Alt Oblik Kas Hiperfonksiyonu Tedavisinde Alt Oblik Kas Geriletmesi ve Miyektomi Yöntemlerinin Karşılaştırılması
Yükleniyor...
Tarih
2016
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Primer ve sekonder alt oblik kas hiperfonksiyonu (AOHF) düzeltilmesinde kullanıan alt oblik kas geriletmesi ve miyektomi yöntemlerinin sonuçlarının karşılaştırılmasıdır. Gereç ve Yöntemler: Ocak 2007-Aralık 2014 tarihleri arasında farklı derecelerde AOHF nedeniyle alt oblik kas zayıflatma cerrahisi uygulanan 74 hastanın 120 gözü bu retrospektif çalışmaya dahil edildi. Hastaların demografik özellikleri, uygulanan cerrahi türü, cerrahi öncesi ve sonrası AOHF derecesi, eşlik eden horizontal kayma ve komplikasyonlar kaydedildi. Hastaların takip süresi medyan değeri 22 ay idi. Cerrahi sonrası AOHF'nin tamamen ortadan kalkmasında standart başarı kriterinin 1 düzeyinde olması ise sınırlı başarı kriteri olarak belirlendi. Bulgular: Hastaların medyan yaşı 7,0 yıl (1,0-32,0), medyan takip süresi 22,0 ay (1,0-81,0) idi. Kırk dokuz (%62,6) hastada primer AOHF, 25 (%33,8) hastada ise sekonder AOHF mevcuttu. Altmış üç (%52,5) göze alt oblik kas miyektomisi, 57 (%47,5) göze alt oblik kas geriletmesi yapıldı. Standart başarı oranları miyektomi için %825, geriletme için %82,4 idi. Miyektomi yapılan gözlerin %12,7'sinde, geriletme yapılan gözlerin %10,5'inde sınırlı başarıya ulaşıldı. Hastaların cerrahi öncesi ve sonrası AOHF düzeylerindeki fark yönünden miyektomi ve geriletme yöntemleri arasında anlamlı fark saptanmadı (p0,163). Cerrahi sonrası toplam 14 (sekiz göze miyektomi, alt1 göze geriletme yapılmış) gözde nüks ve (ikisine de miyektomi yapılmış) gözde adezyon sendromu geliştiği gözlendi. Başka bir komplikasyon izlenmedi. Sonuç: Primer ve sekonder AOHF tedavisinde uygulanan alt oblik kas miyektomi ve geriletme yöntemleri etkili ve güvenilir yöntemlerdir. Her iki yöntem de benzer başarı oranlarına sahiptir. Tekrar cerrahi ihtiyacı olan hastalarda geriletme yönteminin avantajı kasa daha kolay ulaşılmasını sağlamasıdır.
To compare the results of inferior oblique muscle recession and myectomy procedures in the treatment of primary and secondary inferior oblique muscle overaction. Material and Methods: This retrospective study included 120 eyes of 74 patients with inferior oblique muscle overaction at different stages who underwent weakening procedure of the inferior oblique muscle between january 2007 and December 2014. Demographic characteristics of the subjects, type of the surgery, the degree of IOMO before and after the surgery, accompanying horizontal deviation, and complications were recorded. The median value of follow-up time was 22 months. Standard success was defined as complete resolution of IOMO, whereas limited success was defined as 1 residual IOMO. Results: The median age of the subjects was 7.0 years (range 1.0-32.0 years), the median follow-up time was 22.0 months (range 1.0-81.0 months). 49 (66.2%) patients had primary IOMO, while 25 (33.8%) had secondary IOMO. Inferior oblique myectomy was performed in 63 (52.5%) eyes and inferior oblique recession was performed in 57 (47.5%) eyes. Standard success rates were 82.5% for myectomy and 82.4% for recession. Limited success was achieved in 12.7% of patients who underwent myectomy, and in 10.5% of patients who underwent recession. The difference in preoperative and postoperative IOMO was not statistically significant between myectomy and recession procedures (p0.163). total of 14 eyes (8 had undergone inferior oblique myectomy and had undergone recession) had recurrence and eyes (both had undergone inferior oblique myectomy) had adhesion syndrome. No other complications were observed. Conclusion: Recession and myectomy of the inferior oblique muscle are safe and effective methods for the treatment of primary and secondary IOMO and both procedures have similar success rates. The advantage of the recession procedure is enabling easier access to the inferior oblique muscle in subjects requiring repeated surgery.
To compare the results of inferior oblique muscle recession and myectomy procedures in the treatment of primary and secondary inferior oblique muscle overaction. Material and Methods: This retrospective study included 120 eyes of 74 patients with inferior oblique muscle overaction at different stages who underwent weakening procedure of the inferior oblique muscle between january 2007 and December 2014. Demographic characteristics of the subjects, type of the surgery, the degree of IOMO before and after the surgery, accompanying horizontal deviation, and complications were recorded. The median value of follow-up time was 22 months. Standard success was defined as complete resolution of IOMO, whereas limited success was defined as 1 residual IOMO. Results: The median age of the subjects was 7.0 years (range 1.0-32.0 years), the median follow-up time was 22.0 months (range 1.0-81.0 months). 49 (66.2%) patients had primary IOMO, while 25 (33.8%) had secondary IOMO. Inferior oblique myectomy was performed in 63 (52.5%) eyes and inferior oblique recession was performed in 57 (47.5%) eyes. Standard success rates were 82.5% for myectomy and 82.4% for recession. Limited success was achieved in 12.7% of patients who underwent myectomy, and in 10.5% of patients who underwent recession. The difference in preoperative and postoperative IOMO was not statistically significant between myectomy and recession procedures (p0.163). total of 14 eyes (8 had undergone inferior oblique myectomy and had undergone recession) had recurrence and eyes (both had undergone inferior oblique myectomy) had adhesion syndrome. No other complications were observed. Conclusion: Recession and myectomy of the inferior oblique muscle are safe and effective methods for the treatment of primary and secondary IOMO and both procedures have similar success rates. The advantage of the recession procedure is enabling easier access to the inferior oblique muscle in subjects requiring repeated surgery.
Açıklama
Anahtar Kelimeler
Şaşılık, Okülomotor kaslar, Strabismus, Oculomotor muscles
Kaynak
Türkiye Klinikleri Oftalmoloji Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
25
Sayı
2
Künye
Bitirgen, G., Özkağnıcı, A., Soylu, E., Gündüz, M. K.(2016). Alt oblik kas hiperfonksiyonu tedavisinde alt oblik kas geriletmesi ve miyektomi yöntemlerinin karşılaştırılması. Türkiye Klinikleri Oftalmoloji Dergisi, 25, 2, 94-99.
