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Yesilirmak N, Bukan N, Kurt B, Fatsa T, Yuzbasıoglu S, Zhao M, Hosbul T, Bourges JL, Behar-Cohen F. Toll-like receptor-4 expression and oxidative stress in ocular rosacea. Mol Vis 2023; 29:357-364. [PMID: 38577560 PMCID: PMC10994681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 12/20/2023] [Indexed: 04/06/2024] Open
Abstract
Purpose To investigate systemic and ocular toll-like receptor (TLR)-4 expression and its association with oxidative stress markers in ocular rosacea (OR). Methods This prospective study included 40 patients with rosacea with ocular involvement and 20 healthy volunteers. Tear break-up time (TBUT), Schirmer test, meibomoscore, and ocular surface disease index (OSDI) scores were estimated for all participants. TLR-4 expression in conjunctival epithelium and peripheral blood mononuclear cells was quantified using real-time polymerase chain reaction (RT-PCR). In the tears and serum samples of all participants, antioxidant status (TAS), total oxidant status (TOS), and arylesterase (ARE) activation levels were measured using a fully automated spectrophotometric method, and the oxidative stress index (OSI) was calculated. Results TLR-4 expression levels and oxidative stress status (TOS and OSI values) were significantly higher (p < 0.01), and antioxidant status (TAS and ARE values) were significantly lower (p < 0.01) in both ocular and blood samples of patients with OR compared with those in controls. A significant positive correlation was found between the ocular and blood values in all parameters (p < 0.05). According to the clinical associations of these results, we found negative correlations between TLR-4, OSI, and TBUT and between TLR-4 and Schirmer, whereas a positive correlation was observed between TLR-4, OSI, and meiboscore and between TLR-4, OSI, and OSDI (p < 0.05). No correlation was found between the OSI and Schirmer results (p = 0.92). Conclusions TLR-4 and oxidative stress both play important roles in OR pathophysiology and are closely related to clinical findings.
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Affiliation(s)
- Nilufer Yesilirmak
- Centre de Recherche des Cordeliers, INSERM, Université Paris Cité, Sorbonne Université, Physiopathology of ocular diseases: Therapeutic innovations, Paris, France
- Ophthalmopole Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, France
- Department of Ophthalmology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
- Department of Medical Biochemistry, University of Gazi, Ankara, Turkey
| | - Neslihan Bukan
- Department of Medical Biochemistry, University of Gazi, Ankara, Turkey
| | - Busra Kurt
- Department of Ophthalmology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Tugba Fatsa
- Molecular Application and Research Unit of R and D Laboratory, University of Health Sciences, Etlik, Ankara, Turkey
| | - Sema Yuzbasıoglu
- Department of Ophthalmology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Min Zhao
- Centre de Recherche des Cordeliers, INSERM, Université Paris Cité, Sorbonne Université, Physiopathology of ocular diseases: Therapeutic innovations, Paris, France
| | - Tugrul Hosbul
- Department of Medical Microbiology, Gulhane Faculty of Medicine, University of Health Sciences, Etlik, Ankara, Turkey
| | - Jean-Louis Bourges
- Centre de Recherche des Cordeliers, INSERM, Université Paris Cité, Sorbonne Université, Physiopathology of ocular diseases: Therapeutic innovations, Paris, France
- Ophthalmopole Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, France
| | - Francine Behar-Cohen
- Centre de Recherche des Cordeliers, INSERM, Université Paris Cité, Sorbonne Université, Physiopathology of ocular diseases: Therapeutic innovations, Paris, France
- Ophthalmopole Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, France
- Hopital Foch, Suresnes, France
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Yesilirmak N, Bukan N, Kurt B, Yuzbasioglu S, Zhao M, Rodrigues-Braz D, Aktas A, Behar-Cohen F, Bourges JL. Evaluation of Ocular and Systemic Oxidative Stress Markers in Ocular Rosacea Patients. Invest Ophthalmol Vis Sci 2023; 64:22. [PMID: 37843493 PMCID: PMC10584021 DOI: 10.1167/iovs.64.13.22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 09/21/2023] [Indexed: 10/17/2023] Open
Abstract
Purpose To investigate oxidative stress markers in tears and serum of patients with ocular rosacea and to examine their association with both ocular surface parameters and cutaneous rosacea subtypes. Methods This prospective study includes rosacea patients with ocular involvement and healthy controls. We performed ophthalmological examination of all participants and collected tear breakup time (TBUT), Schirmer, Meibomian gland dysfunction (MGD) and Ocular Surface Disease Index (OSDI) scores. We quantified the total antioxidant status (TAS), total oxidant status (TOS), and arylesterase (ARE) levels from tear and serum samples, and calculated the oxidative stress index (OSI). We also classified patients into phymatous, erythematotelangiectatic, papulopustular subtypes. Results We included 90 ocular rosacea patients and 30 healthy controls. Oxidative stress (TOS, OSI) levels were significantly higher (P < 0.01) and antioxidant levels (TAS, ARE) were significantly lower (P < 0.01) in both tear and serum samples of ocular rosacea patients as compared to controls. We found a significant positive correlation between the tear and serum values regarding oxidative stress parameters (P < 0.05). Besides, OSI was negatively correlated with TBUT and positively correlated with MGD score (meiboscore) and OSDI (P < 0.05). The Schirmer score was not correlated with OSI. No difference was found between the cutaneous subtypes with respect to TAS, TOS, ARE, and OSI results. Conclusions In this study, we identified oxidative stress markers in the serum and tears of ocular rosacea patients and showed their correlation with clinical signs of MGD, suggesting that oxidative stress contributes to ocular rosacea pathogenesis and that oxidative stress could be an indicator of MGD severity.
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Affiliation(s)
- Nilufer Yesilirmak
- Centre de Recherche des Cordeliers, INSERM, Université Paris Cité, Sorbonne Université, Physiopathology of ocular diseases: Therapeutic innovations, Paris, France
- Ophthalmopole Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Department of Ophthalmology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
- Department of Medical Biochemistry, University of Gazi, Ankara, Turkey
| | - Neslihan Bukan
- Department of Medical Biochemistry, University of Gazi, Ankara, Turkey
| | - Busra Kurt
- Department of Ophthalmology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Sema Yuzbasioglu
- Department of Ophthalmology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Min Zhao
- Centre de Recherche des Cordeliers, INSERM, Université Paris Cité, Sorbonne Université, Physiopathology of ocular diseases: Therapeutic innovations, Paris, France
| | - Daniela Rodrigues-Braz
- Centre de Recherche des Cordeliers, INSERM, Université Paris Cité, Sorbonne Université, Physiopathology of ocular diseases: Therapeutic innovations, Paris, France
| | - Akin Aktas
- Department of Dermatology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
| | - Francine Behar-Cohen
- Centre de Recherche des Cordeliers, INSERM, Université Paris Cité, Sorbonne Université, Physiopathology of ocular diseases: Therapeutic innovations, Paris, France
- Ophthalmopole Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean-Louis Bourges
- Centre de Recherche des Cordeliers, INSERM, Université Paris Cité, Sorbonne Université, Physiopathology of ocular diseases: Therapeutic innovations, Paris, France
- Ophthalmopole Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
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Tsatsos M, Vartsakis G, Athanasiadis I, Papavasileiou E, Yesilirmak N, Ziakas N. Intraocular lens implantation in the absence of capsular support: iris fixation. Eye (Lond) 2022; 36:1718-1720. [PMID: 35332288 PMCID: PMC9391370 DOI: 10.1038/s41433-022-02023-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 02/02/2022] [Accepted: 03/10/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Michael Tsatsos
- Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgios Vartsakis
- Department of Ophthalmology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ioannis Athanasiadis
- Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | | | | | - Nikolaos Ziakas
- Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Ozdas D, Yesilirmak N, Sarac O, Cagil N. 36-Month Outcomes of Mechanical and Transepithelial PTK Epithelium Removal Techniques Prior to Accelerated CXL for Progressive Keratoconus. J Refract Surg 2022; 38:191-200. [PMID: 35275008 DOI: 10.3928/1081597x-20220114-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the 36-month visual, refractive, and topographic results and the optical quality of the cornea between mechanical and transepithelial phototherapeutic keratectomy (PTK) epithelium removal techniques prior to the accelerated corneal cross-linking (CXL) procedure in patients with progressive keratoconus. METHODS Keratoconic eyes that received either mechanical epithelium removal or transepithelial PTK epithelium removal prior to accelerated CXL with 36 months of follow-up were included. The uncorrected (UDVA) and corrected (CDVA) distance visual acuity, spherical equivalent (SE), manifest astigmatism, flat keratometry (K1), steep keratometry (K2), maximum keratometry (Kmax) readings, thinnest corneal thickness (TCT), topographic astigmatism, point spread function (PSF), and aberrometric parameters including root mean square higher order aberrations (RMS HOAs), vertical coma, and spherical aberration (SA) were assessed preoperatively and 12, 24, and 36 months postoperatively. RESULTS One hundred ten eyes of 110 patients with keratoconus were included (mechanical epithelium removal group: 69 eyes, transepithelial PTK epithelium removal group: 41 eyes). After the CXL procedure, the mean UDVA, CDVA, manifest astigmatism, RMS HOAs, SA, vertical coma, and PSF improved significantly throughout the follow-up visits in both groups (P < .05 for all variables). The improvement in the mean UDVA, CDVA, manifest astigmatism, K1, K2, Kmax, RMS HOAs, SA, vertical coma, and PSF were significantly better in eyes that underwent transepithelial PTK epithelium removal when compared to eyes that underwent mechanical epithelium removal during the follow-up period (P < .05 for all variables). CONCLUSIONS Transepithelial PTK-assisted accelerated CXL seems to be more efficient in improving the visual acuity and the optical quality while stabilizing the cornea compared to the accelerated CXL with mechanical epithelium removal in patients with progressive keratoconus. [J Refract Surg. 2022;38(3):191-200.].
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Gerardy M, Yesilirmak N, Legras R, Behar-Cohen F, Bousquet E. CENTRAL SEROUS CHORIORETINOPATHY: High-Resolution Imaging of Asymptomatic Fellow Eyes Using Adaptive Optics Scanning Laser Ophthalmoscopy. Retina 2022; 42:375-380. [PMID: 34620798 PMCID: PMC8765211 DOI: 10.1097/iae.0000000000003311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate cone density in the asymptomatic fellow eye of patients with unilateral central serous chorioretinopathy (CSCR). METHODS Seventeen asymptomatic fellow eyes of patients with unilateral CSCR and 17 eyes of aged-matched and gender-matched healthy controls underwent adaptive optics ophthalmoscopy. Cone density and spacing were assessed at the fovea. Clinical and multimodal imaging findings were also recorded. RESULTS In the CSCR group, the patient mean age was 48.9 ± 9.8 years. The mean (±SD) subfoveal choroidal thickness was 417.8 ± 125.2 µm. The foveal external limiting membrane and ellipsoid zone were intact in all patients. Adaptive optics fundus imaging showed a significant decrease in cone density at 2° of eccentricity nasal and temporal to the fovea in asymptomatic fellow eyes of patients with unilateral CSCR compared with controls (P = 0.001 and P = 0.027, respectively). No statistically significant difference in cone density was found at 4° of eccentricity nasal and temporal to the fovea between both groups. CONCLUSION Asymptomatic fellow eyes of patients with unilateral CSCR showed a reduced density of foveal cones in the absence of a decreased visual acuity and photoreceptor line disruption on optical coherence tomography. These results suggest that the photoreceptors could be damaged independently of the occurrence of a serous retinal detachment.
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Affiliation(s)
- Melvin Gerardy
- Department of Ophthalmology, OphtalmoPôle, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP, Université de Paris, Paris, France
| | - Nilufer Yesilirmak
- Department of Ophthalmology, OphtalmoPôle, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP, Université de Paris, Paris, France
| | - Richard Legras
- Laboratoire Lumière, Matière et Interfaces, CNRS, ENS Paris-Saclay, Centrale Supelec, Université Paris Saclay, Orsay, France; and
| | - Francine Behar-Cohen
- Department of Ophthalmology, OphtalmoPôle, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP, Université de Paris, Paris, France
- Centre de Recherche des Cordeliers, INSERM U1138, Physiopathology of Ccular Diseases: Therapeutic Innovations, Université de Paris, Paris, France.
| | - Elodie Bousquet
- Department of Ophthalmology, OphtalmoPôle, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP, Université de Paris, Paris, France
- Centre de Recherche des Cordeliers, INSERM U1138, Physiopathology of Ccular Diseases: Therapeutic Innovations, Université de Paris, Paris, France.
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Tasci YY, Yesilirmak N, Yuzbasioglu S, Ozdas D, Temel B. Comparison of effects of mydriatic drops (1% cyclopentolate and 0.5% tropicamide) on anterior segment parameters. Indian J Ophthalmol 2021; 69:1802-1807. [PMID: 34146033 PMCID: PMC8374771 DOI: 10.4103/ijo.ijo_2677_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose The purpose of this study is to investigate and compare the effects of cyclopentolate and tropicamide drops on anterior segment parameters in healthy individuals. Methods Two hundred and fifty-eight eyes of 129 healthy volunteers were included in this randomized clinical study. Cyclopentolate 1% drop was applied to 75 (58%) participants (group 1) and tropicamide 0.5% drop was applied to 54 (42%) participants (group 2). Flat keratometry (K1), steep keratometry (K2), axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), white-to-white (WTW) distance, pupil diameter, total pupil offset and intraocular lens (IOL) power were measured before and after drops, using Lenstar 900 optical biometry. Results The increase in CCT, ACD, pupil diameter, and pupil offset was significant in group 1 after the drop (P < 0.05), while the increase in ACD, pupil diameter, and pupil offset was significant in group 2 (P < 0.05). When the two groups were compared, there was no significant difference in K1, K2, CCT, ACD, WTW, pupil diameter, pupil offset, and IOL power (using Sanders-Retzlaff-Kraff T formula) changes after drops (P > 0.05), whereas the change in AL was significant (P = 0.01). Conclusion The effects of cyclopentolate and tropicamide drops on anterior segment parameters were similar; they did not make significant changes in K1, K2, AL, WTW, and third-generation IOL power calculation. However, ACD values significantly changed after these drops; thus, measuring anterior segment parameters before mydriatic agents should be taken into account particularly for fourth-generation IOL formulas and phakic IOL implantation. The change in pupil offset, which can be important in excimer laser and multifocal IOL applications, was not clinically significant.
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Affiliation(s)
| | - Nilufer Yesilirmak
- Department of Ophthalmology, Ankara City Hospital; Department of Ophthalmology, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Sema Yuzbasioglu
- Department of Ophthalmology, Ankara City Hospital; Department of Ophthalmology, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Demet Ozdas
- Department of Ophthalmology, Ankara Yildirim Beyazit University, Ankara; Department of Ophthalmology, Midyat State Hospital, Mardin, Turkey
| | - Berke Temel
- Department of Ophthalmology, Ankara City Hospital; Department of Ophthalmology, Ankara Yildirim Beyazit University, Ankara, Turkey
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Rodrigues-Braz D, Zhao M, Yesilirmak N, Aractingi S, Behar-Cohen F, Bourges JL. Cutaneous and ocular rosacea: Common and specific physiopathogenic mechanisms and study models. Mol Vis 2021; 27:323-353. [PMID: 34035646 PMCID: PMC8131178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 05/11/2021] [Indexed: 11/21/2022] Open
Abstract
Rosacea is a chronic inflammatory disease that affects the face skin. It is clinically classified into the following four subgroups depending on its location and severity: erythematotelangiectatic, papulopustular, phymatous, and ocular. Rosacea is a multifactorial disease triggered by favoring factors, the pathogenesis of which remains imperfectly understood. Recognized mechanisms include the innate immune system, with the implication of Toll-like receptors (TLRs) and cathelicidins; neurovascular deregulation involving vascular endothelial growth factor (VEGF), transient receptor potential (TRP) ion channels, and neuropeptides; and dysfunction of skin sebaceous glands and ocular meibomian glands. Microorganisms, genetic predisposition, corticosteroid treatment, and ultraviolet B (UVB) radiation are favoring factors. In this paper, we review the common and specific molecular mechanisms involved in the pathogenesis of cutaneous and ocular rosacea and discuss laboratory and clinical studies, as well as experimental models.
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Affiliation(s)
- Daniela Rodrigues-Braz
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, Inserm, UMRS1138, Team 17, Physiopathology of ocular diseases: therapeutic innovations, Paris, France
| | - Min Zhao
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, Inserm, UMRS1138, Team 17, Physiopathology of ocular diseases: therapeutic innovations, Paris, France
| | - Nilufer Yesilirmak
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, Inserm, UMRS1138, Team 17, Physiopathology of ocular diseases: therapeutic innovations, Paris, France
- Department of Ophthalmology, Ankara Yildirim Beyazit University, Ankara, Turkey
- Ophtalmopole, Assistance Publique -Hôpitaux de Paris (AP-HP), Cochin Hospital, Paris, France
| | - Selim Aractingi
- Department of Dermatology, AP-HP, Cochin Hospital, Paris, France
| | - Francine Behar-Cohen
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, Inserm, UMRS1138, Team 17, Physiopathology of ocular diseases: therapeutic innovations, Paris, France
- Ophtalmopole, Assistance Publique -Hôpitaux de Paris (AP-HP), Cochin Hospital, Paris, France
| | - Jean-Louis Bourges
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, Inserm, UMRS1138, Team 17, Physiopathology of ocular diseases: therapeutic innovations, Paris, France
- Ophtalmopole, Assistance Publique -Hôpitaux de Paris (AP-HP), Cochin Hospital, Paris, France
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Diakonis VF, Kounis GA, Yesilirmak N, Warren D, Tsaousis KT, Davis Z, Yoo SH, Donaldson KE. Outcomes of toric intraocular lens implantation after femtosecond laser and traditional cataract surgery. Clin Exp Optom 2020; 104:69-73. [PMID: 32519369 DOI: 10.1111/cxo.13099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
CLINICAL RELEVANCE Having an understanding of the refractive outcomes of different forms of cataract surgery will assist optometrists in explaining the implication of such procedures to patients being referred for such procedures. BACKGROUND The purpose of this study was to compare the refractive outcomes after toric intraocular lens implantation between femtosecond laser-assisted cataract surgery and traditional phacoemulsification. METHODS This retrospective non-randomised case series included 114 eyes of 92 consecutive patients (59 male and 55 female) aged 71.65 ± 10.46-years (range 57 to 92-years), who underwent either femtosecond laser-assisted cataract surgery (using two laser platforms) (group 1) or traditional phacoemulsification (group 2) between August 2013 and September 2015. Pre-operative keratometric values, the attempted refraction from the biometry platform and the toric intraocular lens web-based calculator, and the one month post-operative manifest refraction were assessed to evaluate the refractive outcomes of the two groups. RESULTS Mean pre-operative topographic corneal astigmatism was -1.94 ± 0.73 D (range 0.91 to 4.61 D) and -1.98 ± 0.60 D (range 1.07 to 3.43 D) for groups 1 and 2, respectively (p > 0.05). Mean axial length was 24.22 ± 0.73-mm (range 21.78 to 29.30-mm) and 24.60 ± 1.09-mm (range 21.82 to 25.95-mm) for groups 1 and 2, respectively (p > 0.05). Multivariate vector analysis of the remaining refractive error between the two groups (desired refraction minus achieved refraction) revealed no statistically significant difference (p > 0.05). Analysis within each group demonstrated a higher accuracy of refractive outcomes for the femtosecond laser-assisted cataract surgery eyes (p < 0.05) when compared to the traditional phacoemulsification (p > 0.05). CONCLUSION Femtosecond laser-assisted cataract surgery and traditional phacoemulsification demonstrate similar refractive outcomes after toric intraocular lens implantation, while femtosecond laser-assisted cataract surgery seems to provide a slightly higher accuracy.
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Affiliation(s)
- Vasilios F Diakonis
- Department of Cornea and External Diseases, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine , Miami, Florida, USA
| | - George A Kounis
- Department of Cornea and External Diseases, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine , Miami, Florida, USA
| | - Nilufer Yesilirmak
- Department of Cornea and External Diseases, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine , Miami, Florida, USA
| | - Daniel Warren
- Department of Cornea and External Diseases, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine , Miami, Florida, USA
| | - Konstantinos T Tsaousis
- Department of Cornea and External Diseases, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine , Miami, Florida, USA
| | - Zachary Davis
- Department of Cornea and External Diseases, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine , Miami, Florida, USA
| | - Sonia H Yoo
- Department of Cornea and External Diseases, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine , Miami, Florida, USA
| | - Kendall E Donaldson
- Department of Cornea and External Diseases, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine , Miami, Florida, USA
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Yesilirmak N, Akova YA, Donmez O. Comparison of Mix-and-Match Implanted Bifocal IOLs and Bilateral Implanted Trifocal IOLs After Femtosecond Laser–Assisted Cataract Surgery. J Refract Surg 2019; 35:559-564. [DOI: 10.3928/1081597x-20190806-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 08/06/2019] [Indexed: 11/20/2022]
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Diakonis VF, Anagnostopoulos AG, Moutsiopoulou A, Yesilirmak N, Cabot F, Waren DP, O'Brien TP, Yoo SH, Weinstock RJ, Donaldson KE. The Effect of NSAID Pretreatment on Aqueous Humor Prostaglandin E 2 Concentration in Eyes Undergoing Femtosecond Laser-Assisted Capsulotomy. J Ophthalmol 2018; 2018:1891249. [PMID: 30116626 PMCID: PMC6079456 DOI: 10.1155/2018/1891249] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 06/24/2018] [Indexed: 12/27/2022] Open
Abstract
PURPOSE To assess aqueous humor concentration of prostaglandin E2 (PGE2) after capsulotomy creation using a femtosecond laser (FLAC) in patients pretreated with short-term topical ketorolac versus patients without pretreatment. METHODS This prospective study comprised consecutive patients scheduled to undergo cataract surgery using a femtosecond laser platform to perform only capsulotomies. An identical protocol for preoperative mydriasis was used for all the eyes included in the study, while aqueous humor was extracted from the anterior chamber of all patients immediately after the initial side port incision. ELISA was performed to quantify aqueous humor PGE2. The patients were divided into 2 groups; in group 1, the patients received short-term topical ketorolac preoperatively, while the patients in group 2 did not receive NSAID pretreatment. RESULTS Twenty eyes of 20 patients were included in the study (10 eyes in each group). Mean concentration of aqueous humor PGE2 after FLAC was 392.16 ± 162.00 pg/ml and 622.63 ± 331.84 pg/ml for groups 1 and 2, respectively. A statistically significant difference in aqueous humor PGE2 concentration between the two groups (p < 0.05) was demonstrated, with the eyes that received ketorolac pretreatment demonstrating a lower concentration of PGE2. CONCLUSION Short-term topical use of ketorolac prior to FLAC seems to prevent excessive release of PGE2 in the anterior chamber of the eyes that received NSAID pretreatment when compared to the eyes that did not receive NSAIDs preoperatively.
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Affiliation(s)
- Vasilios F. Diakonis
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- The Eye Institute of West Florida, Largo, FL, USA
| | | | | | - Nilufer Yesilirmak
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Florence Cabot
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Daniel P. Waren
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Terrence P. O'Brien
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sonia H. Yoo
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Kendall E. Donaldson
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
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Yesilirmak N, Telek HH, Sungur G, Ozdemir Y, Yesil NK, Ornek F. Response to risk of hydroxychloroquine retinopathy is not related to systemic lupus erythematosus or rheumatoid arthritis. Doc Ophthalmol 2018; 136:95-96. [PMID: 29383473 DOI: 10.1007/s10633-018-9624-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 01/10/2018] [Indexed: 11/24/2022]
Affiliation(s)
- Nilufer Yesilirmak
- Department of Ophthalmology, Ankara Training and Research Hospital, Sukriye, Ulucanlar St. No: 89, Altindag, 06340, Ankara, Turkey.
| | - Hande Husniye Telek
- Department of Ophthalmology, Ankara Training and Research Hospital, Sukriye, Ulucanlar St. No: 89, Altindag, 06340, Ankara, Turkey
| | - Gulten Sungur
- Department of Ophthalmology, Ankara Training and Research Hospital, Sukriye, Ulucanlar St. No: 89, Altindag, 06340, Ankara, Turkey
| | - Yaprak Ozdemir
- Department of Statistics, Gazi University Hospital, Ankara, Turkey
| | - Nesibe Karahan Yesil
- Department of Rheumatology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Firdevs Ornek
- Department of Ophthalmology, Ankara Training and Research Hospital, Sukriye, Ulucanlar St. No: 89, Altindag, 06340, Ankara, Turkey
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Al-Mohtaseb Z, He X, Yesilirmak N, Waren D, Donaldson KE. Comparison of Corneal Endothelial Cell Loss Between Two Femtosecond Laser Platforms and Standard Phacoemulsification. J Refract Surg 2017; 33:708-712. [DOI: 10.3928/1081597x-20170731-01] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 07/20/2017] [Indexed: 11/20/2022]
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Telek HH, Yesilirmak N, Sungur G, Ozdemir Y, Yesil NK, Ornek F. Retinal toxicity related to hydroxychloroquine in patients with systemic lupus erythematosus and rheumatoid arthritis. Doc Ophthalmol 2017; 135:187-194. [PMID: 28852896 DOI: 10.1007/s10633-017-9607-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 08/15/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE To compare the retinal toxicity due to hydroxychloroquine (HCQ) use in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) using multifocal electroretinography (mfERG), fundus autofluorescence (FAF) and optical coherence tomography (OCT). METHODS Patients who were using HCQ due to SLE and RA, and healthy subjects evaluated in this study. Central foveal thickness (CFT), inner-outer segment (IS-OS) junction irregularity, retinal nerve fiber layer thickness, mfERG and FAF measurements were performed to evaluate retinal toxicity. RESULTS Study included 35 eyes of 35 SLE patients, 40 eyes of 40 RA patients and 20 eyes of 20 healthy subjects. In SLE group, retinal abnormality was found in three eyes with mfERG, in one eye with FAF and in four eyes with OCT. In RA group, retinal abnormality was found in 10 eyes with mfERG, in five eyes with FAF and in nine eyes with OCT. A statistically significant difference was found with respect to mfERG between "eyes with abnormal responses and without abnormal responses" and "eyes with abnormal responses and controls" (p < 0.05). A statistically significant difference was found with respect to CFT between "eyes with IS-OS junction irregularities and without IS-OS junction irregularities" and "eyes with/without IS-OS junction irregularities and controls" (p < 0.05). CONCLUSIONS The use of HCQ seems to cause retinal toxicity more often in RA patients compared to SLE patients. For the early detection of retinal changes, OCT and mfERG can be used as screening tools due to their higher sensitivity rates compared to other tests.
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Affiliation(s)
- Hande Husniye Telek
- Department of Ophthalmology, Ankara Training and Research Hospital, Sukriye, Ulucanlar St. No. 89, Altindag, 06340, Ankara, Turkey
| | - Nilufer Yesilirmak
- Department of Ophthalmology, Ankara Training and Research Hospital, Sukriye, Ulucanlar St. No. 89, Altindag, 06340, Ankara, Turkey.
| | - Gulten Sungur
- Department of Ophthalmology, Ankara Training and Research Hospital, Sukriye, Ulucanlar St. No. 89, Altindag, 06340, Ankara, Turkey
| | - Yaprak Ozdemir
- Department of Statistics, Gazi University Faculty of Sciences, Ankara, Turkey
| | - Nesibe Karahan Yesil
- Department of Rheumatology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Firdevs Ornek
- Department of Ophthalmology, Ankara Training and Research Hospital, Sukriye, Ulucanlar St. No. 89, Altindag, 06340, Ankara, Turkey
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Diakonis VF, Kontadakis GA, Anagnostopoulos AG, Yesilirmak N, Waren DP, Cabot F, Yoo SH, Donaldson KE. Effects of Short-term Preoperative Topical Ketorolac on Pupil Diameter in Eyes Undergoing Femtosecond Laser–Assisted Capsulotomy. J Refract Surg 2017; 33:230-234. [DOI: 10.3928/1081597x-20170111-02] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 01/03/2017] [Indexed: 11/20/2022]
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Diakonis VF, Yesilirmak N, Kymionis GD, Yoo SH. Intraocular lens power overestimation in a patient with history of circling keratorraphy. Saudi J Ophthalmol 2017; 30:198-200. [PMID: 28210183 PMCID: PMC5299111 DOI: 10.1016/j.sjopt.2016.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 02/02/2016] [Accepted: 06/12/2016] [Indexed: 11/24/2022] Open
Abstract
We report a case of cataract extraction and intraocular lens (IOL) power overestimation in a patient with history of hyperopia managed with circling keratorraphy. A 65-year-old female presented to our institute complaining of decreased vision in both eyes. The patient had a history of bilateral hyperopia that was managed 20 years ago (1994) with circling keratorraphy. At presentation her uncorrected distance visual acuity (UDVA) was 20/70 and 20/60 in her right eye (OD) and left eye (OS), respectively, while her corrected distance visual acuity (CDVA) was 20/25 OD and 20/25 OS with manifest refraction of −0.50 + 1.50 × 75 OD and +0.50sph + 1.50cyl × 30 OS. Slit lamp examination revealed the presence of a circular intrastromal corneal suture (6 mm diameter) and mild (+1) nuclear sclerosis in both eyes. The patient was scheduled to undergo cataract extraction targeting plano, using a toric IOL; one month after the surgery, the manifest refraction of the operated right eye was −2.00 + 0.50 × 175, reflecting an overestimation of the intraocular lens (IOL) power for the attempted target. Cataract extraction in patients with history of circling keratorraphy for the management of hyperopia results in IOL power overestimation, consistent with that which is seen in patients with other previous hyperopic corneal refractive procedures.
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Affiliation(s)
- Vasilios F Diakonis
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Nilufer Yesilirmak
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - George D Kymionis
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sonia H Yoo
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
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Yesilirmak N, Diakonis VF, Sise A, Waren DP, Yoo SH, Donaldson KE. Differences in energy expenditure for conventional and femtosecond-assisted cataract surgery using 2 different phacoemulsification systems. J Cataract Refract Surg 2017; 43:16-21. [DOI: 10.1016/j.jcrs.2016.11.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Revised: 10/06/2016] [Accepted: 11/06/2016] [Indexed: 11/30/2022]
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Yesilirmak N, Lee WH, Gur Gungor S, Yaman Pinarci E, Akkoyun I, Yilmaz G. Enhanced depth imaging optical coherence tomography in patients with different phases of Behcet's panuveitis. Can J Ophthalmol 2016; 52:48-53. [PMID: 28237149 DOI: 10.1016/j.jcjo.2016.07.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Revised: 06/22/2016] [Accepted: 07/18/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the changes in choroidal thickness (CT) at 13 different points between "active," "remission," and "end-stage" phase of Behcet's panuveitis and compare this with the age, sex, and spherical equivalent matched healthy controls using enhanced depth imaging optical coherence tomography. DESIGN Prospective study. PARTICIPANTS Eighty-five eyes of 45 patients with Behcet's panuveitis (19 eyes with active phase, 48 eyes with remission phase, and 18 eyes with end-stage phase) and 84 eyes of 42 controls were enrolled in this study. METHODS CT measurements were obtained beneath the fovea and at 500-µm intervals for 3 mm nasal and temporal to the centre of the fovea. Correlation analyses were calculated to assess the relationship of the CT with age and disease duration. RESULTS At all 13 measurement points, CT was significantly thinnest in end-stage-phase eyes and thickest in active-phase eyes (p < 0.01). CT was thicker in remission-phase eyes compared with control eyes at foveal and perifoveal points, but the trend was not statistically significant. The mean CT at each of the 13 measured points showed a negative correlation with age and disease duration (p < 0.01). CONCLUSIONS Submacular CT, as measured by enhanced depth imaging optical coherence tomography, was significantly reduced in eyes with Behcet's panuveitis in the end-stage phase and increased in those in the active phase.
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Affiliation(s)
- Nilufer Yesilirmak
- Department of Ophthalmology, Baskent University, Faculty of Medicine, Ankara, Turkey; University of Miami Miller School of Medicine, Bascom Palmer Eye Institute, Miami, Florida.
| | - Wen-Hsiang Lee
- University of Miami Miller School of Medicine, Bascom Palmer Eye Institute, Miami, Florida
| | - Sirel Gur Gungor
- Department of Ophthalmology, Baskent University, Faculty of Medicine, Ankara, Turkey
| | - Eylem Yaman Pinarci
- Department of Ophthalmology, Baskent University, Faculty of Medicine, Ankara, Turkey
| | - Imren Akkoyun
- Department of Ophthalmology, Baskent University, Faculty of Medicine, Ankara, Turkey
| | - Gursel Yilmaz
- Department of Ophthalmology, Baskent University, Faculty of Medicine, Ankara, Turkey
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Diakonis VF, Yesilirmak N, Sayed-Ahmed IO, Warren DP, Kounis GA, Davis Z, Cabot F, Yoo SH, O'Brien TP, Donaldson KE. Effects of Femtosecond Laser-Assisted Cataract Pretreatment on Pupil Diameter: A Comparison Between Three Laser Platforms. J Refract Surg 2016; 32:84-8. [PMID: 26856424 DOI: 10.3928/1081597x-20151229-03] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 11/20/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess pupil diameter before and after femtosecond laser-assisted cataract surgery (FLACS) pretreatment and compare the outcomes of three laser platforms. METHODS This prospective observational case series included consecutive patients scheduled to undergo cataract extraction using FLACS between August 2013 and February 2015. All eyes received FLACS pretreatment using three laser platforms: LenSx (Alcon Laboratories, Inc., Fort Worth, TX), Catalys (Abbott Medical Optics Inc., Santa Ana, CA), and Victus (Bausch & Lomb, Inc., Rochester, NY). The same protocol for preoperative medical mydriasis was used for all patients, and pupil diameter was assessed immediately before and 3 minutes after FLACS using a surgical ruler. RESULTS A total of 198 eyes of 161 patients were included in the study. Mean pupillary miosis was 1.42 ± 1.26 mm for the LenSx, 0.66 ± 0.89 mm for the Catalys, and 0.14 ± 0.34 mm for the Victus groups. Furthermore, 8 of the 198 eyes (4.0%) demonstrated a pupil diameter of less than 5 mm after FLACS and 48 eyes (24.24%) demonstrated a pupil diameter of 6 mm or less. There was a statistically significant decrease in pupil diameter for all groups individually (P < .05). There was also a statistically significant difference among the three groups (P < .05), with LenSx inducing the highest degree of miosis, followed by Catalys, and finally Victus. A correlation between the pupil diameter before FLACS and degree of FLACS-induced miosis was demonstrated (P < .05), with larger pupil diameter before FLACS associated with greater miosis. CONCLUSIONS FLACS pretreatment seems to induce significant pupillary miosis with all laser platforms assessed in this study. The decrease in pupil diameter after FLACS reached clinical significance for cataract extraction (< 5 mm) in 4.0% of cases, whereas 20.2% of eyes demonstrated small pupil diameter (≤ 6 mm) after FLACS pretreatment.
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Yesilirmak N, Palioura S, Culbertson W, Yoo SH, Donaldson K. Intraoperative Wavefront Aberrometry for Toric Intraocular Lens Placement in Eyes With a History of Refractive Surgery. J Refract Surg 2016; 32:69-70. [PMID: 26812720 DOI: 10.3928/1081597x-20151210-02] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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20
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Pantanelli SM, Diakonis VF, Al-Mohtaseb Z, Cabot F, Yesilirmak N, Kounis GA, Sayed-Ahmed IO, Waren D, Yoo SH, Donaldson KE. Anterior Capsulotomy Outcomes: A Comparison Between Two Femtosecond Laser Cataract Surgery Platforms. J Refract Surg 2016; 31:821-5. [PMID: 26653727 DOI: 10.3928/1081597x-20151118-01] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 09/22/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare capsulotomy outcomes between two femtosecond laser platforms for cataract surgery. METHODS This retrospective case series included 205 eyes of 162 consecutive patients (75 male and 87 female) aged 68.32 ± 10.27 years (range: 38 to 92 years) who underwent femtosecond laser-assisted cataract surgery (FLACS) using either the LenSx (Alcon Laboratories, Inc., Fort Worth, TX) or the Catalys (Abbott Medical Optics, Abbott Park, IL) laser platform. Intraoperative assessment of the capsulotomy was performed and graded as one of the following four types: complete treatment pattern (type 1), microadhesions (type 2), incomplete treatment pattern (type 3), and complete pattern but not continuous (type 4). RESULTS Ninety-seven eyes underwent FLACS using the LenSx platform and 108 eyes using the Catalys platform. Ninety-four capsulotomies in the LenSx group were graded as type 1 (96.91%), and three were graded as type 2 (3.09%); all capsulotomies in the Catalys group were graded as type 1 (100%). There was no statistically significant difference between the LenSx and Catalys groups (P > .05). No intraoperative complications (specifically, no posterior capsular extension or vitreous loss) were noticed in any of the eyes included in the study. CONCLUSIONS The LenSx and Catalys laser platforms demonstrate similar capsulotomy outcomes. The microadhesions that were demonstrated in three cases in the LenSx group did not lead to intraoperative or postoperative complications.
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Yesilirmak N, Ozdemir ES, Altinors DD. Effect of dexamethasone intravitreal implant in a corneal graft rejection. Int J Ophthalmol 2016; 9:475-7. [PMID: 27158625 DOI: 10.18240/ijo.2016.03.28] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 06/16/2015] [Indexed: 11/23/2022] Open
Affiliation(s)
- Nilufer Yesilirmak
- Department of Cornea, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida 33136, USA
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Yesilirmak N, Chhadva P, Diakonis VF, Waren DP, Yoo SH, Donaldson KE. The Effect of LASIK on Timing of Cataract Surgery. J Refract Surg 2016; 32:306-10. [DOI: 10.3928/1081597x-20160217-07] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Accepted: 12/15/2015] [Indexed: 11/20/2022]
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23
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Ruggeri M, de Freitas C, Williams S, Hernandez VM, Cabot F, Yesilirmak N, Alawa K, Chang YC, Yoo SH, Gregori G, Parel JM, Manns F. Quantification of the ciliary muscle and crystalline lens interaction during accommodation with synchronous OCT imaging. Biomed Opt Express 2016; 7:1351-64. [PMID: 27446660 PMCID: PMC4929646 DOI: 10.1364/boe.7.001351] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 03/10/2016] [Accepted: 03/11/2016] [Indexed: 05/21/2023]
Abstract
Two SD-OCT systems and a dual channel accommodation target were combined and precisely synchronized to simultaneously image the anterior segment and the ciliary muscle during dynamic accommodation. The imaging system simultaneously generates two synchronized OCT image sequences of the anterior segment and ciliary muscle with an imaging speed of 13 frames per second. The system was used to acquire OCT image sequences of a non-presbyopic and a pre-presbyopic subject accommodating in response to step changes in vergence. The image sequences were processed to extract dynamic morphological data from the crystalline lens and the ciliary muscle. The synchronization between the OCT systems allowed the precise correlation of anatomical changes occurring in the crystalline lens and ciliary muscle at identical time points during accommodation. To describe the dynamic interaction between the crystalline lens and ciliary muscle, we introduce accommodation state diagrams that display the relation between anatomical changes occurring in the accommodating crystalline lens and ciliary muscle.
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Affiliation(s)
- Marco Ruggeri
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Carolina de Freitas
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Siobhan Williams
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Biomedical Optics and Laser Laboratory, Department of Biomedical Engineering, University of Miami, College of Engineering, Coral Gables, FL, USA
| | - Victor M. Hernandez
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Biomedical Optics and Laser Laboratory, Department of Biomedical Engineering, University of Miami, College of Engineering, Coral Gables, FL, USA
| | - Florence Cabot
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Anne Bates Leach Eye Hospital Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Nilufer Yesilirmak
- Anne Bates Leach Eye Hospital Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Karam Alawa
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Yu-Cherng Chang
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Biomedical Optics and Laser Laboratory, Department of Biomedical Engineering, University of Miami, College of Engineering, Coral Gables, FL, USA
| | - Sonia H. Yoo
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Anne Bates Leach Eye Hospital Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Giovanni Gregori
- Quantitative Imaging Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jean-Marie Parel
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Biomedical Optics and Laser Laboratory, Department of Biomedical Engineering, University of Miami, College of Engineering, Coral Gables, FL, USA
- Vision Cooperative Research Centre, Sydney, NSW, Australia
- Brien Holden Vision Institute, Sydney, NSW, Australia
| | - Fabrice Manns
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Biomedical Optics and Laser Laboratory, Department of Biomedical Engineering, University of Miami, College of Engineering, Coral Gables, FL, USA
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Chhadva P, Yesilirmak N, Cabot F, Yoo SH. Intrastromal Corneal Ring Segment Explantation in Patients With Keratoconus: Causes, Technique, and Outcomes. J Refract Surg 2015; 31:392-7. [PMID: 26046706 DOI: 10.3928/1081597x-20150521-05] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 04/17/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess the causes for intrastromal corneal ring segment (Intacs; Addition Technology Inc., Lombard, IL) explantation in patients with keratoconus, and technique for explantation, long-term outcomes, and secondary procedures to correct visual acuity. METHODS Ten eyes of 8 patients with a history of Intacs explantation between 2004 and 2012 were included in a retrospective study performed at the Bascom Palmer Eye Institute, Miami, Florida. Causes of Intacs removal, surgical technique, preoperative and postoperative corneal examination, and uncorrected and corrected distance visual acuity were documented. Additionally, corneal topography (Tomey, Nagoya, Japan) parameters such as average keratometry and corneal cylinder were assessed. RESULTS Although the segments were well positioned, the most common cause of Intacs removal was worsening visual acuity (80%). There was no statistically significant difference between pre-Intacs placement, post-Intacs placement, and post-Intacs removal in uncorrected and corrected distance visual acuity, average keratometry, or corneal cylinder, except between 1-year post-Intacs placement corrected distance visual acuity (0.57 logMAR [20/75 Snellen]) and 1-month post-Intacs removal corrected distance visual acuity (0.25 logMAR [20/36 Snellen], P =.03). Four patients underwent penetrating keratoplasty after Intacs removal with good visual outcomes. CONCLUSION This study demonstrates the visual and structural outcomes that returned to near baseline after Intacs explantation in keratoconic eyes.
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Yesilirmak N, Diakonis VF, Battle JF, Yoo SH. Application of a Hydrogel Ocular Sealant to Avoid Recurrence of Epithelial Ingrowth After LASIK Enhancement. J Refract Surg 2015; 31:275-7. [DOI: 10.3928/1081597x-20150303-02] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 02/04/2015] [Indexed: 11/20/2022]
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Gokmen O, Yesilirmak N, Kal A, Eroglu FC. Unusual presentation of an intraocular foreign body retained for sixty years. Cont Lens Anterior Eye 2013; 37:234-5. [PMID: 24332359 DOI: 10.1016/j.clae.2013.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Accepted: 11/20/2013] [Indexed: 11/17/2022]
Abstract
Intraocular foreign bodies may remain quiescent for many years particularly if they are not metallic. We report a case of a missed intraocular stone foreign body that had remained asymptomatic underneath the iris for 60 years and appeared during cataract surgery.
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Affiliation(s)
- Onur Gokmen
- Department of Ophthalmology, Baskent University, Faculty of Medicine, Ankara, Turkey
| | - Nilufer Yesilirmak
- Department of Ophthalmology, Baskent University, Faculty of Medicine, Ankara, Turkey.
| | - Ali Kal
- Department of Ophthalmology, Baskent University, Faculty of Medicine, Ankara, Turkey
| | - Fatma C Eroglu
- Department of Ophthalmology, Baskent University, Faculty of Medicine, Ankara, Turkey
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Akkoyun I, Pınarcı E, Yesilirmak N, Yılmaz G. Aderhautdicke nach Buckelchirurgie bei Makula-off-rhegmatogener Ablatio retinae. Ophthalmologe 2013; 111:954-60. [DOI: 10.1007/s00347-013-2978-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Yesilirmak N, Altınors DD. A silicone hydrogel contact lens after 7 years of continuous wear. Cont Lens Anterior Eye 2013; 36:204-6. [DOI: 10.1016/j.clae.2013.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Revised: 03/13/2013] [Accepted: 03/18/2013] [Indexed: 10/26/2022]
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Pinarci EY, Yesilirmak N, Bayar SA, Sizmaz S, Akkoyun I, Yilmaz G. The results of pars plana vitrectomy and silicone oil tamponade for endophthalmitis after intravitreal injections. Int Ophthalmol 2013; 33:361-5. [PMID: 23277209 DOI: 10.1007/s10792-012-9702-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 12/20/2012] [Indexed: 11/29/2022]
Abstract
To report the role of early vitrectomy and silicone oil tamponade in acute endophthalmitis following intravitreal injection. Medical records of eight patients who presented with acute endophthalmitis after intravitreal injection of different drugs were retrospectively reviewed. Initial treatment consisted of vitreous tap with cultures and injection of intravitreal antibiotics, with the patients subsequently undergoing pars plana vitrectomy and silicone oil tamponade within 24 h following initial vitreous tap. The mean time to presentation was 1.7 days (1-3 days). The initial best-corrected visual acuity was hand motion to 0.05 before treatment and 0.05-0.8 (Snellen) after treatment. Vitreous cultures were obtained from all patients, of which four were culture positive. Endophthalmitis was controlled in all patients. There was no retinal detachment or phthisis bulbi during the follow-up period (1-4 years). Acute endophthalmitis following intravitreal injection occurs rapidly and requires urgent treatment. If intravitreal antibiotics fail to control inflammation, early pars plana vitrectomy and silicone oil tamponade would be an appropriate option.
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Affiliation(s)
- Eylem Yaman Pinarci
- Department of Ophthalmology, School of Medicine, Baskent University, Istanbul, Turkey.
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