Using isoosmolar riboflavin solution without dextran causes a steady increase in the corneal thickness during the cross-linking procedure, as opposed to riboflavin with dextran. This result might be beneficial in broadening the spectrum of cross-linking indications in patients with thin corneas.

Cataracts are one of the most common eye diseases associated with blindness (visual acuity worse than 20/400 in the better eye with best correction) worldwide, with an estimated 18 million people thought to be affected, and cataract surgery is the intraocular procedure performed most often worldwide. Over the years, the techniques of cataract surgery have evolved into a safe and successful procedure for visual rehabilitation. The incidence of most complications has significantly decreased with the development of better instrumentation and affordable, high-quality intraocular lens (IOL) implants (1) . Various aspects of cataract surgery that make it safer have changed ABSTRACT Purpose: To analyze the indications for explantation or exchange of intraocular lenses (IOLs), which were originally implanted for the correction of aphakia during cataract extraction. Methods: All cases that involved intraocular lens explantation or exchange in one institution between January 2008 and December 2014 were analyzed re tros pectively. Results: In total, 93 eyes of 93 patients were analyzed. The median time interval between implantation and explantation of the anterior chamber intraocular lenses (AC IOL) and posterior chamber intraocular lenses (PC IOL) was 83.40 ± 83.14 months (range: 1-276 months) and 55.14 ± 39.25 months (range: 1-168 months), respectively. Pseudophakic bullous keratopathy (17 eyes, 38.6%) and persistent iritis (12 eyes, 27.8%) in the AC IOL group and dislocation or decentration (30 eyes, 61.2%) and incorrect IOL power (nine eyes, 18.4%) in the PC IOL group were the most common indications for explantation of IOLs. The mean logMAR best corrected visual acuity (BCVA) improved significantly from 1.30 preoperatively to 0.62 postoperatively in the PC IOL group (p<0.001) but did not improve significantly in the AC IOL group (p=0.186). Conclusions:The primary indication for IOL explantation or exchange was pseudophakic bullous keratopathy in the AC IOL group and was dislocation or decentration in the PC IOL group. PC IOL explantation or exchange is safe and im proves visual acuity.

Keratoconus is a bilateral, asymmetric, non-inflammatory, and slowly progressive corneal disease with an approximate incidence of 1 in 2000 individuals. This condition is characterized by corneal thinning and protrusion, progressive myopia, and irregular astigmatism (1) and has conventionally been treated using modalities, such as rigid contact lenses, intrastromal corneal ring segment implantation, and keratoplasty. However, current treatment objectives include not only improved visual acuity but also the prevention of disease progression (2) . Accordingly, corneal cross-linking (CXL) is a relatively new treatment method designed to increase the mechanical and biochemical strength of the stromal tissue via exposure of the ectatic cornea to riboflavin and ultraviolet-A (UVA) light (3) . This procedure is the only currently available semisurgical therapeutic approach for patients with progressing keratoconus and has been shown to delay ABSTRACT Purpose: To analyze the short-term clinical and topographic outcomes in patients with keratoconus after corneal collagen cross-linking treatment (CXL) with dextran-free isotonic riboflavin solution. Methods: In this retrospective case series, 26 eyes from 26 patients with keratoconus were studied. The best corrected visual acuity (BCVA) and refractive and topographic findings were analyzed at a 6-month follow-up. Results: The mean BCVA (Snellen lines) values before and 1, 3, and 6 months after CXL were 0.51 ± 0.2, 0.48 ± 0.2, 0.57 ± 0.2, and 0.64 ± 0.2, respectively, and the difference between the preoperative and 6-month values was statistically significant (p=0.006). The mean spherical equivalent refraction decreased from -5.6 ± 2.4 diopters (D) preoperatively to -5.0 ± 2.1 D, and mean simulated ke ratometry decreased from 48.5 ± 2.5 D to 47.8 ± 2.6 D at 6 months. (p=0.145 and p=0.001, respectively). In addition, the maximum keratometry decreased progressively and significantly from the preoperative value during follow-up (p=0.003). The central and minimal corneal thicknesses, including those of the epithelium, also decreased from 442.8 ± 25.6 μm and 430.5 ± 23.9 μm preoperatively to 420.7 ± 31.8 μm and 409.3 ± 28.7 μm at the most recent follow-up (p<0.001), respectively. No intraoperative or postoperative complications were observed. Conclusions: CXL with dextran-free isotonic riboflavin solution appears to be a safe treatment alternative for keratoconus and yields sustained short-term improvements in visual acuity, keratometric readings, and corneal thickness. However, long-term results are needed to confirm these outcomes.

Dekstransız izotonik riboflavin solüsyonu ile yapılan kornea kollajen çapraz bağlama (KKÇB) uygulamasında kornea kalınlığının takip edilmesi. Gereç ve Yöntem: Progresif keratokonus olgularına uygulanan KKÇB uygulaması sırasında kornea kalınlığı değerlendirildi. Her olgunun sırası ile kornea epiteli kazındıktan sonra: 0., 15. ve 30. dakikalarda, Ultraviole A (UVA) uygulama sırasında 15. ve 30. dakikalarda santral kornea kalınlığı ultrasonik pakimetri cihazı ile ölçüldü.