Cemile UCGUL ATİLGAN, Pinar KOSEKAHYA, Esat YETKİN, Mehtap CAGLAYAN, Yasin Sakir GOKER, Selam Yekta SENDUL
Cemile UCGUL ATİLGAN, Pinar KOSEKAHYA, Esat YETKİN, Mehtap CAGLAYAN, Yasin Sakir GOKER, Selam Yekta SENDUL
Objectives: The aim of this study was to assess the effects of topical 0.1% nepafenac and 0.1% fluorometholone on macular thickness (MT) after a neodymium: yttrium-aluminum-garnet (Nd:YAG) laser posterior capsulotomy and to compare
the findings with those of untreated patients.
Methods: This prospective study included 75 eyes of 75 patients with posterior capsule opacification. The patients were
divided into 3 groups according to the medications administered after a capsulotomy procedure. Group 1 comprised 25
patients who were prescribed 0.1% nepafenac for a week, Group 2 consisted of 25 patients who were prescribed 0.1%
fluorometholone for a week, and Group 3 consisted of 25 patients who were not prescribed any medication. A circularshaped capsulotomy was performed in all cases. MT was measured before the capsulotomy and at the first day, first week,
and first month after the procedure using spectral domain-optical coherence tomography and the change values were
compared within and between groups.
Results: In Group 1, the superior and nasal parafoveal MT, temporal, and nasal perifoveal MT values at the first month
were statistically significantly greater than those observed in the first week (p<0.05 for all values). In Group 2, the superior
and nasal parafoveal MT and inferior perifoveal MT measurements in the first month were greater than those recorded the
first week (p<0.05 for all values). In Group 3, there was a gradual increase seen in the first day, first week, and first month
in the superior and temporal parafoveal MT value (p<0.05 for all). The change value in the parafoveal temporal quadrant
was significant between groups, indicating a greater increase in the untreated group compared with the nepafenac and
fluorometholone groups (p=0.04).
Conclusion: An increase in MT can occur after an Nd:YAG laser posterior capsulotomy. Both topical 0.1% nepafenac
and 0.1% fluorometholone can prevent this increase. The 2 drugs were comparable; neither demonstrated apparent superiority to the other.
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Objectives: The aim of this study was to compare the accuracy of an image-guided system (Callisto eye; Carl Zeiss,
Oberkochen, Germany) with the manual marking technique in the positioning of a toric intraocular lens (IOL).
Methods: A total of 80 eyes of 80 patients who underwent cataract surgery with a monofocal, single-piece, hydrophobic,
biconvex, toric, aspheric IOL (Acrysof IQ SN6AT, Alcon Laboratories, Inc., Fort Worth, TX, USA) implantation were included. Before surgery, all of the patients underwent a complete eye examination that included evaluation of uncorrected
(UCVA) and corrected distance visual acuity (CDVA), spherical equivalent (SE), astigmatic refraction (AR), keratometry,
biometry, as well as meridian registration with the IOLMaster 700 (Carl Zeiss, Oberkochen, Germany), slit lamp examination, intraocular pressure measurement, and dilated retinal examination. The diopter of the toric IOL was calculated with
an online calculator (Alcon, Fort Worth, TX, USA). At 3 months post surgery, the UCVA, CDVA, SE, and residual astigmatism were recorded, and the pupils of all of the patients were fully dilated to determine the toric IOL marker positions.
Results: Group 1, the Callisto eye system group, comprised 45 eyes, and Group 2, the manual marking technique
group, was composed of 35 eyes. The preoperative values of both groups were statistically similar in terms of the SE,
corneal cylinder, axial length, logMAR UDVA, and logMAR CDVA. At postoperative 3 months, there were no significant
differences between the 2 groups in the logMAR UDVA, logMAR CDVA, degree of misalignment of toric IOL, or mean
deviation from target-induced astigmatism values. The mean deviation degree from the intended axis was 2.04±1.84 in
the Callisto eye system group (Group 1) and 3.24±2.64 in the manual marking technique group (Group 2). However, this
difference did not have any effect on the logMAR UDVA.
Conclusion: The image-guided markerless system was found to be as effective as manual marking in the positioning of
toric IOLs
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Objectives: The aim of this study was to histopathologically compare patients with and without diabetes mellitus who
underwent pterygium excision.
Methods: In this retrospective case-control study, 60 patients with a history of pterygium excision were divided into 2
groups: those with DM and those without DM. Histopathological findings (squamous metaplasia, dysplasia, inflammation,
fibrinoid changes, and vascularization) were compared.
Results: The mean age of the 60 patients (females, 54.5%) included in the study was 58.6±12.8 years. The mean age
was 53.7±13.7 years in the patients with DM and 63.6±9.6 years in the patients without DM. There were no significant
differences in the excised pterygium tissues in terms of squamous metaplasia, dysplasia, fibrinoid changes, inflammation,
or vascularization.
Conclusion: There was no histopathological difference in the pterygium tissue in patients with DM.
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Objectives: The aim of this retrospective study was to evaluate the efficacy of the intravitreal injection of anti-vascular
endothelial growth factor (anti-VEGF) agents to treat choroidal neovascularization (CNV) caused by a pathology other
than exudative type age-related macular degeneration (AMD).
Methods: This was a retrospective study of 43 treatment naive eyes of 35 patients who had been diagnosed with CNV caused
by a pathology other than exudative- type AMD and who underwent intravitreal injection of anti-VEGF agents. Primary and
secondary outcome measures were the best corrected visual acuity (BCVA) and the central macular thickness (CMT).
Results: The mean patient age was 44.6±13.1 years. The mean number of injections was 3.3±1.8. The mean logarithm
of minimal angle of resolution BCVA at baseline and the 12th month follow-up was 0.89±0.50 and 0.73±0.57, respectively
(p=0.120). In all, 44.2% of the eyes gained ≥15 letters of BCVA, whereas 14% lost ≥15 letters of BCVA. The mean CMT
at baseline and the 12th month follow-up was 381±121 and 311±73 microns, respectively (p=0.001).
Conclusion: Stabilized functional and improved anatomic outcomes following intravitreal anti-VEGF agent injection for
CNV unrelated to AMD were seen at the 12th month of follow-up.
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Superior ophthalmic vein thrombosis (SOVT) is a rare clinical entity that may be associated with sino-orbital disease. The
clinical presentation of SOVT may include signs of venous congestion, such as unilateral ptosis, chemosis, ophthalmoplegia,
and eyelid swelling, with or without fundus findings. This case report describes a case of SOVT associated with orbital
cellulitis diagnosed with magnetic resonance imaging and treated using anticoagulant therapy, antibiotherapy, and a corticosteroid. In the presence of orbital cellulitis, clinicians should always keep the possibility of SOVT in mind, as it may result
in mortality and visual loss if not diagnosed early and given appropriate treatment without delay.
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Serdar ÖZATEŞ, Betül Emine DERİNKUYU, Ufuk ELGİN, Melikşah KESKİN, Nursel MURATOĞLU ŞAHİN, Zehra AYCAN
Serdar ÖZATEŞ, Betül Emine DERİNKUYU, Ufuk ELGİN, Melikşah KESKİN, Nursel MURATOĞLU ŞAHİN, Zehra AYCAN
Objectives: The aim of this study was to assess initial changes in blood flow parameters of the ophthalmic artery (OA)
in pediatric patients with type 1 diabetes mellitus (DM).
Methods: Sixty-three subjects were included in this prospective, cross-sectional, observational study. Thirty-one (49.2%)
patients with type 1 DM without diabetic retinopathy formed the DM group. The control group comprised 32 (50.8%)
healthy subjects. The OA of all of the patients was examined with Doppler ultrasonography. The main outcomes were
peak systolic velocity (PSV), end diastolic velocity (EDV), pulsatility index (PI), and resistivity index (RI) measurements.
Results: The mean age at onset of type 1 DM was 10.7±2.0 years and the mean duration was 11.4±11.0 months. The
mean PSV and EDV outcomes in both eyes were significantly higher in the control group than in the DM group, whereas,
the mean PI and RI outcomes in both eyes were significantly higher in the DM group (p<0.05). A mean RI of ≥0.75 indicated vascular hemodynamic changes associated with type 1 DM with a sensitivity of 72% and a specificity of 65% (area
under the curve: 0.702; p=0.007). A mean PI of ≥1.69 predicted vascular hemodynamic changes associated with type 1
DM with a sensitivity of 79% and a specificity of 71% (area under the curve: 0.742; p=0.001).
Conclusion: The results of this study revealed that disturbances in ocular hemodynamics might be present as early as
the first year after a type 1 DM diagnosis. Changes in ocular hemodynamic parameters could be used to predict or screen
for the development of vascular changes.
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Melisa Zişan KARSLIOĞLU, Ayşe Yıldız TAŞ, Cem KESİM, Afsun ŞAHİN, Orkun MÜFTÜOĞLU
Melisa Zişan KARSLIOĞLU, Ayşe Yıldız TAŞ, Cem KESİM, Afsun ŞAHİN, Orkun MÜFTÜOĞLU
Objectives: This study is an analysis of the cosmetic and functional results of patients who underwent keratopigmentation (KTP).
Methods: Sixteen eyes of 16 patients, 7 females (43.75%) and 9 males (56.25%) were included in the study. Intrastromal
and superficial manual KTP were performed under general anesthesia. Patients with no light perception or with only light
perception but total corneal opacification, prosthetic contact lens intolerance, or unwillingness to use a contact lens were
studied. The main outcomes were postoperative patient’s satisfaction, cosmetic results, pigment stabilization and surgical
complications. A grading system (0-5 points) was used to assess patient satisfaction and the cosmetic results.
Results: The mean age of the patients was 30.5±12.06 years (range: 16-53 years). Black pigment was used in 10 patients
(62.5%), a brownish color in 5 patients (31.25%) and a greenish, yellow, blue, and black color pigmentation was used for
1 patient (6.25%). The mean follow-up was 29.31±15.45 months (range: 8-52 months). In 2 of 16 patients, mild to moderate pigment loss was seen 12 months after the surgery and superficial KTP was repeated. Minimal pigment loss was
seen in 5 patients, but the cosmetic results were satisfactory and no secondary surgical procedure was required. Pigment
leakage underneath the conjunctiva was seen in only 1 patient. Otherwise, there were no complications associated with
keratopigmentation. The postoperative mean patient satisfaction score was 4.18±0.75 points (range: 3-5 points).
Conclusion: KTP is a safe surgical procedure that is easy to learn and perform, does not require expensive materials,
and avoids more extensive and invasive reconstructive ocular procedures. Corneal KTP may have a great impact on future
ophthalmic surgical practice from both therapeutic and cosmetic perspectives.
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Bülent KÖSE, Sinan ALBAYRAK
Bülent KÖSE, Sinan ALBAYRAK
Objectives: This study was an evaluation of the effectiveness of the Callisto eye image-guided, markerless system (Carl
Zeiss Meditec AG, Jena, Germany) in toric intraocular lens (IOL) positioning.
Methods: The results of a novel, markerless, alignment system used for IOL positioning were analyzed in this retrospective study. Preoperatively, reference image registration was performed with the IOLMaster 700 biometer (Carl Zeiss
Meditec AG, Jena, Germany) and transferred to the Callisto eye system, which was used in conjunction with an Opmi
Lumera 700 microscope (Carl Zeiss Meditec AG, Jena, Germany). Using the Callisto Z Align technology, a toric IOL was
aligned precisely with the steep axis. One day after surgery, the pupil was fully dilated and a thin slit was placed on the
marker of the toric IOL and the angle was measured using an axis calculator smartphone application. The degree of the
measured angle and the preoperatively determined angle were compared.
Results: Sixty eyes of 46 patients were included. The difference in the absolute angle between the intended and the
postoperative (at day 1) axes was a mean of 2.71±1.64°.
Conclusion: The Callisto eye image-guided, markerless system successfully provided assistance in precisely positioning the toric IOL.
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Halil İbrahim YENER, Muammer ÖZÇİMEN
Halil İbrahim YENER, Muammer ÖZÇİMEN
Objectives: This study was an examination of the long-term results of transcanalicular laser (TCL) and external (EX)
dacryocystorhinostomy (DCR).
Methods: Patients who had undergone TCL-DCR or EX-DCR between 2009 and 2013 were invited for long-term
follow-up in 2019. All of the patients who responded had an ophthalmic examination and were assessed using lacrimal
irrigation. An intranasal evaluation was performed when the irrigation test had non-patent results. TCL procedures were
performed with a diode laser (980 nm). Ostium cleansing with a suction unit and a nasal endoscope was performed in the
first week. In EX-DCR procedures, an anterior flap was created and tented to the orbicularis oculi muscle. A silicon tube
was implanted in both methods and removed at 4-6 months.
Results: A total of 74 EX-DCR patients were assessed. The lacrimal irrigation test was negative in 5 cases. The functional
success rate was 93.2% with a follow-up of 8 years. A total of 63 patients who had undergone TCL-DCR were evaluated
and the irrigation test was negative in 9 patients. The functional success rate was 85.7% with a follow-up of 7 years. The
difference in the success rate was statistically insignificant with a p value of 0.09.
Conclusion: The long-term success rates of both EX-DCR and TCL-DCR were high.
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Erkut KÜÇÜK, Uğur YILMAZ, Kürşad Ramazan ZOR
Erkut KÜÇÜK, Uğur YILMAZ, Kürşad Ramazan ZOR
Objectives: This study was performed to evaluate the Schirmer II test (ST2) results, tear breakup time (TBUT) findings,
and Ocular Surface Disease Index (OSDI) scores of pterygium patients under 30 years of age, and to compare the results
with pterygium patients aged 30 years and older and healthy controls.
Methods: Eighty-four eyes of 60 patients who had primary pterygium and were younger than 30 years of age (Group
1), 79 eyes of 53 patients who had primary pterygium and were 30 years of age and older (Group 2), and 64 eyes of 64
healthy controls (Group 3) were included in the study. The results of ST2 and TBUT tests and the OSDI questionnaire
scores were recorded and compared.
Results: Group 1 had lower TBUT values compared to Group 2 and the control group (p= 0.03 and p<0.001, respectively). Group 1 had lower ST2 values than the control group (p<0.001). There was no significant difference in the ST2
results between Group 1 and Group 2 (p=0.08). Group 1 had higher OSDI scores than the control group (p=0.003). There
was no significant difference in the OSDI scores between Group 1 and Group 2 (p=0.7).
Conclusion: The results indicated that young patients with pterygium had lower ST2 results, lower TBUT values, and
higher OSDI scores compared to the control group, and lower TBUT values compared to older patients with pterygium.
Tear film abnormality may be a factor in the pterygium pathogenesis, especially in young patients, and may increase the
vulnerability of the ocular surface of young people to environmental factors, leading to pterygium formation.
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