Sinan Emre

Recession of the Inferior Rectus Muscle Under Topical Anesthesia in Thyroid Ophthalmopathy

PURPOSEnTo evaluate the results of inferior rectus muscle recession with adjustable loop suture under topical anesthesia for vertical deviations secondary to thyroid ophthalmopathy.nnnPATIENTS AND METHODSnFive patients with a vertical deviation greater than 15 PD and severe limitation of upgaze were enrolled in the study. Before proceeding with corrective strabismus surgery, we waited at least 6 months after stabilization of ocular alignment and normalization of thyroid chemistries. All patients underwent inferior rectus muscle recession with adjustable loop suture under topical anesthesia. The postsurgical follow-up was at least 12 months.nnnRESULTSnPreoperatively, the mean vertical deviation was 24 PD. At 1 year postoperatively, it had decreased to 2.4 PD. Two patients were orthotropic and 3 patients had residual hypotropia ranging from 2 to 6 PD. The limitation of upgaze was relieved significantly in the postoperative period. Two patients had minimal limitation of downgaze, but none complained of diplopia in the primary or reading positions. Surgery did not trigger a flare-up of orbital inflammation in the early postoperative period.nnnCONCLUSIONnWe advocate that recession of the inferior rectus muscle with adjustable loop suture under topical anesthesia is safe and effective in patients with thyroid ophthalmopathy.

Effect of corneal wetting solutions on corneal thickness during ophthalmic surgery.

Purpose: To measure the changes in corneal thickness with wetting solutions used in ophthalmic surgery. Settings: Ege University, School of Medicine, Department of Ophthalmology, İzmir, Turkey. Methods: Thirty‐one adult pigmented rabbits that weighed about 2.5 kg each were anesthetized with pentobarbital sodium. The rabbits were randomly divided into 3 groups to receive 3 wetting solutions: Group 1, Ringers lactate; Group 2, balanced salt solution (BSS®); and Group 3, BSS with glutation (BSS Plus®). The solutions were dropped on the right cornea of the rabbits at a rate of 6.0 cc in 12 minutes using an intravenous infusion pump. Corneal thickness was measured by ultrasonic pachymetry before and after the procedure, and the between‐group changes in corneal thickness were compared. Results: The corneal thickness before and after the procedure was 361.27 &mgr;m ± 19.3 (SD) and 380.00 ± 25.0 &mgr;m, respectively, in Group 1 (P = .000); 372.10 ± 18.8 &mgr;m and 388.60 ± 24.1 &mgr;m, respectively, in Group 2 (P = .003); and 358.10 ± 26.5 &mgr;m and 360.10 ± 24.1 &mgr;m, respectively, in Group 3 (P = .316). Conclusion: As a corneal wetting solution, BSS Plus resulted in significantly fewer changes in corneal thickness than Ringers lactate or BSS. This should be considered in cases involving long intraocular surgery.

Human cataractous lens nucleus implanted in a sheep eye lens as a model for phacoemulsification training

&NA; We describe a realistic and inexpensive experimental cataract model for phacoemulsification training. After a capsulorhexis is performed, a deep cavity in the lens of an enucleated sheep eye is formed by phacoemulsification through a lateral incision. An undamaged human cataractous lens nucleus obtained by extracapsular cataract extraction is inserted in the preformed cavity, resting in the center of a cortex cushion. Phacoemulsification training is performed through a corneal tunnel incision. The experimental model is prepared with a human cataractous lens nucleus of the preferred hardness, simulating nuclear phacoemulsification in humans.

Bilateral aniridia lenticular coloboma and snowflake retinal degeneration.

A 6-year-old boy presented with bilateral aniridia associated with lens coloboma and snowflake retinal degeneration. Ophthalmologic examination revealed bilateral corneal peripheral epithelial thickening and aniridia. Additionally, the patient had lenticular coloboma and snowflake retinal degeneration in both eyes. Intraocular pressure was 22 mm Hg bilaterally. The patient also had pendular nystagmus. Uncorrected visual acuity was counting fingers at 2 meters for both eyes, but improved to 0.2 and 0.05, respectively, with correction. Congenital aniridia has been reported with various ophthalmic pathologies, but this is the first case to display bilateral lenticular coloboma and snowflake retinal degeneration associated with aniridia.

Prevalence of Corneal Astigmatism in Cataract Surgery Candidates from Turkey

ataract is the cause of the half of blindness worldwide and cataract extraction is one of the most commonly performed surgeries.1 Cataract surgery has made great progress since that first performed. Results of the surgeries became more satisfactory with advances in surgery techniques, intraocular lens (IOL) calculation formulas, IOL technologies and biometry techniques. But the patients always demand near-perfect vision in one step surgery without any postop spectacles. After correction of the spherical refractive error, residual corneal astigmatism became main factor affecting postoperative vision. Prevalence of Corneal Astigmatism in Cataract Surgery Candidates from Turkey