Skleral fiksasyonlu göz içi lens implantasyonunda uygulanan iki farklı cerrahi tekniğin anatomik ve fonksiyonel sonuçlarının karşılaştırılması
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Tekirdağ Namık Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Sütürlü veya sütürsüz teknikle skleral fiksasyonlu göz içi lens implantasyonu uygulanmış hastaların; preoperatif görme keskinlikleri, afaki nedenleri, postoperatif görme keskinliği, postoperatif refraktif sonuçlar, postoperatif komplikasyonlar ve göz içi lens pozisyonları değerlendirildi ve iki yöntemin birbirine anatomik ve fonksiyonel sonuçlar açısından üstünlüklerinin karşılaştırılması amaçlandı. Metod: Şubat 2018 ve Kasım 2022 tarihleri arasında skleral fiksasyonlu göz içi lens implantasyonu cerrahisi uygulanan hastaların postoperatif 6 aylık dönemdeki izlem sürecine dair verileri retrospektif olarak değerlendirildi. Hastalar sütürlü skleral fiksasyon cerrahisi uygulanan ve Yamane tekniği uygulanan grup olmak üzere iki gruba ayrıldı. Hastalar, demografik özellikleri, afak kalma nedenleri, revizyon gereksinimi, postoperatif en iyi düzeltilmiş görme keskinliği, refraktif sonuçlar, göz içi lens pozisyonu ve tilt derecesi ile postoperatif komplikasyonlar açısından değerlendirildi ve iki grup karşılaştırıldı. Bulgular: Her iki grupta da skleral fiksasyon cerrahisi endikasyonu olarak en sık neden komplike fakoemülsifikasyon cerrahisi olarak tespit edildi. Her iki hasta grubunda da preoperatif görme keskinliği ile kıyaslandığında postoperatif 30, 90 ve 180. günlerde belirgin görme keskinliği artışı izlendi (p<0,0001). Sütürlü cerrahi uygulanan grupta 2 hastada, Yamane tekniği uygulanan grupta 4 hastada kistoid makula ödemi saptandı. Sütürlü cerrahi uygulanan grupta ön segment komplikasyonları gelişirken; Yamane tekniği uygulanan grupta gözlenmedi. Sütürlü cerrahi uygulanan grupta göz içi lensin superior-temporale desantralize olduğu izlenirken; Yamane tekniği uygulanan grupta superior-nazale desantralize olduğu saptandı. Horizontal düzlemde Yamane tekniği uygulanan grupta daha yüksek tilt oranı izlendi (p=0,025). Tilt açısı ile en iyi düzeltilmiş görme keskinliği ve postoperatif silendirik değer arasında korelasyon saptanmadı. Sütürsüz cerrahide skleral flep hazırlanmasına gerek olmaması, sütür ilişkili komplikasyonların olmaması, bu yöntemin avantajlarıdır. Anahtar Kelimeler: Komplike katarakt cerrahisi, afaki, skleral fiksasyonlu göz içi lens implantasyonu, göz içi lens desantralizasyonu, kistoid makula ödemi
Purpose: Patients who underwent scleral fixation intraocular lens implantation with or without suture technique; preoperative visual acuities, causes of aphakia, postoperative visual acuity, postoperative refractive results, postoperative complications and intraocular lens positions were evaluated and it was aimed to compare the superiority of the two methods to each other in terms of anatomical and functional results. Methods: The postoperative 6-month follow-up data of patients who underwent scleral fixation intraocular lens implantation surgery between February 2018 and November 2022 were evaluated retrospectively. The patients were divided into two groups as sutured scleral fixation surgery group and Yamane technique group. The patients were evaluated in terms of demographic characteristics, causes of aphakia, need for revision, postoperative best-corrected visual acuity, refractive results, intraocular lens position and tilt grade, and postoperative complications, and the two groups were compared. Results: Complicated phacoemulsification surgery was the most common reason for scleral fixation surgery indication in both groups. When compared with preoperative visual acuity in both patient groups, significant visual acuity improvement was observed on postoperative 30th, 90th and 180th days (p<0,0001). Cystoid macular edema was detected in 2 patients in the sutured surgery group and in 4 patients in the Yamane technique group. While anterior segment complications developed in the sutured surgery group; it was not observed in the Yamane technique group. In the sutured surgery group, it was observed that the intraocular lens was decentralized to the superior-temporal; superior-nasal decentralization was detected in the Yamane technique group. A higher tilt rate was observed in the group in which Yamane technique was applied in the horizontal plane (p=0,025). There was no correlation between tilt angle and best corrected visual acuity and postoperative cylindrical value. The advantages of this method are that there is no need for scleral flap preparation and no suture-related complications in sutureless surgery. Key words: Complicated cataract surgery, aphakia, intraocular lens implantation with scleral fixation, intraocular lens decentralization, cystoid macular edema
Purpose: Patients who underwent scleral fixation intraocular lens implantation with or without suture technique; preoperative visual acuities, causes of aphakia, postoperative visual acuity, postoperative refractive results, postoperative complications and intraocular lens positions were evaluated and it was aimed to compare the superiority of the two methods to each other in terms of anatomical and functional results. Methods: The postoperative 6-month follow-up data of patients who underwent scleral fixation intraocular lens implantation surgery between February 2018 and November 2022 were evaluated retrospectively. The patients were divided into two groups as sutured scleral fixation surgery group and Yamane technique group. The patients were evaluated in terms of demographic characteristics, causes of aphakia, need for revision, postoperative best-corrected visual acuity, refractive results, intraocular lens position and tilt grade, and postoperative complications, and the two groups were compared. Results: Complicated phacoemulsification surgery was the most common reason for scleral fixation surgery indication in both groups. When compared with preoperative visual acuity in both patient groups, significant visual acuity improvement was observed on postoperative 30th, 90th and 180th days (p<0,0001). Cystoid macular edema was detected in 2 patients in the sutured surgery group and in 4 patients in the Yamane technique group. While anterior segment complications developed in the sutured surgery group; it was not observed in the Yamane technique group. In the sutured surgery group, it was observed that the intraocular lens was decentralized to the superior-temporal; superior-nasal decentralization was detected in the Yamane technique group. A higher tilt rate was observed in the group in which Yamane technique was applied in the horizontal plane (p=0,025). There was no correlation between tilt angle and best corrected visual acuity and postoperative cylindrical value. The advantages of this method are that there is no need for scleral flap preparation and no suture-related complications in sutureless surgery. Key words: Complicated cataract surgery, aphakia, intraocular lens implantation with scleral fixation, intraocular lens decentralization, cystoid macular edema
Açıklama
Tıp Fakültesi, Göz Hastalıkları Ana Bilim Dalı
Anahtar Kelimeler
Göz Hastalıkları, Eye Diseases
