Göziçi lensi yerleştirilen çocuklarda komplikasyonlar ve görsel sonuçlar
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Date
2011
Authors
Gündüz, Gamze Uçan
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Bu çalışmada katarakt nedeniyle polimetilmetakrilat (PMMA) ve akrilik göziçi lensi (GİL) yerleştirilen çocuklarda görsel sonuçların ve cerrahi sonrası komplikasyonların karşılaştırılması amaçlanmıştır.Uludağ Üniversitesi Tıp Fakültesi Göz Hastalıkları Anabilim Dalı'nda 1994?2010 yılları arasında, iki taraflı doğumsal ya da jüvenil katarakt tanısı alan ve birincil GİL konulan 63 olgunun 117 gözü retrospektif olarak incelendi. Olguların klinik özellikleri, refraksiyon kusurları, cerrahi öncesi ve sonrası görme keskinlikleri ile cerrahi komplikasyonları değerlendirildi.Polimetilmetakrilat GİL yerleştirilen 30 olgunun 58 gözü Grup I, akrilik GİL konulan 33 olgunun 59 gözü Grup II olarak ayrıldı. Olguların cerrahi sırasındaki yaş ortalaması 5,8 yıl (2?12 yıl) idi ve iki grubun yaş ortalaması arasında istatistiksel olarak anlamlı farklılık yoktu. Cerrahi sonrası 6. ayda görme keskinliği 80 gözde (%68,4) 0,5 ve üzerindeydi. Cerrahi sonrası görme keskinlikleri arasında iki grup arasında istatistiksel olarak anlamlı farklılık yoktu. Cerrahiden sonra 6. ayda olguların %51,1'i hipermetrop, %37,6'sı miyop iken, izlem süresi sonunda %32,5'i hipermetrop, %52,1'i miyop hale geldi. Arka sineşi, Grup I'de 7 gözde gelişirken, Grup II'de hiçbir gözde saptanmadı. Grup I'de 28 gözde (%48,3), Grup II'de 16 gözde (%27,1) arka kapsül opasitesi saptandı, bu fark istatistiksel olarak anlamlıydı (p = 0,018). Lens dislokasyonu Grup I'de 3 gözde, Grup II'de 2 gözde meydana geldi. Tüm komplikasyonlar birlikte değerlendirildiğinde, komplikasyon oranı akrilik GİL grubunda PMMA GİL grubundan daha azdı (p = 0,02). Tüm olgular en az 6 ay takip edildi, ortalama izlem süresi 40,5 aydı.Çocuklarda birincil GİL yerleştirilmesi güvenli bir yöntemdir. Akrilik GİL'ler, PMMA GİL'lere kıyasla daha az komplikasyona yol açmaktadır.
In this study, the purpose is to compare the visual results and postoperative complications of polymehtylmethacrylate (PMMA) and acrylic intraocular lenses in children with intraocular lens (IOL) implantation due to pediatric cataract.One hundred and seventeen eyes of 63 children with bilateral congenital or juvenile cataract who underwent primary IOL implantation surgery at Department of Ophthalmology, Uludağ University between 1994?2010 were retrospectively studied. The clinical features, refraction errors, preoperative and postoperative visual acuities and surgical complications were evaluated.The patients were divided into two groups, Group I included 58 eyes of 30 patients with PMMA IOLs, Group II included 59 eyes of 33 patients with acrylic IOLs. Mean age at surgery was 5,8 years (2-12 years) and comparable in the two groups. The visual acuity was 0,5 in 80 eyes (68,4%) at 6 months postoperatively. Postoperative visual acuity was comparable in the two groups. Six months after surgery, 51,1% of all patients were hyperopes while 37,6% were myopes. At the end of the follow up period 32,5% of the patients were hyperopes and 52,1% were myopes. Formation of posterior synechia was noted in none of the eyes in Group II versus 7 eyes in Group I. Posterior capsule opacification was noted in 28 eyes (48,3%) in Group I and 16 (27,1%) eyes in Group II and this difference was statistically significant (p = 0,018). Intraocular lens dislocation occured in 3 eyes in Group I and 2 eyes in Group II. When all complications were considered, there were significantly less complications in the acrylic IOL group than PMMA IOL group (p = 0,020). All patients were followed at least 6 months and mean follow up time was 40,5 months.Pediatric cataract surgery with primary IOL implantation is a safe procedure. Acrylic IOLs may lead to less postoperative complications compared to PMMA IOLs.
In this study, the purpose is to compare the visual results and postoperative complications of polymehtylmethacrylate (PMMA) and acrylic intraocular lenses in children with intraocular lens (IOL) implantation due to pediatric cataract.One hundred and seventeen eyes of 63 children with bilateral congenital or juvenile cataract who underwent primary IOL implantation surgery at Department of Ophthalmology, Uludağ University between 1994?2010 were retrospectively studied. The clinical features, refraction errors, preoperative and postoperative visual acuities and surgical complications were evaluated.The patients were divided into two groups, Group I included 58 eyes of 30 patients with PMMA IOLs, Group II included 59 eyes of 33 patients with acrylic IOLs. Mean age at surgery was 5,8 years (2-12 years) and comparable in the two groups. The visual acuity was 0,5 in 80 eyes (68,4%) at 6 months postoperatively. Postoperative visual acuity was comparable in the two groups. Six months after surgery, 51,1% of all patients were hyperopes while 37,6% were myopes. At the end of the follow up period 32,5% of the patients were hyperopes and 52,1% were myopes. Formation of posterior synechia was noted in none of the eyes in Group II versus 7 eyes in Group I. Posterior capsule opacification was noted in 28 eyes (48,3%) in Group I and 16 (27,1%) eyes in Group II and this difference was statistically significant (p = 0,018). Intraocular lens dislocation occured in 3 eyes in Group I and 2 eyes in Group II. When all complications were considered, there were significantly less complications in the acrylic IOL group than PMMA IOL group (p = 0,020). All patients were followed at least 6 months and mean follow up time was 40,5 months.Pediatric cataract surgery with primary IOL implantation is a safe procedure. Acrylic IOLs may lead to less postoperative complications compared to PMMA IOLs.
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Keywords
Çocukluk çağı kataraktı, Birincil GİL yerleştirilmesi, PMMA GİL, Akrilik GİL, Pediatric cataracts, Primary IOL implantation, PMMA IOL, Acrylic IOL
Citation
Gündüz, G. U. (2011). Göziçi lensi yerleştirilen çocuklarda komplikasyonlar ve görsel sonuçlar. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.