Browsing by Author "Baser, EF"
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Item Efficacy of Selective Laser Trabeculoplasty in Phakic and Pseudophakic EyesSeymenoglu, G; Baser, EFPurpose: To compare the efficacy of selective laser trabeculoplasty (SLT) in phakic and pseudophakic eyes in open-angle glaucoma and ocular hypertension. Materials and Methods: Charts of 28 pseudophakic eyes and 60 phakic eyes that underwent 360-degree SLT were retrospectively reviewed. Patients were examined at 1, 3, 6, and 12 months. Treatment success was defined as >= 20% intraocular pressure (IOP) reduction, with no additional medications, laser, or glaucoma surgery. Mean IOP change, mean percentage of IOP reduction, and success rates for phakic and pseudophakic eyes were compared. Results: Mean percentage of IOP reduction post-SLT at 1-, 3-, 6-, and 12-month visits were 21.4%, 25.8%, 24.8%, and 23.7%, respectively, in the pseudophakic group and 22.8%, 25.0%, 25.7%, and 21.2%, respectively, in the phakic group. Success rates ranged between 60% and 64% in the pseudophakic group and between 58% and 73% in the phakic group. No statistically significant differences in IOP change, percentage of IOP reduction, and success rate were seen between the groups at any of the post-SLT visits (P > 0.05). Conclusions: Application of 360-degree SLT seems to be an efficient and safe treatment option for the management of phakic and pseudophakic open-angle glaucoma and ocular hypertension.Item Comparison of Dorzolamide/Timolol Versus Brimonidine/Timolol Fixed Combination Therapy in the Management of Steroid-Induced Ocular HypertensionSeymenoglu, G; Baser, EF; Öztürk, B; Gülhan, CPurpose: To compare the efficacy of fixed combinations of dorzolamide-timolol (FCDT) and brimonidine-timolol (FCBT) in patients with intraocular pressure (IOP) elevations after intravitreal triamcinolone acetonide (IVTA) injections. Materials and Methods: This was a prospective, randomized, open-label study. Patients who received IVTA injections due to diffuse diabetic macular edema and who had an IOP of 24 mm Hg or higher after IVTA treatment were included. They were randomized to receive either FCBT or FCDT twice daily. Follow-up visits were scheduled on week 4 and 12 weeks after starting the study medication. At all follow-up visits, IOP was measured with Goldmann applanation tonometry. The primary outcome measure was mean IOP, the secondary outcome was reduction in mean IOP at 4 and 12 weeks compared with postinjection values. Results: Sixty patients were randomized in 1: 1 ratio. The FCBT and FCDT groups were similar in terms of age, sex, and preinjection IOP (P > 0.05 for all). Mean postinjection IOP was 31.95 +/- 7.39 and 29.83 +/- 5.17 mm Hg in FCBT and FCDT groups, respectively (P = 0.239). After 4 weeks, mean IOP was 17.05 +/- 3.61 mm Hg in FCBT and 18.93 +/- 3.30 mm Hg in FCDT groups (P = 0.063). After 12 weeks, mean IOP in the FCBT and FCDT study groups was 16.35 +/- 2.70 and 18.43 +/- 2.82 mm Hg, respectively (P = 0.012). Both fixed combinations significantly reduced IOP in comparison with the postinjection values (P < 0.05). Mean reduction in IOP after 4 weeks were 14.90 +/- 7.28mm Hg in FCBT and 10.90 +/- 4.83 mm Hg in FCDT groups (P = 0.024); after 12 weeks, these values were 15.60 +/- 7.77 and 11.40 +/- 5.89 mm Hg in FCBT and FCDT groups, respectively (P = 0.035). Conclusions: Both FCBT and FCDT are effective in controlling IOP elevations after IVTA injections. The results of this study suggest that FCBT is superior to FCDT in reducing IOP and provides better IOP control after IVTA injections.Item Safety and efficacy of panretinal photocoagulation in patients with high-risk proliferative diabetic retinopathy using pattern scan laser versus conventional YAG laserSeymenoglu, RG; Ulusoy, MO; Baser, EFThe purpose of the study was to compare the results of panretinal photocoagulation (PRP) using the pattern scan laser (PASCAL) in a single setting versus multiple sessions of standard YAG laser in patients with proliferative diabetic retinopathy. Charts of 35 eyes that were treated with the PASCAL and an equal number of eyes that were treated with conventional laser were retrospectively reviewed. The whole PRP treatment was performed in one session in the PASCAL group, whereas all the patients in the conventional-laser group completed the entire PRP treatment in two or three sessions. Persistence and/or recurrence of neovascularization, complications encountered, total number of laser spots, and mean power used were compared. Patients treated with the PASCAL received significantly higher number of laser spots than those treated with conventional laser (2885 vs. 1642, p < 0.001). The PASCAL and conventional-laser systems required an average power of 650 mW and 330 mW, respectively (p < 0.001). Patients treated with the PASCAL showed similar rates of treatment failure within 12 months of follow-up compared with patients treated with conventional laser (14% vs. 11%, p > 0.05). In the PASCAL group, vitreous hemorrhage, neovascular glaucoma, retinal hemorrhage, and choroidal detachment were reported in two, two, one, and two patients, respectively, whereas only one each vitreous hemorrhage and neovascular glaucoma were encountered in the conventional-laser group. Our study reports that single-session PRP with the PASCAL has similar efficacy compared with conventional laser, and has a favorable side-effect profile. Copyright (C) 2015, Kaohsiung Medical University. Published by Elsevier Taiwan LLC.Item Ocular manifestations and surgical results in patients with Alport syndromeSeymenoglu, G; Baser, EFWe report the ocular manifestations of Alport syndrome and the surgical results in 4 patients. All 4 patients had anterior lenticonus; 2 also had posterior lenticonus in both eyes, 3 had flecked retina, and 1 had posterior polymorphous dystrophy. In both eyes of the 4 patients, phacoemulsification with intraocular lens (IOL) implantation was performed to treat anterior and posterior lenticonus. The postoperative visual acuity was excellent in all patients. We recommend phacoemulsification with IOL implantation as a safe and effective procedure in patients with lenticonus secondary to Alport syndrome.Item Corneal Biomechanical Properties during the Menstrual CycleSeymenoglu, G; Baser, EF; Zerdeci, N; Gülhan, CPurpose: To determine if corneal biomechanical properties change during phases of the menstrual cycle. Methods: Twenty-five healthy women of reproductive age with no ocular pathology or systemic diseases were recruited. Corneal hysteresis, corneal resistance factor, Goldman-correlated intraocular pressure, and corneal-compensated intraocular pressure were measured by a Reichert ocular response analyzer at three phases of the menstrual cycle, beginning on days 3 to 5 (follicular phase), again at ovulation (days 14-16, ovulatory phase), and at the end of the cycle (days 25-28, luteal phase). Results: Twenty-one participants completed the study. The mean corneal hysteresis values at follicular, ovulatory, and luteal phases were 10.7, 10.7, and 10.7 mmHg (p > 0.05), and the mean corneal resistance factor values at the same time points were 9.9, 9.9, and 9.8 mmHg (p > 0.05), respectively. Corneal-compensated intraocular pressure and Goldman-correlated intraocular pressure readings were stable during the course (p > 0.05 for all). Conclusions: Corneal biomechanical properties and intraocular pressure as measured by an ocular response analyzer do not change statistically significantly during the different phases of the menstrual cycle. We conclude that measurements of the ocular response analyzer can be safely utilized in healthy female subjects without considering the possible effects of varying hormonal levels during the menstrual cycle.Item Corneal endothelial damage in phacoemulsification using an anterior chamber maintainer compared with using an ophthalmic viscosurgical deviceMayali, H; Baser, EF; Kurt, E; Ilker, SSPurpose: To compare the effects of phacoemulsification surgery (PE) using an anterior chamber maintainer (ACM) and conventional PE using an ophthalmic viscosurgical device (OVD) on corneal endothelial cells. Setting: Department of Ophthalmology, Celal Bayar University, Manisa, Turkey. Design: Prospective randomized controlled trial. Methods: Eyes in the OVD group (n = 50) underwent conventional PE, whereas eyes in the ACM group (n = 50) underwent PE using an ACM. Endothelial cell density (ECD), coefficient of variation (CV), hexagonality (HEX), and noncontact central corneal thickness (CCT) measurements were performed by specular microscopy before and at 1 month, 3 months, and 6 months after PE. Results: This study included 100 eyes of 97 patients undergoing PE. The mean age was 64.7 ? 10.6 years in the OVD group, 64.0 ? 12.6 years in the ACM group (P > .05). The groups did not differ significantly in preoperative ECD, CV, HEX, and CCT or total PE time (P > .05 for all). ECD was significantly lower in the ACM group compared with the OVD group at postoperative 1 month, 3 months, and 6 months (P = .002, P = .002, and P = .001, respectively). Similarly, ECD loss compared with preoperative value was greater in the ACM group at all postoperative timepoints (P = .003, P = .001, and P = .001, respectively). CV increased and HEX decreased in both groups postoperatively (P > .05 for both). CCT showed a transient increase of less than 10 mm at postoperative 1 month in both groups (P = .296). Conclusions: PE with ACM was associated with greater corneal ECD loss compared with conventional PE. ACM should not be used during PE in patients with limited corneal endothelial reserve. J Cataract Refract Surg 2021; 47:612?617 Copyright ? 2021 Published by Wolters Kluwer on behalf of ASCRS and ESCRSItem Comparison of Induced Astigmatism After Trabeculectomy and Deep Sclerectomy+Trabeculectomy Surgeries with Vector AnalysisKayikçioglu, ÖR; Emre, S; Mayali, H; Baser, EFPurpose: The aim of this study is to compare the changes in surgically induced astigmatism with time among two different glaucoma surgery techniques that have been used in cases of progressive glaucomatous optic nerve damage. Material and Method: The study group was composed of eyes which have been operated on with classical trabeculectomy (group 1) or deep sclerectomy+trabeculectomy (group 2). Each group consisted of 13 eyes of 12 patients. All eyes were examined preoperatively and postoperatively at 1. week, 1., 3. and 6. month. At these examinations, except intraocular pressure (IOP), corneal power was recorded with keratometer and corneal topographer. The magnitude of absolute astigmatism, and induced astigmatism were determined by vector analysis at each visit and were statistically compared between the study groups. Results: The mean (+/-SD) age of the patients was 56.2+/-24.0 and 52.5+/-24.3 in group 1 and 2, respectively. Preoperatively, IOP were 30.77+/-10.30 and 27.54+/-11.28 mmHg, and at 6 month of surgery decreased to 12.38+/-4.13 and 12.08+/-5.73 mmHg in groups 1 and 2, respectively. At all postoperative visits, a significant decrease in IOP was observed compared to the preoperative measurements (p< 0.05). Postoperatively at 1. week of surgery, the mean induced astigmatism values were 1.50+/-2.16 and 2.60+/-2.65D in group 1, and 1.66+/-1.32 and 2.01+/-1.95D in group 2, with keratometer and corneal topographer, respectively. The difference between the groups was not significant (p>0.05). At following visits, surgically induced astigmatism decreased in both groups with both methods and the difference never reached significant levels with time. Discussion: Glaucoma surgeries, particularly in the early period, are likely to be the reason for the changes in the corneal power. It seems that the addition of deep sclerectomy to trabeculectomy does not cause any significant change in surgically induced astigmatism.Item Comparison of Diagnostic Accuracy of MRA and GPS Algorithms Using HR III Device in Glaucoma PatientsUlusoy, MO; Baser, EF; Seymenoglu, RG; Kayikçioglu, ROObjectives: The aim of this study is to evaluate the diagnostic accuracy of Moorfields regression analysis (MRA) and glaucoma probability score (GPS) and to measure the agreement between these two programs in classifying eyes as normal or abnormal. Materials and Methods: The study included 150 glaucoma patients followed in our glaucoma unit and 120 control subjects without glaucoma. All subjects underwent total ophthalmological examination, standard achromatic perimetry, and imaging of the optic nerve head with the Heidelberg Retina Tomograph II (HRT), using HRT III software, Version 3.0. The HRT parameters were compared between the two groups. The diagnostic accuracies of the two classifications were measured when the borderline was taken as either normal (highest specificity criteria) or abnormal (highest sensitivity criteria). The agreement between them was calculated using the kappa (kappa) coefficient. Results: All HRT parameters except height variation contour in our study showed statistically differences between the control and glaucoma groups (p=0.000). The parameters with the highest area under curves were GPS global score (0.817), vertical cup/disc ratio (0.816), cup/disc area (0.808), and cup area (0.783). According to the highest specificity criteria, MRA had a sensitivity of 66% and specificity of 89.1% and GPS had a sensitivity of 62.7% and specificity of 81.6%. According to the highest sensitivity criteria, MRA had a sensitivity of 85.3% and specificity of 68.3% and GPS had a sensitivity of 90% and specificity of 60.8%. A moderate agreement of 65.9% (178 eyes) with a. coefficient of 0.47 was found between MRA and GPS. Conclusion: In conclusion, GPS and MRA had a similar sensitivity, but the specificity of MRA was found to be higher than that of GPS. A moderate agreement was found between these analysis programs.Item Corneal Haze and Peripheral Corneal Arcus in a Young Patient: Lecithin-Cholesterol Acyltransferase DeficiencyMayali, H; Kiliç, S; Cansiz, C; Türkoglu, MS; Baser, EFA 23-year-old female patient applied to our clinic with the complaints of color changes in both of her corneas. Ophthalmological examination revealed 20/20 vision in both eyes. Intraocular pressure was 14 mmHg on the right eye and 12 mmHg on the left eye. Eye movements were normal and fundus examination revealed normal optic disc, macula, and peripheral retina. Biomicroscopic examination revealed diffuse haze in both of her corneas with circumferential arcus at the limbus and normal conjunctivae. Biochemical parameters were normal except for high-density lipoprotein values below 5 mg/ml, which was confirmed on repetitive tests. Together with ocular manifestations and low high-density lipoprotein values, a diagnosis of lecithin-cholesterol acyltransferase deficiency was made. In this article, a young patient who had low high density lipoprotein serum levels, peripheral corneal arcus, and corneal haze not affecting the visual acuity is presented.Item Long-term results in endoscopic dacryocystorhinostomy: Is intubation really required?Unlu, HH; Gunhan, K; Baser, EF; Songu, MOBJECTIVE: The long-term (median follow-up eight years) results of endoscopic dacryocystorhinostomy approach and silicone intubation were evaluated by various aspects. STUDY DESIGN: Case series with planned data collection of 38 procedures for postsaccal stenosis were analyzed. SUBJECTS AND METHODS: Silicone intubation was not used in 19 of the randomly selected procedures. Anatomical and functional surgical success was evaluated subjectively and objectively. RESULTS: The patients' complaints improved in 84.2 percent of eyes in the intubation group, and in 94.7 percent of the group without intubation, with a mean follow-up of 112 and 96 months after surgery. respectively. Postoperative endoscopic examinations revealed that the rhinostomy opening was visible in 17 sides with intubation (89.5%) and IS sides without intubation (94.7%). CONCLUSIONS: Considering the similar surgical success rates. and disadvantageous factors such as granulation formation, patient discomfort. and cost related to intubation, we recommend endoscopic dacryocystorhinostomy without intubation as the treatment of choice in cases of chronic epiphora due to postsaccal stenosis of the lacrimal drainage system.