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Öğe AI-Based Response Classification After Anti-VEGF Loading in Neovascular Age-Related Macular Degeneration(Mdpi, 2025) Firat, Murat; Firat, Ilknur Tuncer; Ustundag, Ziynet Fadillioglu; Ozturk, Emrah; Tuncer, TanerBackground/Objectives: Wet age-related macular degeneration (AMD) is a progressive retinal disease characterized by macular neovascularization (MNV). Currently, the standard treatment for wet AMD is intravitreal anti-VEGF administration, which aims to control disease activity by suppressing neovascularization. In clinical practice, the decision to continue or discontinue treatment is largely based on the presence of fluid on optical coherence tomography (OCT) and changes in visual acuity. However, discrepancies between anatomic and functional responses can occur during these assessments. Methods: This article presents an artificial intelligence (AI)-based classification model developed to objectively assess the response to anti-VEGF treatment in patients with AMD at 3 months. This retrospective study included 120 patients (144 eyes) who received intravitreal bevacizumab treatment. After bevacizumab loading treatment, the presence of subretinal/intraretinal fluid (SRF/IRF) on OCT images and changes in visual acuity (logMAR) were evaluated. Patients were divided into three groups: Class 0, active disease (persistent SRF/IRF); Class 1, good response (no SRF/IRF and >= 0.1 logMAR improvement); and Class 2, limited response (no SRF/IRF but with <0.1 logMAR improvement). Pre-treatment and 3-month post-treatment OCT image pairs were used for training and testing the artificial intelligence model. Based on this grouping, classification was performed with a Siamese neural network (ResNet-18-based) model. Results: The model achieved 95.4% accuracy. The macro precision, macro recall, and macro F1 scores for the classes were 0.948, 0.949, and 0.948, respectively. Layer Class Activation Map (LayerCAM) heat maps and Shapley Additive Explanations (SHAP) overlays confirmed that the model focused on pathology-related regions. Conclusions: In conclusion, the model classifies post-loading response by predicting both anatomic disease activity and visual prognosis from OCT images.Öğe AN EASY WAY TO PREVENT VELOCITY-RELATED COMPLICATIONS DURING DEXAMETHASONE IMPLANT INJECTION IN VITRECTOMIZED EYES(Lippincott Williams & Wilkins, 2025) Ozturk, Emrah; Adam, Mehmet; Ozdemir, Huseyin BaranPurpose:To assess the impact of inserting an ophthalmic viscoelastic device into the dexamethasone (DEX) implant needle on pellet velocity in simulated vitrectomized eyes.Methods:Dexamethasone implants were injected into a calibrated ex vivo test chamber filled with balanced salt solution. All DEX implants were administered by the same physician, aiming for the same button depression time. In Group 1, three DEX implant injections were performed without an ophthalmic viscoelastic device, while in Group 2, the ophthalmic viscoelastic device was safely inserted into the DEX implant needle using a 27-gauge cannula just before the injection. The slow-motion video mode of the IPhone 14 was used to record the procedures and calculate time and distance measurements.Results:Group 1 exhibited a mean velocity of 450 mm/second for the DEX pellet in balanced salt solution, compared with 54.57 mm/second in Group 2. Furthermore, DEX pellets in Group 1 had horizontal displacements of 24, 29, and 31 mm, while those in Group 2 had displacements of 17, 16, and 15 mm.Conclusion:Injecting an ophthalmic viscoelastic device into the DEX implant needle significantly decreases the velocity of the free pellet in balanced salt solution by 87.87%. This modification may help prevent potential velocity-related complications linked to DEX implantation in vitrectomized eyes.Öğe The Association of Serum Vitamin D Levels with Pseudoexfoliation Glaucoma/Syndrome (vol 19, pg 166, 2019)(Bentham Science Publ Ltd, 2019) Dikci, Seyhan; Ozturk, Emrah; Firat, Penpe Gul; Yilmaz, Turgut; Taskapan, Mehmet Cagatay; Yologlu, Saim[Abstract Not Available]Öğe 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 GulPurpose: 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.Öğe Chorioretinal dystrophy, hypogonadotropic hypogonadism, and cerebellar ataxia: Boucher-Neuhauser syndrome due to a homozygous (c.3524C>G (p.Ser1175Cys)) variant in PNPLA6 gene(Taylor & Francis Inc, 2021) Dogan, Mustafa; Eroz, Recep; Ozturk, EmrahPurpose: The current study aims to raise awareness of Boucher - Neuhauser syndrome (BNHS) that occurs as a rare phenotype due to biallelic pathogenic variants in the PNPLA6 gene. Methods: Detailed family histories and clinical data were recorded. Whole exome sequencing was performed and co-segregation analysis of the family was done by sanger sequencing. Also, review of 28 molecularly confirmed patients with BNHS from the literature was evaluated. Results: We identified a missense homozygous variant (c.3524 C > G (p.Ser1175Cys)) in the PNPLA6 gene, which explains the phenotype of the patient and neurologic, ophthalmologic, endocrine, and genetic evaluations established a diagnosis of BNHS. Symptoms, ethnicity, clinical and genetic findings of 28 molecularly confirmed patients with BNHS from the literature were also presented. Conclusion: We present the main findings of a Turkish family with BNHS together with detailed clinical and genetic profiles of patients diagnosed as BNHS that have been molecularly confirmed in the literature so far.Öğe Clinical effects of the 2021 update of the Turkish retinopathy of prematurity guideline(Bmc, 2025) Ozturk, Emrah; Tug, Nuray; Tuncer Firat, IlknurPurpose This study aims to assess the impact of the 2021 update of the Turkish Retinopathy of Prematurity (ROP) Guidelines within a tertiary care university clinic. Methods A retrospective evaluation was conducted on the medical records of premature infants (n = 366) who underwent ROP screening between September 2021 and June 2024 and attended regular follow-up visits. Among these infants, 217 (59.28%) met the previously established ROP screening criteria. A comprehensive analysis was performed on a dataset of 149 (40.71%) additional screenable premature infants (gestational age > 32 weeks and birth weight > 1500 g) according to the revised criteria. Results A total of 149 patients were included in the study. Among these patients, 65 (43.6%) were female and 84 (56.4%) were male. The mean gestational age was 33.85 +/- 1.17 weeks, and the mean birth weight was 2051.07 +/- 399.63 g. During the follow-up period, 17 patients (11.4%) developed ROP, with four patients (2.7%) exhibiting treatment-requiring ROP. The mean gestational age at delivery for patients who developed ROP was 33.70 +/- 1.24 weeks, and their mean birth weight was 2155.65 +/- 368.75 g. No significant differences were observed between these patients and those who did not develop ROP (p = 0.627, p = 0.521, respectively). Conclusions The recent update to the Turkish ROP guideline has the potential to increase the incidence of screening among infants by up to 68.6%. However, the finding that 2.7% of screened infants developed treatment-requiring ROP underscores the importance of this guideline update.Öğe Correlation between corneal endothelial layer features and age-related macular degeneration severity(Springer, 2024) Ozturk, Emrah; Cankaya, Cem; Yildizli, YakupPurposeThis study aimed to investigate the relationship between corneal endothelial layer features and the severity of age-related macular degeneration (AMD).MethodsThe study included 119 patients, with 47 females and 72 males. Patients were categorized into four groups based on the AREDS grading system: no AMD (group 1), mild AMD (group 2), moderate AMD (group 3), and advanced AMD (group 4). Only the right eye of patients with both eyes suitable for the study was included. Corneal endothelial cell density (CD), coefficient of variation (CoV), hexagonal cell ratio (HEX), and central corneal thickness (CCT) were measured using specular microscopy (Konan Medical Inc., Nishinomiya, Japan).ResultsGroup 1 had 40 patients, group 2 had 27 patients, and groups 3 and 4 had 26 patients each. Significant differences were observed between the mean endothelial CD, CoV, and HEX values among the groups, while no significant difference was found in CCT values (p = 0.049, p = 0.002, p = 0.004, and p = 0.883, respectively). A mild negative correlation was observed between AMD severity and CD and HEX values, while a mild positive correlation was found between AMD severity and CoV.ConclusionIncreasing severity of AMD may negatively impact corneal endothelial layer values.Öğe 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 EkiciPurpose 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.Öğe Double Flip Technique for Graft Transfer in Autograft Pterygium Surgery(Galenos Publ House, 2023) Ozturk, Emrah; Gunduz, AbuzerA 50-year-old man with recurrent pterygium and a 46-year-old woman with primary pterygium underwent surgery using a novel autograft transfer technique that facilitates autograft suturing and ensures correct graft orientation. After removing the pterygium, three edges of the autograft were cut. The autograft was flipped first over the uncut edge and secured to the superior margin of the recipient bed with two sutures. Afterward, the fourth side of the graft was cut and the second flip was done over the sutured edge. Thus, the autograft was in correct surface and side orientation and was sutured to the recipient bed. This simple technique provides both easy transfer and correct orientation of the graft in autograft pterygium surgery.Öğe Effect of Vitamin D Deficiency on Contrast Sensitivity Function(Taylor & Francis Inc, 2020) Ozturk, Emrah; Cankaya, CemPurpose The purpose of this study is to investigate the effects of vitamin D (vit D) deficiency on contrast sensitivity (CS) function and retinal layers. Materials and methods Group 1 consisted of 42 patients aged between 18 and 50 years with vit D deficiency and Group 2 consisted of sex- and age-matched 34 healthy subjects with normal vit D levels. Functional acuity contrast testing (FACT) was performed using the Optec 6500 vision testing system. The average retinal nerve fiber layer (RNFL) thickness and macular thickness (MT) obtained from nine macular areas in the Early Treatment Diabetic Retinopathy Study were evaluated using SD-OCT (RS-3000; Nidek Inc., Fremont, CA, USA) following a detailed ophthalmologic examination. Measurements were performed on both eyes. Results A lower CS was found in Group 1 compared to Group 2 in all spatial frequencies. A statistically significant difference was observed between the groups in 6, 12 and 18 cpd spatial frequencies, respectively. (p = .004, p = .001, p = .042, respectively). There was no statistically significant difference between groups in terms of RNFL thicknesses (p = .200). There was an increase in MT in Group 1. However, this increase was statistically significant in the inferior inner area in the right eye, and in the inferior inner, temporal inner and outer macular areas in the left eye (p = .018, p = .003, p = .033, p = .040, respectively). Conclusion It was observed that vit D deficiency had negative effects on CS function and also caused thickness difference in certain segments of retinal layers.Öğe Evaluation of the equality of medial rectus advancement to medial rectus resection for consecutive exotropia(Cukurova Univ, Fac Medicine, 2022) Gunduz, Abuzer; Ozturk, Emrah; Ozsoy, ErcanPurpose: The aim of this study was to analyze the amount of medial rectus (MR) advancement in the treatment of consecutive exotropia by comparing it with the amount of MR resection in a sample of patients with constant exotropia and evaluate the effectiveness of MR advancement with lateral rectus (LR) recession in the management of consecutive exotropia. Materials and Methods: A retrospective chart review of patients who underwent unilateral MR strengthening with LR weakening due to consecutive or constant exotropia was performed. Patients with consecutive exotropia underwent MR advancement with LR recession, and those with constant exotropia underwent MR resection with LR recession. The surgical dosages were determined according to a standard table. A successful result was defined as alignment within 10 prism diopters of orthotropia. Results: A total of 36 patients fulfilled the inclusion criteria: 18 had consecutive exotropia and 18 had constant exotropia. Successful alignment was obtained in 83.3% of patients with consecutive exotropia and 88.9% of patients with constant exotropia. There was no difference between the amount of MR advancement performed in consecutive patients with exotropia and the amount of MR resection performed in patients with constant exotropia. Postoperatively, while consecutive exotropes with a poor result showed overcorrection, constant exotropes with a poor result showed undercorrection. Conclusion: This study suggests that there is no difference between the amount of previously recessed MR advancement and that of untouched MR resection. They also showed that MR advancement with LR recession is an effective means of correcting secondary exotropia.Öğe The Impact of COVID-19 on Conjunctival Flora(Taylor & Francis Inc, 2021) Gunduz, Ayten; Ozturk, Emrah; Cagasar, OzlemPurpose: This study aims to evaluate the effect of coronavirus disease 2019 (COVID-19) on conjunctival flora in patients hospitalized with COVID-19. Methods: This prospective, controlled study was conducted between June 2020 and December 2020. The study group consisted of 45 confirmed COVID-19 patients and 43 control subjects. The collected samples were inoculated into the Thioglycollate broth media without delay. The samples with growth were then passed on eosin methylene blue agar, sabouraud dextrose agar, chocolate agar, and 5% sheep blood agar solid media. Results: The mean age of the COVID-19 patients was 64.24 +/- 15.4 years, and the control subjects were 59.72 +/- 11.4 years. The culture positivity of conjunctiva samples in COVID-19 patients (95.6%) was statistically significantly higher than control subjects (76.7%) (p = .024). Coagulase-negative staphylococcus and Staphylococcus aureus' positivity was significantly higher in COVID-19 patients than control subjects (p < .05). Conclusion: Patients with COVID-19 demonstrate significantly higher culture positivity on conjunctival flora than the control subjects.Öğe Infantile Esotropia: Clinical Features and Results of Bilateral Medial Rectus Recession(Galenos Publ House, 2023) Gunduz, Abuzer; Ozturk, Emrah; Ozsoy, Ercan; Gunturkun, Pelin NazliIntroduction: To define the characteristics of infantile esotropia and evaluate the results of bilateral medial rectus recession in infantile esotropia. Methods: A retrospective review was performed on medical charts of patients diagnosed with infantile esotropia. All patients underwent an ophthalmological examination to detect the conditions that accompany infantile esotropia. Patients with two years of age or older and without fixation preference or amblyopia underwent bilateral medial rectus recession. Results: There were a total of 117 patients with infantile esotropia patients. Infantile esotropia was accompanied by inferior oblique hyperfunction, fixation preference, cross-fixation, pseudoabduction deficit, pattern deviations, nystagmus, dissociated vertical deviation, convergence insufficiency, and abnormal head position. Approximately forty percent of the patients compatible with visual acuity measurements had amblyopia. Bilateral medial rectus recession decreased the mean esotropia from 43.1 +/- 15.3 to 7.8 +/- 12.8 prism diopters (PD) in 65 patients. Postoperatively, 41 patients had an ocular alignment within 10 PD of orthotropia, 22 patients showed undercorrection and 2 overcorrection. Conclusion: The characteristics of infantile esotropia in our study are substantially consistent with those of early reports, except for convergence insufficiency. This study also showed that bilateral medial rectus recession appears to have a high percentage of undercorrection in short-term postoperative follow-up in infantile esotropia.Öğe Inferior oblique anterior transposition according to a different grading scale for hyperdeviation with inferior oblique overaction(Canadian Ophthal Soc, 2023) Gunduz, Abuzer; Ozturk, Emrah; Firat, MuratObjective: To define an inferior oblique anterior transposition (IOAT) grading scale in patients with hyperdeviation and inferior oblique overaction (IOOA), which we planned based on the data we obtained in our previous retrospective study.Participants: Thirty-eight patients who underwent graded IOAT.Methods: The patients were divided into 5 groups according to the amount of hyperdeviation in the primary position (PPHD). The inferior oblique muscle was transposed 2 mm posterior, 1 mm posterior parallel, 1 mm anterior, and 2 mm anterior to the inferior rectus insertion, respectively. Surgical success was defined as success (PPHD <= 3 PD), partial success (PPHD >3 and <= 6 PD), and nonsuccess (PPHD >6 PD).Results: The mean amount of hyperdeviation correction in groups after IOAT was 9.50 +/- 0.9 PD (range, 8-10 PD), 12.43 +/- 1.5 PD (range, 11-14 PD), 16.67 +/- 1.4 PD (range, 15-18 PD), 19.57 +/- 1.7 PD (range, 16-21 PD), and 22.57 +/- 5.8 PD (range, 14-30 PD), respectively. Surgical success was achieved in 34 patients (89.5%) after surgery, partial success was achieved in 3 patients (7.9%), and nonsuccess was observed in 1 patient (2.6%). All patients in our study had unilateral IOOA preoperatively, and IOOA developed in the contralateral eye of 9 patients (23.7%) during postoperative follow-up. In group 5, 4 patients (57.1%) developed -2 upgaze limitation, but surgery was not required.Conclusions: A high success rate can be achieved with this grading of IOAT in primary and secondary IOOA cases accompanying hyperdeviation in the primary position.Öğe Inferior Oblique Muscle Overaction: Clinical Features and Surgical Management(Hindawi Ltd, 2019) Ozsoy, Ercan; Gunduz, Abuzer; Ozturk, EmrahPurpose. To further define the clinical features of patients with inferior oblique muscle overaction (IOOA) and evaluate the surgical results in a subgroup of these patients. Methods. The medical records of 173 patients who underwent inferior oblique muscle (IO) weakening surgery due to primary or secondary IOOA were retrospectively reviewed. The patients were assigned a surgical group based on severity of IOOA and presence of dissociated vertical deviation (DVD) or hypertropia. Patients with +1 or +2 IOOA underwent recession, patients with +3 or +4 IOOA underwent myectomy, and patients with any grade of IOOA and DVD or hypertropia underwent anterior transposition (AT) surgery. Results. A total of 286 eyes of 173 patients who underwent surgery due to IOOA were included in the study. IOOA was accompanied by esotropia, exotropia, abnormal head posture (AHP), pattern strabismus, convergence insufficiency, DVD, facial asymmetry, and nystagmus. The most common comorbid disorder was esotropia. The recession was used in 173 eyes, myectomy in 64, and AT in 49. Surgical success was obtained in 96.0% of eyes that underwent recession, in 98.4% of eyes that underwent myectomy, and in 93.9% of eyes that underwent AT. In the follow-up, IOOA occurred in the fellow eye in 36.1% of patients who underwent unilateral surgery. Conclusions. This study is a comprehensive report on the concomitants of the IOOA. Also, it showed that all of the three surgical procedures including recession, myectomy, and AT are effective in the surgical management of IOOA when performed in select patient groups.Öğe Optimal timing of capsular tension ring implantation in pseudoexfoliation syndrome(Consel Brasil Oftalmologia, 2021) Ozturk, Emrah; Gunduz, AbuzerPurpose: The aim of this study was to evaluate the appropriate timing of capsular tension ring implantation in cases of zonular weakness due to pseudoexfoliation syndrome. Methods: This prospective, comparative study was performed at the Ophthalmology Department of Inonu University, Malatya, Turkey. There were 43 patients included in the study. Group 1 ( 16 patients) had early capsular tension ring implantation, and group 2 (27 patients) had late capsular tension ring implantation. Patients with pseudoexfoliation syndrome who underwent phacoemulsification surgery, posterior chamber intraocular lens implantation, and capsular tension ring implantation were included in the study. Intraoperative complications and difficulties with either capsular tension ring implantation or cortex removal were evaluated in each eye. Results: There was no significant difference between the groups in the difficulty of capsular tension ring implantation (p=0.124). The difficulty of cortex removal differed significantly between the groups (p=0.003). Intraoperative complications were observed in 3 patients in group 1 and 11 patients in group 2; the difference between the groups was not significant (p=0.18). Posterior capsule fluctuations were observed in 8 patients (29.5%) in group 2, which resulted in posterior capsule rupture in 2 patients. Conclusions: Cortex removal is more difficult with early capsular tension ring implantation, and posterior capsule fluctuations may cause problems with late capsular tension ring implantation. The surgeon must consider the risk-to-benefit ratio of early versus late insertion for the optimal timing of capsular tension ring implantation.Öğe Pars Plana Vitrectomy with Foveal Cyst Aspiration as a Treatment Option for Macular Retinoschisis in a Coat-Like Retinitis Pigmentosa Case(Wolters Kluwer Health, 2025) Ozdek, Sengul; Ozturk, Emrah; Kucukbalcı, Tugce; Kayhan, GulsumPurpose: To present a patient with macular retinoschisis in coat-like retinitis pigmentosa (RP) who underwent pars plana vitrectomy with foveal cyst aspiration. Methods: Case report involving clinical examination, fundus photography, fluorescein angiography, optical coherence tomography, B-scan ultrasonography, and surgical video. Results: A 45-year-old female with CRB1 mutation related RP was referred for vitreoretinal surgery due to macular detachment. The patient was diagnosed with bilateral bullous macular retinoschisis secondary to Coats-like RP. The patient received a total of six anti-VEGF injections and laser ablation of telangiectatic vessels twice in both eyes without any response. Both eyes underwent pars plana vitrectomy, cyst aspiration with 39G needle, endolaser to telangiectatic vessels, and sulfur hexafluoride tamponade one month apart. The surgical treatment resulted in anatomical and functional improvement. Conclusion: Surgical microaspiration of macular cyst may be an option for patients with severe cystic macular retinoschisis in Coats-like RP. Copyright © by Ophthalmic Communications Society, Inc.Öğe Scleral-fixated intraocular lens implantation with irregular, knotless, zigzag-shaped scleral tunnel suture technique combined with pars plana vitrectomy or anterior vitrectomy(Wolters Kluwer Medknow Publications, 2024) Gunduz, Abuzer; Ozturk, Emrah; Cankaya, Cem; Atas, Pamuk B. U.PURPOSE: This study aims to introduce a new suture method and report surgical outcomes of patients who underwent scleral-fixated intraocular lens (SF-IOL) implantation combined with either pars plana vitrectomy (PPV) or anterior vitrectomy (AV). METHODS: Twenty-three eyes performed SF-IOL implantation combined with PPV (Group 1), and 34 eyes performed SF-IOL implantation combined with AV (Group 2) were included in the study prospectively. The SF-IOL, either polymethyl methacrylate or foldable IOL, was sutured into the sclera using PC-9 sutures in an irregular, knotless, and zigzag-shaped manner. The scleral tunnel was approximately 12-15 mm long, with at least four sharp edges. Suture tips were trimmed within the scleral tunnel. Postoperative outcomes and complications were evaluated. RESULTS: Both groups showed no complications such as suture tip expulsion, suture reaction, IOL dislocation, or increased intraocular pressure during postoperative visits. Group 1 exhibited a statistically significant improvement in visual acuity compared to preoperative values (P = 0.036 for the 1st month, <0.001 for the 3rd month). Similarly, Group 2 demonstrated a statistically significant improvement in visual acuity compared to the preoperative period (P = 0.001 for the 1st month, <0.001 for the 3rd month). CONCLUSION: The irregular, knotless, and zigzag-shaped scleral tunnel suture technique yielded favorable results in terms of IOL stability and visual acuity. This technique can be safely employed in patients undergoing SF-IOL implantation combined with PPV or AV.Öğe The impact of utilizing a single iris hook as a capsular hook during the implantation of capsular tension rings(Consel Brasil Oftalmologia, 2026) Demirel, Ersan Ersin; Ozturk, Emrah; Gunduz, AbuzerPurpose: To evaluate the effect of using a single iris retractor, affixed to the anterior capsulorhexis at the 12 o'clock position, on the ease of capsular tension ring implantation. Methods: This prospective comparative study comprised 37 patients with zonular weakness attributed to pseudoexfoliation syndrome who underwent capsular tension ring implantation during cataract surgery. In Group 1, a single iris retractor was inserted into the anterior capsulorhexis at the 12 o'clock position. Group 2 did not receive this intervention. Zonular weakness was graded on a scale of 1-5, and the subjective difficulty of capsular tension ring implantation was categorized as easy, medium, or difficult. Results: Group 1 and 2 comprised 20 and 17 patients, respectively. There were no significant differences between the groups in age, sex distribution, and presence of glaucoma (p=0.53, p=0.28, and p=1.00, respectively). The mean zonular weakness score was significantly higher in Group 1 (3.35 +/- 0.45) than in Group 2 (2.71 +/- 0.59; p=0.02). Capsular tension ring implantation was significantly easier in the iris retractor group (p<0.001). Conclusions: Placement of a single iris retractor attached to the anterior capsulorhexis at the 12 o'clock position may facilitate easier capsular tension ring implantation, even in patients with greater zonular weakness. This technique could reduce the risk of capsular tension ring displacement into the iridocorneal angle or ciliary sulcus.
