Performance of ChatGPT-4 Omni and Gemini 1.5 Pro on Ophthalmology-Related Questions in the Turkish Medical Specialty Exam - Turkish Journal of Osteoporosis

Background/Objectives: The aim of this paper was to evaluate the two-year outcomes of phacoemulsification combined with gonioscopy-assisted transluminal trabeculotomy (PHACO-GATT) versus standalone GATT in terms of efficacy, safety, and surgical success. Methods: This retrospective, comparative study included 64 eyes of 64 patients with moderate-to-severe open-angle glaucoma: 35 patients (54.7%) with primary open-angle glaucoma (POAG) and 29 patients (45.3%) with pseudoexfoliative glaucoma (PEG). Group 1 (n = 38) underwent PHACO-GATT, and Group 2 (n = 26) underwent standalone GATT. Data, including intraocular pressure (IOP), the number of anti-glaucomatous medications, and complications, were analyzed preoperatively and postoperatively (1st, 3rd, 6th, 12th, and 24th months). Surgical success was defined as achieving a ≥ 20% IOP reduction or IOP ≤ 21 mmHg with or without medications. Results: The mean age was 74.4 ± 7.2 years in Group 1 and 70.8 ± 7.3 years in Group 2. Both groups achieved significant IOP reductions at the 24-month follow-up: Group 1 from 28.6 ± 6.3 mmHg to 12.7 ± 2.4 mmHg, and Group 2 from 27 ± 4.8 mmHg to 13 ± 1.7 mmHg (both p < 0.001). BCVA in Group 1 improved significantly from 0.77 ± 0.29 logMAR to 0.28 ± 0.13 logMAR at 24 months (p < 0.001), while in Group 2, it remained stable at 0.46 ± 0.19 logMAR at baseline and 0.47 ± 0.19 logMAR at 24 months (p > 0.05). The mean number of anti-glaucoma medications decreased significantly in both groups (p < 0.001) without significant intergroup differences (p > 0.05). Complication-free rates were 68.4% in Group 1 and 69.2% in Group 2 (p = 0.899). Surgical success rates were comparable between groups at 12 (100% in both groups) and 24 months (94.7% in Group 1, 96.2% in Group 2). Conclusions: Both PHACO-GATT and standalone GATT demonstrated comparable efficacy and safety over a two-year period. PHACO-GATT provided significant visual acuity improvements due to cataract extraction, making it a suitable option for patients with coexisting cataracts and glaucoma.

Background/Objectives: This study aims to evaluate the computed tomography (CT) scans of glaucoma patients using prostaglandin analogs (PGA) in one eye, investigate findings associated with prostaglandin-associated periorbitopathy (PAP), and compare these findings with those of the contralateral eyes. Methods: Patients with open-angle glaucoma who had CT images of the orbital region taken for another reason at least one month after starting PGA treatment in one eye were included in the study. Enophthalmos measurements from thin-slice CT images, along with 3D volume measurements of orbital fat tissue, periorbital muscles, and the optic nerve, were performed. Ophthalmological examination findings and treatment information were collected. The values were compared with those of the contralateral eyes of the same patients not using PGA. Intraclass correlation coefficients (ICCs) were computed to evaluate measurement repeatability. Results: Forty patients were included in the study. Among them, 29 (72.5%) used latanoprost, 9 (22.5%) used bimatoprost, and 2 (5%) used travoprost. The mean enophthalmos values on the treated side (15.5 ± 2.0 mm) were lower than on the untreated side (16.1 ± 1.4 mm), but this difference was not statistically significant (p = 0.07). In 29 patients (72.5%), enophthalmos measurements were smaller on the treated side, with 7 patients (17.5%) showing a difference of 2 mm or more. No significant correlation was found between the duration of PGA use and enophthalmos measurements (p = 0.768 r = −0.048). Additionally, no significant differences were found in orbital fat volume, total extraocular muscle volume, and optic nerve volume (p > 0.05). ICC values demonstrated excellent reliability (ICC > 0.75) for all measurements. Conclusions: We did not find significant differences in enophthalmos measurements, orbital fat volume, total muscle volume, and optic nerve volume between the PGA-treated and untreated eyes.