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Carotid Endarterectomy Cuma Bulent GUL, MD ASSISTAND EDITOR & WEB DESIGN Rıza EROKSUZ, MD Nazmi ZENGIN The European Research Journal (EuRJ) Bursa Association of Public Hospitals 75. Yıl Bulvarı, Park Caddesi, No:1 Nilüfer/BURSA -TURKEY Tel : +90(224) 600 33 98/99 I TABLE OF CONTENTS Original Articles The factors affecting surgical success rate for the patients with congenital esotropia 33-38 Tugba Goncu, Funda Dilmen, Ali Akal, Fatih Mehmet Adibelli, Sevim Cakmak Carotid endarterectomy: a comparison on general and local anesthesia 39-43 Faruk Toktas, Tugrul Goncu, Suleyman Surer, Gunduz Yumun, Kadir Kaan Ozsin, Burak Erdolu, Senol Yavuz, Arif Gucu Clinical assessment of the severity of chronic hand eczema: correlations between six 44-49 assessment methods Nilay Duman, Erol Uzunali Differential diagnosis and proper aproach for ophthalmomyiasis externa: an 50-54 experience of 12 patients Gulsah Usta, Melisa Zisan Karslioglu, Ramazan Adanir An analysis of publications related to emergency medicine originating from Turkey 55-60 Mahmut Firat Kaynak, Zulfi Engindeniz, Sibel Gafurogullari, Esra Askin Bas, Mumin Karaali, Nizameddin Koca, Ismail Altintop COPD cases detected by spirometry on world COPD day event in Bursa 61-65 Ozlem Sengoren Dikis, Seyhan Us Dülger, Mehmet Karadag, Hakan Demirci Case Reports Amputation for upper extremity ischemia following shoulder dislocation: case report 66-70 and a review of literature Murat Songur, Ercan Sahin, Mahmut Kalem, Sinan Zehir Adult unilateral duplex system ureterocele with multiple calculi 71-73 Semih Tangal, Mehmet Salih Boga, Kutsal Onal, Ahmet Hakan Haliloglu Acute pancreatitis and type 2 diabetes mellitus: who is guilty? 74-77 Ferit Kerim Kucukler Spontaneous uvula hematoma: an unusual case 78-80 Hacer Baran, Ozan Gokdogan Aneurysmal bone cyst of the parietal bone: case report 81-84 Mehmet Ali Ekici, Zuhtu Ozbek, Burak Kazanci, Bulent Guclu Hair loss due to aripipirazole use: a case report 85-87 Yelda Yenilmez Bilgin, Ibrahim Yagci, Serhat Tunc, Murat Ilhan Atagün The European Research Journal Original Article http://www.eurj.org e-ISSN: 2149-3189 DOI: 10.18621/eurj.2015.1.1.33 The factors affecting surgical success rate for the patients with congenital esotropia Tugba Goncu1, Funda Dilmen1, Ali Akal1, Fatih Mehmet Adibelli1, Sevim Cakmak1 1 Department of Ophthalmology, Harran University, School of Medicine, Sanliurfa, Turkey ABSTRACT Objective. To evaluate the factors and preoperative clinical features affecting surgical success rate in patients Method. with congenital esotropia. The medical files of patients who underwent surgery for congenital esotropia between June 2012 and September 2014 were retrospectively reviewed. Data from the patients' full ophthalmological examination included visual acuity, ocular alignment, duction, versions and sensory tests for binocularity, cycloplegic retinoscopy and fundus evaluation. Presence of previous ambliyopia treatment, fixation preference, cross-fixation, anisometropia >1.5D, ocular motility abnormalities were noted. Result. The relationship of these variables with the surgical success rate was evaluated. A total of 48 patients (25 female,52.1%) were included. The mean age of the patients was 4.4±5.2 years. Successful surgical outcome was achieved in 39 (81.3%). All the patients were followed for 14.1±4.4 months. There was no relation between surgical success and patients' gender, positive family history, consanguinity, previous ambliyopia treatment, anisometropia, abnormal ocular motility and cross-fixation and mean cycloplegic refraction (p>0,05). However, fixation preference and mean preoperative deviation found to be related with Conclusion. surgical failure (p<0,05). In this study many variables such as epidemiologic characteristics and clinical features of patients were investigated for their possible association with surgical success rate. Only preoperative fixation preference without ambliyopia and mean preoperative deviation were found to be risk factors for the surgical failure in this group of patients with infantile esotropia. Eur Res J 2015;1(2):33-38 Keywords: Congenital esotropia, surgical success, ambliyopia, anisometropia, fixation preference Introduction Strabismus is an ophthalmological disorder in neurological, mechanical, refractive, genetic and which the eyes are misaligned; it affects 2-4% of accommodative [2,3]. Congenital esotropia is a children [1]. About half of these disorders are common type of esotropia, representing 28% to 54% esodeviations, whose causes are anatomical, of all esotropias and having an incidence of about Address for correspondence: Tugba Goncu M.D, Assistant Professor in Ophthalmology, Harran University, Faculty of Medicine, Department of Ophthalmology 63100, Sanliurfa, Turkey Tel:+90(532) 490 81 02, Fax: +90(414) 318 31 92 Email: [email protected] Received: 22.03.2015; Accepted: 24.05.2015: Published Online: 04.07.2015 Copyright © 2015 by Bursa Association of Public Hospitals 33 Eur Res J 2015;1(2):33-38 Surgical success in congenital esotropia 1% to 2% of general population [4,5]. It is method), duction, versions and sensory tests for characterized by a constant esodeviation with onset binocularity (Worth 4 dot test) and stereopsis (Titmus prior to 6 months of age. The treatment of choice is fly test), as well as cycloplegic retinoscopy and surgery [6-10]. The surgical success rate is reported detailed biomicroscopic and fundus evaluation. in a range of 19% to 79% in the literature [6-11]. The Presence of positive family history, previous risk factors for surgical failure and reoperation are ambliyopia treatment and consanguineous marriage still controversial. However, earlier surgery before were noted from medical history. 15 months of age, larger angle, presence of amblyopia, Fixation preference was defined as fixing with one positive family history and accompanying ocular eye during examination period however, there was motility abnormalities such as inferior oblique muscle spontaneous alternating of fixation with cover test. overaction (IOOA), dissociated vertical deviation According to the mean cycloplegic refraction obtained, (DVD), latent nystagmus are suggested to be the risk patients were classified as emetropic (-1 to +1 diopters factors for reoperation [6-8]. However, for congenital D), mild hyperopic (+1 to +3 D), moderate hyperopic esotropia, the impact of consanguineous marriage, (+3 to +6D), severe hyperopic (more than +6 D) and fixation preference, presence of cross-fixation or myopic ( more than -1 D). Oblique muscle function anisometropia on postoperative outcomes are not was subjectively graded on a scale of -4 (underaction) investigated previously. to +4 (overaction), with 0 being normal. A difference The purpose of this study was to evaluate the factors of 1.5 D or more in spherical equivalent between the and preoperative clinical features affecting surgical two eyes, was defined as anisometropia. A successful success rate in patients with congenital esotropia with outcome was defined as orthotropia or a horizontal a minumum postoperative follow-up period of 6 tropia of 10 prism diopters (PD) or less, at distance months. and/or near in the primary position. The preoperative examination which was performed 1 or 2 days before surgery and postoperative examinations were Materials and methods performed at final visit were analysed. Statistical Analysis Medical records of consecutive patients who underwent surgery for congenital esotropia in Harran All analyses were performed with SPSS (Statistical University, Faculty of Medicine, Department of Packages for Social Sciences) for Windows version Ophthalmology between June 2012 and September 17.0 (SPSS®, Chicago, IL, USA). All data were 2014 were reviewed. The study design was approved expressed as mean and standard deviation. Histogram by Institutional Ethics Committee and the study was graphs and the Kolmogorov-Smirnov test were used carried out in accordance with the Declaration of to test whether the distribution of the data differed Helsinki. The patients who underwent surgery for significantly from normal. The differences between the correction of esotropia were included in the study. the patient groups were assessed for statistical The patients who had ocular, neurological, significance using the Mann Whitney U test, chi- chromosomal, or congenital disease and history of square test and Fisher Exact test when appropriate. previous ocular surgery were excluded from the study. A p value less than 0.05 was considered as statistically Among patients, only ones who had postoperative significant. follow-up for at least 6 months were eligible for the study. Data from the patients' full ophthalmological Results examination included visual acuity (if visual acuity assessment could not be performed with Lea figures After reviewing the medical charts, 48 patients who or Snellen, then fixation pattern was evaluated), met the criteria were included in the study. The mean fixation preference, presence of cross-fixation, ocular age of the patients was 4.4±5.2 years, with a range alignment (if the patient was cooperative, of 0.5 to 23 years at initial examination. There were measurements were performed with alternating prism 25 (52.1%) female and 23 (47.9%) male patients. cover test; if not, the Krimsky test was the preferred The mean follow-up was 14.1±4.4 months, with a 34 Eur Res J 2015;1(2):33-38 et al Goncu preoperative clinical characteristics of all patients are As shown in Table 2, there was no relation between shown in Table 1 surgical success
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