The Efficacy of the Combined Procedure in Involutional Entropion Surgery: A Comparative Study

Didem Serin,Ibrahim Bulent Buttanri,Safak Karslioglu,Mehmet Sahin Sevim,Bahtinur Buttanri,Muslime Akbaba 대한안과학회 2013 Korean Journal of Ophthalmology Vol.27 No.6

Purpose: To evaluate the efficacy of the combined procedure in the management of involutional entropion. Methods: In this study, we reviewed 45 eyes of 36 patients who underwent the combined procedure (lateral tarsalstrip, retractor tightening, and everting sutures) for the management of involutional lower eyelid entropionand compared the results with 31 eyes of 25 patients who underwent the Wies procedure. Exclusion criteriaincluded previous lower eyelid surgery and follow-up of less than 6 months. Results: No patients demonstrated entropion on the first postoperative day. The mean follow-up period was18.4 months (6 to 52 months) in the Wies group and 22.6 months (6 to 59 months) in the combined proceduregroup. During the follow-up period, 9 of 31 eyes in the Wies group presented with recurrence and only 1 of 45eyes in the combined procedure group presented with recurrence (p = 0.001). The average time of recurrencewas 4.8 months in the Wies group. Recurrence occurred at 2 months postoperatively in the patient in the combinedprocedure group. Six of the 9 recurrences in the Wies group were managed by the combined procedure. None of these patients had further recurrence after correction. Three patients complained about a visibleincision line after the Wies procedure. Conclusions: The combined procedure seems to be more effective than the Wies procedure in the managementof involutional entropion. The combined procedure addresses the three major causative factors in involutionalentropion and makes it possible to perform the surgery using a small incision.

Original Article:Levator Resection in the Management of Myopathic Ptosis

( Ibrahim Bulent Buttanri ),( Didem Serin ) 대한안과학회 2014 Korean Journal of Ophthalmology Vol.28 No.6

Purpose: To evaluate the results of levator resection in patients with myopathic ptosis. Methods: The medical records of consecutive patients who underwent levator resection surgery performed for myopathic ptosis between October 2009 and March 2013 were reviewed. Indications for surgery were ptosis obscuring the visual axis and margin-reflex distance ≤2 mm. Surgical success was defined as clear pupillary axis when the patient voluntarily opened his eye and margin-reflex distance ≥3 mm. We analyzed the effect of levator function and Bell`s phenomenon on the rates of success and corneal complication. Results: This series included six male and six female patients. Levator function was between 4 and 12 mm. We performed bilateral levator resection surgery in all patients. The mean follow-up time was 14.8 months (range, 6 to 36 months). No patient was overcorrected. Adequate lid elevation was achieved after the operation in 20 eyes. Ptosis recurred in three out of 20 eyes after adequate lid elevation was achieved. Our overall success rate was 70.8%. In three eyes with poor Bell`s phenomenon, corneal irritation and punctate epitheliopathy that required artificial eye drops and ointments developed in the early postoperative period, although symptoms resolved completely within 2 months of the resection surgery. No patients required levator recession or any other revision surgery for lagophthalmos or corneal exposure after levator resection. Conclusions: Levator resection seems to be a safe and effective procedure in myopathic patients with moderate or good Bell`s phenomenon and levator function greater than 5 mm.

Human Papillomavirus Genotype Distribution and E6/E7 Oncogene Expression in Turkish Women with Cervical Cytological Findings

Tezcan, Seda,Ozgur, Didem,Ulger, Mahmut,Aslan, Gonul,Gurses, Iclal,Serin, Mehmet Sami,Giray, Burcu Gurer,Dilek, Saffet,Emekdas, Gurol Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.9

Background: Infection with certain human papillomavirus (HPV) genotypes is the most important risk factor related with cervical cancer. The objective of the present study was to investigate the prevalence of HPV infection, the distribution of HPV genotypes and HPV E6/E7 oncogene mRNA expression in Turkish women with different cervical cytological findings in Mersin province, Southern Turkey. Materials and Methods: A total of 476 cytological samples belonging to women with normal and abnormal cervical Pap smears were enrolled in the study. For the detection and genotyping assay, a PCR/direct cycle sequencing approach was used. E6/E7 mRNA expression of HPV-16, 18, 31, 33, and 45 was determined by type-specific real-time NASBA assay (NucliSENS EasyQ$^{(R)}$HPV v1.1). Results: Of the 476 samples, 106 (22.3%) were found to be positive for HPV DNA by PCR. The presence of HPV was significantly more common (p<0.001) in HSIL (6/8, 75%) when compared with LSIL (6/14, 42.9%), ASC-US (22/74, 29.7%) and normal cytology (72/380, 18.9%). The most prevalent genotypes were, in descending order of frequency, HPV genotype 66 (22.6%), 16 (20.8%), 6 (14.2%), 31 (11.3%), 53 (5.7%), and 83 (4.7%). HPV E6/E7 oncogene mRNA positivity (12/476, 2.5%) was lower than DNA positivity (38/476, 7.9%). Conclusions: Our data present a wide distribution of HPV genotypes in the analyzed population. HPV genotypes 66, 16, 6, 31, 53 and 83 were the predominant types and most of them were potential carcinogenic types. Because of the differences between HPV E6/E7 mRNA and DNA positivity, further studies are required to test the role of mRNA testing in the triage of women with abnormal cervical cytology or follow up of HPV DNA positive and cytology negative. These epidemiological data will be important to determine the future impact of vaccination on HPV infected women in our region.

Outcome of External Dacryocystorhinostomy and Monocanalicular Intubation in Patients with Total Obstruction of One Canalicus

Ibrahim Bulent Buttanri,Bahtınur Buttanrı,Didem Serin 대한안과학회 2019 Korean Journal of Ophthalmology Vol.33 No.2

Purpose: We sought to evaluate the outcomes of external dacryocystorhinostomy (DCR) and mono-canalicularintubation in patients with total obstruction of one canalicus. Methods: Sixteen eyes of 16 patients with nasolacrimal duct obstruction and a single canaliculus obstructionwho had undergone external DCR and monocanalicular intubation of the intact canaliculus were retrospectivelyincluded in the present study. The monocanalicular tube (Mini Monoka) was left in place for at least twomonths. Munk epiphora grading for the evaluation of epiphora and irrigation was performed both preoperativelyand at 6 months postoperatively. Results: Mean patient age was 46 ± 14.2 (range, 18 to 76) years. The inferior canaliculus was obstructed innine eyes (group A) and the superior canaliculus was obstructed in seven eyes (group B), respectively. Eighteyes had chronic dacryocystitis and two of these eyes also had a history of acute dacryocystitis attack. Meanpreoperative Munk scores were 3.89 in group A and 4.0 in group B. Ocular surface irritation occurred in oneeye in group A. Artificial eye drops were prescribed and early tube removal was not performed. Spontaneoustube dislocation was recorded in one eye in group B. No other corneal, punctal, or canalicular complicationswere found. At six months, irrigation of intact canaliculus was patent in all eyes. Mucoid discharge, conjunctivalhyperemia, and chronic conjunctivitis were also resolved. Postoperative Munk scores were 1.11 ± 0.9 in groupA and 0.86 ± 0.9 in group B. Of note, preoperative and postoperative Munk scores were significantly differentin both groups (group A, p = 0.006; group B, p = 0.017). The postoperative Munk scores were not statisticallydifferent between the two groups (p = 0.606). Conclusions: In patients with nasolacrimal duct obstruction and a total of one canaliculus obstruction, externalDCR and monocanalicular intubation of the intact canaliculus is an effective surgical option.