Raşit KILIÇ, Sarper KARAKÜÇÜK, Ertuğrul MİRZA, Ahmet Osman POLAT, Ayşe ÖNER, Kuddusi ERKILIÇ

Tedaviye dirençli glokom olgularında seton implantasyonu sonuçlarımız

Amaç. Medikal tedavi ile kontrol altına alınamayan glokomlarda seton implantasyonu sonuçlarınıdeğerlendirmek. Yöntem. Kliniğimizde, Ocak 2004-Ocak 2011 tarihleri arasında medikaltedaviyle kontrol altına alınamayıp seton implantasyonu yapılan 123 glokom hastasından, dosyabilgilerine ulaşılan ve düzenli takiplerine gelen 31 olgunun dosya bilgileri retrospektif olarakincelenmiştir. Bulgular. 24 olguya neovasküler glokom, 4 olguya üveitik glokom, 2 olguya afakikglokom, 1 olguya psödoeksfolyatif glokom tanısı ile seton implantasyonu yapılmıştır. 25 olgudaAhmed, 3 olguda Molteno, 2 olguda Baerveldt, 1 olguda Keiki Mehta implantı kullanılmıştır.Ameliyat öncesi göz içi basıncı ortanca değeri 40 mmHg (23-66) olarak bulunmuştur. Olgularıntakip sürelerinin ortanca değeri 10 ay (3-78) olarak saptanmıştır. Son kontroldeki GİB ortancadeğeri 15,5 mmHg (6-67) olarak bulunmuştur. Ameliyat sonrası komplikasyonlar; 3 olguda kronikhifema, 1 olguda hifema ve hipotoni, bir olguda hipotoni ve sonrasında ftizis bulbi, 1 olguda ağrılıgöz nedeni ile evisserasyon, 1 olguda epiretinal membran, 1 olguda lokalize endotelyal yetmezlikgörülmüştür. Sonuç. Seton implantasyonu medikal tedaviye dirençli glokom olgularında etkili birtedavi yöntemidir.

Results of seton implantation in ref ractory glaucoma

Aim. To evaluate our glaucoma tube implantation results for glaucoma cases that cannot becontrolled with medication therapy. Method. The records of 31 cases whose medical records couldbe reached and and who could come to regular follow up visits among 123 patients that applied toour clinic between January 2004-January 2011 with refractory glaucoma for medical therapy wereevaluated retrospectively. Results. Glaucoma tube implantation was performed with diagnosis ofneovascular glaucoma in 24 cases, uveitic glaucoma in 4 cases, aphakic glaucoma in 2 cases,pseudoexfoliation glaucoma in 1 case. Ahmed valve for 25 cases, Molteno for 3 cases, Baerveldtfor 2 cases, keiki mehta for one case were implanted. Preoperative intraocular pressure medianvalue was 40 mmHg (23-66).The median value of follow up duration was found to be 10 months(3-78). The median value of intraocular pressures for last follow up visit was 15.5 mmHg (6-67).As postoperative complications, chronic hyphema in 3 cases, hypotony and hyphema in 1 case,hypotony and following phthisis bulbi in 1 case, painful eye and following evisceration in 1 case,epiretinal membrane in 1 case, endothelial failure in 1 case were observed. Conclusion. Glaucomatube implantation is efficient alternative treatment method for refractory.

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