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Öğe Anterior chamber fixation of a posterior chamber intraocular lens: A novel technique(Medknow Publications & Media Pvt Ltd, 2014) Kükner, Ahmet Şahap; Alagöz, Gürsoy; Erdurmuş, Mesut; Serin, Didem; Doğan, ÜmitWe aimed to evaluate the implantation of a posterior chamber intraocular lens (IOL) in the anterior chamber (AC) with the haptics passing through two iridectomies to the posterior chamber. A total of 33 eyes of 33 patients with inadequate posterior capsular support due to either previous aphakia or posterior capsular rupture during cataract extraction were included in the study. A double iridectomy was performed on all patients using a vitrectomy probe on the midperiphery of the iris. IOLs were implanted in the AC, and the haptics were passed through the iridectomies to the posterior chamber. The mean follow-up time was 25.3 months. AC hemorrhage occurred in five patients during the iridectomy procedure. Corneal edema was detected in eight of 14 patients with primary IOL insertions. Haptic dislocation was detected in only one patient. This technique may be a good alternative to scleral-fixated IOL implantation in eyes with aphakia.Öğe Antioxidant status and oxidative stress in primary open angle glaucoma and pseudoexfoliative glaucoma(Taylor & Francis Inc, 2011) Erdurmuş, Mesut; Yağcı, Ramazan; Atış, Ömer; Karadağ, Remzi; Akbaş, Ali; Hepşen, İbrahim F.Purpose: The aim of this study was to establish the antioxidant status and oxidative stress in patients with primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PEG). Methods: Serum levels of total antioxidant capacity (TAC) and superoxide dismutase (SOD) as indicators of antioxidant status; and total oxidant status (TOS), nitric oxide (NO), protein carbonyl (PC), and malondialdehyde (MDA) as indicators of oxidative stress were measured from the blood samples of patients with POAG (n = 23), PEG (n = 24) and healthy control subjects (n = 19) by spectrophotometry. Results: Mean TAC level was 0.6 +/- 0.1 mmol/L in the POAG group; 0.5 +/- 0.1 mmol/L in the PEG group and 1.2 +/- 0.3 mmol/L in the control group (p = 0.001). Mean SOD level was 13 +/- 0.5 mg/L in the POAG group, 11.6 +/- 0.2 mg/L in the PEG group and 9.4 +/- 0.6 mg/L in the control group (p = 0.001). Mean TOS level was 19.6 +/- 2.6 mu mol/L in the POAG group, 21.2 +/- 4.2 mu mol/L in the PEG group and 15.1 +/- 7 mu mol/L in the control group (p = 0.001). Mean NO level was 74.3 +/- 14.4 mu mol/L in the POAG group, 66.1 +/- 8.1 mu mol/L in the PEG group and 62.3 +/- 13.5 mu mol/L in the control group (p = 0.005). Mean PC level was 641.5 +/- 102.5 nmol/mg in the POAG group, 988.3 +/- 214.7 nmol/mg in the PEG group and 654.4 +/- 150.7 nmol/mg in the control group (p = 0.001). Mean MDA level was 1.9 +/- 0.2 mu mol/L in the POAG group, 1.7 +/- 0.4 mu mol/L in the PEG group and 1.1 +/- 0.2 mu mol/L in the control group (p = 0.001). Conclusion: The findings of the present study are potentially of significance and add to the growing body of evidence for oxidative stress in POAG and PEG. Decreased antioxidant defense and increased oxidative stress system may play an important role in the pathogenesis of POAG and PEG.Öğe Aqueous humour and serum concentration of asymmetric dimethyl arginine in pseudoexfoliation syndrome(Bmj Publishing Group, 2012) Tosun, Mehmet; Erdurmuş, Mesut; Buğdaycı, Güler; Çelebi, Serdal; Alçelik, AytekinObjective Asymmetric dimethyl arginine (ADMA) is the major endogenous inhibitor of nitric oxide synthase. ADMA is related to endothelial dysfunction and is an independent cardiovascular risk factor. This study aimed to evaluate the concentration of ADMA in aqueous humour and serum samples of patients with pseudoexfoliation (PEX) syndrome. Materials and Methods 21 cataract patients with PEX syndrome (PEX group) and 18 cataract patients without PEX syndrome (control group) were enrolled in the study. ADMA was measured in the aqueous humour and serum of the PEX and control groups. ELISA was used to determine the ADMA concentration. Results Mean aqueous humour ADMA concentration in the PEX group was 0.39 +/- 0.07 mu mol/l and in the control group was 0.34 +/- 0.06 mu mol/l. Mean serum ADMA concentration in the PEX group was 0.5660.21 mu mol/l and in the control group was 0.4460.12 mu mol/l. ADMA concentration of aqueous humour in the PEX group was significantly higher than the control group (p=0.026). Similarly, ADMA concentration of serum in the PEX group was significantly higher than the control group (p=0.039). Conclusions The findings of the present study could suggest that ADMA might play a role in the aetiopathogenesis of PEX syndrome. Higher aqueous and serum levels of ADMA might be potential evidence of endothelial dysfunction in PEX syndrome.Öğe Bilgisayar kullanıcılarında oküler yüzey hastalık indeksi ile kuru göz testleri ve demografik özellikler arasındaki ilişki(2014) Simavlı, Hüseyin; Önder, Halil İbrahim; Bucak, Yasin Yücel; Erdurmuş, Mesut; Güler, Emre; Hepşen, İbrahim FeyziAmaç: Bu çalışmanın amacı; bilgisayar kullanıcılarında oküler yüzey hastalık indeksinin (OSDİ) değerlendirilmesi ve bu indeks ile kuru göz testleri ve demografik özellikler arasındaki ilişkisinin incelenmesidir. Gereç ve Yöntem: Bu prospektif çalışmaya; günlük yaşamının büyük bir kısmını bilgisayar karşısında geçiren, 20-40 yaş arası 178 birey dahil edilmiştir. Olguların tam bir oftalmolojik muayenelerinin yanı sıra bazal sekresyon testi, gözyaşı kırılma zamanı testi ve oküler yüzey boyanma paterni değerlendirilmiştir. Ayrıca tüm olgulara OSDİ anketi uygulanmıştır. Bulgular: Yaş ortalamaları 28,8±4,5 yıl olan 178 birey (101 kadın, 77 erkek) çalışmaya alındı. Ortalama bilgisayar başında kalma süresi 7,7±1,9 (5-14) saat/gün ve ortalama bilgisayar kullanım süresi 71,1±39,7 (4-204) aydı. Ortalama OSDİ skoru 44,1±24,7 (0-100) idi. OSDİ skoru ile sağ göz (p=0,005 r=-0,21) ve sol göz (p=0,003 r=-0,22) gözyaşı kırılma zamanı arasında anlamlı bir negatif korelasyon saptandı. OSDİ skoru ile kadın cinsiyet (p=0,014 r=0,18) ve günlük bilgisayar başında kalma süresi (p=0,008 r=0,2) arasında anlamlı bir pozitif korelasyon saptandı. Her iki gözün oküler yüzey boyanma paterni ile de OSDİ skoru arasında anlamlı bir pozitif korelasyon mevcuttu (sağ: p=0,03 r=0,16, sol: p=0,03 r=0,17). Yaş, sigara kullanımı, bilgisayarın türü, gözlük kullanımı, semptomların varlığı ve bazal sekresyon testi ile OSDİ skoru arasında herhangi bir ilişki saptanmadı. Sonuç: Uzun süre bilgisayar kullanımı, oküler yüzey problemlerine neden olmaktadır. Bu çalışmada; bilgisayar kullanıcılarında OSDİ ile gözyaşı kırılma zamanı, cinsiyet, günlük bilgisayar kullanım süresi ve oküler yüzey boyanma paterni arasında ilişki olduğu saptanmıştır. (Turk J Ophthalmol 2014; 44: 115-8)Öğe Cataracts : an overview(Elsevier Academic Press Inc, 2014) Erdurmuş, Mesut; Simavlı, Hüseyin; Aydın, BahriThe human lens grows continuously throughout life, due to the addition of new subcortical lens fibers. A cataract, which is any opacity within a lens, is the most prevalent cause of visual impairment in elderly people, and it remains the most common cause of blindness in the developing world. Morphologic types of age-related cataracts are nuclear, cortical, subcapsular, and mixed lenticular opacities. Numerous potential risk factors have been linked to cataract development, including smoking, corticosteroid use, diabetes, family history, myopia, obesity, ultraviolet light exposure, environmental factors, and genetics. Pathogenic mechanisms that lead to cataracts may involve oxidative stress, advanced glycation end products, aggregation of lens proteins, Na+/K+ ATPase underaction, polyol pathways, and genetic abnormalities. Management of a visually significant cataract is primarily surgical. Cataract surgery and intraocular lens implantation is the most frequently performed operation in older individuals. The preferred technique for removing an opacified lens is extracapsular cataract extraction, most commonly by phacoemulsification.Öğe The effect of beta receptor blockade through propranolol on corneal neovascularization(Mary Ann Liebert, Inc, 2014) Simavlı, Hüseyin; Erdurmuş, Mesut; Terzi, Elçin Hakan; Bucak, Yasin Yücel; Önder, Halil İbrahim; Kükner, Ahmet ŞahapPurpose: To evaluate the inhibitory effects of propranolol, a nonselective and lipophilic -adrenergic receptor blocker, on alkali-induced corneal neovascularization (NV). Methods: Corneal NV was induced in 24 eyes of 24 Wistar rats using NaOH. Following alkali burn, animals were randomized into 4 groups according to topical treatment. Group I received 0.9% NaCl, Group II received preservative-free dexamethasone sodium phosphate 1mg/mL, Group III received propranolol hydrochloride 1mg/mL, and Group IV received 0.5mg/mL propranolol hydrochloride drops twice a day for 7 days. The inhibitory effects of the drugs were compared as the percent areas of cornea covered by NV. Anti-vascular endothelial growth factor (VEGF) and anti-active caspase-3 immunostainings were also performed in corneal sections. Results: The median percent area of corneal NV was 59% (40.3-65.6) in Group I, 25.5% (20.9-43.4) in Group II, 68.9% (36.7-78.0) in Group III, and 50.4% (42.2-63.3) in Group IV. Group III and IV did not show any difference in comparison to Group I. Group II showed a statistically significant smaller area of corneal NV compared with Group I, III, and IV (P=0.004 for each comparison). Anti-VEGF immunostaining was significantly less in Group II compared with the other groups. Anti-active caspase-3 immunostaining was not different among the treatment groups. Conclusions: Topical propranolol 1 or 0.5mg/mL does not have a significant inhibitory effect on alkali-induced corneal NV in rats.Öğe Efficacy of daptomycin on experimental methicillin-resistant staphylococcus aureus keratitis in rabbits(Mary Ann Liebert, Inc, 2013) Mengeloğlu, Fırat Zafer; Küçükbayrak, Abdulkadir; Bucak, Yasin Yucel; Erdurmuş, Mesut; Taş, Tekin; Özyalvaçlı, Gülzade; Bayram, Recep; Bucak , Özlem; Akdeniz, HayrettinPurpose: We aimed to compare the efficacy of topical daptomycin (DAP) with that of vancomycin (VA) in the treatment of keratitis caused by methicillin-resistant Staphylococcus aureus (MRSA). Methods: One hundred colony-forming unit MRSA bacteria were injected intrastromally into both corneas of 28 rabbits. Sixteen hours after injection, the rabbits' eyes were treated with 1 drop of topical DAP (10 or 50mg/mL), VA (50mg/mL), or isotonic saline for 19 doses. Their eyes were examined for clinical severity before and after treatment. Results: The minimum inhibitory concentration values of VA and DAP against the bacterial strain were found to be 2 and 0.5g/mL, respectively. The mean pre- and post-treatment clinical scores of the eyes did not differ significantly among the groups. However, the mean difference between the post- and pretreatment clinical scores was significantly lower in the 50mg/mL DAP group than in the other groups (P=0.042). A marked decrease in bacterial load was detected in all treatment groups compared to the control group (P=0.002). Although there were no significant differences in bacterial load among the treatment groups, the 50mg/mL DAP group showed the greatest decrease. The mean % epithelial erosion rate tended to be higher in the 50mg/mL VA group than in the other groups (P=0.31). Conclusions: Topical DAP significantly reduced the bacterial load and showed activity against MRSA comparable to that of fortified VA in this experimental model.Öğe Geç başlangıçlı toksik anterior segment sendromu(2013) Erdurmuş, Mesut; Bucak, Yasin Yücel; Ulaş, Fatih; Çelebi, SerdalSeksen yaşında erkek hasta görmede azalma şikayeti ile kliniğimize başvurdu. Yapılan of- talmolojik muayenede bilateral kortikonükleer katarakt saptandı. Düzeltilmiş görme keskinli- ği sağ gözde 20/200 ve sol gözde 20/50 düzeyinde idi. Sağ göze komplikasyonsuz fakoemülsi- fikasyon ve göz içi lens implantasyonu yapıldı. Postoperatif 1. hafta kontrolünde görme kes- kinliği 20/20 idi. Bununla birlikte hastada miyopik kayma ve kapsüler blok sendromu saptan- dı. Nd:YAG laser ile ön kapsülotomiyi takiben hastada yoğun fibrinöz reaksiyon ve kornea ödemi gelişti. Hastanın görme keskinliği 20/60’a düştü. Yoğun topikal steroid tedavisi ile has- tanın klinik bulgularında hızlı bir iyileşme gözlendi. Bu olgu sunumunda, laser kapsülotomi sonrası toksik anterior segment sendromu geliştiğini düşündüğümüz bir olguyu ve tedavisini tartışmayı amaçladık.Öğe Geç dönem solar makülopatili bir olgu(2015) Mısır, Remzi; Kalaycı, Defne; Erdurmuş, MesutSolar makülopati; makülanın güneş ışınlarına direkt maruziyeti sonucu oluşan maküler hasar olarak tanımlanır. Maküler hasarın temelinin güneş ışığının retina üzerindeki fotokimyasal ve termal etkilerin kombinasyonu sonucu oluştuğu düşünülmektedir. Bu olgu sunumunun amacı; görme azlığı şikayeti ile olan ve bilateral geç dönem solar makülopati tanısı konan 46 yaşındaki bir olgunun; optik koherens tomografi ve fundus flouresan anjiografi bulguları ile beraber değerlendirilmesi ve tartışılmasıdır.Öğe Genç olgularda retinal ven oklüzyonu: MTHFR ve PAI-1 mutasyonu birlikteliği(2012) Erdurmuş, Mesut; Çelebi, Serdal; Düzenli, Selma Gepdiremen; Çelebi, HarikaBu olgu sunumunda retinal ven oklüzyonu gelişen 3 genç hasta rapor edildi. Ayrıntılı sistemik araştırmalar sonucunda hiçbir olguda bir risk faktörü saptanamadı. Yapılan genetik analizlerde, her 3 olguda da metilentetrahidrofolat redüktaz C677T ve A1298C ile plazminojen aktivatör inhibitör-1 heterozigot gen mutasyonları saptandı. Retinal ven oklüzyonlu genç hastalarda trombofilik risk faktörlerinin varlığı dikkate alınmalıdır.Öğe Glaucoma and antioxidant status(Elsevier Academic Press Inc, 2014) Tosun, Mehmet; Yağcı, Ramazan; Erdurmuş, MesutÖğe Göz içi lens opasifikasyonunu taklit eden geç kapsüler blok sendromu(2013) Çelik, Fatih; Simavlı, Hüseyin; Erdurmuş, Mesut; Kükner, Ahmet ŞahapKapsüler blok sendromu (KBS) katarakt ameliyatının nadir görülen bir komplikasyonudur. Nükleus veya göz içi lensi (GİL) ile ön kapsül açıklığının kapanması sonucu kapsüler kese içerisinde viskoelastik madde, sıvı veya likefiye olmuş madde birikimiyle karakterize bir sendromdur. İntraoperatif, erken postoperatif ve geç postoperatif olmak üzere 3 tip klinik formu vardır. Geç KBS’de GİL arkasında sütsü bir m ateryal birikebilmekte ve tanıda güçlüklere neden olabilme ktedir. Bu olgu sunumunda, komplikasyonsuz fakoemülsifikasyon ve üç parçalı GİL implantasyonu yapılan bir hastada 8 yıl sonra gelişmiş olan GİL opasifikasyonunu taklit ede n bir geç KBS olgusu rapor edilmiştir.Öğe Göz içi lensi yüzeyinde fakik paternde psödoeksfoliyasyon materyal birikimi(2014) Güler, Emre; Tenlik, Aylin; Akyüz, Tuba Kara; Erdurmuş, Mesut; Hepşen, İbrahim FeyziPsödofakik psödoeksfoliasyon, psödoeksfoliasyon materyalinin katarakt ekstraksiyonu sonrası göz içi lens yüzeyinde birikmesidir. Psödoeksfoliasyon materyalinin göz içi lens yüzeyinde birikimi vakaların çoğunda diffüz olmakla birlikte, nadiren üç zondan oluşan fakik gözlerdekine benzer birikim görülebilmektedir. Bu olgu sunumunda, kapsüler kese içine yerleştirilen bir göz içi lens ön yüzeyinde fakik paternde psödoeksfoliasyon materyali birikimi bildirilmiştir. (Turk J Ophthalmol 2014; 44: 156-7)Öğe Inhibitory effects of regorafenib, a multiple tyrosine kinase inhibitor, on corneal neovascularization(Ijo Press, 2014) Önder, Halil İbrahim; Erdurmuş, Mesut; Bucak, Yasin Yücel; Simavlı, Hüseyin; Oktay, Murat; Kükner, Ahmet ŞahapAIM: To evaluate the inhibitory effects of regorafenib (BAY 73 -4506), a multikinase inhibitor, on corneal neovascularization (NV). METHODS: Thirty adult male Sprague -Dawley rats weighing 250-300 g, were used. Corneal NV was induced by NaOH in the left eyes of each rat. Following the establishment of alkali burn, the animals were randomized into five groups according to topical treatment. Group 1 (n= 6) received 0.9% NaCl, Group 2 (n = 6) received dimethyl sulfoxide, Group 3 (n = 6) received regorafenib 1 mg/mL, Group 4 (n=6) received bevacizumab 5 mg/mL and Group 5 (n= 6) received 0.1% dexamethasone phosphate. On the 7d, the corneal surface covered with neovascular vessels was measured on photographs as the percentage of the cornea's total area using computer -imaging analysis. The corneas obtained from rats were semiquantitatively evaluated for caspase 3 and vascular endothelial growth factor by immunostaining. RESULTS: A statistically significant difference in the percent area of corneal NV was found among the groups (P <0.001). Although the Group 5 had the smallest percent area of corneal NV, there was no difference among Groups 3, 4 and 5 (P >0.005). There was a statistically significant difference among the groups in apoptotic cell density (P=0.002). The staining intensity of vascular endothelial growth factor in the epithelial and endothelial layers of cornea was significantly different among the groups (P<0.05). The staining intensity of epithelial and endothelial vascular endothelial growth factor was significantly weaker in Groups 3, 4 and 5 than in Groups 1 and 2. " CONCLUSION: Topical administration of regorafenib 1 mg/mL is partly effective for preventing alkali induced corneal NV in rats.Öğe Inhibitory effects of topical cyclosporine A 0.05 % on immune-mediated corneal neovascularization in rabbits(Springer, 2013) Bucak, Yasin Yücel; Erdurmuş, Mesut; Terzi, Elçin Hakan; Kükner, Aysel; Çelebi, SerdalWe aimed to study the inhibitory effects of topical cyclosporine A (CsA) 0.05 % on immune-mediated corneal neovascularization, and to compare its efficacy with those of dexamethasone 0.1 % and bevacizumab 0.5 %. Immune-mediated corneal neovascularization was created in 36 right eyes of 36 rabbits. The rabbits were then randomized into four groups. Group I received CsA 0.05 %, Group II received dexamethasone 0.1 %, Group III received bevacizumab 0.5 %, and Group IV received isotonic saline twice a day for 14 days. The corneal surface covered with neovascular vessels was measured on the photographs. The rabbits were then sacrificed and the corneas excised. Paraffin-embedded sections were stained with hematoxylin-eosin and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay. The means of percent area of corneal neovascularization in Group I, II, III, and IV were 24.4 %, 5.9 %, 37.1 %, and 44.1 %, respectively. The inhibitory effect of CsA 0.05 % was found to be better than the effect found in the bevacizumab 0.5 % and control groups (p = 0.03 and p = 0.02, respectively). CsA 0.05 % was found to have significantly lesser inhibitory effects on corneal neovascularization than dexamethasone 0.1 % (p < 0.001). Apoptotic cell density was higher in Group III and Group IV than in Group I and Group II. There was no difference between Group I and Group II in terms of apoptotic cell density (p = 0.7). Topical CsA 0.05 % was shown to have an inhibitory effect on immune-mediated corneal neovascularization in rabbits.Öğe Isolated lateral rectus muscle involvement as a presenting sign of euthyroid Graves disease(Mosby-Elsevier, 2011) Erdurmuş, Mesut; Çelebi, Serdal; Özmen, Sedat; Bucak, Yasin Y.A 27-year-old man who presented with diplopia and proptosis and was diagnosed with euthyroid Graves disease and restrictive strabismus. It was determined that his symptoms were caused by isolated lateral rectus muscle involvement. Diplopia resolved and ocular motility improved substantially following 6 weeks of oral corticosteroid therapy.Öğe Isolated lateral rectus muscle involvement as a presenting sign of euthyroid Graves disease reply(Mosby-Elsevier, 2012) Erdurmuş, Mesut; Ulaş, Fatih; Çelebi, SerdalTo the Editor: We thank Dr. Mostofavi and colleagues for their valuable comments on our case report.1 In fact, the authors have already indicated the unusual characteristics of the present case, including euthyroid Graves disease, the absence of eyelid retraction, isolated lateral rectus muscle involvement, unilateral presentation, and exotropia. We do not agree with the authors regarding blepharoptosis. In our opinion, clinical examinations and photographic documentations of the patient did not show eyelid ptosis.Öğe Katarakt cerrahisinde sedasyonun yeri(2013) Önder, Halil İbrahim; Tekelioğlu, Ümit Yaşar; Demirhan, Abdullah; Erdurmuş, MesutTopikal anestezi, saydam kornea kesisinden yapılan fakoemülsifikasyon katarakt cerrahisi için genellikle yeterli ve etkin oküler anestezi sağlamaktadır. Ancak aşırı endişeli, kaygılı ve kooperasyonu güç olan olgularda intraoperatif problemlerle karşılaşma hiç de azımsanmayacak kadar çoktur. Bu olgularda uygulanan oral veya intravenöz sedasyon, bu problemleri büyük oranda ortadan kaldırmaktadır. Bu derlemenin amacı, saydam kornea kesisinden yapılan fakoemülsifikasyon kata rakt cerrahisinde sedasyonun rolü ve olası sedasyon alternatifl e rinin değerlendirilmesidir.Öğe Köstebek tabancası ile oluşan bilateral göz perforasyonu: Olgu sunumu(2014) Ocak, Tarık; Duran, Arif; Erdurmuş, Mesut; Tekelioğlu, Ümit Y.; Maltaş, Mehmet Ş.Göz travmaları, insan hayatını etkileyen ciddi morbiditeye neden olabilir. Travmaya bağlı gelişen perforan göz yaralanmaları ise hemen daima unilateraldir. Bu olgu sunumunda, 63 yaşında erkek hastada ilkel olarak üretilen köstebek tabancası ile oluşan bilateral göz perforasyonu rapor edilmiştir.Öğe Lens içi yabancı cisim ve yönetimi(2012) Soydan, Adem; Bucak, Yasin Yücel; Erdoğan, Selçuk; Doğan, Ümit; Erdurmuş, MesutKırk sekiz yaşında erkek hasta spiral ile metal keserken sol gözüne metal parçası geldiğini fark etmiş. Acil servise başvuran hastanın ilk muayenesinde sol gözde görme keskinliği 20/60 idi. Biomikroskopik muayenede sol kornea nazalinde parasantral alanda perforasyon hattı saptandı. Seidel testi negatif idi. Lens ön kapsülünün delinmiş olduğu ve yabancı cismin lens içine saplandığı görüldü. Arka kapsül intakt olarak izlendi. İlk 24 saatlik izlem sonucu inflamasyonun giderek artması ve lenste kesafet gelişmesi üzerine cerrahi planlandı. Yapılan yabancı cisim çıkarılması, lens aspirasyonu ve göz içi lens implantasyonu sonucu hastanın görmesi postoperatif 4. haftada 20/20 düzeyine ulaştı. Bu olgu sunumunda arka kapsülün sağlam kaldığı metalik lens içi yabancı cisim yaralanması olan hastanın tedavisi rapor edilmiştir.
