Şerife BAYRAKTAR, Yasemin DERE, Belgin İZGİ

TRABEKÜLEKTOMİ OPERASYONU SONRASI ERKEN DÖNEMDE YÜKSEK GÖZ İÇİ BASINCI İÇİN YAPILAN LAZERLE SÜTÜR KESİLMESİNİN ETKİNLİĞİ

Amaç: Trabekülektomi operasyonu sonrası erken dönemde yüksek göz içi basıncı (GİB) için yapılan lazerle sütür kesilmesinin (LSK) etkinliğini değerlendirmek. Gereç ve Yöntem: 2005 ile 2013 yılları arasında trabekülektomi cerrahisi sonrası erken dönemde yüksek GİB’ları olan, masajla blebleri belirginleşen ve bu sebeple LSK yapılan 42 hastanın 47 gözü retrospektif olarak değerlendirildi. Bulgular: Olguların 22si kadın, 20si erkekti ve ortalama yaşı 62,1±16 (min 34; max 81) idi. Kırk yedi olgunun 22 sinde (%46,8) sadece 1 kez, 25 inde (%53,2) >1 kez LSK yapıldı. Yapılan ortalama LSK sayısı 1,63±0,7 (1-3) idi. Trabekülektomi öncesi ortalama GİB 30,2 mmHg, LSK öncesi ise 24,1±6,3 mmHg (14-42 mmHg) idi. LSK ile trabekülektomi arasında geçen süre ortalama 7,9±6,3 gündü. Bir kez LSK yapılan grupta LSK öncesi ortalama GİB 24,15±6,93 mmHg, LSK sonrası 17,47±5,81 mmHg idi. >1 kez LSK yapılan grupta ise LSK öncesi ortalama GİB 23,96±7,0 mmHg, LSK sonrası ise 16,6±4,61 mmHg idi. Her iki gruptada aradaki fark istatistiksel olarak anlamlı bulundu (p<0.001). Olguların son muayenesindeki ortalama GİB 14,6±4,07 mmHg idi (4-25 mmHg) (p<0,001). Olguların ortalama takip süresi 21,4±20,01 (1-89 ay) aydı.Sonuç: Trabekülektomi sonrası erken dönemde GİB yüksek bulunan olgularda hedef GİBna ulaşmak için argon lazerle sütür kesilmesi etkin ve güvenilir bir yöntemdir ve birden çok kez uygulanabilir. Anahtar kelimeler: Glokom; trabekülektomi; lazerle sütür kesilmesi.

Anahtar Kelimeler:

Glokom, trabekülektomi, lazerle sütür kesilmesi

EFFECTIVENESS OF LASER SUTURE LYSIS AFTER TRABECULECTOMY WITH EARLY-POSTOPERATIVE HIGH INTRAOCULAR PRESSURE

Objective: To evaluate the effectiveness of laser suture lysis (LSL) in patients with early high intraocular pressure (IOP) after trabeculectomy.Material and Methods: Fourty seven eyes of 42 patients who had high IOP and bleb formation after ocular massage in early postoperative period after trabeculectomy and undergone LSL between 2005 and 2013 were evaluated resrospectively. Results: Twenty-two patients were female, 20 patients were male and the mean age was 62.1±16 (34-81). LSL was performed once in 22 eyes (46.8%) and more than once in 25 eyes(53.2%). The mean number of LSL was 1.63±0.7. The mean IOP before trabeculectomy was 30.2 mmHg and it was 24.1±6.3 mmHg (14-42 mmHg) before LSL. The mean interval time between trabeculectomy and performance of suture lysis was 7.9±6.3 days. The mean IOPs before and immediately after laser suture lysis were 24.15±6.93 mmHg and 17.47±5.81 mmHg respectively in patients that LSL was performed once (p<0.001). The mean IOPs before and immediately after laser suture lysis were 23.96±7 mmHg and 16.6±4.61 mmHg respectively in patients that LSL was performed more than once (p<0.001). The difference was statistically significant in two groups (p<0.001). At the last visit, the mean IOP was 14.6±4.07 mmHg (4-25 mmHg) (p<0.001). The mean follow-up time was 21.4±20.01months (1-89 months).Conclusion: Laser suture lysis is a safe and effective method in the management of the patients in whom the target IOP was not reached after trabeculectomy and it can be performed more than once. Key words: Glaucoma; trabeculectomy; laser suture lysis.

Keywords:

Glaucoma, trabeculectomy, laser suture lysis,

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