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Article Citation - WoS: 4Citation - Scopus: 6Surgical Outcomes of Posterior Persistent Fetal Vasculature Syndrome: Cases With Tent-Shaped and Closed Funnel-Shaped Retinal Detachment(Springernature, 2023) Zeydanli, Ece Ozdemir; Ozdek, Sengul; Acar, Burak; Ozdemir, Huseyin Baran; Aktas, Zeynep; Gurelik, Gokhan; Atalay, Hatice TubaBackground/objectives To determine the role of vitreoretinal surgery (VRS) for two different forms of posterior persistent fetal vasculature syndrome (PFVS); with tent-shaped tractional retinal detachment (TRD) and closed funnel-shaped TRD. Subjects/methods Retrospective, single surgeon, consecutive case series of 52 eyes of 44 patients with posterior PFVS who underwent VRS. Cases were divided into "tent-shaped TRD" and "funnel-shaped TRD" groups based on the preoperative TRD configuration. Associated anomalies, functional and anatomical outcomes were evaluated. The cosmetic appearance was defined as poor if there was phthisis bulbi, gross buphthalmos, or corneal opacification; acceptable if there was apparent leukocoria; and excellent if none were noted at the last follow-up. Results Thirty eyes of 29 patients presented with tent-shaped TRD; 70% of which obtained counting fingers or better vision and 90% showed significant reversal of tenting achieving retinal reattachment. The cosmetic appearance was excellent in 87%. Two eyes (7%) became phthisic. Twenty-two eyes of 15 patients presented with funnel-shaped TRD and leukocoria; 45% achieved LP vision and 70% of patients with bilateral pathology had LP in at least one eye. The cosmetic appearance was acceptable to excellent in 73%. Three eyes (14%) became phthisic, one (5%) of which required enucleation. The median follow-up time was 16 (6-71) months. Conclusions VRS often provides functional vision and anatomy in posterior PFVS with tent-shaped TRD morphology. In the funnel-shaped TRD morphology, where no treatment has historically been recommended, surgery may be considered with an aim of restoring light perception and globe preservation, particularly in bilateral cases.Article Citation - WoS: 5Citation - Scopus: 8Clinical Characteristics of Patients With Intraocular Lens Calcification After Pars Plana Vitrectomy(Mdpi, 2023) Bopp, Silvia; Ozdemir, Huseyin Baran; Aktas, Zeynep; Khoramnia, Ramin; Yildirim, Timur M.; Schickhardt, Sonja; Ozdek, SengulAim: To determine the clinical risk factors that may increase the occurrence of intraocular lens (IOL) calcification in patients who had undergone pars plana vitrectomy (PPV). Methods: The medical records of 14 patients who underwent IOL explantation due to clinically significant IOL opacification after PPV were reviewed. The date of primary cataract surgery, technique and implanted IOL characteristics; the time, cause and technique of PPV; tamponade used; additional surgeries; the time of IOL calcification and explantation; and IOL explantation technique were investigated. Results: PPV had been performed as a combined procedure with cataract surgery in eight eyes and solely in six pseudophakic eyes. The IOL material was hydrophilic in six eyes, hydrophilic with a hydrophobic surface in seven eyes and undetermined in one eye. The endotamponades used during primary PPV were C2F6 in eight eyes, C3F8 in one eye, air in two eyes and silicone oil in three eyes. Two of three eyes underwent subsequent silicone oil removal and gas tamponade exchange. Gas in the anterior chamber was detected in six eyes after PPV or silicone oil removal. The mean interval between PPV and IOL opacification was 20.5 +/- 18.6 months. The mean BCVA in logMAR was 0.43 +/- 0.42 after PPV, which significantly decreased to 0.67 +/- 0.68 before IOL explantation for IOL opacification (p = 0.007) and increased to 0.48 +/- 0.59 after the IOL exchange (p = 0.015). Conclusions: PPV with endotamponades in pseudophakic eyes, particularly gas, seems to increase the risk for secondary IOL calcification, especially in hydrophilic IOLs. IOL exchange seems to solve this problem when clinically significant vision loss occurs.Review Citation - WoS: 11Citation - Scopus: 13Current Surgical Techniques for the Management of Pediatric Glaucoma: a Literature Review(Frontiers Media Sa, 2023) Aktas, Zeynep; Ikiz, Gokcen Deniz Gulpinar; Surgical Sciences; Surgical SciencesPediatric glaucoma surgery is challenging due to its diverse and complex pathophysiology, altered anterior segment anatomy, greater potential for failure, and complications compared to adult patients. Moreover, numerous challenges are associated with long-term postoperative management. Thus, when dealing with childhood glaucoma, it is important to consider the potential complications in addition to the benefits of each intervention. The purpose of this article is to review recently published literature to shed light on the most recent surgical techniques for the safe and effective treatment of childhood glaucoma. Current literature shows that goniotomy and trabeculotomy are the first choices for the management of primary congenital glaucoma. Although older children with phakic eyes seem to benefit from trabeculectomy with adjunctive mitomycin C, it carries a long-term risk of bleb-related endophthalmitis. Glaucoma drainage devices may be preferred for patients with secondary or refractory glaucoma. However, hypotony or tube-related complications are common and encountered more often in children than in adults. Cyclodestructive procedures are also an option for cases in which filtering surgery has failed, but they can also be used as a temporizing measure to reduce the rate of complications in high-risk patients. However, their outcomes can be unpredictable, in terms of efficiency and complications. Finally, minimally invasive glaucoma surgery (MIGS) as the sole alternative treatment or as an adjunctive surgical procedure is a relatively new path for pediatric patients.Article Surgical Treatment of a Patient With Recurrent Bleb Leak and Glaucoma: Bleb Excision Combined With Gonioscopy-Assisted Transluminal Trabeculotomy(Galenos Publ House, 2022) Boluk, Ceyda Eristi; Aktas, ZeynepHere we present a case of intermittent bleb leakage with increased intraocular pressure (IOP) during recovery periods that was treated with gonioscopy-assisted transluminal trabeculotomy (GATT) combined with avascular bleb excision. A 60-year-old woman exhibiting simultaneous leaking bleb and glaucoma underwent GATT and bleb revision. At her final visit, the bleb leakage had resolved and IOP was under control without any further antiglaucoma medication. GATT may be useful for glaucoma patients exhibiting intermittent bleb leakage after failed trabeculectomy.Article Citation - WoS: 2Citation - Scopus: 3Gonioscopy-Assisted Transluminal Trabeculotomy Versus Bent Ab Interno Needle Goniectomy in Patients With Open-Angle Glaucoma(Galenos Publ House, 2025) Ucgul, Ahmet Yucel; Ucgul, Rukiye Kilic; Aktas, ZeynepAmaç: Açık açılı glokomlu (AAG) hastalarda gonyoskopi yardımlı translüminal trabekülotomi (GATT) ile eğik iğne ab interno gonyektominin (BANG) etkinlik ve güvenliğini karşılaştırmak. Gereç ve Yöntem: Bu retrospektif karşılaştırmalı çalışma, GATT (34 göz) veya BANG (31 göz) uygulanan AAG tanılı 65 gözü içermektedir. Göz içi basınç (GİB), başlangıçta ve postoperatif takip vizitlerinde Goldmann applanasyon tonometresi ile ölçüldü. Cerrahi başarı, kısmi (GİB ≤21 mmHg ve ≥%20 azalma) ve tam (aynı kriterler ilaçsız) olarak kategorize edildi. Komplikasyonlar ve ek cerrahi gereksinimi not edildi. Bulgular: Ameliyat öncesi ortalama GİB, GATT grubunda 32,9±6,1 mmHg iken, BANG grubunda 31,8±5,4 mmHg idi. Son kontrolde, GATT grubunda ortalama GİB 15,8±4,5 mmHg’ye düşerken (%51,9 azalma), BANG grubunda 17,9±5,7 mmHg’ye (%43,7 azalma) düştü. Tam cerrahi başarı oranı GATT prosedürü için %88,2, BANG prosedürü için %61,3’tü. Erken cerrahi başarısızlıklar BANG grubunda daha sık görülürken, GATT grubunda erken başarısızlıklar daha nadir olsa da, geç dönemde cerrahi başarısızlıklar BANG grubuna göre daha sık izlendi. Her iki prosedürde de minimal komplikasyonlar görülmüş olup; en yaygın komplikasyon ise geçici hifemaydı. Sonuç: Bu çalışmada, GATT cerrahisinin, BANG cerrahisine kıyasla daha büyük ve daha sürdürülebilir GİB azalması sağladığı ve daha yüksek cerrahi başarı oranlarına sahip olduğu dikkate alındığında, AAG’nin yönetiminde GATT’ın daha güvenilir bir seçenek olduğu söylenebilir.
