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Öğe Anterior segment ischemia and retinochoroidal vascular occlusion after intralesional steroid injection(Lippincott Williams & Wilkins, 2008) Yagci, Ayse; Palamar, Melis; Egrilmez, Sait; Sahbazov, Cahit; Oezbek, Sueha SureyyaA 19-year-old woman was admitted with sudden severe pain and loss of tight perception that began immediately after eyelid injection of the depot form of corticosteroid. Ecchymosis of the lower eyelid, corneal edema, and a fixed dilated pupil were noted. Fundus examination could not be performed because of corneal edema. Embolic material packed in the episcleral vessels was detected. With these findings, the diagnosis was anterior and posterior segment ischemia. Despite administration of an intravenous hyperosmotic agent, in addition to topical and systemic pulse corticosteroid (1.0 g/day), vision was not recovered. The most serious complication of intralesional injection of corticosteroid is vascular occlusion. This catastrophic complication after intralesional steroid injection should prompt immediate ophthalmoscopic fundus examination to allow early recognition of ischemic signs and immediate intervention.Öğe Are our cornea waiting lists dynamic enough?(Springer, 2016) Palamar, Melis; Egrilmez, Sait; Yagci, AyseThe purpose of this study was to evaluate the dynamic reality of the corneal transplant (CT) waiting list and if the CT candidates are really eager to operation. We evaluated the response of consecutive 96 CT candidates to call for operation. The age, functional visual acuity, CT indication, waiting period, and the excuse of refusal for candidates that postponed the operation were also evaluated. The patients were classified into two groups according to the availability (Group 1, available; Group 2, unavailable). To find an available candidate for transplantation of 48 consecutive corneal tissues, 96 patients had to be called. The mean age of the patients was 57.49 +/- A 18.75. The mean age of Group 1 and Group 2 was 54.28 +/- A 18.12 (13-80) and 60.44 +/- A 19.01 (9-88) years, respectively (p = 0.108). It was found that the call refusal was higher in patients elder than age 70 (p = 0.04). The mean time between being added to the list and the call was 22.96 +/- A 7.80 (9-39) months for Group 1, 27.02 +/- A 8.25 (9-53) months for Group 2 (p = 0.015). The estimation point for waiting period was 22 months (p = 0.044). The most common reasons of excuse were inconvenience of timing, giving up operation, and secondary health problems, whereas anticoagulant use was the most common reason for postponement. As the waiting period gets longer and CT candidates get older, they tend to give up operation. The secondary health problems and use of systemic anticoagulants are important problems that might cause postponing the CT surgery and ruin the dynamicity of the waiting lists.Öğe Black Tears (Melanodacryorrhea) From Argyrosis(Amer Medical Assoc, 2010) Palamar, Melis; Midilli, Rasit; Egrilmez, Sait; Akalin, Taner; Yagci, AyseÖğe Chronically retained feathery chestnut-burr spine-related corneal injury: clinical features and outcome(Springer, 2020) Karaca, Irmak; Selver, Ozlem Barut; Palamar, Melis; Egrilmez, SaitPurpose To establish the clinical features and outcomes of patients with chronically retained, feathery chestnut-burr spine-related corneal injury. Methods the data of the patients who presented with chestnut-burr-related corneal injury between 2010 and 2018 were retrospectively evaluated. Nineteen eyes of 19 patients, with chronically retained corneal intrastromal feathery chestnut-burr spines, were included. Results the mean age of the patients (11 male and 8 female) was 29.8 +/- 19.9 years. Best-corrected visual acuity was 0.13 +/- 0.23 logMAR at initial examination and increased to 0.0 +/- 0.0 logMAR at last visit. Chestnut-burr spines were located in the peripheral cornea in 14 eyes (73.7%) and in the central cornea in 5 eyes (26.3%). Localized corneal edema surrounding the chestnut-burr spines were detected in all eyes. No eyes were Seidel positive. Three eyes (15.8%) had low-grade anterior chamber reaction. None of the patients had epithelial ulceration or any sign of infection at initial presentation. in order to control acute localized inflammation, all patients were put on topical steroid (loteprednol etabonate). the mean duration of topical steroid treatment was 3.8 +/- 1.8 (range 2-7) months. During the follow-up period, inflammation was controlled and no sign of reinflammation occurred. Conclusion Acute inflammation in intrastromal chestnut-burr spines can be well controlled with easy tapering of topical steroids. However, as the reinflammation possibility cannot be excluded, long-term follow-up of these patients is mandatory.Öğe Clinical Characteristics and Severity Distribution of Tertiary Eye Center Attendance by Ocular Chemical Injury Patients(Lippincott Williams & Wilkins, 2022) Akgun, Zeynep; Palamar, Melis; Egrilmez, Sait; Yagci, Ayse; Selver, Ozlem BarutObjectives: To report demographic characteristics, types and grades of injury, regional distribution of injury severity, clinical findings, and long-term results of acute ocular chemical burns. Methods: Medical records of patients with chemical burns between 2010 and 2020 who were admitted to Ege University less than 72 hr after the injury were reviewed. Age, gender, cause of the burn, injury severity, initial and final best-corrected visual acuity, surgical intervention, and complications were recorded. The injury severity was graded according to Dua classification. Results: A total of 104 patients (137 eyes) were included. The mean age was 42.69 +/- 17.39 (7-90) years with a male-to-female ratio of 86:18. The most common causes were home (32.6%) and industrial accidents (45.1%). The causative agent percentages for alkaline, acid, and neutral were 49.0%, 35.5%, and 5.7%, respectively. The percentages of eyes in each grade (1-6) were 16.0%, 16.0%, 15.3%, 16.7%, 17.5%, and 18.2%, respectively. Complications mostly occurred in eyes with grade 2 or higher injuries (83.7%). The relationship between injury grade and limbal stem-cell deficiency was statistically significant (P<0.001). Surgery was mostly needed in grade 4 or higher injuries (44 eyes). Conclusion: The severity of the burn is one of the most important prognostic factors in chemical burns. It is important to determine the spreading of the regional injury severity beside the global one to predict complication risk of the injuries. In the present study, the injury distribution was homogeneous in all grades. Limbal stem-cell deficiency development took place mostly in grade 5 and 6 burns as expected.Öğe Clinical efficacy of the smartplug (TM) in the treatment of primary Sjogren's syndrome with keratoconjunctivitis SICCA: one-year follow-up study(Springer Heidelberg, 2011) Egrilmez, Sait; Aslan, Fatih; Karabulut, Gonca; Kabasakal, Yasemin; Yagci, AyseTo evaluate the efficacy of a thermo-sensitive punctum plug, (SmartPlug (TM)) in Primary Sjogren's Syndrome (pSS) patients with dry eyes, whose symptoms persist despite preservative-free artificial tear treatment. In this study, 22 Primary Sjogren's Syndrome (pSS), as defined by American-European Consensus Group Classification Criteria. All patients being followed up by Ege University Departments of Rheumatology and Ophthalmology. The patients had positive Schirmer test results (< 5 mm without anesthesia). SmartPlug (TM) (Medennium, Irvine, California, USA) was inserted into the inferior lacrimal canaliculi of both eyes. Visual acuity measurements, Schirmer I test measurements, lissamine green staining scores, and tear-film breakup times (BUT) were noted before plug insertion and at the 1st, 6th, and 12th months following the procedure. Minimum follow-up period was 6 months for 19 patients and 12 months for 16 patients. Significant improvements were seen in the Schirmer I test scores (before insertion: 1.98 +/- A 2.67; 1st month: 5.68 +/- A 6.69; 6th month: 5.35 +/- A 5.38; 12th month 6.43 +/- A 5.14 P = 0.006), tear-film BUT in seconds (before insertion: 4.64 +/- A 3.7; 1st month: 5.80 +/- A 2.36; 6th month: 7.53 +/- A 2.92; 12th month 7.50 +/- A 2.52, P < 0.0001), respectively. Thermodynamic punctum plug insertion only in inferior canaliculus is a simple, effective, and comfortable option for treatment of severe aqueous tear deficiency that cannot be controlled using preservative-free tears.Öğe Clinical outcomes of trabeculectomy versus Ahmed glaucoma valve implantation in patients with penetrating keratoplasty(Springer, 2016) Ates, Halil; Palamar, Melis; Yagci, Ayse; Egrilmez, SaitÖğe Clinically correlated dose of the amniotic membrane extract is superior to its transplantation in corneal wound healing(Molecular Vision, 2024) Korkmaz, Ilayda; Kocamanoglu, Meltem; Gurdal, Mehmet; Arici, Mesut; Yaman, Banu; Palamar, Melis; Egrilmez, SaitPurpose: This study investigates the superiority of sterile lyophilized amniotic membrane extract (AME) prepared at a clinically correlated dose over amniotic membrane transplantation (AMT) in an experimental corneal wound model. Methods: AME was prepared from a pool of five amniotic membranes. After homogenizing the membranes, they were lyophilized and sterilized by gamma radiation to obtain sterile, lyophilized AME powder. The total protein amount and growth factor levels were measured in the AME samples. AME eye drops were prepared considering the protein concentration of the standard-size amniotic membrane weight used for transplantation, and this total amount was used as the daily dose. For the experimental animal corneal wound model, a full-thickness mechanical corneal epithelial defect was created in 15 eyes of 15 New Zealand rabbits. The rabbits were divided into four groups: Group 1: AME eye drop (n = 4 eyes), Group 2: AMT (n = 4 eyes), Group 3: preservation-free artificial tear (n = 4 eyes), and Group 4: control (n = 3 eyes). Daily anterior segment evaluation and photography were performed to determine the clinical efficacy of the AME. The rabbits were euthanized on day 7, and wound healing was examined histopathologically. Results: The total protein amount in the AME was 0.149 +/- 0.01 mg/ml. The growth factor levels were as follows: EGF = 41.19, FGF = 43.11, HGF = 203.67, KGF = 328.03, NGF = 207.92, and TGF-beta = 506.93 pg/ml AME. On clinical examination, the mean wound closure times in Groups 1, 3, and 4 were 2.75 +/- 0.50 (2-3), 3.5 +/- 1.0 (3-5), and 3.33 +/- 1.52 (2-5) days, respectively (p > 0.05). Histopathological examination revealed Group 1 corneal epithelium with full thickness, regular healing pattern, and normal anterior stromal keratocytes. In the remaining three groups, there were interruptions in epithelial healing, and loss of anterior stromal keratocytes was evident. Inflammation was more prominent in Group 2. Conclusions: AME is a liquid product that contains the essence of the amniotic membrane after homogenization and centrifugation. AME has the potential to overcome the disadvantages of AMT, such as surgery requirement and the limitation of postoperative objective clinical observation due to the semi-opaque nature of the amniotic membrane. Although, there are studies showing the advantages of AME over AMT in the literature, the preparation, preservation and sterilization of AME are still controversial. This study is specifically addressing the shortcomings of acquiring AME in the literature, such as minimizing inter-donor variability in AME by pooling amniotic membranes from different donors, lyophilizing AME to preserve its biochemical composition, and preventing infection transmission by using gamma sterilization. Herein, we observed that the AME prepared with this method contains high concentrations of growth factors. In the present study, the dose of AME was correlated with clinical use for the first time, and for the first time, the superiority of sterile lyophilized AME over AMT was clinically demonstrated in a corneal wound model. Furthermore, histopathological findings confirmed that AME seems to not only promote epithelial proliferation during wound healing but also prevent stromal keratocyte loss, inhibit inflammation and accelerate collagen remodeling.Öğe Comparison of Culture-Positive and -Negative Microbial Keratitis(Turkish Ophthalmological Soc, 2022) Yarimada, Semir; Selver, Ozlem Barut; Palamar, Melis; Egrilmez, Sait; Aydemir, Sabire Sohret; Polat, Suleyha Hilmioglu; Yagci, AyseObjectives: To evaluate and compare the risk factors, presenting features, and outcomes of patients with culture-positive and culture-negative microbial keratitis (MK) who presented to a tertiary referral center. Materials and Methods: We conducted a retrospective review of the medical records of 314 patients who were diagnosed with MK in our clinic between 2012 and 2019. Results: Among 314 patients, 142 had positive cultures (45.2%). The mean ages of the culture-positive and-negative patients at the time of diagnosis were 51.39 +/- 21.31 (range, 14-90) years and 56.68 +/- 21.34 (7-94) years, respectively (p=0.028). The mean best corrected visual acuity (BCVA) of the culture-positive and-negative patients were1.74 +/- 1.25 (0-3.1) LogMAR and 1.91 +/- 1.23 (0-3.1) LogMAR prior to treatment and increased to 1.21 +/- 1.30 (0-3.1) LogMAR and 1.27 +/- 1.29 (0-3.1) LogMAR at last visit, respectively. There was no statistically significant difference between culture-positive and-negative patients' BCVA levels at presentation or last visit. Ninety-two patients (64.7%) were infected with bacteria and 50 patients (35.2%) with fungi. The most common pathogen was Pseudomonas aeruginosa (18.3%), followed by Streptococcus pneumoniae (11.2%) and Fusarium spp. (11.2%). Keratitis foci were either centrally or paracentrally located in 105 eyes (73.9%) of culture-positive patients and 149 eyes (86.6%) of culture-negative patients. Multiple foci were present mostly in culture-positive patients (p=0.001). There was no significant difference between the culture-positive and-negative groups in terms of hypopyon presence (p=0.364). The proportion of contact lens (CL) wearers was 33% (n=47) among culture-positive MK patients and 13.3% (n=23) among culture-negative MK patients, respectively (p<0.001). Culture positivity was found to be significantly higher in keratitis associated with CL use (p=0.0001). Conclusion: Microbiological analysis and culture evaluation are important steps in order to manage proper treatment in microbial keratitis. Prognosis mostly depends on the infectivity of the microbiological agent.Öğe CONJUNCTIVAL BIOPSY AS A FIRST CHOICE TO CONFIRM A DIAGNOSIS OF SARCOIDOSIS(Mattioli 1885, 2016) Ekren, Pervin Korkmaz; Mogulkoc, Nesrin; Toreyin, Zehra Nur; Egrilmez, Sait; Veral, Ali; Akalin, Taner; Bacakoglu, FezaBackground: Sarcoidosis is a granulomatous systemic disease of unknown aetiology. The diagnosis needs histological confirmation of the presence of non-caseating granulomata. One option is a conjunctival biopsy. The aims of this study were to evaluate conjunctival biopsy for the diagnosis of sarcoidosis with respect to its sensitivity and to assess its cost effectiveness by comparison with other histopathological diagnostic procedures. Methods: Patients were identified from the database of the Interstitial Lung Disease Clinic (ILDC) of the Chest Department of Ege University Hospital from May 2008 to June 2014. The patients who had biopsy procedures performed for the definitive diagnosis of sarcoidosis were assessed. Their diagnostic procedures and the cost of procedures were recorded. The cost per positive result for each procedure was calculated. Results: In total, 280 patients were followed up with a diagnosis of sarcoidosis, of whom 174 had histological confirmation; these constitute the study population. There were 127 females and 47 males with a median age of 46 years (range 14-78 years). Forty three patients had conjunctival biopsy and we could establish a diagnosis in 54% of these by means of conjunctival biopsy. Moreover, we showed that this biopsy can provide positive result for sarcoidosis patients who lack abnormal eye findings. Additionally, it is cost effective approach and without complications. Conclusion: This study re-asserts the value of conjunctival biopsy, which was described in the past but is not commonly used nowadays. In the presence of suggestive clinic and radiologic findings, we recommend conjunctival biopsy as the first choice for the histopathological confirmation of sarcoidosis.Öğe Contact Lens-Associated Microbial Keratitis in a Tertiary Eye Care Center in Turkey(Lippincott Williams & Wilkins, 2020) Karaca, Irmak; Selver, Ozlem Barut; Palamar, Melis; Egrilmez, Sait; Aydemir, Sohret; Yagci, AyseObjectives: To evaluate the risk factors, causative microorganisms, and presenting features of infection in patients with contact lens-associated microbial keratitis (CLAMK) admitted to a tertiary referral center in Turkey. Methods: A retrospective review of the medical records of 62 patients who were diagnosed as CLAMK in our clinic between 2012 and 2018 was conducted. Results: the mean age of the patients (22 men and 40 women) at the time of diagnosis was 24.5 +/- 8.3 years (range, 16-48). the mean best-corrected visual acuity (BCVA) was 0.7 +/- 0.9 log of minimal angle of resolution (logMAR) (0-3) before treatment and increased to 0.1 +/- 0.1 logMAR (0-0.4) at the end of the follow-up. All patients, except one using rigid gas-permeable CL, were frequent replacement soft CL users. Thirty-one (50%) patients declared overnight wear, and 37 (58.9%) patients declared showering or swimming in CLs regularly. Cultures of either corneal scrapings or CL materials were positive in 40 (64.5%) eyes, 12 (19.4%) of which had mixed infections. Thirteen strains of microorganisms were demonstrated, among which there were seven (53.8%) gram-negative bacteria, one (7.7%) gram-positive bacteria, four (30.7%) fungi, and Acanthamoeba (7.7%). the most common pathogen was Pseudomonas aeruginosa, followed by Serratia marcescens and Stenotrophomonas maltophilia. According to culture results, P. aeruginosa infections were associated with significantly worse BCVA. Keratitis foci were either centrally or paracentrally located in 39 (62.9%) eyes, and 16 eyes (25.8%) presented with hypopyon. Conclusion: Along with growing number of CL users, CLAMK constitutes an important problem with possibly worse visual outcomes. Thus, in addition to meticulous treatment, management of risk factors and behavioral modifications is crucial.Öğe Corneal Biomechanical Properties of Keratoconic Eyes Following Penetrating Keratoplasty(Turkish Ophthalmological Soc, 2018) Gobeka, Hamidu; Selver, Ozlem Barut; Onay, Melis Palamar; Egrilmez, Sait; Yagci, AyseObjectives: To investigate the corneal biomechanical properties of keratoconic eyes following penetrating keratoplasty (PKP). Materials and Methods: Thirty-five patients (70 eyes) were enrolled to this prospective study. Operated and contralateral keratoconic eyes were defined as Group 1 and 2, respectively. All patients underwent ophthalmological examination and measurements of corneal biomechanical properties by Ocular Response Analyzer (ORA), intraocular pressure (IOP) by Goldmann applanation tonometry, and central corneal thickness (CCT) by Pentacam. Shapiro-Wilk W test was performed to test normality of the data. The statistical significance was evaluated with the paired t-test and Wilcoxon signed ranks test. Pearson correlation and Spearman rho tests were used for correlation analysis. Results: The average age and male/female ratio were 31.34 +/- 11.65 (15-60) years and 21/14, respectively. The mean values of the data obtained from Group 1 and 2 respectively were: corneal hysteresis (CH): 9.35 +/- 1.66, 8.18 +/- 1.84 mmHg (p=0.013), corneal resistance factor (CRF): 9.48 +/- 1.96, 7.14 +/- 2.05 mmHg (p<0.001), IOPcc: 16.90 +/- 4.32, 14.26 +/- 3.69 mmHg (p=0.004), IOPg: 15.45 +/- 4.61, 10.91 +/- 3.97 mmHg (p<0.001), IOPapl: 14.26 +/- 3.11, 13.09 +/- 2.54 mmHg (p=0.046), and central corneal thickness (CCT): 545.64 +/- 60.82, 442.60 +/- 68.14 mu M (p<0.001). The positive correlation between CH and CRF was moderate (r=0.444) in Group 1 and strong (r=0.770) in Group 2. There was a moderate negative correlation between CH and IOPcc in both groups (r=-0.426, r=-0.423), but CH was not correlated with IOPg or IOPapl in either group. There were weak to strong positive correlations between CRF and all IOP values in both groups. There was no correlation between CRF and CCT in Group 1 (r=0.075) and a very weak correlation in Group 2 (r=0.237). Only IOPcc and IOPg were strongly correlated in both groups. Conclusion: Better understanding of corneal biomechanical properties is essential for elucidating the pathophysiology and diagnosis of several corneal pathologies such as keratoconus. The biomechanical properties of keratoconic eyes seem to be closer to normal values after PKP.Öğe Correction of high astigmatism with toric intraocular lens in eyes with corneal transplant(Sage Publications Ltd, 2022) Devebacak, Ali; Degirmenci, Cumali; Selver, Ozlem Barut; Palamar, Melis; Egrilmez, SaitObjectives To evaluate the results of toric intraocular lens (IOL) implantation during cataract surgery in eyes with high regular astigmatism associated with prior penetrating keratoplasty (PK). Methods A retrospective data analysis of patients with prior PK, who underwent uncomplicated cataract surgery with hydrophobic toric single piece IOL (EyeCryl Toric (R), Biotech Vision Care, Luzern, Switzerland). Results A total of 18 eyes of 18 patients were included in the study. The mean age was 53.4 +/- 12.4 (25-70) years. The mean follow-up period was 15.5 (4-24) months. The mean best corrected visual acuity (BCVA) significantly increased from 1.36 +/- 1.0 logMAR to 0.31 +/- 0.17 logMAR (p < .001) pre- and post-operative 4 weeks, respectively. There was no significant change in mean BCVA during follow-up; mean BCVA was 0.32 +/- 0.17 logMAR at the last visit. The mean pre-operative topographic astigmatism was 6.52 +/- 1.80 diopters (D). The mean manifest refraction astigmatism was decreased from 6.55 +/- 1.62 D to 2.80 +/- 1.43 D (p<0.001). The mean Surgically induced astigmatism (SIA) was 3.74 +/- 0.77 D according to vector analysis. There was no patient with graft rejection or failure, the mean endothelial cell loss rate was 12.75 +/- 3.76% (7-17%). There was no patient requiring IOL reposition. Conclusions Toric IOL implantation during cataract surgery provides an option to correct astigmatism in post-PK eyes with high regular astigmatism. When appropriate patients are selected it is a safe method to achieve significant improvements in visual acuity and astigmatism.Öğe COVID-19 Pandemic and Ophthalmologists Response(Turkish Ophthalmological Soc, 2020) Bozkurt, Banu; Egrilmez, Sait; Sengor, Tomris; Yildirim, Ozlem; Irkec, Murat[No Abstract Available]Öğe The COVID-19 Pandemic: Clinical Information for Ophthalmologists(Turkish Ophthalmological Soc, 2020) Bozkurt, Banu; Egrilmez, Sait; Sengor, Tomris; Yildirim, Ozlem; Irkec, Murat[No Abstract Available]Öğe Does topical voriconazole trigger dysplastic changes on the ocular surface?(Maney Publishing, 2015) Palamar, Melis; Egrilmez, Sait; Yilmaz, Suzan Guven; Polat, Suleyha Hilmioglu; Gunduz, Omur UcakhanPurpose: Systemic voriconazole treatment was reported to cause photosensitivity and related cutaneous malignancies. The aim of this report is to demonstrate a graft-related Candida endophthalmitis case that developed ocular surface dysplastic changes after receiving topical 1% voriconazole treatment. Methods: Full ocular examination, photography, and in vivo confocal microscopy examination (Rostock Cornea Module/HRT II, Heidelberg, Germany) were performed. Results: A 73-year-old male with graft-related Candida endophthalmitis that was on topical 1% voriconazole for 4 months developed a whitish gelatinous lesion on the cornea originating from the nasal limbus. In vivo confocal microscopy examination revealed mild dysplastic changes in the cornea epithelium. Conclusion: Topical voriconazole might trigger neoplastic changes on the ocular surface as reported with systemic use in other sun-exposed parts of the body. Further studies are needed to relate topical use of voriconazole with ocular surface dysplasia.Öğe EDITORIAL(Turkish Ophthalmological Soc, 2018) Egrilmez, SaitÖğe Öğe Effect of gingival inflammation on the inflammatory response in patients with idiopathic uveitis(Wiley, 2016) Akcali, Aliye; Yilmaz, Suzan Guven; Lappin, David F.; Egrilmez, Sait; Buduneli, NurcanObjectivesThis study aimed to investigate the levels of 11 oral species in plaque samples and cytokine levels in biofluid samples of patients with idiopathic uveitis (IU) and systemically healthy individuals (H) with or without gingival inflammation. Material & MethodsTwenty-one patients with IU (n=21), and 22 systemically healthy individuals (n=22) were enrolled in the study. Clinical periodontal measurements were recorded. Cytokine levels in the biofluid samples were determined by ELISA. Bacterial gene copy numbers were determined by qPCR on plaque microbial DNA preparations. ResultsAccording to two-step cluster analysis, anova and t-test: GCF, serum and salivary TNF-, IL-17A, IL-17A/E; GCF and serum IL-6; salivary IL-17F, and salivary and serum IL-17A/F levels were higher in the IU group than the H group (p<0.05). However, serum IL-10 and IL-17E levels were higher in the H group than the IU group (p<0.05). A.actinomycetemcomitans, F.nucleatum, S.oralis, A.naeslundii, and V.dispar counts were higher in IU group compared to H group (p<0.05). ConclusionAltered local and systemic cytokine profiles are associated with differences in the microbial plaque composition in IU. Anti-inflammatory cytokines; IL-10, IL-17E are reduced in patients with IU and Th-1 and Th-17 driven inflammatory responses in biofluids are altered.Öğe Effect of polyethylene cover on the treatment of exposure keratopathy inICU(Wiley, 2020) Kocacal, Elem; Eser, Ismet; Egrilmez, SaitBackground Exposure keratopathy may lead to serious complications such as microbial keratitis, corneal perforation, and visual impairment if not treated. Aim To compare the effect of carbomer eye drops when used alone and in combination with polyethylene covers in the healing of exposure keratopathy. Methods A single blind randomized-controlled trial (RCT) in two intensive care units (ICUs) was carried out in a university hospital in Western Turkey between September 2011 and December 2012.The control group received only carbomer, eye drops while the intervention group received both carbomer eye drops and polyethylene covers. the primary outcome was the decrease or absence of corneal damage, which refers to healing. Corneal damage was followed up with a fluorescein dye test (decrease/absence of the corneal staining) by the same ophthalmologist for 10 days. Results A total of 43 corneas in 24 patients were studied. Corneal epithelial defects decreased in the intervention group by day 2 and progressed or remained unchanged in the control group every day (P= .001). Patient characteristics did not affect the grade ranges of corneal staining in the groups except for level of consciousness. Conclusion Carbomer eye drops, when used in combination with polyethylene covers, were effective in managing exposure keratopathy. Relevance to clinical practice Corneal damage and further ocular complications can be reduced with the utilization of polyethylene covers in nursing care and treatment.
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