Penetran keratoplasti sonrası oküler travma
Küçük Resim Yok
Tarih
2004
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Penetran keratoplastili (PK) gözlerde, kalıcı yara zayıflığı söz konusu olduğundan, ameliyattan yıllar sonra dahi, travma, yara yerinde ayrılmaya neden olabilmektedir. Bu çalışmada, PK yapılmış gözlerin maruz kaldığı travmaların özellikleri ve klinik sonuçları araştırılmıştır. Gereç ve Yöntem: 1995 ve 2003 yılları arasında, oküler travma nedeniyle kliniğimizde ameliyat ettiğimiz, PK yapılmış 7 hastanın 7 gözü çalışmaya dahil edildi. Dosyalar, yaralanma özelliği, görme düzeyleri, cerrahi yöntemler ve klinik sonuçlar yönünden incelendi. Bulgular: PK ile yaralanma arasında geçen süre ortalama 14.1 ay olup, 1.4 ay ile 37.0 ay arasında değişmekteydi. Yara ayrılmalarının tümü greft-alıcı bileşkesinde olup, bir olguda alıcı korneaya da 1 mm kadar uzanan radyal yırtık mevcuttu. Ayrılma genellikle 6±1 saat kadranı boyutunda (7 olgunun 5'inde) olmakla birlikte, bir olguda greft total olarak ayrılmıştı. En sık eşlik eden ön segment bulguları, iris ve vitreus prolapsusudur. Bir olgu irisini tamamen kaybetmiştir (360 derece iridodializ). Dört fakik olgunun üçünde saydam lensin gözden atılmış olması en dikkat çekici ön segment tutulumudur. Koroid dekolmanı ve vitreus içine kanama en sık rastlanan arka segment bulguları olup, bu tutulum hiçbir olguda kalıcı görme azlığına neden olmamıştır. Sonuç: PK sonrası travmatik yara ayrılmaları seyrek değildir. Buna karşın, kalıcı arka segment hasarının nadir oluşu ve greftlerin çoğunda saydamlığın yeniden kazanılması nedeniyle, görsel sonuçlar tatminkardır.
Purpose: the surgical wound after penetrating keratoplasty (PK) is more vulnerable to trauma than the intact cornea. We evaluated the risks and consequences of trauma after PK. Material and Methods: Seven eyes of 7 patients who had been treated in our hospital from 1995 to 2003 for traumatic wound dehiscence after PK were included to the study. Records of patients were reviewed for type of insult, visual acuity, operative methods, and outcome. Results: the interval between PK and trauma ranged from 1.4 month to 37.0 months, with a mean of 14.1 months. Globe rupture occurred at the donor-recipient interface in all of the patients. in one patient the laceration extended to the recipient's cornea 1mm radially. in most of the patients (5 of 7), the extent of the rupture was 6±1 clock hours. However, one patient had complete loss of the corneal button. the most common anterior segment involvements were iris and vitreous prolapse. One patient had complete iris loss (360 degree of iridodialysis). Lens expulsion in 3 of 4 phakic eyes were found as the most striking anterior segment involvement. the most common posterior segment involvements were choroidal detachment and vitreous hemorrhage, which were not responsible from any permanent visual disturbance. Conclusion: Traumatic wound dehiscence is not rare after PK. However, because of the permanent posterior segment damage is rare and most of the graft's clarity could be restored, visual results are satisfactory.
Purpose: the surgical wound after penetrating keratoplasty (PK) is more vulnerable to trauma than the intact cornea. We evaluated the risks and consequences of trauma after PK. Material and Methods: Seven eyes of 7 patients who had been treated in our hospital from 1995 to 2003 for traumatic wound dehiscence after PK were included to the study. Records of patients were reviewed for type of insult, visual acuity, operative methods, and outcome. Results: the interval between PK and trauma ranged from 1.4 month to 37.0 months, with a mean of 14.1 months. Globe rupture occurred at the donor-recipient interface in all of the patients. in one patient the laceration extended to the recipient's cornea 1mm radially. in most of the patients (5 of 7), the extent of the rupture was 6±1 clock hours. However, one patient had complete loss of the corneal button. the most common anterior segment involvements were iris and vitreous prolapse. One patient had complete iris loss (360 degree of iridodialysis). Lens expulsion in 3 of 4 phakic eyes were found as the most striking anterior segment involvement. the most common posterior segment involvements were choroidal detachment and vitreous hemorrhage, which were not responsible from any permanent visual disturbance. Conclusion: Traumatic wound dehiscence is not rare after PK. However, because of the permanent posterior segment damage is rare and most of the graft's clarity could be restored, visual results are satisfactory.
Açıklama
Anahtar Kelimeler
Göz Hastalıkları
Kaynak
MN Oftalmoloji
WoS Q Değeri
Scopus Q Değeri
Cilt
11
Sayı
3
