Nd: YAG Lazer Kapsülotominin Göz İçi Basınç ve Kornea Endoteli Üzerine Erken Dönemde Etkisi

Amaç: Neodymium: yttrium-aluminum garnet (Nd: YAG) lazer kapsülotomi olgularında, işlem sonrası erken dönemde göz içi basınç (GİB) ve kornea endoteli morfolojisindeki değişimi araştırmak. Gereç ve Yöntemler: Çalışmaya arka kapsül kesafeti olan 58 hastanın 74 gözü dahil edildi. Hastaların başlangıç GİB değerleri Nd: YAG lazer kapsülotomiden sonraki ilk saat ve ilk ay değerleri ile karşılaştırıldı. Ayrıca endotel hücre yoğunluğu (EHY), hücre alanının varyasyon katsayısı (VK), hekzagonal hücrelerin yüzdesi (HHY) ve merkezi kornea kalınlığı (MKK) ölçümleri speküler mikroskopi ile analiz edildi ve karşılaştırıldı. Bulgular: Hastaların yaş ortalaması 66,84±9,51 yıldı. Ortalama GİB değeri lazer öncesi ile lazer sonrası birinci saatte ve birinci ayda benzerdi (sırasıyla p=0,361 ve p=0,516). Ortalama EHY lazer öncesine (2025,73±470,18 hücre/mm2) göre lazer sonrası birinci saatte (1968,31±465,27 hücre/mm2) ve birinci ayda (1984,72±453,55 hücre/mm2) anlamlı olarak azaldı (sırasıyla p=0,001 ve p=0,021). Lazer öncesi, lazer sonrası birinci saatte ve lazer sonrası birinci ayda ortalama VK, HHY ve MKK değerleri arasında anlamlı farklılık yoktu (p>0,05). Korneal endotel kaybı ile toplam lazer enerji gücü arasında birinci saatte ve birinci ayda anlamlı korelasyon yoktu (sırasıyla r=-0,046, p=0,699 ve r=0,134, p=0,257). Sonuç: Nd: YAG lazer kapsülotomi sonrası anlamlı GİB artışı izlenmemiştir. İşlem sonrası tüm hastaların anti-glokomatöz tedavi kullanması gerekmemektedir. Lazer sonrası kornea endotel hücre sayısında azalma görülmüştür. Dolayısıyla kornea endotel sayısı düşük olan hastalarda bu işlem daha dikkatli uygulanmalıdır.

Anahtar Kelimeler:

Arka kapsül kesafeti, Göz içi basınç, Kornea endotel morfolojisi, Nd: Yag lazer kapsülotomi

Effect of Nd: YAG Laser Capsulotomy on Intraocular Pressure and Corneal Endothelium in the Early Period

Objective: To investigate the changes in intraocular pressure (IOP) and corneal endothelial morphology in neodymium: yttrium-aluminum-garnet (Nd: YAG) laser capsulotomy cases in the early period after the procedure. Material and Methods: Seventy four eyes of 58 patients with posterior capsular opacification were included in the study. The baseline IOP of the patients was compared to the first hour and first-month values after Nd: YAG laser capsulotomy. Also, endothelial cell density (ECD), coefficient of variation (CV), hexagonality rate (HEX), and central corneal thickness (CCT) measurements were analyzed by specular microscopy and compared. Results: Mean age of the patients was 66.84±9.51 years. Mean IOP value was similar at pre-laser and post-laser first hour and first month (p=0.361 and p=0.516, respectively). Mean ECD was significantly decreased at the first hour (1968.31±465.27 cells/mm2) and the first month (1984.72±453.55 cells/mm2) after laser compared to pre-laser (2025.73±470.18 cells/mm2), (p=0.001 and p=0.021, respectively). There was no significant difference between the mean CV, HEX, and CCT values before laser, at the first hour and first month after laser (p>0.05). There was no significant correlation between corneal endothelial loss and total laser energy power at the first hour and first month (r=- 0.046, p=0.699 and r=0.134, p=0.257, respectively). Conclusion: No significant IOP increase was observed after Nd: YAG laser capsulotomy. Not all patients need to use anti-glaucomatous therapy after the procedure. A decrease in the number of corneal endothelial cells was seen after laser. Therefore, this procedure should be applied more carefully in patients with low corneal endothelium count.

Keywords:

Posterior capsular opacification, Intraocular pressure, Corneal endothelial morphology, Nd: Yag laser capsulotomy,

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