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Öğe Anatomical and functional results of pars plana vitrectomy+ ILM peeling+ gas endotamponade in patients with idiopathic stage 4 macular hole(2019) Dikci, Seyhan; Demirel, Soner; Tuncer Firat, Ilknur; Yilmaz, TurgutAim: To evaluate the anatomical and functional results in cases underwent 23-gauge pars plana vitrectomy (PPV) due to idiopathic stage 4 macular hole.Material and Methods: 17 eyes of 17 patients who underwent PPV due to idiopathic stage 4 macular hole between March 2013 and March 2016 at İnönü University Turgut Özal Medical Center Department of Ophthalmology were included in the study. The medical records of the patients were retrospectively reviewed. Macular hole staging was performed according to biomicroscopic examination and optical coherence tomography findings. Anatomical success was evaluated according to the condition of the macular hole after the surgery and functional success was evaluated according to the visual acuity.Results: 9 (53%) of the cases were females and 8 (47%) were males, the mean age was 66.6 ± 6.6 (55-81). PPV, internal limiting membrane (ILM) peeling and gas tamponade were applied to all cases. The mean follow-up period was 13.9±9.7 (4-30) months. ILM peeling was performed using trypan blue in three (17.6%) of the cases, brillant blue in 4 (23.5%) of the cases and membrane blue in 10 (58.8%) of the cases. Three cases (17.6%) were treated with C3F8 and 14 cases (82.3%) with SF6 gas tamponade. The mean preoperatively best-corrected visual acuity (BCVA) was 0.08±0.06 (0.03-0.2) and the mean postoperatively BCVA was 0.16±0.15 (0.03-0.5). Visual acuity did not change in two eyes (11.7%) and decreased in two eyes (11.7%). Macular hole had not closed in four patients (23.5%).Conclusion: 23 gauge PPV, ILM peeling and C3F8 or SF6 gas tamponade provides anatomical and functional success in the treatment of idiopathic stage 4 macular hole.Keywords: Internal limiting membrane; Macular hole; Pars plana vitrectomy.Öğe Anterior chamber fixation of a posterior chamber intraocular lens: A novel technique(Medknow Publications & Media Pvt Ltd, 2014) Kukner, A. Sahap; Alagoz, Gursoy; Erdurmus, Mesut; Serin, Didem; Dogan, Umit; Yilmaz, TurgutWe aimed to evaluate the implantation of a posterior chamber intraocular lens (IOL) in the anterior chamber (AC) with the haptics passing through two iridectomies to the posterior chamber. A total of 33 eyes of 33 patients with inadequate posterior capsular support due to either previous aphakia or posterior capsular rupture during cataract extraction were included in the study. A double iridectomy was performed on all patients using a vitrectomy probe on the midperiphery of the iris. IOLs were implanted in the AC, and the haptics were passed through the iridectomies to the posterior chamber. The mean follow-up time was 25.3 months. AC hemorrhage occurred in five patients during the iridectomy procedure. Corneal edema was detected in eight of 14 patients with primary IOL insertions. Haptic dislocation was detected in only one patient. This technique may be a good alternative to scleral-fixated IOL implantation in eyes with aphakia.Öğe Anterior vitrectomy and partial capsulectomy via anterior approach to treat chronic postoperative endophthalmitis(Ijo Press, 2013) Guler, Mete; Yilmaz, TurgutAIM: To describe the results of vitrectomy and partial capsulectomy via anterior approach surgical technique in treatment of chronic postoperative endophthalmitis (CPE). METHODS: Clinical records of 9 patients treated for CPE between 2006 and 2010 were reviewed retrospectively. All of these patients were treated with vitrectomy and partial capsulectomy via anterior approach. RESULTS: Six of 9 patients were male. The average patients' age was (60 +/- 8.1) years. The average period between cataract extraction and onset of signs and symptoms was (3.6 +/- 1.3) weeks. The average presenting visual acuity was 0.3 +/- 0.1 and the average final post operative visual acuity was 0.7 +/- 0.2. The mean follow-up period was (28.1 +/- 8.9) weeks. In all patients, the inflammation subsided after surgery. CONCLUSION: Our results suggest that anterior vitrectomy and partial capsulectomy via anterior approach may be considered as potentially useful and relatively less invasive technique to treat CPE.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 Bilateral retinal vasculitis in a patient with lichen planus(Consel Brasil Oftalmologia, 2016) Dikci, Seyhan; Genc, Oguzhan; Yilmaz, Turgut; Firat, Penpe GulLichen planus (LP) is an autoimmune, inflammatory disease of unknown etiology that commonly affects the skin and mucous membranes. Retinal vasculitis is a group of vision-threatening disorders, in which autoimmunity is thought to play a role in pathogenesis. We present the case of a patient who was diagnosed with retinal vasculitis and who was followed up for mucosal LP. LP has not been reported as a cause of retinal vasculitis in the literature. We believe that the retinal vasculitis in this case was related to LP because cellular immunity plays a role in the pathogenesis of both entities.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 intravitreal ranibizumab and bevacizumab treatment for retinopathy of prematurity(Consel Brasil Oftalmologia, 2016) Ceylan, Osman Melih; Dikci, Seyhan; Genc, Oguzhan; Yilmaz, Turgut[Abstract Not Available]Öğe Comparison of Nd:YAG laser (532 nm green) vs diode laser (810 nm) photocoagulation in the treatment of retinopathy of prematurity: an evaluation in terms of complications(Springer London Ltd, 2020) Dikci, Seyhan; Demirel, Soner; Firat, Penpe Gul; Yilmaz, Turgut; Ceylan, Osman Melih; Bag, Harika Gozde GozukaraPurpose To compare the anterior and posterior segment complications of diode (810 nm) laser photocoagulation (LPC) and Nd:YAG (532 nm green) LPC in the treatment of retinopathy of prematurity (ROP). Patients and methods The 84 eyes of 43 patients treated with diode LPC (group 1) and 58 eyes of 31 patients treated with Nd:YAG LPC (group 2) for ROP in our clinic were enrolled in the study. Medical records of all patients were investigated retrospectively. The patients in each group were examined in terms of birth weights, gestational weeks, stage of retinopathy, number of lasers pots, laser parameters, and anterior and posterior complications of LPC. Results The mean birth weeks of group 1 patients were postmenstrual 27.7 +/- 2.5 (23-33), while the mean birth weights were 1006.0 +/- 334.5 (540-1980) grams. The mean birth weeks of group 2 patients were postmenstrual 27.4 +/- 2.6 (23-33), while the mean birth weights were 1073.8 +/- 329.2 (480-1720) grams. The mean numbers of laser spots were 1036.0 +/- 515.2 (430-2410) in group 1 per eye, while the mean numbers of laser spots were 1085.4 +/- 526.0 (445-2530) in group 2 per eye (p >= 0.05). Additional laser application was performed in four eyes (4.8%) in group 1 and four eyes (6.9%) in group 2. Four eyes (4.8%) treated with diode LPC and one eye (1.7%) treated with Nd:YAG laser developed retinal detachment. Two eyes of a patient (3.4%) applied Nd:YAG LPC developed cataract. Conclusion Cataract may develop when Nd:YAG laser is used; however, posterior segment complications may be more likely to appear with the use of diode laser in these cases.Öğe Comparison of Visual Field Parameters in Early and Advanced Stages of Multiple Sclerosis Patients Without a History of Optic Neuritis(Taylor & Francis As, 2013) Guler, Mete; Turkcuoglu, Peykan; Yilmaz, Turgut; Yoldas, Tahir Kurtulus; Channa, RoomasaThis study compared the visual field parameters of multiple sclerosis patients without optic neuritis in early versus advanced stage of the disease. Patients were divided into two groups: group 1 (early stage, n = 14) constituted of patients with Expanded Disability Status Scale scores <3 and group 2 (advanced stage, n = 13) constituted of patients with Expanded Disability Status Scale scores >= 3. Mean visual acuities in both groups were similar (p = 0.674). Mean sensitivity, mean defect, loss of variance, reliability factor parameters (Octopus 101 perimeter) of groups 1 and 2 were 24.17 +/- 3.62, 21.81 +/- 3.04; 4.14 +/- 3.05, 6.49 +/- 2.58; 21.61 +/- 22.17, 33.31 +/- 18.67; and 1.57 +/- 2.79, 2.59 +/- 3.09, respectively. Compared with group 1, mean sensitivity was significantly lower in group 2 (p = 0.013). Mean defect (p = 0.004) and loss of variance (p = 0.042) parameters in group 2 were significantly higher than in group 1. Mean reliability factor was similar between two groups (p = 0.211). Multiple scleorisis may alter visual field parameters without severe loss of visual acuity by possibly involving optic pathways other than optic nerve.Öğe Computed Tomography Diagnostic Abilities for Open-Globe Injuries in Pediatric Versus Adult Patients(Lippincott Williams & Wilkins, 2021) Dikci, Seyhan; Yildirim, Ismail Okan; Firat, Murat; Firat, Penpe Gul; Demirel, Soner; Yilmaz, Turgut; Tuncer, IlknurObjectives The aim of this study was to compare the role of computed tomography (CT) in the diagnosis of open-globe trauma and intraocular foreign body (IOFB) in pediatric and adult age groups. Methods Medical records of cases with open-globe trauma at Inonu University Hospital's Ophthalmology Emergency Service were retrospectively evaluated. Preoperative orbital CT images of the cases obtained at emergency services and their clinical and/or surgical findings were compared in pediatric and adult groups. Results We included 47 eyes of 47 cases aged 18 years and below (pediatric group) and 85 eyes of 82 cases over 18 years (adult group). The mean +/- SD age was 10.80 +/- 5.11 years (range, 2-18 years) in the pediatric group and 46.34 +/- 19.01 years (range, 19-82 years) in the adult group. Computed tomography images revealed 21.7% of the cases with corneal lacerations, 55.5% with scleral lacerations, and 91.6% with corneoscleral lacerations in the pediatric group, whereas the respective numbers were 48.4%, 66.6%, and 61.9% in the adult group. The detection rates of corneal penetrations and vitreous hemorrhage with CT were significantly lower in the pediatric group than in the adult group (P < 0.05). The CT scans diagnosed 66.6% of the pediatric cases and 90% of the adult cases with an IOFB. Conclusions Corneal lacerations and IOFBs can be missed, especially in the pediatric group, because the eye is smaller in adults. Pediatric patients with a history of ocular trauma should undergo an examination under general anesthesia followed by surgical exploration if necessary.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 Outcomes of vitreoretinal surgery in patients with posterior segment intraocular foreign body(2021) Dikci, Seyhan; Yilmaz, TurgutAim: This study aims to examine the outcomes of vitreoretinal surgery (VRS) in the treatment of cases detected to have posterior segment intraocular foreign body (IOFB) due to eye trauma. Materials and Methods: Files of patients who were detected to have posterior segment intraocular foreign bodies due to eye trauma and underwent VRS in our clinic between January 2014 and December 2018 were retrospectively reviewed. Patient age, sex, preoperative and final best corrected visual acuity (BCVA), initial eye examinations, nature of the foreign body and site of penetration into the eye, methods of foreign body removal, surgical methods, and complications were recorded. Results: Of the 16 patients included in the study, 15 (93.7%) were male and 1 (6.3%) was female. Mean age of the cases was 32.8±13.7 (14-58) years. Foreign body was metallic in 15 eyes, and a stone in one eye. Median time between trauma and IOFB removal was 3 days. Foreign bodies were removed via an enlarged sclerotomy in 13 eyes, and a limbal incision in 3 eyes. Visual acuity improved during postoperative follow-up in 12 patients, deteriorated in three patients, and remained unchanged in one patient. Mean initial BCVA of the cases was 1.54±0.57 logMAR and mean final BCVA was 1.03±0.6 logMAR (p=0.014). Four eyes demonstrated recurrent/new retinal detachment (RD), two eyes macular scaring, one eye a transient increase in intraocular pressure, one eye aphakia, one eye hemorrhagic choroidal detachment, and one eye phthisis bulbi. Median follow-up time was 14 (3-58) months. Conclusion: VRS is an effective and safe procedure for the removal of posterior segment intraocular foreign bodies; however, visual and anatomic outcomes can be affected by various factors in these cases. Macular scaring and a recurrent or new RD are associated with poor final visual outcomes.Öğe Pre-, intra- and post-operative management in phacoemulsification surgery for completely monocular cases(2019) Demirel, Soner; Dikci, Seyhan; Firat, Penpe Gul; Ozturk, Emrah; Ceylan, Osman Melih; Turkoglu, Elif Betul; Yilmaz, Turgut; Gunduz, Abuzer; Gozukara Bag, Harika GozdeAim: To evaluate the results of phacoemulsification (PE) surgery in completely monocular cases and to emphasize the important points in the pre-, intra- and post-operative periods. Material and Methods: A total of 42 patients who had no light perception in one eye and had underwent PE surgery in the other eye at our clinic between January 2014 and March 2016 were included in the study. The charts of the patients were evaluated retrospectively. The age and gender of the cases, whether there was an additional pathology in the eye undergoing surgery, the reason of visual loss in the other eye, the type of anesthesia used, pre- and post-operative best corrected visual acuity (BCVA) with the Snellen chart, intraocular pressure and intra- and post-operative complications were investigated. Results: There were17 (40.5%) female and 25 (59.5%) male patients with a mean age of 74.2±10.5 (45-93) years. The most common causes of the monocular state were glaucoma, cataract and trauma, the most common accompanying pathologies in the eyes undergoing cataract surgery were glaucoma, zonular weakness and age-related macular degeneration. Mean BCVA was 0.07±0.1 (0.01-0.4) pre-operatively and 0.5±0.3 (0.01-1) post-operatively (p≤0.001). The mean follow-up duration was 3.9±5.6 months (1 week to 24 months). The most common post-operative complication was corneal edema. Conclusion: The stress created by cataract surgery on the physician and patient is quite high in monocular cases. However, satisfactory results with PE are obtained in these cases by carefully using pre-, intra- and post-operative methods.Öğe Results of Diod Laser Photocoagulation in the Treatment of Retinopathy of Prematurity(Karger, 2014) Dikci, Seyhan; Genc, Oguzhan; Yilmaz, Turgut; Firat, Penpe Gul; Demirel, Soner[Abstract Not Available]Öğe Toxic effects of systemic cisplatin on rat eyes and the protective effect of hesperidin against this toxicity(Taylor & Francis Ltd, 2016) Polat, Nihat; Ciftci, Osman; Cetin, Asli; Yilmaz, TurgutContext: In the present study, cisplatin (CP) induced eye toxicity and the beneficial effect of hesperidin (HP) was investigated.Methods: Twenty-eight rats were equally divided into four groups; the first group was kept as control. In the second and third group, CP and HP were given at the doses of 7mg/kg and 50mg/kg/d, respectively. In the fourth group, CP and HP were given together at the same doses. Tissue samples were collected on day 14 of CP treatment.Results: The results demonstrated that CP caused a significant increase in thiobarbituric acid reactive substances (TBARS) levels and decrease of glutathione levels and antioxidant enzyme activity (catalase, superoxide dismutase and glutathione peroxidase) in eye tissues compared to other groups, HP prevented these effects of CP. Besides, CP led to histopathological damage in the retina and cornea. On the other hand, HP treatment prevented histopathological effects of CP.Conclusion: CP had severe dose-limiting toxic effects and HP treatment can be beneficial against the toxic ocular effects of CP. Thus, it appears that co-administration of HP with CP may be a useful approach to attenuate the negative effects of CP on the eye.Öğe Vitreoretinal surgery in patients with intraocular lens dislocation into the vitreous(2021) Dikci, Seyhan; Yilmaz, TurgutAim: To evaluate the demographic and clinical characteristics of patients who underwent pars plana vitrectomy (PPV) for intraocular lens (IOL) dislocation into the vitreous cavity and the visual and anatomical outcomes of PPV in these patients. Material and Methods: This retrospective study reviewed the files of patients who underwent PPV for IOL dislocation into the vitreous in our clinic between January 2014 and December 2018. Patient age, gender, preoperative and postoperative best corrected visual acuity (BCVA), intraocular pressure (IOP), comorbid ocular pathologies, causes of IOL dislocation, time from IOL dislocation to PPV surgery, surgical methods, and preoperative and postoperative complications were recorded. Results: This study included 15 eyes of 15 patients with IOLs dislocated into the vitreous, of which 5 (33.3%) were female and 10 (66.7%) were male. Mean patient age was 60.8±22.67 (12-94) years. Seven (46.7%) of 15 eyes underwent a secondary IOL implantation in the same session as IOL extraction, whereas eight eyes were planned to undergo a secondary IOL implantation in a second session. Meanwhile, 2 (13.3%) eyes did not undergo IOL implantation. Median preoperative BCVA was 1.7 (0.4-1.92) logMAR and median postoperative BCVA was 0.5 (0-2) logMAR across all patients (p=0.002). After surgery, BCVA was higher in 12 patients (80%), unchanged in 2 patients (13.3%) and lower in one patient (6.7%). In our series, 3 eyes were detected to have preoperative RD and 2 eyes high IOP, whereas one patient showed recurrent RD and 4 eyes showed high IOP postoperatively. Median postoperative BCVA was significantly higher in patients who underwent secondary IOL implantation in a second session than those who underwent IOL implantation in the same session (p=0.035). Conclusion: PPV is a safe method for achieving successful visual and anatomical outcomes in patients with IOL dislocated into the vitreous cavity. In these patients, performing the secondary IOL implantation in a second session can result in a higher final visual acuity. Also, monitoring these complex cases closely is important in order to achieve better visual and anatomical outcomes.Öğe Which dose of bevacizumab is more effective for the treatment of aggressive posterior retinopathy of prematurity: lower or higher dose?(Consel Brasil Oftalmologia, 2018) Dikci, Seyhan; Ceylan, Osman Melih; Demirel, Soner; Yilmaz, TurgutPurpose: To compare 0.5 mg and 0.625 mg of bevacizumab for treating aggressive posterior retinopathy of prematurity (AP-ROP). Methods: The medical records of patients with AP-ROP who were administered intravitreal bevacizumab (IVB) as a primary treatment at a university clinic were evaluated retrospectively. Five eyes of three patients (Group 1) who received 0.625 mg/0.025 ml IVB and 10 eyes of another five patients (Group 2) who received 0.5 mg/0.02 ml IVB were evaluated. Laser photocoagulation was used as additional treatment after relapses. Anatomic results and complications were evaluated in both groups. Results: We evaluated 15 eyes of eight patients (four girls and four boys) with a flat demarcation line at posterior zone 2 and plus disease or stage-3 disease in this study. The mean gestational age of the three babies in Group 1 was 26 +/- 1 weeks and the mean birth weight was 835.33 +/- 48.01 g. The corresponding values were 25.2 +/- 1.6 weeks and 724 +/- 139.03 g, respectively, for the five babies in Group 2. Retinal vascularization was completed at a mean postmenstrual duration of 53.6 +/- 1.5 weeks without additional treatment in the five eyes in Group 1. Laser photocoagulation for relapse was administered to five of the 10 eyes in Group 2. Retinal vascularization was completed at a mean postmenstrual duration of 47.6 +/- 1.5 weeks in the remaining five eyes. None of the patients developed complications such as cataract, glaucoma, retinal tear, retinal or vitreous hemorrhage, or retinal detachment. Conclusion: Although lower IVB doses in the treatment of AP-ROP are expected to be safer in terms of local and systemic side effects in premature infants, these patients may require additional treatment with IVB or laser photocoagulation.
