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      • KCI등재

        Evaluation of Anterior Segment Parameter Changes Using the Sirius after Uneventful Phacoemulsification

        Ali Şimşek,Musa Çapkın,Şemsettin Bilak,Mete Güler,Ali Hakim Reyhan,Burak Bilgin 대한안과학회 2016 Korean Journal of Ophthalmology Vol.30 No.4

        Purpose: To investigate changes in anterior chamber depth (ACD), corneal volume (CV), anterior chamber angle(ACA), anterior chamber volume (ACV), central corneal thickness (CCT), horizontal visible iris diameter (HVID),pupil diameter (PD), and intraocular pressure (IOP) after uneventful phacoemulsification cataract surgery withintraocular lens implantation. Methods: A total of 132 eyes of 132 patients (87 men and 45 women) that underwent uneventful phacoemulsificationcataract surgery and intraocular lens implantation were prospectively studied. The mean age of thepatients was 63.68 ± 12.51 years. All patients were evaluated preoperatively and at 1 month postoperativelywith the Sirius 3D Rotating Scheimpflug camera topography system. The ACD, CV, ACA, ACV, CCT, HVID,and PD measurements were recorded. IOP was measured using the Goldmann applanation tonometer, whichwas corrected for CCT of the Sirius device using Ehlers’ formula. Results: The preoperative mean ACD, ACV, ACA, CCT, CV, PD, HVID, and IOP were 2.79 ± 0.45 mm, 124.73 ±25.72 mm3, 42.09 ± 7.490, 523.87 ± 41.97 microns, 55.37 ± 4.89 mm3, 3.98 ± 1.23 mm, 11.72 ± 0.67 mm, and14.74 ± 2.59 mmHg, respectively. Three months postoperatively, the mean ACD, ACV, ACA, CCT, CV, PD,HVID, and IOP were 3.45 ± 0.6 mm, 162.52 ± 23.79 mm3, 51.46 ± 5.630, 526.21 ± 44.45 microns, 56.23 ± 5.12mm3, 2.87 ± 0.45 mm, 11.91 ± 0.75 mm, and 12.02 ± 1.83 mmHg, respectively. There was a statistically significantincrease in mean postoperative ACD, ACV, ACA, CV, and HVID compared with the corresponding preoperativevalues (p < 0.05). CCT remained stable after surgery. Postoperative PD and IOP were significantlydecreased compared to corresponding preoperative values (p < 0.05). Conclusions: Preoperative measurements by the Sirius 3D Rotating Scheimpflug camera topography systemmight help surgeons to predict postoperative changes resulting from phacoemulsification and intraocular lensimplantation. This is a noncontact, noninvasive, and comfortable system for patients that is highly reliable andrepeatable for anterior segment measurements.

      • KCI등재

        Assessment of Patient Pain Experience during Intravitreal 27-Gauge Bevacizumab and 30-Gauge Ranibizumab Injection

        Mete Güler,Burak Bilgin,Musa Çapkın,Ali Şimşek,Şemsettin Bilak 대한안과학회 2015 Korean Journal of Ophthalmology Vol.29 No.3

        Purpose: To compare pain scores of patients during intravitreal 27-gauge bevacizumab and 30-gauge ranibizumab injection procedures. Methods: Seventy eyes of 70 patients who had not previously undergone intravitreal anti-vascular endothelial growth factor therapy were included in this study. Thirty-five patients received ranibizumab and 35 patients received bevacizumab. The diagnoses of the patients were: 27 age related macular degeneration, 15 diabetic macular edema, 9 diabetic vitreous hemorrhage, 6 central retinal vein occlusion, 11 branch retinal vein occlusion and 2 central serous chorioretinopathy. Bevacizumab (1.25 mg/0.05 mL) was injected into the vitreous cavity using a 27-gauge needle, and ranibizumab (0.5 mg/0.05 mL) was injected with 30-gauge needle. Patients were asked just after the injection to rate their perceived pain during the injection using the visual analogue scale (VAS) of 0 (no pain) to 10 (unbearable/ worst pain). The average of these scores was used as the primary outcome. Results: The VAS pain scores in the ranibizumab and bevacizumab groups were 1.06 ± 0.91 (range, 0 to 3) and 1.94 ± 1.55 (range, 0 to 7), respectively, a significant difference (p = 0.005). Patients <65 and ≥65 years of age in both the ranibizumab and bevacizumab groups were then compared. For patients <65, there was a significant difference in the average VAS pain scores between groups (p = 0.003). However, for patients ≥65 years, there was not a significant difference in the average VAS pain scores between groups (p = 0.238). Female and male patients in both ranibizumab and bevacizumab groups were also compared. For female patients, there was a significant difference in the average VAS pain scores between groups (p = 0.016), although not for male patients (p = 0.078). Conclusions: Thirty-gauge intravitreal injection is more comfortable than 27-gauge injection. Injection of bevacizumab with 30-gauge needle syringes may be more tolerable for patients.

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