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Yildirim A.,Fatih University | Uslu H.,Fatih University | Kara N.,Gaziantep Sehitkamil State Hospital | Cakir H.,Turkiye Hospital Eye Clinic | And 3 more authors.
American Journal of Ophthalmology | Year: 2014

Purpose To report the long-term results of combined same-day intrastromal corneal ring segment placement and corneal collagen cross-linking (CXL) for postoperative laser in situ keratomileusis (LASIK) ectasia. Design Retrospective, interventional case series. Method This retrospective, interventional cases series was performed in Turkiye Hospital Eye Clinic and the Department of Ophthalmology, Fatih University Medical Faculty Hospital, Istanbul, Turkey. Sixteen eyes of 14 patients with postoperative ectasia after LASIK were enrolled. All consecutive patients were treated with femtosecond laser-assisted intrastromal corneal ring segment implantation and followed by same-day corneal collagen cross-linking for ectasia occurring after LASIK. Main outcome measures included uncorrected distance visual acuity, corrected distance visual acuity, spherical and cylindrical refraction, and simulated keratometry values. Results The mean age ± standard deviation of the 10 women and 4 men was 33.0 ± 6.5 years (range, 23 to 44 years), and the mean follow-up was 43 months (range, 36 to 62 months). The uncorrected distance visual acuity improved significantly from 1.18 ± 0.42 logarithm of the minimal angle of resolution (logMAR) units to 0.44 ± 0.22 logMAR (P <.001), and the corrected distance visual acuity improved significantly from 0.46 ± 0.26 logMAR to 0.21 ± 0.14 logMAR (P <.001). The mean spherical and cylindrical refraction decreased significantly (P <.001 for both). The maximum keratometry value decreased from baseline by 49.3 ± 4.9 diopters (D) to 43.9 ± 2.8 D at the last visit, and the minimum keratometry value decreased from 44.3 ± 4.7 D to 41.5 ± 3.5 D (P <.001 for both). No serious complications were shown during follow-up. Conclusions Implantation of intrastromal corneal ring segment implantation combined with same-day corneal collagen cross-linking was a safe and effective treatment for ectasia occurring after LASIK. It also significantly improved the visual acuity, refraction, and keratometry values. © 2014 by elsevier inc. all rights reserved. Source


Barbaros U.,Istanbul University | Sumer A.,Kas State Hospital | Tunca F.,Istanbul University | Gozkun O.,Istanbul University | And 6 more authors.
Surgical Laparoscopy, Endoscopy and Percutaneous Techniques | Year: 2010

BACKGROUND: Most of the laparoscopic surgeons have been attempting to reduce incisional morbidity and improve cosmetic outcomes by using fewer and smaller ports. Single-incision laparoscopic surgery (SILS) is a new laparoscopic procedure. Herein we would like to present our experiences. Patients and Methods: Between January 2009 and October 2009, data of the 32 patients who were operated through SILS are evaluated prospectively. There were 22 females and 10 males with a mean age of 45.1±14.8 years. Ten splenectomies for idiopathic thrombocytopenic purpura, 16 cholecystectomies for acute cholecystisis or asymptomatic gallstones, 3 appendectomies for acute apendicitis, one distal pancreatosplenectomy for Renal Cell Cancer metastases, 1 adrenalectomy for Conn Syndrome and 1 case of liver resection for hepatic adenoma were carried out. The most common splenectomy indication was idiopathic trombocytopenic purpura, cholecystectomy indication was acute cholecystitis (n=8), and asymptomatic cholelithiasis (n=8), appendectomy indication was acute appendicitis, distal pancreatosplenectomy indication was renal cell cancer metastases, adrenalectomy indication was Conn syndrome and liver resection indication was left hepatic mass in between segments 1 and 2. SILS was carried out successfully in 31 patients. Only in 1 patient conversion was required owing to bleeding. Results: All procedures were carried out through a 2-cm umbilical incision. There was no mortality and morbidity recorded. Conclusions: In experienced hands of minimally invasive surgeons, SILS incision laparoscopic surgery could be carried out successfully in a wide range of surgical operations. However, to be able to show the differences between Standard laparoscopic surgery and single SILS, prospective randomized comparative studies are required. Copyright © 2010 by Lippincott Williams & Wilkins. Source


Yildirim A.,Fatih University | Cakir H.,Turkiye Hospital Eye Clinic | Kara N.,Gaziantep Sehitkamil State Hospital | Uslu H.,Fatih University | And 3 more authors.
Journal of Cataract and Refractive Surgery | Year: 2014

Purpose: To report the long-term results of corneal collagen crosslinking (CXL) treatment for post-laser in situ keratomileusis (LASIK) ectasia.Design: Retrospective case series study.Methods: Consecutive patients with ectasia after LASIK were treated with CXL. The main outcome measures were uncorrected (UDVA) and corrected (CDVA) distance visual acuities, spherical and cylindrical refractions, and simulated keratometry (K) values.Results: The study enrolled 20 eyes (14 patients; 7 women) with a mean age of 34.8 years ± 6.0 (SD) (range 25 to 45 years) and mean follow-up of 42 months (range 36 to 60 months). The UDVA and CDVA improved significantly, from 0.78 ± 0.61 logMAR to 0.53 ± 0.36 logMAR (P=.007) and from 0.27 ± 0.23 logMAR to 0.19 ± 0.13 logMAR, respectively (P≤.028). No eye lost 1 or more Snellen lines of UDVA or CDVA. Although the mean spherical refraction was not significantly different at the last visit (P=.074), the mean cylindrical refraction decreased significantly (P=.036). The maximum K value decreased from 46.0 ± 4.4 diopters (D) at baseline to 45.6 ± 3.8 D at the last visit (P=.013). By the last visit, the maximum K value decreased (≥1.0 D) in 5 eyes and remained stable in 15 eyes. No serious complications occurred.Conclusions: Corneal collagen crosslinking yielded long-term stability in cases with post-LASIK corneal ectasia without significant side effects. Improvements in visual acuity, cylindrical refraction, and maximum K values occurred.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. © 2014 ASCRS and ESCRS. Settings: Turkiye Hospital Eye Clinic and Fatih University Medical Faculty, Department of Ophthalmology, Istanbul, Turkey. Source


Ozgurhan E.B.,Beyoglu Eye Research and Training Hospital | Kara N.,Gaziantep Sehitkamil State Hospital | Bozkurt E.,Beyoglu Eye Research and Training Hospital | Gencer B.,Canakkale Onsekiz Mart University | And 4 more authors.
BioMed Research International | Year: 2013

Purpose. To evaluate the effect of a fluorometholone/tetrahydrozoline fixed combination on conjunctival graft morphology after primary pterygium excision. Methods. The patients who underwent pterygium excision with conjunctival autograft transplantation were randomized into three groups based on postoperative medications as the fluorometholone/tetrahydrozoline group, fluorometholone group, and dexamethasone group. Conjunctival graft thickness was measured with anterior segment optical coherence tomography. The conjunctival graft hyperemia was evaluated using a high definition external camera. Results. The mean graft thickness was significantly lower in the fluorometholone/ tetrahydrozoline group compared with fluorometholone and dexamethasone groups at 2 weeks (P=0.002 and P=0.012, resp.) and at 1 month after surgery (P=0.003 and P=0.013, resp.). The conjunctival hyperemia score was significantly lower in the fluorometholone/tetrahydrozoline group compared with fluorometholone and dexamethasone groups at 2 weeks (P=0.000 and P=0.000, resp.) and at 1 month (P=0.039 and P=0.040, resp.). The graft thickness and conjunctival hyperemia score were similar among the groups at 1 week and 3 months (P>0.05). Conclusion. The findings of the present study revealed that treatment with the fluorometholone/tetrahydrozoline fixed combination may be helpful to decrease graft edema and to achieve better cosmetic appearance at 2 weeks and 1 month after pterygium excision. © 2013 Engin Bilge Ozgurhan et al. Source

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