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Biomedical subjects

Feray Koc

Publications and source records attributed to Feray Koc.

4 recordsLinked to original sources

Visual acuity in children with glaucoma.

PURPOSE: To investigate the risk factors that influence outcome of visual function in children with glaucoma. DESIGN: Retrospective noncomparative interventional case series. PARTICIPANTS: One hundred twenty-six patients (204 eyes) who had childhood glaucoma observed over 30 years, with a mean follow-up of 11.6 years. INTERVENTIONS: Full ophthalmologic examination, including measurement of corrected visual acuity (VA), slit-lamp and fundus examinations, intraocular pressure (IOP) measurement, and gonioscopic evaluation; periodic cycloplegic refraction and perimetry; and treatment of amblyopia. MAIN OUTCOME MEASURES: Type of glaucoma; final best-corrected VA of good (6/6-6/12), fair (6/15-6/30), or poor (< or =6/60); patient age at time of development of glaucoma complications; and percentage of IOP measurements of < or =19 mmHg, perimetry results, and cup-to-disc (C/D) ratio during follow-up. RESULTS: The most recently measured VAs of children treated for glaucoma were good in 29%, fair in 24%, and poor in 47%. The most favorable outcome was for patients with primary infantile glaucoma followed by secondary glaucoma. Amblyopia and optic nerve damage due to glaucoma were the most frequent complications affecting VA. Patients with an IOP of < or =19 mmHg on 80% of determinations had stable optic nerve C/D ratios and visual fields. CONCLUSIONS: Vision sufficient to qualify for a motor vehicle driving license was attainable in almost 30% of affected eyes. Visual acuity achieved at 6 years of age remained stable over the study period. Treatment of amblyopia is important to achieve this result.

Adolescent↗

Topical apraclonidine testing discloses pupillary sympathetic denervation in diabetic patients.

BACKGROUND: Autonomic denervation is common in diabetes mellitus (DM). Pupillary sympathetic denervation (PSD) has been found in Horner syndrome following instillation of apraclonidine 0.5%. We have applied this technique to investigate the prevalence of PSD in DM. METHODS: Apraclonidine 0.5% was instilled in the eyes of 50 patients with DM and 30 age-matched and gender-matched subjects without DM (control subjects). Pupil diameters (PD) were measured before and 60 minutes after instillation. The duration of DM and the degree of diabetic retinopathy (DR) were recorded for each patient. RESULTS: Apraclonidine instillation caused an average of 0.9 mm of mydriasis (range 0 to 4.5 mm) in DM and -0.1 mm miosis (range 0.5 to -1 mm) in control subjects (P < 0.001). Mydriasis of at least 1 mm was observed in 42% of DM patients. The change in PD was highly correlated with the duration of DM (r = 0.368, P = 0.008) and the presence of DR (r = 0.532, P < 0.001). CONCLUSION: Apraclonidine testing, which is easy to perform and not distressing to the patient, identified PSD in nearly half of DM patients, the degree of mydriasis being correlated to the duration of DM and the presence of DR.

Administration, Topical↗

Single-stage adjustable strabismus surgery under topical anesthesia and propofol.

AIM: To present our experience with single-stage adjustable strabismus surgery (SSASS) under topical anesthesia and propofol. MATERIALS AND METHODS: Sixteen patients who either had diplopia before the surgery or were at risk of developing diplopia after the surgery were selected for this operation after evaluating their tolerance for an eyelid speculum. Recession of the lateral recti, recession, resection and advancement of the medial recti, anteriorization of the inferior oblique and marginal myotomy to the superior rectus were the procedures done under topical anesthesia and propofol. The operations were done in two phases; in the first phase, the patients were sedated for 10 minutes with intravenous propofol (2 mg/kg) and the operation was done under topical anesthesia with 2% lidocaine. In the second phase, the patients were conscious and the adjustments were made. RESULTS: None of the patients complained of significant pain during the surgery. No complications occurred during and after the procedure and no patients had diplopia during the postoperative follow-up. CONCLUSIONS: Single-stage adjustable surgery is practical and avoids the risks of regional and general anesthesia. The only disadvantage is the pain that some patients experience. We found that it is feasible to use propofol for this surgery; it provides deep sedation and prevents pain from being felt during the operation, and its short elimination half-life provides rapid awakening for the adjustment phase.

Adolescent↗

Analysis of changes in corneal shape and bulbus geometry after retinal detachment surgery.

PURPOSE: To investigate changes in corneal shape and anterior segment following retinal detachment surgery. MATERIAL AND METHODS: 25 consecutive patients with retinal detachment were enrolled in this study. Computer-assisted videokeratography was performed before and after retinal detachment surgery and changes in the anterior segments of postoperative patients were also noted. RESULTS: In the local buckling group, statistically significant changes were observed in the anterior chamber depth, lens thickness, and vitreous length (distance from posterior surface of lens to the retina) in the postoperative period. However, in the encircling group, statistically meaningful changes were observed in the vitreous length, axial length of the globe, and the central corneal curvature and thickness in the postoperative period. CONCLUSION: Corneal topography and axial measurements may be useful for evaluating the shape of the cornea after retinal detachment surgery. Because the resultant refractive changes are very important for the visual rehabilitation of the patients.

Adolescent↗