Browsing by Author "Cakir, Hanefi"

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Comparison of Anterior Chamber Depth Measurements Taken With the Pentacam, Orbscan Iiz and Iolmaster in Myopic and Emmetropic Eyes
(Wiley, 2009) Utine, Canan Asli; Altin, Feyza; Cakir, Hanefi; Perente, Irfan
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. 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 also investigated. The results were analysed using Bland-Altman analyses, single-sample t-test and Pearson's correlation test. 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). 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.
Intracorneal Inlay To Correct Presbyopia: Long-Term Results
(Elsevier Science inc, 2011) Yilmaz, Omer F.; Alagoz, Nese; Pekel, Gokhan; Azman, Engin; Aksoy, Ebru F.; Cakir, Hanefi; Demirok, Ahmet
PURPOSE: To evaluate the long-term visual results of Acufocus ACI-7000 (now Kamra) intracorneal inlay implantation in presbyopic phakic patients. SETTING: Beyoglu Eye Training and Research Hospital, Istanbul, Turkey. DESIGN: Clinical trial. METHODS: This study comprised patients with emmetropic or post-laser in situ keratomileusis (LASIK) presbyopia. Patients had an uncorrected near visual acuity (UNVA) of 20/40 or worse, correctable to 20/25 or better at distance. The inlay was implanted on the stromal bed after the LASIK flap was relifted or a flap created. The inlay was centered on the presurgical position of the first Purkinje reflex. The main outcome measures were distance and near vision and the complication rate. RESULTS: The study enrolled 39 patients aged 45 to 60 years. At the 4-year follow-up, all patients (N = 22) had 2 or more lines of improvement in UNVA with no significant loss in distance vision. The mean final UNVA was 20/20 (Jaeger [J1]); 96% of patients could read J3 or better. The uncorrected distance acuity was 20/40 or better in all eyes. Five patients had cataract progression, and 2 had a change in refractive status. No eye with an intracorneal inlay had intraoperative complications during cataract extraction. Four inlays were explanted during the study. There were no severe corneal complications that affected final vision. CONCLUSION: Intracorneal inlay implantation was an effective, safe, and reversible procedure for the long-term surgical treatment of presbyopia.
Intracorneal Ring Implantation Using Intralase® With Partial Coverage of the Cone in a Patient After an Alkaline Injury
(Dove Medical Press Ltd, 2011) Cakir, Hanefi; Utine, Canan Asli; Baykara, Mehmet
Purpose: To report the use of intracorneal ring segment (ICRS) implantation in a case of severe corneal thinning and irregularity secondary to alkali burn. Case report: A 33-year-old man who had a history of ocular alkali burn in the right eye was admitted. His best corrected visual acuity was 0.16 with manifest refraction of +5.00 (-7.00 x 180 degrees). Orbscan II (R) revealed steepening of >53 D superiorly, excessive thinning inferiorly with thinnest pachymetric reading of 269 mu m. Two KeraRing (R) segments, 200 mu m thick and 90 degrees arced, were implanted. During intrastromal channel creation by Intralase (R), the inferior half of the applanating cone was covered by a gelatinous paper to prevent the penetration of the laser beam into the anterior chamber. In the first year postoperation, best corrected visual acuity was 0.7 with manifest refraction of +1.50 (-3.50 x 35 degrees). Visante (R) opticial coherence tomography displayed ICRS at a depth of similar to 370 similar to mu m. Conclusion: ICRS implantation with this novel approach may be an option in eyes with severe corneal irregularity and thinning.
Lift and Crack Technique for Risky Cataract Cases
(Elsevier Science inc, 2010) Cakir, Hanefi; Utine, Canan Asli
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 just 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.
Long-Term Outcomes of Intrastromal Corneal Ring Segment Implantation for Post-Lasik Ectasia
(Elsevier, 2014) Yildirim, Aydin; Cakir, Hanefi; Kara, Necip; Uslu, Hasim
Purpose: To report the long-term results of intrastromal corneal ring segments (ICRS) for postoperative LASIK ectasia. Method: In this retrospective interventional cases series, 8 eyes of 6 patients who underwent femtosecond laser-assisted ICRS implantation for post-LASIK ectasia were enrolled. Main outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent refraction, and average keratometry (K-avg) values were assessed. Results: Mean +/- SD follow-up was 67 +/- 21 months (range, 36-96 months). The mean UDVA, CDVA, spherical equivalent refraction, and K-avg values were significantly improved at all postoperative visits when compared to baseline values. No serious complications were observed during follow-up. Conclusion: Our long-term findings showed that ICRS yielded improvements in visual acuity, refractive status, and keratometric values without any progression in cases with post-LASIK corneal ectasia. (C) 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Same-Day Intrastromal Corneal Ring Segment and Collagen Cross-Linking for Ectasia After Laser in Situ Keratomileusis: Long-Term Results
(Elsevier Science inc, 2014) Yildirim, Aydin; Uslu, Hasim; Kara, Necip; Cakir, Hanefi; Curler, Bulent; Colak, Hatice Nur; Ozgurhan, Engin Bilge
PURPOSE: To report the long-term results of combined same-day intrastromal corneal ring segment placement and corneal collagen cross-linking (CXL) for postoperative laser in situ keratomileusis (LASIK) ectasia. DESIGN: Retrospective, interventional case series. METHOD: This retrospective, interventional cases series was performed in Turkiye Hospital Eye Clinic and the Department of Ophthalmology, Fatih University Medical Faculty Hospital, Istanbul, Turkey. Sixteen eyes of 14 patients with postoperative ectasia after LASIK were enrolled. All consecutive patients were treated with femtosecond laser-assisted intrastromal corneal ring segment implantation and followed by same-day corneal collagen cross-linking for ectasia occurring after LASIK. Main outcome measures included uncorrected distance visual acuity, corrected distance visual acuity, spherical and cylindrical refraction, and simulated keratometry values. RESULTS: The mean age +/- standard deviation of the 10 women and 4 men was 33.0 +/- 6.5 years (range, 23 to 44 years), and the mean follow-up was 43 months (range, 36 to 62 months). The uncorrected distance visual acuity improved significantly from 1.18 +/- 0.42 logarithm of the minimal angle of resolution (logMAR) units to 0.44 +/- 0.22 logMAR (P < .001), and the corrected distance visual acuity improved significantly from 0.46 +/- 0.26 logMAR to 0.21 +/- 0.14 logMAR (P < .001). The mean spherical and cylindrical refraction decreased significantly (P < .001 for both). The maximum keratometry value decreased from baseline by 49.3 +/- 4.9 diopters (D) to 43.9 +/- 2.8 D at the last visit, and the minimum keratometry value decreased from 44.3 +/- 4.7 D to 41.5 +/- 3.5 D (P < .001 for both). No serious complications were shown during follow-up. CONCLUSIONS: Implantation of intrastromal corneal ring segment implantation combined with same-day corneal collagen cross-linking was a safe and effective treatment for ectasia occurring after LASIK. It also significantly improved the visual acuity, refraction, and keratometry values. (C) 2014 by Elsevier Inc. All rights reserved.