Leyla Niyaz

Incidence of retinopathy of prematurity in the middle Black Sea region of Turkey over a 10-year period.

PURPOSE To report the incidence of retinopathy of prematurity (ROP) in babies with a birth weight of ≤1750 g over a 10-year period in the north of Turkey. METHODS The medical records of 2,365 preterm babies who had been referred for ophthalmological examination were retrospectively reviewed, and children with a birth weight of ≤1750 g were included. The incidence of ROP was compared between two successive 5-year periods: 2004-2008 and 2009-2013. RESULTS A total of 1,565 babies were included: 624 in the first period and 941 in the second. The incidence of ROP significantly increased during the second period compared to the first (35.3% vs 48.2% [P < 0.001]). The number of patients who required treatment was 11.9% in the first period and 11.4% in the second (P = 0.768). CONCLUSIONS Although the incidence of ROP increased during the latter period of study (2009-2013), the numbers of treatment-requiring cases were similar in both periods.

A propranolol nonresponsive mass: lymphangioma-mimicking hemangioma.

the surgeons understanding of the paranasal sinus anatomy and helpful in performing a more complete anatomic dissection. This helped to reduce intraoperative complications and provide better outcomes. Moreover, we found the navigation platform a valuable teaching tool in the residency training program in our institute. To conclude, the use of intraoperative navigation system is firmly established as a valuable technology in the management of paranasal sinus disease. It may improve the confidence of the surgeon by confirming the position within the challenging anatomic fields. This increases surgical effectiveness and improves surgical safety. The effect of navigation-aided endoscopic surgery on the clinical outcomes is to date not demonstrated.

Infrequent Complications of Inferior Oblique Recession Surgery

ABSTRACT Purpose: To report the infrequent complications, including antielevation and adherence syndrome, after a unilateral and bilateral inferior oblique (IO) recession procedure and to discuss the possible causes. Methods: A retrospective chart review was conducted for patients on whom unilateral or bilateral IO weakening surgeries were performed. Results: Forty-three patients were included in the study. In 23 patients unilateral and in 20 patients bilateral IO weakening was performed. All patients underwent IO recession surgery. Mild limitation of elevation developed in two patients and adherence syndrome developed in one patient. All occurred after unilateral IO recession. No duction deficiency was observed in patients after bilateral IO recession. Conclusion: Antielevation and adherence syndrome can develop after unilateral IO recession surgery. Care should be taken not to tighten the neurofibrovascular bundle of the IO muscle during surgery.

Pseudoexfoliation syndrome in chronic kidney disease patients.

Abstract This study was performed to determine whether chronic kidney disease (CKD) is associated with an increased risk of pseudoexfoliation (PEX) syndrome. This is an age-matched case control study evaluating frequency of PEX in patients over age 40 with the diagnosis of stage 1–4 CKD and those undergoing hemodialysis (HD). Subjects over age 40 with hypertension and/or diabetes mellitus (DM) and normal kidney functions were studied as a control group. CKD was diagnosed as decreased glomerular filtration rate (GFR) of less than 60 mL/min/1.73 m2 for at least 3 months. Study groups were arranged as group 1 consisting of HD receiving CKD patients, group 2 consisting of CKD patients who do not need HD and group 3 as a control. Demographic properties and the prevalence of PEX were evaluated and compared between groups. Because of the effect of DM on PEX occurrence, it was also evaluated after exclusion of diabetic patients. A total of 101 cases in group 1, 106 cases in group 2 and 117 cases in group 3 were included in the study. Pseudoexfoliation was found in 7 (6.9%) patients in group 1, 5 (4.7%) patients in group 2 and 7 (5.9%) patients in group 3 (p > 0.05). After exclusion of diabetic patients the prevalence of PEX changed as 4 (5.6%) in group 1, 2 (4.4%) in group 2 and 1 (1.8%) in group 3 (p > 0.05). In conclusion, CKD was not associated with increased prevalence of PEX in this study.

Esthesioneuroblastoma With Poor Outcome Despite Extensive Treatment.

Esthesioneuroblastoma is a rare malignant tumor of neuroectodermal origin. It usually presents with nonspecific symptoms, such as nasal obstruction, epistaxis, and pain, but has an aggressive course if the treatment is delayed. The authors report a case of esthesioneuroblastoma in a 47-year-old woman, treated with extensive surgical resection, radiotherapy, and chemotherapy. Despite intensive treatment, the patient developed a local recurrence with systemic metastasis and succumbed 4 months later.

Suspected Endothelial Pencil Graphite Deposition

A 14-year-old male patient had an ocular trauma with a pencil. Biomicroscopic examination revealed a broken part of pencil into the cornea. Foreign body removal and corneal wound closure were performed in the same day. After corneal repair, there was a grade 4+ anterior chamber reaction just like in preoperative examination. Dilated examination showed a very small piece broken tip of pencil on the upper nasal quadrant of the lens. A small and linear deposition was also seen on endothelial surface. Endothelial deposition and foreign body disappeared with intensive topical steroid treatment.

The effect of strabismus surgery on choroidal thickness

Purpose: To determine the effects of strabismus surgery on choroidal thickness. Methods: This was a prospective randomized study. The measurements of subfoveal and macular choroidal thickness of patients who underwent strabismus surgery were obtained by enhanced depth imaging optic coherence tomography. The patients were grouped as patients who had 1 horizontal muscle surgery (group 1), 1 oblique muscle surgery (group 2), 2 horizontal muscle surgeries (group 3), or 1 horizontal and 1 oblique muscle surgery (group 4). Choroidal thickness of the patients was measured preoperatively and on the postoperative first day, second week, first month, and third month. Choroidal thickness was measured at subfoveal area (S) and at the nasal (N1, N2) and temporal (T1, T2) fovea with 500-μm intervals. Results: The average age of the 37 patients was 15.59 ± 13.84 years. In preoperative and postoperative first day comparison, a decrease in choroidal thickness was found in all areas in group 1. In group 2, a significant decrease was found in N2, N1, and S values. In group 3, a significant decrease was found in N2, N1, and T2 values. In group 4, a significant decrease was found in N1 value. The second week comparison of all groups showed significant postoperative decrease in choroidal thickness in all areas. On the postoperative first month, a significant decrease in choroidal thickness was found only in the subfoveal area of group 1 and the N1 area of group 2. At the postoperative third month, there was no change in any group. Conclusions: Strabismus surgery causes a decrease in choroidal thickness in the early postoperative period.

Choroidal Thickness in Strabismus and Amblyopia Cases

ABSTRACT Purpose: The aim of our study was to examine the effect of hypermetropia and anisometropic, exotropic, and esotropic amblyopia on choroidal thickness. Methods: A prospective, cross-sectional, comparative study of 120 children under the age of 16 years was conducted. Choroidal thickness was measured in patients with hypermetropia, anisometropia, esotropia, exotropia, and controls. Results: The mean subfoveal choroidal thickness in the control and hypermetropia groups was 323.9±69.0 µm and 348.9±64.5 µm, respectively. Mean choroidal thickness in amblyopic and fellow eyes was 387.4 and 351.9 µm in anisometropic, 353.8 and 338.7 µm in exotropic, 347.5 and 336.5 µm in esotropic, and 389.3 and 359.3 µm in esotropic+anisometropic groups, respectively. Choroid was significantly thicker in amblyopic eyes of anisometropic group compared to fellow (P=0.004) and control (P=0.03) eyes. The difference of choroidal thickness was not significant between both eyes and when compared to control eyes in the other groups. Conclusions: Anisometropic amblyopic eyes had thicker choroids compared to controls and fellow eyes. However the choroidal thickness was not significantly different between amblyopic and fellow eyes of esotropic or exotropic patients.

Medial and Lateral Rectus Muscle Insertion Distance and Width in Esotropia and Exotropia Patients

ABSTRACT Purpose: The hypothesis that the extraocular muscle insertion distance and muscle width may be associated with the type and size of deviation was tested. Methods: This was a prospective study of 129 patients who had surgery for horizontal strabismus or retinal detachment. The insertion distances and widths of the medial rectus (MR) and lateral rectus (LR) muscles were measured intraoperatively in esotropia, exotropia, and buckling surgery (control group) patients. Statistical analysis was performed to compare measured factors between the groups. Results: Median medial and lateral muscle insertions were 5.7 and 6.9 mm in esotropia (ET), 6.0 and 7.1 mm in exotropia (XT), and 5.5 and 6.7 mm in the control groups (p > 0.05). The widths of the medial and lateral muscles ranged from 7.0 to 13.0 mm in ET and XT groups and from 9.5 to 11.0 mm in the control group (p > 0.05). Muscle insertion distance and LR muscle width were not correlated with deviation size. Only the MR muscle width was positively correlated with the deviation size. Conclusions: Insertion distances of the medial and LR muscles are not statistically different in ET, XT, and control patients. Only MR muscle width was affected by the size of the deviation in ET patients.

Hyaluronidase in ophthalmic evisceration surgery

Background To research the effectiveness of hyaluronidase in evisceration surgery. Methods A total of 34 patients were studied as three groups: conventional surgery group (n = 13); isotonic fluid group (n = 8); and hyaluronidase group (n = 13). Hyaluronidase and isotonic fluid were introduced into the uveo-scleral space. Intraocular content was removed, if possible by a one-scoop method, with the aid of a spoon. Results Removing all the intraocular content as a one-scoop method was achieved in 10 of 13 (77%) in the hyaluronidase group and four of eight (50%) in the isotonic fluid group. The one-scoop method was not possible in any case without the introduction of fluid. The mean durations for the evisceration procedure were 32, 36.6 and 40.5 min in the three groups, respectively (P < 0.05). Conclusions Using hyaluronidase in evisceration surgery greatly facilitates and speeds up the removal of all the intraocular content in ophthalmic evisceration surgery.