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    5-fluorouracil as chemoadjuvant for primary pterygium surgery: Preliminary report
    (Lippincott Williams & Wilkins, 2003) Akarsu, C; Taner, P; Ergin, A
    Purpose. To investigate the safety and efficacy of intraoperative application of 5-fluorouracil as an adjuvant in primary pterygium surgery and to evaluate the effect of postoperative subconjunctival 5-fluorouracil injections on the recurrent pterygium. Methods. Of 25 consecutive white patients, 28 eyes with primary pterygium underwent pterygium excision with intraoperative application of 5-fluorouracil (25 mg/mL for 3 minutes). The superior and inferior conjunctiva was approximated to cover the scleral bed within I mm of the limbus. Recurrence of pterygium was defined as postoperative fibrovascular growth more than 1 mm onto the cornea. Eyes with recurrence less than 2 mm were treated with subconjunctival 5-fluorouracil injections. Results. After a mean follow-up of 14.1 +/- 3.9 months (mean +/- standard deviation), 7 recurrences (25%) were observed. All recurrences were detected within 12 months. In 4 of 7 recurrences, the fibrovascular growths were less than 2 mm. We, therefore, performed subconjunctival 5-fluorouracil injections. In 3 (75%) of 4 recurrences, the fibrovascular growths became atrophic. No serious complications were observed during and after the surgery. However, superficial punctate keratitis,:Pain, and hyperemia were detected in all patients in the early postoperative period. As a result, of 28 eyes, 4 (14%) had unacceptable cosmetic results and growing recurrences. Conclusions. This study suggests that intraoperative applications of 5-fluorouracil is both efficient and safe in the treatment of primary pterygium. Additionally, postoperative subconjunctival 5-fluorouracil injections may prevent the progression of fibrovascular tissue.
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    The effects of cyclopentolate on intraocular pressure and retrobulbar hemodynamics in patients with pseudoexfoliation syndrome and pseudoexfoliation glaucoma
    (Wichtig Editore, 2004) Taner, P; Unal, B; Demirbas, E; Ergin, A
    PURPOSE. To evaluate the changes of intraocular pressure (IOP) and retrobulbar hemodynamics after cyclopentolate administration in patients with pseudoexfoliation syndrome and pseudoexfoliation glaucoma. METHODS. Eighteen patients with pseudoexfoliation syndrome and 18 patients with pseudoexfoliation glaucoma were enrolled in the study. After baseline measurements of IOP, the peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistivity index (RI) of the ophthalmic, central retinal, and posterior ciliary arteries were investigated by color Doppler imaging. Then, 1% cyclopentolate was instilled in one eye of each subject. After 45 minutes of instillation of the cyclopentolate, the measurements of IOP and retrobulbar blood flow velocities were repeated. The results were compared with those of 20 age-matched normal subjects. RESULTS. Neither IOP nor retrobulbar blood flow velocities changed significantly in control subjects after cyclopentolate administration. IOP increased significantly after cyclopentolate instillation in pseudo exfoliation syndrome (p=0.004). Retrobulbar blood velocities did not change significantly after the cyclopentolate in this group. In pseudoexfoliation glaucoma group, it was observed that basal mean IOP showed a statistically significant increase after cyclopentolate drop (p=0.002). Although blood flow velocities of ophthalmic artery did not change significantly, PSV and EDV of the central retinal and posterior ciliary arteries decreased significantly (p<0.05) and RI of the posterior ciliary artery increased significantly (p=0.01) after cyclopentolate instillation. CONCLUSIONS. On the basis of our findings, pseudoexfoliation appears to be a predictive factor for an IOP rise after cyclopentolate. In pseudoexfoliation glaucoma patients, an increase of IOP after cyclopentolate could lead to a decreased retrobulbar blood flow. IOP must be rechecked after cyclopentolate administration in these patients to avoid further damage to the ganglion cells.
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    The effects of hormone replacement therapy on ocular surface and tear function tests in postmenopausal women
    (Karger, 2004) Taner, P; Akarsu, C; Atasoy, P; Bayram, M; Ergin, A
    Purpose: To prospectively investigate the impact of various hormone replacement therapies (HRT) on ocular surface and tear function tests. Methods: A total of 70 women in the postmenopausal period were enrolled in the study. The groups consisted of 16 women who were not on HRT ( group 1), 29 women who were on HRT with tibolone ( group 2) and 25 women who received estradiol plus medroxyprogesterone acetate treatment ( group 3). All patients underwent tear film break-up time (TF-BUT), Schirmer's test and conjunctiva cytology at the time of enrollment and at 6 months' follow-up. Results: Patients in group 2 showed improved Schirmer's test and TFBUT results (p < 0.001); however, no significant changes occurred in group 1 and group 3 patients (p > 0.05). Conjunctival cytology scores did not differ at the time of enrollment and at 6 months' follow-up in all groups. Conclusions: This is the first comparative clinical study on the effects of tibolone and estradiol plus medroxyprogesterone acetate on ocular surface and tear function tests. HRT with tibolone seems to improve tear function tests in postmenopausal women. Copyright (C) 2004 S. Karger AG, Basel.
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    Frontalis sling operation with deep temporal fascial graft in blepharoptosis repair
    (Lippincott Williams & Wilkins, 2002) Tellioglu, AT; Saray, A; Ergin, A
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    Short-term effect of latanoprost on ocular circulation in ocular hypertension
    (Blackwell Publishing Asia, 2004) Akarsu, C; Bilgili, YK; Taner, P; Unal, B; Ergin, A
    Purpose: To determine the short-term effects of latanoprost on retrobulbar circulation in ocular hypertension. Methods: Forty-six eyes of 23 consecutive bilateral ocular hypertensive patients with an intraocular pressure (IOP) of greater than 22 mmHg were evaluated in a prospective controlled study. All subjects received a single drop of latanoprost 0.005% in one eye and placebo in the fellow control eye. Systemic circulatory parameters, intraocular pressure, blood flow velocities, and resistance indices of the ophthalmic, short posterior ciliary and central retinal arteries were measured using colour Doppler imaging at baseline and 2 h and 8 h after dosing, Results: Latanoprost lowered IOP significantly after 2 h and 8 h (P < 0.01). The mean IOP reduction was 6.7 mmHg 8 h after dosing. At baseline, there were no statistically significant differences in any retrobulbar vessels of eyes that received a single drop of latanoprost when compared with the eyes that received placebo (P > 0.05). Comparisons with baseline and latanoprost conditions revealed that latanoprost did not alter the blood flow velocities and resistance indices in the ophthalmic (P > 0.05), posterior ciliary (P > 0.05) and central retinal (P > 0.05) arteries 2 h and 8 h after dosing. The systolic and diastolic blood pressures (P = 0.74, P = 0.29, respectively) and pulse rate (P = 0.68) remained unchanged over the 8-h period. Conclusions: This study found that a single drop of latanoprost significantly reduces intraocular pressure 8 h after dosing. However, it does not have any short-term effects on the retrobulbar haemodynamics in ocular hypertensive eyes.