Effects of body mass index on intraocular pressure and ocular pulse amplitude

AIM: To investigate the effects of body mass index (BMI) on intraocular pressure (IOP) and ocular pulse amplitude(OPA). METHODS: Totally 140 healthy individuals without any systemic diseases were included in the study. BMI (kg/m2) was calculated for every individual. IOP and OPA were measured with Pascal Dynamic contour tonometer (DCT). Blood pressure was also measured along with the DCT. The patients were divided into three groups according to BMI as: Group1, BMI<25; Group2, 25≤BMI<30; Group3, BMI≥30. Mean values of IOP, OPA, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were used in statistical analysis.RESULTS: In Group1, the means of IOP, OPA, were 16.8±2.3mmHg, 2.7±0.7mmHg respectively; and SBP, DBP were 120.0±6.1mmHg, and 77.4±5.6mmHg respectively. In group2, the mean IOP, OPA, SBP, and DBP were found to be 16.6±2.1mmHg, 2.4±0.7mmHg, 121.7±5.3mmHg, and 79.5±4.9mmHg respectively. In group3, the mean IOP, OPA, SBP, and DBP were found to be 17.3±1.7mmHg, 2.1±0.7mmHg, 122.4±5.7mmHg, and 79.7±5.2mmHg respectively. There were no statistically significant difference between groups in terms of IOP, SBP and DBP, while OPA values were significantly lower in group3 (P=0.001). CONCLUSION: Decreased OPA values in individuals with higher BMI may indicate that subjects with higher BMI have lower choroidal perfusion and lower ocular blood flow.

Comparison of clinical outcomes of deep anterior lamellar keratoplasty and excimer laser assisted anterior lamellar keratoplasty in keratoconus

AIM: To compare and evaluate the clinical outcomes of deep anterior lamellar keratoplasty(DALK) and excimer laser assisted anterior lamellar keratoplasty(ELLK) in eyes with keratoconus.METHODS: In this study, 57 eyes of 56 patients operated between 2013 to 2017 were included. Thirty-one eyes underwent big-bubble DALK and twenty-six eyes underwent ELLK. Preoperative and at control visits complete ophthalmic examination was performed. RESULTS: The mean patient age at the time of DALK surgery was 27 y and mean follow-up period was 21±5.4 mo. The mean patient age at the time of ELLK surgery was 27 y and mean follow-up period was 40±18 mo. Mean best spectacle corrected visual acuity(BSCVA) at postoperative period was significantly higher for DALK group(0.66±0.11) versus ELLK group(0.4±0.2)(P<0.05). Descemet's membrane microperforation was occurred in 7 patients in DALK group versus in 1 patient in ELLK group. In 4 eyes, interface irregularity was developed in ELLK group. None of the patients in follow-up had graft rejection in both groups.CONCLUSION: In ELLK group, complication rate is lower, the surgical technique is simpler, faster and safer and also ELLK requires less experience with respect to DALK. Further, DALK can be performed unless satisfactory visual acuity is achieved after ELLK.

A reasonable option in vitrectomized eyes: manual small incision cataract surgery

Dear Sir,It is known that cataract surgery is challenging in vitrectomized eyes.Cataract surgeons may have encountered with posterior capsular complications and nucleus drop events even with minimal ocular manipulations and low irrigation bottle height.Inadvertent damage to the zonular fibers,posterior or peripheral lens capsule with ocutome or microvitreoretinal(MVR)blade in previous