Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Cilt Yoluyla Levator Rezeksiyonu Yapılan Hastalarda Kuru Göz Parametrelerinin ve Meibomian Bez Morfolojisinin Değerlendirilmesi
Evaluation of Dry Eye Parameters and Meibomian Gland Morphology in Patients Who Underwent Transcutaneous Levator Resection
Rüveyde BOLAÇ UNCULUa, Hatice Elvin YILDIZb, Didem SERİNb, Ece TURAN VURALb, İbrahim Bülent BUTTANRIb
aGöz Hastalıkları Kliniği, Niğde Ömer Halisdemir Üniversitesi Eğitim ve Araştırma Hastanesi, Niğde
bGöz Hastalıkları Kliniği, Sağlık Bilimleri Üniversitesi Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, İstanbul
Turkiye Klinikleri J Ophthalmol. 2018;27(4):255-9
doi: 10.5336/ophthal.2017-58367
Article Language: TR
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Amaç: Cilt yoluyla levator rezeksiyonu yapılan hastalarda, kuru göz parametreleri ve meibomian bez morfolojisini değerlendirmek. Gereç ve Yöntemler: Ocak 2015-Mart 2015 tarihleri arasında, Sağlık Bilimleri Üniversitesi Haydarpaşa Numune Eğitim ve Araştırma Hastanesi Göz Kliniği'nde aponevrotik pitoz nedeni ile cilt yoluyla levator rezeksiyonu yapılan 11 hastanın 21 gözü prospektif olarak çalışmaya alındı. On sekiz yaşından küçük hastalar, aponevrotik pitoz dışındaki hastalar ile geçirilmiş göz kapağı cerrahisi ya da travması olanlar çalışmaya alınmadı. Rutin oftalmolojik muayenenin yanı sıra preoperatif ve postoperatif 1.ayda Schirmer 1 testi, gözyaşı kırılma zamanı (GKZ) ölçümü ve meibografi (Sirius CSO korneal topografi) yapıldı. Bulgular: On bir hastanın 7 (%64)'si erkek idi. Yaş ortalaması 56,10±8,03 yıl idi. Preoperatif ortalama Schirmer 1 testi 18,76±4,69 mm iken postoperatif 1. ayda 15,90±4,07 mm ölçüldü. Preoperatif ortalama GKZ 5,57±1,89 saniye iken postoperatif 1. ayda 7,05±2,20 saniye olarak değerlendirildi. Preoperatif üst kapak meibografide ortalama alan kaybı %33,75±8,43 iken, postoperatif 1.ayda %34±9,67 hesaplandı. Preoperatif alt kapak meibografide ortalama alan kaybı %22,05±5,05 iken, postoperatif 1. ayda %21,94±6,57 hesaplandı. Sonuç: Cilt yoluyla levator rezeksiyonu yapılan olgularda postoperatif erken dönemde Schirmer 1 testinde anlamlı kısalma izlendi. GKZ hem preoperatif dönemde hem de postoperatif 1.ayda <10 saniye saptandı. Üst ve alt göz kapağında meibomian bez alan kaybında anlamlı değişiklik izlenmedi. Çalışmamız; cilt yoluyla levator rezeksiyonunun meibomian bez morfolojisini etkilemeden erken dönemde kuru göze neden olabileceğini göstermiştir.

Anahtar Kelimeler: Blefaropitozis; kuru göz sendromları; meibomian bezler
ABSTRACT
Objective: To evaluate dry eye parameters and meibomian gland morphology in patients who underwent transcutaneus levator resection. Material and Methods: Twenty one eyes of 11 patients who underwent transcutaneus levator resection between January 2015-March 2015 at Haydarpasa Numune Training and Research Hospital Ophthalmology Clinic were included in this prospective study. Patients younger than 18 years old, except for aponeurotic ptosis, past eyelid surgery or trauma cases were not included. In addition to routine ophthalmologic examination, Schirmer 1 test, tear break up time (TBUT) and meibography (Sirius CSO corneal topography) was performed preoperatively and postoperative 1th month. Results: Seven of the 11 patients were male (64%). Mean age was 56.10±8,03. Preoperative mean Schirmer 1 test was 18,76 ± 4,69 mm and postoperative 1th month was 15,90±4,07 mm. Preoperative mean TBUT was 5,57±1,89 sec and postoperative 1th month was 7.05±2.20 sec. The preoperative mean area loss in the upper eyelid meibography was 33.75±8.43%, whereas in the postoperative 1th month 34±9.67%. The preoperative mean area loss in the lower eyelid meibography was 22,05±5,05%, whereas in the postoperative 1th month 21,94±6,57%. Conclusion: Schirmer 1 test results were significantly lower at postoperative 1th month after transcutaneus levator resection. TBUT was <10 sec in both preoperative and postoperative 1th month. No significant changes was observed in the upper and lower eyelid meibomian gland area loss. Our study indicate that transcutaneus levator resection may cause dry eye without affecting meibomian gland morphology in the early postoperative period.

Keywords: Blepharoptosis; dry eye syndromes; meibomian glands

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