The influence of selective laser trabeculoplasty on the success of trabeculectomy.

PURPOSE: The purpose of this to investigate whether selective laser trabeculoplasty (SLT) has any effect on the success of trabeculectomy. PATIENTS AND METHODS: Thirteen-one eyes of 29 primary open-angle glaucoma patients who underwent SLT before trabeculectomy and 29 eyes of 27 patients with the same inclusion criteria which underwent trabeculectomy without prior SLT in the Sifa University and in the Batigöz Eye Hospital in January 2012 and November 2012 were reviewed. All patients underwent trabeculectomy for uncontrolled open-angle glaucoma with the same technique. The results were evaluated 3, 6, 12, 18, and 24 months later after surgery. The statistical analysis was performed with the Mann-Whitney U-test. Fisher's Exact Chi-square test was used to compare the continuous and categorical variables. RESULTS: The mean intraocular pressure (IOP) before surgery was 24.1 ± 1.9 in the SLT-performed group and 26.7 ± 1.6 in the non-SLT-performed group. Twenty-four months later, the mean IOP was 15.1 ± 1.2 in the SLT-performed group and 15.4 ± 1.4 in the non-SLT performed group. There was no difference in the IOP drop after trabeculectomy between the two groups (P = 0.531). CONCLUSIONS: SLT has no influence on trabeculectomy success.

Evaluation of the effect of daily activities on intraocular pressure in healthy people: is the 20 mmHg border safe?

PURPOSE: The aim of this prospective study was to evaluate the intraocular pressure (IOP) variations during daily activities such as reading, speaking and carrying in regard to investigating whether an elevation or decrease exists. SUBJECTS AND METHODS: Forty-four eyes of 44 healthy subjects were evaluated. The IOP was measured in relaxation and after reading, speaking and carrying a shopping bag for 5 min on different days, respectively. The subjects rested for 15 min between the activities. Mean initial IOP levels were compared with mean IOP levels after reading, speaking and carrying a shopping bag with paired t test. A p value of 0.05 was considered as statistically significant. RESULTS: We observed no changes in mean IOP after reading (p = 0.188). Mean IOP was increased after speaking and carrying compared with mean basic IOP (p = 0.001 and p = 0.001, very significant, respectively). The mean IOP began to decrease 15 min after speaking and carrying and came back to the baseline values one hour later. CONCLUSIONS: The IOP is not stable during daily activities. Simple actions such as carrying or speaking have an increasing effect on IOP. This should be taken into consideration in glaucoma patients during control measurements, especially in patients in whom the IOP was near to the 20 mmHg border.

Chemokine CXCR-4 and cyclooxygenase-2 in the pathogenesis of pterygium

Background/aim: This study aimed to investigate the expression of chemokine receptor 4 (CXCR-4) and cyclooxygenase-2 (COX-2) in the epithelium and stroma of pterygium tissue in comparison with healthy conjunctiva. Materials and methods: The expression of CXCR4 and COX-2 was investigated by immunohistochemistry in the epithelium and stroma of the pterygium tissue of 29 eyes and compared with healthy conjunctival tissues. The correlation between CXCR4 and COX-2 expression as well as the correlation of these markers with the area of pterygium were evaluated statistically. Results: COX-2 staining scores were 1.75 ± 0.63 in the epithelium and 1.20 ± 0.62 in the stroma of the pterygium tissue. Mean CXCR-4 staining in the epithelium was 0.069 ± 0.37, whereas it was 5.0 ± 2.84 cells in the stroma. There was almost no staining of COX-2 and CXCR4 in the control samples. There was a strong positive correlation between the expression of CXCR-4 and COX-2 in the stroma of the pterygium. Conclusion: CXCR-4 and COX-2 may play important roles in the pathogenesis of pterygium.

The Influence of Chemokine CXCR4 and Cyclooxygenase-2 in the Recurrence of Pterygium.

PURPOSE: To investigate the role of CXCR4 and cyclooxygenase-2 in pterygium recurrence. METHODS: A total of 18 primary and 9 recurrent pterygium samples were analyzed. Immunohistochemical staining using primary antibodies against cyclooxygenase-2 and CXCR4 was performed. The cyclooxygenase-2 and CXCR4 expressing cells were calculated separately on the epithelium and stroma. In addition, a correlation between the area of pterygium and CXCR4 and cyclooxygenase-2 levels was investigated. RESULTS: In the primary pterygium group, cyclooxygenase-2 staining was more intense in the epithelium and more dominant in the stroma of the recurrence samples. The CXCR4 expression was more intense in the stroma of both groups. The highest CXCR4 expression was observed in the recurrent pterygium group. There was a strong correlation between the area of pterygium and CXCR4 and cyclooxygenase-2 of stroma. CONCLUSIONS: CXCR4 and cyclooxygenase-2 may play an important role in the recurrence of pterygium.

Intraocular lens implantation without the use of ophthalmic viscosurgical device.

The purpose of this study was to determine whether single-piece hydrophilic acrylic intraocular lens can be safely implanted without the use of ophthalmic viscosurgical devices. This retrospective study comprised 100 eyes having phacoemulsification and intraocular lens implantation without the use of ophthalmic viscosurgical device. 80 eyes with the use of a viscosurgical device are used as control group. In this intraocular lens implantation technique, the anterior chamber was maintained with an irrigation cannula and intraocular lens was implanted with a lens injector. Visual acuity, corneal clarity and edema, intraocular pressure, and corneal endothelial cell count were evaluated preoperatively and postoperatively at days 1, 7, and 30. Corneal endothelial cell count was repeated 2 weeks after surgery. Complications of this technique were also evaluated. No significant complications of this intraocular lens implantation technique, such as posterior capsule rupture, intraocular lens buttonholing, zonular dialysis, Descemet's tear/detachment, occurred. On the seventh postoperative day, 90 % of eyes achieved 20/20 or better vision. There was no difference in corneal endothelial cell loss between viscoelastic device-used and not-used cases (p = 0.356). When implanting intraocular lens without the use of ophthalmic viscosurgical device, significant intraoperative complications did not occur. The possible advantages are shortened surgery time, avoidance of postoperative IOP spike from ocular viscosurgical device (OVD) remnant, and reduced cost.

Evaluation of Meibomian Gland Dysfunction in Polycystic Ovary Syndrome and Obesity.

Purpose/Aim of the study: The purpose of this study was to evaluate the interaction between Polycystic ovary syndrome (PCOS) and Meibomian gland dysfunction (MGD) and obesity, to reveal whether there is a correlation between the testosterone levels and body-mass index (BMI) levels and the dry-eye complaints of these patients. MATERIAL AND METHODS: The study included 92 patients with PCOS and 52 healthy patients from March 2013 to March 2014. All patients underwent a physical examination, pelvic ultrasound, and clinical and biochemical tests, including free testosterone levels to confirm the diagnosis of PCOS. The BMIs of all subjects were recorded. In addition, the presence of posterior blepharitis, as an indicator of MGD, was recorded. All patients underwent the dry-eye tests including Schirmer 1 and tear film break-up time (BUT). Complaints of dry-eye of the patients were evaluated with the ocular surface disease index (OSDI) questionnaire. The scores of both groups were compared. RESULTS: The presence of MGD was 72.82% in the PCOS group and 61.53% in the control group. There was no correlation between the testosterone levels and study parameters in both groups. BUT levels negatively correlated with BMI in subjects without PCOS (r = -0.520, p = 0.001), whereas positively correlated with MGD and OSDI scores (r = 0.610, p = 0.632; p = 0.001, p = 0.001; respectively). CONCLUSION: Tear film instability due to MGD is common in PCOS and in subjects with high BMI. The MGD in PCOS patients is independent of the BMI.

Evaluation of Different Power of Near Addition in Two Different Multifocal Intraocular Lenses.

Purpose. To compare near, intermediate, and distance vision and quality of vision, when refractive rotational multifocal intraocular lenses with 3.0 diopters or diffractive multifocal intraocular lenses with 2.5 diopters near addition are implanted. Methods. 41 eyes of 41 patients in whom rotational +3.0 diopters near addition IOLs were implanted and 30 eyes of 30 patients in whom diffractive +2.5 diopters near addition IOLs were implanted after cataract surgery were reviewed. Uncorrected and corrected distance visual acuity, intermediate visual acuity, near visual acuity, and patient satisfaction were evaluated 6 months later. Results. The corrected and uncorrected distance visual acuity were the same between both groups (p = 0.50 and p = 0.509, resp.). The uncorrected intermediate and corrected intermediate and near vision acuities were better in the +2.5 near vision added intraocular lens implanted group (p = 0.049, p = 0.005, and p = 0.001, resp.) and the uncorrected near vision acuity was better in the +3.0 near vision added intraocular lens implanted group (p = 0.001). The patient satisfactions of both groups were similar. Conclusion. The +2.5 diopters near addition could be a better choice in younger patients with more distance and intermediate visual requirements (driving, outdoor activities), whereas the + 3.0 diopters should be considered for patients with more near vision correction (reading).

Diurnal Alterations of Refraction, Anterior Segment Biometrics, and Intraocular Pressure in Long-Time Dehydration due to Religious Fasting.

PURPOSE: To investigate the effects of dehydration due to fasting on diurnal changes of intraocular pressure, anterior segment biometrics, and refraction. SUBJECTS AND METHODS: The intraocular pressures, anterior segment biometrics (axial length: AL; Central corneal thickness: CCT; Lens thickness: LT; Anterior chamber depth: ACD), and refractive measurements of 30 eyes of 15 fasting healthy male volunteers were recorded at 8:00 in the morning and 17:00 in the evening in the Ramadan of 2013 and two months later. The results were compared and the statistical analyses were performed using the Rstudio software version 0.98.501. The variables were investigated using visual (histograms, probability plots) and analytical methods (Kolmogorov-Smirnov/Shapiro-Wilk test) to determine whether or not they were normally distributed. RESULTS: The refractive values remained stable in the fasting as well as in the control period (p = 0.384). The axial length measured slightly shorter in the fasting period (p = 0.001). The corneal thickness presented a diurnal variation, in which the cornea measured thinner in the evening. The difference between the fasting and control period was not statistically significant (p = 0.359). The major differences were observed in the anterior chamber depth and IOP. The ACD was shallower in the evening during the fasting period, where it was deeper in the control period. The diurnal IOP difference was greater in the fasting period than the control period. Both were statistically significant (p = 0.001). The LT remained unchanged in both periods. CONCLUSIONS: The major difference was shown in the anterior chamber shallowing in the evening hours and IOP. Our study contributes the hypothesis that the posterior segment of the eye is more responsible for the axial length alterations and normovolemia has a more dominant influence on diurnal IOP changes.