PURPOSE: To identify the relationship between dry eye disease (DED) and type 2 diabetes mellitus (DM) and also to explore whether meibomian gland dysfunction was a significant predictor for the development of DED.
METHODS: This prospective cross-sectional study involved patients with type 2 DM and age- and sex-matched healthy con-trols. All of the participants underwent dry eye tests, including meibomian gland function. Based on the DEW II diagnostic method, which included both symptom and objective tests, diabetic patients were grouped as DED+ and DED-. All findings were compared, and predictive factors for DED were identified.
RESULTS: Of the 76 patients with type 2 DM, 47 (61.8%) were diagnosed as DED. In patients with type 2 DM, there was a signif-icant increase in the ocular surface disease index, corneal surface staining, eyelid margin abnormality, and meibomian gland dysfunction, and a significant decrease in tear break-up time and Schirmer I test (p<0.05). Measurements of dry eye tests were more severe with the presence of DED (p<0.05). Duration of DM and HbA1c level were significantly correlated with ocular surface and meibomian gland dysfunction parameters (p<0.05). Duration of DM (p=0.001), HbA1c level (p=0.005), and presence of diabetic peripheral neuropathy (p<0.001) were found to be independent and significant predictors of DED.
CONCLUSION: Type 2 DM was found to be significantly associated with ocular surface abnormalities, including meibomian gland dysfunction. Furthermore, duration of DM, HbA1c level, and diabetic peripheral neuropathy were predictive factors of DED in type 2 DM.

PURPOSE: Ahmed glaucoma valve (AGV) implantation is an effective surgical option for glaucoma. However, subconjunctival fibrosis is a limiting factor that decreases surgical success. It has been proposed that introducing aqueous suppressants (AS) in the early post-operative period may reduce subconjunctival inflammatory mediators and fibrotic reactions. Starting AS early, before intraocular pressure (IOP) rises, may reduce plate fibrosis and improve post-operative surgical outcomes.
The objective of this study was to evaluate the effect of the early introduction of a timolol and carbonic anhydrase inhibitor (TCAI) fixed combination, a commonly used AS drug, on the outcomes of AGV implantation.
METHODS: his study included all eyes that underwent AGV implant surgery between 2017 and 2022. Eyes that received TCAI within the first 2 post-operative weeks to reduce IOP or control subconjunctival fibrosis around the plate were included in Group 1. Group 2 consisted of eyes in which antiglaucoma medications were introduced stepwise only when IOP increased during follow-up visits after the first 2 post-operative weeks. Patients who received antiglaucomatous drugs other than TCAI within the first 2 post-operative weeks were excluded. Follow-up data were analyzed and compared between the two groups in terms of IOP control and surgical success.
RESULTS: IOP decreased from 36.8±10.3 mmHg and 37.5±12.0 mmHg to 13.5±5.49 mmHg and 14.5±6.47 mmHg at the last visit in Groups 1 and 2, respectively (p<0.001 for both). Surgical success at the last visit was 86.1% in Group 1 and 78.2% in Group 2 (p>0.05). The median number of needling procedures showed a significant difference between the groups: 0 (range, 0–2) in Group 1 and 1 in Group 2 (range, 0–4) (p<0.05). Although TCAI therapy was initiated when IOP was >10 mmHg in Group 1, no hypotony-related complications were observed in this group.
CONCLUSION: Initiating TCAI in the early post-operative period after AGV implantation has a beneficial effect in reducing the need for needling procedures.

PURPOSE: The purpose is to evaluate anterior segment parameters using Pentacam Scheimpflug camera system in patients using α1-adrenergic receptor antagonists for benign prostatic hyperplasia (BPH).
METHODS: In this cross-sectional study, 102 left eyes of patients receiving α1-adrenergic receptor antagonists for BPH were compared with 102 age- and gender-matched healthy controls. Anterior segment parameters were measured using Pentacam Scheimpflug camera system under standardized dark conditions. Parameters included are central corneal thickness, corneal volume, anterior chamber depth, anterior chamber volume, anterior chamber angle width, and pupil diameter.
RESULTS: The mean age was 62.7±7.1 years in the treatment group and 62.1±7.8 years in controls (p=0.781). Mean duration of drug use was 16.98±16.3 months (range: 6–60). Anterior chamber depth (p=0.045), anterior chamber volume (p=0.018), anterior chamber angle width (p=0.038), and pupil diameter (p=0.024) were significantly lower in the treatment group compared to controls. No significant differences were found in central corneal thickness (p=0.812) or corneal volume (p=0.165).
CONCLUSION: α1-adrenergic receptor antagonist use is associated with significant changes in anterior segment parameters, especially causing a decrease in anterior chamber parameter values and pupil diameter. These findings may help to predict intraoperative floppy iris syndrome risk and highlight the importance of regular glaucoma screening in these patients.

PURPOSE: The purpose of the study was to evaluate the pathological outcomes and malignancy rates of eyelid masses that clinically appear benign.
METHODS: In this study, the pathology results of 122 patients (49 males, 73 females) who underwent simple excisional mass excision at the district state hospital Hendek/Sakarya between 2016 and 2020 were retrospectively examined. The patients’ ages, the localization and number of masses, and histopathological results were recorded. Patients with large, irregularly bordered masses requiring eyelid reconstruction and suspected to be malignant were referred to specialized units without undergoing surgery at the clinic.
RESULTS: Mean age of 122 patients (49 males, 73 females) aged 12–88 was 52.37±18.34 years. A statistically significant relationship was found between age and pathology results (p=0.005). No statistically significant relationship was found between gender and pathology results (p=0.551). In this study, a total of 113 (92.6%) benign tumors were identified, including 21 xanthelasmas, 20 dermal nevi, 17 squamous cell papillomas, 14 seborrheic keratoses, 10 chalazions, 9 fibroepithelial polyps, 6 verrucas, 5 epidermal cysts, 2 eccrine poromas, 8 warts, and 1 capillary hemangioma. In addition, 2 (1.63%) premalignant tumors were detected: One case of dysplasia and one carcinoma in situ. A total of 7 (5.74%) malignant tumors were identified, comprising 5 basal cell carcinomas, 1 keratoacanthoma, and 1 squamous cell carcinoma.
CONCLUSION: Many eyelid lesions that are clinically assessed as benign and operated on may turn out to be malignant. In our study, it was seen that among the masses that were initially diagnosed as benign and underwent simple excision, premalignant ones were detected in younger age groups, and malignant ones were detected in older age groups. Therefore, any suspicious lesion should be sent for pathological examination.

PURPOSE: Determination of demographic and surgical factors affecting oculocardiac reflex (OCR) in strabismus surgery.
METHODS: 38 patients were included in the study. 74 muscles were operated. Horizontal muscle recession or resection, inferior oblique (IO) muscle recession surgery were performed. Patient’s age, gender, heart rate (HR) at the beginning of surgery, surgery duration, presence of OCR, number of muscles, and muscle type were recorded. A 20% decrease in HR during muscle traction constituted the patient group with OCR.
RESULTS: : 43 medial rectus (MR), 19 lateral rectus (LR), 9 IO, 2 superior rectus, and 1 inferior rectus muscle surgeries were performed. OCR occurred in 20 (52.6%) patients. When the OCR and non-OCR groups were compared, no significant differences were found in terms of age, gender, surgery duration, and HR. The mean number of operated muscles in patients with OCR was 2.15±0.87 muscles, and in patients without OCR, it was 1.72±0.46 muscles (p=0.72). 4 (20%) of the patients with OCR had undergone single muscle surgery, 8 (40%) had undergone 2 muscle surgeries in the same eye, and 8 (40%) had undergone bilateral surgery (p=0.70). In the OCR group, there were 14 (32.6%) MR, 4 (21.1%) LR, and 7 (75%) IO, and the difference was due to IO (p=0.024). OCR occurred in 18 (40%) muscles in horizontal muscle recession, 2 (10.5%) in resection, and 7 (75%) in IO recession (p=0.02), and the difference was due to IO recession. When muscle traction was released, OCR returned to normal in all patients.
CONCLUSION: OCR is a life-threatening process that may have complications such as bradycardia and asystole. We think that OCR will be frequently encountered during IO surgery and that the surgery should be performed with low traction.

PURPOSE: The purpose of the study was to determine the rate of endophthalmitis in intravitreal injection (IVI) cases performed in the IVI cabinet inside the semi-sterile room developed in accordance with the operating room conditions and to evaluate the results of the performance tests of the IVI cabinet.
METHODS: The number of IVIs, the type of drug administered intravitreally, ocular pathologies leading to IVI, possible endophthalmitis occurrence, and demographic characteristics of the patients were retrospectively analyzed between February 2023 and March 2024 in the IVI cabinet inside the semi-sterile IVI room in the Ophthalmology Department of Giresun Training and Research Hospital.
RESULTS: A total of 1082 patients were included in the study. A total of 4380 IVIs were performed. The drugs used in IVIs were Bevacizumab in 2776 (63.4%), Ranibizumab in 697 (15.9%), Aflibercept in 678 (15.5%), and Dexamethasone implant in 229 (5.2%). The indication diagnoses for IVI were diabetic macular edema in 573 (53%) patients, exudative age-related macular degeneration in 292 (27%) patients, retinal vascular occlusion in 163 (15%) patients, non-infectious uveitis in 39 (3.6%) patients, and myopic choroidal neovascularization in 15 (1.4%) patients. None (0%) of the IVIs administered to the patients in the IVI cabinet in a semi-sterile room developed endophthalmitis.
CONCLUSION: IVIs can be administered effectively and safely in the IVI cabinet system in a semi-sterile chamber.

PURPOSE: This bibliometric study analyzed the characteristics, citation patterns, and scientific impact of the 100 most-cited articles in Turkish ophthalmology journals from 2010 to 2023.
METHODS: A comprehensive bibliometric analysis was conducted using the Dimensions.ai database between October 20 and 25, 2024. The analysis included citation metrics (total citations, recent patterns, Relative Citation Ratio [RCR], Field Citation Ratio [FCR], and Altmetric scores), content characteristics (study design, subspecialty categorization, keyword analysis), and institutional contributions. We evaluated the temporal distribution of publications, mapped collaboration networks, and analyzed the evolution of research themes. Study designs were categorized as reviews, original research, or case reports, while institutional analysis identified leading research centers and their collaborative patterns.
RESULTS: The Turkish Journal of Ophthalmology dominated the highly cited publications, most of which were review articles published between 2015 and 2021. The most cited article, focused on thyroid-associated ophthalmopathy, received 105 citations (RCR: 4.03, FCR: 27.8). Ege University, Ankara University, and Başkent University were among the leading institutions, with significant contributions from Sait Eğrilmez and Melis Palamar. Main research areas included retinal diseases, corneal/ocular surface disorders, and cataract/refractive surgery. Recent publications (2020–2021) demonstrated notable citation momentum in the fields of artificial intelligence and allergic conjunctivitis.
CONCLUSION: This study provides an updated profile of ophthalmology research in Türkiye, highlighting prevalent topics, influential institutions, and publication trends. While aligning with global trends, Turkish research also focuses on regional interests such as thyroid-associated ophthalmopathy. Enhancing international collaboration and diversifying research topics may further increase the global impact and visibility of Turkish ophthalmology literature.

We want to present a case of Serratia marcescens keratitis after the use of the scleral lens with an autologous serum fluid reservoir. The epithelial defect of a 75-year-old male patient who underwent penetrating keratoplasty due to perforating eye injury persisted for 4 months post-operatively despite intensive treatment. The patient was hospitalized to perform autologous serum application in a gas-permeable scleral contact lens reservoir. After 6 days, the corneal surface was completely epithelialized. He was discharged with topical steroid drops and copious preservative-free sodium hyaluronate treatment. An appointment was made for examination 1 week later. Keratitis was detected in the patient who presented with pain and decreased vision on the 10th day after discharge. S. marcescens was grown in corneal scraping samples. Re-keratoplasty was performed on the patient who did not resolve stromal infiltration despite fortified topical antibiotic therapy. The application of autologous serum in the scleral lens reservoir is recommended for the treatment of persistent epithelial defects resistant to other methods. However, one should be aware of the complication of microbial keratitis when using scleral lenses. We emphasize that the use of preservative-free antibiotics in the scleral lens reservoir may be safer for infection control.

Postoperative endophthalmitis is a serious complication with significant visual consequences. While common pathogens are usually involved, rare organisms such as Stenotrophomonas maltophilia can also cause this condition. Identifying and treating the source of infection is critical for improving outcomes. We report three cases of acute postoperative endophthalmitis occurring within the same week. All patients underwent pars plana vitrectomy (PPV) with vitreous sampling, followed by empiric treatment with systemic and topical moxifloxacin and systemic trimethoprim-sulfamethoxazole, adjusted according to culture sensitivities. Two patients responded well to PPV and medical therapy but a diabetic patient required intravitreal injections and intraocular lens explantation. The probable source of infection was reused phacoemulsification device cassette. This case series highlights the need for strict infection control practices and disposable devices to prevent postoperative infections caused by atypical pathogens such as S. maltophilia.

Glaucoma is the leading cause of blindness worldwide. Ocular surface disease (OSD) is commonly found with glaucoma and could be initiated or exacerbated by topical glaucoma treatments. The preservative agents are important in multidose drugs. The main etiological factor of OSD is preservative agents. OSD with normal and glaucomatous people are evaluated frequently with diagnostic testing including clinical examination and questionnaires to explain the visual function and quality of life. Glaucoma treatments can be related with toxicities to the ocular surface, usually because of the preservatives included in the eye drops; however, the incidence of toxicity can be decreased with the preservative-free medications, or decreased preservative medications, or treatment of dry eye disease. The aim of this review to evaluate the prevalence, causes, and treatment of OSD in glaucoma patients through curent literature, especially those on topical therapy.