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RISS 인기검색어
- 검색키워드
- 저자 : Mehmet Serhat Mangan (검색결과 4 건)
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Mehmet Serhat Mangan,Serap Yurttaser Ocak,Ece Turan Vural,Elvin Yildiz 대한안과학회 2021 Korean Journal of Ophthalmology Vol.35 No.1
Purpose: To examine the efficacy of ptosis correction with a Müller muscle-conjunctival resection with or without tarsectomy(MMCR±T), combined with bandage contact lens (BCL) use, in corneal graft patients. Methods: Seven patients with corneal grafts who underwent MMCR±T for treatment of ptosis were evaluated retrospectively. A BCL was applied to the grafts at the end of the surgery. The collected data included preoperative and postoperativevisual acuity, marginal reflex distance 1 (MRD-1), presence of Hering’s dependency by the phenylephrine test, symmetry outcomes,and complications after MMCR±T. Results: The average duration between the penetrating keratoplasty and MMCR±T was 14 months, with a follow-up timeof 10.4 months after MMCR±T. Hering’s dependency was observed in four (57.2%) patients before MMCR±T, and MRD-1 wasincreased in all patients based on preoperative phenylephrine tests. The mean preoperative MRD-1 was -0.14 ± 0.55 mm, andthe mean postoperative MRD-1 was 2.35 ± 0.89 mm (p < 0.0001). Symmetry outcomes of perfect (<0.5 mm), good (0.5–1mm), and fair (≥1 mm) were noted after MMCR±T in three, three, and one patients, respectively. During the follow-up, no obviouscorneal epitheliopathy, keratitis, or corneal graft rejection/failure were noted in any cases. BCL use was well toleratedby all patients. Conclusions: Most patients achieved good surgical outcomes with the application of the BCL to protect the graft and withthe use of the phenylephrine test and Hering’s dependency to predict the final eyelid position and symmetry. MMCR±T combinedwith BCL may therefore represent an alternative approach for correction of ptosis in patients with corneal graft.
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Mehmet Serhat Mangan,Akin Cakir,Serhat Imamoglu 대한안과학회 2021 Korean Journal of Ophthalmology Vol.35 No.5
Purpose: Even though it is stated that external levator advancement (ELA) has a much longer learning curve than Müller muscle-conjunctival resection (MMCR) in the treatment of aponeurotic ptosis, there is no study in the literature regarding the learning curves of these two surgical techniques. We aimed to objectively determine the length of the learning curves of ELA and MMCR using cumulative sum (CUSUM) analysis. Methods: The first 30 unilateral ELA and the first 30 unilateral MMCR consecutively performed by a single surgeon were retrospectively reviewed. The CUSUM method was used to analyze the learning curves of ELA and MMCR based on operation times of consecutive surgeries and the clinical outcomes were compared. Results: CUSUM analyses revealed that the operation time stabilized after around 11 ELA surgeries and 12 MMCR surgeries and R2 value for ELA and MMCR were 0.93 and 0.91, respectively. There was no significant difference in these stratified analyses. Mean operation time was 45.7 minutes in the ELA group and 34.1 minutes in the MMCR group (p = 0.002). Total number of intraoperative complications was 37 in the ELA group and 16 in the MMCR group (p = 0.015). Symmetry success rate was significantly higher (p < 0.0001) and reoperation rate was significantly lower in the MMCR group (p = 0.045). Conclusions: Even though ELA is more challenging than MMCR, comparable learning curves indicate that surgeons in training need to be encouraged to perform both techniques. The challenges and obstacles that the surgeons in training face in these two techniques need to be analyzed in detail.
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Serap Yurtta er Ocak,Mehmet Serhat Mangan,Mustafa Nuri Elç , ioğ , lu 대한안과학회 2021 Korean Journal of Ophthalmology Vol.35 No.6
Purpose: To report the intraoperative corneal pachymetry changes during accelerated corneal cross-linking (A-CXL) in progressivekeratoconus patients with thin corneas. Methods: Thirty-six eyes (mean age, 22.26 ± 4.02 years) with progressive keratoconic thin corneas (<400 μm without epithelium)who underwent A-CXL with ultraviolet (UV)-A (UVA) (9 mW/cm2) using isotonic riboflavin5-phosphate 0.1% with 1.1%hydroxypropyl methycellulose (RF-HPMC, MedioCROSS M) were included in this retrospective study. Intraoperative cornealpachymetric changes were noted before the procedure, after removal of epithelium, after RF-HPMC instillation, before andafter UV irradiation. The mean of corneal pachymetric values were compared statistically. Results: The mean corneal pachymetry reduced from 415.72 ± 29.66 to 369.50 ± 23.45 μm after removal of the epithelium(p < 0.05). After the application of RF-HPMC solution the mean thinnest corneal pachymetry (TCP) increased to 412.89 ±26.94 μm. Statistically significant increase was observed in TCP after saturation with RF-HPMC (p = 0.001). The mean cornealpachymetry before and after UVA irradiation was 419.86 ± 10.41 and 417.47 ± 8.25 μm, respectively (p > 0.05). Conclusions: Isotonic RF-HPMC lead to a significant increase in intraoperative mean TCP. RF-HPMC seems to be a favorableriboflavin option in keratoconus patients with thin corneas.
KCI
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