Muhammed Batur

In Vivo Confocal Microscopy and Biomicroscopy of Filtering Blebs After Trabeculectomy.

Purpose:The aim of this study is to analyze filtering blebs (FBs) after trabeculectomy with in vivo confocal microscopy (IVCM) and slit-lamp biomicroscopy. Materials and Methods:IVCM using the Heidelberg Retina Tomograph/Rostock Cornea Module and biomicroscopic examination were performed in 67 FBs in 55 patients 3 months to 30 years postoperatively (mean, 3.2±2.1 y). Although the blebs were evaluated by slit-lamp biomicroscopy, standardized FB classification was used. Results:Of the patients, 9 were female (16.3%) and 46 were male (83.7%), ranging in age from 32 to 81 (51.5±13.2) years. The absence of vascularization and tortuous vessels and the presence of epithelial microcysts on the bleb were significantly correlated with good bleb function (P=0.001). IVCM findings significantly correlated with good bleb function, including the number of epithelial microcysts (P=0.002), the stromal cysts without capsule (P<0.001), minimal vascularization (P=0.002), and the absence of tortuous conjunctival vessels (P=0.003) and reticular and trabecular bleb patterns (P=0.01 and <0.01, respectively). In contrast, a hyperreflective condensed bleb stroma was significantly associated with bleb failure (P<0.001). Conclusions:IVCM supports biomicroscopic evaluation as the mainstay for FB analysis and permits diagnostic imaging of FBs to evaluate and follow-up the bleb, differentiation between good and insufficient bleb function, and a microscopic analysis at a cellular level including the structural pattern of the bleb.

Wiedemann-Rautenstrauch Syndrome With Bilateral Tarsal Kink: Three Sutures for Correction

The authors describe a 5-month-old male infant with Wiedemann-Rautenstrauch syndrome, which is an extremely rare condition. He had tarsal kink in upper eyelids in both eyes. The authors treated bilateral tarsal kink with an everting suture via a transconjunctival approach under local anesthesia.The authors describe a 5-month-old male infant with Wiedemann-Rautenstrauch syndrome, which is an extremely rare condition. He had tarsal kink in upper eyelids in both eyes. The authors treated bilateral tarsal kink with an everting suture via a transconjunctival approach under local anesthesia.

Epidemiology of Open Globe Injury in Children

Purpose: The purpose of this study was to evaluate the epidemiology and outcomes of pediatric open globe injury (OGI). Method: The medical records of all patients diagnosed with OGI in the authors’ clinic between 1996 and 2015 were screened retrospectively. A total of 893 eyes of 892 patients aged 16 years or younger were included in the study. Open globe injury was classified according to the ocular trauma classification (OTS). Age, sex, history, cause and month of trauma, treatment received, visual acuity at presentation, final visual acuity, and cause of vision loss were recorded. Results: Children aged 16 years or younger comprised 67.7% of all OGI patients within the studied time period. The annual incidence of OGI in children was 5.16 per 100,000 overall, with 6.12 per 100,000 boys and 4.14 per 100,000 girls. Open globe injuries occurred most frequently in the 3 to 7 year age group and in the summer months. The most common scene of injury was playgrounds (50.2%). A strong, linear, negative correlation was found between OTS values and final visual acuity in logMAR (rp = −0.550, P = 0.0001). Conclusion: The authors’ study revealed that a high proportion of all OGIs in the authors’ region occurred in children under 17 years old. As with adults, OGI in children often results in significant vision loss. However, considering the varying degrees of visual recovery demonstrated by some of the authors’ patients, particularly those with no light perception at admission, the authors believe an eye-sparing approach is warranted in pediatric OGI.

Posterior Capsular Opacification in Preschool- and School-Age Patients after Pediatric Cataract Surgery without Posterior Capsulotomy

Objectives: We aimed to evaluate the development of posterior capsular opacification (PCO) in preschool- and school-age children with cataract who underwent cataract surgery without posterior capsulotomy and anterior vitrectomy. Materials and Methods: The records of 30 eyes of 21 patients who underwent pediatric cataract surgery and intraocular lens (IOL) implantation were retrospectively reviewed. Patients’ age, PCO status and duration, need for neodymium-doped yttrium aluminium garnet (Nd:YAG) laser treatment based on coverage of visual axis, and follow-up period were recorded. Results: The mean age of the patients was 7.6±2.83 (4-12) years. Unilateral cataract surgery and IOL implantation were performed in 12 patients (57.14%) and bilateral cataract surgery and IOL implantation were performed in nine patients (42.86%). Average follow-up time was 17.7±22.67 (3-83) months. PCO developed in 21 eyes (70%) and covered the visual axis in 15 eyes (50%), which therefore required Nd:YAG laser posterior capsulotomy. The mean duration of postoperative PCO development was 8.91±18.7 months (1 week-71 months). Conclusion: We believe that with adequately experienced surgeons, performing both cataract surgery and posterior capsulotomy with anterior vitrectomy in the same session is appropriate for selected preschool- and school-age children with cataract.

Pulmonary functions in pseudoexfoliation syndrome

It is well‐known that pseudoexfoliative material deteriorates iris dilatation function. This material was also found in lung tissue. The aim of the study was to evaluate pulmonary function in patients with pseudoexfoliation.

The Stabilization Time of Ocular Measurements after Cataract Surgery.

ABSTRACT Purpose: To determine the stabilization time of automated refraction, ocular biometric parameters, keratometry, and central corneal thickness (CCT) and to find the optimal time for glasses’ prescription after cataract surgery. Methods: This was a prospective, case series study of 62 consecutive eyes with senile cataracts. Patients undergoing uncomplicated phacoemulsification surgery were included in the study. Automated refraction, keratometry, ocular biometric parameters, and CCT were recorded at baseline before cataract surgery and at follow-up visits at one day, one week, two weeks, and four weeks after surgery. Results: The study was composed of 62 eyes of 62 patients with a mean age of 66±12.38 (range, 40 to 84 years). The automated refraction stabilized one week after surgery and changed minimally between the first week and the first month after cataract surgery. The stabilization of average keratometric corneal astigmatism in keratometry, average anterior chamber depth, and CCT was achieved after the second postsurgical week. Conclusion: It may be possible to prescribe glasses starting from two weeks after an uneventful phacoemulsification cataract surgery for most patients.

Congenital Hypothyroidism in Axenfeld-Rieger Syndrome

This report was presented as a poster presentation “43. National Congress of Turkish Ophthalmology Association, 11 -15 November 2009, Beldibi, Antalya, Turkey”. *Corresponding Author: Erbil Seven MD. Department of Ophthalmology, Faculty of Medicine, Yuzuncu Yil University, 65080, Tusba, Van, Turkey, Phone Number: +90 (505) 292 56 28, Fax Number: +90 (432) 216 83 52, E-mail address: erbilseven@gmail.com Received: 06.12.2016, Accepted: 05.01.2017 CASE REPORT

Anterior Lens Capsule and Iris Thicknesses in Pseudoexfoliation Syndrome

ABSTRACT Purpose: The aim of this study was to evaluate anatomic properties of the lens capsule and iris by anterior segment optical coherence tomography (AS-OCT) in patients with pseudoexfoliation (PEX). Methods: This prospective study included 62 eyes of 62 patients with PEX syndrome and 43 eyes of 43 age- and gender-matched controls. All subjects underwent full ophthalmologic examinations including AS-OCT. Pupillary diameter, midperipheral stromal iris thickness, central and temporal lens capsule thicknesses, and peripheral pseudoexfoliation material thickness on the anterior lens capsule surface were measured and recorded. Results: Mean age was 66.8 ± 9.3 years in the PEX group and 65.5 ± 8.9 years in the control group (p = 0.44). The PEX group consisted of 62 patients: 38 men (61.3%) and 24 women (38.7%); the control group included 43 subjects: 25 men (58.1%) and 18 women (41.9%). Pupillary diameter after pharmacologic mydriasis was 21% smaller in the PEX group than controls. Mean midperipheral iris thickness was 36 ± 7.2 μm (7.8%) thinner in the PEX group than that of control group (p = 0.047). The central anterior capsule was a mean of 3.40 ± 0.51 μm (18%) thicker in the PEX group compared to the control group (p = 0.0001). The temporal anterior lens capsule was a mean of 0.17 ± 0.15 μm thicker in the PEX group compared to the control group (p = 0.81). Conclusions: With high-resolution OCT imaging, it has become possible to evaluate the anterior lens capsule without histologic examination and demonstrate that it is thicker than normal in PEX patients.

Ultrasonic Elastography Evaluation in Optic Neuritis.

ABSTRACT Purpose: In the present study, we attempted to determine whether ultrasonic elastography (USE) evaluation can be used in a diagnosis of optic neuritis (ON). Materials and Methods: Thirteen patients who each had one normal eye and one eye with a diagnosis of ON were included in the study. Ultrasonography (US) and USE examinations were performed on the affected and non-affected eyes of all participants. Optic nerve and adjacent fat tissue regions at the same depth were selected, and USE measurements were obtained. The optic nerve diameter was measured in both normal and affected eyes. Results: The mean USE values for the optic nerve were 2.58 ± 0.50 m/s in ON eyes and 1.91 ± 0.39 m/s in normal eyes (p = 0.001). The mean USE values for the optic-nerve adjacent tissue were 2.26 ± 0.45 m/s in ON eyes and 1.77 ± 0.22 m/s in normal eyes (p = 0.001). The mean optic-nerve diameter was 3.80 ± 1.09 mm in ON eyes and 3.28 ± 0.98 mm in normal eyes (p = 0.005). Conclusions: USE may be considered an accessible, safe technique for the detection of significant optic-nerve tissue stiffness in ON and may be used an adjunctive tool for confirming this diagnosis.

Epidemiology of Adult Open Globe Injury.

Objective:The aim of this study was to evaluate the epidemiology and outcomes of adult open globe injuries (OGI) in the eastern part of Turkey. Methods:The retrospective study included all the patients who were diagnosed with OGI (436 eyes in 425 patients) at our clinic between 1997 and 2015. The OGI patients aged over 16 years were included into the study. Open globe injuries were classified according to the Ocular Trauma Classification. Age, gender, medical history, time between trauma and hospital admission, and mechanism of injury were recorded for each patient. Results:The incidence of OGI in adults was found to be 3.40/100,000, with 5.00/100,000 in males and 1.67/100,000 in females. Open globe injuries were mostly seen in the age group of 17 to 29 years and in October and November. The patients included 79.5% males and 20.5% females. Intraocular foreign body was detected in 99 (22.7%) eyes. A strong, linear, negative correlation was found between the Ocular Trauma Classification values and final visual LogMAR (rp = −0.602, P = 0.0001). The most common mechanism of injury was occupational accident (38.4%). Conclusion:Open globe injuries remain a serious public health problem, resulting in significant vision loss. Open globe injuries are mostly seen in the young, middle-aged, and male working population. Additional preventive measures should be taken for the individuals in these groups.