PurposeTo evaluate the accuracy of the SRK/T formula using ultrasound (US) biometry in predicting a target postoperative refraction of ±1.00D in eyes with medium axial length (AL) that underwent phacoemulsification.MethodsThe present study was a retrospective analysis, which included 538 eyes with an AL from 22.0 to 24.60 mm that underwent phacoemulsification and foldable intraocular lens (IOL) implantation (six different IOLs) in the bag. Preoperative AL was measured by US biometry and IOL power (IOLp) was calculated with the SRK/T formula. Patients had a complete ophthalmic examination, preoperatively and 1, 7, and 30 days after surgery. The achieved spherical equivalent (SE) and the prediction error (PE) were calculated. The prediction error was defined as the difference between attempted predicted target refraction and the achieved postoperative SE refraction. Statistical analysis was performed with SPSS V21.ResultsThe mean age of the patients was 66.96±9.67 years, the mean AL was 23.29±0.62 mm, the mean K1 was 43.62±1.49D, the mean K2 was 43.69±1.53D, the mean IOL power was 21.066±1.464D, the mean attempted (predicted) SE was −0.178±0.266D, and the mean achieved SE was −0.252±0.562D. The mean PE (difference between predicted and achieved SE) showed a relatively hyperopic shift (mean ± standard deviation: 0.074±0.542D, ranging from −1.855 to 2.170D, P=0.001). A total of 93.87% of eyes were within ±1.00D of the PE and 92.75% of eyes within ±1.00D of achieved postoperative refraction. A total of 39 eyes (7.25%) had a refractive surprise. A total of 32 of 39 eyes were more myopic than −1.00D and 7 of them were more hypermetropic than +1.00D. There was no correlation between the mean PE and IOL type, AL, K1, K2, and IOLp. There were a positive statistically significant correlation between PE and age (r=0.095; P=0.028) and a negative statistically significant correlation between achieved SE and AL (Spearman’s r=−0.125; P=0.04), and age (r=−0.141; P=0.01).ConclusionThe IOLp calculation using the SRK/T formula with US biometry may demonstrate very good postoperative refractive outcomes in medium eyes with a few refractive surprises.

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IntroductionChronic dacryocystitis is a long-lasting, non-infectious inflammation of the lacrimal sac that leads to epiphora (1). It is more common in females than males (2), which may be due, at least in part, to the anatomically narrower nasolacrimal duct in females (3). The exact pathophysiology is not clear.Age seems an important factor, since most chronic dacryocystitis patients are middle-aged, although young individuals may also be affected. A lack of the estrogen hormone may be a cause and explain the presence of the disease in some males, (4) but this does not explain the presence of chronic dacryocystitis in premenopausal females. The presence or Objectives: Chronic dacryocystitis is usually seen in middle-aged or older women, suggesting that decreased estrogen and progesterone serum levels may be a causative factor in the disease pathology. However, the occurrence of the disease in premenopausal females and males suggests that there may be more to the explanation than the level of female sex hormones. The purpose of the present study was to investigate estrogen and progesterone receptor positivity in the lacrimal sacs of individuals with and without chronic dacryocystitis. Methods: The study group included 50 female and 20 male patients diagnosed with chronic dacryocystitis. Lacrimal sac samples were taken during a dacryocystorhinostomy. The control group comprised 29 cadavers with no evidence of lacrimal system pathology in the health records. The samples were obtained transconjunctivally. Lacrimal sac samples from both groups were stained with the estrogen and progesterone receptor protein antigen. Fisher's exact test and a chi-square test were used to compare the receptor positivity results of premenopausal and postmenopausal women, and samples of those with dacryocystitis and cadaver sacs without the disease. Results: In the control group, estrogen receptor positivity was observed in the samples of 2 premenopausal females. In the study group, estrogen receptor positivity was seen in 4 premenopausal females. There was no significant difference in estrogen receptor positivity between the premenopausal and postmenopausal female groups (p=0.41). A similar result was not established between the premenopausal and postmenopausal females in case group (p=0.056). No comparison was made of the progesterone receptor because only 1 example of progesterone receptor positivity was found in a premenopausal female in the dacryocystitis group. Conclusion: Estrogen receptor positivity did not seem to be a factor in chronic dacryocystitis physiopathology.

AIM: To investigate the magnetic resonance imaging (MRI) results of patients complaining from diplopia with ocular nerve palsy. MATERIAL and METHODS: A routine ophthalmic examination was performed, a neurological consultation was requested, and cranial MRI was performed for all patients. The image results were sorted into four groups: ischemic lesions, demyelinating disease lesions, tumors, and no lesions. White matter gliosis and cerebral infarcts were included in the ischemic lesion group. The medical histories of the patients were acquired from medical records. The chi-squared test was used to analyze the relationship between age and cranial MRI images and to analyze the relationship between the image and paresis type. The statistical significance threshold was set at p<0.05, unless otherwise stated. RESULTS: Ischemic MRI images were the most common image type seen in our study. Third nerve paresis was significantly correlated with ischemic cerebral lesions observed by MRI (p=0.009). Furthermore, lesions were significantly correlated with patients aged above 50 years (p=0.004). There were no significant correlations between fourth or sixth nerve paresis and cranial ischemic images (p=0.680 and p=0.678, respectively). There were two instances of cerebral artery aneurysm, three instances of cerebral infarct, and one instance of intracranial mass, all in patients aged over 50 years. CONCLUSION: Although our patients had minimal or nonexistent neurological symptoms, some had serious cranial pathologies. These pathologies were commonly seen in patients aged over 50 years. We recommend performing MRI on all patients with binocular diplopia.

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