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Objectives: To investigate the indications and outcomes of amniotic membrane transplantation (AMT). Materials and Methods: A total of 87 eyes who underwent amnion membrane transplantation in our clinic between February 2010 and April 2013 were included in this study. Mean follow-up period was 7.49±7.84 months (range 1-29 months). Amnion membrane defrosted at room temperature and washed three times with saline covered all over the cornea independent of the position and size of the lesion and was sutured to the peripheral cornea circumferentially by 10/0 monofilament suture. At the end of the operation, therapeutic contact lens was placed. All cases were evaluated with respect to duration of surface epithelial healing, visual acuity, presence of recurrence, and infection. Results: Forty-six of the 87 patients (52.8%) were men and 41 (47.1%) were women. The mean age was 57.02±19.74 years (range 31-89 years) in men and 66.69±16.56 years (range 8-88 years) in women. The indications were: ulcers in 27 eyes, keratitis in 24 eyes, topical anesthetic abuse in 10 eyes, bullous keratopathy in 7 eyes, conjunctival mass in 7 eyes, symblepharon in 3 eyes, chemical burns in 3 eyes, pterygium in 2 eyes, endophthalmitis in 2 eyes, dellen in 1 eye, and conjunctival laceration in 1 eye. After AMT, 12 patients required second AMT, and 2 cases required third AMT. 2 eyes were eviscerated, 1 eye was exenterated. At the final follow-up visit, except for patients who underwent evisceration and exenteration, improved visual acuity was observed in 45 of the 84 eyes (53.5%). The average of healing time was between 4 and 6 weeks. No infectious, inflammatory, immunologic, or toxic/allergic reactions related to AMT was observed. Conclusion: Amniotic membrane transplantation is a safe and effective technique in ocular surface diseases. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effects of artificial tears on corneal higher order aberrations in dry eye patients. Materials and Methods: 30 right eyes of 30 newly diagnosed dry eye patients were evaluated in this prospective study. After routine ophthalmological examination, Schirmer test and tear break-up time (TBUT) test were performed in all patients. Anterior corneal aberrations were derived from conversion of the corneal elevation profile into corneal wavefront data with 6.0 mm pupil diameter using Zernike polynomails by corneal topography before and 5 minutes after instillation of artificial tear (Eyestil®). Corneal optical aberrations were compared before and after instillation of eyedrop. Results: The study included 17 women and 13 men; the average age of the patients was 44.36±13.22 years. Mean TBUT was 4.78±2.78 seconds and mean Schirmer value was 3.58±2.45 mm/5 minutes. After instillation of artificial tear, significant reductions in corneal total aberration from 1.120±0.35 μm to 0.960±0.34 μm, higher order aberration from 0.674±0.26 μm to 0.464±0.18 μm, coma-like aberration from 0.283±0.10 μm to 0.238±0.09 μm, and spherical-like aberration from 0.254±0.11 μm to 0.221±0.08 μm were detected (all, p<0.001). After eyedrop instillation, statistically significant increment was observed in Strehl ratio (p<0.001). Conclusion: As well as reducing the dry eye symptoms, artificial tears also cause increment in optical quality of the eye. Benefits of artificial tears on visual quality can be evaluated objectively via corneal wavefront aberrations. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the indications, intra- and post-operative complications, and visual results of combined cataract surgery and pars plana vitrectomy. Materials and Methods: Medical records of patients who underwent combined surgery between January 2008 and January 2011 were retrospectively evaluated. Indications for surgery, complications, pre-operative and post-operative visual acuities were recorded. Results: Sixty-four eyes of 64 patients were included in the study. Thirty-fve (55%) of the patients were men and 29 (45%) were women; mean age was 53±21 (6-88) years. Mean follow-up time was 13±12 (1-51) months. The main indications for combined surgery were intravitreal hemorrhage in 19 patients (29.7%), epiretinal membrane in 12 (18.8%), intraocular foreign body in 11 (17.2%), retinal detachment in 9 (14.1%), and macular edema in 7 (11%) patients. Posterior capsule rupture in 3 cases and corneal edema in 2 cases were the complications encountered during surgery. Postoperatively, hypotonia occurred in 5 cases and corneal edema in 1. Intraocular pressure elevation was observed in 1 silicon-injected case and 1 propane gas-injected case. The average preoperative visual acuity was 1.90±1.9 (0.22 to 3.10) LogMAR. The average postoperative visual acuity at the last visit was 1.1±1.0 (0.00 to 4.00) LogMAR. The visual acuity increase was statistically signifcant (p<0.001). Conclusion: Combined surgery is a feasible option for patients with vitreoretinal diseases and cataract. Visual results and complications depend primarily on the underlying posterior segment pathology. [ABSTRACT FROM AUTHOR]

Objectives: To compare the outcomes of external dacryocystorhinostomy (DCR) and transcanalicular multidiode dacryocystorhinostomy (TC-DCR) operations in our clinic. Materials and Methods: This retrospective study included patients diagnosed with acquired nasolacrimal duct obstruction. The results of external DCR surgery performed in 15 eyes of 15 patients were compared with the results in 15 eyes of 13 patients who underwent TC-DCR surgery. The patients with external DCR were followed for an average of 9.7±3.2 months, and the cases that underwent TK-DSR were followed for an average of 8.3±2.9 months. Results: The surgical success rate was 53.3% in patients with TK-DCR, while it reached 87% in cases with external DCR. Mean operative time was 50.0±2.5 minutes in external DCR group and 30.0±2.0 minutes in TK-DCR group. There was no significant complication during operations in both groups. Conclusion: In dacryostenosis surgery, external DCR is the golden standard with high success rates. Even though success rate of TCDSR is less than that of external DSR, no need of skin incision, less damage to the lacrimal pump system, less bleeding, and a shorter duration of the operation are the main advantages of this method. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of amniotic membrane transplantation (AMT) in the treatment of corneal ulcers resulting from herpetic keratitis (HK) and bacterial keratitis (BK). Material and Method: Forty-six patients (25 HK, 21 BK) treated with AMT for HK or BK-related corneal ulcers between January 2009 and September 2011 were followed prospectively. The visual acuities and ulcer characteristics (depth and localization) prior to AMT and epithelialization time, as well as final visual acuities after AMT, were evaluated. Results: The mean age was 51.9±17.0 years in HK and 53.3±22.0 years in BK and the mean follow-up time was 12.6±6.1 (5-33) months and 10.2±6.8 (3-27) months, respectively. The ulcers were mostly central in HK (72%) and paracentral in BK (52.4%) (p=0.03). Ulcer depth was deeper than 1/2 of the cornea in 14 (56%) HK and in 7 (33.3%) BK (p=0.290). Eight HK patients had scars from previous herpetic keratitis episodes. The mean epithelialization time was 22.3±8.5 (12-50) days in HK and 22.1±10.9 (8-45) days in BK (p=0.488). While epithelialization was achieved in all the patients with BK, 3 HK patients needed adjunctive surgeries (conjunctival flap, tectonic penetrating keratoplasty) in spite of three AMTs. Although visual acuities improved significantly in both groups, this improvement was more evident in BK cases (p=0.018 for HK and p<0.001 for BK). Discussion: Amniotic membrane transplantation is an effective and safe treatment for bacterial and herpetic corneal ulcers. The reason for the lower final visual acuities in the herpetic group was thought to be related to a more central location, deeper involvement and scars due to previous attacks [ABSTRACT FROM AUTHOR]

Purpose: To present our results of limbal conjunctival autograft technique (LCAT) for recurrent pterygium which developed after different surgical techniques for primary pterygium. Material and Method: Cases, who underwent LCAT for the treatment of recurrent pterygium, were evaluated. The cases were divided into three groups based on the primary surgery performed. Recurrent pterygium developed after bare sclera technique in group 1, LCAT in group 2, and amniotic membrane graft technique in group 3. Corneal epithelization, recurrence rate, and postoperative complications were compared among groups. Results: Forty-two eyes of 42 patients were evaluated. Nineteen eyes of 19 patients formed group 1, 11 eyes of 11 patients - group 2, and 12 eyes of 12 patients - group 3. Mean age (years) was 45.38±12.22 (24-72) in group 1, 46.81±13.41 (25-73) in group 2, and 44.83±11.92 (27-66) in group 3. Follow-up (months) was 19.38±6.03 (9-32) in group 1, 21.37±7.41 (11-34) in group 2, and 20.93±7.26 (10-34) in group 3. Postoperative corneal epithelization was completed after 5.62±1.74 (2-7) days in group 1, 4.33±0.91 (2-7) days in group 2, and 4.79±1.39 (2-7) days in group 3 (p=0.035). Recurrence was detected in 4 eyes in group 1 (21%), 3 eyes in group 2 (27%), and 3 eyes in group 3 (25%) (p=0.092). Postoperative complications were not observed in neither of the groups. Discussion: LCAT seems to be an efficient treatment for recurrent pterygium with high success and low recurrence rates regardless of the primary surgery. Low recurrence rates in LCAT may be due to the limbal stem cells transplanted with conjunctival autograft to pterygium excision area. Early corneal epithelization in recurrences following LCOT may be an indication of the maintenance to a certain degree of activities of the limbal stem cells transplanted in the primary surgery. [ABSTRACT FROM AUTHOR]

Purpose: To compare pain response of patients undergoing panretinal photocoagulation (PRP) for proliferative diabetic retinopathy (PDR) using 532 nm standard laser versus multispot pattern scan laser and to evaluate the relationship between pain response and patient characteristics. Material and Method: Thirty-five patients had PRP with the Pascal system in a single session, while other 35 patients had PRP with conventional laser in 2 sessions. Parameters used in conventional laser were as follows: spot size 200 μm, exposure time 0.2 s, and power sufficient to produce visible grey-white burns. We used same spot size, 20-30 ms exposure time, and higher levels of laser power in order to get a similar endpoint in the Pascal system. The patients were required to evaluate the severity of pain on a visual analog scale (VAS) and verbally 5 minutes after PRP with Pascal and 5 minutes after the first session of PRP with conventional laser. The relationship between pain experienced and patient characteristics was evaluated. Results: At baseline, both groups did not differ significantly (p >0.05, for all) with respect to sex, age, duration of diabetes, most recent HbA1c, treatment regimen, or patient experience. The patients in the Pascal group had a mean pain score of 0.55±0.70 on verbal scale and 1.54±1.22 on VAS compared to 2.17±1.18 and 5.54±3.28, respectively in the conventional laser group which was, statistically, significantly different in both scales (p<0.05). Discussion: Our study confirms that new generation pattern scanning photocoagulators satisfactorily decrease the pain by shortening the exposure time while increasing the laser power. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy and safety of 23-gauge (23G) pars plana vitrectomy (PPV) in dislocated intraocular lens (IOL) cases: In early- and late-term follow-up. Material and Method: In this retrospective study, the medical records of 17 patients who underwent 23 G PPV treatment for dislocated IOL between January 2009 and June 2011 were analyzed. Detailed ophthalmologic examination was performed in all patients; intraoperative and postoperative complications were recorded. Results: In this study, mean follow-up time was 9.0 (4-22) months and mean age was 60.8 (8-82) years. Mean time after cataract surgery was variable (mean of 28.3 (0-80) months). Four patients had trauma history, five patients had pseudoexfoliation syndrome, and two patients had pathologic myopia. Dislocated IOL was placed into the sulcus in nine patients (52.9%). In two cases (11.7%), the IOLs were removed, and the patients were left aphakic. In two cases out of other 6 (11.7%), the dislocated IOL was changed with scleral fixation lens, whereas in the other four cases (23.5%), IOL was changed with iris claw lens. One patient (5.8%) remained at the same level of vision, while twelve (70.5%) cases increased two or more lines in BCVA. The vision was decreased in two cases. Intraocular pressure elevation controlled by medication was observed in one case. For two days, hypotony was observed in one patient. Discussion: 23 G PPV technique is an effective and safe method for removing and repositioning of dislocated IOL in the vitreous. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the intraoperative complications and postoperative visual outcomes of phacoemulsification surgery for the secondary cataract in vitrectomized eyes. Material and Method: We retrospectively evaluated 51 previously vitrectomized eyes of 51 patients who had undergone phacoemulsification and intraocular lens (PHACO+IOL) implantation surgery. PHACO+IOL surgery was performed in our clinic between October 2008 and May 2011. Intraoperative complications and postoperative best-corrected visual acuity (BCVA) outcomes were analyzed. Results: In this study, 31 out of 51 eyes had posterior subcapsular cataract. Cataract surgery was performed after a mean of 21.39±26.4 (6- 120, median 10.75) months following PPV. Mean preoperative and postoperative BCVA was measured to be 1.52±0.88 logMAR and 0.74±0.73 logMAR, respectively. In 25 eyes which had been filled with silicon oil, mean BCVA was 1.95±0.91 logMAR preoperatively and 1.15±0.84 logMAR postoperatively. In 18 (35.3%) eyes which had been filled with sulfur hexafluoride tamponade, mean BCVA was 1.17±0.47 logMAR preoperatively and 0.38±3.6 logMAR postoperatively. Peroperative zonular dialysis with instable deep anterior chamber occurred in two eyes, and posterior capsular tear occurred in one eye. Four eyes had Nd:YAG capsulotomy due to the posterior capsular opacity during the follow-up period. Discussion: Despite the well-known difficulties encountered in vitrectomized eyes such as zonular weakness, increased mobility of the lens-iris diaphragm, posterior capsular instability and posterior capsular plaques, phacoemulsification in vitrectomized eyes proved to be a safe surgery, and increase in visual acuity can be achieved. [ABSTRACT FROM AUTHOR]