Biomedical subjects

Tulay Simsek

Publications and source records attributed to Tulay Simsek.

5 recordsLinked to original sources

PubMed2006

Efficacy and complications of releasable suture trabeculectomy and standard trabeculectomy.

PURPOSE: To compare the efficacy and complications of releasable suture trabeculectomy and standard trabeculectomy. PATIENTS AND METHODS: Sixty-four patients with uncontrolled glaucoma despite maximally tolerated medical therapy were included in a prospective, comparative, randomized clinical study. Standard trabeculectomy was performed on the 32 patients (Group 1) by one ophthalmologist and releasable suture trabeculectomy was also performed on the 32 patients (Group 2) by another ophthalmologist. Intraocular pressure, hypotony, shallow anterior chamber, iridocorneal touch and other complications were evaluated postoperatively. Examinations were performed daily for 1 week, for the 1st month and thereafter for every 3 months. RESULTS: The mean follow-up period was 11.0 +/- 2.4 months in Group 1 and 11.5 +/- 3.8 months in Group 2. On the first postoperative day mean intraocular pressure was determined 9 +/- 2.7 mmHg in Group 1, and 21.6 +/- 1.1 mmHg in Group 2 (p = 0.007). The mean intraocular pressure was 10.1 +/- 1.4 mmHg in Group 2 after suture removal. Shallow anterior chamber was observed in 11 (34.3%) patients of Group 1 and 2 (6.2%) patients of the Group 2 in the early postoperative period (p = 0.005). Iridocorneal touch was observed in 5 (15.6%) patients of Group 1 and 1 (3.1%) patient of Group 2 (p = 0.196). There was no statistically significant difference in the mean intraocular pressure between the two groups at 3, 6 and 12 months (p = 0.663, p = 0.362, p = 0.182, respectively). DISCUSSION: Releasable scleral flap sutures reduce the incidence of shallow anterior chamber and iridocorneal touch after trabeculectomy. Releasable scleral flap suture technique and standard trabeculectomy are similar in terms of lowering intraocular pressure at 1-year-follow up.

Female↗

PubMed2006

Fluorescein and indocyanine green angiography in ocular toxoplasmosis.

PURPOSE: To document fluorescein and indocyanine green angiographic findings in patients with ocular toxoplasmosis. METHODS: Charts of patients with ocular toxoplasmosis who were evaluated with fluorescein and indocyanine green angiograpy were reviewed. RESULTS: In this study, eight (38%) females and 13 (62%) males with a mean age of 20.3 years were included. Of the 21 patients, five (24%) had bilateral involvement with active or inactive toxoplasmic lesion. There were active lesions in 12 (46%) eyes and inactive lesions in 14 (54%) eyes. Indocyanine green angiograpy showed hypofluorescence of the active and inactive retinochoroiditis lesions at all phases. Hypofluorescent multiple satellite dark dots were observed in 11 (92%) eyes with active retinochoroiditis and in two (14%) eyes with inactive lesions. In two patients with unilateral active toxoplasmic retinochoroiditis, hyperfluorescent plaques were observed in the fellow eyes on indocyanine green angiograpy. The fundus examination and fluorescein angiography of the fellow eyes were normal and had a visual acuity of 10/10. Choroidal neovascularization was observed in two (8%) eyes. In eyes with active inflammation, fluorescein angiography revealed early hypo-fluorescence and late intense hyper-fluorescence with fuzzy margins of the retinochoroiditis lesion (12 eyes), hyperfluorescence of the optic nerve head (four eyes) and leakage from the vessels and/or vascular sheathing (four eyes) and neuroretinitis (one eye). CONCLUSION: Toxoplasmic retinochoroiditis is a more widespread inflammation than visible fundus lesions. Indocyanine green angiography is a useful method for evaluating the amount of inflammatory activity and late complications in patients with ocular toxoplasmosis.

Adolescent↗

PubMed2006

Comparative analysis of the effects of brimonidine and dorzolamide on ocular blood flow velocity in patients with newly diagnosed primary open-angle glaucoma.

The aim of this study was to evaluate the effects of brimonidine 0.2% and dorzolamide 2% on the ocular blood flow velocity in patients with newly diagnosed primary open-angle glaucoma (POAG). Forty-four (44) patients with newly diagnosed POAG were included in a prospective, comparative, randomized clinical study. Twenty-six (26) healthy volunteers, whose age and gender matched, were recruited to compare the baseline hemodynamic characteristics of the patients. After a complete eye examination, baseline blood flow velocity measurements of the retrobulbar vessels were made with color Doppler ultrasonography. Patients were randomly assigned to receive either brimonidine 0.2% or dorzolamide 2% for a 3-month period. Blood flow velocity measurements were repeated after 3 months. Both brimonidine and dorzolamide significantly reduced the intraocular pressure. The baseline ophthalmic artery pulsatility index was higher in patients with POAG than control subjects. Whereas there was a significant increase in peak systolic velocity of the central retinal artery, no significant change was observed in the other vessels with brimonidine and dorzolamide treatment. There was little difference, in terms of ocular blood flow velocity, between newly diagnosed glaucoma patients and control subjects. Both topical brimonidine and dorzolamide significantly reduced the intraocular pressure without altering ocular blood flow velocity in patients with newly diagnosed POAG.

Antihypertensive Agents↗

PubMed2006

Trabeculectomy with mitomycin C combined with direct cauterization of peripheral iris in the management of neovascular glaucoma.

PURPOSE: To determine the outcomes of trabeculectomy with mitomycin C (MMC) combined with direct cauterization of peripheral iris before iridectomy in the management of neovascular glaucoma (NVG), and to demonstrate the effect of this surgical technique on decreasing the incidence of intraoperative bleeding and early postoperative hyphema. METHODS: This prospective study was based on 72 eyes of 72 patients with NVG who underwent primary trabeculectomy with MMC combined with direct cauterization of peripheral iris before iridectomy. The patients were evaluated for intraoperative and early postoperative complications such as hyphema, and operative success rates. Operative success was defined as an intraocular pressure (IOP) < or =22 mm Hg (+/-medical therapy) in the absence of phthisis. The mean IOP and the mean number of antiglaucomatous medications at baseline and at the posttrabeculectomy sixth month were compared by paired Student t test. RESULTS: The mean preoperative IOP was 39.3+/-5.6 mm Hg (range, 29 to 60 mm Hg) whereas it was 20.02+/-4.3 mm Hg (range, 14 to 38 mm Hg) at the postoperative sixth month. The mean preoperative number of antiglaucoma medications was 3.2+/-0.4 (range, 2 to 4) but it reduced to 1.8+/-0.6 (range, 1 to 4) at the postoperative sixth month. These differences were statistically significant (P<0.00001). The IOP was < or =22 mm Hg (+/-medical therapy) in 69 eyes (95.8%) at the postoperative first week, in 62 eyes (86.1%) at the postoperative first month, in 60 eyes (83.3%) at the postoperative third month and in 48 eyes (66%) at the postoperative sixth month. Hyphema occurred in 15 eyes (20.8%) within the first week of the surgery. In 12 eyes it was transient; however, in 3 eyes irrigation of anterior chamber was required. CONCLUSIONS: Trabeculectomy with MMC combined with direct cauterization of peripheral iris decreases the incidence of both intraoperative bleeding, and early postoperative hyphema, and provides reduction of IOP and the number of antiglaucomatous medications in cases with NVG in a 6-month follow-up period.

Adult↗

PubMedDate not supplied

Traumatic optic nerve avulsion.

A 10-year-old boy presented with optic nerve avulsion associated with ptosis and limitation of elevation and adduction secondary to blunt ocular trauma. At the initial examination the funduscopic view was hazy because of concurrent vitreous hemorrhage. Ultrasonography revealed a posterior ocular wall defect and a hypolucent area in the region of the optic nerve head.

Child↗