Katarakt cerrahisi sonrası Nd-YAG lazer ile arka kapsülotomi sonuçları
Küçük Resim Yok
Tarih
1997
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Günümüzde modern katarakt cerrahisi olan PEKKE ve GİL implantasyonunun en önemli geç komplikasyonu AKK'dir. Bu çalışmada AKK gelişmiş 54 olgunun 60 gözüne Nd-YAG lazer ile arka kapsülotomi yapıldı. Olgular görme keskinliği artışı ve postoperatif komplikasyonlar açısından değerlendirildi. Gözlerin 17'si (%28.3) afak, 43'ü (%71.7) psödofaktı (2 ÖK-GİL, 41 AK-GİL). Katarakt cerrahisi ile arka kapsülotomi arası ortalama geçen süre 27.30±11.80 ay olup, kapsülotomi sonrası takip süresi üç aydı. Kapsülotomi için kullanılan ortalama atım enerisi 1.75±0.68 mj, atım sayısı 74.40±37.26, total enerji 129.85±78.14 mj'du. Kapsülotomi sonucunda %93.3 olguda görme artışı sağlandı. Kapsülotomi öncesi ortalama görme keskinliği 0.19, kapsülotomi sonrası 0.77 olup, ortalama artış 0.58 olarak bulundu. Olguların %41.66'sında kapsülotomi öncesine göre anlamlı kabul edilen 1. ve 3. saattlerde GİB artışı görüldü. GİB, antiglokomatöz tedavi ile 24 saat içinde kapsülotomi öncesi değerlere düşürüldü. Olguların %45'inde kapsülotomi sonrası hafif ve orta derecede ön kamarada hücre reaksiyonu gözlendi. Topikal steroid damlalarla en geç bir hafta içinde tüm olgularda ön kamaradaki hücre reaksiyonu kayboldu. Psödofak 43 gözün 10'unda (%23.25) GİL'nde YAG lazer kapsülotomi işlemi sırasında minimal hasar saptandı. Afak 17 gözün dördünde ön hiyaloid membran rüptürü ve ön kameraya vitreus prolapsusu görüldü. Hiçbir olguda KMÖ ve RD gibi arka segment komplikasyonları görülmedi. Nd-YAG lazer arka kapsülotomi her yaştaki olguya, ayaktan, kısa sürede ve kolayca uygulanabilen, başarı şansı yüksek olan bir yöntemdir. Bu yöntem, nadir görülen komplikasyonlarla birlikte cerrahi kapsülotomiden daha üstün bir tekniktir.
he most important late complication of planned extracapsular cataract extraction and intraocular lens implantation which is nowadays modern cataract surgery, is posterior capsular opacity. In this study, 60 eyes of 54 patients who developed posterior capsular opacity had Nd-YAG laser posterior capsulotomy. Patients were evaluated according to improvement in visual acuity and postoperative complications. 17 (28.3%) eyes were aphakic and 43 (71.7%) eyes were pseudophakic (2 anterior chamber, 41 posterior chamber intraocular lenses implanted). The mean duration between cataract surgery and posterior capsulotomy was 27.30±11.82 months and follow-up duration after capsulotomy was 3 months. For capsulotomy, the mean shoot energy used, was 1.75±0.68 mj, the number of shoots was 74.40±37.26, and total energy was 129.85±78.14 mj. After capsulotomy 93.3% of subjects had improvement in visual acuity. Before capsulotomy, the mean visual acuity was 0.19, after capsulotomy it was 0.77 and the mean increase was 0.58. 41.66% of subjects, in comparison with precapsulotomy period, had significant increase in intraocular pressure in the first and third hour. With antiglaucomatous therapy, the intraocular pressure was reduced to precapsulotomy values, in 24 hours. After capsulotomy, 45% of subjects had mild to moderate anterior uveitis. This condition was treated with topical steroids within one week. During YAG laser capsulotomy procedure, 10 (23. 25%) of 43 pseudophakic eyes had minimal damage on their intraocular lens implant. In 4 of 17 aphakic eyes, anterior hyaloid membrane rupture and vitreus prolapsus into anterior chamber was observed. None of the subjects had posterior segment complications like cystoid macular edema or retinal detachment. Nd-YAG laser posterior capsulotomy is a method which can be applied easily and in a short time to outpatients, regardless of their age, and its success rate is high. This method, with its rare complications, is superior to surgical cap sulotomy.
he most important late complication of planned extracapsular cataract extraction and intraocular lens implantation which is nowadays modern cataract surgery, is posterior capsular opacity. In this study, 60 eyes of 54 patients who developed posterior capsular opacity had Nd-YAG laser posterior capsulotomy. Patients were evaluated according to improvement in visual acuity and postoperative complications. 17 (28.3%) eyes were aphakic and 43 (71.7%) eyes were pseudophakic (2 anterior chamber, 41 posterior chamber intraocular lenses implanted). The mean duration between cataract surgery and posterior capsulotomy was 27.30±11.82 months and follow-up duration after capsulotomy was 3 months. For capsulotomy, the mean shoot energy used, was 1.75±0.68 mj, the number of shoots was 74.40±37.26, and total energy was 129.85±78.14 mj. After capsulotomy 93.3% of subjects had improvement in visual acuity. Before capsulotomy, the mean visual acuity was 0.19, after capsulotomy it was 0.77 and the mean increase was 0.58. 41.66% of subjects, in comparison with precapsulotomy period, had significant increase in intraocular pressure in the first and third hour. With antiglaucomatous therapy, the intraocular pressure was reduced to precapsulotomy values, in 24 hours. After capsulotomy, 45% of subjects had mild to moderate anterior uveitis. This condition was treated with topical steroids within one week. During YAG laser capsulotomy procedure, 10 (23. 25%) of 43 pseudophakic eyes had minimal damage on their intraocular lens implant. In 4 of 17 aphakic eyes, anterior hyaloid membrane rupture and vitreus prolapsus into anterior chamber was observed. None of the subjects had posterior segment complications like cystoid macular edema or retinal detachment. Nd-YAG laser posterior capsulotomy is a method which can be applied easily and in a short time to outpatients, regardless of their age, and its success rate is high. This method, with its rare complications, is superior to surgical cap sulotomy.
Açıklama
Anahtar Kelimeler
Arka kapsül kesifliği, Katarakt çıkartılması, Lazer tedavisi
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Yıldız, M. K. (1997). Katarakt cerrahisi sonrası Nd-YAG lazer ile arka kapsülotomi sonuçları. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Göz Hastalıkları Anabilim Dalı, Konya.
