Orbita, Fontal Sinüs ve Ön Kranyal Fossa İçinde Çok Sayıda Yabancı Cisimle Birlikte Üst Orbita Du... more Orbita, Fontal Sinüs ve Ön Kranyal Fossa İçinde Çok Sayıda Yabancı Cisimle Birlikte Üst Orbita Duvar Kırığı Olgusu Yasemin KATIRCIOĞLU, Serkan DURAN, Deniz SOMER, Remzi KASIM, Sunay DUMAN. ÖZET Üst orbita duvar kırıkları nadir görülen orbita duvar kırıklarıdır. ...
Ge lifl Ta ri hi/Re cei ved: 04.07.2011 Ka bul Ta ri hi/Ac cep ted: 02.11.2011 Özet On yaşında, s... more Ge lifl Ta ri hi/Re cei ved: 04.07.2011 Ka bul Ta ri hi/Ac cep ted: 02.11.2011 Özet On yaşında, sağ gözünde şişlik ve öne doğru büyüme şikayeti ile başvuran kız hastada yapılan radyolojik görüntüleme yöntemlerinden sonra orbita içine uzanan kitle saptandı. Kitle Beyin Cerrahisi kliniği tarafından transkranial girişimle eksize edilip histopatolojik incelemede ossifiye fibroma olarak tanımlandı. Postoperatif birinci haftada baş pozisyonu ve diplopi gelişen ve muayenesinde troklea bölgesinde şişlik saptanan olguya cerrahi travma sonrası gelişen Canine Tooth Sendromu tanısı konuldu.(Turk J Oph thal mol 2012; 42: 163-5) Anah tar Ke li me ler: Ossifiye fibroma, Canine Tooth sendromu, ttroklear travma Sum mary After radiological imaging analysis, a mass extending into the orbit was detected in a 10-year-old girl with complaints of swelling and protrusion in the right eye. The mass was excised by the neurosurgery department through transcranial approach and found to be ossifying fibroma in histopathological examination. The case, presenting with head position and diplopia as well as trochlear swelling in physical examination in the postoperative first week, was diagnosed with canine tooth syndrome developing after surgical trauma.
The review provides strategies based on an evaluation of the published data regarding the dosage ... more The review provides strategies based on an evaluation of the published data regarding the dosage and duration of the patching time to be planned following the refractive adaptation period (the first 18 weeks after the use of glasses). Amblyopia studies utilizing occlusion dose monitors “Monitored Occlusion Treatment of Amblyopia Study Cooperative Group (MOTAS), United Kingdom” and “Randomized Occlusion Treatment of Amblyopia Cooperative Group (ROTAS), United Kingdom” and non-monitoring “Pediatric Eye Disease Investigator Group Amblyopia Treatment Studies (PEDIG ATS), United States of America (USA)” methods were reviewed and compared in order to ascertain the reasons for major discrepancies in dose-response information given in publications. Examining the doseoutcome relationship in monitorized occlusion studies (MOTAS, ROTAS) reveals that the results in children prescribed 3 to 6 hours or 6 to 12 hours of occlusion per day (not objective occlusion time) are surprisingly similar. These studies suggest that similar results in visual acuity improvement in different groups were due to a lack of adherence to longer duration prescribed doses. Although different occlusion doses were recommended and ‘knowing being monitored’, different groups actually received similar objective occlusion doses due to parent/child non-adherence to treatment. Occlusion times to be recommended by physicians should be determined in line with MOTAS and ROTAS publications, in the light of the knowledge that families will apply the occlusion times for less than the ones determined in these publications in current clinical practices, where they know that they will not be monitored. In the aforementioned studies on dose-effectiveness in amblyopia, it is also possible to compare the results to the visual increase observed with refractive correction alone prior to initiating occlusion therapy; thus, in the final section of the review, the visual increase observed with only refractive correction (refractive adaptation period) is discussed separately.
Ambliyopi ve Tedavisinde Binoküler Akomodatif Cevabın Değerlendirilmesi F. Gül YILMAZ ÇINAR, Elif... more Ambliyopi ve Tedavisinde Binoküler Akomodatif Cevabın Değerlendirilmesi F. Gül YILMAZ ÇINAR, Elif ERDEM, Deniz SOMER, Banu ŞATANA, Nida ŞEN, Ayşe BURCU, Firdevs ÖRNEK. ÖZET Amaç: Farklı tip ve derinlikteki ...
Ad dress for Cor res pon den ce/Ya z›fl ma Ad re si: Uğur Acar MD, Ministry of Health Kastamonu D... more Ad dress for Cor res pon den ce/Ya z›fl ma Ad re si: Uğur Acar MD, Ministry of Health Kastamonu Dr. Munif Islamoglu State Hospital, Kastamonu, Turkey Gsm.: +90 505 797 76 18 E-pos ta: [email protected] Re cei ved/Ge lifl Ta ri hi: 22.08.2012 Ac cep ted/Ka bul Ta ri hi: 04.01.2013 Sum mary Pur po se: To determine the factors that influence surgical success in patients with intermittent exotropia. Ma te ri al and Met hod: We retrospectively evaluated the records of patients with intermittent exotropia who were diagnosed, operated, and followed up. Successful outcome was defined as alignment ≤10 prism diopters (PD) esophoria or exophoria at the last follow-up visit. The clinical findings, exodeviation types, surgical ages, operation types, preoperative and postoperative deviation amounts, presence of anisometropia and amblyopia, presence of Aor V-pattern, and presence of binocular vision and stereoacuity of patients were evaluated. We investigated the independent variables that affe...
Journal of Binocular Vision and Ocular Motility, 2018
ABSTRACT Introduction and Purpose: To investigate the role that dynamic retinoscopy can play in r... more ABSTRACT Introduction and Purpose: To investigate the role that dynamic retinoscopy can play in reducing the occurrence of infantile accommodative esotropia and facilitating emmetropization in infants with high hyperopia. Patients and Methods: 211 orthotropic infants under 1 year of age (3.5 to 12 months) identified as having ≥5 diopters of hyperopia in their more hyperopic eye on a routine eye exam. On enrollment, infants underwent an assessment of accommodation using dynamic retinoscopy as well as a cycloplegic refraction. Infants who showed normal accommodation were followed without spectacles. If dynamic retinoscopy showed subnormal accommodation, partial hyperopic correction that allowed for full binocular accommodative responses at near were prescribed. Main outcome measures were the occurrence of esotropia, changes in refractive error, and visual acuity. Results: Of the 211 infants enrolled, 146 showed normal accommodation and were followed without glasses (Group 1). None of these patients developed strabismus. Sixty-five patients showed subnormal accommodation and received partial hyperopic correction (Group 2). Thirty-four of the 65 (52%) in Group 2 did not develop strabismus (Group 2A) and 31 of the 65 (48%) developed strabismus (Group 2B). All 3 groups showed a reduction of hyperopia of 0.37D ± 0.25/year, 0.50D ± 0.28/year, and 0.60D ± 0.20/year in groups 1, 2A, and 2B, respectively. None of the differences between groups were statistically significant. Conclusions: Normal accommodation on dynamic retinoscopy in orthotropic hyperopic infants is a predictor of continued good alignment and such infants can be followed without spectacles. Partial spectacle correction based on dynamic retinoscopy may have a beneficial effect on reducing the development of strabismus without impeding emmetropization. Early binocular accommodative behavior seems to be predictive of infants at risk of developing strabismus.
Journal of American Association for Pediatric Ophthalmology and Strabismus, 2017
To study prospectively the effect of extirpating the proprioceptive impulse at the myotendinous j... more To study prospectively the effect of extirpating the proprioceptive impulse at the myotendinous junction combined with recession of the medial rectus muscles in patients with convergence excess esotropia. A total of 21 patients with different sizes of AC/A ratios (high, 8; normal, 12; low, 1) underwent a surgical procedure consisting of combining resection of 2.5 mm of the insertional end of the medial rectus muscles with recession from the original insertion, based on the patient's angle of esotropia at 1/3 m while wearing full cycloplegic refraction, with an additional recession of 1 mm for each rectus muscle based on current surgical tables. A satisfactory outcome was defined as orthotropia or esotropia of <10(Δ) at near and distance fixations with available correction and reduction of the distance--near disparity to <10(Δ). All patients, regardless of the size of AC/A ratio and the amount of near-distance disparity, had satisfactory alignments at near and distance fixations, with residual near-distance disparity of <10(Δ). Consecutive distance exotropia did not develop even when there was preoperative distance orthotropia. Outcome measures remained stable for a mean of 4.3 years. None of the 8 patients with high AC/A ratios required bifocal wear or overcorrection prescriptions to maintain alignment postoperatively. This technique of combined resection and recession of the medial rectus muscle shows promise in the treatment of convergence excess esotropia. The main advantage is improvement in distance alignment while selectively reducing the near angle in patients with different levels of AC/A ratios.
Miller Fisher syndrome (MFS) is characterised by the triad of ophthalmoplegia, ataxia, and arefle... more Miller Fisher syndrome (MFS) is characterised by the triad of ophthalmoplegia, ataxia, and areflexia. A case with external ophthalmoplegia and absence of ataxia and areflexia until the end of second week is presented. Electrophysiological findings became apparent after the third week and showed reduced amplitudes of sensory nerve action potentials and prolonged latencies of F with no evidence of conduction blocks. There was no response to intravenous immunoglobulin, but there was response to corticosteroids. This case may represent an atypical MFS with late presenting electrophysiological abnormalities. Corticosteroids can be a therapeutic option when intravenous immunoglobulin fails to control clinical symptoms.
ÖZET Amaç: Yük sek kay ma açı lı sa bit ek zot rop ya nın cer ra hi te da vi sin de, cer ra hi ba... more ÖZET Amaç: Yük sek kay ma açı lı sa bit ek zot rop ya nın cer ra hi te da vi sin de, cer ra hi ba şa rı kri ter le ri ile has ta mem nu ni ye ti ni kar şı laş tır mak. Ge reç ve Yön tem ler: 2000-2008 yıl la rı ara sın da kli ni ği miz de ta kip ve te da vi edi len yük sek kay ma açı lı [≥40 prizm di op tri (PD)] sa bit ek zot rop ya ta nı lı has ta la rın ka yıt la rı ret ros pek tif ola rak in ce len di. Has ta la rın kli nik bul gu la rı (amb li yo pi, A-V pa tern, ani zo met ro pi, bi no ku la ri te ve ste re op sis var lı ğı), cer ra hi uy gu la nan yaş la rı, uy gu la nan cer ra hi tek nik, cer ra hi ön ce si ve son ra sı kay ma mik tar la rı ve cer ra hi son ra sı has ta mem nu ni ye ti de ğer len di ril di. Cer ra hi son ra sı son kon tro lün de kay ma mik ta rı ya kın ve uzak ta 10 PD’nin al tın da ezo for ya ve ya ek zo for ya olan ol gu lar ba şa rı lı ola rak de ğer len di ril di ğin de bu ba ğım sız de ğiş ken le rin ba şa rı yı et ki le yip et ki le me di ği araş tı rıl dı. Bul gu lar: Ça lış ma kri ter le ri ne uy gun 41 (%58.57)’i ka dın 29 (%41.43)’u er kek, top lam 70 has ta nın or ta la ma ta kip sü re si 22.66 ± 20.93 ay ola rak tes pit edil di. Has ta la rın ope ras yon ön ce si or ta la ma kay ma mik ta rı ya kın da 51.54 ± 11.34 PD iken, uzak ta 52.94 ± 11.29 PD idi. Son kontrol le rin de ki kay ma mik ta rı na gö re cer ra hi ba şa rı ora nı sa de ce %44.29 (31 has ta) idi. Cer ra hi ba şa rı lı ve ba şa rı sız grup lar ara sın da de ğer len di ri len hiç bir ba ğım sız de ğiş ken de is ta tis tik sel ola rak an lam lı bir fark bu lu na ma dı (p> 0.05). Has ta la rın 23 (%32.86)’üne re zi dü ek zot rop ya ne de niy le ikin ci cer ra hi ge rek si nim gö rül dü. Bu has ta la rın 17 (%73.91)’si ope ras yon so nu cu nun ken di le ri için ye ter li ol du ğu nu be yan ede rek ikin ci cer ra hi yi ka bul et me di. So nuç: Yük sek kay ma açı lı sa bit ek zot rop ya da cer ra hi ba şa rı ora nı, has ta mem nu ni ye ti göz önü ne alın dı ğın da ar tış gös ter mek te dir. Bu an lam da yük sek kay ma açı lı ek zot rop ya da, sa de ce 10 PD’nin al tın da ki ezo for ya ve ya ek zo for ya nın ba şa rı kri te ri ola rak ka bul edil me si nin sor gu la na bi lir ol du ğu dü şün mek te yiz.
Purpose – The purpose of this paper is to present knowledge in estimating yield surfaces of heter... more Purpose – The purpose of this paper is to present knowledge in estimating yield surfaces of heterogeneous media by use of homogenization, especially where the macroscopic behaviour is driven by weak interfaces between phase constituents. Design/methodology/approach – A computational homogenization procedure is used to determine the yield surface of a Representative Volume Element (RVE) that contains a fully debonded inclusion embedded within ideally plastic matrix, whereby the interface is modelled by a Coulomb type friction law. Findings – The macroscopic behaviour of the RVE is shown to coincide an RVE with a hole for expanding loads, whereas for compressive loads, it was shown to approach an RVE with a fully bonded inclusion. Originality/value – The present paper builds on Gurson’s work in estimating macroscopic yield surfaces of heterogeneous materials. The work is novel in the sense that there had been no previous publications discussing influence of weak interfaces on yield su...
To record emmetropization, visual acuity, and strabismus outcomes among hyperopic infants followe... more To record emmetropization, visual acuity, and strabismus outcomes among hyperopic infants followed with partial hyperopic corrections given in accordance with dynamic retinoscopy (DR). Infants (3.5-12 months of age) with ≥5 D hyperopia were followed without glasses or partial hyperopic corrections prescribed according to their near dynamic accommodative abilities determined by DR responses at the initial visit and follow-ups. Refraction and binocular accommodative ability assessments were made at 3-month intervals up to the age of 1 and at 6-month intervals afterwards for a mean 35.4±2.1 months; main outcome measures being the development of esotropia, emmetropization rate, and visual acuity level after emmetropization period. Among 211, 146 were normal accommodators initially (Group 1). These infants were followed without treatment and none presented with strabismus. Sixty-five infants were hypo-accommodators (Group 2) and received minimum DR-based corrections. Of the 65 infants 31...
Orbita, Fontal Sinüs ve Ön Kranyal Fossa İçinde Çok Sayıda Yabancı Cisimle Birlikte Üst Orbita Du... more Orbita, Fontal Sinüs ve Ön Kranyal Fossa İçinde Çok Sayıda Yabancı Cisimle Birlikte Üst Orbita Duvar Kırığı Olgusu Yasemin KATIRCIOĞLU, Serkan DURAN, Deniz SOMER, Remzi KASIM, Sunay DUMAN. ÖZET Üst orbita duvar kırıkları nadir görülen orbita duvar kırıklarıdır. ...
Ge lifl Ta ri hi/Re cei ved: 04.07.2011 Ka bul Ta ri hi/Ac cep ted: 02.11.2011 Özet On yaşında, s... more Ge lifl Ta ri hi/Re cei ved: 04.07.2011 Ka bul Ta ri hi/Ac cep ted: 02.11.2011 Özet On yaşında, sağ gözünde şişlik ve öne doğru büyüme şikayeti ile başvuran kız hastada yapılan radyolojik görüntüleme yöntemlerinden sonra orbita içine uzanan kitle saptandı. Kitle Beyin Cerrahisi kliniği tarafından transkranial girişimle eksize edilip histopatolojik incelemede ossifiye fibroma olarak tanımlandı. Postoperatif birinci haftada baş pozisyonu ve diplopi gelişen ve muayenesinde troklea bölgesinde şişlik saptanan olguya cerrahi travma sonrası gelişen Canine Tooth Sendromu tanısı konuldu.(Turk J Oph thal mol 2012; 42: 163-5) Anah tar Ke li me ler: Ossifiye fibroma, Canine Tooth sendromu, ttroklear travma Sum mary After radiological imaging analysis, a mass extending into the orbit was detected in a 10-year-old girl with complaints of swelling and protrusion in the right eye. The mass was excised by the neurosurgery department through transcranial approach and found to be ossifying fibroma in histopathological examination. The case, presenting with head position and diplopia as well as trochlear swelling in physical examination in the postoperative first week, was diagnosed with canine tooth syndrome developing after surgical trauma.
The review provides strategies based on an evaluation of the published data regarding the dosage ... more The review provides strategies based on an evaluation of the published data regarding the dosage and duration of the patching time to be planned following the refractive adaptation period (the first 18 weeks after the use of glasses). Amblyopia studies utilizing occlusion dose monitors “Monitored Occlusion Treatment of Amblyopia Study Cooperative Group (MOTAS), United Kingdom” and “Randomized Occlusion Treatment of Amblyopia Cooperative Group (ROTAS), United Kingdom” and non-monitoring “Pediatric Eye Disease Investigator Group Amblyopia Treatment Studies (PEDIG ATS), United States of America (USA)” methods were reviewed and compared in order to ascertain the reasons for major discrepancies in dose-response information given in publications. Examining the doseoutcome relationship in monitorized occlusion studies (MOTAS, ROTAS) reveals that the results in children prescribed 3 to 6 hours or 6 to 12 hours of occlusion per day (not objective occlusion time) are surprisingly similar. These studies suggest that similar results in visual acuity improvement in different groups were due to a lack of adherence to longer duration prescribed doses. Although different occlusion doses were recommended and ‘knowing being monitored’, different groups actually received similar objective occlusion doses due to parent/child non-adherence to treatment. Occlusion times to be recommended by physicians should be determined in line with MOTAS and ROTAS publications, in the light of the knowledge that families will apply the occlusion times for less than the ones determined in these publications in current clinical practices, where they know that they will not be monitored. In the aforementioned studies on dose-effectiveness in amblyopia, it is also possible to compare the results to the visual increase observed with refractive correction alone prior to initiating occlusion therapy; thus, in the final section of the review, the visual increase observed with only refractive correction (refractive adaptation period) is discussed separately.
Ambliyopi ve Tedavisinde Binoküler Akomodatif Cevabın Değerlendirilmesi F. Gül YILMAZ ÇINAR, Elif... more Ambliyopi ve Tedavisinde Binoküler Akomodatif Cevabın Değerlendirilmesi F. Gül YILMAZ ÇINAR, Elif ERDEM, Deniz SOMER, Banu ŞATANA, Nida ŞEN, Ayşe BURCU, Firdevs ÖRNEK. ÖZET Amaç: Farklı tip ve derinlikteki ...
Ad dress for Cor res pon den ce/Ya z›fl ma Ad re si: Uğur Acar MD, Ministry of Health Kastamonu D... more Ad dress for Cor res pon den ce/Ya z›fl ma Ad re si: Uğur Acar MD, Ministry of Health Kastamonu Dr. Munif Islamoglu State Hospital, Kastamonu, Turkey Gsm.: +90 505 797 76 18 E-pos ta: [email protected] Re cei ved/Ge lifl Ta ri hi: 22.08.2012 Ac cep ted/Ka bul Ta ri hi: 04.01.2013 Sum mary Pur po se: To determine the factors that influence surgical success in patients with intermittent exotropia. Ma te ri al and Met hod: We retrospectively evaluated the records of patients with intermittent exotropia who were diagnosed, operated, and followed up. Successful outcome was defined as alignment ≤10 prism diopters (PD) esophoria or exophoria at the last follow-up visit. The clinical findings, exodeviation types, surgical ages, operation types, preoperative and postoperative deviation amounts, presence of anisometropia and amblyopia, presence of Aor V-pattern, and presence of binocular vision and stereoacuity of patients were evaluated. We investigated the independent variables that affe...
Journal of Binocular Vision and Ocular Motility, 2018
ABSTRACT Introduction and Purpose: To investigate the role that dynamic retinoscopy can play in r... more ABSTRACT Introduction and Purpose: To investigate the role that dynamic retinoscopy can play in reducing the occurrence of infantile accommodative esotropia and facilitating emmetropization in infants with high hyperopia. Patients and Methods: 211 orthotropic infants under 1 year of age (3.5 to 12 months) identified as having ≥5 diopters of hyperopia in their more hyperopic eye on a routine eye exam. On enrollment, infants underwent an assessment of accommodation using dynamic retinoscopy as well as a cycloplegic refraction. Infants who showed normal accommodation were followed without spectacles. If dynamic retinoscopy showed subnormal accommodation, partial hyperopic correction that allowed for full binocular accommodative responses at near were prescribed. Main outcome measures were the occurrence of esotropia, changes in refractive error, and visual acuity. Results: Of the 211 infants enrolled, 146 showed normal accommodation and were followed without glasses (Group 1). None of these patients developed strabismus. Sixty-five patients showed subnormal accommodation and received partial hyperopic correction (Group 2). Thirty-four of the 65 (52%) in Group 2 did not develop strabismus (Group 2A) and 31 of the 65 (48%) developed strabismus (Group 2B). All 3 groups showed a reduction of hyperopia of 0.37D ± 0.25/year, 0.50D ± 0.28/year, and 0.60D ± 0.20/year in groups 1, 2A, and 2B, respectively. None of the differences between groups were statistically significant. Conclusions: Normal accommodation on dynamic retinoscopy in orthotropic hyperopic infants is a predictor of continued good alignment and such infants can be followed without spectacles. Partial spectacle correction based on dynamic retinoscopy may have a beneficial effect on reducing the development of strabismus without impeding emmetropization. Early binocular accommodative behavior seems to be predictive of infants at risk of developing strabismus.
Journal of American Association for Pediatric Ophthalmology and Strabismus, 2017
To study prospectively the effect of extirpating the proprioceptive impulse at the myotendinous j... more To study prospectively the effect of extirpating the proprioceptive impulse at the myotendinous junction combined with recession of the medial rectus muscles in patients with convergence excess esotropia. A total of 21 patients with different sizes of AC/A ratios (high, 8; normal, 12; low, 1) underwent a surgical procedure consisting of combining resection of 2.5 mm of the insertional end of the medial rectus muscles with recession from the original insertion, based on the patient's angle of esotropia at 1/3 m while wearing full cycloplegic refraction, with an additional recession of 1 mm for each rectus muscle based on current surgical tables. A satisfactory outcome was defined as orthotropia or esotropia of <10(Δ) at near and distance fixations with available correction and reduction of the distance--near disparity to <10(Δ). All patients, regardless of the size of AC/A ratio and the amount of near-distance disparity, had satisfactory alignments at near and distance fixations, with residual near-distance disparity of <10(Δ). Consecutive distance exotropia did not develop even when there was preoperative distance orthotropia. Outcome measures remained stable for a mean of 4.3 years. None of the 8 patients with high AC/A ratios required bifocal wear or overcorrection prescriptions to maintain alignment postoperatively. This technique of combined resection and recession of the medial rectus muscle shows promise in the treatment of convergence excess esotropia. The main advantage is improvement in distance alignment while selectively reducing the near angle in patients with different levels of AC/A ratios.
Miller Fisher syndrome (MFS) is characterised by the triad of ophthalmoplegia, ataxia, and arefle... more Miller Fisher syndrome (MFS) is characterised by the triad of ophthalmoplegia, ataxia, and areflexia. A case with external ophthalmoplegia and absence of ataxia and areflexia until the end of second week is presented. Electrophysiological findings became apparent after the third week and showed reduced amplitudes of sensory nerve action potentials and prolonged latencies of F with no evidence of conduction blocks. There was no response to intravenous immunoglobulin, but there was response to corticosteroids. This case may represent an atypical MFS with late presenting electrophysiological abnormalities. Corticosteroids can be a therapeutic option when intravenous immunoglobulin fails to control clinical symptoms.
ÖZET Amaç: Yük sek kay ma açı lı sa bit ek zot rop ya nın cer ra hi te da vi sin de, cer ra hi ba... more ÖZET Amaç: Yük sek kay ma açı lı sa bit ek zot rop ya nın cer ra hi te da vi sin de, cer ra hi ba şa rı kri ter le ri ile has ta mem nu ni ye ti ni kar şı laş tır mak. Ge reç ve Yön tem ler: 2000-2008 yıl la rı ara sın da kli ni ği miz de ta kip ve te da vi edi len yük sek kay ma açı lı [≥40 prizm di op tri (PD)] sa bit ek zot rop ya ta nı lı has ta la rın ka yıt la rı ret ros pek tif ola rak in ce len di. Has ta la rın kli nik bul gu la rı (amb li yo pi, A-V pa tern, ani zo met ro pi, bi no ku la ri te ve ste re op sis var lı ğı), cer ra hi uy gu la nan yaş la rı, uy gu la nan cer ra hi tek nik, cer ra hi ön ce si ve son ra sı kay ma mik tar la rı ve cer ra hi son ra sı has ta mem nu ni ye ti de ğer len di ril di. Cer ra hi son ra sı son kon tro lün de kay ma mik ta rı ya kın ve uzak ta 10 PD’nin al tın da ezo for ya ve ya ek zo for ya olan ol gu lar ba şa rı lı ola rak de ğer len di ril di ğin de bu ba ğım sız de ğiş ken le rin ba şa rı yı et ki le yip et ki le me di ği araş tı rıl dı. Bul gu lar: Ça lış ma kri ter le ri ne uy gun 41 (%58.57)’i ka dın 29 (%41.43)’u er kek, top lam 70 has ta nın or ta la ma ta kip sü re si 22.66 ± 20.93 ay ola rak tes pit edil di. Has ta la rın ope ras yon ön ce si or ta la ma kay ma mik ta rı ya kın da 51.54 ± 11.34 PD iken, uzak ta 52.94 ± 11.29 PD idi. Son kontrol le rin de ki kay ma mik ta rı na gö re cer ra hi ba şa rı ora nı sa de ce %44.29 (31 has ta) idi. Cer ra hi ba şa rı lı ve ba şa rı sız grup lar ara sın da de ğer len di ri len hiç bir ba ğım sız de ğiş ken de is ta tis tik sel ola rak an lam lı bir fark bu lu na ma dı (p> 0.05). Has ta la rın 23 (%32.86)’üne re zi dü ek zot rop ya ne de niy le ikin ci cer ra hi ge rek si nim gö rül dü. Bu has ta la rın 17 (%73.91)’si ope ras yon so nu cu nun ken di le ri için ye ter li ol du ğu nu be yan ede rek ikin ci cer ra hi yi ka bul et me di. So nuç: Yük sek kay ma açı lı sa bit ek zot rop ya da cer ra hi ba şa rı ora nı, has ta mem nu ni ye ti göz önü ne alın dı ğın da ar tış gös ter mek te dir. Bu an lam da yük sek kay ma açı lı ek zot rop ya da, sa de ce 10 PD’nin al tın da ki ezo for ya ve ya ek zo for ya nın ba şa rı kri te ri ola rak ka bul edil me si nin sor gu la na bi lir ol du ğu dü şün mek te yiz.
Purpose – The purpose of this paper is to present knowledge in estimating yield surfaces of heter... more Purpose – The purpose of this paper is to present knowledge in estimating yield surfaces of heterogeneous media by use of homogenization, especially where the macroscopic behaviour is driven by weak interfaces between phase constituents. Design/methodology/approach – A computational homogenization procedure is used to determine the yield surface of a Representative Volume Element (RVE) that contains a fully debonded inclusion embedded within ideally plastic matrix, whereby the interface is modelled by a Coulomb type friction law. Findings – The macroscopic behaviour of the RVE is shown to coincide an RVE with a hole for expanding loads, whereas for compressive loads, it was shown to approach an RVE with a fully bonded inclusion. Originality/value – The present paper builds on Gurson’s work in estimating macroscopic yield surfaces of heterogeneous materials. The work is novel in the sense that there had been no previous publications discussing influence of weak interfaces on yield su...
To record emmetropization, visual acuity, and strabismus outcomes among hyperopic infants followe... more To record emmetropization, visual acuity, and strabismus outcomes among hyperopic infants followed with partial hyperopic corrections given in accordance with dynamic retinoscopy (DR). Infants (3.5-12 months of age) with ≥5 D hyperopia were followed without glasses or partial hyperopic corrections prescribed according to their near dynamic accommodative abilities determined by DR responses at the initial visit and follow-ups. Refraction and binocular accommodative ability assessments were made at 3-month intervals up to the age of 1 and at 6-month intervals afterwards for a mean 35.4±2.1 months; main outcome measures being the development of esotropia, emmetropization rate, and visual acuity level after emmetropization period. Among 211, 146 were normal accommodators initially (Group 1). These infants were followed without treatment and none presented with strabismus. Sixty-five infants were hypo-accommodators (Group 2) and received minimum DR-based corrections. Of the 65 infants 31...
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