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    Intravitreal Dexamethasone Implant in the Treatment of Pseudophakic Cystoid Macular Edema or Irvine-Gass Syndrome
    (2020) Kaldırım, Havva; Kürşat, Atalay; Nacaroğlu, Şenay Aşık; Yazgan, Serpil; Kırgız, Ahmet
    Purpose: To evaluate the effectiveness of intravitreal injections of dexamethasone (DEX) implant in patients with pseudophakic cystoidmacular edema (PCME) or Irvine-Gass Syndrome (IGS).Material and Methods: Patients with ME secondary to uncomplicated cataract surgery who underwent single intravitreal injections of DEXimplant from January 2015 to January 2017 were retrospectively reviewed. The patients were examined at base-line and day 1, week 1, month1, 3, 6 and 12 after intravitreal injection. All patients underwent a complete ophthalmic evaluation, including biomicroscopy, best-correctedvisual acuity (BCVA), intraocular pressure by applanation tonometry, and central macular thickness (CMT) measurement with a spectraldomainoptical coherence tomography (SD-OCT).Results: Nineteen eyes of 18 patients were evaluated. The alteration of mean BCVA and CMT were statistically signifi cantly better than baselinevalues at fi rst, third, sixth and twelfth months (p< 0.001). At 1st week, 1st month and 3rd month intraocular pressure (IOP) values signifi cantlyhigher than baseline (p=0.001, p=0.006, p=0.001, respectively). At 6th month and 12th month IOP values not signifi cantly different at baseline(p=0.506, p=0.650).Conclusion: Both BCVA and mean CMT had signifi cantly improved from baseline values after treatment with single doz intravitreal DEXimplant in patients with IGS.
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    Novel Bacterial Cellulose Membrane to Reduce Fibrosis Following Trabeculectomy
    (Lippincott Williams & Wilkins, 2021) Yazgan, Serpil; Tekin, Ishak Ozel; Akpolat, Nusret; Koc, Ozhan
    Purpose: The aim was to evaluate the effectiveness of bacterial cellulose membrane (BCM) in preventing fibrosis in trabeculectomy and the biocompatibility of BCM with conjunctiva and sclera. Materials and Methods: Twenty-one eyes of 21 adult rabbits underwent fornix-based trabeculectomy. Standard surgery was done to control group (CG, n = 7). Mitomycin-C (MMC) (0.3 mg/mL, 3 min) was applied to MMC group only (MMCG, n = 7). BCM (similar to 100 mu m thick, 10x 10 mm, single layer) was covered on the sclerotomy area before conjunctiva was closed in BCM group (BCMG, n = 7). Intraocular pressures (TOP) were measured before, and 7, 14, 28, and 45 days after surgery (IOP-POD7, POD14, POD28, POD45). The IOP decrease were expressed as DIOP%-POD7, DIOP%-POD14, DIOP%-POD28, and DIOP%-POD45. The rabbits were sacrificed on the 45th day. Conjunctival vessel number, degrees of fibrosis, total inflammation, foreign body reaction, inflammatory cell types (B cells, T cells, plasma cells), macrophages, bleb spaces and the expression of a-smooth muscle actin were studied using histopathology and immunohistochemistry techniques. The groups were compared using nonparametric tests. Results: There was no statistically significant difference between the groups regarding baseline IOP and DIOP%-POD7 (P > 0.05). While DIOP%-POD14, 28 and 45 were similar between BCMG and MMCG, they were significantly lower in CG (P < 0.05). The lowest conjunctival vessel number was detected in the MMCG but the difference was not significant. There was no difference between BCMG and CG with regard to the numbers of B cells, T cells, and macrophages, however, these cells were significantly lower in MMCG (P < 0.05). Five cases had mild and 2 cases had moderate foreign body reaction in the BCMG. There was mild to moderate inflammation in all BCM cases. While fibrosis and alpha-smooth muscle actin staining were higher in the CG (P < 0.001), they were minimal in the BCM and MMCGs. Conclusions: BCM showed good biocompatibility and provided better control of IOP with minimal fibrosis at the trabeculectomy site compared with the control group.