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Abstract Purpose: To evaluate six different premium IOLs retrospectively in respect to both subjective and objective refraction after cataract operation. Methods: Five hundreds and seventy eyes of 285 patients with bilateral cataract who had undergone phacoemulsification and IOL implantation operation between February 2017 and September 2018 were enrolled in this study. The mean age of the patients was 57.78 ± 7.49 (41-71) years. Out of 285 patients 137 were male (48.07%) and 148 were female (51.93%). TheIOLsusedare: RayOne Trifocal (Rayner, Worthing, UK), Lucidis (Swiss Advanced Vision, Neuchâtel, Switzerland), PanOptix (Alcon, Fort Worth, USA), LentisMplus (Oculentis, Berlin, Germany), TecnisSymfony (Abbott, Illinois, USA) and Acriva Trinova (VSY Biotechnology, Istanbul, Turkey). Results: There were no significant differences among the groups regarding age, sex, axial length, the mean preoperative and postoperative uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), the mean preoperative spherical equivalent (SE) and the mean postoperative SE (subjective measurement) (P> .05). The postoperative refractions measured with autorefractometer were more myopic than subjective refractions in all patients except the patients who had PanOptix IOL. In postoperative twelfth month, the mean UCVA arrived 0.00 logMAR in 405 eyes (78.48%) , however, the mean autorefractometric measurement was -1.28 ± 1.02 (0.00_-2.75) D. Conclusion: The autorefractometer measurements of all patients who had premium IOLs except PanOptix IOL were not coherent with their visual acuities postoperatively. The ophthalmologists and/or optometrists should be careful while examining these types of patients.

AIM: To evaluate ocular penetration of topically applied 1% tigecycline. METHODS: Forty-two New Zealand White rabbits were divided into 3 groups. A 50 μL drop of 1% tigecycline was administered in group 1. In groups 2 and 3, the drop was administered every 15min for 60min (keratitis protocol). Aqueous humor samples in groups 1 and 2 were collected under general anesthesia at 15, 30, 45, 60, 120, and 180min after the last drop. All animals in group 3 were euthanatized. Cornea, vitreous and blood samples were collected 60 and 120min after the last drop. Tigecycline concentrations were measured using high performance liquid chromatography-mass spectrometry (LC-MS/MS). RESULTS: The peak aqueous humor tigecycline concentration [mean 0.73±0.14 mg/L (SD) and 2.41±0.14 mg/L, respectively] occurred 45min after topical drug application in groups 1 and 2. Group 3 mean values in the cornea, and vitreous, were 3.27±0.50 µg/g, and 0.17±0.10 mg/L at 60min and 3.17±0.77 µg/g and 0.20±0.07 mg/L at 120min, respectively. Tigecycline serum concentrations were negligible. CONCLUSION: Tigecycline levels in the aqueous humor in groups 1 and 2, and in the cornea in group 3 exceeded the minimum inhibitory concentrations of most gram-positive organisms that cause bacterial keratitis and endophthalmitis.

AIM: To evaluate the visual outcomes and intraoperative and postoperative complications of phacoemulsification surgery in patients with cataract and pseudoexfoliation syndrome(PEX)and the usage of proper surgical techniques and appropriate devices intraoperatively.METHODS: Sixty-seven eyes of 53 patients with PEX and cataract who had undergone phacoemulsification and intraocular lens(IOL)implantation surgery were evaluated retrospectively. The mean age was 71.68±9.96(53-89)y, and there were 24(45%)males and 29(55%)females. Nuclear, cortical, posterior subcapsular, and mature cataracts were all represented.RESULTS: Nuclear cataract was significantly more common than other types(P=0.00). The mean preoperative best corrected visual acuity(BCVA)was 0.99±0.30(SD)(0.40-1.50)logMAR, and the mean postoperative BCVA was 0.32±0.31(SD)(0.00-1.00)logMAR(P=0.00). Iris retractors were used in 12(18%)eyes. Capsular tension ring(CTR)implantation was used in 15(22%)eyes, it was planned in 8(12%)and unplanned in 7(10%). Posterior capsule rupture occurred in 4(6%)eyes, and vitreous loss occurred in 2(3%)eyes. Anterior vitrectomy was performed in these 2 eyes. Conversion to extracapsular cataract extraction(ECCE)was needed in these 2(3%)eyes due to large posterior capsular rupture. Persistent corneal edema was observed in 4(6%)eyes, and anterior chamber reaction in 5(7%)eyes. IOL dislocation occurred in 4(6%)eyes, but repositioning was only needed in 1(1.5%)eye. Posterior capsule opacification(PCO)requiring Nd:YAG laser capsulotomy developed in 13(20%)eyes.CONCLUSION: Postoperative visual acuities of patients with cataract and PEX are satisfactory. However, intraoperative and postoperative complications like posterior capsule rupture, vitreous loss, conversion to ECCE, persistent corneal edema, anterior chamber reaction and IOL dislocation may be observed. To avoid these complications, proper surgical techniques and the use of appropriate devices intraoperatively are essential.

AIM: To evaluate the safety and efficacy of intracameral moxifloxacin in preventing endophthalmitis after cataract surgery.METHODS:Sixty-five eyes of 65 patients underwent cataract surgery between January and June 2012. Some patients received intracameral moxifloxacin at the end of surgery, while others did not(controls). Pre- and postperative logarithm of the minimum angle of resolution(logMAR)best corrected visual acuity(BCVA), intraocular pressure(IOP), corneal edema, and anterior chamber(AC)status were examined.RESULTS: Thirty-three patients(19 males, 14 females); average age, 64.81±11.61y(range: 41-82y)received moxifloxacin and 32 patients(15 males, 17 females); average age, 65.43±11.10y(range: 42-81y)did not. The differences in patient age(P=0.827)and sex(P=0.396)were insignificant. Preoperative BCVA was approximately 20/130 in both groups. After surgery, moxifloxacin and control patients had a BCVA of 20/25 and 20/23, respectively(P=0.160). Preoperative IOP was 14.93±2.77mmHg(range: 11-21mmHg)in moxifloxacin patients and 15.06±2.42mm Hg(range: 12-21mmHg)in controls(P=0.850). After surgery, IOP was not statistically different between two groups(moxifloxacin: 14.06±2.31(range: 10-19mmHg), controls: 14.03±2.36mmHg(range: 10-19mmHg), P=0.960). Slight differences in corneal edema(P=0.623)and anterior chamber cell(P=0.726)incidences between two groups were not statistically significant. CONCLUSION: Intracameral moxifloxacin is safe and effective in preventing endophtalmitis after cataract surgery.

Letter to the Edtor

We evaluated the effect of phacoemulsification surgery on intraocular pressure (IOP), anterior chamber depth (ACD), iridocorneal angle (ICA), and central corneal thickness (CCT) of the patients with cataract and ocular hypertension. The decrease in IO P values of the 1 st week, 1 st month, 3 rd month, 6 th month, and 1 st year was statistically significant, but that of the 2 nd year was not significant. The increase in ACD and ICA values of the 1 st week, 1 st month, 3 rd month, 6 th month, and 1 st year was statistically significant, but that of the 2 nd year was not significant. The increase in CCT values of 1 st week and 1 st month was statistically significant, but those of 3 rd month, 6 th month, 1 st year, and 2 nd year were not significant. In conclusion, phacoemulsification surgery decreases IOP and increases ACD and ICA in the short-term. However, in the long-term it does not cause any significant changes.