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23 ve 20 gauge sklerotomi yöntemleri ile silikon yağı boşaltılmasının karşılaştırılması
(Retina-Vitreus, 2011) Doğanay, Selim; Koç, Bekir; Çankaya, Cem; Demirel, Soner
Öz: 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.
An Algorithm Recommendation to Detect Specific Pathology of the Lacrimal Sac
(Lippincott Williams & Wilkins, 2022) Demirel, Soner; Firat, Murat; Firat, Ilknur Tuncer; Dikci, Seyhan
We aimed to recommend an efficient algorithm to detect the presence of specific pathologies of the lacrimal sac (LS). The charts of 296 patients who had undergone LS biopsy were reviewed retrospectively. The age, gender, history, examination and radiological findings, sac appearance, and pathology results of the patients were recorded. The power of our data to predict the presence of potential specific pathology was identified by regression analysis. After the causality evaluation of the statistical results, an algorithm was created to differentiate specific LS pathologies from chronic dacryocystitis. Our algorithm was mainly formed by deciding on radiological examination and biopsy according to the risk scoring created by the examination findings. A specific LS pathology was observed in 11(3.7%) patients. When we applied the recommended algorithm to cases with a suspicion of specific pathology and/or found to have a specific pathology, 36.4% of the patients would not require radiological examination and 29.6% of them would not require a biopsy. On the other hand, 80% of the frozen biopsies had been conducted on cases without a specific pathology. Managing the cases according to our algorithm would mean that frozen biopsy would be recommended in only 1 (12.5%) case without a specific pathology. Besides, the detection of cases with a specific pathology would not be prevented and the necessary diagnostic procedures would continue to be performed. Specific LS pathologies can be detected adequately, whereas decreasing unnecessary examinations and procedures in cases without a specific pathology by using our algorithm.
Allojen limbal kök hücre ve otolog oral mukozal greftiyle oküler yüzey rekonstrüksiyonu: iki olgu
(Türk Oftalmoloji Dergisi, 2013) Orman, Gözde; Demirel, Soner; Doğanay, Selim; Şüheda, Behice Duman; Kütükde, Derya
Öz: Her iki gözünde ciddi oküler yüzey hasarı olan olguların rekonstrüksiyonunda az sayıda metot uygulama şansı vardır. Her iki gözünde limbal kök hücre eksikliği olan ilk olguya allojen limbal kök hücre nakli, tekrarlayan pterjiyum ve sembleferonu olan ikinci olguya ise otojen ağız içi mukoza transplantasyonu uygulandı. Bu çalışmada, her iki oküler yüzey bozukluğu olan olguların rekonstrüksiyonunda uygulanabilecek yöntemler tartışıldı.
Anatomical and functional results of pars plana vitrectomy+ ILM peeling+ gas endotamponade in patients with idiopathic stage 4 macular hole
(2019) Dikci, Seyhan; Demirel, Soner; Tuncer Firat, Ilknur; Yilmaz, Turgut
Aim: To evaluate the anatomical and functional results in cases underwent 23-gauge pars plana vitrectomy (PPV) due to idiopathic stage 4 macular hole.Material and Methods: 17 eyes of 17 patients who underwent PPV due to idiopathic stage 4 macular hole between March 2013 and March 2016 at İnönü University Turgut Özal Medical Center Department of Ophthalmology were included in the study. The medical records of the patients were retrospectively reviewed. Macular hole staging was performed according to biomicroscopic examination and optical coherence tomography findings. Anatomical success was evaluated according to the condition of the macular hole after the surgery and functional success was evaluated according to the visual acuity.Results: 9 (53%) of the cases were females and 8 (47%) were males, the mean age was 66.6 ± 6.6 (55-81). PPV, internal limiting membrane (ILM) peeling and gas tamponade were applied to all cases. The mean follow-up period was 13.9±9.7 (4-30) months. ILM peeling was performed using trypan blue in three (17.6%) of the cases, brillant blue in 4 (23.5%) of the cases and membrane blue in 10 (58.8%) of the cases. Three cases (17.6%) were treated with C3F8 and 14 cases (82.3%) with SF6 gas tamponade. The mean preoperatively best-corrected visual acuity (BCVA) was 0.08±0.06 (0.03-0.2) and the mean postoperatively BCVA was 0.16±0.15 (0.03-0.5). Visual acuity did not change in two eyes (11.7%) and decreased in two eyes (11.7%). Macular hole had not closed in four patients (23.5%).Conclusion: 23 gauge PPV, ILM peeling and C3F8 or SF6 gas tamponade provides anatomical and functional success in the treatment of idiopathic stage 4 macular hole.Keywords: Internal limiting membrane; Macular hole; Pars plana vitrectomy.
Anatomical and functional results of pars plana vitrectomy+ ILM peeling+ gas endotamponade in patients with idiopathic stage 4 macular hole
(2019) Dikci, Seyhan; Demirel, Soner; Tuncer Fırat, İlknur; Yılmaz, Turgut
Abstract: Aim: To evaluate the anatomical and functional results in cases underwent 23-gauge pars plana vitrectomy (PPV) due to idiopathic stage 4 macular hole. Material and Methods: 17 eyes of 17 patients who underwent PPV due to idiopathic stage 4 macular hole between March 2013 and March 2016 at İnönü University Turgut Özal Medical Center Department of Ophthalmology were included in the study. The medical records of the patients were retrospectively reviewed. Macular hole staging was performed according to biomicroscopic examination and optical coherence tomography findings. Anatomical success was evaluated according to the condition of the macular hole after the surgery and functional success was evaluated according to the visual acuity. Results: 9 (53%) of the cases were females and 8 (47%) were males, the mean age was 66.6 ± 6.6 (55-81). PPV, internal limiting membrane (ILM) peeling and gas tamponade were applied to all cases. The mean follow-up period was 13.9±9.7 (4-30) months. ILM peeling was performed using trypan blue in three (17.6%) of the cases, brillant blue in 4 (23.5%) of the cases and membrane blue in 10 (58.8%) of the cases. Three cases (17.6%) were treated with C3F8 and 14 cases (82.3%) with SF6 gas tamponade. The mean preoperatively best-corrected visual acuity (BCVA) was 0.08±0.06 (0.03-0.2) and the mean postoperatively BCVA was 0.16±0.15 (0.03-0.5). Visual acuity did not change in two eyes (11.7%) and decreased in two eyes (11.7%). Macular hole had not closed in four patients (23.5%). Conclusion: 23 gauge PPV, ILM peeling and C3F8 or SF6 gas tamponade provides anatomical and functional success in the treatment of idiopathic stage 4 macular hole.
Ancient schwannoma in phthisis bulbi: Case ReporT
(2019) Ozcan, Mehmet; Akatli, Ayse Nur; Turkmen Samdanci, Emine; Demirel, Soner
Abstract: Schwannoma is benign nerve sheath tumor of Schwann cells. A 41-year-old female patient presented with pain and a complaint of inability to see. A mass revealed in left eye. Mass was histopathologically evaluated as schwannoma. This lesion in a rare location is presented with the literature
Apart From Surgical Procedures, Another Important Point to Note in Lacrimal Canalicular Lacerations: Traumatic Retinal Tears
(Lippincott Williams & Wilkins, 2019) Demirel, Soner; Dikci, Seyhan; Firat, Penpe Gul; Genc, Oguzhan; Mutlu, Kayhan
Background: To evaluate fundus examinations in terms of traumatic retinal tears or dialysis that may be related to canalicular lacerations (CLs). Materials and Methods: This retrospective study was conducted on patients with CL repair from June 1, 2009 to May 30, 2018. The authors collected the data from the patients' medical records, including their demographic details, mechanism and setting of injury, associated ocular injuries, type of stent used, setting of repairs, duration of follow-up, complications, pre- or intraoperative findings of biomicroscopic and fundus examinations, refractive errors, postoperative follow-up of fundus examination, and management. Results: Sixty patients (43 males and 17 females) were included in the study. The mean age of all the patients was 27.50 +/- 21.72 (min: 1-max: 94) years. Isolated CL was found in 38 patients. Nonisolated CL, which means with some additional pathologies, were found in 22 patients (37%, approximately 1/3). Retinal follow-up records were available in 49 patients with a mean follow-up period of 7.48 +/- 9.82 months. Retinal tears were seen in 3 patients (0.05%) with no predisposing risk factors. Two of these tears were found in the follow-up period after the traumas. Conclusion: Consequent retinal tears after canalicular lacerations were not strongly addressed in previous works. In this study, the authors aimed to view CL from a different perspective. Canalicular laceration is also an ocular trauma that may threaten vision. The authors emphasized that performing detailed fundus examinations and follow-up in all canalicular traumas is necessary.
Assessment of the Utility of Plusoptix A09 Handheld Photo-refractometer in Screening Refractory Errors and Amblyopia in Children
(Georg Thieme Verlag Kg, 2021) Sinanoglu, Muhammed Selcuk; Yakinci, Cengiz; Demirel, Soner
The aim of this study is to find out the frequency of anisometropic amblyopia in children and to increase awareness about this disease. All children between the ages of 4 and 10 years who were attending 11 kindergarten and primary schools determined by provincial directorate for national education in the center of Malatya were included. A screening team including interns and a resident from the Department of Pediatrics have used Plusoptix A09 handheld photo-refractometer device for detecting amblyopia and its reasons. A total of 7,000 students were screened. The mean age of the students was 7.4 +/- 2 years. Amblyopia was suspected in 357 cases with the Plusoptix S09 screening. After eye examinations performed by an ophthalmologist, 303 cases were found to have pathologic eye examination. Amblyopia was found in 67 (18.8%) of the 303 cases, and anisometropic amblyopia was found in 59 of 67 cases. As a result of the screening, sensitivity of Plusoptix A09 was found to be 88.1%, while its specificity was found to be 88.6%. Its positive predictive value was found to be 64.0% and its negative predictive value was found to be 97.0%. We believe that with screenings performed by health professionals who are given short-term training by using a device that can conduct remote measurements, detection of anisometropic amblyopia, which is the most frequent reason for amblyopia, can be done in a fast and relatively less expensive way and with the minimum number of specialist physician required. This way, children with amblyopia can reach the ophthalmologist earlier for treatment.
The association of outer retinal tubulation with vitreomacular adhesion and epiretinal membrane in eyes with age-related macular degeneration
(2020) Dikci, Seyhan; Ulucan, Pamuk Betül; Demirel, Soner; Fırat, Penpe Gül; Yılmaz, Turgut
Abstract: Aim of this study to investigate the relationship between outer retinal tubulation (ORT) and vitreomacular adhesion (VMA) or epiretinal membrane (ERM) in eyes with age-related macular degeneration (ARMD). 251 eyes of 138 (46 female, 92 male) patients were included in the study. Of those, 84 eyes were with dry type ARMD, 167 eyes were with wet type ARMD. Medical records of the cases were evaluated retrospectively. Evaluation of the vitreomacular interface (including VMA and ERM), and ORT was checked by using optical coherence tomography. VMA was observed in 26 eyes of 251 eyes and ERM in 46 of 251 eyes. In eyes with VMA, while ORT was not found in dry type ARMD, ORT was found in 5 (29.4%) of 17 eyes with wet type ARMD. In eyes with ERM, while ORT was found in one of 13 eyes (7.7%) with dry type ARMD, ORT was found in 6 (18.2%) of 33 eyes with wet type ARMD. No statistically significant difference was found between ORT presence and ERM or VMA presence in dry or wet type ARMD patients (p?0.05). Our study results suggest that, although there is no correlation between VMA and ERM with development of ORT in ARMD, further large-scale studies are required to confirm these findings and to establish a definite conclusion.
Canalicular Incisional Approach for Recanalization of Punctum: A Modified Surgical Treatment for Acquired Complete Upper and Lower Punctum Occlusions as an Alternative to Bypass Methods
(Lippincott Williams & Wilkins, 2020) Demirel, Soner; Ozturk, Emrah; Dikci, Seyhan; Firat, Penpe Gul
Purpose: To define the success of surgical technique used in the treatment of epiphora that is caused by bi-canalicular acquired complete punctum occlusion. Materials and Methods: The study is a retrospective consecutive case series, who underwent canalicular incisional approach for recanalization (CIAFOR) for acquired bi-canalicular punctum occlusions. The authors have used this technique in the cases not possible to perform a punctum dilatation and not possible to determine the punctum location exactly due to severe fibrosis. Functional and anatomical success was evaluated by the absence of epiphora and with lavage at post-operative 6th months. Results: Seven eyes of 5 patients (3 males and 2 females) were included in the study. The ages of the patients were 70, 65, 45, 64, and 70 years, respectively. Current follow-up periods vary between 6 and 23 months. Although functional and anatomical success achieved in all eyes, complication such as accessory punctum observed. Conclusions: CIAFOR seems to be a successful and simple surgical technique to treat acquired total punctum occlusion.
Central serous chorioretinopathy due to low dose exogenous corticosteroid administered for a bee sting: a complication or coincidence?
(2018) Fırat, Murat; Yılmaz, Turgut; Gündüz, Abuzer; Demirel, Soner; Dikici, Seyhan; Öztürk, Emrah
Abstract: Central serous chorioretinopathy (CSCR) is a posterior segment disorders characterized by localized and limited serous retinal detachment and/or retinal pigment epithelium detachment. The etiopathogenesis has not been fully elucidated. Local or systemic steroid administration through various routes and endogenous steroid increase are known to cause CSCR. It is believed that steroids cause CSCR development by delaying the healing of retinal pigment epithelium or increase choriocapillaris permeability through various mechanisms. The role of an allergic reaction in CSCR development is controversial. We evaluated a case that developed CSCR following a single intramuscular injection of 8 mg dexamethasone (Dekort, Deva) for a bee sting in this study. The systemic steroid dose used in our case was much lower than other doses reported to cause CSCR in the literature. This suggests that some molecules in the bee venom may have contributed to CSCR development in our case.
Comparison of Nd:YAG laser (532 nm green) vs diode laser (810 nm) photocoagulation in the treatment of retinopathy of prematurity: an evaluation in terms of complications
(Springer London Ltd, 2020) Dikci, Seyhan; Demirel, Soner; Firat, Penpe Gul; Yilmaz, Turgut; Ceylan, Osman Melih; Bag, Harika Gozde Gozukara
Purpose To compare the anterior and posterior segment complications of diode (810 nm) laser photocoagulation (LPC) and Nd:YAG (532 nm green) LPC in the treatment of retinopathy of prematurity (ROP). Patients and methods The 84 eyes of 43 patients treated with diode LPC (group 1) and 58 eyes of 31 patients treated with Nd:YAG LPC (group 2) for ROP in our clinic were enrolled in the study. Medical records of all patients were investigated retrospectively. The patients in each group were examined in terms of birth weights, gestational weeks, stage of retinopathy, number of lasers pots, laser parameters, and anterior and posterior complications of LPC. Results The mean birth weeks of group 1 patients were postmenstrual 27.7 +/- 2.5 (23-33), while the mean birth weights were 1006.0 +/- 334.5 (540-1980) grams. The mean birth weeks of group 2 patients were postmenstrual 27.4 +/- 2.6 (23-33), while the mean birth weights were 1073.8 +/- 329.2 (480-1720) grams. The mean numbers of laser spots were 1036.0 +/- 515.2 (430-2410) in group 1 per eye, while the mean numbers of laser spots were 1085.4 +/- 526.0 (445-2530) in group 2 per eye (p >= 0.05). Additional laser application was performed in four eyes (4.8%) in group 1 and four eyes (6.9%) in group 2. Four eyes (4.8%) treated with diode LPC and one eye (1.7%) treated with Nd:YAG laser developed retinal detachment. Two eyes of a patient (3.4%) applied Nd:YAG LPC developed cataract. Conclusion Cataract may develop when Nd:YAG laser is used; however, posterior segment complications may be more likely to appear with the use of diode laser in these cases.
Comparison of the results between monocanalicular and bicanalicular silicone tube intubation in children with congenital nasolacrimal duct obstruction
(2021) Demirel, Soner; Demir, Ulku
Aim: In this study we aimed to compare the retrospective results of the success rates in children with congenital nasolacrimal duct obstruction undergoing monocanalicular and bicanalicular silicone tube intubation. Materials and Methods: Bicanalicular (Group 1) and monocanalicular (Group 2) silicone tube intubation was performed in 48 eyes of 42 patients using the Ritleng method. Sixteen of the patients were boys and 26 were girls. Bicanalicular silicone tube intubation was performed in 26 eyes of 22 patients, and monocanalicular silicone tube intubation was performed in 22 eyes of 20 patients. Results: The mean age of patients was 5.68±1.83 years (2-9 years) in the first group, and 5.05±1.76 years (3-9 years) in the second group. The period of leaving the silicone tube was 3.61±1.38 months (1-6 months) in the first group, and 3.18±1.00 months (1-6 months) in the second group. The mean follow up period of the patients was found to be 11.8 months (6-36 months) in the bicanalicular group and 14.0 months (6-36 months) in the monocanalicular group.The success rate was 92.30% (22 of 26 eyes) in the first group and 95.45% (21 of 22 eyes) in the second group. In the first group, 2 patient’s bicanalicular tube was removed spontaneously 2 months ago, 2 patients were performed dacryocystorhinostomy, 1 patient developed pyogenic granuloma and laceration occurred in the lower canaliculus of 1 patient. In the second group, the tubes of 2 patients were removed spontaneously 2 months ago and silicone tube intubation was performed again with the same method. In this group, 1 patient was then performed dacryocystorhinostomy and 1 patient developed conjunctivitis. There were no corneal or conjunctival complications in either group. Conclusion: There was no statistically significant difference in success rates between the groups (p>0.05)
Comparison of the results between monocanalicular and bicanalicular silicone tube intubation in children with congenital nasolacrimal duct obstruction
(2021) Demirel, Soner; Demir, Utku
Abstract: Aim: In this study we aimed to compare the retrospective results of the success rates in children with congenital nasolacrimal duct obstruction undergoing monocanalicular and bicanalicular silicone tube intubation. Materials and Methods: Bicanalicular (Group 1) and monocanalicular (Group 2) silicone tube intubation was performed in 48 eyes of 42 patients using the Ritleng method. Sixteen of the patients were boys and 26 were girls. Bicanalicular silicone tube intubation was performed in 26 eyes of 22 patients, and monocanalicular silicone tube intubation was performed in 22 eyes of 20 patients. Results: The mean age of patients was 5.68±1.83 years (2-9 years) in the first group, and 5.05±1.76 years (3-9 years) in the second group. The period of leaving the silicone tube was 3.61±1.38 months (1-6 months) in the first group, and 3.18±1.00 months (1-6 months) in the second group. The mean follow up period of the patients was found to be 11.8 months (6-36 months) in the bicanalicular group and 14.0 months (6-36 months) in the monocanalicular group.The success rate was 92.30% (22 of 26 eyes) in the first group and 95.45% (21 of 22 eyes) in the second group. In the first group, 2 patient’s bicanalicular tube was removed spontaneously 2 months ago, 2 patients were performed dacryocystorhinostomy, 1 patient developed pyogenic granuloma and laceration occurred in the lower canaliculus of 1 patient. In the second group, the tubes of 2 patients were removed spontaneously 2 months ago and silicone tube intubation was performed again with the same method. In this group, 1 patient was then performed dacryocystorhinostomy and 1 patient developed conjunctivitis. There were no corneal or conjunctival complications in either group. Conclusion: There was no statistically significant difference in success rates between the groups (p>0.05).
Computed Tomography Diagnostic Abilities for Open-Globe Injuries in Pediatric Versus Adult Patients
(Lippincott Williams & Wilkins, 2021) Dikci, Seyhan; Yildirim, Ismail Okan; Firat, Murat; Firat, Penpe Gul; Demirel, Soner; Yilmaz, Turgut; Tuncer, Ilknur
Objectives The aim of this study was to compare the role of computed tomography (CT) in the diagnosis of open-globe trauma and intraocular foreign body (IOFB) in pediatric and adult age groups. Methods Medical records of cases with open-globe trauma at Inonu University Hospital's Ophthalmology Emergency Service were retrospectively evaluated. Preoperative orbital CT images of the cases obtained at emergency services and their clinical and/or surgical findings were compared in pediatric and adult groups. Results We included 47 eyes of 47 cases aged 18 years and below (pediatric group) and 85 eyes of 82 cases over 18 years (adult group). The mean +/- SD age was 10.80 +/- 5.11 years (range, 2-18 years) in the pediatric group and 46.34 +/- 19.01 years (range, 19-82 years) in the adult group. Computed tomography images revealed 21.7% of the cases with corneal lacerations, 55.5% with scleral lacerations, and 91.6% with corneoscleral lacerations in the pediatric group, whereas the respective numbers were 48.4%, 66.6%, and 61.9% in the adult group. The detection rates of corneal penetrations and vitreous hemorrhage with CT were significantly lower in the pediatric group than in the adult group (P < 0.05). The CT scans diagnosed 66.6% of the pediatric cases and 90% of the adult cases with an IOFB. Conclusions Corneal lacerations and IOFBs can be missed, especially in the pediatric group, because the eye is smaller in adults. Pediatric patients with a history of ocular trauma should undergo an examination under general anesthesia followed by surgical exploration if necessary.
Correlation between intraocular pressure obtained with water drinking test versus modified diurnal tension curve measurement in pseudoexfoliation glaucoma
(Springer, 2021) Firat, Penpe Gul; Dikci, Seyhan; Firat, Ilknur Tuncer; Demirel, Soner; Firat, Murat; Ozturk, Emrah; Gok, Zarife Ekici
Purpose The aim of this paper was to study the correlation and agreement between the intraocular pressure (IOP) peak value and fluctuations detected with the modified diurnal tension curve (mDTC) and the water drinking test (WDT) in pseudoexfoliation glaucoma (XFG) patients. Methods This prospective observational study enrolled 42 eyes of 42 XFG patients. The IOPs were measured at 2-h intervals from 8 am to 4 pm with a Goldmann applanation tonometer by a single observer to establish the mDTC. The WDT was then performed between 4 and 5 pm on the same day and the IOP was measured 4 times at 15-min intervals after water ingestion. The IOPpeak, IOPmean, IO (min), and IOPfluctuation were measured with both the mDTC and WDT. The paired sample t test, Spearman's correlation coefficient and Bland-Altman plots were used for statistical analysis. Results The mean age of the 42 patients consisting of 24 females and 18 males was 66.9 +/- 6.8 years, and the mean central corneal thickness was 517.7 +/- 29.1 mu m. The mean values with the mDTC and WDT measurements were 15.05 +/- 2.75 mmHg and 17.17 +/- 3.25 mmHg (p <= 0.0001, r = 0.884) for IOPmean, 16.76 +/- 3.45 mmHg and 18.92 +/- 3.94 mmHg (p <= 0.0001, r=0.787) for IOPpeak, and 13.61 +/- 2.56 mmHg and 15.11 +/- 2.84 mmHg (p <= 0.0001, r=0.824) for IOPmin, respectively, and a positive correlation was present between these values. Conclusion There was a positive correlation between the peak, minimum, and mean IOP values determined using the mDTC and WDT in treated XFG patients. WDT can be used as an alternative in the assessment of the IOP in these patients as a more practical method.
Effective management of exposure keratopathy developed in intensive care units: The impact of an evidence based eye care education programme
(Elsevier Sci Ltd, 2014) Demirel, Soner; Cumurcu, Tongabay; Firat, Penpegul; Aydogan, Mustafa Said; Doganay, Selim
Objectives: To assess the impact of eye care education on the incidence of corneal exposure in intensive care units (ICU). Research methodology/design: Approximately 300 ICU personnel were educated about eye care to reduce the incidence of corneal exposure. The patients were divided into two groups: pretraining (Group 1: Between February 1, 2011 and March 31, 2011 [2 months]) and post-training periods (Group 2: Between April 1, 2011 and April 1 2012 [1 year]). We compared the groups for keratopathy incidence to evaluate the efficacy of this education. Results: The number of patients were 762 in Group 1 and 6196 in Group 2 (p=0.335). Medians of patients followed in pre training ICU and post training ICU for each month were found to be 476 (interquartile range, 433-539) and 515 (interquartile range, 490-528). Exposure keratopathy was identified in 8 eyes of 6 patients (3 males and 3 females) in pre training ICU with the mean age of 27.6 +/- 31.8 years and 5 eyes of 3 patients (1 male and 2 females) in post training ICU with the mean age of 41.3 +/- 32.1 years. No significant difference was noticed between two groups in terms of the medians of patients followed in ICUs for each month (p =0.335). The time of hospitalisation in ICU when the patients were consulted for the first ocular assessment in pre training ICU and post training ICU were found to be 13 +/- 8.7 days and 8 +/- 1.7 days, respectively. After the training, the decrease in incidence of exposure keratopathy was found to be highly significant (p<0.001). Conclusion: We observed a highly significant reduction in the incidence of corneal exposure, following the eye-care education programme. (C) 2013 Published by Elsevier Ltd.
Effects of ketamine propofol mixture on intraocular pressure and hemodynamic in elderly patients a randomized double blind trial
(Turkish Journal of Anesthesia and Reanimation, 2014) Aydoğan, Mustafa Said; Demirel, Soner; Erdoğan, Mehmet Ali; Fırat, Penpegül; Çolak, Cemil; Durmuş, Mahmut
Objective: The aim of this study was to compare the effects of a ketamine-propofol mixture (ketofol) and propofol on intraocular pressure (IOP) and haemodynamics in elderly patients during anaesthetic management at each repeated measurement times. Methods: Forty elderly ASA I and II patients were divided into two random groups and received either propofol (1.5 mg kg-1; group P, n=20) or ketofol (1:1 single syringe mixture of 5 mg mL-1 ketamine and 5 mg mL-1 propofol; group KP, n=20). A proseal laryngeal mask airway (PLMA) was inserted 60 seconds after induction of anaesthesia. IOP, systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) values were recorded at preinduction (t0), immediately following induction (t1), and at 1 (t2), 3 (t3), and 5 (t4) minutes after induction. Haemodynamic complications and the need for ephedrine were also recorded. Results: Patient characteristics at the beginning of the procedure were similar between the groups. SBP and HR were significantly increased in group KP compared to group P at t1 and t4 (p=0.044). Induction of both anaesthetic agents significantly decreased the IOP values from the t0 (p=0.026). A significant decrease in IOP was found at t1 and t4 in group P compared to group KP (p=0.018). The total dose of ephedrine was statistically different in group P (p=0.034). Conclusion: Ketofol can be an alternative agent to provide haemodynamic stability with a moderate decrease in IOP during anaesthesia induction in elderly patients.
Effects of Ketamine-Propofol Mixture on Intraocular Pressure and Haemodynamics in Elderly Patients: A Randomised Double-Blind Trial
(Aves, 2014) Aydogan, Mustafa Said; Demirel, Soner; Erdogan, Mehmet Ali; Firat, Penpegul; Colak, Cemil; Durmus, Mahmut
Objective: The aim of this study was to compare the effects of a ketamine-propofol mixture (ketofol) and propofol on intraocular pressure (IOP) and haemodynamics in elderly patients during anaesthetic management at each repeated measurement times. Methods: Forty elderly ASA I and II patients were divided into two random groups and received either propofol (1.5 mg kg(-1); group P, n=20) or ketofol (1:1 single syringe mixture of 5 mg mL(-1) ketamine and 5 mg mL(-1) propofol; group KP, n=20). A proseal laryngeal mask airway (PLMA) was inserted 60 seconds after induction of anaesthesia. IOP, systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) values were recorded at preinduction (t0), immediately following induction (t1), and at 1 (t2), 3 (t3), and 5 (t4) minutes after induction. Hemodynamic complications and the need for ephedrine were also recorded. Results: Patient characteristics at the beginning of the procedure were similar between the groups. SBP and HR were significantly increased in group KP compared to group P at t1 and t4 (p=0.044). Induction of both anaesthetic agents significantly decreased the IOP values from the t0 (p=0.026). A significant decrease in IOP was found at t1 and t4 in group P compared to group KP (p=0.018). The total dose of ephedrine was statistically different in group P (p=0.034). Conclusion: Ketofol can be an alternative agent to provide haemodynamic stability with a moderate decrease in IOP during anaesthesia induction in elderly patients.
Effects of third generation mobile phone-emitted electromagnetic radiation on oxidative stress parameters in eye tissue and blood of rats
(Taylor & Francis Ltd, 2012) Demirel, Soner; Doganay, Selim; Turkoz, Yusuf; Dogan, Zumrut; Turan, Bahadir; Firat, Penpe Gul Bozgul
Purpose: To investigate the effects of electromagnetic radiation (EMR) emitted by a third generation (3G) mobile phone on the antioxidant and oxidative stress parameters in eye tissue and blood of rats. Methods: Eighteen Wistar albino rats were randomly assigned into two groups: Group I (n = 9) received a standardized a daily dose of 3G mobile phone EMR for 20 days, and Group II served as the control group (n = 9), receiving no exposure to EMR. Glutathione peroxidase (GSH-Px) and catalase (CAT) levels were measured in eye tissues; in addition, malondialdehyde (MDA) and reduced GSH levels were measured in blood. Results: There was no significant difference between groups in GSH-Px (p = 0.99) and CAT (p = 0.18) activity in eye tissue. There was no significant difference between groups in MDA (p = 0.69) and GSH levels (p = 0.83) in blood. Conclusions: The results of this study suggest that under a short period of exposure, 3G mobile phone radiation does not lead to harmful effects on eye tissue and blood in rats.

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