Browsing by Author "Cinal, A"

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Age-Related Differences in Normal Corneal Topography
(Slack inc, 2004) Topuz, H; Ozdemir, M; Cinal, A; Gumusalan, Y
BACKGROUND AND OBJECTIVE: The aim of this study was to compare age-related differences in the corneal topography of a normal population using a computerized corneal topography system. PATIENTS AND METHODS: The randomized comparative study included 240 eyes of 120 subjects with normal corneas. Subjects were divided into six age groups: 5 to 10 years (group 1), 11 to 20 years (group 2), 21 to 30 years (group 3), 31 to 40 years (group 4), 41 to 50 years (group 5), and 51 years or older (group 6). Average corneal power and corneal astigmatism were examined. An average corneal topography map was constructed and the astigmatism pattern was determined in each age group. RESULTS: Average corneal power values were 41.64 +/- 0.85 diopters (D), 42.35 +/- 0.90 D, 42.63 +/- 0.99 D, 42.94 +/- 0.93 D, 43.38 +/- 0.77 D, and 43.53 +/- 0.88 D in groups 1 to 6, respectively (P <.001). Mean astigmatism values were similar in all age groups (P = .225). Younger subjects had with-the-rule astigmatism, but older subjects showed a shift to oblique or against-the-rule astigmatism. The averaged maps of groups 1 to 3 showed a vertical bow-tie pattern, but the central steep area gradually extended horizontally and it became a round configuration in groups 4 to 6. CONCLUSION: This study suggests that the normal cornea becomes steeper in the horizontal line and superior vertical quadrant and shifts from with-the-rule to against-the-rule astigmatism, but the amount of physiological corneal astigmatism does not change with age.
Chiasmatic Glioblastoma of Childhood - a Case Report
(Munksgaard int Publ Ltd, 2000) Cirak, B; Unal, O; Arslan, H; Cinal, A
A 6-year-old girl presented with visual deterioration that had progressively worsened over 2 months. MR imaging revealed a sellar, para- and suprasellar lesion. Subtotal tumor resection was performed. Histopathological diagnosis was glioblastoma of the optic chiasma. Chiasmatic glioblastoma is rare in adults and extremely uncommon in children. Surgical resection implies a risk of severe endocrinologic and opthalmologic complications.
Comparison of Argon Laser Photocoagulation Induced Cutaneous Inflammation and Skin Pathergy Test in Behcet's Disease
(B M J Publishing Group, 2003) Sayarlioglu, M; Calka, O; Cinal, A; Sayarlioglu, H; Akdeniz, N; Topcu, N; Gul, A
Early and Late Effects of Pterygium Surgery on Corneal Topography
(Slack inc, 2005) Ozdemir, M; Cinal, A
Square Backround and Objective: The aim of this study was to compare the corneal topographic changes at the early and late postoperative period after pterygium surgery. square PATIENTS AND METHODS: Sixteen eyes of 15 patients with primary pterygium were included in the study. All of the pterygia were excised primarily. Computerized corneal topography measurements were taken before surgery and at the second week (postoperative early period) and third month (postoperative late period) after the operation. Keratometric astigmatism, total mean corneal refractive power, and flattened or steepened areas of the cornea were detected at each visit. The topographical changes were evaluated using the analysis of variance. Multiple comparison analyses were made with the Tukey HSD test. square RESULTS: Keratometric astigmatism was 2.58 +/- 2.33 diopters (D) at the preoperative period, 1.30 +/- 1.24 D at the postoperative early period, and 0.61 0.38 D at the postoperative late period (P < .001). The surgically induced corneal astigmatism was 3.23 +/- 2.33 D (range, 0.52 to 8.32 D) at the postoperative early period and 2.70 +/- 2.24 D (range, 0.47 to 7.72 D) at the postoperative late period (P = .287). Astigmatism was 81.25% with-the-rule at the preoperative period, 43.75% oblique and 37.50% against-the-rule at the postoperative early period, and 62.50% with-the-rule at the postoperative late period. Total mean corneal refractive power was 42.51 +/- 1.99 D at the preoperative period, 43.95 +/- 1.58 D at the postoperative early period, and 43.89 +/- 1.80 D at the postoperative late period (P = .014). square CONCLUSION: Corneal topographic changes induced by pterygium greatly improve at the postoperative early period. However, normal corneal topography patterns are formed at the postoperative late period.
The Effect of 0.25% Apraclonidine in Preventing Intraocular Pressure Elevation After Nd:yag Laser Posterior Capsulotomy
(Wichtig Editore, 1998) Simsek, S; Ertürk, H; Demirok, A; Cinal, A; Yasar, T; Karadenizli, G
Purpose. The efficacy and adverse effects of 0.25% apraclonidine on intraocular pressure (IOP) after Nd: YAG laser posterior capsulotomy were investigated, and the results were compared with placebo, 0.50% timolol maleate and 1% apraclonidine. Methods. Eighty eyes were randomly assigned to four groups of 20 eyes. In a double-masked design, the groups were treated with placebo (group I), 0.50% timolol maleate (group 2), 1% apraclonidine (group 3), 0.25% apraclonidine (group 4) one hour before and five minutes after Nd:YAG laser posterior capsulotomy. IOP was measured by applanation tonometry I hour before (baseline IOP) and 1, 3, 24 hours after capsulotomy. Results. The average baseline IOP increased respectively 3.90 +/- 5.35, 5.95 +/- 5.32, 1.15 +/- 3.20 mmHg in the first group 1, 3 and 24 hours post-treatment. There were significant differences between baseline IOP and 1 and 3 hours but not at 24 hours (p=0.004, p=0.001, p=0.13). IOP increased 0.40 +/- 4.08, 0.75 +/- 5.33, 0.80 +/- 6.03 mmHg in the second group at the same times. The differences between the average baseline IOP and the 1, 3 and 24 h measurement were not significant (p=0.83, p=0.65, p=0.93). In the third group, IOP decreased 3.70 +/- 2.40, 3.30 +/- 2.47, 2.65 +/- 1.56 mmHg at the measurement times, with significant differences between the average baseline IOP and the 1, 3 and 24 hour measurements (p=0.001, p=0.0001, p=0.01). In the fourth group IOP increased 0.35 +/- 3.32 mmHg at 1 hour, but decreased 1.25 +/- 3.41, 0.90 +/- 2. 07 mmHg at 3 and 24 hours. The differences were not significant (p = 0.94, p = 0.16, p = 0.08). When the 0.25% and 1% apraclonidine groups were compared, there were significant differences between the average IOP at 1 hour in both groups but not at 3 and 24 hours (p=0.01, p = 0.17, p = 0.21). Similarly, there were no significant differences between the average IOP at the same times when the 0.25% apraclonidine group was compared with the timolol group (p = 0.30, p = 0.08, p = 0.16). Some systemic and local side effects were seen in the timolol and 1% apraclonidine groups, but none with 0.25% apraclonidine. Conclusions. It was concluded that 0.25% apraclonidine is effective in preventing the early elevation of IOP after Nd:YAG laser posterior capsulotomy and may offer an alternative to 0.50% timolol maleate and 1% apraclonidine.
The Effect of Altitude on Radial Keratotomy
(Elsevier Science inc, 1998) Simsek, S; Demirok, A; Cinal, A; Yasar, T; Yilmaz, OF
The authors analyzed refractive results of patients who underwent radial keratotomy (RK) at sea level and high altitude and evaluated the effects of the altitude. A total of 102 eyes undergoing RK procedures performed in two clinical centers having different altitude were analyzed. The results compared between subjects who had undergone RK at sea level (Istanbul/Turkey) and at an altitude of 5750 feet (Van/Turkey) were compared. Subjects were 19-42 years old with myopia from -4.00 to -12.00 diopters (D). The average preoperative spherical equivalent cycloplegic refractions (SECR) were -8.01 +/- 1.86 D and -6.99 +/- 2.15 D in the istanbul and Van groups, respectively. These were divided into subgroups according to myopia degree and number of incisions and optic zone size. The RK procedures were performed by the same surgeon with diamond blade in standard Russian style. The average changes in SECR were 5.09 +/- 1.29 D and 6.50 +/- 2.24 D in subjects who had undergone RK at sea level and at 5750 feet, respectively. There was a significant difference between the subgroups (P < 0.0002). This difference was especially higher in the high myopia subgroups. Additionally, we obtained a partial relation between increase of RK incision number and SECR change at high altitude but not at sea level. No notable regression and progression were seen in the 3 months of follow up at high altitude. These results support hy potheses suggesting both corneal hypoxic expansion in the area of RK incisions, which may lead to central corneal flattening, and barometric pressure directly altering corneal shape, which is responsible for the hyperopic shift induced by altitude. Ophthalmologists performing RK surgery at high altitude had better consider redesigning their RK nomograms in light of these findings. However, when the nomogram used at sea level was used at high altitude, the subjects became hyperopic. (C) 1998 Japanese Ophthalmological Society.
Effect of Infliximab on Refractory Uveitis in Behcet's Disease
(Harvey Whitney Books Co, 2004) Sayarlioglu, M; Cinal, A; Topcu, N; Demirok, A
The Effect of Pterygium Surgery on Corneal Topography
(Slack inc, 2001) Cinal, A; Yasar, T; Demirok, A; Topuz, H
OBJECTIVE: The aim of this prospective randomized clinical study was to evaluate the effect of pterygium surgery on the corneal topography using a computerized corneal topography system. PATIENTS AND METHODS: Computerized corneal topography was performed on 27 patients with primary pterygium before and after pterygium excision surgery. The topographical changes that occurred following surgery were evaluated using paired and unpaired two-tailed t-test and Pearson coefficient of correlation analyses. Simulated keratometric astigmatism at the central 3 mm and the total mean refractive powers of the whole cornea were measured before and after surgery. Following surgery, fattened or steepened corneal areas were determined. RESULTS: Simulated keratometric astigmatism at 3 mm was found to be 2.30 +/- 2.08 D (0.2 - 7.63) preoperatively and 0.82 +/- 0.74 D (0.06 - 2.79) postoperatively. The difference between these two values was statistically significant (t = -3.46, P = 0.002). Total mean refractive power of the whole cornea was found to be 42.26 +/- 0.63 (40.80 - 43.64) preoperatively and 43.69 +/- 0.88 (41.50 - 44.90) postoperatively and the difference was 1.42 +/- 0.87. There was a statistically significant high difference (t = 28.36, P < 0.001). When preoperative and postoperative corneal topographies were compared, the whole cornea was found steeper at the postoperative period except a little region in the superior nasal quadrant. CONCLUSION: We believe that corneal topographical changes caused by the pterygium are almost reversible after surgical treatment, and postoperatively the cornea becomes steeper.
Effect of Superior and Temporal Clear Corneal Incisions on Astigmatism After Sutureless Phacoemulsification
(Elsevier Science inc, 1998) Simsek, S; Yasar, T; Demirok, A; Cinal, A; Yilmaz, OF
Purpose: To evaluate the effect of superior and temporal clear corneal incisions on astigmatism after sutureless, small incision phacoemulsification. Setting: World Eye Hospital, Istanbul, Turkey. Methods: This prospective study evaluated 40 eyes of 20 patients with cataract having bilateral, sutureless, small incision phacoemulsification by the same surgeon. A superior clear corneal incision was used in all right eyes and a temporal clear corneal incision in ail left eyes. Mean preoperative astigmatism was 0.63 diopter(D) +/- 0.21 (SD) and 0.65 +/- 0.20 D, respectively. Mean patient age was 66.45 years. Patients were examined preoperatively and 1 day, 1 week and 1 and 3 months postoperatively. Results: Three months postoperatively, mean astigmatism was 1.60 +/- 0.37 D in the superior incision group and 0.83 +/- 0.19 D in the temporal incision group. Induced astigmatism calculated by vector analysis was 1.44 +/- 0.31 D and 0.62 +/- 0.28 D, respectively. The temporal incision group had significantly lower astigmatism at all follow-ups (P = .000). Conclusion: Upper lid pressure on the superior corneal incisions led to fluctuating, against-the-rule astigmatism that was significantly higher than that induced by temporal incisions.
Effects of Fibrovascular Traction and Pooling of Tears on Corneal Topographic Changes Induced by Pterygium
(Nature Publishing Group, 2003) Yasar, T; Ozdemir, M; Cinal, A; Demirok, A; Ilhan, B; Durmus, AC
Aim To investigate the effects of fibrovascular traction and the pooling of tears at the pterygium apex on the corneal topographic changes induced by pterygium. Methods A total of 16 eyes of 14 cases with primary pterygium were included in the study. A computerized corneal topography system was used for corneal topography examinations. Baseline keratographs were taken two times at straight gaze. A repeat corneoscope photograph was immediately obtained in temporal gaze. Then the tears at the pterygium apex were dried with a cellulose sponge, and a new corneoscope photograph was immediately obtained without allowing one to blink. Corneal topographic maps ( numeric maps) were divided into 301 fields in 24 meridians. One colour was allocated to each field, representing its mean refractive power for all groups. In all eyes, keratometric astigmatism at the 3 mm central cornea and total mean corneal refractive power were found. Data were compared using paired-samples two-tailed t-tests. Results Keratometric astigmatism at the 3 mm central cornea was significantly reduced at the temporal gaze (3.10 +/- 2.34 D, t = 3.40, P = 0.027) and dried eyes (2.12 +/- 1.01 D, t = 4.74, P = 0.001) according to the first baseline measurement (4.31 +/- 1.91 D) of the total mean corneal refractive power was found to be 43.45 +/- 1.28 D (39.29-45.87) at the first baseline measurement. There was no change at the temporal gaze (43.54 +/- 1.06 D, P>0.05). However, the total corneal refractive power was significantly higher in dried eyes (44.26 +/- 0.93 D, t = 34.92, P<0.001). The steepest region of corneal topography was a superior quadrant, and the flattest area was a nasal quadrant at the baseline. At the temporal gaze, the cornea was significantly flatter in the superior and inferior sides of the pterygium meridian. After dried pooling of tears, topographic abnormalities returned, and the cornea became more uniform and symmetric. Conclusion We conclude that the pooling of tears at the pterygium apex plays an important role, but fibrovascular traction has no effect on the corneal topographical changes induced by pterygium.
A Newbom With Lipemia Retinalis
(Slack inc, 2003) Ozdemir, M; Bay, A; Yasar, T; Cinal, A
Lipemia retinalis is a rare ocular manifestation of certain types of hyperlipidemia. A case of a newborn with lipemia retinalis evaluated by laboratory and clinical findings is described. A creamy white appearance of all retinal blood vessels was demonstrated by color fundus photographs. The patient had elevated levels of triglycerides (29,000 mg/dL) and cholesterol (1,470 mg/dL). Lipid electrophoresis indicated hyperprebetalipoproteinemia. Type IV primary hyperlipoproteinemia was diagnosed.
Peribulbar Anesthesia: One Versus Two Injections
(Slack inc, 1997) Demirok, A; Simsek, S; Cinal, A; Yasar, T
BACKGROUND AND OBJECTIVE: The authors describe their prospective, randomized study of a single peribulbar injection into the junction of the lateral third and medial two thirds of the lower lid compared with the standard two-injection peribulbar technique. PATIENTS AND METHODS: One hundred twenty patients undergoing elective intraocular surgery were randomly allocated to receive either one or two injections of a mixture of balanced salt solution, 2% lidocaine, 0.5% bupivacaine, and hyaluronidase. Preoperative akinesia was assessed following the injections. At the end of surgery, the patients were asked if they had experienced any pain or discomfort during surgery. RESULTS: There was no significant difference in pain or globe akinesia between the two groups. CONCLUSION: The single peribulbar injection was found to be as effective as the standard two-injection peribulbar technique.