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Abstract
Objectives To evaluate the demographic data, ocular and systemic findings, clinical management, and outcomes of patients with ocular cicatricial pemphigoid (OCP). Materials and Methods The medical records of 11 patients diagnosed as having OCP in the ophthalmology department of Ege University between 2008 and 2021 were evaluated retrospectively. Results The patients' mean follow-up time was 14±5.76 months. All eyes (100%) had conjunctival involvement and 18 (81.81%) had corneal involvement. According to the Tauber staging system, 7 (31.81%), 8 (36.36%), and 7 (31.81%) of the eyes were stage 2, 3, and 4, respectively. The diagnosis was confirmed in 6 (66.66%) of 9 patients who underwent biopsy. Amniotic membrane transplantation was performed in 7 eyes, entropion surgery in 2 eyes, and electrocauterization for trichiasis in 5 eyes. Systemic involvement was observed in 45.45% (5/11) of patients, most commonly oral mucosal involvement (18.18%). Review of medical records showed that alkylating agents, steroids, and dapsone were used in patients treated before 2020. Mycophenolate mofetil was preferred to be used in combination with corticosteroids. Although treatment responses before mycophenolate mofetil usage could not be evaluated well because of loss to follow-up, 4 (66.66%) of 6 patients who received steroid treatment combined with mycophenolate mofetil showed partial or complete clinical remission. No serious side effects and drug withdrawal were observed. Conclusion OCP is a sight-threatening autoimmune disease that affects older adults. Although positive biopsy results are valuable for diagnosis, negative results do not exclude the diagnosis. The main treatment is systemic immunosuppressives. Disease activity can be suppressed, especially with early initiation of drug therapy. These patients require a multidisciplinary approach. Especially in the presence of isolated ocular findings, ophthalmologists should be able to make the decision to start immunosuppressive treatment, and systemic treatment should not be delayed.
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Affiliation(s)
| | - İlayda Korkmaz
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Türkiye
| | - Melis Palamar
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Türkiye
| | - Banu Yaman
- Ege University Faculty of Medicine, Department of Pathology, İzmir, Türkiye
| | - Sait Eğrilmez
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Türkiye
| | - Ayşe Yağcı
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Türkiye
| | - Taner Akalın
- Ege University Faculty of Medicine, Department of Pathology, İzmir, Türkiye
| | - Özlem Barut Selver
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Türkiye
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2
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Abstract
Objectives: To evaluate and compare the risk factors, presenting features, and outcomes of patients with culture-positive and culturenegative microbial keratitis (MK) who presented to a tertiary referral center. Materials and Methods: We conducted a retrospective review of the medical records of 314 patients who were diagnosed with MK in our clinic between 2012 and 2019. Results: Among 314 patients, 142 had positive cultures (45.2%). The mean ages of the culture-positive and -negative patients at the time of diagnosis were 51.39±21.31 (range, 14-90) years and 56.68±21.34 (7-94) years, respectively (p=0.028). The mean best corrected visual acuity (BCVA) of the culture-positive and -negative patients were1.74±1.25 (0-3.1) LogMAR and 1.91±1.23 (0-3.1) LogMAR prior to treatment and increased to 1.21±1.30 (0-3.1) LogMAR and 1.27± 1.29 (0-3.1) LogMAR at last visit, respectively. There was no statistically significant difference between culture-positive and -negative patients’ BCVA levels at presentation or last visit. Ninety-two patients (64.7%) were infected with bacteria and 50 patients (35.2%) with fungi. The most common pathogen was Pseudomonas aeruginosa (18.3%), followed by Streptococcus pneumoniae (11.2%) and Fusarium spp. (11.2%). Keratitis foci were either centrally or paracentrally located in 105 eyes (73.9%) of culture-positive patients and 149 eyes (86.6%) of culture-negative patients. Multiple foci were present mostly in culture-positive patients (p=0.001). There was no significant difference between the culture-positive and -negative groups in terms of hypopyon presence (p=0.364). The proportion of contact lens (CL) wearers was 33% (n=47) among culturepositive MK patients and 13.3% (n=23) among culture-negative MK patients, respectively (p<0.001). Culture positivity was found to be significantly higher in keratitis associated with CL use (p=0.0001). Conclusion: Microbiological analysis and culture evaluation are important steps in order to manage proper treatment in microbial keratitis. Prognosis mostly depends on the infectivity of the microbiological agent.
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Affiliation(s)
- Semir Yarımada
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Özlem Barut Selver
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Melis Palamar
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Sait Eğrilmez
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | | | | | - Ayşe Yağcı
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
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Kocaçal E, Eşer İ, Eğrilmez S. Effect of polyethylene cover on the treatment of exposure keratopathy in ICU. Nurs Crit Care 2020; 26:282-287. [PMID: 32830416 DOI: 10.1111/nicc.12542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Exposure keratopathy may lead to serious complications such as microbial keratitis, corneal perforation, and visual impairment if not treated. AIM To compare the effect of carbomer eye drops when used alone and in combination with polyethylene covers in the healing of exposure keratopathy. METHODS A single blind randomized-controlled trial (RCT) in two intensive care units (ICUs) was carried out in a university hospital in Western Turkey between September 2011 and December 2012. The control group received only carbomer, eye drops while the intervention group received both carbomer eye drops and polyethylene covers. The primary outcome was the decrease or absence of corneal damage, which refers to healing. Corneal damage was followed up with a fluorescein dye test (decrease/absence of the corneal staining) by the same ophthalmologist for 10 days. RESULTS A total of 43 corneas in 24 patients were studied. Corneal epithelial defects decreased in the intervention group by day 2 and progressed or remained unchanged in the control group every day (P = .001). Patient characteristics did not affect the grade ranges of corneal staining in the groups except for level of consciousness. CONCLUSION Carbomer eye drops, when used in combination with polyethylene covers, were effective in managing exposure keratopathy. RELEVANCE TO CLINICAL PRACTICE Corneal damage and further ocular complications can be reduced with the utilization of polyethylene covers in nursing care and treatment.
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Affiliation(s)
- Elem Kocaçal
- Department of Fundamentals of Nursing, İzmir Demokrasi University, Faculty of Health Sciences, İzmir, Turkey
| | - İsmet Eşer
- Department of Fundamentals of Nursing, Ege University Faculty of Nursing, İzmir, Turkey
| | - Sait Eğrilmez
- Department of Ophthalmology, Ege University Medical Hospital, İzmir, Turkey
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Bozkurt B, Eğrilmez S, Şengör T, Yıldırım Ö, İrkeç M. Response to Letter to the Editor. Turk J Ophthalmol 2020; 50:198-199. [PMID: 32631036 PMCID: PMC7338741 DOI: 10.4274/tjo.galenos.2020.37729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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5
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Affiliation(s)
- Banu Bozkurt
- Selçuk University Faculty of Medicine, Department of Ophthalmology, Konya, Turkey
| | - Sait Eğrilmez
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey (E)
| | - Tomris Şengör
- İstanbul Bilim University Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey (E)
| | - Özlem Yıldırım
- Mersin University Faculty of Medicine, Department of Ophthalmology, Mersin, Turkey
| | - Murat İrkeç
- Hacettepe University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey (E)
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Abstract
Objectives: To compare data obtained by Scheimpflug camera (Pentacam) from both eyes of unilateral keratoconus patients and normal controls. Materials and Methods: This study was performed by retrospective chart review of 919 keratoconus patients. From these patients, 31 keratoconus eyes of 31 patients with unilateral keratoconus (Group 1), 31 normal fellow eyes of these patients (Group 2), and 30 right eyes of 30 normal controls (Group 3) were included in the study. Detailed ophthalmologic examination and Pentacam parameters at initial examination were analyzed and relationships between Groups 1, 2, and 3 were statistically evaluated. ROC curve analysis was also performed to determine the sensitivity and specificity of parameters that could be used to differentiate Group 2 from Groups 1 and 3. Results: The mean age was 30.07±11.00 (15-60) in Group 1-2 patients and 32.33±9.30 (18-45) in Group 3 patients (p=0.392). In comparison of Pentacam data, there were statistically significant differences between Groups 1 and 2 in all parameters except corneal volume (p<0.05). Group 1 and Group 3 were significantly different in all evaluated parameters (p<0.05). Steep keratometry, flat keratometry, mean keratometry, and posterior elevation (PE) were statistically similar between Groups 2 and 3 (p>0.05), while the other evaluated parameters differed significantly (p<0.05). ROC curve analysis showed that the difference in corneal thickness between the apex and thinnest point, progression index, index of surface variance, index of height asymmetry and inferior-superior had the highest sensitivity and specificity in differentiating Group 2 from Group 3, while CCTapex, CCTmin, PE, and minumum radius had the highest sensitivity and specificity in differentiating Group 2 from Group 1. Conclusion: In patients with unilateral keratoconus, fellow eyes appear to not be completely normal. Thus, it is recommended that fellow eyes also be evaluated in every examination of unilateral keratoconus patients.
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Affiliation(s)
- Cumali Değirmenci
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Melis Palamar
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | | | - Sait Eğrilmez
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Ayşe Yağcı
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
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Barut Selver Ö, Eğrilmez S, Hasanov S, Yılmaz Dağ M, Tunger A. The Utility of Colistin in Multiple Drug-Resistant <i>Pseudomonas aeruginosa</i> Bacterial Keratitis in a Kaposi’s Sarcoma Patient. Turk J Ophthalmol 2019; 49:220-223. [PMID: 31486610 PMCID: PMC6761381 DOI: 10.4274/tjo.galenos.2019.79999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
A 71-year-old male patient presented with decreased visual acuity, redness, and discharge in his right eye for 5 days. He had undergone evisceration of his left eye several years earlier. Before presentation, he had received chemotherapeutic agents for Kaposi’s sarcoma of the scalp. Slit-lamp examination revealed severe hypopyon and an extensive corneal ulcer with surrounding infiltrate, which extended to the deep stroma. Microbiological evaluation identified the causative agent to be multiple drug-resistant Pseudomonas aeruginosa. Based on culture and susceptibility results, the patient was started on topical colistin 0.19% instilled hourly. Complete resolution of keratitis with residual corneal scarring was observed. In recent years, there has been an increase in drug resistance in P. aeruginosa keratitis. The lack of new antimicrobial agents against these resistant strains has led clinicians to reconsider colistin, which is an old drug. In this report, we aimed to stress the utility of colistin in multiple drug-resistant P. aeruginosa bacterial keratitis in a Kaposi’s sarcoma patient.
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Gobeka H, Barut Selver Ö, Palamar Onay M, Eğrilmez S, Yağcı A. Corneal Biomechanical Properties of Keratoconic Eyes Following Penetrating Keratoplasty. Turk J Ophthalmol 2018; 48:171-177. [PMID: 30202612 PMCID: PMC6126104 DOI: 10.4274/tjo.79664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 01/03/2018] [Indexed: 12/01/2022] Open
Abstract
Objectives To investigate the corneal biomechanical properties of keratoconic eyes following penetrating keratoplasty (PKP). Materials and Methods Thirty-five patients (70 eyes) were enrolled to this prospective study. Operated and contralateral keratoconic eyes were defined as Group 1 and 2, respectively. All patients underwent ophthalmological examination and measurements of corneal biomechanical properties by Ocular Response Analyzer (ORA), intraocular pressure (IOP) by Goldmann applanation tonometry, and central corneal thickness (CCT) by Pentacam. Shapiro-Wilk W test was performed to test normality of the data. The statistical significance was evaluated with the paired t-test and Wilcoxon signed ranks test. Pearson correlation and Spearman rho tests were used for correlation analysis. Results The average age and male/female ratio were 31.34±11.65 (15-60) years and 21/14, respectively. The mean values of the data obtained from Group 1 and 2 respectively were: corneal hysteresis (CH): 9.35±1.66, 8.18±1.84 mmHg (p=0.013), corneal resistance factor (CRF): 9.48±1.96, 7.14±2.05 mmHg (p<0.001), IOPcc: 16.90±4.32, 14.26±3.69 mmHg (p=0.004), IOPg: 15.45±4.61, 10.91±3.97 mmHg (p<0.001), IOPapl: 14.26±3.11, 13.09±2.54 mmHg (p=0.046), and central corneal thickness (CCT): 545.64±60.82, 442.60±68.14 μM (p<0.001). The positive correlation between CH and CRF was moderate (r=0.444) in Group 1 and strong (r=0.770) in Group 2. There was a moderate negative correlation between CH and IOPcc in both groups (r=-0.426, r=-0.423), but CH was not correlated with IOPg or IOPapl in either group. There were weak to strong positive correlations between CRF and all IOP values in both groups. There was no correlation between CRF and CCT in Group 1 (r=0.075) and a very weak correlation in Group 2 (r=0.237). Only IOPcc and IOPg were strongly correlated in both groups. Conclusion Better understanding of corneal biomechanical properties is essential for elucidating the pathophysiology and diagnosis of several corneal pathologies such as keratoconus. The biomechanical properties of keratoconic eyes seem to be closer to normal values after PKP.
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Affiliation(s)
- Hamidu Gobeka
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Özlem Barut Selver
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Melis Palamar Onay
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Sait Eğrilmez
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Ayşe Yağcı
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
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9
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Barut Selver Ö, Yağcı A, Eğrilmez S, Gürdal M, Palamar M, Çavuşoğlu T, Ateş U, Veral A, Güven Ç, Wolosin JM. Limbal Stem Cell Deficiency and Treatment with Stem Cell Transplantation. Turk J Ophthalmol 2017; 47:285-291. [PMID: 29109898 PMCID: PMC5661179 DOI: 10.4274/tjo.72593] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 02/06/2017] [Indexed: 12/01/2022] Open
Abstract
The cornea is the outermost tissue of the eye and it must be transparent for the maintenance of good visual function. The superficial epithelium of the cornea, which is renewed continuously by corneal stem cells, plays a critical role in the permanence of this transparency. These stem cells are localized at the cornea-conjunctival transition zone, referred to as the limbus. When this zone is affected/destroyed, limbal stem cell deficiency ensues. Loss of limbal stem cell function allows colonization of the corneal surface by conjunctival epithelium. Over 6 million people worldwide are affected by corneal blindness, and limbal stem cell deficiency is one of the main causes. Fortunately, it is becoming possible to recover vision by autologous transplantation of limbal cells obtained from the contralateral eye in unilateral cases. Due to the potential risks to the donor eye, only a small amount of tissue can be obtained, in which only 1-2% of the limbal epithelial cells are actually limbal stem cells. Vigorous attempts are being made to expand limbal stem cells in culture to preserve or even enrich the stem cell population. Ex vivo expanded limbal stem cell treatment in limbal stem cell deficiency was first reported in 1997. In the 20 years since, various protocols have been developed for the cultivation of limbal epithelial cells. It is still not clear which method promotes effective stem cell viability and this remains a subject of ongoing research. The most preferred technique for limbal cell culture is the explant culture model. In this approach, a small donor eye limbal biopsy is placed as an explant onto a biocompatible substrate (preferably human amniotic membrane) for expansion. The outgrowth (cultivated limbal epithelial cells) is then surgically transferred to the recipient eye. Due to changing regulations concerning cell-based therapy, the implementation of cultivated limbal epithelial transplantation in accordance with Good Laboratory Practice using xenobiotic-free systems is becoming widely accepted both in Turkey and worldwide.
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Affiliation(s)
- Özlem Barut Selver
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Ayşe Yağcı
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Sait Eğrilmez
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Mehmet Gürdal
- Ege University Faculty of Medicine, Department of Medical Biochemistry, İzmir, Turkey
| | - Melis Palamar
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
| | - Türker Çavuşoğlu
- Ege University Faculty of Medicine, Department of Histology and Embriology, İzmir, Turkey
| | - Utku Ateş
- İstanbul Bilim University Faculty of Medicine, Department of Histology and Embryology, İstanbul, Turkey
| | - Ali Veral
- Ege University Faculty of Medicine, Department of Pathology, İzmir, Turkey
| | - Çağrı Güven
- Ege University Faculty of Medicine, Department of Gynecology and Obstetrics, İzmir, Turkey
| | - Jose Mario Wolosin
- Icahn Faculty of Medicine at Mount Sinai, Department of Ophthalmology and Black Family Stem Cell Institute, New York, USA
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Karatepe AS, Köse S, Eğrilmez S. Factors Affecting Contrast Sensitivity in Healthy Individuals: A Pilot Study. Turk J Ophthalmol 2017; 47:80-84. [PMID: 28405481 PMCID: PMC5384124 DOI: 10.4274/tjo.93763] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 06/11/2016] [Indexed: 12/01/2022] Open
Abstract
Objectives: To determine the demographic and ocular features affecting contrast sensitivity levels in healthy individuals. Materials and Methods: Seventy-four eyes of 37 subjects (7-65 years old) with refractive errors less than 1.0 diopter, no history of ocular surgery, and 20/20 visual acuity were included in the study. The participants were divided by age into three groups: group 1, 7-19 years, n=11; group 2, 20-49 years, n=15; and group 3, 50-65 years, n=11. All subjects underwent anterior and posterior segment evaluation, intraocular pressure measurements, refraction measurements, and clinical evaluation for strabismus. Contrast static test was performed using Metrovision MonPack 3 vision monitor system after measuring pupil diameter. Photopic and mesopic measurements were taken sequentially from right eyes, left eyes, and both eyes together. Results: Contrast sensitivity at intermediate and high spatial frequencies was lower with increasing age. Binocular measurements were better than monocular, and mesopic measurements were better than photopic measurements at all spatial frequencies. Contrast sensitivity at higher spatial frequency was lower with hyperopic refraction values. Conclusion: Increasing age, small pupil diameter, hyperopia, and photopic conditions were associated with lower contrast sensitivity in healthy individuals. Binocular contrast sensitivity measurements were better than monocular contrast sensitivity measurements in all conditions and spatial frequencies.
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Affiliation(s)
| | | | - Sait Eğrilmez
- Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
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11
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Kocaçal Güler E, Eşer İ, Eğrilmez S. Nurses can play an active role in the early diagnosis of exposure keratopathy in intensive care patients. Jpn J Nurs Sci 2017; 15:31-38. [PMID: 28169512 DOI: 10.1111/jjns.12165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 12/06/2016] [Accepted: 12/15/2016] [Indexed: 11/30/2022]
Abstract
AIM This study was conducted in order to determine nurses' ability to diagnose exposure keratopathy reliably in the early stage in intensive care patients. METHODS This methodological and descriptive study was carried out between 2011 and 2012 in the Neurology and Anesthesiology and Reanimation Intensive Care Units of a teaching hospital in western Turkey. The sample consisted of 4354 ocular assessments in 156 corneas of 78 patients. A patient identification form and a fluorescein test patient tracking chart were used in the data collection. The corneas of the patients were checked by a fluorescein dye test by the same nurse and ophthalmologist. RESULTS The mean age of the patients was 59 ± 15.5 years and 47.4% of them were female. The consistency between the nurse and the ophthalmologist was almost perfect in terms of determining the presence of exposure keratopathy, characteristics, and the grade of corneal staining. Exposure keratopathy was detected at a rate of 2% by the ophthalmologist. A significant relationship was found between the presence of lagophthalmos and the development of exposure keratopathy. A positive correlation was found between the grade of corneal staining and the degree of the eyelid position of the patients and the duration of mechanical ventilation therapy. CONCLUSION After eye care and assessment training, intensive care nurses can play an effective role in detecting early-stage exposure keratopathy in intensive care patients.
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Affiliation(s)
- Elem Kocaçal Güler
- Department of Fundamentals of Nursing, Faculty of Nursing, Ege University, İzmir, Turkey
| | - İsmet Eşer
- Department of Fundamentals of Nursing, Faculty of Nursing, Ege University, İzmir, Turkey
| | - Sait Eğrilmez
- Department of Ophthalmology, Ege University Medical Hospital, İzmir, Turkey
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12
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Abstract
BACKGROUND The aim of this study was to evaluate risks and consequences of traumatic wound dehiscence after penetrating keratoplasty (PK). METHODS Data regarding 34 eyes of 34 patients who were treated for traumatic wound dehiscence after PK between 1995 and 2014 were studied. Patient records were reviewed for type and time of insult, corrected distance visual acuity (CDVA), clinical presentation signs, operative method, and outcome. RESULTS The interval between PK and trauma ranged from 1 month to 100 months, with median of 14 months. Median age at trauma was 31.5 years (range: 5-81 years). Wound dehiscence occurred at donor-recipient interface in all patients. In 58.8% of patients, extent of dehiscence was ≥6 clock hours. Most frequent type of trauma was blunt trauma by hand/finger (35.2%). Median CDVA before and just after trauma were 0.5 logMAR (range: 0.1-3.0 logMAR) and 3.0 logMAR (range: 0.7-3.0 logMAR), respectively. Wound dehiscence was managed with primary wound closure in all patients. Most frequent additional surgical procedure was anterior vitrectomy (26.4%). Anatomical globe loss occurred in 2 patients. Median CDVA was 0.7 logMAR (range: 0.1-3.0 logMAR) at final visit. Most common complication after primary suturation was graft failure (23.5%). Graft remained clear in 67.6% of patients. CONCLUSION Traumatic wound dehiscence is one of the potentially devastating postoperative complications that can occur following PK. Prognosis depends on existence and severity of additional anterior/posterior segment damage. In order to prevent this catastrophic condition, patients should be warned against ocular trauma after undergoing PK.
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Affiliation(s)
- Özlem Barut Selver
- Department of Ophthalmology, Ege University Faculty of Medicine, İzmir-Turkey
| | - Melis Palamar
- Department of Ophthalmology, Ege University Faculty of Medicine, İzmir-Turkey.
| | - Sait Eğrilmez
- Department of Ophthalmology, Ege University Faculty of Medicine, İzmir-Turkey
| | - Ayşe Yağcı
- Department of Ophthalmology, Ege University Faculty of Medicine, İzmir-Turkey
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Akcalı A, Güven Yılmaz S, Lappin DF, Eğrilmez S, Buduneli N. Effect of gingival inflammation on the inflammatory response in patients with idiopathic uveitis. J Clin Periodontol 2016; 43:637-45. [DOI: 10.1111/jcpe.12555] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Aliye Akcalı
- Department of Periodontology; School of Dentistry; Ege University; İzmir Turkey
| | - Suzan Güven Yılmaz
- Department of Ophthalmology; Faculty of Medicine; Ege University; İzmir Turkey
| | - David F. Lappin
- Infection and Immunity Group; Dental Hospital and School; School of Medicine; College of Medical, Veterinary and Life Sciences; University of Glasgow; Glasgow UK
| | - Sait Eğrilmez
- Department of Ophthalmology; Faculty of Medicine; Ege University; İzmir Turkey
| | - Nurcan Buduneli
- Department of Periodontology; School of Dentistry; Ege University; İzmir Turkey
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Üstündağ-Okur N, Gökçe EH, Bozbıyık Dİ, Eğrilmez S, Ertan G, Özer Ö. Novel nanostructured lipid carrier-based inserts for controlled ocular drug delivery: evaluation of corneal bioavailability and treatment efficacy in bacterial keratitis. Expert Opin Drug Deliv 2015; 12:1791-807. [DOI: 10.1517/17425247.2015.1059419] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Kocatürk T, Erkan E, Eğrilmez S, Çakmak H, Dündar SO, Dayanir V. Surgically Induced Corneal Astigmatism Following Intravitreal Ranibizumab Injection. Open Ophthalmol J 2015; 9:121-5. [PMID: 26401170 PMCID: PMC4578144 DOI: 10.2174/1874364101509010121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 03/18/2015] [Accepted: 03/24/2015] [Indexed: 11/22/2022] Open
Abstract
Purpose : To evaluate surgically induced astigmatism (SIA) after an intravitreal ranibizumab (IVR) injection. Methods : Fifty eight eyes of 58 patients who underwent IVR injection due to age-related macular degeneration (wet form)
or macular edema were included in this study. Patients’ pre- and postoperative detailed ophthalmologic examinations
were done and topographic keratometric values (K1, K2) were noted. Pre- and postoperative measurements were
compared. Results : The mean preoperative astigmatism of 0.87 Diopters (D) was found to be 0.95 D, 0.75 D, 0.82 D and 0.78 D on
the 1st day, 3rd day, 1st week and 1st month, respectively. After injection, absolute change in astigmatism was found to
be 0.08 D, 0.12 D, 0.05 D and 0.09 D on the 1st day, 3rd day, 1st week and 1st month, respectively. The absolute change
in astigmatism seemed to be insignificant in terms of refractive analysis, however; when we performed a vectorial
analysis, which takes into account changes in the axis of astigmatism, the mean value of induced astigmatism were found
to be 0.33±0.22 D, 0.32±0.29 D, 0.41±0.37 D, 0.46±0.32 D on the 1st day, 3rd day, 1st week and on 1st month,
respectively. Conclusion : Intravitreal injection is a minimally invasive ophthalmologic procedure, however; it may still cause
statistically significant induced astigmatism when evaluated from a vectorial point of view.
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Barut Selver Ö, Eğrilmez S. Katarakt Ameliyatı Sonrası Akut Kornea Ödeminin Bir Nedeni: Descemet Membran Dekolmanı Ayırıcı Tanısı ve Tedavisi. Turk J Ophthalmol 2014. [DOI: 10.4274/tjo.71598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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17
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Ustündağ-Okur N, Gökçe EH, Bozbıyık Dİ, Eğrilmez S, Ozer O, Ertan G. Preparation and in vitro-in vivo evaluation of ofloxacin loaded ophthalmic nano structured lipid carriers modified with chitosan oligosaccharide lactate for the treatment of bacterial keratitis. Eur J Pharm Sci 2014; 63:204-15. [PMID: 25111119 DOI: 10.1016/j.ejps.2014.07.013] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 07/31/2014] [Indexed: 11/17/2022]
Abstract
The objective of this study was to explore the potential of the nanostructured lipid carriers (NLCs) modified with chitosan oligosaccharide lactate (COL) for topical ocular application. Ofloxacin (OFX) loaded NLCs were prepared by microemulsion or high shear homogenization methods. For combination of NLCs Compritol HD5 ATO was used as solid lipid, oleic acid as liquid lipid, Tween 80 as surfactant, ethanol as co-surfactant. The optimum NLCs was modified with 0.75% COL. The properties of NLCs in the absence or presence of OFX (0.3%) were characterized as zeta potential, particle size, viscosity and pH, TEM, drug loading, encapsulation efficiency and anti-microbial properties. Ex-vivo penetration/permeation studies were performed with rabbit cornea in Franz-diffusion cells. The penetration rate of OFX from NM-COL4OFX and NH-COL4OFX were significantly higher than commercial solution. Based on the selected formulations, in vivo tests were carried out by eye-drop instillation of NLCs in rabbit. The addition of COL improved the preocular residence time, controlled the drug release and enhanced the corneal bioavailability. In conclusion, OFX COL modified NLCs prepared by high shear homogenization method could be offered as a promising strategy for ocular drug delivery.
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Affiliation(s)
- Neslihan Ustündağ-Okur
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Ege, 35100 Bornova, Izmir, Turkey.
| | - Evren Homan Gökçe
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Ege, 35100 Bornova, Izmir, Turkey.
| | | | - Sait Eğrilmez
- Department of Ophthalmology, School of Medicine, University of Ege, 35100 Bornova, Izmir, Turkey.
| | - Ozgen Ozer
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Ege, 35100 Bornova, Izmir, Turkey.
| | - Gökhan Ertan
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Ege, 35100 Bornova, Izmir, Turkey.
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Üstündag-Okur N, Gökçe EH, Eğrilmez S, Özer Ö, Ertan G. Novel Ofloxacin-Loaded Microemulsion Formulations for Ocular Delivery. J Ocul Pharmacol Ther 2014; 30:319-32. [DOI: 10.1089/jop.2013.0114] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Neslihan Üstündag-Okur
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Ege, Izmir, Turkey
| | - Evren Homan Gökçe
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Ege, Izmir, Turkey
| | - Sait Eğrilmez
- Department of Ophthalmology, School of Medicine, University of Ege, Izmir, Turkey
| | - Özgen Özer
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Ege, Izmir, Turkey
| | - Gökhan Ertan
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Ege, Izmir, Turkey
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Kaya E, Yılmaz SG, Onay MP, Eğrilmez S, Yağcı A. Correlation of Biomicroscopic Findings with Confocal Microscopy in Eyes with Amiodarone-Induced Cornea Verticillata. Turk J Ophthalmol 2014. [DOI: 10.4274/tjo.98704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Seyhan Karatepe A, Palamar Onay M, Eğrilmez S, Yağcı A. Menstrüel Siklusun Ön Kamara Parametreleri Üzerine Etkisinin Pentacam ile Araştırılması. Turk J Ophthalmol 2014. [DOI: 10.4274/tjo.43.97759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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21
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Seyhan Karatepe A, Palamar Onay M, Eğrilmez S, Yağcı A. Sürücü Belgesi Sahiplerinin Geç Dönem Görsel Yeterlilikleri. Turk J Ophthalmol 2013. [DOI: 10.4274/tjo.43.97720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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22
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Onay MP, Eğrilmez S, Civan BB, Yağcı A. Penetran Keratoplasti Sonrası Hasta Memnuniyeti. Turk J Ophthalmol 2013. [DOI: 10.4274/tjo.53765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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23
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Eğrilmez S, Ekici M, Gözen O. First serum treatment of ocular surface disease in written literature. J Ocul Pharmacol Ther 2012. [PMID: 23205897 DOI: 10.1089/jop.2012.0156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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24
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Eğrilmez S, Özgür Aktaş E. Principles of Forensic Reporting in Ocular Trauma. Turk J Ophthalmol 2012. [DOI: 10.4274/tjo.42.s15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Palamar Onay M, Eğrilmez S, Yağcı A. Pterjiyum Cerrahisine Bağlı Kornea Perforasyonunda Tektonik Kornea Greftlemesi. Turk J Ophthalmol 2011. [DOI: 10.4274/tjo.41.68077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Onay MP, Karatepe AS, Eğrilmez S, Yağcı A. Evaluation of Cornea and Anterior Chamber with Pentacam in Scleroderma Cases. tjo 2011. [DOI: 10.4274/tjo.41.63825] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Palamar M, Karatepe AS, Eğrilmez S, Yağcı A. Skleroderma olgularında kornea ve ön kamaranın Pentacam ile değerlendirilmesi. Turk J Ophthalmol 2011. [DOI: 10.4274/tjo.41.638250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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29
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Kocaçal Güler E, Eşer İ, Eğrilmez S. Effectiveness of polyethylene covers versus carbomer drops (Viscotears®) to prevent dry eye syndrome in the critically ill. J Clin Nurs 2011; 20:1916-22. [DOI: 10.1111/j.1365-2702.2010.03559.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Palamar M, Eğrilmez S, Yağcı A. Severe Anterior Chamber Reaction in two Post-Cataract Surgery Cases Due to Inadvertent Substitution of Tobrex for Tobradex. Turk J Ophthalmol 2011. [DOI: 10.4274/tjo.41.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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31
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Palamar M, Yaldız H, Eğrilmez S, Yağcı A. Conjunctival Necrosis Due to Subconjunctival Depot Corticosteroid Injection. Turk J Ophthalmol 2010. [DOI: 10.4274/tod.40.248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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32
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Palamar M, Eğrilmez S, Kayıkçıoğlu M, Yağcı A. Bilateral Nasal Ectopia Lentis with no Skeletal Abnormality: Is it Marfan Syndrome? Turk J Ophthalmol 2010. [DOI: 10.4274/tod.40.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Gökçe EH, Sandri G, Eğrilmez S, Bonferoni MC, Güneri T, Caramella C. Cyclosporine a-loaded solid lipid nanoparticles: ocular tolerance and in vivo drug release in rabbit eyes. Curr Eye Res 2010; 34:996-1003. [PMID: 19958116 DOI: 10.3109/02713680903261405] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To determine the in vivo efficacy of cyclosporine A-loaded solid lipid nanoparticles (SLNs) in rabbit eyes. METHODS SLNs were prepared and administered to the cul-de-sac of rabbits, and the drug amount in aqueous humor was detected by high performance liquid chromatography (HPLC). The irritation was evaluated by modified Draize testing. RESULTS The particle size of SLNs was detected as 225.9 +/- 5.5 nm with a negative surface charge. Aqueous humor drug levels reached 50.53 ng/mL, and there was no serious irritation in rabbit eyes. CONCLUSIONS Topical ophthalmic efficacy of cyclosporine A was enhanced via administration of SLNs.
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Affiliation(s)
- Evren H Gökçe
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Ege, Izmir, Turkey.
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Kayikçioğlu O, Eğrilmez S, Emre S, Erakgün T. Human cataractous lens nucleus implanted in a sheep eye lens as a model for phacoemulsification training. J Cataract Refract Surg 2004; 30:555-7. [PMID: 15050248 DOI: 10.1016/j.jcrs.2003.08.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2003] [Indexed: 11/25/2022]
Abstract
We describe a realistic and inexpensive experimental cataract model for phacoemulsification training. After a capsulorhexis is performed, a deep cavity in the lens of an enucleated sheep eye is formed by phacoemulsification through a lateral incision. An undamaged human cataractous lens nucleus obtained by extracapsular cataract extraction is inserted in the preformed cavity, resting in the center of a cortex cushion. Phacoemulsification training is performed through a corneal tunnel incision. The experimental model is prepared with a human cataractous lens nucleus of the preferred hardness, simulating nuclear phacoemulsification in humans.
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Affiliation(s)
- Ozcan Kayikçioğlu
- Celal Bayar University Faculty of Medicine, Department of Ophthalmology, Manisa, Turkey.
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