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    ACUTE-ONSET ENDOPHTHALMITIS AFTER CATARACT SURGERY Success of Initial Therapy, Visual Outcomes, and Related Factors
    (Lippincott Williams & Wilkins, 2009) Altan, Tugrul; Acar, Nur; Kapran, Ziya; Unver, Yaprak Banu; Yurttaser, Serap; Kucuksumer, Yasar; Eser, Ilker
    Purpose: To evaluate the success of initial treatment and the factors influencing the outcome in acute-onset endophthalmitis after cataract surgery. Methods: We retrospectively reviewed the medical records of all patients with acute postoperative endophthalmitis between 2000 and 2007. We performed pars plana vitrectomy (PPV) to all eyes with initial visual acuity of light perception. Eyes with visual acuity of hand motions or better underwent either intraocular antibiotic injection (IOAI) or PPV. Eyes that did not give a good clinical response to initial therapy within 60 hours underwent a second procedure. The main outcome measure was the rate of early reintervention after PPV and IOAI. Results: We evaluated 88 eyes of 88 patients. Thirty-seven patients underwent PPV and 51 patients underwent IOAI alone. Six of 37 (16.2%) patients required 1 or more procedures within 60 hours of the initial procedure in the PPV group. Twenty-eight of 51 eyes (54.9%) in the IOAI group underwent PPV within 60 hours. The rate of response to primary PPV was significantly higher than to primary IOAI (P < 0.001). Gram-negative organisms composed 35.1% of the isolates. Conclusion: Pars plana vitrectomy may be preferable to IOAI in postoperative endophthalmitis since the rate of early reintervention is lower with initial PPV. RETINA 29:606-612, 2009
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    Investigation of the Relationship Amongst Refraction, Keratometric and Pachymetric Measurements
    (Turkish Ophthalmological Soc, 2008) Eser, Ilker; Kaya, Vedat; Kucuksumer, Yasar; Yilmaz, Omer Faruk
    Purpose: To investigate the relationship amongst refraction, central corneal thickness (CCT) and keratometric measurements. Methods: A retrospective study of the subjective refraction of 1022 eyes of 511 consecutive subjects who presented for refractive surgery evaluation was performed. Of the subjects, 241(48%) were male and 270(52%) were female. Mean age of male and female were 32.1 +/- 9 and 30.1 +/- 8.1 respectively. Javal Keratometer was used for keratometric measurements. CCT was obtained with DGH 4000B A-Scan/Pachymeter. The statistical forecasting methods used are Mann-Whitney U-test, Spearman Correlation, Wilcoxon signed rank test, Kruskal-Wallis methods as implemented in the software package SPSS version 11.5. A p-value of <0.05 was considered to be statistically significant. Results: The relation between the age of the patients and CCT, and keratometric measurements were not statistically significant (p=0.598, p=0.403) respectively. While CCT were higher in male (p=0.002), keratometric values were higher in female (p=0.0001). Spherical equivalent (SE) showed a correlation with CCT values (p=0.04), and a negative lineer correlation with the keratometric values (p=0.0001). While females were found to be more myopic, males were more hyperopic (p=0.0001). CCT were higher in the eyes those >+5.00 Diopter(D) (p=0.04), and keratometric values were higher in the eyes those less than -6.00 D (p=0.0001). Conclusions: Males had lower keratometric measurements and were more likely to be hyperopic or mix hyperopic astigmatism than female. Females were more mix myopic astigmatism than males. CCT was higher in high hyperops and low in high myopes. A negative linear correlation between the keratometric measurements and SE was found. We believe that, investigation of these parameters would be helpful in better understanding of the biometric characteristics of the eye and choosing the appropriate technique in refractive surgery.