Afaki tedavisinde üç parçalı göziçi lensin sütürsüz intraskleral fiksasyonu

Amaç: Bu çalışmanın amacı kliniğimizde yetersiz arka kapsül desteği olan hastalarda uyguladığımız üç parçalı göz içi lensin (GİL) intraskleral fiksasyon yöntemini sunmaktır.Gereç ve Yöntem: Bu çalışma retrospektif vaka serisinden oluşmaktadır. Oluşturulan skleral tünelden GİL haptiğini çıkarmak için 27 gauge iğne kullanıldı. Haptik uçları topuz şeklinde koterize edildi ve haptikler skleral tünel içine yerleştirildi. Ameliyat öncesi ve sonrası düzeltilmiş görme keskinliği, göz içi basıncı ve komplikasyonlar değerlendirildi.Bulgular: 54 hasta (24 kadın, 30 erkek) çalışmaya dahil edildi. Ortalama yaş 52.4±14.5 yıldı. Ortalama takip süresi 12±6.8 aydı. Ameliyat öncesi görme keskinliği 20/500 idi. Ameliyat sonrası 1. ayda 20/80 idi. Göz içi basınç ameliyat öncesi 12.5±3.5 mm Hg iken 1. ayda 12.8±6.5 mm Hg idi. Ameliyat sonrası komplikasyon olarak 12 hastada subkonjonktival kanama, 2 hastada hifema, 1 hastada vitreus hemorajisi gelişti. Hiçbir hastada haptik exposure, GİL desentralizasyonu takip süresinde gelişmedi.Sonuç: Üç parçalı lensin sütürsüz intraskleral fiksasyon metodu güvenilir, hızlı ve uygulaması kolay bir methodtur. Cerrahi sonrası göziçi basıncında önemli değişiklikler olmamakta, kalıcı komplikasyon gelişmemektedir. Ayrıca görme keskinliğinde artış sağladığı için başarılı bir yöntemdir.

Anahtar Kelimeler:

Afaki, sütürsüz fiksasyon, intraskleral fiksasyon

Intrascleral sutureless fixation of three-piece intraocular lens for aphakia management

Purpose: The aim of this study was to report the technique of sutureless intrascleral fixation (SIF) of three-piece foldable intraocular lens (IOL) in patients with insufficient posterior capsule support.Material and Methods: This study is a retrospective case series. We performed our modified technique on 54 patients. A 27-gauge needle was used to remove the haptics of the IOL from the scleral tunnel. The tips of the haptic were cautherized and then inserted into the scleral tunnel. The preoperative and postoperative best-corrected visual acuity (BCVA), intraocular pressure (IOP), and complications were evaluated.Results: Fifty-four patients (24 women, 30 men) were included. The mean age was 52.4±14.5 years. The mean follow-up was 12±6.8 months. The mean preoperative BCVA (Snellen) was 20/500. At the postoperative first month, the mean BCVA was 20/80. The mean preoperative IOP was 12.5±3.5 mm Hg, at first month it was 12.8±6.5 mm Hg. Postoperative complications included subconjunctival hemorrhage in 12 patients, hyphema in 2 patients, and vitreous hemorrhage in 1 patient. There was no occurrence of haptic exposure, IOL tilted or decentration during the follow-up in this study.Conclusion: SIF of three-piece IOL is a reliable, rapid and easy to apply method. There are no significant changes in IOP and no permanent complications after surgery. It is also a succesful method in view of the consequential apparent improvement in visual acuity.

Keywords:

Aphakia, sutureless fixation, intrascleral fixation,

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