Publications by authors named "Ertugrul Can"

29 Publications

  • Page 1 of 1

Use of choroidal vascularity index for choroidal structural evaluation in smokers: an optical coherence tomography study.

Cutan Ocul Toxicol 2020 Dec 14;39(4):298-303. Epub 2020 Jul 14.

Department of Ophthalmology, Ondokuzmayıs University Hospital, Samsun, Turkey.

Purpose: To compare the choroidal vascularity index (CVI) and choroidal thickness (CT) in smokers and healthy non-smoking subjects using spectral-domain optical coherence tomography (SD-OCT).

Methods: Forty-two smokers with no systemic disorders and 46 age-sex matched healthy volunteers were included in the study. SD-OCT was used to measure choroidal thickness at the fovea and 1500 µm intervals from the foveal centre in both nasal and temporal directions. Choroidal images were binarized and segmented to the luminal area (LA), stromal area (SA), and total choroidal area (TCA) using ImageJ software. The choroidal vascularity index was calculated as the ratio of LA to TCA. Smoking subjects were divided into three groups according to pack-year exposure: 10-20 pack-years, 20-30 pack-years, and >30 pack-years. Subgroup analysis was performed to evaluate the relationship between CT/CVI/LA/SA/TCA and pack-years.

Results: The mean age of the smokers and non-smokers was 43.1 ± 7.26 years and 41.82 ± 9.92 years, respectively ( = 0.51). The mean subfoveal choroidal thickness was 301.57 ± 55.04 µm in smokers and 303.38 ± 53.42 µm in non-smokers ( = 0.826). No significant difference was observed between groups for CT values in the subfoveal location or at 1500 µm intervals in the nasal and temporal direction from the fovea. The CVI was significantly lower in smokers (65.4 ± 2.3%) than in non-smokers (66.3 ± 2.5%) ( = 0.021). In the subgroup analysis, subjects with >20 pack-years of smoking had a significantly lower CVI than non-smokers, but those between 10-20 pack-years did not. A negative correlation was found between the CVI and smoking, as measured by cigarette pack-years ( = -0.226,  = 0.04).

Conclusion: The CVI was significantly decreased in smokers compared to healthy controls. The study results suggest that the CVI could be a non-invasive tool for evaluating choroidal vascular changes in smokers.
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http://dx.doi.org/10.1080/15569527.2020.1793162DOI Listing
December 2020

Comparison of central corneal thickness measurements using different imaging devices and ultrasound pachymetry.

Indian J Ophthalmol 2019 Apr;67(4):496-499

Department of Ophthalmology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey.

Purpose: To compare central corneal thickness (CCT) measurements obtained by the AL-Scan, Lenstar LS900, Galilei, and ultrasound pachymetry (UP) in normal and cataractous eyes.

Methods: Eighty eyes of healthy subjects were included in the study. Each subject was assessed by four different methods of measurements using the AL-Scan, Lenstar LS900, Galilei, and UP by a single examiner. To assess the intraobserver repeatability, three consecutive measurements were taken for the AL-Scan.

Results: The mean CCT [± standard deviation (SD)] for the AL-Scan, Lenstar LS900, Galilei, and UP were 554.6 ± 30.9 μm, 542.9 ± 31.3 μm, 570.7 ± 30 μm, and 552.7 ± 32.8 μm, respectively. The differences between pairs of mean CCT for the methods are statistically significant for the pairs of Galilei-UP, AL-Scan-Galilei, and Lenstar LS900-Galilei. Bland-Altman plots showed that AL-Scan-UP have the closest agreement, followed by Lenstar-UP and AL-Scan-Lenstar. Galilei was found to have the poorest agreement with the other three methods. The intraobserver repeatability of the AL-Scan was very good with an intraclass correlation coefficient (ICC) of 0.980.

Conclusion: We found that CCT measurements between the AL-Scan-UP, Lenstar LS900-UP, and AL-Scan-Lenstar LS900 showed very strong correlation and comparable agreement. AL-Scan-UP showed the closest agreement and these devices can be used interchangeably in clinical practice. Galilei significantly showed higher value of CCT compared to other methods. It was also observed that the Al-Scan had excellent intraobserver repeatability.
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http://dx.doi.org/10.4103/ijo.IJO_960_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446636PMC
April 2019

Chromosomal microarray analysis of patients with Duane retraction syndrome.

Int Ophthalmol 2019 Sep 26;39(9):2057-2067. Epub 2018 Nov 26.

Department of Medical Biology and Genetics, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.

Purpose: Duane retraction syndrome (DS) is a rare congenital strabismus with genetic heterogeneity. The genetic causes of DS are not always of monogenic origin; various chromosomal copy number variations (CNVs) have also been reported. The objective of our study was to characterize the CNVs, including gains and losses detected by high-resolution chromosomal microarray in patients with DS.

Methods: Twenty patients with DS were investigated using high-resolution chromosomal microarray analysis (CMA) (Affymetrix CytoScan Array 750 K). Conventional cytogenetic analysis was also performed.

Results: All samples revealed normal karyotype by cytogenetic analysis. However, in all our patients, multiple CNVs, including gains and losses, were detected using the high-resolution CMA method. Chromosomal loci 1q21.2, 2p11.2-q11.1, 2q21.1-q21.2, 4p16.1, 7p11.2-q11.21, 14q32.33, 17p11.2-q11.1 and 20p11.1-q11.21 were the most frequently affected regions.

Conclusions: This study emphasized that CNVs in several chromosomal regions are known to be involved in DS. We also underscore the genetic heterogeneity of DS. Our suggestion is that genes located in the most frequently affected regions should be focused on in the following candidate gene studies.
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http://dx.doi.org/10.1007/s10792-018-1042-8DOI Listing
September 2019

Flapless and sutureless intrascleral fixation of posterior chamber intraocular lens for correction of aphakia.

Authors:
Ertuğrul Can

J Cataract Refract Surg 2018 Aug;44(8):929-931

From the Ondokuz Mayıs University Faculty of Medicine, Department of Ophthalmology, Samsun, Turkey. Electronic address:

A new intrascleral fixation technique for a standard 3-piece posterior chamber intraocular lens (PC IOL) using a simple guide is described. To secure the haptics, 27-gauge scleral tunnels are created. Both haptics are secured extraocularly. The leading haptic of the PC IOL placed in the cartridge is released partly and introduced into the lumen of the guide. The PC IOL is inserted into the eye, and the leading haptic is externalized by pulling the guide gently through the 27-gauge sclerotomy site. The trailing haptic is externalized using the same procedure. This technique facilitates achieving minimally invasive sutureless intrascleral PC IOL fixation.
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http://dx.doi.org/10.1016/j.jcrs.2018.03.037DOI Listing
August 2018

Evaluation of the lamina cribrosa in patients with diabetes mellitus using enhanced depth imaging spectral-domain optical coherence tomography.

Diab Vasc Dis Res 2018 09 12;15(5):442-448. Epub 2018 Jun 12.

4 Department of Ophthalmology, Ondokuz Mayis Universitesi Tip Fakultesi, Samsun, Turkey.

Purpose: To compare the lamina cribrosa thickness and anterior lamina cribrosa depth between patients with and without diabetes mellitus and to investigate the effect of metabolic control and duration of diabetes mellitus on lamina cribrosa thickness and anterior lamina cribrosa depth using enhanced depth imaging spectral-domain optical coherence tomography.

Methods: A total of 70 patients were enrolled in this cross-sectional study and were divided into the diabetes and control groups. Intraocular pressure, circumpapillary retinal nerve fibre layer thickness, anterior lamina cribrosa depth and lamina cribrosa thickness were compared between the groups.

Results: In the control group, the mean intraocular pressure was 14.6 ± 3.1 (mean ± standard deviation) mmHg, mean circumpapillary retinal nerve fibre layer thickness was 105.41 ± 5.86 μm, mean anterior lamina cribrosa depth was 420.3 ± 90.2 μm and mean lamina cribrosa thickness was 248.5 ± 5.4 μm. In the diabetes group, the mean intraocular pressure was 13.9 ± 2.2 mmHg, mean circumpapillary retinal nerve fibre layer thickness was 101.37 ± 10.97 μm, mean anterior lamina cribrosa depth was 351.4 ± 58.6 μm and mean lamina cribrosa thickness was 271.6 ± 33.9 μm. Lamina cribrosa thickness was significantly higher ( p < 0.001) and anterior lamina cribrosa depth was significantly lower ( p = 0.003) in the diabetes group. There was no statistical difference between the groups with regard to age, spherical equivalent, axial length, circumpapillary retinal nerve fibre layer thickness and intraocular pressure ( p  = 0.69, 0.26, 0.47, 0.06 and 0.46, respectively). Lamina cribrosa thickness and anterior lamina cribrosa depth were not significantly correlated with duration of diabetes mellitus (lamina cribrosa thickness: r = -0.078, p = 0.643; anterior lamina cribrosa depth: r = -0.062, p = 0.710) or HbA1c levels (lamina cribrosa thickness: r = -0.078, p = 0.596; anterior lamina cribrosa depth: r = -0.228, p = 0.169).

Conclusion: The results of this study showed that the optical coherence tomography measurement of lamina cribrosa revealed thicker and more anteriorly positioned lamina cribrosa for patients with diabetes mellitus compared with those for healthy controls.
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http://dx.doi.org/10.1177/1479164118782091DOI Listing
September 2018

Posterior Capsular Opacification in Preschool- and School-Age Patients after Pediatric Cataract Surgery without Posterior Capsulotomy.

Turk J Ophthalmol 2016 Oct 17;46(5):205-208. Epub 2016 Oct 17.

Yüzüncü Yıl University Faculty of Medicine, Department of Ophthalmology, Van, Turkey.

Objectives: We aimed to evaluate the development of posterior capsular opacification (PCO) in preschool- and school-age children with cataract who underwent cataract surgery without posterior capsulotomy and anterior vitrectomy.

Materials And Methods: The records of 30 eyes of 21 patients who underwent pediatric cataract surgery and intraocular lens (IOL) implantation were retrospectively reviewed. Patients' age, PCO status and duration, need for neodymium-doped yttrium aluminium garnet (Nd:YAG) laser treatment based on coverage of visual axis, and follow-up period were recorded.

Results: The mean age of the patients was 7.6±2.83 (4-12) years. Unilateral cataract surgery and IOL implantation were performed in 12 patients (57.14%) and bilateral cataract surgery and IOL implantation were performed in nine patients (42.86%). Average follow-up time was 17.7±22.67 (3-83) months. PCO developed in 21 eyes (70%) and covered the visual axis in 15 eyes (50%), which therefore required Nd:YAG laser posterior capsulotomy. The mean duration of postoperative PCO development was 8.91±18.7 months (1 week-71 months).

Conclusion: We believe that with adequately experienced surgeons, performing both cataract surgery and posterior capsulotomy with anterior vitrectomy in the same session is appropriate for selected preschool- and school-age children with cataract.
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http://dx.doi.org/10.4274/tjo.24650DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5200831PMC
October 2016

Comparison of Anterior Segment Measurements with Optical Low-coherence Reflectometry and Partial-coherence Interferometry Optical Biometers.

Middle East Afr J Ophthalmol 2016 Oct-Dec;23(4):288-292

Department of Ophthalmology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.

Aims: To evaluate a new noncontact optical biometer using partial-coherence interferometry and to compare the clinical measurements with those obtained from the device using optical low-coherence reflectometry (OLCR).

Setting And Design: Ondokuz Mayis University, Samsun, Turkey. Nonrandomized, prospective clinical trial.

Subjects And Methods: The study was performed on the healthy phakic eyes of volunteers in the year 2014. Measurements of axial length (AL), anterior chamber depth (ACD), central corneal thickness (CCT), mean keratometry (K), and white-to-white (WTW) measurements obtained with the low-time coherence interferometry (LTCI) were compared with those obtained with the OLCR.

Statistical Analysis Used: The results were evaluated using Bland-Altman analyses. The differences between both methods were assessed using the paired -test, and its correlation was evaluated by Pearson's coefficient.

Results: We examined seventy participants with a mean age of 33.06 (±9.7) (range: 19-53) years. AL measurements with LTCI and OLCR were 23.7 (±1.08) mm and 23.7 (±1.1) mm, respectively. ACD was 3.6 (±0.4) mm and 3.5 (±0.4) mm for LTCI and OLCR, respectively. The mean CCT measurements for both devices were 533 (±28) mm and 522 (±28) mm, respectively. The mean K readings measurements for LTCI and OLCR were 43.3 (±1.5) D and 43.3 (±1.5) D, respectively. The mean WTW distance measurements for both devices were 12.0 (±0.5) mm and 12.1 (±0.5) mm, respectively.

Conclusions: Measurements with LTCI correlated well with those with the OLCR. These two devices showed good agreement for the measurement of all parameters.
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http://dx.doi.org/10.4103/0974-9233.194075DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5141620PMC
April 2017

Dexamethasone Implant in Chronic Diabetic Macular Edema Resistant to Intravitreal Ranibizumab Treatment.

Ophthalmic Res 2017 8;57(3):161-165. Epub 2016 Dec 8.

Department of Ophthalmology, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey.

Purpose: The aim of this study was to assess the efficacy of a single intravitreal dexamethasone implant (IDI) over 6 months in eyes with chronic diabetic macular edema (DME) that were resistant to intravitreal ranibizumab (IR) treatment.

Methods: This retrospective study was conducted at the Ondokuz Mayis University Hospital, Samsun, Turkey. Efficacy outcomes were considered as the change from baseline in best corrected visual acuity (BCVA) and central macular thickness (CMT).

Results: Thirty eyes of 20 patients with a mean age of 61.6 ± 8.8 (45-85) years were included in the study. The mean BCVA significantly increased from 0.68 ± 0.27 to 0.56 ± 0.30 logMAR (p = 0.001) and 0.57 ± 0.30 logMAR (p = 0.002) at months 1 and 2, respectively. The proportion of patients who gained 3 or more lines in BCVA was 20%. The mean CMT significantly decreased from 578.93 ± 17.95 µm at baseline to 282.10 ± 21.42, 292.26 ± 19.69, 371.70 ± 21.23, and 463.60 ± 23.16 µm at months 1, 2, 3, and 4, respectively (p = 0.001). Intraocular pressure (IOP) increase occurred in 5 (16.7%) eyes. Cataract surgery was required in 3 (13%) out of 23 phakic eyes.

Conclusion: IDI provides significant benefits in visual acuity gains and anatomic improvements in eyes with chronic DME that are resistant to IR treatment. Increases in IOP and cataract progression can be observed in IDI-treated patients. However, its safety profile is acceptable.
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http://dx.doi.org/10.1159/000452422DOI Listing
April 2017

Comparison of Anterior Segment Parameters Obtained by Dual-Scheimpflug Analyzer Before and After Cycloplegia in Children.

J Pediatr Ophthalmol Strabismus 2016 Jul 17;53(4):234-7. Epub 2016 May 17.

Purpose: To assess the changes of anterior segment parameters with cycloplegia.

Methods: A cross-sectional study of healthy pediatric patients was performed. Anterior segment parameters were obtained by the Galilei Dual-Scheimpflug analyzer (Ziemer Group, Port, Switzerland) before and 40 minutes after the instillation of cyclopentolate. The effect of gender was evaluated.

Results: There were 43 boys and 50 girls with a mean age of 7.76 ± 2.7 years. There was a significant increase in anterior chamber depth, anterior chamber volume, and pupil diameter after the cycloplegia (P < .05). The anterior chamber angle increased after cycloplegia in the nasal, temporal, and inferior quadrants (P < .05), but not in the superior quadrant (P > .05). The mean values of anterior segment parameters were similar in both genders.

Conclusions: The values of anterior chamber depth, anterior chamber volume, anterior chamber angle, and pupil diameter measured with the Galilei Dual-Scheimpflug analyzer increased significantly after cycloplegia. Gender did not have an effect on anterior segment parameters. [J Pediatr Ophthalmol Strabismus. 2016;53(4):234-237.].
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http://dx.doi.org/10.3928/01913913-20160427-02DOI Listing
July 2016

Ab-interno scleral suture loop fixation with cow-hitch knot in posterior chamber intraocular lens decentration.

Indian J Ophthalmol 2016 Feb;64(2):124-6

Department of Ophthalmology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey.

Aim Of Study: To describe a simplified ab-interno cow-hitch suture fixation technique for repositioning decentered posterior chamber intraocular lens (PC IOL).

Materials And Methods: Two cases are presented with the surgical correction of decentered and subluxated IOL. Ab-interno scleral suture fixation technique with hitch-cow knot in the eye was performed with a ciliary sulcus guide instrument and 1 year follow-up was completed.

Results: Both of the patients had well centered lenses postoperatively. Corrected distant and near visual acuities of the patients were improved. There was no significant postoperative complication. In the follow-up period of 1 year, no evidence of suture erosion was found.

Conclusions: Ab-interno scleral suture loop fixation with hitch-cow knot in the eye was effective in repositioning decentered or subluxated PC IOLs with excellent postoperative centered lenses and visual outcomes.
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http://dx.doi.org/10.4103/0301-4738.179712DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4850806PMC
February 2016

Comparison of the corneal biomechanical properties, optic nerve head topographic parameters, and retinal nerve fiber layer thickness measurements in diabetic and non-diabetic primary open-angle glaucoma.

Int Ophthalmol 2016 Oct 9;36(5):727-36. Epub 2016 Feb 9.

Department of Ophthalmology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

The purpose of this study is to investigate the corneal biomechanical properties, optic nerve head (ONH) topographic parameters, and retinal nerve fiber layer (RNFL) thickness changes in primary open-angle glaucoma (POAG) patients with and without diabetes, as well as to evaluate the effect of the metabolic control of diabetes on corneal biomechanical properties, ONH topography, and RNFL thickness. A total of 101 eyes of 101 POAG patients (60 with diabetes and 41 without diabetes) were recruited in this prospective study. Corneal hysteresis and corneal resistance factor (CRF) were both measured using the ocular response analyzer. Optic disk parameters were evaluated using the Heidelberg Retina Tomograph-III. RNFL thickness was measured by using Spectralis HRA + OCT. CRF, mean rim area, and rim volume were found to be significantly higher in the diabetic group when compared with non-diabetic group (p = 0.01 for CRF, p = 0.04 for rim area and p = 0.02 for rim volume). ANCOVA analysis showed statistically insignificant effects of age, gender, MD, and PSD values over rim area and rim volume (p > 0.05). CRF was not significantly correlated with HbA1c levels (p > 0.05). Cup area (CA), cup volume (CV), and cup shape measure (CSM) were weakly correlated with HbA1c levels (r = 0.35 and p = 0.006 for CA; r = 0.32 and p = 0.01 for CV; r = 0.32 and p = 0.01 for CSM). The difference in mean RNFL thickness values between the groups was found to be insignificant (p > 0.05). The results of this study raise doubts whether or not diabetes does in fact shield POAG patients from glaucomatous optic nerve damage from various perspectives.
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http://dx.doi.org/10.1007/s10792-016-0191-xDOI Listing
October 2016

Surgical management of intraocular lens dislocations.

Arq Bras Oftalmol 2015 Sep-Oct;78(5):313-7

Ophthalmology Department, Ondokuz Mayis University, Samsun, TR.

Purpose: To report and compare the surgical, visual, and anatomical outcomes following treatment of dislocated intraocular lenses (IOLs).

Methods: The medical records of 28 eyes of 28 patients were evaluated. Age, gender, pre-and postoperative best-corrected visual acuity (BCVA), surgical methods, and complications were recorded.

Results: Pre-and postoperative BCVA ranged from counting fingers to 20/32 and from counting fingers to 20/25, respectively. Late-onset dislocations were the most frequently observed complication. The most frequent surgical method was IOL repositioning in 15 of 28 patients, followed by IOL exchange in 11 patients, and IOL removal in 2 patients. Only 1 patient required surgical re-intervention with IOL capture.

Conclusions: Visual acuity improved following the use of either IOL repositioning or IOL exchange. No superiority of one method over the other was observed. In the present retrospective case series, management of dislocated IOLs with repositioning or exchange of the primary implant conferred comparable surgical and visual outcomes.
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http://dx.doi.org/10.5935/0004-2749.20150082DOI Listing
April 2016

A safe method of ciliary sulcus fixation of foldable intraocular lens using a ciliary sulcus guide.

Int Ophthalmol 2016 Aug 6;36(4):463-8. Epub 2015 Oct 6.

Department of Ophthalmology, Faculty of Medicine, Ondokuz Mayis University, 55139, Samsun, Turkey.

To describe a novel technique for implantation of intraocular lens in the absence of capsular support using a ciliary sulcus guide. Based on the anatomic knowledge of the ciliary sulcus and the sclera, a new instrument was developed to pierce the needle safely through the ciliary sulcus and sclera. While the foldable lens is stored inside the cartridge, the leading haptic is sutured with a cow-hitch knot. The needle is then inserted into the ciliary sulcus guide. The tip of the guide is inserted from the corneal incision and proceeded under the iris to touch and fit the ciliary sulcus. The needle is pushed from back side. The needle comes out at precise point at the sclera. Implantation of the lens was performed through a 2.8 mm clear cornea incision using the injector. The trailing haptic is tied after implantation, and then the same procedure is performed at the opposite side. We performed this technique to 15 aphakic eyes without sufficient capsular support. There was no bleeding or other intraoperative complication. All the points coming out the sclera were between 2 and 2.5 mm from the limbus. The ab interno technique for scleral fixation of IOL is quicker, easier and less traumatic then ab externo techniques. A new ciliary sulcus guide which is usable with both straight and curved needles eliminates the blind maneuvers of ab interno technique and makes this technique more safe and precise.
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http://dx.doi.org/10.1007/s10792-015-0132-0DOI Listing
August 2016

A Possible Cause of Nasolacrimal Duct Obstruction: Narrow Angle Between Inferior Turbinate and Upper Part of the Medial Wall of the Maxillary Sinus.

Curr Eye Res 2016 06 13;41(6):729-33. Epub 2015 Aug 13.

a Ophthalmology Department .

Background: To search the relationships between the primary nasolacrimal duct obstruction and the angle between the bony inferior turbinate and upper part of the medial wall of the maxillary sinus.

Design: Retrospective study.

Participants And Methods: Computed tomography findings of 35 patients with primary nasolacrimal duct obstruction and 100 sides of 50 individuals were reviewed. While the study group was composed of patients who had external dacryocystorhinostomy surgery, the control group was composed of patients who had CT scans due to headache, sinusitis and smell dysfunction. Epiphora complaint was evaluated with the lacrimal syringing. The exclusion criteria were: age less than 20 years, previous nose, sinus, turbinate or lacrimal surgery, prior history of maxillofacial fracture, nasopharyngeal malignancy, reflex hypersecretion, and associated pathology of the lacrimal canaliculi.

Main Outcome Measures: The angle of inferior turbinate.

Results: The mean angles were 53.2° (range, 37.9-82.9°) for affected side of the study group, 58.6° (range, 32-85.3°) for the unaffected side of the study group and 56.8° (range, 41.2-76.9°) in the control group. The difference between the angles was statistically significant between the study and the control groups (p < 0.05). The difference between the operated and non-operated sides of the study group was also statistically significant (p < 0.05).

Conclusion: Although this study was performed in a small group, we thought that the narrow angle between the bony inferior turbinate and upper part of the medial wall of the maxillary sinus might be a possible causative factor in primary acquired nasolacrimal duct obstructions.
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http://dx.doi.org/10.3109/02713683.2015.1052520DOI Listing
June 2016

Re: Scleral fixation of one piece intraocular lens by injector implantation.

Authors:
Ertugrul Can

Indian J Ophthalmol 2015 May;63(5):466-7

Ondokuz Mayıs Üniversitesi, Tıp Fakültesi, Göz Hastalıkları Anabilim Dalı, Samsun, Turkey.

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http://dx.doi.org/10.4103/0301-4738.159905DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4501153PMC
May 2015

The effect of pupil dilation on AL-Scan biometric parameters.

Int Ophthalmol 2016 Apr 27;36(2):179-83. Epub 2015 Jun 27.

Department of Ophthalmology, Faculty of Medicine, Ondokuz Mayıs University, 55139, Samsun, Turkey.

The purpose of this study was to investigate the effects of pupil dilation on the parameters of the AL-Scan (Nidek Co., Ltd, Gamagori, Japan). We compared the measurements of axial length (AL), anterior chamber depth (ACD), central corneal keratometry reading, pupil diameter, and intraocular lens (IOL) power of 72 eyes of 72 healthy volunteers and patients scheduled for cataract surgery before and 45 min after instillation of cyclopentolate hydrochloride 1 % using the AL-Scan. Intraobserver repeatability was assessed by taking three consecutive recordings of ACD and AL. Only ACD readings were significantly different between predilation and postdilation (P < 0.001). The difference of the other measurements between two sessions was not statistically significant (P > 0.001). Only two cases in the study demonstrated changes in IOL power higher than 0.5 D. The intraobserver repeatability of both devices was good (CV values for ACD and AL were 0.16 and 0.20 %, respectively). Dilated pupil size did not affect the measurement of IOL power using the A-Scan optical biometer, but increase in ACD after dilation should be taken into account when performing refractive surgeries in which ACD is very important such as phakic anterior chamber IOL implantation.
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http://dx.doi.org/10.1007/s10792-015-0097-zDOI Listing
April 2016

Anterior Chamber Stabilization in Combined Penetrating Keratoplasty With Scleral-Sutured Posterior Chamber Intraocular Lens Implantation.

Cornea 2015 Aug;34(8):985-90

*Department of Ophthalmology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey; and †Organ and Tissue Transplantation Coordination Center, Local Health Authority of Samsun, Samsun, Turkey.

Purpose: To describe a novel technique for a stabilized penetrating keratoplasty procedure with implantation of a scleral-sutured posterior chamber intraocular lens in which the anterior chamber (AC) is maintained and the globe stabilized without using a Flieringa ring.

Methods: In this procedure, a deep anterior corneal lamella separation was created. Four small incisions were made in each quadrant along the outer edge of the trephination groove of the residual stromal bed (RSB). The first incision at the 9-o'clock position was advanced with scissors in both clockwise and counterclockwise directions. This procedure was repeated in the remaining 3 quadrants, creating 4 small bridges between the RSB and corneal rim. A donor corneal button coated with a viscoelastic material was sutured at 3 incision sites leaving 1 quadrant sutureless to allow sufficient incision width for IOL insertion for scleral fixation. Scleral fixation of a 1-piece polymethyl methacrylate (PMMA) IOL was performed. After sequential cutting of the bridges, the RSB was removed from the AC. Ten eyes of 10 patients underwent this procedure without significant complications.

Results: There were no complications related to the open-sky procedure. Globe stabilization was achieved in all surgeries. Endothelial cell loss, visual acuities, and graft failure rates were comparable with the reports of AC-protecting penetrating keratoplasty surgeries.

Conclusions: This technique provides a secured AC and stabilized globe without the use of a Flieringa ring and increases the surgical safety without a significant reduction of the graft endothelial cell density.
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http://dx.doi.org/10.1097/ICO.0000000000000469DOI Listing
August 2015

Hyaluronidase in ophthalmic evisceration surgery.

Trop Doct 2015 Apr 15;45(2):100-4. Epub 2014 Dec 15.

MD, Department of Opthalmology, Ondokuz Mayis University, Samsun, Turkey.

Background: To research the effectiveness of hyaluronidase in evisceration surgery.

Methods: A total of 34 patients were studied as three groups: conventional surgery group (n = 13); isotonic fluid group (n = 8); and hyaluronidase group (n = 13). Hyaluronidase and isotonic fluid were introduced into the uveo-scleral space. Intraocular content was removed, if possible by a one-scoop method, with the aid of a spoon.

Results: Removing all the intraocular content as a one-scoop method was achieved in 10 of 13 (77%) in the hyaluronidase group and four of eight (50%) in the isotonic fluid group. The one-scoop method was not possible in any case without the introduction of fluid. The mean durations for the evisceration procedure were 32, 36.6 and 40.5 min in the three groups, respectively (P < 0.05).

Conclusions: Using hyaluronidase in evisceration surgery greatly facilitates and speeds up the removal of all the intraocular content in ophthalmic evisceration surgery.
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http://dx.doi.org/10.1177/0049475514562018DOI Listing
April 2015

A propranolol nonresponsive mass: lymphangioma-mimicking hemangioma.

J Craniofac Surg 2015 Jan;26(1):327-8

Department of Ophthalmology Ondokuz Mayis University, Kurupelit Samsun, Turkey Department of Plastic and Reconstructive Surgery Ondokuz Mayis University, Kurupelit Samsun, Turkey Department of Ophthalmology Ondokuz Mayis University, Kurupelit Samsun, Turkey.

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http://dx.doi.org/10.1097/SCS.0000000000001265DOI Listing
January 2015

Scleral fixation of one piece intraocular lens by injector implantation.

Indian J Ophthalmol 2014 Aug;62(8):857-60

Department of Ophthalmology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey.

Aim Of Study: With an ab-interno technique of transscleral suturing of current one-piece posterior chamber intraocular lenses (PC IOLs) by injector implantation in the absence of capsular support, we aimed to demonstrate the possibility of the implantation of one-piece acrylic PC IOLs that might be produced in the future for only scleral fixation through small clear corneal incision.

Materials And Methods: Case report and literature review.

Results: This procedure has been performed in eight aphakic eyes with four different types of IOLs. Good centration was achieved with minimal technical effort. All patients had well-centered and stable lenses postoperatively during 9-18 months follow-up.

Conclusion: We managed to decrease the risks of surgical trauma and intricate surgical maneuvers requirement. With this technique, excessive fluid leakage and consecutive hypotony can be minimized.
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http://dx.doi.org/10.4103/0301-4738.141042DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4185163PMC
August 2014

Comparison of Optic Nerve Head Topographic Parameters in Patients With Primary Open-Angle Glaucoma With and Without Diabetes Mellitus.

J Glaucoma 2016 Jan;25(1):49-53

*Department of Ophthalmology, Dişkapi Yildirim Beyazit Training and Research Hospital ‡Department of Ophthalmology, Faculty of Medicine, Yildirim Beyazit University, Ankara †Department of Ophthalmology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.

Purpose: To evaluate the optic nerve head (ONH) parameters of primary open-angle glaucoma (POAG) patients with and without diabetes and to investigate the effect of the metabolic control of diabetes on ONH topography.

Materials And Methods: A study group of 60 eyes of 60 POAG patients with type 2 diabetes mellitus and a control group of 41 eyes of 41 POAG patients without diabetes were recruited for the study. Complete ophthalmic examinations of all patients were performed and the quantitative optic disc parameters were evaluated with Heidelberg retina tomography (HRT) III. HbA1c measurements of diabetic patients were assessed on the same day when the ophthalmic assessments were performed.

Results: Mean rim area and rim volume of the study group was statistically higher than the control group (P=0.04 for rim area and P=0.02 for rim volume). The difference in other parameters of the HRT between the groups were insignificant (P>0.05). In the study group, the duration of the diabetes was not significantly correlated to rim area and rim volume (r=0.03, P=0.81 for rim area; r=0.03, P=0.79 for rim volume). Analysis of covariance showed insignificant effects of age, sex, MD, and PSD values over rim area and rim volume (P>0.05). There were weak but statistically significant correlations between HbA1c levels and some HRT parameters including disc area, cup area, cup volume, and cup shape measure (r=0.35 and P=0.006 for disc area; r=0.35 and P=0.006 for cup area; r=0.32 and P=0.01 for cup volume; r=0.32 and P=0.01 for cup shape measure).

Conclusions: The results of this study imply the protective effect of diabetes over glaucomatous optic nerve damage in POAG patients. However, larger and controlled studies are warranted to confirm those findings.
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http://dx.doi.org/10.1097/IJG.0000000000000096DOI Listing
January 2016

Suspected endothelial pencil graphite deposition.

Case Rep Ophthalmol Med 2013 10;2013:369374. Epub 2013 Dec 10.

Ondokuz Mayis University, Ophthalmology Department, Korfez Mah, Mehmet Akif Ersoy Bulvarı, No. 84/15, Atakum, 55100 Samsun, Turkey.

A 14-year-old male patient had an ocular trauma with a pencil. Biomicroscopic examination revealed a broken part of pencil into the cornea. Foreign body removal and corneal wound closure were performed in the same day. After corneal repair, there was a grade 4+ anterior chamber reaction just like in preoperative examination. Dilated examination showed a very small piece broken tip of pencil on the upper nasal quadrant of the lens. A small and linear deposition was also seen on endothelial surface. Endothelial deposition and foreign body disappeared with intensive topical steroid treatment.
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http://dx.doi.org/10.1155/2013/369374DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3872378PMC
January 2014

Clinical features and in-vivo confocal microscopic imaging of fleck corneal dystrophy.

Semin Ophthalmol 2013 Jul 29;28(4):239-41. Epub 2013 Apr 29.

Ondokuz Mayıs University, School of Medicine, Department of Ophthalmology, Samsun, Turkey.

Purpose: To evaluate the value of in-vivo confocal microscopy (CM) in the diagnosis of Fleck corneal dystrophy.

Methods: Case report and literature review. After complete eye examination of the patient, in-vivo CM was performed. The morphologies of the corneal layers were evaluated by in-vivo CM.

Results: Slit-lamp examination revealed bilateral gray-white, oval or round discrete opacities in the stroma. Confocal microscopy showed hyper-reflective opacities in enlarged and unremarkable keratocyte nuclei throughout the stroma. The surface epithelium, subbasal nerves, and endothelium showed normal morphology.

Conclusion: The diagnosis of rare corneal dystrophies such as Fleck corneal dystrophy should sometimes be made only after performing in-vivo confocal microscopy.
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http://dx.doi.org/10.3109/08820538.2012.760629DOI Listing
July 2013

Scleral fixation of a single-piece multifocal intraocular lens.

Eur J Ophthalmol 2013 Mar-Apr;23(2):249-51

Department of Ophthalmology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey.

Purpose: We describe an ab interno technique for injector implantation of a one-piece multifocal intraocular lens (IOL).

Methods: Transscleral fixation of multifocal posterior chamber IOL implantation using an injector with ab interno technique was performed in an eye of a 9-year-old girl who had undergone pars plana lensectomy 2 years before for bilateral lens subluxation with unknown etiology.

Results: No major complications were encountered during a 3-month follow-up of the patient and excellent centration was observed during the follow-up period. Her preoperative best spectacle-corrected distance visual acuity of 20/32 improved to uncorrected distance visual acuity of 20/25.

Conclusions: Closed-loop design of IOL served the function of eyelets and position of the IOL was provided using only a 2-point fixation. Intraoperative position adjustment of the IOL provided an excellent centralization of multifocal IOL.
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http://dx.doi.org/10.5301/ejo.5000225DOI Listing
May 2013

Cataract surgery evaluation tool.

J Cataract Refract Surg 2012 Oct;38(10):1875-6; author reply 1876

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http://dx.doi.org/10.1016/j.jcrs.2012.08.021DOI Listing
October 2012

Intravenous methylprednisolone pulse therapy for acute posterior segment uveitis attacks in Behçet's disease.

Ann Ophthalmol (Skokie) 2007 ;39(3):194-7

Department of Ophthalmology, Ankara University Medical School, Ankara, Turkey.

We evaluated the efficacy and safety of high-dose intravenous methylprednisolone (1 g x 3 days) pulse therapy followed in the management of acute posterior segment uveitis attacks in 25 patients with Behçet's disease. High-dose intravenous methylprednisolone pulse therapy may be beneficial in the prompt control of severe ocular inflammation and in preventing visual loss.
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http://dx.doi.org/10.1007/s12009-007-0018-5DOI Listing
December 2007
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