?2, Fisher's and McNemar's tests. We obtained 89 positive culture samples [52.4%] before prep [including 38 samples in the normal saline group and 51 samples in the betadine group], 12 positive culture samples [7.1%] after prep, and 8 positive culture samples [4.7%] at the end of surgery. There was no significant relationship between the two groups; however, irrigation was found to be effective in reducing positive cultures in both groups [p<0.001]. Using 5% betadine for periocular prep and normal saline for conjunctival irrigation is as effective as using betadine for prep and irrigation in terms of reducing positive cultures after cataract surgery

Conjunctival bacterial flora and antibiotic resistance pattern in patients undergoing cataract surgery

The purpose of this study was to evaluate the conjunctival bacterial flora and its antibiotic susceptibility pattern in eyes of patients undergoing cataract surgery. Conjunctival soap was obtained on the day of surgery before the application of topical anesthetic, antibiotic or povidone-iodine. Culture and antibiotic susceptibility tests were performed. The data was analyseed with X[2] and T tests. Of the 170 patients 89 cases [52.4%] had positive cultures in the eyes. In 79 eyes [88.8%] found coagulase-negative Staphylococcus [CoNS]. Eighty two cases [95.3%] of isolated Staphylococcus were susceptible to Amikacin, 86[100%] sensitive to Ciprofloxacin and 42 [48.8%] sensitive to Ceftazidime. Average susceptibility and resistancy to antibiotics was 2.6 [ +/- 1.8] antibiotics in women and 1.6 [ +/- 1 .4] in men [P= 0.009]. This study showed that the bacterium most frequently found in the conjunctival flora of the patients undergoing cataract surgery was CoNS. Isolates of this bacterium had low CoNS susceptibility rates to Caftazidime and Vancomycin and high susceptibility to Ciprofloxacin and Amikacin