Biomedical subjects
Ahmet Maden
Publications and source records attributed to Ahmet Maden.
The effect of Nd:YAG laser capsulotomy size on refraction and visual acuity.
PURPOSE: To determine the effect of Nd:YAG laser posterior capsulotomy size on refraction and visual acuity. METHODS: A total of 128 pseudophakic eyes (108 patients) were included in this study and divided into two groups by capsulotomy size: 80 eyes had small capsulotomies (<4 mm) without dilating the pupil and 48 eyes had large capsulotomies (> or = 4 mm and <7 mm) after dilating the pupil. Visual acuities and refractive errors were measured preoperatively and 1, 14, 30, and 90 days postoperatively. Results were analyzed statistically. RESULTS: The change in spherical equivalent refraction was 0.38 +/- 0.52 diopters (D) in the small capsulotomy group and 0.22 +/- 0.36 D in the large capsulotomy group. No statistically significant differences were noted in spherical equivalent refraction change (P=.47) or capsulotomy size (P=.0387) between the two groups. CONCLUSIONS: The size of posterior capsulotomy does not significantly affect refraction and visual acuity.
Severe fungal keratitis treated with subconjunctival fluconazole.
PURPOSE: To assess the efficacy and safety of subconjunctival fluconazole treatment as an alternative therapy for severe fungal keratitis refractory to the conventional antifungal medical treatment. DESIGN: Prospective, interventional case series. METHODS: This study included 13 eyes of 13 patients (mean age 49.6 years, range 28 to 75) with severe fungal keratitis that did not respond to initial therapy with topical and intravenous fluconazole plus oral itraconazole. All patients were injected with subconjunctival fluconazole 2%, up to 1.0 mL twice daily, for at least 5 days. If necessary, therapy was continued once daily for a maximum of 14 days after 5 days of injections. RESULTS: Six eyes were successfully treated after 5 days of subconjunctival injections of fluconazole. Seven patients required repeated injections for more than 5 days, but one of them finally underwent evisceration. The final visual acuity depended on the location of the remaining scar; in four cases, corneal transplantation was necessary. Neither local nor systemic toxic side effects were observed. CONCLUSION: Subconjunctival fluconazole could be effective for treatment of severe fungal keratitis and could be very useful to avoid surgical intervention at an acute stage of this infection. Although the efficacy of the various doses cannot be determined from this series, the dose used in this study seems to be safe and effective for fungal corneal ulcer with hypopyon.
Traumatic subconjunctival crystalline lens dislocation.
PURPOSE: To evaluate the clinical features and visual outcomes in patients with traumatic subconjunctival crystalline lens dislocation. SETTING: Izmir Atatürk Education and Research Hospital, Department of Ophthalmology, Izmir, Turkey. METHODS: The clinical records of 5 patients with subconjunctival crystalline lens dislocation secondary to blunt trauma were reviewed. RESULTS: The median age of 3 women and 2 men was 63 years (range 62 to 73 years). The lenses were dislocated to the superior (n = 1), temporal (n = 1), superotemporal (n = 1), and superonasal (n = 2) quadrants. All patients had various degrees of hyphema and vitreous hemorrhage. One patient had traumatic optic neuropathy. Visual acuity improved in all patients after lens removal and scleral rupture repair. CONCLUSION: With timely intervention, the visual outcome was reasonably good in patients with subconjunctival dislocation of the crystalline lens.
Strabismus in Down syndrome.
PURPOSE: To determine the distribution of refractive errors and clinical characteristics of strabismus in patients with Down syndrome. PATIENTS AND METHODS: Patients with Down syndrome attending the Izmir Association for Supporting Patients With Down Syndrome in Izmir, Turkey, were screened for strabismus and refractive errors. All patients underwent a complete eye examination including cycloplegic refraction and dilated fundus examination. Ocular alignment was evaluated using the cover test and either the Krimsky or the Hirschberg corneal reflex test depending on the cooperation of the patient. Strabismic and nonstrabismic patients were compared for refractive errors, anisometropia, and amblyopia. RESULTS: Fifty-seven patients with an average (+/- standard deviation) age of 9.30 years (+/- 6.14 years; range, 1 to 31 years) were screened. Twenty-five (44%) were female and 32 (56%) were male. Eleven patients (19%) had strabismus. Ten (18%) had esotropia and 1 (2%) had exotropia. Infantile esotropia was observed in 3 patients who had no significant refractive errors. Seven patients had acquired esotropia; they had clinically significant refractive errors and anisometropia. A higher frequency of hypermetropia was noted in patients with strabismus (P < .05). CONCLUSIONS: Esotropia and hypermetropia are common in patients with Down syndrome. Early diagnosis and treatment of strabismus and associated ocular conditions such as refractive errors and amblyopia may improve the quality of life for these patients.