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Okuyan E, Akgül O, Baysal Z, Mangan MS, Bayramoglu D, Tureyici L. The Effect of Hyperemesis Gravidarum on Macular Thickness, Corneal Thickness, and Intraocular Pressure in Pregnancy. Z Geburtshilfe Neonatol 2024. [PMID: 38698625 DOI: 10.1055/a-2299-3345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
AIM Physiological changes in intraocular pressure as well as in the cornea and macula may occur during pregnancy. Therefore, we decided to investigate the effect of hyperemesis gravidarum on macular thickness, corneal thickness and intraocular pressure (IOP). MATERIAL AND METHODS A total of 110 people, 55 of whom were diagnosed with hyperemesis gravidarum and 55 of whom were in the control group, were included in the study. The inclusion criteria for the study were as follows: first trimester (8-14 weeks of gestation) pregnancy with positive fetal heartbeat and no history of systemic disease, no continuous use of medication, diagnosis of hyperemesis gravidarum (ketonuria and weight loss of more than 3 kilograms or 5% of body weight), body mass index (BMI) within normal limits, age between 18 and 40, no alcohol use or smoking. RESULTS In the HG group compared to the control group, there was a difference between the CCT values of both the right and left eyes (p<0.01). There was a difference in both right and left IOP values in patients in the HG group compared to the control group (p<0.05), and there was no correlation between ketonuria scores and right and left eye CCT values, right and left eye macular thickness, and right and left eye pressure in patients diagnosed with HG (p>0.05). CONCLUSION In hyperemesis gravidarum, changes occur in IOP, corneal thickness, and macular thickness. In ophthalmic examinations in the pregestational period, especially for women with systemic disease, it may be important for clinicians to take the necessary precautions in this regard.
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Affiliation(s)
- Erhan Okuyan
- Department of Obstetrics and Gynecology, Batman Training and Research Hospital, Batman, Turkey
| | - Ozlem Akgül
- Department of Obstetrics and Gynecology, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Zeki Baysal
- Department of Ophthalmology, Batman Training and Research Hospital, Batman, Turkey
| | - Mehmet Serhat Mangan
- Department of Ophthalmology, University of Health Science, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, Istanbul, Turkey
| | - Denizhan Bayramoglu
- Department of Obstetrics and Gynecology, Mardin Training and Research Hospital, Mardin, Turkey
| | - Lena Tureyici
- Department of Obstetrics and Gynecology, Batman Training and Research Hospital, Batman, Turkey
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Tekcan H, İmamoğlu S, Mangan MS. Anterior Segment Changes and Refractive Outcomes after Cataract Surgery Combined with Gonioscopy-Assisted Transluminal Trabeculotomy in Open-Angle Glaucoma. Turk J Ophthalmol 2023; 53:369-376. [PMID: 38047480 PMCID: PMC10750090 DOI: 10.4274/tjo.galenos.2023.36080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/14/2023] [Accepted: 05/29/2023] [Indexed: 12/05/2023] Open
Abstract
Objectives To compare the accuracy of intraocular lens (IOL) calculation formulas in patients undergoing phacoemulsification combined with gonioscopy-assisted transluminal trabeculotomy (phaco-GATT) and to determine the predictive factors for refractive errors. Materials and Methods Fifty-three eyes of 53 patients undergoing phaco-GATT were retrospectively reviewed. The preoperative and postoperative 3-month anterior segment (AS) parameters were measured by Scheimpflug camera. The mean prediction error (PE), mean absolute error (MAE) in the Sanders-Retzlaff-Kraft/theoretical (SRK/T), Barrett- Universal II, Hill-radial basis function (Hill-RBF) and Kane formulas were compared. The influence of biometric parameters on PE were analyzed by correlation analysis. Results Postoperatively, there was a statistically significant decrease in axial length (AL) and significant enlargement in anterior chamber depth (ACD), anterior chamber angle (ACA), and anterior chamber volume (p<0.001). The mean PE using SRK/T (-0.08 diopters [D]) was more myopic than in the Barret (0.01 D) and Hill-RBF (0.01 D). The PE closest to zero was in the Kane formula (0.001 D). The Kane formula provided a lower MAE (0.30±0.28 D) than the SRK/T (0.38±0.32 D) and Barrett (0.36±0.30 D) (p<0.001). The MAE in Hill-RBF (0.32±0.28) was comparable with that in Kane (p=0.02). Preoperative AL was significantly associated with PE in all formulas except Kane. Barrett was the only formula that did not have a significant correlation between PE and postoperative ACD and ACA. Conclusion The Kane formula may provide higher predictability of the IOL power calculation than the SRK/T and Barrett-Universal II formulas in phaco-GATT surgery, which can cause significant changes in the AS and AL.
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Affiliation(s)
- Hatice Tekcan
- University of Health Sciences Türkiye, Haydarpaşa Numune Training and Research Hospital, Clinic of Ophthalmology, İstanbul, Türkiye
| | - Serhat İmamoğlu
- University of Health Sciences Türkiye, Haydarpaşa Numune Training and Research Hospital, Clinic of Ophthalmology, İstanbul, Türkiye
| | - Mehmet Serhat Mangan
- University of Health Sciences Türkiye, Haydarpaşa Numune Training and Research Hospital, Clinic of Ophthalmology, İstanbul, Türkiye
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Ercalik NY, Turkseven Kumral E, Mangan MS, Alpogan O, Imamoglu S, Ozcelik Kose A, Tekcan H. Changes in pupil size, ocular wavefront aberrations, and accommodation in healthcare workers using FFP3 masks. Int Ophthalmol 2023; 43:4991-4996. [PMID: 37843764 DOI: 10.1007/s10792-023-02902-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 09/10/2022] [Accepted: 09/27/2023] [Indexed: 10/17/2023]
Abstract
PURPOSE To evaluate changes in pupil size, ocular wavefront aberrations (WA), and accommodation in healthcare workers after 4-h usage of Filtering Facepiece class 3 (FFP3) masks. MATERIAL AND METHODS This prospective study included 22 healthy healthcare workers. Pupil size, ocular WA, and accommodation changes before and after FFP3 mask usage were evaluated using a Hartmann Schack aberrometer. Accommodative responses to stimulus ranging from 0 to 5 diopters (D) in increments of 0.5 D were assessed. Ocular high-order aberrations (HOAs) were recorded at baseline and at every accommodative stimulus. Oxygen saturation (SpO2) was measured by pulse oximetry before and after the mask usage. RESULTS The mean age was 36.6 ± 8.5 years. The SpO2 significantly decreased from 98.95 to 97.95% after usage of the FFP3 mask (p < 0.001). The mean pupil size did not significantly differ before (6.22 ± 0.75 mm) and after (6.38 ± 0.83 mm) the 4-h mask usage (p = 0.093). The mean total RMS of the total HOAs was 0.36 ± 0.17 before and 0.39 ± 0.15 after the mask usage (p = 0.071). Post-mask accommodation showed a significant decrease at the 2 D (p = 0.041), 2.5D (p = 0.022), and 3 D (p = 0.025) stimuli. CONCLUSION The present study shows that after 4 h-usage of FFP3 mask, both SpO2 and accommodative response to increasing stimuli might be significantly decreased.
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Affiliation(s)
- Nimet Yesim Ercalik
- University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Tibbiye Cad. No:23, Uskudar, Istanbul, 34668, Turkey.
| | - Esra Turkseven Kumral
- University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Tibbiye Cad. No:23, Uskudar, Istanbul, 34668, Turkey
| | - Mehmet Serhat Mangan
- University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Tibbiye Cad. No:23, Uskudar, Istanbul, 34668, Turkey
| | - Oksan Alpogan
- University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Tibbiye Cad. No:23, Uskudar, Istanbul, 34668, Turkey
| | - Serhat Imamoglu
- University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Tibbiye Cad. No:23, Uskudar, Istanbul, 34668, Turkey
| | - Alev Ozcelik Kose
- University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Tibbiye Cad. No:23, Uskudar, Istanbul, 34668, Turkey
| | - Hatice Tekcan
- University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Tibbiye Cad. No:23, Uskudar, Istanbul, 34668, Turkey
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Tekcan H, Mangan MS, Celik G, Imamoglu S. Lens factor as an underlying mechanism in primary angle closure with gonioscopically-visualized ciliary body processes. Jpn J Ophthalmol 2023; 67:678-684. [PMID: 37596442 DOI: 10.1007/s10384-023-01021-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/18/2023] [Accepted: 07/23/2023] [Indexed: 08/20/2023]
Abstract
PURPOSE To compare the differences in anterior segment parameters between eyes with primary angle closure (PAC) with and without gonioscopically-visualized ciliary body processes (CBP). STUDY DESIGN Prospective, observational, comparative clinical study. METHODS Detailed ocular examinations and gonioscopy were performed in 89 eyes of 89 patients with PAC to determine the visibility of the CBP. Anterior chamber depth (ACD), anterior chamber width, lens thickness (LT), lens vault (LV) and pupil diameter were determined using ultrasound biomicroscopy. The lens-axial length factor (LAF) and relative lens position (RLP) were calculated. All parameters were compared between eyes with and without gonioscopically visible CBP (PAC+CBP and PAC-CBP groups) after adjusting for age and gender. The association of the parameters with visible CBP was analyzed by univariate logistic regression analysis. RESULTS PAC+CBP group included 41 eyes and the PAC-CBP group, 48 eyes. The axial length and ACD were statistically significantly smaller (p = 0.009 and p = 0.005, respectively) and LT, LV and LAF were statistically significantly greater (p = 0.03, p = 0.008 and p = 0.004, respectively) in the PAC+CBP group. In the PAC eyes with glaucoma, the LT, LV and LAF were statistically significantly greater in the PAC+CBP group (p = 0.02, p = 0.001 and p = 0.02, respectively). The LAF had the strongest association with visible CBP in the regression analysis (Odds ratio = 141.70, p = 0.002). CONCLUSION Gonioscopical visualization of ciliary processes may suggest that anterior segment crowding, especially lens factor is the underlying mechanism in PAC. It may provide a practical gonioscopic examination method for predicting the predominant pathophysiology of PAC.
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Affiliation(s)
- Hatice Tekcan
- Ophthalmology Department, University of Health Sciences, Haydarpasa Numune Research and Training Hospital, Tıbbiye Street, No: 40, Uskudar, Istanbul, Turkey
| | - Mehmet Serhat Mangan
- Ophthalmology Department, University of Health Sciences, Haydarpasa Numune Research and Training Hospital, Tıbbiye Street, No: 40, Uskudar, Istanbul, Turkey.
| | - Gökhan Celik
- Ophthalmology Department, University of Health Sciences, Zeynep Kamil Gynecologic and Pediatric Training Research Hospital, Istanbul, Turkey
| | - Serhat Imamoglu
- Ophthalmology Department, University of Health Sciences, Haydarpasa Numune Research and Training Hospital, Tıbbiye Street, No: 40, Uskudar, Istanbul, Turkey
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Bolac R, Ozcelik-Kose A, Imamoglu S, Yildiz E, Ozturk Y, Mangan MS. Evaluation of Schlemm Canal Parameters Using Swept-Source Optical Coherence Tomography in Eyes That Underwent Keratoplasty. Eye Contact Lens 2023; 49:379-385. [PMID: 37418302 DOI: 10.1097/icl.0000000000001011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 05/17/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVES In this study, we aimed to evaluate Schlemm canal parameters using anterior segment swept-source optical coherence tomography in eyes that underwent keratoplasty and compare them with keratoconus and healthy control groups. METHODS The study included 32 patients who underwent penetrating keratoplasty or deep anterior lamellar keratoplasty once due to keratoconus and age-matched and sex-matched 20 keratoconus patients and 30 healthy controls. In all the patients, a single horizontal image centered on the central cornea was obtained from the nasal and temporal quadrants with low-intensity scanning to visualize Schlemm canal. RESULTS There was no statistically significant difference between the groups for age and gender ( P ˃0.05). In the keratoplasty group, the area and diameter of Schlemm canal were 2.266±1.141μm 2 and 160.77±65.08 μm, respectively, in the nasal quadrant and 2.623±1.277 μm 2 and 158.81±68.05 μm, respectively in the temporal quadrant, which were statistically significantly lower compared with other groups ( P <0.001 for all). There was no significant difference between the penetrating and deep anterior lamellar keratoplasty subgroups for Schlemm canal parameters. CONCLUSION This is the first study to report anterior segment optical coherence tomography after surgery shows SC parameters that are, on average, less than age-matched and keratoconus controls.
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Affiliation(s)
- Ruveyde Bolac
- Department of Ophthalmology, University of Health Sciences, Haydarpasa Numune Training and Research Hospital (R.B., A.O-K., S.I., M.S.M.), Istanbul, Turkey; North American Lasik and Eye Surgery Center (E.Y.), Dubai, United Arab Emirates; and Dunya Goz Hospital (Y.O.), Istanbul, Turkey
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Mangan MS, Tekcan H, Yurttaser Ocak S, Ozcelik Kose A, Balci S, Ercalik NY, Imamoglu S. Müller Muscle-Conjunctival Resection for Treatment of Contralateral Ptosis following Unilateral External Levator Advancement. Plast Reconstr Surg 2023; 152:533-539. [PMID: 36827478 DOI: 10.1097/prs.0000000000010309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
BACKGROUND One of the main causes of unsatisfactory outcomes after unilateral blepharoptosis surgery is asymmetry of the upper eyelid height, which occurs as a result of a contralateral eyelid droop. Therefore, the authors evaluated the efficacy of Müller muscle-conjunctival resection (MMCR) for the treatment of contralateral ptosis following unilateral external levator advancement (ELA). METHODS This study analyzed 26 eyelids of 26 patients with upper eyelid height asymmetry following unilateral ELA who underwent contralateral MMCR retrospectively. The phenylephrine test was performed before ELA and before MMCR. The main outcome measures were symmetry outcomes and clinical outcomes. RESULTS The mean patient age was 55.81 ± 7.98 years (range, 44 to 70 years); 15 were female (57.7%). The Hering dependency was observed in 13 of the patients (50%) before ELA. An adequate response to phenylephrine was observed before MMCR but not before ELA. Symmetry outcomes after MMCR were perfect (<0.5 mm), good (≥0.5 mm and <1 mm), and fair (≥1 mm) in seven, 17, and two patients, respectively. An optimal upper eyelid height was noted in 47 of the 52 eyelids after the MMCR, whereas three of the 52 eyelids had minimal overcorrection, and two eyelids had undercorrection. The mean change in marginal reflex distance 1 of the contralateral eyelid droop was greater for patients with than without the Hering dependency ( P < 0.0001) after ELA but not after MMCR. Two patients (7.6%) underwent revision ELA surgery. CONCLUSION MMCR and use of the phenylephrine test to predict the eyelid position may represent an alternative approach in patients who require management of contralateral ptosis following unilateral ELA. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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Affiliation(s)
- Mehmet Serhat Mangan
- From the Division of Oculoplastic and Reconstructive Surgery, University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Clinic
| | - Hatice Tekcan
- From the Division of Oculoplastic and Reconstructive Surgery, University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Clinic
| | - Serap Yurttaser Ocak
- Department of Ophthalmology, University of Health Sciences, Okmeydani Education and Research Hospital
| | - Alev Ozcelik Kose
- From the Division of Oculoplastic and Reconstructive Surgery, University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Clinic
| | - Sevcan Balci
- From the Division of Oculoplastic and Reconstructive Surgery, University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Clinic
| | - Nimet Yesim Ercalik
- From the Division of Oculoplastic and Reconstructive Surgery, University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Clinic
| | - Serhat Imamoglu
- From the Division of Oculoplastic and Reconstructive Surgery, University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Clinic
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Yucel Gencoglu A, Mangan MS. Orbital Inflammatory Pseudotumor following mRNA COVID-19 Vaccination. Ocul Immunol Inflamm 2023; 31:1141-1144. [PMID: 35914301 DOI: 10.1080/09273948.2022.2093757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/15/2022] [Revised: 06/20/2022] [Accepted: 06/20/2022] [Indexed: 10/16/2022]
Abstract
The authors present a case of orbital pseudotumor after mRNA COVID-19 vaccination. A 40-year-old otherwise healthy woman was referred to our oculoplastics unit because of left blepharoptosis of 2 months duration starting 1 week after she received her first Pfizer-BioNTech mRNA vaccination. On presentation, her best-corrected visual acuity was 20/20 in each eye. The external examination revealed left blepharoptosis and mild upper eyelid swelling. Orbital magnetic resonance imaging revealed left lacrimal gland enlargement with homogeneous contrast enhancement and diffuse mild enlargement of the left lateral and superior rectus muscles. The results of the extended workup for autoimmune and infectious etiologies and the systemic examination findings were normal. Systemic corticosteroids were started for the orbital pseudotumor. The presented case of orbital pseudotumor development after the mRNA vaccine may be considered to be an immunological process targeting the orbital tissue following immunization, although the cause-effect relationship remains uncertain.
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Affiliation(s)
- Aysun Yucel Gencoglu
- Division of Ophthalmic Plastic and Reconstructive Surgery, University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, Istanbul, Turkey
| | - Mehmet Serhat Mangan
- Division of Ophthalmic Plastic and Reconstructive Surgery, University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, Istanbul, Turkey
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Un Y, Imamoglu S, Tekcan H, Celik G, Ozturk Y, Mangan MS. Factors defining the intraocular pressure-lowering effect of phacoemulsification and laser peripheral iridotomy in patients with primary angle closure : Factors defining IOP lowering effect of PE and LPI in PAC. Lasers Med Sci 2023; 38:100. [PMID: 37059933 DOI: 10.1007/s10103-023-03772-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 09/15/2022] [Accepted: 04/08/2023] [Indexed: 04/16/2023]
Abstract
To identify whether gonioscopic ciliary body visibility and factors including anterior chamber depth (ACD), axial length (AL), acute attack history, and preoperative intraocular pressure (IOP) had any effect on IOP decrease in primary angle closure (PAC) and primary angle-closure glaucoma (PACG) after phacoemulsification (PE) and/or laser peripheral iridotomy (LPI). This retrospective-design study was conducted with 81 eyes with PAC and PACG; 33 eyes whose IOP was controlled with LPI and PE constituted group 1, and 48 eyes whose IOP was controlled using LPI alone comprised group 2. The effects on preoperative and last-visit IOP levels, ciliary body visibility, ACD, AL, and acute attacks were analyzed. Eyes within the groups were similar in AL, ACD, and preoperative IOP except for acute attack history, which was found to be higher in group 1. For group 1, none of the factors was found to have a differentiative effect on IOP decrease after PE, except eyes with preoperative IOP > 21 mm Hg, which had significantly more IOP reduction. For group 2, no difference was found in ciliary body visibility, and higher or lower ACD. However, eyes with AL ≥ 22 mm, positive acute attack history, and higher preoperative IOP were associated with significantly better IOP reduction. We found no relationship between ciliary body visibility and an IOP-reducing effect of PE and LPI. Although we found PE effective in IOP reduction in all eyes, we determined LPI to have a lesser IOP-reducing effect in eyes with IOP ≤ 21 mm Hg and AL < 22 mm.
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Affiliation(s)
- Yasemin Un
- Department of Ophthalmology, Istanbul Haydarpasa Numune Training and Research Hospital, Uskudar, 34668, Istanbul, Turkey.
| | - Serhat Imamoglu
- Department of Ophthalmology, Istanbul Haydarpasa Numune Training and Research Hospital, Uskudar, 34668, Istanbul, Turkey
| | - Hatice Tekcan
- Department of Ophthalmology, Istanbul Haydarpasa Numune Training and Research Hospital, Uskudar, 34668, Istanbul, Turkey
| | - Gokhan Celik
- Department of Ophthalmology, Zeynep Kamil Obstetric and Pediatric Hospital Uskudar, 34668, Istanbul, Turkey
| | - Yucel Ozturk
- Department of Ophthalmology, Istanbul Haydarpasa Numune Training and Research Hospital, Uskudar, 34668, Istanbul, Turkey
| | - Mehmet Serhat Mangan
- Department of Ophthalmology, Istanbul Haydarpasa Numune Training and Research Hospital, Uskudar, 34668, Istanbul, Turkey
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Tekcan H, Mangan MS, İmamoglu S. Uneventful Phacoemulsification after Trabeculectomy in Pseudoexfoliation Glaucoma versus Primary Open-Angle Glaucoma. Ophthalmic Res 2023; 66:672-680. [PMID: 36822166 DOI: 10.1159/000529642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 09/26/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023]
Abstract
INTRODUCTION Conflicting results have been reported on phacoemulsification in the filtered eyes with open-angle glaucoma. In this study, we aim to compare the effect of phacoemulsification after trabeculectomy between pseudoexfoliation glaucoma (XFG) and primary open-angle glaucoma (POAG). METHODS Consecutive patients with XFG and POAG who underwent uneventful phacoemulsification after trabeculectomy with 5-fluorouracil (TRAB-PHACO group) were reviewed retrospectively and matched to patients who underwent trabeculectomy only (TRAB group). Comparisons were performed for IOP, medication numbers, and success rates. Surgical failure was defined as IOP >21 mm Hg or IOP ≤21 mm Hg with additional medication or glaucoma surgery. Survival analysis was investigated by Kaplan-Meier test and the factors influencing final success by multivariate logistic regression analysis. RESULTS The records of 204 patients were reviewed. In XFG, when compared with the baseline, increase in IOP became statistically significant at the at 24-month visit in the TRAB-PHACO group (p = 0.002), at the 6-month visit (p = 0.001) in the TRAB group and remained so throughout the follow-up. In the TRAB-PHACO group, increase of glaucoma medications was statistically significant only at the last visit (p = 0.001) in XFG, at the 6-month visit (p = 0.02) in POAG and remained so throughout the follow-up. Two glaucoma types did not differ statistically from one another in terms of survival analysis. In the TRAB group, the additional glaucoma surgery was more common in XFG compared to POAG (p = 0.02). The trabeculectomy failure after phacoemulsification was related with an IOP spike >25 mm Hg at postoperative first 24h (p = 0.04). CONCLUSIONS In the filtered eyes with XFG, uneventful phacoemulsification may delay time-related worsening in IOP control and may decrease the additional glaucoma surgery need.
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Affiliation(s)
- Hatice Tekcan
- Ophthalmology Department, Health Sciences University Turkey, Haydarpaşa Numune Research and Training Hospital, Istanbul, Turkey
| | - Mehmet Serhat Mangan
- Ophthalmology Department, Health Sciences University Turkey, Haydarpaşa Numune Research and Training Hospital, Istanbul, Turkey
| | - Serhat İmamoglu
- Ophthalmology Department, Health Sciences University Turkey, Haydarpaşa Numune Research and Training Hospital, Istanbul, Turkey
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Mangan MS, Turan SG, Ocak SY. Pediatric canalicular laceration repair using the Mini Monoka versus Masterka monocanalicular stent. Arq Bras Oftalmol 2023; 86:46-51. [PMID: 35170641 DOI: 10.5935/0004-2749.20220084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 04/06/2021] [Indexed: 01/01/2023] Open
Abstract
PURPOSE One of the most important disadvantages of using Mini Monoka stents in pediatric canalicular laceration repair is premature stent loss. In this study, we aimed to compare clinical outcomes between the use of Mini Monoka and Masterka monocanalicular stents in children and discuss the potential causes of premature stent loss. METHODS The medical records of 36 patients who underwent surgical repair of canalicular lacerations were retrospectively reviewed. Children aged <18 years who underwent canalicular laceration repair with either Mini Monoka or Masterka and had at least 6 months of follow-up after stent removal were included in the study. The patients' demographics, mechanism of injury, type of stent used, premature stent loss, and success rate were analyzed. Success was defined as stent removal without subsequent epiphora and premature stent loss. RESULTS Twenty-seven children fulfilled our study criteria, and their data were included in the analyses. Mini Monoka was used in 14 patients (51.9%), whereas Masterka was used in 13 patients (48.1%). The preoperative clinical features, including age, sex, and mechanism of injury, were similar between the two groups. The mean age was 8.3 ± 5.5 years in the Mini Monoka group and 7.8 ± 5.9 years in the Masterka group (p=0.61). Three patients in the Mini Monoka group (21.4%) underwent reoperation due to premature stent loss. No premature stent loss was observed in the Masterka group. As a result, the rate of success was 78.6% in the Mini Monoka group, whereas it was 100% in the Masterka group (p=0.22). CONCLUSIONS Even though the two groups did not show any statistically significant difference in success rate, we did not observe any premature stent loss in the Masterka group. Further studies with larger and randomized series are warranted to elaborate on these findings.
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Affiliation(s)
- Mehmet Serhat Mangan
- Division of Ophthalmic Plastic and Reconstructive Surgery, Sadik Eratik Eye Clinic, Haydarpasa Numune Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Sevil Gul Turan
- Division of Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology, Okmeydani Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Serap Yurttaser Ocak
- Division of Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology, Okmeydani Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
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Mangan MS, Acar Z. Isolated Sudden-Onset Trochlear Nerve Palsy Associated with Mild Novel Coronavirus Disease (COVID-19) Infection. J Binocul Vis Ocul Motil 2023; 73:11-14. [PMID: 36066931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE To present a case of sudden isolated unilateral trochlear nerve palsy of new onset associated with a COVID-19 infection without a severe course. METHODS A 49-year-old previously healthy man suddenly noticed seeing double while going down the stairs to go out for the first time the day after the completion of medical treatment and home isolation for COVID-19. There was no systemic disease or history of trauma. RESULTS Magnetic resonance imaging of the brain and orbits was normal and the neurology examination revealed no pathology. The acute onset of the diplopia, the small vertical fusion amplitude, and the lack of facial asymmetry supported acquired trochlear nerve palsy. CONCLUSIONS Trochlear nerve palsy has rarely been reported in association with the various types of viral infections. To the best of our knowledge, this is the first case of isolated unilateral trochlear nerve palsy with no additional neurological finding or any radiological finding that is possibly associated with mild SARS-CoV-2 infection.
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Affiliation(s)
- Mehmet Serhat Mangan
- Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, Division of Pediatric Ophthalmology and Strabismus, University of Health Sciences, Istanbul, Turkey
| | - Zeynep Acar
- Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, Division of Pediatric Ophthalmology and Strabismus, University of Health Sciences, Istanbul, Turkey
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Abstract
PURPOSE To evaluate clinical and in vivo confocal microscopy (IVCM) findings of a patient who developed multiple unilateral subepithelial stromal opacities following conjunctivitis that developed during a COVID-19 infection. METHODS A 22-year-old female presented to our clinic with blurred right vision. The history revealed that she had experienced a COVID-19 infection one month ago. Redness and stinging of the right eye had started at the same time and she had been prescribed topical antibiotic drops and ointments. The redness in the right eye had decreased but blurred vision had then developed. RESULTS Slit lamp examination revealed a normal left eye. Several tiny subepithelial infiltrates without fluorescein staining of the cornea were present in the right eye. The anterior chamber, lens and fundus were bilaterally normal. IVCM revealed irregular corneal epithelial cells with bright borders in addition to scattered inflammatory cells and cell debris in the right eye. There were activated dendritic cells in the subbasal epithelial area with a significant decrease in the subbasal corneal nerve plexus. Clusters of highly reflective cells with an irregular shape were seen in the anterior corneal stroma together with foci of activated keratocytes. The corneal endothelial cell layer was normal. The left eye IVCM findings were all within normal limits. The right eye also showed decreased corneal sensitivity compared to the left. CONCLUSIONS The possible role of corneal infiltrates as a trigger for COVID-19 could be explained with an immune-mediated mechanism. SARS-CoV-2 can result in decreased corneal sensitivity through corneal nerve involvement. The clinical results of this effect need to be evaluated in larger series.
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Affiliation(s)
- Mehmet Serhat Mangan
- Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, University of Health Sciences, Istanbul, Turkey
| | - Ayse Yildiz-Tas
- Department of Ophthalmology, Koc University School of Medicine, Istanbul, Turkey
| | - Merve Beyza Yildiz
- Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, University of Health Sciences, Istanbul, Turkey
| | - Elvin Yildiz
- Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, University of Health Sciences, Istanbul, Turkey
| | - Afsun Sahin
- Department of Ophthalmology, Koc University School of Medicine, Istanbul, Turkey
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Ercalik NY, Tekcan H, Mangan MS, Ozcelik Kose A, Imamoglu S. Analysis of risk factors and ocular hypotony characteristics in choroidal detachment after penetrating glaucoma surgery. Int Ophthalmol 2022; 42:3431-3440. [PMID: 35590027 DOI: 10.1007/s10792-022-02342-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 01/22/2021] [Accepted: 04/18/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To analyze the risk factors and ocular hypotony characteristics of choroidal detachment (CD) after penetrating glaucoma surgery and to compare between eyes with and without CD. METHODS This retrospective study enrolled 173 eyes of 168 patients. Patients who underwent trabeculectomy or Ahmed glaucoma valve implantation due to medically uncontrolled glaucoma and who had intraocular pressure (IOP) < 9 mmHg at any time during the first postoperative week were included. RESULTS The study population consisted of 61 (36.3%) females and 107 (63.7%) males with a mean age of 60.7 ± 14.2 years. The postoperative median follow-up time was 24 months (range, 12-40 months). Postoperatively, CD developed in 47 (27.1%) eyes. Multivariate analyses demonstrated that eyes with high preoperative IOP (> 40 mmHg) were 12.1 times more likely to develop CD (p = 0.000) and that presence of IOP < 9 mmHg on the first day of surgery increased the CD risk 3.8 times (p = 0.002); male gender raised the risk 2.7 times (p = 0.028). The mean preoperative IOP in CD eyes was significantly higher than in non-CD eyes (p = 0.000). The mean IOP change between preoperative and lowest IOP was significantly greater in those with CD than in those without CD (p = 0.000). The mean lowest IOP in the CD eyes was significantly lower than in the non-CD eyes (p = 0.037). For the surgical failure rate, no significant difference was found between the CD and the non-CD groups (p = 0.14). CONCLUSIONS The present study demonstrated that high preoperative IOP, presence of IOP < 9 mmHg on the first postoperative day, and male gender were significantly associated with CD after penetrating glaucoma surgery. Choroidal detachment accompanied by hypotony did not affect the final outcome negatively.
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Affiliation(s)
- Nimet Yesim Ercalik
- Sadik Eratik Eye Institute, Haydarpasa Numune Education and Research Hospital, University of Health Sciences, Tibbiye Cad. No: 23, 34668, Uskudar, Istanbul, Turkey
| | - Hatice Tekcan
- Sadik Eratik Eye Institute, Haydarpasa Numune Education and Research Hospital, University of Health Sciences, Tibbiye Cad. No: 23, 34668, Uskudar, Istanbul, Turkey
| | - Mehmet Serhat Mangan
- Sadik Eratik Eye Institute, Haydarpasa Numune Education and Research Hospital, University of Health Sciences, Tibbiye Cad. No: 23, 34668, Uskudar, Istanbul, Turkey.
| | - Alev Ozcelik Kose
- Sadik Eratik Eye Institute, Haydarpasa Numune Education and Research Hospital, University of Health Sciences, Tibbiye Cad. No: 23, 34668, Uskudar, Istanbul, Turkey
| | - Serhat Imamoglu
- Sadik Eratik Eye Institute, Haydarpasa Numune Education and Research Hospital, University of Health Sciences, Tibbiye Cad. No: 23, 34668, Uskudar, Istanbul, Turkey
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14
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Tekcan H, Mangan MS, Alpogan O, Imamoglu S, Kose AO, Ercalık NY. The effect of uneventful cataract surgery in pseudoexfoliation glaucoma with or without previous mitomycin C-augmented trabeculectomy. Int Ophthalmol 2022; 42:3531-3539. [PMID: 35556202 DOI: 10.1007/s10792-022-02351-0] [Citation(s) in RCA: 1] [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: 07/25/2021] [Accepted: 04/18/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE To analyze the effect of uneventful cataract surgery on intraocular pressure (IOP) in pseudoexfoliation glaucoma (PXG) eyes with and without a history of Mitomycin C-augmented trabeculectomy. METHODS Eyes with PXG that had underwent uneventful cataract surgery were enrolled. The IOP and the medication numbers before cataract surgery, and 1, 3, 6, 12, 18, 24 months after cataract surgery, and at the last visit were recorded in PXG with and without previous trabeculectomy. Failure was defined as IOP > 21 or ≤ 21 mmHg with additional medication or surgery. In the postoperative first 24 h, IOP > 50% above baseline was defined as an IOP spike. RESULTS In the trabeculectomized eyes (n = 37), the increase in the mean IOP (p = 0.024) and the increase in the mean number of medications (p = 0.007) was significant at the last visit when compared with baseline. In the non-trabeculectomized eyes (n = 42) there was a significant decrease in the mean IOP (p = 0.016) and in the mean number of medications (p = 0.038) at the last visit. Twelve eyes (32.4%) in trabeculectomized group and six (14.3%) in the non-trabeculectomized group experienced failure. An IOP spike was seen in one eye in the trabeculectomized group, in 15 eyes in the non-trabeculectomized group (p < 0.0001). The IOP spike was a significant risk factor for failure (p = 0.027). CONCLUSION Uneventful cataract surgery may have significant negative effect on the IOP control in the trabeculectomized PXG eyes. After cataract surgery, the non-trabeculectomized PXG eyes had a higher risk of IOP spike and an IOP spike may be a risk factor for failure.
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Affiliation(s)
- Hatice Tekcan
- Haydarpasa Numune Training and Research Hospital, Health Sciences University Turkey, Tıbbiye Caddesi, No:40, 34662, Istanbul, Turkey.
| | - Mehmet Serhat Mangan
- Haydarpasa Numune Training and Research Hospital, Health Sciences University Turkey, Tıbbiye Caddesi, No:40, 34662, Istanbul, Turkey
| | - Oksan Alpogan
- Haydarpasa Numune Training and Research Hospital, Health Sciences University Turkey, Tıbbiye Caddesi, No:40, 34662, Istanbul, Turkey
| | - Serhat Imamoglu
- Haydarpasa Numune Training and Research Hospital, Health Sciences University Turkey, Tıbbiye Caddesi, No:40, 34662, Istanbul, Turkey
| | - Alev Ozcelik Kose
- Haydarpasa Numune Training and Research Hospital, Health Sciences University Turkey, Tıbbiye Caddesi, No:40, 34662, Istanbul, Turkey
| | - Nimet Yesim Ercalık
- Haydarpasa Numune Training and Research Hospital, Health Sciences University Turkey, Tıbbiye Caddesi, No:40, 34662, Istanbul, Turkey
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Mangan MS, Sarici AM, Yalcin O, Aydin D, Yegen G, Seyahi E. Orbital Mass as the Only Presenting Sign with Overlapping Features of Lupus Erythematosus Panniculitis and Subcutaneous Panniculitis-Like T-Cell Lymphoma. Ocul Immunol Inflamm 2022; 31:717-720. [PMID: 35404730 DOI: 10.1080/09273948.2022.2054430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE Even though subcutaneous panniculitis-like T-cell lymphoma (SPTCL) and lupus erythematosus panniculitis (LEP) are two separate entities, recently they were claimed to represent two ends of a spectrum of T-cell-mediated orbital lymphoproliferative diseases. METHODS A 78-year-old woman presented with a 1-month history of right-sided periorbital swelling and redness. There was a palpable mass in the medial right lower eyelid with restriction of upward and lateral gaze. MRI revealed a 14 × 7 mm hypointense lesion in the anteromedial orbit. RESULTS The systemic and ocular findings, orbital biopsy with histopathology and immunochemistry showed overlapping features of LEP and SPTCL. The patient was consulted with rheumatology and hematology, and the physicians arrived at a consensus that the patient existed in the above-mentioned disease spectrum. She was started on systemic immunosuppressive treatment and her clinical findings improved substantially. CONCLUSIONS This is the first report of a patient, who presented with orbital mass causing vision loss and gaze restriction that had overlapping clinical and histopathologic features of LEP and SPTCL consistent with this novel disease spectrum, in the literature.
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Affiliation(s)
- Mehmet Serhat Mangan
- Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, Division of Ophthalmic Plastic and Reconstructive Surgery, University of Health Sciences, Istanbul, Turkey
| | - Ahmet Murat Sarici
- Cerrahpasa Faculty of Medicine, Department of Ophthalmology, Division of Ocular Oncology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ozben Yalcin
- Okmeydani Education and Research Hospital, Department of Pathology, University of Health Sciences, Istanbul, Turkey
| | - Demet Aydin
- Okmeydani Education and Research Hospital, Department of Internal Medicine, Division of Hematology, University of Health Sciences, Istanbul, Turkey
| | - Gulcin Yegen
- Istanbul Faculty of Medicine, Department of Pathology, Istanbul University, Istanbul, Turkey
| | - Emire Seyahi
- Cerrahpasa Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Abstract
There is no consensus on the choice of systemic and ophthalmic treatment for patients who develop ocular toxicity with erlotinib in the few cases reported previously. Various ocular complications related to erlotinib have been reported, with one of the most serious being corneal perforation. Our patient was at risk of potential corneal perforation because of severe cicatricial ectropion and diffuse punctate corneal epitheliopathy. Therefore, erlotinib treatment was temporarily discontinued with the approval of the oncology department and the patient was closely followed. She was prescribed steroid eye ointment, single-use preservative-free artificial tears, and eye lubricant gel to protect the ocular surface. On day 4 of treatment, the patient’s findings were significantly improved. After 1 week, the cicatricial ectropion had dramatically improved and the patient’s complaints were completely resolved. To our knowledge, there is no case report of a patient with both ocular toxicity after long-term use that shows dramatic improvement with drug cessation, and severe cicatricial ectropion affecting the entire lower eyelid. Here, we described a patient who used erlotinib for 3 years due to non-small cell lung cancer and developed severe cicatricial ectropion which improved dramatically within one week of temporarily discontinuing erlotinib and discussed the possible reasons. Although ocular complications with erlotinib are usually encountered early in treatment, it should be kept in mind that erlotinib-related ocular complications may also arise with long-term use.
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Affiliation(s)
- Mehmet Serhat Mangan
- Haydarpaşa Numune Training and Research Hospital, Sadık Eratik Eye Clinic, İstanbul, Turkey
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17
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Tekcan H, Mangan MS, Imamoglu S, Alpogan O. Refractive Outcomes of Uneventful Cataract Surgery in Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma. Korean J Ophthalmol 2022; 36:226-235. [PMID: 35067015 PMCID: PMC9194734 DOI: 10.3341/kjo.2021.0183] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/22/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose To compare the refractive outcomes after cataract surgery between patients with and without pseudoexfoliation, and to evaluate the risk factors of refractive error. Methods Retrospective review of 210 eyes with pseudoexfoliation (study group) and 510 normal eyes (control group) that underwent uneventful phacoemulsification with intraocular lens implantation. The study group included pseudoexfoliation syndrome and pseudoexfoliation glaucoma (PXG) subgroups. The main outcome measure was refractive error, defined as the difference between the target refraction and postoperative refraction in diopter (D). A refractive error >±1.0 D was identified as a large-magnitude refractive error. The frequency of the large-magnitude refractive error was compared between study and control groups, and also between each subgroup and normal eyes. The factors influencing refractive error were analyzed by logistic regression. Results There was a significantly higher frequency of a refractive error >± 1.0 D and hyperopic error >1.0 D in the study group than in the control group (p = 0.001 and p = 0.003, respectively). In the multivariate logistic regression analysis, PXG and poor preoperative visual acuity were related with a large-magnitude refractive error (p = 0.001 and p = 0.02, respectively) Refractive error >± 1.0 D and hyperopic error >1.0 D were noted more often in PXG eyes that had an intraocular pressure spike >25 mmHg at postoperative first 24 hours (p = 0.01 and p=0.03, respectively). Conclusions The eyes with pseudoexfoliation were at a high risk for refractive error, especially in the presence of glaucoma. In PXG, the only significant risk factor for refractive error was observed to be the presence of an intraocular pressure spike.
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Affiliation(s)
- Hatice Tekcan
- Department of Ophthalmology, Haydarpasa Numune Research and Training Hospital, Health Sciences University Turkey, Istanbul, Turkey
| | - Mehmet Serhat Mangan
- Department of Ophthalmology, Haydarpasa Numune Research and Training Hospital, Health Sciences University Turkey, Istanbul, Turkey
| | - Serhat Imamoglu
- Department of Ophthalmology, Haydarpasa Numune Research and Training Hospital, Health Sciences University Turkey, Istanbul, Turkey
| | - Oksan Alpogan
- Department of Ophthalmology, Haydarpasa Numune Research and Training Hospital, Health Sciences University Turkey, Istanbul, Turkey
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Mangan MS, Bolac R, Yildiz MB, Imamoglu S, Vural ET, Yenerel NM. Simultaneous posterior eyelid ptosis repair and strabismus surgery: a single-stage approach. Arq Bras Oftalmol 2022:S0004-27492022005004203. [DOI: 10.5935/0004-2749.20230020] [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] [Received: 04/19/2021] [Accepted: 08/29/2021] [Indexed: 11/20/2022] Open
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Mangan MS. Orbital emphysema after probing for congenital nasolacrimal duct obstruction. J AAPOS 2021; 25:356-357. [PMID: 34582955 DOI: 10.1016/j.jaapos.2021.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/28/2021] [Indexed: 10/20/2022]
Abstract
A 22-month-old boy with bilateral epiphora since birth and positive fluorescein dye disappearance test in both eyes underwent nasolacrimal duct probing, with multiple passes to ensure that the obstruction was resolved. Immediately after the procedure was completed, bilateral orbital emphysema developed. The patient was started on systemic antibiotics and systemic steroids and monitored closely. Fundus examination revealed no abnormalities. The emphysema began to resolve on postoperative day 2 and had resolved completely by postoperative day 10.
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Affiliation(s)
- Mehmet Serhat Mangan
- University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, Istanbul, Turkey.
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20
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Mangan MS, Ozcan Z, Ozkan Aksoy N. Clinical time course of the neglected giant sebaceous gland carcinoma. Rom J Ophthalmol 2021; 65:290-292. [PMID: 35036655 PMCID: PMC8697785 DOI: 10.22336/rjo.2021.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2021] [Indexed: 11/18/2022] Open
Abstract
In this report, we discussed the progression from the initial presentation until surgical intervention, clinical course, and devastating outcome of a neglected giant sebaceous gland carcinoma of the eyelid in a poorly compliant elderly patient. A 79-year-old woman was referred for treatment of a giant ulcero-nodular lesion in the right upper eyelid. Nine months before, an orange lesion arising from the tarsal conjunctiva in the upper eyelid was observed in her examination undergone in the healthcare center where she initially presented, and the cornea appeared transparent. Surgical excision was recommended, which she declined. The examination three months before in the same center revealed that the lesion invaded the globe and anterior segment architecture could not be visualized. She was then recommended surgical removal of the eyeball, which she also refused. Radiological imaging demonstrated a 33x35 mm mass lesion in the superior lateral of orbit with exophytic growth and invasion of the globe and no systemic metastases were found. Total orbital exenteration surgery was immediately planned and performed. Histopathological examination revealed sebaceous gland carcinoma. Elderly patients with poor compliance should discuss their condition with a psychiatrist and should be managed by a multidisciplinary approach. This way, patients with eyelid malignancies can be encouraged to undergo surgery and receive early treatment, decreasing the need for exenteration, improving clinical outcomes, and reducing the risk of morbidity and mortality.
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Affiliation(s)
- Mehmet Serhat Mangan
- Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, Istanbul, Turkey
| | - Zuhal Ozcan
- Department of Pathology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey
| | - Nilgun Ozkan Aksoy
- Department of Ophthalmology, Sakarya University Education and Research Hospital, Sakarya, Turkey
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Ocak SY, Mangan MS, Elçioğlu MN. The intra-operative corneal pachymetry changes during accelerated corneal cross-linking in progressive keratoconus patients with thin corneas. ACTA ACUST UNITED AC 2021; 35:438-442. [PMID: 34488256 PMCID: PMC8666252 DOI: 10.3341/kjo.2021.0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 07/16/2021] [Accepted: 08/13/2021] [Indexed: 11/23/2022]
Abstract
Purpose To report the intra-operative corneal pachymetry changes during accelerated corneal cross-linking (A-CXL) in progressive keratoconus patients with thin corneas. Methods Thirty-six eyes (mean age: 22.26 ± 4.02 years) with progressive keratoconic thin corneas (< 400 µm without epithelium) who underwent A- CXL with ultraviolet A (9 mW/cm2) using isotonic RF-HPMC (riboflavin5-phosphate 0.1% with 1.1% hydroxypropyl methycellulose/Mediocross M®) were included in this retrospective study. Intra-operative corneal pachymetric changes were noted before the procedure, after removal of epithelium, after RF-HPMC instillation, before and after UV irradiation. The mean of corneal pachymetric values were compared statistically. Results The mean corneal pachymetry reduced from 415.72±29.66 µm to 369.50±23.45 µm after removal of the epithelium (p<0.05). After the application of RF-HPMC solution the mean TCP increased to 412.89±26.94 µm. Statistically significant increase was observed in TCP after saturation with RF-HPMC (p=0.001). The mean corneal pachymetry was before and after UV-A irradiation respectively 419.86±10.41 µm, 417.47±8.25 µm (p>0.05). Conclusion Isotonic RF-HPMC lead to a significant increase in intra-operative mean TCP. RF-HPMC seems to be a favorable riboflavin option in keratoconus patients with thin corneas.
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Affiliation(s)
- Serap Yurttaşer Ocak
- University of Health Sciences, Okmeydanı Prof.Dr.Cemil Tascioglu Education and Research Hospital, Department of Ophtalmology , Istanbul, Turkey
| | - Mehmet Serhat Mangan
- University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute ,Department of Ophtalmology, Istanbul, Turkey
| | - Mustafa Nuri Elçioğlu
- University of Health Sciences, Okmeydanı Prof.Dr.Cemil Tascioglu Education and Research Hospital, Department of Ophtalmology , Istanbul, Turkey
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Mangan MS, Cakir A, Imamoglu S. Cumulative sum analysis of the learning curve of ptosis surgery: External levator advancement versus Müller's muscle-conjunctival resection. ACTA ACUST UNITED AC 2021; 35:383-390. [PMID: 34344132 PMCID: PMC8521322 DOI: 10.3341/kjo.2021.0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 04/15/2021] [Accepted: 07/15/2021] [Indexed: 12/03/2022]
Abstract
Purpose Even though it is stated that external levator advancement (ELA) has a much longer learning curve than Müller muscle-conjunctival resection (MMCR) in the treatment of aponeurotic ptosis, there is no study in the literature regarding the learning curves of these two surgical techniques. We aimed to objectively determine the length of the learning curves of ELA and MMCR using cumulative sum (CUSUM) analysis. Methods The first 30 unilateral ELA and the first 30 unilateral MMCR consecutively performed by a single surgeon were retrospectively reviewed. The CUSUM method was used to analyze the learning curves of ELA and MMCR based on operation times of consecutive surgeries and the clinical outcomes were compared. Results CUSUM analyses revealed that the operation time stabilized after around 11 ELA surgeries and 12 MMCR surgeries and R2 value for ELA and MMCR were 0.93 and 0.91, respectively. There was no significant difference in these stratified analyses. Mean operation time was 45.7 minutes in the ELA group and 34.1 minutes in the MMCR group (p = 0.002). Total number of intraoperative complications was 37 in the ELA group and 16 in the MMCR group (p = 0.015). Symmetry success rate was significantly higher (p < 0.0001) and reoperation rate was significantly lower in the MMCR group (p = 0.045). Conclusions Even though ELA is more challenging than MMCR, comparable learning curves indicate that surgeons in training need to be encouraged to perform both techniques. The challenges and obstacles that the surgeons in training face in these two techniques need to be analyzed in detail.
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Affiliation(s)
- Mehmet Serhat Mangan
- University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, Division of Oculoplastic and Reconstructive Surgery, Istanbul, Turkey
| | - Akin Cakir
- University of Health Sciences, Okmeydani Education and Research Hospital, Department of Ophthalmology, Istanbul, Turkey
| | - Serhat Imamoglu
- University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, Division of Oculoplastic and Reconstructive Surgery, Istanbul, Turkey
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Mangan MS. Direct Corneal Injury During Radiofrequency-Assisted Upper Blepharoplasty. Dermatol Surg 2021; 47:1146-1147. [PMID: 33867460 DOI: 10.1097/dss.0000000000003037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Mehmet Serhat Mangan
- Division of Ophthalmic Plastic and Reconstructive Surgery, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, University of Health Sciences, Istanbul, Turkey
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Mangan MS, Cakir A, Yurttaser Ocak S, Tekcan H, Balci S, Ozcelik Kose A. (Methods of analysis regarding strabismus videos on YouTube). Strabismus 2021; 29:60. [PMID: 33871301 DOI: 10.1080/09273972.2021.1914508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Mehmet Serhat Mangan
- Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Clinic, University of Health Sciences, Istanbul
| | - Akin Cakir
- Okmeydani Education and Research Hospital, Department of Ophthalmology, University of Health Sciences, Istanbul
| | - Serap Yurttaser Ocak
- Okmeydani Education and Research Hospital, Department of Ophthalmology, University of Health Sciences, Istanbul
| | - Hatice Tekcan
- Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Clinic, University of Health Sciences, Istanbul
| | - Sevcan Balci
- Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Clinic, University of Health Sciences, Istanbul
| | - Alev Ozcelik Kose
- Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Clinic, University of Health Sciences, Istanbul
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Mangan MS, Imamoglu S. Preseptal cellulitis associated with cosmetic eyelash lifting procedure. J Cosmet Dermatol 2021; 20:1846-1848. [PMID: 33829632 DOI: 10.1111/jocd.14142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/23/2021] [Accepted: 04/01/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The increased popularity of periocular cosmetic applications in recent years has resulted in the appearance of various complications. The cosmetic eyelash lifting is one of these new techniques and is gradually becoming more popular. There are no previous reports of any complications of this procedure in the literature. AIMS In this study, we present a clinical case of preseptal cellulitis following cosmetic eyelash lifting procedure. PATIENT/METHODS A 55-year-old woman presented with bilateral eyelid swelling and redness. The history revealed that she had undergone cosmetic eyelash lifting procedure 2 days ago. There was no ocular movement limitation or pain. The biomicroscopic examination revealed bilateral eyelid edema and hyperemia, conjunctival hyperemia, chemosis, and mucopurulent secretion. The diagnosis was preseptal cellulitis when the clinical examination was evaluated together with the results of the laboratory tests and radiological imaging. RESULTS Systemic and topical antibiotics were started, and the signs recovered in the first week. CONCLUSIONS Cosmetic eyelash lifting can rarely be one of the causes of preseptal cellulitis. It is important to detect and treat any blepharitis or meibomitis before the procedure. Eyelid hygiene and the proper sterilization conditions during the procedure must also be ensured.
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Affiliation(s)
- Mehmet Serhat Mangan
- Division of Ophthalmic Plastic and Reconstructive Surgery, University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, Istanbul, Turkey
| | - Serhat Imamoglu
- Division of Ophthalmic Plastic and Reconstructive Surgery, University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, Istanbul, Turkey
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Abstract
Purpose: The authors present a case of unilateral orbital myositis of new onset following COVID-19 without a severe course.Methods: The patient had been received topical treatment with a preliminary diagnosis of conjunctivitis but no recovery had been noticed. The history revealed that the ocular signs had started 1 week after the COVID-19.Results: The examination revealed sectoral hyperemia of the temporal region in the bulbar conjunctiva together with marked limitation of right inward gaze. MRI of the orbits demonstrated diffuse fusiform enhancing enlargement of the right lateral rectus and superior rectus. The results of the laboratory tests and examination findings were normal. Systemic corticosteroids were started for the orbital myositis.Conclusions: Although conjunctivitis is the more common ocular disease following COVID-19, the possibility of orbital myositis should be considered in cases with resistance to topical treatment and/or gaze limitation. The possible role of orbital myositis as a trigger for COVID-19 could be explained with an immune-mediated mechanism.
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Affiliation(s)
- Mehmet Serhat Mangan
- Division of Ophthalmic Plastic and Reconstructive Surgery, University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, Istanbul, Turkey
| | - Elvin Yildiz
- Division of Cornea and Ocular Surface, University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, Istanbul, Turkey
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Mangan MS, Ocak SY, Vural ET, Yildiz E. Müller Muscle-conjunctival Resection with or without Tarsectomy and Combined with Bandage Contact Lens Use in Ptosis Patients with Corneal Graft. Korean J Ophthalmol 2021; 35:10-17. [PMID: 33307624 PMCID: PMC7904405 DOI: 10.3341/kjo.2020.0119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 09/17/2020] [Accepted: 10/29/2020] [Indexed: 12/25/2022] Open
Abstract
PURPOSE To examine the efficacy of ptosis correction with a Müller muscle-conjunctival resection with or without tarsectomy (MMCR±T), combined with bandage contact lens (BCL) use, in corneal graft patients. METHODS Seven patients with corneal grafts who underwent MMCR±T for treatment of ptosis were evaluated retrospectively. A BCL was applied to the grafts at the end of the surgery. The collected data included preoperative and postoperative visual acuity, marginal reflex distance 1 (MRD-1), presence of Hering's dependency by the phenylephrine test, symmetry outcomes, and complications after MMCR±T. RESULTS The average duration between the penetrating keratoplasty and MMCR±T was 14 months, with a follow-up time of 10.4 months after MMCR±T. Hering's dependency was observed in four (57.2%) patients before MMCR±T, and MRD-1 was increased in all patients based on preoperative phenylephrine tests. The mean preoperative MRD-1 was -0.14 ± 0.55 mm, and the mean postoperative MRD-1 was 2.35 ± 0.89 mm (p < 0.0001). Symmetry outcomes of perfect (<0.5 mm), good (0.5-1 mm), and fair (≥1 mm) were noted after MMCR±T in three, three, and one patients, respectively. During the follow-up, no obvious corneal epitheliopathy, keratitis, or corneal graft rejection/failure were noted in any cases. BCL use was well tolerated by all patients. CONCLUSIONS Most patients achieved good surgical outcomes with the application of the BCL to protect the graft and with the use of the phenylephrine test and Hering's dependency to predict the final eyelid position and symmetry. MMCR±T combined with BCL may therefore represent an alternative approach for correction of ptosis in patients with corneal graft.
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Affiliation(s)
- Mehmet Serhat Mangan
- Division of Ophthalmic Plastic and Reconstructive Surgery, Sadik Eratik Eye Clinic, Haydarpasa Numune Education and Research Hospital, University of Health Sciences, Istanbul,
Turkey
| | - Serap Yurttaser Ocak
- Division of Cornea, Department of Ophthalmology, Okmeydani Education and Research Hospital, University of Health Sciences, Istanbul,
Turkey
| | - Ece Turan Vural
- Division of Cornea, Sadik Eratik Eye Clinic, Haydarpasa Numune Education and Research Hospital, University of Health Sciences, Istanbul,
Turkey
| | - Elvin Yildiz
- Division of Cornea, Sadik Eratik Eye Clinic, Haydarpasa Numune Education and Research Hospital, University of Health Sciences, Istanbul,
Turkey
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Mangan MS, Ozturan SG, Ocak SY, Arici C, Uyar Y. A case of cutaneous fistula at the incision site following external dacryocystorhinostomy in a patient with rheumatoid arthritis and reconstruction via bilobed flap technique. Indian J Ophthalmol 2020; 68:2520-2521. [PMID: 33120666 PMCID: PMC7774119 DOI: 10.4103/ijo.ijo_463_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Mehmet Serhat Mangan
- University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Clinic, Istanbul, Turkey
| | - Seyma Gulcenur Ozturan
- Department of Ophthalmology, University of Health Sciences, Okmeydani Education and Research Hospital, Istanbul, Turkey
| | - Serap Yurttaser Ocak
- Department of Ophthalmology, University of Health Sciences, Okmeydani Education and Research Hospital, Istanbul, Turkey
| | - Ceyhun Arici
- Department of Ophthalmology, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Yavuz Uyar
- Department of Otorhinolaryngology, University of Health Sciences, Okmeydani Education and Research Hospital, Istanbul, Turkey
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Mangan MS, Basar E. Comparison of the Efficiency of the Botulinum Toxin for the Treatment of Esotropia in Children with and without Neurological Disease and/or Prematurity. J Binocul Vis Ocul Motil 2020; 70:163-169. [PMID: 33095106 DOI: 10.1080/2576117x.2020.1826288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To compare the effect of botulinum toxin injection for the management of esotropia in patients with and without neurological disease and/or prematurity. METHODS A single-center, retrospective, nonrandomized controlled study was performed on botulinum toxin in 87 children divided into two groups: study group of esotropia in 56 children with neurological disease and/or prematurity and, control group of 31 healthy children with infantile esotropia. All patients were followed for at least 24 months after injection. Success was defined as motor alignment with 10Δ of orthotropia after single bilateral botulinum injection. RESULTS Mean age at treatment was similar in both groups (15.5 vs 14.8 months; p = .555). Mean pretreatment deviation was similar in both groups (50.8Δ vs 50Δ; p = .855). The success rate was better in the control group (61.2% vs 51.7%, p = .265) at 24 months after injection, but the change in the mean angle of deviation was not statistically significant between the groups at 12 and 24 months after injection (p = .264 and p = .547, respectively). Multivariate regression analysis showed that pretreatment angle of deviation and presence of retinopathy of prematurity were significant predictors at 12 months after injection (p = .0001 and p = .004, respectively), while pretreatment angle of deviation was found to be a predictor at 24 months after injection (p = .0001). CONCLUSIONS Decreased angle of deviation and absence of retinopathy of prematurity were associated with a better result. There was no difference in motor alignment of esotropia in children with and without neurological disease and/or prematurity. In these patients, botulinum injection may be used as an alternative to surgery.
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Affiliation(s)
- Mehmet Serhat Mangan
- University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Clinic , Istanbul, Turkey
| | - Emel Basar
- Department of Ophthalmology, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa , Istanbul, Turkey
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Mangan MS, Tekcan H, Yurttaser Ocak S. Efficacy of Bandage Contact Lenses versus Eye Patching in Early Postoperative Period of Müller's Muscle-Conjunctival Resection. Ophthalmic Res 2020; 64:139-144. [PMID: 33091917 DOI: 10.1159/000512470] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/22/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE Patients with blepharoptosis who are treated with Müller's muscle-conjunctival resection (MMCR) may experience postoperative pain and discomfort related to the suture material on the palpebral conjunctiva. This study aims to compare the postoperative subjective complaints, such as pain and discomfort, with a visual analog scale (VAS), and objectively evaluate the cornea with a tear break-up time (TBUT) test and fluorescein staining following MMCR that was managed by either a bandage contact lens (BCL) or eye patching. METHODS Forty patients who had undergone a unilateral MMCR were randomized into 2 groups. Group 1 (n = 20) received a BCL, and group 2 (n = 20) received an eye patch following the MMCR. Patients were evaluated postoperatively at 1 and 7 days in this prospective study. The postoperative pain was measured using a VAS, and the requirement for anti-inflammatory medication was analyzed. A slit-lamp examination was performed to evaluate the cornea with a TBUT test and fluorescein staining by objectively using the National Eye Institute (NEI) classification. RESULTS BCL treatment decreased the VAS score, the need for anti-inflammatory medications, and fluorescein staining using the NEI score and increased the TBUT score significantly compared with the eye patch treatment (p < 0.001). CONCLUSIONS Our findings suggest that the use of a BCL may be beneficial in terms of reducing early postoperative pain and eye stinging, protecting the cornea, and retaining the ability to perform daily activities following a MMCR.
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Affiliation(s)
- Mehmet Serhat Mangan
- Division of Ophthalmic Plastic and Reconstructive Surgery, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Clinic, University of Health Sciences, Istanbul, Turkey,
| | - Hatice Tekcan
- Division of Ophthalmic Plastic and Reconstructive Surgery, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Clinic, University of Health Sciences, Istanbul, Turkey
| | - Serap Yurttaser Ocak
- Department of Ophthalmology, Okmeydani Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
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Mangan MS, Cakir A, Yurttaser Ocak S, Tekcan H, Balci S, Ozcelik Kose A. Analysis of the quality, reliability, and popularity of information on strabismus on YouTube. Strabismus 2020; 28:175-180. [DOI: 10.1080/09273972.2020.1836002] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Mehmet Serhat Mangan
- Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Clinic, University of Health Sciences, Istanbul
| | - Akin Cakir
- Okmeydani Education and Research Hospital, Department of Ophthalmology, University of Health Sciences, Istanbul
| | - Serap Yurttaser Ocak
- Okmeydani Education and Research Hospital, Department of Ophthalmology, University of Health Sciences, Istanbul
| | - Hatice Tekcan
- Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Clinic, University of Health Sciences, Istanbul
| | - Sevcan Balci
- Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Clinic, University of Health Sciences, Istanbul
| | - Alev Ozcelik Kose
- Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Clinic, University of Health Sciences, Istanbul
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Tuncer I, Bilgin S, Zengin MÖ, Mangan MS, Karaca A, Doğan C, Çınar E. Effect of brimonidine tartrate 0.15% on scotopic pupil size and upper eyelid position: controlled trial. Eye (Lond) 2020; 35:672-675. [PMID: 32518394 DOI: 10.1038/s41433-020-1007-9] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/18/2020] [Accepted: 05/26/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND To evaluate the effect of brimonidine tartrate 0.15% ophthalmic solution on pupil size under scotopic condition and upper eyelid position. METHODS This study comprised 72 eyes of 36 healthy subjects. A single drop of brimonidine tartrate 0.15% ophthalmic solution was instilled in the right eye and artificial tear was instilled in the left eye. Pupil size was measured using an infra-red pupillometer under scotopic condition before and at 30 min, 2, 4, 6, 8 and 10 h after instillation. Measurement of margin reflex distance 1 (MRD1) was performed using a millimetre ruler before and after at 10 min after instillation. RESULTS The mean age of the subjects was 32.19 ± 11.43 years (range 10-52 years), 17 were female and 19 were male. Before brimonidine instillation, the mean pupil size was 6.09 ± 1.03 mm in the brimonidine eyes and 6.06 ± 1.04 mm in the control eyes. There was a significant decrease in mean pupil size at 30 min (4.45 ± 1.04), 2 h (4.49 ± 1.06), 4 h (4.59 ± 1.06), 6 h (4.89 ± 1.06) and 8 h (5.38 ± 1.02) after instillation compared to before in brimonidine eyes (p < 0.001 for all). There was a significant miosis continued for at least 6 h (5.95 ± 1.03) in control eyes (p < 0.001). There was no significant change in MRD1, before and after instillation both in brimonidine and control eyes. CONCLUSIONS Brimonidine tartrate 0.15% had a significant miosis under scotopic condition for at least 8 h after instillation and had a significant miosis on the untreated eye for at least 6 h.
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Affiliation(s)
| | | | | | | | | | - Cezmi Doğan
- Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
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Arıcı C, Hagverdiyeva S, Mergen B, Mangan MS, Arslan OS. First report of traumatic scleral rupture after penetrating keratoplasty. ULUS TRAVMA ACIL CER 2019; 25:631-634. [PMID: 31701505 DOI: 10.5505/tjtes.2018.55014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Globe rupture is a major postoperative complication after penetrating keratoplasty (PK). Because the corneal wound is never comparable with that of healthy corneal tissue, globe rupture following blunt trauma occurs at the corneal graft-host junction. In this study, we report a case of scleral rupture that arose from blunt trauma occurring after PK. A 60-year-old female presented with loss of vision, redness and pain in the left eye, which was the consequence of blunt trauma, was our case in this study. Slit-lamp examination revealed ecchymosis on the eyelids, diffuse subconjunctival hemorrhage and total hyphema. The donor cornea was intact. The right eye showed PK, the cornea was transparent, and the sclera was blue. A 2 mm rupture behind the limbus extending from 3 o'clock to 9 o'clock in the upper half of the sclera was observed during exploratory surgery. She did not report any coexisting medical conditions except for systemic hypertension. The differential diagnosis of the bluish discoloration of her sclera was investigated. In detailed anamnesis, the patient reported that she had been treated for severe allergic eye disease during childhood. Vernal keratoconjunctivitis complication was diagnosed. It should be kept in mind that closed scleral perforation may occur in the patient with PK and blue sclera due to blunt trauma.
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Affiliation(s)
- Ceyhun Arıcı
- Department of Ophthalmology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul-Turkey
| | - Samira Hagverdiyeva
- Department of Ophthalmology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul-Turkey
| | - Burak Mergen
- Department of Ophthalmology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul-Turkey
| | - Mehmet Serhat Mangan
- Department of Ophthalmology, Okmeydanı Training and Research Hospital, İstanbul-Turkey
| | - Osman Sevki Arslan
- Department of Ophthalmology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul-Turkey
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Tanyıldız B, Kandemir B, Mangan MS, Tangılntız A, Göktaş E, Şimşek Ş. Bilateral Serous Macular Detachment After Attempted Suicide with Pregabalin. Turk J Ophthalmol 2018; 48:254-257. [PMID: 30405948 PMCID: PMC6216534 DOI: 10.4274/tjo.70923] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 03/02/2018] [Accepted: 05/05/2018] [Indexed: 12/02/2022] Open
Abstract
A 24-year-old female presented with bilateral vision loss following attempted suicide with pregabalin. Her best-corrected visual acuity (BCVA) was 20/40 in the right eye and 20/50 in the left eye. The bilateral visual disturbance was associated with serous macular detachment. Fundus examination of both eyes showed foveal serous retinal detachment, which was confirmed by optical coherence tomography. Topical nepafenac 0.1% eye drops were started as single drop every 8 hours for 4 weeks. One month later, the serous macular detachment had regressed and BCVA increased to 20/20 in both eyes. To the best of our knowledge, this is the first reported case of bilateral serous macular detachment presumably caused by pregabalin intoxication.
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Affiliation(s)
- Burak Tanyıldız
- İstanbul Kartal Dr. Lütfi Kırdar Training and Research Hospital, Ophthalmology Clinic, İstanbul, Turkey
| | - Baran Kandemir
- İstanbul Kartal Dr. Lütfi Kırdar Training and Research Hospital, Ophthalmology Clinic, İstanbul, Turkey
| | - Mehmet Serhat Mangan
- İstanbul Okmeydanı Training and Research Hospital, Ophthalmology Clinic, İstanbul, Turkey
| | - Aise Tangılntız
- Bezmiâlem Vakıf University Faculty of Medicine, Department of Psychiatry, İstanbul, Turkey
| | - Eren Göktaş
- İstanbul Kartal Dr. Lütfi Kırdar Training and Research Hospital, Ophthalmology Clinic, İstanbul, Turkey
| | - Şaban Şimşek
- İstanbul Kartal Dr. Lütfi Kırdar Training and Research Hospital, Ophthalmology Clinic, İstanbul, Turkey
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Dikkaya F, Sarıcı AM, Erbek F, Celkan T, Mangan MS, Aydın Ö, Demirkesen C, Pazarlı H. Evaluation of high-risk features of primary enucleation of patients with retinoblastoma in a tertiary center of a developing country in the era of intra-arterial chemotherapy. Int Ophthalmol 2017; 38:151-156. [PMID: 28058667 DOI: 10.1007/s10792-016-0436-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 12/02/2016] [Accepted: 12/27/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the frequency of high-risk histopathologic factors in Turkish children enucleated for retinoblastoma and to analyze the association between growth pattern, rosetta formation, tumor thickness, presence of necrosis, calcification, neovascularization, rate of mitosis, and high-risk histopathologic factors. METHODS Pathology reports of 59 eyes who had received enucleation for retinoblastoma were reviewed retrospectively. The histopathologic data included presence of choroidal invasion, optic nerve invasion, scleral extension, tumor thickness, presence of necrosis, calcification, neovascularization, rosetta formation and lymphocyte infiltration, rate of mitosis, and growth pattern. RESULTS This study included 59 eyes from 30 (50.8%) male and 29 (49.2%) female patients. The mean age was 22.87 ± 18.99 months. There were 30 (50.8%) eyes with choroidal invasion, 30 (50.8%) eyes with optic nerve invasion, and 5 (8.5%) eyes with scleral invasion. Endophytic growth pattern was seen in 27 (45.8%) eyes, exophytic growth pattern was seen in 2 (3.4%) eyes, and combined growth pattern was seen in 30 (50.8%) eyes. Exophytic growth pattern was found statistically related to choroidal invasion (p = 0.00). Although tumor with greater thickness tended to have more choroidal invasion (p = 0.02), there was no relation between tumor thickness and optic nerve invasion (p = 0.09). CONCLUSIONS Incidences of choroidal and optic nerve invasion showed similarity with other developing countries. Because of higher incidence of high-risk factors, intra-arterial chemotherapy with its targeted effect should be preferred carefully.
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Affiliation(s)
- Funda Dikkaya
- Department of Ophthalmology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Ahmet Murat Sarıcı
- Department of Ophthalmology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey.
| | - Firuze Erbek
- Department of Pediatrics, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Tiraje Celkan
- Department of Pediatrics, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Serhat Mangan
- Department of Ophthalmology, Okmeydanı Training and Research Hospital, Istanbul, Turkey
| | - Övgü Aydın
- Department of Pathology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Cuyan Demirkesen
- Department of Pathology, School of Medicine, Acıbadem University, Istanbul, Turkey
| | - Halit Pazarlı
- Department of Ophthalmology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
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Mangan MS, Arıcı C, Tuncer İ, Yetik H. Isolated Anterior Lens Capsule Rupture Secondary to Blunt Trauma: Pathophysiology and Treatment. Turk J Ophthalmol 2017; 46:197-199. [PMID: 28058159 PMCID: PMC5200829 DOI: 10.4274/tjo.85547] [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: 09/07/2014] [Accepted: 10/24/2014] [Indexed: 12/01/2022] Open
Abstract
A 25-year-old man suffered an isolated lens anterior capsular tear and mature cataract formation following blunt injury to his right eye. One week after the trauma, best-corrected visual acuity (BCVA) in the right eye was hand motion. B-scan ultrasonography showed that the lens posterior capsule was intact; no vitreous foreign body or retinal pathology were observed. Orbital computed tomography revealed narrowed anterior chamber and increased lens material volume and lens reflectivity in the injured right eye. The globe was intact and no bone fractures were observed. The cataractous lens material was removed by phacoemulsification and a foldable, acrylic, posterior chamber intraocular lens was implanted in the bag. Postoperative BCVA in the right eye was 20/20.
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Affiliation(s)
- Mehmet Serhat Mangan
- Okmeydanı Training and Research Hospital, Ophthalmology Clinic, İstanbul, Turkey
| | - Ceyhun Arıcı
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey
| | | | - Hüseyin Yetik
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey
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Arici C, Iskeleli G, Atalay E, Mangan MS, Kilic B. Molten metal-related ocular thermal burn: report on two cases. Arq Bras Oftalmol 2016; 78:379-81. [PMID: 26677043 DOI: 10.5935/0004-2749.20150100] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 01/19/2015] [Indexed: 11/20/2022] Open
Abstract
We report two cases of severe thermal burns on the ocular surface and its adnexal appendages that developed secondary to exposure to molten heavy metal with a melting temperature of near-thousand degree Celsius. Despite aggressive intervention and strict monitoring, the profound inflammation caused significant damage to the ocular surface, ending up in an intractable infection with an unfavorable outcome. The heat of the molten metal at impact, the heat-retaining capacity of the heavy metal, the total area of the ocular surface exposed to the molten metal, and the duration of exposure determined the severity of the injury. The unfavorable outcome, despite an intensive treatment, in terms of visual acuity and cosmetic appearance, should be explicitly explained to the patient, and a psychiatrist consultation should be considered if necessary.
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Affiliation(s)
- Ceyhun Arici
- Department of Ophthalmology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Guzin Iskeleli
- Department of Ophthalmology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Eray Atalay
- Department of Ophthalmology, Kars State Hospital, Kars, Turkey
| | - Mehmet Serhat Mangan
- Department of Ophthalmology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Belgin Kilic
- Department of Ophthalmology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
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Mangan MS, Atalay E, Arıcı C, Tuncer İ, Bilgeç MD. Comparison of Different Types of Complications in the Phacoemulsification Surgery Learning Curve According to Number of Operations Performed. Turk J Ophthalmol 2016; 46:7-10. [PMID: 27800250 PMCID: PMC5076311 DOI: 10.4274/tjo.83788] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 12/07/2014] [Accepted: 02/25/2015] [Indexed: 12/01/2022] Open
Abstract
Objectives: To compare the differences in intraoperative complications rates by the number of resident-performed sequential phacoemulsification surgeries. Materials and Methods: Preoperative and postoperative ophthalmological examination records and intraoperative data of 180 eyes of 140 patients who underwent cataract surgery by two residents between November 2009 and February 2012 were analyzed retrospectively. The data of 180 eyes were separated into 3 groups based on the number of operations performed: Group A (first 1-60 eyes), group B (61-120 eyes) and group C (last 121-180 eyes). The number of direct supervisor interventions and the rates of different types of complications were compared between the three groups. Results: The number of direct supervisor interventions was 45, 35 and 19 in group A, B and C, respectively. The number of complications anterior to the iris plane was 3, 4 and 12 in group A, B and C, respectively. The difference in the rate of complications between group B and C was statistically significant (p=0.029). The number of complications posterior to the iris plane was 6, 14 and 3 in group A, B and C, respectively. The difference in the rate of complications between the groups was statistically significant (p=0.042, p=0.004). Conclusion: This study provides insight into which types of complications might arise during the phacoemulsification training period. The trends in the rates of different complication types in clinics may be analyzed, and this analysis may be used to improve and modify phacoemulsification training programmes according to the needs of residents.
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Affiliation(s)
- Mehmet Serhat Mangan
- Okmeydanı Education and Research Hospital, Ophthalmology Clinic, İstanbul, Turkey
| | - Eray Atalay
- Kars State Hospital, Ophthalmology Clinic, Kars, Turkey
| | - Ceyhun Arıcı
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey
| | | | - Mustafa Değer Bilgeç
- Osmangazi University Faculty of Medicine, Department of Ophthalmology, Eskişehir, Turkey
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Mangan MS, Arıcı C, Atalay E, Tanyıldız B, Oruçoğlu F. Four Cases of Pediatric Photokeratitis Present to the Emergency Department After Watching the Same Theater Show. Turk J Ophthalmol 2015; 45:226-228. [PMID: 27800238 PMCID: PMC5082247 DOI: 10.4274/tjo.67625] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 02/01/2014] [Accepted: 06/05/2014] [Indexed: 12/01/2022] Open
Abstract
We report four consecutive cases of photokeratitis that presented to the emergency department, interestingly after having watched the same theatre performance in the same school. The patients’ ages (3 male, 1 female) ranged from 9 to 13 years. All patients presented with similar complaints consisting of pain, tearing, foreign body sensation, photophobia and blurred vision in both eyes. Patients reported watching a theatre performance in the same school approximately 4 hours before symptom onset. On slit-lamp examination, conjunctival injection and corneal punctate epithelial erosions were observed in the interpalpebral zone in both eyes. On fundus examination, no pathology was observed in the vitreous, posterior pole or peripheral retina. All cases were treated with topical antibiotics and lubricant eye drops. Corneas were clear two days later in the control visit. In this case report, exposure to ultraviolet light from high-power lamps used in the theatre was proposed as a possible cause of corneal epithelial cell damage and subsequent photokeratitis.
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Affiliation(s)
- Mehmet Serhat Mangan
- Okmeydanı Education and Research Hospital, Clinic of Ophthalmology, İstanbul, Turkey
| | - Ceyhun Arıcı
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey
| | - Eray Atalay
- Kars State Hospital, Clinic of Ophthalmology, Kars, Turkey
| | - Burak Tanyıldız
- İstanbul University İstanbul Faculty of Medicine, Department of Ophthalmology, İstanbul, Turkey
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Mangan MS, Erdoğan M, Atalay E, Arıcı C. Tek Taraflı İzole Epikapsüler Stara Sekonder Gelişen Görme Azlığı. Turk J Ophthalmol 2014. [DOI: 10.4274/tjo.02360] [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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Arslan OS, Arici C, Unal M, Cicik E, Mangan MS, Atalay E. Safety of prophylactic intracameral moxifloxacin ophthalmic solution after cataract surgery in patients with penetrating keratoplasty. Int J Ophthalmol 2014; 7:795-9. [PMID: 25349795 DOI: 10.3980/j.issn.2222-3959.2014.05.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Accepted: 11/25/2013] [Indexed: 11/02/2022] Open
Abstract
AIM To determine the safety of prophylactic intracameral moxifloxacin after cataract surgery in patients with penetrating keratoplasty (PKP). METHODS In this retrospective study of consecutive patients who had phacoemulsification cataract surgery after PKP, were treated with intracameral moxifloxacin 0.5% ophthalmic solution (0.5 mg/0.1 mL). The main outcome measures were anterior chamber reaction, best corrected visual acuity (BCVA), corneal endothelial cell count (ECC), and central corneal thickness (CCT). RESULTS Fifty-five patients were recruited (26 males, 29 females). The mean age was 54.36±4.97y (range 45-64y). All eyes had improved postoperative BCVA. The mean BCVA was 0.25 preoperatively and 0.57 postoperatively, which was statistically significant (P<0.001). One eye had 3+, 7 eyes had 2+, 12 eyes had 1+ and 8 eyes had trace amount of aqueous cells on the first day after surgery. All eyes had no anterior chamber cells at subsequent follow up examinations. Effective phacoemulsification time was 4.33±1.01s. The mean ECC was 2340.20 cells/mm(2) preoperatively and 1948.75 cells/mm(2) 1mo postoperatively (P<0.001). The increase of 21.09 µm in postoperative pachymetry 1mo after surgery was statistically significant (P<0.001). CONCLUSION No untoward effects were observed after intracameral injection of moxifloxacin (0.5 mg/0.1 mL) in terms of anterior chamber reaction, CCT, ECC, and visual rehabilitation at the conclusion of cataract surgery in patients with PKP.
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Affiliation(s)
- Osman Sevki Arslan
- Department of Ophthalmology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul 34098, Turkey
| | - Ceyhun Arici
- Department of Ophthalmology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul 34098, Turkey
| | - Mustafa Unal
- Department of Ophthalmology, Medical Faculty, Akdeniz University, Antalya 07070, Turkey
| | - Erdogan Cicik
- Department of Ophthalmology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul 34098, Turkey
| | - Mehmet Serhat Mangan
- Department of Ophthalmology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul 34098, Turkey
| | - Eray Atalay
- Department of Ophthalmology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul 34098, Turkey
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Seyahi E, Tahir Turanli E, Mangan MS, Celikyapi G, Oktay V, Cevirgen D, Kuzuoglu D, Ozoglu S, Yazici H. The prevalence of Behçet's syndrome, familial Mediterranean fever, HLA-B51 and MEFV gene mutations among ethnic Armenians living in Istanbul, Turkey. Clin Exp Rheumatol 2010; 28:S67-S75. [PMID: 20868574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Accepted: 07/30/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVES We investigated the prevalence of Behçet's syndrome (BS) among the ethnic Armenians in Istanbul using Familial Mediterranean Fever (FMF) as a comparator disease. We also studied HLA-B51 and MEFV mutations among a group of healthy Armenians and a non-Armenian population. METHODS The prevalence study was conducted in 2 parts in the Armenian primary schools in Istanbul, using the enrolled students as index cases to study the core family. In Part I, a questionnaire seeking only whether either parent had previously been diagnosed as having BS or FMF by a physician was distributed to a total of 1873 index students registered at 10 schools. A total of 1380 parents filled in the questionnaire, yielding a response rate of 37% (1380 / 3746). In Part II, eight schools participated with a response rate of 83 % (1183/1428). Also, genomic DNA samples of 108 healthy (14 M/94 F) Armenians and 97 (45 M/ 52 F) non-Armenians, were studied for HLAB51 and MEFV gene mutations. RESULTS In Part I, none of the parents turned out to have been diagnosed as BS, whereas a total of 12 / 1380 (870/105) had been diagnosed as FMF. In the second part the estimated prevalence of BS was 90 /105 and that of FMF was 760/ 105. HLA-B51 carrier rate was found to be similar between the Armenian (27%, 29/108) and the non-Armenian participants (19%, 18/97), (p=0.158). Overall carrier rate of MEFV gene mutations was significantly higher in the Armenian group (36% vs. 20%, p=0.015). CONCLUSIONS The genetic load for FMF is considerably higher among the Armenians when compared to the load for BS among the same ethnic group. On the other hand, the rather low frequency of BS among the Armenians when compared to the frequency among the general population living in the same environment is further evidence for a genetic predisposition to BS. HLA- B51 does not seem to play a dominant role in the said predisposition. Finally, as we have used an unorthodox epidemiological methodology in data collection our results might need to be further verified by more conventional methods.
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Affiliation(s)
- Emire Seyahi
- Department of Medicine, University of Istanbul, Istanbul, Turkey.
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