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    Amblyopia and Refractive Errors Among School-Aged Children With Low Socioeconomic Status in Southeastern Turkey
    (Slack Inc, 2013) Caca, Ihsan; Cingu, Abdullah Kursat; Sahin, Alparslan; Ari, Seyhmus; Dursun, Mehmet Emin; Dag, Umut; Balsak, Selahattin
    Purpose: To investigate the prevalence of refractive errors and other eye diseases, incidence and types of amblyopia in school-aged children, and their relation to gender, age, parental education, and socioeconomic factors. Methods: A total of 21,062 children 6 to 14 years old were screened. The examination included visual acuity measurements and ocular motility evaluation. Autorefraction under cycloplegia and examination of the external eye, anterior segment, media, and fundus were performed. Results: There were 11,118 females and 9,944 males. The average age was 10.56 +/- 3.59 years. When all of the children were evaluated, 3.2% had myopia and 5.9% had hyperopia. Astigmatism 0.50 D or greater was present in 14.3% of children. Myopia was associated with older age, female gender, and higher parental education. Hyperopia was inversely proportional with older age. Spectacles were needed in 4,476 (22.7%) children with refractive errors, and 10.6% of children were unaware of their spectacle needs. Amblyopia was detected in 2.6% of all children. The most common causes of amblyopia were anisometropia (1.2%) and strabismus (0.9%). Conclusion: Visual impairment is a common disorder in school-aged children. Eye health screening programs are beneficial in early detection and proper treatment of refractive errors. [J Pediatr Ophthalmol Strabismus 2013;50:37-43.]
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    Asistan göz hekimlerinin dikey C/D oranı ölçümleri ile optik kohorens tomografi sonuçlarının karşılaştırılması
    (2008) Akkuş, Zeki; Keklikçi, Selahattin Uğur; Balsak, Selahattin; Şakalar, Yıldırım Beyazıt; Ünlü, Kaan; Çaça, İhsan; Arı, Şeymus
    AMAÇ: 2., 3. ve 4. yıl asistan göz hekimlerinin oftalmoskopik muayene ile belirledikleri dikey C/D oranlarını, kendi aralarında ve optik kohorens tomografi(OKT) dikey C/D oranı ölçümleri ile karşılaştırmak. YÖNTEM-GEREÇ: Glokom biriminde takip edilen 72 olgunun 110 gözü çalışmaya dahil edildi. Her bir asistan göz hekimi tarafından Goldman 3 aynalı lensi kullanılarak oftalmoskopik muayene ile dikey C/D oranları belirlendi ve diğer göz hekimlerinden bağımsız olarak kaydedildi. Pupil genişletilmesi sonrası Stratus Optik Kohorens Tomografi cihazı optik sinir başı analizi ile dikey C/D oranı ölçümleri alınarak kaydedildi. Elde edilen tüm dikey C/D oranı sonuçları birbirleri arasında karşılaştırıldı. BULGULAR: Çalışmaya alınan olguların 30’u erkek 42’si kadın olup yaş ortalaması 51.43±19.32 idi. 2. yıl asistan göz hekiminin belirlediği dikey C/D oranı ortalama 0.556±0.246, 3.yıl asistan göz hekiminin belirlediği dikey C/D oranı ortalama 0.534±0.251, 4. yıl asistan göz hekimi tarafından belirlenen dikey C/D oranı ortalama 0.529±0.250 olarak bulundu. Optik kohorens tomografi ile alınan dikey C/D oranı ölçümleri ise ortalama 0.651±0.223’tü. Yapılan istatistiksel çalışma sonucunda göz hekimlerinin belirledikleri C/D oranları arasında istatistiksel olarak anlamlı bir fark bulunmadı(p>0.05). Her bir hekim tarafından belirlenen C/D oranı ortalamalarının OKT’de ölçülen C/D oranlarından istatistiksel olarak anlamlı derecede daha düşük olduğu saptandı(p<0.05).TARTIŞMA: Asistan göz hekimleri tarafından oftalmoskopik muayene ile belirlenen vertikal C/D oranları ile optik kohorens tomografi optik sinir başı analizi ile elde edilen vertikal C/D oranları arasında farklılık olabilmektedir.
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    Associations between red reflex abnormality, consanguinity and intensive care hospitalization of newborns in Turkey
    (Who Eastern Mediterranean Regional Office, 2018) Ozkurt, Zeynep; Balsak, Selahattin; Tildirim, Yusuf; Yuksel, Harun; Caca, Ihsan
    Background: Red reflex screening is the primary but unheeded test for the detection of vision- and life-threatening eye conditions. Aims: To evaluate the red reflex of newborns, percentage of ocular diseases resulting in red reflex abnormality, and their relation with consanguinity in Southeast Turkey. Methods: Newborns (n = 1358) were examined with pencil light and direct ophthalmoscopy. Results: Eight hundred of these newborns were hospitalized in a rooming-in unit. (RIU) and 558 were in the neonatal intensive care service (NICS). In the RIU there were 7 (0.88%) newborns with abnormal red reflex and in the NICS there were 14 (2.51%). Sensitivity of pencil light examination was 71.4%. Studies from the Middle East have shown potential recessive genetic causes of common paediatric ocular conditions. In our study, consanguineous marriage was found to have a significant association with red reflex abnormality (P = 0.017). Conclusions: Red reflex screening test is important in the early diagnosis of vision- and life-threatening eye disorders in Southeast Turkey where consanguinity is common.
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    Blefaropitozis olgularında maksimal levator rezeksiyonu sonuçlarımız
    (2016) Balsak, Selahattin; Keklikçi, S. Uğur
    Amaç: kötü levator fonksiyonu olan blefaropitozis olgularda maksimal levator rezeksiyonu cerrahisi sonuçlarını değerlendirmek Materyal metod: Ocak 2009 – Aralık 2009 tarihleri arasında Dicle Üniversitesi Tıp Fakültesi Göz Hastalıkları Kliniği’nde kötü levator fonksiyonlu 20 olgunun 22 gözüne anterior yaklaşımla maksimal levator rezeksiyonu uygulandı. Tüm olgularda operasyona başlamadan kapak kıvrımı işaretlendi, intraoperatif kanamanın minimal olması ve dokuların daha iyi disseke edilebilmesi için insizyon bölgesine % 2’lik lidokain enjekte edildi ve 7 dakika beklendi. Postoperatif iyi bir kapak kıvrımı elde edebilm için cilt kapatılırken kapağın orta, nazal ve temporalinden sırasıyla alt cilt kesi dudağı, orbiküler kas, levator aponörozu ve üst cilt kesi dudağından geçilmek üzere dört adet sütür kondu. Bulgular: 18 olgunun 20 gözünde (%91) başarılı sonuçlar elde edildi. Hiçbir oguda postoperatif kapak kıvrım asimetrisi izlenmedi, 3 aydan 1 yıla kadar yapılan takiplerde bu olgularda herhangi bir komplikasyona rastlanmadı. Başarısız sonuçlar elde edilen 2 olgunun levator fonksiyonu çok kötüydü (2mm), bu 2 olguya 6 ay sonra silikon rod ile frontal askılama cerrahisi uygulandı. Sonuç: Maksimal levator rezeksiyonu kötü levator fonksiyonu olan tek taraflı blefaropitozis olgularında başarılı anatomik ve kozmetik sonuçlar veren etkili ve güvenli bir cerrahi tedavi yöntemi olarak gözükmektedir.
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    Brimonidine-timolol versus brinzolamide-timolol for treatment of elevated intraocular pressure after phacoemulsification surgery
    (Springer, 2018) Balsak, Selahattin; Kaydu, Ayhan; Erdem, Seyfettin; Alakus, M. Fuat; Ozkurt, Zeynep Gursel
    To compare the efficacy of the fixed combination of brimonidine-timolol (FCBT) and the fixed combination of brinzolamide-timolol (FCBZT) treatments for elevated intraocular pressure (IOP) after phacoemulsification cataract surgery. A randomised, prospective, double-blinded study was conducted on 277 eyes of 257 patients who underwent phacoemulsification cataract surgery. Patients were divided into three groups based on the medication administered after cataract surgery as follows: FCBT, FCBZT and a control group where no antiglaucoma medications were used. IOP was recorded at preoperative and postoperative hours 6 and 24 and days 3 and 5. No statistical differences were observed among the groups regarding age, sex and baseline IOP levels (p > 0.05). Mean IOP levels were significantly lower in the treatment groups than in the control group at postoperative hours 6 and 24 and days 3 and 5 (p < 0.001). Administration of one drop of FCBT or FCBZT demonstrated similar effects on preventing IOP spikes within 24 h of phacoemulsification cataract surgery. FCBZT more effectively lowered IOP than FCBT at days 3 and 5 (p < 0.05). We demonstrate that the postoperative administration of FCBT or FCBZT is effective in lowering IOP after phacoemulsification cataract surgery; FCBZT more effectively lowered IOP than FCBT at postoperative days 3 and 5.
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    Comparison of Different Methods for Measurement of Intraocular Pressure and Evaluation of Effect of Central Corneal Thickness on Measurement Results
    (Turkish Ophthalmological Soc, 2010) Sakalar, Yildirim Bayezit; Keklikci, Ugur; Balsak, Selahattin; Dogan, Eyyup; Unlu, Kaan
    Purpose: To compare measurements of intraocular pressure (IOP) by Goldmann applanation tonometer ( GAT), tonopen and non-contact tonometer (NCT) in normal eyes, and determine the relationship between the results of IOP measurement and central corneal thickness (CCT). Material and Method: Seventy-nine eyes of 41 patients, whose ophthalmologic examination and visual field test revealed no glaucoma, were included into the study. IOP was measured by GAT, NCT and tonopen. CCT was measured with an ultrasonic pachymeter. Results: The mean IOP measured by GAT was 12.63 +/- 2.94 mmHg, by tonopen - 8.51 +/- 2.66 mmHg and by NCT - 13.34 +/- 3.88 mmHg. In terms of measurement results, there was a statistically significant difference between the three methods (p<0.05). Although the correlation between tonopen and CCT was insignificant (p>0.05), there was a significant correlation between GAT and CCT, as well as between NCT and CCT (p<0.05). Discussion: There was a significant difference between measurements of IOP by GAT, NCT and tonopen in normal eyes. Tonopen may not be affected by CCT in normal eyes, while a significant correlation existed between CCT and GAT or NCT in normal eyes.
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    Comparison of Vertical C/D Ratio Obtained by Assistant of Ophthalmology with Results of Optical Cohorence Tomography
    (Turkish Ophthalmological Soc, 2008) Sakalar, Yildirim Bayezit; Unlu, Kaan; Keklikci, Selahattin Ugur; Caca, Ihsan; Ari, Seyhmus; Balsak, Selahattin; Akkus, Zeki
    Purpose: To compare vertical C/D ratio that measured with ophthalmoscopic examination of second, third and fourth year assistant of ophthalmology with vertical C/D ratio obtained by optical cohorence tomography. Materials and Methods: One hundred and ten eyes of 72 glaucoma patients which are followed in glaucoma unit were included to study. Each assistant examined vertical C/D ratio by Goldman tree mirror lens and results were recorded independently from results of the other assistants. The measurements of vertical C/D ratio were obtained by optic nerve head analyses of Stratus Optical Cohorence Tomography after pupillary dilatation and vertical C/D ratio were enlisted. All measurements of vertical C/D ratio were compared each other. Results: Thirty patients were male and 42 patients were female, mean age was 51.43 +/- 19.2. Mean vertical C/D ratio measured by second year asisstant was 0.556 +/- 0.246, mean vertical C/D ratio measured by third year assistant was 0.534 +/- 0.251, mean vertical C/D ratio measured by fourth year assistant was 0.529 +/- 0.250. Mean vertical C/D ratio obtained by optical cohorence tomography was 0.651 +/- 0.223. There was no statistically signicant differences among vertical C/D ratio measured by assistants (p>0.05). The mean vertical C/D ratio that measured by each assistant was statistically lower than obtained by optical cohorence tomography (p<0.05). Conclusions: The vertical C/D ratio that measured with ophthalmoscopic examination by assistant of ophthalmology will be different from vertical C/D ratio obtained by optic nerve head analyses of optical cohorence tomography.
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    Diyarbakır ilinde aile hekimlerinin bebek ve çocuk göz sağlığı taramalarına yaklaşımı
    (Galenos Yayınevi, 2019) Özkurt, Zeynep Gürsel; Balsak, Selahattin; Çamçi, Mehmet Sinan; Bilgen, Kadir; Katran, İbrahim Halil; Aslan, Adar; Han, Çağla Çilem
    Amaç: Ülkemizde aile hekimleri koruyucu hekimlik hizmetleri ile bebek ve çocuk takiplerinden sorumludur. Bu kapsamda gözve görme taramaları da aile hekimlerince yapılmaktadır. Bu çalışma ile Diyarbakır ilinde görevli aile hekimlerinin göz ve görmetaramalarına olan yaklaşımlarını incelemektir.Gereç ve Yöntem: Diyarbakır ili merkez ve ilçellerinde çalışan 100 aile hekimi ile 16 soruluk anket dolduruldu.Bulgular: Hekimlerin 88’i (%88) kırmızı refle tarama testini bildiklerini ifade ederken, 12’si (%12) hiç duymadıklarını belirttiler.Hekimlerin sadece 16’sının (%16) düzenli olarak kırmızı refle baktığı, 36’sının (%36) ise sadece arada şüphelenirse baktığını belirtildi.On hekim (%10) tarama yapmadıkları halde bebeği göz hekimine de yönlendirmediklerini söylediler. Altmış dokuz hekimin (%69)doğumsal kataraktı saptasa bile tedavi zamanını bilmedikleri görüldü. Beş hekimin (%5) merkezlerinde direkt oftalmoskobununbulunmadığı öğrenildi. On iki hekim (%12) oftalmoskop kullanmayı hiç bilmediklerini bildirdiler. Çocuklarda okul öncesindeçocukların görme keskinliğini alan hekim sayısı 40 idi (%40). Eşel ile görme keskinliği tarif edemeyecek küçük çocuklarda ise refraksiyonmuayenesi için göz hekimine gönderen hekim sayısı 66 idi (%66). Şaşılık saptadıkları zaman dört hekim (%4) hastayı ameliyat yaşınakadar bekleteceğini belirtti. Doksan üç hekim (%93) bu konuda eğitici seminer yapılmasının faydalı olacağını bildirdi.Sonuç: Aile hekimlerimiz bebek ve çocuk göz taramaları açısından bilgilendirilmelileri için eğitici seminerler verilebilir. Aile hekimliğimerkezlerinin tıbbi cihaz ve malzeme açısında denetlenmeleri gerekmektedir. Negatif performans uygulamasına bebek ve çocuk göztaramalarının da eklenmesi bu husustaki duyarlılığı artıracaktır. Gelişmiş ülkelerdeki ayrıntılı göz tarama programlarını ülkemizdeuygulayabilmek için gerekli alt yapıların oluşturulmaya başlanmalıdır.
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    The effect of I-gel™ airway on intraocular pressure in pediatric patients who received sevoflurane or desflurane during strabismus surgery
    (Wiley-Blackwell, 2012) Sahin, Alparslan; Tufek, Adnan; Cingu, Abdullah Kursat; Caca, Ihsan; Tokgoz, Orhan; Balsak, Selahattin
    Objectives: The aim of this study was to investigate the effect of I-gelTM laryngeal mask airway on intraocular pressure (IOP) in children with strabismus undergoing balanced anesthesia with sevoflurane or desflurane. Methods: Forty-seven children, ASA physical status I, were scheduled for elective strabismus surgery. Patients were randomly assigned to one of the two inhalation anesthetic groups. Sevoflurane group comprised of 27 children, and desflurane group comprised of 20 children. Anesthesia was induced and maintained with sevoflurane or desflurane. No muscle relaxant was used. IOPs were measured before anesthesia, at 2 and 5 min after insertion of I-gelTM and after removal of I-gelTM. IOP measurements were obtained by Tonopen (R). Results: Intraocular pressure significantly decreased 2 min after insertion of I-gelTM in both sevoflurane and desflurane groups (P < 0.001). Measurements 5 min after I-gelTM insertion were also significantly lower than those of before insertion in both groups (P < 0.01). However, no significant differences were found between the preoperative measurement and the measurement after removal of I-gelTM within two groups (P = 0.072 and P = 0.547, respectively). No significant differences were found in all IOP measurements between sevoflurane and desflurane groups. Conclusion: Insertion of I-gelTM laryngeal mask airway with giving sevoflurane or desflurane inhalation anesthetics seemed not to cause any increase in IOPs in pediatric ophthalmic surgery.
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    The effects of delivery type and gender on intraocular pressure and central corneal thickness in newborns
    (Consel Brasil Oftalmologia, 2016) Ozkurt, Zeynep Gursel; Balsak, Selahattin; Balsak, Berrin; Guclu, Hande; Sahin, Muhammed; Yuksel, Harun; Turkcu, Fatih M.
    Purpose: To analyze intraocular pressure (IOP) and central corneal thickness (CCT) in newborns during the first 12 h of life. Methods: Forty-three newborns born by vaginal delivery (VD) and 30 newborns born by cesarean section (CS) were evaluated. IOP and CCT were measured using Tono-Pen and handheld pachymeter, respectively, at both the 5th minute after delivery and at the 12th h of life. Results: The mean IOP for the VD group was significantly higher than that of the CS group at both the 5th minute and 12th h (p=0.042 and p=0.018, respectively). In both groups, the IOP decreased by the 12th h, but the decrease was only significant for the CS group (p=0.020). The decrease in CCT over the 12 h was significant for both groups (p<0.001). In the VD and CS groups, the IOP values of the males were significantly higher than those of the females at the fifth minute only (p=0.024 and p=0.043, respectively). No other values were significantly different between the genders. Conclusions: Newborn IOP is affected by the mode of delivery and gender. A higher IOP was found in vaginally delivered newborns than in CS newborns for at least 12 h postpartum. CCT showed a significant decline within 12 h. Male newborns have significantly higher IOP values in the first minutes of life.
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    Effects of hesperidin on the changes made in the retinal damage induced by traumatic head injury
    (Sci Printers & Publ Inc, 2021) Balsak, Selahattin; Deveci, Engin
    OBJECTIVE: To investigate the protective effect of hesperidin on retinal damage induced by traumatic head injury. STUDY DESIGN: Thirty rats were divided into 3 groups: control, trauma, and trauma+hesperidin. The control group received only saline for 7 days without injury. Craniotectomy was created under anesthesia in the trauma group and the rats were administered intragastrically with saline solution for 7 days. In the trauma+hesperidin group, after craniotomy, 30 mg/kg hesperidin was administered for 7 days. At the end of the experiments, blood samples were collected and retinal tissues were processed. RESULTS: After trauma injury, hesperidin treatment reduced MDA and MPO values and increased GSH content in the trauma+hesperidin group. Dilation, inflammation, degenerated ganglion and photoreceptor cells, and Bcl-2 and TNF-alpha expressions were decreased in the trauma+hesperidin group. Hesperidin administration improved histology of the retina mostly in the trauma+hesperidin group. CONCLUSION: It has been predicted that hesperidin is effective in the regulation of cytokine activity, the TNF reaction, and the reduction of cell apoptosis triggered afterwards. It has been thought that the apoptotic process, which progresses in the direction of cell degeneration, may have a slowing effect in the nuclear loss phase of hesperidin treatment.
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    Evaluation of subclinical papilledema in patients with obstructive sleep apnea syndrome
    (Yüzüncü Yıl Üniversitesi Tip Fakültesi, 2019) Özkurt, Zeynep Gürsel; Demir, Melike; Yıldırım, Yusuf; Balsak, Selahattin; Karaalp, Ümit
    The aim of this study is to analyze optic nerve head total retinal thickness (TRT) in Obstructive Sleep Apnea Syndrome (OSAS) and demonstrate a possible subclinical papilledema Thirty-six patients with suspected OSAS underwent standard overnight polysomnography and were grouped into mild, moderate and severe. Seventy eyes of thirty six OSAS patients and seventy -two eyes of healthy controls were included. Retinal nerve fiber layer thicknesses (RNLF) and TRT s were measured by optic coherence tomography. RNFL segment values showed no difference between OSAS and control groups. RNFL superior segment and inferonasal segments of the mild OSAS subgroup were found to be thinner than the moderate and severe OSAS subgroups (p=0.034, p=0.025, respectively). RNFL point values also showed no difference between the two groups. The RNFL inferior point of the mild OSAS subgroup was found to be thinner than the moderate and severe subgroups (p=0.036). OSAS TRTs were thinner than the controls at inferior and temporal points (p=0.005, p=0.033, respectively). The TRT inferior point of the mild OSAS subgroup was found to be thinner than the moderate and severe subgroups (p=0.006). At all points RNFL values were subtracted from the TRT values and compared. At the temporal point the OSAS group’s TRT-RNFL was thinner than that of the control groups (p=0.029). TRT measurements could not demonstrate a possible subclinical papilledema. Thinning of RNFL thickness and TRT in OSAS patients could be the result of hypoxemia related chronic atrophy.
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    Glokom ve topikal antiglokom ilaçların depresyonla ilişkisi
    (Gazi Göz Vakfı, 2007) Keklikçi, Uğur; Yaşan, Aziz; Ünlü, Kaan; Ceylan, Veysi; Balsak, Selahattin
    Amaç: Bu çalışmada glokom, topikal antiglokom tedavisi ve depresyon arasındaki ilişki araştırıldı. Gereç ve Yöntem: Çalışmaya glokomlu olan ve topikal antig- lokom ilaç tedavisi alan 120 olgu dahil edildi. Olguların yaş ortalaması 52.37±16.46 yıl olup, 64’ü erkek, 56’sı kadındı. Antiglokom tedavisi alan hasta grubu, topikal beta bloker kullananlar ve topikal prostaglandin analo- gu kullananlar olmak üzere iki gruba ayrılarak değerlen- dirildi. Kontrol grubu olarak kırılma kusuru dışında göz ve sistemik rahatsızlığı olmayan aynı yaş grubu 60 olgu dahil edildi. Kontrol grubundaki olguların yaş ortalaması 51.80±13.96 yıl olup 36’sı erkek, 24’ü kadındı. Çalışma- ya alınan bireylere demografik veri formu, depresyon ta- nısı için yapılandırılmış klinik görüşme çizelgesi klinik ver- siyonu (SCID I) ve depresyon şiddeti için Beck depresyon envanteri (BDE) uygulandı. Bulgular: Glokomlu olgu grubunda depresyon oranı (%25.2) kontrol gurubuna (%10) göre daha yüksekti (p=0.013). Beta bloker kullananlarda depresyon oranı %29.50, pros- taglandin analogu kullananlarda ise %22.03 idi ve arala- rında istatiksel olarak anlamlı fark yoktu (p=0.350). Ancak beta bloker kullananlarda BDE puanlarına göre depresyon şiddeti, prostaglandin analogu kullanan olgular (p=0.010) ve kontrol grubundan (p=0.000) daha yüksekti. Sonuç: Glokomlu hasta grubunda depresyon oranı kontrol grubuna göre daha yüksekti. Ayrıca tedavi olarak topi- kal beta bloker kullananlarda ortalama depresyon pua- nı, prostaglandin analogu kullananlara göre daha yüksek bulundu. Glokom tedavisi için başvuranlarda ve tedavide beta bloker kullananlarda bu durumun göz önünde bulun- durulması gerektiğini düşünüyoruz.
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    Göz içi basıncı ölçümünde farklı yöntemlerin karşılaştırılması ve santral kornea kalınlığının ölçüm sonuçlarına etkisinin değerlendirilmesi
    (2010) Doğan, Eyyüp; Ünlü, Kaan; Keklikçi, Uğur; Balsak, Selahattin; Şakalar, Yıldırım Bayezit
    Amaç: Normal gözlerde Goldmann applanasyon tonometresi (GAT), tonopen ve non-kontakt tonometre (NKT) ile göz içi basıncı (GİB) ölçümlerini karşılaştırmak ve ölçüm sonuçlarının santral kornea kalınlığı (SKK) ile ilişkisini belirlemek. Gereç ve Yöntem: Oftalmolojik muayene ve görme alanında glokom saptanmayan normal 41 olgunun 79 gözü çalışmaya dahil edildi. GİB ölçümleri GAT, tonopen ve NKT ile gerçekleştirildi. SKK ultrasonik pakimetre ile ölçüldü. Bulgular: Ortalama GİB GAT ile 12.63 ± 2.94 mmHg, tonopen ile 8.51 ± 2.66 mmHg, NKT ile 13.34 ± 3.88 mmHg olarak ölçüldü. Ölçüm sonuçları açısından üç yöntem arasında istatistiksel olarak anlamlı farklılık bulundu (p<0.05). SKK ile tonopen arasında anlamlı korelasyon olmamasına rağmen (p>0.05) SKK ile GAT ve SKK ile NKT arasında anlamlı korelasyon mevcuttu (p<0.05).Sonuç: Normal gözlerde GAT, NKT ve tonopen ile GİB ölçümleri arasında anlamlı farklılık mevcuttur. Normal gözlerde GAT ve NKT, SSK’dan anlamlı olarak etkilenmekte iken tonopen normal gözlerde SKK’dan diğer yöntemlere göre daha az etkilenebilir.
  • Küçük Resim
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    Katarakt cerrahisi ile aynı seansta skleral askılı göz içi lens yerleştirilmesi
    (Dicle Üniversitesi Tıp Fakültesi, 2019) Balsak, Selahattin; Özkurt, Zeynep Gürsel
    Amaç: Bu çalışmada amacımız, ameliyat öncesi zonül veya kapsül zaafiyeti olan ve fakoemülsifikasyon (FAKO) cerrahisi ile aynı seansta skleral askılı göz içi lensi (GİL) yerleştirilmesi yaptığımız hastaların operasyon sonrası oftalmolojik bulgularını değerlendirmektir. Yöntemler: Ameliyat öncesinde hastaların Snellen eşeli ile görme keskinlikleri ölçüldü, ön ve arka segmentler incelendi, göz içi basınçları aplanasyontonometri ile ölçüldü. Kornea keratometri değerleri otorefraktokeratometre ile K1 ve K2 olarak en dik ve en düz meridyenlerde ölçüldü. Ameliyatta aynı seansta FAKO cerrahisi ile skleral askılı GİL yerleştirilmesi yapıldı. Hastalar en az 6 ay takip edildi. Bulgular: Çalışmaya 31 hastanın 36 gözü dahil edildi. Olguların 14’ü (%45,1) kadın, 17’si (%54,9) erkek idi. Yaş ortalaması 51.7±24.0 (25-65) yıl idi. Olguların 16’sında (%44,5) pseudoeksfoliasyona 10’unda (%27,8) travmaya ve 10’unda (%27,8) MarfanSendromu’na bağlı zonülzaafiyeti vardı. Ortalama görme keskinlikleri ameliyat öncesi 0.1±0.1 iken, ameliyat sonrası 6. ay da 0.6±0.3 idi (p≤0.000). Göz içi basıncı değerlerinde ameliyat sonrası istatiksel olarak anlamlı düşüş izlendi (p=0.036). Korneaların K1 ve K2 değerlerinde ameliyat sonrası değişiklikler istatiksel olarak anlamlı değildi (p=0.351; p=0.875 sırasıyla). Gözlerin ameliyat sonrası ölçülen sferik değerleri ortalama +0.50±0.50D idi. Ameliyat sırasında olgularda komplikasyona rastlanmadı. Ameliyat sonrası dönemde ise beş (%13,9) olguda göz içi basıncı artışı ve iki olguda (%5,5) vitre içi kanama oluştu. Sonuç ve Yorum: Katarakt cerrahisi ile aynı seansta skleral askılı GİL yerleştirilmesi erken görsel rehabilitasyon için önemlidir. Ayni seansta fakoemülsifikasyon ve skleral askılı GİL yerleştirilmesi ayrı seanslarda yapılan cerrahilere göre komplikasyon oranlarını arttırmamıştır.
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    Öğe
    Kene enfestasyonuna bağlı preseptal selülit
    (2010) Şakalar, Yıldırım Bayezit; Ünlü, Kaan; Keklikçi, Uğur; Balsak, Selahattin; Alakuş, Mehmet Fuat; Arserim, Neval Berrin
    Dört yaşında kız çocuğu başında ve sol üst göz kapağı üzerinde kene ısırığı şikayeti ile başvurdu. Kene ısırıkları bir gün önce hastanın ailesi tarafından fark edilmişti. Muayenede sağ üst göz kapağı kirpik kenarında kene enfestasyonu saptandı. Her iki gözde kapaklar ödemliydi ve sol göz kapağı hafif hiperemikti. Künt uçlu bir forseps yardımıyla, uygun teknikle kene çıkartıldı ve profilaktik sistemik antibiyotik tedavisi başlandı. Olguda yüksek ateş ve kanama pıhtılaşma zamanlarında uzama gibi bulgular izlenmedi. Mikroskobik incelemede kenenin Ixodes türleri olduğu saptandı. Her iki göz kapağındaki ödem 3 gün sonra düzeldi ve sistemik herhangi bir komplikasyon gözlenmedi. Serolojik incelemelerde Kırım Kongo Kanamalı ateşi yönünden etken tespit edilmedi.
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    Öğe
    Metallic corneal foreign bodies: an occupational health hazard
    (Consel Brasil Oftalmologia, 2014) Ozkurt, Zeynep Gursel; Yuksel, Harun; Saka, Gunay; Guclu, Hande; Evsen, Sina; Balsak, Selahattin
    Purpose: To analyze the risk factors, outcomes, demographic characteristics, and attitudes of workers with metallic corneal foreign body (FB) injury. Methods: One hundred consecutive patients who presented with a metallic corneal FB to the eye clinic at Diyarbakir Training and Research Hospital were evaluated. The patients completed a questionnaire and were examined to determine features of the injury. Results: All patients were male. The mean age was 32.46 +/- 1.03 years. Fifty-five percent of the patients were unregistered workers, 59% were working in the metal industry sector, and 65% injuries resulted from metal cutting. Protective goggles were available in the workplace of 64% patients. However, 57% patients were not wearing goggles when the accident occurred, and 43% were injured despite goggle use. Most patients (52%) attempted to remove FBs by themselves. FBs were located in the central zone of the cornea in 16% patients. Rust marks remained after FB removal in 26% patients. Corneal scars from previous FB injuries were present in 58% patients. Only 8% workplaces provided compensation for physician visits for occupation-related illnesses. Conclusions: Workplaces with a high risk for eye injuries should increase their protective measures, and educational programs should be implemented for both workers and occupational physicians. The government should enforce laws regarding unregistered workers in a better manner.
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    Öğe
    Novel FGF10 mutation in autosomal dominant aplasia of lacrimal and salivary glands
    (Springer Heidelberg, 2017) Seymen, Figen; Koruyucu, Mine; Toptanci, Ismet Rezani; Balsak, Selahattin; Dedeoglu, Serkan; Celepkolu, Tahsin; Shin, Teo Jeon
    Aplasia of lacrimal and salivary glands (ALSG) is a rare autosomal dominant inherited disease, characterized by aplasia, atresia, or hypoplasia of the lacrimal and salivary systems with variable expressivity. The purpose of this study was to identify genetic etiology of an ALSG family. We recruited a Turkish family with ALSG and performed a mutational analysis, based on the candidate gene approach, to clarify the molecular genetic etiology. The candidate gene sequencing of the FGF10 gene identified a novel heterozygous nonsense mutation (c.237G > A, p.Trp79*) in the exon 1. The identified novel mutation would result in a haploinsufficiency of the FGF10, because of nonsense-mediated mRNA decay caused by a premature stop codon. This report further confirms that ALSG is caused by the haploinsufficiency of functional FGF10. Identification of the genetic etiology of the ALSG will help both the family members and dentist understand the nature of the disorder. Therefore, it will positively motivate oral health care to avoid further destruction of the tooth due to the lack of salivary production.
  • Küçük Resim
    Öğe
    Outcomes of maximal levator resection procedure in cases of congenital myogenic ptosis
    (Dicle Üniversitesi Tıp Fakültesi, 2019) Balsak, Selahattin; Dağ, Umut; Güneş, Yakup; Çakmak, Sevim; Keklikçi, Uğur
    Objective: This study aimed to evaluate the outcomes of maximal levator resection in cases of congenital myogenic ptosis with poor levator function. Method: Thirty-threeptotic eyelids of 30 cases undergoing maximal levator resection were retrospectively included. There were 18 male and 12 female cases. The mean age of the cases was 12.55±5.3 years (range, 4-26 years). For all eyes, vertical palpebral aperture, margin reflex distance, levator functions, and upper eyelid crease height were measured. Ptosisseverity was “mild” when the eyelid elevation was ≤2 mm; “moderate” when the eyelid elevation was 3 mm; and “severe” when the eyelid elevation was ≥4 mm. The mean age of the cases (18 males and 12 females) was 12.55±5.3 years (range, 4-26 years). Results and Conclusion: The mean ptosis severity (vertical palpebral aperture) was 5.136 mm preoperatively and 0.818 mm at the postoperative Month 3 (p<0.001). Surgical outcomes were successful in 26 eyes (78%), satisfactory in 4 eyes (12%), and unsuccessful in 3 eyes (9%).Conclusively, successful outcomes were obtained after maximal levator resection in ptosis cases with poor levator functionin most of casses.
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    Öğe
    Preseptal Cellulitis Related to Tick Infestation
    (Turkish Ophthalmological Soc, 2010) Sakalar, Yildirm Bayezit; Arserim, Neval Berrin; Keklikci, Ugur; Balsak, Selahattin; Alakus, Mehmet Fuat; Unlu, Kaan
    A 4-year-old girl presented with complaint of tick bite on the left upper eyelid and head. The tick bites were noticed by her parents one day ago. On her examination, tick infestation was found in the lash margin of the right upper eyelid. Bilateral eyelid edema and mild hyperemia of the left upper yelid were observed. The tick in the eyelid was removed with a proper technique using a blunt-ended forceps and prophylactic systemic antibiotic therapy was started. Signs such as high fever or prolongation of clotting time were not observed in the patient. The species of tick was identified as Ixodes species on microscopic examination. The edema of both eyelids resolved 3 days later and no systemic complications were observed. The Crimean Congo hemorrhagic fever was not detected on serological investigations.