PubMed İndeksli Açık & Kapalı Erişimli Yayınlar
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Item Combined Rectus Muscle Transposition With Posterior Fixation Sutures (Augmented Knapp Procedure) for the Surgical Treatment of Double Elevator Palsy(2022) Akar, Serpil; Gokyigit, Birsen; Ozturker, Zeynep Kayaarasi; 34435907Purpose:To evaluate the surgical results of full horizontal tendon rectus muscle transposition to the superior rectus muscle insertion, augmented by posterior fixation sutures, in patients with double elevator palsy. Methods: In this retrospective comparative study, 17 patients treated by the augmented Knapp procedure (study group) were compared with 28 patients treated by the standard Knapp procedure (control group). Preoperative and postoperative vertical deviation in primary position, ocular motility, binocular function, and rate of reoperation were evaluated. Results: The mean preoperative near and distance deviations (hypotropia) decreased by 93% and 97% in the study group and 68% and 69% in the control group, respectively. The improvement in near and distance deviation was statistically more significant in the study group than the control group (P= .001 for each parameter). The mean preoperative elevation deficiency in abduction and adduction improved by 64% and 66% in the study group and 37% and 39% in the control group, respectively. The improvement in elevation deficiency in abduction and adduction was statistically significantly greater in the study group than the control group (P = .001 and .04, respectively). Reoperation was required in 15 patients (54%) in the control group and 2 (12%) in the study group during the follow-up period of 26 +/- 4 months. Conclusions: The postoperative improvement in near and distance deviation and elevation deficiency in abduction and adduction was significantly better in the augmented Knapp procedure than the standard Knapp procedure. This procedure demonstrated a stronger effect in the treatment of double elevator palsy.Item Microperimetry, Humphrey field analyzer, and optical coherence tomography in detecting glaucoma: a comparative performance study(2022) Akar, Serpil; Tekeli, Oya; Ozturker, Zeynep Kayaarasi; 35023012Purpose To evaluate and compare the diagnostic performance of microperimetry (MP), visual field (VF) 10-2 and 24-2 tests, and spectral-domain optical coherence tomography (SD-OCT) in primary open-angle glaucoma (POAG). Methods The study consisted of 35 POAG and 42 control eyes were enrolled in this prospective study. Eligible participants were >= 50 years old. VF assessments were carried out using the Humphrey field analyzer (HFA) and Macular Integrity Assessment. Optic nerve head (ONH), retinal nerve fiber layer thickness (RNFLT), and ganglion cell inner-plexiform-layer thickness (GCIPLT) were measured by SD-OCT. Areas under the receiver operating characteristic curves (AUC) and sensitivities at 95% specificity were calculated for each parameter. Results HFA 24-2 had the largest AUC value among the functional parameters to differentiate POAG from control eyes [AUC: 0.950 (0.906-0.994), sensitivity at 95%:60]. HFA 24-2 showed a significantly better performance than the 10-2 test (p = 0.036). Among the SD-OCT structural parameters, minimum GCIPLT had the largest AUC value to differentiate POAG from control eyes [AUC: 0.952 (0.905-0.999), sensitivity at 95%:80]. In comparison of the functional and structural parameters, HFA 24-2 showed a significantly better performance than the 10-2 test (p = 0.036). In macular parameters, minimum GCPLT performed significantly better than HFA 10-2 (p = 0.015) in detecting POAG. There was no statistically significant difference between the comparative diagnostic performance of the RNFL, ONH, HFA, and MP (p > 0.05 for all comparisons). Conclusion The structural and functional test results revealed that GCIPLT measurements had the highest diagnostic performance in detecting POAG. HFA 24-2 test performed better than 10-2 test in distinguishing glaucoma from healthy eyes. MP showed a similar performance with HFA 10-2 and may be considered a complementary diagnostic tool.Item Periventricular leukomalacia mimicking normal-tension glaucoma: a case report(2021) Kayaarasi Ozturker, Zeynep; Akar, Serpil; 0000-0001-6442-250X; 0000-0002-5513-9857; 33689645Item Cyclic strabismus: what measured angle of strabismus should guide surgery?(2019) Celik, Selcen; Inal, Asli; Ocak, Osman Bulut; Aygit, Ebru Demet; Akar, Serpil; Gokyigit, Birsen; 31746262Purpose: Here we aimed to describe seven pediatric patients with cyclic strabismus and report the outcome of their surgical treatment. Methods: Seven children with acquired esotropia manifesting in a 48-h cycle were included in the study. Four of them were boys, and three of them were girls. All cases had a large angle of deviation and associated suppression on the esotropic day and small angle of deviation with fusion on the other day. A complete ocular motility examination was performed for seven consecutive days. For all cases, we planned strabismus surgery according to the amount of deviation on the strabismic day. Postoperatively, the deviation angles were recorded at the first week, first month, and third month. Later, the patients were examined at 3-month intervals. Results: The mean age at presentation was 4.42 +/- 3.69 years (1-12 years). The mean angle of esotropia at near fixation preoperatively was 36.4 +/- 14.9 pd (prism dioptre) (20-60 pd) on the esotropic day. The mean angle of esotropia on the esotropic day at distance fixation was 32.1 +/- 6.9 pd (20-40 pd). The mean follow-up period was 18.4 +/- 5.5 months (12-25 months). The mean duration of esotropia before surgery was 11.1 +/- 9.4 months (3-29 months). Following surgery, orthophoria within 10 pd was achieved and maintained in all cases. Conclusion: When treating children with cyclic strabismus, the best surgical results can be achieved when surgery is planned according to the amount of deviation on the strabismic day.