Osman Saatci

Pseudoexfoliation and glaucoma in eyes with retinal vein occlusion

Purpose: To evaluate pseudoexfoliation (PE) and pre-existent glaucoma in eyes with branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). Methods: Consecutive eyes with a diagnosis of BRVO (73 eyes of 70 patients) and CRVO (53 eyes of 49 patients) examined between July and December 1998 comprised the study eyes. Age-matched control group consisted of 384 eyes of 192 outpatients. The prevalence of PE and glaucoma were determined and appropriate statistical tests were performed. Results: PE was present in six of 73 eyes with BRVO (8.2%), 11 of 53 eyes with CRVO (20.8%) and 20 of 384 control eyes (5.2%). Two of 73 eyes with BRVO (2.7%) and 10 of 53 eyes with CRVO (18.9%) had glaucoma. Compared with the control eyes, PE was significantly more common in eyes with CRVO and coexistent glaucoma was significantly more common both in eyes with CRVO and in eyes with BRVO. Conclusion: While glaucoma seems to be a risk factor both for BRVO and CRVO, PE is a likely risk factor for CRVO.

Unilateral retinal vasculitis, branch retinal artery occlusion and subsequent retinal neovascularization in Crohn's disease

Purpose: To report on a case of Crohns disease and unilateral retinal vasculitis, branch retinal artery occlusion and subsequent retinal neovascularization. Methods: We examined a 38-year-old woman with severe left visual loss and biopsy-proven Crohns disease diagnosed four years prior to the ocular involvement. A Heidelberg scanning laser ophthalmoscope was used for fundus fluorescein angiography and indocyanine green angiography. Retinal neovascularization was detected during the follow-up. Results: Successful regression of retinal neovascularization was achieved after argon green laserpanretinal photocoagulation in addition to oral steroid and salazopyrine. Conclusion: Retinal vascular involvement is a rare ocular feature of Crohns disease and may result in retinal neovascularization that may necessitate prompt laser photocoagulation.

Late postoperative opacification of hydrophilic acrylic intraocular lenses.

BACKGROUND AND OBJECTIVE To evaluate the incidence of postoperative opacification of hydrophilic acrylic intraocular lenses (IOLs) and discuss the surgical management. PATIENTS AND METHODS Seventy-two eyes of 72 consecutive patients who received the same type of hydrophilic acrylic IOL (Intraocular Optical International, I.O.I., California, USA) after uneventful phacoemulsification were evaluated retrospectively. Systemic status, follow-up time, recognition time of IOL opacification, time lapse between implantation and explantation, and surgical technique during explantation were reported. RESULTS IOL opacification was noted in 3 patients (4.1%). Time lapse between implantation and first recognition of opacification was 6.3+/-1.5 months (range: 5-8 months). Two of the patients had insulin-dependent diabetes mellitus and both were on renal dialysis for diabetic nephropathy, whereas one had no systemic disease. Opacified hydrophilic acrylic IOLs were exchanged with Acrysof IOL, and no further opacification occurred after lens exchange. CONCLUSION Use caution on implantation of hydrophilic IOLs because late opacification is a serious complication requiring further surgery.

Interaction of Intraocular Lenses with Various Concentrations of Silicone Oil: An Experimental Study

The aim of this study was to evaluate the interaction between various widely used intraocular lenses (IOLs) and silicone oils of different viscosities. Four groups of IOLs, including monoblock foldable hydrophilic acrylic IOLs (Morcher, type 92s); monoblock hydrophobic acrylic IOLs (Acrysof®-SA60AT, Alcon); single-piece rigid polymethylmethacrylate (PMMA) IOLs (Intraocular Optical International-IOI-65130) and a three-piece foldable silicone optic IOL (CeeOn® Edge 911A, Pharmacia UpJohn) were analyzed in vitro to determine the percentage adherence 1,000-centistoke, 1,300-centistoke or 5,000-centistokes silicone oil on the IOL optic. For each IOL type, there was no statistically significant difference in the mean silicone oil coverage (MSC) of the IOL optics for the different viscosities of silicone oil. Silicone IOLs had the highest MSC percentage (79.9%) whereas hydrophilic acrylic IOLs were the least silicone-covered IOLs (7.8%) compared to the other IOL types tested in this study. It is not the concentration of silicone oil that affects silicone oil coverage. When performing small-incision cataract surgery in patients who may require silicone oil injection, foldable hydrophilic acrylic or hydrophobic acrylic lenses should be preferred over standard foldable silicone lenses.

Nd:YAG laser posterior hyaloidotomy in subhyaloid hemorrhage

Subhyaloid hemorrhage is usually a benign condition that generally improves spontaneously and rarely causes visual loss. However, because subhyaloid hemorrhage may be associated with permanent macular changes before it spontaneously resolves, posterior Nd:YAG hyaloidotomy may be indicated in selected patients. We performed Q-switched Nd:YAG laser posterior hyaloidotomy via the transcorneal route in two cases of subhyaloid hemorrhage. The hemorrhage instantaneously drained into the vitreous cavity, resulting in a dramatic increase in visual acuity.

Pre-Descemet’s membrane hemorrhage after secondary intraocular lens implantation

A 6.0 x 4.0 mm pre-Descemets membrane hemorrhage with very sharp borders appeared at the temporal portion of the cornea. There was no hyphema in the anterior chamber on the first day after secondary intraocular lens implantation. The hemorrhage resolved almost totally in 1 year without intervention, leaving slight, deep pigmentary changes and minimal diffuse corneal edema.

Effect of Sildenafil Citrate on Retinal Functions: Preliminary Report on Humphrey Visual Field Analysis

Objective: To assess the effect of sildenafil citrate treatment on visual field analysis (VFA) in patients using sildenafil citrate for erectile dysfunction. Materials and Methods: In this prospective study on 18 male volunteers with erectile dysfunction, bilateral VFA was performed using the Humphrey 30-2 central standard threshold test. White-on-white (W/W) and blue-on-yellow (B/Y) protocols were used prior to treatment (baseline VFA) and after treatment (repeat VFA) with sildenafil citrate. W/W and B/Y baseline VFA and repeat VFA mean deviations (MD) were compared. Results: The baseline MD for W/W and B/Y protocols were –1.34 ± 1.8 and –2.59 ± 2.1 dB, respectively, whereas the mean repeat MD for W/W and B/Y protocols were –1.79 ± 2.21 and –2.83 ± 3.31 dB, respectively. There was no statistically significant difference between W/W and B/Y baseline and repeat VFA with respect to MD (p > 0.05). Conclusion: Sildenafil citrate causes no significant changes in Humphrey VFA in patients with erectile dysfunction.

Adie's syndrome in childhood

An 8‐year‐old girl with a history of mild amblyopia who had occlusion therapy, but her anisocoria went unnoticed, was studied. Old photographs of the patient were reviewed and a 0.1% pilocarpine test was performed. Review of her old photographs suggested that she had anisocoria at least since she was 3 years old. The 0.1% pilocarpine test confirmed a diagnosis of Adies syndrome. In light of this case, it must be kept in mind that though rare, Adies syndrome can be encountered in early childhood.

Phacoemulsification and foldable intraocular lens implantation in eyes filled with silicone oil

BACKGROUND AND OBJECTIVE To evaluate the visual outcome of phacoemulsification and foldable intraocular lens (IOL) implantation in eyes already filled with silicone oil. PATIENTS AND METHODS Following vitrectomy and silicone oil injection, 16 eyes of 16 consecutive patients undergoing phacoemulsification and IOL implantation were included in the study. RESULTS The mean age of patients was 58.3 +/- 9.2 years (range, 38 to 71 years). The time interval between the cataract surgery and silicone oil injection was 5.8 +/- 1.7 months (range, 4 to 9 months). The mean number of previous surgeries was 2.0 +/- 0.8 (range, 1 to 4). Trypan blue (0.4%) was used for anterior capsule staining in 3 eyes with white cataract. Dispersive viscoelastic material was used during all steps of phacoemulsification. A capsular tension ring was inserted after capsulorhexis and hydrodissection in all cases. An IOL with a 6.0-mm optic was implanted in all eyes. The preoperative best-corrected visual acuity ranged from hand motions to 0.3. The mean postoperative best-corrected visual acuity was 0.3 +/- 0.1 (range, 0.1 to 0.6); best-corrected visual acuity increased in all eyes. A small amount of silicone oil moved into the anterior chamber during phacoemulsification in 1 eye and was evacuated. In all eyes, no silicone oil was present in the anterior chamber postoperatively. CONCLUSION The use of dispersive viscoelastic and a capsular tension ring provides safer phacoemulsification and foldable IOL implantation in eyes already filled with silicone oil.

Choroidal folds associated with a sellar mass.

We report a case with progressive visual loss whose ophthalmic examination revealed bilateral optic atrophy and choroidal folds in the left eye. Neuroimaging demonstrated a sellar mass compressing the optic chiasm and the left optic nerve was to be stretched. We assume the traction created on the optic nerve by the mass stretched the optic nerve and caused the choroidal folds.