Evaluation of early results of quick-chop phacoemulsification in the patients with high myopic cataract.

AIM: To assess the early surgical outcomes of quick-chop phacoemulsification technique in patients with high myopia. METHODS: The data of patients with high myopia who underwent quick-chop phacoemulsification were reviewed retrospectively. There were 42 eyes of 31 patients. The axial length was more than 26 mm in all eyes. All eyes underwent quick-chop phacoemulsification surgery with the placement of an intraocular lens (IOL) in the capsular bag. Postoperative visits were performed at 1, 3d; 2wk, 1mo. Early postoperative best corrected visual acuity (BCVA), preoperative and postoperative corneal endothelial cell density (ECD), central corneal thickness (CCT) and postoperative complications were assessed. Paired sample t-test or Wilcoxon tests were used to compare data between preoperative and postoperative data. RESULTS: There was no statistically significant difference between preoperative and postoperative ECD and CCT. Retinal detachment was developed in one eye at postoperative first day. There was an iris prolapsus from side port insicion. CONCLUSION: Quick-chop phacoemulsification technique is a safe surgical technique. However we can encounter some complications in high myopic eyes due to histopathological differences. Both side port and clear corneal tunnel insicion size is crucial for preventing postoperative complications. If any persistent leakage is noticed, suture should be placed.

Use of endocanalicular dacryocystorhinostomy with multidiode laser in children.

OBJECTIVE: To evaluate the clinical outcome and efficacy of endocanalicular laser dacryocystorhinostomy using a multidiode laser in cases unresponsive to medical therapy, probing or intubation of pediatric nasolacrimal duct obstruction. METHODS: Eight children with nasolacrimal duct obstruction were treated with a multidiode laser. The study was prospective, non-randomized, and noncomparative. The patients, 2 (25%) males and 6 (75%) females, ranged in age from 8 to 13 years (mean 11.25±2.43). Surgery was performed under general anesthesia. All procedures were performed using a multidiode laser. The nasal passage was visualized with a 30° nasal video endoscope. In all cases, silicone stents were inserted. The main outcome measure was resolution or improvement of the epiphora and no major laser damage intranasally. Patients were followed for at least 6 months. RESULTS: The endocanalicular laser dacryocystorhinostomy failed in one of the 8 (12.5%) cases, which had been secondary to trauma. The others were due to primary nasolacrimal duct obstruction. External dacryocystorhinostomy was performed on the failed case. None of the cases with primary nasolacrimal duct obstruction had obstruction after the endocanalicular laser dacryocystorhinostomy operation. CONCLUSIONS: Endocanalicular laser dacryocystorhinostomy using a multidiode laser appears to be an effective technique in cases unresponsive to medical therapy, probing or intubation of primary nasolacrimal duct obstruction.

Is it necessary to accompany probing with endoscopy in cases of congenital nasolacrimal canal obstruction?

OBJECTIVE: To compare the results of probing with and without endoscopy in cases of congenital nasolacrimal duct obstruction who had previously not undergone probing. METHODS: Fifty-one children with congenital nasolacrimal duct obstruction who underwent surgical intervention between June 2007 and April 2009 in our hospital were included in the study. Patients who had had previous probings were excluded from the study. Conventional probing was performed in 37 eyes of 25 patients, and probing with intranasal endoscopic visualization in 36 eyes of 26 patients. Diagnosis was based on history of epiphora since birth or shortly after, and fluorescein dye disappearance test. RESULTS: Thirty-two of 37 eyes (86.48%) were cured by probing. Of the 5 cases with complaints, 1 had lacrimal sac fistula. Thirty-four of 36 eyes (94.44%) were cured by probing guided by endoscope observation. Thirty-two cases had stenosis at the lower end of the nasolacrimal duct which required probing. In two cases the probe passed submucosally to the floor of the nose. In two cases a false passage was made at the upper end of the inferior meatus. In these cases, the operation was continued by repeating the process until the distal end of the nasolacrimal canal was seen to have been passed. CONCLUSION: Probing with endoscopy may be excessive in primary cases but in cases which have undergone unsuccessful probing, it is useful for visualization of anomalies in the lower nasolacrimal canal and to obtain the correct anatomic position for the probe.

A new method for removing displaced silicone tubing from the nasolacrimal duct.

Silicone tubes are widely used in lacrimal system surgery. A common complication associated with the use of silicone tubes is lateral migration or displacement of the tubes. In some cases, the distal part of the silicone tube passes through the rhinostomy area, where it may become embedded in the lacrimal sac. The silicone tubes could not be seen in the nose endoscopically. The distal part of the silicon tube could not be seen in the rhinostomy area, so it was removed using a new method.

Evaluation of perforating eye injuries by using cluster analysis.

We evaluated the epidemiology, visual outcome, and clinical characteristics of serious eye injuries and identified preventable risk factors. We concluded that many accidents and their resulting injuries were preventable by education, greater intensive care and workplace safety. Perforating ocular injuries in rural environment are still a big therapeutic, social and economic problem.

Phakomatous choristoma of the lower eyelid: a case study with a review of the literature.

We report a case of phakomatous choristoma of the lower eyelid. A 2-week-old girl was referred with a tumor of the right lower eyelid near the inner canthus, present since birth. No other abnormalities were noted. The tumor was excised, and histopathologic examination of the tumor showed phakomatous choristoma of the eyelid. This is the first report of phakomatous choristoma of the eyelid in Turkey.

Conjunctival-limbal autograft, amniotic membrane transplantation, and intraoperative mitomycin C for primary pterygium.

We evaluated and compared the safety and efficacy of the conjunctival-limbal autograft, amniotic membrane transplantation, and intraoperative application of mitomycin C in 94 patients undergoing primary pterygium surgery and concluded that conjunctival-limbal autografting and amniotic membrane methods were more effective and safer than intraoperative mitomycin C.

Surgical technique and postoperative complications in congenital cataract surgery.

BACKGROUND: We evaluated cases that underwent congenital cataract surgery in terms of the surgical technique, post-operative complications, and visual prognosis. MATERIAL/METHODS: We retrospectively evaluated 132 eyes in 76 patients with congenital cataracts who underwent cataract surgery between January 1995 and December 2000. The patient age at surgery, surgical technique, post-operative complications, and final visual prognosis were evaluated. RESULTS: Thirty eyes underwent aspiration, posterior capsulotomy, and intraocular lens (IOL) implantation; 22 eyes underwent aspiration and posterior capsulotomy; 39 eyes underwent aspiration, posterior capsulotomy, and anterior vitrectomy; and 41 eyes underwent aspiration, posterior capsulotomy, anterior vitrectomy, and IOL implantation. The most frequent complications were secondary cataract (24.2%), posterior synechiae (9.1%), and glaucoma (3%). Groups were compared according to surgical technique and incidence of complications. Complications occurred most frequently with aspiration and posterior capsulotomy and occurred less frequently with aspiration, posterior capsulotomy, and anterior vitrectomy; these differences were statistically significant (p<0.05). The difference in the final visual prognosis was statistically significant in the aspiration, posterior capsulotomy, anterior vitrectomy, and IOL implantation groups as compared with the other groups (p<0.05). The mean follow up times was 15.5+/-1.78 months. CONCLUSIONS: The most frequent complication of congenital cataract surgery is secondary cataract formation. Today, posterior capsulotomy with anterior vitrectomy is the preferred method for decreasing the incidence of this complication.

Intraocular pressure and quality of blockade in peribulbar anesthesia using ropivacaine or lidocaine with adrenaline: a double-blind randomized study.

The aim of this study was to compare the effects of ropivacaine with those of lidocaine on the intraocular pressure (IOP) and the quality of the blockade in peribulbar anesthesia for cataract surgery. Fifty patients were allocated randomly into two groups and received 7-10 ml of 0.75% ropivacaine or 2% lidocaine with adrenaline, though the peribulbar two-point injection. The quality of the blockade was assessed by ocular and eyelid akinesia, pain during the peribulbar injection, and surgical satisfaction. The duration of the motor block was also evaluated after surgery. The IOP was measured using a Tonopen before the blockade (control) and at 1, 5, and 10 min after injection of the anesthetic. Lidocaine induced significantly lower akinesia scores at 6, 8, and 10 min post-injection than did ropivacaine. The mean IOP (mmHg) was significantly lower with respect to the baseline level at 10 min after blockade in the ropivacaine group compared with the lidocaine group. Ropivacaine also caused less pain on injection. There was no difference in surgical satisfaction between the groups. The duration of the motor block obtained with ropivacaine was longer than that obtained with lidocaine. Our data indicate that ropivacaine has efficacy similar to lidocaine, with slightly longer onset and duration of the motor blockade. In addition, ropivacaine (0.75%) induces lower IOP and less pain on injection than does lidocaine (2%) when used in peribulbar anesthesia for cataract surgery.

Conjunctival inverted follicular keratosis: a case report.

BACKGROUND: We report a case of inverted follicular keratosis (IFK) on the conjunctiva. A few cases of IFK have been reported in the literature, but it appears that IFK on the conjunctiva has never been reported. CASE: A 21-year-old man was referred for evaluation of a conjunctival mass. OBSERVATIONS: By slit-lamp biomicroscopy, an 8 x 5 x 3 mm mass was observed over the nasal conjunctiva adjacent to the limbus in the left eye. An excisional biopsy of the lesion was carried out. The results of a pathologic examination showed IFK. During the 9-month follow-up period, the patient had no recurrence of the lesion. CONCLUSION: IFK can be considered in the differential diagnosis of conjunctival masses as a rare specific lesion.

Cutaneous anthrax on eyelids.

BACKGROUND: Ophthalmologists should be aware of the signs and symptoms of anthrax, although it is a rare disease in humans. We report our successful treatment of three patients with cutaneous lesions in the periorbital area. CASES: In this study, we report on the treatment of three female patients who were initially diagnosed as having preseptal cellulitis. OBSERVATIONS: Gram-positive robs were revealed in the microscopic examination of scrapings taken from the lesions. Bacillus anthracis was found in only two of the three scraping-material cultures. Intravenous penicillin G was administered in all cases. Black and necrotic eschar, which is characteristic of anthrax, developed on the eyelids of all three patients during treatment. At the final examinations of the patients after the completion of treatment, we recognized the development of cicatrisation, lagophthalmos, and slight ectropion in the upper eyelid of the first patient, and, in the second patient, restriction of upper eyelid movement and development of a corneal scar from exposure keratopathy and ectropion. The cutaneous lesions healed without any eyelid pathology in the third patient. CONCLUSION: Although it is a rare disease in humans, anthrax should be considered in the differential diagnosis of preseptal and orbital cellulitis.

Color doppler imaging of ocular hemodynamic changes in Behçet's disease.

PURPOSE: A prospective evaluation of the ocular blood flow velocity in patients with BehCet's disease was carried out to determine its changes. METHODS: Subjects were divided into three groups: those with ocular involvement in BehCet's disease (group I), those without ocular involvement in BehCet's disease (group II), and a control group (group III). Twenty-seven eyes in group I and 28 eyes each in groups II and III were investigated. The blood flow in the central retinal artery (CRA), ophthalmic artery (OA), nasal posterior ciliary artery (NPCA), and the temporal posterior ciliary artery (TPCA) was measured using color Doppler ultrasonography (CDU) to determine the peak systolic velocity (PSV), end diastolic velocity (EDV), and resistivity index (RI). The mean blood flow velocity of the central retinal vein (CRV) was also measured. These results were then compared among the three groups of subjects. RESULTS: The PSV values of CRA in groups I and II were found to be significantly lower than those in the control group ( P < 0.001, P = 0.018, respectively). The PSV values of CRA in group I were found to be significantly lower than those in group II ( P< 0.001). The EDV values of CRA in groups I and II were found to be significantly lower than those in the control group ( P< 0.001, P = 0.034, respectively). The EDV values of CRA in group I were significantly lower than those in group II ( P = 0.041). The PSV values of OA in group I were significantly lower than those in the control group ( P = 0.002). The EDV values of OA in group I were significantly lower than those values in group II or the control group ( P = 0.001 and P = 0.037, respectively). The PSV values of NPCA in group I were significantly lower than those in the control group ( P = 0.007). The PSV values of TPCA in groups I and II were significantly lower than those in the control group ( P< 0.001, P < 0.001, respectively). The EDV values of TPCA in group I were significantly lower than those values in group II or the control group ( P = 0.014 and P = 0.003, respectively). There were no significant differences in the mean blood flow values of the CRV among all three groups ( P > 0.05). CONCLUSIONS: There are significant reductions in the blood flow values of the orbital arteries in patients with BehCet's disease, and they are more evident in those with ocular involvement. This might be the result of occlusive vasculitis, which is frequently seen in the retinal vessels of patients with BehCet's disease.

Effects of soft contact lenses on conjunctival surface.

PURPOSE: To examine the effects of soft contact lenses on tear breakup time (TBUT), basal Schirmer test result, and the conjunctival surface in patients wearing contact lenses. METHODS: In this study, conjunctival cytologic changes, TBUT, and Schirmer test function alterations of soft contact lens wearers were evaluated by impression cytology. The study included 100 eyes of 50 soft contact lens wearers who were followed up in the Department of Ophthalmology of Dicle University and 80 eyes of 40 subjects as a control group. After TBUT and basal Schirmer test, conjunctival surface epithelial morphology was investigated using impression cytology. After the materials were appropriately stained, they were evaluated according to the Nelson grading scale. RESULTS: Contact lens wearers were divided into three groups according to the duration of contact lens wear. When these groups were evaluated according to the Nelson grading method, 21% of cases were grade 0; 32% were grade 1; and 28% were grade 3. There were statistically significant differences in epithelial cell morphology, goblet cell density, snakelike chromatin changes, TBUT, and basal Schirmer test result between the control and study groups. CONCLUSIONS: We suggest that TBUT and Schirmer test result be carefully monitored in contact lens wearers. Impression cytology may be used as a safe, simple, and noninvasive method in the diagnosis of ocular surface alternations in patients with contact lens intolerance.

Orbital myiasis: case report.

BACKGROUND: Orbital myiasis cases are very rare worldwide. We are reporting this case caused by Hypoderma bovis because invasive parasitic larvae can cause massive destruction. CASE: An 85-year-old female patient was admitted to the Department of Ophthalmology of the Dicle University School of Medicine with the complaint of a wound in her right eye for over one year. Larvae had been in the same eye for one week. OBSERVATIONS: The clinical examination showed no light perception in her right eye. The eyelid was thickened and there was a necrotic lesion 3 x 4 cm in diameter, invading inferiorly into the upper side of the maxilla, superiorly to the roof of the orbita, medially to the lateral part of the nose, and laterally to the ossa zygomatica. Pathological examination of orbital tissue specimens confirmed basal cell carcinoma. CONCLUSIONS: Orbital exenteration, total maxillectomy and graft repair were conducted in the right eye. During the six-month follow-up period, orbital tomography was performed. No recurrence or metastasis was observed.