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    Corneal dellen development after strabismus surgery
    (Taylor & Francis Inc, 2021) Sakallioglu, Ahmet Kursad; Garip, Ruveyde
    This study aimed to evaluate the frequency of corneal dellen development, the healing process, and associated factors that affecting the development and healing of corneal dellen formation after strabismus surgery. In this retrospective study, the records of 714 eyes of 1264 patients who underwent limbal approach strabismus surgery between January 2005 and January 2020 were examined and 47 eyes of 44 patients with corneal dellen were included in the study. Demographic features, ophthalmological examination findings, dellen occurrence and healing time, dellen localization, and the type of surgery were obtained from the medical records of the patients. Corneal dellen development rate was found to be 3.7%. A moderate positive correlation was determined between both mean dellen occurrence time (r = 0.387, p = .007), and mean dellen healing time (r = 0.376, p = .014) with age. In patients who underwent monocular two muscle surgery had significantly higher rates of dellen formation compared to patients who underwent single muscle surgery (p<0.001). Corneal dellen was significantly higher in eyes undergoing single muscle rectus resection surgery than single muscle rectus recession surgery (p < .001). It was observed that corneal dellen developed more frequently after resection surgery, developed earlier in younger patients, and heals later in elderly patients. Therefore, patients can be followed up closely, keeping in mind the development of dellen, especially after resection surgery.
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    Corneal epithelium and limbal region alterations due to glaucoma medications evaluated by anterior segment optic coherence tomography: a case-control study
    (Taylor & Francis Ltd, 2021) Guclu, Hande; Cinar, Ayca Kupeli; Cinar, Abdulkadir Can; Akaray, Irfan; Aykutlu, Merve Sambel; Sakallioglu, Ahmet Kursad; Gurlu, Vuslat
    Aim To investigate the corneal epithelial and limbal epithelial alterations in patients under topical glaucoma treatment using anterior segment-OCT (AS-OCT) and to determine the changes of the limbal region due to the preservatives and glaucoma drugs, that can progress to limbal stem cell deficiency (LSCD). Limbal thickness was measured by AS-OCT to evaluate limbal cell deficiency. Methods Forty-seven patients using topical medication for glaucoma, and 48 control subjects were enrolled in this matched case-control study. The patients were divided into four groups according to the treatment regimens. Group 1: One-drug regimen, Group 2: Two-drug regimen, Group 3: Three-drug regimen, Group 4: Four-drug regimen For the ocular surface evaluation; tear break-up time with standard fluorescein sodium sterile strip application, Schirmer test-I, Ocular Surface Disease Index Questionnaire, and AS-OCT were performed. Results A total of 95 subjects were included: 47 eyes of 47 patients with glaucoma medication and 48 eyes of 48 healthy subjects. There was a statistically significant difference between patients and controls according to BUT, SCH, and OSDI (p < 0.001). The mean central corneal epithelium thickness was 48.5 +/- 5.3 in patients and 54.5 +/- 5.9 in controls (p < 0.001). The mean central total corneal thickness was 529.2 +/- 41.2 in patients and 536 +/- 35.3 in controls (p = 0.335). The mean limbal epithelium thickness was 64.1 +/- 9.1 in patients and 76 +/- 11.5 in controls (p < 0.001). Conclusion Using at least one glaucoma drug caused limbal area injury, changed ocular surface measurements, and significantly reduced the limbal epithelial thickness where the stem cells reside. The limbal epithelial thickness measurement by AS-OCT seems to be an innovative, non-invasive, and promising technique for detecting and staging corneal damage in topical glaucoma therapy.
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    Evaluation of the educational quality and reliability of YouTube videos addressing eyelid ptosis surgery
    (Taylor & Francis Inc, 2022) Garip, Ruveyde; Sakallioglu, Ahmet Kursad
    Purpose: To evaluate the educational content, quality, and reliability of YouTube videos addressing anterior approach ptosis surgery. Methods: A search on YouTube using the term ptosis surgery was performed between March 20 and March 26 2021. The quality, reliability, and accuracy of the contents of 38 videos meeting the inclusion criteria were evaluated by two independent ophthalmologists using the DISCERN questionnaire and the Journal of the American Medical Association (JAMA) benchmark criteria. The Global Quality Score (GQS) and a surgical scoring system were used to assess the educational value of the content. Results: The mean DISCERN score was 32.8 +/- 10, and the mean JAMA score was 1.3 +/- 0.5, indicating poor quality; the mean global quality score was 3.1 +/- 1.1, indicating moderate quality; and the mean surgical score was 7.5 +/- 2.7, indicating moderate to good quality. The surgical, DISCERN, and GQS scores of the videos uploaded by physicians were significantly higher than those of the videos uploaded by private clinics (p = .015, p = .049, and p = .01, respectively). There was a significant positive correlation between the surgical, DISCERN, JAMA, and GQS scores (p < .001). A significant positive correlation was found between video duration and surgical score (p = .013), DISCERN score (p < 0.001), and GQS score (p < 0.001). Conclusion: Videos with known sources, uploaded by physicians, and supported by audio narration may be useful in obtaining educational information. However, the available videos are not a reliable source of educational information about ptosis surgery.
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    Prognostic factors associated with the course of vitreomacular traction in eyes with age-related macular degeneration
    (Elsevier, 2022) Garip, Ruveyde; Cinar, Ayca K.; Cinar, Abdulkadir C.; Sakallioglu, Ahmet Kursad; Guclu, Hande; Gurlu, Vuslat
    Clinical relevance: Vitreomacular traction(VMT) is a clinical syndrome that can cause decreased vision and may affect the treatment response in cases of age-related macular degeneration(AMD). Factors affecting the course of VMT in AMD cases will guide the clinician in terms of patient management.Background: The aim of this study was to determine the prevalence of VMT in patients with AMD, to evaluate the natural course of VMT, and to investigate factors associated with the prognosis of VMT in eyes with AMD.Methods: This retrospective case series was conducted with 55 eyes of 46 patients who were diagnosed as having AMD accompanying with VMT. Demographic data, complete ophthalmologic examination findings, type of AMD, receiving an intravitreal injection(IVI), number of IVIs, and the presence of complete spontaneous release were obtained from the medical records of the patients. The horizontal length of VMT(HLVMT), central macular thickness(CMT), the horizontal length of choroidal neovascularization(HLCNV) were evaluated from spectral -domain optical coherence tomography(SD-OCT) images.Results: Spontaneous release was observed in 7(28%) eyes of the exudative AMD group and 10(33.3%) eyes of the nonexudative AMD group. On the last visit, the HLVMT was increased in 22(40%) of the eyes and a decrease in HLVMT was observed in 8(14.5%) of the eyes. In the remaining 12(21.8%) eyes had unchanged HLVMT. In all eyes with CNV, the area of VMT corresponded in 100% with localization of the CNV complex. No significant difference was found between the eyes with spontaneous release and persistent traction in terms of the type of AMD, IVI, HLVMT, age, gender, and crystalline lens status. Conclusion: In this study, VMT was observed at higher rates in eyes with exudative AMD compared to the eyes with nonexudative AMD. However, spontaneous release rates were found close to those with idiopathic VMT independently of the type of AMD, HLVMT, and IVI.
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    The reliability of trabeculectomy surgical videos on the internet for educational purposes in the changing world
    (Royal College Surgeons Edinburgh, 2022) Sakallioglu, Ahmet Kursad; Garip, Ruveyde
    Background and purpose of the study: The use of social media that facilitates access to surgical training is increasing among general practitioners/surgeons. The present study aimed to evaluate the educational quality of videos on social media and the medical education websites in terms of trabeculectomy surgery.Methods: In this cross-sectional and register-based study, the term trabeculectomy has been searched on 22 websites containing medical surgery training videos. Demographical features and descriptive statistics of videos are noted. All videos were evaluated independently by two ophthalmologists according to DISCERN, Journal of American Medical Association, and Global Quality scoring system. The main 11 steps of trabeculectomy surgery were taken into consideration in each video and Video Quality Score was determined based on these steps.The main findings: In total, 731 videos were watched and 634 were excluded and 97 videos were included in the study. The total quality of all videos according to DISCERN, JAMA, GQS, and VQS scores were 31.6 +/- 9.1 (poor quality), 1.3 +/- 0.4 (poor quality), 2.6 +/- 0.9 (fair quality), and 6.9 +/- 2.1 (poor quality) respectively. Only 6 of the 97 evaluated videos included all the steps of trabeculectomy surgery. Videos have longer duration, videos with narration or videos with descriptive subtitles were found to be significantly higher quality than those are not.Conclussion: The educational quality of internet videos may be far from the quality it should be and it is indisputable that it is necessary to be able to access surgical educational videos that are peer-viewed and whose quality is not doubted.(c) 2021 Published by Elsevier Ltd on behalf of Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland.
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    The role of inflammatory biomarkers in predicting primary acquired nasolacrimal duct obstruction and postoperative recurrence
    (Nagoya Univ, Sch Med, 2023) Garip, Ruveyde; Sakallioglu, Ahmet Kursad
    This study aims to determine the relationship between systemic inflammatory biomarkers and primary acquired nasolacrimal duct obstruction and to evaluate whether they can be used as indicators in determining the risk of recurrence after dacryocystorhinostomy. This retrospective, comparative case series was conducted with 57 primary acquired nasolacrimal duct obstruction patients and 58 age-and gender-matched controls. All subjects underwent a complete ophthalmologic examination and complete blood count measurements. The mean neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune-inflammation index were significantly higher in patients with primary acquired nasolacrimal duct obstruction (p = 0.005, p = 0.01, and p = 0.003, respectively). In recurrent patients, the neutrophil-to-lymphocyte ratio was significantly higher than in those who did not develop a recurrence (p = 0.029). The area under the curve was determined as 0.775 (p = 0.029) for the neutrophil-to-lymphocyte ratio in predicting recurrence. The neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune-inflammation index levels were significantly higher in patients with primary acquired nasolacrimal duct obstruction compared to healthy controls. The neutrophil-to-lymphocyte ratio might be used as a simple and inexpensive indicator for predicting recurrence in patients with primary acquired nasolacrimal duct obstruction.
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    What Hundreds of Millions of Patients With Dry Eye Will Find on YouTube: A Quality and Reliability Research of the YouTube Videos
    (Lippincott Williams & Wilkins, 2022) Sakallioglu, Ahmet Kursad; Garip, Ruveyde
    Purpose: The aim of this study was to evaluate the demographic features, quality, and reliability of YouTube videos addressing dry eye disease (DED). Methods: The term dry eye disease has been searched on YouTube. The first 500 videos that emerged using the defined search term were evaluated. Duplicated-split videos, videos shorter than 60 seconds, videos with a language other than English or videos with an unintelligible English accent, and videos unrelated to DED were excluded. Video uploaders, types, origins, durations, and viewer interactions of the videos were noted. DISCERN, the Global Quality Score, and the Video Quality Score (created by the authors) were used to evaluate the video quality. Results: Of the 500 videos, 262 videos were excluded, and the remaining 238 videos were evaluated. Videos were of moderate quality on all 3 scoring systems. The medical institute and academic society videos had the highest quality (P < 0.05). The quality of videos uploaded by physicians was significantly lower than medical institute and academic society videos and was higher than the others (P < 0.05). User interactions and video duration were weakly positively correlated with the video quality (P < 0.05). Conclusions: Among YouTube videos on DED, only a minority are of good or excellent quality. Videos uploaded by medical institutes or academic societies scored higher in quality than those uploaded by physicians, which, in turn, scored higher than those uploaded by all others. User interactions were weakly correlated with quality values, suggesting user interactions are not good indicators of the quality of YouTube videos on DED.