Kapsül ve/veya Zonül Yetmezlikli Olguların Cerrahi Tedavisinde Tek Parça Katlanabilir Arka Kamara Göz İçi Lenslerin İrise Sütürlü Olarak Kullanılması

Year 2022, Volume: 12 Issue: 4, 737 - 746, 28.12.2022

Ali Altan Ertan Boz , Mahmut Atum , Erkan Çelik , Gürsoy Alagöz

https://doi.org/10.31832/smj.1163160

Abstract

Amaç: Kapsül yetmezliğinde, katlanabilir arka kamara (AK) göz içi lenslerin irise sütürlü (İSGİL) implantasyonunun avantajları, dezavantajları, cerrahi tekniği ve postoperatif komplikasyonlar araştırıldı.
Gereç ve Yöntemler: Kapsül ve zonül yetmezliği nedeni ile kapsül içi GİL implantasyonu yapılamayan, bu nedenle katlanabilir AK GİL’i irise sütüre ederek implante ettiğimiz 30 hastanın 30 gözü retrospektif olarak incelendi. Hastalar 2,8 mm’lik kesiden primer İSGİL implantasyonu (Grup 1), 6 mm’lik kesiden primer İSGİL implantasyonu (Grup 2), sekonder İSGİL implantasyonu (Grup 3) ve GİL stabilizasyonu (Grup 4) olmak üzere 4 gruba ayrıldı. Olguların tümünde preoperatif ve postoperatif en iyi düzeltilmiş görme keskinliği (EDGK), göz içi basıncı (GİB), merkezi korneal kalınlık (MKK) ve postoperatif GİL-endotel arası mesafe ölçümleri yapıldı. Postoperatif komplikasyonlar kaydedildi.
Bulgular: Gruplarda EDGK preoperatif 0,58±0,20 /2,44±0,89 /0,53±0,26 /0,90±0,73 LogMAR iken postoperatif 0,33±0,57 /0,80±0,84 /0,50±0,62 /0,95±1,37 LogMAR seviyesinde idi. Postoperatif GİL-Endotel arası mesafe 3,11±0,28 /2,77±0,32 /3,09±0,37 /3,09±0,37 mm idi. Postoperatif dönemde, Grup 1’de 2 hastada kistoid maküler ödem (KMÖ), 1 hastada üveit, 1 hastada GİL desantralizasyonu; Grup 2’de 1 hastada KMÖ, 3 hastada GİL desantralizasyonu; Grup 3’te 2 hastada üveit ve KMÖ, 1 hastada retina dekolmanı (RD), 3 hastada GİL desantralizasyonu; Grup 4’te 1 hastada KMÖ, 1 hastada RD saptandı.
Sonuç: Kapsül yetmezliğinde, GİL implantasyon yöntemi seçiminde hastanın klinik özellikleri, mevcut ekipmanların durumu ve cerrahın tecrübesi önemlidir. Her GİL implantasyon yönteminin, kendine has avantaj ve dezavantajları mevcuttur. Uyguladığımız GİL implantasyon yönteminin kapsül yetmezlikli hastalarda nispeten kolay uygulanması, özellikli GİL gereksinimi olmaması gibi yönleriyle, GİL implantasyon yöntemlerine alternatif olacağını düşünmekteyiz.

Keywords

GİL implantasyonu, ; irise sütürlü GİL, kapsül yetmezliği, katlanabilir arka kamara GİL, zonül yetmezliği.

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