Browsing by Author "Altinors, Dilek D."

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Descemet Membrane Endothelial Keratoplasty: Outcomes in the First Year of Experience
(2018) Altinors, Dilek D.; Asena, Leyla; 0000-0001-5223-0279; 0000-0002-6848-203X; 29528002; AAK-8077-2021; E-5914-2016
Objectives: We aimed to report the clinical outcomes of Descemet membrane endothelial keratoplasty in our first year of experience. Materials and Methods: Patients who underwent Descemet membrane endothelial keratoplasty at the Baskent University Faculty of Medicine, Department of Ophthalmology, between 2015 and 2016 were included in the study. Patient demographics, cause of endothelial dysfunction, best-corrected visual acuity, central corneal thickness, graft survival, follow-up duration, and intraoperative and postoperative complications were recorded. Results: Five eyes of 5 patients (4 female, 1 male) with a mean age of 53.4 +/- 12.7 years were included. Cause of endothelial dysfunction included corneal endothelial dystrophy in 3 patients, pseudophakic bullous keratopathy in 1 patient, and endothelial graft failure after previous penetrating keratoplasty in 1 patient. Pre-stripped Descemet membranes obtained from the Ankara State Hospital Eye Bank were used. Mean duration of postoperative follow-up was 7.4 +/- 3.7 months. Mean preoperative Snellen best-corrected visual acuity and central corneal thickness were 0.24 +/- 0.15 and 625.5 +/- 97.4 mu m. Mean best-corrected visual acuity increased to 0.67 +/- 0.26 (P = .02) in the first month and to 0.84 +/- 0.11 (P < .01) at the end of follow-up. Mean central corneal thickness decreased to 546.6 +/- 28.4 pm (P = .03). Graft detachment was observed in 1 patient on the first postoperative day, and it was reattached successfully by injection of air into the anterior chamber. There were no intra-operative complications. All corneas were clear at the end of follow-up. Conclusions: Descemet membrane endothelial keratoplasty provides a new and exciting option for endothelial transplant and has the potential to become the primary procedure for surgical management of Fuchs endothelial dystrophy and corneal endothelial disease. Rapid visual rehabilitation with few and manageable complications and good visual outcomes are the major advantages of this procedure.
Effect of dexamethasone intravitreal implant in a corneal graft rejection
(2016) Yesilirmak, Nilufer; Ozdemir, Evin Singar; Altinors, Dilek D.; 27158625
Galectin-3, IL-1A, IL-6, and EGF Levels in Corneal Epithelium of Patients With Recurrent Corneal Erosion Syndrome
(2020) Candar, Tuba; Asena, Leyla; Alkayid, Husamadden; Altinors, Dilek D.; 0000-0001-5223-0279; 0000-0002-6848-203X; 32732704; E-5914-2016; AAK-8077-2021
Purpose: To determine the galectin-3 (Gal3), interleukin-1 (IL-1), interleukin-6 (IL-6), and epidermal growth factor (EGF) levels in corneal epithelium of patients with recurrent corneal erosion (RCE) syndrome and compare them with healthy controls. Methods: In this prospective interventional case control study, 32 eyes of 32 patients with RCE syndrome who had corneal epithelial erosions and 28 eyes of 28 healthy participants scheduled for photorefractive keratectomy (control group) were included. Exclusion criteria included corneal dystrophies, ectasia, dry eye, previous ocular surgery or topical medications, and systemic diseases. Epithelial samples were obtained during epithelial debridement in the study group and mechanical epithelial keratectomy in the control group. Galectin-3 levels were studied by the chemiluminescent microparticle immunoassay method. IL-1, IL-6, and EGF levels were determined using corresponding ELISA kits. Results: The median Gal3 levels were 132.25 ng/mL in the study group and 106.50 ng/mL in the control group. The median IL-1 and IL-6 levels were 6.24 pg/mL and 10.16 pg/mL, respectively, in the study group which were higher than that in the control group. The median EGF level in the study group was lower than that the control group with 1.30 pg/mL versus 2.67 pg/mL. In the control group, there was a significant positive correlation between EGF and IL-6 (r = 0.554;P= 0.040). A similar correlation was not observed in patients with RCE (r = -0.071;P= 0.794). Conclusions: The lack of increased EGF expression and the imbalance between growth factors, adhesion molecules, and interleukins may be the reason for the impaired wound healing response in RCE syndrome.
Visual Rehabilitation After Penetrating Keratoplasty
(2016) Asena, Leyla; Altinors, Dilek D.; 0000-0002-6848-203X; 0000-0001-5223-0279; 27805532; E-5914-2016; AAK-8077-2021
Objectives: Here, our aim was to report our treatment strategies and their results performed for visual rehabilitation after penetrating keratoplasty. Materials and Methods: The medical records of 98 patients (54 male/44 female), with results from 104 eyes, who underwent penetrating keratoplasty between January 2013 and January 2015 at the Baskent University Faculty of Medicine, Department of Ophthalmology were reviewed. Patient age, indication for penetrating keratoplasty, interventions performed for visual rehabilitation, follow-up duration, topo graphic and refractive astigmatism at the end of follow-up, and final best corrected visual acuity results were recorded. Results: Mean age of patients was 54 +/- 23 years. Indications for penetrating keratoplasty included keratoconus, Fuchs endothelial dystrophy, pseu dophakic bullous keratopathy, and corneal scarring. The mean duration of follow-up was 23 +/- 11.5 months. Topography-guided suture adjustment and selective suture removal were performed 2 to 6 weeks and after 3 months in eyes with more than 3 diopters of corneal astigmatism in patients who had continuous and interrupted sutures. Spectacle correction was administered for 86 eyes (83%), and contact lenses including rigid gas-permeable and scleral lenses were fitted in 18 eyes (17%) in patients who were unsatisfied with spectacle correction. Relaxing corneal incisions were performed in 23 eyes (22%), and toric intraocular lens implantations were performed in 34 eyes (33%) with cataracts. The mean topographic and absolute refractive astigmatism at the end of followup was 3.4 +/- 2.6 and 3.6 +/- 1.9 diopters. Conclusions: Topography-guided suture adjustment and selective suture removal are effective for minimizing early postoperative astigmatism. If significant astigmatism remains after suture removal, which cannot be corrected by optical means, then further surgical procedures including relaxing incisions and toric intraocular lens implantation can be performed.