Search

To quantitatively evaluate the acute effects of pseudoephedrine on the macular microvasculature using optical coherence tomography angiography (OCTA).Randomized placebo-controlled clinical study.In this study, 60 right eyes of 60 healthy subjects were divided into 2 groups. The study group received 60 mg of pseudoephedrine and the control group received a placebo. All participants underwent OCTA at baseline and 1 h after oral intake. Superficial macular flow area, foveal avascular zone (FAZ), superficial macular vessel density, central foveal thickness (CFT) and subfoveal choroidal thickness (SFCT) were analyzed.Baseline superficial macular flow area, FAZ area, superficial macular vessel density, CFT and SFCT measurements in the study and control groups showed no significant difference (p 0.05 for all). Oral pseudoephedrine intake caused a significant reduction in superficial macular flow area, FAZ area, superficial macular vessel density and SFCT measurements when compared with baseline (p 0.05 for all). However, there was no significant difference in CFT after oral pseudoephedrine intake (p 0.05).Oral pseudoephedrine intake causes a significant decrease in superficial macular blood flow and SFCT. Impairmant of macular microcirculation can be detected noninvasively and quantitavitely by OCTA.

BACKGROUND: To investigate the effect of cycloplegia on the ocular biometry and intraocular lens (IOL) power in different age groups. METHODS: This cross-sectional study enrolled 240 right eyes of 240 healthy volunteers. Three groups were formed (range to years; group 1: 50–60, group 2: 30–40 and group 3: 10–20, respectively). We measured keratometry, central corneal thickness (CCT), white-to-white (WtW) distance, anterior chamber depth (ACD), and axial lentgh (AL) both before and after cycloplegia. The IOL powers were calculated using Sanders–Retzlaff–Kraff/theoretical (SRK/T), Holladay 1 and Haigis formulas. AL-Scan (Nidek Co., Gamagori, Japan) was used for all measurements. RESULTS: There was a significant increased in keratometry, CCT, ACD, AL, and Holladay 1 after cycloplegia (p 0.05). Keratometry, SRK/T, Haigis, and Holladay 1 significantly decreased; ACD and WtW significantly increased postcycloplegia (p 0.05). Significant increased in ACD, CCT, WtW, and AL, significant decreased in SRK/T and Haigis were observed postcycloplegia (p 0.05). CONCLUSIONS: This study demonstrated there is significant difference in many ocular parameters and IOL power formulas before and after cycloplegia. Especially, ACD showed significant changes in all age groups. Therefore, to avoid refractive prediction errors the IOL power calculation formulas using the ACD should be considered.

BACKGROUND: To evaluate the effect of brimonidine tartrate 0.15% ophthalmic solution on pupil size under scotopic condition and upper eyelid position. METHODS: This study comprised 72 eyes of 36 healthy subjects. A single drop of brimonidine tartrate 0.15% ophthalmic solution was instilled in the right eye and artificial tear was instilled in the left eye. Pupil size was measured using an infra-red pupillometer under scotopic condition before and at 30 min, 2, 4, 6, 8 and 10 h after instillation. Measurement of margin reflex distance 1 (MRD1) was performed using a millimetre ruler before and after at 10 min after instillation. RESULTS: The mean age of the subjects was 32.19 ± 11.43 years (range 10–52 years), 17 were female and 19 were male. Before brimonidine instillation, the mean pupil size was 6.09 ± 1.03 mm in the brimonidine eyes and 6.06 ± 1.04 mm in the control eyes. There was a significant decrease in mean pupil size at 30 min (4.45 ± 1.04), 2 h (4.49 ± 1.06), 4 h (4.59 ± 1.06), 6 h (4.89 ± 1.06) and 8 h (5.38 ± 1.02) after instillation compared to before in brimonidine eyes (p

Purpose: To compare perioperative and postoperative outcomes of the first and following 50 cases of transcanalicular laser dacryocystorhinostomy performed by a surgeon team. Methods: Results of 124 eyes of 115 patients who had a diagnosis of distal obstruction of the lacrimal drainage system and underwent transcanalicular laser dacryocystorhinostomy procedures were retrospectively detected. Initial 50 eyes were considered as group 1; 74 following eyes were accepted as group 2. Groups were compared regarding age, gender, total surgical time, time for creation of osteotomy, pain score, bleeding score, anatomic and functional success rates. Results: The average total surgical time was 43.2 ± 6.0 minutes (range: 31 to 65 minutes) in group 1, and 30.0 ± 6.4 minutes (range: 21 to 57 minutes) in group 2 (p < 0.001). Laser osteotomy creation required 25.0 ± 4.2 minutes (range: 14 to 34 minutes) in group 1, and 14.6 ± 3.6 months (range: 9 to 28 minutes) (p < 0.001). Intraoperative pain and bleeding scores were significantly better in group 2 (p < 0.001 and p < 0.001 respectively). Success rate was 54.0% in group 1, and 85.1% in group 2 (p < 0.001). Conclusion: The results of current study clearly showed that increased experience of a surgeon results with improvement of better surgical outcomes. Initial studies about a novel technique should make clear if the study cases are the beginning cases of the authors.

A 25-year-old man suffered an isolated lens anterior capsular tear and mature cataract formation following blunt injury to his right eye. One week after the trauma, best-corrected visual acuity (BCVA) in the right eye was hand motion. B-scan ultrasonography showed that the lens posterior capsule was intact; no vitreous foreign body or retinal pathology were observed. Orbital computed tomography revealed narrowed anterior chamber and increased lens material volume and lens reflectivity in the injured right eye. The globe was intact and no bone fractures were observed. The cataractous lens material was removed by phacoemulsification and a foldable, acrylic, posterior chamber intraocular lens was implanted in the bag. Postoperative BCVA in the right eye was 20/20.

The aim of this study was to investigate the association between choroidal thickness (CT) and sex, age, refractive error (RE), and axial length in healthy subjects. This is a study of 154 eyes in 154 healthy subjects. CT measurements were performed by the same experienced technician using a spectral domain optical coherence tomography device. CT was measured perpendicularly from the outer edge of the retinal pigment epithelium to the choroid–sclera boundary at the fovea and at six more points which are located at, respectively, 500 µm nasal to the fovea, 1,000 µm nasal to the fovea, and 1,500 μm nasal to the fovea, 500 μm temporal to the fovea, 1,000 μm temporal to the fovea, and 1,500 μm temporal to the fovea. The RE was measured by autorefractometry, and the axial length was measured by interferometry. Statistical analysis was performed to evaluate CT at each location, and to the correlations of CT with sex, age, RE, and axial length. The mean subfoveal CT was 265.86 ± 60.32 µm, the mean age was 49.01 ± 19.19 years, the mean RE was −0.17 ± 1.20 diopters (D), and the mean axial length was 23.39 ± 0.76 mm. CT profile indicated that the choroid was thicker at the fovea than at temporal and nasal locations. Univariable linear regression analysis showed that subfoveal CT decreased 3.14 µm for each year of age and decreased 79.33 µm for each mm of axial length (P = 0.000, R 2 = 0.249; P = 0.000, R 2 = 0.487, respectively). In a similar analysis, subfoveal CT was found to decrease by 50.24 µm/D myopia-shifted change in refraction (P = 0.000, R 2 = 0.201). The subfoveal choroid was 99.16 µm (39.22 %) thicker in men than women when adjusting for age and axial length (P = 0.000, R 2 = 0.249). CT decreases with increasing myopia, age, and axial length. Men had thicker choroid than women, and CT varies depending on location.

To investigate the effect of oral caffeine intake on choroidal thickness using optical coherence tomography (OCT).Eighteen otherwise healthy caffeine users and 18 controls were enrolled. All participants underwent OCT scanning with high-speed and resolution spectral-domain OCT device (3D OCT 2000, Topcon, Japan) at baseline, and 1 and 3 h following 200-mg oral caffeine intake in the study and after oral placebo in the control group. The measurements were taken in the morning (10-12 am) to avoid diurnal fluctuation.The median choroidal thickness at the fovea prior to oral caffeine intake was 337.00 (IQR 83.75) μm, which decreased to 311.00 (IQR 79.25) μm at 1 h and 311.00 (IQR 75.00) μm at 3 h following oral caffeine intake (p = 0.001, 0.002, respectively). The median choroidal thickness was also significantly decreased following oral caffeine intake at other five extrafoveal points (p 0.05 for all). The difference in choroidal thickness was not statistically significant between 1 and 3 h of caffeine intake at all six points. In the control group, the median baseline choroidal thickness at the fovea was 330.00 (IQR 88.75) μm, which was 330.50 (IQR 80.75) μm at 1 h and 330.50 (IQR 90.75) μm at 3 h (p = 0.552, 0.704, respectively).Caffeine causes a significant decrease in choroidal thickness following oral intake. This decrease might be a result of reduced ocular blood flow due to its vasoconstrictive effect.

Purpose To evaluate the relation of central corneal thickness (CCT) and intraocular pressure (IOP) in preterm and full-term newborns. Methods The study included preterm infants who were admitted to the neonatal intensive care unit. A group of consecutive full-term newborns served as control group. Linear and multiple regression analysis were carried out to assess the association of IOP with sex, gestational/postconceptional age, birthweight, mean oxygenation time, stages of retinopathy of prematurity (ROP), and CCT. Linear and multiple regression analysis were also carried out to assess the association of CCT with sex, gestational/postconceptional age, birthweight, mean oxygenation time, and stages of ROP. Results Mean IOP was 17.5 ± 2.1 mm Hg in premature newborns and 16.3 ± 1.9 mm Hg in full-term newborns (p = 0.001). Mean CCT was 576.5 ± 16.8 µm in premature newborns and 562.7 ± 18.5 mm in full-term newborns (p = 0.000). Intraocular pressure was not correlated with CCT in preterm infants. Intraocular pressure was moderately correlated with CCT in full-term infants. Sex, postconceptional age at birth and at measurement, age after birth at measurement, birthweight, mean oxygenation time, and stage of ROP were not related to IOP. Central corneal thickness was not correlated with any parameter. Conclusions Our results showed that the CCT does not affect IOP significantly in preterm infants. More prospective studies are needed for determining the effect of CCT and other ocular and systemic factors on IOP in preterm infants.

BACKGROUND AND OBJECTIVE: To investigate the correlation of choroidal thickness with the outer and inner retinal layers. PATIENTS AND METHODS: A retrospective OCT scan review was conducted for healthy patients. Choroidal, outer retinal layer, and inner retinal layer thicknesses were measured at the fovea and 500 μm, 1,000 μm, and 1,500 μm temporal and nasal to the fovea. Retinal thickness was also measured at the foveal center. Choroidal thickness (CT) was compared at different locations, and correlation of CT with the outer and inner retinal layers was examined. RESULTS: Mean CT was thinnest nasally, thicker in the subfoveal region, and then thinner again temporally. Correlations found between CT and outer retinal layer thicknesses at temporal points to the fovea were slightly higher than correlations between CT and inner layer thicknesses. CONCLUSION: The correlation between choroidal thickness and the outer retinal layer was very weak. Similar prospective trials are needed to assess the correlation of CT with retinal layers. [ Ophthalmic Surg Lasers Imaging Retina. 2013;44:544–548.]

To compare the stereo fundus photography and fundus fluorescein angiography (FFA) for the incidence of cilioretinal arteries. A total of 3,200 eyes of 1,600 patients were included in the study. Patients studied with stereo fundus photography were grouped as group I, which studied with FFA accepted as group II. Stereo fundus photographs from files in the Alfagoz Eye Center were reviewed sequentially at group I. Group II selected from rapid sequence FFA images. The presence, number, and location of cilioretinal artery were evaluated by two masked experienced ophthalmologists. In total, 1,600 patients and 3,200 eyes were enrolled in this study. Group I included 1,100 patients and 2,200 eyes with mean age of 51.96 ± 17.39 (range 17–82) years and group II included 500 patients and 1,000 eyes with mean age of 52.92 ± 17.48 (range 19–82) years. One or more cilioretinal arteries were seen in 29.10 % of patients and 17.18 % of eyes in group I, 38.20 % and 26 % in group II, respectively. The difference between two groups was statistically significant (p = 0.000). Of the total number of cilioretinal arteries were located 81.75 % temporally, 11.90 % nasally, and 6.35 % bilaterally in group I, 80.77 %, 12.31 % and 6.92 % in group II, respectively. The incidence of cilioretinal artery in FFA group (38.20 %) was significantly higher than stereo fundus photography group (29.10 %). We believe that FFA should be the standard method for examination of cilioretinal artery.

Purpose: This study was designed to compare the normal and glaucomatous eyes regarding retinal nerve fiber layer (RNFL) thickness and peripapillary choroidal thickness (PCT), and to investigate the correlation of RNFL thickness and PCT. Subjects and Methods: Subjects were selected as a convenience sample of those from a tertiary referral practice of glaucoma. Thirty-two glaucomatous eyes were accepted as group 1; 30 normal eyes were accepted as group 2. Groups were compared for RNFL thickness and PCT. Correlations of RNFL thickness and PCT were assessed for each peripapillary location. Results: Mean inferior and superior RNFL thickness in group 1 were significantly lower than the control group; mean thicknesses of temporal and nasal quadrants were not different in the two groups. Mean PCT at 500 mu m distance in the inferior, at 1500 mu m distance in the superior, at 500, 1000, and 1500 mu m distance in the temporal, and at 1000 and 1500 mu m distance in nasal quadrants were found to be significantly thinner in the glaucoma group compared with the control group. Retinal nerve fiber thickness was strongly correlated with PCT at all points of inferior quadrants at 500 mu m distance in the superior. There was no correlation between RNFL thickness and PCT at any point in the control group. Conclusion: Peripapillary choroidal thickness was thinner in glaucomatous eyes compared with normal eyes. Correlation of PCT and RNFL thickness found in patients with glaucoma did not exist in normal subjects.

WOS: 000408113400002 PubMed ID: 28955580 Purpose: Bisphosphonates are commonly used drugs in pediatric patients in the treatment of osteoporotic diseases and various types of cancers. The purpose of this study was to evaluate the effects of pamidronate administration on mandibular growth and tooth eruption in new born rats. Materials and Methods: Forty Sprague Dawley rats were included in the study and divided into four groups as; 14th day pamidronate group, 30th day pamidronate group, 14th day control group and 30th day control group. Pamidronate groups were daily injected with 1.25 mu g/g pamidronate disodium subcutaneously whereas control groups were injected with sterile saline. Eruption levels of lower incisor and molar teeth were assessed macroscopically. Mandibular growth was assessed by measuring reference points in cone beam tomography. Histological and histomorphometric examinations were performed under light microscope to evaluate tooth morphology and number of osteoclasts. Results: Retardation in mandibular growth, decrease in number of osteoclasts, delay in tooth eruption, degeneration in both tooth morphology and structure were observed in the pamidronate groups compared to control groups. Conclusion: Pamidronate administration during growth and development stage may adversely affect tooth eruption and mandibular growth in new born rats.

AIM:To investigate the retinal nerve fiber layer (RNFL) thickness changes in patients with obstructive sleep apnea syndrome (OSAS) for one year follow-up. To discuss the possibility of detecting tendency of glaucoma in this population by using spectral domain optical coherence tomography (3D-OCT-2000 Spectral domain).METHODS:After polysomnographic study, all subjects (64 OSAS patients and 40 controls) underwent detailed ophthalmological examination. After these examinations, patients with glaucoma and patients who had ophthalmological and/or systemic disease were excluded from the study. Totally, 20 patients in OSAS group and five patients in controls were excluded from the study in the first examination and follow-up period. The RNFL thickness was assessed with OCT. Forty-four OSAS patients and 35 control subjects were followed up 12mo. RNFL thickness change and OSAS patients were evaluated for severity of disease by Apnea-Hypopnea Index (AHI).RESULTS:Forty-four OSAS patients and 35 controls were enrolled in the study. Statistically significance was found between OSAS patients and controls at the 12th mo. Average RNFL thickness was found to be significantly lower in last measurements in OSAS patients when compared with first measurements and control subjects (P<0.001, 0.002, respectively). There was a statistically significant correlation among AHI, and RNFL thickness (P<0.05).CONCLUSION:The results suggest that the patients with OSAS were related with a proportional decrease in the RNFL thickness. These patients should be followed up regularly for glaucomatous changes. Detecting more RNFL thinning in severe OSAS was important.

We aimed to evaluate the association of subfoveal choroidal thickness (SFCT) with age and to determine its relationship with axial length (AL) and ocular biometric parameters, in children and young adults during growth period.One hundred and sixty patients (80 male, 80 female) aged between 4 and 23 years were included. Patients were classified into five groups according to their ages as group 1 (4-7 years of age), group 2 (8-11 years), group 3 (12-15 years), group 4 (16-19 years), and group 5 (20-23 years). SFCT was assessed using spectral-domain optical coherence tomography (3D OCT-2000). The measurements were taken at the same daytime (1000-1200 hours) to avoid diurnal fluctuation. Ocular AL and anterior segment parameters were measured using optical biometry (Lenstar LS900)).The average SFCT was 308.1±47.6 μm, ranging from 206 to 410 μm. The mean SFCT values in group 1 to 5 were measured as 306.8±42.0, 297.8±48.1, 283.2±38.9, 326.9±57.4, and 325.8±35.9 μm, respectively. The mean CT of group 3 was significantly thinner than group 4 and 5 (P0.05 for two groups), however, there was no statistical significance compared with group 1 (P=0.227) and group 2 (P=0.693). On stepwise regression analysis, age exhibited a positive association with SFCT (B=2.8, P0.001) and AL exhibited a negative association with choroidal thickness (B=-16.7, P0.001).We found that SFCT shows no age-related difference until age of 15, whereas 16-23-year old participants had thicker SFCT compared with the younger ones. In that aspect, a thicker choroid associated with age in certain age groups suggests an age period of SFCT increase to a plateau in young adulthood. Larger studies are warranted to elucidate the age-related changes in SFCT in childhood, as improved evaluation of normal choroidal thicknesses during eye growth should assist in the diagnosis of choroidal abnormalities associated with eye disease.

Amaç: Neodymium: yttrium-aluminum-garnet (Nd: YAG) lazer kapsülotomi öncesi ve sonrasında görme keskinliği, göz içi basıncı (GİB), santral kornea kalınlığı (SKK) ve sferik ekivalan (SE) değişimlerinin değerlendirilmesi. Gereç ve Yöntem: Arka kapsül kesafeti bulunan 68 (40 erkek, 28 kadın) hastanın 68 gözü çalışmaya dahil edildi. Gereken en az enerji ve şut sayısıyla Nd: YAG lazer kapsülotomi uygulandı. İşlem öncesi ve sonrasında birinci hafta, birinci ay ve üçüncü ay tüm hastalara en iyi düzeltilmiş görme keskinliği (EDGK), SE, GİB ve SKK ölçümleri yapıldı. Veriler istatistiksel olarak analiz edildi. Bulgular: Lazer sonrası görme keskinliklerinde lazer öncesine göre artış gözlendi. Lazer öncesi ve lazer kapsülotominin birinci ay ve üçüncü ay sonrası sonuçlar arasında anlamlı bir artış mevcuttu (p0,05). Lazer öncesi ortalama SE değerlerinde lazer sonrasına göre hipermetropik yöne kayma izlendi. Lazer öncesi ve lazer kapsülotominin birinci hafta, birinci ay ve üçüncü ay sonrası sonuçlar arasında anlamlı bir artış mevcuttu (p, Objectives: To evaluate the changes in best-corrected visual acuity (BCVA), intraocular pressure (IOP), central corneal thickness (CCT), and spherical equivalent (SE) before and after Nd: YAG laser capsulotomy. Materials and Methods: This study included 68 patients (40 men, 28 women) who had posterior capsule opacification. the subjects underwent Nd: YAG laser capsulotomy with a minimal energy and shooting number. BCVA, IOP, CCT, and SE were measured before and 1 week, 1 and 3 months after laser capsulotomy. the post-treatment measurements were compared with the pre-treatment ones statistically. Results: There were statistically significant differences between pre- and post-laser BCVA values at 1 week, 1 month, and 3 months (p0.05). There were statistically significant differences between pre- and post-laser SE values at 1 week, 1 month, and 3 months (p

Amaç: Primer yırtıklı retina dekolmanı (YRD) tedavisinde ameliyat mikroskopu altında yapılan skleral çökertme (SÇ) ile ameliyat mikroskopu kullanılmadan yapılan SÇ cerrahisinin karşılaştırılması. Gereç ve Yöntem: Çalışmaya primer YRD nedeniyle opere edilmiş 74 hastanın 74 gözü dahil edildi. Ameliyat mikroskopu kullanılarak SÇ yapılan 35 hasta Grup 1, ameliyat mikroskopu kullanılmadan SÇ yapılan 39 hasta Grup 2 olarak kabul edildi. Post- ekvatoryal yırtık, 90°’den daha geniş yırtık, C2 ve üzeri evre proliferatif vitreoretinopatisi bulunanlar ile takip süresi altı aydan kısa olan hastalar çalışmaya alınmadı. Gruplar yaş, cinsiyet, etyoloji, anatomik başarı ve cerrahi komplikasyonlar (skleral perforasyon, iatrojenik retinal yırtık, vitreus içi hemoraji, sörklaj malpozisyonu ve vorteks ven hasarı) açısından karşılatırıldı. Bulgular: Grup 1’deki hastaların 17’si erkek, 18’i kadın, yaş ortalaması 64,11±7,91 yıl, yaş aralığı 55-79 yıl, Grup 2’deki hastaların 19’u erkek, 20’si kadın, yaş ortalaması 65,20±6,15 yıl, yaş aralığı 56-80 yıl idi. Gruplar arasında ortalama yaş ve cinsiyet bakımından anlamlı fark yoktu (p=0,508 ve p=0,990 sırasıyla). Etyolojiler arasında miyopi, periferik retina dejenerasyonu, psödofaki, afaki, travma ve idyopatik nedenler yer almaktaydı. İki grup arasında etyolojik nedenler açısından anlamlı fark yoktu (hepsi için, p>0,05). Cerrahi komplikasyon oranları Grup 2’de daha yüksek bulunsa da aradaki farklar istatistiksel olarak anlamlı değildi (hepsi için, p>0,05). Anatomik başarı oranı her iki grupta benzerdi (Grup 1’de %80, Grup 2’de %79,5, p=0,956). Sonuç: Ameliyat mikroskopu altında yapılan SÇ ile ameliyat mikroskopu kullanılmadan yapılan SÇ cerrahileri birçok yönden benzer sonuçlar ortaya koysa da, özellikle sklera problemi olan hastalarda ameliyat mikroskopu altında yapılan SÇ cerrahisi komplikasyonları azaltabilir. (Turk J Ophthalmol 2014; 44: 175-8), Objectives: To compare the results of scleral buckling surgery with and without use of operating microscope for primary rhegmatogenous retinal detachment (RRD). Materials and Methods: This comparative study consisted of 74 eyes of 74 patients who underwent scleral buckling for primary RRD. Group 1 consisted of 35 patients (17 male and 18 female) who were operated using operating microscope and Group 2 consisted of 39 patients (19 male and 20 female) who were operated without operating microscope. Patients with post-equatorial breaks, retinal breaks greater than 90°, proliferative vitreoretinopathy (≥C2), and those with follow-up period of less than sıx months were excluded from the study. the two groups were compared based on age, sex, etiology, anatomic success, and surgical complications (scleral perforation, iatrogenic retinal breaks, vitreous hemorrhage, buckle malposition, and vortex vein damage). Results: Mean age was 64.11±7.91 years (range, 55-79 years) in Group 1 and 65.20±6.15 years (range, 56-80 years,) in Group 2. Mean age and gender were not statistically significantly different between the groups (p=0.508 and p=0.990, respectively). Etiological causes were revealed as myopia, peripheral retinal degeneration, pseudophakia, aphakia, trauma, and idiopathic. Etiological causes were not significantly different between the two groups (p>0.05, for all). Surgical complication rates were higher in Group 2, however, the differences were not statistically significant (p>0.05, for all). Anatomical success rates was similar between the two groups (80% in Group 1 and 79.5% in Group 2, p=0.956). Conclusion: the results of scleral buckling surgery with and without use of operating microscope were not significantly different; However, operating microscope should be used especially in presence of risk factors for scleral complications. (Turk J Ophthalmol 2014; 44: 175-8)

Purpose To report the clinical outcomes of deep anterior lamellar keratoplasty (DALK) in patients with anterior corneal stromal scars associated with various etiologies. Methods A total of 79 eyes of 79 patients with corneal stromal scars sparing the Descemet membrane and the endothelium underwent DALK by using big-bubble technique. The main outcome measures of the study were the ability to successfully complete DALK, intraoperative and postoperative complications, best spectacle-corrected visual acuity, refraction, and graft clarity. Results Seventy-two of the surgical procedures were carried out as DALK, and the mean follow-up time was 28.1 ± 17.9 months (range, 12-78 months). The most frequent indication for DALK surgery was postherpetic keratitis (44%). Complete Descemet membrane exposure via big bubble (descemetic DALK) could be achieved in 57 cases (79%). Fifteen eyes (21%) required layer-by-layer manual dissection (predescemetic DALK). Best spectacle-corrected visual acuity of 6/12 or better was present in 59 eyes (82%) postoperatively. The mean spherical equivalent and topographic astigmatism were -3.32 ± 2.13 (range, -9.13 to +4.75) and -2.97 ± 1.94 (range, -8.0 to +4.50) diopter, respectively. There were 2 instances of stromal graft rejection, which responded to medical therapy. Conclusions DALK big-bubble technique may be a valuable and safe treatment in patients with corneal stromal scar with healthy endothelium. The visual and refractive outcomes are comparable to standard penetrating keratoplasty, avoiding the risk of endothelial rejection.

The aim of the study was to compare conventional surgery with carbon dioxide (CO(2)) laser applied on oral soft tissue pathologies and to evaluate the effect of collateral thermal damage on histopathological diagnosis. Anesthesia need, postoperative pain, and intraoperative and postoperative complications were examined as part of the comparison.Forty-three patients (32 female and 11 male) with a mean age of 54 (54 +/- 7.0) requiring soft tissue surgeries were randomly assigned to receive treatment either with conventional surgery using a scalpel or with a CO(2) laser technique. Anesthesia method and need, postoperative pain, systemic pain medications if needed, and intra- and postoperative complications were recorded. Excised tissues were evaluated histopathologically for the effect of thermal damage.All patients were anesthetized with local anesthesia in the conventional group whereas only 10 (42%) patients needed local anesthesia after topical anesthetic application in the laser group. In the conventional group, 18 (90%) patients need analgesics after the operation, compared with seven (29%) patients in the laser group. No intra- or postoperative complications were seen for either procedure. Histological examination of 39 specimens showed that collateral thermal damage on the incision line did not affect the histopathological diagnosis.CO(2) laser is an effective instrument for soft tissue excisional biopsies with minimal intraoperative and postoperative complications and good pain control. CO(2) laser applications are suggested as an alternative method to conventional surgery on oral soft tissues.