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Purpose: To compare Plusoptix (Gmbh, Nuremberg, Germany), 2WIN (Adaptica, Padua, Italy), the benchtop refractometer (Auto-Kerato-Refractometer KR-8900; Topcon Co, Tokyo, Japan), and retinoscopy with regard to the consistencies.Materials and Methods: In our prospective study, 200 eyes of 100 patients were included. We analyzed the demographics and characteristics of the patients, the percentage of patients from whom measurements could not be obtained, the measurements from both patients' eyes of pupil diameter, spherical, cylindrical, axis, and spherical equivalence.Results: The mean age ± SD was 7.8±4.5 years (range, 1-18 years). Pupil diameter measurements were found to be consistent (Cronbach's alpha value >0.8). The sphere and spherical equivalence measurements for both eyes were found to be consistent with each other in all apparatus (Cronbach's alpha value >0.8). However, consistency was found to be lower in cylindrical values and the Jackson cross-cylinder measurements at 0° and 45° axis were found to be inconsistent with each other (Cronbach's alpha value <0.8).Conclusions: While consistency was observed in all methods in terms of sphere and spherical equivalence, consistency dropped in cylindrical values and no consistency was observed in axis values. It is important to take this point into consideration, especially in axis measurements. [ABSTRACT FROM AUTHOR]

Purpose: To present a case of fungal keratitis that was successfully treated with direct intrastromal medication delivery through a corneal incision created with the femtosecond laser.Methods: A 71-year-old female patient with recurrent episodes of an unresponsive, deep stromal keratitis for six months' duration, resistant to various therapeutic approaches, was referred to our institute. The 150 kHz Intralase iFS laser (Abbott Medical Optics Inc., Santa Ana, CA) was used to create a corneal pocket in an attempt to permit drug delivery directly into the corneal abscess.Results: Five days after the intrastromal injections, the clinical condition was improved. Two years after the procedure, the cornea is stable and free of any clinical signs or symptoms of recurrence.Conclusions: In this case report, an alternative application of femtosecond laser technology is presented, performing intrastromal drug delivery through a corneal incision for the treatment of fungal keratitis. [ABSTRACT FROM AUTHOR]

Purpose: To review the current literature on in vivo confocal microscopy anterior segment applications (cornea, conjunctiva, and glaucoma) and discuss its advantages in different pathological conditions. Methods: Review of selected relevant literature on in vivo confocal microscopy and its different applications. Results: In vivo confocal microscopy can be used to visualize most layers of the cornea and conjunctiva, providing excellent resolution. In the past, it was mainly utilized as a research tool; lately there seems to be an increasing interest for clinical applications; confocal microscopy aids the diagnosis and follow-up of many anterior segment disorders, such as corneal dystrophies, corneal and conjunctival inflammatory and neoplastic diseases, glaucoma patients, and assessment of surgical procedures. Conclusion: In vivo confocal microscopy is an important addition to the ophthalmic diagnostic tools with several anterior segment applications. Its clinical applications are being continuously explored and are quickly expanding to cover many new pathological aspects. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate combination treatment with reduced-fluence photodynamic therapy (RDPDT) with Verteporfin and intravitreal bevacizumab, compared to bevacizumab alone, for choroidal neovascularization (CNV) in age-related macular degeneration. Methods: This was a prospective, randomized comparative study comprising 95 patients with CNV. 49 patients received RDPDT (25 J/cm2) followed by intravitreal bevacizumab 1.25 mg one hour later, while 46 received intravitreal bevacizumab alone. Patients were followed for 12 months at four-week intervals with visual acuity (VA) assessment and Optical Coherence Tomography (OCT) of the macula. Bevacizumab re-injections were performed as needed. Results: On average, patients were re-injected 4.45 times in the combination group and 6.96 times in the bavacizumab group ( p < 0.001). At 12 months, VA improved by 8.64 letters in the bevacizumab group and by 8.37 letters in the combination group ( p = 0.922). Conclusion: Adding a reduced-fluence PDT arm in combination with bevacizumab offers similar results to those of intravitreal bevacizumab alone with significantly reduced number of injection repetitions. [ABSTRACT FROM AUTHOR]

Purpose: To examine patients with persistent watery epiphora following patent external dacryocystorhinostomy (DCR) with magnetic resonance imaging dacryocystography (MR-DCG). Methods: Patients with unobstructed nasolacrimal irrigation following external DCR were included. Five patients with watery epiphora constituted the study group (SG). Five patients without epiphora constituted the control group (CG). All patients underwent MR-DCG following the instillation of artificial tears in the conjunctival fornix. The osteotomy site was identified in T1-weighted coronal images. Lacrimal flow was assessed with modified T2-weighted (True Fast Imaging Steady State Pulse, 'TrueFISP') coronal images before and 10 min after repeated blinking. Signal intensities at three regions of interest (ROIs), corresponding to the eyeball (ROI-1), conjunctival sac (ROI-2), and anastomotic site (ROI-3) were measured. Results: Differences in the diameter of both osseous and soft tissue ostia between SG and CG were statistically not significant. A post-blink increase in signal intensity at ROI-3 was noted in both groups, whereas differences in signal intensity for ROI-1 and ROI-2 were statistically not significant. The post-blink signal intensity increase in ROI-3 was significantly more pronounced in the CG, compared with the SG. Conclusions: The fact that signal intensity increase at ROI-3 was less pronounced in the SG, compared with CG, implies a compromised 'lacrimal pump' mechanism in the former group. The methodology presented may be used for the evaluation of post-DCR epiphora. [ABSTRACT FROM AUTHOR]

Purpose: Previous studies have examined factors affecting the position of the eyeball to the orbit. This study examined the role of effective orbital volume (EOV), defined as the difference between orbital and eyeball volume, as a determinant of eyeball position, using MRI scans. Methods: Forty-six patients were recruited from the Department of Ophthalmology of the University Hospital of Heraklion, Crete Greece. Patients with a history of orbital disease were excluded. Distances between eyeball poles and orbital landmarks were measured in T1 weighted transverse, sagittal and coronal orbital images. The protrusion of the eyeball in the sagittal and transverse planes was recorded. The volume of the eyeball and bony orbit, the EOV, the volume of the extraocular muscles as well as clinical information (age, gender, Hertel exophthalmometry) were also recorded. Results: EOV was significantly associated with orbital volume but not with eyeball volume. EOV was also significantly associated with transverse and sagittal globe ptotrusions. Females displayed significantly lower orbital and eyeball volumes as well as EOV than males but higher transverse globe protrusion than males. Conclusions: Variations in EOV are associated with orbital volume rather than with eyeball volume. EOV is associated with globe protrusion and may be taken into account in the planning of various procedures, including orbital decompression, treatment of enophthalmos or the size of orbital implants following enucleation. [ABSTRACT FROM AUTHOR]

Ocular rigidity is a macroscopic parameter characterizing the relationship between pressure and volume changes in the human eye. Ocular rigidity depends on the architecture and material properties of the globe. Measurements of ocular rigidity have mainly been performed by means of invasive manometric devices or paired Schiotz tonometry. These measurements pertain to the injection (or displacement) of a given volume in the eye and measurement of the associated intraocular pressure change. Ocular volume, age, intraocular pressure, arterial pressure and ocular blood volume have all been suggested to influence ocular rigidity. Moreover, rigidity has been shown to be altered in patients with glaucoma and age-related macular degeneration. The significance of an accurate assessment of this parameter is apparent in tonometry, tonography and pulsatile ocular blood flow measurements, while its possible role in the pathogenesis of ocular disease remains to be elucidated. [ABSTRACT FROM AUTHOR]

Introduction: A variety vascular disorders can affect the orbit, often manifesting as solitary space-occupying lesions. This study presents a case series of 3 patients with multi-focal orbital vascular conditions emphasizing on the clinical and imaging findings which could assist in the diagnosis and treatment planning. Methods: Retrospective consecutive case series of 3 patients with multifocal orbital vascular conditions treated at the Department of Ophthalmology of the University Hospital of Heraklion, in Crete, Greece. Results: Presenting symptoms included diplopia with compensatory head tilt (1 case) and eyelid protrusion enhanced by Valsalva maneuver (2 cases). MRI and CT studies showed multiple contrast-enhancing vascular lesions, associated with calcifications (1 case). Two lesions were surgically removed, proving to be orbital varices. Conclusions: Orbital vascular lesions may present multi-focally and displace adjacent structures. MRI and CT imaging may reveal their multi-focal presence as well as associated features, such as phleboliths. [ABSTRACT FROM AUTHOR]

A review of the literature is presented regarding a new advanced surface ablation procedure, epipolis-laser in situ keratomileusis (Epi-LASIK). Histological findings suggest that the repositioning of the separated epithelial sheet might modulate corneal wound healing after photoablation. Recent clinical studies provide evidence that Epi-LASIK is an effective, safe and predictable method for the treatment of low-to-moderate myopia. However, like other surface treatments, slow visual recovery and postoperative discomfort remain drawbacks of Epi-LASIK in the early postoperative period. Large comparative studies between Epi-LASIK, photorefractive keratectomy and laser epithelial keratomileusis will draw conclusions about the possible advantages of Epi-LASIK over other photorefractive procedures. [ABSTRACT FROM AUTHOR]

Purpose. To evaluate the effect of an intraocular gas bubble on ocular wall pulsation. Method. Eight patients that underwent vitrectomy with intraocular gas injection for various reasons were studied. Ocular pulsation was evaluated in a semi-quantitative way by means of Goldman applanation tonometry in both eyes before and after the operation. Vitreous cavity gas fill in the operated eye was estimated by means of indirect ophthalmoscopy and was correlated with ocular pulsation. The follow up lasted until the gas totally disappeared. Result. Ocular pulsation disappeared postoperatively in the operated eye and gradually reappeared when the gas fill diminished. Pulsation returned to preoperative level when the gas disappeared from the vitreous cavity. A negative statistical correlation between ocular pulsation and gas fill could be documented. Conclusion. The compressible nature of the intraocular gas bubble results in absorption of the vascular pulsation and prevents its transfer to the ocular wall. This leads to attenuation or even cancellation of ocular wall pulsation when a gas bubble exists within the eye. [ABSTRACT FROM AUTHOR]

Purpose: To report a patient fifteen years after anterior chamber phakic intraocular lens (AC-PIOL) implantation in one and laser in situ keratomileusis (LASIK) in the fellow eye. Methods: Case report. Results: A 56-year-old male underwent AC-PIOL implantation in one eye and LASIK in the fellow eye fifteen years ago. Preoperative uncorrected visual acuity (UCVA) was finger count in both eyes. Preoperative best spectacle-corrected visual acuity (BSCVA) was 20/25 (−16.75 −0.50 × 40) in the LASIK eye and 20/32 (−24.50 −0.50 × 90) in the AC-PIOL eye. Fifteen years postoperatively, UCVA was finger count in the LASIK eye and 20/200 in the AC-PIOL eye, while BSCVA was 20/32 and 20/25, respectively. Endothelial cell density (ECD) was 2020±47 in the LASIK eye and 945±22 in the AC-PIOL eye. Conclusion: Both procedures had similar visual outcomes. Furthermore, lower ECD was found in the AC-PIOL eye in comparison to the LASIK eye. [ABSTRACT FROM AUTHOR]

Purpose: To report a case of excimer laser photorefractive keratectomy (PRK) in a patient with epithelial basement membrane dystrophy (EBMD). Methods: Interventional case report. Results: A 36-year-old male with clinical manifestations of EBMD underwent bilateral, simultaneous PRK for low myopia correction. A delay (up to 17 days) in the epithelial healing process with unstable epithelium was observed. During the first three postoperative months a visually significant subepithelial haze was developed in both eyes. One year postoperative, an improvement in haze formation and visual acuity in both eyes was found. Conclusions: PRK in patients with EBMD could result in favorable refractive and clinical outcome. [ABSTRACT FROM AUTHOR]

Purpose. To report a case of Parinaud's oculoglandular syndrome (POS) in which, despite the initially negative, a late onset of serologic positive titers was observed. Methods. Case report. Results. A 65-year-old man was examined for a foreign body in the left eye associated with granulomatous nodule on the palpebral conjuctiva, chemosis and a swollen preauricular lymph node. Despite the initially negative serologic titers to Bartonella henselae , a clinical diagnosis of POS was made and treatment was instituted initially with oral ciprofloxacin (500 mg twice a day). Three weeks later, serologic positive titers were found which confirmed the diagnosis of POS. Conclusion. Even though the improvements in diagnostic testing such as indirect immunofluorescence antibody, negative titles could be initially observed, confusing the diagnostic process. Other techniques (such as polymerase chain reaction (PCR) testing) should be also taken into consideration in cases with increased clinical suspicious of B. henselae indections. [ABSTRACT FROM AUTHOR]