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Öğe Central retinal artery occlusion secondary to orbital cellulitis and abscess following dacryocystitis(Sage Publications Ltd, 2011) Coskun, Mesut; Ilhan, Ozgur; Keskin, Ugurcan; Ayintap, Emre; Tuzcu, Esra; Semiz, Hilal; Oksuz, HuseyinPurpose. To report a case of dacryocystitis that progressed to orbital abscess resulting in the rare complication of central retinal artery occlusion. Methods. A patient without any other known health problems presented with dacryocystitis complicated by orbital cellulitis, orbital abscess, and finally central retinal artery occlusion despite medical treatment. Results. After 48 hours of medical treatment, there was no recovery, and there was loss of light perception; because of this, surgery indication was determined. Fundus fluorescein angiogram demonstrated findings of central retinal artery occlusion. There was no recovery of light perception after surgical intervention. Conclusions. We report a case of orbital abscess following dacryocystitis in a healthy middle-aged woman resulting in the rare complication of central retinal artery occlusion. To our knowledge, this is the first report of central retinal artery occlusion secondary to orbital abscess following dacryocystitis.Öğe Comparison of sub-tenon triamcinolone acetonide and intravitreal bevacizumab for the treatment of macular edema due to branch retinal vein occlusion(2013) Ilhan, Nilüfer; Ayhan Tuzcu, Esra; Da?lio?lu, Mutlu Cihan; Coşkun, Mesut; Ilhan, Özgür; Ayintap, Emre; Keskin, U?urcanPurpose: To evaluate the effect of subtenon triamcinolone acetonide (STA) and intravitreal bevacizumab (IVB) injections in the treatment of macular edema due to branch retinal vein occlusion (BRVO). Materials and Methods: In this retrospective study, 41 eyes of 41 patients with macular edema due to BRVO were included. The records of 21 patients of triamcinolone and 20 patients of bevacizumab group were analyzed retrospectively. Before injection and 1., 3. and 6 months after the treatment, best-corrected visual acuity (BCVA) (logMAR), intraocular pressure (IOP) and central foveal thickness (CFT) detected by optical coherence tomography were recorded. Results: In the triamcinolone group baseline values including BCVA (logMAR) and CFT were 0.94±0.42 logMAR and 552±70 ?m. In the bevacizumab group, they were 0.98±0.50 logMAR and 541±94 ?m. At 6th month BCVA and CFT were 0.57±0.35 logMAR and 342±34 ?m in the triamcinolone group whereas these values were 0.41±0.23 logMAR and 289±15?m in the bevacizumab group. During the follow up, the mean BCVA was not significantly different but the mean CFT was significantly different at 3rd and 6th month between groups. Five patients (23.8%) from triamcinolone group, IOP exceeded 24 mm Hg postoperatively. No complications observed in the bevacizumab group. Conclusion: The visual outcome of STA and IVB injections in patients with macular edema due to BRVO was similar. Increased IOP after injection limits the usage of STA. However the effect of IVB on the macular edema seems better than STA.Öğe The Effect of Enoxaparin-Containing Irrigation Fluid Used During Cataract Surgery on Postoperative Inflammation in Patients With Diabetes(Elsevier Science Inc, 2013) Ilhan, Ozgur; Ilhan, Nilufer; Coskun, Mesut; Daglioglu, Mutlu Cihan; Tuzcu, Esra Ayhan; Ayintap, Emre; Keskin, UgurcanPURPOSE: To investigate effects of enoxaparin on postoperative inflammation in patients with moderate nonproliferative diabetic retinopathy (NPDR) and nuclear cataract. DESIGN: Prospective masked controlled trial. METHODS: SETTING: Institutional practice. STUDY POPULATION: The study included 51 eyes of 51 diabetes mellitus (DM) patients with moderate NPDR and grade 2-3 nuclear cataracts. Group 1 included randomly selected patients who received enoxaparin in balanced salt solution (BSS) during cataract surgery, while standard BSS was used in Group 2. OBSERVATION PROCEDURE: Patients were followed up 1 day, 1 week, and 1 and 2 months after the surgery. MAIN OUTCOME MEASURES: Anterior chamber cell and flare. RESULTS: Postoperatively, 20 patients from Group 1 and 4 patients in Group 2 had less than a mean of 10 cells at day 1 (P = .012). At the first week, 20 patients from Group 1 and 10 patients from Group 2 had less than a mean of 10 cells (P = .004). When compared for flare, 20 patients from Group 1 and 8 patients from Group 2 had a flare between 0 and + 1 at postoperative day 1 (P < .001). By the end of postoperative first week, 24 patients from Group land 18 patients from Group. 2 had a flare between 0 and + 1 (P = .012). There was no difference between groups in terms of postoperative inflammation at the first and second months after the surgery. CONCLUSION: The results of the study suggest that enoxaparin added into the infusion fluid may reduce postoperative inflammation in patients with DM, and this result supports the anti-inflammatory effect of enoxaparin. ((C) 2013 by Elsevier Inc. All rights reserved.)Öğe The effects of soft contact lens use on cornea and patient's recovery after autograft pterygium surgery(Elsevier Science Bv, 2014) Daglioglu, Mutlu Cihan; Coskun, Mesut; Ilhan, Nilufer; Tuzcu, Esra Ayhan; Ilhan, Ozgur; Keskin, Ugurcan; Ayintap, EmrePurpose: To investigate usage of soft contact lens (SCL) on post-operative pain relief and daily, activity due to pterygium surgery. Methods: Autograft pterygium surgery was performed to 63 eyes of 63 patients. After surgery in 30, eyes of 30 patients in group-1, SCL was placed on the cornea. In 33 patients of group-2, antibiotic, pomade was applied and tightly covered with bandage. Follow-up visits were performed on 24th and, 48th h after the surgery. Re-epithelization time and pain scores were compared. Results: Patients' 24th h pain score was 2.96 +/- 0.76 in group-1, and 4.15 +/- 0.75 in group-2. The mean, pain score for 48 h was 1.66 +/- 0.66 in group-1, and 2.96 +/- 0.68 in group-2. Patients' pain scores for, both 24th h and 48th h were lower in group-1 (p < 0.01). The mean re-epithelization times in, group 1 and 2 were 48 and 56.7 h, respectively. Corneal re-epithelization is improved in patients, with SCL compared to group 2. Conclusion: SCL seems effective on reducing post-operative pain and eye stinging, and may accelerate, corneal re-epithelization and maintaining daily activities. Crown Copyright (C) 2013 Published by Elsevier Ltd on behalf of British Contact Lens Association. All rights reserved.Öğe Effects of sub-Tenon's anaesthesia on ocular hemodynamics(Canadian Ophthal Soc, 2014) Coskun, Mesut; Daglioglu, Mutlu Cihan; Davran, Ramazan; Ilhan, Niluefer; Ilhan, Oezguer; Tuzcu, Esra Ayhan; Ayintap, EmreObjective: To research the effects of sub-Tenon's anaesthesia (STA) on ocular hemodynamics in patients with cataract using colour Doppler imaging (CDI). Design: Prospective clinical study. Participants: Thirty-four eyes of 34 patients with age-related cataract. Methods: Peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) values of the ophthalmic artery (OA), central retinal artery, and central retinal vein were measured by CDI before and immediately after performing sub-Tenon block using 2 mL of 2% lidocaine with adrenaline (1:200 000). Results: Both PSV and EDV values were significantly decreased after sub-Tenon injection in all the studied vessels of the patients. However, no important changes were observed in the RI values of the vessels. Conclusions: STA markedly reduced ocular blood flow. The reduction may be more acceptable compared with other retrobulbar block methods. Sub-Tenon block should be performed carefully to senile patients with cataract with vascular occlusive disorder.Öğe Effects of Topical Phenylephrine HCI 2.5% used before Cataract Surgery on Systemic Blood Pressure(Turkish Ophthalmological Soc, 2011) Ayintap, Emre; Keskin, Ugurcan; Coskun, Mesut; Ilhan, Ozgur; Semiz, Hilal; Oksuz, HuseyinPurpose: To evaluate the effect of topical phenylephrine HCI 2.5% (Mydfrin), used as a fast and effective mydriatic before cataract surgery, on systemic blood pressure. Material and Method: Topical phenylephrine HCI 2.5% was administered 3 times with 5-minute intervals before cataract surgery to 44 eyes of 44 patients. The systemic blood pressure was measured preoperatively and at 15 and 30 minutes. Results: The mean systolic blood pressure before the topical administration of phenylephrine HCI 2.5% was 119.7mmHg, while 15 and 30 minutes later, it was 125.3 mmHg and 121.2 mmHg, respectively. The mean diastolic blood pressure before the topical administration of phenylephrine HCI 2.5% was 75.9 mmHg; 15 and 30 minutes later, it was 76.9 mmHg and 75.3 mmHg, respectively. The increase in systolic blood pressure at 15 and 30 minutes was statistically significant (p=0.003 and p=0.042). The change in diastolic blood pressure was not statistically significant. Discussion: Phenylephrine HCI 2.5%, which is used preoperatively as a fast and effective mydriatic for cataract surgery, can increase the systolic blood pressure. This effect is most significant at 15 minutes and lasts at least 30 minutes. This agent should be used with care in hypertensive patients.Öğe Gyrate atrophy of the choroid and retina(2013) Ilhan, NilÜfer; Keskin, U?urcan; Ilhan, ÖzgÜr; Tuzcu, Esra Ayhan; Ayintap, Emre; Da?lio?lu, Mutlu; ÖksÜz, HÜseyinGyrate atrophy of the choroid and retina is an autosomal recessive chorioretinal dystrophy associated with separated chorioretinal atrophy areas in midperiphery retina and slowly progression. Gyrate atrophy causes hyperornithinemia secondary to the deficiency of ornithine aminotransferase activity. Low night vision, high myopia and peripheral visual field limitation are the earliest findings which occur in late childhood. The main aim in the treatment is to reduce plasma ornithine level. In the current study, we present a case of gyrate atrophy whose serum levels of ornithine decreased by vitamine B6 therapy and a diet with low protein.Öğe The Injection of Air/Oxygen Bubble into the Anterior Chamber of Rabbits as a Treatment for Hyphema in Patients with Sickle Cell Disease(Hindawi Ltd, 2014) Ayintap, Emre; Keskin, Ugurcan; Sadigov, Fariz; Coskun, Mesut; Ilhan, Nilufer; Motor, Sedat; Semiz, HilalPurpose. To investigate the changes of partial oxygen pressure (PaO2) in aqueous humour after injecting air or oxygen bubble into the anterior chamber in sickle cell hyphema. Methods. Blood samples were taken from the same patient with sickle cell disease. Thirty-two rabbits were divided into 4 groups. In group 1 (n = 8), there was no injection. Only blood injection constituted group 2 (n = 8), both blood and air bubble injection constituted group 3 (n = 8), and both blood and oxygen bubble injection constituted group 4 (n = 8). Results. The PaO2 in the aqueous humour after 10 hours from the injections was 78.45 +/- 9.9 mmHg (Mean +/- SD) for group 1, 73.97 +/- 8.86 mmHg for group 2, 123.35 +/- 13.6 mmHg for group 3, and 306.47 +/- 16.5 mmHg for group 4. Therewas statistically significant difference between group 1 and group 2, when compared with group 3 and group 4. Conclusions. PaO2 in aqueous humour was increased after injecting air or oxygen bubble into the anterior chamber. We offer to leave an air bubble in the anterior chamber of patients with sickle cell hemoglobinopathies and hyphema undergoing an anterior chamber washout.Öğe A Novel Capsulorhexis Technique in White Cataract Surgery(Informa Healthcare, 2015) Daglioglu, Mutlu Cihan; Coskun, Mesut; Ilhan, Ozgur; Tuzcu, Esra Ayhan; Ilhan, Nilufer; Ayintap, Emre; Taskin, IbrahimPurpose: To investigate the efficacy and safety of novel capsulorhexis technique in white cataract surgery using the irrigation-aspiration system of a phaco device. Materials and Methods: 53 eyes of 50 patients were included in the study. Patients were randomly divided into two groups. To 27 eyes of 27 patients in Group 1, continuous curvilinear capsulorhexis (CCC) was made using an irrigation-aspiration system by a phaco machine. To 26 eyes of 23 patients in Group 2, CCC was made using an ocular visco-elastic device (OVD) and utrata forceps. Surgical results were compared between two groups. Results: No difference in outcome endothelial cell count or central corneal thickness was noted between the two groups. CCC-2 has been completed totally in Group 1 but only 22 eyes in the other group. Conclusions: Capsulorhexis with described technique is safe in white cataracts. This technique may be an alternative in capsulorhexis to the other method, which is made using OVD and forceps.Öğe Optic nerve infarct following traumatic hyphema of sickle cell trait(2013) Tuzcu, Esra Ayhan; Çoskun, Mesut; Ilhan, Özgür; Ayintap, Emre; Keskin, U?urcan; Öksüz, HüseyinBlunt ocular trauma, eye surgery, pathologies of iris and situations that thrombocytopenia can cause to hyphema. From these causes the most common is blunt ocular trauma and it occurs commonly in children. Hypema may often be treated without any complications in the normal individuals. However vision threatening complications are common in hyphemas seen in patients with hemoglobinopathy. These complication include optic nerve damage due to high intraocular pressure, recurrent hyphema, obstruction in retinal vascularite and infarction of optic nerve. Optic nerve infarction is usually associated with retinal vein occlusion and intraocular pressure elevation. In this report, a case with optic nerve infarct resulted from hyphema which was caused by a minimal blunt trauma in a sickle cell trait child is presented.Öğe Peripheral Facial Nerve Paralysis After Upper Third Molar Extraction(Lippincott Williams & Wilkins, 2010) Cakarer, Sirmahan; Can, Taylan; Cankaya, Burak; Erdem, Mehmet Ali; Yazici, Sinem; Ayintap, Emre; Ozden, Ali VeyselPeripheral facial nerve paralysis (PFNP) after mandibular interventions has been reported in the literature. In most cases, paralysis begins immediately after the injection of the mandibular anesthesia, and duration of facial weakness is less than 12 hours. However, there are few documented cases of PFNP after maxillary dental or surgical procedures. A variety of mechanisms have been associated to PFNP, including viral reactivation, demyelination, edema, vasospasm, and trauma. The purpose of this presentation was to report a rare case of facial paralysis that occurred after an upper third molar extraction. The cause of the PFNP and the importance of the multidisciplinary approach in the management are emphasized.Öğe Posterior Hyaloidotomy by Nd:YAG Laser Application in a Patient with Postpartum Depression Caused by Valsalva Retinopathy(Karger, 2013) Daglioglu, Mutlu Cihan; Coskun, Mesut; Ilhan, Nilufer; Tuzcu, Esra Ayhan; Ari, Mustafa; Ayintap, Emre; Ilhan, OzgurPurpose: The aim of this report is to present a case of premacular hemorrhage in a 37-week pregnant woman with concurrent presence of postpartum depression secondary to her ocular disease. Methods: A 27-year-old woman in her 37th week of pregnancy presented with Valsalva retinopathy, which occurred in her left eye secondary to severe coughing. Her visual acuity was reduced to perception of hand motions, and she was agitated because of the loss of vision. The patient, who gave birth by cesarean section, was admitted for control examination 2 weeks after birth. No change was observed in premacular hemorrhage in control examination. However, the patient's relatives stated that the patient was very agitated and disinterested in her baby. For this reason, the patient was referred to the psychiatry clinic, and she was diagnosed with postpartum depression. The anatomical location of the premacular hemorrhage was determined by spectral domain optical coherence tomography. Results: Neodymium yttrium aluminum garnet (Nd:YAG) laser hyaloidotomy was performed to her left eye on the same day. Rapid release of premacular hemorrhage into the vitreous cavity was observed immediately after Nd:YAG laser application. Two days after the application, the patient's visual acuity had improved to 20/20. The clinical improvement positively impacted on the patient's mood. Conclusion: In pregnant patients suffering from Valsalva retinopathy during the postpartum period, posterior hyaloidotomy by Nd:YAG laser can be implemented in terms of the patients' own and their babies' physical and mental health.Öğe Protective effects of N-acetylcysteine on triamcinolone acetonide-induced lens damage in rats(Taylor & Francis Ltd, 2014) Tuzcu, Esra Ayhan; Tuzcu, Kasim; Basarslan, Fatmagul; Motor, Sedat; Coskun, Mesut; Keskin, Ugurcan; Ayintap, EmreObjective: To examine the relationship of cataract forming effect of intravitreal triamcinolone acetonide (IVTA) injection with oxidative status and the effect of N-acetylcysteine (NAC) on these alterations. Materials and methods: Twenty-six Wistar-Albino rats were included in the study. Rats were assigned into four groups as follows: intravitreal saline injection group (controls); IVTA injection group; IVTA + intraperitoneal NAC injection group (IVTA + NAC); and intraperitoneal NAC injection group (NAC). Triamcinolone acetonide was intravitreally injected at a dose of 1 mg. NAC was intraperitoneally injected at a dose of 150 mg/g body weight. Animals were sacrificed and lens specimens were analyzed for levels of malondialdehyde (MDA) and protein carbonyl (PC) and activities of glutathione (GSH) and glutathione peroxidase (GSH-Px). Results: We found that the MDA and PC levels of lenses were increased in the IVTA group (p < 0.01). It was seen that GSH and GSH-Px in lenses were decreased in the IVTA group (p < 0.01). NAC administration significantly ameliorated these changes in the IVTA + NAC group (p<0.05). Conclusion: These results indicate that the NAC produces a protective mechanism against IVTA-induced cataract and suggest a role of oxidative stress in pathogenesis.Öğe Repair of Iridodialysis Using 8-0 Polypropylene(Taylor & Francis Inc, 2014) Daglioglu, Mutlu Cihan; Coskun, Mesut; Ilhan, Nilufer; Ayintap, Emre; Tuzcu, Esra Ayhan; Ilhan, Ozgur; Oksuz, HuseyinPurpose: Investigate the effectiveness of repair of iridodialysis with 8-0 polypropylene. Methods: We present four cases of traumatic iridodialysis that were repaired by 8-0 polypropylene suture. Results: Better iris reposition and stability were achieved with 8-0 polypropylene suture despite wide degree traumatic iridodialysis in all patients. Conclusion: In this study, we used 8-0 polypropylene suture, which is thicker, cheaper, and more durable than 10-0 sutures. We suggest that usage of 8-0 polypropylene sutures may provide better iris repositioning.Öğe Results of pars plana capsulectomy and anterior vitrectomy in cases which nd:yag capsulotomy was inappropriate(2011) Ayintap, Emre; Coşkun, Mesut; Ilhan, Özgür; Keskin, U?urcan; Ayhan Tuzcu, Esra; ÖksüZ, HüseyinPurpose: To evaluate pars plana capsulectomy (PPC) and anterior vitrectomy (AV) results in posterior capsule opacification (PCO), which can develop after cataract surgery, in pediatric and adult patients in which Nd:YAG laser capsulotomy cannot be performed and/or is not effective because of dense thickening of the posterior capsule. Materials and Methods: Pediatric and adult patients with PPC and AV were included in the study in different groups retrospectively. Results: Nine eyes of 6 pediatric patients and 6 eyes of 6 adults were included in the study. Mean age was 6.1 years (1-11) in the pediatric patients and 59.25 (23-80) in the adults. The mean period of PCO development was 7.6 months in the pediatric patients and 48.2 (2-60) months in the adults. In 7 eyes of 5 pediatric patients who were able to express visual acuity, preoperative best corrected visual acuity (BCVA) was logmar 1.16±0.44 (1-1.6) (Snellen equivalent SE: 0.05-0.1), while it was logmar 0.54±0.26 (0.2-1) (SE: 0.25-0.3) postoperatively. In adults preoperative BCVA was logmar 1.28±0.32 (1-1.6) (SE: finger counting at 3 meters) and it was logmar 0.80±0.2 (0.2-1) (SE: 0.16) postoperatively. At postoperative day one and at 13.6 months mean follow up, a clear optic axis and increase in BCVA were achieved in all eyes. Conclusion: PPC with AV is a preferable management when Nd:YAG laser capsulectomy cannot be performed and/or with the presence of very severe capsule thickening or in cases with cortex reminant on capsule and in cases in which Nd:YAG laser capsulotomy is not effective. We think that performing nearly 5-mm diameter posterior capsulectomy is an important factor in obtaining long period success.Öğe Terson Syndrome (A case Report)(Turkish Ophthalmological Soc, 2012) Ilhan, Ozgur; Ilhan, Nilufer; Coskun, Mesut; Ayintap, Emre; Keskin, Ugurcan; Semiz, Hilal; Oksuz, HuseyinTerson syndrome is a vitreous hemorrhage that occurs after intracranial hemorrhages (subarachnoid or subdural) and generally visual deficit or low vision is observed. In this paper, the case of a patient who had undergone pars plana vitrectomy due to Terson syndrome is presented. Visual acuity of the patient was 0.1 prior to the operation, but 1 month postoperatively, it reached 0.7. There was no complication during the surgery and at postoperative follow-up.Öğe Vacuum-Assisted Continuous Circular Capsulorhexis Using Bimanual Irrigation and Aspiration System of Phaco Machine in Immature Cataract(Hindawi Ltd, 2013) Oksuz, Huseyin; Daglioglu, Mutlu C.; Coskun, Mesut; Ilhan, Ozgur; Tuzcu, Esra Ayhan; Ilhan, Nilufer; Ayintap, EmreSeventy-eight eye of 65 patients were enrolled in this retrospective clinical study. Two-side ports are made with a 23-gauge stiletto knife. The irrigation handpiece is introduced into the anterior chamber through one side port and 27-gauge cystotome is introduced through the other one. Anterior capsular flap is created with cystotome. The capsular flap is vacuumed with a 25-gauge visco elastic's cannula, which connected to the phaco machine vacuum. The continuous circular capsulorhexis (CCC) is completed with the using bimanual irrigation and aspiration system of phaco machine. Vacuum-assisted CCC technique was used in 78 cases of uncomplicated immature senile cataracts. All cases were done under sub-Tenon's anesthesia. A complete CCC was achieved in all cases. Performing CCC with our technique is easy, safe, and cheap. It may be an alternative method to CCC by using OVD and forceps.
