Umit Kamis

Effect of altered eating habits and periods during Ramadan fasting on intraocular pressure, tear secretion, corneal and anterior chamber parameters.

PurposeTo determine whether altered eating habits and periods, especially the pre-dawn meal, during Ramadan fasting have any significant effect on intraocular pressure (IOP), tear secretion, corneal and anterior chamber parameters.MethodsIOP, basal tear secretion (BTS), reflex tear secretion (RTS), and Pentacam measurements of 31 healthy volunteers were performed at 0800 and 1600 hours during Ramadan fasting and 1 month later during non-fasting period.ResultsComparison of measurements between fasting and non-fasting periods at 0800 hours revealed significantly higher values for IOP (P=0.005), RTS (P=0.006), and BTS (P=0.014) during fasting. Conversely at 1600 hours, IOP was significantly lower during fasting (P=0.013) and no statistically significant difference was noted for RTS and BTS. IOP showed a diurnal variation of 2.45 mmHg (P<0.001) and BTS showed a 3.06 mm decrease (P=0.04) during the fasting period. No significant differences could be found in the corneal and anterior chamber parameters during fasting and non-fasting periods.ConclusionsOur results revealed that fluid loading at the pre-dawn meal during Ramadan fasting might increase the IOP and tear secretion in the early morning period and these values decrease remarkably at the end of 12 h of fasting due to dehydration.

Characteristics of the Anterior Segment Biometry and Corneal Endothelium in Eyes with Pseudoexfoliation Syndrome and Senile Cataract.

Objectives: To evaluate the anterior segment biometric features and corneal endothelial changes in eyes with pseudoexfoliation (PEX) syndrome and senile cataract. Materials and Methods: The central corneal thickness, anterior chamber depth (ACD), pupil diameter, lens thickness, endothelial cell density (ECD), and percentages of polymegathism and pleomorphism of 52 subjects with PEX and cataract were compared with 51 age- and gender-matched control subjects with cataract using optical low-coherence reflectometry (OLCR, Lenstar LS 900; Haag Streit AG, Switzerland) and in-vivo confocal microscopy (Confo Scan 4, Nidek Co. Ltd, Osaka, Japan). Nineteen subjects with PEX syndrome had glaucoma and were using anti-glaucoma medications. Only one eye of the subjects was used in statistical analysis and a p value less than 0.05 was considered statistically significant. Results: None of the OLCR parameters reached statistically significant differences among the 3 groups (ANOVA p>0.05). The percentage of eyes with ACD <2.5 mm was 13.7% in the control group, 24.2% in PEX eyes without glaucoma and 21.1% in PEX eyes with glaucoma, with no statistically significant differences (p=0.45). There was a significant difference in mean ECD among the 3 groups (ANOVA p=0.02), whereas no differences could be found in respect to polymegathism and pleomorphism (p>0.05). Mean ECD was significantly lower in the PEX glaucoma group (2,199.5±176.8 cells/mm2) than the control group (2,363±229.3 cells/mm2) (p=0.02), whereas no difference was found in mean ECD of PEX eyes without glaucoma and the control group (p=0.42). ECD was less than 2,000 cells/mm2 in 15.8% of PEX subjects with glaucoma, 9.8% of control subjects and 6.1% of PEX eyes without glaucoma, with no statistically significant difference (p=0.52). Conclusion: As eyes with both PEX glaucoma and cataract seem to be associated with decreased endothelial cell number, specular or confocal microscopy screening should be done for the patients scheduled for intraocular surgery.

Assessment of capsular block syndrome with Scheimpflug camera

342 CAN J OPHTHALMOL—VOL. 44, NO. 3, 2009 iris phagocytosis by macrophages and (or) trabecular meshwork cells in the pathophysiology of pseudophakic traumatic aniridia. This hypothesis was founded on ultrasound biomicroscopy imaging demonstrating a band of echogenic particles at the level of the anatomic iris position. Our case further illustrates the phenomenon of total aniridia after blunt trauma even through an incision as small as 2.75 mm and as late as 7 years postoperatively. The finding of the capsule plugging the internal aspect of the corneal tunnel incision, which, to the best of our knowledge, has never been reported before, strengthens the view that posttraumatic aniridia can be attributed to sudden iris disinsertion and expulsion through the wound rather than a result of phagocytosis within the eye.

Acute postoperative endophthalmitis with an unusual infective agent: Acinetobacter baumannii

that the haptics of the IOL were cut and the IOL was divided in 2 parts to facilitate explantation. B, C, andD: Light photomicrographs. Dense deposits can be observedmostly on the anterior surface of the optic component, highlighting the marks caused by forceps during the folding process. Confluent deposits are arranged in a confluent pattern (unstained, original magnification 20, 40, 40, respectively). E: Light photomicrograph also showing confluent deposits on the haptics anterior surface (unstained, original magnification 40). F: Calcium confluent deposits on the anterior surface (Alizarin red, original magnification 100). 143 CORRESPONDENCE

Tip 2 diabetes mellituslu hastalarda plazma homosistein düzeyinin normal popülasyonla karşılaştırılması

Objectives: To compare the plasma homocysteine levels between control group and diabetic patients with no diabetic retinopathy, with preproliferative diabetic retinopathy, with proliferative diabetic retinopathy. Materials and methods: Plasma homocysteine levels of 23 diabetic patients were measured and were compared with 25 age-matched controls with no systemic problem and no ocular disease. Plasma homocysteine levels were measured using high-performance liquid chromatography.

Frequency of Chromosome 17 Aneuploidy in Primary and Recurrent Pterygium by Interphase-Fluorescence in situ Hybridization

Aim:To investigate chromosome 17 numerical aberrations by using fluorescence in situ hybridization (FISH) in pterygia and to find out whether there is any association between chromosome 17 aneuploidy and recurrent pterygia. Methods: Pterygium tissue samples were taken from 21 patients by surgical excision. Eighteen of them had primaryand 3 had recurrent pterygium. Peripheral whole blood interphase cells obtained from 11 healthy subjects were assigned as control group. The cells from pterygium tissue and peripheral blood were incubated with a hypotonic solution and fixed in order to obtain interphase nuclei. FISH analysis with chromosome-17-specific α-satellite DNA probe was performed on both the interphase nuclei of pterygium tissue (of patients) and peripheral whole blood cells of controls. Results: The mean percentage of chromosome 17 aneuploidy was 4.71% for the pterygia group and 4.41% for the controls. No significant difference of chromosome 17 aneuploidy was observed between the patients and the controls. When the group of patients with recurrences was compared with the group without recurrences, there was a significant difference in the frequency of chromosome 17 aneuploidy (U = 17, p = 0.029). Conclusions: Chromosome 17 aneuploidy is probably not an important factor in the formation of pterygium, but it may be related to recurrence.

Correlation of Corneal Endothelial Cell Density with Corneal Tomographic Parameters in Eyes with Keratoconus

Objectives: To examine changes in corneal endothelial cell density (ECD) in different stages of keratoconus and evaluate its correlation with corneal tomographic parameters. Materials and Methods: Two hundred six patients with keratoconus were enrolled in the study. Corneal topography was performed by Sirius (CSO, Italy), which has a rotating Scheimpflug camera and a Placido disc topographer. Automatic endothelial analysis was done with the non-contact endothelial microscope (20x probe) of Confoscan-4 (NIDEK, Japan). The eyes were classified into stages based on steepest keratometric value as follows: mild <45 D; moderate 45-52 D; severe >52 D and according to thinnest cornea thickness (TCT) as <400 μm, 400-450 μm, and >450 μm. Tomographic and endothelial cell parameters were compared among the groups using Kruskal-Wallis test and the correlations between them were analyzed using Spearman correlation. Results: The study included 391 eyes of 100 male (24.29±7.7 years, range 11-47 years) and 106 female (26.26±7.5 years, range 13-45 years) patients (p=0.07). Mean ECD values were 2628±262 cells/mm2, 2541.9±260.4 cells/mm2, and 2414.6±384.3 cells/mm2 in mild, moderate, and severe keratoconus, respectively (p<0.001) and 2592.3±277 cells/mm2, 2502±307 cells/mm2 and 2348±296 cells/mm2 in corneas with TCT values >450 µm, 400-450 µm, and <400 µm, respectively (p<0.001). ECD showed significant negative correlation with keratometric and elevation parameters and positive correlation with pachymetric parameters (p<0.05). Conclusion: As endothelial cell numbers seem to decrease with the progression of keratoconus, specular/confocal microscopy screening should be carried out, especially in eyes with advanced stages and corneas with TCT <400 µm.

Corneal Collagen Crosslinking Treatment in a Case with Pneumococcal Keratitis

Bacterial keratitis is a serious ocular infectious disease that can threaten vision. The disease generally progresses rapidly and can lead to corneal scar, stromal abscess formation, perforation, and dissemination to adjacent tissues if not treated properly. Recent studies showed that corneal collagen crosslinking (CCC) using ultraviolet-A/riboflavin is effective in the treatment of bacterial keratitis refractory to topical antibiotic treatment. In addition to being bactericidal, CCC also decreases risk of perforation by strengthening the corneal collagen structure. Herein, we report a male patient with Streptococcus pneumonia keratitis 6 months after a keratoplasty procedure, which did not respond to fortified topical antibiotic therapy and was treated successfully with riboflavin/ultraviolet-A CCC. His pain decreased remarkably in a few days. The corneal epithelial defect healed and infiltration regressed within 2 weeks after CCC. His vision improved significantly from hand movement to 20/400. CCC might be used as adjuvant treatment in bacterial keratitis refractory to medical treatment.