Fakoemülsifikasyon sırasında Vitreusa dislpke olan nukleus parçalarında tedavi sonuçları
Küçük Resim Yok
Tarih
2002
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Fakoemülsifikasyon sırasında nukleus parçalarının vitreus boşluğuna disloke olduğu olgularda görsel sonuçları ve komplikasyonları sunmak Gereç ve Yöntem: Fakoemülsifikasyon sırasında nukleus dislokasyonu gelişen, yaşları 55 ile 81 arasında değişen 19 olgunun klinik bilgileri retrospektif olarak incelendi. 12 olguda pars plana vitrektomi (PPV) + lensektomi uygulandı. Nukleusu sert olan dört olguda ise, PPV yi takiben nukleus perflorokarbon kullanımını ile limbal insizyondan ekstrakte edildi. Üç olguda değişik nedenlerden dolayı PPV yapılamadı. Vitrektominin zamanlaması dislokasyon sonrası 1 ila 6 hafta arasında değişmekteydi. İlk cerrahide afak bırakılmış olgulardan yedisine PPV sonrası aynı seansta arka kamaraya intraoküler lens (IOL) implantasyonu yapıldı. Vitrektomi sonrası takip süresi 1 hafta ile 1 yıl arasında değişmekte idi. Bulgular: Olguların PPV öncesi en iyi düzeltilmiş görme keskinlikleri P+ P+ ile 8/10 arasında idi. Sadece dört olgunun görme keskinliği 2/10 ve daha iyi idi. Vitrektomi sonrası en iyi düzeltilmiş görme keskinlikleri P+P+ ile 10/10 arasında iken, 11 olguda en iyi düzeltilmiş görme keskinliği 2/10 ve daha iyi idi. Vitrektomi öncesi dönemde üveit ve/ veya >25mmHg' dan yüksek GİB saptanan olguların tümünde, PPV ile bu komplikasyonlar ortadan kalktı. Takip süresince 3 olguda retina dekolmanı gelişirken, bir olguda kistoid makula ödemi saptandı. Sonuç: Nukleus ve parçalarının vitreusa disloke olması fakoemülsifikasyon cerrahisi sırasında gelişen ciddi bir komplikasyondur. Dislokasyona eşlik eden korneal ödem, koroid dekolmam ve glokom gibi patolojiler ikincil bir cerrahiyi geciktirse de, bu olgularda vitreöretinal cerrahi tekniklerle tatmin edici anatomik ve görsel sonuçlar alınabilmektedir.
Purpose: To present the visual results and complications in patients in whom nuclear fragments were dislocated into the vitreus cavity during phacoemulsification. Methods: The data of 19 cases, ranging in age from 55 to 81 years, in whom nucleus drop was developed during phacoemulsification were retrospectively reviewed. Twelve cases underwent pars plana vitrectomy (PPV) + lensectomy. In four cases in whom nucleus was too hard, nucleus was extracted through the limbal incision with the use of perfluorocarbon liquids after PPV. In three cases, PPV could not have been performed due to various reasons. The timing of vitrectomy ranged from 1 to 6 weeks after nucleus drop had occured. In seven cases who were left aphakic at the first operation, posterior chamber intraocular lens (IOL) was inserted at the same session after PPV. Postvitrectomy follow- up period ranged from 1 week to 1 year. Conclusion: Previtrectomy best- corrected visual acuities ranged from P+ P+ to 8/10. Only four cases had visual acuity of 2/10 or better. Postvitrectomy best- corrected visual acuities ranged from P+ P+ to 10/10, in eleven cases best corrected visual acuity was 2/10 or better, In all cases in whom uveitis or IOP greater than 25mmHg was present in the pievitrectomy period, PPV caused resolving of these complications. In three cases retinal detachment was developed and in one case cystoid macular edema was detected during the follow-up period. Comment: Dislocation of nuclear fragments into the vitreus cavity is a serious complication that develops during phacoemulsification. Although accompanying pathologies, like corneal edema, choroidal detachment and glaucoma, might postpone the secondary surgery, we could still get satisfactory anatomic and visual outcomes with vitreoretinal surgical procedures in these cases. Ret-vit 2001; 10 : 127 -134.
Purpose: To present the visual results and complications in patients in whom nuclear fragments were dislocated into the vitreus cavity during phacoemulsification. Methods: The data of 19 cases, ranging in age from 55 to 81 years, in whom nucleus drop was developed during phacoemulsification were retrospectively reviewed. Twelve cases underwent pars plana vitrectomy (PPV) + lensectomy. In four cases in whom nucleus was too hard, nucleus was extracted through the limbal incision with the use of perfluorocarbon liquids after PPV. In three cases, PPV could not have been performed due to various reasons. The timing of vitrectomy ranged from 1 to 6 weeks after nucleus drop had occured. In seven cases who were left aphakic at the first operation, posterior chamber intraocular lens (IOL) was inserted at the same session after PPV. Postvitrectomy follow- up period ranged from 1 week to 1 year. Conclusion: Previtrectomy best- corrected visual acuities ranged from P+ P+ to 8/10. Only four cases had visual acuity of 2/10 or better. Postvitrectomy best- corrected visual acuities ranged from P+ P+ to 10/10, in eleven cases best corrected visual acuity was 2/10 or better, In all cases in whom uveitis or IOP greater than 25mmHg was present in the pievitrectomy period, PPV caused resolving of these complications. In three cases retinal detachment was developed and in one case cystoid macular edema was detected during the follow-up period. Comment: Dislocation of nuclear fragments into the vitreus cavity is a serious complication that develops during phacoemulsification. Although accompanying pathologies, like corneal edema, choroidal detachment and glaucoma, might postpone the secondary surgery, we could still get satisfactory anatomic and visual outcomes with vitreoretinal surgical procedures in these cases. Ret-vit 2001; 10 : 127 -134.
Açıklama
Anahtar Kelimeler
Göz Hastalıkları
Kaynak
Retina-Vitreus
WoS Q Değeri
Scopus Q Değeri
Cilt
10
Sayı
2
