ISSN 2757-8135 | E-ISSN 2757-9816
Volume: 1  Issue: 1 - April 2021
1.Full Issue

Page I

Filiz Afrashi
Page VII

3.Comparison of anterior and posterior chamber implantation of iris claw lens in corneal transplant patients
Mine Esen Barış, Melis Palamar, Sait Eğrilmez, Ayşe Yağcı
doi: 10.14744/eer.2021.09719  Pages 1 - 5
PURPOSE: This study aims to compare the surgical outcomes of anterior chamber (AC) and posterior chamber (PC) implantation of iris claw lens (ICL) combined with penetrating corneal transplantation (P-CT), in eyes with no capsular support.

METHODS: The records of 20 P-CT cases who underwent ICL implantation were retrospectively evaluated. The eyes were grouped according to the location of implantation; AC ICL and PC ICL. Pre- and post-surgical best-corrected visual acuity (BCVA), post-operative complications, and graft rejection rates were compared between the two groups. Mean follow-up time was 28 (range, 12 and 76) months.

RESULTS: ICLs were implanted during P-CT surgery in 14 (70%) eyes and as a secondary procedure after P-CT in 6 (30%) eyes. ICLs were implanted in PC in 12 (60%) and in AC in 8 (40%) eyes. Mean pre-operative BCVA was 0.064 (range, 0.001–0.02) in the PC group and 0.02 (range, 0.001–0.1) in the AC group (p=0.86). Mean post-operative BCVA was 0.17 (range, 0.0001–1.0) in the PC group and 0.14 (range, 0.0001–0.4) in the AC group (p=0.81). Glaucoma developed in 5 (41.6%) eyes with PC ICL. No eye with AC ICL developed glaucoma overtime.

CONCLUSION: Both AC and PC ICL implantations provide favorable visual outcomes and complication rates in CT patients. However, PC implantation of ICL seems to increase glaucoma incidence.

4.The characteristics of pseudoexfoliation glaucoma in Ankara, the capital of Turkey
Sirel Gür Güngör, Ahmet Akman, Atilla Bayer, Ufuk Elgin, Oya Tekeli, Tamer Takmaz, Umit Ekşioğlu, Alper Yarangumeli, Tarkan Mumcuoğlu, Zeynep Aktaş, Ahmet Karabulut, Özlem Evren Kemer
doi: 10.14744/eer.2021.88597  Pages 6 - 12
PURPOSE: The purpose of the study was to study the profile, clinical characteristics, and associated ocular and systemic comorbidities of pseudoexfoliation glaucoma (PEXG) in a cross-sectional multicentric study.
METHODS: A total of 7500 eyes of 3750 subjects with glaucoma and suspected glaucoma underwent complete ophthalmic evaluation including history, visual acuity testing, slit-lamp examination, applanation tonometry, gonioscopy, and dilated examination of the optic disc and fundus between March 15, 2015, and May 16, 2015. Patients with PEXG were identified and their data were analyzed with respect to age, sex, intraocular pressure, ocular, and systemic diseases.
RESULTS: A total of 1180 eyes of 666 subjects had PEXG (mean age: 72.7±9.0 years (38–97 years). The percentage of the patients with PEXG within patients with glaucoma (4604 eyes of 2541 subjects) was 26.2%. Male-to-female ratio was 402/264 (60.3%/39.6%). One hundred and three patients (15.4%) had a positive family history. Four hundred and seventy-four patients (71.17%) had an additional systemic disease and the most prevalent comorbidities were hypertension and diabetes mellitus. Five hundred and fourteen patients (77.1%) had bilateral disease. The most common surgery performed in patients with PEXG was trabeculectomy (281 eyes; 23.8%). Six hundred and thirty-six patients (95.5%) had open angle glaucoma and 30 patients had closed angle glaucoma (4.5%).

CONCLUSION: PEXG is common in Turkey and one-quarter of glaucoma patients were found to have PEXG in this hospital-based study. In addition, with this multicentric study, we were able to document the demographic properties of PEXG in a large study population in the Central Anatolian metropolitan area.

5.The influence of light condition on anterior segment parameters with Pentacam in healthy subjects
Pelin Özyol, Irmak Karaca, Melis Palamar
doi: 10.14744/eer.2021.08208  Pages 13 - 16
PURPOSE: The objectives of the study were to determine whether different light conditions influence anterior segment parameters of healthy subjects as measured with Pentacam.
METHODS: Anterior segment parameters of 50 healthy subjects were measured with Pentacam under dim light condition and room light condition. Paired t test was used to compare measurements under different light conditions.

RESULTS: Mean age in the study group was 31.7±8.5 (range; 22–43) years. Measurements between 2 sessions were significantly different for the parameters of anterior chamber depth, anterior chamber volume (ACV), and pupilla diameter (p<0.05).

CONCLUSION: Taking Pentacam Scheimpflug measurements in room light causes a significant increase in anterior chamber angle and decrease in ACV as well as pupilla diameter in healthy subjects. When using Pentacam, the effect of light condition on these parameters should be considered and all measurements should be obtained under standard dim light conditions as suggested by the manufacturer.

6.Correlation of corpus callosum index and optic coherence tomography findings in multiple sclerosis with or without optic nerve involvement
Pınar Altıaylık Özer, Refah Sayın, Gökçe Ataç, Ebru Sanhal, Mehmet Fatih Kocamaz, Ahmet Şengün
doi: 10.14744/eer.2021.03522  Pages 17 - 24
PURPOSE: To evaluate the correlation of spectral domain optical coherence tomography (SD-OCT) parameters including peripapiller retinal nerve fiber length (RNFL) and ganglion cell layer (GCL) analysis with corpus callosum volumes, which were determined by corpus callosum index (CCI) radiologically in multiple sclerosis (MS) patients.
METHODS: Forty MS patients, with or without optic neuritis in history, were involved in the study on which RNFL and GCL analysis by SD-OCT were performed. Anterior, middle, posterior, and overall CCI were calculated for all subjects on 1.5 T magnetic resonance imaging scans, on conventional best mid-sagittal T1W image.
RESULTS: Seventeen patients had unilateral optic neuritis in history (42.5%) and had significantly lower CCIs compared to cases without optic nerve involvement (p<0.05 for each); lower RNFL measurements and lower GCL values in involved eyes compared to uninvolved side (p=0.03 and p<0.001, respectively). Overall CCI was lower in patients with more attacks in history and in elder MS patients (p=0.011 and p=0.06, respectively). Overall CCI was also lower in cases with lower mean RNFL and mean GCL measurements possessing a high positive correlation coefficient (p=0.047, p=0.002; r=0.316, p=0.478, respectively).
CONCLUSION: This study demonstrated that involvement of optic nerve in MS patients is with lower anterior, middle, posterior, and overall CCI values in addition to lower mean RNFL and GCL values of OCT. The positive correlation of CCIs with OCT parameters shows that the neuroaxonal degeneration in MS simultaneously affects the retina and the brain.

7.Biometric features and amblyopia risk factors in children with congenital nasolacrimal duct obstruction that underwent probing after 1-year-old
Elif Demirkılınç Biler, Melis Palamar, Önder Üretmen
doi: 10.14744/eer.2021.43434  Pages 25 - 30
PURPOSE: The purpose of the study was to evaluate the biometric values of children with congenital nasolacrimal duct obstruction (CNLDO) who underwent nasolacrimal probing after 1-year-old and to determine the effect of probing success and laterality on these values.
METHODS: The medical records of children with CNLDO who underwent probing were retrospectively reviewed. Biometric measures (cycloplegic refraction, keratometric data, and axial length measurements), presence of anisometropia, and other amblyopia risk factors were analyzed according to both probing success and laterality. In unilateral cases, the affected eyes were compared with contralateral eyes.
RESULTS: A total of 49 eyes of 39 patients were examined. One or more amblyopia risk factors were detected in 13 (33.3%) patients. Clinically significant anisometropia was detected in six (20.7%) of 29 unilateral cases and two (20%) of 10 bilateral cases. Six eyes of 6 patients (18.8%) among the 32 eyes for which probing was successful and six eyes of 5 patients (35.3%) among the 17 eyes for which probing failed had at least one risk factor with no statistically significant difference between the groups. In unilateral CNLDO cases, the spherical equivalent refraction of the eyes with CNLDO was significantly higher than that of contralateral eyes (p=0.03). However, no significant differences in terms of keratometric or axial length measurements were detected.
CONCLUSION: The data yielded by this study show amblyopia risk factors in patients with CNLDO regardless of probing results and significantly higher refraction in unilateral CNLDO eyes compared to contralateral eyes.

8.Simple limbal epithelial transplantation method in the treatment of unilateral limbal stem cell deficiency due to chemical burn
Dilay Özek, Emine Esra Karaca, Özlem Evren Kemer
doi: 10.14744/eer.2021.32032  Pages 31 - 36
PURPOSE: The objectives of the study were to evaluate the success of the simple limbal epithelial transplantation (SLET) method in the treatment of unilateral limbal stem cell deficiency (LSCD) due to chemical burn.
METHODS: Seventeen patients with unilateral LSCD due to chemical burn were included in this retrospective study. Mean age of patients was 50.3±20.8 (28–75) years. Mean duration of follow was 18.9±6.9 (12–24) months. In the recipient eye following peritomy, pannus tissue was cleared and covered with amniotic membrane with fibrin glue. Limbal stem cell received from the fellow eye was implanted cornea surface 2–3 mm inside limbus with fibrin glue on the amniotic membrane and placed contact lens. In control examination of all patients who completed minimum 12 months postoperatively, regression in corneal vascularization, duration of epithelial healing, visual acuity, need for keratoplasty, and complications (dropping of contact lenses, separation of amniotic membrane, and graft failure) were evaluated.
RESULTS: Corneal epithelization was completed between 4 and 6 weeks in all patients. Total and partial separations in the amniotic membrane occurred in two patients. Marked regression in corneal vascularization and increase in visual acuity was observed in all patients. Five patients (29.4%) underwent keratoplasty in the follow-up period. Limbal failure did not occur in healthy eyes. In two patients (11.7%), corneal vascularization recurred after 6 months.

CONCLUSION: SLET technique is an efficient method in unilateral LSCD in that it requires a lesser amount of donor tissue than keratolimbal autograft transplantation. Moreover, regress vascularization before keratoplasty in LSCD eyes may decrease graft rejection rates.

9.Stem cells in degenerative retinal diseases
Ali Devebacak, Filiz Afrashi
doi: 10.14744/eer.2021.98608  Pages 37 - 42
Degenerative retinal diseases are very common and can be encountered in all age groups. They are a major cause of blindness and result in significant morbidity. Treatment options are either very limited or not available. Therefore, it raises the need for regenerative treatments. Clinical studies have been conducted with different stem cell types and different application methods. Especially in retinal pigment epithelium replacement and studies utilizing neurotrophic effects of stem cells, significant evidence has been obtained in efficacy and safety. In this review, clinical trials were evaluated and case reports in the literature were investigated to collect clues about current knowledge, possible complications and issues that may cause concern.

10.Accidentally detected unilateral peripapillary retinoschisis: A case presentation
Mahmut Kaya, Ferdane Atas
doi: 10.14744/eer.2021.99609  Pages 43 - 46
This study aims to describe an atypical presentation of peripapillary retinoschisis (PPRS) in a young myopic patient. A 14-year-old female with high myopia −10.50 diopters in the right and −12.0 diopters in the left eye and good visual acuity (20/20) in both eyes. She presented with splitting of the inner retinal layers in the superior peripapillary quadrant as an incidental finding on spectral-domain optical coherence tomography (SD-OCT) on her left eye. The macula and outer retinal layers were unaffected and it was not associated with any other ocular pathology except myopia in both eyes. Our patient represents an atypical form of PPRS determined incidentally on SD-OCT with schisis of inner retinal layers without macular involvement.

11.Simple limbal epithelial transplantation in limbal stem cell deficiency after chemical eye injury
Barbaros Hayrettin Unlu, Canan Aslı Utine, Ismet Durak
doi: 10.14744/eer.2021.81300  Pages 47 - 52
To present a pediatric patient with unilateral limbal stem cell deficiency (LSCD) after acetone burn, managed by simple stem cell transplantation simple limbal epithelial transplantation (SLET) surgery and to review the literature on limbal stem cell transplantation techniques. A 12-year-old boy was admitted to the emergency department for acetone burn on his left eye. Following acute management of the chemical injury and amniotic membrane transplantation, the cornea healed with extensive conjunctivalization. He suffered severe photophobia and visual acuity (VA) loss up to 0.16 Snellen lines. Because of severe clinical findings of LSCD, SLET surgery was performed. He had dramatic improvement in corneal epithelialization, stromal transparency, and disappearance of photophobia 2 weeks after the surgery. At 1 year postoperatively, his VA was 0.7 with a stable epithelial surface and minimal corneal haze and he had returned to normal life. SLET is a viable alternative technique in the management of unilateral LSCD and should be present in the armamentarium of all corneal surgeons.

12.Torpedo maculopathy: A single entity with three different presentations
Ceren Durmaz Engin, Ziya Ayhan, Ayşe Tulin Berk, Ali Osman Saatçı
doi: 10.14744/eer.2021.76486  Pages 53 - 56
Torpedo maculopathy (TM) is a benign and non-progressive congenital lesion of the retina pigment epithelium in association with the disruption of outer retinal layers. In this case series, three patients with unilateral torpedo lesions who displayed different clinical features were reported. In all cases, there was somewhat distortion of the outer retinal layers with a corresponding increase in the choroidal reflectance under the lesion in optical coherence tomography (OCT). Fluorescein angiography and OCT angiography were performed in the only adult case. As TM is mostly a benign entity without causing any visual disturbance, its differential diagnosis carries paramount importance.