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Öğe Autologous serum effect on corneal endothelial damage in the phacoemulsification rabbit model(Derman Medical Publ, 2017) Usta, Gülşah; Oğurel, Reyhan; Onaran, Zafer; Pekcan, Zeynep; Oğurel, Tevfik; Karsli, Birkan; Gökçinar, Nesrin BüyüktortopAim: This study used specular microscopy to evaluate the possible effects of applying autologous serum to the anterior chamber on the corneal endothelial damage created by the ultrasonic vibrations of phacoemulsification (PHACO) in rabbits. Material and Method: The study, which was approved by the Ethics Committee, involved both eyes of nine 5 month-old (about 3 kg) New Zealand genus albino male rabbits. Group 1(6 eyes) received only an application of 0.2 ml autologous serum; Group 2 (6 eyes) received only the ultrasonic vibrations for 20 seconds: and Group 3 (6 eyes) received 0.2 ml autologous serum followed by ultrasonic vibrations for 20 seconds. Measurements were made before the intervention and at the 1st and 7th days postoperatively using specular microscopy, intraocular pressure, and pachymetry metrics, and the data were compared statistically. Results: Postoperative 1st week, the cornea thickness increased from 385 mu to 445 mu in Group 2 (PHACO only) and from 398 mu to 402 mu in Group 2 (PHACO plus autologous serum). However, this difference was not statistically significant. Postoperative 1st day standard deviation (p < 0.05) and variation coefficient (p < 0.05) values of the specular microscopy parameters for Groups 2 and 3 were higher than for Group 1. Postoperative 1st week it was observed that the parameters of the three groups were similar and had returned to the preoperational values. Between the endothelial cell numbers, the cell density, the cell space average, the largest and the smallest percentage of the cell and the hexagonal cell area values, there were no statistically significant differences at the three measurement time points. Discussion: This study showed that, after the phacoemulsification process, autologous serum applied to the anterior chamber can, by positive possible effects on endothelial pump functions, reduce corneal edema without morphological changes, which can be confirmed with specular microscopyÖğe Glokomu olmayan hipertansif bireylerde dipper ve non-dipper kan basıncı paterninin retina sinir lifi kalınlığı üzerine etkisi(2014) Onaran, Zafer; Oğurel, Reyhan; Ebinç, Haksun; Usta, Gülşah; Şahin, Ömer; Örnek, KemalAmaç: Yirmi dört saat ayaktan kan basıncı izlemi sonucu kan basıncı seyri dipper ve non-dipper olarak saptanan hipertansif hasta- larda retina sinir lifi tabakası (RSLT) kalınlığının ölçülmesi ve farklı kan basıncı paternlerinin RSLT üzerine etkisinin araştırılması. Gereç ve Yöntem: Çalışmaya hipertansiyon tanısı almış 25 hasta ile 22 sağlıklı birey dahil edildi. Hipertansif hastalar 24 saatlik ayaktan kan basıncı ölçümü yapılarak 2 gruba ayrıldı. Arteriyel kan basınçlarının gece ortalaması gündüz ortalamasından %10 ve daha fazla düşük olanlar dipper hipertansiyon grubu (n13), düşüş olmayanlar ise non-dipper hipertansiyon grubu (n12) olarak belirlendi. Takiben çalışmaya katılan tüm bireylerin RSLT kalınlığı NFAII-GDx cihazı ile ölçüldü. Bulgular: Dipper ve non-dipper gruplarında gündüz ve gece ölçülen ortalama kan basıncı değerlerinin kontrol grubundan anlamlı derecede yüksek olduğu tespit edildi (p0.05). RSLT kalınlığının değerlendirilmesinde kullanılan GDx parametrelerinden TSNIT, superior average ve inferior average değerlerinin non-dipper grubunda hem kontrol grubundan hem de dipper grubundan daha düşük olduğu görüldü. En belirgin ve istatistiksel olarak anlamlı olan farkın da kontrol grubu ile non-dipper grubu arasındaki inferior average değerinde olduğu gözlendi (67.03 ?9.15 ve 59.31?6.38, p0.01). Sonuç: Gece boyunca çoğu kişide gözlenen kan basıncı düşüşünün olmadığı (non-dipper) hipertansif kişilerde hedef son organ hasarı- nın daha ciddi boyutlarda olduğu gösterilmiştir. Çalışmanın sonucunda saptanmış olan non-dipper paternde hipertansiyonun RSLT’da oluşturduğu incelme nedeniyle glokomatöz hasar için ek bir risk faktörü olarak geniş kapsamlı çalışmalarda incelenmesi faydalı olabilir.Öğe Hyaluronic Acid Viscoelastic Medium as an Aid for Microsurgical Venous Anastomoses(Lippincott Williams & Wilkins, 2013) Yazici, İlker; Usta, Gülşah; Boybeyi, Özlem; Onaran, Zafer; Fariz, SevinThe thin-walled structure of veins leads them to stay collapsed during anastomoses, thereby the incidence of technical failures is more common than arterial anastomoses. In order to overcome this problem, we are introducing the use of viscoelastic material based on our experience on rats. Six rats were used in order to study the technical feasibility of the viscoelastic material during microsurgical vein anastomosis. End-to-end anastomoses were performed on rat jugular veins using 0.5-1 mL of the viscoelastic medium applied to the ends of the veins and surgical field under X30 operating microscope magnification. Then 1.8% (n:3) and 3.0% (n:3) hyaluronic acid was used as a viscous medium in order to keep the vein lumens open during anastomosis. In conclusion, we have found that 3.0% hyaluronic acid viscoelastic medium facilitates microvenous anastomosis in rat. Studies involving human practice are needed for further evaluation of this technical refinement.Öğe Intralesional trypan blue-colored viscoelastic injection for the surgical management of dacryops(2013) Usta, Gülşah; Onaran, Zafer; O?urel, Reyhan; Örnek, KemalDuring the surgical excision of dacryops which is a simple cyst of the lacrimal gland, a perforation of the thin wall of the cyst may lead to collapse of the lesion and complicate the surgery. Here we describe trypan blue-colored methylcellulose injection in the surgery of dacryops performed in a 53-year-old female patient to overcome this problem. In this way, since the application of the injection reduces the risk of complications and facilitates the surgical procedure, it could be considered as a useful modification of dacryops surgery. © Galenos Yayinevi.Öğe Topical ophthalmic cyclosporine in the treatment of toxic epidermal necrolysis(Hindawi Limited, 2011) Onaran, Zafer; Usta, Gülşah; Koçak, Mukadder; Örnek, Kemal; Büyükkoçak, ÜnaseAim. To describe a case of toxic epidermal necrolysis (TEN) with ocular involvement treated with topical ophthalmic cyclosporine. Case Presentation. A 20-year-old woman developed TEN following administration of carbamazepine that was prescribed for epilepsy. Ophthalmic examination revealed bilateral pseudomembranous conjunctivitis. She was hospitalized in the intensive care unit and treated with intravenous corticosteroid and immunoglobulin. Topical cyclosporine was used in combination with topical corticosteroids for ocular surface disease. Following two months of ocular treatment, she recovered without any severe ocular complication. Ocular examination at the four-month followup showed a 2mm of symblepharon in the lower fornix as the sole pathologic finding. Conclusion. Topical ophthalmic cyclosporine may contribute to decrease the ophthalmic complications of TEN and should be considered in the acute stage of the disease. © 2011 Zafer Onaran et al.
