Effect of keratorefractive surgery on choroidal thickness in anisometropic amblyopia.

PURPOSE: To evaluate postoperative change in choroidal thickness (CT) in patients with anisometropic amblyopia undergoing keratorefractive surgery. METHODS: Anisometropic amblyopic patients and nonamblyopic patients who underwent keratorefractive surgery were included in the study. The eyes were divided into three groups. Group 1 consisted of eyes with anisometropic amblyopia, group 2 were the nonamblyopic fellow eyes, and group 3 (control group) were nonamblyopic eyes which had undergone keratorefractive surgery. At the third postoperative month, the CT of these eyes were measured by Enhanced Depth Imaging OCT (EDI-OCT). The choroidal thickness (CT) was measured in the subfoveal area and at 500 micron intervals nasally and temporally. RESULTS: Twenty-three anisometropic amblyopia patients with amblyopic and fellow eyes and 23 control eyes were enrolled. The mean subfoveal choroidal thickness (CT) was 387.3±168.8µm in group 1, 412.2±88.8µm in group 2 and 337.3±99µm in group 3 (P: 0.019). Group 1 and group 2 showed higher choroidal thickness (CT) in the nasal and temporal quadrants than group 3 (P: 0.03, P: 0.04). At the third postoperative month, central foveal choroidal thickness was 356.6±115.5µm in group 1, 375.1±112.5µm in group 2 and 284.4±98.9µm in group 3 (P: 0.071). Choroidal thickness (CT) in the nasal and temporal quadrants at the third postoperative month was also similar (P: 0.210, P: 0.103). CONCLUSIONS: The macular choroid is thicker in amblyopic eyes and non-amblyopic fellow eyes than in the nonamblyopic controls. Improved fixation after refractive surgery may normalize CT.

Surgical outcomes of Pars Plana Vitrectomy for recurrent retinal detachment in eyes previously treated with Pars Plana Vitrectomy or Scleral Buckling.

PURPOSE: To report anatomical and functional outcomes of pars plana vitrectomy (PPV) for recurrent retinal detachment (RD) after failed scleral buckling (SB) or primary PPV. METHODS: Retrospective analysis of 59 eyes with recurrent RD treated previously with SB or PPV was performed. All eyes underwent 23 gauge PPV. The primary outcome was single surgery success rate (SSSR) for retinal reattachment at the final visit. Secondary outcomes were visual acuity change and number of reoperations. RESULTS: SSSR was 77.4 % in the SB group and 67.9 % in the PPV group (P=0.41). The mean change in visual acuity was not significantly different between the two groups (P=0.35). The mean number of reoperations was 1.2±0.5 and 1.4±0.6 in the SB and PPV groups, respectively (P=0.38). CONCLUSION: PPV was found to be an effective technique for the management of recurrent RD after SB and PPV surgeries. However, the small sample size and the retrospective design prevent any claims of advantages or disadvantages of one surgical technique over the other.

Comparison of botulinum toxin-A injection in lacrimal gland and conjunctivodacryocystorhinostomy for treatment of epiphora due to proximal lacrimal system obstruction.

PurposeTo investigate and compare the efficacy of botulinum toxin-A injection in the lacrimal gland and conjunctivodacryocystorhinostomy surgery for the treatment of epiphora caused by proximal lacrimal system obstruction.MethodsCharts of the patients with proximal canalicular obstruction who had undergone conjunctivodacryocystorhinostomy with permanent tube insertion (18 patients, group 1) or 4 units of botulinum toxin-A injection in the palpebral lobe of the lacrimal gland (20 patients, group 2) were reviewed retrospectively. The upper lacrimal system obstruction was diagnosed by lacrimal system irrigation. Schirmer-1 test and Munk epiphora grading for evaluation of epiphora were performed before the interventions and on tenth day, first, third, and sixth months after the interventions.ResultsImprovement of epiphora was statistically significant at all visits when compared with values before injection (P<0.001) in both of groups. When two techniques were compared, difference in degree of epiphora before and after intervention was not statistically significant (P<0.05). In group 2, none of the patients had punctate epitheliopathy, although there was a significant decrease in Schirmer test results (P<0.001, paired t-test). In group 1, 9 cases (50%) had tube dislocation, 4 cases (22.2%) had obstruction, and granuloma formation. Five cases (25%) had ptosis in group 2.Conclusion Conjunctivodacryocystorhinostomy requires surgical experience, special postoperative care, and multiple revisions. As botulinum toxin-A injection in the lacrimal gland is technically easy, less-invasive, safe, with reversible effects, it can be considered as an alternative treatment in patients with proximal lacrimal system obstruction.

Talon cusp variations: 2 case reports.

Talon cusps in anterior teeth are relatively rare developmental anomalies. They are characterized by the presence of an accessory cusp-like structure projecting from the cingulum area or cementoenamel junction. Facial talons occur very rarely; <10 cases have been described in the literature. This article attempts to describe the variants of this anomaly with 2 case reports involving facial and bilateral palatal manifestation.

A rare case of unicystic ameloblastoma with luminal, intraluminal, and intramural proliferation.

Unicystic ameloblastoma (UCA) is a cystic lesion that shows clinical, radiographic, or gross features of an odontogenic cyst, but reveals a typical ameloblastomatous epithelium lining in the cyst cavity, with or without luminal and/or mural tumor growth. This article reports the case of a 22-year-old man with dull intermittent pain and swelling in the mandible. Histopathological examination revealed a UCA of a luminal, intraluminal, and intramural histological subgroup, which has a high risk for recurrence.

Efficacy and safety of pneumatic trabeculoplasty versus timolol added to latanoprost in primary open angle glaucoma.

BACKGROUND: To compare the safety and short-term additive hypotensive effect of pneumatic trabeculoplasty (PNT) versus timolol among patients receiving topical latanoprost for primary open angle glaucoma (POAG). PATIENTS AND METHODS: This study prospectively evaluated 30 eyes of 30 patients with POAG receiving latanoprost monotherapy. We randomly assigned 15 eyes to PNT plus latanoprost (Group A), and 15 eyes to latanoprost/timolol fixed combination therapy (Group B). PNT treatment was performed at days 0, 7, and 90. Follow-up visits occurred at day 1, week 1, and months 1 and 3. RESULTS: Compared to baseline values, both treatments significantly lowered IOP (p ≤ 0.001).The mean IOP for Group A was 21.13 ± 1.6 mmHg at baseline and 18.7 ± 1.5 mmHg at three months (p ≤ 0.001). For Group B, mean IOP was 20.8 ± 1.9 mmHg at baseline and 18.9 ± 0.8 mmHg at three months (p ≤ 0.001). Transient conjunctival hyperaemia, the only adverse effect occurring after PNT, was observed in all patients in Group A. CONCLUSION: The additive IOP-lowering effect of PNT was similar to timolol in patients with POAG receiving latanoprost.

Salivary ascorbic acid levels in betel quid chewers: A biochemical study.

BACKGROUND: Quid chewing practice has been a part of our tradition since centuries with little known evidence of oral cancer. However, recent trends show a rise in occurrence of oral cancer often associated with tobacco and arecanut usage. Ascorbic acid is an important salivary antioxidant. Betel leaf which is used in quid is known to contain ascorbic acid. AIM: The aim of our study was to assess the salivary levels of ascorbic acid in traditional quid chewers so as to determine whether the betel leaf has protective antioxidant action. MATERIALS AND METHODS: Salivary ascorbic acid levels of 60 subjects were estimated using the Dinitrophenyl hydrazine method. RESULTS: The results revealed that quid chewers who used betel leaf had higher salivary ascorbic acid content compared to nonbetel leaf quid chewers. This could possibly be due to the protective antioxidants in the betel leaf.

Subconjunctival bevacizumab injection in the surgery of primary pterygium: comparison with intraoperative mitomycin-C.

PURPOSE: To assess the efficacy of subconjunctival bevacizumab injection as adjuvant therapy in the prevention of recurrence following the surgical treatment of pterygium by comparison with intraoperative mitomycin-C application. METHODS: This prospective comparative study included thirty consecutive patients with primary nasal pterygium that were surgically treated with simple excision. In addition to surgical excision, subconjunctival bevacizumab was injected in 15 eyes (group A), and, in the remaining 15 eyes, topical mitomycin-C 0.2 mg/mL was applied for 2 minutes (group B). The postoperative outcome was followed clinically for a minimum of 12 months. The main outcome criteria were recurrence rate and postoperative complications. RESULTS: A significantly higher recurrence rate was found in bevacizumab group (66.7%) compared to MMC group (26.7%) (P= 0.028). In group A, conjunctival wound separation was observed in 3 of 15 eyes; however, no conjunctival separation was observed in Group B and no other serious complications were observed in either group. CONCLUSION: The intraoperative use of subconjunctival bevacizumab does not seem to be effective in reducing the rate of pterygium recurrence following excision when compared with intraoperative mitomycin-C application.

The three-dimensional structure of apopain/CPP32, a key mediator of apoptosis.

Cysteine proteases related to mammalian interleukin-1 beta converting enzyme (ICE) and to its Caenorhabditis elegans homologue, CED-3, play a critical role in the biochemical events that culminate in apoptosis. We have determined the three-dimensional structure of a complex of the human CED-3 homologue CPP32/apopain with a potent tetrapeptide-aldehyde inhibitor. The protein resembles ICE in overall structure, but its S4 subsite is strikingly different in size and chemical composition. These differences account for the variation in specificity between the ICE- and CED-3-related proteases and enable the design of specific inhibitors that can probe the physiological functions of the proteins and disease states with which they are associated.