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    Immediate Sequential Bilateral Vitrectomy Surgery for Retinopathy of Prematurity: A Single Surgeon Experience
    (Turkish Ophthalmological Soc, 2021) Ozdek, Sengul; Ozmen, Mehmet Cuneyt; Yalinbas, Duygu; Atalay, Hatice Tuba; Coskun, Demet
    Objectives: We report the safety and efficacy of simultaneous bilateral vitrectomy for stage 4 and stage 5 retinopathy of prematurity (ROP). Materials and Methods: Babies who had immediate sequential bilateral vitrectomy surgery for stage 4 or stage 5 ROP were included in this retrospective study. Clinical history, demographic characteristics of the patients, surgical procedure details, perioperative and postoperative ophthalmic and systemic complications, and postoperative anatomical success rates were evaluated. General anesthesia features were also recorded. Results: Seventy eyes of 35 babies who had immediate sequential bilateral vitrectomy surgery for stage 4 or stage 5 ROP were reviewed. At the time of surgery, the mean age was 41.4 +/- 4.9 weeks. There was preoperative plus disease in 58.6% of the eyes. The mean surgery/eye ratio was 1.2. Mean anesthesia time was 95 +/- 64 minutes. The mean follow-up was 28.1 months (3 to 84 months). Anatomical success was 95.7% for stage 4A (44/46 eyes), 83.3% for stage 4B (15/18 eyes), and 50% for stage 5 (3/6 eyes) ROP. Patients with stage 5 ROP had significantly less anatomical success than stage 4A and 4B (p=0.004). None of the patients had endophthalmitis and anesthesia-related severe complications. Conclusion: Immediate sequential bilateral vitrectomy surgery can be considered an option for patients with active bilateral stage 4 and stage 5 ROP. The risk of endophthalmitis should be weighed against the risks of disease progression and anesthesia-related complications.
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    Safety of Polyacrylamide 1.5% Left in Anterior Chamber in Combined Phacoemulsification and Pars Plana Vitrectomy Surgery
    (TAYLOR & FRANCIS INC, 2016) Karaca, Emine Esra; Ozdek, Sengul; Ozmen, Mehmet Cuneyt; Dursun, Ayhan; Yalcin, Nuriye Gokcen
    Purpose: To evaluate safety, efficacy and postoperative characteristics of polyacrylamide 1.5% ophthalmic viscosurgical device (OVD) left in anterior chamber during and at the end of combined phacoemulsification and pars plana vitrectomy surgery. Materials and Methods: This prospective study comprised 20 eyes that received combined phacoemulsification and pars plana vitrectomy performed by the same surgeon. Polyacrylamide 1.5% was left in anterior chamber at the end of the surgery. Preoperative and postoperative examinations (4, 12 and 24 hours; 14 days; 1 and 3 months) included measurement of intraocular pressure (IOP), central corneal thickness (CCT), endothelial cell density and assessment of any ocular adverse reactions. Results : Four of the 20 patients (20%) showed increased IOP at hours postoperatively and needed medical treatment for IOP control. There was no significant difference in IOP between the preoperative visit and postoperative 3 months (p>0.05). CCT measurements were similar between preoperative and postoperative visits (p>0.05). A mean endothelial cell density loss of 6.7% was observed at postoperative day 14, however there was no change after this visit. Conclusion: Polyacrylamide 1.5% is safe, well-tolerated and protective in eyes undergoing combined phacoemulsification and pars plana vitrectomy.
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    Treatment of Nanophthalmos-Related Uveal Effusion with Two- vs. Four-Quadrant Partial-Thickness Sclerectomy and Sclerotomy Surgery
    (Turkish Ophthalmological Soc, 2022) Ozdek, Sengul; Yeter, Duygu Yalinbas; Ozmen, Mehmet Cuneyt; Hasanreisoglu, Murat
    Objectives: To report visual and anatomical outcomes following two-or four-quadrant partial-thickness sclerectomy and sclerotomy surgery to treat nanophthalmos (NO)-related uveal effusion (UE). Materials and Methods: Consecutive patients with NO-related UE were treated with four-quadrant or two-quadrant (for those with associated glaucoma) partial-thickness sclerectomy and sclerotomy surgery. Axial length, extent of UE, preoperative, postoperative, and final best corrected visual acuity (BCVA), time to retinal reattachment, and rates of retinal reattachment and recurrence were noted. Results: Fourteen eyes of 10 patients with NO-related UE were operated. Retinal detachment (RD) involved mainly the peripheral retina in 7 (50%) eyes, macula in 2 eyes (14.2%), both macula and peripheral retina in 4 eyes (28.6%), and the whole retina in 1 eye. Eleven eyes had four-quadrant surgery, and 3 eyes with associated glaucoma had two-quadrant surgery. External subretinal drainage was performed in one patient who had total RD. The mean preoperative logMAR BCVA of 1.50 +/- 0.53 increased significantly to 0.92 +/- 0.49 after surgery (p=0.002). Resolution of RD could be achieved with two-quadrant surgery in only 1 of 3 eyes. In the other 2 eyes, retinal reattachment was achieved after a secondary surgery for the remaining two quadrants to complete four-quadrant sclerectomy. Final outcome was total reattachment of the retina in 11 eyes (78.6%), partial reattachment in 1 eye (7.1%), and recurrence of macular detachment in 2 (14.3%) eyes. Conclusion: Quadrantic partial-thickness sclerectomy and sclerotomy surgery seems effective for treating UE in eyes with NO. Two quadrant surgery may be tried for mild UE associated with glaucoma to preserve the superior quadrants for future possible glaucoma surgeries, but secondary surgery for the superior quadrants may be needed. External drainage of subretinal fluid may be an option in severe cases to achieve quicker resolution.