Tear function tests and conjunctival impression cytology before and after hormone replacement therapy in postmenopausal women

PURPOSE

To investigate the effect of hormone replacement therapy (HRT) on postmenopausal tear function and the conjunctival epithelium.

METHODS

Schirmer I-Jones test, tear film break-up time (BUT), and impression cytology findings were analyzed in 34 eyes of 17 women who were at least two years postmenopausal and not taking HRT: This series of tests was repeated after three months on HRT.

RESULTS

The patients' average age was 53.82 +/- 3.6 years, and the mean time postmenopause was 35.29 +/- 11.59 months. There was no significant difference in the Schirmer I-Jones test results before and after three months of HRT (p > 0.05). However, the BUT (p < 0.05) and impression cytology (p < 0.05) findings were significantly affected by HRT.

CONCLUSIONS

HRT may alleviate postmenopausal dry eye symptoms by increasing goblet cell density.

Results of cataract surgery in renal transplantation patients

PURPOSE

To evaluate the results of conventional extracapsular cataract extraction and phacoemulsification cataract surgery, in renal transplant patients.

METHODS

A total of 11 eyes of eight renal transplant recipients who underwent cataract surgery in Ankara between 1995 and January 2001 were evaluated. Each individual underwent routine ophthalmologic examination including visual acuity with Snellen chart testing, slit-lamp examination, intraocular pressure measurement, and fundus examination. Of these, seven patients had posterior subcapsular cataracts and four had nuclear cataracts. Conventional extracapsular cataract extraction (cECCE) was performed in four eyes with single-piece all-polymethylmethacrylate posterior chamber intraocular lens implantation. The other seven eyes were treated with small-incision phacoemulsification and implantation of a foldable hydrophilic acrylic lens.

RESULTS

We observed intraoperative posterior capsule rupture and vitreous loss in one patient, postoperative intraocular tension elevation in one patient, and sterile suture infiltration in one patient in our series. Average of the visual acuities 6 months after the operation was 20/30 (range, 20/60-20/20).

CONCLUSIONS

In this, the first published report to describe outcomes of cataract surgery in renal transplant patients, most complications were associated with high of steroids use and immunosuppressives, and were independent of the type of cataract surgery used, either ECCE or phacoemulsification surgery. The study suggests the need for additional care before, during, and after operation.

Macular ischaemia in Behçet's disease

PURPOSE

To report macular ischaemia and visual loss in patients with panuveitis due to Behçet's disease.

METHODS

We describe macular ischaemia, a rare finding, in 3 eyes of 3 patients with panuveitis who were diagnosed and treated as having Behçet's disease. The patients underwent fundus fluorescein angiography (FFA) using a digital imaging system and were treated with topical and oral steroids and cyclosporine in 2 cases, and with added azathioprine in the third case.

RESULTS

The 3 eyes showed macular ischaemia associated with peripheral retinal vasculitis on FFA and control of inflammation was achieved in all cases. After an average of 2 years follow-up, visual acuity and macular ischaemia improved in 2 eyes, while no recovery was seen in the third.

CONCLUSION

The presence of macular ischaemia on FFA in Behçet's disease is a predictor of poor visual outcome. Macular ischaemia may show partial recovery with the treatment of the disease.

[Pterygium excision with intra-operative administration of low dosage mitomycin C]

Pterygium excision with postoperative instillation of mitoymcin C (MMC, 0.4 mg/ml) is encouraging because of the technical simplicity and low recurrence rates, but serious postoperative complications have been described (scleral necrosis, corneal perforation, glaucoma, cataract). The authors studied the efficacy and safety of pterygium excisions with a single intraoperative application of low-dose MMC (0.2 mg/ml). Pterygium excision (bare sclera technique) was performed in 18 patients with primary or recurrent pterygia. MMC (0.2 mg/ml) was applied intraoperatively (5 min) to the exposed sclera. Patients were followed up for signs of recurrence and complications. There were four recurrences (mean follow-up 13.8 months). Postoperative complications consisted of granuloma formation (n = 2). Delayed conjunctival healing was observed in all cases. Scleral necrosis, corneal complications, cataract, or glaucoma were not seen. Intraoperative application of MMC apparently reduces the recurrence rate after pterygium excision. The use of a 0.2 mg/ml concentration of MMC appears to be safe.