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Öğe Choroidal melanoma causing contralateral amaurosis via orbital invasion [Orbital i·nvazyonla kontralateral amorozise neden olan koroid melanomu](2011) Onay M.P.; Yagci; A.; Akalin; T.To report a case of tumor invasion into the ipsilateral orbit/optic chiasm and into the contralateral optic nerve. A 51-year-old male who declared removal of his left eye ten years ago elsewhere, attended to our clinic for swelling of the left eyelids and pain. He was ophthalmologically and radiologically evaluated. A hyperpigmented mass was detected at the socket conjunctiva of the patient whose eyelids were swollen and hyperemic. Anterior and posterior segments of the right eye were normal, and the best corrected visual acuity was 10/10. On orbital computed tomography, the left orbit was found to be filled with mass. No intracranial invasion was detected. Exenteration was performed to the patient who had no systemic metastasis. Histopathological examination revealed malignant melanoma. Ten months later, the patient presented with sudden visual loss. Light perception was absent in the right eye. Optic nerve head was pale at fundus examination. No p100 wave was obtained from the right eye with visual evoked potentials. On orbital magnetic resonance imaging, a mass invading the optic chiasm and the right optic nerve was evident. When treated with appropriate methods, choroidal malignant melanoma with no extraocular extension has pretty good prognosis. When performing enucleation in patients with intraocular tumor suspicion, extra care should be spent not to make any unnecessary maneuver leading to extraocular spread. In the presence of extraocular dissemination, exenteration should be performed.Öğe Current approaches in periocular hemangioma [Perioküler bölge hemanjiyomlarının tedavisinde güncel yaklaşımlar](Turkish Ophthalmology Society, 2014) Onay M.P.Herein, besides clinical aspects of periocular region hemangioma, current treatment modalities have been discussed. © 2014, Turkish Ophthalmology Society. All rights reserved.Öğe Evaluation of cornea and anterior chamber using pentacam in pediatric cases [Pediatrik olgularda kornea ve ön kamarani{dotless}n pentacam ile degerlendirilmesi](2011) Onay M.P.; Egilmez S.; Üretmen Ö.; Yagci A.; Köse S.Purpose: To evaluate the anterior segment structures using Pentacam in pediatric cases. Material and Method: One hundred sixty-two eyes (study group) of 81 healthy children who attended our clinic were compared with 114 eyes (control group) of 57 healthy adults. The central corneal thickness, anterior chamber volume, and anterior chamber depth of all cases were evaluated with Pentacam. Independent t-test and Pearson's correlation analysis were used for statistics. Results: The mean age of the study group (40 male, 41 female) was 9.99±2.80 (range: 6-16) years. The mean central corneal thickness in the right eyes was 580.74±42.04 (range: 492-669) micrometers and in the left eyes was 586.52±43.51 (range: 495-699) micrometers. The mean anterior chamber depth, volume, and anterior chamber angle were 3.02±0.29 (range: 2.39-3.9) mm, 176.43±31.77 (range: 117-272) mm3 and 36.23±5.41 (range: 25.8-50.7) degree, respectively. When the right and the left eyes were compared, significant differences were observed between central corneal thickness (p=0.001) and anterior chamber angles (p=0.05). The mean left eye keratometry was found to be significantly flatter in children (p=0.002). The mean anterior chamber depth, anterior chamber volume, and anterior chamber angle values were higher in children than in adults (p<0.001). Discussion: Pentacam is an easy-to-use and noninvasive technique that can be used for the evaluation of central corneal thickness and anterior chamber even in pediatric cases. Significant differences were detected in measurements with this device between adults and pediatric cases, and between the right and left eyes. Being aware of these differences in normal eyes will be a guide in correct evaluation of pathologic eyes.Öğe Evaluation of the effects of menstrual cycle on anterior chamber parameters as measured with pentacamp [Menstrüel siklusun ön kamara parametreleri üzerine etkisinin pentacam ile araşti{dotless}ri{dotless}lmasi{dotless}](2013) Karatepe A.S.; Onay M.P.; Egrilmez S.; Yagci A.Purpose: To evaluate the effects of endogenous gonadotropic hormones (follicle-stimulating hormone, luteinizing hormone) and sex steroids (progesterone, estrogen) to anterior segment parameters. Material and Method: Thirty healthy females who had a menstrual cycle of 28±1 day and with a mean age of 36.5±7.56 (range, 20 - 46) years were included in the study. Starting from the first day of their cycle, Pentacam Scheimpflug camera measurements were performed on the 1st, 3rd, 7th, 12th, 16th, 21st, 26th, and 28th days. The central corneal thickness, anterior chamber depth, anterior segment volume, keratometric values, anterior chamber angle value, and pupilla diameter of both eyes were evaluated. Repeated measures analysis of variance test was used for statistical analysis. Results: No difference that reaches statistical significance was found in the means of central corneal thickness, anterior chamber volume, keratometric values, anterior chamber angle, and pupilla diameter between the days. Mean anterior chamber depth measurement of the right eyes on the 1st day was 2.72±0.44 mm, whereas it was 2.77±0.46 mm on the 26th day. Mean anterior chamber depth measurement of the left eyes on the 1st day was 2.74±0.42 mm, whereas it was 2.80±0.43 mm on the 26th day. This increment of anterior chamber depth value from the 1st to the 26th days was found to be statistically significant (p?0.05). Discussion: Progesterone and estrogen that rise in the second half of the menstrual cycle might have a deepening effect on the anterior chamber. These findings should be further investigated with more profound studies that also evaluate the hormonal values and their correlations with anterior segment parameters. (Turk J Ophthalmol 2013; 43: 15-8).Öğe Giant tarsal keratinous cyst mimicking chalazion [Şalazyonu taklit eden dev keratinöz kist](2013) Onay M.P.; Yagci A.; Akalin T.Reports on keratinous cysts involving the tarsal plate are very rare. Herein, we present a 69-year-old male patient with a giant tarsal keratinous cyst of the right upper eyelid who was misdiagnosed as chalazion of the eyelid. Interventional case report with cytopathologic correlation. Due to recurrence after the surgery for presumed chalazion, the patient was referred to our clinic for tumor evaluation. In the second surgery, which was performed in our clinic, the lesion was found to have a fine capsule and was totally excised. Histopathologic examination revealed keratinous cyst of the tarsal plate. Keratinous cyst must be considered in the differential diagnosis of tarsal plate lesions, as the curettage of the keratinous cyst might result in multiple recurrences.Öğe Non-recurrence complications of pterygium surgery [pterjiyum cerrahisinin nüks d{dotless}ş{dotless} komplikasyonlar{dotless}](2011) Onay M.P.; Egrilmez S.; Yagci A.Summary Purpose: To draw attention to non-recurrence complications of pterygium surgery by reporting the cases of patients who were referred to our clinic. Material and Method: The data of 20 eyes of 18 patients were evaluated retrospectively. Age, gender, accompanying diseases, best corrected visual acuities at the time of referral and at last visit, and data related to primary surgery were assessed. The treatment modalities we used were noted. Results: The mean age of the patients was 51.62±9.86 (range: 37-67) years. All cases had been operated for primary pterygium. Bare sclera technique had been used in 9 eyes and intraoperative mitomycin C (MMC) had been applied in 9 eyes. Complications related to poor suturing technique were observed in 5 eyes and to excessive cauterisation - in 3 eyes. The detected complications were pyogenic granuloma, inclusion cyst, dellen, scleromalacia, limbal insufficiency, and globe perforation. Medical therapy was sufficient in 6 cases, whereas the remaining 14 eyes had to undergo surgical treatment. Discussion: Pterygium surgery should not be underestimated. Maximum attention must be paid in every step of the surgery and complications that might develop related to adjuvant agents should not be neglected. Perioperative antimitotic agent use should be saved for selected cases, excessive cauterisation and wide surgical dissections that might trigger cicatrisation must be avoided.Öğe Patient satisfaction after penetrating keratoplasty [Penetran keratoplasti sonrasi{dotless} hasta memnuniyeti](2013) Onay M.P.; Egrilmez S.; Civan B.B.; Yagci A.Purpose: To evaluate the patient satisfaction after penetrating keratoplasty (PK). Material and Method: A 15-question survey was given to 100 consecutive patients who had undergone PK in our clinic. Quality of life, expectancy and result satisfaction of the patients were graded. Results: Mean age of the 100 (52 female, 48 male) consequtive patients who participated in the survey was 47.2±21.5 (10-85) years. Mean follow-up time of the patients after PK was 26.1±26.0 months, with a minimum of 12 months. The indications of PK were keratoconus (27%), bullous keratopathy (26%), keratitis sequela (25%), corneal dystrophy (12%), and trauma sequela (10%). Mean preoperative visual acuity was counting fingers from 3 meters (light perception - 0.3), whereas mean postoperative visual acuity was 0.4 (light perception - 1.0) (p<0.01). Seventy seven percent of the patients declared that prior to PK, they expected to see better after the transplantation. Seventy percent of the patients expressed that their quality of life was better after transplantation. No statistically significant correlation of patient satisfaction with gender, age and preoperative visual acuity was detected (p>0.05). Final visual acuity was the only statistically significant parameter (p=0.01). When patient satisfaction was grouped according to indications, the ranking was as keratitis sequela, corneal dystrophy, trauma sequela, keratoconus, and bullous keratopathy. Discussion: The sole parameter in the means of patient satisfaction after PK was found to be the final visual acuity. For this reason, every patient who will undergo PK should be specifically informed according to indication. Moreover, these patients should also be enlightened about the potential final visual acuity and probable postoperative problems.Öğe Severe anterior chamber reaction in two post-cataract surgery cases due to inadvertent substitution of Tobrex for Tobradex [İki katarakt ameliyati{dotless} olgusunda Tobradex yerine yanli{dotless}şli{dotless}kla Tobrex verilmesine Bagli{dotless} ciddi ön kamara reaksiyonu](2011) Onay M.P.; Egrilmez S.; Yagci A.To report the severe uveitic reaction that occurred due to inadvertent substitution of Tobrex for Tobradex in two post-cataract surgery cases. Tobramycine 0.03%- dexamethasone 0.01% (Tobradex, Alcon, USA) fixed combination was prescribed to two different patients who had uneventful phacoemulsification and intraocular lens implantation in our clinic. The patients were asked to come for control visit on the 5 th postoperative day and severe anterior chamber reaction was observed in both cases. When interrogating the patients, it was found out that Tobrex eye drops were used, because they had been inadvertently substituted for Tobradex eye drops in the pharmacy. Total recovery was achieved with administration of dexamethasone 0.01% eye drops in both cases. When prescribing drugs that might have similar names, patients should be advised to check the drugs they receive. Additionally, to avoid undesired events, drug representatives and pharmacists should also be warned about this subject.Öğe Spectral Domain Optical Coherence Tomography in Simple Retina Pigment Epithelium Hamartoma [Basit retina pigment epitel hamartomunda spektral domain optik koherans tomografit](2012) Onay M.P.; Yagci A.To report the spectral-domain optical coherence tomographic findings in a case of a simple hamartoma of the retinal pigment epithelium. A 55-year-old female patient with simple hamartoma of the retinal pigment epithelium was evaluated with ultrasonography and spectraldomain optic coherence tomography. The patient was found to have a pitch-black lesion measuring one-half of the disk diameter, located at about 1 disk diameter temporal to the foveola. B-mode ultrasonogram revealed a 0.8-mm thick retinal lesion with high internal reflectivity which was consistent with simple hamartoma of the retinal pigment epithelium. Spectral-domain optical coherence tomography demonstrated an elevated lesion extending from the retinal layer toward the vitreous. The high resolution of spectral-domain optical coherence tomography allows detailed observation of the retinal pigment epithelium hamartomas and is useful in the differential diagnosis and management of pigmented fundus lesions.Öğe Tectonic corneal grafting after corneal perforation due to pterygium surgery [Pterjiyum cerrahisine bagli{dotless} kornea perforasyonunda tektonik kornea greftlemesi](Turkish Ophthalmology Society, 2011) Onay M.P.; Egrilmez S.; Yagci A.To report three cases of corneal perforation after pterygium surgery with primary conjunctival closure and intraoperative mitomycin C, and its treatment with corneal grafting. Three patients, who had undergone pterygium excision with primary conjunctival closure and intraoperative mitomycin C elsewhere, were referred to our clinic for corneal perforation. Nasally located corneal perforation was evident in all cases. Corneal grafting was performed to repair the perforation. The grafting was successful in all cases and no complication or need for further treatment was observed. Corneal perforation is a rare complication of pterygium surgery. Tectonic corneal grafting is a reliable and final surgical method for the repair of corneal perforation due to pterygium surgery.Öğe Trichloroacetic acid injection in a conjunctival cyst formed in an anophthalmic socket [Anoftalmik sokette gelişen konjonktiva kisti tedavisinde trikloroasetik asit enjeksiyonu](2011) Onay M.P.; Ceylan N.; Yagci A.Purpose: To report the efficacy of trichloroacetic acid injection in the management of a conjunctival cyst in an anophthalmic socket that recurred after previous aspiration. Material and Method: A 34-year-old male, who underwent left enucleation and polymethyl methacrylate sphere implantation due to trauma 5 years earlier, presented with the complaint of prosthesis instability. Examination revealed a lobulated appearing cystic mass filling the socket. Magnetic resonance imaging showed a cystic lesion occupying the entire anterior orbit in front of the implant. The conjunctival cyst that reportedly recurred after an attempt of aspiration in another clinic was injected with 20% trichloroacetic acid (IL-33, 10 ml solution, Istanbul Ilaç Sanayi ve Tic. A.S.). Results: The conjunctival cyst, which was pushing the prosthesis forward before treatment, disappeared after the injection. The exophthalmic appearance resolved. Prosthesis could be used properly. No recurrence was detected at 12-month follow-up visit. Discussion: Conjunctival cysts, which are occasionally monitored in anophthalmic sockets, can be refractory to various treatment modalities. Though less desirable, these cases may even require explantation of the implant, since relapse is inevitable after basic aspiration. In the treatment of anophthalmic conjunctival cysts, the injection of 20% trichloroacetic acid into the cyst is a cosmetically successful and recurrence-abolishing procedure.
