Reis AVŞAR, Fatih GÜMÜŞ, Bora YÜKSEL, Tuncay KÜSBECİ

AĞIR GÖZ SENDROMLU BİR OLGUNUN KLİNİK ÖZELLİKLERİ VE TEDAVİSİ

Giriş: Ağır Göz Sendromlu bir olgunun klinik özelliklerini ve tedavisini sunmak. Olgu: Elli dört yaşındaki kadın hasta, bir aydır sağ gözde içe kayma şikâyeti ile nöroloji kliniği tarafından kliniğimize danışıldı. Hastanın her iki gözünün psödofakik olduğu görüldü ve en iyi düzeltilmiş görme keskinliği Snellen eşeli ile sağ gözde 0,4, sol gözde 0,3 olarak ölçüldü. Primer pozisyonda sağ gözde ezotropya ve hipotropya mevcuttu. Prizma örtme testi ile sağda 45 prizma diyoptri ezotropya, 12 prizma diyoptri hipotropya saptandı. Sağ gözde yukarı ve dışa bakış -3 kısıtlı olarak izlendi. Hastanın orbita MR ve BT tetkikleri tamamlandı. Fundus muayenesinde bilateral patolojik myopi ile uyumlu olguya “Ağır Göz Sendromu” tanısı konuldu. Sağ gözde iç rektus kasına geriletme ve loop myopeksi ameliyatı uygulandı. Ameliyat sonrası birinci günde ortoforik izlendi. Cerrahi komplikasyon gelişmeyen hastanın ameliyat sonrası 12. ayda ortoforik pozisyonu devam etmekteydi. Tartışma: İç rektus geriletmesi ile birlikte loop myopeksi cerrahisi Ağır Göz Sendromu hastaların tedavisinde etkin bir seçenektir.

CLINICAL FEATURES AND SURGICAL MANAGEMENT OF A PATIENTS WITH HEAVY EYE SYNDROME

Introduction: To present clinical features and surgical management of a patients with heavy eye syndrome. Case: A 54-year-old female patient was consulted to our clinic by the neurology clinic with a complaint of right eye esotropia for a month. Both eyes of the patient were found to be pseudophakic and best corrected visual acuity was measured with Snellen chart as 0.4 in the right eye and 0.3 in the left eye. There was esotropia and hypotropia in the right eye in the primary position. Prism Cover test revealed 45 prism diopter esotropia and 12 prism diopter hypotropia on the right. In the right eye, upward and outward gaze was limited (-3). Orbital MR and BT examinations of the patient were completed. In the fundus examination, the case consistent with bilateral degenerative myopia was diagnosed with "heavy eye syndrome". Loop myopexy of the superior rectus and lateral rectus and recession to the medial rectus muscle was performed in the right eye. Postoperatively, the patient was orthophoric in primary position. There was no surgical complications. The ortophoria in primary position was maintained in the 12 th month after the operation. Discussion: The loop myopexy with medial rectus recession seems to be an effective treatment option in heavy eye syndrome patients.

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