OBJECTIVES: To compare the clinical outcomes of phacoemulsification combined with intraocular lens implantation in patients with Fuchs endothelial corneal dystrophy (FECD) and individuals with healthy corneas.
METHODS: This retrospective study included eyes that underwent phacoemulsification and intraocular lens (IOL) implantation between January 2021 and September 2022. Phacoemulsification was performed using a contemporary oscillatory ultrasound mode; device-logged energy and fluidics metrics were recorded. Best corrected visual acuity (BCVA) and specular microscopy (CEM-530™; Nidek) were evaluated preoperatively and at postoperative week 1, month 1, and month 3. Endothelial cell density (ECD) and central corneal thickness (CCT) were recorded. The primary outcome measures were post-operative BCVA, ECD, and CCT changes. The study included 32 eyes with FECD and 29 control eyes with healthy corneas.
RESULTS: In both groups, mean BCVA improved significantly from 0.7 LogMAR preoperatively to 0.15 LogMAR at 1 month postoperatively (p<0.001). The endothelial cell loss at 3 months was significantly higher in the FECD group compared to controls (20.9% vs. 17.9%, p=0.022). Baseline ECD was 2065.5 cells/mm² in the FECD group and 2289.4 cells/mm² in the control group, decreasing to 1633.1 and 1878.9 cells/mm², respectively, at 3 months. CCT increased from 564.5 µm to 584.1 µm in the FECD group (p=0.006), and from 550.5 µm to 557.7 µm in the control group (p=0.124). No cases of postoperative corneal decompensation were observed.
DISCUSSION AND CONCLUSION: Phacoemulsification yielded meaningful visual improvement in FECD eyes without early corneal decompensa-tion. Endothelial loss was higher and CCT recovery slower than in controls, supporting energy-minimizing techniques and closer early follow-up in FECD.

OBJECTIVES: To assess the repeatability and reliability of anterior and posterior corneal measurements in keratoconus patients who underwent corneal allogenic intrastromal ring segment (CAIRS) implantation using a Scheimpflug-based tomography system.
METHODS: This prospective observational study included 42 eyes: 20 keratoconic eyes that had undergone CAIRS implantation and 22 healthy controls. All participants were imaged with the Pentacam HR (Oculus Optikgeräte GmbH, Germany). Each eye underwent three consecutive scans during a single session. Repeatability was evaluated using within-subject standard deviation (Sw), repeatability index (RI), and tolerance index (TI), and reliability was assessed using intraclass correlation coefficients (ICC). A TI>0.36 was considered indicative of reduced repeatability.
RESULTS: Anterior corneal curvature parameters (K1 and K2) and pachymetric indices demonstrated excellent reliability (ICC>0.90) and acceptable repeatability (TI<0.36). In contrast, CAIRS-implanted eyes exhibited greater variability in Kmax, Kmean, anterior elevation, and several posterior corneal metrics, with TI values exceeding 0.36. Despite having high ICC values, posterior elevation showed the greatest variability. Pachymetry at the corneal vertex and the thinnest corneal thickness remained highly reproducible (TI 0.08 and 0.18, respectively), suggesting strong measurement accuracy.
DISCUSSION AND CONCLUSION: The implantation of CAIRS alters the shape of the cornea and decreases the repeatability of several tomography-derived metrics, especially posterior corneal indices and Kmax. Although overall reliability remains high, clinicians should cautiously interpret small postoperative changes in monitoring these parameters. Pachymetric measurements maintain excellent precision and can be reliably used for postoperative follow-up and progression assessment after CAIRS surgery.

OBJECTIVES: To evaluate the acute effects of cigarette smoking on corneal tomography and ocular biometry.
METHODS: This prospective, controlled study included 92 healthy volunteers (46 smokers and 46 non-smokers); only the right eye was analyzed. Baseline ophthalmological examination, corneal tomography and biometry were performed. Participants remained outdoors for 10 minutes under standardized conditions; smokers smoked one cigarette, whereas controls did not. Measurements were then repeated, and within-group changes and between-group differences in change (Δ) were analyzed.
RESULTS: Baseline demographic, tomographic, and biometric measurements were similar between groups (all p>0.05). Within the smoking group, significant reductions were observed in corneal thickness at the pupil center, corneal vertex, and thinnest point (p=0.011, p=0.012, and p=0.017, respectively). Within the smoking group, anterior chamber depth also decreased from 3.08±0.44 mm to 2.98±0.52 mm (p=0.034); however, the between-group difference in Δ values was not statistically significant (p=0.068). In contrast, no significant changes were observed in anterior chamber volume, keratometric values, axial length, or emmetropia-targeted intraocular lens power calculated using the Barrett Universal II formula (p>0.05 for all). No significant changes were observed in any of the parameters examined in the control group. In the between-group comparison of Δ values, changes in pupil-center pachymetry and thinnest corneal thickness were significantly different (p=0.002 and p=0.004). Anterior 0–2 mm densitometry decreased in smokers, with a significant between-group difference in Δ (p=0.029).
DISCUSSION AND CONCLUSION: Acute cigarette smoking was associated with measurable alterations in corneal thickness, anterior chamber depth and several corneal densitometry parameters. However, these changes did not significantly affect keratometric values, axial length, or intraocular lens power calculations. Recent cigarette smoking may affect anterior segment measurements, and recent cigarette smoking should be considered when interpreting measurements, especially in situations requiring sensitive corneal assessment.

OBJECTIVES: To evaluate the etiological causes, demographic characteristics, surgical procedures, implant features, com-plications, and additional surgical interventions in patients undergoing anophthalmic surgery over a 20-year period.
METHODS: The records of patients who underwent evisceration, enucleation, sphere exchange, secondary sphere im-plantation, and anophthalmic socket reconstruction at our institution between 2003 and 2023 were reviewed. Etiologic and demographic data, surgical procedures, orbital implant diameter and material, postoperative complications, additional surgical procedures, and follow-up periods were recorded. Female patients were classified as group 1 and male patients as group 2, and both groups were subjected to comparative analysis.
RESULTS: A total of 603 patients were divided into two groups: Group 1 (female, 32.2%) and Group 2 (male, 67.8%). The mean age at the time of surgery was comparable between the two groups (p=0.830). Trauma was the most common etiology, malignancy the least common. Evisceration was the most frequently performed procedure, and enucleation the least. The mean diameter of implanted spheres was significantly smaller in Group 1 (p=0.001). No significant difference in implant materials was observed (p=0.590). Conjunctival suture dehiscence and infection were the most common compli-cations, showing similar profiles in both groups.
DISCUSSION AND CONCLUSION: Trauma was the leading cause in both groups, with evisceration as the most frequently performed proce-dure. These procedures addressed the underlying ocular pathologies and contributed to orbital volume restoration when indicated.

OBJECTIVES: Eyelid tumors are neoplasms commonly diagnosed in routine ophthalmology practices. Some malignant tumors may mimic benign lesions and inflammatory conditions, which can lead to delayed diagnosis and treatment. The study aimed to identify the clinical characteristics of eyelid tumors at a tertiary eye hospital by analyzing retrospective data from a 3-year observational study.
METHODS: A descriptive retrospective study was carried out on 1295 patients diagnosed with eyelid tumors between January 2022 and December 2024. All patients with eyelid tumors who underwent histopathological examination were included. Eyelid tumor characteristics, surgical procedures, and histopathological characteristics were collected.
RESULTS: The study comprised 837 (65%) female patients and 458 (35%) male patients. A total of 922 benign lesions (71%) and 373 malignant neoplasms (29%) were identified. Among the benign lesions, the most prevalent types were nevus (26%), epidermoid cyst (15%), and dermoid cyst (12%). The most common malignant neoplasms were basal cell car-cinoma (35%), sebaceous gland carcinoma (25%), and malignant lymphoma (19%). Most benign lesions were managed with excision and direct closure of the eyelid defect (47%), and malignant neoplasms were excised with reconstruction (57%).
DISCUSSION AND CONCLUSION: This study found majority of eyelid tumors were benign, with a higher number of female patients compared to males. Intradermal nevus was the most common benign eyelid lesion, while basal cell carcinoma was the most prevalent malignant neoplasm. The surgical technique of eyelid tumor excision followed by histopathological examination can provide excellent cosmetic and functional results.

OBJECTIVES: The results of ptosis surgery and revision surgery performed in blepharoptosis of different etiologies in the paediatric age group were evaluated.
METHODS: The 78 eyes of 66 patients followed up at our clinic between 2020 and 2024 were retrospectively examined. The patient's age, gender, etiology, preoperative and postoperative Best Corrected Visual Acuity (BCVA), levator function, Mar-gin Reflex Distance-1 (MRD-1), surgical techniques and revisions performed, amount of lagophthalmos, Bell's phenomenon, strabismus and amblyopia status were evaluated.
RESULTS: The mean age of the patients was 9.05±4.18 years, and the follow-up period was 21.19±12.90 months. The etiology of ptosis was congenital myogenic in 49 (74.4%) patients, congenital neurogenic in 13 (19.6%) patients, and ac-quired in 4 (6%) patients. Strabismus was detected in 12 patients (18%), and amblyopia was detected in 35 eyes (44.9%). The most frequently used surgical techniques were frontal suspension with silicone (30.8%), müller muscle conjunctival resection (28.2%), and levator surgery (25.6%). Revision surgery was performed in 29 eyes (37.2%). The preoperative MRD-1 (0.72±1.26 mm) showed a significant increase at 6 months postoperatively (2.20±1.42 mm) (p<0.001). A positive correlation was found between final BCVA and preoperative BCVA (r=0.579, p<0.001). A low to moderate significant correlation was found between postoperative lagophthalmos and punctate staining (r=0.308, p=0.012). Lagophthalmos was more pronounced in the silicone sling group.
DISCUSSION AND CONCLUSION: In pediatric ptosis surgery, a high rate of functional and aesthetic success is achieved through the selection of surgery appropriate to the etiology and careful postoperative follow-up.

OBJECTIVES: To evaluate retinal layers, subfoveal choroidal thickness, and optic nerve head parameters in adults with unilateral anisometropic amblyopia using optical coherence tomography.
METHODS: This comparative cross-sectional study included 41 adults with unilateral anisometropic amblyopia and 35 healthy controls. Optical coherence tomography measurements were obtained from amblyopic eyes, fellow eyes, and control eyes. Retinal analysis included the nerve fiber layer, inner plexiform layer, outer plexiform layer, inner segment/outer segment (IS/OS) junction, retinal pigment epithelium, and subfoveal choroidal thickness. Peripapillary retinal nerve fiber layer, ganglion cell complex, mean macular thickness, Bruch’s membrane opening, Bruch’s membrane opening-minimum rim width, and lamina cribrosa-related parameters were also assessed. Comparisons were performed using linear mixed-effects models, with Bon-ferroni correction for post hoc analyses.
RESULTS: After adjustment for age, significant between-group differences were mainly limited to the IS/OS parameter, mean macular thickness, and selected lamina cribrosa measurements. IS/OS was significantly higher in amblyopic eyes than in control eyes (172.55±42.50 vs 151.26±26.14; overall p=0.029, adjusted p=0.029), whereas mean macular thickness was lower in amblyopic eyes (246.00±20.90 vs 261.99±14.67; overall p=0.015, adjusted p=0.016). Temporal lamina cribrosa curve value (p=0.005), superior lamina cribrosa depth (p=0.016), temporal lamina cribrosa depth (p=0.017), and tempo-ral lamina cribrosa width (p=0.005) also differed significantly after age adjustment. Retinal nerve fiber layer, ganglion cell complex, Bruch’s membrane opening, Bruch’s membrane opening-minimum rim width, subfoveal choroidal thickness, and lamina cribrosa curvature index showed no significant differences.
DISCUSSION AND CONCLUSION: In adults with unilateral anisometropic amblyopia, structural changes after age adjustment were subtle and region-specific rather than diffuse. The main differences involved the IS/OS parameter, mean macular thickness, and selected lamina cribrosa-related measurements, while other retinal, choroidal, and optic nerve head parameters were largely similar across groups.

OBJECTIVES: This study aimed to assess and compare retinal nerve fibre layer (RNFL) and ganglion cell layer (GCL) thickness in migraine patients versus controls and to analyze differences between chronic and episodic migraine.

METHODS: A cross-sectional, case-control study was conducted from June 2022 to December 2023. A total of 100 migraine patients (33 chronic, 67 episodic) and 102 controls underwent detailed ocular evaluation using OCT. RNFL and GCL parameters were compared between cases and controls using an independent t-test. Paired t-tests assessed differences between chronic and episodic migraine, as well as between the right and left eyes.
RESULTS: Photophobia (90%) and ocular pain (85%) were the most common symptoms. Migraine patients showed a significant reduction in average (106 µm), superior (129 µm), and nasal (80 µm) RNFL thickness compared to controls. Chronic migraine patients exhibited significant thinning in the temporal (67 µm) and nasal (72 µm) RNFL quadrants and superotemporal (67 µm) and superonasal (70 µm) GCL quadrants in the right eye. Episodic migraine patients had reduced superotemporal GCL thickness (71 µm) in the left eye.
DISCUSSION AND CONCLUSION: The retinal nerve fibre layer (RNFL) and ganglion cell layer (GCL) thickness is reduced in chronic and episodic type of migraine patients. Hence, ophthalmologists should consider the potential impact of migraine headaches on the thickness of RNFL and GCL.

OBJECTIVES: To evaluate the safety, visual outcomes, and complication profile of femtosecond laser-assisted cataract surgery (FLACS) combined with 25-gauge pars plana vitrectomy (PPV) in patients with concurrent cataract and vitreoretinal disease.

METHODS: This retrospective study included 57 eyes of 57 patients who underwent FLACS with a standardized 4.8-mm capsulotomy followed by 25-gauge PPV at a tertiary referral center in Istanbul, Türkiye, between August 2020 and May 2025. Data collected included intraoperative events, postoperative best-corrected visual acuity (BCVA, Snellen converted to logMAR for analysis), intraocular pressure (IOP), and complication rates over a mean follow-up of 15.8±1.8 months.
RESULTS: Mean BCVA significantly improved from 0.68±0.34 logMAR preoperatively to 0.28±0.14 logMAR at 1 month, 0.19±0.11 logMAR at 3 months, and 0.15±0.14 logMAR at the final visit (all p<0.001). All eyes achieved meaningful visual recovery with stable and well-centered intraocular lenses and attached retinas. On postoperative day 1, post-hoc pairwise analysis revealed a significantly lower IOP in the air tamponade group compared with the SF6 and BSS groups (MD=−4.24, p<0.001); no significant IOP differences were found between groups at week 1, month 1, or month 3. Intraoperative complications included loss of cone suction (n=2, 3.5%) and incomplete capsulorhexis (n=2, 3.5%). Miosis occurred in 6 eyes (10.5%), and sclerotomy leakage requiring suturing in 7 eyes (12.3%).
DISCUSSION AND CONCLUSION: Combined FLACS and 25-gauge PPV is a safe and effective option for the management of coexisting cataract and vitreoretinal pathologies. The procedure provides favorable anatomical and visual outcomes with a low incidence of intraoperative and postoperative complications, supporting its use in appropriately selected patients. Prospective con-trolled studies are warranted to confirm these findings.

OBJECTIVES: To investigate the effect of internal limiting membrane peeling on vascular density of macula and optic disc in idiopathic epiretinal membrane surgery.
METHODS: Thirty-six eyes of 36 patients who underwent combined phacoemulsification with intraocular lens implantation followed by pars plana vitrectomy and epiretinal membrane (ERM) removal were prospectively included in this study. Based on the intraoperative status of the internal limiting membrane (ILM) after ERM removal, the eyes were classified into two groups: The ILM-peeled group (n=22) and the ILM-unpeeled group (n=14). Vascular density of superficial capillary plexus, deep capillary plexus, optic nerve head and radial peripapillary capillary plexus were obtained by optical coherence tomography angiography before and up to 3 months after surgery.
RESULTS: After surgery, superficial capillary plexus fovea vascular density and foveal thickness decreased significantly in the internal limiting membrane unpeeled group. (p=0.016; p=0.048 respectively). There was no significant change in superficial capillary plexus paravofea (p=0.257), deep capillary plexus fovea (p=0.569), deep capillary plexus parafovea (p=0.457), optic nerve head (p=0.545) and radial peripapillary capillary plexus (p=0.975) vascular density comparison between groups.
DISCUSSION AND CONCLUSION: Internal limiting membrane peeling has no significant effect on deep capillary plexus and the optic disc vascular density, but can reduce vascular density in the superficial capillary plexus after idiopathic epiretinal membrane peeling surgery.

OBJECTIVES: To report long-term clinical manifestations and genetic findings of a hereditary vitreoretinopathy exhibiting phenotypical characteristics of Wagner Syndrome in a multigenerational Turkish family originating from the same district in Central Anatolia.
METHODS: Data from detailed medical histories and ophthalmological examinations were evaluated. Family pedigree was constructed. PCR and sequence analysis were performed to assess splice sites of introns 7 and 8 of the VCAN gene associated with Wagner syndrome.
RESULTS: Thirty family members were examined, and 21 affected individuals were followed for 2–18 years. Cohort included 12 females and 9 males, with a mean age of 31±19 years (4–71), mean spherical equivalent of -3.87±5.03 diopters. Sixteen patients (76%) were myopic (≤-0.50 D). Rhegmatogenous retinal detachment (RD) was presenting diagnosis in seven patients (33%). Hollow vitreous cavity with fibrous bands was detected in nine individuals (43%). Peripheral retinal pathology included multiple breaks in 16/21 (76%), snail-track degeneration in 3/21 (14%), lattice degeneration in 5/21 (24%), white without pressure in 2/21 (9.5%). One 20-year-old male with bilateral RD also had an optic nerve head astrocytoma. Mean age at onset was 21.6±13.5 years (4–50). Earliest RD occurred at age 10, retinal breaks with attached retina were identified at age 8. Youngest patient (age 4) exhibited high axial myopia and vitreous bands. Laser prophylaxis was effective in 10 patients, although one later developed RD. Three patients (14%) developed phthisis, seven (33%) underwent cataract surgery, and four (19%) had glaucoma. Sequence analysis revealed no mutations in VCAN intron 7 or 8 splice sites.
DISCUSSION AND CONCLUSION: This study presents a Turkish family with hereditary vitreoretinopathy exhibiting phenotypical characteristics of Wagner Syndrome. Although genetic analysis was inconclusive, detailed presentation of long-term clinical manifestations may provide valuable information about hereditary vitreoretinopathies and emphasize the importance of early and regular follow-up and prophylactic treatment for prevention of RD.

OBJECTIVES: To describe ophthalmic phenotypes prompting genetic testing and to calculate the molecular diagnostic yield retrospectively in a real-world tertiary health center cohort.


METHODS: This retrospective observational study employed a phenotype-first review of archived clinical genetic testing records. Unique individuals with documented ocular manifestations were identified and deduplicated using demographic and phenotype consistency rather than laboratory patient number alone. Patients were assigned one primary molecular outcome: Phenotype-concordant pathogenic or likely pathogenic diagnosis, candidate/variant of uncertain significance/partial finding, unresolved, or secondary/non-diagnostic pathogenic or likely pathogenic finding. Variants of uncertain significance, single pathogenic alleles for recessive disorders, and unphased biallelic variants were not counted as definitive diagnoses.
RESULTS: Among 33 unique individuals, phenotype-concordant molecular diagnoses were established in 18.2% (6/33), while candidate, variant of uncertain significance, or partial findings were more frequent at 54.5% (18/33). Diagnoses involved REEP6, TYR, PTEN, BRPF1, and CACNA1F. An additional patient with albinism carried two heterozygous TYR pathogenic or likely pathogenic variants, but phase was not established; confirmation in trans would increase the yield to 21.2%. Excluding a CACNA1F case with a nonspecific archived phenotype reduced the yield to 15.2%.
DISCUSSION AND CONCLUSION: The conservative molecular diagnostic yield was 18.2%, with candidate and partial findings substantially outnumbering definitive diagnoses. This gap underscores the importance of phenotype concordance, inheritanceaware interpretation, and segregation analysis in real-world ophthalmic genetics, where unresolved cases represent a reanalysis cohort rather than a diagnostic dead end.

Lipoid proteinosis (LP) is a rare autosomal recessive disorder resulting from mutations in the ECM1 gene and characterized by mucocutaneous thickening and deposition of hyaline material. We present a 10-year-old male with hoarseness, moniliform blepharosis, oral mucosal nodules, and cutaneous lesions. Histopathology showed PAS-positive hyaline material deposition. Genetic analysis by next-generation sequencing identified a homozygous synonymous variation, ECM1 c.879G>A (p.Ser293=), which has not been previously reported in a homozygous form. Segregation analysis showed heterozygosity in both parents. In accordance with ACMG guidelines, the variant meets criteria PS4, PM2, PM3, PP3, and PP4, supporting its reclassification as pathogenic. This case highlights the diagnostic value of combining clinical, histological, and genomic data, especially in the evaluation of variations of uncertain significance. Genotyping in patients clinically and histopathologically compatible with LP is crucial to inform disease management and enhance understanding of its genetic background.

Cidofovir is an antiviral agent used in the treatment of viral infections but is associated with ocular toxicities. We report a case of a 71-year-old immunocompromised woman who developed bilateral anterior uveitis, marked hypotony, and choroidal effusion following intravenous cidofovir treatment for refractory herpes simplex virus type 2 infection. Ophthalmic examination and multimodal imaging, including optical coherence tomography and ocular ultrasonography, confirmed bilateral choroidal folds and effusion. Extensive systemic evaluation excluded infectious, inflammatory, and autoimmune etiologies. The close temporal relationship between cidofovir administration and symptom onset supported a diagnosis of cidofovirinduced ocular toxicity. Discontinuation of cidofovir and initiation of intensive topical corticosteroid therapy resulted in clinical improvement. This case highlights the importance of early recognition of cidofovirrelated ocular adverse effects and the need for close ophthalmic monitoring during therapy.

Ectopic lacrimal glands, also known as lacrimal gland choristomas, are seen in various areas of the eyes and are character-ized by their placement outside of their typical anatomical position. While tarsal lacrimal gland choristomas are uncom-mon, the bulbar conjunctiva and limbal area have been identified as the most frequent sites. Herein, we report a 32-year-old female with a mass on the left lower eyelid conjunctiva that is histopathologically proved to be a lacrimal gland choristoma.