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Öğe 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, KayhanBackground: 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.Öğe Choroidal tuberculoma showing paradoxical worsening in a patient with miliary TB(Taylor & Francis Inc, 2015) Yilmaz, Turgut; Selcuk, Engin; Polat, Nihat; Mutlu, KayhanTuberculosis (TB) remains an important public health problem worldwide. Ocular involvement in patients with systemic TB has traditionally been considered uncommon. Diagnosing ocular TB is challenging and often delayed, especially in the absence of pulmonary signs or symptoms typical of TB. Here we describe a case of paradoxical reaction after antituberculosis therapy in an immunocompetent patient with ocular TB.Öğe Comparison of the effects of direct laryngoscopy and fiberoptic oral endotracheal intubation on the intraocular pressures of non-ophthalmic patients: A prospective, randomised, clinical trial(2022) Yıldırım, Sait; Akbaş, Sedat; Durmus, Mahmut; Özkan, Ahmet Selim; Karaaslan, Erol; Polat, Nihat; Mutlu, KayhanAbstract Aim: In this prospective, randomised, clinical study; we aimed to compare the effects of endotracheal intubation (ETI) via direct laryngoscope (DLS) and fiberoptic bronchoscope (FOB) on intraocular pressure (IOP) and hemodynamic data of non-ophthalmic patients. Materials and Methods: Fifty-four adult patients undergoing non-ophthalmic surgeries performed in the supine position under general anesthesia requiring orotracheal intubation were included into the study. The patients were randomly and prospectively divided into 2 groups: Group DLS (n=27) and Group FOB (n=27). Mean arterial pressure (MAP), Heart rate (HR), IOP were measured at before induction (basal), post-induction and 1st, 2nd, 3rd, and 5th minutes of intubation. Results: There was no statistically significant difference in distribution of patient characteristics. Duration of intubation was significantly longer in Group FOB (p<0.001). There was no statistically significant difference in MAP and HR when groups compared each other. Statistically significant increase was found in IOP at 1st minute of intubation in Group DLS when compared with Group FOB (p<0.001). No significant difference was found in terms of IOP in other time periods. Conclusion: We thought that endotracheal intubation by FOB could be more useful with respect to endotracheal intubation by DLS in patients with high IOP due to significantly less rise caused in IOP when performed by experienced anesthesiologists.Öğe Does the use of cannabinoids affect the ocular surface?(2022) Mutlu, Kayhan; Cumurcu, Tongabay; Cumurcu Elbozan, BirgülAim: To examine tear functions and ocular surface variables in patients with cannabis addiction. Materials and Methods: This clinical trial was planned as a prospective case-control study. In this study, 51 male patients with cannabis addiction (group 1) and 51 healthy volunteers (group 2) with similar demographic characteristics were included. Visual acuity, spherical equivalent, biomicroscopic examination, Schirmer test, tear break-up time (TBUT), and impression cytology (Nelson scores) results were recorded, and the 2 groups were compared with each other. Results: The mean Schirmer values were 9.68 ± 6.8 mm and 8.39 ± 4.08 mm in group 1 and group 2 (p = 0.97), respectively, whereas the mean TBUT values were 9.96±3.9 and 9.29±4.01s. (p = 0.35) and the mean Nelson scores were 1.49±1 and 1.25±0.97 in group 1 and group 2, respectively (p = 0.26). Conclusion: In this study, the effects of cannabis addiction on the ocular surface were evaluated using Schirmer, TBUT, and impression cytology methods. In the statistical analysis, no significant difference was found compared to the control group. This study showed that tear production, tear film stability, and impression cytology of patients with cannabis addiction were not different from the control group.Öğe Multiple Intravitreal Ranibizumab Injections for Persistant Choroidal Neovascularization Associated with Presumed Ocular Histoplasmosis Syndrome(Turkish Ophthalmological Soc, 2017) Yilmaz, Turgut; Dikci, Seyhan; Genc, Oguzhan; Mutlu, KayhanPresumed ocular histoplasmosis syndrome (POHS) is a clinical entity that is characterized by small, round, discrete, macular or mid peripheral atrophic (punched out) chorioretinal lesions (histo spots), peripapillary scarring, choroidal neovascularization (CNV), and the absence of anterior uveitis and vitritis. Diagnosis of this disorder is based upon characteristic clinical findings and a positive histoplasmin skin test or residence in an endemic region for Histoplasma capsulatum. There is no active systemic disease during diagnosis of POHS. Disciform scarring and macular CNV secondary to POHS is a well-known complication which leads to loss of visual acuity or visual disturbance. Without therapy, the visual prognosis in these patients is unfavorable. Submacular surgery, radiation, steroids, photodynamic therapy, and most recently anti-vascular endothelial growth factor therapy are current therapeutic options for this condition. We report a case with persistent CNV secondary to POHS in a middle-aged woman with moderate myopia and the clinical course of treatment with multiple intravitreal ranibizumab (Lucentis (R), Novartis) injections.Öğe Tetrahidrocannabinoid (Esrar) bağımlılığının oküler yüzey üzerindeki etkilerinin değerlendirilmesi(İnönü Üniversitesi, 2016) Mutlu, KayhanGiriş: Esrarın etken maddesi THCdir. Kliniğimizde daha önce madde bağımlılığının bir türü olan alkol bağımlılığı üzerine yapmış olduğumuz çalışmada kronik alkol bağımlılığı tanısı almış bireylerin Schirmer, Gözyaşı Kırılma Zamanı (GKZ) parametrelerinin ve impresyon sitolojisi skorlarının normal popülasyona göre azalmış olduğunu bulunmuştu. Literatürü araştırdığımızda THCin göz içi basıncı (GİB) üzerine etkilerinin çalışıldığının ancak, gözyaşı işlevleri ve oküler yüzey arasındaki ilişkinin daha önceden çalışılmamış olduğunu gözlemledik. Materyal Metod: Bu prospektif vaka kontrol çalışmasında 2015 Temmuz, 2015 Aralık ayları arasında hastanemiz psikiatri servisine THC bağımlılığı ile başvurmuş 51 erkek hastanın sağ gözü değerlendirildi. Yaş ve cinsiyet gibi dermografik özellikleri benzer olan sağlıklı kontrol grubu ile karşılaştırıldı. Tüm hastaların görme keskinliği, sferik ekivalanı, GKZ, Schirmer, göz içi basınç değerleri ve impresyon sitolojisi sonuçları kayıt altına alınarak spss v16.0 ile analiz edildi. Veriler Mann-Whitney U, Willcoxon W ve Z testleri ile analiz edildi. Kolmogorow Simirnow test istatistiğine göre veriler normal dağılıma uygun olmadığında (p<0.05) non parametrik istatistiklerinden iki grubu karşılaştırmak için Mann-Whitney U test istatistiği kullanılmıştır. Bulgular Schirmer değerleri ortalaması sırasıyla grup 1 ve grup 2 de 9,7±3.9 ve 8,4±4 olarak bulundu. GKZ değerleri ortalaması sırasıyla grup 1 ve grup 2 de 10±4 ve 9,3±4 olarak bulundu. Nelson skorları ortalaması sırasıyla grup 1 ve grup 2 de 1,5±1 ve 1,25±1 olarak bulundu. Schirmer değerleri (p=0,9), GKZ (p=0,34), Nelson skorları (p=0,25) değerlerinde istatistiksel olarak anlamlı fark olmadığı izlenmiştir (p>0,05). Sonuç: Çalışmamızda THC bağımlısı bireylerin Schirmer, GKZ ve impresyon sitolojisi parametrelerinin kontrol grubuna göre istatiksel olarak anlamlı farklılığı olmadığı bulunmuştur. Anahtar kelimeler: Tetrahidrocannabinoid bağımlılığı, impresyon sitolojisi, oküler yüzey parametreleri, gözyaşı işlevleri.Öğe Traumactic superior oblique tendon rupture: case presentation(Medicine Science, 2016) Gunduz, Abuzer; Firat, Murat; Mutlu, Kayhan; Demirel, Ersin ErsanÖz (İngilizce): We present a 47-year-old male with superior oblique (SO) tendon rupture that developed due to a broken metal hook while installing snow chains on his car. The patient presented to our clinic as an emergency for the right eye trauma and pain. The examination revealed a small cut in the right upper eyelid and an edematous tendinous structure that extended downwards through the conjunctival cut at the upper fornix. This structure was thought to be the SO tendon. Emergency exploration and SO tendon repair were performed under general anesthesia. The SO tendon was sutured to its own insertion region 5 mm in width and 5 mm behind a point 3 mm temporal to the superior rectus muscle. The conjunctiva was also repaired. There was 6 PD (prism diopter) right hypertropia and vertical diplopia on postoperative follow-up. The diplopia symptoms improved in the postoperative 3rd month. The patient had no diplopia at the 6th month follow-up but 4 PD hypertropia continued
