Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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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 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 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