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Background/Aim: Posterior capsular opacification (PCO) is a common complication that develops after cataract surgery, and it can be treated neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy. In this study, we aimed to investigate the effects of different intraocular lenses (IOLs) on the development of posterior capsule opacification (PCO), to determine the time between surgery and Nd:YAG laser capsulotomy, and to evaluate the efficacy, effectiveness, and complications of capsulotomy in patients who underwent cataract surgery with the phacoemulsification method and subsequently developed PCO. Methods: The cohort study included one eye of each of 153 cases (63 males, 90 females) who underwent cataract surgery with the phacoemulsification method in our clinic from August 1, 2006, through August 1, 2008, and subsequently developed PCO. According to the type of IOL implanted, the cases were divided into three groups: polymethylmethacrylate IOL (Group 1), hydrophilic acrylic IOL (Group 2), and hydrophobic acrylic IOL (Group 3). The control examinations of the patients who underwent Nd:YAG laser capsulotomy were undertaken before capsulotomy and at the first week, first month, and third month after capsulotomy. Results: Visual acuity improvement was detected in 96.7% of the 153 cases. It was determined that 9.1% of the cases had an intraocular pressure (IOP) increase of more than 5 mmHg at the third hour after capsulotomy and approached baseline values at the end of 1 week. The mean total energy used in all the cases was 37.20 (14.70) mjl. The mean total energy used in 14 patients with an IOP elevation of above 5 mmHg was 71.07 (10.59) mjl. Nd:YAG laser capsulotomy was performed at an average of 6.29 (4.91) months in Group 1, 7.81 (4.35) months in Group 2, and 17.7 (12.35) months in Group 3. After capsulotomy, clinically significant cystoid macular edema was observed in 1.9% of the cases, IOL damage in 3.9%, and vitreous hemorrhage in 0.6%. Conclusion: In this study, the incidence of PCO development was found to be lower in the patients who underwent hydrophobic acrylic IOL implantation; therefore, this type of lens should be preferred for implantation. Although Nd:YAG laser capsulotomy is an outpatient treatment method that can be applied quickly and can increase visual acuity, it can also lead to complications. To eliminate most of these complications, it would be beneficial to minimize the energy used during the laser procedure. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aimed to evaluate the efficacy of Nd:YAG and Er:YAG lasers in removing the smear layer and to study the morphological and chemical alterations of the root surface using scanning electron microscopy (SEM) and infrared (IR) spectroscopy. Material and Methods: Fifty-five extracted upper incisor teeth were collected and 110 specimens of size 3 mm x 4 mm x 1 mm were prepared. For SEM evaluation, these samples were divided into six groups: A, B, and C. Group A comprised five samples that served as control. Groups B and C were further divided into five subgroups and each subgroup comprised five samples. All the specimens within the subgroups of B and C irradiated with 100, 200, 300, 400, and 500 mJ of Er:YAG laser and 211.66, 423.33, 635, 846.66, and 1058.33 J/cm² of Nd:YAG laser, respectively. The morphological changes of the laser-treated sites were observed qualitatively using an arbitrary scale under SEM. The data obtained were statistically analyzed by one-way analysis of variance (ANOVA) multiple range test by Turkey's honestly significant difference and Mann--Whitney U test. In chemical structural changes, Group D comprised five samples that served as nonirradiated control and Groups E and F were irradiated with the same aforementioned parameter and evaluated using Fourier-transform infrared spectroscopy. Results: Er:YAG laser at 100 mJ effectively removed smear layer without any crater formation. The Nd:YAG laser removed the smear layer at the energy density of 211.66 J/cm² and 423.33J/cm². The energy density of 1058.33 J/cm² showed visible charring and deep crater with increased area of melted and resolidified minerals in SEM. In the chemical changes, IR spectroscopy graph showed the reduction in peak intensity beyond 846.66 J/cm2 of and new absorption band was noticed (2010 cm-1 and 2017 cm-1) at samples treated with 846.66 and 1058.33 J/cm² of Nd:YAG laser. Conclusion: Er:YAG laser at lower energy density effectively removed smear layer without production of toxic substance as compared with Nd:YAG laser. Thus, Er:YAG laser can be used as an effective root biomodification agent. [ABSTRACT FROM AUTHOR]

Classical homocystinuria is the most commonly inherited disorder of sulfur metabolism, caused by the genetic alterations in human cystathionine beta-synthase (CBS) gene. In this study, we present comprehensive clinical findings and the genetic basis of homocystinuria in a cohort of Turkish patients. Excluding some CBS mutations, detailed genotype-phenotype correlation for different CBS mutations has not been established in literature. We aimed to make clinical subgroups according to main clinical symptoms and discussed these data together with mutational analysis results from our patients. Totally, 16 different mutations were identified; twelve of which had already been reported, and four are novel (p.N93Y, p.L251P, p.D281V and c.829-2A>T). The probands were classified into three major groups according to the clinical symptoms caused by these mutations. A psychomotor delay was the most common diagnostic symptom (n=12, 46.2% neurological presentation), followed by thromboembolic events (n=6, 23.1% vascular presentation) and lens ectopia, myopia or marfanoid features (n=5, 19.2% connective tissue presentation). Pyridoxine responsiveness was 7.7%; however, with partial responsive probands, the ratio was 53.9%. In addition, five thrombophilic nucleotide changes including MTHFR c.677 C>T and c.1298 A>C, Factor V c.1691 G>A, Factor II c.20210 G>A, and SERPINE1 4G/5G were investigated to assess their contributions to the clinical spectrum. We suggest that the effect of these polymorphisms on clinical phenotype of CBS is not very clear since the distribution of thrombophilic polymorphisms does not differ among specific groups. This study provides molecular findings of 26 Turkish probands with homocystinuria and discusses the clinical presentations and putative effects of the CBS mutations., (Crown Copyright © 2013. Published by Elsevier B.V. All rights reserved.)