Browsing by Author "Eksioglu, Umit"
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Item Assessing risk factors for postoperative hypotony in Ahmed glaucoma valve implantation surgery(2021) Kaderli, Ahmet; Demirok, Gulizar; Uney, Guner; Yakin, Mehmet; Gunal, Berku; Eksioglu, Umit; 34019191Purpose To assess the risk factors associated with the development of hypotony after Ahmed glaucoma valve (AGV) implantation. Methods One hundred and ninety-three eyes of 177 patients with various types of glaucoma that were treated with AGV implantation were retrospectively evaluated. Intraocular pressure lower than 6 mmHg related to the surgery is defined as postoperative hypotony. Patients' demographic characteristics, type of glaucoma, preoperative and postoperative visual acuity, necessity of antiglaucoma treatments, lens status, previous ocular surgeries, intraocular pressure (IOP) measurements before and after surgeries, the need for additional procedures and postoperative complications were recorded from the patients' charts. Results Hypotony was seen in 68 of 193 eyes (35.2%) postoperatively. In 45 eyes (23.3%), it has occurred in first postoperative day and in 23 eyes (11.9%) after the first day within the first week. There was no difference in intraocular pressures between two groups in the first year follow-up. Pre- and postoperative best-corrected visual acuities, age and gender were not statistically different between hypotony and no hypotony groups (p > 0.05). Also, lens status, history of previous ocular surgery, type of glaucoma and number of preoperative glaucoma medication usage were not found to be different between groups (p > 0.05). Conclusions Potential risk factors such as age, sex, lens status, history of previous ocular surgeries, preoperative glaucoma medication usage or glaucoma type are not found to influence upon postoperative hypotony prevalence for AGV surgery. Surgery type and personal ocular factors, which could not be determined beforehand, could be more important than demographic features.Item Characteristics of uveitic glaucoma in Turkish patients(2020) Tekeli, Oya; Elgin, Ufuk; Takmaz, Tamer; Eksioglu, Umit; Bas, Zeynep; Yarangumeli, Alper; Karakurt, Ahmet; Evren Kemer, Ozlem; Mumcuoglu, Tarkan; Aktas, Zeynep; Akman, Ahmet; Bayer, Atilla; 32799547Purpose: To evaluate the prevalence of uveitic glaucoma (UG) in the Turkish population and investigate the primary underlying diseases. Methods: This multicenter, cross-sectional, prospective study included patients who presented to the glaucoma units of 10 tertiary ophthalmology departments in Ankara, Turkey from 15th March to 16th May 2015 and fulfilled the criteria of UG. Patients were inspected for age, sex, medical history, best corrected visual acuity, biomicroscopic findings, intraocular pressure values, and visual field results. Results: During the study period, 4604 eyes of 2541 patients with glaucoma were screened and 145 eyes of 104 patients (4.1%) were identified as having UG. One hundred and thirty-four eyes (92.4%) had open-angle glaucoma and 11 eyes (7.6%) had closed-angle glaucoma. The mean patient age was 47 +/- 16 (6-90) years. Idiopathic uveitis (54 eyes), Behcet's disease (26 eyes), Fuchs heterochromic cyclitis (21 eyes), Herpes Simplex virus infectious uveitis (14 eyes), and ankylosing spondylitis (six eyes) were the leading types of uveitis associated with glaucoma. Acute anterior uveitis was the most common type of uveitis diagnosed in 72 patients (105 eyes), whereas 21 patients (27 eyes) had panuveitis, eight patients (nine eyes) had intermediate uveitis, and three patients (four eyes) had posterior uveitis. The need for surgical intervention was 37.2% among all cases and the most common surgery was trabeculectomy in 45 eyes. Conclusion: UG is a vision-threatening complication commonly seen in patients with uveitis. This study demonstrates the epidemiological features and underlying etiologies of UG in the Turkish population. The most common primary causes of UG were Behcet's disease and Fuchs heterochromic cyclitis.Item Effect of trabeculectomy and Ahmed glaucoma valve implantation surgery on corneal biomechanical changes(2020) Kaderli, Ahmet; Demirok, Gulizar; Kaderli, Sema Tamer; Oktem, Caglar; Karnaz, Ali; Ozen, Dogukan; Eksioglu, Umit; 0000-0002-3061-7162; 32300919; ABG-2501-2020Purpose To evaluate alterations in corneal biomechanical properties before and 6 months after conventional trabeculectomy (TRAB) and Ahmed glaucoma valve (AGV) implantation. Methods Thirty-nine eyes of 39 patients were evaluated retrospectively. Complete ophthalmological examinations including evaluation of corneal biomechanical properties using the Ocular Response Analyzer were performed before and after 6 months postoperatively. A mean of four measurements for corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann correlated intraocular pressure (IOPg), and corneal compensated intraocular pressure (IOPcc) was recorded. The participants had undergone trabeculectomy or shunt surgery as the first surgical procedure for glaucoma treatment of uncontrolled IOP with maximum antiglaucoma eyedrops. Results There were 20 eyes of 20 patients in trabeculectomy group and 19 eyes of 19 patients in AGV implantation group. There was no significant difference between two groups in terms of sex, age, eye laterality, lens status, antiglaucoma drug usage, preoperatively measured Mean Deviation of Humphrey Visual Field Analyzer, CH, CRF, IOPcc, and IOPg (p > 0.05). CH and CRF increased significantly after shunt surgery (p < 0.001). CH increased in trabeculectomy group postoperatively (p < 0.001); however, CRF showed a small amount of decrease, but this reduction was not statistically significant (p > 0.05). CH and CRF showed higher increase after AGV surgery than trabeculectomy surgery (p < 0.05). There was no significant correlation between IOP changes and CH-CRF changes in both TRAB and AGV groups (p > 0.05). Conclusion According to our results, surgical technique differences may have an impact on postoperative corneal biomechanical outcomes. AGV surgery offers better corneal biomechanical results than standard trabeculectomy in 6-month follow-up.Item Factors affecting the surgical success of trabeculectomy performed as the first surgery in primary pediatric glaucoma(2022) Demirok, Gulizar; Ozkan, Guner; Kaderli, Ahmet; Guvenc, Umay; Yakin, Mehmet; Eksioglu, Umit; 0000-0002-3061-7162; 35353293; ABG-2501-2020Purpose To present the outcomes and factors affecting the success of trabeculectomy performed as the first surgery in primary pediatric glaucoma. Methods Pediatric patients with primary glaucoma who underwent trabeculectomy as the first surgery were retrospectively reviewed. Age, gender, preoperative intraocular pressure (IOP), operation age, axial length, corneal diameter, anterior segment findings, antimetabolite used, complications, and 1-month, 3-months, 1-year, and most recent postoperative findings were recorded. Postoperative IOP with/without medication of 18 mmHg or less was considered successful. Factors that may have affected surgical success were also evaluated using multivariate analysis. Results Included in the study were 48 patients, of whom 30 had primary congenital glaucoma and 18 had juvenile glaucoma. The mean preoperative IOP was 36.84 +/- 6.30 mmHg, and the mean follow-up time was 7.95 +/- 6.93 years. The median operation age value was 100.00 +/- 100.83 (median: 60; IQR: 153) months. The postoperative IOP at the 1-month, 3-months, 1-year, and most recent follow-ups were 15.39 +/- 6.88, 15.70 +/- 7.36, 16.28 +/- 7.86, and 17.48 +/- 8.44 mmHg, respectively (p = 0.565). While there were no postoperative complications in 24 of the patients (50.0%), the most common complications were choroidal detachment and hypotony. Postoperative complication development was found to be significant as a factor affecting surgical success in the multivariate logistic regression analysis. Surgical success rates for all of the patients were 71.7%, 65.9%, 65.0%, and 61.4% at the 1-month, 3-months, 1-year, and most recent follow-ups, respectively. A significant difference was found between the congenital and juvenile groups in terms of surgical success only at 3 months (p = 0.953, p = 0.042,p = 0.191, p = 0.218; respectively). Discussion/Conclusion The fact that surgical success was partially higher in the juvenile group confirmed the idea that the results of trabeculectomy will be more favorable in patients of older age and without anterior segment anomalies.Item Optical Coherence Tomography Angiography Findings in Primary Open-Angle and Pseudoexfoliation Glaucoma(2022) Duezova, Emrah; Demirok, Gulizar; Ueney, Guner; Kaderli, Ahmet; Yakin, Mehmet; Ozbek Uzman, Selma; Eksioglu, Umit; 0000-0002-3061-7162; 36017118; ABG-2501-2020Objectives: To compare the optical disc and macular vascular density values of patients with glaucoma and healthy individuals by using optical coherence tomography angiography and evaluate the relationship between structural and functional test results and vascular density.Materials and Methods: The study included 128 eyes in total: 31 with pseudoexfoliation glaucoma (PEG), 55 with primary open -angle glaucoma (POAG) and similar visual field defects, and 42 healthy eyes. Whole image peripapillary vessel density (wpVD), intradisc vessel density (idVD), peripapillary vessel density (pVD), whole image macular vessel density (wmVD), and parafoveal vessel density (pfVD) values were compared between the groups. Correlations between visual field findings, retinal nerve fiber layer (RNFL) and optic nerve head measurements and peripapillary and macular vascular density were analyzed.Results: In the PEG and POAG groups, wpVD, idVD, wmVD, and pfVD values were significantly lower in than the control group. In the PEG group, wpVD was found to be significantly lower than the POAG group (p<0.001). There was no significant difference between the PEG and POAG groups in wmVD and pfVD except for nasal pfVD. There were strong positive correlations between RNFL thickness and pVD in the glaucoma groups (p<0.001). Significant correlations were found between visual field mean deviation and pattern standard deviation values and peripapillary and macular vessel density values in the glaucoma groups.Conclusion: Vascular density values were lower in glaucoma patients compared to normal individuals, and there is a strong correlation between structural and functional tests and vessel density values. The lower vascular density in the PEG group compared to the POAG group indicates that vascular damage may be more common in PEG patients.Item Peripapillary and Macular Vascular Densities in Healthy, Ocular Hypertensive, and Different Stages of Glaucomatous Eyes(2023) Ozturk, Caner; Gungor, Sirel Gur; Eksioglu, Umit; Sezenoz, Almila Sariguel; Colak, Meric; 0000-0002-3061-7162; 38111931; ABG-2501-2020AIM: To investigate vascular changes in different stages of glaucoma and to evaluate the role of optical coherence tomography angiography (OCTA) in the early diagnosis of glaucoma.METHODS: Glaucoma patients and healthy controls (n= 29 eyes) were investigated in this cross-sectional comparative study. Glaucoma patients were grouped as ocular hypertension (n=44 eyes), preperimetric glaucoma (PPG; n=32 eyes), early glaucoma (EG; n=35 eyes), moderate stage glaucoma (MG; n=36 eyes), and advanced glaucoma (AG; n=35 eyes). Peripapillary and macular vascular densities (VDs) of all participants were compared and correlations of VDs and retinal nerve fiber layer thickness (RNFLT), ganglion cell analysis (GCA), and visual field (VF) tests were evaluated. Area under the receiver operation characteristic curves (AUC) of the peripapillary and macular VD parameters were obtained.RESULTS: VD values decreased with the progression of glaucoma. Most peripapillary and macular VD parameters of PPG and EG groups were lower than healthy controls (P<0.001). There was no significant difference in RNFLT between the PPG and EG groups, but most peripapillary and macular VDs were found to be lower in EG group than in PPG group (P<0.05). In most disease group, VDs were significantly correlated with OCT parameters (P<0.001) and VF index (P<0.05). There were no significant correlations between VF and RNFLT indices in the AG group, but significant correlations were found between VF and VD values (P<0.05). AUC for discriminating between healthy and glaucomatous eyes were highest in whole image peripapillary VD (AUC: 0.865, 0.929, and 0.986, respectively in EG, MG, and AG groups).CONCLUSION: OCTA can be used in the early diagnosis of glaucoma and can be useful in follow-up of the advanced disease. In cases where limitations or suspicions in structural and functional tests are present, OCTA can be used as a supportive diagnostic test, both in EG and AG.Item Response to comment on: Factors affecting the early and mid-term success of needling for early failure of filtering bleb(2021) Demirok, Gulizar; Kaderli, Ahmet; Kaderli, Sema Tamer; Uney, Guner; Yakin, Mehmet; Eksioglu, Umit; 34571676