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Öğe Bilateral cataract surgery in adult and pediatric patients in a single session(Elsevier Science Inc, 2000) Totan, Y; Bayramlar, H; Çekiç, O; Aydin, E; Erten, A; Daglioglu, MCPurpose: To evaluate the results of bilateral simultaneous cataract surgery in adult and pediatric patients under local or general anesthesia. Setting: Department of Ophthalmology, Inonu University, Turgut Ozal Medical Center, Malatya, Turkey. Methods: Eighty-two eyes of 41 patients were included in the study. Twelve of 17 pediatric patients with congenital cataract had bilateral simultaneous lensectomy, posterior capsulotomy, and anterior vitrectomy; 5 patients, aged 10 to 19 years, had bilateral extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (PC IOL) implantation. Forty-eight eyes of 24 adult patients had bilateral simultaneous ECCE with primary (43 eyes) or secondary (5 eyes) PC IOL implantation. Local anesthesia was administered to 20 adult patients by retrobulbar injection; the other cases were performed using general anesthesia. The procedures were treated as 2 separate surgeries in the same session; care was taken to ensure surgical asepsis. Results: No serious intraoperative complications occurred such as posterior capsule rupture, vitreous loss, endophthalmitis, and anesthesia-related problems. Of patients tested, 84.4% achieved a final best corrected visual acuity of 6/12 or better and 31.0%, of 6/6 or better. Conclusions: Simultaneous bilateral cataract surgery was not associated with an increased rate of complications, and visual results were good. If strict rules of surgical asepsis are followed, this may be a useful option in a variety of bilateral cases using general or local anesthesia. J Cataracr Refract Surg 2000; 26:1008-1011 (C) 2000 ASCRS and ESCRS.Öğe Bilateral retrobulbar neuritis following measles in an adult(Nature Publishing Group, 1999) Totan, Y; Çekiç, O[Abstract Not Available]Öğe Does convergence, not accommodation, cause axial-length elongation at near?: A biometric study in teens(Karger, 1999) Bayramlar, H; Çekiç, O; Hepsen, IFTo determine whether convergence rather than accommodation has a primary effect on the changes in axial length and other biometric components during near fixation, we measured the anterior chamber depth, lens thickness, vitreous length and axial length in the right eyes of 124 young male subjects while their left eyes focused at distance (6 m) and near (20 cm). The measurements were performed before and after cycloplegia in the right eye, so we aimed to study biometric components of the eye in the states of ac-commodation and nonaccommodation, but converging at near. While the left eye focused at near, the axial length increased significantly with and without cycloplegia (p < 0.0005 and p < 0.0005). The vitreous length was the main increasing ocular biometric component at near both with and without cycloplegia (p < 0.044 and p = 0.001, respectively). At near, there was no difference between two mean axial length and two vitreous length measurements both with and without cycloplegia (p = 0.672 and p = 0.595, respectively), Under cycloplegia, anterior chamber depth also increased significantly at near fixation (p = 0.012). Axial elongation at near fixation, mainly due to an increase in vitreous length, may result from the effect of accommodative convergence rather than accommodation itself. Much use of convergence, not accommodation, may be one of the contributing factors in adult onset and adult progression of myopia.Öğe Effect of caffeic acid phenethyl ester on corneal neovascularization in rats(Swets Zeitlinger Publishers, 2001) Totan, Y; Aydin, E; Çekiç, O; Daglioglu, MC; Borazan, M; Daglioglu, KPurpose. Caffeic acid phenethyl ester (CAPE), a biologically active component of propolis from honeybee hives, has potent antiinflammatory and antioxidant properties. We aimed to evaluate the ability of topically applied CAPE in comparison with known steroidal (dexamethasone sodium phosphate) and nonsteroidal (indomethacin) topical agents to reduce corneal neovascularization (CNV) induced by silver nitrate cauterization in rats. Methods. Following silver nitrate cauterization on both eyes, male rats were randomly assigned to the study and control groups, each consisting of ten rats. The inhibitory effects of the test drugs against a placebo (isotonic saline) on CNV were tested and compared to each other using a previously described method in which extent of neovascularization and burn stimulus intensity were scored by a masked examiner. Briefly, burn stimulus intensity was scored from 0 to + 3 according to the height of blister from corneal surface, and extent of neovascularization was recorded from 0 to + 6 according to the distance from limbus to the end point of CNV toward the central corneal burn. Results. The mean burn stimulus score were not different among the groups (P=0.807). Percent inhibition of CNV compared to the placebo control and its significance were 31.5%, P=0.011 for indomethacin; 56%, P<0.001 for dexamethasone; and 52%, P<0.001 for CAPE. Dexamethasone was significantly (P<0.05) more effective than indomethacin in inhibition of neovascular growth. CAPE was found to be superior (P<0.05) to indomethacin and almost as effective as (P>0.05) dexamethasone in reducing CNV. Conclusion. Topically applied CAPE was demonstrated to have an inhibitory effect, comparable to that of topical dexamethasone, on CNV in this rat model. Antiinflammatory and antioxidant properties of CAPE may contribute to its suppression on CNV.Öğe Evaluation of hemodynamic changes in the ophthalmic artery with color Doppler ultrasonography after strabismus surgery(Slack Inc, 2000) Bayramlar, H; Totan, Y; Çekiç, O; Yazicioglu, KM; Aydin, EPurpose: To investigate the blood flow changes in ophthalmic artery with color Doppler ultrasonography after strabismus surgery. Methods: Twenty eyes of 19 patients who underwent recession or resection surgery on two horizontal rectus muscles in 1 eye were examined using color Doppler ultrasonography preoperatively and 1 week and 1 month postoperatively. Measurements from both eyes of 16 age- and sex-matched normal subjects served as control data. The systolic maximum velocity, mean velocity, end-diastolic velocity, pulsatility index, and resistance index of the ophthalmic artery were determined. The Mann-Whitney U test was performed for comparison of the control and study group preoperatively for any hemodynamic parameter. Statistical comparison of the preoperative and postoperative measures in the study group was performed with Friedman's two-way analysis of variance. Results: No difference (P>.05) was observed preoperatively between the study and control groups for any hemodynamic parameter in the ophthalmic artery. Although the ophthalmic artery showed a slight increase in systolic maximum velocity 1 month postoperatively, there were no statistically significant differences (P>.05) in velocities or resistance in the ophthalmic artery at any interval. Conclusion: Two horizontal rectus muscle operations in a previously unoperated eye do not cause significant hemodynamic changes in the ophthalmic artery. However, further studies are needed to obtain more information about the effect of multiple vertical rectus muscle operations on the blood flow parameters of the ophthalmic artery.Öğe Incidence of keratoconus in subjects with vernal keratoconjunctivitis(Elsevier Science Inc, 2001) Totan, Y; Hepsen, IF; Çekiç, O; Gündüz, A; Aydin, EPurpose: To detect the incidence of keratoconus by videokeratography in patients with vernal keratoconjunctivitis (VKC) and to evaluate the clinical characteristics of VKC associated with keratoconus, Design: A prospective, cross-sectional (prevalence) study. Participants: Eighty-two consecutive subjects with the diagnosis of VKC, Methods: Both eyes of VKC subjects were investigated by videokeratography in comparison with slit-lamp biomicroscopy and keratometry, To detect keratoconus, corneal topography maps were examined with modified Robinowitz-McDonnell test. Main Outcome Measures: In this test, maps with central corneal power greater than 47.2 diopters and/or the inferosuperior asymmetry value greater than 1.4 were considered to have a keratoconus pattern. The findings of VKC were also recorded. Results: The distribution of clinical forms of VKC were as follows: 46.34% mixed, 43.90% palpebral, and 9.76% limbal types. Twenty-six (31.7%) of 82 subjects had complications with kerotopathy such as pseudogerontoxon, punctate keratitis, and shield ulcer. Forty-four eyes (26.8%) were detected as keratoconus by quantitative evaluation of videokeratography maps, 14 eyes (8.5%) by biomicroscopy, and 30 eyes (18.3%) by keratometry, The increased incidence of keratoconus was associated with male gender, long-standing disease, mixed and palpebral forms, and advanced corneal lesions. Conclusions: The higher incidence of keratoconus in our study compared with the previous reports may result from early detection of mild keratoconus by interpretation of color-coded videokeratographic maps with a sensitive quantitative method. (C) 2001 by the American Academy of Ophthalmology.Öğe Manual tunnel incision extracapsular cataract extraction using the sandwich technique(Amer Soc Cataract Refractive Surgery, 1999) Bayramlar, H; Çekiç, O; Totan, YSmall incision extracapsular cataract extraction (ECCE) using the sandwich technique is described. After capsulorhexis, hydrodissection, and hydrodelineation, the endonucleus is moved into the anterior chamber and extracted by sandwiching it between the irrigating vectis and iris spatula. In a series of 37 eyes, most achieved a best corrected visual acuity of 5/10 or better postoperatively. Complications were posterior capsule rupture, vitreous loss, and transient corneal edema. Small incision ECCE using the sandwich technique is safe, easy, and does not require expensive instrumentation.Öğe Plasma malondialdehyde and nitric oxide levels in age related macular degeneration(British Med Journal Publ Group, 2001) Totan, Y; Çekiç, O; Borazan, M; Uz, E; Sögüt, S; Akyol, ÖAims-To evaluate alteration of plasma malondialdehyde (MDA) and nitric oxide (NO) levels in patients with exudative age related macular degeneration (ARMD). Methods-Plasma. nitrite plus nitrate concentrations as an index of plasma NO levels and plasma MDA level as a marker of lipid peroxidation were measured in patients with exudative ARMD and age and sex matched healthy subjects. Results-Significantly higher MDA and lower NO levels were detected in plasma of patients with ARMD compared with their controls (p=0.01, p=0.001, respectively). Conclusion-The results may support involvement of oxidative damage and vascular theory in the pathogenesis of ARMD as part of the ageing process.Öğe Small incision extracapsular cataract surgery with manual phacotrisection(Amer Soc Cataract Refractive Surgery, 2000) Hepsen, IF; Çekiç, O; Bayramlar, H; Totan, YPurpose: To evaluate the safety and efficacy of small incision extracapsular cataract extraction (ECCE) using the manual phacotrisection technique. Setting: Department of Ophthalmology, Turgut Ozal Medical Center, Inonu University, Malatya, Turkey. Methods: Fifty-nine eyes of 54 patients had small incision ECCE by the manual phacotrisection technique. Mean follow-up was 10 months. After capsulorhexis and hydrodissection were performed, the endonucleus was prolapsed into the anterior chamber and trisected using an anteriorly positioned triangular trisector and posteriorly placed solid vectis. Pieces were extracted with a forceps through a small incision. Results: Postoperatively, best spectacle-corrected visual acuity of 20/40 or better was achieved in 48 eyes (83%) and of 20/25 or better in 28 eyes (47%). The most frequent intraoperative complication was posterior capsule rupture (n = 5). Of eyes that developed posterior capsule rupture, 3 had vitreous loss and 2 had implantation of an anterior chamber intraocular lens (IOL), in 44 eyes, the IOL was implanted in the bag and in 12 eyes, in the ciliary sulcus. The most significant postoperative complication was transient corneal edema, which developed in 32 eyes (54%). No permanent complications (e.g., corneal endothelial decompensation) occurred in any case. Conclusion: Manual phacotrisection has several advantages such as nucleus safety, less dependence on assistant personnel, the elimination of the phaco machine, and cost effectiveness. J Cataract Refract Surg 2000; 26:1048-1051 (C) 2000 ASCRS and ESCRS.Öğe Topically applied water extract of propolis to suppress corneal neovascularization in rabbits(Karger, 1999) Hepsen, IF; Er, H; Çekiç, OPurpose: Propolis, a natural honey bee hive product, has anti-inflammatory and antioxidative properties. We aimed to assess the possible contribution of topically applied propolis to the suppression of corneal neovascularization (CNV). Methods: The effect of a water extract of propolis (WEP) 1% drops (group 1) in comparison with dexamethasone 0.1% (group 2) and saline (group 3) on CNV was tested in rabbit corneas injured by silver nitrate cauterization. The extent of CNV was quantitated as the area of CNV and the percent area of CNV for each cornea of the three groups (12 right eyes per group) in the first week of the treatment. The mean percent CNV was used for statistical analysis. Results: The corneas treated with the topical WEP 1% had an almost equal percent CNV as compared with the corneas treated with topical dexamethasone 0.1% and had less percent CNV than the control eyes. The quantitative analysis in groups 1, 2 and 3 revealed that the mean percent CNV was 41.0 +/- 14.1, 39.4 +/- 11.0 and 56.9 +/- 18.4, respectively. The differences between both groups 1 and 3 as well as groups 2 and 3 were statistically significant (p = 0.02 and p = 0.01, respectively), whereas the difference between groups 1 and 2 was not significant (p = 0.86). Conclusions The topical application of a WEP 1% has an inhibitory effect on CNV in the rabbit's cornea. The inhibitory effect of propolis was shown to be comparable to that of topical dexamethasone 0.1%, a potent inhibitor of angiogenesis. We suggest that the effect of propolis may partially be due to its inhibitory effect on the activity of both cyclo-oxygenase and lipo-oxygenase.
