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Öz:Amaç: Bu çalışmanın amacı Nd:YAG lazer kapsülotomi yapılan hastalarda gelişen ön kamara reaksiyonunun şiddetini ve bunun erken dönem komplikasyonlarla ilişkisini belirlemektir. Gereç ve Yöntem: Göz Hastalıkları kliniğimizde takipli veya kliniğimize yönlendirilmiş, arka kapsül kesafeti (AKK) bulunan 27 hastanın 30 gözüne Nd:YAG lazer kapsülotomi uygulandı. Hastalara kapsülotomiden önce, 1 gün sonra ve 1 hafta sonra sikloplejinli tam oftalmolojik muayene yapıldı ve lazer flaremetre ölçümleri not edildi. Tüm hastalara kapsülotomiden 1 saat önce 125 mg tek doz asetozolamid tablet ile kapsülotomi sonrası tek doz apraklonidin HCl oftalmik damla 1x1 ve bir hafta süreyle deksametazon asetat oftalmik damla 6x1 uygulandı. Bulgular: Hastaların 15'i erkek 12'si kadındı. Hastaların yaş ortalaması 62.4±7.2 yıldı. Nd:YAG lazer kapsülotomi işlemi sırasında ortalama 2.2±0.7 mJ enerjiyle, ortalama 25±15 atış yapılarak dairesel şekilde arka kapsülotomi yapıldı. Ortalama 80.3±25.5 mJ total enerjiye ulaşıldı. Ortalama flare değerleri Nd:YAG lazer kapsülotomi öncesi 9.8±2.5 foton/milisaniye (foton/ms), birinci günde 11.7±3.2 foton/ms; birinci haftada ise 10.1±2.2 foton/ms idi. Flare değişimleri istatistiksel açıdan anlamlı değildi (p>0.05). Ortalama göz içi basıncı (GİB) değerleri bakımından, kapsülotomi öncesi dönem (15.5±2.3 mmHg) ile kapsülotomi sonrası birinci gün (16.5±2.8 mmHg) ve birinci hafta (15.9±1.7 mmHg) ölçümleri arasında istatistiksel açıdan anlamlı bir farklılık gözlenmedi (p>0.05). Hastaların Snellen eşelleri ile ölçülen görme keskinlikleri Nd:YAG lazer kapsülotomi öncesi ortalama 0.53±0.12; iken kapsülotomi sonrası birinci haftada 0.74±0.15'e yükseldi (p=0.012). Gözlerin %10'unda meydana gelen az miktarda ve görmeyi etkilemeyen lens hasarı hariç Nd:YAG lazer kapsülotomiye bağlı komplikasyon gelişmedi. Sonuç: AKK nedeni ile Nd:YAG lazer kapsülotomi gereken hastalarda; yöntem dikkatlice ve fazla enerji kullanılmadan yapıldığında ve gerekli proflaksi verildiğinde kan-aköz bariyerinin bozulmasına bağlı gelişebilecek flare artışı ve makula ödemi ile ön kamarada partikül artışına bağlı gelişebilecek GİB artışı görülmemektedir. Abstract:Purpose: The aim of this study is to determine the relationship between the severity of anterior chamber (AC) reaction and complications in patients with Nd:YAG laser capsulotomy. Materials and Methods: Nd:YAG laser capsulotomy was performed to 30 eyes of 27 patients with posterior capsule opacification (PCO) directed to or followed-up in our ophthalmology clinic. A comprehensive ophthalmologic examination was performed and AC flare measurements were noted before capsulotomy, in 1st day and 1st week after capsulotomy. All patients used a single dose of acetazolamide 125 mg orally 1 hour before capsulotomy; apraclonidin HCl ophthalmic drop 1x1 following capsulotomy and dexamethasone acetate ophthalmic drops 6x1 for a week after capsulotomy. Results: Fifteen patients were male and 12 were female. The mean age was 62.4±7.2 years. A circular posterior capsulotomy was achieved with average 80.3±25.5 mJ of total energy. Preoperative and postoperative 1st week average visual acuity (VA) by Snellen charts was 0.53±0.12 and 0.74±0.15 respectively (p=0.012). Preoperative, postoperative 1st day and postoperative 1st week mean AC flare values were 9.8±2.5 photons/ ms, 11.7±3.2 photons/ms and 10.1±2.2 photon/ms respectively (p>0.05). Mean intraocular pressure (IOP) was 15.5±2.3 mmHg preoperatively and measured as 16.5±2.8 mmHg at 1st day and 15.9±1.7 mmHg at 1st week postoperatively (p>0.05). Except a small amount of damage on IOL optics occurring in 10% of the eyes due to Nd: YAG laser capsulotomy no other complication noted. Conclusion: Nd:YAG laser capsulotomy should be performed carefully with low total energy and with sufficient prophylactic medication in order to avoid complications such as macular edema that may be associated with blood-aqueous barrier breakdown or IOP rise that may result from particle discharge into the aqueous humor.

Objectives: To describe ocular manifestations, diagnosis, and treatment of cat scratch disease. Materials and Methods: Clinical records of patients with ocular cat scratch disease were reviewed. Results: Thirteen eyes of 10 patients (7 female, 3 male) with a mean age of 26.9 +/- 18.5 years were included. Nine patients had a history of cat contact and had systemic symptoms associated with cat scratch disease 2-90 days prior to the ocular symptoms. Ocular signs were: neuroretinitis in 4 eyes (associated with serous retinal detachment in the inferior quadrant in 1 eye), optic neuropathy in 2 eyes (1 papillitis and optic disc infiltration, 1 optic neuritis), retinal infiltrates in 6 eyes, retinochoroiditis in 1 eye, branch retinal arteriolar occlusion in 3 eyes, and endophthalmitis in 1 eye. Visual acuities at presentation were 1.0 in 7 eyes, 0.3 in 1 eye, = 0.1 in 4 eyes, and light perception in 1 eye. Bartonella henselae immunoglobulin (Ig) M and/or IgG were positive in all patients. Systemic antibiotic therapy was administered in all patients. Systemic corticosteroid treatment (15-40 mg/day) was added to the therapy in 4 patients, following 5 days of intravenous pulse methylprednisolone in 2 patients. Treatment was ongoing for 1 patient and the mean treatment duration of the other 9 patients was 47 +/- 14.5 days. Visual acuities at final visit were 1.0 in 9 eyes, 0.8 in 1 eye, 0.4 in 1 eye, and no light perception in 1 eye. Conclusion: Cat scratch disease may present with different ocular signs and should be considered in the differential diagnosis in patients with such presentations., NA