Facial Dermatoses in Patients With Blepharitis: a Cross-sectional Prospective Analysis.

Introduction: The relationship between facial dermatoses and blepharitis has been known for a long time. Objectives: We aimed to investigate the frequency of accompanying facial dermatoses in patients with blepharitis and their relationship with the severity of blepharitis. Methods: In this cross-sectional study, 95 patients with blepharitis were examined for attending facial dermatoses. The type of blepharitis, the severity of blepharitis, and the degree of dry eye were determined in the patients. Dermoscopic and microscopic examinations were used in the diagnosis of facial dermatoses. The history of allergic rhinitis was questioned because Demodex species frequently accompany blepharitis, facial dermatoses, and allergic rhinitis patients. Mann-Whitney U test was used compare 2 independent groups. In comparing categorical variables, Pearson chi-Squared, Fishere Exact, and Fisher-Freeman-Holton tests were used. Results: At least 1 facial dermatosis was detected in 84.2% patients, and we did not see any facial dermatosis in 15.8% ones. No patients had acne, which is one of the most common facial dermatoses. The most common facial dermatosis detected in our patients was facial demodicosis (57.9%). It was followed by seborrheic dermatitis (22.1%) and rosacea (12.6%), respectively. In addition, 2.1% of the patients had atopic eyelid dermatitis, 23.2% had a history of allergic rhinitis, and 63.2% had ocular demodicosis. Conclusions: It is essential to perform dermatological examinations of all patients with blepharitis in terms of accompanying facial dermatoses and their early diagnosis.

Traumatic wound dehiscence after deep anterior lamellar keratoplasty.

PURPOSE: To analyze the outcomes of traumatic wound dehiscence after deep anterior lamellar keratoplasty (DALK). DESIGN: Retrospective and interventional case series. SETTING: Single hospital. PATIENTS: A total of 338 consecutive cases were reviewed. Eleven eyes that had wound dehiscence related to ocular trauma were included. MAIN OUTCOME MEASURES: Incidence and causes, best-corrected visual acuity (BCVA), and endothelial cell density were evaluated. Complications and secondary surgeries were recorded. RESULTS: Seven patients were male (63.6%) and 4 patients were female (36.4%), with a mean age of 30.6 years (range, 24-40 years). The incidence of wound dehiscence was 3.2% (11/338). The mean interval between the initial DALK procedure and wound dehiscence was 9.45 months (range, 2-16 months). The mean follow-up time was 6 years. The most common trauma was a fist blow injury (36.3%). Descemet membrane perforation was observed in 8 eyes (72.7%); lens damage and vitreous prolapse occurred in 2 eyes (18.1%). The final BCVA was 0.51 and was maintained in 4 eyes (36.3%). At the final visit, 10 grafts (90.9%) were clear. The mean endothelial cell loss was 55.8% between before DALK and last visit. CONCLUSION: Although the intact Descemet membrane protects against dehiscing traumas after DALK, a relative weakness at the graft-host junction tends to persist and a severe deforming force may result in graft dehiscence. This case series indicates that despite the fact that the visual results following the repair are acceptable, corneal endothelium seems to be subjected to severe damage, which puts graft survival chances at risk in the long term.

Changes in central macular thickness after uncomplicated corneal transplantation for keratoconus: penetrating keratoplasty versus deep anterior lamellar keratoplasty.

PURPOSE: The aim of this study was to assess changes in macular thickness by means of optical coherence tomography after penetrating keratoplasty (PKP) and deep anterior lamellar keratoplasty (DALK) for keratoconus. METHODS: This prospective study comprised 60 eyes of 60 patients who had keratoplasty for the treatment of keratoconus. Eyes were divided into 2 groups according to the keratoplastic technique applied: PKP group and DALK group. Measurements of central macular thickness were performed preoperatively and 1, 3, and 6 months after surgery. RESULTS: The final analysis included 33 eyes in the PKP group and 24 eyes in the DALK group. In the PKP group, the central macula was found to be 6.5%, 6.3%, and 4.5% thicker in the first, third, and sixth month, respectively. Similarly, the central macula was 5.6%, 5.4%, and 2.9% thicker at months 1, 3, and 6 in the DALK group. The 2 groups did not differ significantly in terms of macular thickening. The percentage of eyes showing more than 10% increase in the macular region at any time during the follow-up period was 43.2% in the PKP group and 50.0% in the DALK group (P = 0.614). The percentage of eyes found to have a central macular thickness more than 250 µm at any time during the follow-up period was 10.8% in the PKP group and 18.2% in the DALK group (P = 0.424). CONCLUSIONS: The study showed that DALK, although it is a closed-system technique, has a similar impact on the macula compared with PKP.