Emrah ÖZTÜRK, Abuzer GÜNDÜZ, Nur GÜNGÖR, Zarife EKİCİ GÖK

İnfantil Ekzotropyada Preoperatif Deviasyonun Cerrahi Başarı ve Duyusal Fonksiyon Üzerindene Etkisi

Amaç: Bu çalışma, infantil ekzotropyada preoperatif deviasyonun cerrahi başarı ve duyusal fonksiyon üzerine etkisini değerlendirmeyi amaçlamaktadır. Ayrıca, bu hastalarda geç cerrahi zamanlamanın etkilerini değerlendirmektedir. Materyal ve metod: Bu retrospektif çalışmada, 2012-2018 yılları arasında infantil ekzotropyası olan ve cerrahi tedavi uygulanan 16 hasta değerlendirdi. Preoperatif kayma açısının cerrahi başarı ve duyusal fonksiyon üzerine etkisini değerlendirmek için kayma açısı ≤ 50 prizm diyoptri (PD) olan hastalar Grup 1'e, > 50 PD olan hastalar ise Grup 2'ye dahil edildi. Cerrahi başarı ≤5 PD esotropya ve ≤10 PD ekzotropya olarak tanımlandı. Duyusal fonksiyon değerlendirmesi için Titmus stereopsis ve Worth 4-Nokta testleri kullanıldı. Bulgular: Hastaların ortalama preoperatif kayma açısı 50,63 ± 18,7 PD (20-90) idi. Ameliyat anında ortanca yaş 73 (24-400) aydı. İlk ameliyattan sonra hastaların% 75'inde cerrahi başarı sağlanırken, ikinci ameliyattan sonra tüm hastalarda cerrahi başarı gözlendi. Duyusal fonksiyon 11 test edilebilir hastada (% 68.7) değerlendirildi. Bu hastaların 5'inde (% 45.4) Worth 4- nokta testinde füzyon görüldü ve 2'sinde (% 18.1) ölçülebilir stereopsis elde edildi. Preoperatif kayma açısının füzyon üzerine etkisi saptanırken stereopsis ve cerrahi başarı üzerine etkisi olmadığı gözlendi (sırasıyla p = 0,015; p = 0,45; p = 0,77). Sonuç: Daha düşük preoperatif kayma açısı, daha yüksek oranda duyusal füzyon gelişimi ile ilişkili olabilir. Ayrıca bu hastalarda geç cerrahi zamanlama ile nispeten yüksek cerrahi başarı elde edilebilir.

Anahtar Kelimeler:

Ekzotropya, Preoperatif kayma açısı, Stereopsis, Şaşılık

The Clinical Effect of Preoperative Deviation on Surgical Success and Sensory Function in Infantile Exotropia

Background: This study aims to assess the impact of preoperative deviation on surgical success and sensory function in infantile exotropia. Furthermore, to assess the effects of late surgical timing in these patients.Materials and Methods: This retrospective study evaluated 16 subjects with infantile exotropia that underwent surgical management between 2012 and 2018. Patients with deviation ≤ 50 prism diopters (PD) were added to Group 1, and Patients with deviation > 50 PD were added to Group 2 to assess the impact of preoperative deviation on surgical success and sensory function. The surgical success is descri-bed as ≤5 PD esotropia and ≤10 PD exotropia for patients. The Titmus stereopsis and Worth 4-Dot tests were used for sensory function assessment.Results: The average preoperative deviation was 50,63 ± 18,7 PD (20-90). The median age at the time of surgery was 73 (24-400) months. Surgical success was observed in 75% of the patients after the first surgery, and surgical success was observed in all patients after the second surgery. The sensory function was assessed in 11 testable patients (68.7%), of which 5 (45.4%) fusion was observed in the Worth 4-Point test, and 2 (18.1%) achieved measurable stereopsis. While the preoperative deviation had an effect on fusion, it had no effect on stereopsis and surgical success(p=0,015; p=0,45; p=0,77 respectively).Conclusions: The smaller preoperative deviation may be associated with a higher rate of sensorial fusion development. Furthermore, relatively high surgical success can be achieved with late surgical timing in these patients.Keywords: Exotropia, Preoperative deviation, Strabismus, Stereopsis

Keywords:

Exotropia, Preoperative deviation, Strabismus, Stereopsis,

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