İdiyopatik maküla deliği olan 167 hastanın tedavi sonuçları
Küçük Resim Yok
Tarih
2012
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: İdiyopatik maküla deliği (İMD) nedeniyle ameliyat edilen olgularda anatomik ve görsel sonuçların değerlendirilmesi. Gereç ve Yöntem: İMD nedeni ile ameliyat edilen yaşları 44 ile 79 arasında değişen 167 olgunun klinik bilgileri retrospektif incelendi. Olguların tamamına 23 Gauge (g) transkonjonktival pars plana vitrektomi (PPV) ve iç limitan membran (İLM) soyulması, 72 olguya ek olarak fakoemüsifikasyon ve göz içi lens implantasyonu uygulandı. Takiplerde anatomik ve fonksiyonel başarı ile komplikasyonlar incelendi. Anatomik ve fonksiyonel başarı üzerine etkileri araştırılan faktörler yaş, semptom süresi, ameliyat öncesi görme keskinliği, delik çapı ve evresi, lensin durumu, ameliyat tipi, ameliyatta kullanılan boya ve endotamponad idi. Bulgular: Olguların bulanık görme ve/veya metamorfopsi süresi ortalaması 10.0±5.2 aydı. Yirmiyedi olguda (%16.2) evre 2, seksenaltısında (%51.5) evre 3 ve ellidörtünde (%32.3) evre 4 maküla deliği mevcuttu. Tek bir operasyon sonrasında kapanma oranı 146/167 (%87.4) idi. Ameliyat sonrası 116 gözde (%69.5) görme keskinliğinin arttığı, 47’sinde (%28.1) aynı kaldığı, 4’ünde (%2.4) azaldığı saptandı. Lojistik regresyon analizinde; istatistiksel olarak anlamlı anatomik başarısızlığa yol açan faktörlerin semptom süresi, delik çapı, kullanılan boya olduğu bulunurken (odd oranları sırasıyla; 1.238, 1.014 ve 5.079; tüm p değerleri, <0.05), fonksiyonel başarısızlığa yol açan tek faktörün semptom süresi olduğu saptandı (odd oranı:1.082, p=0.15). Sonuç: Pars plana vitrektomi, İLM soyulması ve intravitreal gaz tamponadının kullanılması İMD tedavisinde başarılı bir cerrahidir, yüz güldürücü anatomik ve görsel sonuçlar sağlayabilmektedir.
Purpose: To evaluate postoperative anatomical and visual results of patients with idiopathic macular hole (IMH). Materials and Methods: in this retrospective study, 167 patients aged between 44-79 years underwent 23 gauge transconjunctival pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling. Phacoemulsification and intraocular lens implantation were performed in 72 cases as additional operations. During the follow-up period, anatomical and functional success and complications were evaluated. Age, symptom duration, preoperative visual acuity, hole diameter and stage, lens status, operation type, paint and internal tamponade used in surgery were the factors, which were evaluated for their effects on anatomical and functional success. Results: the average duration of blurred vision and/or metamorphopsia of cases were 10.0±5.2 months. Twenty-seven (16.2%), eighty-six (51.5%) and fifty-four (32.3%) patients had stage 2, -3, and -4 macular hole, respectively. the closure rate following a single operation was 146/167 (87.4%). Postoperatively visual acuity was increased in 116 eyes (69.5%) while remaining the same in 47 (28.1%) and decreasing in 4 (2.4%) patients. As analyzed by multiple logistic regression model, symptom duration, hole diameter, and used paint were found to be associated with anatomical failure (odds ratios were: 1238, 1014 and 5.079, respectively; all p values, <0.05), symptom duration was detected to be the only factor causing functional failure (odds ratio: 1.082, p=0.15). Conclusion: Pars plana vitrectomy, ILM peeling and the use of intravitreal gas tamponade are standard and successful treatment in IMH surgery and provide satisfactory anatomical and functional results.
Purpose: To evaluate postoperative anatomical and visual results of patients with idiopathic macular hole (IMH). Materials and Methods: in this retrospective study, 167 patients aged between 44-79 years underwent 23 gauge transconjunctival pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling. Phacoemulsification and intraocular lens implantation were performed in 72 cases as additional operations. During the follow-up period, anatomical and functional success and complications were evaluated. Age, symptom duration, preoperative visual acuity, hole diameter and stage, lens status, operation type, paint and internal tamponade used in surgery were the factors, which were evaluated for their effects on anatomical and functional success. Results: the average duration of blurred vision and/or metamorphopsia of cases were 10.0±5.2 months. Twenty-seven (16.2%), eighty-six (51.5%) and fifty-four (32.3%) patients had stage 2, -3, and -4 macular hole, respectively. the closure rate following a single operation was 146/167 (87.4%). Postoperatively visual acuity was increased in 116 eyes (69.5%) while remaining the same in 47 (28.1%) and decreasing in 4 (2.4%) patients. As analyzed by multiple logistic regression model, symptom duration, hole diameter, and used paint were found to be associated with anatomical failure (odds ratios were: 1238, 1014 and 5.079, respectively; all p values, <0.05), symptom duration was detected to be the only factor causing functional failure (odds ratio: 1.082, p=0.15). Conclusion: Pars plana vitrectomy, ILM peeling and the use of intravitreal gas tamponade are standard and successful treatment in IMH surgery and provide satisfactory anatomical and functional results.
Açıklama
Anahtar Kelimeler
Göz Hastalıkları
Kaynak
Retina-Vitreus
WoS Q Değeri
Scopus Q Değeri
Cilt
20
Sayı
3
