Surgery for full-thickness macular holes.
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Humans↗
Biomedical subjects
C Aras
Publications and source records attributed to C Aras.
Silicone oil in the surgical treatment of endophthalmitis associated with retinal detachment.
PURPOSE: To investigate the use of silicone oil in the patients who had undergone vitrectomy for the treatment of endophthalmitis associated with retinal detachment. METHODS: Six consecutive cases of endophthalmitis associated with retinal detachment were included in the study. The mean age of the 4 males and 2 females was 47.25 +/- 23.76 years. Endophthalmitis associated with retinal detachment occurred following perforating injuries in 4 eyes, pneumatic retinopexy in I eye and cataract surgery complicated with vitreous loss in I eye. Preoperative visual acuity was light perception-only in all eyes. Red reflex was absent in all eyes. All the patients underwent vitreous tapping, encirclement, vitrectomy, liquid-gas exchange, endolaser photocoagulation and silicone oil injection. RESULTS: Mean follow-up time was 14.3 +/- 7.20 months. The microorganisms that were isolated from the vitreous aspiration were Staphylococcus epidermidis in 3 cases, Staphylococcus aureus in 1 case. Remaining cases were culture negative. Retinal breaks could be found in 4 eyes. Inflammation subsided significantly at 5 days in all cases. Final retinal reattachment and treatment of endophthalmitis was achieved in 5 eyes at the end of follow-up. Final visual acuity was 20/40 in I case, counting finger in 4 cases and no light perception in 1 case. The postoperative complications were optic atrophy in 1 eye, epiretinal membrane in 2 eyes and phitisis bulbi in 1 eye. CONCLUSION: Silicone oil, a retinal tamponading agent that has antimicrobial activity, may have benefical effect in the surgical treatment of endophthalmitis associated with retinal detachment.
Adult↗
Epithelial deposits after hyperopic LASIK.
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Corneal Diseases↗
Optical coherence tomography for evaluation of anatomical changes in the cornea after laser in situ keratomileusis.
PURPOSE: To examine the use of optical coherence tomography (OCT) in evaluating anatomical changes after laser in situ keratomileusis (LASIK) and complications related to the interface and corneal flap. SETTING: Istanbul University Eye Research Center and Department of Ophthalmology, Cerrahpasa Medical School, Istanbul, Turkey. METHODS: Eleven eyes of 11 patients who had myopic LASIK were included in the study. Mean age of the 7 men and 4 women was 29.4 years +/- 6.9 (SD). Cases analyzed included uneventful LASIK (4 eyes), epithelial ingrowth (5 eyes), and flap striae (2 eyes). Corneas were examined by OCT (Humphrey Systems). RESULTS: Optical coherence tomography resolved corneal flap and residual stromal layers in all cases. The mean thickness of the corneal flap and residual stroma was 138.2 +/- 16.5 microm and 321.7 +/- 32.1 microm, respectively. Interface between the corneal flap and residual stroma was shown by OCT. Optical coherence tomography revealed that the eye with flap striae had flap displacement undetected by biomicroscopy. Epithelial ingrowth was shown as a highly reflective area. CONCLUSION: Optical coherence tomography appears to be a promising method for evaluating anatomical changes in the cornea after LASIK.
Adult↗
Corneal iron ring associated with iatrogenic keratectasia after myopic laser in situ keratomileusis.
A 23-year-old woman had bilateral myopic laser in situ keratomileusis (LASIK). Two months postoperatively, she reported decreased visual acuity. Biomicroscopic examination revealed a corneal epithelial iron ring around the central keratectasia on both corneas. The appearance of the ring pattern was similar to the iron deposits of the Fleischer ring of keratoconus.
Adult↗
Reproducibility of corneal flap thickness in laser in situ keratomileusis using the Hansatome microkeratome.
PURPOSE: To evaluate the reproducibility of flap thickness during laser in situ keratomileusis (LASIK) and to analyze the effect of preoperative central corneal thickness and corneal keratometric power on flap thickness. SETTING: Department of Ophthalmology, Cerrahpasa Medical School, Istanbul, Turkey. METHODS: One hundred forty eyes with a mean preoperative pachymetry of 554.4 microm +/- 36.3 (SD) and a mean keratometry of 43.5 +/- 1.9 diopters had LASIK using the Hansatome automated microkeratome (Bausch & Lomb Surgical) and a 193 nm argon-fluoride excimer laser (Summit SVS Apex Plus). The 180 microm microkeratome plate was used in all procedures. Corneal thickness was measured with an ultrasonic pachymeter (Advent, Mentor O&O Inc.) before and during the flap procedure, and the difference was taken as flap thickness. The data were analyzed using a 1-tailed t test and Pearson correlation coefficient. RESULTS: The mean flap thickness was 120. 8 +/- 26.3 microm. There was a low correlation between baseline central corneal thickness and corneal flap thickness (P =.6, r = 0. 046). There was no correlation between preoperative keratometry and flap thickness (P =.01, r = 0.203). CONCLUSIONS: The Hansatome microkeratome does not always produce a corneal flap of the intended thickness. Factors other than keratometry and pachymetry must affect flap thickness.
Adult↗
Apical nodular subepithelial corneal scar after retreatment in hyperopic photorefractive keratectomy.
PURPOSE: To report a complication, apical nodular subepithelial corneal scar, that can occur after hyperopic photorefractive keratectomy (PRK) retreatment. SETTING: Istanbul University Eye Research Center, Istanbul, Turkey. METHODS: Twelve eyes of 6 patients with apical nodular subepithelial corneal scar were retrospectively studied. Mean age of the 5 men and 1 woman was 30.2 years +/- 5.4 (SD). All eyes had hyperopic PRK retreatment for regression 9.5 +/- 1.44 months after primary hyperopic PRK. Mean spherical equivalent refraction of the residual hyperopia before retreatment was +4.67 +/- 0.81 diopters (D). All patients had a corneal haze grade of less than 1+. Hyperopic PRK retreatment was performed with a 193 nm excimer laser (Chiron Technolas Keracor 116). RESULTS: Apical nodular subepithelial corneal scars developed within the first month of hyperopic PRK retreatment and progressed until the third month in 12 eyes of 6 patients. The lesion was round and symmetrical in both eyes, smaller than 2.0 mm, and centrally located. During the mean 40.66 +/- 2.46 month follow-up, the lesion did not change in size or density. Mean spherical equivalent refraction after retreatment was 2.88 +/- 0.88 D (range +1.50 to +4.00 D) at 1 month and +4.36 +/- 1.83 D at last follow-up. Refraction was unmeasurable in 3 eyes. Five eyes lost 1 line of best spectacle-corrected visual acuity and 7 eyes, 2 or more lines. The surface regularity indexes were higher than 2.00 in all the eyes. CONCLUSION: Hyperopic PRK retreatment may cause the sight-threatening complication of apical nodular subepithelial corneal scar. This complication behaves unlike corneal haze and does not resolve spontaneously over time.
Adult↗
Topical anesthesia in posterior vitrectomy.
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Anesthesia, Local↗
Secondary laser in situ keratomileusis 1 year after primary LASIK for high myopia.
PURPOSE: To report the results of the laser in situ keratomileusis (LASIK) using a second-cut hinged corneal flap to treat regression 1 year after primary LASIK for high myopia. SETTING: Istanbul University, Eye Research Center, Istanbul, Turkey. METHODS: Six eyes of 4 patients who had a mean myopic regression of -6.20 diopters (D) +/- 1.10 (SD) 1 year after primary LASIK were retreated with secondary LASIK performed using the Automated Corneal Shaper (Chiron Vision) and a 193 nm excimer laser (Chiron Technolas, Keracor 116). Fluence was 130 mJ/cm2 and the repetition rate, 10 Hz. RESULTS: Mean follow-up was 12.16 +/- 0.75 months. At the last follow-up, the mean spherical equivalent was -0.18 +/- 0.77 D (range +0.12 to -1.25 D). Two eyes (33.3%) remained within +/- 0.50 D of emmetropia; 5 eyes (83.3%) were within +/- 1.00 D of emmetropia. No patient lost best spectacle-corrected visual acuity. No complications occurred such as detachment of the former corneal flap and rolling, irregularity, or tearing of the new corneal flap. CONCLUSION: Secondary LASIK was an effective, safe method to treat regression after primary LASIK for high myopia.
Adult↗
Corneal iron ring after hyperopic laser-assisted in situ keratomileusis.
PURPOSE: To report a new corneal iron ring after hyperopic laser-assisted in situ keratomileusis (LASIK). METHODS: Three patients underwent hyperopic LASIK for the correction of hyperopia in both eyes. Spherical equivalent refraction of the patients ranged from +3.37 to +6.50 diopters. LASIK procedure was performed using automated corneal shaper and 193-nm argon fluoride excimer laser. RESULTS: Both eyes of the patients were noted to have a corneal iron ring located at the paracentral area at 6-7 months after surgery. The localization of iron ring corresponded with outside border of central steep zone. Twelve-month examination showed there was no change in color, shape, and density of corneal iron ring. CONCLUSIONS: Corneal topographic changes induced by hyperopic LASIK may cause corneal iron ring to develop.
Adult↗
Changes in tear flow and tear film stability after photorefractive keratectomy.
PURPOSE: To investigate the changes in tear flow and tear film stability after photorefractive keratectomy (PRK) for myopia. MATERIAL AND METHOD: One eye of 32 patients underwent unilateral PRK procedure for the correction of myopia ranging from -1.50 to -6.00 diopters (D) (mean -3.65 +/- 1.55 D). Schirmer test values and break-up time (BUT) scores were measured 6 weeks after the PRK procedure. Unoperated, contralateral eyes were used as control eyes for each patient. The Schirmer test scores and BUT values were statistically analyzed using independent t test. RESULTS: The mean Schirmer test value was 14.45 +/- 7.79 mm in the operated eyes. It was 28.83 +/- 5.89 in the control eyes. The decrease in Schirmer test value was statistically significant (t = 8.28, p = 0.0001). The mean BUT scores were 13.19 +/- 5.09 s in the operated eyes and 27.83 +/- 9.31 s in the control eyes. The decrease was statistically significant (t = 7.86, p = 0.0001). CONCLUSION: PRK causes a decrease in tear flow and tear film stability that is probably caused by decreased corneal sensation after PRK.
Adult↗
In vitro antimicrobial activity of silicone oil against endophthalmitis-causing agents.
PURPOSE: To investigate the antimicrobial activity of silicone oil against endophthalmitis-causing agents in vitro. METHODS: The antimicrobial activity of silicone oil was tested on Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Candida albicans, and Aspergillus spp. The bacteria and fungi were separately inoculated into 1,300 centistokes silicone oil. Control inoculations were done in two different media: physiologic saline and brain-heart infusion (BHI) for bacteria and Sabouraud broth and physiologic saline for fungi. From each medium, 0.001-mL samples were taken and plated in Petri dishes. After overnight incubation, colony-forming units (CFUs) were enumerated. Culturing from the initially prepared specimens, incubating overnight, and counting CFUs was repeated until no growth of microorganisms was seen in the silicone oil-containing media. Macroscopic photography of the colonies and light microscopic photography of microorganisms were performed. RESULTS: All the microorganisms showed an apparent decrease in CFUs, with elimination between 7 and 21 days in silicone oil. Colony-forming units of microorganisms remained stable in physiologic saline during the study, with the exception of gradual decrease in CFUs of S. aureus and S. epidermidis from the beginning of the third day. In BHI and Sabouraud broth, both bacteria and fungi showed a growth pattern that was compatible with the growth curve of microorganisms. CONCLUSION: Silicone oil has an antimicrobial activity against S. aureus, S. epidermidis, P. aeruginosa, C. albicans, and Aspergillus spp., which are common endophthalmitis-causing agents.
Bacteria↗
Silicone oil removal using a self-sealing corneal incision under topical anesthesia.
BACKGROUND AND OBJECTIVE: To report the results of silicone oil removal from aphakic eyes using a self-sealing clear corneal incision under topical anesthesia. PATIENTS AND METHODS: Twenty-two eyes of 22 patients who had pars plana vitrectomy combined with silicone oil injection underwent silicone oil removal under topical anesthesia using a self-sealing clear corneal incision. Mean time between silicone oil injection and removal was 3.1+/-1.42 months. Fourteen eyes were filled with 1300 cs of silicone oil and 8 eyes were filled with 5700 cs of silicone oil. The removal was performed with passive washout in the eyes filled with 1300 cs of silicone oil and with active aspiration in the eyes filled with 5700 cs of silicone oil. RESULTS: All of the 22 silicone oil removal procedures performed under topical anesthesia had clear corneal incisions that did not require suturing at the end of surgery. Three cases that had 1300 cs of silicone oil required aspiration because of residual silicone oil bubbles. CONCLUSION: Silicone oil can be removed from the aphakic eye using a self-sealing corneal tunnel incision under topical anesthesia.
Adult↗
Laser in situ keratomileusis after photorefractive keratectomy for myopic regression.
PURPOSE: To assess the efficacy and safety of laser in situ keratomileusis (LASIK) for regression after excimer laser photorefractive keratectomy (PRK). SETTING: Eye Research Center, Istanbul University, Istanbul, Turkey. METHODS: Laser in situ keratomileusis to treat residual myopia ranging from 1.50 to 12.50 diopters (D) (mean 5.96 D +/- 3.06 [SD]) was performed in 45 eyes of 25 patients. Cylindrical corrections were done in 7 eyes (15.6%) and spherical ablations, in 38 (84.4%). The mean interval between primary PRK and LASIK retreatment was 18.50 +/- 8.12 months. The procedure was performed under a hinged corneal flap using the Chiron Automated Corneal Shaper and Chiron Keracor 116 excimer laser. RESULTS: Six months after LASIK retreatment, mean spherical equivalent refraction was -0.67 +/- 0.77 D. Thirty-six eyes (80%) were within +/- 1.00 D of emmetropia. Uncorrected visual acuity was 20/40 or more in 31 eyes (68.9%); 2 eyes (4%) lost 2 lines of best spectacle-corrected visual acuity. There was no statistically significant difference in corneal haze before and after LASIK. CONCLUSION: Laser in situ keratomileusis was safe and effective for treating residual myopia after excimer laser PRK.
Adult↗
Bilateral retinal detachment associated with giant retinal tear after laser-assisted in situ keratomileusis.
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Adult↗
The effects of topical steroids on refractive outcome and corneal haze, thickness, and curvature after photorefractive keratectomy with a 6.0-mm ablation diameter.
BACKGROUND AND OBJECTIVE: To study the effect of topical prednisolone acetate after photorefractive keratectomy (PRK) using a 6.0-mm ablation diameter on the refractive and visual outcomes, corneal haze, corneal thickness, and corneal curvature in a prospective, double-masked, randomized manner. PATIENTS AND METHODS: Seventy-two eyes of 36 patients who had excimer laser PRK for correction of myopia ranging from -3.00 to -6.00 D (-4.11 +/- 0.84 D in eyes treated with steroids and -4.38 +/- 0.79 D in eyes treated with placebo; mean +/- SD) were enrolled. PRK procedures were performed using a 193-nm argon-fluoride excimer laser with 180-ml/cm2 fluence, a 10-Hz repetition rate, and a 6.0-mm ablation diameter. One eye of each patient was treated with the steroid (prednisolone acetate) and the other eye with placebo. Patients were observed for at least 12 months after PRK. RESULTS: There was no statistically significant difference between the steroid and the placebo groups with regard to refraction measurements that were taken postoperatively at 3 months (P = .39) and 12 months (P = .51). The corneas showed an increase in thickness after PRK in both groups, but the difference was not statistically significant at 12 months postoperatively (P = .45). The corneal haze score was not statistically different at any stage between groups (P = .30 at 3 months, P = .84 at 12 months). Keratometric data derived from corneal topography did not show any statistically significant difference (P = .85 at 3 months, P = .96 at 12 months). The rate of uncorrected visual acuity of 20/40 or more was 79.4% (27 eyes) in the steroid group and 70.5% (24 eyes) in the placebo group (P = .40). The rate of loss of 2 or more lines in best spectacle-corrected visual acuity was 5.85% (2 eyes) in the steroid group and 8.8% (3 eyes) in the placebo group (P = 1.0). CONCLUSION: Topical prednisolone acetate use for 3 months after PRK with a 6.0-mm ablation diameter has no effect on refractive and visual outcome, corneal haze, corneal thickness, and corneal curvature.
Administration, Topical↗
Two-year results of photorefractive keratectomy with scanning spot ablation for myopia of less than -6.0 diopters.
BACKGROUND AND OBJECTIVE: To investigate the efficacy, predictability, stability, and safety of photorefractive keratectomy (PRK) with scanning spot ablation for the treatment of myopia of less than -6.0 D. PATIENTS AND METHODS: Twenty eyes of 20 patients (11 men, 9 women) were enrolled into the study. The mean age was 26.2 +/- 5.4 years. Mean spherical equivalent myopia was -3.53 +/- 1.13 D, ranging from -2.25 to -6.00 D. Patients underwent excimer laser PRK for the treatment of myopia. Follow-up time was at least 24 months in all patients. RESULTS: Mean spherical equivalent refraction was +0.84 +/- 0.99 D at 1 month, +0.19 +/- 0.54 at 3 months, -0.01 +/- 0.53 at 12 months, and -0.13 +/- 0.50 at 24 months. There was a mean regression of 0.65 D between 1 and 3 months. At 24 months, 16 (80%) of the eyes remained within +0.50 D of emmetropia and 18 (90%) of the eyes remained within +/- 1.0 D of emmetropia. Nineteen (95%) of the eyes had uncorrected visual acuity of 20/40 or better. The mean corneal haze score was maximum at 3 months (0.88 +/- 0.22). There was no clinically significant corneal haze (greater than 2+). One eye (5%) lost 2 or more lines of best-corrected visual acuity. CONCLUSION: Excimer laser PRK with the scanning spot ablation technique is effective, predictable, stable, and safe for the treatment of myopia of less than -6.0 D.
Adult↗
[Photorefractive keratectomy in hypermetropia].
PURPOSE: The purpose of this study was to assess the predictability and efficiency of the photorefractive keratectomy in hyperopia. MATERIAL AND METHODS: Thinty-eight eyes of 21 patients with the mean age of 34.6 were included. The eyes were divided into 3 groups according to their hyperopia. Group 1: 14 eyes with hyperopia greater than +7.25 D. Group 2: 13 eyes had hyperopia ranging from +4.25 D to +7.00 D and Group 3: 11 eyes with hyperopia less than or equal to +4.00 D. All of the eyes underwent photorefractive keratectomy procedure with 193 nm argon-fluoride excimer laser (Chiron Technolas) with 10 to 30 Hz repetition rate and 120 mJ/cm2 fluence. The mean follow-up time was 12 months. RESULTS: The mean postoperative refraction was +5.05 +/- 1.25 D. in the group 1, +4.71 +/- 1.23 D. in the groupe 2 and +1.65 +/- 0.93 D in the group 3 at the end of the year. CONCLUSION: As a result, we suggest photorefractive keratectomy is efficient, predictable and safe for correcting hyperopia inferior to +4.00 D.
Adult↗