Konjenital Kataraktlı Olgularımızda Cerrahi Tedavi ve Takip Sonuçlarımız

Amaç: Konjenital katarakt tanısı almış ve klinik takibimizde olan hastaların cerrahi tedavi ve takip sonuçlarını incelemektir. Gereç ve Yöntem: Bu çalışmada konjenital katarakt tanısı konularak, ön kesintisiz kürvilineer kapsüloreksis (ÖKKK), fakoaspirasyon, arka kesintisiz kürvilineer kapsüloreksis (AKKK), anterior vitrektomi operasyonu yapılmış, afakik takipte olan veya siliyer sulkusa göz içi lensi (GİL) implantasyonu uygulanmış, ameliyat tarihinde yaşları 0- 34 yıl arasında olan, 50 hastanın 84 gözü çalışma kapsamında değerlendirilmiştir. Bulgular: Takip süreleri ortalama 30.9±23 ay olarak tespit edildi. 16 göz ortalama 33 ay takip edildikten sonra, ortalama 45. Ayda, 57 göze ise ilk operasyonda siliyer sulkusa GİL uygulaması yapıldı. Takip süresince 7 gözde sekonder glokom, 9 gözde GİL dislokasyonu, 17 gözde pupilla düzensizliği ve irisde lokalize iris atrofileri, 5 gözde ön vitreusta membran geliştiği görüldü. Hastaların preoperatif en iyi düzeltilmiş görme keskinliği(EİDGK) 0.08±0.02(P+P+ veya el hareketleri seviyesi (EHS)- 5 metreden parmak sayma (mps)), postoperatif EİDGK 0.4±0.3 tespit edilmiş olup, istatiksel olarak anlamlıydı( P<0.001).Afakik takibi yapılıp sekonder GİL uygulanan 16 hastanın son kontrol muayenelerindeki görme düzeyleri ortalama 0.2 seviyesinde tespit edildi. Sonuç: Konjenital kataraktın cerrahi tedavisinde, ÖKKK, fakoaspirasyon, AKKK, Anterior Vitrektomi ve/veya Siliyer Sulkusa GİL İmplantasyonu, arka kapsül kesafetini önlemede ve cerrahiye ait komplikasyonların minimalize edilmesinde etkili, güvenilir, iyi görsel sonuçlar veren tekniktir.

Anahtar Kelimeler:

Afakik tashih, anterior vitrektomi, arka kesintisiz kürvilineer kapsüloreksis, göz içi lens implantasyonu, konjenital katarakt

Surgical Treatment And Follow-Up Results In Our Congenital Cataract Cases

Objective: Our aim to examine the results of surgical treatment and follow-up of patients diagnosed with congenital cataract and who are under our clinical follow-up. Material and Method: In this study, a diagnosis of congenital cataract was made, anterior continuous curvilinear capsulorhexis, phacoaspiration,posterior continuous curvilinear capsulorhexis, anterior vitrectomy operation and/or intraocular lens implantation was performed in the ciliary sulcus, apakic follow-up was performed, and patients aged 0-34 years at the time of surgery. 84 eyes of 50 patients were evaluated Results: The mean follow-up period was 30.9±23months.After an average of 33 months of follow-up in 16 eyes, intraocular lens was applied to the ciliary sulcus in 57 eyes at an average of 45 months. During the follow-up period, secondary glaucoma was observed in 7eyes, intraocular lens dislocation in 9 eyes, pupillary irregularity and localized iris atrophy in 17 eyes,and anterior vitreous membrane development in 5 eyes. The preoperative best corrected visual acuity of the patients was 0.08±0.02 (P+P+ or hand motion-5m counting finger), and the postoperative best corrected visual acuity was 0.4±0.3, which was statistically significant(P<0.001).Apakic follow-up and secondary intraocular lens were applied to 16 patients, with an average visual acuity of 0.2. Conclusion: In the surgical treatment of congenital cataracts, anterior continuous curvilinear capsulorhexis, phacoaspiration, posterior continuous curvilinear capsulorhexis, anterior vitrectomyand/or intraocular lens implantation into the ciliary sulcus is an effective, reliable, and good visual technique in preventing posterior capsule occlusion and minimizing surgical complications.

Keywords:

Afakik tashih, anterior vitrektomi, arka kesintisiz kürvilineer kapsüloreksis, göz içi lens implantasyonu, konjenital katarakt,

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