Objectives:To evaluate anatomic and functional results after switching from intravitreal bevacizumab or ranibizumab treatment to aflibercept for wet (neovascular) age-related macular degeneration.Materials and Methods:This retrospective study included 22 eyes of 22 patients resistant to treatment with at least 6 injections of bevacizumab or ranibizumab. The first three injections had been applied monthly, the others pro re nata (PRN). Outcome measures were follow-up period, injection number, best corrected visual acuity (BCVA), central retinal thickness (CRT) and pigment epithelial detachment (PED) height. Dosing regimen of aflibercept was determined PRN. The patients were examined monthly. In all visits, BCVA and optical coherence tomography results were assessed together and injections were applied according to these findings. Patients with at least three months of follow-up were included in the study.Results:Twenty-two eyes of 22 patients treated with bevacizumab or ranibizumab were switched to aflibercept therapy. Seven patients had serous PED and 4 patients had fibrovascular PED. The mean follow-up periods for these groups were 20.59±6.76 months and 8.68±3.79 months, respectively. The mean injection numbers were 10.5±3.61 vs 4.54±1.56. Statistically significant reductions were noted in CRT (533.86±164.06 µm vs 412.04±143.86 µm, p<0.05). BCVA levels were almost equal before and after switching (0.18±0.17 vs 0.18±0.14). Serous and fibrovascular PED heights decreased suboptimally from 460±281.51 µm to 282.42±175.76 µm (p>0.05) for serous PEDs and 251.25±43.85 µm to 225.75±73.09 µm (p>0.05) for fibrovascular PEDs.Conclusion:Switching to aflibercept resulted in significant improvement in CRT, but not in BCVA or PED heights.
Purpose. To report an unknown complication of laser in situ keratomileusis (LASIK) surgery. Case Presentation. A 28-year-old female presented with photophobia and glare to our eye service. She stated in her medical history that she had undergone femtosecond assisted LASIK surgery in both eyes 15 months ago and her symptoms started just after this surgery. On admission, her best-corrected visual acuity was 10/10 in both eyes. She had mydriatic pupils with no direct light reflex. Examination of the anterior segment revealed bilateral iris atrophy projecting within the LASIK ablation zone and a transillumination defect was remarkable on the slit lamp examination. Conclusion. We hypothesized that this condition may have been caused by the abnormally increased IOP that resulted in ischemia in the iris vascular plexus during the suction process of surgery.
The aim of this study was to investigate the safety and efficacy of ab interno trabeculectomy which is a minimally invasive glaucoma surgery, in the late period, performed via trabectome instrument. A total of 70 eyes followed up with a diagnosis of open-angle glaucoma (OAG) and undertaken trabectome surgery were included in the study. Preoperative and postoperative intraocular pressures (IOPs), number of the drugs used, and complications were retrospectively investigated and the data were evaluated. The criteria of success were accepted as an IOP value ≤21 mmHg or ≥30 % reduction in IOP and no need for a second operation. Mean IOP was decreased by 38 % from a preoperative value of 28.77 ± 5.34 to 17.62 ± 2.81 mmHg at the end of 18 months. Likewise, mean drug usage was decreased by 48 % from a preoperative value of 3.3 ± 1.01 to 1.7 ± 1.16 at the end of 18 months. Both decreases were statistically significant (p < 0.05). Postoperative success rates were 82.8 % in the 6th month, 81.4 % in the 9th month, 77.1 % in the 12th month, and 70 % in the 18th month. Most common complication observed was intraoperative reflux hemorrhage and no serious complication was observed. Trabectome surgery is an effective and safe method in early-stage open-angle glaucoma types that cannot be controlled despite maximal medical therapy. This procedure is a proper surgical option in patients targeted for moderate IOP without the need for a topical medication or with less drug usage.
Background: To evaluate the long-term effects of intravitreal ranibizumab treatment on both choroidal and retinal layers thicknesses using spectral domain optical coherence tomography (SD-OCT) and Enhanced Depth Imaging (EDI) mode.
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