Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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2014 - 20162

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Author: search.filters.author.Akova, Yonca AydinHas files: No

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    Vascularization of Conjunctival Autografts in Pterygium Surgery: Comparison of Fibrin Glue with Sutures
    (2014) Kucukerdonmez, Cem; Karalezli, Aylin; Zengin, Mehmet Ozgur; Akova, Yonca Aydin; 24729145
    Purpose: To monitor the development of graft vascularization after pterygium excision with conjunctival autograft transplantation (CAT) using indocyanine green angiography (ICGA) and to compare the graft vascularization between 2 different fixation techniques (fibrin glue and sutures). Methods: A total of 26 eyes of 26 patients with primary pterygium were randomly assigned after pterygium excision as having either fibrin glue (13 eyes) or Vicryl sutures (13 eyes) for CAT. Anterior segment ICGA findings were evaluated postoperatively at 1, 7, and 15 days and the percentages of graft vascularization in both groups were compared using pixel analysis software program. Results: The mean +/- SD age of patients in the suture and fibrin glue groups was 52.1 +/- 12.7 years and 57.1 +/- 9.82 years, respectively. There was no statistically significant difference between the groups regarding age, sex, or follow-up (p<0.05 for all). Also, the mean intraoperative defect size was not significantly different between the groups, which was measured as 20.11 +/- 10.44 mm(2) in the suture group and 23.44 +/- 12.34 mm(2) in the fibrin glue group (p = 0.343). The mean percentage of vascularized graft area at postoperative day 1 and 7 was 18.1 +/- 7.8% and 25.3 +/- 8.6% in the suture group and 34.8 +/- 10.2% and 66.1 +/- 17.8% in the fibrin glue group. The difference between the groups was statistically significant (p<0.01 for both). At postoperative day 15, all grafts were 100% perfused in both groups. Conclusions: Fibrin glue fixation of conjunctival autografts led to more vascularization in the early postoperative period than suture fixated grafts, which in turn may have significance in terms of graft health and pterygium recurrence.
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    Suramin, Genistein and Collagen Matrix (DuraGen) for Delayed Adjustment after Strabismus Surgery: Which One is Best?
    (2016) Oktem, Caglar; Oto, Sibel; Toru, Serap; Bakar, Coskun; Ozdemir, Handan; Akova, Yonca Aydin; https://orcid.org/0000-0003-0171-4200; 25859732; AAJ-4668-2021
    Aim: To evaluate the efficacy and safety of suramin, genistein and collagen matrix for the prevention of inflammation, the reduction of fibrosis and the delay in adjustment after strabismus surgery on a rabbit model. Methods: By using an adjustable suture technique, a recession of the superior rectus muscle (SRM) was made in 36 eyes of 18 rabbits. Three study groups were created using genistein, suramin and collagen matrix (n = 6 per group). Two control groups utilized dimethyl sulphoxide (DMSO) (n = 6) and balanced salt solution (n = 12). The adjustments and measurements were made on days 2, 7, 14. After enucleation was done on day 21, the degree of inflammation was evaluated quantitatively in histopathological sections and immunohistochemical investigations were performed for tissue expression of cytoplasmic vascular endothelial growth factor (VEGF), MAC 387, TGF-beta and bFGF. Results: The adhesions between conjunctiva and SRM were significantly less in the collagen matrix and suramin groups (p = 0.002) and adhesions between the sclera and SRM were considerably reduced in the genistein and DMSO groups (p = 0.006) on day 7. Force exerted for adjustment was significantly less in the collagen matrix and suramin groups on day 14 (p = 0.006). Expression of b-FGF was significantly lower in the conjunctival epithelium in the suramin and genistein groups (p = 0.0001 for both). TGF-beta was significantly lower (p = 0.001) in the suramin group and VEGF expression was totally absent. MAC 387 expression was lower in the genistein and suramin groups (p = 0.0001). Conclusion: Suramin, genistein and collagen matrix successfully reduce adhesions, and facilitate adjustment following recession surgery. Both suramin and genistein effectively suppress growth factor expression, while collagen matrix offers the longest time interval for adjustability after strabismus surgery.