Cakir, H. | Utine, C.A.
Article | 2010 | Journal of Cataract and Refractive Surgery36 ( 4 ) , pp.539 - 541
We describe a technique to manage dense cataract cases. After a capsulorhexis of 6.0 to 7.0 mm diameter has been created, the phaco tip is inserted into the nucleus centrally and high vacuum is used to lift the nucleus and elevate it with a tilt to protrude outside the capsular bag distally. The chopper is used to segment the nucleus centripetally, starting from the lens equator or just behind, without applying stress to the capsular bag or zonules. Further phacoemulsification is maintained by holding the nucleus centrally and chopping it into smaller triangular sectoral pieces. In this horizontal chopping technique, which is done j . . .ust outside the capsular bag, grasping the nucleus in the center and elevating it with high vacuum instead of depressing one edge of the nucleus to elevate the other edge prevents additional stress to the capsule and zonules. Financial Disclosure: Neither author has a financial or proprietary interest in any material or method mentioned. © 2010 ASCRS and ESCRS Daha fazlası Daha az
Acar, N. | Kapran, Z. | Utine, C.A. | Büyükbabani, N.
Article | 2007 | International Ophthalmology27 ( 4 ) , pp.277 - 280
Background: The Toxocara organism may cause direct injury to the eye, but most commonly, host inflammatory reactions are responsible for the resulting compromise. The inflammatory response created by the ocular involvement may result in epiretinal membrane formation, tractional or combined tractional-rhegmatogenous retinal detachment. The treatment of choice is pars plana vitrectomy (PPV), which also has diagnostic significance. Methods: We report a pediatric case in which PPV recovered the Toxocara canis organism. For the total tractional retinal detachment diagnosed after the cataract surgery, PPV, preretinal and subretinal membra . . .ne peeling, 180° retinotomy, silicone oil injection were performed. The fibrous membrane specimen obtained during PPV recovered the Toxocara canis organism. Results: The intense postoperative inflammatory reaction had to be managed surgically, also. Retinal reattachment was achieved with subsequent improvement of the visual acuity. Conclusion: The importance of vitreous biopsy examination following PPV, in eyes in which etiology is uncertain and the intense antiinflammatory therapy applied within and following vitreoretinal surgery is emphasized. © Springer Science+Business Media, Inc. 2007 Daha fazlası Daha az
Tay, E. | Utine, C.A. | Akpek, E.K.
Article | 2010 | Archives of Ophthalmology128 ( 6 ) , pp.779 - 782
We herein present a surgical technique for the management of corneal melt following Boston type I keratoprosthesis implantation. The technique was performed using new-generation dehydrated human amniotic membrane. The membrane was fashioned in the shape of 2 crescentic patches using disposable corneal trephines. A double layer of grafts was then sutured into the host bed with interrupted 10-0 nylon sutures. Rapid healing with corneal epithelization and vascularization was noted within days. The main advantage of the amniotic membrane that we used is that it is thicker than the older generation (110 vs 40 ?m) and suitable for tectoni . . .c purposes. It is also readily available with a long shelf life and does not require a lamellar dissection unlike a donor corneal patch. This surgical technique may potentially serve as another tool in a cornea surgeon's armamentarium. ©2010 American Medical Association. All rights reserved Daha fazlası Daha az
Cakir, H. | Utine, C.A.
Article | 2011 | Journal of Refractive Surgery27 ( 2 ) , pp.119 - 126
PURPOSE: To evaluate the results of combined intracorneal ring (Keraring, Mediphacos Ltd) and anterior chamber, iris-fixated, phakic intraocular lens (pIOL) (Artisan and Artiflex, Ophtec BV) implantation in patients with ectatic corneal conditions and secondary high myopic and astigmatic refractive error. METHODS: Ten eyes of eight consecutive patients with different ectatic corneal diseases underwent sequential intracorneal Keraring and iris-fixated pIOL implantation. Two eyes with keratoconus, one eye with pellucid marginal degeneration, and one eye with iatrogenic corneal ectasia were implanted with the Artisan pIOL; six eyes wit . . .h keratoconus were implanted with the Artiflex pIOL. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent (MRSE), topographic findings, and complications were recorded. RESULTS: Mean UDVA improved from 0.02±0.10 preoperatively to 0.11±0.06 after Keraring implantation and to 0.54±0.18 after pIOL implantation ( Daha fazlası Daha az
Utine, C.A. | Altunsoy, M. | Basar, D.
Article | 2010 | International Ophthalmology30 ( 1 ) , pp.81 - 84
A patient with anterior chamber gas bubbles after LASIK flap formation with femtosecond laser is presented. A 33-year-old male patient had LASIK for myopia with corneal flap formation with IntraLase® FS30 femtosecond laser. In the right eye, air bubbles were observed in anterior chamber after successful flap formation. Laser correction was completed successfully, by Wavelight® Allegretto WaveTM Eye-Q excimer laser, without eye-tracker. Visante® anterior segment optical coherence tomography imaging displayed that the pocket extended to limbal area, with stromal bed thickness of >600 µm at that area. We propose as possible causes o . . .f the air bubbles scattering of femtosecond laser beam producing direct photodissociation of aqueous humor, or direct cavitation effect in aqueous humor due to rapid pressure changes in corneal lamellar interface during the femtosecond laser procedure. Other causes such as migration of intrastromal bubbles through peripheral corneal stroma and trabecular meshwork, or through posterior stroma and endothelium, seem to be unlikely © 2008 Springer Science+Business Media B.V Daha fazlası Daha az
Utine, C.A. | Cakir, H. | Egemenoglu, A. | Perente, I.
Article | 2008 | Journal of Refractive Surgery24 ( 5 ) , pp.464 - 472
PURPOSE: To evaluate the results of LASIK for hyperopia in pediatric eyes with amblyopia resulting from anisometropia. METHODS: Thirty-two children with anisometropic amblyopia in whom conventional therapy was unsuccessful underwent unilateral LASIK between 1999 and 2005. Mean patient age was 10.3+.3.1 years (range: 4 to 15 years), and mean follow-up was 20.1±15.1 months (range: 12 to 60 months). At the last follow-up examination, spherical equivalent refraction, uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and complications were recorded. RESULTS: Mean preoperative and postoperative manifest sph . . .erical equivalent refraction of the treated eyes was 5.17±1.65 and 1.39±1.21 diopters (D), respectively ( Daha fazlası Daha az
Utine, C.A. | Durak, I.
Review | 2012 | Turk Oftalmoloiji Dergisi42 ( 4 ) , pp.294 - 297
Recently, pepper spray has been used by both civilians, as a non-lethal personal defense spray, and law enforcement agencies in population movements. People exposed to pepper spray experience panic and disorientation due to acute severe pain, blepharospasm, tearing and sometimes blurred vision and even temporary blindness. Having knowledge about the properties and mechanism of action of pepper spray and the different aspects of this exposure from other ocular chemical injuries is important for timely and correct interventions and appropriate management of the condition by the ophthalmologists in emergency care.
Kaya, V. | Utine, C.A. | Ylmaz, O.F.
Article | 2012 | Cornea31 ( 5 ) , pp.486 - 490
Tzu, J.H. | Utine, C.A. | Stern, M.E. | Akpek, E.K.
Article | 2012 | Cornea31 ( 6 ) , pp.649 - 654
Purpose: To evaluate the long-term effectiveness of the combination of topical cyclosporine drops and tacrolimus ointment in the treatment of steroid-dependent atopic keratoconjunctivitis (AKC). Methods: Ten patients with moderate to severe AKC participated in the study. Topical cyclosporine 0.05% was used, as a monotherapy, 6 times daily during the first month of the study, followed by 4 times daily during the second month. The patients were then instructed to self-treat with topical cyclosporine at a dose ranging from 2 to 6 times daily depending on the severity of the disease. Tacrolimus ointment 0.03% was applied on the lid skin . . .. Follow-up examinations were performed approximately every 3 months. Each patient completed a follow-up period of at least 12 months. Symptoms and signs of AKC were assessed on the day of enrollment, on days 28, 56, and 63, and at subsequent follow-up visits. Flare-ups of AKC requiring steroid use and progression of the disease findings were also recorded. Results: All patients experienced significant improvement of their symptoms and signs during the first 2 months of the study. Two patients were lost to follow-up after the initial 2 months. One patient was noncompliant and continued the treatment only for 7 months. During the median treatment period of 21.5 months for the 7 continuing patients, a total of only 2 flare-up episodes were noted requiring topical steroids. Conclusions: Adequate topical immunomodulation using topical calcineurin inhibitors may eliminate the need for steroids and favorably alter the long-term prognosis of patients with AKC. Copyright © 2012 by Lippincott Williams & Wilkins Daha fazlası Daha az
Utine, C.A. | Gehlbach, P.L. | Zimmer-Galler, I. | Akpek, E.K.
Article | 2010 | Cornea29 ( 12 ) , pp.1401 - 1405
Mathews, P.M. | Ramulu, P.Y. | Friedman, D.S. | Utine, C.A. | Akpek, E.K.
Article | 2013 | Ophthalmology120 ( 11 ) , pp.2241 - 2248
Purpose: To evaluate the subjective and objective measures of ocular surface disease in patients with glaucoma. Design: Cross-sectional study. Participants: Sixty-four glaucoma subjects with bilateral visual field (VF) loss and 59 glaucoma suspects with normal VFs. Methods: Consecutive patients were recruited prospectively from the Wilmer Eye Institute Glaucoma Clinic. Main Outcome Measures: Tear film breakup time (TBUT), corneal staining score (0-15), and Schirmer's test results were included as objective metrics, whereas the Ocular Surface Disease Index (OSDI) questionnaire was administered to assess symptoms. Total OSDI score, vi . . .sion-related subscore (derived from questions about vision and task performance), and discomfort-related subscore (derived from questions about ocular surface discomfort) were calculated for each subject. Results: Seventy-five percent (48/64) of glaucoma subjects and 41% (24/59) of glaucoma suspects were receiving topical medications. The corneal staining grade was greater in glaucoma subjects than in glaucoma suspects (6.4 vs. 4.1; P0.20 for both). Glaucoma subjects had significantly higher total OSDI scores than glaucoma suspects (16.7 vs. 7.9; Daha fazlası Daha az