Utine, C.A. | Altin, F. | Cakir, H. | Perente, I.

Article | 2009 | Acta Ophthalmologica87 ( 4 ) , pp.386 - 391

Purpose: This study determined to assess the degree of agreement between anterior chamber depth (ACD) measurements obtained using three different devices and to analyse the relationship between ACD and spherical equivalent (SE) refraction. Methods: In this cross-sectional study, 42 eyes of 42 patients with a mean SE of - 4.69 ± 4.61 D (range 0.00 D to - 14.88 D) were analysed. Measurements of ACD between the corneal epithelium and the anterior surface of the crystalline lens, obtained using the Pentacam, Orbscan IIz and IOLMaster, were compared. The relationships between SE and ACD measurements obtained with different devices were a . . .lso investigated. The results were analysed using Bland-Altman analyses, single-sample t-test and Pearson's correlation test. Results: Orbscan ACD measurements were an average of 0.05 mm less than Pentacam measurements (p = 0.01). IOLMaster measurements were an average of 0.06 mm less than Orbscan measurements (p < 0.001). None of the ACD values measured by any of the devices were correlated with increasing SE (p > 0.05 for all). There was a weak positive correlation between SE and the difference in ACD measurements with Pentacam and Orbscan (p = 0.04); however, the differences between Pentacam and IOLMaster ACD measurements and Orbscan and IOLMaster ACD measurements seemed to be independent of SE (p = 0.17 and p = 0.54, respectively). Conclusions: The ACD in clinically normal eyes is measured differently by various non-ultrasonic devices. However, the observed mean error between these modalities is too small to create any noticeable difference in refractive outcome. No significant relationship was found between SE and ACD measurements obtained by Pentacam, Orbscan or IOLMaster. © 2008 Acta Ophthalmol Daha fazlası Daha az

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

Perente, I. | Utine, C.A. | Cakir, H. | Yilmaz, O.F.

Article | 2007 | Cornea26 ( 9 ) , pp.1138 - 1140

PURPOSE: To report a case of laser in situ keratomileusis (LASIK) that used the Intralase femtosecond laser 14 years after radial keratotomy (RK) for residual myopic astigmatism. METHODS: A 39 year-old male patient had undergone a bilateral RK operation for myopic correction. The manifest refraction was -1.25 -3.00 × 175 D, with uncorrected visual acuity (UCVA) of 20/50 and best-corrected visual acuity (BCVA) of 20/20. The central and thinnest pachymetry measurements were 582 and 576 µm, respectively, by Orbscan II. RESULTS: Intralase was used for LASIK, and initially, a loss of suction was seen during flap formation. The flap could . . . be created again at the same intracorneal plane. During flap lifting, the RK incisions were separated, and one of the RK incisions progressed to the corneal center with the force applied by the blunt spatula. No piece was separated completely from the flap. Excimer laser treatment and flap repositioning could be done without any problems. At the fifth postoperative month, his UCVA was 20/20. All RK incisions seemed well aligned. There was no haze or epithelial ingrowth. CONCLUSIONS: This case showed that the Intralase femtosecond laser not only has no unique benefit as opposed to the mechanical keratome for post-RK eyes but also can lead to serious complications. We recommend that femtosecond laser flap formation not be used in post-RK eyes. © 2007 Lippincott Williams & Wilkins, Inc Daha fazlası Daha az

Utine, C.A. | Gehlbach, P.L. | Zimmer-Galler, I. | Akpek, E.K.

Article | 2010 | Cornea29 ( 12 ) , pp.1401 - 1405

PURPOSE

Utine, C.A. | Tzu, J.H. | Akpek, E.K.

Article | 2011 | American Journal of Ophthalmology151 ( 1 ) , pp.170 - 1740

Purpose To report the clinical outcomes of lamellar keratoplasty using sterile, gamma-irradiated corneal tissues (VisionGraft) for partial-thickness corneal defects. Design Interventional case series. Methods The medical records of 10 patients with partial-thickness corneal defects who were operated at The Wilmer Eye Institute between April 2009 and December 2009 were retrospectively reviewed. Indications for surgery included corneal melt with microperforation (n = 6), keratoprosthesis-associated corneal melt (n = 2), and noninflammatory limbal lesions (n = 2). The grafts were fashioned from full- or partial-thickness tissues using . . .disposable trephines, based on the depth, shape, and size of the defect in the recipient bed, and were secured with multiple interrupted 10/0 nylon sutures. Rate of epithelialization and clarity of the grafts at the last visit were assessed retrospectively. Results All but 1 graft became epithelialized between postoperative 1st and 13th days. Corneal inflammation progressed in the 1 patient with Boston type 1 keratoprosthesis- associated corneal melt, probably attributable to the progression of underlying Sjgren syndrome, despite initiation of systemic immunomodulatory treatment, and required replacement of the device. The donor tissues remained clear in all the other cases over a period of 7 to 15 months. No immune rejection, infection, significant opacification, or neovascularization of the donor tissues were noted during a follow-up period. Conclusions VisionGraft may be considered in lieu of fresh donor corneas for lamellar corneal patch grafts because of its availability, easy handling, and lack of immunogenicity Daha fazlası Daha az

Kaya, V. | Utine, C.A.

Letter | 2012 | Cornea31 ( 12 ) , pp.1508 - 1509

[No abstract available]

Perente, I. | Utine, C.A. | Ozturker, C. | Cakir, M. | Kaya, V. | Eren, H. | Yilmaz, O.F.

Article | 2007 | Current Eye Research32 ( 3 ) , pp.241 - 247

Purpose: To evaluate the effect of uncomplicated phacoemulsification surgery on macula by optical coherence tomography (OCT). Methods: A total of 110 eyes of 102 patients who underwent uncomplicated phacoemulsification and foldable intraocular lens implantation at Beyoglu Eye Research and Training Hospital between February and March 2005 and who were without any systemic disease, fundus or other ocular pathology were included. Postoperatively, topical prednisolone acetate (6 x 1) and ofloxacine (5 x 1) was started, and by decreasing the dosage progressively, treatment was continued for 6 weeks. Full ophthalmologic and OCT examinatio . . .ns were done preoperatively and at the postoperative 1st day, 1st week, 1st, 3rd, and 6th months. Mean retinal thicknesses, volumetric analyses at central fovea, superior, inferior, temporal, and nasal macular quadrants, and thinnest foveal retinal thicknesses were recorded. Preoperative and postoperative measurements were analyzed statistically by using ANOVA test, paired samples t-test with Bonferroni correction, and Pearson's correlation test. Results: The mean central foveal retinal thickness was preoperatively 202.4 ± 25.9 µm, postoperatively 200.4 ± 26.1 µm at 1st day (p = 0.29), 208.4 ± 27.6 µm at 1st week (p = 0.29), 226.2 ± 54.9 µm at 1st month, 215.2 ± 24.0 µm at 3rd month, 213.5 ± 29.4 µm at 6th month (p < 0.001). Perifoveal macular thicknesses at superior, inferior, temporal, and nasal quadrants were 264.9 ± 28.8 µm, 266.1 ± 29.5 µm, 255.0 ± 31.3 µm, 260.3 ± 34.0 µm, respectively, preoperatively; 287.9 ± 28.4 µm, 288.0 ± 26.3 µm, 286.8 ± 33.1 µm, 272.0 ± 32.4 µm, respectively, at postoperative 1st month (p < 0.001). The change in mean central foveal thickness, foveal thinnest retinal thickness, mean perifoveal retinal thickness and volumetric analyses was insignificant at postoperative 1st day (p > 0.05), and significant at 1st week, 1st, 3rd, and 6th months (p < 0.05 for all measurements). Conclusions: Statistically significant increase in macular thickness was detected at postoperative early periods, after the 1st week after uncomplicated cataract operation. The increase in macular thickness starts from parafoveal regions. Longer follow-up of patients is required for the macular consequences, and different treatment protocols should be studied in a randomized controlled fashion. Copyright © Informa Healthcare 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

Acar, B.T. | Utine, C.A. | Ozturk, V. | Acar, S. | Ciftci, F.

Article | 2014 | Eye and Contact Lens40 ( 4 ) , pp.207 - 212

Objective: To evaluate the effect of transepithelial corneal collagen crosslinking (CXL) with prolonged riboflavin application by in vivo confocal microscopy and to compare this effect with that of standard CXL with complete epithelial debridement. Methods: In eyes with progressive keratoconus, CXL procedure was performed with standard technique and transepithelial technique after prolonged riboflavin drop application for 2 hr. Patients were evaluated with in vivo confocal microscopic examination preoperatively and at postoperative months 1 and 6. Results: The depth of CXL effect was similar in both groups (i.e., 380.86±103.23 mm in . . . standard CXL group and 342.2±68.6 mm in transepithelial CXL group) (P=0.4). The endothelial cell counts and morphological parameters (i.e., pleomorphism and polymegathism) were not significantly affected in both groups (P >0.05 for all). In the standard CXL group, in vivo confocal microscopy revealed anterior stromal acellular hyperreflective honeycomb edema with posteriorly gradually decreasing reflectivity and increasing number of keratocytes and some sheets of longitudinally aligned filamentary deposits. The keratocytes were seen to repopulate in the posterior-to-anterior direction. In transepithelial CXL group, although the depth of CXL effect was similar, less pronounced keratocyte damage, extracellular matrix hyperreflectivity, and sheets of filamentary deposits at the posterior stroma was observed. Conclusions: Transepithelial CXL with prolonged peroperative riboflavin application can achieve similar depth of effect in the stroma with less pronounced confocal microscopic changes as compared with the standard CXL with complete epithelial debridement Daha fazlası Daha az

Kaya, V. | Utine, C.A. | Altunsoy, M. | Oral, D. | Yilmaz, O.F.

Article | 2008 | Cornea27 ( 5 ) , pp.531 - 534

PURPOSE: To evaluate the corneal topographic characteristics of first-degree relatives of patients with keratoconus with corneal topography to determine the incidence of clinical keratoconus and topographic abnormalities. METHODS: Between February and August 2006, Orbscan II analysis was done in 144 eyes of 72 cases who were first-degree relatives of patients diagnosed with clinical keratoconus. The findings were compared with preoperative Orbscan analyses of 52 clinically normal individuals who underwent laser in situ keratomileusis surgery and did not develop corneal ectasia in 3 years of follow-up. RESULTS: In 8 of the 72 first-d . . .egree relatives of patients with keratoconus, clinical keratoconus was diagnosed by the topographic pattern in Orbscan and clinical examination (group 1). The remaining 64 subjects (group 2) were compared with the control group (group 3). The central corneal thickness was 523.7 ± 40.4 µm in group 2, whereas it was 546.3 ± 33.1 µm in group 3 (P < 0.05). The central corneal thickness, thinnest pachymetric reading, posterior elevation value, distance between the greatest anterior/posterior elevation points, and corneal center, posterior best fit sphere (BFS) values, posterior BFS:anterior BFS ratio, and irregularity values were significantly different between group 2 and group 3 (P < 0.05). CONCLUSIONS: The keratoconus incidence was found to be 11% in first-degree relatives of patients with keratoconus as opposed to a reported incidence of keratoconus of 0.05% in the general population. In first-degree relatives of patients with keratoconus who did not have a topographic keratoconus pattern, abnormal corneal topographic values were detected. The asymptomatic relatives of patients with keratoconus should undergo a thorough preoperative analysis for subtle topographic abnormalities before any keratorefractive surgery. © 2008 by Lippincott Williams & Wilkins Daha fazlası Daha az

Utine, C.A. | Biçakçigil, M. | Yavuz, S. | Çiftçi, F.

Article | 2011 | Current Eye Research36 ( 8 ) , pp.683 - 690

Background: To evaluate the tear osmolarity in patients with dry eye syndrome related to primary Sjögren's Syndrome (SS). Materials and Methods: Twenty eyes of 10 patients with dry eye and primary SS (Group 1) and 20 eyes of 20 subjects who do not have dry eye syndrome (Group 2) were included in this cross-sectional study. In all eyes, ophthalmic examination was performed in the same order: International Ocular Surface Disease Index survey, visual acuity assessment, conjunctival hyperemia scoring, tear osmolarity measurement with TearLab™ Osmolarity System, tear film break-up time assessment, corneal fluorescein staining scoring, oc . . .ular surface Lissamine Green staining scoring, anesthetized Schirmer test. Dry eye severity was graded according to Dry Eye Workshop (DEWS) classification system. Results: Four eyes with grade 1, four eyes with grade 2, seven eyes with grade 3, and five eyes with grade 4 dryness, according to DEWS system, were included. The mean tear osmolarity value was 301.9 ± 11.40 mOsm/L (range: 290328) in Group 1, and 294.85 ± 8.33 mOsm/L (range: 283311) in Group 2 (p = 0.03). In Group 1, tear osmolarity values were positively correlated with OSDI scores (r(18) = 0.55, r2 = 0.31, p = 0.01), DEWS classification grades (r(18) = 0.73, r2 = 0.54, p < 0.01), temporal and total corneal staining scores (r(18) = 0.67, r2 = 0.44, p < 0.01, and r(18) = 0.51, r2 = 0.26, p = 0.02, respectively), temporal conjunctival staining scores (r(18) = 58, r 2 = 0.34, p < 0.01); and negatively correlated with anesthetized Schirmer test results (r(18) = -0.62, r2 = 0.38, p < 0.01) and TFBUT (r(18) = -0.50, r2 = 0.25, p = 0.02). Conclusions: Tear osmolarity values were found to be greater in patients with dry eye syndrome related to primary SS compared to control subjects, and positively correlated with the severity of dry eye. © 2011 Informa Healthcare USA, Inc 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