MİKROKOAKSİYAL FAKOEMÜLSİFİKASYON CERRAHİSİYLE KOAKSİYAL FAKOEMÜLSİFİKASYON CERRAHİSİNİN CERRAHİYE BAĞLI ASTİGMATİZMA VE KORNEAL PAKİMETRİ DEĞİŞİMLERİNİN KARŞILAŞTIRILMASI

DOI: 10.26650/IUITFD.396179Amaç: 2,2 mm’lik kesi ile yapılan mikrokoaksiyal fakoemülsifikasyon cerrahisini, 2,75 ve 3,2 mm’lik kesi ile yapılan standart koaksiyal fakoemülsifikasyon cerrahisi ile cerrahiye bağlı astigmatizma (CBA) ve pakimetrik değişimler açısından karşılaştırmak.Gereç ve Yöntem: Katarakt operasyonu yapılan 39 olgunun kayıtları retrospektif olarak incelendi. Olguların hangi büyüklükte kesi ile opere edilecekleri rastgele belirlendi. Mikrokoaksiyal grupta 15 göz, standart koaksiyal grupta ise 24 göz bulunmaktaydı, Olgulara preoperatif ve postoperatif 1. ayda Pentacam Scheimpflug kamera (OCULUS Inc., Almanya) ile kornea topografisi analizi yapıldı. Pentacam’ın iki topografi arasındaki değişikliği hesaplayan fark haritasındaki astigmatizma ve pakimetri değerleri karşılaştırıldı. Vektöryel analiz programı kullanarak cerrahiye bağlı astigmatizma değerleri hesaplandı.Bulgular: Postoperatif 1. aydaki vektöryel analiz programı ile hesaplanan CBA değerleri mikrokoaksiyal cerrahi grubunda 0,55±0,37 D, koaksiyal cerrahi grubundaki 0,53±0,24 D olarak ölçüldü ve aralarında anlamlı bir fark yoktu (p=0,743). Pentacam fark haritasında ölçümlerde mikrokoaksiyal cerrrahi grubunda astigmatizma değişimi 0,41±0,62 D saptanırken koaksiyal cerrahi grubunda 0,44 ± 0,40 D saptandı. Gruplar arasında anlamlı farklılık yoktu (p=0,578 ). Postoperatif 1. haftadaki görme keskinliği anlamlı bir şekilde mikrokoaksiyal grupta daha yüksek düzeydeydi. (p=0,004).Mikrokoaksial kesi ile opere edilen grupta kornea kalınlığında postoperatif 1. ayda ortalama 6,47 ± 21,16 mikron azalma saptanırken diğer grupta ortalama 12,62 ±30,01 mikron artış saptandı. Aralarındaki fark anlamlı bulundu (p=0,004). Sonuç: Postoperatif 1. aydaki CBA değerleri, literatürdeki CBA değerleri ile benzer sonuçlar vermiş ancak iki grup arasında anlamlı bir farklılık saptanmamıştır. Mikrokoaksiyal cerrahi grubunda postoperatif görsel rehabilitasyon daha erken sağlanmaktadır.

Anahtar Kelimeler:

Astigmatizma, fakoemülsifikasyon, katarakt, kornea topografisi, tedavi sonucu

COMPARISON OF CORNEAL PACHYMETRY CHANGES AND SURGICALLY INDUCED ASTIGMATISM OF MICROCOAXIAL PHACOEMULSIFICATION SURGERY AND COAXIAL PHACOEMULSIFICATION SURGERY

DOI: 10.26650/IUITFD.396179Objective: This study aimed to evaluate the corneal pachymetry changes and surgically induced astigmatism (SIA) values in microcoaxial phacoemulsification surgery with a 2.2 mm incison and to compare those of the standard coaxial phacoemulsification surgery with a 2.75 mm and 3.2 mm incision.Materials and Methods: The medical records of 39 cases who underwent cataract surgery were retrospectively evaluated. There were 15 eyes in the microcoaxial surgery group and 24 eyes in the standard coaxial surgery group. The preoperative and postoperative 1-month corneal topographies of the cases were analysed with a Pentacam Scheimpflug camera (OCULUS Inc., Germany). The astigmatism and pachymetry values in the Pentacam difference map were compared. Surgically induced astigmatism values were calculated with a vectorial analysis programme.Results: The SIA calculated with the vectorial analysis programme on the postoperative at 1 month was 0.55±0.37 D in the microcoaxial surgery group and 0.53±0.24 D in the coaxial surgery group (p=0.743). The astigmatism in the Pentacam difference map is 0.41±0.62 D in the microcoaxial surgery group and 0.44±0.40 D in the coaxial surgery group (p=0.578). Postoperative visual acuity at 1 week was significantly higher in the microcoaxial group (p=0.004). The corneal thickness decreased by/6.47±21.16 microns in the microcoaxial group and increased by/ 12.62±30.01 microns in the coaxial group (p=0.004). Conclusion: The postoperative 1 month SIAs of the groups are similar to the values of previous studies but there isn’t any significant difference between groups. Postoperative visual rehabilitation is provided earlier in the microcoaxial surgery group.

Keywords:

Astigmatism, cataract, corneal topography, phacoemulsification, treatment outcome,

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1. Kuyumcu S, Horoz H, Erbil HH: 5.5 mm’lik kesiyle fakoemülsifikasyon sonrası oluşan cerrahiye bağlı astigmatizma. T Oft Gaz 2001;31:50-3.
2. Agarwal A, Agarwal A, Agarwal S, Narang P, Narang S. Phakonit: phacoemulsification through 0.9 mm corneal incision. J Cataract Refract Surg 2001;27(10):1548-52.
3. Kurz S, Krummenauer F, Gabriel P, Pfeiffer N, Dick HB. Biaxial microincision versus coaxial small-incision clear cornea cataract surgery. Ophthalmology 2006;113(10):1818-26.
4 Stratas BA. Clear corneal paracentesis: a case of chronic wound leakage in a patient having bimanual phacoemulsification. J Cataract Refract Surg 2005;31(5):1075.
5. Berdahl JP, DeStafeno JJ, Kim T. Corneal wound architecture and integrity after phacoemulsification; evaluation of coaxial,microincision coaxial, and microincision bimanual techniques. J Cataract Refract Surg 2007;33(3):510-5.
6. Osher RH, Injev VP.Thermal study of bare tips with various system parameters and incision sizes.J Cataract Refract Surg 2006;32(5):867-72.
7. Minassian DC, Rosen P, Dart JK, Reidy A, Desai P, Sidhu M, et al. Extracapsular cataract extraction compared with small incision surgery by phacoemulsification: a randomised trial. Br J Ophthalmol 2001;85(7):822-9.
8. Osher RH, Injev VP. Microcoaxial phacoemulsification. Part 1: laboratory studies. J Cataract Refract Surg 2007;33(3):401-7.
9. Chylack LT Jr, Wolfe JK, Singer DM, Leske MC, Bullimore MA, Bailey IL, et al. The lens opacities classification system ııı.the longitudinal study of cataract study group. Arch Ophthalmol 1993;111(6):831-6.
10. Eğrilmez S, Dalkılıç G, Yağcı A. Astigmatizma analizinde vektöryel analiz programı. T Oft Gaz 2003;3:404-16.
11. Koch MJ, Kohnen T. Refractive cataract surgery. Cur Opin Ophthalmol 1999;10(1):10-5.
12. Cavallini GM, Verdina T, De Maria M, Fornasari E, Torlai G, Volante V, et al.Bimanual microincision cataract surgery with implantation of the new Incise® MJ14 intraocular lens through a 1.4 mm incision. Int J Ophthalmol 2017;10(11):1710-5.
13. Clayman HM. Evolution and current status of cataract surgery. Ophthalmic surgery principles and techniques. Albert DM. Ed. Oxford: Blackwell Science, Inc. 1999; Vol. 2, Chapter 21:250-6.
14. Alió JL, Rodriguez-Pratts JL, Vianello A, Galal A. Visual outcome of microincision cataract surgery with implantation of an Acri. smart lens. J Cataract and Refract Surg 2005;31(8):1549-56.
15. Olson RJ. Clinical experience with 21-gauge manual microphacoemulsification using Sovereign Whitestar technology in eyes with dense cataract. J Cataract Refract Surg 2004;30(1):168-72.
16. Tsuneoka H, Shiba T, Takahashi Y. Feasibility of ultrasound cataract surgery with a 1.4 mm incision. J Cataract Refract Surg 2001;27(6):934-40.
17. Chee SP, Bacsal K. Endophthalmitis after microincision cataract surgery. J Cataract Refract Surg 2005;31(9):1834-5.
18. Kaufmann C, Thiel MA, Esterman A, Dougherty PJ, Goggin M. Astigmatic change in biaxial microincisional cataract surgery with enlargement of one incision: a prospective controlled study. Clin Experiment Ophthalmol 2009;37(3):254-61
19. Can I, Takmaz T, Yıldız Y, Bayhan HA, Soyugelen G, Bostancı B. Coaxial, microcoaxial, and biaxial microincision cataract surgery: Prospective comparative study. J Cataract Refract Surg 2010;36(59):740-6.
20. Hayashi K, Yoshida M, Hayashi H. Postoperative corneal shape changes: microincision versus small-incision coaxial cataract surgery. J Cataract Refract Surg 2009;35(2):233-9.
21. Tejedor J, Pérez-Rodríguez JA. Astigmatic change induced by 2.8-mm corneal incisions for cataract surgery. Invest Ophthalmol Vis Sci 2009;50(3):989-94.
22. Ernest P, Potvin R. Effects of preoperative corneal astigmatism orientation on results with a low-cylinder-power toric intraocular lens. J Cataract Refract Surg 2011;37(4):727-32.
23. Borasio E, Mehta JS, Maurino V. Torque and flattening effects of clear corneal temporal and on-axis incisions for phacoemulsification. J Cataract Refract Surg 2006;32(12):2030-8.
24. Rainer G, Menapace R, Vass C, Annen D, Findl O, Schmetterer K.Corneal shape changes after temporal and superolateral 3.0 mm clear corneal incisions. J Cataract Refract Surg 1999;25(8):1121-6.
25. Yu YB, Zhu YN, Wang W, Zhang YD, Yu YH, Yao K. A comparable study of clinical and optical outcomes after 1.8, 2.0 mm microcoaxial and 3.0 mm coaxial cataract surgery. Int J Ophthalmol 2016;9(3):399-405.
26. Denoyer A, Ricaud X, Van Went C, Labbé A, Baudouin C. Influence of corneal biomechanical properties on surgically induced astigmatism in cataract surgery. J Cataract Refract Surg 2013;39(8):1204-10.
27. Wang J, Zhang EK, Fan WY, Ma JX, Zhao PF. The effect of micro-incision and small-incision coaxial phaco-emulsification on corneal astigmatism. Clin Exp Ophthalmol 2009;37(7):664-9.
28. Musanovic Z, Jusufovic V, Halibasica M, Zvornicanin J. Corneal astigmatism after micro-incision cataract operation. Med Arh 2012;66(2):125-8.
29. Wei YH, Chen WL, Su PY, Shen EP, Hu FR. The influence of corneal wound size on surgically induced corneal astigmatism after phacoemulsification. J Formos Med Assoc (2012);111(5):284-9.
30. Kohnen T, Lambert RJ, Koch DD. Incision sizes for foldable intraocular lenses. Ophthalmology 1997;104(8):1277-86.
31. Mamalis N. Incision width after phacoemulsification with foldable intraocular lens implantation. J Cataract Refract Surg 2000;26(2):237-41.
32. Osher RH. Microcoaxial phacoemulsification Part 2: clinical study. J Cataract Refract Surg 2007;33(3):408-12.
33. Kohnen T, Kasper T. Incision sizes before and after implantation of 6-mm optic foldable intraocular lenses using Monarch and Unfolder injector systems. Ophthalmology 2005;112(1):58-66.
34. Kohnen T, Klaproth OK. Incision sizes before and after implantation of SN60WF intraocular lenses using the Monarch injector system with C and D cartridges. J Cataract Refract Surg 2008;34(10):1748-3.
35. Sedaghat MR, Daneshvar R, Kargozar A, Derakhshan A, Daraei M. Comparison of central corneal thickness measurement using ultrasonic pachymetry, rotating Scheimpflug camera, and scanning-slit topography. Am J Ophthalmol 2010;150(6):780-9
36. Binder PS, Sternberg H, Wickham MG, Worthen DM. Corneal endothelial damage associated with phacoemulsification. Am J Ophthalmol 1976;82(1):48-54
37. Sugar J, Mitchelson M, Kraff M. The effect of phacoemulsification on corneal endothelial cell density. Arch Ophthalmol 1978;96(3):446-8.
38. Rao GN, Shaw EL, Arthur EJ, Aquavella JV. Endothelial cell morphology and corneal deturgescence. Ann Ophthalmol 1979;11(6):885-99.
39. Salvi SM, Soong TK, Kumar BV, Hawksworth NR. Central corneal thickness changes after phacoemulsification cataract surgery. J Cataract Refract Surg 2007 Aug;33(8):1426-8.
40. Dosso AA, Cottet L, Burgener ND, Di Nardo S. Outcomes of coaxial microincision cataract surgery versus conventional coaxial cataract surgery. J Cataract Refract Surg 2008;34(2):284-8.
41. Alió JL, Agdeppa MC, Rodríguez-Prats JL, Amparo F, Pinero DP. Factors influencing corneal biomechanical changes after microincision cataract surgery and standard coaxial phacoemulsification. J Cataract Refract Surg 2010;36(6):890-7.
42. Jin C, Chen X, Law A, Kang Y, Wang X, Xu W, et al.Different-sized incisions for phacoemulsification in age-related cataract. Cochrane Database Syst Rev 2017;20;9:CD010510.

Başlangıç: 1916
Yayıncı: İstanbul Üniversitesi Yayınevi

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