Konjenital kataraktta konservatif olarak izlenen ve cerrahi uygulanan olgular
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Date
2018
Authors
Çalışkan, Enver
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Amaç: Konjenital kataraktta konservatif olarak izlenen olguların görsel ve anatomik sonuçlarını cerrahi yapılanlar ile karşılaştırarak değerlendirmek. Gereç ve Yöntem: Ocak 1990 - Aralık 2017 tarihleri arasında birimimize başvurmuş, konjenital katarakt tanısı almış, konservatif izlenen veya ameliyat edilen, 95 hastanın 154 gözü retrospektif olarak incelendi. Olgular izlem (Grup 1) ve cerrahi uygulanan (Grup 2) olmak üzere iki gruba ayrılarak kataraktın morfolojisi, tanı yaşı, cerrahi yaşı, ek patolojiler, görsel sonuçlar ile komplikasyonlar açısından değerlendirildi. İstatistiksel analiz için SPSS 21 programı kullanıldı. Bulgular: Toplam 95 olgunun 46'sı erkek (%48,4), 49'u kız (%51,6) idi. 40 hastanın 58 (%37,6) gözü izlem grubunda (Grup 1) iken, 55 hastanın 96 (%62,3) gözüne cerrahi uygulanmıştı (Grup 2). Takip süresi grup 1'de ortalama 6-68 ay (ort 29±22); grup 2'de (Grup 2) 6-204 aydı (ort 57±44). Grup 1'de 22 unilateral, 36 bilateral; grup 2'de 11 unilateral, 85 bilateral olgu yer almaktaydı. İzlem grubunda unilateralite istatiksel anlamlı derecede yüksek bulundu. Morfolojik olarak iki grupta da en sık zonuler katarakt görüldü. Son kontroldeki en iyi düzeltilmiş görme keskinlikleri (EİDGK) değerlendirildiğinde Grup 1'de 0,26 logMAR; Grup 2'de 0,43 logMAR olduğu görüldü. Unilateral olgularda EİDGK Grup 1'de 0,36±0,24 logMAR; Grup 2'de 0,90±0,49 logMAR; bilateral olgularda EİDGK ise grup 1'de 0,21±0,15; grup 2'de 0,44±0,41 logMAR olduğu görüldü. Morfolojiye göre; grup 1'de zonuler kataraktlarda 0,31±0,13 logMAR; polar kataraktlarda 0,25±0,22 logMAR; Grup 2'de zonuler kataraktlarda 0,34±0,30 logMAR; ön ve arka polar kataraktlarda 0,53±0,47 logMAR, total kataraktlarda 0,52±0,43 logMAR sonuçlarına ulaşıldı. Sonuç: Retina reflesi rahatlıkla izlenebilen, total nitelikte olmayan, ambliyopi bulguları mevcut olmayan konjenital katarakt olgularında konservatif takip; cerrahi tedavinin olumsuz sonuçlarından koruyarak daha iyi bir görme düzeyi sağlayabilir.
We evaluated the results of clinical monitoring of patients with congenital cataract without surgical indication compared applied surgery patients. Between January 1990 and December 2017, 154 eyes of 95 patients who were diagnosed as congenital cataract and were monitored conservatively or underwent surgical indication were retrospectively analyzed. The cases were divided into two groups as follow-up (Group 1) and surgery (Group 2) and were evaluated in terms of morphology of cataract, age of diagnosis, age of surgery, surgical technique applied, additional pathologies, visual results and complications. SPSS 21 program was used for statistical analysis. 46 were male (48.4%) and 49 were female (51.6%) of total 95 patients. While 58 (37.6%) eyes of 40 patients were in the non-surgical follow-up group (Group 1), 96 (62.3%) eyes of 55 patients underwent surgery (Group 2). The mean follow-up period was 6-68 months (mean 29 ± 22 months) in the non-operative group (Group 1); In the surgical group (Group 2) the follow-up period was 6-204 months (mean 57 ± 44 months). In group 1; there were 22 unilateral, 36 bilateral cases; on the other hand there were 11 unilateral and 85 bilateral cases in the group 2. Unilaterality was significantly higher in the patients who were followed-up. Cases were analyzed for morphology, in each group zonular cataracts were most. When we look at the cataract placement, group 1 had more than 2 optic axes. When the final visual acuities were evaluated; group 1 result 0.26 logMAR; Group 2 performed 0.43 logMAR was seen. The final visual acuity was evaluated and compared according to the laterality and morphology. The best-corrected visual acuity of unilateral patients in the final follow-up was in Group 1. 0.36 ± 0.24 logMAR; In Group 2, 0,90 ± 0,49 logMAR; The best-corrected visual acuity in the final follow-up of bilateral cases was 0.21 ± 0.15 in Group 1; In Group 2, it was found to be 0.44 ± 0.41 logMAR. According to morphology, in Group 1, the best corrected visual acuity was 0.31 ± 0.13 logMAR in zonular cataracts; 0.25 ± 0.22 logMAR in anterior and posterior polar cataract; on the other hand in group 2 0.34 ± 0.30 logMAR in zonular cataracts, 0.53 ± 0.47 logMAR in polar cataracts and 0.52 ± 0.43 logMAR in total cataracts were achieved. Deciding on cases with congenital cataract; retinal reflex easily observed, in the non-total morphological characteristics, without amblyopia clinic, can achieve better visual results than surgery.
We evaluated the results of clinical monitoring of patients with congenital cataract without surgical indication compared applied surgery patients. Between January 1990 and December 2017, 154 eyes of 95 patients who were diagnosed as congenital cataract and were monitored conservatively or underwent surgical indication were retrospectively analyzed. The cases were divided into two groups as follow-up (Group 1) and surgery (Group 2) and were evaluated in terms of morphology of cataract, age of diagnosis, age of surgery, surgical technique applied, additional pathologies, visual results and complications. SPSS 21 program was used for statistical analysis. 46 were male (48.4%) and 49 were female (51.6%) of total 95 patients. While 58 (37.6%) eyes of 40 patients were in the non-surgical follow-up group (Group 1), 96 (62.3%) eyes of 55 patients underwent surgery (Group 2). The mean follow-up period was 6-68 months (mean 29 ± 22 months) in the non-operative group (Group 1); In the surgical group (Group 2) the follow-up period was 6-204 months (mean 57 ± 44 months). In group 1; there were 22 unilateral, 36 bilateral cases; on the other hand there were 11 unilateral and 85 bilateral cases in the group 2. Unilaterality was significantly higher in the patients who were followed-up. Cases were analyzed for morphology, in each group zonular cataracts were most. When we look at the cataract placement, group 1 had more than 2 optic axes. When the final visual acuities were evaluated; group 1 result 0.26 logMAR; Group 2 performed 0.43 logMAR was seen. The final visual acuity was evaluated and compared according to the laterality and morphology. The best-corrected visual acuity of unilateral patients in the final follow-up was in Group 1. 0.36 ± 0.24 logMAR; In Group 2, 0,90 ± 0,49 logMAR; The best-corrected visual acuity in the final follow-up of bilateral cases was 0.21 ± 0.15 in Group 1; In Group 2, it was found to be 0.44 ± 0.41 logMAR. According to morphology, in Group 1, the best corrected visual acuity was 0.31 ± 0.13 logMAR in zonular cataracts; 0.25 ± 0.22 logMAR in anterior and posterior polar cataract; on the other hand in group 2 0.34 ± 0.30 logMAR in zonular cataracts, 0.53 ± 0.47 logMAR in polar cataracts and 0.52 ± 0.43 logMAR in total cataracts were achieved. Deciding on cases with congenital cataract; retinal reflex easily observed, in the non-total morphological characteristics, without amblyopia clinic, can achieve better visual results than surgery.
Description
Keywords
Pediyatrik katarakt, Afaki rehabilitasyonu, Görme keskinliği, Deprivasyon ambliyopisi, Pediatric cataract, Aphakic rehabilitation, Visual acuity, Deprivation ambliyopia
Citation
Çalışkan, E. (2018). Konjenital kataraktta konservatif olarak izlenen ve cerrahi uygulanan olgular. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.