Keratokonusta korneal cross-linking sonrasında intraoküler lens gücü hesaplaması

Amaç: Keratokonusta korneal kollajen cross-linking (CXL) tedavisi sonrası Barret formülü ile ölçülen monofokal göz içi lens (İOL) dioptrisi değişiminin araştırılması. Materyal ve Metod: Yirmi dört progresif keratokonuslu hastanın 30 gözü bu retrospektif çalışmaya dahil edildi. Progresif keratokonus nedeniyle CXL yapılan hastalardan, tedavi öncesi ve postoperatif 12. ayda optik biyometri analizleri optik düşük-kohorens reflektometre (Lenstar LS 900) ile yapılan gözlerin Barret formülü ile hesaplanan ortalama İOL ölçümleri ve aksiyel uzunluk (AU) değerleri hesaplandı. İstatistik için tekrarlı varyans analizi kullanıldı. Bulgular: Hastaların ortalama yaşı 18.66±0.77 yıl (12-27 yıl) idi. CXL öncesi ortalama İOL ölçümü 12.95±0.95 D iken, postoperatif 12. ayda 12.65±0.83 D olarak ölçüldü (p=0.441). AU değeri CXL öncesinde 23.58±0.12 mm iken, postoperatif 12.ayda 23.63±0.11mm olarak ölçüldü (p=0.001). Hiçbir hastada CXL sonrasında, keratometrik progresyon ve görme kaybına yol açabilecek komplikasyon saptanmadı. Tartışma: Keratokonusta CXL tedavisi sonrası takiplerde, topografik ve keratometrik parametreler yol gösterici olarak kullanılmaktadır. Bu nedenle tedavi sonuçları, keratometrik değerler ve aksiyel uzunluk gibi İOL ölçümü parametrelerinde etkili olabilmektedir. Çalışmamızda İOL ölçüm sonuçlarında anlamlı farklılık saptanmazken, AU değeri CXL sonrasında anlamlı düzeyde artmıştır.

Anahtar Kelimeler:

aksiyel uzunluk, biyometri, cross-linking, lens

Calculation of intraocular lens power after corneal cross-linking in keratoconus

Background: Investigation of monofocal intraocular lens (IOL) measurement with Barret Formula after corneal collagen cross-linking (CXL) treatment in keratoconus.Material and Methods: Thirty eyes of twenty-four progressive keratoconus patients were included in this retrospective study. Optic biometry measurements and axial length (AU) values were analyzed by optical low coherence reflectometer at preoperative and postoperative 12th month follow-up of patients with CXL due to keratoconus. The mean IOL measurements calculated by the Barret formula were used in the study. Repeated variance analysis was applied in the statistical evaluation.Results: The mean age of the patients was 18.66 ± 0.77 years (12-27 years). The mean IOL measurement before CXL was 12.95 ± 0.95 diopter (D), and 12.65 ± 0.83 D at postoperative 12 months (p = 0.441). The AL value was 23.58 ± 0.12 mm before CXL and 23.63 ± 0.11 mm at postoperative 12th month (p =0.001). None of the patients had any complications that could lead to progression and visual loss after CXL.Conclusions: Topographic and keratometric parameters are used as a guideline for follow-up after CXL treatment in keratoconus. For this reason, treatment results can be effect in IOL measurement parameters such as keratometry values and axial length. In our study, no significant difference was found the IOL measurement results, but the AL value was significantly increased after CXL.

Keywords:

Axial length, Biometry, Cross-linking, Lens,

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