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We present the case of a 19-years old boy with microspherophakia who reported blunt trauma on his right eye 10 days ago. The patient had been diagnosed with glaucoma 4 years ago and he had been using a combination of antiglaucoma eye drops. The best corrected visual acuity (BCVA) was 3.00 logMAR with a refractive error of -21.00 (-2.00x155) dioptri (D). On slit-lamb examination, the lens was dislocated towards to the anterior chamber, and in the anterior chamber vitreus was detected. Intraocular pressure (IOP) was 36 mmHg. We performed intracapsuler lens extraction with implantation of a scleral fixation intraocular lens (IOL). At postoperative 1th month, the IOL was well centered with no anterior chamber reaction. Uncorrected visual acuity was 0.4 logMAR, BCVA was 0.2 logMAR with a refractive error of -1.50x55 D and IOP was 12 mmHg without antiglaucoma medication. In this case, we reported the management of traumatic lens dislocation in microspherophakia. [ABSTRACT FROM AUTHOR]

Purpose: In this study, we aimed to evaluate the relation between obstructive sleep apnea (OSA) and central serous retinopathy (CSR). Methods: Twenty-three consecutive subjects aged >18 years with the diagnosis of CSR were included in this prospective study. Overnight polysomnography was performed to all subjects. Desaturation index and apnea-hypopnea index (AHI) were recorded. Obstructive sleep apnea was classified according to AHI as mild, moderate, or severe. Statistical analysis was performed using chi-square test, Fisher's exact test, and Mann-Whitney U test. Results: Fourteen of 23 CSR patients (60.9%) had OSA. Prevalence of OSA was significantly higher in male subjects with CSR compared to female subjects with CSR ( p = 0.018). One (16.7%) female subject with CSR had OSA whereas thirteen (76.5%) male subjects were found to have OSA. Desaturation index was found to be 5.1 ± 4.2 in females and 12.9 ± 11.1 in males ( p = 0.036). Conclusion: Obstructive sleep apnea is seen nearly in 2/3 of patients with the diagnosis of CSR. There are possible common pathophysiological mechanisms like oxidative stress, vasoconstriction, or blood coagulation abnormalities. Screening for OSA should be considered in subjects with the diagnosis of CSR. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the prevalence of primary open-angle glaucoma (POAG) in subjects aged over 40 years in Western Turkey and to quantify its association with several systemic risk factors. Material and Method: The research was conducted in Afyonkarahisar, a middle Anatolian city, between November 2005 and February 2006. A total of 1533 subjects aged 40 years or more were included in the study. Diabetes mellitus, hypertension, atherosclerotic cardiac disease, obesity, smoking, alcohol consumption, and dietary habitus (meat, chicken, and fish consumption) were asked. Level of blood glucose, serum total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, very-low-density lipoprotein, Vitamin B12, and thyroid-stimulating-hormone were determined. Ophthalmic examination was performed, and intraocular pressure was measured by tonopen. Subjects with an IOP of 21 mmHg or more and/or with a cupping/disc ratio of 0.3 or more were told to come to the clinic for visual field analysis and gonioscopy. Subjects with a typical glaucomatous visual field defect and an open angle were recorded as POAG. Risk factors for POAG were determined by chi-square test. Results: Prevalence of POAG was found to be 2% (30 subjects) and the only associated risk factor was age (p=0.05). Dietary habitus was also not associated with glaucoma (p>0.05). Discussion: This study provides a population-based data about the prevalence and risk factors of POAG in Turkey. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the results of knotless Z-suture scleral fixation intraocular lens (IOL) implantation technique to ciliary sulcus. Materials and Methods: Twenty subjects whom Z- suture scleral fixation IOL implantation was performed, were included in the study. Visual acuity, intraocular pressure, operative and postoperative complications were recorded. Results: Best corrected visual acuity at postoperative 2. month was significantly higher compared to the best corrected visual acuity at preoperative period (p=0.037). Best corrected visual acuity remained the same at 6 subjects and increased at 14 subjects and except 1 case all subjects achieved a visual acuity of logMAR 0.3 or better. Only in 1 subject, hyphema was seen during operation. At the postoperative period, suture exposure was seen at 1 subject at 1. month and 2 subjects developed secondary open angle glaucoma which was controlled by medical treatment. No intraocular lens dislocation or tilt was seen. Conclusion: Complications of Z-suture scleral fixation IOL implantation technique are minimal and it can be performed in short duration, easily and safely. [ABSTRACT FROM AUTHOR]

Age-related macular degeneration (AMD) is a disease with multifactorial etiology characterized by irreversible loss of central visual acuity. The discovery of susceptive single-nucleotide polymorphisms (SNPs) has progressed our understanding of AMD. Complement factor H ( CFH) gene Y402H polymorphism and high-temperature requirement A-1 ( HTRA1) LOC387715 gene A69S polymorphisms are the most important SNPs reported in the literature. Determination of genetic risk factors and genotype-phenotype relationship in AMD may result in rapid and cost-effective therapeutic applications for young and old population. In this study, we hypothesized a potential association between CFH gene Y402H and HTRA1 LOC387715 gene A69S polymorphism in Turkish AMD patients. In blood samples from a total of 252 individuals, 147 clinically diagnosed as AMD and the others control, polymorphic sites in CFH, Y402H ( Tsp509I T/C), and HTRA1, LOC387715 A69S ( FnuHI G/T), were determined by polymerase chain reaction-restriction fragment length polymorphism analysis. There was significant difference between CFH genotypes in the AMD group, TT 21.8%, TC 48.3%, and CC 29.9%, and in the control subjects, TT 45% ( p=0.003), TC 41% ( p=0.0001), and CC 14% ( p=0.0001). Further, the A69S polymorphism of LOC387715 was investigated and found to be significantly associated with AMD. LOC387715 genotypes in the AMD group were GG 30.6%, GT 38.1%, and TT 31.3% and in the control subjects were GG 59% ( p=0.027), GT 39% ( p=0.0001), and TT 2% ( p=0.0001), respectively. We also found that Y402H C and A69S T allele were associated with AMD. This is the first study showing that Y402H and LOC387715 are associated with AMD in Turkish population. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the long-term effects of intravitreal bevacizumab injection in patients with macular edema secondary to branch retinal vein occlusion. Materials and Methods: In this retrospective interventional case series, 20 eyes of 20 patients with macular edema secondary to branch retinal vein occlusion for 6 months or more were treated with intravitreal bevacizumab (1.25 mg/0.05 mL). Standardized ophthalmic evaluation, best corrected visual acuity (BCVA) measurement with ETDRS chart, and fundus fluorescein angiography (FFA) were performed at baseline, at 1 month and 3 months, and at 3-month intervals thereafter. Intravitreal bevacizumab injection was repeated in recurring macular edema. The follow-up period was 18 months. Results: No ocular toxicity or adverse effects were observed. The mean number of injections per patient was 2.35±0.9. At baseline mean BCVA was logMAR 1.18±0.7 and improved to 0.62±0.5 after 1 month (p=0.002), 0.61±0.5 at 3 months (p=0.001), 0.66±0.5 at 6 months (p=0.003), 0.67±0.5 at 12 months (p=0.003), and 0.57±0.4 (p=0.006) at 18 months. In 13 eyes, VA increased 2 or more lines. FFA showed a complete or partial decrease in macular edema in all eyes after baseline injections and the same favorable response was obtained after re-injections in cases of recurrences. Conclusion: Intravitreal injection of bevacizumab appears to result in a significant improvement in visual acuity and angiographic findings in patients with macular edema secondary to branch retinal vein occlusion during a followup of 18 months. [ABSTRACT FROM AUTHOR]

Purpose: To assess the corneal biomechanical properties by ocular response analyzer in pseudophakic patients and compare them with those in healthy subjects. Materials and Methods: Forty eyes of 40 patients who underwent uneventful phacoemulsification cataract surgery were included in the study. Group 1 (n=40) consisted of pseudophakic eyes, group 2 (n=40) consisted of nonoperated fellow eyes of the same patients, and group 3 (n=40) consisted of eyes of age-matched healthy subjects. Corneal-compensated intraocular pressure (IOPcc), Goldmann-correlated IOP (IOPg), corneal hysteresis (CH), and corneal resistance factor (CRF) were measured by ocular response analyzer (ORA) at the postoperative 2nd month. Intraocular pressure with Goldmann applanation tonometer (GAT IOP) and central corneal thickness (CCT) with ultrasonic pachymeter were also measured. Statistical analyses were performed using ANOVA, Student's t-test, and Pearson's correlation analysis. Results: All measurements were performed at postoperative 8.6±2.8 weeks in pseudophakic patients. Mean IOPcc was 17.1±3.9 mmHg, IOPg was 16.4±4.5 mmHg, CRF was 10.4±2.4 mmHg, CH was 10.07±1.9 mmHg, and CCT was 558 μm in pseudophakic patients (p=0.252, 0.663, 0.219, 0.92, 0.121, respectively). IOPcc-GAT IOP mean difference was 2.1 mmHg (p=0.006) and IOPg-GAT IOP mean difference was 1.4 mmHg (p=0.09) in pseudophakic patients. IOPg, CH, and CRF showed significant correlations with CCT (r=0.437, p=0.005; r=0.568, p=0.001; r=0.632, p=0.001, respectively) but there were no correlation between CCT and IOPg (r=0.144, p=0.375), or between CCT and GAT IOP (r=0.154, p=0.343) in pseudophakic patients. Conclusion: Corneal biomechanical parameters measured by ORA do not change significantly in pseudophakic patients and cataract surgery seems not to affect the viscoelastic properties of the cornea at the 2nd postoperative month. [ABSTRACT FROM AUTHOR]

Sarcoidosis is a systemic granulomatous disorder of unknown aetiology. About 20-35% of patients with systemic sarcoidosis develop cutaneous manifestations. Skin lesions can also occur in the absence of systemic disease. Scar sarcoidosis is a well-known manifestation of skin sarcoid and often associated with erythema nodosum, hilar lymphadenopathy and uveitis. In this study, A 35 year-old man with bilateral panuveitis associated with tattoo-induced scar sarcoidosis was presented. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the short term effects of selective laser trabeculoplasty (SLT) on the intraocular pressure (IOP), central corneal thickness (CCT) and corneal endothelial cell analysis. Materials and Methods: Thirty eyes of 30 primary open angle glaucoma (OAG) patients were included in this study. SLT was performed on all patients at 360 degrees of trabecular meshwork. Corneal endothelial cell analysis, CCT and IOP measurements were performed at baseline before SLT as well as 1 week and 1 month after SLT. Results: Thirteen of 30 patients were male (43.3%) and 17 were female (56.7%). The mean age of the patients was 70.03 ± 8.4 years. Although IOP increased at the fi rst hour following SLT, a statistically significant decrease occurred during follow-up (p<0.05). No significant difference was found in corneal endothelial cell analysis after SLT when compared with baseline measurements (p>0.05). Although a slight increase in CCT was observed during follow-up, the difference between pre-and post- SLT values was not statistically significant (p>0.05). Conclusions: This study demonstrated that SLT provides a significant decrease in IOP at the 1 st week and 1 st month after the procedure. Also, no harmful effect was observed on endothelial cell function and CCT. Further studies are necessary to confirm our fi ndings. [ABSTRACT FROM AUTHOR]

Purpose: To demonstrate fundus lesions affecting asymptomatic individuals for a group that includes subjects between 12 and 75 years of age who presented for a routine eye examination only based on refractive symptoms. Materials and Methods: 1654 subjects who applied to our ophthalmology outpatient clinic with a purely refractive complaint without the knowledge of any preexisting ocular and systemic illness enrolled in the study. Fundus findings were noted and subjects were divided into 4 age strata including younger than age 20, between 21 and 40, between 41 and 60 and older than age 60. The distribution of fundus findings were analyzed according to these age groups. Results: Asymptomatic fundus findings were detected in 84 patients (5.1%). The most common diagnosis was diabetic retinopathy. The prevalence of these conditions increased with increasing subject age. The percentage was 0.8% in subjects younger than 20 years and it was 11.2% in subjects older than 60 years. Conclusions: We believe that our study support the significance of regular fundus examinations, especially in elderly patients. Therefore, a routine dilated fundus examination should be an integral part of the routine eye examination and it should be performed at specific time intervals in certain age groups in developing countries. [ABSTRACT FROM AUTHOR]

Glaucoma drainage implants (GDI) are used as alternatives to trabeculectomy and cyclodestructive procedures in medical treatment resistant glaucoma treatment. Strabismus is one of the possible complication after GDI surgery. The incidence of strabismus after this surgery has been reported between 2.1 % and 77%. In this case report, we aimed to present a rare case of acquired Brown's syndrome occurring after superior nasal implantation of GDI. A 44-year-old woman with glaucoma uncontrolled by medications underwent Ahmed glaucoma implant surgery which was placed in the superonasal quadrant of right eye. Two week after surgey, the patient applied with complaint of newly developed diplopia. The elevation of the right eye was conspicuously limited during adduction. There was hypodeviation of 4 prism diopter (PD) and exodeviation of 2 PD in the right eye at the primary position.The patient was diagnosed with acquired Brown's syndrome. The complaint of diplopia was completely recovery with prismatic glass. Because of the risk of acquired Brown's syndrome which is caused diplopia, clinicians should avoid placing GDI in the superior nasal quadrant in eyes that have good visual acuity. [ABSTRACT FROM AUTHOR]

A 43-year-old female patient presented with headache, vomiting episode, blurring of vision, and photophobia. Patient had no prior history of glaucoma and/or any other ocular abnormalities but had a history of migraine and was started with topiramate acetate 2 days prior to admission. Slit lamp examination revealed conjunctival hyperemia, chemosis and shallow anterior chambers. Intraocular pressure was measured as 40 mm Hg in both eyes. Fundoscopic examination findings were normal. Ultrasound scan was performed and demonstrated separation between the choroidal layer and the sclera. A diagnosis of bilateral uveal effusion associated with the use of oral topiramate was made. Patient's symptoms responded well to topiramate discontinuation, topical and systemic anti glaucomatous medications and topical cycloplegic agents. In the follow-up period, visual acuity, intraocular pressure, gonioscopic and anterior segment optical coherence tomography findings returned to normal. Bilateral acute angle closure may develop after ingestion of topiramate. So, the possibility of bilateral acute angle closure glaucoma must be kept in mind in adult and elderly subjects with headache and blurred vision after the use of topiramate. Due to the possible ophthalmic side effect, patients should be informed and warned before topiramate intake. This side effect is rare but can lead to irreversible vision loss if it is not recognized in time and if it is not managed immediately by an ophthalmologist. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the incidence, occurrence period, progression and risk factors for intraocular pressure (IOP) elevation after Penetrating Keratoplasty (PK) as well as its management and treatment results. Materials and Methods: Data of 342 eyes who had PK between 2003-2014 with a regular follow-up and IOP measurements of at least 1 year were reviewed retrospectively. 102 eyes with a rise in IOP exceeding 21 mmHg during follow-up were spared and analysed. Results: IOP increase occurred in 29.8% of the patients. Mean time of occurrence was 16.8±13.3 (2-52) post-operative week. Mean age was 60.6±17.6 (14-83). Number of patients under age 40 was 30 (27.0%). Mean preoperative IOP of 14.6±2.9 (5-20) mmHg increased to 25.7±4.1 (22-45) mmHg. Combined procedures during PK had no significant effect on postoperative pressure elevation (p=0.076, Chi-square test). Age, gender and trephine diameters were not significant risk factors. However, pseudophakic bullous keratopathy with an incidence of 48.1% was found as the most significant risk factor (p=0.002, Ki-kare testi). IOP was controlled with one topical agent in 44 eyes (43.1%), with fixed combination in 51 eyes (50.0%), in 6 eyes (5.9%) which were resistant to medical therapy trabeculectomy was performed in eye (1.0%) Ahmed Glaucoma Device was implanted. Conclusion: IOP elevation is a serious complication after PK which is not rare. Especially pseudophakic bullous keratopathy is a significant risk factor. In order to protect graft clarity and optic disc functions, IOP should be monitored closely after PK and aggressively treated if found to be high. [ABSTRACT FROM AUTHOR]

Purpose: To compare intraocular pressure (IOP) changes between sitting and supine position in individuals with pseudoexfoliation syndrome (PXS) and healthy volunteers. Materials and Methods: Fifty five eyes with PXS and 49 eyes of healthy individuals were included in this prospective, controlled study. Slit lamp examination, gonioscopy and IOP measurement with iCare tonometer (ICT) in sitting and supine positions were performed to all patients in both groups. Results: Mean age was 67.3 years in PXS group and 66.3 years in control group (p=0.432). Mean IOP in sitting position with ICT was 16.2±3.4 mmHg in PXS group and 16.7±2.9 mmHg in the control group (p=0.368). Mean IOP with GAT was 0.4 mmHg higher than ICT measurements in PEX group (p=0.055). Mean IOP with GAT was 0.32 mmHg higher than ICT measurements in control group (p=0.207). Mean IOP measured with ICT in supine position was 19.9±4.1 mmHg in PXS group and 19.0±3.2 mmHg in control eyes (p=0.348). We noticed that mean IOP rise was 3.65 mmHg in PXS group and 2.25 mmHg in the control group in supine position (p<0.001, p<0.001; respectively). When compared with the control group, IOP rise in supine position was statistically significant in PXS group (p<0.001). Conclusion: IOP rises significantly in supine position both PXS and control groups, but this increase is more in PXS groups. IOP measurement with ICT is reliable and practical for supine and sitting body positions. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the astigmatic effect of 2.8 mm clear corneal incisions performed on steep corneal axis in phacoemulsification. Materials and Methods: 49 eyes of 49 patients who had corneal astigmatism over 0.5 diopters (D) were randomly distrubuted into two groups. A superior clear corneal incision was performed in group 1 (25 eyes) and steep axis incision was performed in group 2 (24 eyes). Corneal topography was performed in all cases at preoperative and postoperative first day, second and fourth weeks. Changes in corneal astigmatism were calculated by vector analysis method. Results: In group 1, mean corneal astigmatism increased from 1.09±0.44 D to 1.40±0.70 D after surgery. In group 2, mean astigmatism decreased from 1.35±0.85 D to 0.95 ±0.78 D 1 month after surgery. The change in mean corneal astigmatism at first month between two groups was statisticially significant (p<0.001). The astigmatism created by corneal incisions were compared between two groups by vector analysis method. Although surgically induced astigmatism was lower in group 2, this difference was not statistically significant. Conclusion: Clear corneal incision performed on steep axis results in less postoperative astigmatism compare to standard superior incision in phacoemulsification. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate anatomic, functional success, results of scleral buckling surgery performed to rhegmatogenous retinal detachment cases and factors affecting the surgery results. Materials and Methods: Skleral buckling surgery was performed to 78 rhegmatogenous retinal detachment cases in our clinic between June 2005 and August 2011 and medical records of these cases were evaluated retrospectively. General characteristics of the patients, etiologic factors, anatomical and functional successes and possible factors those may have a role on these results were evaluated. Results: 45 of the eyes (57.7%) were phakic, 29 were pseudophakic (37.2%) and 4 of them were aphakic (5.1%). It was determined that phakic patients had both anatomically and functionlly more successful results. The short duration of the application time was found to be significant for functional success, but not to be effect for anatomical success (respectively p=0.003, p=0.127).. Before the surgery in 67 of the cases (85.9%), macula was inside the detachment area, in 11case (14.1%) macula was reattached. Macular involvement was compared for anatomic and functional success and no significant difference was established. After an average of 23.7 months follow-up; functional success in 47 (60.3%) cases and anatomic success in 66 (84.6%) cases were obtained. Conclusions: Best results may be obtained when the appropriate surgical method was performed on time with the use of appropriate material for the scleral buckling surgery of rhegmatogenous retinal detachment. [ABSTRACT FROM AUTHOR]

Tube exposure is frequent complication of Ahmed glaucoma valve implantation. Our patient was 48 -year-old man who had penetrating keratoplasty for corneal scar due to dynamite explosion. He had corneal grafting 5 times and trabeculectomy 2 times between 2003-2015. Ahmed glaucoma valve implantation was performed in December 2014. Tube exposure occurred 7 weeks after the surgery. An autologous scleral patch graft was used to cover the tube with an initial success. However, tube exposure recurred after 8 weeks. This time, autologous temporal muscle fascia was used to cover the tube exposure on April 2015. Temporal fascial graft is widely used in craniofascial surgery to repair scalp defects and also well tolerated by the ocular structures. Amniotic membrane coverage of the graft enhances patient comfort and provides better cosmetic appearance. [ABSTRACT FROM AUTHOR]

Olfactory neuroblastoma (ONB), which is a neuroectodermal tumor of the nasal cavity, is a rare and locally aggressive malignancy that may invade the orbit via local destruction. In this study, we report a patient with proptosis, external ophthalmoplegia, and compressive optic neuropathy caused by ONB. A detailed clinical examination including ocular imaging and histopathological studies were performed. The 62-year-old female patient presented to our clinic with complaints of proptosis and visual deterioration in the left eye. Her complaints started 2 months prior to admission. Visual acuity in the left eye was counting fingers from 2 meters. There was relative afferent pupillary defect. She had 6 mm of proptosis and limitation of motility. Fundus examination was normal in the right eye, but there was a hyperemic disc, and increased vascular tortuosity and dilation of the retinal veins in the left eye. Computerized tomography and magnetic resonance imaging of the brain and orbits demonstrated a large heterogeneous mass in the left superior nasal cavity with extensions into the ethmoidal sinuses as well as into the left orbit, compressing the medial rectus muscle and optic nerve. Endoscopic biopsy of the lesion was consistent with an ONB (Hyams' grade III). Orbital invasion may occur in patients with ONB. Therefore, it is important to be aware of this malignancy because some patients present with ophthalmic signs such as external ophthalmoplegia, proptosis, or compressive optic neuropathy., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Objectives: To determine factors influencing compliance in patients with neovascular age-related macular degeneration (n-AMD) undergoing intravitreal anti-vascular endothelial growth factor (VEGF) therapy., Materials and Methods: The files of n-AMD patients recommended treatment with ranibizumab were reviewed retrospectively. The treatment regimen was 3 consecutive monthly injections followed by monthly follow-up with intravitreal injections as needed (pro re nata, PRN). Demographic and ocular characteristics were recorded. The patients were categorized into 2 groups: full compliance to treatment, or incomplete loading schedule and/or irregular maintenance treatment. All patients were interviewed by phone about factors affecting continuation of treatment., Results: Mean age of the 314 patients (160 female, 154 male) included in the study was 71.6±9.1 years. A total of 246 patients (78.3%) could complete 3 consecutive injections at 1-month intervals after the start of treatment; 57 patients (18.2%) did not attend monthly follow-up during the 1-year follow-up period following the 3 consecutive monthly injections. Overall, 39.8% of the patients were not able to fully comply with the ranibizumab treatment by PRN regimen for 1 year. Better visual acuity at baseline, smaller lesion size, living closer to the hospital, higher education and sociocultural level, and better financial status were determined as factors affecting patient compliance. The most frequent reasons to discontinue treatment were fear of injection, disbelief in the benefit of the treatment, financial limitations, continuation of treatment at another center, and comorbid systemic diseases., Conclusion: Patient compliance and success rates of anti-VEGF therapy may be increased by determining the factors affecting patient compliance and raising awareness about n-AMD among patients and their relatives., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Aim: To compare visual, surgical and topographic outcomes of deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK) for keratoconus (KC)., Methods: In this multicenter, prospective, randomized clinical trial 76 eyes of 71 KC patients operated between January 2011 and July 2014 in 2 tertiary referral hospitals were included. Consecutive patients were alternately selected to receive one of the two surgical methods. Thirty eight eyes underwent DALK with the big-bubble technique and 38 eyes underwent PK., Results: Mean best spectacle corrected visual acuity (BSCVA) at the first postoperative week ( P =0.012) and the first postoperative month ( P <0.001) was statistically significantly higher in DALK group. The mean BSCVA at 12mo was not significantly different for DALK (0.30±1.99 logMAR) versus PK (0.40±0.33 logMAR) ( P =0.104). The 76.3% of the eyes had a BSCVA over 0.5 in DALK and 47.4% in PK group ( P =0.009). The 7.9% of the eyes had a BSCVA of 1.0 in DALK and 5.3% in PK group ( P =0.644). Mean spherical equivalent was -2.94 D in DALK and -3.09 D in PK group. Mean topographic astigmatism was 4.62 D and 4.18 D respectively. Regular topographic patterns were observed in 31 (81.6%) of DALK and 29 (76.3%) of PK ( P =0.574). The most frequent topographic pattern was oblate asymmetric bow tie, seen in 39.5% in DALK and 23.7% in PK., Conclusion: Big bubble DALK provides an earlier visual improvement compare to PK. However, visual and topographic outcomes are similar to those in PK at 1y. Postoperative complications including rejection and intraocular pressure elevation are more frequent in PK. DALK is a safer alternative to PK for KC. However, intraoperative perforation of the Descemet's membrane is a significant complication.

We present a case of transpupillary argon laser cyclophotocoagulation (TALC) in a patient with traumatic aniridia and aphakia secondary to blunt trauma who had previous bilateral trabeculectomy. Four months after the trauma the patient's intraocular pressure (IOP) rose to 35 mmHg despite topical antiglaucomatous medication. Inferior 180 degrees cyclophotocoagulation was performed with transpupillary argon laser in the first session and his IOP fell to values of 12-17 mmHg. Twelve weeks after TALC, his IOP rose to 22 mmHg and we had to apply TALC to the residual ciliary processes. Seven months later his IOP was 13 mmHg with topical dorzolamide/timolol and latanoprost administration. TALC may be an effective treatment alternative for lowering IOP in patients with visible ciliary processes who do not respond to conventional medical or laser treatment., Competing Interests: No conflict of interest was declared by the authors. Financial Disclosure The authors declared that this study received no financial support.