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  • Küçük Resim
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    The Effects of Remifentanil and Esmolol on Increase in Intraocular Pressure Due to Laryngoscopy and Tracheal Intubation: A Double-Blind, Randomized Clinical Trial
    (Lippincott Williams & Wilkins, 2015) Tuzcu, Kasim; Tuzcu, Esra A.; Karcioglu, Murat; Davarci, Isil; Coskun, Mesut; Ilhan, Ozgur; Daglioglu, Mutlu C.
    Purpose:This study aimed to compare the effects of remifentanil and esmolol on the elevation of intraocular pressure (IOP) and hemodynamic response.Methods:After approval of the institutional Ethics Committee and obtaining informed consent, 60 adult patients with American Society of Anesthesiologists I-II status undergoing elective, nonophthalmic surgery were included in the study. Exclusion criteria were preexisting eye disease, neuromuscular disease, esophageal reflux, hiatus hernia, allergy to any of the study drugs, and the use of -blockers, diuretics, or other antihypertensive agents. The patients were randomized into 2 groups by using the sealed-envelope method, as follows: group E (esmolol) and group R (remifentanil). A single intravenous dose of esmolol (0.5 mg/kg) or remifentanil (1 g/kg) just before induction agents were given to patients in groups E and R, respectively. IOP, heart rate (HR), and mean arterial pressure (MAP) values were recorded before intubation and at 1, 3, 5, and 10 minutes after intubation.Results:The IOP decrease in group R was statistically significant compared with group E (P<0.01). HR values at 10 minutes after intubation were significantly decreased in group E compared with group R (P<0.05). There was no significant difference in MAP values between the groups.Conclusions:It was concluded that remifentanil is more effective than esmolol in preventing IOP elevation related to laryngoscopy and tracheal intubation, while there is no significant difference between the 2 agents in terms of HR and MAP.
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    Effects of Smoking on Central Corneal Thickness and the Corneal Endothelial Cell Layer in Otherwise Healthy Subjects
    (Lippincott Williams & Wilkins, 2016) Ilhan, Nilufer; Ilhan, Ozgur; Coskun, Mesut; Daglioglu, Mutlu C.; Tuzcu, Esra Ayhan; Kahraman, Hilal; Keskin, Ugurcan
    Objectives:The effects of smoking on central corneal thickness (CCT), corneal endothelial cell density (ECD), and morphology were evaluated in otherwise healthy subjects.Methods:The study included 103 current smokers and 106 healthy nonsmoking subjects without any eye disease apart from refractive errors. Endothelial cell density, percentage of hexagonality, and coefficient of variation (CV) in cell size were measured using noncontact specular microscopy. Central corneal thickness was measured by ultrasound pachymetry.Results:The mean age of participants in the nonsmoker group was 31.4 5.1 years (18-60) and 33.0 +/- 9.1 years (18-58) in the current smoker group. The mean CCT value was 523.7 +/- 34 m in the nonsmoker group and 518.5 +/- 37 m in the smoker group. The mean ECD, CV, and percentage of hexagonality values were 2,881 +/- 293.7 cells per square millimeter, 32.5 +/- 6%, and 56.6 +/- 11% in the nonsmoker group, and 2,681 +/- 323.9 cells per square millimeter, 33.4 +/- 5%, and 55.5 +/- 10% in the smoker group, respectively. Although there was no difference between the groups in terms of CCT, CV, and percentage of hexagonality values, a significant difference was determined in the case of ECD values (P<0.001). The smoker group comprised 67 light smokers (65.0%) and 36 (35.0%) heavy smokers. Between these groups, there was no statistically significant difference in the mean values of CCT, ECD, CV, and the percentage of hexagonality.Conclusions:Although cigarette smoking has no effect on cell polymorphism and polymegethism, the results suggest that smoking reduces endothelial cell count.
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    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, Emre
    Seventy-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.