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    Glucose-insulin-potassium solution before cardiopulmonary bypass in coronary artery surgery
    (2000) Turkoz A.; Toprak H.I.; Sari S.; Ozturk E.; Durmus M.; Turkoz R.; Ersoy M.O.
    Glucose-insulin-potassium (GIK) solution has been advocated for the treatment of ischemic myocardium. This prospective, randomized clinical study was conducted to evaluate whether GIK solutions would cause benefit for the patients in addition to anterograd and retrograd combined blood cardioplegia undergoing coronary artery bypass grafting because of depressed left ventricle and unstable angina. The study group consisted of 33 patients with depressed left ventricle and unstable angina who underwent coronary artery bypass grafting, 2 patients were excluded from the study because of catheter dislocation. In 15 patients GIK solution (500 mL of 30 % dextrose, 70 units insuline, 80 mEq potassium) was given intravenously at 1 mL/kg per hour started with induction of anaesthesia, until the stage of cardiopulmonary bypass (CPB). Sixteen patients received ringer's lactate as the control group. The patients were analysed for hemodynamic changes, blood glucose and potassium levels. Pulmonary capillary wedge pressure, cardiac output, systemic vascular resistance, pulmonary vascular resistance were not different between two groups immediately before and after CPB. Blood glucose levels were not different between the two groups, but in both groups the levels increased after the end of the infusion of GIK solution, on the fifteenth minutes and at the end of the CPB. No differences were determined at the end of operation. There was no difference in serum potassium levels between the two groups, but potassium levels increased significantly during and immediately after CPB and decreased to the basal levels at the end of the operation in both groups. There was no significant difference between the groups in perioperative myocardial infarction, incidence of atrial and ventricular arrhythmias, times of ventilator support, length of stay in the intensive care unit and mortality. In this study, GIK therapy did not produce any additional positive hemodynamic effects and postoperative recovery from depressed left ventricle and urgent coronary artery bypass grafting.
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    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 A.; Ozturk E.; Cankaya C.; Atas P.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. © 2024 Saudi Journal of Ophthalmology | Published by Wolters Kluwer - Medknow.