Münir KARAYEL, İbrahim İnan HARBİYELİ, Begüm SULANÇ, Elif ERDEM, Meltem YAĞMUR

Farklı endikasyonlarda terapötik kontakt lenslerin etkinliği

Amaç: Bu çalışmanın amacı farklı endikasyonlar için terapötik amaçlı yumuşak kontakt lens (TKL) uygulanan olgularda tedavi etkinliğini ve komplikasyonları incelemektir. Gereç ve Yöntem: Aralık 2011 – Haziran 2020 tarihleri arasında TKL uygulanan olguların tıbbi kayıtları retrospektif olarak incelendi. Demografik özellikler, klinik endikasyonlar, tedavi öncesi ve sonrası en iyi düzeltilmiş görme keskinlikleri (EİDGK), tedavi sonrası klinik bulgularda iyileşme ve TKL ile ilişkili komplikasyonlar kaydedildi. Bulgular: Yaşları 10-90 yıl arasında (ort. 56,08±21,18) değişen 86 olgunun (36 kadın, 50 erkek) 95 gözü çalışma kapsamına alındı. Tüm olgulara yumuşak silikon hidrojel kontakt lens (KL) uygulandı. Olguların ortalama TKL kullanım süresi 40±70,2 hafta idi (1 gün-416 hafta). TKL uygulaması için en sık endikasyonlar; büllöz keratopati (39 göz, %41,1), epitel defektleri (15 göz, %15,8) ve filamenter keratit (14 göz, %14,7) idi. TKL ile 45 gözde (%47,4) klinik bulgularda iyileşme, 30 gözde (%35,3) EİDGK’de artış saptandı. Komplikasyon olarak 8 gözde (%8,4) TKL kaybı ve 4 gözde (%4,2) mikrobiyal keratit gelişimi gözlendi. Nörotrofik kornea ülserli 10 gözde (%90,9), filamenter keratitli 11 gözde (%78,6) ve epitel defektli 10 gözde (%66,7) klinik bulgularda iyileşme saptandı. Kornea bulgularındaki iyileşmeyle paralel olarak filamenter keratitli 10 gözde (%71,4), epitel defektli 6 gözde (%40) ve nörotrofik kornea ülserli 3 gözde (%30) EİDGK’de artış saptandı. Sonuç: Uygun endikasyonlarda TKL kullanımı klinik iyileşmeye yardımcı, cerrahi girişim gereksinimini azaltabilen başarılı bir uygulamadır.

Anahtar Kelimeler:

büllöz keratopati, epitel defektleri, filamenter keratit, nörotrofik kornea ülseri, terapötik yumuşak kontakt lens

Efficacy of therapeutic contact lenses in different indications

Purpose: The aim of this study was o examine the efficacy and complications of treatment in cases where therapeutic soft contact lenses (TCL) are applied for different indications. Materials and Methods: The medical records of the cases who fitted with TCL between December 2011 and June 2020 were reviewed retrospectively. Demographic characteristics, clinical indications, best corrected visual acuity (BCVA) before and after treatment, improvement in clinical findings after treatment, and complications associated with TCL were recorded. Results: Ninety-five eyes of 86 cases (36 females, 50 males) aged between 10-90 years (mean 56.08±21.18 years) were included in the study. Soft silicone hydrogel contact lens (CL) was applied to all cases. The mean duration of TCL use was 40±70.2 weeks (1 day-416 weeks). The most common indications were; bullous keratopathy (39 eyes, 41.1%), epithelial defects (15 eyes, 15.8%), and filamentary keratitis (14 eyes, 14.7%). With TCL, clinical findings improved in 45 eyes (47.4%) and BCVA increased in 30 eyes (35.3%). Complications were; loss of TCL in 8 eyes (8.4%) and development of microbial keratitis in 4 eyes (4.2%). Clinical findings improved in 10 eyes (90.9%) with neurotrophic corneal ulcers, 11 eyes (78.6%) with filamentary keratitis, and 10 eyes (66.7%) with epithelial defects. Parallel to the improvement in corneal findings, BCVA increased in 10 eyes (71.4%) with filamentary keratitis, 6 eyes (40%) with epithelial defects, and 3 eyes (30%) with neurotrophic corneal ulcers. Conclusion: The use of TCL in appropriate indications is a successful application that can help clinical recovery and reduce the need for surgical intervention.

Keywords:

Bullous keratopathy, epithelial defects, filamentary keratitis, neurotrophic corneal ulcer, therapeutic soft contact lens,

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