Yazar "Yilmaz, H" seçeneğine göre listele

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    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, UC
    Background: 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.
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    Intravitreal cortisone injection for refractory diffuse diabetic macular edema
    (Karger, 2005) Er, H; Yilmaz, H
    Purpose: The purpose of this study was to evaluate the safety and efficacy of intravitreal triamcinolone acetonide injection in patients with diffuse diabetic macular edema. We also compared the effect of intravitreal triamcinolone with macular grid laser photocoagulation in macular edema. Patients and Methods: Thirty patients with diabetic diffuse macular edema unresponsive to grid laser photocoagulation for at least 4 months received 0.1 ml ( 4 mg/ml) intravitreal triamcinolone acetonide ( Kenakort-A) injection as treatment. This study group was compared with a control group of 30 patients ( 30 eyes) who had undergone grid laser macular coagulation. Mean follow-up time was 17 months ( range 14 - 24 months) in the study group and 19 months ( range 16 - 24 months) in the control group. Results: In the study group, mean improvement in visual acuity measured 3.8, 3.4, 0.9 and 0.2 Snellen lines at the follow-up intervals of 1, 3, 6 and 12 months, respectively. Improvement in visual acuity was statistically significant only at 1 month ( p = 0.002) and 3 months ( p = 0.003) after injection. Visual acuity was significantly ( p < 0.05) better in the study group than the control group at 1 and 3 months. Overall, 6 of 30 eyes ( 20%) required a second injection and 3 eyes ( 10%) a third due to regression in visual acuity. Towards the end of the follow-up period, the visual acuity decreased to almost baseline levels. Elevation of intraocular pressure was found in 4 patients and controlled with topical antiglaucomatosis treatment. Sterile endophthalmitis was detected in only one eye. No eye exhibited cataract progression during the follow-up period. Conclusion: Intravitreal injection of triamcinolone may be beneficial for temporarily increasing visual acuity in patients with diabetic diffuse macular edema who are unresponsive even to grid laser photocoagulation. But the regression of visual acuity looks inevitable in the long term after injection. Therefore, repeated injections with/without increasing doses might be required for the stabilization of visual acuity. Copyright (c) 2005 S. Karger AG, Basel.
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    Myopic shift from the predicted refraction after sulcus fixation of PMMA posterior chamber intraocular lenses
    (Canadian Ophthal Soc, 2006) Bayramlar, H; Hepsen, IF; Yilmaz, H
    Background: 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.
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    Preventive effect of lacrimal occlusion on topical timolol-induced bronchoconstriction in asthmatics
    (Wiley, 2004) Hepsen, IF; Yildirim, Z; Yilmaz, H; Kotuk, M
    Aim: 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.
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    Use of caffeic acid phenethyl ester and cortisone may prevent proliferative vitreoretinopathy
    (Hindawi Ltd, 2004) Turkoz, Y; Er, H; Borazan, M; Yilmaz, H; Mizrak, B; Parlakpinar, H; Cigremis, Y
    PURPOSE: To investigate whether caffeic acid phenethyl ester ( CAPE) and cortisone prevent proliferative vitreoretinopathy (PVR). Methods: Twenty pigmented rabbits were used in this study. All rabbits except controls received an intravitreal injection of 0.15 ml (75,000 U) of platelet-rich plasma into their left eye. The animals were divided into four groups: group I was treated with intraperitoneal injection of 0.5 ml (15 mumol/kg) of CAPE for 3 days, group II received 0.15 ml (4 mg/kg) of intravitreal cortisone, group III received nothing ( blank group), and group IV ( control group) received only 1 ml of 1% ethanol intraperitoneally daily for 3 days. Proliferative changes were graded in a masked fashion by indirect ophthalmoscopy for a 15-day follow-up period. The malondialdehyde (MDA), reduced glutathione (GSH) and total nitrite ( NO) levels were measured in the vitreous humor. Results: The grades of PVR were B - C in group I, and C - D in group II. The PVR grade in the control group was C - D. The mean MDA level in group I (4.0 +/- 0.8 mumol/l) was significantly lower than in the blank group (6.0 mumol/l) (p< 0.05). The mean GSH level in group I (71.0 +/- 11.2 mu mol/l) was significantly different than in the blank group (p< 0.05). The MDA and GSH levels in group II were 4.7 +/- 0.6 mumol/l and 53.8 +/- 7.8 mumol/l, respectively. Both these levels were not significantly different from the blank group (p > 0.05). The NO levels in both treatment groups were significantly lower than in the blank group ( p< 0.001). Conclusion: These findings suggest an inhibitory effect of CAPE on PVR. The inhibitory effect was supported by lower MDA and NO with higher GSH levels in treatment groups than in the blank group. There was no detected significant effect of cortisone for preventing PVR experimentally.