ISSN: 2459 - 1777 | E-ISSN 2587-0394
Volume: 3
Issue: 3
Year: 2018
Beyoglu Eye J: 3 (3)
Volume: 3  Issue: 3 - 2018
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1.The Use of Donor Corneas Which Have Undergone Refractive Surgery in Keratoplasty
Eda Asılyazıcı, Banu Açıkalın, Murat Garlı, Yıldırım Kocapınar
doi: 10.14744/bej.2018.05706  Pages 101 - 104
Due to the rapid developments in techniques and devices used in refractive surgery, these surgeries are applied to more than before and different techniques are emerging every day. Laser in situ keratomileusis (LASIK), photorefractive keratectomy(PRK) and radial keratotomy(RK) are the procedures performed most frequently. Eye Bank Association of America medical standards do not permit corneas from patients who have undergone refractive procedures to be used in penetrating keratoplasty, anterior lamellar keratoplasty, or tectonic grafting procedures. But these standards allow these corneas for endothelial keratoplasty. According to these standards identification of these corneas iscritical and studies for identification methods are going on. Several case reports have highlighted the difficulty in using postrefractive surgery corneas in penetrating keratoplasty. However, these corneas have been used successfully for endothelial keratoplasty with equivalent outcomes in topography, endothelial cell count, and visual acuity. The increase in endothelial keratoplasty procedures and the successful results of endothelial keratoplasty with postrefractive corneas are promising.

2.Consistency of Ocular Palpation Tonometry with Goldman Applanation Tonometry and Its Reproducibility by Separate Examiners
Mehmet Özveren, Beril Tülü Aygün, Gönül Karataş Durusoy, Çiğdem Altan, Muhittin Taşkapılı
doi: 10.14744/bej.2018.08370  Pages 105 - 108
INTRODUCTION: Elevated intraocular pressure (IOP) remains to be the best known modifiable risk factor for glaucoma. Ocular palpation tonometry (OPT) is an old, fast and simple method for IOP measurement. Our aim is to investigate accuracy, reproducibility of ocular palpation tonometry and its suitability to be used for screening purposes.
METHODS: Consecutive patients without corneal pathology and glaucoma diagnosis history were included in the study. After routine ophthalmologic examination the IOP was measured by an ophthalmology specialist with Goldmann applanation tonomety (GAT). Later a blinded other ophthalmology specialist and a resident evaluated the same patients’ IOP with ocular palpation tonometry. Agreement between GAT and OPT, reproducibility of OPT were evaluated using Cohen Kappa Analysis.
RESULTS: 214 eyes of 107 patients were included in the study with a mean IOP of 16.4±3.6 (min: 8, max: 27) mmHg with GAT. OPT measurements by the resident ophthalmologist and the ophthalmology specialist were in concordance with GAT for 44.4% and 50.5% of the evaluations, respectively. We couldn’t detect a significant kappa value for the agreement between GAT and OPT measurements by the resident ophthalmologist (p=0.333). Whereas a slight agreement was found between GAT and OPT measurements by the ophthalmology specialist (K=0.176, p=0.001). OPT measurements showed slight reproducibility (K=0.153, p=0.009).
DISCUSSION AND CONCLUSION: Ocular palpation tonometry has low reliability, reproducibility and is not suitable to be used as a screening test. Except obligatory states, it should not be used as a primary and only test, and must be verified by other methods.

3.Multifocal Electroretinography in Diabetic Patients without Retinopathy
Özgür Balta, Gulten Sungur, Mehmet Yakın, Nurten Unlu, Oyku Bezen Balta, Eyup Ozcan, Firdevs Ornek
doi: 10.14744/bej.2018.29491  Pages 109 - 115
INTRODUCTION: This study aimed to assess the multifocal electroretinography (mfERG ) findings in diabetic patients without retinopathy according to HbA1c levels and diabetes duration.
METHODS: Sixty two eligible patients with type 2 diabetes mellitus and 30 healthy controls which were matched by age and sex were included in the study. Only the right eye of each patient was analyzed. All of the participants underwent a comprehensive ophthalmic examination, and the mfERG responses which were N1-P1 amplitude, N1 implicit times and P1 implicit times were calculated.
RESULTS: The mfERG N1-P1 amplitude was significantly reduced in diabetic patients compared to controls in inner two rings. There was significantly difference between controls and stable patients’ mfERG P1 implicit times in ring 2. It was found that there was negative correlation trends between diabetes duration and mfERG N1-P1 amplitude, there were negative positive correlation trends between diabetes duration and N1 implicit times and P1 implicit times in all rings. There was statistically significant negative correlation between diabetes duration and N1-P1 amplitude only in ring 5. Also, it was found that there were statistically significant positive correlations between diabetes duration and N1 implicit times in ring 1, 2 and 5. There was significantly correlation between diabetes duration and P1 implicit times only in ring 2.
DISCUSSION AND CONCLUSION: We demonstrated that mfERG N1-P1 amplitude was reduced in inner retinal areas (ring1 and ring 2), and P1 implicit time was delayed only in ring 2 in Turkish diabetic patients without retinopathy. There was statistically significant correlation between diabetes duration and N1-P1 amplitude and N1 implicit times in some retinal areas.

4.Clinical outcomes of a new aspheric monofocal intraocular lens
Baha Toygar, Özge Yabaş Kızıloğlu, Okan Toygar, Ali Murat Hacımustafaoğlu
doi: 10.14744/bej.2018.63634  Pages 116 - 121
INTRODUCTION: To evaluate the clinical outcomes of a new aberration-free aspheric monofocal intraocular lens (IOL).
METHODS: This single-center retrospective study included eyes of cataract patients implanted with a new aberration-free aspheric IOL. Medical records of patients who were followed for 6 months were reviewed. Data on visual acuity (distance, intermediate and near), refractive error (sphere, cylinder and manifest spherical equivalent [MSE]), contrast sensitivity and adverse events were collected and analyzed.
RESULTS: Thirty-eight eyes of 30 patients with a mean age of 65.7±10.6 years were included in the study. At 6 months postoperative, 100% of the eyes had achieved a corrected distance visual acuity of 0.2 logMAR or better, 89% of the eyes had achieved a corrected intermediate visual acuity of 0.2 logMAR or better and 89% of the eyes had achieved a corrected near visual acuity of J3 or better. Postoperatively, there was a significant reduction in the spherical (p<0.01) and cylindrical (p=0.01) refraction compared to baseline with a mean final MSE of 0.03±0.40 diopters. Postoperative low contrast (10%) visual acuity remained stable (p= 0.54) through follow-up visits with a mean of 0.35±0.17 logMAR at the 6-month visit. There were no adverse events associated with the study IOL.
DISCUSSION AND CONCLUSION: The study IOL was safely implanted without any adverse events and improved visual acuity in cataract surgery patients while preserving visual quality over the 6-month follow-up period. Further studies with larger study groups and long term follow-up are necessary to confirm these results.

5.Elevated red cell distribution width levels in patients with pseudoexfoliation syndrome and pseudoexfoliation glaucoma
Bengi Ece Kurtul, Emrah Utku Kabataş
doi: 10.14744/bej.2018.53825  Pages 122 - 127
INTRODUCTION: To assess the levels of red cell distribution width (RDW) in patients with pseudoexfoliation syndrome (PEX) and to compare the RDW values of patients with PEX, PEX glaucoma (PXG), and healthy controls.
METHODS: In total, 45 patients with PEX, 14 patients with PXG, and 43 age- and sex-matchd healthy control subjects were enrolled in this retrospective study. Complete ophthalmologic examination and complete blood count measurements were performed of all subjects. Complete blood counts were performed within 1 h of blood collection.
RESULTS: RDW levels were significantly higher in patients with PEX and PXG than in those with controls (p = 0.037 and p < 0.001, respectively). Also, a significant difference was found in RDW values between PXG and PEX groups (p = 0.028). RDW levels were gradually increased from control group to PXG group (p < 0.001 for one-way ANOVA). Multivariate logistic regression analysis revealed that RDW was independently associated with the presence of PEX/PXG (odds ratio 1.698, 95% confidence interval 1.077-2.677, p = 0.023).
DISCUSSION AND CONCLUSION: The present study for the first time provides evidence that RDW may be an useful marker for predicting the presence of PEX and progression to PXG.

6.The incidence of retinopathy of prematurity in a tertiary care center in Turkey
Dilbade Yıldız Ekinci, Sadik Etka Bayramoglu, Asli Deger Vural
doi: 10.14744/bej.2018.32032  Pages 128 - 132
INTRODUCTION: The objective of our study was to determine the incidence of retinopathy of prematurity in our hospital, which gives tertiary health services.
METHODS: In this retrospective study, the medical files of the infants, who were born before the 36th gestational age and applied for the examination of retinopathy of prematurity between 2014 and 2017 to Istanbul Kanuni Sultan Suleyman Training and Research Hospital, were investigated. The birthweight, gestational age, type of delivery, the development of retinopathy of prematurity were recorded.
RESULTS: The mean gestational age and mean birthweight of 2913 infants, who were screened for retinopathy of prematurity, were 32.3±2.9 (22-36) weeks and 1846 ± 580 g (360 - 4300) respectively. 48.7 % of the patients were females and 51.3 % were males. 32.4 % of the patients had retinopathy of prematurity at any stage. 8.8 % of the infants had severe retinopathy of prematurity and were treated accordingly. The mean gestational age and the mean gestational weight of the infants in this group were 28.0±2.6 weeks (22-35) and 1171.9±417.5 g (360-2500) respectively. The mean birthweight was lower in the severe retinopathy of prematurity group compared to the group with no retinopathy of prematurity development. 28 infants (0.9 %) with a birthweight over 2500 g (2502-3740) had only mild retinopathy of prematurity and improved spontaneously.
DISCUSSION AND CONCLUSION: As it was determined that the mean gestational age and weight were lower in infants with retinopathy of prematurity than the infants with no retinopathy of prematurity development, so the importance of the low birthweight and the gestational age was confirmed as risk factors for retinopathy of prematurity development.

7.Retinopathy of Prematurity Screening Criteria in Turkey’s South Marmara Region
Sadık Görkem Çevik, İrfan Perente
doi: 10.14744/bej.2018.19483  Pages 133 - 137
INTRODUCTION: Retinopathy of prematurity (ROP) is the leading cause of preventable blindness in premature infants and a growing problem in middle and low income countries. In order to prevent ROP, effective screening, prevention, and treatment programs are essential, they should be modified according to each country’s requirements.In this study, we offered modified screening criteria for Turkish children.
METHODS: The medical records of the patients who had ROP screening between January 2015 and May 2018 were retrospectively reviewed.Five different criteria were applied to all 1,720 babies, as follows: ≤ 35 weeks and/or 2,600 g, ≤ 34 weeks and/or 2,400 g, ≤ 33 weeks and/or 2,100 g, ≤ 32 weeks and/or 2,000 g, and ≤ 31 weeks and/or 1,800 g. The sensitivities and specificities were found for all the strategies.
RESULTS: In this study, a total of 1,720 babies screened for ROP (774 girls and 946 boys) were evaluated retrospectively.The mean GA of the babies examined was 32.1 ± 2.9 weeks (range 24–36 weeks), and the mean BW of the babies screened was 1,817 ± 594 g (range 510–3360 g). ROP was diagnosed in 430 (25%) of the patients, and of these, 165 (9% of all patients) required treatment.Overall, the screening protocols of ≤ 33 weeks of gestational age (GA) and ≤ 2,100 g of birth weight (BW) had 100% sensitivity to detect treatment-requiring babies.
DISCUSSION AND CONCLUSION: The screening protocols used in highly developed countries are not suitable for all countries, especially for low and middle income countries. Thus, the criteria may miss high number of ROP treatment-requiring patients. Neonatal intensive care unit (NICU) should coordinate system and continuously update the ROP screening guidelines so that these data could form a basis for the national ROP standards. We recommend screening premature patients of ≤ 33 weeks of GA or ≤ 2,100 g of BW for our region

8.To Evaluate Corneal Biomechanical Changes after Strabismus Surgery with Ocular Response Analyzer
Ebru Demet Aygıt, Ali Demircan, Zeynep Alkın, Alper Agca, Birsen Gökyigit
doi: 10.14744/bej.2018.73792  Pages 138 - 141
INTRODUCTION: Corneal biomechanical changes were also suspected and investigated after some scleral procedures but not after strabismus surgery. In this study we aimed to evaluate corneal biomechanical changes following strabismus procedures.with ocular responce analyser.

METHODS: Methods: This study a retrospective case series. Corneal biomechanical properties were assessed using the Ocular Response Analyzer (ORA, Reichert Inc., Depew, New York, USA) before, and 6 months after the surgery in 67 eyes of 67 patients performing strabismus surgery. Preoperative and postoperative changes in corneal hysteresis (CH) and corneal resistance factor (CRF) outcomes were examined.

RESULTS: Results: In the study group were divided Group1 and Group2 for the performed surgery. Preoperative and postoperative CRF were showed statistically significant differences in Group 1 and Group 2. In Group 1 at preoperative the mean CH was 11.7 ± 2.4 mmHg and 12.3 ± 2.5 mmHg at postoperative. The differences were not statistically significant in Group1.

DISCUSSION AND CONCLUSION: This is the first study aimed at evaluating the corneal biomechanical changes after strabismus surgery. and CRF were found to statistically significance at 6 month after strabismus surgery.

9.Conjunctivodacryocystorhinostomy using Mateireau tube with endoscopy assistance
Gamze Öztürk Karabulut
doi: 10.14744/bej.2018.69775  Pages 142 - 145
INTRODUCTION: To analyze the surgical outcome of conjunctivodacryocystorhinostomy operations with permanent silicone tube implantation (Métaireau tube) with aid of nasal endoscopy and to obtain subjective measure of patient satisfaction.
METHODS: Charts of 13 eyes of 13 patients (5 males, 8 females) with proximal canalicular obstruction who had undergone conjunctivodacryocystorhinostomy with permanent silicone tube insertion were reviewed retrospectively. Diagnosis of the upper lacrimal system obstruction was confirmed by lacrimal system irrigation. During operation the length of the tube was adjusted with aid of nasal endoscopy using the endoscopic scissors in order to prevent contact of the distal end of the tube to the nasal septum in the nasal cavity. The patients were asked to subjectively rate their epiphora according to Munk Epiphora Grading System before surgery and at first, third, sixth months and one year following surgery.
RESULTS: Improvement of epiphora was statistically significant at all visits when compared with values before injection (p< 0.001). Tube dislocation was seen in 4 patients (30.7%), proximal obstruction due to conjunctival granuloma formation was seen in 3 patients (23%). Two patients who had tube dislocation intranasally were revised for two times with endoscopy and proximal ends of tubes were resutured. Repositioning of the tube by pulling out from caruncle area with fine forceps was performed only once in two patients.
DISCUSSION AND CONCLUSION: Conjunctivodacryocystorhinostomy with permanent silicone tube insertion and adjustment of the length of the tube with assistance of endoscopy provides easier and efficient approach in patients with proximal lacrimal system obstruction.

10.A Rare Case Report: Acute Spontaneous Suppurative Dacryoadenitis
Ayşegül Penbe, Özlen Rodop Özgür
doi: 10.14744/bej.2018.39974  Pages 146 - 149
We report a case of acute suppurative bacterial dacryoadenitis (ASBD) with abscess formation which is rarely seen in daily practice. 67 years old male had been suffering from swelling and purulent discharge on right eye consulted to our ophthalmology clinics. We noted the ocular and orbit CT findings for the diagnosis at the beginning. Also, we described the treatment options and its conclusions with the help of its MRI findings.

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