Necile Erkam

Effects of amniotic membrane on wound healing and adhesions in experimental strabismus surgery.

Purpose To evaluate the efficiency of amniotic membrane in prevention of adhesion formation after strabismus surgery. Methods A prospective, controlled study was conducted on 20 eyes of 10 pigmented rabbits. After disinsertion of the superior rectus muscle, under the muscle insertion area to induce adhesion formation, a partial-thickness 4 × 4 mm sclerectomy was performed in both eyes. In the right eyes, a piece of appropriate size human amniotic membrane was sutured on the sclerectomy site. As the control group, left eyes were operated with a similar procedure but without amniotic membrane transplantation. After 2 months, both eyes were enucleated to perform histopathologic examination. Results There was no adhesion between the sclera and muscle in the amniotic membrane group; however, there were various degrees of adhesions in the control group (p=0.004). Fibrosis in rectus muscle was present in 40% of the specimens in the amniotic membrane group and 90% in the control group with a higher grade (p=0.023). The mean number of inflammatory cells was significantly higher in the amniotic membrane group (p=0.005). Conclusions According to our results, amniotic membrane has antifibrotic effect but no anti-inflammatory effect in rabbit eyes due to possible xenograft reaction to human tissues. It is effective in prevention of adhesion formation with possible physical barrier action.

Emmetropization in Anisometropic Amblyopia

Purpose: To investigate the process of emmetropization in anisometropic amblyopic subjects during childhood and to determine the effects of spectacle use only and patching. Methods: Retrospectively, the records of patients who were diagnosed as anisometropic amblyopes were reviewed and 132 subjects who were between the ages of 5 to 8 at the time of diagnosis, with minimum follow-up of 3 years, were included in the study. Full ophthalmological examination was performed in every subjects and the information from every visit was retrieved for evaluation. Patients were divided into two groups according to the treatment they applied: patching and spectacle alone. Results: The emmetropization process was similar to normal subjects after 3 years of follow-up, with a change of −0.71 D from the baseline spheric retinoscopy measurement in the spectacle group and −0.53 D in patching group (p > 0.809). Patching and spectacle use did not change the decrease in hypermetropia. Astigmatism and anisometropia scores did not show any difference in two groups in the 3-year follow-up period. Conclusion: The emmetropization process is similar to normal population in anisometropic subjects and spectacle use and patching therapy have no effects on this process. The anisometropia score does not change with patching and stays relatively the same during the follow-up in childhood.

Comparison of anisometropes with and without amblyopia.

Background: To compare binocular functions in amblyopic and non-amblyopic anisometropes and to investigate the possible associated factors for amblyopia development such as type of refractive error and initial age of refractive error correction. Materials and Methods: Prospectively anisometropic subjects with (n=42) and without amblyopia (n=33) were included in the study. Full ophthalmological examination including binocularity and motility was performed. Results: There was no statistically significant difference between the ages at the time of initial refractive error correction ( P =0.946). All of the anisometropes (100%) had fusion with Worth 4-dot test and Bagolini glasses. However 81% of amblyopic subjects had fusion with Worth 4 dot test and 88.1% had normal response with Bagolini glasses. Median stereopsis was 60 sec of arc in anisometropic subjects and 400 sec of arc in amblyopes. Conclusion: Our data support that, binocular functions are well developed in anisometropes without amblyopia and initial age at correction of refractive error has no primary effect on development of amblyopia.