BackgroundIndications for corneal transplantation in developed and developing nations differ according to the different spectrum of corneal disease in each country.ObjectiveThe purpose of this study is to analyze the changing indications and surgical techniques for corneal transplantation over the past 20 years at a tertiary referral center in Turkey.MethodsWe retrospectively reviewed the records of patients who underwent keratoplasty from January 1995 to December 2014 (between 1995 and 2004, period 1, and between 2005 and 2014, period 2). Patients’ demographic data, indications for corneal transplantation, and the type of surgery were recorded.ResultsThe number of keratoplasties performed ranged from 548 in period 1 to 782 in period 2. Between 1995 and 2004, the leading indications were keratoconus (34.1%), bullous keratopathy (17%), and non-herpetic corneal scar (13.3%), and between 2005 and 2014, they were keratoconus (33.8%), corneal stromal dystrophy (14.2%), and bullous keratopathy (12.7%). All the keratoplasties performed in the 1995–2004 period were penetrating keratoplasty (PKP). During the period 2005–2014, PKP accounted for 93%, automated lamellar keratoplasty 5.8%, and deep anterior lamellar keratoplasty 1.2% of all corneal transplantations.ConclusionKeratoconus was the leading indication for keratoplasty in both periods. In the 2005–2014 period, corneal stromal dystrophy increased significantly. All the keratoplasties performed in period 1 and 93% of all keratoplasties performed in period 2 were PKP.

SM-UP pair showed a higher agreement in diabetic patients. According to subgroup analyses, Hb A1c level, rather than the duration of diabetes, may determine the agreement of these pachymetry devices. But the difference in CT measurements between devices can still influence clinical diagnosis and treatment. Therefore, these methods are not completely interchangeable.

ÖzetAmaç: Primer pterijium cerrahisinden sonra nükslerin engellenmesi için int- Application of 0.02% mitomycin C for 5 minutes seems to be more effective than 5-FU for prevention of recurrence. A larger study population is needed to substantiate this result.

Central serous chorioretinopathy (CSCR) is characterized by neurosensory retinal detachment. Because the retina pigment epithelium and choroidal pathology is the current mechanism in CSCR, many studies in the literature focused on the outer retinal layers. There is little information about the functional or histological structure of the detached retina. In this study, we assess the ganglion cell complex (GCC) thickness using optical coherence tomography (OCT) in patients with acute and chronic CSCR. The medical records of 16 acute and 19 chronic CSCR patients which have no other disorders that cause a serous macula detachment were analyzed. Chronic cases were also divided into two subgroups: chronic active and chronic nonactive CSCR. The eyes with extramacular involvement or cystoid degeneration and cases which developed choroidal neovascularization were excluded from the study. The mean, minimum, superior-nasal, superior, superior-temporal, inferior-nasal, inferior, and inferior-temporal GCC values obtained using OCT were used for analysis. The duration from the onset was 7.8 ± 4.5 weeks and the mean age was 45.0 ± 10.7 years in acute CSCR, and in chronic cases the values were 36.0 ± 6.2 weeks and 52.9 ± 10.5 years, respectively. There were no significant differences in sex distribution. The chronic cases were statistically significantly older than acute cases (p = 0.02). While there was no difference between the acute and chronic cases, there were statistically significant differences between the chronic CSCR and control group in all values of GCC. Additionally, there were statistically significant differences between the acute CSCR and control group in mean, minimum, and superior-temporal GCC thicknesses. Although choroid and outer retinal layers play an important role in the pathogenesis of CSCR, there is scant information about the functional or histological structure of the detached retina in CSCR. Our results showed that GCC was significantly reduced in both acute and chronic CSCR compared to healthy subjects. Analysis of ganglion cell helps us understand the etiology of the patients which healed anatomically but had limited visual improvement in CSCR.

Purpose: To evaluate long-term corneal morphological changes after photorefractive keratectomy (PRK) using in vivo confocal microscopy (IVCM) and specular microscopy. Methods: This comparative case–control study included 16 eyes of 8 patients who underwent PRK for mild to moderate myopia 20 years ago and 30 eyes of 15 sex- and age-matched healthy controls. Corneal epithelial cells, sub-basal nerves, keratocytes (anterior, midstromal, and posterior), and endothelial cells were evaluated in both groups 10 and 20 years after surgery. Long-term visual outcomes were also recorded. Results: In vivo confocal microscopy examination revealed similar epithelial morphology, sub-basal nerve fiber morphology/density, mid/posterior stromal keratocyte density, and endothelial cell density between PRK patients and controls at their 10th and 20th year follow-up. Anterior stromal keratocyte density was lower at 10th year; however, it reached to control group value at 20th year follow-up. Extracellular matrix reflectivity was slightly higher, and there was a trace subepithelial corneal haze in PRK group (milder in 20th year than 10th year) compared with controls. At the 20th year, uncorrected distance visual acuity was 20/20 or more in 6 eyes (37.5%), 20/40 or more in 16 eyes (100%), and all eyes had corrected distance visual acuity of 20/20 or better (spherical equivalent −0.31±0.37 D). Conclusions: Photorefractive keratectomy in low to moderate myopia seems to be safe and effective method in the long term with preserving corneal morphology (including anterior stromal keratocyte and sub-basal nerve fiber density) and refractive outcomes as shown in this study. In appropriate patients, this method can be considered confidently.