Penetran keratoplasti sonrası gelişen yüksek astigmatizmanın düzeltilmesinde wedge rezeksiyon
Küçük Resim Yok
Tarih
2007
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info:eu-repo/semantics/openAccess
Özet
Amaç: Penetran keratoplasti sonrası yüksek astigmatizmanın düzeltilmesinde wedge rezeksiyon yönteminin etkinliğini ve güvenirliliğini araştırmak. Gereç ve Yöntem: Penetran keratoplasti sütürleri alındıktan sonra korneadaki astigmatizması 6 dioptri ve üzerinde olan, bu nedenle wedge rezeksiyon yapılan saydam korneal greftlere sahip 24 hastanın 24 gözü çalışmaya alındı. Penetran keratoplastiden wedge rezeksiyona kadar geçen ortalama süre 23.7±14.5 aydı. Wedge rezeksiyon sonrası 1. ayda ve son kontrolde net ve vektöryel astigmatik değişimler, düzeltilmemiş ve düzeltilmiş görme keskinliği incelendi. Bulgular: Olgular en az 6 ay ve en fazla 32 ay olmak üzere ortalama 17.7±7.9 ay süre ile izlendi. Ameliyat öncesi ortalama 9.5±2.4 dioptri olan keratometrik astigmatizma, wedge rezeksiyon sonrası 1. ayda ortalama 3.9±2.0 dioptri ve son kontrolde 3.0±1.3 dioptri olarak bulundu. Girişim sonrası indüklenen vektöryel astigmatizma 1. ayda 10.6±4.8 dioptri ve son kontrolde 7.8±2.8 dioptri idi. Düzeltilmemiş görme keskinliği ameliyat öncesinde ortalama 1.17±0.23 logMAR iken wedge rezeksiyon sonrası 1. ayda 0.80±0.31 logMAR ve son kontrolde 0.74±0.30 logMAR idi. Düzeltilmiş görme keskinliği ameliyat öncesinde ortalama 0.35±0.15 logMAR iken ameliyat sonrası 1. ayda 0.26±0.20 logMAR ve son kontrolde 0.21±0.15 logMAR idi. Takip sırasında 2 olguda tedavi ile düzelen greft reddi izlendi. Sonuç: Penetran keratoplasti sonrası yüksek astigmatizmanın düzeltilmesinde wedge rezeksiyonun etkili ve güvenli bir yöntem olduğu gözlenmiştir. Ancak cerrahi sonrası görsel düzelme için belirli bir süreye ihtiyaç vardır.
Purpose: To evaluate the efficacy and safety of wedge resection in the treatment of high astigmatism following penetrating keratoplasty (PK). Material and Methods: Twenty four eyes of 24 clear grafted patients who underwent corneal wedge resection for residual high astigmatism of 6.00 diopters (D) or greater after PK suture removal were included in this study. The average time interval between PK and wedge resection was 23.7±14.5 months. Absolute and vectorial reductions in astigmatism, uncorrected and best corrected visual acuities were measured at first month and at the last control visit after wedge resection. Results: The patients were followed 6 to 32 months and the mean follow-up time was 17.7±7.9 month. The mean preoperative keratometric astigmatism was 9.5±2.4 D. After wedge resection, the mean keratometric astigmatism was 3.9±2.0 D at first month and 3.0±1.3 D in the last control visit. Induced vectorial astigmatism following the procedure was 10.6±4.8 D at first month and 7.8 D±2.8 in the last control visit. Mean preoperative uncorrected visual acuity was 1.17±0.23 logMAR, while it was 0.80±0.31 logMAR at the first month and 0.74±0.30 logMAR in the last visit. Mean preoperative best corrected visual acuity was 0.35±0.15 logMAR, while it was 0.26±0.20 logMAR at first month and 0.21±0.15 logMAR in the last visit. During the follow-up, in 2 cases a graft rejection attack that was treated succesfully has occured. Conclusion: Corneal wedge resection is safe and effective procedure for residual high astigmatism after penetrating keratoplasty. However, a determined time is necessary after surgery for visual improvement.
Purpose: To evaluate the efficacy and safety of wedge resection in the treatment of high astigmatism following penetrating keratoplasty (PK). Material and Methods: Twenty four eyes of 24 clear grafted patients who underwent corneal wedge resection for residual high astigmatism of 6.00 diopters (D) or greater after PK suture removal were included in this study. The average time interval between PK and wedge resection was 23.7±14.5 months. Absolute and vectorial reductions in astigmatism, uncorrected and best corrected visual acuities were measured at first month and at the last control visit after wedge resection. Results: The patients were followed 6 to 32 months and the mean follow-up time was 17.7±7.9 month. The mean preoperative keratometric astigmatism was 9.5±2.4 D. After wedge resection, the mean keratometric astigmatism was 3.9±2.0 D at first month and 3.0±1.3 D in the last control visit. Induced vectorial astigmatism following the procedure was 10.6±4.8 D at first month and 7.8 D±2.8 in the last control visit. Mean preoperative uncorrected visual acuity was 1.17±0.23 logMAR, while it was 0.80±0.31 logMAR at the first month and 0.74±0.30 logMAR in the last visit. Mean preoperative best corrected visual acuity was 0.35±0.15 logMAR, while it was 0.26±0.20 logMAR at first month and 0.21±0.15 logMAR in the last visit. During the follow-up, in 2 cases a graft rejection attack that was treated succesfully has occured. Conclusion: Corneal wedge resection is safe and effective procedure for residual high astigmatism after penetrating keratoplasty. However, a determined time is necessary after surgery for visual improvement.
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MN Oftalmoloji
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Scopus Q Değeri
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14
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1
