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Purpose: This study was designed to analyze the risk factors resulting in high intraocular pressure (IOP), which was accepted as IOP higher than 22 mmHg, following uncomplicated phacoemulsification., Materials and Methods: The records of 812 eyes of 584 patients who underwent uncomplicated phacoemulsification were evaluated. There were 330 men and 254 women ranging between the age of 26 and 89 years (65.4 ± 9.8 years). The preoperative, postoperative first day (day 1), first week (day 7), and first month (day 30) IOP values were analyzed. Data on history of diabetes, glaucoma, pseudoexfoliation (PXF), incision site, capsular staining with trypan blue, and surgeon were recorded. A multinomial regression analysis was performed to analyse the relationship of the factors with postoperative high IOP., Results: The mean IOP was 15.6 ± 4.3 mmHg preoperatively. Postoperatively that were changed to 19.7 ± 9.0 mmHg at day 1, 12.7 ± 4.5 mmHg at day 7, and 12.8 ± 3.7 mmHg at day 30. The factors such as surgeon, presence of PXF, diabetes, surgical incision site, and trypan blue were not related to the postoperative high IOP (P > 0.05, in all). The only factor that related to high IOP at all visits was glaucoma (P < 0.005)., Conclusion: According to our results, preoperative diagnosis of glaucoma seems to be the only factor to affect the postoperative IOP higher than 22 mmHg.

Purpose: To investigate the effects of central corneal thickness (CCT) on intraocular pressure (IOP) measurements of the Pascal dynamic contour tonometry (DCT), Canon TX-10 non-contact tonometry (NCT) and Goldmann applanation tonometry measurements (GAT) in healthy subjects., Methods: IOP values of 135 eyes with normal corneas of 135 healthy volunteers were determined by DCT, NCT and by GAT. The CCT was measured using an ultrasonic pachymeter after all IOP determinations had been made., Results: When DCT measurements were compared (IOP = 17.52 +/- 2.0 mmHg) with NCT measurements (IOP = 16.54 +/- 2.77 mmHg) and GAT measurements (IOP = 15.07 +/- 2.35 mmHg), DCT measurements were significantly higher than NCT and GAT (p < 0.001). There was a significant correlation between CCT with both NCT (r = 0.260, p = 0.003) and GAT measurements (r = 0.257, p = 0.005). There was a weak correlation that was not statistically significant between CCT and DCT (r = 0.160, p = 0.079)., Conclusion: The IOP measurements with DCT seem to be less dependent on CCT. NCT appears to be more affected by variation in CCT than GAT.

Purpose: To compare the effectiveness of brinzolamide 1%, brimonidine 0.2%, acetazolamide 250 mg, intracameral acetylcholine, and timolol 0.5% in preventing intraocular pressure (IOP) peaks during the early period after phacoemulsification in which sodium chondroitin sulfate 4%-sodium hyaluronate 3% (Viscoat) was used as the ophthalmic viscosurgical device (OVD)., Setting: Department of Ophthalmology, Baskent University Medical Faculty, Ankara, Turkey., Methods: This prospective randomized study comprised 185 eyes of 185 patients with uncomplicated cataract scheduled for phacoemulsification using Viscoat as the OVD. Patients were randomly assigned to 1 of 6 groups: postoperative application of topical brinzolamide 1%, brimonidine 0.2%, oral acetazolamide 250 mg, intracameral acetylcholine, timolol 0.5%, or no ocular hypotensive agent (control group). The IOP was measured at baseline (preoperatively) as well as 6 hours, 20 to 24 hours, and 1 week after surgery., Results: The mean preoperative IOP values were not significantly different between the groups. Six hours and 20 to 24 hours postoperatively, the mean IOP was significantly lower in all groups receiving an ocular hypotensive agent than in the control group (P<.01). Six hours after surgery, the mean IOP significantly increased in all groups but was higher in the control group. At 20 to 24 hours, the mean IOP decreased significantly in all ocular hypotensive agent groups but remained significantly high in the control group. One week after surgery, there were no significant differences between the groups., Conclusion: Brinzolamide, brimonidine, acetazolamide, intracameral acetylcholine, and timolol had similar effects in reducing IOP increases after phacoemulsification performed using Viscoat.

Purpose: To compare the effectiveness of brinzolamide 1% (Azopt) and brimonidine 0.2% (Alphagan) with a placebo in preventing an early increase in intraocular pressure (IOP) after phacoemulsification., Setting: Department of Ophthalmology, Baskent University, School of Medicine, Ankara, Turkey., Methods: In this prospective double-masked study, 90 eyes of 90 patients having clear corneal phacoemulsification were randomly divided into 3 groups of 30 eyes each. One hour before surgery, 1 group received 1 drop of brinzolamide 1%, another received 1 drop of brimonidine 0.2%, and the third received 1 drop of a balanced saline solution (placebo). The IOP was measured preoperatively and 3 and 16 to 20 hours postoperatively., Results: Three hours postoperatively, the mean IOP increased by 4.2 mm Hg +/- 7.0 (SD), 3.2 +/- 6.4 mm Hg, and 5.3 +/- 4.2 mm Hg in the brinzolamide, brimonidine, and placebo groups, respectively. The IOP increase from baseline was significant in all 3 groups (all P<.01), with no difference between the groups (P>.05). The change in IOP at 16 to 20 hours was 0.2 +/- 2.8 mm Hg, 0.2 +/- 2.4 mm Hg, and -0.8 +/- 2.4 mm Hg, respectively. The changes were not significant compared to baseline (all P>.05). Six eyes (20%) in the brinzolamide group, 5 eyes (16.7%) in the brimonidine group, and 7 eyes (23.3%) in the placebo group had an IOP higher than 25 mm Hg 3 hours postoperatively; the difference between groups was not significant (P =.8)., Conclusion: Prophylactic use of 1 drop of brinzolamide or brimonidine was not more effective than a placebo in controlling early postoperative IOP elevations after clear corneal phacoemulsification.

Background/aim: To compare the central corneal thickness (CCT) of type II diabetes mellitus patients with age- and sex-matched healthy subjects and to determine the association of the severity of diabetic retinopathy and CCT. Materials and methods: Type II diabetes mellitus patients without retinopathy, with nonproliferative retinopathy, and with proliferative retinopathy were organized as the three subgroups of the study group, and an age- and sex-matched control group was formed. All subjects underwent full ophthalmological examination and CCT measurement with ultrasonographic pachymetry. CCT values were compared between diabetic and healthy subjects and between the three diabetic subgroups. Correlation analysis was performed to determine any relationship between CCT and intraocular pressure. Results: The average CCT was significantly higher in diabetic patients than in the control group (P = 0.04). CCT in diabetic patients without retinopathy did not significantly differ from that of patients with retinopathy (P = 0.64). Similarly, there was no significant difference in CCT between nonproliferative and proliferative diabetic retinopathy patients (P = 0.47). In the whole study population, CCT was significantly correlated with intraocular pressure (P < 0.01). Conclusion: CCT is significantly increased in type II diabetes mellitus patients with respect to controls. Retinal disease severity does not seem to have an effect on corneal thickness. [ABSTRACT FROM AUTHOR]

Objectives: To analyze the clinical characteristics and findings in patients with intermediate uveitis. Materials and Methods: The records of the 35 patients diagnosed as intermediate uveitis in our clinic between years 1996 and 2011 were reviewed retrospectively. Best-corrected visual acuity, intraocular pressure, slit lamp examination, dilated fundus examination, fundus fluorescein angiography, and systemic examination results of the patients were noted. Results: The mean follow-up time was 6.2 years (2-16 years). The mean age at diagnosis of intermediate uveitis was 32.4 years (8-68 years). 17.1% of patients were under 18 years old. 65.7% of patients were women, 34.2% were men, and both eyes were affected in 54.3% of patients. The most frequent findings were vitritis (100%), snowball opacities (97.1%), retinal vasculitis (65.7%), and snowbanking (45.7%). Concurrent iridocyclitis was determined in 71.4% of patients. Systemic association was found in 40.1% of patients, with disease being multiple sclerosis (22.9%), sarcoidosis (11.4%), tuberculosis (2.9%), or Lyme disease (2.9%). The most common complication that developed during the follow-up period included secondary glaucoma (22.9%), cataract formation (17.1%), and cystoid macular edema (17.1%). The visual acuity of 3 patients was less than 0.5 due to the optic atrophy, macular hole, and cystoid macular edema sequel, respectively. The mean final visual acuity of the remaining patients was 0.9±0.2. Conclusion: When the inflammation and complications are treated effectively in intermediate uveitis, the visual prognosis is fairly good. Detailed clinical evaluation of such cases may reveal systemic diseases at the initial examinations or follow-up visits. [ABSTRACT FROM AUTHOR]

To investigate the visual field with FASTPAC 30-2 program before and after hemodialysis in patients with end stage renal disease. Twenty eyes of 20 patients on regular hemodialysis were included in the study. Twenty eyes of 20 healthy patients were chosen as control group. Intraocular pressures (IOP) were measured one hour before and one hour after the same hemodialysis session, and visual field was tested at the same times. When IOP was compared before and after hemodialysis, no statistically significant difference was found (p > 0.05), however Mean Deviation (MD) (p = 0.008) improved after hemodialysis. When we compared first global indices of the control group with pre-hemodialysis global indices, we noted significant difference in MD (p = 0.009). Visual field testing should be done after hemodialysis in patients who are on regular hemodialysis program. [ABSTRACT FROM AUTHOR]

Glaucoma is a group of diseases with progressive optic disk and /or visual fields changes. The mainstays of current therapies (medical, laser, surgery) are focused of lowering intraocular pressure (IOP). The problems and failures with such therapies and the studies on physiopathology and genetics of glaucoma started explorations for new therapeutic modalities. Advances in our understanding of the genetic basis of glaucoma include the discovery of 14 linked sites (GLC 1A through GLC 1N) in primary open-angle glaucoma with three genes identified at these loci: myocilin, optineurin, and WDR 36. In the secondary glaucomas such as pseudoexfoliation syndromes, LOXL1 gene polymorphisms have been identified. Gene therapy can be used to replace a mutated gene that causes disease with a healthy copy of the gene, to inactivate or wipe out the aberrant gene that is responsible for the disease. This therapy can also be used to add or remove genes that are indirectly related to the pathophysiology of the disease. Ocular gene therapy can also provide the advantage of delivery of genes that express therapeutic proteins in a localized and sustained way. Gene therapy studies for the treatment of glaucoma are focused on lowering intraocular pressure and neuroprotection. An ideal gene delivery system is one that is able to efficiently deliver the genes to the target tissue with specificity and safety. Both viral and nonviral vector delivery systems have been tested in the animal eyes. The target tissues of gene therapy are trabecular meshwork, ciliary body, ciliary muscle, retina and optic disk. [ABSTRACT FROM AUTHOR]

Purpose: This clinical study was conducted to compare the performance of a rebound tonometer with that of the Goldmann applanation tonometer (GAT) in the measurement of intraocular pressure (IOP) and to evaluate the effect of central corneal thickness (CCT) on IOP measurement with both devices. Materials and Methods: One hundred and sixty-five healthy subjects were tested using rebound tonometer and GAT by two observers. The patients were divided into 3 groups according to CCT measurement and OHTS criteria as follows: group 1 with CCT<555 µm; group 2 with CCT 555-584 µm; and group 3 with CCT≥585 µm. Correlation analysis was performed to compare the 2 devices; paired sample t test, Bland and Altman analysis were used. Results: The mean IOP levels measured by rebound tonometer and GAT were 13.9±2.3 and 13.5±2.5 mm Hg in Group1 (p=.587), 15.76±2.7 and 15.3±3.1 mmHg in Group 2 (p=.563), and 17.76±2.6 and 18.42±3.03 mm Hg in Group 3 (p=.878), respectively. Rebound tonometry and GAT readings were strongly correlated in terms of IOP measurement in all CCT groups (r=0.78, p<.0001). Conclusions: The use of rebound tonometer is effective and safe in comparison to GAT readings. In eyes with a healthy cornea, the IOP measurements from the rebound tonometer and the GAT seemed to be similarly affected by CCT. [ABSTRACT FROM AUTHOR]

Purpose: To determine the long-term efficacy and reliability of intravitreal bevacizumab injection in neovascular glaucoma. Materials and Methods: Eighteen eyes of twelve patients (8 men, 4 women) with diagnosis of neovascular glaucoma were included in this study group. Twelve eyes had proliferative diabetic retinopathy (66.7%) and 6 eyes (33.3%) had central retinal vein occlusion. Intravitreal bevacizumab (1.25 mg/0.05 ml, Altuzan) was injected in all eyes after the completion of laser therapy. Best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were measured before and at 1st week, 1st month, 3rd month, and 6th month after the injection; and anterior segment angiography images were obtained before and at the 1st week, 3rd month and 6th month after the injection. Angiographic images were evaluated according to the grading system of iris neovascularization (Stage 0-4). Results: The decrease of symptoms and regression in grade of neovascularization were determined at the first week in all eyes. The mean IOP values were 26.32±1.37 mmHg, 24.14±2.03 mmHg, 26.78±2.19 mmHg, and 27.72±2.28 mmHg at the 1st week, 1st month, 3rd month, and 6th month after injection, respectively (p<0.05). The mean BCVA was 1.14±0.21 LogMAR (0.7-2.0) at the 6th month, and there was no significant difference from preinjection values (p>0.05). Discussion: Intravitreal injection of bevacizumab seems to be effective and safe treatment modality for neovascular glaucoma in long-term period and it can be used as an adjuvant therapy to the panretinal photocoagulation and antiglaucomatous agents. [ABSTRACT FROM AUTHOR]

Purpose: To compare the effects of topical loteprednol etabonate 0.5% and prednisolone acetate 1% on postoperative inflammation after cataract surgery. Materials and Methods: Forty eyes of 40 patients who underwent uncomplicated cataract surgery between October 2008 and February 2009 were included in this study. The patients were divided into two groups randomly; loteprednol etabonate 0.5% and prednisolone acetate 1% were used in group 1 and group 2, respectively. Preoperative and postoperative examinations were performed after 1 day, 1 week, and 1 month, and the anterior chamber cells, flare, best-corrected visual acuity (VA), and intraocular pressure (IOP) of the patients were compared statistically. Results: There were no statistically significant differences in mean VA or mean IOP measurements between the two groups at any postoperative visit. Although there were no significant differences in mean anterior chamber cells or flare of the patients between the two groups on postoperative day 1, mean anterior chamber cells and flare were significantly higher in group 1 than in group 2 at the first postoperative week (p=0.03, p=0.02). None of the patients had anterior chamber cells or flare at the first postoperative month in the groups. Fibrin reactions were observed in two patients in group 1 and gentamycine+dexamethasone were applied subconjunctivally for treatment. Conclusion: Loteprednol etabonate 0.5% is effective in controlling postoperative inflammation after cataract surgery, but less effective than prednisolone acetate 1%. Patients who receive loteprednol etabonate 0.5% treatment after uncomplicated cataract surgery must be followed up frequently. [ABSTRACT FROM AUTHOR]