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Öğe Aqueous humor penetration of topically applied ciprofloxacin, ofloxacin and tobramycin(Ecv-Editio Cantor Verlag Medizin Naturwissenschaften, 1997) Durmaz, B; Marol, S; Durmaz, R; Oram, O; Hepsen, IF; Gunal, SThe purpose of this study was to determine the aqueous humor concentrations of topically applied ciprofloxacin (GAS 86393-32-0), ofloxacin (GAS 82419-36-1) and tobramycin (GAS 79645-27-5). Thirty patients undergoing cataract extraction or trabeculectomy were randomly divided into three groups and each of the group received either 0.3 % ciprofloxacin, ofloxacin or tobramycin topical drops preoperatively. Eyedrops were instilled for six times at a frequency of one drop every 15 minutes, beginning 90 minutes before initiation of the surgery. At the time of surgery, 0.1 mi aqueous fluid was aspirated from the anterior chamber. Concentrations of the antimicrobial agents were determined using the microbroth dilution procedure outlined by the National Committee for Clinical Laboratory Standards. Escherichia coli (ATCC 25922) was used as a standard strain for determination of minimal inhibitory concentrations (MICs). The mean aqueous levels of ciprofloxacin and ofloxacin were found to be 0.092 +/- 0.077 mu g/ml, 0.964 +/- 0.693 mu g/ml, respectively. Tobramycin did not reach the concentration that could be detected by applied method. Conclusion: The mean aqueous humor levels of ofloxacin and ciprofloxacin were more than the MICs levels for most of the ocular pathogens which may cause postoperative endophthalmitis.Öğe Autonomic nervous system involvement in Behcet's disease -: A pupillometric study(Lippincott Williams & Wilkins, 1998) Bayramlar, H; Hepsen, IF; Uguralp, M; Bölük, A; Özcan, CThe aim of this study was to elucidate whether autonomic nervous system dysfunction exists in patients with Behcet's disease by pupillometric tests. Thirty-one patients with Behcet's disease with a mean age of 41.3 years (range 21-64) and 41 control subjects with a mean age of 39.5 years (range 18-66) were selected for the study. To test the autonomic nervous system, four pupillometric techniques were used: pupil cycle time (PCT), dark-adapted pupil size (DAPS), 0.05% pilocarpine drop test, and 1% phenylephrine drop test. In all four tests, there were significant differences between the patients and controls. Mean PCTs were 1,156 ms (range 856-1,560 ms) and 919 ms (range 650-1,261 ms) in the patients and controls, respectively (p < 0.0001). The mean DAPS was 0.45 (range 0.31-0.66) in the patients, whereas it was 0.56 (range 0.42-0.67) in controls (p < 0.001). Iris sensitivity to both 0.05% pilocarpine and 1% phenylephrine showed significant differences between patients and controls, respectively (p < 0.05, p < 0.05). Among all four tests, only 0.05% pilocarpine sensitivity was correlated with the duration of Behcet's disease (p < 0.05). The results suggest that the autonomic nervous system innervating the iris is affected in Behcet's disease. This involvement may be due to the vasculitic nature of Behcet's disease.Öğe Bilateral myopia following blunt trauma to one eye(Wichtig Editore, 2001) Doganay, S; Er, H; Hepsen, IF; Evereklioglu, CPURPOSE. To evaluate bilateral myopia following blunt trauma to one eye. CASE REPORT. Traumatic myopia is a rare transient situation which may be seen in the injured eye or both eyes after blunt ocular trauma. We examined one case with transient myopia in the left eye which had been exposed to a blunt ocular injury. Myopia was also observed in the right eye 12 hours after the trauma. The right eye and left eye had reverted to emmetropia respectively two and six weeks after trauma. DISCUSSION. The myopia may have been due to ciliary spasm arising from stimulation of the efferent autonomic system in the right eye and ciliary body edema in the left eye. CONCLUSIONS. To our knowledge, this is the first reported case developing bilateral transient myopia after the blunt trauma to only one eye.Öğe Caffeic acid phenethyl ester to inhibit posterior capsule opacification in rabbits(Elsevier Science Inc, 1997) Hepsen, IF; Bayramlar, H; Gultek, A; Ozen, S; Tilgen, F; Evereklioglu, CPurpose: To assess whether caffeic acid phenethyl ester (CAPE) prevents posterior capsule opacification (PCO) by suppressing the transformation of the lens epithelial cells. Setting: Departments of Ophthalmology, Chemistry, and Pathology, Turgut Ozal Medical Center, University of Inonu, Malatya, Turkey. Methods: Twenty pigmented island rabbits having phacoemulsification in their right eyes were randomized into two groups. In Group 1, 10 mu g/ml of CAPE was added to the anterior chamber irrigating solution and a 1% solution of CAPE was injected subconjunctivally for 3 weeks postoperatively. The irrigating solution in Group 2 (control) did not include CAPE. The development of PCO was assessed weekly and its density was graded by slitlamp biomicroscopy. Histologic analysis was performed 3 months after surgery. Results: Group I had clear capsules or minor PCO. Group 2 developed more severe PCO or complete opacification. The difference between the two groups was statistically significant (P = .04). Conclusion: These preliminary results indicate that CAPE is effective in suppressing PCO in pigmented rabbits and may be beneficial in clinical use in humans because it has no documented harmful effects on normal cells.Öğe Comparison of the results of primary and secondary implantation of flexible open-loop anterior chamber intraocular lens(Royal Coll Ophthalmologists, 1998) Bayramlar, H; Hepsen, IF; Cekic, O; Gunduz, APurpose To assess and compare the results of primary and secondary implantation of flexible open-loop anterior chamber intraocular lenses (AC-IOLs). Methods A series of 57 eyes of 56 patients with flexible AC-IOLs were reviewed in two groups. In group I (n = 35) an AC-IOL was implanted primarily, because of posterior capsule problems during extracapsular cataract extraction (ECCE), and in group II (n = 22) secondarily after intracapsular cataract extraction (ICCE). Follow-up was from 12 to 38 months. Results Mean post-operative best-corrected visual acuity in group I was significantly lower (20/37.38) than that of group II (20/29.20) (p = 0.044). Best: corrected visual acuity of 20/40 or better was achieved in 19 of 29 eyes (65%) in group I, and in 16 of 21 eyes (76%) in group II. The difference was not statistically significant (p > 0.05). In group II 18 eyes (86%) maintained or improved visual acuity. In group I, 17 eyes (49%) had a total of 22 complications, while 7 eyes (32%) had 9 complications in group IP (p > 0.05). Conclusions Flexible open-loop AC-IOLs are suitable for both primary and secondary implantation to correct aphakia. Secondary implantation of flexible open-loop AC-IOLs after ICCE seems to have a more favourable visual outcome and a lower complication rate than primary implantation in complicated ECCE cases.Öğe The comparison of topical ibopamine 2% with tonography to identify the outflow resistance in eyes with ocular hypertension(Karger, 2005) Hepsen, IF; Yilmaz, H; Keskin, UCBackground: To evaluate the ability of topical ibopamine 2% to detect outflow resistance by comparing it with the tonography test in eyes with ocular hypertension (OHT). Methods: 62 eyes with OHT and 33 control eyes were included in this prospective study. Tonography was done manually as a standard outflow facility measurement. We used a C value of 0.18 mu l/min/ mm Hg or less and a P-o/C value of 100 and above as a positive tonographic test. The ibopamine test performed on the following day was considered positive if there was an intraocular pressure (IOP) change of at least 3 mm Hg. Results: The sensitivity of the tonography and ibopamine tests was 69 and 53%, respectively, in eyes with OHT. The specificity of both tests was 97%. Although the sensitivity of the tonography test is higher than that of the ibopamine test, the difference between both was not statistically significant in these eyes ( p = 0.409). Positive results in tonography were associated with higher IOP, while the results were not dependent on the IOP in the ibopamine test. Both tests together were positive in 33.87% ( 21 eyes) and negative in 11.29% ( 7 eyes) in 62 eyes with OHT. Conclusion: This study revealed that the ibopamine provocation test can detect outflow system resistance in eyes with OHT comparable with tonography which is a traditional outflow facility measurement. Ibopamine, however, can detect the eye with outflow impairment by a different and IOP-independent way, while tonography depends on IOP. Copyright (C) 2005 S. Karger AG, Basel.Öğe Defective visual field tests in chronic heavy smokers(Wiley, 2001) Hepsen, IF; Evereklioglu, CPurpose: To evaluate the visual field changes in smokers, Methods: In 24 healthy chronic, heavy cigarette smokers and 16 age and sex-matched healthy non-smokers, central 30-2 threshold tests were evaluated, The quantitative perimetric indices as objective retinal sensitivity measures were recorded in both eyes, but only those from the second eye were chosen for analysis. The visual field defects were also assessed. Results: All subjects had normal visual acuity, The central visual fields in smokers showed relative to absolute scotomas in 20 degrees to 30 degrees. Quantitative perimetric indices including total threshold dB with red and white target, MD, PSD, and CPSD values were significantly different (p<0.05) between the groups. Smokers showed both diffuse and localised retinal sensitivity decrease, SF showed no significant difference (p>0.05) between the groups. Conclusion: In healthy, chronic, heavy cigarette smokers, retinal sensitivity was found to be decreased although central vision was not affected. This is possibly due to a cumulative effect of chronic smoking onto the retinal and/or optic nerve functions without clinically evident optic neuropathy.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 Early contrast sensitivity loss and oxidative damage in healthy heavy smokers(Wiley, 2003) Hepsen, IF; Uz, E; Sogut, S; Büyükba, S; Akyol, OObjective: The purpose of this study was 1) to evaluate visual functions and the activities of antioxidant enzymes in plasma and erythrocytes in smokers in comparison with non-smokers, 2) to evaluate the correlations between visual functions and the oxidant/antioxidant system. We hypothesized that the changes in antioxidant system and consequently lipid peroxidation depend on smoking may affect sophisticated visual tests including contrast sensitivity (CS) and pattern visual evoked potentials (PVEP). Subjects: This non-randomised control study included 24 chronic, heavy smokers who were smoking more than 20 cigarettes per day at least for last 10 years. Sixteen age and sex-matched, healthy, non-smokers were taken as controls. All volunteer subjects were accumulated from the outpatient clinic. To rule out the effect of alcoholism and malnutrition, we chose young, healthy heavy smokers who maintained adequate diet and who had no alcohol consumption history. Following visual acuity and color vision tests, all subjects were applied to CS and PVEP tests. Values of CS, N75-P100 amplitude and P100 wave latency were compared between the study and control subjects. Superoxide dismutase (SOD) and catalase (CAT) activities in plasma and erythrocytes were determined by spectrophotometer. Plasma malondialdehyde (MDA) level, as an end product of lipid peroxidation, was assessed by spectrofluorometric method. Results: CS was determined to be significantly reduced in smokers compared to nonsmokers, although central vision and PVEP responses were not affected. Erythrocyte SOD activity and plasma MDA levels were significantly increased in smokers compared to controls. There were positive correlations between plasma SOD and erythrocyte SOD; CS and erythrocyte SOD; and CS and plasma SOD. Conclusions: The results suggest the possible association between early CS loss and increase in antioxidant enzyme activities thus reflecting an increased oxidative damage due to cumulative effect of chronic smoking. Elevated concentrations of lipid peroxidation products in the plasma of smokers may directly show the increased oxidative damage in these subjects.Öğe The effect of reading and near-work on the development of myopia in emmetropic boys: a prospective, controlled, three-year follow-up study(Pergamon-Elsevier Science Ltd, 2001) Hepsen, IF; Evereklioglu, C; Bayramlar, HThis study aimed to investigate the effect of reading and near work on myopic development in emmetropic boys in school age. It involved totally 114 children in two groups. Right eyes of 67 randomly selected students (mean age = 12.93) with mean 6 h of reading and near work (Group 1) were compared with the right eyes of 47 apprentices (mean age = 12.96) working as skilled laborers (Group 2). Cycloplegic refraction, keratometric readings and biometric measurements including anterior chamber depth (ACD), lens thickness (LT), vitreous chamber depth (VCD) and axial length (AL) were performed for 3 years at 18 month intervals. Two analyses were conducted: (1) for subjects in both groups with baseline refractive error from + 0.50 to - 0.50 D: (2) for all subjects in both groups with baseline refractive error from + 1.00 to - 1.00 D. For subjects with baseline refractive error of + 0.50 D, myopic shift was present in 20 of 41 (48.8%) in group I and in seven of 37 (18.9%) in group 2 at the end of the study. The magnitude of the myopic shift was 0.56 and 0.07 D in group I and I respectively. For subjects with a baseline refractive error of +/- 1.00 D. myopic progression was present in 40 of 67 (59.7%) in group I and in 10 of 47 (21.3%) in group 2 at the last readings. In this larger refractive range, the magnitude of the myopic shift was 0.61 and 0.12 D in group I and 2. respectively. The mean ACID, VCD and AL were significantly higher in the last readings after 36 months than in the first readings (for each, P = 0.0001) in group 1. There was no statistically significant difference between two measurements of these parameters in group 2. The final keratometric dioptric readings were lower than the first values (for each, P = 0.0001) in both groups at the end of the study. This prospective and controlled study suggested that reading and near work., important environmental factors, might cause refractive myopic shifts in emmetropic students. The myopic shift was primarily related to significant increases in ACID, VCD and AL in this young age group. (C) 2001 Elsevier Science Ltd. All rights reserved.Öğe Effects of some probable antioxidants on selenite-induced cataract formation and oxidative stress-related parameters in rats(Elsevier Ireland Ltd, 1999) Orhan, H; Marol, S; Hepsen, IF; Sahin, GThe effect of several natural and synthetic compounds on selenite-induced cataract was investigated in rat pups. Simultaneous determination of glutathione S-transferase (GST), selenium dependent glutathione peroxidase (Se-GPx), catalase (CAT), superoxide dismutase (SOD) activities and malondialdehyde (MDA) levels were carried out in the lens, erythrocyte and plasma. The results showed that propolis, diclofenac, vitamin C (Vit-C) and quercetin prevented cataract formation to the extent of 70, 60, 58.4, and 40%, respectively. Standardized extract of Ginkgo biloba (Egb 761) did not affect the cataract formation. Selenite treatment caused a significant decrease in the activity of erythrocyte SOD. This was accompanied by a simultaneous increase in the levels of MDA either in lens and in plasma. A significant increase was shown in erythrocyte GST (substrate ethacrynic acid; eaa), and GPx activities and lens GST (substrate chlorodinitro benzene; cdnb) activity. Antioxidant treatment caused significant changes in enzyme activities and MDA levels. There was no effect of selenite and antioxidants on total body weight increase during the course of the study. Blood parameters did not correlate to lens parameters following selenite treatment. Our results suggest that antioxidant supplementation following selenite exposure may prevent the cataract formation and may enhance antioxidant defence of blood and lens. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.Öğe Hammer-chisel technique in endoscopic dacryocystorhinostomy(Annals Publ Co, 2003) Cokkeser, Y; Tercan, M; Evereklioglu, C; Hepsen, IFWe performed a prospective evaluation of endoscopic hammer-chisel dacryocystorhinostomy (DCR) procedures on 62 eyes of 44 patients (40 female and 4 male) with chronic epiphora or dacryocystitis (26 unilateral and 18 bilateral). The technique included chisel removal of bone over the lacrimal sac. The follow-up period was 12 to 54 months (mean, 28 months), and the patients' ages ranged from 17 to 67 years (mean, 35.5 years). The success rate of the consecutive endoscopic: hammer-chisel DCR procedures was 87%. During operation, 8 patients had mild mucosal hemorrhage, which did not prevent the successful completion of the operation. Excellent patient tolerance was observed, with minimal morbidity and no major complications. As compared to the external approach, endoscopic hammer-chisel DCR is less traumatic, is less time-consuming, and is practical and cosmetically convenient, with minimal perioperative and postoperative complications. It also allows the simultaneous correction of any intranasal disease. It requires minimal instrumentation and is a relatively easy and fast technique.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 Lenticular astigmatism in tilted disc syndrome(Elsevier Science Inc, 2002) Gündüz, A; Evereklioglu, C; Er, H; Hepsen, IFPurpose: To evaluate whether an abnormal optic disc shape in patients with tilted disc syndrome (TDS) is associated with an abnormal configuration of the crystalline lens measured as lenticular astigmatism. Setting: Department of Ophthalmology, Inonu University Medical Faculty, Turgut Ozal Medical Center, Malatya, Turkey. Methods: This cross-sectional masked case-control study comprised 32 eyes of 32 patients with established TDS (13 men, 19 women; mean age 21.31 years +/- 7.05 [SD]) and 20 age- and sex-matched healthy control subjects (8 men, 12 women; mean age 22.65 +/- 7.11 years) with a comparable amount of myopic astigmatism (spherical equivalent) without TDS. The optic disc was morphometrically analyzed by planimetric evaluation of optic disc photographs. The total refractive and keratometric corneal astigmatism was obtained, and lenticular astigmatism was calculated by vector analysis. The Mann-Whitney U test was used for statistical analysis; 1 eye of each patient was evaluated in both groups. A P value less than 0.05 was considered statistically significant. Results: The mean spherical equivalent refraction was comparable in TDS patients (-4.73 +/- 1.12 diopters [D]) and controls (-4.28 +/- 1.29 D) (P = .210). The mean total astigmatism was higher in TDS patients (-2.96 +/- 1.04 D) than in the controls (-2.51 +/- 1.09 D), but the difference was not significant (P = .151). The mean corneal astigmatism was comparable in TDS patients (-2.07 +/- 0.83 D) and controls (-2.28 +/- 0.87 D) (P = .454), but the calculated mean lenticular astigmatism was significantly higher in TDS patients (-1.31 +/- 0.98 D and -0.20 +/- 0.35 D, respectively) (P < .001). Twenty-nine of 32 TDS patients (90.6%) had lenticular astigmatism; in 16 (50%), it was greater than -1.00 D. Lenticular astigmatism was present in 7 controls (35%); in 2 (10%), it was greater than -1.00 D. The mean keratometry was significantly higher in TDS patients (43.84 +/- 1.06 D) than in the controls (42.75 +/- 1.45 D) (P = .011). Conclusions: Clinically significant lenticular astigmatism was present in TDS patients. If an abnormal optic disc shape is found on ophthalmoscopy, lenticular astigmatism as well as corneal astigmatism should be carefully evaluated to prevent an unsatisfactory refractive outcome, especially in refractive surgery candidates. (C) 2002 ASCRS and ESCRS.Öğe Myopic shift from the predicted refraction after sulcus fixation of PMMA posterior chamber intraocular lenses(Canadian Ophthal Soc, 2006) Bayramlar, H; Hepsen, IF; Yilmaz, HBackground: To evaluate the refractive results of sulcus-fixated polymethylmethacrylate (PMMA) posterior chamber intraocular lenses (PC IOLs) after cataract surgery with and without posterior capsule complications. Methods:The charts of patients who had undergone cataract surgery were reviewed, and eyes that had received sulcus-fixated PMMA PC IOLs were included in the study. Postoperative refraction, predicted postoperative refraction for in-the-bag IOL with the same diopter, intraoperative posterior capsular complications and vitrectomy, axial eye length, incision type (corneal or scleral), and surgery type were recorded and analyzed. The difference between actual postoperative refraction and predicted refraction for the in-the-bag lens was calculated for each patient. Results: Of 143 patients (84 men and 59 women), 162 eyes with a sulcus-fixated posterior chamber intraocular lens were investigated. Mean age was 63.7 +/- 12.1 years. A mean myopic shift of -1.02 +/- 0.96 D from the predicted in-the-bag refraction was found. There were no significant differences between eyes with or without vitreous loss-vitrectomy (p = 0.8), eyes with scleral or corneal incisions (p = 0. 11), and eyes having phacoemulsification or extracapsular cataract extraction (p = 0.93). In terms of axial length, there were no significant differences between long, normal, or short eyes (p = 0.85). Interpretation: Sulcus fixation of a PMMA IOL originally planned for in-the-bag fixation caused approximately -1.00 D myopic shift in this study. We recommend that when sulcus fixation is necessary PMMA OOL power should be approximately 1.25 to 1.50 D less than the power for in-the-bag fixation. Axial length, incision type, vitreous loss and use of vitrectomy, and type of the surgery do not appear to alter the postoperative refraction significantly in eyes with sulcus fixation.Öğe Periorbital solitary-type infantile myofibromatosis(Slack Inc, 1997) Bayramlar, H; Hepsen, IF; Sarac, K; Hasanoglu, A; Tecimer, T; Ozgen, U; Senol, M[Abstract Not Available]Öğe Potential toxicity of mitomycin C and 5-fluorouracil: An experimental study(Lippincott-Raven Publ, 1997) Tilgen, F; Er, H; Mizrak, B; Hepsen, IF[Abstract Not Available]Öğe Preventive effect of lacrimal occlusion on topical timolol-induced bronchoconstriction in asthmatics(Wiley, 2004) Hepsen, IF; Yildirim, Z; Yilmaz, H; Kotuk, MAim: To evaluate the potential preventive role of lacrimal occlusion on the topical timolol-induced bronchoconstriction in asthmatics. Methods: This was a prospective and single-masked study. Fourteen volunteer subjects with asthma were included. Collagen plugs were inserted into both canaliculi on one side to inhibit lacrimal drainage. The effect of lacrimal occlusion on lung function tests was measured before and 60 min after the instillation of a timolol drop in unplugged and plugged eyes. The spirometric measurements include forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, and mid expiratory flow-rate (FEF25-75). Results: The timolol (0.5%) drop administration into the eye caused a significant decrease in pulmonary functions in patients with asthma in whom the lacrimal punctae had not been occluded by collagen plug. P values were 0.008 for FVC and 0.001 for FEV1 and FEF25-75. The occlusion of the lacrimal duct by intracanalicular plugs significantly reduced this decrease in pulmonary function. P values were 0.6 for FVC, 0.8 for FEV1, and 0.5 for FEF25-75. The lacrimal occlusion did not affect heart rate and blood pressures. Three subjects complained of epiphora. Conclusions: Lacrimal occlusion with intracanalicular collagen plugs may almost completely prevent the bronchoconstriction caused by topical timolol in asthmatics by inhibiting or decreasing systemic absorption of the medication.Öğe The relationship between serum trace element changes and visual function in heavy smokers(Wiley, 2003) Uz, E; Sahin, S; Hepsen, IF; Var, A; Sogut, S; Akyol, OPurpose: The aim of this prospective study was to evaluate serum manganese (Mn), zinc (Zn) and copper (Cu) levels and visual functions including visual acuity, colour vision, pattern visual evoked potentials (PVEPs), and contrast sensitivity in heavy smokers and to compare these with the equivalent levels and functions in non-smokers. Methods: Data were recorded in 24 healthy, chronic and heavy cigarette smokers and 16 healthy, non-smoking control subjects. Serum Zn, Cu and Mn concentrations in all subjects were measured by atomic absorption spectrophotometry. Results: Both study and control subjects had normal visual acuity and colour vision. Pattern visual evoked potentials were normal in all study and control subjects. Contrast sensitivity was significantly reduced in heavy smokers compared to non-smokers (p<0.023), despite the fact that central vision and PVEP responses were not affected. Mean serum Mn and Zn levels were significantly lower in smokers than in non-smokers (p<0.0001 and p<0.005, respectively). Conclusions: Reduced contrast sensitivity values associated with low levels of serum Mn and Zn, which function as cofactors of superoxide dismutase in erythrocyte and other nucleated cells, suggest a possible role of trace elements in smoking-induced early retinal toxicity.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.
