İris arkasına intraoküler lens implantasyonu sonuçlarımız
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Date
2017
Authors
Erseven, Cansu
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Amaç: Birincil veya ikincil olarak iris arkasına iris kıskaçlı lens (İKL) implantasyonu uygulanan hastaların klinik ve cerrahi sonuçlarının değerlendirilmesi. Gereç ve Yöntem: Çalışmaya Uludağ Üniversitesi Göz Kliniğinde Kasım 2008-Aralık 2015 arasında iris arkasına İKL implantasyonu uygulanan 99 hastanın 101 gözü dahil edildi. Dosyalar geriye dönük olarak incelendi, eksik veri kaydı olan hastalar çalışma dışı bırakıldı. Olguların yaşı, cinsiyeti, ameliyat endikasyonları, travma öyküsü, uygulanan cerrahi işlem, ameliyat öncesi (AÖ) ve sonrası (AS) sferik eşdeğer (SE), en iyi düzeltilmiş görme keskinliği (EİDGK), göz içi basınç (GİB), biyomikroskopik bulguları kaydedildi. 38 hastanın 40 gözünde, 44,6 ay sonra santral kornea kalınlığı (SKK) ve endotel sayısı (ES) ölçümleri değerlendirildi. Sonuçlar: Olguların ortalama yaşı 66,9±19,7; 39'u (%39,4) kadın, 60'ı (%60,6) erkekti. AÖ'ne göre AS 1.ayda SE'de anlamlı düzelme (p=0,007) ve AS 1.hafta ve 1.ayda EİDGK'de anlamlı artış saptandı (p=0,001). 1.ayda tüm gözlerde ve 44,6 ay sonra 40 gözde İKL fikse ve santralizeydi, 9 hastada lokalize iris atrofisi, 2 hastada pigment dispersiyonu mevcuttu. Bu hastaların İKL implantasyonu uygulanan gözünün ES değerleri aynı hastanın fakik (n=21) olan diğer gözleri ile karşılaştırıldığında anlamlı olarak düşük (p=0,003), psödofakik (n=15) olan diğer gözleri ile karşılaştırıldığında daha düşük olmakla birlikte bu farkın anlamlı olmadığı (p=0,520) görüldü. Tartışma: İKL implantasyonu, tecrübeye bağımlı olarak, cerrahi sürenin kısa, komplikasyonların az olması nedeniyle sık tercih edilen güvenli ve etkili bir yöntemdir. Klasik iris önüne implantasyon ile kıyaslandığında iris arkasına implantasyon daha zor olmakla birlikte, lensin daha anatomik yerleşimi nedeniyle ikincil GİL seçiminde ilk tercihimizdir.
Purpose: To evaluate clinical and surgical outcomes of primary and secondary iris-claw lens (ICL) implantation. Materials and Methods: Onehundred and one eyes of 99 patients who underwent ICL implantation in Uludag University Ophthalmology Department between November 2008-December 2015, were included in this retrospective study. Data recorded for each subject consisted of age, gender, surgical indications, trauma history, surgical procedure, preoperative and postoperative spherical equivalent (SE), best corrected visual acuity (BCVA), intraocular pressure (IOP) and biomicroscopy examination findings. Central corneal thickness (CCT) and endothelial cell count (ECC) values were recorded for 40 eyes of 38 patients with followed-up period of 44,6 months. Results: The subjects were %39,4 female, %60,6 male and the mean age was 66,9±19,7 years. With compare to preoperative values, SE at first month was significantly improved (p=0,007); BCVA at first week and first month were significantly increased (p=0,001). Iris-claw lenses were centralized in all eyes at first month and in 40 eyes after 44,6 months; localized iris atrophy was seen in 9 patients and pigment dispersion in 2 patients. Endothelial cell count values in ICL implantated eyes were significantly lower (p=0,003) when compared to the fellow phakic eyes of the same patients (n=21). Although ECC values in ICL implantated eyes were lower than pseudophakic eyes of the same patients (n=15), it was not statistically significant (p=0,520). Conclusion: Iris-claw lens implantation is a safe, effective method that is frequently preferred due to its shorter surgery time and low complication rates. Although retropupillary ICL implantation might be seen as a challenging procedure than anterior chamber ICL implantation, it is our first choice due to its more adequate anatomic positioning.
Purpose: To evaluate clinical and surgical outcomes of primary and secondary iris-claw lens (ICL) implantation. Materials and Methods: Onehundred and one eyes of 99 patients who underwent ICL implantation in Uludag University Ophthalmology Department between November 2008-December 2015, were included in this retrospective study. Data recorded for each subject consisted of age, gender, surgical indications, trauma history, surgical procedure, preoperative and postoperative spherical equivalent (SE), best corrected visual acuity (BCVA), intraocular pressure (IOP) and biomicroscopy examination findings. Central corneal thickness (CCT) and endothelial cell count (ECC) values were recorded for 40 eyes of 38 patients with followed-up period of 44,6 months. Results: The subjects were %39,4 female, %60,6 male and the mean age was 66,9±19,7 years. With compare to preoperative values, SE at first month was significantly improved (p=0,007); BCVA at first week and first month were significantly increased (p=0,001). Iris-claw lenses were centralized in all eyes at first month and in 40 eyes after 44,6 months; localized iris atrophy was seen in 9 patients and pigment dispersion in 2 patients. Endothelial cell count values in ICL implantated eyes were significantly lower (p=0,003) when compared to the fellow phakic eyes of the same patients (n=21). Although ECC values in ICL implantated eyes were lower than pseudophakic eyes of the same patients (n=15), it was not statistically significant (p=0,520). Conclusion: Iris-claw lens implantation is a safe, effective method that is frequently preferred due to its shorter surgery time and low complication rates. Although retropupillary ICL implantation might be seen as a challenging procedure than anterior chamber ICL implantation, it is our first choice due to its more adequate anatomic positioning.
Description
Keywords
İkincil iris kıskaçlı lens, Görme keskinliği, Endotel sayısı, Secondary iris claw lens, Best corrected visual acuity, Endothelial cell count
Citation
Erseven, C. (2017). İris arkasına intraoküler lens implantasyonu sonuçlarımız. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.