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Background: The aim of the present study was to evaluate the effect of uncomplicated cataract surgery on macular thickness in diabetic and nondiabetic patients. Methods: The cases of patients who underwent phacoemulsification surgery between March and June 2013 were retrospectively evaluated. Patients with over 6% HbA1c, uncontrolled diabetes mellitus, systemic disease, concurrent ocular disease, use of drugs that may affect macular thickness, and complicated surgeries were excluded. Preoperative and postoperative 3rd-month visual acuity and intraocular pressure were measured, and biomicroscopy and fundus examinations were performed. Cirrus HD-OCT model 4000 optic coherence tomography (Carl Zeiss Inc., Oberkochen, Germany) was used for macular thickness analysis. All data was statistically analyzed. Results: Twenty-four eyes were included in the diabetic patient group; 34 eyes were included in the control group. Corrected visual acuity at final visit had increased in both groups (p<0.05). By the end of the 3rd month, mean change in central foveal thickness was 16.03±4.5 µm in the diabetic group (p<0.05), and 7.31±3.3 µm in the control group (p<0.05). Postoperatively, perifoveal thicknesses of 3 and 6 mm increased significantly in both groups. By follow-up, clinically significant macular edema (CME) had developed in 1 eye of a diabetic patient, while no CME had developed in the control group. When data was compared between groups, foveal and perifoveal mean thickness changes were significantly higher in the diabetic group (p<0.05). Conclusion: While significant macular thickness increase was postoperatively observed in both groups, it was found that this increase was higher in diabetic patients. Ophtalmalogic surgeons should be careful when planning cataract sugery in diabetic patients without rethinopathy although HbA1c levels are normal. [ABSTRACT FROM AUTHOR]

Purpose: In calculating intraocular lens (IOL )power we compared the results of optical coherence biometry and ultrasound biometry and used predicted postoperative refraction to determine success. We also observed the effects of experience on ultrasound biometry. Materials and Methods: We selected 54 randomn cataract patients for our study. IOLMaster( Carl-Zeiss IOLMaster 500 ) was used to measure the biometry of the catarct patients. Ultrasonic biometry was measured by a senior and junior registrar. Cataract surgery was performed using phacoemulsification and foldable intraocular lens was implanted. Postoperatively refraction was taken at the first month postopertively. The spheric error measured by the IOLMaster , was compared to the spheric error on comparison of ultrasonic measurements in the junior and senior registrar. Results: Axial length measurements between the IOLMaster and the ultrasound measurements of the junior and senior registrar were statisticaly significant (p<0.05), however there was no statistical difference between the measurements made by the junior and senior registrar. K1 and K2 measurements showed no statisticaly significant difference between the groups. .IOLMeasurement calculation differed among the groups p>0.05 Postoperative refraction calculated by the IOLMaster was -0.48±0.74 dioptres. Whereas the predicted post operative refraction for the IOLs calculated by the senior and junior registrars was -1.06±1.33 and -1.22±1.08 respectively. IOLMaster biometry refractive error when compared to ultrasound biometry was statisticaly significant (p<0.05). Conclusions: IOLMaster when compared to ultrasound biometry iol calculation and axialaxial length gave statistically better results. The error in ultrasonic biometry was due to inexperience. [ABSTRACT FROM AUTHOR]

Background: To evaluate the visual and refractive outcomes and potential complications of Deep Anterior Lamellar Keratoplasty (DALK) using the big-bubble technique in eyes with keratoconus. Methods: In this study, 203 keratoconic eyes of 184 patients who underwent DALK surgery using the big-bubble technique were analyzed. Preoperatively and at control visits, a complete ophthalmic examination was performed including uncorrected visual acuity (UCVA), bestspectacle corrected visual acuity (BSCVA), refraction, keratometric readings, endothelial cell count and biomicroscopy. Also, all surgical complications were recorded. Results: The mean age of the patients was 26.3 and the mean follow up period was 48.6 months. UCVA was mean 0.03 before surgery. At the last visit after surgery, UCVA was better than 0.2 in 178 eyes (87.8%). The mean BSCVA improved from 0.10 to 0.79 at the last postoperative examination. The mean maximum keratometry (Kmax) was decreased from 61.3 Diopter (D) to 45.6 D at the last examination. Preoperative and concluding examinations determined that the mean keratometric astigmatism decreased from 8.6 D to 3.8 D, respectively. Preoperative assessment showed a mean endothelial cell count of 2769±533 cells/mm². At the first year mark, the mean endothelial cell count was 2586±572 cells/mm² (6.6%loss), whereas the sixty year mark was 2424±482cells/mm² (12.6% loss). At last visit, the mean endothelial cell count was 2394±544 cells/mm². Descemet’s membrane (DM) microperforation occurred in 26 eyes (12.8%). DM detachment was seen in the early postoperative period in 8 eyes (3.9%). After air injection into the anterior chamber, DM detachment was fixed in 7 eyes. DM detachment in one eye developed a double anterior chamber and penetrating keratoplasty was performed after 6 months. Acute glaucoma with pupillary block was seen in 7 eyes (3.4%). Stromal corneal graft rejection was developed in 5 eyes (2.5%) and medication graft rejection was resolved. Conclusion: In keratoconic eyes, DALK surgery using the big-bubble technique provides good final visual and refractive outcomes. Due to its clearer interface, DALK should be considered a reasonable alternative to penetrating keratoplasty. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate and compare visual and optical performance outcomes by means of analysis of the contrast sensitivity function (CSF) and ocular higher order aberrations (HOA) in patients with keratoconus who had deep anterior lamellar keratoplasty (DALK) or penetrating keratoplasty (PK)., Methods: In this prospective, randomised case series, 174 eyes of 140 consecutive patients with moderate to advanced keratoconus were included. The big-bubble technique was attempted to perform DALK. Intraoperative and postoperative complications, uncorrected visual acuity, best spectacle-corrected visual acuity (BSCVA), refraction, topographic astigmatism, CSF and ocular HOA were evaluated., Results: The DALK and PK groups consisted of 99 and 75 eyes, respectively. Postoperative BSCVA was 20/40 or better in 64 eyes (85%) in the PK group and and 82 eyes (83%) in the DALK group (p>0.05). The mean spherical equivalent and maximum keratometry were -1.50 (-6.25 to +4.75) and 46.85 (40.60 to 56.00) in the PK group and -2.25 (-8.75 to +4.00) and 46.90 (40.60 to 53.60) in the DALK group, respectively. The differences were not statistically significant (p=0.08 and p=0.66, respectively). No significant differences in photopic contrast sensitivity were found for each of the spatial frequencies (p>0.05 for all). However, mesopic contrast sensitivity for three cycles/degree was significantly higher in the DALK group (p=0.01). No significant differences between groups were detected for any of the aberrometric parameters (p>0.05)., Conclusions: DALK is an alternative treatment option in eyes with moderate to advanced keratoconus, providing comparable results to PK in terms of visual acuity, refraction, CSF and HOA.