Evaluation of Subfoveal Choroidal Thickness in Internal Carotid Artery Stenosis.

Purpose. To evaluate the relationship between internal carotid artery (ICA) stenosis and subfoveal choroidal thickness (SFCT) in the elderly population. Methods. A total of 42 eyes of 21 patients with more than 70% ICA stenosis (Group 1) on one side and less than 70% stenosis (Group 2) on the other side were recruited for this study. ICA stenosis was diagnosed using both the B-mode and Doppler ultrasound. The two groups were compared in terms of the percentage of stenosis, SFCT measurements, intraocular pressure, ocular perfusion pressure, refractive error, and peak systolic velocity. Eyes were examined with the RTVue-100 OCT device by the EDI-OCT technique. Results. The mean age of the patients was 71.9 ± 10.8 years. The mean percentage of ICA stenosis was 74 ± 4.9% in Group 1 and 47.5 ± 7.7% in Group 2. The mean SFCT was 231.9 ± 44.6 µm in Group 1 and 216.2 ± 46.8 µm in Group 2, which was significantly lower (P = 0.028). A statistically significant positive correlation was found between the percentage of internal carotid artery stenosis and SFCT (r = 0896, P = 0.001). Conclusions. Compensatory SFCT increase can be seen in ipsilateral internal carotid artery stenosis greater than 70%.

23-Gauge transconjunctival sutureless vitrectomy for retained lens fragments after complicated cataract surgery.

PURPOSE: The purpose of this study was to evaluate the effectiveness and safety of 23-gauge (23-G) transconjunctival sutureless vitrectomy in patients with retained lens fragments after complicated cataract surgery. METHODS: In this retrospective consecutive case series, 17 eyes of 17 patients with retained lens fragments after complicated cataract surgery and managed by using 23-G transconjunctival sutureless vitrectomy were evaluated between January 2007 and March 2009 at our institution. RESULTS: Mean follow-up time was 8.5 ± 3.00 months. Nine patients (53%) were pseudophakic, and 8 (47%) were aphakic. A foldable acrylic intraocular lens was implanted in eight eyes with aphakia. In 2 eyes (11.8%), one of 23-G sclerotomy port was enlarged and intravitreal phacoemulsification was performed with 20-gauge phacofragmatome to remove hard nucleus. Visual acuity improved in 100% of eyes and was 20/40 or better in 70.6% of eyes. Postoperative complications were transient elevation of intraocular pressure (29.4%), decentralization of the intraocular lens (5.9%), fibrin reaction (5.9%), mild vitreous hemorrhage (5.9%), and macular retinal pigment epithelial changes (5.9%). CONCLUSION: Twenty-three-gauge transconjunctival sutureless vitrectomy was observed to be effective and safe in patients with retained lens fragments after complicated cataract surgery. In cases with hard nucleus, 23-G vitrectomy probe may not be adequate to remove the lens fragments.

Corneal topographic changes after transconjunctival 23-gauge sutureless vitrectomy.

To evaluate the topographic changes of cornea after pars plana vitrectomy (PPV) with the 23-gauge- (23-G) transconjunctival sutureless vitrectomy (TSV) system within the first postoperative month. In this prospective study, corneal topographic changes were evaluated in 24 eyes of 24 patients who underwent PPV with the 23-G TSV system. All eyes underwent computer-assisted videokeratography using NAVIS (Nidek Advanced Vision Information System) software preoperatively and at the first day, first week, and first month postoperatively. The topographic parameters that were analyzed statistically were the average corneal power (ACP), corneal surface cylinder (CSC), surface asymmetry index (SAI), and surface regularity index (SRI). Mean induced astigmatism was estimated by vector analysis software. The Wilcoxon test was used for statistical analysis. Mean ACP was 43.12±1.16 diopters (D) preoperatively and 42.88±1.44 D at first day (P=0.301), 43.04±1.14 D at first week (P=0.796), and 43.32±1.17 D at first month postoperatively (P=0.187). Mean CSC was 0.61±0.32 D preoperatively and 0.71±0.48 D at first day (P=0.918), 0.60±0.25 D at first week (P=0.826), and 0.70±0.33 D at first month postoperatively (P=0.414). Mean SAI was 0.12±0.05 preoperatively and 0.21±0.16 at first day (P=0.070), 0.15±0.06 at first week (P=0.176), and 0.16±0.09 at first month postoperatively (P=0.198). Mean SRI was 0.41±0.37 preoperatively and 1.05±0.41 at first day (P=0.001), 0.54±0.42 at first week (P=0.211), and 0.41±0.5 at first month postoperatively (P=0.861). Mean surgically induced astigmatism was 0.67±0.7 D at first day, 0.36±0.2 D at first week, and 0.33±0.17 D at first month postoperatively. Corneal surface and astigmatic changes were observed to be insignificant in the early postoperative period after PPV with the 23-G TSV system.

Quantitative assessment of photoreceptor layer in eyes with resolved edema after pars plana vitrectomy with internal limiting membrane removal for diabetic macular edema.

BACKGROUND/AIMS: To evaluate the correlation between visual acuity (VA) and photoreceptor integrity in eyes with resolved diabetic macular edema (DME) after pars plana vitrectomy (PPV). METHODS: Eleven eyes with resolved macular edema following PPV with internal limiting membrane removal for DME were included in this retrospective study. The integrity of the external limiting membrane (ELM) and inner and outer segments (IS/OS) of the photoreceptor junction was evaluated by spectral domain optical coherence tomography. The main outcome measures were percentage of disrupted ELM and IS/OS lines, and correlation between VA and photoreceptor integrity. RESULTS: The mean time after PPV was 78 ± 17 months. The mean lengths of the disrupted ELM and IS/OS lines were 223 ± 167 µm (63%) and 189 ± 175 µm (54%) in the foveola, and 900 ± 522 µm (60%) and 835 ± 582 µm (55%) in the fovea, respectively. Intact ELM and IS/OS lines were positively correlated with VA in both the fovea (p = 0.09 and p = 0.02, respectively) and foveola (p = 0.004 and p = 0.03, respectively). Linear regression analysis showed a statistically significant association of intact ELM and IS/OS lines with VA in the fovea. Disrupted ELM and IS/OS lines had a strong correlation with each other in both the fovea (r = -0.71, p = 0.013) and foveola (r = 0.81, p = 0.02). CONCLUSIONS: The integrity of the ELM and IS/OS lines was positively correlated with VA in eyes with resolved DME after PPV.