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    Intraocular lens explantation or exchange: indications, postoperative interventions, and outcomes
    (Consel Brasil Oftalmologia, 2015) Oltulu, Refik; Ersan, Ismail; Satirtav, Gunhal; Donbaloglu, Meryem; Kerimoglu, Hurkan; Ozkagnici, Ahmet
    Purpose: To analyze the indications for explantation or exchange of intraocular lenses (IOLs), which were originally implanted for the correction of aphakia during cataract extraction. Methods: All cases that involved intraocular lens explantation or exchange in one institution between January 2008 and December 2014 were analyzed retrospectively. Results: In total, 93 eyes of 93 patients were analyzed. The median time interval between implantation and explantation of the anterior chamber intraocular lenses (AC IOL) and posterior chamber intraocular lenses (PC IOL) was 83.40 +/- 83.14 months (range: 1-276 months) and 55.14 +/- 39.25 months (range: 1-168 months), respectively. Pseudophakic bullous keratopathy (17 eyes, 38.6%) and persistent iritis (12 eyes, 27.8%) in the AC IOL group and dislocation or decentration (30 eyes, 61.2%) and incorrect IOL power (nine eyes, 18.4%) in the PC IOL group were the most common indications for explantation of IOLs. The mean logMAR best corrected visual acuity (BCVA) improved significantly from 1.30 preoperatively to 0.62 postoperatively in the PC IOL group (p<0.001) but did not improve significantly in the AC IOL group (p=0.186). Conclusions: The primary indication for IOL explantation or exchange was pseudophakic bullous keratopathy in the AC IOL group and was dislocation or decentration in the PC IOL group. PC IOL explantation or exchange is safe and improves visual acuity.
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    Relationship of inferior oblique overaction to macular and subfoveal choroidal thickness
    (Mosby-Elsevier, 2015) Ersan, Ismail; Oltulu, Refik; Altunkaya, Orhan; Satirtav, Gunhal; Arikan, Sedat; Donbaloglu, Meryem; Ozkagnici, Ahmet
    PURPOSE To evaluate the macular and subfoveal choroidal thickness of eyes with inferior oblique muscle overaction (IOOA) using enhanced depth imaging spectral domain optical coherence tomography (EDT SD-OCT). METHODS The measurements of macular and subfoveal choroidal thickness obtained by EDI SD-OCT of patients with IOOA (24 patients) were compared with those of age- and sex-matched controls (25 subjects). RESULTS There were no morphological abnormalities of the macula in patients with IOOA or in control subjects. There were no statistically significant differences in macular and subfoveal choroidal thickness between the eyes with IOOA and the eyes of the control subjects (P > 0.05). When the patients with IOOA were assigned to two distinct groups according to the degree of IOOA, the macular thickness did not differ between groups (P = 0.66), whereas subfoveal choroidal thickness measures were significantly lower in eyes with severe IOOA compared to eyes of the controls (P = 0.01). CONCLUSIONS IOOA has no effect on the morphology and the thickness of the macula. Severe IOOA seems to be related to thinning of subfoveal choroid due to possible external mechanical effect.
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    RELATIONSHIP OF INFERIOR OBLIQUE OVERACTION TO MACULAR AND SUBFOVEAL CHOROIDAL THICKNESS REPLY
    (Mosby-Elsevier, 2016) Ersan, Ismail; Oltulu, Refik; Altunkaya, Orhan; Satirtav, Gunhal; Arikan, Sedat; Donbaloglu, Meryem; Ozkagnici, Ahmet
    [Anstract Not Available]
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    The Effect of Dehydration and Fasting on Corneal Biomechanical Properties and Intraocular Pressure
    (Lippincott Williams & Wilkins, 2016) Oltulu, Refik; Satirtav, Gunhal; Ersan, Ismail; Soylu, Erkan; Okka, Mehmet; Zengin, Nazmi
    Purpose: To evaluate the changes in corneal biomechanical properties and intraocular pressure (IOP) during fasting period in healthy subjects. Methods: Seventy-two eyes of 72 fasting subjects (study group), and 62 eyes of 62 nonfasting subjects (control group) were enrolled in this prospective study undertaken at a single university hospital. All subjects underwent complete ophthalmologic examination including ocular biomechanical evaluation with ocular response analyzer. Ocular response analyzer measurement was performed on the right eyes of the subjects between 5.00 and 6.00 PM after approximately 14 hr of fasting for the study group and after a nonfasting period for the control group. The corneal hysteresis, corneal resistance factor, mean corneal compensated IOP (IOPcc), and Goldmann-correlated IOP (IOPg) values were measured with a patented dynamic bidirectional applanation process. Results: Goldmann-correlated IOP and IOPcc measurements in the study group and the control group were found as 13.8 +/- 2.8 mm Hg, 14.6 +/- 2.6 mm Hg and 16.3 +/- 2.2 mm Hg, 15.7 +/- 2.4 mm Hg, respectively. There was statistically significant difference within the two groups in IOPg and IOPcc (P < 0.001). In addition, corneal hysteresis and corneal resistance factor significantly decreased in study group compared with control group (P < 0.001, P = 0.012, respectively). Conclusion: Prolonged fasting causes a significant decrease in IOPg, IOPcc, corneal hysteresis, and corneal resistance factor in healthy subjects, altering the biomechanical properties of the cornea.