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Öğe 23 ve 20 gauge sklerotomi yöntemleri ile silikon yağı boşaltılmasının karşılaştırılması(Retina-Vitreus, 2011) Doğanay, Selim; Koç, Bekir; Çankaya, Cem; Demirel, SonerÖz: Amaç: Silikon yağı boşaltılmasında kullanılan 23 ve 20 Gauge (G) sklerotomi tekniklerini karşılaştırmak. Gereç ve Yöntem: Retina dekolmanı ve proliferatif diyabetik retinopatinin komplikasyonları nedeniyle pars plana vitrektomi (PPV) uygulanıp göz içi tamponad madde olarak silikon yağı kullanılan olgular, 20 G sklerotomiler yoluyla silikon yağı boşaltılanlar (Grup 1; 39 olgu) ve 23 G transkonjonktival sklerotomi yoluyla silikon yağı boşaltılanlar (Grup 2; 34 olgu) olmak üzere 2 gruba ayrıldı. Gruplar ameliyat sonrası en iyi düzeltilmiş görme keskinliği (EDGK) değişimi, göz içi basınç (GİB) değişimi, ameliyat sırasında ve sonrasında görülen komplikasyonlar açısından değerlendirildi. Bulgular: Ameliyat sonrası takiplerde ortalama EDGK değerleri Grup 1’de 1. gün, 1. hafta, 1. ay, 3. ay ve 6. ayda sırasıyla LogMAR 1.2±1.0, 1.0±1.0, 0.96±0.9, 0.9±0.85, 0.86±0.8, Grup 2’de 1. gün, 1. hafta, 1. ay, 3. ay ve 6. ayda sırasıyla LogMAR 1.2±1.2, 0.96±1.0, 0.94±0.9, 0.9±0.94, 0.9±0.94 olarak tespit edildi. Ameliyat sonrası takiplerde ortalama GİB değerleri Grup 1’de 1. gün, 1. hafta, 1. ay, 3. ay ve 6. ayda sırasıyla 13±1.7, 14±2.6, 14±1.7, 14±1.6, 15±3.2 mmHg, Grup 2’de 1. gün, 1. hafta, 1. ay, 3. ay ve 6. ayda sırasıyla 11±3.5, 12±1.8, 13±1.8, 13±2.0, 14±2.6 mmHg olarak tespit edildi. Grup 1’de ameliyat sonrası hiçbir olguda 1. gün hipotoni görülmezken, Grup 2’de 3 (%8.8) olguda hipotoni tespit edildi. Ameliyat sonrası takiplerde Grup 1’de 4 (%10.2) olguda redekolman, 3 (%7.6) olguda yeniden VK (vitreus kanaması), Grup 2’de ise 2 (%5.8) olguda redekolman, 2 (%5.8) olguda da yeniden VK meydana geldi. Sonuç: Silikon yağı boşaltılmasında 23 G transkonjonktival sütürsüz pars plana vitrektomi ve 20 G pars plana vitrektomi sistemleri benzer özellikler gösterir. Bununla beraber 23G sistem kapalı sistemin sağladığı avantajlar, konjonktivanın açılmaması, sütüre bağlı komplikasyonların oluşmaması gibi ek avantajlar sağlar. Başlık (İngilizce): Comparison of silicone oil removal using 23 gauge and 20 gauge sclerotomy systems Öz (İngilizce): Purpose: To compare 23 and 20 Gauge (G) sclerotomy methods for silicone oil removal. Materials and Methods: Patients that had undergone pars plana vitrectomy (PPV) and received silicone oil as intraocular tamponade material because of retinal detachment and the complications of proliferative diabetic retinopathy were divided into two groups: those undergoing removal of silicone oil through 20 G sclerotomy (Group 1; 39 patients) and those undergoing removal of silicone oil through 23 G transconjunctival sclerotomies (Group 2; 34 patients). The groups were evaluated with regard to postoperative changes in BCVA and IOP, and complications that occurred during and after surgery. Results: In the postoperative follow-up, the mean values of BCVA on the first day, at the first week, and at the first, third, and sixth months were LogMAR 1.2±1.0, 1.0±1.0, 0.96±0.9, 0.9±0.85, and 0.86±0.8, respectively, in Group 1, and LogMAR 1.2±1.2, 0.96±1.0, 0.94±0.9, 0.9±0.94, and 0.9±0.94, respectively, in Group 2. In the postoperative follow-up, the mean values of IOP on the first day, at the first week, and at the first, third, and sixth months were 13±1.7, 14±2.6, 14±1.7, 14±1.6, and 15±3.2 mmHg, respectively, in Group 1, and 11±3.5, 12±1.8, 13±1.8, 13±2.0, and 14±2.6 mmHg, respectively, in Group 2. No patients from the Group 1 developed hypotonia on the first day after surgery, whereas hypotonia was determined in 3 patients (8.8%) from Group 2. During the postoperative checkups, re-detachment was found in 4 patients (10.2%) from Group 1, recurring vitreous hemorrhage (VH) was found in 3 patients (7.6%) from Group 1, re-detachment occurred in 2 patients (5.8%) from Group 2, and recurring VH occurred in 2 patients (5.8%) from Group 2. Conclusion: Silicone oil removal using a 23 G transconjunctival sutureless pars plana vitrectomy and the 20 G pars plana vitrectomy system shows similar characteristics. However, the 23 G transconjunctival system provides additional benefits such as the advantages of a closed system, the conjunctiva is not opened, and the complications due to the sutures are reduced.Öğe Acinetobacter baumannii endophthalmitis following ıntravitreal ranibizumab ınjection(Retina-Vitreus, 2013) Çankaya, Cem; Cumurcu, Tongabay; Doğanay, SelimÖz: Çalışmamızda, vitreus içi Ranizumab (Lucentis®) uygulaması sonrası Acitenobacter Baumannii endoftalmisi gelişen bir olguyu sunmayı amaçlamaktayız. Yetmişdokuz yaşında erkek hasta, her iki gözünde görme azlığı şikayeti ile kliniğimize başvurdu. Hastanın yapılan Fundus floresein anjiografisinde (FA) sağ gözde kuru tip yaşa bağlı maküla dejenerasyonu (YBMD), sol gözde ise subfoveal klasik tip koroid neovasküler membran ve buna ikincil subretinal hemoraji tespit edildi. Hastanın sol gözüne 3 doz birer ay arayla intravitreal Ranibizumab (Lucentis®) tedavisi planlandı. Olgumuz, 3. doz uygulamayı takiben 3. günde görme kaybı, şiddetli göz ağrısı ve kırmızı göz ile kliniğimize başvurdu. Hastanın görme keskinliği ışık hissi düzeyindeydi. Biyomikroskobik muayenesinde ve B tarama ultrasonografide endoftalmi tablosu izlendi. Hasta acil olarak hospitalize edildi ve medikal tedavisine başlandı. Sol gözden vitreus örneği alınmasını takiben intravitreal Vankomisin ve Seftazidim uygulandı. Topikal sikloplejik ajanlarla birlikte sistemik sefazolin ve gentamisin, topikal fortifiye seftazidim ve vankomisin ve topikal moksifloksasin tedavisine başlandı. Yoğun kornea opasifikasyonu nedeni ile pars plana vitrektomi uygulanamadı. Tedavinin başlangıcından 4 gün sonra vitreus kültüründe Acinetobacter baumannii üremesi olduğu bildirildi. Takip eden günlerde klinik tabloda bir iyileşme izlenmedi ve görme keskinliği ışık hissi kaybına kadar ilerledi. Vitreus içi Ranibizumab uygulamasından sonra akut Acinetobacter baumannii endoftalmisi çok hızlı oluşabilir ve ciddi görme kaybına neden olabilir. Acinetobacter baumannii'ye bağlı endoftalmi tablosu nadir olmasına rağmen, oftalmologlar bu etyolojik ajana karşı daha dikkatli olmalıdırlar. Başlık (İngilizce): İntravitreal ranibizumab enjeksiyonu sonrası gelişen acinetobacter baumannii endoftalmisi Öz (İngilizce): We aimed to report a case who developed Acitenobacter baumannii endophthalmitis after intravitreal Ranibizumab (Lucentis®) injection. A 79-year-old male patient was admitted with vision loss in both eyes. Fluorescein angiography showed dry type age-related macular degeneration (ARMD) in the right eye and subretinal hemorrhage secondary to subfoveal classic type choroidal neovascular membrane in the left eye. Intravitreal injections of 3-dose Ranibizumab (Lucentis®) at monthly intervals were planned for the left eye of the patient. After the injection of the third dose of Ranibizumab, on the third day, the patient returned to the clinic with a complaint of excruciating ocular pain, red eye and vision loss in the left eye. The visual acuity of the patient was at the level of light perception. A slit lamp examination and B-mode ultrasonography revealed endophthalmitis. The patient was promptly hospitalised and medical treatment was started. After the sampling of vitreous from the left eye, vancomycin and ceftazidime were intravitreally administered. Systemic cefazolin and gentamicin, topical fortified vancomycin and ceftazidime, and topical moxifloxacin along with topical cycloplegic drops were started. Pars plana vitrectomy could not be performed due to corneal opacification. Four days after the initialisation of the therapy, the culture of the vitreous sample yielded Acinetobacter baumannii. In the following days, no regression in the clinical picture was determined and the level of the visual acuity worsened to light perception loss. Acute Acinetobacter baumannii endophthalmitis following intravitreal Ranibizumab injection occurs rapidly and can result in severe loss of vision. Although endophthalmitis is rare, ophthalmologists should be alert to the possibility of patients having endophthalmitis caused by A. baumannii.Öğe Active silicone oil removal with 23 gauge transconjunctival system; ‘’Doganay silicone oil extraction system’’(2019) Doğanay, Derya; Doğanay, Selim; Çankaya, CemAbstract: Aim: To describe a new and simple silicone oil removal method with 23-gauge (G) transconjunctival vitrectomy system.Material and Methods: This is a prospective, single center, interventional clinical trial. A hundred thirty-three eyes of 133 patientswere enrolled in this study. 1000 centistoke (cSt) silicone oil was removed with our new method. Main outcome measurements weresilicone oil removal time, number of sutured 23 G sclerotomy sites, intraoperative and postoperative complications, preoperative andpostoperative intraocular pressure (IOP) alterations, and preoperative and postoperative visual acuity changes.Results: The mean time between pars plana vitrectomy surgery with silicone oil endotamponade and silicone oil removal was 8.5±3.5months. Mean silicone oil removal time was 141.7±37.7 seconds. 210 of total 293 sclerotomies sites required suture. A statisticallysignificant decrease in postoperative IOP was found only on day 1 (p<0.05). Mean preoperative (before silicone oil removal) bestcorrect visual acuity (BCVA) was LogMAR 1.39±0.74 and mean postoperative BCVA at the final visit was LogMAR 1.23±0.88 (p<0.05).Mean postoperative follow-up was 7.2±6.2 months. Postoperative transient hypotony occurred in 23 eyes (IOP < 7 mm-Hg), revitreoushemorrhage occurred in 5 eyes and retinal re-detachment occurred in 7 (5.3%) eyes.Conclusion: Removal of 1000 cSt silicone oil with our new method is effective, safe, easy, and fast.Öğe Autoimmune polyglandular syndrome type III which accompanies to multiple sclerosis: A case report(2019) Gorgel, Ahmet; Tecellioğlu, Mehmet; Çankaya, CemAbstract: Autoimmune polyglandular syndrome type III (APS III) is characterised by autoimmune destruction of various endocrine and nonendocrine tissues. It differs from APS I and APS II in terms of without adrenal involvement. Although APS III includes a series ofautoimmune disorders, it is rarely associated with multiple sclerosis (MS). A 41-year-old female patient had diplopia, visual blurring,dizziness, and giddiness for 2 weeks. In her medical history, she had a diagnosis of MS and using Teriflunomide. It was detectedpositivity of antinuclear antibody (ANA), anti-thyroid peroxidase (Anti-TPO) and anti-thyroglobulin (Anti-TG) antibodies. Based onthese results, the patient with MS who has chronic autoimmune thyroiditis and primary ovarian failure was diagnosed with APSIII. The coexistence of APS-III and MS is a rare clinical entity. Moreover, hypothyroidism has been detected during teriflunomidetherapy in the patient. Hypothyroidism was most likely a component of APS-III in our case, but it may also have been triggered byteriflunomide.Öğe Cataract Surgery and Customized Toric Intraocular Lens Implantation in Patients with Cataract and High Astigmatism After Penetrating Keratoplasty(2024) Doğanay, Derya; Çankaya, Cem; Doğanay, SelimPhacoemulsification and implantation of a customized toric intraocular lens (IOL) Acriva BB T UDM 611 was performed in 3 eyes of 3 patients with cataract and more than 13 diopters of astig- matism after penetrating keratoplasty at least 6 months after complete suture removal. Pre- and postoperative uncorrected and corrected vi- sual acuity, manifest refractions, corneal topographies, autorefracto- metric keratometry values, posterior segment examinations and intraocular pressure measurements were performed in all patients. The corneal astigmatism was a relatively regular bow-tie pattern in all three patients. Astigmatic changes were also evaluated. No compli- cations were observed during surgery or at follow-up. Customized toric IOL implantation seems to be a predictable and safe procedure in patients with cataract and high astigmatism after penetrating ker- atoplasty. Longer follow-up is required to confirm these predictable clinical results, particularly with regard to IOL misalignment and bag stability.Öğe Conjunctival Limbal Autograft Combined with Amniotic Membrane Transplantation to Treat a Moderate Chemical Eye Injury(2019) Çankaya, CemAbstract: A 25-year-old male patient presented at the clinic with chemical trauma to the left eye. His visual acuity according to Snellen chart measurement was 0.05/10 in the left eye and 10/10 in the right eye. On slit lamp examination, conjunctival hyperemia and limbal ischemia were observed between the 1 o’clock and 6 o’clock hours (approximately 5 clock hours). The cornea was edematous in this area, and a corneal epithelial defect adjacent to the limbal ischemia area was present. The anterior chamber, iris, and lens were normal; the fundus could not be concurrently evaluated. Conjunctivalization and excessive neovascularization were observed in the limbal ischemic area at the end of the fourth week of medical treat-ment. Visual acuity in the left eye was 0.3 and the epithelial defect had healed. At the end of the sixth week, a conjunctival limbal autograft (CLAU) combined with amniotic membrane (AM) transplantation surgery was performed. Subsequently, the corneal neovascularization was noted to have completely vanished in the ischemic area where the CLAU and AM transplantation were performed. Visual acuity improved to 0.7 and the symptoms of the patient decreased.Öğe Corneal endothelial changes in behcet's patients with ınactive ocular ınvolvement(TAYLOR & FRANCIS INC, 530 WALNUT STREET, STE 850, PHILADELPHIA, PA 19106 USA, 2018) Çankaya, Cem; Cumurcu, Tongabay; Gündüz, Abuzer; Fırat, İlknurPurpose: The purpose of this article is to evaluate alterations in the corneal endothelial layer in Behcet's disease (BD) with inactive ocular involvement using specular microscopy.Materials and Methods: Thirty-three eyes of 33 BD patients who had at least one anterior segment involvement and no active inflammation in the last 3months were included in the study (group 1). Twenty-seven of the 33 BD patients had an anterior uveitis attack and six of them had a panuveitis (both anterior and posterior involvement) attack. Thirty-three eyes of 33 age- and sex-matched healthy subjects were enrolled in the control group (group 2). Corneal endothelial cell density (CD), coefficient of variation (CV), hexagonal cell ratio (HEX), and central corneal thickness (CCT) were measured using specular microscopy (Konan Medical, Nishinomiya, Japan), and the results were compared between groups.Results: The mean CD was 2739164.18 cells/mm(2) in group 1 and 2922 +/- 107.60 cells/mm(2) in group 2 (p=0.001). The mean CV was 32.9 +/- 4.76 in group 1 and 28.5 +/- 3.06 in group 2 (p=0.001). The mean HEX was 44.7 +/- 6.51 in group 1 and 49.7 +/- 6.10 in group 2 (p=0.019). The mean CCT was 545.75 +/- 40.89 in group 1 and 545.66 +/- 30.09 in group 2 (p>0.05).Conclusions: Ocular attacks in our BD patients may have caused permanent changes in the corneal endothelial layer. However, these changes did not lead to corneal decompensation, but further studies are necessary to confirm these results.Öğe Corneal endothelial changes in patients with vitamin D deficiency(WOLTERS KLUWER MEDKNOW PUBLICATIONS, WOLTERS KLUWER INDIA PVT LTD , A-202, 2ND FLR, QUBE, C T S NO 1498A-2 VILLAGE MAROL, ANDHERI EAST, MUMBAI, 400059, INDIA, 2018) Çankaya, Cem; Cumurcu, Tongabay; Gündüz, AbuzerPurpose: The purpose of this study is to evaluate the effect of vitamin D deficiency on corneal endothelial layer using specular microscopy. Methods: Fifty-eight eyes of 58 patients whose vitamin 13 level was below 15 ng/ml and who had no ocular pathology were included in the study (Group 1). Forty eyes of 40 age-and sex-matched subjects were enrolled as control group (Group 2). Corneal endothelial cell density (CD), coefficient of variation (CV), hexagonal cell ratio (HEX), and central corneal thickness (CCT) were measured using specular microscopy (Konan Medical Inc., Nishinomiya, Japan). The obtained data were compared between the groups. Results: There was no significant difference between the groups in terms of age and gender (P = 0.344, P = 0.399, respectively). The mean CD value was 2772.79 +/- 202.21 cells/mm(2) in Group 1 and 2954.97 +/- 116.89 cells/mm(2) in Group 2 (P = 0.001). The mean CV value was 30.31 +/- 3.65 in Group 1 and 28.20 +/- 2.71 in Group 2 (P = 0.003). The mean HEX value was 46.56 +/- 6.32 in Group 1 and 51.07 +/- 5.28 in Group 2 (P = 0.001). The mean CCT value was 555.87 +/- 36.90 mu in group 1 and 549.0 +/- 37.39 mu in Group 2 (P = 0.96). Conclusion: Vitamin D deficiency may affect the corneal endothelial layer. Patients with vitamin D deficiency should be evaluated for endothelial parameters in particular before an intraocular surgery. Further studies are needed to confirm our results.Öğe Diyabetik olgularda pars plana vitrektomiden önce uygulanan intravitreal bevacizumabın cerrahi başarıya etkisi(Retina-Vitreus, 2010) Doğanay, Selim; Koç, Bekir; Çankaya, Cem; Düz, Cem; Bilak, ŞemsettinÖz: Amaç: Diyabetik olgularda pars plana vitrektomiden (PPV) önce uygulanan intravitreal bevacizumabın cerrahi başarıya olan etkisini araştırmak. Gereç ve Yöntem: Tüm hastalar ameliyat öncesi bevacizumab uygulananlar (Grup 1; 32 olgu) ve uygulanmayanlar (Grup 2; 50 olgu) olmak üzere 2 gruba ayrıldı. Gruplar ameliyat sırasında retinal yırtık görülme sıklığı, aktif kanama görülme sıklığı, ameliyat sonrası en iyi düzeltilmiş görme keskinliği (EDGK) ve göz içi basınç (GİB) değişimi, ameliyat sonrası retina dekolmanı görülme sıklığı, yeniden vitreus kanaması (VK) görülme sıklığı ve rubeozis gelişimi açısından karşılaştırıldı. Bulgular: Ameliyat sırasında Grup 1’de 2 (%6.3), Grup 2’de 4 (%8) olguda retinal yırtık, Grup 1’de 2 (%6.3), Grup 2’de 4 (%8) olguda aktif kanama izlendi. Ameliyat sonrası Grup 1’de 1 (%3.1), Grup 2’de 2 (%4) olguda retina dekolmanı, Grup 1’de 4 (%12.5), Grup 2’de 14 (%28) olguda yeniden VK izlendi. Ameliyat sonrası takiplerde Grup 1’de 6 (%18.8), Grup 2’de 9 (%18) olguda GİB artışı görüldü. Ameliyat sonrası takiplerde Grup 1’de 24 (%75), Grup 2’de 32 (%64) olgunun ortalama EDGK değerinde artış tespit edildi. Sonuç: PDR’li olgularda ameliyat öncesi uygulanan anti-VEBF (vasküler endotelyal büyüme faktörü) ilaçlar, aktif yeni damarların gerilemesini sağlayarak cerrahi sırasında membranların daha kolay temizlenmesini sağlayıp, ameliyat sonrası yeniden kanama riskini azaltarak cerrahi başarıyı olumlu yönde etkilemektedirler. Ayrıca anti-VEBF ilaçların anti-ödematöz ve anti-enflamatuvar etkileri sayesinde daha iyi görme keskinlikleri elde edilmektedir. Başlık (İngilizce): The effect on surgical success of ıntravitreal bevacizumab given before pars plana vitrectomy in diabetic patients Öz (İngilizce): Purpose: To investigate the effect on surgical success of intravitreal bevacizumab given before pars plana vitrectomy in diabetic patients. Materials and Methods: All patients were divided into two groups: those given bevacizumab before surgery (Group 1; 32 patients) and those not given bevacizumab (Group 2; 50 patients). The groups were compared with regard to the frequencies of retinal tear and active bleeding during surgery, postoperative changes in best corrected visual acuity (BCVA) and intraocular pressure (IOP), postoperative frequencies of retinal detachment and recurrent vitreous hemorrhage (VH), and development of rubeosis. Results: During the surgery, retinal tear was observed in 2 patients (6.3%) from Group 1 and in 4 patients (8%) from Group 2; active bleeding was seen in 2 patients (6.3%) from Group 1 and in 4 patients (8%) from Group 2. After the surgery, retinal detachment was found in 1 patient (3.1%) from Group 1 and in 2 patients (4%) from Group 2; recurrent VH was found in 4 patients (12.5%) from Group 1 and in 14 patients (28%) from Group 2. In the postoperative controls, an increase in IOP was determined in 6 patients (18.8%) from Group 1 and in 9 patients (18%) from Group 2. In the postoperative controls, an increase in the mean BCVA value was determined in 24 patients (75%) from Group 1 and in 32 patients (64%) from Group 2. Conclusion: In the patients with PDR, anti-VEGF (vascular endothelial growth factor) drugs positively influence the surgical success by causing the active new vasculature to be regressed and consequently allowing easy cleaning of the membranes during surgery. Due to the anti-inflammatory and anti-edematous effect of anti-VEGF drugs, better BCVA is obtained after surgery.Öğe “Doğanay silikon alma sistemi” ile eş zamanlı fakoemülsifikasyon cerrahisi(2012) Doğanay, Selim; Fırat, Penpe Gül; Kütükde, Derya; Çankaya, Cem; Gündüz, GökselÖz: Amaç: ‘'Doğanay silikon alma sistemi'' ile eş zamanlı fakoemülsifikasyon (FAKO) cerrahisinin etkinliğini değerlendirmek. Gereç ve Yöntemler: Çalışmaya 23 gauge (G) yöntemle pars plana vitrektomi (PPV) yapılıp göz içi tamponad madde olarak 1000 cSt silikon yağı konan, 18 olgunun 20 gözü dahil edildi. Tüm olgulara peribulber anestezinin ardından 2.2 mm mikrokoaksiyel FAKO cerrahisi uygulandı. Daha sonra ‘Doğanay silikon alma sistemi'' kullanılarak silikon yağı çıkarımı yapıldı. Tüm olguların silikon yağı çıkarım süreleri, ameliyat sonrası takip süreleri, ameliyat sırasında ve sonrasında görülen komplikasyonlar, ameliyat sırasında yapılan ek işlemler, ameliyat öncesi ve sonrası göz içi basıncı (GİB), ameliyat öncesi ve sonrası en iyi düzeltilmiş görme keskinlikleri (EDGK) kaydedildi. Bulgular: Olguların 11'i kadın, 7'si erkek, yaş ortalamaları 59.28±9.27 yıldı. Ortalama takip süreleri; 5.2±3.02 ay, ortalama silikon yağı kalım süresi; 9.0±2.62 ay, ortalama silikon çıkarım süresi ise; 145.3±21.6 saniyeydi. Olguların hiçbirinde ameliyat sırasında komplikasyon gelişmedi. Ameliyat sonrası 1 gözde redekolman, 1 gözde vitre kanaması görüldü. Olguların ameliyat öncesi ve sonrası EDGK'leri arasında istatistiksel olarak anlamlı fark vardı (Grafik 1, p<0.05). GİB değerlerinde ise ameliyat öncesi ve ameliyat sonrası son kontroller karşılaştırıldığında anlamlı fark olmadığı görüldü (Grafik 2, p>0.05). Sonuç: ‘'Doğanay silikon alma sistemi'' ile beraber FAKO güvenli, hızlı ve kolay bir cerrahi yöntemdir.Öğe Evaluation of corneal biomechanical properties after uneventful standard coaxial phacoemulsification surgery(2018) Doğanay, Selim; Fırat, Penpe Gül; Doğanay, Derya; Ulaş, Fatih; Çankaya, CemAbstract: Aim: This study was designed to investigate the alteration of intraocular pressure measurements and biomechanical properties of the cornea in patients who underwent uneventful standard coaxial phacoemulsification cataract surgery through 2.75 mm corneal main incision with intraocular lens implantation. Material and Methods: 15 eyes of 15 patients admitted to our clinic because of the cataract problems in the study. Corneal hysteresis (CH), corneal resistance factor (CRF) measurements, Goldmann correlated (IOPg), and corneal compensated intraocular pressure (IOPcc) values were recorded by ocular response analyzer (ORA) before and 1 day, 1 week and 1 month after surgery. Results: The mean age of the patients was 64.3 ± 8.06 years. Preoperative mean CH, CRF, IOPg and IOPcc values were 8.23±2.10, 9.33±2.27, 18.54±3.42 and 19.66±3.22, respectively. The mean CH, CRF, IOPg and IOPcc values were 5.50±2.07, 8.69±2.04, 22.29±3.37 and 23.83±3.32, respectively on the first day after the surgery. The mean CH, CRF, IOPg and IOPcc values were 5.25±1.83, 8.29±2.10, 18.86±2.72 and 20.20±3.37, respectively of the first week after the surgery. The mean CH, CRF, IOPg and IOPcc values were 7.88±1.99, 8.37±1.83, 15.81±2.60 and 16.41±2.80, respectively in the first month after the surgery. Conclusion: These results revealed that the biomechanical properties of the cornea may change during the first one month period after uneventful standard coaxial phacoemulsification surgery.Öğe Evaluation of macular and retinal nerve fiber layer thicknesses in episodic-type cluster headache patients by optical coherence tomography(2019) Tecellioglu, Mehmet; Çankaya, CemAbstract: Aim: This study evaluated macular and retinal nerve fiber layer (RNLF) thicknesses using spectral domain optical coherence tomography (SD-OCT) in patients with episodic-type cluster headaches.Material and Methods: In total, 33 eyes of 33 patients with episodic-type cluster headaches were included in this study. The eyes were ipsilateral to the pain, and all measurements were performed during attacks. The control group consisted of 33 eyes of 33 age- and sex-matched healthy individuals. The average RNFL thickness and macular thickness (MT) obtained from nine macular areas in the Early Treatment Diabetic Retinopathy Study (ETDRS) were evaluated using SD-OCT (RS-3000; Nidek Inc., Fremont, CA, USA) following a detailed ophthalmologic examination. The results of the two groups were then compared.Results: The mean RNFL thickness was 104.73 ± 8.7 in the cluster headache patients and 106.86 ± 8.6 in the controls. The difference in RNFL thickness between the groups was not significant (p = 0.418). The MT measurements according to the ETDRS showed statistically significant thinning of the outer temporal area in the cluster headache patients (295.95 ± 13.5 vs. 312.77 ± 15.9 in the controls, p = 0.001). The differences between the two groups with respect to the other ETDRS areas (central macula, superior-inner, inferior-inner, nasal-inner, temporal-inner, superior-outer, inferior-outer, nasal-outer, and total average macula) were not significant (p = 0.482, p = 0.672, p = 0.65, p = 0.679, p = 0.062, p = 0.455, p = 0.818, p = 0.845, and p = 0.189, respectively).Conclusion: Although the difference in thinning of the internal temporal region was not statistically significant between the patient and control groups, a vascular aetiology leading to thinning of the temporal region and thus to cell damage may contribute to the aetiology of episodic-type cluster headaches.Öğe Familial association of keratoconus and granular corneal dystrophy: The familial case series(2019) Çankaya, Cem; Gündüz, Abuzer; Cumurcu, Tongabay; Demirel, Soner; Savacı, Saliha Serap; Çavdar, MüfideAbstract: OBJECTIVE: The aim of the present study was to evaluate the coexistence of bilateral keratoconus and granular corneal dystrophy (GCD) in the members of a family. METHODS: A total of 22 patients were examined in four generations of the family tree in this family screening study. Visual acuity test, biomicroscopic examination, and fundus examination were performed in all patients. The diagnosis of granular dystrophy was based on biomicroscopic examination findings. Corneal topography was performed on the patients diagnosed with granular dystrophy and other family members aged >5 years with normal examination findings. Corneal photographs were obtained from all patients with granular dystrophy except one case. RESULTS: Keratoconus or subclinical keratoconus was detected in seven cases. In addition, GCD type 1 was found in six of the seven cases. All patients diagnosed with keratoconus and granular dystrophy were females. On the other hand, there was no ophthalmologic problem in the men of the family tree. Although an autosomal dominant inheritance was found, the onset of the disease only in women suggests that there may be a variant expression. CONCLUSION: The present study showed an association of GCD and keratoconus in four generations of a family. More research is required to further explain this association.Öğe Glokomlu hastalarda vitreus sıvısında ve korpus genikülatum lateralede glutamat ve diğer aminoasit miktarlarının mr-spektroskopi ile değerlendirilmesi(İnönü Üniversitesi, 2009) Çankaya, CemGlokomlu olgularda, vitreus sıvısı ve korpus genikulatum lateralede glutamat ve diğer aminoasit miktarlarındaki değişimleri, MR-Spektroskopi (MRS) yöntemi ile değerlendirmek. MATERYAL-METOD: Glokom dışında herhangi göz patolojisi veya sistemik hastalığı bulunmayan yaş ve cinsiyet karşılaştırmalı, 29 glokomlu olgunun 29 gözü (Grup 1) ve rutin göz muayeneleri normal olan 13 sağlıklı bireyin 13 gözü (Grup 2) çalışma kapsamına alındı. Olguların korpus vitreusunda; Glutamate-glutamin (Glx)/Kreatin (Cr), laktat pikleri ve aynı taraf korpus genikulatum laterale bölgesinde Glx/Cr, N-asetil aspartat (NAA)/Cr, Kolin (Cho)/Cr oranları ve laktat pikleri MRS yöntemi ile değerlendirildi. BULGULAR: Sağlıklı bireylerin, vitreus sıvılarındaki ortalama Glx/Cr değeri 2.24±1.51, korpus genikulatum laterale bölgelerindeki ortalama Glx/Cr değeri 0.38±0.35, NAA/Cr 1.44±0.57 ve Cho/Cr değeri 0.79±0.32 olarak hesaplandı. Glokomlu olguların vitreus sıvılarındaki ortalama Glx/Cr değeri 10.87±8.58, korpus genikulatum laterale bölgelerindeki ortalama Glx/Cr değeri 1.29±1.21, NAA/Cr değeri 1.15±0.56 ve Cho/Cr değeri 1.36±1.30 olarak tespit edildi. Grup 1'deki glokomlu olguların 11'inin vitreus sıvılarında laktat piki saptanırken, sağlıklı bireylerin vitreus sıvılarında hiçbir olguda laktat piki saptanmadı. Sağlıklı bireyler ile glokomlu bireylerin vitreus sıvılarında ve korpus genikulatum lateralede Glx/Cr değerleri arasında istatistiksel olarak anlamlı fark tespit edildi (p<0.01). Korpus genikulatum laterale bölgelerindeki NAA/Cr ve Cho/Cr değerleri arasında istatistiksel olarak anlamlı fark tespit edilmedi (p>0.05). SONUÇ: Glokomlu olgularda vitreus sıvısında ve korpus genikulatum lateralede glutamat değerlerinin yüksek bulunması glokomun etyopatogenezinde apoptozis teorisini destekler niteliktedir. Dokuların biyokimyasal yapısını ve metabolitlerini ölçebilen ve bir spektrumda gösterebilen MRS, glokomun erken teşhisinde kullanılabilecek yeni ve non invaziv bir yöntem olabilir.Öğe Investigation of the morphometric structure of the retinal nerve fiber layer in patients with chronic obstructive pulmonary disease by optical coherence tomography(2024) Karabaş, Sibel Ateşoğlu; Çetin, Aymelek; Gülbaş, Gazi; Çankaya, Cem; Şenol, DenizAim: To examine the changes in the retinal nerve fiber layer (RNFL) with Spectral-Domain Optical Coherence Tomography (SD-OCT) in individuals diagnosed with Chronic Obstructive Pulmonary Disease (COPD), according to Global Initiative For Chronic Obstructive Lung Disease (GOLD). Materials and Methods: The study consisted of people 18 years or older, including 76 patients with COPD and 80 healthy control groups. Patients with COPD have been examined in four groups A, B, C and D, according to GOLD. RNFL thickness was examined through Optic Nerve Head (ONH) centered in four quadrants; superior, inferior, temporal, and nasal. Results: In the Optic Nerve Head-centered peripapillary area, the RNFL thickness was observed to be thinner than control group in the inferior quadrant in GOLD B, GOLD C, and GOLD D groups compared to the control group (p=0.002). In the temporal quadrant, GOLD A and GOLD C groups were the thickest (p=0.001). Conclusion: The patients with COPD included in our study were divided into groups by evaluating them according to the updated GOLD criteria and we think that this aspect has contribution to the literature. It has been observed that COPD causes changes in the RNFL, especially in its later stages. It would be appropriate to consult in terms of eye diseases for the evaluation of retinal functions in COPD patients.Öğe Pars plana vitrektomi ile kombine fakoemülsifikasyon ve göz içi lens implantasyonu cerrahisi sonuçlarımız(Retina-Vitreus, 2011) Koç, Bekir; Doğanay, Selim; Çankaya, CemÖz: Amaç: Pars plana vitrektomi ile kombine fakoemülsifikasyon (FAKO) ve göz içi lens (GİL) implantasyonu cerrahisi sonuçlarımızı değerlendirmek. Gereç ve Yöntem: PPV ile kombine FAKO cerrahisi+GİL uygulanan 29 olgunun 29 gözü çalışmaya dahil edildi. Olguların ameliyat öncesi ve ameliyat sonrası 1. gün, 1. hafta, 1. ay, 3. ay ve 6. ayda en iyi düzeltilmiş görme keskinlikleri (EDGK) ve göz içi basınçları (GİB) ölçüldü. Arka segmentin değerlendirilemediği olgularda A ve B-scan ultrasonografi yapıldı. Hastalar EDGK değişimi, GİB değişimi, ameliyat sırasında ve sonrasındaki komplikasyonlar açısından değerlendirildi. Bulgular: Ameliyat sonrası olguların 6. aydaki muayene bulguları esas alındığında, 29 olgunun 25’inde (%86.2) EDGK’da ameliyat öncesine göre artış elde edildi. Ameliyat sonrası takiplerde 6 hastada GİB yüksekliği tespit edildi. YRD nedeniyle ameliyat edilen hastaların 3’ünde (%27.3) redekolman, diyabetik VK nedeniyle ameliyat edilen olguların 2’sinde (%18.1) nüks VK meydana geldi. Sonuç: PPV ile kombine FAKO cerrahisinin, sağladığı kolaylıklar ve ayrı cerrahilerin getireceği dezavantajlar göz önüne alındığında, uygun olgularda kombine cerrahi güvenli bir tercih olabilir. Başlık (İngilizce): Outcomes of pars plana vitrectomy combined with phacoemulsification and intraocular lens implantation Öz (İngilizce): Purpose: To investigate the outcomes of pars plana vitrectomy combined with phacoemulsification (PHACO) and intraocular lens (IOL) implantation surgery. Materials and Methods: The study included 29 eyes of 29 patients underwent PHACO surgery combined with PPV+IOL implantation. Patients’ the best corrected visual acuities (BCVAs) and intraocular pressures (IOPs) were measured prior to surgery, and postoperatively on the first day, at the first week, on the first, third and sixth months. In the patients whose posterior segments were not evaluated, A- and B-scan ultrasonography was performed. The patients were controlled for the alterations in BCVA, IOP, intraoperative and postoperative complications. Results: On the basis of the findings of examinations on the postoperative sixth month, BCVA improved in 25 of 29 patients (86.2%) compared to preoperative values. On postoperative follow up, an increase in IOP occurred in 6 patients. Three patients (27.3%) of those who underwent surgery because of retinal detachment with tears developed redetachment, and recurrent VH occurred in two (18.1%) of the patients underwent surgery because of VH. During operation, iatrogenic retinal tear occurred in one patient and corneal epithelial edema occurred in four patients. Conclusion: Considering benefits of PHACO surgery combined with PPV and disadvantages of separate surgeries, combined surgery may be a safe way for appropriate patients.Öğe Surgical Management of Primary Inferior Oblique Muscle Overaction: A Subgroup-Specific Surgical Approach(2020) Özsoy, Kadir Ercan; Gündüz, Abuzer; Öztürk, Emrah; Çankaya, CemObjectives: The aim of this research was to assess the surgical results of recession and myectomy procedures in a subgroup of patients who had primary inferior oblique muscle overaction.Methods: The records of 94 patients who had been treated due to primary inferior oblique muscle overaction were retrospectively analyzed. The patients were classified into 2 groups according to the severity of the inferior oblique hyperfunction. Recession was performed for patients with a low grade (+1 or +2) inferior oblique hyperfunction, and patients with high grade (+3 or +4) hyperfunction underwent myectomy surgery. Patients demonstrating a horizontal misalignment underwent conventional horizontal muscle surgery along with an inferior oblique weakening procedure.Results: A total of 134 eyes fulfilled the inclusion criteria. Recession was performed in 95 eyes and myectomy in 39. Surgical success was obtained in 96.8% of the eyes that underwent recession and 97.4% of the eyes that underwent myectomy. Residual inferior oblique hyperfunction was observed in 3 eyes after recession and in 1 eye after myectomy. After surgery, about one-quarter of the patients with unilateral inferior oblique overaction subsequently developed a contralateral inferior oblique overaction.Conclusion: The results of this study demonstrated that both recession and myectomy procedures are effective for treating primary inferior oblique hyperfunction with minimal complications when applied in the appropriate patient.Öğe Transfusion transmitted virus DNA in serum tear and aqueous humour of patients undergoing cataract operation(Clinical & Experimental Ophthalmology, 2007) Emre, Sinan; Otlu, Barış; Çankaya, Cem; Doğanay, Selim; Durmaz, RızaPurpose: Transfusion-transmitted virus (TTV) is a novel non-enveloped, single-stranded DNA virus with unclear pathogenesis throughout the world. Many studies were conducted to determine this virus in various body fluids and different primer sets have been tested for accurate diagnosis.This study aimed to collect data on the prevalence of TTV in serum, tear and aqueous humour of patients undergoing planned cataract surgery and to determine effi- cacy of three different polymerase chain reaction (PCR) techniques. Methods: A total of 72 specimens (24 each of serum, tear and aqueous humour specimens) were collected from 24 patients (11 male and 13 female) having age-related cataract. The patients did not have any other ocular pathology. TTV DNA was investigated by three different PCR methods: a seminested PCR performed with Okamato’s primers, a one-step PCR performed with degenerative Takashi’s primers and a commercial real-time PCR system. Results: TTV DNA was detected in 20 (83.3%) of the 24 serum specimens by the one-step PCR and real-time PCR system. However, seminested PCR yielded a positivity rate of 25%.TTV DNA positivities of the one-step PCR and the real-time PCR system were 33.3% and 66.6% of the 24 tear specimens, respectively. Seminested PCR did not yield positive result in these specimens. From aqueous humour specimens, TTV DNA was detected in 3 (12.5%) of the 24 specimens only by the real-time PCR.TTV DNA positivity of seminested PCR was significantly low in all specimens. Conclusions: TTV DNA was detected in serum, tear and aqueous humour of patients undergoing cataract surgery, suppor ting the idea that this virus can be detected almost all of the body fluids but at different rates under various PCR conditions and primer sets. Using commercial real-time PCR significantly increased the TTV DNA positivity.
