Arka segment yerleşimli göziçi yabancı cisimlerinde pars plana vitrektomi: Erken sonuçlarımız
Küçük Resim Yok
Tarih
2003
Yazarlar
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Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Perforan göz yaralanması sonucu arka segmentte yerleşen göziçi yabancı cisim (GİYC) sebebiyle pars plana vitrektomi ve yabancı cisim ekstraksiyonu uygulanan hastalarda anatomik ve görsel sonuçların değerlendirilmesi. Gereç ve Yöntem: Kasım 2000- Mayıs 2002 tarihleri arasında kliniğimize perforan yaralanma+ GİYC sebebiyle başvuran 17 hastanın 17 gözüne, pars plana vitrektomi (PPV)+ yabancı cisim ekstraksiyonu uygulandı. Yabancı cisim ekstraksiyonunda, yabancı cismin yapısına ve büyüklüğüne göre yabancı cisim forsepsi, standart miroforseps, internal elektromagnet veya GİYC ekstraksiyonu için tasarlanmış ve intravenöz kanül ve prolen sutürden oluşturulan kement aleti kullanıldı. Hastaların 4'üne ilk cerrahi olarak primer sutürasyon, ikinci cerrahi olarak PPV+ GİYC ekstraksiyonu uygulanırken (%23), 13'üne tüm müdaheleler ilk cerrahide yapıldı (%77). Onbir hastada endotanıponad olarak silikon yağı (%64), 4 hastada C3F8 kullanılırken (%24), 2 hastada endotamponad kullanılmadı (%11). Uygulanan cerrahinin erken anatomik ve görsel sonuçları retrospektif olarak değerlendirildi. Bulgular: Onaltısı erkek, l'i kadın toplam 17 hastanın yaşları 11 ile 49 arasında değişmekteydi (ort. 26.7±13.5). Travma ile yabancı cisim ekstraksiyonuna kadar geçen süre l gün ile 20 gün arasında değişmekteydi (ort. 6.7gün±7.1). Postoperatif dönemde hastalar 3 ile 18 ay arasında takip edildiler (ort. 8.7ay±4.8). Takip süresi boyunca, 12 hastada retina yatışık seyrederken (%71), 3 hastada kısmi (%18), 2 hastada ise total retina dekolmanı geliştiği görüldü (%11). Ameliyat öncesi görme keskinlikleri, P(+)-P(+) ile 0.7 arasında değişmekteydi. Ameliyat sonrasında görme keskinlikleri P(+)-P(+) ile 0.7 arasında değişirken, 10 hastada 0.1 ve üzeri (%59), 2 hastada ise 0.5 ve üzeri görme keskinliği elde edildi (%11). Hiçbir hastada postoperatif endof-talmi gelişimi izlenmedi. Sonuç: Her ne kadar perforan yaralanma sonucu arka segmentte yerleşen göziçi yabancı cisimlerinde prognoz ciddiyetini korusa da, özellikle son 20 yılda vitreoretinal cerrahi tekniklerin gelişmesi, özellikle yabancı cismin yapısına ve büyüklüğüne uygun farklı cerrahi aletlerin kullanılması ile, anatomik başarının yanısıra, büyük ölçüde görsel başarının da kazanılması sağlanabilmektedir.
Aim: To evaluate anatomic and functional outcomes of pars plana vitrectomy and intraocular foreign body (IOFB) removal in patients presenting with openglobe injuries due to lacerations by retained IOFB s. Methods: Pars plana vitrectomy and foreign body extraction was performed in 17 eyes of 17 patients presenting with openglobe injury with intraocular foreign body between November 2000 and May 2002. According to the nature and the size of the IOFB, foreign body forceps, standart micfoforceps, internal electromagnet, or a snare instrument made by an angiocath and a prolene suture which is designed for IOFB extraction was used for the extraction. In 4 patients, IOFB was removed in a second operation after the closure of the lacerations (23%), all the interventions were performed in one step in 13 patients (77%). As an intraocular endotamponade, silicone oil was used in ll patients (64%), C3F8 in 4 patients (24%) and no tamponade was used in 2 patients (11%). Early anatomic and functional outcomes of the surgery was evaluated retrospectively. Results: All patients but one were male with an average age of 26.7±13.5 (ranged between 11 and 49 years). Time between trauma and foreign body extraction ranged between 1 and 20 days (average 6.7±7.1 day). Mean follow-up time was 8.7months±4.8 (ranged between 3 and 18 months. During the follow-up, retina was attached in 12 patients (71%), partial retinal detach-ment was seen in 3 patients (18%) and total retinal detachment in 2 patients (11%). Preoperative visual acuities (VA) were between P(+)-P(+) and 0.7. Postoperative VA were also between P(+)-P(+) and 0.7 and VA>0.1 was achieved in lOpatients (59%), >0.5 was achieved in 2 patients (11%). No endophthalmitis was seen during the follow-up. Conclusion: Although the prognosis is still not good in patients presenting with open-globe injuries due to lacerations by retained lOFBs, the development in vitreoretinal surgical techniques, especially by using proper instruments according to the nature and the size of the IOFB, enables to achieve a reasonable functional success besides the anatomic succes.
Aim: To evaluate anatomic and functional outcomes of pars plana vitrectomy and intraocular foreign body (IOFB) removal in patients presenting with openglobe injuries due to lacerations by retained IOFB s. Methods: Pars plana vitrectomy and foreign body extraction was performed in 17 eyes of 17 patients presenting with openglobe injury with intraocular foreign body between November 2000 and May 2002. According to the nature and the size of the IOFB, foreign body forceps, standart micfoforceps, internal electromagnet, or a snare instrument made by an angiocath and a prolene suture which is designed for IOFB extraction was used for the extraction. In 4 patients, IOFB was removed in a second operation after the closure of the lacerations (23%), all the interventions were performed in one step in 13 patients (77%). As an intraocular endotamponade, silicone oil was used in ll patients (64%), C3F8 in 4 patients (24%) and no tamponade was used in 2 patients (11%). Early anatomic and functional outcomes of the surgery was evaluated retrospectively. Results: All patients but one were male with an average age of 26.7±13.5 (ranged between 11 and 49 years). Time between trauma and foreign body extraction ranged between 1 and 20 days (average 6.7±7.1 day). Mean follow-up time was 8.7months±4.8 (ranged between 3 and 18 months. During the follow-up, retina was attached in 12 patients (71%), partial retinal detach-ment was seen in 3 patients (18%) and total retinal detachment in 2 patients (11%). Preoperative visual acuities (VA) were between P(+)-P(+) and 0.7. Postoperative VA were also between P(+)-P(+) and 0.7 and VA>0.1 was achieved in lOpatients (59%), >0.5 was achieved in 2 patients (11%). No endophthalmitis was seen during the follow-up. Conclusion: Although the prognosis is still not good in patients presenting with open-globe injuries due to lacerations by retained lOFBs, the development in vitreoretinal surgical techniques, especially by using proper instruments according to the nature and the size of the IOFB, enables to achieve a reasonable functional success besides the anatomic succes.
Açıklama
Anahtar Kelimeler
Göz Hastalıkları
Kaynak
Türk Oftalmoloji Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
33
Sayı
4
