Posterior segment ocular trauma is one of the most serious causes of vision loss in ophthalmology, often accompanied by traumatic cataract. Management of these cases requires a multidisciplinary approach and surgical planning based on the analysis of trauma type, posterior segment status, and visual prognosis. This review aims to provide a comprehensive overview of diagnostic methods, surgical strategies, intraocular lens options, and novel technological approaches in the context of traumatic cataract associated with posterior segment trauma.

ÖZET Psödofakik kistoid makula ödemi, komplikasyonsuz katarakt cerrahisini takiben en sık görülen komplikasyonlardan biridir. Çoğu vakada, macula ödemi iyi huyludur, kendi kendini sınırlar ve görme bozukluğu olmadan kendiliğinden düzelir; ancak, dirençli kistoid ödem ve inatçı vakalar ortaya çıkabilir ve görme keskinliğini azaltabilir. Anahtar Kelimeler: Katarakt, kistoid maküler ödem, psödofaki

Purpose To compare the repeatability and reproducibility of the Schirmer test (ST) without anesthesia when the eyes are open (STo) and closed (STc) in previously undiagnosed patients with suggestive symptoms of dry eye. Methods In a comparative, observational series case study, 31 patients were included in the study. STo and STc were alternately applied for a total of six times. The ST was applied two times with the eyes open (S1) and closed (S2), respectively, by a single ophthalmologist. Then the ST was repeated four times with the eyes open (S3, S5) and closed (S4, S6), respectively, by a single nurse. Results S1, S3, and S5 were 23.4, 23.7, and 23.3 mm, respectively. S2, S4, and S6 were 14.7, 15.6, and 16.6 mm, respectively. STc scores were found to be statistically lower than the STo’s in general (right: t = 2.033, p = 0.048; left: t = 3.474, p = 0.004). There was no statistically significant difference in the scores of the three tests with open eyes: S1, S3, and S5 (p = 0.462). There was also no statistically significant difference in the scores of the three tests with closed eyes: S2, S4, and S6 (p = 0.05). Conclusions Our study suggests that although administering the ST with the patient’s eyes open produces higher readings than STc in patients with suggestive symptoms of dry eye, there was an acceptable reliability among tests performed open and closed. Moreover, intraexaminer reliability was higher than interexaminer reliability for both with the eyes open and closed.

Précis: The purpose of this study was to determine changes in optical coherence tomography (OCT) color codes after applying a myopic normative database. The diagnostic performance of the retinal nerve fiber layer analysis improved with the use of this database. Purpose: To evaluate the peripapillary retinal nerve fiber layer (pRNFL) OCT color codes based on a newly generated myopic normative database in comparison to the built-in normative database. Materials and Methods: A total of 371 subjects were included in this validation study in an attempt to generate a myopic normative database. Eighty myopic glaucomatous and 80 myopic healthy eyes were evaluated to determine the diagnostic performance of this database. The distribution of the color codes was investigated among the groups with reference to the built-in and myopic normative databases, and the 2 databases were compared in terms of abnormal color code frequency. The diagnostic performance of the myopic database was presented with sensitivity, specificity and area under the receiver operating characteristic curve values. Results: The agreement between the databases decreased with increasing myopia degree. The distribution of the color codes of the built-in software significantly differed among the study groups in all sectors (P=0.009 for the temporal sector and P<0.001 for the remaining sectors). When the myopic database was used, there were no longer significant differences among the groups for the temporosuperior, temporoinferior, temporal, and nasal sectors (P=0.561, 0.299, 0.201, and 0.089, respectively). After applying the myopic normative database, the specificity of the pRNFL color codes increased from 70.1% to 90.2%, and the area under the receiver operating characteristic curve value from 0.851 to 0.945. Conclusions: The use of a myopic normative database for pRNFL using SD-OCT significantly decreased differences among myopia severity groups, and may help to more reliably assess glaucoma in myopic eyes.

Purpose: To establish whether clinical factors were correlated with deviation control in intermittent exotropia. Methods: This retrospective study included 54 patients with intermittent exotropia. The patient's sex, family history, age at first admission, best corrected visual acuity, refractive errors after cycloplegia, angles of ocular deviation at near and distance, and near, distance, and total deviation control were evaluated. Ocular deviation controls were determined according to the Mayo Clinic's office-based scale. Correlation analysis was performed between the deviation control and the determined clinical factors. Results: Spearman correlation analyses revealed a mild correlation between age with total exotropia control score and age with the control of near exotropia control score (r = 0.320, P = .018 and r = 0.339, P = .012, respectively). The angle of deviation at near showed a significant moderate correlation between total exotropia control score and near exotropia control score (r = 0.523, P < .001 and r = 0.780, P < .001, respectively). The deviation angle at distance showed a mild correlation with distance exotropia control score and total exotropia control score (r = 0.423, P = .001 and r = 0.288, P = .034, respectively). The angle of deviation at distance showed a mild correlation with the angle of deviation at near (r = 0.359, P= .008). The deviation angle at distance was established as an independent factor for predicting total exotropia score (P = .037, P = .015, respectively). Conclusions: The high deviation angle correlates positively with poor deviation control. The distance deviation angle is an independent predictor of total deviation control for the first time in the literature.

To compare the correlation and agreement between the central corneal thickness (CCT) measurements with ultrasound pachymeter and three different non-contact pachymeters and to analyze their influence on intraocular pressure (IOP) measurements.This prospective study included 102 healthy adults.Optical biometer (OB), scheimpflug corneal topographer (TOPO), ultrasound pachymeter (UP), and non-contact pachytonometer (NCP) were carried out to measure the corneal thickness.Pearson and Spearman correlation and a 95% limit of agreement were calculated.In this prospective study, the CCT of 102 right eyes of 102 healthy volunteers were analyzed.CCT measured with optic biometer, corneal topography, ultrasound pachymeter and non-contact pachytonometer were 534.7 (438-629), 544.8 (444-634), 553.1 (449-674) and 562.9 (464-665 µm), respectively.There were strong correlations between all pachymeters by Pearson correlation analysis.The correlation of Pearson between all measurement methods were over 0.9 50.When the CCT was divided into the three groups according to corneal thickness ranges, the correlation was higher than 0.7 in all groups (r=0.72-0.91 for <510 µm, r=0.85-0.95 for 510-580 µm, r=0.82-0.93 for >580 µm) by Spearman correlation analysis.A significant positive correlation was observed between the IOP values and CCT obtained by all pachymeters with a trend toward increasing the IOP with increasing corneal thickness.The correlations between the pachymeters were high in normal corneal thicknes s, whereas it was slightly lower in the thick and thin cornea.A significant positive correlation was observed between IOP and CCT in all pachymeters.

The aim of this case presentation is to describe ocular findings of a 22-year-old patient with Best vitelliform macular dystrophy accompanied by pachychoroid neovasculopathy. Color fundus photography, fundus autofluorescence (FAF), optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA) images were reviewed. Funduscopic examination showed bilateral yellowish vitelliform-like submacular deposits. FAF revealed these deposits as hyperautofluorescent spots. OCT showed flat irregular pigment epithelial detachments corresponding to these submacular deposits. OCT showed choroidal thickening and dilatation of the large outer oval choroidal vessels. Fundus fluorescein angiography could not be performed because the patient was pregnant. En face OCTA images of the choriocapillaris illustrated the choroidal neovascular network. In this case report, we describe for the first time the coexistence of Best vitelliform macular dystrophy and pachychoroid neovasculopathy with OCTA images enabling visualization of the neovascular network in a patient with contraindication for fluorescein angiography.

Amaç: Katarakt cerrahisi sonrası göz içi basıncı (GİB) ve merkezi kornea kalınlığı (MKK) değişimlerini incelemek. Gereç ve Yöntem: Çalışmaya senil kataraktı bulunan 62 hastanın 62 gözü dahil edildi. Tüm hastalar komplike olmamış fakoemülsifikasyon ve göz içi lensi (GİL) implantasyonu içeren katarakt cerrahisi geçirdiler. GİB, nonkontakt tonometre ile katarakt ameliyatından önce ve sonrasında 3. saatte, 1. günde, 1. haftada, 2. haftada ve 1. ayda ölçüldü. GİB ve MKK ölçümleri tekrarlanan ölçümler için varyans analizleri (ANOVA) ile test edildi. Bulgular: Çalışmaya ortalama yaşları 66±12.38 (40-84) olan 62 hasta dahil edildi. Hastaların 35'i kadın (% 56.5), 27'si (% 43.5) erkekti. Preoperatif ortalama MKK 535,69 µ idi. Preoperatif ortalama GİB 14.63 (10-21) mmHg idi. GİB, 3. saatte 19,95 (9-58), 1. günde 14.50 (8-29), 1. haftada 12.83 (8-19), 2. haftada 12.91 (7-18), 1. ayda 12.72 (8-18) idi. Preoperatif GİB 14.63 mmHg iken 3. saatte istatiksel anlamlı olarak 19,95 mmHg'ya (%26) yükseldi (p lt;0.001). 1. günde ise istatiksel olarak anlamlı şekilde 14.5 mmHg'ye düştü (p lt;0.05). Preoperatif ve postoperatif 1. gün arasında istatiksel olarak anlamlı fark yoktu (p gt;0.05). 1. gün ve 1. hafta arasında 1.67 mmHg düşüş görüldü. Bu fark istatiksel olarak anlamlı idi (p lt;0.05). Gözlerin 7'sinde ciddi derecede GİB yüksekliği mevcuttu ( gt;30 mmHg). Bu gözlerde herhangi bir tedaviye gerek duyulmadan GİB normale döndü. Sonuç: Katarakt cerrahisi sonrası ilk saatlerde anlamlı şekilde GİB yükselmekte. 1. günde ise normale dönmektedir. GİB'teki yükselmeler sağlıklı gözlerde muhtemelen zararsızdır, fakat riskli optik diskli hastalarda geçici yükselmeler dahi zararlı olabilir. Risk altındaki hastalarda GİB yükselmesi için gerekli önlemler alınmalıdır.

Surgery was conducted under general anesthesia. Eyelids and surrounding area were cleaned with povidone iodine 10% for three minutes. Povidone iodine 5% was instilled for three minutes into both fornices before surgery. A seven mm recession to both lateral recti muscles was performed using a fornix-based approach. Recti were fixated to sclera with 6/0 absorbable sutures (Biosorb, Alcon, USA). Conjunctival incisions were closed with 8/0 absorbable sutures (Biosorb, Alcon, USA). A topical antibiotic (ofloxacin 0.3%) and a topical steroid (dexamethasone 0.1%), each to be administered six times per day, were prescribed as postoperative treatment. The patient was examined and discharged on the first day, postoperatively.

Purpose: To determine the stabilization time of automated refraction, ocular biometric parameters, keratometry, and central corneal thickness (CCT) and to find the optimal time for glasses' prescription after cataract surgery. Methods: This was a prospective, case series study of 62 consecutive eyes with senile cataracts. Patients undergoing uncomplicated phacoemulsification surgery were included in the study. Automated refraction, keratometry, ocular biometric parameters, and CCT were recorded at baseline before cataract surgery and at follow-up visits at one day, one week, two weeks, and four weeks after surgery. Results: The study was composed of 62 eyes of 62 patients with a mean age of 66 +/- 12.38 (range, 40 to 84 years). The automated refraction stabilized one week after surgery and changed minimally between the first week and the first month after cataract surgery. The stabilization of average keratometric corneal astigmatism in keratometry, average anterior chamber depth, and CCT was achieved after the second postsurgical week. Conclusion: It may be possible to prescribe glasses starting from two weeks after an uneventful phacoemulsification cataract surgery for most patients.

This report was presented as a poster presentation “43. National Congress of Turkish Ophthalmology Association, 11 -15 November 2009, Beldibi, Antalya, Turkey”. *Corresponding Author: Erbil Seven MD. Department of Ophthalmology, Faculty of Medicine, Yuzuncu Yil University, 65080, Tusba, Van, Turkey, Phone Number: +90 (505) 292 56 28, Fax Number: +90 (432) 216 83 52, E-mail address: erbilseven@gmail.com Received: 06.12.2016, Accepted: 05.01.2017 CASE REPORT

To investigate the accuracy of the measurements of Nidek AL-Scan by comparing with Sirius (CSO, Florence, Italy), a corneal tomography which also employs the Scheimpflug principle, and a commonly used device, ultrasound biometry (UB) (Aviso A/B, Quantel Medical, MT, USA). Right eyes of 85 healthy volunteers (58 women 27 men) with a mean age of 39.24 ± 14.37 years (range 15–68) were enrolled into this comparative prospective study. Average K 2.4, average K 3.3, CCT (central corneal thickness), WTW (white to white distance), ACD (anterior chamber depth) and AL (axial length) were obtained from the AL-Scan and compared with average SimK, CCT, WTW (horizontal anterior chamber diameter) and ACD obtained from Sirius and also compared with ACD and AL obtained from UB. The statistically significant difference was found between all of the measurements (p < 0.001) except the average keratometry values (K2.4, K3.3, SimK) (p = 0.083). There was a perfect correlation between keratometry, CCT and AL measurements of the devices (ICC = 0.977, 0.954, 0.923, respectively) and there was a strong correlation between the WTW measurements of AL-Scan and Sirius (ICC = 0.865). While ACD parameter of AL-Scan and UB showed a perfect correlation (ICC = 0.977), there was a moderate correlation between AL-Scan and Sirius and also between UB and Sirius (ICC = 0.608 and 0.664, respectively). There was a high correlation between the all measurements, besides ACD, of AL-Scan and Sirius and they can be used interchangeably for average keratometry and WTW confidently. However, ACD and CCT have a broader 95 % LoA (−0.039 to 0.744 and −24.985 to 3.691, respectively). In addition, AL-Scan and UB were in good agreement regarding ACD, while differences in AL measurements of UB and AL-Scan were clinically important (95 % LoA = −0.091 to 0.703). Furthermore, UB and Sirius have a moderate agreement regarding ACD (95 % LoA = −0.047 to 0.680).

Amaç: Göz kapağı tümörlerinin demografik, klinik ve histopatolojik sonuçlarını değerlendirmektir. Gereç ve Yöntemler: Aralık 2012-Ekim 2015 tarihleri arasında, Hitit Üniversitesi Eğitim ve Araştırma Hastanesinde göz kapağı tümörü nedeni ile ameliyat edilen hastaların kayıtları geriye dönük olarak incelendi. Yaş, cinsiyet, kitlenin yeri ve boyutu ile histopatolojik sonuçlar kaydedildi. Bulgular: Yaş ortalamaları 49,18±17,6 (3-95) yıl olan 348'i kadın, 225'i erkek 573 hastanın 674 gözü çalışmaya dâhil edildi. Sık görülen iyi huylu göz kapağı tümörleri %20 oranla nevüs, %16,4 oranla seboreik keratoz ve %10,2 oranla ksantelezma idi. Kötü huylu göz kapağı tümörlerinin 29 (%82,8)'u bazal hücreli karsinom, 4 (%11,4)'ü skuamöz hücreli karsinom, 1 (%2,4)'i sebase bez karsinomu ve 1 (%2,4)'i malign melanom idi. Melanositik nevüs, ksantelezma ve siringoma kadınlarda daha sıktı (p<0,001). Bazal ve skuamöz hücreli karsinom iyi huylu tümörlere göre yaşlılarda daha sık gözlemlendi (sırasıyla 65,86 ve 61,5 yaş). Pilomatriksoma ve molluskum kontagiozum gençlerde diğer iyi huylu tümörlere göre daha sıktı. Ortalama tümör boyutu 0,62±0,43 cm idi. Skuamöz hücreli karsinom bütün tümörler içinde en büyük boyutlara sahipti (1,6 cm). Sonuç: Çalışmamızda bölgemizde en sık görülen iyi huylu tümör nevüs, en sık görülen kötü huylu tümör ise bazal hücreli karsinom olarak saptanmıştır.

We report the case of a 72-year-old female who developed macular edema (ME) due to hemicentral retinal vein occlusion in her right eye. A dexamethasone implant was inadvertently injected into the crystalline lens. The patient was followed without repositioning of the dexamethasone implant during the 12 months. Besides, the posterior subcapsular cataract and ME had progressed significantly; hence, cataract extraction and intravitreal ranibizumab injection were performed in the same session. A three-piece intraocular lens was implanted in the sulcus with optic captured, and then intravitreal ranibizumab injection was performed. The patient had an uncomplicated postoperative recovery. At 2 months, best-corrected visual acuity was 0.7, and the macula was dry.