Reyhan Oğurel

Comparison of the antimicrobial effect of heavy silicone oil and conventional silicone oil against endophthalmitis-causing agents.

Purpose: To conduct an in vitro experimental study comparing the effectiveness of conventional silicone oil and heavy silicone oil against endophthalmitis-causing agents. Materials and Methods: The antimicrobial activity of conventional silicone oil (RS OIL 5000) and heavy silicone oil (heavySil 1500) was tested. The antimicrobial effects of both silicone oils were determined by the growing capability of the microorganism. Results: The number of Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Pseudomonas aeruginosa, and Candida albicans decreased to zero levels at the second day of inoculation in heavy silicone oil. In conventional silicone oil, the microorganisms survived longer than in heavy silicone oil. Conclusion: Heavy silicone oil seems to be more effective than conventional silicone oil against endophthalmitis-causing agents.

Effect of 1% brinzolamide and 0.5% timolol fixed combination on intraocular pressure after cataract surgery with phacoemulsification.

AIM To evaluate the effect of brinzolamide-timolol fixed combination on intraocular pressure (IOP) after cataract surgery. METHODS The study included 92 eyes of 87 patients who underwent cataract surgery and intraocular lens implantation. Patients scheduled for phacoemulsification were assigned to 1 of 2 groups. The treatment group received 1 drop of brinzolamide-timolol fixed combination immediately after surgery, and the control group received no treatment. The IOP was measured preoperatively and at 2h and 24h postoperatively. RESULTS The mean IOP change was lower in the treatment group than in the control group at 2h postoperatively. The difference between the mean IOP values of the two groups at 2h postoperatively was found to be statistically significant. Twenty-four hours after the surgery, the mean IOP change was still higher in the control group when compared to the treatment group. CONCLUSION The fixed combination brinzolamide-timolol can effectively reduce IOP after cataract surgery.

Congenital hypothyroidism in Rieger Syndrome

Abstract Rieger syndrome (RS) is a multiple malformation syndrome characterized by ocular manifestations and extraocular defects. Herein, we report a 9-year-old boy who exhibited Rieger Syndrome phenotype as well as congenital hypothyroidism which may be an underappreciated feature of RS.

Bilateral Recurrent Optic Neuropathy with Unilateral Oculomotor Nerve Palsy in Giant Cell Arteritis

Giant cell arteritis (GCA) is a systemic vasculitis of the elderly affecting large and medium-size cranial arteries. Late recurrent ischemic optic neuropathy (ION) in GCA is not common. Recurrent symptoms generally include malaise, weight loss, myalgia, headache, or scalp tenderness. The oculomotor nerve palsy in GCA may be self-limited and respond to corticosteroid treatment. We report for the first time the combination of recurrence of bilateral optic neuropathy and unilateral third cranial nerve palsy in a case of histologically proven GCA. A 68-year-old man with sudden onset of painless visual loss in both eyes for 5 days was referred to us in 2008. He had suffered from scalp tenderness and headache. The right vision deteriorated rapidly in 2 days. Visual acuity in the left eye decreased the day before he was admitted. Visual acuities were 1/10 on the right and 2/10 on the left. Ophthalmoscopic examination revealed pale swelling of both optic discs. Superficial temporal arteries were hardened with absent pulsation on the right and reduced pulsation on the left. Laboratory investigations revealed an erythrocyte sedimentation rate (ESR) of 96 mm/h. A biopsy of the right superficial temporal artery revealed fragmentation of the internal elastic lamina. The vascular wall was infiltrated with lymphocytes and giant cells. The patient was treated with 1 mg/kg/day oral prednisolone. The symptoms resolved rapidly and visual acuities improved to 2/10 to 3/10, respectively. Four years later, the patient was admitted to us with a 4-week history of pain on his scalp and in the occipital area with bilateral acute vision loss and ptosis of the left eye. He complained of cloudy vision in both eyes. He had also experienced weight loss and fatigue during the last months. Ocular examination revealed a visual acuity of 1/10 in the right eye and perception of light with correct light projection in the left eye. The left pupil measured 6 mm in dim illumination and did not constrict to direct light. The left upper eyelid had 2 mm of ptosis (Figure 1). In the left eye, abduction was normal, but adduction, supraduction, and infraduction were absent. Ophthalmoscopy of the both eyes revealed pale optic discs. The ESR was 69 mm/h (normal value 515 mm/h), and C-reactive protein (CRP) was 8.2 mg/L (normal value 56 mg/L). Neurological examination and brain MRI was found to be normal. We started with a 3-day induction dose of iv methylprednisolone, 1 g/day, followed by oral prednisone maintenance therapy at an initial dose of 1 mg/kg/day. Three weeks later, the features of third cranial nerve palsy had disappeared except for a dilated unreactive pupil. The visual loss improved to 2/10 and counting fingers at 5 m, respectively. At the seventh month, the patient is still being treated with 10 mg/day oral prednisolone with monthly monitoring of ESR and CRP levels. Late recurrence of ION and oculomotor nerve palsy are rarely seen in patients with GCA. Liu et al. reported recurrent ION in the same eye in 2 patients after initiation of prednisone therapy in a series of 45 patients with GCA. Calamia and Hunder described a recurrent ipsilateral visual loss 5 months after initiation of treatment. Bilateral recurrent visual loss and unilateral oculomotor nerve palsy with pupillary involvement occurred in our patient. Pupillary sparing is the hallmark of an ischemic oculomotor palsy, as seen

0.1% Nepafenac reduces pain and increases patient comfort during cataract surgery

PURPOSE To evaluates analgesic effectiveness of 0.1% nepafenac during cataract surgery. METHODS This prospective randomized randomized double-masked, placebo-controlled study comprised 80 eyes of 40 consecutive patients who underwent bilateral cataract surgery and implantation of foldable intraocular lens with topical anesthesia with and without topical nepafenac drops. Each eye of patients was assigned to group 1 and group 2. Topical anesthesia combined with 0.1% nepafenac used three times a day the day before the surgery and once half an hour just before the surgery was group 1, consisting of 40 eyes, and topical anesthesia with using placebo was group 2 consisting of 40 eyes. Patients were asked to score their pain using a visual analog scale (VAS) and verbal pain scale (VPS) immediately following the surgery. When the patient moved or squeeze the eye during surgery, the surgical comfort was evaluated as bad and otherwise, it was evaluated as good. RESULTS When the intensity of pain during the surgery was evaluated, the percentage of patients reporting mild or no pain in group 1 was %825 and in group 2 was %45. Mean VAS pain score and mean VPS pain score in group 1 was significantly lower than that in group 2(p = 0.024, p < 0.001). Surgical comfort in group 1 was %825 and in group 2%65(P = 0.075). CONCLUSION 0.1% nepafenac reduces pain of patients who undergone routine clear corneal phacoemulsification with topical anesthesia and may increase patient comfort during the surgery when used preoperatively.

Endophthalmitis after tooth extraction in a patient with previous perforating eye injury

The aim of this stuty is to describe a case of endophthalmitis after tooth extraction in a patient with previous perforating eye injury. 50 years old male patient attempted to our clinic with complaints of sudden severe pain, reduced vision, light sensitivity and redness in the right eye. The patient stated that severe pain in his eye began approximately 12 hours following tooth extraction. The patients ocular examination revealed a visual acuity of hand motion in the right eye. Anterior segment examination of the right eye showed intense conjunctival hyperemia, chemosis, a fine keraticprespitat and corneal edema. Dental procedures of the patients who had recently underwent ocular surgery or trauma should be done in a more controlled manner under anti -infective therapy or should be postponed in elective procedures.

Branch Retinal Artery Occlusion following Dental Extraction.

Aim. To describe a case of branch retinal artery occlusion following dental extraction and to point out the ophthalmic complications of dental procedures to ophthalmologists and dentists. Case. A 51-year-old woman was referred to our clinic with painless sudden visual loss in her left eye after tooth extraction two days ago. In her left eye the best corrected visual acuity was 6/30 and fundus examination revealed peripapillary flame-shaped hemorrhages and pale retina in the upper temporal arcuate. The right eye examination was unremarkable. Conclusion. Dental procedures can lead to miscellaneous ophthalmic complications possibly due to the close proximity of the anatomic structures. Retinal arterial occlusion is a rare but serious cause of permanent visual loss among these dental procedures where the exact pathologic mechanism is still obscure.