Combined ocular anesthesia via a single entry.

Although topical anesthesia techniques for cataract surgery are evolving, injections are unavoidable in some cases. Our technique of injecting local anesthetic agents for akinesia of the orbicularis oculi and the globe via a single entry near the lateral canthus decreases the pain and patient anxiety about the number of injections and avoids the complications of retrobulbar injection.

Relation between corneal thickness and intraocular pressure measurement by noncontact and applanation tonometry.

PURPOSE: To assess whether there is a significant difference in intraocular pressure (IOP) measurements between noncontact and applanation methods and if so, whether the difference is correlated with corneal thickness. SETTING: Isik Eye Clinic, Ankara, Turkey. METHODS: This prospective study comprised 120 eyes of 60 randomly selected patients. Noncontact tonometry, applanation tonometry, and pachymetry were performed in each eye. The results were compared and an analysis was performed to determine whether there was a correlation between the differences in IOP measurements and corneal thickness in the entire group and in subgroups composed of the halves and quarters of the group. RESULTS: The mean IOP in the entire group was 20.38 mm Hg +/- 4.97 (SD) with the noncontact tonometer and 18.84 +/- 4.47 mm Hg with the Goldmann applanation tonometer. The difference between the measurements with the noncontact method and those with the applanation method was statistically significant (P <.01) except in cases having a corneal thickness between 513 microm and 539 microm (P >.01). There was a positive correlation between corneal thickness and the difference in measurements by noncontact and applanation tonometry, and the magnitude of correlation was greater in cases with thicker corneas. CONCLUSION: The reliability of tonometers decreased with increasing corneal thickness, in which case higher readings were found, especially with the noncontact tonometer.

Correlation between intraocular pressure and corneal stromal thickness after laser in situ keratomileusis.

PURPOSE: To assess the relationship between intraocular pressure (IOP) and corneal stromal thickness following laser in situ keratomileusis (LASIK) for myopia or myopic astigmatism. SETTING: Private clinic in Turkey. METHODS: The database of patients who had LASIK was retrospectively reviewed. Preoperative and postoperative IOP and corneal thickness were measured in both eyes of 353 patients by noncontact tonometry and ultrasonic pachymetry, respectively. The correlation between changes in IOP and corneal thickness was evaluated by regression analysis. RESULTS: Laser in situ keratomileusis was associated with a mean decrease in pachymetry of 46.7 microm +/- 28.9 (SD) and a mean decrease in IOP of 2.8 +/- 2.1 mm Hg. There was a significant correlation between the decreases in IOP and pachymetry (P <.001). CONCLUSION: The decrease in IOP after LASIK was related to the decrease in corneal stromal thickness, although there may be other contributing factors.

Outcome of flap subluxation after laser in situ keratomileusis: results of 6 month follow-up.

PURPOSE: To evaluate the long-term outcome in cases with flap subluxation after laser in situ keratomileusis (LASIK). SETTING: Private clinic in Turkey. METHODS: Data of all patients who had LASIK were documented and the follow-ups of those who had flap subluxation evaluated. The number of LASIK cases was 1481 and the number of flap subluxations, 21. Laser in situ keratomileusis was performed with the Moria microkeratome and the VISX Twenty/Twenty B excimer laser using a multizone profile and the sutureless hinged corneal flap technique. RESULTS: The incidence of flap subluxation was 1.42%. Statistical analysis of uncorrected visual acuities, best corrected visual acuities, and mean spherical equivalents in eyes with and without flap subluxation was performed. No significant differences were found, although the results in eyes with flap subluxation were worse than those in eyes without flap subluxation. Additional complications were also higher in eyes with flap subluxation. CONCLUSION: Flap subluxation is a serious but manageable complication of LASIK. If it is detected early, the visual prognosis is as good as that in eyes without flap subluxation.

Accurate time interval in repeated tonometry.

PURPOSE: Determination of the accurate interval between the measurements in repeated tonometry. METHODS: Two hundred-and-seventy subjects were randomly divided into 6 groups. Two successive intraocular pressure (IOP) measurements were performed with Goldmann-type applanation tonometer at different time intervals in each group. The time intervals between the two measurements were 1, 2, 3, 4, 5 and 10 minutes. The results in each group were statistically analyzed with the significance test for matched observations. RESULTS: We recorded a statistically significant difference between the first and the second IOP measurements at 1, 3, 4 and 5-minute-intervals. The differences were not significant at 2 and 10 minute-groups. CONCLUSION: The time interval between successive IOP measurements should be 2 or 10 minutes for accurate tonometry.