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Öğe A Minor Modification of Direct Browplasty Technique in a Patient with Brow Ptosis Secondary to Facial Paralysis: Copy-Paste-Excise and Stitch(Hindawi Ltd, 2013) Comez, Arzu Taskiran; Gencer, Baran; Kara, Selcuk; Tufan, Hasan AliPurpose. This report aimed to describe a minor modification of the traditional direct browplasty technique that aids in surgical planning for patients with brow ptosis secondary to facial paralysis without changing the shape of the brow. Case Report. A 74year-old male patient with left facial paralysis secondary to chronic otitis media was referred with a complaint of low vision due to brow ptosis. We performed direct browplasty with a minor modification in order to aid a treatment customized to the patient. In this technique, a transparent film paper is used to copy the brow shape. A brow-shaped excision is facilitated just superior to the ptotic brow. Conclusion. The authors found that the copy-paste-excise and stitch technique was effective and successful for deciding the shape and the amount of excision that should be performed in patients with brow ptosis without resulting in asymmetrical, arched, and feminized brows.Öğe Alterations in Iris Structure and Pupil Size Related to Alpha-1 Adrenergic Receptor Antagonists Use: Implications for Floppy Iris Syndrome(Mary Ann Liebert, Inc, 2013) Tufan, Hasan Ali; Gencer, Baran; Kara, Selcuk; Comez, Arzu Taskiran; Kurt, Hasan Anil; Alan, CabirPurpose: To evaluate structural alterations of iris and pupil diameters (PDs) in patients using systemic alpha-1-adrenergic receptor antagonists (alpha-1ARAs), which are associated with intraoperative floppy iris syndrome (IFIS). Methods: Eighty-eight eyes of 49 male were evaluated prospectively. Patients were assigned to 2 different groups. Study group included 23 patients taking any systemic alpha-1ARAs treatment, and control group included 26 patients not taking any systemic alpha-1ARAs treatment. All patients underwent anterior segment optical coherence tomography to evaluate iris thickness at the dilator muscle region (DMR) and at the sphincter muscle region (SMR). The PD was measured using a computerized infrared pupillometer under scotopic and photopic illumination. Results: The study group included 46 eyes of 23 patients and the control group included 42 eyes of 26 patients. Most treated patients were on tamsulosin (16/23). Mean age was similar in the study and control groups (61.9 +/- 7.1 vs. 60.3 +/- 8, 2 years, nonsignificant). DMR (506.5 +/- 89.4 vs. 503.6 +/- 83.5 mu m), SMR (507.8 +/- 78.1 vs. 522.1 +/- 96.4 mu m) and the DMR/SMR ratio (1.0 +/- 0.15 vs. 0.99 +/- 0.23 mm) was similar in the study and control groups and these differences were nonsignificant. Scotopic PDs were also similar in both groups (3.99 +/- 1.11 vs. 3.74 +/- 1.35, nonsignificant). A significantly reduced photopic PD (2.89 +/- 0.55 vs. 3.62 +/- 0.64, P < 0.001) and an increased scotopic/photopic PD (1.42 +/- 0.44 vs. 1.02 +/- 0.30, P < 0.001) were found in the study group. Conclusions: Evaluating PD alterations might be more useful than evaluating iris structural alterations in predicting IFIS. There is still a need for a reliable method that will determine the possibility of IFIS.Öğe Bilateral multifocal pseudomonas aeruginosa keratitis in a contact lens -wearing diabetic patient treated with a custom compounded 5% imipenem-cilastatin topical solution(Ophthoscience Publ, 2020) Comez, Arzu Taskiran; Yildiz, AydinPseudomonas aeruginosa is a devastating agent of fulminant keratitis in contact lens-wearers, immunosuppressive patients, and refractive surgery patients which may lead to substantial loss of vision, and in severe cases, blindness. In this case report, a 30-year-old diabetic contact lens wearer who had history of sleeping with lenses and prolonged use of the same contact lens presented with multiple foci of keratitis in each eye. No pathogen was detected from corneal scrapings, but the contact lenses and the contact lens case were culture positive for Pseudomonas aeruginosa. The keratitis was only partially responsive to topical fortified ceftazidime, topical fortified vancomycin, and topical fluconazole. A decision was made to switch to topical imipenem-cilastatin due to the multiple risk factors, including diabetes, contact lens overuse, and bilateral multifocal corneal involvement, after which the keratitis resolved. Topical imipenem-cilastatin may be a successful alternative treatment in patients with Pseudomonas keratitis who do not respond to conventional antibiotic therapy.Öğe Chronic dacryocystitis secondary to Stenotrophomonas maltophilia and Staphylococcus aureus mixed infection(BMJ Publishing Group, 2014) Comez, Arzu Taskiran; Koklu, Asiye; Akcali, AlperA 40-year-old woman with a history of recurrent attacks of dacryocystitis for 2 years developed a lacrimal sac abscess. ?-Lactam antibiotics, considered the first-line treatment for dacryocystitis, were ineffective. She underwent dacryocystorhinostomy. Cultures from the lacrimal sac demonstrated the presence of Stenotrophomonas maltophilia and methicillin-sensitive Staphylococcus aureus, both of which are sensitive to trimethoprim- sulfamethoxazole. This rare and antibiotic-resistant bacterial species should be considered in atypical cases of dacryocystitis, and appropriate antibiotics should be started immediately. Copyright 2014 BMJ Publishing Group. All rights reserved.Öğe Comparison of Transcanalicular Diode Laser Dacryocystorhinostomy and External Dacryocystorhinostomy in Patients with Primary Acquired Nasolacrimal Duct Obstruction(Wiley-Blackwell, 2014) Comez, Arzu Taskiran; Karadag, Onur; Arikan, Sedat; Gencer, Baran; Kara, SelcukBackground and Objective: To compare the success, complication, and patient discomfort rates of transcanalicular diode laser dacryocystorhinostomy (TCDL-DCR) and external dacryocystorhinostomy (EX-DCR) surgeries performed in patients with primary acquired nasolacrimal duct obstruction. Materials and Methods: Eighty consecutive patients were included in the study, and groups were assigned according to DCR technique. Thirty-four (42.5%) patients received TCDL-DCR (Group A) and 46 (57.5%) patients (Group B) received EX-DCR with temporary silicone stent intubation. The success of surgery was determined by the relief of epiphora, patient satisfaction, endoscopic evaluation of ostium patency, and lacrimal system syringing. Pearson Chi-Square test, Fisher's Exact test, and Student's t-test were used for statistical analyses. Results: Group A included 22 females and 12 males with a mean age of 49.1 +/- 15.1 years, Group B included 35 females and 11 males with a mean age of 50.8 +/- 11.7 years. There was no difference between groups in terms of age and gender (P=0.905 and P=0.167, respectively). The duration of the operation was 22.2 +/- 4.8 minutes for Group A, while it was 56.3 +/- 15.7 minutes for group B (P=0.0001). In two patients in Group A, injury in the medial turbinate was recorded, and in Group B, 14 patients experienced mild to severe perioperative bleeding. The perioperative complication rate was significantly different between the groups (P=0.004). Success in relieving symptoms was 79.4% for Group A and 89.1% for Group B. The difference in the success rates was not statistically significant (P=0.229). Conclusions: Although EX-DCR success rate was higher than that achieved with TCDL-DCR, the latter, with its shorter duration of surgery, lower perioperative complication rate, and a similar success rate, may be a good and acceptable surgical alternative in treatment of primary acquired nasolacrimal duct obstruction. Lasers Surg. Med. 46:275-280, 2014. (C) 2014 Wiley Periodicals, Inc.Öğe Effect of Topically Applied Azithromycin on Corneal Epithelial and Endothelial Apoptosis in a Rat Model of Corneal Alkali Burn(Lippincott Williams & Wilkins, 2016) Arikan, Sedat; Karaca, Turan; Ertekin, Yusuf Haydar; Comez, Arzu Taskiran; Ersan, Ismail; Demirtas, Selim; Elmas, SaitPurpose: To investigate the antiapoptotic effect of topically administered azithromycin (AZM) on corneal epithelial and endothelial cells in a rat model of corneal alkali burn. Methods: Twenty-four Wistar albino rats were divided into 4 equal groups as pseudovehicle (group 1), control (group 2), alkali burned (group 3), and treatment (group 4) groups. Alkali injury was induced only in the right corneas of rats belonging to groups 3 and 4 using 1N NaOH. The rats in group 3 and the rats in group 4 were respectively treated either with an artificial tear gel or with 1.5% AZM eye drops for 5 days. At the fifth day of the experiment, the apoptosis in the corneal epithelium and endothelium of all rats was assessed using a terminal dUTP nick-end labeling (TUNEL) assay. In addition, tumor necrosis factor-alpha (TNF-alpha) density in the corneal epithelium was measured in all rats. Results: The mean numbers of TUNEL+ cells in the corneal epithelium and endothelium of rats in group 3 were 117.1 +/- 23.8 and 34.6.+/- 11.3, respectively, whereas in group 4, they were 75.8 +/- 15.7 and 14.7 +/- 3.5, respectively. Also the mean TNF-alpha densities in the corneal epithelium in group 3 and group 4 were 2.65 +/- 1.3 and 1.65 +/- 1.1, respectively. There was a significant decrease in the mean number of TUNEL+ cells in the corneal epithelium and endothelium and in the mean TNF-alpha density in the corneal epithelium of rats in group 4, when compared with group 3. Conclusions: Topically applied AZM can decrease TNF-alpha-induced apoptosis in corneal alkali burn.Öğe Effects of Lubricating Agents with Different Osmolalities on Tear Osmolarity and Other Tear Function Tests in Patients with Dry Eye(Taylor & Francis Inc, 2013) Comez, Arzu Taskiran; Tufan, Hasan Ali; Kocabiyik, Omer; Gencer, BaranPurpose: To evaluate the effects of different artificial tear eye drops on Ocular Surface Disease Index (OSDI), tear osmolarity, Schirmer's I test, and tear break-up time (TBUT) in patients with dry eye disease. Materials and methods: This 12-week, single-institution, single-masked, randomized, pilot study was conducted in Turkey between March and July 2012 in patients with dry eye. Patients were randomly assigned to receive Systane (R) for their right eye and Eyestil (R) for their left eye or to receive Tears Naturale II (R) for their right eye and Refresh Tears (R) for their left eyes. Outcomes were assessed at baseline and weeks 2, 4 and 12 after treatment initiation. Results: Twenty-two patients received Systane (right eye) and Eyestil (left eye) and 21 patients received Tears Naturale (right eye) and Refresh (left eye). At each visit and for each outcome, each treatment group demonstrated a significant improvement from baseline (p<0.001); however, none of these outcomes were significantly different among treatment groups at any visit. At week 12, the mean OSDI improvement was similar between the Systane/Eyestil group (-26.4 +/- 10.6) and the Tears Naturale/Refresh group (-27.6 +/- 14.8). The mean tear osmolarity decrease (mOsm/L) at week 12 was -33.8 +/- 8.3 for Eyestil, -30.3 +/- 9.2 for Refresh, 28.4 +/- 8.2 for Systane and 25.7 +/- 13.1 for Tears Naturale. The mean Schirmer's test increase at week 12 (mm/5 min) was 6.7 +/- 3.4 for Eyestil, 6.4 +/- 2.9 for Systane, 4.7 +/- 2.4 for Tears Naturale and 4.7 +/- 2.8 for Refresh. The mean TBUT increase at week 12 (s) was 7.0 +/- 3.4 for Systane, 6.1 +/- 3.3 for Eyestil, 5.8 +/- 2.3 for Tears Naturale, and 5.6 +/- 2.8 for Refresh. Conclusion: All four artificial tear formulations were effective in relieving dry eye signs and symptoms. Although the greatest improvement in two of the objective tests was achieved by Eyestil, the drug with the lowest osmolality, differences among the four artificial tear eye drops were not statistically significant.Öğe Evaluation of possible factors affecting contrast sensitivity function in patients with primary Sjogren's syndrome(Consel Brasil Oftalmologia, 2015) Arikan, Sedat; Gokmen, Ferhat; Comez, Arzu Taskiran; Gencer, Baran; Kara, Selcuk; Akbal, AylaPurpose: The contrast sensitivity (CS) function in patients with primary Sjogren's syndrome (pSS) may be impaired either frequently as a result of dry eye diseases or rarely as a result of optic neuropathy. In this study, we aimed to evaluate the CS function in pSS patients as well as to assess corneal aberrations and thickness of the peripapillary retinal nerve fiber layer (pRNFL). Methods: Fourteen eyes of 14 pSS patients (pSS group) and 14 eyes of 14 healthy participants (control group) were subjected to assessment of CS at the spatial frequencies of 1.5, 3.0, 6.0, 12, and 18 cycles/degree (cpd) using a functional visual acuity contrast test (FACT); measurement of corneal high-order aberrations (HOAs) in terms of coma-like, spherical-like, and total HOAs using Scheimpflug corneal topography; and measurement of the thickness of both the macular ganglion cell-inner plexiform layer (mGCIPL) and pRNFL in all quadrants using optical coherence tomography. None of the participants were under treatment with artificial tears. Results: The results of the CS test did not differ between the 2 groups at all spatial frequencies (p>0.05). In addition, there were no statistically significant differences between the 2 groups in terms of corneal HOAs (p>0.05) and thickness of mGCIPL (p>0.05). However, among all quadrants, only the inferior quadrant of pRNFL in pSS patients was statistically significantly thinner than that in the healthy participants (p=0.04). Conclusions: The CS function in pSS patients can be maintained with normal thickness of both pRNFL and mGCIPL and with lack of increased corneal HOAs, which may be present even in the absence of artificial tear usage.Öğe Evisceration with and without cornea preservation with posterior sclerotomies(Wiley-Blackwell, 2013) Comez, Arzu Taskiran; Akcay, Levent; Ozgur, Ozlen; Dogan, Omer[Anstract Not Available]Öğe Is Normative Database of Optical Coherence Tomography Device Comprise Turkish Population(Turkish Ophthalmological Soc, 2009) Eser, Ilker; Komur, Baris; Comez, Arzu TaskiranPurpose: To compare the retinal nerve fiber layer (RNFL) thickness normative values measured by Optical Coherence Tomography(OCT) with healthy subjects. Methods: Thirty-nine randomized right or left eyes of 39 healthy subjects(18 female, 21 male), with a mean age of 25.1 +/- 3.0(19-29) years were included in the study. Subjects without family history of glaucoma and who were evaluated by intraocular pressure(IOP) measurements, central corneal thickness(CCT), cup/disc ratio and OCT measurement results, and who were accepted as not in risky group for glaucoma were included in the study. Three sequential measurements were taken by Spectral OCT/SLO [Opko/OTI, Inc., Miami, FL] analyzer, by the same operator in the same day, and mean of these 3 measurements was used for the analysis. One sample t-test was used for statistical analysis. Results: The mean values of the subjects and the normative RNFL thickness database used by the device were; 142.5 +/- 16.5 mu and 134.4 +/- 17.0 mu(p=0.004) in the superior quadrant, 97.4 +/- 11.5 mu and 90.2 +/- 15.3 mu (p=0.0001) in the nasal quadrant, 145.4 +/- 16.3 mu and 136.75 +/- 16.0 mu(p=0.002) in the inferior quadrant and 73.6 +/- 8.6 mu and 74.3 +/- 13.0 mu(p=0.659) in the temporal quadrant, respectively. There was 6.1-8% RNFL thickness difference between the values measured in the superior, nasal and inferior quadrants and the normative data used by the device; while compatibility of the values between temporal quadrants and normative data was obtained. Conclusion: The RNFL thickness in the superior, nasal and inferior quadrants were found to be statistically significant thicker in subjects included in the study. If the lower normative database used by the device were taken into account, errors in early diagnosis and the treatment of glaucoma would be inevitable. The initial data of our continuing study, reveal that the RNFL thickness values in healthy subjects of our population might not be plug-compatible with the normative database used by the device and this may result in a need to develop Turkish normative database.Öğe Is Single Measurement Enough to Get a Reliable Result with Optical Coherence Tomography?(Turkish Ophthalmological Soc, 2012) Comez, Arzu Taskiran; Eser, Ilker; Bakar, Coskun; Komur, BarisPurpose: To evaluate the repeatability and reliability of retinal nerve fiber layer (RNFL) thickness measurements using optical coherence tomography (OCT). Material and Method: Two hundred sixty-six eyes of 135 subjects (glaucoma, glaucoma suspects and healthy) were included in this study. Three sequential inferior, superior, nasal and temporal RNFL thickness measurements were performed using Spectral OCT [Opko/OTI, Inc., Miami, FL] by one operator at one session without pupillary dilatation. The differences between these three measurements of each quadrant in each eye were compared in microns and percentages. Repeated measures analysis of variance was performed for statistical analysis. Reliability is measured by intraclass correlation coefficient (ICC) for each quadrant. Results: ICCs of all quadrants ranged between 0.77 and 0.92, with the measurements of nasal quadrant being the least reproducible and the inferior being the most reproducible of all quadrants. RNFL measurement errors over 20% were seen in 9.63% of nasal quadrant, 5.3% of temporal quadrant, 0.6% of superior quadrant and only 0.3% of inferior quadrant measurements. Discussion: In order to get more repeatable and reliable results with OCT, sequential measurements more than one should be considered. We believe that special attention is required in the analysis of data of nasal and temporal quadrants.Öğe Ocular aspergillosis: Obtaining a specimen is crucial for diagnosis. A report of three cases(Elsevier Science Bv, 2012) Comez, Arzu Taskiran; Komur, Baris; Akcali, Alper; Otkun, Muserref TatmanAspergillus species have been implicated in a wide variety of primary ocular conditions, characterized by either slow and asymptomatic infection, or rapid, uncontrollable progression and sometimes death. The study design is a case series including chronic asymptomatic dacryocystitis, dacryocystitis with dacryoliths and endogenous endophthalmitis. Due to this variable clinical presentation of aspergillosis a high level of suspicion must be maintained as fulminant aspergillosis may lead to a rapidly progressive infection which may result in death. (C) 2012 International Society for Human and Animal Mycology. Published by Elsevier B.V.Öğe Ophthalmia Nodosa as an Occupational Disease: Is It Usual or Is It Casual?(Informa Healthcare, 2013) Comez, Arzu Taskiran; Tufan, Hasan Ali; Gencer, Baran[Anstract Not Available]Öğe Primary Malignant Tumors of the Eyelids(Turkish Ophthalmological Soc, 2012) Comez, Arzu Taskiran; Akcay, Levent; Dogan, Omer KamilPurpose: To evaluate the clinical and histopathological features of primary malignant tumors of the eyelids as well as the results of the surgical procedures performed. Material and Method: Fifty-one patients, who had lesions proven to be malignant by histopathological examination, were retrospectively evaluated for age, localization, clinical and histopathological diagnosis, surgical technique, perioperative and postoperative complications. Results: Of 51 patients, twenty three (45%) were male and 28 (55%) were female with a mean age of 62.5 (range: 35- 80) years. The histopathological results of the excisional biopsy materials revealed basal cell carcinoma (BCC) in 38 (74.5%), squamous cell carcinoma (SCC) in 10 (19.6%), malignant melanoma (MM) in 1 (1.96%), sebaceous gland carcinoma (SGC) in 1 (1.96%), and non-Hodgkin lymphoma (NHL) in 1 (1.96%) patient. In 76.5% (n=39) of the eyelid malignancies, histopathological examination results were in concordance with the clinical diagnosis. In 9 (17.6%) cases, residual tumour cells were detected. The recurrence rate in all cases was 3.92%, while it was 2.63% for BCC and 10% for SCC. Discussion: BCC and SCC were the most common tumors in the eyelids. Surgical excision and histopathological evaluation are the best diagnostic and treatment procedure if a proper selection of the patients is done.Öğe Recurrent Dacryocystitis and Lacrimocutaneous Fistula Caused by a Retained Griffiths' Collar Button Stent(Taylor & Francis Inc, 2014) Comez, Arzu Taskiran; Guclu, Oguz; Gencer, Baran; Kara, Selcuk; Tufan, Hasan AliA 42-year-old man presented with a white plastic-like material exposed in the left medial canthal area, with a fistula and purulent discharge. He had undergone endonasal dacryocystorhinostomy 7 years earlier for left eye epiphora; he had persistent postoperative epiphora and recurrent dacryocystitis despite multiple drainage attempts and antibiotics elsewhere. Computed tomography showed bilateral enlarged cystic lacrimal sacs, with a well-defined contoured tunnel-like hole at the center of the left sac. Treatment included excision of the foreign body, which was a Griffiths' collar button nasolacrimal stent, excision of the fistula tract, and revision dacryocystorhinostomy with implantation of bicanalicular silicone stent. He recovered with no further symptoms or complications. This case highlights the importance of follow-up for removal of an implanted Griffiths' stent after dacryocystorhinostomy. Patients with recurrent dacryocystitis may benefit from a detailed history of previous surgery, careful examination, and imaging to evaluate for endogenous and exogenous foreign bodies such as lacrimal sac calculi, and retained lacrimal sac stents.Öğe Retina and Optic Disc Characteristics in Amblyopic and Non-amblyopic Eyes of Patients with Myopic or Hyperopic Anisometropia(Turkish Ophthalmological Soc, 2017) Comez, Arzu Taskiran; Ulu, Elif Sanal; Ekim, YelizObjectives: To compare retinal and optic disc characteristics between amblyopic and non-amblyopic eyes in patients with myopic and hyperopic anisometropia measured with optical coherence tomography (OCT). Materials and Methods: Patients with myopic (25 patients: 17 female, 8 male; median age 27 years, range 16-40 years) and hyperopic (31 patients: 19 female, 12 male; median age 20 years, range 13-41 years) anisometropic amblyopia were included. Eye examination included determination of best-corrected visual acuity (BCVA) with a Snellen chart, measurement of manifest and cycloplegic refraction after pupillary dilation, alternate cover testing, globe movement evaluation, A-scan biometry for axial length, biomicroscopy, fundus examination, and OCT scanning. Main outcome measures were spherical equivalence, BCVA, axial length, retinal nerve fiber layer (RNFL) thickness, macular thickness, macular volume, and optic disc area. Results: In both myopic and hyperopic patients, the absolute value of the mean spherical equivalence was significantly greater in the amblyopic than non-amblyopic eyes, and the mean BCVA was significantly less in the amblyopic than the non-amblyopic eyes. In both myopic and hyperopic patients, there were no significant differences in mean RNFL thickness, macular thickness, macular volume, axial length, or optic disc area between amblyopic and non-amblyopic eyes. Conclusion: The amblyopic process may have no significant effect on the RNFL, macula, or optic disc. Further studies with more patients, including postmortem studies, may clarify the retinal, histopathologic, and anatomic differences between amblyopic and nonamblyopic eyes.Öğe Schwannoma in the anterior orbita(BMJ Publishing Group, 2014) Comez, Arzu Taskiran; Muratli, AsliA schwannoma is a rare benign tumour of peripheral nerve origin. We present a case of a 65-year-old woman with a 1-year history of a slowly enlarging, painless and movable mass, palpable by fingers in her right lower eyelid, adjacent to the inferior orbital rim. No apparent mass was present by macroscopic examination. A subciliary incision and blunt dissection through the septum revealed a pearl-like round and encapsulated cystic mass between the fat pads just below the septum. A total excision of the tumour was performed. Histopathology and immunohistochemistry led to the diagnosis of schwannoma. Although rare, schwannoma should be considered in the differential diagnosis of well-capsulated masses in the periorbital region. Copyright 2014 BMJ Publishing Group. All rights reserved.Öğe Serum cortisol and testosterone levels in chronic central serous chorioretinopathy(Springer, 2013) Tufan, Hasan Ali; Gencer, Baran; Comez, Arzu TaskiranTo investigate the potential role of serum cortisol and testosterone levels in chronic central serous chorioretinopathy (CSC). Serum cortisol and testosterone levels of six male patients with chronic CSC were evaluated by chemiluminescent immunassay. Hormone levels were compared with the normal reference values of healthy people. All patients were male, and the median age was 48 years (range: 42-54). The median duration of visual disturbance at presentation was 23 months (range: 12-48). Median 8:00 a.m. serum cortisol level was 11.6 mu g/dl (min. 4.74, max. 18.3) and the cortisol levels were within the normal range in five of the six patients. All patients had normal serum testosterone levels, with a median value of 549.5 ng/ml (min. 246, max. 794). Serum cortisol and testosterone levels were within normal ranges and in patients with chronic CSC. The association between these hormones and chronic CSC might be weak.Öğe Silicone perforated punctal plugs for the treatment of punctal stenosis(Consel Brasil Oftalmologia, 2019) Comez, Arzu Taskiran; Karakilic, Azersara Vural; Yildiz, AydinPurpose: Punctal stenosis can result in symptoms such as epiphora and can significantly reduce the quality of life of patients. Perforated punctal plug insertion is an easy procedure that is commonly used as the first step of treatment for punctal stenosis. Methods: Clinical, demographic, and outcome data were retrospectively collected for 54 eyes of 21 males and 11 females who consecutively presented to our Oculoplastic Clinic and underwent silicone Micro Flow perforated punctal plug insertion. All patients had epiphora with punctal stenosis. Results: Of the 54 plugs, 26 plugs (48.1%) were lost and 28 (51.8%) stayed in place. Of the latter, eight were explanted because of the occlusion of the plug with secretions and recurrent conjunctivitis; moreover, two plugs migrated deep into the vertical canaliculus. Of the 54 plugs, only 18 (33.3%) were well-tolerated with significant symptomatic improvement. Conclusion: Plug loss is a prominent problem in patients implanted with perforated punctal plugs. Silicone punctal plugs failed in 66.7% of our patients over a mean follow-up of 14.2 months.Öğe Simplified Technique for Sealing Corneal Perforations Using a Fibrin Glue-Assisted Amniotic Membrane Transplant-Plug(Hindawi Ltd, 2014) Kara, Selcuk; Arikan, Sedat; Ersan, Ismail; Comez, Arzu TaskiranPurpose. To describe a surgical technique using amniotic membrane transplant (AMT) with fibrin glue (FG) for treating smaller corneal perforations more practically and appropriately filling the defect. Method. A patient with noninfectious central corneal perforation, in 1mm in diameter, was treated with FG-assisted AMT-plug. An AMT was folded in on itself twice by using FG then a small piece of this FG-AMT mixture was cut to maintain an appropriate plug for the site of the corneal perforation. The FG-assisted AMT-plug was placed in the perforation area by using FG. An amniotic membrane patch was placed over the plug, which was then secured by a bandage contact lens. Result. Surgery to restore corneal stromal thickness without recurrence of perforation. Conclusion. The FG-assisted AMT-plug allowed a successful repair of 1mm in diameter corneal perforation. This technique was easily performed, thus seeming to be a good alternative to treat corneal perforations with restoring corneal thickness.
