The effect of parental age on NF1 patients in Turkey.

Neurofibromatosis type 1 (NF1) is the most common neurogenetic disorder worldwide, and its clinical presentations are highly variable. NF1 is caused by mutations in the NF1 gene, and 50% of NF1 cases are sporadic, which occur in the absence of a family history of the disease and usually result from a new mutation in the germline of a parent. Advanced paternal age may increase the risk for germinal NF1 mutations; however, some dominant conditions, including neurofibromatosis, have shown a lesser association with paternal age, although there are conflicting reports in the literature. We investigated the effects of paternal and maternal age in 241 NF1 patients (121 sporadic and 120 familial cases) who were seen in Hacettepe hospital, a reference center for genetic diseases in Turkey. For statistical analysis, Spearman's and Chi-square tests were used. In this study, we evaluated paternal and maternal age at birth in sporadic and familial cases of NF1. We also compared the effect of parental age on the appearance and coexistence of various NF1 symptoms. There were no significant statistical differences between paternal age and coexistence of the NF1 symptoms. However, a slightly negative correlation was observed between paternal age and the coexistence of NF1 symptoms in familial cases (p < 0.05). We did not find strong evidence for the effect of parental age on the clinical severity of NF1.

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.

A new combined surgical approach in a patient with microspherophakia and developmental iridocorneal angle anomaly.

BACKROUND: We describe a patient with microspherophakia due to Weill-Marchesani syndrome accompanied by developmental angle anomaly who was successfully treated with a surgery of combined PPL and goniotomy. CASE: We report ocular findings of a 1-year-old girl who was diagnosed with Weill-Marchesani syndrome with a positive family history of glaucoma in her cousins and glaucoma with anterior segment dysgenesis in her older brother. Anterior segment examination revealed clear corneas with 13 mm horizontal diameter in the right and 12.5 mm in the left and very shallow anterior chambers centrally and peripherally in both eyes. Although axial lengths were 18.9 mm in the right and 19.1 mm in the left eye, cycloplegic refractive errors were -7.75 DS (-2.75 at 1800) in the right eye and -8.50 DS (-2,75 at 1800) in the left eye. Intraocular pressures were 34 mmHg in the right and 38 mmHg in the left eye. OBSERVATION: Following pars plana lensectomy, gonioscopy revealed developmental iridocorneal angle anomaly and goniotomy was performed at the same session. During 3 years of follow-up, the patient experienced no complications. IOP was 12 mmHg without medication in the last visit; cup-to-disc ratio and corneal diameters were stable. CONCLUSION: The coexistent microspherophakia and developmental iridocorneal angle anomaly can be successfully treated with combined pars plana lensectomy and goniotomy.

Remove, rotate, and reimplant: a novel technique for the management of exposed porous anophthalmic implants in eviscerated patients.

PURPOSE: To describe and to evaluate a new and relatively easy technique for porous implant exposure repair. METHODS: Eleven patients with exposed porous orbital implants after evisceration were included in this study. Five patients with large exposures (diameter >7 mm) and six patients with small exposures of orbital implants (diameter <7 mm) that persisted despite posterior vaulting of the prosthesis and usage of antibiotics and steroids for more than 6 weeks, underwent revision surgery with the remove-rotate-reimplant technique (3R technique). Negative microbiological culture taken from the exposed socket surface before surgery was the major inclusion criterion. Five patients with insufficient conjunctival tissue also underwent additional mucosa or hard palate grafting of the defect in addition to the remove-rotate-reimplant procedure. RESULTS: Patients have been followed up for more than 18 months (ranging from 18-30 months). None of them received motility peg insertion after repair. Implant reexposure was detected in one patient during the follow-up period, which was managed by dermis fat grafting with implant removal. CONCLUSION: The remove-rotate-reimplant technique is an effective surgical method for repairing exposed porous anophthalmic implants after evisceration with a 90% success in this study. It avoids the removal of the implant from the sclera, which is a traumatic procedure that may lead to the tearing and loss of scleral tissue covering the implant. Saving the porous implant and scleral cover reduces the surgical time and cost.

Retinal thickness change in relation to visual acuity improvement after 23-gauge vitrectomy for idiopathic epimacular membrane.

PURPOSE: To assess the course of macular thickness change in relation to visual acuity improvement, in patients being operated for idiopathic epimacular membrane by 23-gauge pars plana vitrectomy. MATERIALS AND METHODS: The clinical charts of 21 eyes of 19 consecutive patients (9 male and 10 female) were assessed retrospectively. Postoperatively, patients were followed up by best-corrected Snellen visual acuity (BCVA), a thorough ophthalmological examination, including fundoscopy, retinal thickness, and macular morphology as demonstrated by optical coherence tomography. The main outcome measures of the study were changed in central macular thickness (CMT)and visual acuity during the follow-up period. RESULTS: The mean duration of follow-up was 15.9 ± 1.0 months (range 12-24 months). Mean baseline BCVA improved from 0.22 ± 0.03 (decimal fraction) to 0.50 ± 0.07 at the last visit (P = 0.001), whereas baseline CMT (408 µm) decreased to 283 µm at final examination (P = 0.001). During the follow-up, 10 eyes (47%) achieved 0.5 or better BCVA. The first significantly lower CMT readings were obtained at third-month visit while BCVA showed an improvement with the significant difference following 9 months after the surgery. In total, 8 out of 11 phakic eyes underwent cataract extraction with a mean of 6.8 months (range 1-12 months). CONCLUSIONS: After a successful epimacular membrane removal, functional recovery takes at least 9 months in comparison to much early resolution in macular oedema that was evident at third month following the surgery.

Higher-order dispersion compensation to enable a 3.6 micros wavelength-maintaining delay of a 100 Gb/s DQPSK signal.

We demonstrate a method for dispersion slope compensation of a conversion/dispersion-based optical delay to enable 100 Gb/s operation based on a spatial light modulator and fiber Bragg gratings. A continuous delay of up to 3.6 micros for 100, 80, and 20 Gb/s differential quadrature phase-shift-keyed (DQSPK) and 50, 40, and 10 Gb/s differential phase-shift-keyed (DPSK) waveforms is shown. A time-delay bit-rate product of approximately 360,000 for 100 Gb/s DQPSK with wavelength-maintaining operation is achieved.

Continuously tunable 1.16 micros optical delay of 100 Gbit/s DQPSK and 50 Gbit/s DPSK signals using wavelength conversion and chromatic dispersion.

We demonstrate a variable optical delay element that uses tunable wavelength conversion and phase conjugation in highly nonlinear fiber and uses chromatic dispersion in dispersion-compensating fiber. A continuous delay of up to 1.16mus, equaling a >110,000 time-delay bit-rate product for 100 Gbit/s non-return-to-zero differential quadrature phase-shift-keying (NRZ-DQSPK) and >55,000 for 50 Gbit/s NRZ differential phase-shift-keying (NRZ-DPSK) modulation formats, is demonstrated. Bit error rates <10(-9) are demonstrated for each waveform at various delay settings.

Fine tuning of conversion/dispersion based optical delays with a 1 pm tunable laser using cascaded acousto-optic mixing.

We demonstrate a technique for fine tuning of optical delays using cascaded acousto-optic modulators to improve the delay resolution by 5 orders of magnitude compared to a 1 pm tunable laser. A 256 ns delay with <0.5 ps resolution is shown for 40 Gbits/s return-to-zero on-off keying with no added penalty.

The effects of posterior continuous curvilinear capsulorhexis on contrast sensitivity.

PURPOSE: We aimed at evaluating the effects of posterior continuous curvilinear capsulorhexis (PCCC) on contrast sensitivity. MATERIALS AND METHODS: In this prospective, randomized, bilateral clinical study, 40 eyes of 20 patients who underwent bilateral cataract surgery were included. The phacoemulsification machine, viscoelastic substances, surgical tools, and intraocular lenses (IOLs) were the same for both eyes. The only difference was that we conducted the PCCC procedure before IOL implantation to one of the eyes of the patients. The selection of the eye that underwent the PCCC procedure was decided randomly. RESULTS: The mean photopic contrast sensitivity values at spatial frequencies of 1.5, 3, 6, 12, and 18 cpd (cycles per degree) were 41.55, 59.90, 61.25, 32.35, and 9.75, respectively, and for the control group these values were 39.05, 56.60, 57.95, 29.80, and 8.75, respectively. The mean mesopic contrast sensitivity values at special frequencies of 1.5, 3, 6, 12, and 18 cpd were 41.20, 54.75, 55.55, 31.70, and 9.00, respectively, and for the control group these values were 38.35, 51.70, 52.15, 30.05, and 8.00, respectively. The mean contrast sensitivity values of the eyes that underwent the PCCC procedure were slightly better than the fellow eyes at all spatial frequencies, but the difference was statistically insignificant (P>0.05). CONCLUSIONS: In early post-operative period, the PCCC procedure exerts some positive effects on contrast sensitivity although these effects are statistically insignificant.

Post-trabeculectomy choroidal detachment: not an adverse prognostic sign for either visual acuity or surgical success.

PURPOSE: To report the incidence of choroidal detachment (CD) following trabeculectomy and to evaluate its effect on long-term surgical success and best-corrected visual acuity (BCVA). METHODS: A total of 253 eyes of 198 subjects who underwent trabeculectomy between 1993 and 2003 with at least 1 year follow-up were reviewed retrospectively. Twenty-eight eyes of 28 subjects which developed CD postoperatively were classified as Group 1 and the remaining 225 eyes of 170 subjects as Group 2. The risk factors for the development of CD and the influence of CD on BCVA and on the success of trabeculectomy were analyzed and compared between the two groups. RESULTS: In Group 1, preoperative BCVA was significantly lower and cup to disc ratio and the frequency of pseudoexfoliative glaucoma were higher with respect to the control group (p=0.009, p=0.01, p=0.02). The correlations between the development of CD and postoperative findings such as shallowing of the anterior chamber, hypotony, hypotonic maculopathy, hyphema, and fibrin reaction in the anterior chamber were statistically significant.CD was not associated with a significant reduction of BCVA. Intraocular pressures at postoperative first day, sixth month, and first year were lower in Group 1. The success of trabeculectomy and the average number of medications used were not significantly different between the two groups. CONCLUSIONS: CD following trabeculectomy occurred in 11% of our patients. CD was not associated with either a significant drop in BCVA or an adverse influence on long-term IOP control.

ThinOptX vs AcrySof: comparison of visual and refractive results, contrast sensitivity, and the incidence of posterior capsule opacification.

PURPOSE: To evaluate the visual and refractive results, the changes in contrast sensitivity, and the incidence of posterior capsule opacification (PCO) after the implantation of UltraChoice 1.0 ThinOp-tX (ThinOptX Inc.) intraocular lens (IOL) and conventional acrylic foldable IOL (AcrySof MA30AC). METHODS: Twenty-five patients were randomized into two groups prospectively. In Group 1, microincisional phacoemulsification and the ThinOptX IOL implantation were applied in one eye, and in Group 2, conventional phacoemulsification and the AcrySof IOL implantation were applied in the fellow eye. Uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), surgically induced astigmatism (SIA), contrast sensitivity, and the incidence of PCO were observed in the two groups and comparisons were made. RESULTS: Mean follow-up period was 12.8+/-1.5 months (range 11 to 14 months). In the last follow-up examination, UCVA and BCVA were significantly lower and the PCO scores were significantly higher in Group 1 (p<0.05). Although SIA was lower in Group 1, the difference was not statistically significant. Contrast sensitivity in higher spatial frequencies was significantly lower in Group 1 in the 6th month and 12th month visits. Capsular contraction was seen in 3 eyes (12%) in Group 1 whereas there was no capsular contraction or phimosis in Group 2. CONCLUSIONS: Long-term evaluation of the ThinOptX IOL concludes with an increased rate of PCO, a diminished resistance to the capsular contraction vs the AcrySof IOL, and a decrease in visual performance. The poor after cataract performance of this rollable lens shows that microphacoemulsification and ThinOptX IOL implantation is not as effective as conventional hacoemulsification and AcrySof IOL implantation in the long term.

Radial keratotomy for the optical rehabilitation of mild to moderate keratoconus: more than 5 years' experience.

PURPOSE: To present the authors' long-term experience of radial keratotomy (RK) for the optical rehabilitation of patients with mild to moderate keratoconus--central corneal thickness of greater than 400 microm and without apical scarring. METHODS: In this observational, noncomparative series of cases, all consecutive patients with mild or moderate keratoconus, treated by RK between 1990 and 2002, with at least 1 year follow-up were included. A total of 170 eyes of 96 patients were investigated. Mean follow-up was 42.08 +/- 28.14 months. Visual acuity, refraction, corneal curvature, central corneal thickness, and complications were evaluated. RESULTS: In all of the control visits, mean uncorrected and best spectacle corrected visual acuities were better than preoperative values (p<0.0001). Preoperative myopic spherical refraction decreased significantly (p<0.0001), and remained relatively unchanged throughout the follow-up (p=0.43). A small but statistically significant decrease from baseline was ob-served in astigmatism (p=0.038), which almost disappeared 1 year after the surgery (p=0.47). The surgery produced a statistically significant flattening of the corneal curvature (p<0.0001). Central corneal thickness did not change significantly (p>0.05) in either control visit. In 33 eyes (19.4%), re-deepening of the incisions was required. In 3 eyes (1.8%) penetrating keratoplasty was performed, due to disease progression in 2 eyes (1.2%) and acute traumatic hydrops in 1 eye (0.6%). In 4 eyes (2.2%) microperforation, in 2 eyes (1.2%) macroperforation, in 1 eye (0.6%) infectious keratitis, and in 1 eye (0.6%) hyperopic shift occurred. CONCLUSIONS: RK surgery was found to be a reasonable option for the rehabilitation of a selected group of keratoconus patients in the early or moderate stages.

Radial keratotomy for the optical rehabilitation of mild to moderate keratoconus: More than 5 years experience.

PURPOSE: To present the authors long-term experience of radial keratotomy (RK) for the optical rehabilitation of patients with mild to moderate keratoconus central corneal thickness of greater than 400 m and without apical scarring. METHODS: In this observational, noncomparative series of cases, all consecutive patients with mild or moderate keratoconus, treated by RK between 1990 and 2002, with at least 1 year follow-up were included. A total of 170 eyes of 96 patients were investigated. Mean follow-up was 42.08 28.14 months. Visual acuity, refraction, corneal curvature, central corneal thickness, and complications were evaluated. RESULTS: In all of the control visits, mean uncorrected and best spectacle corrected visual acuities were better than preoperative values (p<0.0001). Preoperative myopic spherical refraction decreased significantly (p<0.0001), and remained relatively unchanged throughout the follow-up (p=0.43). A small but statistically significant decrease from baseline was ob-served in astigmatism (p=0.038), which almost disappeared 1 year after the surgery (p=0.47). The surgery produced a statistically significant flattening of the corneal curvature (p<0.0001). Central corneal thickness did not change significantly (p>0.05) in either control visit. In 33 eyes (19.4%), re-deepening of the incisions was required. In 3 eyes (1.8%) penetrating keratoplasty was performed, due to disease progression in 2 eyes (1.2%) and acute traumatic hydrops in 1 eye (0.6%). In 4 eyes (2.2%) microperforation, in 2 eyes (1.2%) macroperforation, in 1 eye (0.6%) infectious keratitis, and in 1 eye (0.6%) hyperopic shift occurred. CONCLUSIONS: RK surgery was found to be a reasonable option for the rehabilitation of a selected group of keratoconus patients in the early or moderate stages.

Capsular tension ring implantation after capsulorhexis in phacoemulsification of cataracts associated with pseudoexfoliation syndrome. Intraoperative complications and early postoperative findings.

PURPOSE: To evaluate the effect of an endocapsular tension ring in preventing zonular complications during phacoemulsification of cataracts associated with pseudoexfoliation syndrome. SETTING: Eye Clinic of Beyoglu Education and Research Hospital, Istanbul, Turkey. METHODS: A prospective randomized study comprised 78 eyes with cataract and pseudoexfoliation syndrome that were randomly divided into 2 groups. The age, sex, cataract density, iridodonesis, axial length, anterior chamber depth, best corrected visual acuity (BCVA), and intraocular pressure (IOP) were matched between groups. In 39 eyes, a capsular tension ring (CTR) was implanted after capsulorhexis and hydrodissection but before nucleus emulsification. Thirty-nine eyes that did not have a CTR implanted served as a control. The main outcome measures were the rates of intraoperative zonular separation and capsular fixation of a foldable intraocular lens (IOL). Posterior capsule rupture without zonular dialysis, vitreous loss, corneal edema, fibrin in the anterior chamber, BCVA, and IOP in the immediate postoperative period were also compared between the 2 groups. RESULTS: Five eyes (12.8%) in the control group and no eye in the CTR group had intraoperative zonular separation (P =.02). Posterior capsule rupture without zonular separation occurred in 3 eyes (7.7%) in the control group and 2 (5.2%) in the CTR group. Capsular IOL fixation was achieved in 37 eyes (94.9%) in the CTR group and 31 eyes (74.3%) in the control group (P =.012). The difference in BCVA was not statistically significant between the 2 groups (P =.44); however, uncorrected visual acuity (UCVA) was significantly better in the CTR group (P =.026). CONCLUSION: In cases of cataract associated with pseudoexfoliation syndrome, implanting a CTR before phacoemulsification of the nucleus reduced intraoperative zonular separation, increased the rate of capsular IOL fixation, and improved UCVA.

Influence of scan radius correction for ocular magnification and relationship between scan radius with retinal nerve fiber layer thickness measured by optical coherence tomography.

PURPOSE: To investigate how optical coherence tomography (OCT) modifies the preset scan parameters to correct the errors resulting from ocular magnification, the influence of examiner's final correction of those already modified parameters on retinal nerve fiber layer (RNFL) thickness measurements, the induced change on RNFL thickness measurements and RNFL estimated integrals (RNFL(estimated integrals)) by adjusting the actual scan radius during RNFL examinations performed by OCT. METHODS: Thirty-five healthy patients underwent an RNFL examination by OCT four times using different scan radii. The first scan was performed with the preset circular scan diameter of 3.46 mm; the actual scan diameter was different, however, because it was modified by the OCT instrument. The second, third, and fourth scans were generated after readjusting the already modified scan diameter by the examiner to 3.46, 3.20, and 3.60 mm. The relationship of axial length and refractive error with the actual scan radius (with ocular magnification calculated by OCT), with the influence of the examiner's final correction on RNFL thickness measurements, with the relationship between scan radius with RNFL thickness measurements, and with RNFL(estimated integrals) were investigated. RESULTS: The actual scan diameter was found to be primarily determined by axial length (R = 0.97, P < 0.0001), but the influence of refractive error was small (R = -0.26, P = 0.067). Final correction of the actual scan radius by the examiner had a significant influence on RNFL thickness measurements (P = 0.025). RNFL thickness measurements obtained without correction of the actual scan radius for magnification were found to be inversely correlated with axial length (R = -0.54, P = 0.001), whereas no similar relationship was found when RNFL thickness measurements were obtained with correction (R = 0.21, P = 0.11). A reciprocal relationship between 1/scan radius with RNFL thickness measurements (they tended to be thinner as scan radii were increased) was found (R = 0.41, P = 0.169), but RNFL(estimated integrals) areas were found to be independent of the scan radius (P = 0.521). CONCLUSION: To increase the accuracy of RNFL thickness measurements, it will be appropriate for the examiner to manually correct the actual scan parameters to the desired or preset ones after their automatic modification performed by the OCT instrument. Keeping the actual scan radius constant for repeated exams is also recommended because RNFL thickness measurements were found to depend on scan size. Alternatively, RNFL(estimated integrals) could be used because they were found to be independent of the scan size.

The refractive changes and long-term (3 years) results of radial keratotomy performed at high altitude.

PURPOSE: To evaluate the development of regression or progression following radial keratotomy (RK) performed at high altitude (1,720 meters) at long-term follow-up (3 years). METHODS: Thirty-nine eyes of 21 myopia patients (between -3.25 D and -11.00 D) whose ages were 19-32 years were included in the study. The RK procedures were performed in standard Russian style. RESULTS: The average spherical equivalent cycloplegic refractions were -5.49 D +/- 2.08 (SD) preoperatively, -1.64 +/- 1.59 D in the short-term (3.41 +/- 1.46 months) and -1.40 +/- 1.71 D in the long-term (30.72 +/- 4.36 months) follow-up period. There was no statistically significant difference between these values at the short- and long-term follow-up measurements (t = -1.57, P =.12). CONCLUSIONS: The refractive changes following RK performed at high altitude occur through a combination of both the direct effect of reduced barometric pressure and the edematous corneal expansion because of hypoxia. An ophthalmologist performing RK surgery at high altitude must consider the long-lasting therapeutic effects of high altitude surgery compared to surgery at sea level.

Posterior capsule opacification 3 years after implantation of an AcrySof and a MemoryLens in fellow eyes.

PURPOSE: To compare the rates of lens epithelial cell (LEC) migration and posterior capsule opacification (PCO) 1 and 3 years after sutureless small incision phacoemulsification and in-the-bag implantation of 2 acrylic polymer intraocular lenses (IOLs)-the AcrySof and MemoryLens-in fellow eyes of patients. SETTING: Eye Clinic, Beyoglu Education and Research Hospital, Istanbul, Turkey. METHODS: Fifty patients with no systemic or ocular problems that would interfere with postoperative visual acuity were included in this prospective study. Each patient had in-the-bag implantation of an AcrySof IOL in 1 eye and a MemoryLens in the fellow eye in a randomized fashion after uneventful phacoemulsification through a sutureless clear corneal incision. RESULTS: At 1 year (n = 32 patients), there was no significant difference between fellow eyes in postoperative best corrected visual acuity (BCVA) and contrast sensitivity. In the MemoryLens group, 10 eyes (31.3%) had PCO and 9 (28.1%), LEC migration. In the AcrySof group, no eye had PCO and 2 eyes (6.3%) had LEC migration (P <.001). At 3 years (n = 21 patients), 1 eye (4.7%) in the AcrySof group had PCO and 3 eyes (14.4%) had LEC migration without PCO. In the MemoryLens group, 1 eye (4.7%) had a clear posterior capsule, 11 eyes (52.4%) had LEC migration, and 9 eyes (42.9%) had PCO (P <.001). A neodymium:YAG capsulotomy was required in 4 eyes (19.0%) in the MemoryLens group but no eye in the AcrySof group. At 3 years, BCVA was lower in the MemoryLens group than in the AcrySof group (P <.05). CONCLUSION: The 3 year clinical data of fellow eyes indicate that the AcrySof IOL causes less PCO than the MemoryLens.

Relation of optic disc topography and age to thickness of retinal nerve fibre layer as measured using scanning laser polarimetry, in normal subjects.

AIMS: To evaluate the relation of the optic nerve head topographic measurements and age with the thickness of the retinal nerve fibre layer (RNFL) in normal Caucasoid subjects by means of scanning laser polarimetry and tomography. METHODS: Topographic optic disc measurements and RNFL thickness values of 38 normal Caucasoid subjects of both sexes aged 20 to 78 were measured using a confocal scanning laser ophthalmoscope and a confocal scanning laser polarimeter. One eye was randomly selected for statistical analysis. The effects of optic disc size, age, and optic disc head topographic measurements of total and regional RNFL thickness were evaluated. RESULTS: Age showed a significant correlation with the integral of the total RNFL thickness (R=-0.341, p<0.05). The optic disc size showed a significant correlation with the integral of the total, superior, and inferior quadrant RNFL thickness (R=0.425, p<0.01), (R=0.361, p<0.05), (R=0.468, p<0.05). Neuroretinal rim area (NRA) had a correlation with the superior and inferior quadrant RNFL thickness values (R=0.339, p<0.05) (R=0.393, p<0.05). There was no significant correlation between the other optic disc topographic measurements and RNFL thickness values (p>0.05). CONCLUSION: The thickness of total as well as superior and inferior quadrant peripapillary RNFL as measured by scanning laser polarimetry increased significantly with an increase in optic disc size. The cross sectional area occupied by superior and inferior polar RNFL increased significantly with an increase in NRA. The total cross sectional area occupied by RNFL decreased significantly with an increase in age. The effects of optic disc size, age, and NRA should be considered when the peripapillary RNFL thickness is evaluated.

Phakic posterior chamber plate intraocular lenses for high myopia.

PURPOSE: Refractive correction of high myopia with phakic minus power intraocular lenses (IOLs) may give dramatic visual results. Various types of lenses developed for this purpose have not gained widespread use due to complications. Long-term results and complications of phakic posterior chamber lenses are yet unknown. The purpose of this study was to evaluate long-term refractive results and complications of early design phakic posterior chamber lenses. METHODS: Thirty-four high myopic eyes implanted with phakic posterior chamber IOLs designed by Fyodorov were evaluated retrospectively. Follow-up time ranged from 36 to 62 months. Corneal endothelial cell counts were made at the central cornea preoperatively and in the sixth month in 18 eyes and in the twelfth month in 14 eyes. RESULTS: Preoperative refractions were between -7.75 and -21.00 D; refractions at the end of the follow-up period were between -5.75 and +3.00 D. Sixty-three percent of eyes were in the +/-2.00-D range. Endothelial cell loss was 9% at 6 months and 10.22% at 12 month. The difference in endothelial cell counts at 6 and 12 months was not statistically significant. CONCLUSIONS: Early design phakic posterior chamber IOLs implanted in this study were developed by Fyodorov and are not used currently. These IOLs provided a stable and reversible refractive correction without leading to cataract formation. Endothelial loss was limited to surgical trauma. Moderate predictability of refractive correction and frequent decentrations with these lenses were linked to the early design of these IOLs.