Nilufer Yesilirmak

Anterior segment complications after phacovitrectomy in diabetic and nondiabetic patients

Purpose. To evaluate early and late postoperative anterior segment complications of phacovitrectomy and foldable intraocular lens (IOL) implantation in eyes with cataract and coexisting vitreoretinal disease in diabetic and nondiabetic patients. Setting. Department of Ophthalmology, Baskent University Hospital, Ankara, Turkey. Methods. The records of 189 consecutive patients with cataract and posterior segment pathology necessitating phacovitrectomy were retrospectively analyzed. Patient profile, indications for surgery, preoperative findings, intraoperative and postoperative course, and postoperative outcome were evaluated. Phacoemulsification was performed through a clear corneal incision with IOL implantation prior to 23-G pars plana vitrectomy. Results. There were 97 (51.3%) diabetic and 92 (48.6%) nondiabetic patients. The most common indications for surgery were vitreous hemorrhage (57; 58.7%), tractional detachment (35; 36%), and premacular hemorrhage (5; 5.1%) in diabetic patients, and rhegmatogenous retinal detachment (40; 43.4%), macular hole (22; 23.9%), epiretinal membrane (20; 21.7%), and vitreomacular traction (10; 10.8%) in nondiabetic patients. Early (within 4 weeks) postoperative complications included elevation of intraocular pressure, fibrinous uveitis, corneal edema, and development of posterior synechia. Long-term (after 4 weeks) complications included migration of silicone oil into the anterior chamber, posterior capsule opacification, and decentered IOL. The ratio of fibrinous uveitis, posterior synechia, and posterior capsule opacification was found higher in the diabetic group (all p<0.05). Conclusions. Combined vitreoretinal surgery and phacoemulsification is safe and effective in treating vitreoretinal abnormalities coexisting with cataract in diabetic and nondiabetic patients. Diabetic patients should be monitored more carefully for fibrinous uveitis and posterior synechia in the early postoperative period and for posterior capsular opacification in the late postoperative period.

A silicone hydrogel contact lens after 7 years of continuous wear

PURPOSE To report an unusual case with a bandage silicone hydrogel lens that was applied over cyanoacrylate glue application for corneal perforation. DESIGN Retrospective, interventional case report. METHODS A 67-year-old woman with a history of corneal trauma experienced spontaneous corneal perforation in her left eye. Upon arrival, her anterior chamber was flat and Seidel test was positive. After initial treatment with cyanoacrylate adhesive and a bandage silicone hydrogel contact lens, there was no leakage and the anterior chamber was formed at the follow-up period. She was started topical antibiotics. RESULTS After 7 years, she came back with the complaint of permanent redness in her left eye with the same silicone hydrogel lens in her eye. CONCLUSIONS Corneal healing may occur under cyanoacrylate adhesive glue with therapeutic contact lenses and with proper antibiotic application. Silicone hydrogel contact lenses exhibit good efficacy and safety when utilized as a continuous wear therapeutic lens with antibiotics.

Aderhautdicke nach Buckelchirurgie bei Makula-off-rhegmatogener Ablatio retinae

BACKGROUND Enhanced depth imaging (EDI) optical coherence tomography (OCT) provides high-definition cross-sectional images of the choroid. Information on alterations in choroidal thickness (CT) after scleral buckling surgery (SBS) is rare. PATIENTS AND METHODS The medical charts of 122 patients (122 eyes) who underwent SBS for macula-off rhegmatogenous retinal detachment (RRD) were retrospectively analyzed. Patients with a follow-up ≥ 6 months were included. Postoperative EDI-OCT images concerning CT were evaluated 1 week, 1 month and 6 months postoperatively in 4 groups: group 1 cerclage + cryopexy (n = 39 eyes), group 2 cerclage + cryopexy + sponge (n = 28 eyes), group 3 SBS + subretinal fluid drainage (SRD) (n = 25 eyes) and group 4 SBS + sponge + SRD (n = 30 eyes). Subfoveal CT was compared between the groups and with the non-operated fellow eye. RESULTS Subfoveal CT in groups 1, 2, 3 and 4 was thicker 1 week postoperatively. There were no significant differences between the groups or when comparing the operated eye with the fellow eye 1 and 6 months postoperatively. CONCLUSION There were no differences in subfoveal CT 1 and 6 months after SBS between the eye with macula-off RRD and the fellow eye. The use of a sponge or SRD induced no differences concerning subfoveal CT.

Unusual presentation of an intraocular foreign body retained for sixty years.

Intraocular foreign bodies may remain quiescent for many years particularly if they are not metallic. We report a case of a missed intraocular stone foreign body that had remained asymptomatic underneath the iris for 60 years and appeared during cataract surgery.

Effect of dexamethasone intravitreal implant in a corneal graft rejection.

Department of Cornea, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida 33136, USA 2Ankara Training and Research Hospital, Ankara 06340, Turkey Baskent University Hospital, Ankara 06490, Turkey Correspondence to: Nilufer Yesilirmak. Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17 St., Miami, Florida 33136, USA. nxy28@med.miami.edu Received: 2015-02-10 Accepted: 2015-06-16

[Choroidal thickness after scleral buckling surgery in macula-off rhegmatogenous retinal detachment].

BACKGROUND Enhanced depth imaging (EDI) optical coherence tomography (OCT) provides high-definition cross-sectional images of the choroid. Information on alterations in choroidal thickness (CT) after scleral buckling surgery (SBS) is rare. PATIENTS AND METHODS The medical charts of 122 patients (122 eyes) who underwent SBS for macula-off rhegmatogenous retinal detachment (RRD) were retrospectively analyzed. Patients with a follow-up ≥ 6 months were included. Postoperative EDI-OCT images concerning CT were evaluated 1 week, 1 month and 6 months postoperatively in 4 groups: group 1 cerclage + cryopexy (n = 39 eyes), group 2 cerclage + cryopexy + sponge (n = 28 eyes), group 3 SBS + subretinal fluid drainage (SRD) (n = 25 eyes) and group 4 SBS + sponge + SRD (n = 30 eyes). Subfoveal CT was compared between the groups and with the non-operated fellow eye. RESULTS Subfoveal CT in groups 1, 2, 3 and 4 was thicker 1 week postoperatively. There were no significant differences between the groups or when comparing the operated eye with the fellow eye 1 and 6 months postoperatively. CONCLUSION There were no differences in subfoveal CT 1 and 6 months after SBS between the eye with macula-off RRD and the fellow eye. The use of a sponge or SRD induced no differences concerning subfoveal CT.

Case Report of Unilateral Silent Sinus Syndrome with Variable Enophthalmos

Sessiz sinüs sendromu (SSS) nadir görülen tek taraflı enoftalmus, hipoglobus ve asemptomatik maksiller sinüzit ile karakterize bir durumdur.1 Genellikle 30-60 yaş arası bireylerde görülmekle beraber cinsiyetten bağımsızdır.2 Osteomeatal açıklığın tıkanması sonucu maksiller sinüsün sekonder hipoventilasyonu sonucu gelişir.3 Sinüsteki kronik negatif basınç yavaşça orbita tabanını aşağıya çekerek orbita anatomisini değiştirebilir veya orbita içi yapıların fonksiyonunu etkileyebilir.4 Diplopi, enoftalmus ve yüzde asimetriye sebebiyet verir, ancak bu bulguların ayırıcı tanıları arasında sıklıkla düşünülmez.1 Bilgisayarlı tomografi (BT) tanıda altın standarttır.5

Aderhautdicke nach Buckelchirurgie bei Makula-off-rhegmatogener Ablatio retinae@@@Choroidal thickness after scleral buckling surgery in macula-off rhegmatogenous retinal detachment

BACKGROUND Enhanced depth imaging (EDI) optical coherence tomography (OCT) provides high-definition cross-sectional images of the choroid. Information on alterations in choroidal thickness (CT) after scleral buckling surgery (SBS) is rare. PATIENTS AND METHODS The medical charts of 122 patients (122 eyes) who underwent SBS for macula-off rhegmatogenous retinal detachment (RRD) were retrospectively analyzed. Patients with a follow-up ≥ 6 months were included. Postoperative EDI-OCT images concerning CT were evaluated 1 week, 1 month and 6 months postoperatively in 4 groups: group 1 cerclage + cryopexy (n = 39 eyes), group 2 cerclage + cryopexy + sponge (n = 28 eyes), group 3 SBS + subretinal fluid drainage (SRD) (n = 25 eyes) and group 4 SBS + sponge + SRD (n = 30 eyes). Subfoveal CT was compared between the groups and with the non-operated fellow eye. RESULTS Subfoveal CT in groups 1, 2, 3 and 4 was thicker 1 week postoperatively. There were no significant differences between the groups or when comparing the operated eye with the fellow eye 1 and 6 months postoperatively. CONCLUSION There were no differences in subfoveal CT 1 and 6 months after SBS between the eye with macula-off RRD and the fellow eye. The use of a sponge or SRD induced no differences concerning subfoveal CT.

Transient homonymous hemianopia caused by cerebral venous sinus thrombosis: case report.

rare nonspecific atypical cells. He is currently being followed closely by medical oncology, otolaryngology, our ophthalmic plastic surgery clinic, and the familial oncology clinic. The latter clinic ruled out Muir-Torre syndrome and hereditary nonpolyposis colorectal cancer syndrome. Sixteen months after his initial presentation to our institution, he remains recurrence-free. Sebaceous cell carcinomas can be locally invasive and can metastasize to lymph nodes and distant organs. There are a few reports in the literature of eyelid sebaceous cell carcinomas producing lymph node metastases after the original tumour was excised. Where reported, the time span between excision and metastasis detection ranged from 17 months to 7 years. In Shields et al.’s article, it is unclear whether their one case of caruncular sebaceous cell carcinoma had a metastasis. Therefore, to our knowledge, this is the first reported case of a caruncular sebaceous cell carcinoma presenting with lymph node metastasis after surgical excision of the original lesion. Moreover, there were only six months between the initial excision of the caruncular mass and the appearance of the lymph node metastasis, which is a significantly shorter period than what is reported in the literature. This can be partially explained by the fact that sebaceous cell carcinomas are known to masquerade as more benign lesions, thus evading timely diagnosis and excision. Sebaceous cell carcinoma is primarily a disease of older adults. Shields et al. reported a median age at presentation of 72 years. When sebaceous cell carcinoma occurs in much younger patients, there is typically a history of irradiation for a childhood malignancy, especially retinoblastoma. However, our patient has no such history, making his case even more unique. Given that sebaceous cell carcinoma can invade the surrounding conjunctiva and even cornea via pagetoid spread, some authors recommend map biopsies of