Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Sütürsüz İntraskleral Göz İçi Lens Fiksasyonu Takip Sonuçlarımız
Sutureless Intraskleral Intraocular Lens Fixation Follow up Results
İbrahim Ethem AYa, Ahmet Burak BİLGİNb
aAfyonkarahisar Sandıklı Devlet Hastanesi, Göz Hastalıkları Kliniği, Afyon, TÜRKİYE
bAkdeniz Üniversitesi Tıp Fakültesi, Göz Hastalıkları ABD, Antalya, TÜRKİYE
Turkiye Klinikleri J Ophthalmol. 2020;29(4):308-15
doi: 10.5336/ophthal.2019-71916
Article Language: TR
Full Text
ÖZET
Amaç: Bu çalışmada, sütürsüz intraskleral göz içi lens fiksasyonu uygulanan olguların takip sonuçları çeşitli yönleriyle irdelenerek tartışılmaktadır. Gereç ve Yöntemler: Bu retrospektif çalışmaya Mart 2017-Şubat 2018 tarihleri arasında sütürsüz intraskleral göz içi lens fiksasyonu uygulanan 20 hastanın 21 gözü dahil edildi. En iyi düzeltilmiş görme keskinliği, korneal astigmatizma, göz içi lens dislokasyonu, intravitreal hemoraji, göz içi basıncı yüksekliği, kistoid makula ödemi, retina dekolmanı ve endoftalmi gibi postoperatif komplikasyonlar açısından olgular değerlendirildi. Bulgular: En iyi düzeltilmiş görme keskinliği tüm gözlerde artmış olup, ortalama en iyi düzeltilmiş görme keskinliği preoperatif dönemde 1,67±0,18 (3,10-0,22) logMAR iken, postoperatif dönemde 0,47±0,08 (1,60- 0,00) logMAR olarak bulundu (p<0,003). Korneal topografi ölçümleri ile preoperatif korneal astigmatizma değeri ortalama 1,38±0,26 D (0,25-2,75) ve postoperatif korneal astigmatizma değeri ortalama 1,53±0,18 D (0,25-3,50) bulundu (p=0,045). Üç (%14) olguda göz içi lens revizyon cerrahisini gerektiren ve bir (%4) olguda vitreus içi hemoraji nedeniyle vitrektomi cerrahisi gerektiren komplikasyon tespit edildi. Üç (%14) olguda göz içi basıncı artışı ve dört (%19) olguda kistoid maküla ödemi tespit edildi. Postoperatif endoftalmi ve retina dekolmanı gözlenmedi. Sonuç: Sütürsüz skleral göz içi lens implantasyonu cerrahisi konvansiyonel yöntemlerle kıyaslandığında daha az invaziv ve sütüre bağlı komplikasyonların görülmediği bir cerrahi yöntemdir.

Anahtar Kelimeler: Katarakt ekstraksiyonu; afaki; göz içi lens implantasyonu
ABSTRACT
Objective: The aim of this study is to report and discuss clinical results of sutureless intrascleral intraocular lens implantation. Material and Methods: Twenty one eyes of 20 patients who underwent sutureless intrascleral intraocular lens fixation surgery between March 2017 to February 2018 were included in this retrospective study. Best corrected visual acuity, corneal astigmatism and postoperative complications like intravitreal hemorrhage, cystoid macular edema, high intraocular pressure, intraocular lens dislocation, retinal detachment and endophthalmitis were analyzed. Results: The best corrected visual acuity was increased in all eyes. Mean preoperative best corrected visual acuity was logMAR 1.67±0.18 (3.10-0.22) and mean postoperative best corrected visual acuity was logMAR 0.47±0.08 (1.60-0.00) (p<0.003). Preoperative mean corneal astigmatism value was 1.38±0.26 D (0.25-2.75) and mean postoperative corneal astigmatism value was 1.53±0.18 D (0.25-3.50) with corneal topography measurements (p<0.045). Three (14%) patients required intraocular lens revision surgery due to intraocular lens dislocation and 1 (4%) patient had pars plana vitrectomy for intravitreal hemorrhage. We found high intraocular pressure in 3 (14%) cases and cystoid macular edema in 4 (19%) cases. Postoperative endophthalmitis and retinal detachment was not observed. Conclusion: Sutureless scleral intraocular lens implantation is a new surgical method which has comparable results with conventional scleral fixation procedure and it is a less invasive procedure with no complications related to scleral sutures.

Keywords: Cataract extraction; aphakia; intraocular lens implantation
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