Browsing by Author "Dogruya, S"

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    Changes in optic nerve head and macula optical coherence tomography angiography parameters before and after trabeculectomy
    Güngör, D; Kayikçioglu, OR; Altinisik, M; Dogruya, S
    Purpose To evaluate the effects of lowering intraocular pressure (IOP) on foveal avascular zone (FAZ), peripapillary and macular vessel density (VD) by optical coherence tomography angiography (OCTA) in patients with open angle glaucoma after trabeculectomy. Study design Prospective study Methods Twenty eyes of 20 patients with primary open angle glaucoma (POAG) or exfoliation glaucoma (EG) who were followed up to six months and underwent trabeculectomy were included in our study. OCTA, AngioVue (Optovue Inc.) software was used to analyse the FAZ, peripapillary VD, macular superficial capillary plexus (SCP) and deep capillary plexus (DCP) VD. The parameters of the preoperative and postoperative controls were compared statistically. Results Twelve of the patients (60%) had POAG and eight (40%) had EG. Mean IOP measured was 22.4 +/- 2.4 mmHg preoperatively and 14.9 +/- 2.4 mmHg in the postoperative sixth month (p <0.001). There were no significant changes in OCTA optic disc and macular SCP VD values at the end of the sixth month. In macular DCP parameters; whole image VD (WI-VD), foveal VD (F-VD), parafoveal VD (PAF-VD) and perifoveal VD (PEF-VD) values increased statistically (p=0.003; p=0.026; p=0.006; p=0.004). There was a statistically significant decrease in FAZ area (FAZ-A) and FAZ perimeter (FAZ-P); and a significant increase was found in foveal density values (FD) (p=0.026; p=0.049; p=0.005). Conclusions We found that reducing IOP by trabeculectomy did not affect the microcirculation of the peripapillary region and macular SCP, while there was a significant increase in the DCP parameters of the macular region.
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    Efficacy of subthreshold micropulse laser combined with ranibizumab in the treatment of diabetic macular edema
    Biçak, F; Kayikcioglu, ÖR; Altinisik, M; Dogruya, S; Kurt, E
    Purpose In this study, we aimed to evaluate and compare the visual acuity, macular volume, central macular thickness, change in number of intravitreal ranibizumab injections with micropulse laser applications after loading dose of anti-VEGF to DME patients. Study Design Retrospective study. Methods This study was carried out on 97 patients (45 ranibizumab and 52 micropulse grid laser+ranibizumab) with diabetic macular edema patients who were followed in the Retina Unit. At the control visit after three loading ranibizumab injections administered once a month, micropulse grid laser was applied to one group and ranibizumab injection was continued PRN to both groups for an average of 9.27 +/- 2.42 months and central macular thickness, macular volume and visual acuity were recorded. Results There was no significant difference between the groups in terms of gender, smoking and systemic diseases, initial central macular thickness, macular volume and visual acuity measurements (p > 0.05). Central macular thickness, macular volume and visual acuity values measured at the last follow-up of the patients were not significantly different between the groups (p > 0.05). The mean post-treatment injection requirement was 4.19 +/- 1.01 for the ranibizumab with micropulse laser combination group and 5.53 +/- 1.14 for the ranibizumab group (p < 0.001). Conclusion Micropulse laser treatment after initial loading doses reduces the need for anti-VEGF injections. There is no deleterious effect on visual acuity and retinal imagings. Therefore, while combination therapy provides an effective treatment, it can also reduce the risk of complications of intravitreal anti-VEGF injections. Studies with the participation of more patients may help in the selection of treatment methods by comparing micropulse laser combined with different injection protocols.
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    Unintentional Staining of the Anterior Vitreous With Trypan Blue During Cataract Surgery
    Kayikçioglu, ÖR; Mayali, H; Dogruya, S; Alp, S; Yilmazlar, AA; Kurt, E
    During phacoemulsification and intraocular lens (IOL) implantation surgery, the trypan blue dye used to stain the anterior capsule passed into vitreous cavity and stained the anterior capsule and anterior vitreous in 6 patients. There was history of trauma in 2 patients, uveitis in 1 patient, mature cataract in 1 patient, and no risk factors in the other patients. IOL was implanted in-the-bag without problem in 5 patients. In the patient with iris and zonular defects due to trauma, a sutured IOL was implanted in the same session. The migration of trypan blue into the vitreous cavity through damaged or intact lens zonules is a rare but important complication that makes subsequent surgical steps substantially more difficult.
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    Short-term results of surgical treatment in large idiopathic macular hole cases
    Dogruya, S; Karabacak, DD; Altinisik, M; Delibay, Y; Kayikcioglu, OC; Kayikçioglu, ÖR
    Purpose To evaluate results of the surgical treatment for large stage (Stage 3 and 4) idiopathic macular hole cases with and without ILM flap technique. Methods Sixty eyes of 60 patients diagnosed with idiopathic macular hole (MH) were included in the study. Complete ophthalmologic examination and SD-OCT examination were performed in all eyes. MH stages, MH base diameter, height and closest distance were measured quantitatively. Postoperative and 3 months visits were evaluated. Results The mean age of the cases was 65.0 +/- 8.0 (range 30-84) years, there were 31 (51.7%) female and 29 (48.3%) male patients with a mean follow-up period of 18.1 +/- 16.7 (range 3-63) months. The mean best corrected visual acuity recorded at preoperative and third month control visits were 0.89 +/- 0.40(preoperative) logMAR, 0.82 +/- 0.60(3 month) logMAR (p < 0.05). The mean MH index was 0.48 +/- 0.16, the closest hole distance was 517.86 +/- 210.89 m and mean basal diameter of holes was 947.78 +/- 361.90 mu m and the average height was 448.93 +/- 79.80 microns. There was no statistically significant difference between anatomic results of macular hole surgery with (n = 22) and without (n = 38) flap in terms of hole closure (86.4% vs. 92.1% p > 0.05). In 90% (54 cases) of the cases, closure was observed after the first surgery. Two eyes that failed macular hole surgery were reoperated. In one of these eyes, anatomical success was obtained with macular hole massage and mechanical cytumulation. However, anatomical success could not be achieved in the other eye. Conclus & imath;on In the treatment of large macular holes, pars plana vitrectomy, internal limiting membrane peeling with/without flap and gas tamponade demonstrated high anatomical and functional success.
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    Anterior Chamber Migration of Ozurdex Implants
    Kayikcioglu, Ö; Dogruya, S; Sarigül, C; Mayali, H; Kurt, E
    We present patient characteristics and follow-up results of cases with anterior chamber dexamethasone implant migration. The common feature of all six presented cases was vitrectomized eyes. Four of the patients had sutured intraocular lens (IOL) implantation due to complicated cataract surgery, one had combined retinal detachment surgery with sutured IOL implantation, and one had vitrectomy for diabetic intravitreal hemorrhage cleaning and uncomplicated cataract surgery. Anterior chamber implant migration caused corneal edema in all cases and elevated intraocular pressure in three cases. In two cases, the dexamethasone implant was directed into the vitreous cavity after maximum pupillary dilation and corneal manipulation with cotton tip applicator with the patient in reverse Trendelenburg position. There was no other complication until dexamethasone implant degradation, with clear cornea at final examination. In two cases, the implant was removed from the anterior chamber by aspiration, but keratoplasty surgery was planned due to endothelial cell loss and persistent corneal edema during follow-up. In the last two cases, the dexamethasone implant was redirected into the vitreous chamber with a 23-gauge catheter and anterior chamber maintainer but they migrated into the anterior chamber again. In one of these patients, the implant was aspirated by catheter and corneal transplantation was performed due to corneal edema, while the other patient's implant was redirected into the vitreous chamber with no further anterior migration. The risk of dexamethasone implants migrating into the anterior chamber of vitrectomized eyes and those with sutured IOL implantation should be kept in mind and the patient should be informed and advised to see an ophthalmologist immediately before permanent corneal endothelial damage occurs.