Posterior Subtenon's Capsule Triamcinolone Acetonide Injection for the Treatment of Diabetic Macular Edema.

PURPOSE: To evaluate and compare the efficacy of posterior subtenon's triamcinolone injections versus grid laser photocoagulation (GLP) combined with posterior subtenon's triamcinolone injection in eyes with diabetic macular edema (DME). METHODS: In this prospective clinical study, 42 eyes with DME that showed a decrease in visual acuity (VA) were included. The first group consisted of 22 eyes that received a posterior subtenon's injection of 40 mg of triamcinolone acetonide under topical anesthesia. The second group of 20 eyes received macular GLP applied 1 month after subtenon's triamcinolone acetonide (STTA) injection. All patients were evaluated at baseline and 1 day; 1, 2, 4, 6, and 8 weeks; and 3 and 6 months after injection. In some patients, injections were repeated after 3 months. The main outcome measures were VA, central macular thickness (CMT), intraocular pressure, cataract progression, and frequency of complications. RESULTS: The mean baseline CMT for Group I was 456.85 ± 56.90 µm. The mean baseline CMT for Group II was 455.66 ± 57 µm. In the first group, mean CMTs for second week, 8th week, 12th week, and 6th month were 258.15, 276.50, 280.05, and 433.30 µm, respectively. In the second group, mean CMTs for second week, 8th week, 12th week, and 6th month were 261.42, 272.76, 284.71, and 291.76 µm, respectively. Before treatment, in the first group, the mean best-corrected visual acuity (BCVA) measured using a Snellen chart was 0.19, while the first week, third, and sixth month BCVA means were 0.59, 0.57, and 0.41, respectively. Before treatment, BCVA in the second group was 0.17, while the first week, third, and sixth month means were 0.61, 0.64, and 0.60, respectively. Treatment complications included cataracts in 4 eyes and glaucoma in 1 eye. CONCLUSION: There is a temporary therapeutic effect of posterior subtenon's triamcinolone injection without laser photocoagulation. GLP improves VA and reduces the risk of recurrent macular edema after posterior STTA injection.

Comparison of burst, pulse, and linear modes used in phacoemulsification surgery.

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 microm on day 1, 555.54+/-39.31 microm at week 1, 543.29+/-33.88 microm at month 1, and 543.29+/-33.88 microm at month 3 in Group I; 549.83+/-49.18 microm on day 1, 530.03+/-46.42 microm at week 1, 524.32+/-45.76 microm at month 1, and 521.32+/-45.26 microm at month 3 in Group III; and 572.91+/-39.12 microm on day 1, 545.91+/-32.67 microm at week 1, 537.70+/-29.77 microm at month 1, and 534.04+/-28.64 microm 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.

Administration of the fixed combination of latanoprost 0.005% and timolol 0.5% in glaucoma patients with an intraocular pressure over 30 mmHg.

PURPOSE: To evaluate the intraocular pressure (IOP) reducing effect of a fixed combination of 0.005% latanoprost and 0.5% timolol in patients with an IOP of 30 mmHg or higher. DESIGN: Prospective, randomized clinical trial. PARTICIPANTS: Twenty-eight patients. METHODS: Patients had received no prior medical glaucoma treatment. Routine ophthalmic examinations and visual field tests were performed before and after treatment for each patient. RESULTS: Mean IOP was 32.28 +/- 0.92 mmHg before treatment. Mean IOP levels were 18.75 +/- 0.68 for the first day, 17.96 +/- 0.90 for the first week and 17.64 +/- 0.66 for the first month after treatment. CONCLUSION: A fixed combination of latanoprost 0.005% and timolol 0.5% is effective in significantly reducing IOP in glaucoma patients with an IOP greater than 30 mmHg.

Refraction, intraocular pressure and anterior chamber depth changes after Nd:YAG laser treatment for posterior capsular opacification in pseudophakic eyes.

PURPOSE: The aim was to investigate the effect of Nd:YAG capsulotomy on refraction, intraocular pressure and anterior chamber depth changes and complications of Nd:YAG laser treatment for posterior capsular opacification in pseudophakic eyes. METHODS: Our study includes 26 eyes (23 patients) with posterior capsular opacification after uncomplicated phacoemulsification surgery and intraocular lens implantation. Complete ocular examinations were performed for all patients. The visual acuity, intraocular pressure and anterior chamber depth measurements were obtained in all examinations. Nd:YAG capsulotomy was measured in all patients. Eyes received one drop of aproclonidine 0.5 % before and immediately after YAG laser capsulotomy. Data were analysed statistically. RESULTS: Mean patient age was 53.73 +/- 13.53 years. Before Nd:YAG capsulotomy mean anterior chamber depth was 4.03 +/- 0.58 mm and in the first day after capsulotomy the mean value was 4.02 +/- 0.46 mm. Mean spherical equivalent refraction before laser treatment was -0.52 D and on the first day after laser treatment was -0.49 D. An improvement in visual acuity was achieved in all cases. Before Nd:YAG capsulotomy mean visual acuity was 0.38 +/- 0.13 and on the first day after capsulotomy, the mean value was 0.93 +/- 0.11, the difference of which was statistically significant. There were no statistically significant differences between the anterior chamber depth and intraocular pressure measurements before laser capsulotomy and on the first day, first month and third month after laser. CONCLUSION: Nd:YAG laser capsulotomy is an effective and safe method of treatment of posterior capsular opacification.

Rose K contact lens fitting for keratoconus.

PURPOSE: We evaluated the clinical outcome and fitting characteristics with Rose K contact lenses in patients with irregular astigmatism due to keratoconus. METHODS: About 19 patients with keratoconus were fitted with Rose K lens in the Cornea Department at the Fatih Sultan Mehmet Training and Research Hospital between May 2005 and April 2006. Patients were between 19 and 32 years of age. All the patients underwent a complete ophthalmic examination and best-corrected visual acuity measurements were taken with glasses at the baseline visit. During biomicroscopic evaluation, position, and centralization of the contact lens and fluorescein staining were noted. Visual acuity, contact lens comfort, and daily contact lens wearing time after fitting were evaluated. RESULTS: A total of 96% of the patients tolerated the fitting. The mean daily wearing time was 10.7 h. There was a significant increase in visual acuity with Rose K lens compared with best-corrected spectacle visual acuity. CONCLUSION: Rose K lenses are a viable alternative in the visual rehabilitation of patients with keratoconus.