Browsing by Author "Kesim, Enes"

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    The efficacy of different anti-vascular endothelial growth factor agents, and dexamethasone implant therapy in patients with serous retinal detachment caused by Irvine-Gass syndrome
    (Sage Publications Ltd, 2024) Karasu, Bugra; Kesim, Enes; Celebi, Ali Riza Cenk
    Purpose The aim of this study is to compare the efficacy of intravitreal aflibercept (IVA), bevacizumab (IVB), ranibizumab (IVR), and dexamethasone implant (IVDI) in the treatment of serous retinal detachment (SRD) caused by Irvine-Gass syndrome (IGS). Design Retrospective cohort, comparative study. Methods and Materials The medical records of 128 eyes with no previous history of intravitreal agents in 128 IGS patients with SRD that received IVA, IVB, IVR, and IVDI monotherapy were retrospectively reviewed. The patients were divided into 4 groups, according to treatment. Patients with recurrence and/or were unresponsive following a course of topical steroids and non-steroidal anti-inflammatory drugs (NSAIDs) were included in the study. Best corrected visual acuity (BCVA), central macular thickness (CMT), subfoveal choroidal thickness (SFCT), and SRD were compared between the 4 treatment groups at baseline, at follow-up months 1, 3, 6, and 12, and at the final follow-up visit. Results Serous retinal detachment completely resolved in 74%, 45.7%, 66.4%, and 40.8% of the eyes at month 1 (P = 0.042), 87%, 50.9%, 75.8%, and 80.9% at month 3 (p = 0.031), 88.9%, 50.4%, 75.7%, 80.2% at month 6 (p = 0.028), 81.7%, 72.8%, 68.7%, 80.1% at month 12 (p = 0.580), and 100%, 66.4%, 87.9%, 93.2% (p = 0.478) at final follow-up visit in the IVA, IVB, IVR, and IVDI groups, respectively. BCVA was significantly better in the IVA group at all follow-up time points (month 1: p < 0.001; month 3: p < 0.001; month 6: p = 0.002; month 12: p = 0.009, final follow-up visit: p < 0.001). CMT was significantly lower in the IVA group at months 3 (p = 0.008), 6 (p = 0.011), and 12 (p = 0.010), and at the final follow-up visit (p < 0.001). Recurrence was observed after a longer period of time and fewer injections were needed in the IVDI and IVA groups (p < 0.05). Resolution of CME was most rapid in the IVA group (p = 0.032). Conclusion All intravitreal agents were effective in terms of visual results in the SRD patients; however, eyes treated with IVA and IVDI required fewer injections, as compared to the eyes treated with IVB and IVR. Furthermore, SRD entirely resolved in all eyes in the IVA group at the final follow-up visit.
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    (2024) Karasu, Buğra; Kesim, Enes; Celebi, Ali Riza Cenk
    Amaç: Koter yöntemi ile üst göz kapağı blefaroplastisi (ÜGB) yapılan dermatoşalazisli (DŞ) hastaların cerrahi sonuçlarını bildirmek amaçlanmıştır. Yöntemler: DŞ nedeniyle 18 hastanın 36 gözüne koter yöntemi ile ÜGB ameliyatı yapıldı. Sarkmış ve işaretlenmiş cilt bölgesine kalem uçlu koter uygulandı ve çıkarıldı. Hastalar ameliyat öncesi ve ameliyat sonrası 1. gün, 3. gün, 2. hafta, 3. ay ve 6. ayda muayene edildi. Bulgular: Yaş ortalaması 54.6±7.9 yıl (dağılım, 46-67 yıl) olup, 10’u kadın, 8’i erkekti. Ortalama operasyon süresi (2 üst göz kapağı için 1 seans) 36.7 ± 5.8 dakika (dağılım, 28-46 dakika) idi. Ortalama yara iyileşme süresi 7,7 ± 1,6 gündü (aralık, 5 ila 12 gün). Deri ekimozu yaklaşık 24,8±3,7 gün (dağılım, 19 ila 38 gün) devam etti. Ameliyattan 6 ay sonra 34 hastada (%94) dikiş izi görülmezken, 2 hastada dikiş izi mevcuttu. Cilt ekimozu ve dikiş skarının kaybolması açısından 6 aylık dönemde istatistiksel olarak anlamlı değişiklik saptandı (p<0,001). Yara iyileşme süresi ile dikiş izi arasında pozitif bir ilişki bulundu (R2=0.879, p<0.001). Ayrıca ameliyat süresi ile inatçı cilt ekimozu arasında pozitif korelasyon saptandı (R2=0.918, p<0.001). Sonuçlar: Üst göz kapağı blefatoplastisi ile koter, ÜG’yi yeniden şekillendirmek için güvenilir bir şekilde kullanılabilen uygulanabilir bir tekniktir. Bu işlem, normal ÜGB ile mümkün olmayan uzun bir iz bırakmaz, hasta memnuniyeti ve ameliyat sonrası iyileşme konforu sağlar.