Keratokonusta Kornea İçi Halka ve İris Kıskaçlı Fakik Göziçi Lensi İmplantasyonu ile Görme Rehabilitasyonu

AMAÇ: Keratokonuslu hastalarda kornea içi halka ve iris kıskaçlı fakik göz içi lens implantasyonu ile görme rehabilitasyonunun incelenmesiYÖNTEM: 17 ve 25 yaşında iki hasta kontakt lens intoleransı nedeniyle tek taraflı kornea nakli cerrahisi amacıyla refere edilmişti. Bir hastada geçirilmiş cross-linking cerrahisi öyküsü mevcuttu. Nakil planlanmış gözlerde düzeltilmemiş görme keskinlikleri Snellen eşeli ile 0.05 ve 50cmps; en iyi düzeltilmiş görme keskinlikleri (EİDGK) -7.00(-5.75 @105) ile 0.1 ve -9.00(-5.75@25) ile 0.2; ortalama keratometri değerleri 56D ve 52.05D; merkezi kornea kalınlıkları 401 µm ve 432 µm idi. Önce silindirik maksimum düzeltme hedefleyen kornea içi halka implantasyonu, ardından yüksek miyopik düzeltme amacıyla iris kıskaçlı fakik GİL implantasyonu planlandı.BULGULAR: Nomograma göre femtosaniye laser ile açılan 5.0-5.7 mm iç-dış çaplarda, 360 µm ve 430 µm derinlikte oluşturulmuş intrastromal kanallara 160° ve 300 µm kalınlıkta birer adet KeraRing® kornea içi halka implantasyonu gerçekleştirildi. Postoperatif 6. ayda keratometrik astigmatizmalar 3.4D ve 3.5D’den 0.5D ve 2.0D’ye düştü. EİDGK Snellen eşeliyle -12.00(-2.50@115) refraksiyon ile 0.2 ve - 7.00(-2.00@20) refraksiyon ile 0.2 seviyesine geldi. İris kıskaçlı fakik göziçi lensi (Opthec -12.5 ve - 9.5D) implantasyonu uygulandı (Görsel 1). Postoperatif 6. ayda EİDGKleri Snellen eşeliyle, sırasıyla +0.50(-4.25@100) refraksiyon ile 0.6 ve -1.00(-1.50@25) refraksiyon ile 0.4 idi. Hastaların kornea topografilerinde kon bölgelerinin merkeze yönlenmesi ve diklik parametrelerinde belirgin iyileşme gözlendi (Görsel 2, 3). Hastaların 3 yılı aşkın takiplerinde korneada endotel dekompanzasyonu saptanmadı.</p

Topical matrix regenerative theraphy for corneal advanced neurotrophic ulcers

opical matrix regenerative theraphy for corneal advanced neurotrophic ulcers</p

Evaluation of Corneal Biomechanical Changes After Collagen Crosslinking in Patients with Progressive Keratoconus by Ocular Response Analyzer

Objectives:To evaluate corneal biomechanics before and after collagen crosslinking (CXL) in patients with progressive keratoconus.Materials and Methods:In this prospective study, CXL was performed under topical anesthesia after removal of the epithelium (epi-off technique) by applying ultraviolet A (UVA) light at a wavelength of 365 nm and power of 3 mW/cm2 or 5.4 joule/cm2. Isoosmolar 0.1% riboflavin solution was administered before and during UVA irradiation. In addition to ophthalmologic examination, ocular response analyzer measurements were performed pre- and postoperatively. Corneal hysteresis (CH), corneal resistance factor (CRF), corneal compensated intraocular pressure (IOPcc), Goldmann-correlated intraocular pressure (IOPg), and central corneal thickness (CCT) were recorded.Results:The study included 35 eyes of 30 patients with progressive keratoconus. The mean age was 28.2±6.5 years and postoperative follow-up time was 20.2±14.7 months (range: 6-74 months). The mean CH was 8.60±1.23 mmHg preoperatively, 8.96±2.05 mmHg in the early postoperative period (1-6 months), (p=0.28) and 8.96±1.28 mmHg in the late postoperative period (10-29 months) (p=0.48). Mean CRF was 7.13±1.50 mmHg preoperatively, 8.48±2.16 mmHg in the early postoperative period (p=0.009), and 7.71±1.29 mmHg in the late postoperative period (p=0.40). Mean IOPcc was 12.78±2.34 mmHg preoperatively, 15.38±4.21 mmHg in the early postoperative period (p=0.12) and 13.68±3.61 mmHg in the late postoperative period (p=0.48). Mean IOPg was 9.56±2.73 mmHg preoperatively, 13.01±4.45 mmHg in the early postoperative period (p=0.046), and 10.86±3.47 mmHg in the late postoperative period (p=0.44). Mean CCT was 484.43±41.26 µm preoperatively, 474.16±64.74 µm in the early postoperative period (p=0.70), and 470.38±33.64 µm in late postoperative period (p=0.71).Conclusion:CXL is a treatment modality believed to affect corneal biomechanics in keratoconus, but the results of larger patient series with longer follow-up periods may enable a better evaluation

Is 25(OH)D Associated with Cognitive Impairment and Functional Improvement in Stroke? A Retrospective Clinical Study

Background: In recent years, vitamin D deficiency has been suggested as a risk factor for ischemic stroke and stroke severity in both animal models and clinical studies. In this retrospective study, we investigated the relationship between 25-hydroxyvitamin D [25(OH)D] levels and functional outcomes in stroke patients during neurological rehabilitation program. We also investigated whether there is an association between 25(OH)D levels and cognitive impairment. Methods: The study included the medical records of 120 stroke patients who participated in a neurological rehabilitation program. The motor and cognitive components of the Functional Independence Measurements of all patients at admission and discharge were recorded. The Functional Ambulatory Scale was used to assess motor functional status, and the Turkish-validated version of the minimental state examination test was used to assess cognitive status. Results: A significant correlation was found between 25(OH)D level and cognitive impairment among patients who had ischemic strokes. High levels of 25(OH)D were associated with greater functional gain during the rehabilitation program in both ischemic stroke patients and hemorrhagic stroke patients. Conclusions: High 25(OH)D levels might be associated with greater functional improvement and with less cognitive impairment in stroke patients

Turkish Thoracic Society early career members task force group's virtual congress notes: European Respiratory Society International Congress 2020

In this article, Early Career Task Force Group members of the Turkish Thoracic Society summarize the European Respiratory Society 2020 virtual congress. Current developments in the field of respiratory diseases were compiled with the addition of sessions specific to coronavirus disease 2019 this year. Almost all of the congress sessions were examined, and the important and striking results of the congress were highlighted. Congress sessions were attended by expert researchers, and the prominent messages of each session were highlighted in short summaries. They were then grouped under relevant titles and ranked in order of meaning and relation. It was finalized by a team of researchersTurkish Thoracic Society (TTS