Nilufer Gozum

Relationship between retinal lesions and axial length, age and sex in high myopia.

We analysed the relationship between central and peripheral retinal lesions and axial length (AL), patients age and sex with myopia greater than 6 diopters. A total of 212 eyes of 109 patients with high myopia underwent detailed funduscopy and A-scan ultrasonography. AL was measured, and central and peripheral retinal lesions were noted. Results were analysed using Students t-test. Sixty-one patients (118 eyes) were female and 48 (94 eyes) male. Mean age was 31.00 ± 13.67 years, and mean AL was 28.31 ± 2.02 mm. Chorioretinal atrophy, Fuchs’ spot, posterior staphyloma and posterior vitreous detachment increased significantly with AL and age. Fuchs’ spot was more common in females. White-without-pressure (WWP) was inversely correlated with AL and age, and was more common in males. The high frequency of WWP in younger patients and moderate AL suggests that these lesions result from vitreoretinal tractions. Lattice degeneration was also a frequent finding in high myopia, and tended to increase with AL and age, though without reaching statistical significance.

Pseudo-accommodation with intraocular lenses implanted in the bag

PURPOSE To evaluate the accommodation potential in eyes after intraocular lens in-the-bag implantation. METHODS Fifty-one consecutive patients were included in the study. Group 1 included 26 eyes that had phacoemulsification with continuous curvilinear capsulorhexis and in-the-bag implanted foldable IOL. Twenty-five eyes in Group 2 had capsulotomy with extracapsular cataract extraction and were implanted with polymethylmethacrylate IOL. Time elapsed from surgery was at least 6 months. There was no significant difference for age or gender between groups (P > .05). We measured accommodation amplitude and depth of the anterior chamber at distance and near fixation with an ultrasonic biometry device. The results were compared using the unpaired Student t-test. RESULTS The anterior chamber depths while fixating at a distant object were not significantly different between groups (P>.05), however, at near the difference was statistically significant (P=.008). The change in depths between far and near fixation was significantly different (P=.002) and was more pronounced in the the capsulorhexis group (P < .001). The accommodation amplitudes in this group were significantly greater than in the capsulotomy group (P = .025). CONCLUSION Patients who had uncomplicated small incision phacoemulsification surgery with continuous curvilinear capsulorhexis and in-the-bag implanted lens seemed to preserve some pseudo-accommodation after surgery.

Visual results and complications of posterior chamber intraocular lens implantation after capsular tear during phacoemulsification.

BACKGROUND AND OBJECTIVE To determine the visual outcome and complications of posterior chamber intraocular lens implantation after capsular tear in patients undergoing phacoemulsification at Istanbul University, Istanbul Faculty of Medicine, Department of Ophthalmology, Istanbul, Turkey. PATIENTS AND METHODS The medical records of patients who underwent phacoemulsification surgery for senile cataract from January 1, 1996, to December 31, 1998, were reviewed. Patient inclusion criteria were implantation of a posterior chamber intraocular lens after phacoemulsification, being operated on by one of two surgeons, and a follow-up of at least 1 year. There were 58 eyes in the group with capsular tear and 159 eyes in the group with intact capsule. RESULTS A final visual acuity of 0.8 or more was more common in eyes with uncomplicated phacoemulsification surgery (chi-square = 16.25, P = .03). Refraction stabilized most commonly at 2 to 6 months postoperatively in patients with capsular tear and 1 to 21 days postoperatively in patients with uncomplicated phacoemulsification (chi-square = 22.61, P < .001). Complications such as retinal detachment (odds ratio = 11.70, P < .05), cystoid macular edema (odds ratio = 26.33, P < .01), increased intraocular pressure (odds ratio = 14.54, P < .05), and decentration of the intraocular lens (odds ratio = 32.79, P = .001) were more frequently observed in eyes with capsular tear. CONCLUSIONS It takes longer for the refraction to stabilize in eyes with posterior chamber intraocular lens implantation after capsular tear during phacoemulsification. Complications such as retinal detachment, cystoid macular edema, increased intraocular pressure, and decentration of the intraocular lens are more common in these patients, and therefore they should be observed for a longer period of time.

Lens Opacities in Bloom Syndrome: Case Report and Review of the Literature

Bloom syndrome is an autosomal recessive disorder characterized by proportionate short stature, photosensitivity, immunodeficiency, hypogonadism and a tendency to develop various malignancies. The greatly increased frequency of sister chromatid exchanges (reciprocal exchange of homologous segments between the two sister chromatids of a chromosome) is regarded as pathognomonic for BS. We describe an 18-year old girl who presented with short stature. She was diagnosed with BS based on an extremely increased frequency of sister chromatid exchanges. Ophthalmological examination revealed mild lens opacities bilaterally, which, to our knowledge, has not been previously reported to be associated with BS.

Holmium laser thermal keratoplasty for hyperopia in eyes overcorrected with laser in situ keratomileusis for myopia.

PURPOSE To assess the efficacy and safety of holmium laser thermal keratoplasty (Ho:LTK) for hyperopia in eyes overcorrected after laser in situ keratomileusis (LASIK) for myopia. METHODS We performed a prospective evaluation of Ho:LTK in eyes with secondary hyperopia from +1.00 to +5.50 D after LASIK. Thirty-seven eyes of 23 patients received one concentric 8-spot application at the 6-mm-diameter zone. Mean patient age was 41.3 +/- 13.0 years (range 20 to 68 yr). Mean corneal thickness was 455.86 +/- 31.20 microm (range 373 to 506 microm). RESULTS Mean spherical equivalent refraction changed from +2.30 +/- 1.08 D to +0.45 +/- 1.00 D at 12 months after Ho:LTK. Thirty-one eyes (84%) were within +/- 1.00 D of emmetropia and 25 eyes (68%) were within +/- 0.50 D at 1 year. Mean change in refraction was 1.84 +/- 0.92 D. No eye lost 2 lines of best spectacle-corrected visual acuity. CONCLUSIONS Ho:LTK is a suitable alternative for correcting secondary hyperopia resulting from LASIK for myopia. Parameter adjustments may be necessary for improving the results.

Effect of Apraclonidine Versus Dorzolamide on Intraocular Pressure After Phacoemulsification

BACKGROUND AND OBJECTIVE To investigate the efficacy of 1% apraclonidine hydrochloride and 2% dorzolamide hydrochloride in controlling postoperative intraocular pressure elevation in patients undergoing phacoemulsification. PATIENTS AND METHODS A prospective, randomized, double-blind, placebo-controlled study was conducted. Seventy-five patients were randomized to receive either 1% apraclonidine hydrochloride, 2% dorzolamide hydrochloride, or artificial tears immediately after uncomplicated phacoemulsification. Intraocular pressure was measured by Goldmann applanation tonometer 1 to 3 hours preoperatively and 24 hours and 5 days postoperatively. RESULTS Mean intraocular pressure measured at 24 hours and 5 days after surgery was not significantly different between groups. None of the patients had an elevated intraocular pressure of 30 mm Hg or higher. No marked difference was observed in patient age, preoperative intraocular pressure, mean ultrasound time, degree of nuclear hardness, and amount of postoperative intraocular inflammation between groups. CONCLUSION Uneventful phacoemulsification involving meticulous cortical and viscoelastic removal does not cause a significant increase in intraocular pressure 24 hours following surgery.