Incidence of complications in 25-gauge transconjunctival sutureless vitrectomy based on the surgical indications.

BACKGROUND AND OBJECTIVE: The complications of 25-gauge transconjunctival sutureless vitrectomy based on the surgical indications were reviewed. PATIENTS AND METHODS: Thirty-eight patients underwent 25-gauge transconjunctival sutureless vitrectomy. Indications for vitrectomy, preoperative and postoperative best-corrected visual acuity, preoperative and postoperative intraocular pressure, and any intraoperative or postoperative complications were recorded. RESULTS: Complications included the need to suture a leaking sclerotomy intraoperatively in four eyes (9%), all of which involved oil removal; postoperative hypotony with choroidals in two eyes (5%); mild progression of nuclear sclerotic cataract in one eye (2% of all eyes, 4% of phakic eyes); the need to switch to 20-gauge pars plana vitrectomy in one eye (2%); corneal abrasion in one eye (2%); and retinal detachment in one eye (2%). Sclerotomy leakage and hyopotony with choroidals were only encountered in cases involving previously vitrectomized eyes, whereas none of the eyes without previous vitrectomy had leakage-related complications. CONCLUSIONS: Previously vitrectomized eyes have a higher incidence of complications related to postoperative leakage, possibly due to the lack of plugging effect of peripheral vitreous on the unsutured sclerotomy. One should consider suturing any leaking sclerotomy at the conclusion of surgery involving previously vitrectomized eyes.     

Subthreshold (invisible) modified grid diode laser photocoagulation in diffuse diabetic macular edema (DDME)

BACKGROUND AND OBJECTIVE: To determine the effectiveness of subthreshold (invisible) diode laser (810 nm) modified grid photocoagulation for the treatment of diffuse diabetic macular edema (DDME). METHODS: Fifty eyes of 29 patients were treated with subthreshold (invisible) diode laser modified grid photocoagulation for DDME in a prospective pilot clinical trial. Follow-up was conducted for a minimum of 6 months (average: 14.11 +/- 6.15 months). Re-treatment was performed for residual edema involving the foveal avascular zone. Ten patients were tested with Goldman visual field pre- and post-treatment. Visual improvement, visual loss, visual field, reduction/elimination of macular edema, and the number of treatments per eye were studied. RESULTS: Reduction/elimination of DDME was observed in 39% of the eyes after 1 to 3 treatments (2.22 +/- 0.84 treatments) in 6 to 12 months; and in 74% of eyes after 1 to 5 treatments (2.90 +/- 1.02 treatments) 15-24 months follow-up. The presence of cystoid macular edema, initial poor visual acuity, or a history of systemic hypertension did not affect the outcome. Patients without a history of systemic vascular diseases had a better chance of visual stabilization or improvement. Eighty-eight percent of the patients had at least stable vision at the last follow-up. Two out of 10 visual field tests showed a decrease in paracentral scotomas; no post-treatment subjective complaints of increased paracentral scotomas were encountered. CONCLUSION: Subthreshold (invisible) diode laser modified grid photocoagulation is effective in reducing/eliminating DDME, although resolution of edema may be slightly prolonged. However, this method may be advantageous in that it appears to reduce the objective and subjective effect on the paracentral visual field. Subthreshold (invisible) diode laser modified grid photocoagulation substantially reduces the post-treatment atrophic scarring.     

Predictors of success in macular hole surgery with emphasis on the internal limiting membrane (ILM) and ILM peeling.

BACKGROUND AND OBJECTIVE: To study the predictors of success in macular hole surgery. PATIENTS AND METHODS: Twenty-two eyes of 21 patients underwent macular hole surgery. The hole closure rate and the visual improvement were studied based on the preoperative visual acuity, stage and duration of the macular hole, the type of intravitreal tamponade used, and internal limiting membrane peeling. The internal limiting membrane was peeled only when it was clinically prominent. RESULTS: Macular holes were closed in 19 of the 22 eyes and visual improvement of 2 lines or more was achieved in 17 eyes. Preoperative visual acuity, duration of the macular hole, type of intraocular tamponade used, and internal limiting membrane peeling did not affect the outcome. A final visual acuity of 20/70 or better was more common after surgery for stage 2 holes (P = .019). CONCLUSION: The best predictor of outcome was the stage of the hole, with best results obtained in stage 2 holes.     

Autoimmune estrogen dermatitis in an infertile female

Autoimmune estrogen dermatitis is a cyclical cutaneous eruption that occurs premenstrually and goes to the rapid resolution within a few days of menstrual cycles. The disorder has variable clinical manifestations consisting of macules, papules, vesicles, urticarial lesions, bullae, eczematous plaques, and erythema multiforme-like lesions. Herein, we present a case of a 30-year-old woman with attacks of edema and erosions involving the oral and genital mucosal sites on every first day of her menstruation period. She had also multiple endocrinological problems such as hypotroidism and infertility. To determine the sex hormon sensitivity, intradermal skin tests were performed. Based on her personal history and skin test findings, a diagnosis of autoimmune estrogen dermatitis was made. After the oophorectomy, she was free from the skin and mucosal symptoms. We propose that it is important to suspect the diagnosis of autoimmune estrogen dermatitis in patients who present with recurrent cylic eruptions and it must be kept in mind that these patients might have a concomitant infertility.     

Dye functionalized cryogel columns for reversible lysozyme adsorption

In this study, poly (methyl methacrylate–glycidyl methacrylate) [poly(MMA-GMA)] cryogels were prepared by radical cryocopolymerization of MMA with GMA as a functional comonomer. Reactive Green 19 dye was then attached to the cryogel by nucleophilic substitution reaction, and this dye-attached cryogel column was used for lysozyme adsorption. Characterization of the cryogel was performed by Fourier transform infrared spectroscopy, environmental scanning electron microscopy, Brunauer–Emmett–Teller, and energy dispersive X-ray analysis. Pore size of the cryogels was 15–30?μm and pores were interconnected structure. Attached amount of Reactive Green 19 to cryogel support was calculated as 106.25?μmol/g cryogel. Lysozyme adsorption studies were carried out by using a continuous system. It was found that the maximum amount of lysozyme adsorption (32?mg/g cryogel) obtained from experimental results was found to be approximately same with the calculated Langmuir adsorption capacity (33?mg/g cryogel). Desorption of adsorbed lysozyme was carried out by using 1.5?M NaCl in pH 4.5 acetate buffer, and desorption yield was found to be 97.4%. Cryogels were very stable, and it was found that there was no remarkable reduction in the adsorption capacity at the end of ten adsorption–desorption cycles. As a result, Reactive Green 19-attached cryogels have great advantages such as easy preparation, rapid adsorption, and desorption, being economic and allowing the direct separation of proteins.     

Immobilization of amyloglucosidase onto macroporous cryogels for continuous glucose production from starch

Poly(methyl methacrylate-glycidyl methacrylate) [Poly(MMA-GMA)] cryogels were synthesized using monomers of methylmethacrylic acid and epoxy group bearing GMA via radical cryopolymerization technique. Synthesized cryogels were used for the immobilization of amyloglucosidase to the cryogel surface using epoxy chemistry. Characterizations of the free and immobilized amyloglucosidase were carried out by comparing the optimum and kinetic parameters of enzymes. For this, pH and temperature profiles of free and immobilized preparation were studied and, it was found that, optimum pH of enzyme was not change upon immobilization (pH 5.0), while optimum temperature of the enzyme shifted 10 °C to warmer region after immobilization (optimum temperatures for free and immobilized enzyme were 55 and 65 °C, respectively). Kinetic parameters of free and immobilized enzyme were also investigated and K_m values of free and immobilized amyloglucosidase were found to be 2.743 and 0.865 mg/mL, respectively. V_max of immobilized amyloglucosidase was found to be (0.496 µmol/min) about four times less than that of free enzyme (2.020 µmol/min). Storage and operational stabilities of immobilized amyloglucosidase were also studied and it was showed that immobilized preparation had much more stability than free preparation. In the present work, amyloglucosidase immobilized poly(MMA-GMA) cryogels were used for continuous glucose syrup production from starch for the first time. Efficiency of immobilized enzyme was investigated and released amount of glucose was found to be 2.54 mg/mL at the end of the 5 min of hydrolysis. The results indicate that the epoxy functionalized cryogels offer a good alternative for amyloglucosidase immobilization applications with increased operational and thermal stability, and reusability. Also, these cryogels can be used for immobilization of other industrially valuable enzymes beyond amyloglucosidase.     

Evaluation of radiopacities of CAD/CAM restorative materials and resin cements by digital radiography

Clinical Oral Investigations - This study aims to compare the radiopacities of computer-aided design/computer-aided manufacture (CAD/CAM) blocks and the adhesive cements used for their bonding. 1...