Ozgur Bulent Timucin

Long-term results of a suture burial technique.

Purpose To report the long-term (minimum 24 months of follow-up) results of a scleral suture fixation technique. Methods Surgical databases from one surgeon were reviewed for consecutive cases from March 2003 to August 2005 in which the scleral suture fixation technique was used and a minimum follow-up of 24 months was completed. In this study, by knotting the suture onto itself, the author has buried the end and the knot of the suture into the sclera for scleral fixation, to stay put within the sclera. Intraoperative technical complications, postoperative visual outcomes, intraocular pressures, and suture-related complications were evaluated for each patient. Results A total of 150 scleral-sutured free suture ends were evaluated after a minimum 24 months of follow-up in 75 eyes of 75 patients. No technical or suture-related complications (suture exposure, irritation, granulomas, giant papillary conjunctivitis, suture abscess) were recorded throughout the follow-up period. Conclusions Long-term follow-up of the suture burial technique - which allows avoidance of scleral incision, flap, or tunnel formation, as well as patch grafts for scleral fixation of intraocular lenses - showed it to be safe and effective.

Methylene blue-related corneal edema and iris discoloration

We report the case of a 70-year-old female patient who developed corneal edema and iris discoloration following the inadvertent use of 1% methylene blue instead of 0.025% trypan blue to stain the anterior capsule during cataract phacoemulsification surgery. Copious irrigation was performed upon realization of incorrect dye use. Corneal edema and iris discoloration developed during the early postoperative period and persisted at 24-months follow-up. However, keratoplasty was not required. The intracameral use of 1% methylene blue has a cytotoxic effect on the corneal endothelium and iris epithelium. Copious irrigation for at least 30 min using an anterior chamber maintainer may improve outcomes.

Role of scheimpflug imaging in the diagnosis and management of keratitis caused by caterpillar seta

A 16-year-old boy presented with a history of an accidental hit to the left eye by a butterfly (Lepidoptera). One seta fragment was found to be embedded into the cornea and inflammation secondary to penetration of caterpillar seta was seen around the seta fragment. Scheimpflug imaging was performed in the area showing caterpillar seta. Corneal infiltration was imaged as a hyper-reflective area. Lesion dimensions were measured with calipers. Scheimpflug imaging is a potential tool for localization of corneal lesions, monitoring the progress of the injury and evaluating the treatment response objectively.

Psychophysical assessment of koniocellular pathway in patients with schizophrenia versus healthy controls

This study was designed to perform psychophysical assessment of koniocellular pathway in patients with schizophrenia versus healthy controls. A total of 26 patients diagnosed with schizophrenia and 15 healthy controls were included. Snellen Visual Acuity Chart scores and Short Wavelength Automated Perimetry (SWAP) visual field testing including global visual field indices [mean deviation (MD), pattern standard deviation (PSD), test time (min)], reliability parameters [false negative responses (%), false positive responses (%) and fixed losses (%)] and average threshold sensitivity [central (parafovea), peripheral area, and four quadrants] were recorded in both groups. Significantly lower MD scores, higher PSD scores and lower average threshold sensitivity at each location across the visual field were noted in schizophrenia relative to control group. In conclusion, our findings revealed a deficit in koniocellular pathway with impaired SWAP global indices and lower threshold sensitivity at each location across the visual field among chronic schizophrenic patients as compared with control subjects. Our findings emphasize potential application of SWAP outside its original intended purpose as a glaucoma test, to provide deeper understanding of the specific contribution of lateral geniculate nucleus to the visual and cognitive disturbances of schizophrenia.

Contact lenses, migraine, and allodynia.

Clinical trials and electrophysiologic studies demonstrated increased perceptual sensitivity in patients suffering from migraines. At least, one triggering factor is described in 85% of migraine patients. The aim of this report was to investigate the relationship between contact lens (CL) usage and migraine attacks in two cases. Two patients who were diagnosed with migraine reported that the frequency of migraine attacks increased after they switched to using CL with different base curves (BCs). These two patients, who began using CL with different BCs experienced discomfort and dryness of the eye. The ocular complaints were followed by migraine attacks. CL intolerance was also developed during migraine attack in one of the cases. The frequency of migraine attacks decreased and allodynia relieved significantly when flatter BCs were selected. CL related stimulus could have triggered the migraine attack. CLs should be well fitted in migraine patients with allodynia.

Bimanual microincisional phacoemulsification combined with viscocanalostomy plus deeper sclerectomy.

Purpose The aim of the study was to evaluate the safety and effectiveness of a new technique, two-site bimanual microincisional cataract surgery combined with viscocanalostomy plus deeper sclerectomy (two-site bimanual MICS-VC-DS), in patients with cataract and glaucoma. Methods Noncomparative, interventional case series. From December 2005 to October 2007, a consecutive series of 12 patients (12 eyes) with uncontrolled primary open angle glaucoma (POAG) and cataract have undergone two-site bimanual MICS-VC-DS. Postoperative evaluation included visual acuity (VA), intraocular pressure (IOP), average retinal nerve fiber layer (RNFL) thickness measurement, and gonioscopic, biomicroscopic, and funduscopic examination. Paired-samples t test was used. A p value of <0.05 was taken as significant. Results The mean duration of follow-up was 14.6 months (SD 5.8). At 9 months, mean IOP was 17.0 (SD 4), the mean IOP reduction was 13.2 mmHg (SD 5.86). At 9 months post-surgery, the complete success rate was 75%. Qualified success was achieved in 100% of patients. At 9 months, the mean number of antiglaucoma medications was 0.58 (SD 1.24) (p<0.05). Visual acuity improved by a mean value of 2.8 lines. Average RNFL thickness did not change significantly during the follow-up period (p=0.781). Conclusions Two-site bimanual MICS-VC-DS appears to be an effective and safe procedure with quick visual rehabilitation, acceptable mid-term IOP control, and the advantage of having fewer complications.