Objectives:This study investigated the retinal layer thickness, choroidal thickness (CT), and retinal nerve fiber layer (RNFL) parameters in 3 refractive groups.Methods:A total of 201 eyes of 201 subjects were enrolled in this prospective and comparative study. The patients were divided into 3 groups according to refractive status: Group 1 consisted of 60 eyes of myopic subjects, Group 2 comprised 72 eyes of emmetropic subjects, and 69 eyes of hyperopic subjects were categorized as Group 3. The retinal layer thickness, CT, and RNFL parameters were measured using optical coherence tomography and compared between groups.Results:The mean age of the patients was 22.33±10.11 years in Group 1, 21.55±8.3 years in Group 2, and 23.73±11.08 years in Group 3 (p=0.741). Group 1 consisted of 34 women and 26 men, Group 2 contained 44 women and 28 men, and Group 3 was made up of 45 women and 24 men (p=0.124). The mean spherical equivalent value was −6.16±2.01 D in Group 1, 0.13±0.5 D in Group 2, and 5.48±1.32 D in Group 3 (p<0.001). The RNFL and macular thickness values were lower in the myopic patients compared with those of the other groups (p<0.05). The CT measurement was lower in the myopic patients and higher in the hyperopic patients compared with the emmetropic patients (p<0.05).Conclusion:The myopic patients had a lower CT and RNFL thickness measurement than the emmetropic and hyperopic patients, whereas the hyperopic patients had a higher CT than the other patient types.

Objectives:This study describes a new scleral fixation technique to treat a subluxated intraocular lens (IOL).Methods:Four eyes of 4 patients were treated for a subluxated IOL with the described technique at Batigoz Eye Hospital. Demographic data, IOL type, and follow-up details were recorded, including the length of follow-up, postoperative refraction error, and complications.Results:The study included 2 female and 2 male patients. The median age was 54 years (range: 45-66 years). The mean duration of follow-up was 8 months (range: 5-13 months). Two of the subluxated IOLs were a monoblock subluxation of the IOL and the capsular tension ring, 2 were a 3-piece IOL. Follow-up examinations revealed no astigmatism >1.50 D. An anterior vitrectomy was performed in 1 patient who had preoperatively prolapsed vitreous in the anterior chamber. No complication was observed throughout the follow-up.Conclusion:This new scleral fixation technique facilitates fixation of a dislocated IOL. Compared with previous methods, this technique provides fixation of the subluxated IOL to the sclera with a less invasive procedure and less intraocular manipulation.

Objectives:This study was conducted to compare refractive error measurements recorded using the Nidek HandyRef-K handheld autorefractometer (HDY; Nidek Co. Ltd., Tokyo, Japan), Plusoptix A09 photorefractor (PO; Plusoptix GmbH, Nuremberg, Germany), Retinomax K-plus 3 (RTX; Right Mfg. Co. Ltd., Tokyo, Japan), and a table-mounted autorefractometer/keratometer (TTR; URK 800, Unicos Co. Ltd., Daejeon, Republic of Korea).Methods:Patients aged ≥18 years underwent measurement of refraction without cycloplegia using 4 devices and the spherical power (SP), cylindrical power (CP), and spherical equivalent (SE) values were analyzed and compared.Results:A total of 181 eyes of 181 patients were enrolled in the study. The mean age of the patients was 33.08±0.95 years (range: 18-79 years). There was a significantly significant difference in the SP, CP, and SE values determined by the devices (p<0.001). The SP and SE values of the RTX and the HDY were similar, while the other device results were different (Wilcoxon signed-rank test, p=0.004). The CP values of the PO and the TTR, the HDY and the TTR were also comparable.Conclusion:The HDY, RTX, and the PO are suitable for screening in clinical practice, but the findings strongly suggest that they should be used with caution.

Objectives:This study was a comparison of the outcomes of transcanalicular multidiode laser dacryocystorhinostomy (TCLDCR) and external dacryocystorhinostomy (EXDCR) treatment for patients with acquired nasolacrimal duct obstruction.Methods:Thirty-one consecutive patients who underwent TCLDCR (TCLDCR group) and 68 consecutive patients who underwent EXDCR (EXDCR group) due to acquired nasolacrimal duct obstruction were enrolled in the study. Follow-up visits were performed on the first day, and at the first week, first month, third month, sixth month, and every six months thereafter. Surgical success was defined as achievement of a patent osteotomy and a successful bicanalicular silicone intubation during the procedure. Anatomical success was defined by observation of a patent osteotomy on lacrimal irrigation, regardless of epiphora. The surgery time and intra- and postoperative complications were noted for each patient.Results:The TCLDCR group had a significantly shorter mean surgery time (27.9±5.5 minutes) compared with the EXDCR group (58.5±12.0 minutes) (p<0.001). However, the mean anatomical and functional rates of TCLDCR (58.0% and 54.8%, respectively) were significantly lower than those of the EXDCR group (94.1% and 91.1%, respectively) (both p<0.001). Two patients had “cheese wiring” damage of the lower canaliculus and 1 patient in the TCLDCR group had a full-thickness skin defect in the medial canthal region. No serious intra- or postoperative complication occurred in the EXDCR group.Conclusion:Although a TCLDCR procedure decreased the surgical time, it had a significantly lower success rate in the treatment of acquired nasolacrimal duct obstruction compared to EXDCR. The decision of the type of surgery should be made based on the cosmetic and success expectations of the patients and the presence of systemic problems.

This case report illustrates the successful use of the double-layer amniotic membrane technique in a child with glaucoma and aniridia. A 3.5-year-old girl with bilateral congenital glaucoma as well as aniridia, lens coloboma, nystagmus, and strabismus had been followed up since birth. Medical treatment did not result in the desired intraocular pressure improvement. An Ahmed glaucoma valve was implanted bilaterally. In a follow-up visit at 2 years of age, there were complaints of redness with watery discharge in the right eye. A biomicroscopic evaluation revealed tube erosion of the conjunctiva. The eroded area was dissected from the surrounding tissue and the area was closed using the new double-layer amnion membrane technique. After the surgery, the intraocular pressure was normal. Subsequent follow-up indicated that the erosion defect was closed and stabilized. The double-layer amniotic membrane technique can be used successfully in cases of conjunctival tube erosion. To the authors' knowledge, this is the first published pediatric case report of using the novel technique of amniotic membrane transplantation for tube erosion.

Objectives:The purpose of this study was to evaluate the body mass index (BMI) value and serum 25-hydroxyvitamin D [25(OH)D3] level in children with vernal keratoconjunctivitis (VKC).Methods:A total of 40 healthy, non-atopic children (control group) and 46 children with VKC (study group) were included in the study. The serum vitamin D [25(OH)D3] levels and BMI values were measured and compared between the 2 groups.Results:The mean vitamin D level measured in the healthy children (mean: 19.01±5.66 ng/mL, range: 9–33.09 ng/mL) was significantly different from the mean vitamin D level in the VKC-affected children (mean: 14.06±5.02 ng/mL, range 4.37–31 ng/mL) (p<0.001). The mean BMI in the VKC group (17.1±2.5 kg/m2) was significantly higher than the mean BMI of the healthy children (mean: 16.5±2.3 kg/m2; p=0.046). A negative correlation (Spearman’s rho=-0.275; p=0.01) was observed between the vitamin D level and the BMI value.Conclusion:The results indicated that children with VKC had a lower serum vitamin D level and a higher BMI value compared with healthy, age- and sex-matched children.

Objectives:The aim of this study was to evaluate the effectiveness and safety of an intravitreal bevacizumab injection (IVB) in the treatment of retinopathy of prematurity (ROP).Methods:The medical records of patients who had received IVB treatment for ROP between January 2014 and October 2018. Anatomical and functional outcomes were evaluated. The Denver II Developmental Screening Test was administered and fluorescein angiography (FA) was performed in some cases.Results:Thirty-eight eyes of 19 infants were included in the study. An IVB injection was administered to 9 infants with aggressive posterior ROP (APROP) disease (Group 1), 6 infants with any stage ROP with plus disease in zone I (Group 2), and 4 infants with stage 2-3 ROP with plus disease in zone II (Group 3). Complete retinal vascularization was observed in 24 eyes of 12 infants who received a single dose of bevacizumab without any additional treatment. Recurrence of the disease was observed in 12 eyes of 6 infants diagnosed with APROP and laser photocoagulation was performed. FA was performed to 5 IVB patients whose parents approved the procedure. The Denver II Developmental Screening Test was administered to all of the participants, and the test outcomes were consistent with the corrected age of the children, though 2 infants demonstrated a developmental delay in gross motor development tasks. Overall, good anatomical and functional results were obtained.Conclusion:IVB is an effective and relatively safe treatment modality for infants with ROP; however, prospective studies are required to provide more detailed information about systemic side effects.

Objectives:This study was an evaluation of demographic and histopathologic features of eyelid lesions.Methods:The medical records of 261 patients (296 eyelid lesions) who attended a single clinic between 1997 and 2011 were examined retrospectively. The incidence of benign and malignant lesions, the pathological classification, and age and sex data were investigated.Results:A total of 204 benign lesions (68.9%) and 92 malignant neoplasms (31.1%) were found. Among these, the most frequently seen types of benign neoplasms were xanthelasma (28.4%), papilloma (14.7%), chalazion (8.8%), nevus (6.4%), moll cyst (5.9%), and capillary hemangioma (4.9%). The most frequently seen malignant neoplasms were basal cell carcinoma (72.8%), squamous cell carcinoma (13%), and sebaceous gland carcinoma (5.4%). The study group was made up of 149 (57%) female patients and 112 (43%) male patients. The majority of benign lesions were seen in women, whereas malignant neoplasms were observed more often in male patients. The mean age of patients with benign lesions and malignant neoplasms was 38.1±21.7 and 62.7±15.3 years, respectively. Benign lesions involved the upper eyelid more frequently than the lower, while malignant lesions were seen more frequently in the lower eyelid, with the exception of sebaceous gland carcinoma.Conclusion:The majority of eyelid lesions were benign and malignant neoplasms were seen more frequently in the older population. Basal cell carcinoma was the most common malignant eyelid tumor. The most common site of malignant tumor origin was the lower eyelid, with the exception of sebaceous gland carcinoma.

Objectives:This study was an evaluation of the effectiveness of the Callisto eye image-guided, markerless system (Carl Zeiss Meditec AG, Jena, Germany) in toric intraocular lens (IOL) positioning.Methods:The results of a novel, markerless, alignment system used for IOL positioning were analyzed in this retrospective study. Preoperatively, reference image registration was performed with the IOLMaster 700 biometer (Carl Zeiss Meditec AG, Jena, Germany) and transferred to the Callisto eye system, which was used in conjunction with an Opmi Lumera 700 microscope (Carl Zeiss Meditec AG, Jena, Germany). Using the Callisto Z Align technology, a toric IOL was aligned precisely with the steep axis. One day after surgery, the pupil was fully dilated and a thin slit was placed on the marker of the toric IOL and the angle was measured using an axis calculator smartphone application. The degree of the measured angle and the preoperatively determined angle were compared.Results:Sixty eyes of 46 patients were included. The difference in the absolute angle between the intended and the postoperative (at day 1) axes was a mean of 2.71±1.64°.Conclusion:The Callisto eye image-guided, markerless system successfully provided assistance in precisely positioning the toric IOL.

Objectives:The aim of this study was to assess initial changes in blood flow parameters of the ophthalmic artery (OA) in pediatric patients with type 1 diabetes mellitus (DM).Methods:Sixty-three subjects were included in this prospective, cross-sectional, observational study. Thirty-one (49.2%) patients with type 1 DM without diabetic retinopathy formed the DM group. The control group comprised 32 (50.8%) healthy subjects. The OA of all of the patients was examined with Doppler ultrasonography. The main outcomes were peak systolic velocity (PSV), end diastolic velocity (EDV), pulsatility index (PI), and resistivity index (RI) measurements.Results:The mean age at onset of type 1 DM was 10.7±2.0 years and the mean duration was 11.4±11.0 months. The mean PSV and EDV outcomes in both eyes were significantly higher in the control group than in the DM group, whereas, the mean PI and RI outcomes in both eyes were significantly higher in the DM group (p<0.05). A mean RI of ≥0.75 indicated vascular hemodynamic changes associated with type 1 DM with a sensitivity of 72% and a specificity of 65% (area under the curve: 0.702; p=0.007). A mean PI of ≥1.69 predicted vascular hemodynamic changes associated with type 1 DM with a sensitivity of 79% and a specificity of 71% (area under the curve: 0.742; p=0.001).Conclusion:The results of this study revealed that disturbances in ocular hemodynamics might be present as early as the first year after a type 1 DM diagnosis. Changes in ocular hemodynamic parameters could be used to predict or screen for the development of vascular changes.