Primer Göz İçi Lens Yerleştirilen Konjenital Kataraktlı Olgularda Uzun Dönem Sonuçlarımız

Amaç: Primer göz içi lens implantasyonu yapılan konjenital kataraktlı olgularda uzun dönem sonuçlarımızı bildirmek. Gereç ve Yöntem: 2008-2012 yılları arasında kliniğimizde lensektomi ile aynı seansta primer göz içi lens implantasyonu (GİL) uygulanan 2 yaşından büyük ve 1 yıldan uzun süreyle takip edilen konjenital kataraktlı 43 olgu retrospektif olarak değerlendirildi. Tüm gözlere aynı cerrah tarafından lensektomi ve GİL implantasyonu ile birlikte bazı gözlere arka kapsülotomi ve ön vitrektomi yapıldı. Olgular görme fonksiyonları ve ameliyat sonrası komplikasyonları açısından değerlendirildi. Bulgular: Ortalama yaşları 83.6±52.4 ay ( 24-192 ay) olan 43 olgunun 19’u kız, 24’ü erkek idi. Çalışmaya dahil edilen 43 olgunun 19’u tek taraflı, 24’ü çift taraflı kataraktlı idi ve ortalama 24.16±19.94 ay (12 ay-6 yıl) takip edildi . Cerrahi sırasında ortalama yaşı 9.56±3.56 olan 16 olgunun, 25 gözüne arka kapsülotomi uygulanmadı. Bu 25 gözün 11’inde (%44) AKO gelişti. AKO gelişen tüm gözlere topikal anestezi altında Nd:Yag Lazer ile arka kapsülotomi işlemi uygulanabildi. Gözlerin %50.7’sinde postoperatif görme keskinliği 0.5 ve üzerinde saptandı. Tüm gözlerde en sık gelişen komplikasyonlar sırasıyla arka kapsül opasitesi, pupil düzensizli- ği, fibrinoid reaksiyon ve pupiller membran idi. Sonuç: Primer GİL implantasyonu yapılan konjenital kataraktlı hastalarda uygun cerrahi teknik, uygun GİL diyoptri ve tipi seçimi, postoperatif hasta takibi ve komplikasyonların yönetimi ile ambliyopi yönünden sıkı takip görsel prognozu olumlu yönde etkilemektedir.

Long Term Results of Congenital Cataract Patients with Primary Intraocular Lens Implantation

Purpose: To evaluate the long-term outcome of patients who had cataract extraction with primary intra ocular lens implantation. Material and Methods: Forty three children older than 2 years old who had cataract extraction with primary intra ocular lens implantation (IOL) in the same session between 2008 and 2012 and followed up more than 1 year were reviewed retrospectively. Lensectomy and IOL implantation was performed in all eyes,where primary posterior capsulotomy and anterior vitrectomy was performed on some.The patients were evaluated for the long-term visual outcome and the surgical complications after cataract surgery. Results: The mean age of the 43 patients (19 female/24 male) at the time of surgery was 83.6±52.4 (24-192 ) months.19 were unilateral and 24 were bilateral. Mean follow-up period was 24.16±19.94 months (12 months - 6 years).Posterior capsule was left intact in 25 eyes of 16 patients and the mean age of them was 9.56±3.56 months at the time of surgery.Posterior capsular opacification (PCO) occured in 11 of 25 (44%) children whose posterior capsules were left intact at surgery. Nd:YAG laser posterior capsulotomy was performed in all eyes with PCO under topical anesthesia. Final visual acuity was 0.5 or better in 50.7 percent. Most frequently encountered post-operative complications were posterior capsular opacification, pupillary irregularities, fibrinous reaction and pupillary membrane. Conclusions: In congenital cataract patients undergoing primary IOL implantation,a good final visual prognosis depends on appropriate surgical technique, proper selection of IOL type and diopter, postoperative intense patient monitoring and management of complications and amblyopia.

Kaynakça

1. Kuğu S, Gücükoğlu A, Gözüm N. Pediatrik (çocukluk çağı) katarakt cerrahi yöntemleri. Turk J Ophthalmol 1996;26:107-13.

2. Gimbel HV, Basti S, Ferensowicz M, et al. Results of bilateral cataract extraction with posterior chamber intraocular lend implantation in children. Ophthalmology 1997;104:1737-43.

3. Knight-Nanan D, O’Keefe M, et al. Outcome and complications of intraocular lenses in children with cataract: J Cataract Refreact Surg 1996;22:730-6.

4. Pamukçu K, Üretmen Ö. Konjenital kataraktin tedavisi ve görsel rehabilitasyonu. Turk J Ophthalmol 2000;30:134-43.

5. Yılmaz S, Bozbıyık Dİ, Köse S ve ark. Tek taraflı çocukluk çağı kataraktlı olgularımızda katarakt cerrahisinin geç dönem sonuçları. Turk J Ophthalmol 2012;2:42:103-10.

6. Foster A, Gilbert C, Rahi J. Epidemiology of cataract in childhood: a global perspective. J Cataract Refract Surg1997;23:601-4.

7. Özcetin H, Özmen AT. Kataraktlar. In: Özcetin H eds. Katarakt ve

8. Wilson ME, Trivedi RH, Morrison DG, et al. Infant Aphakia Treatment Study Group. The Infant Aphakia Treatment Study: evaluation of cataract morphology in eyes with monocular cataracts. J AAPOS. 2011;15:421-6.

9. Gimbel HV, Ferensowicz M, Ranaan M, et al. Implantation in children. J Pediatr Ophthalmol Strabismus. 1993;30:69-79.

10. Hiles DA, Hered RW. Modern intraocular lens implants in children with new age limitations. J Cataract Refract Surg 1987;13:493-7.

11. Sinskey RM, Karel F, Dal Ri E. Management of cataracts in children. J Cataract Refract Surg 1989;15:196-200.

12. Kora Y, Inatomi M, Fukado Y. Long term study of children with implanted intraocular lenses. J Cataract Refract Surg 1992;18:485-8.

13. Vasavada A, Desai J. Primary posterior capsulorhexis with and without anterior vitrectomy in congenital cataracts J Cataract Refract Surg 1997;23:645-51.

14. Keech RV, Tongue AC, Scott WE. Complication after surgery for congenital and infantil cataracts. Am J Ophthalmol 1989;108:136-41.

15. Guo S, Wagner RS, Caputo A. Management of the anterior and posterior lens capsules and vitreus in pediatric cataract surgery. J Pediatr Ophthalmol Strabismus 2004;41:330-7.

16. Trivedi RH Wilson ME. Posterior Capsulotomy and anterior vitrectomy for the management of pediatric cataracts. In: Wilson ME, Trivedi RH, Pandey SK, eds. Pediatric cataract surgery: techniques, complications, and management. Philadelphia: Lippincot t Williams and Wilkins 2005:83-93.

17. Luo Y, Lu Y, Lu G, et al. Primary posterior capsulorhexis with anterior vitrectomy in preventing posterior capsule opacification in pediatric cataract microsurgery. Microsurgery 2008;28:113-6.

18. Vasavada AR, Praveen MR, Tassignon MJ, et al. Posterior capsule management in congenital cataract. J Cataract Refract Surg 2011;37:173-93.

19. Koch DD, Kohnen T.A retrospective comparison of techniques to prevent secondary cataract formation following posterior chamber intraocular lens implantation in infants and children. Trans Am Ophthalmol Soc. 1997;95:351-65.

20. Vasavada A, Desai J. Primary posterior capsulorhexis with and without Anterior vitrectomy in congenital cataracts. J Cataract Refract Surg 1997;23:645-51.

21. Ağca A, Eltutar K, Doğan M ve ark. Konjenital kataraktlar: etiyoloji, hastaya yaklaşım ve cerrahi prosedür. Glo-Kat. 2011;6;3:135-42.

22. Hiles DA. Intraocular lens implantation in children. Ann Ophthalmol 1977;9:789-97.

23. Plager DA, Lynn MJ, Buckley EG, et al, Infant Aphakia Treatment Study Group. Complications, adverse events, and additional intraocular surgery 1 year after cataract surgery in the Infant Aphakia Treatment Study. Ophthalmology 2011;118:2330-4.

24. Basti S. Results of a prospective evaluation of three methods of management of pediatric cataracts. Ophthalmol 1996;103:713-19.

25. Zwaan J. Pediatric intraocular lens implantation. Ophthalmol 1998;105:112-19.

26. Rosenbaum AL, Maskett S. Intraocular lens implantation in children. Am J Ophthalmol 1995;120:105-7.

27. Dahan E. Choice of lens and dioptric power in pediatric pseudophakia. J Cataract Refract Surg 1997;23:618-23.

28. Brady KM, Atkinson CS. Cataract surgery and intraocular lens implantation in children. Am J Ophthalmol 1995;120:1-9.

29. Sinskey RM. Catarct extraction and intraocular lens implantation in an infant with a monocular congenital cataract.J Cataract Refract Surg 1994;20:647-51.

30. Ben Ezra D. Correspondance: Cataract surgery and intraocular lens implantation in children and intraocular lens implantation in children. Am J Ophthalmol1996;121:224-6.

31. Lambert SR, Buckley EG, Drews-Botsch C and et al. Infant Aphakia Treatment Study Group. A randomized clinical trial comparing contact lens with intraocular lens correction of monocular aphakia during infancy: grating acuity and adverse events at age 1 year. Arch Ophthalmol 2010;128:810-8.

32. Andreo LK, Wilson ME, Saunders RA. Predictive value of regression and theoretical GİL formulas in paediatric intraocular lens implantation. J Pediatr Ophthalmol Strabismus 1997;34:240-3.

33. Chan WH, Biswas S, Ashworth JL and et al. Congenital and infantile cataract: aetGİLogy and management. Eur J Pediatr 2012;171:625-30.

34. Vanderveen DK, Trivedi RH, Nizam A and et al. infant aphakia treatment study group. predictability of intraocular lens power calculation formulae in infantile eyes with unilateral congenital cataract: results from the infant aphakia treatment study. Am J Ophthalmol 2013;156:1252-60.

35. Neely DE, Plager DA, Borger SM and et al. Accuracy of intraocular lens calculations in infants and children undergoing cataract surgery. J AAPOS 2005;9:160-5.

36. Vanderveen DK, Trivedi RH, Nizam A, et al; Infant Aphakia Treatment Study Group. Predictability of intraocular lens power calculation formulae in infantile eyes with unilateral congenital cataract: Results from the Infant Aphakia Treatment Study. Am J Ophthalmol 2013;156:1252-60.

37. Hutchinson A, Wilson ME, Saunders RA. Outcomes and ocular growth rates after intraocular lens implantation in the first 2 years of life. J Cataract Refract Surg 1998;24:846-52.

38. Wilson ME, Elliott L, Johnson B, et al. AcrySof acrylic intraocular lens implantation in children: clinical indications of biocompatibility. J AAPOS 2001;5:377-80.

39. Lundvall A, Zetterström C, Lundgren B, et al. Effect of 3 piece Acrysof and downsized heparin surface modified polymethyl methacrylate intraocular lenses in infant rabbit eyes. J Cataract Refract Surg 2003;29:159-63.

40. Kugelberg M, Shafiei K, Zetterström C. Single piece AcrySof in the new born rabbit eye. J Cataract Refract Surg 2004;30:1345-50.

41. Nihalani BR, Vasavada AR. Single piece Acrysof intraocular lens implantation in children with congenital and developmental Cataract J Cataract Refract Surg 2006;32:1527-34.

42. Cochener B, Jacq P, Colin J. Capsule Contraction after continious curvilinear capsulorhexis polymethylmethacrylate versus silicone intraocular lenses. J Cataract Refract Surg 1999;25:136-9.

43. Wilson ME, Trivedi RH. Choice of intraocular lens for pediatric cataract surgery: survey of AAPOS members. J Cataract Refract Surg 2007;33:1666-8.

44. Gordon RA, Donzis PB. Refractive development of the human eye. Arch Ophthalmol.1985;103:785-9.

45. Prost ME. GİL calculations in cataract operations in children. Klin Oczna 2004;106:691-4.

46. Cheng KP, Hiles DA, Biglan A W. Visual results after early surgical treatment of unilateral congenital cataracts. Ophthalmol 1991;98:903-10.

47. Burke JP, Willshaw HE, Young JDH. Intraocular lens implants for uniocular cataracts in childhood. Br J Ophthalmol 1989;73:760-3.

48. Dahan E, Salmenson BD. Pseudophakia in children: Precautions, technique and feasibility. J Cataract Refract Surg 1990;16:75-82.

49. Markham RHC, Bloom PA, Chadna A and et al. Results of intraocular lens implantation in pediatric aphakia. Eye 1992;6:493-8.

50. Neumann D. The effectiveness of daily wear contact lenses for the correction of infantile aphakia. Arch Ophthalmol. 1993;111:927-30.

51. Gelbart SS, Hoyt CS, Jastrebeski G, et al. Long term results in bilateral congenital cataracts. Am J Ophthalmol 1982;93:615-21.

52. Bradfort G.M, Keech R.V, Scott WE. Factors affecting visual outcome after surgery for bilateral congenital cataracts. Am J Ophthalmol 1994;120:1-9.

53. Speeg-Schatz C, Flament J, Weissrock M. Congenital cataract extraction with primary aphakia and secondary intraocular lens implantation in the ciliary sulkus. J Cataract Refract Surg 2005;31:750-6.

54. Huban A, Erkam N. Pediatrik kataraktlarda tedavi ve takip. T Klin J Ophthalmol 2000;9:59-68.

55. Jensen AA, Basti S, Greenwald MJ, et al. When may the posterior capsule be preserved in pediatric intraocular lens surgery? Ophthalmology 2002;109:324-7.

56. Vasvada AR, Nihalani BR. Pediatric cataract surgery. Current Opinion in Ophthalmology. 2006;17:54-61.

57. Guo S, Wagner RS, Caputo A. Management of the anterior and posterior lens capsules and vitreous in pediatric cataract surgery. J Pediatr Ophthalmol Strabismus 2004;41:330-7.

58. Vasavada A, Trivedi RH. Role of optic capture in congenital cataract and intraocular lens surgery in children. J Cataract Refract Surg 2000;26:824-31.

59. Gimbel HV, DeBroof BM. Posterior capsulorhexis with optic capture : maintaining a clear visual axis after pediatric cataract surgery. J Cataract

60. DeGroot V, Willekens B, Rakic J-M. et al. Closure of posterior continuous curvilinear capsulorhexis; an in vitro model study. ARVO Abstracts. Invest Ophthalmol Vis Sci. 1998;39:211.

61. Küçüksümer Y, Utine CA, Perente İ ve ark. Pediatrik katarakt olgularına cerrahi yaklaşımlarımız. Turk J Ophthalmol 2006;36:118-24.

62. Tuncer S, Gucukoglu A, Gozum N. Cataract extraction and primary hydrophobic acrylic intraocular lens implantation in infants. J AAPOS 2005;9:250-6.

63. Sarı A, Adıgüzel U, Kurtuluş UC ve ark. Pediyatrik kataraktlarda cerrahi yaklaşım ve kısa dönem sonuçlarımız. Glo-Kat 2008;3:171-5.

64. Zwaan J, Mullaney PB, Awad A, et al. Pediatric intraocular lens implantation. Surgical results and complications in more than 300 patients. Ophthalmology 1998;105:112-8.

65. Yaman A, Berk AT, Durak İ ve ark. Gelişimsel ve konjenital katarakt hastalarında tedavi sonuclarımız. T Klin J Ophthalmol 2003;12:29-36.

66. Michaelides M, Bunce C, Adams GGW. Glaucoma following congenital cataract surgery the role of early surgery and posterior capsulotomy. BMC Ophthalmology 2007;7:13.

67. Asrani S, Freedman S, Hasselblad V, et al. Does primary intraocular lens implantation prevent “aphakic” glaucoma in children? J AAPOS 2000;4:33-39.

68. Lawrence MG, Kramarevsky NY, Christiansen SP, et al. Glaucoma following cataract surgery in children: surgically modifiable risk factors. Trans Am Ophthalmol Soc 2005;103:46-55.

69. Beck AD, Freedman SF, Lynn MJ, et al. Infant Aphakia Treatment Study Group. Glaucoma-related adverse events in the Infant Aphakia Treatment Study: 1-year results. Arch Ophthalmol 2012;130:300-5.

70. Parks M M. Visual results in aphakic children. Am J Ophthalmol 1982;94;441-9.

71. Drews-Botsch CD, Celano M, Kruger S, et al. Infant Aphakia Treatment Study. Adherence to occlusion therapy in the first six months of follow-up and visual acuity among participants in the Infant Aphakia Treatment Study (IATS). Invest Ophthalmol Vis Sci 2012;53:3368-75.

Kaynak Göster

1251 827

Arşiv
Sayıdaki Diğer Makaleler

Glokom Cerrahisinde Minimal İnvaziv Bir Prosedür: Trabektom

Yıldıray YILDIRIM, Eyüp DÜZGÜN, Taner KAR

Study of Final Visual Outcome in Penetrating Sub Group of Open Globe Injuries Following Surgical Treatment of Traumatic Cataract According to Birmingham Eye Trauma Terminology System

Mehul SHAH, Shreya SHAH, Parth KALYANI, Ruchir MEHTA, Prerna SHAH

Korneal Astigmatizması ve Kataraktı Olan Hastalarda Torik Göz İçi Lensi İmplantasyonu Sonuçları

Sabite Emine GÖKÇE, Orhan AYAR, MEHMET CÜNEYT ÖZMEN, SERPİL YAZGAN, MEHMET ORÇUN AKDEMİR, MUSTAFA KOÇ

Primer Göz İçi Lens Yerleştirilen Konjenital Kataraktlı Olgularda Uzun Dönem Sonuçlarımız

İdil GÖKSEL, Sevda ERTEKİN, AYŞE AYÇA SARI

Göz İçi Mercek Gücü Hesaplamasında Özelleştirilmiş A Sabiti Kullanımı

Emine Deniz EĞRİLMEZ, Emrah MAT, Arda KARAGÖZ, İlkay MERMUT ÇAKIR, Şeyda UĞURLU

Kataraktı ve Beraberinde Kornea Opasitesi Olan Gözlerde Fakoemülsifikasyon

ERKAN ÇELİK, Emine DOĞAN, Sibel ALİŞAN, BURÇİN ÇAKIR, Elif Betül TÜRKOĞLU, MUSTAFA GÜRKAN ERDOĞAN, GÜRSOY ALAGÖZ

Vitreusa Spontan Lens Dislokasyonu Görülen Bir Ektopia Lentis ET Pupilla Olgusu

MEHMET ALİ ŞEKEROĞLU, Mustafa Alpaslan ANAYOL, Bayram GÜLPAMUK, Başak CERAN BOSTANCI, Pelin YILMAZBAŞ

Farklı Kornea Kalınlıklarına Sahip Normal Bireylerde Non-kontakt Tonometre ve Pnömotonometre ile Ölçülen Göz İçi Basıncı Değerlerinin Karşılaştırılması

Adem TÜRK, Süleyman MOLLAMEHMETOĞLU, Mehmet KOLA, Ahmet KALKIŞIM, Halil İbrahim İMAMOĞLU

Hiperbarik Oksijen Tedavisi Sonrası Geçici Myopik Kayma

Kadir KIRBOĞA, Mustafa KÖŞKER

Persistan Epitel Defekti Varlığında Kontrolsüz Topikal Streroid Kullanımı Sonrası Gelişen Korneal Perforasyon ve Göz İçi Lens Prolapsusu

Musa ÇAPKIN, ALİ ŞİMŞEK, BURAK BİLGİN, Ali Hakim REYHAN