Bilateral Eşzamanlı İntravitreal Enjeksiyonlarda İlaç ve Göz Spekulumunun Göziçi Basıncına Etkisi

Amaç:Bilateral aynı seansta intravitreal ranibizumab(IVR) ve aflibercept(IVA) enjeksiyon hastalarında göz spekulumunun(blefarosta) göziçi basıncı(GİB) değişimine etkisinin incelenmesiGereç-Yöntem: Diabetik retinopati ve makula ödemi nedeniyle ilk defa IVR ve IVA yapılan 36 şar hastanın 72 şer gözü değerlendirilmeye alındı.Önceden oküler cerrahi veya ilaç kullanım hikayesi olan hastalar çalışmaya alınmadı.Her iki gruptaki hastaların bir gözüne açık blefarosta(A),diğer gözüne kapalı blefarosta(K) uygulandı. Blefarosta takılmadan önce göziçi basıncı(AÖGİB,KÖGİB), takıldıktan sonra göziçi basıncı(ABGİB,KBGİB) ve enjeksiyon sonrası göziçi basıncı(AEGİB,KEGİB) kontakt el tonometresi ile ölçüldü. Bulgular:IVR grubunda 17 erkek,19 kadın,yaş ortalaması 67.0 ±8.5 yıl, IVA grubunda 18 erkek,18 kadın yaş ortalaması 64.90 ±6.32 yıldı,gruplar arasında istatistiksel farklılık yoktu.(sırasıyla p=0.6,p=0.12) IVR grubunda AÖGİB 18.07±4.60 mmHg, ABGİB 19.90 ± 5.59 mmHg, AEGİB 47.53 ±7.25 mmHg, KÖGİB 18.93 ±4.60 mmHg, KBGİB 22.33± 6.32 mmHg, KEGİB 52.07 ±2.62 mmHg iken IVA grubunda AÖGİB 17.17 ±3.24 mmHg, ABGİB 19.70 ±3.31mmHg, AEGİB 48.20 ±6.46 mmHg, KÖGİB 16.97±2.94 mmHg, KBGİB 19.57± 3.21 mmHg, KEGİB 39.70± 4.21 mmHg bulundu. AÖGİB,ABGİB,AEGİB,KÖGİB değerleri açısından gruplar arasında istatistiksel farklılık yoktu.(sırasıyla p değerleri 0.38, 0.86, 0.86, 0.054) KBGİB ve KEGİB değerleri IVA grubunda istatistiksel anlamlı derecede düşük bulundu.(sırasıyla p değerleri 0.037, 0.001) IVR grubunda AÖGİB-ABGİB farkı -1.83± 1.85, AÖGİB-AEGİB farkı -29.46 ±12.47, ABGİB-AEGİB farkı -27.63 ±12.60, KÖGİB-KBGİB farkı -3.40 ±3.57, KÖGİB-KEGİB -34.13 ±9.06, KBGİB-KEGİB farkı -30.73 ±9.56 iken IVA grubunda AÖGİB-ABGİB farkı -2.53± 2.40, AÖGİB-AEGİB farkı 31.03 ±16.96, ABGİB-AEGİB farkı -28.50 ±16.89, KÖGİB-KBGİB farkı -2.60 ±2.52, KÖGİB-KEGİB farkı -22.73 ±19.05, KBGİB-KEGİB farkı -20.13 ±18.94 bulundu. Gruplar arasında AÖGİB-ABGİB, AÖGİB-AEGİB, ABGİB-AEGİB, KÖGİB-KBGİB fark değerleri açısından istatistiksel farklılık yoktu.(sırasıyla p değerleri 0.21,0.68,0.82,0.32) IVA grubunda KÖGİB-KEGİB, KBGİB-KEGİB fark değerleri istatistiksel olarak anlamlı derecede düşüktü.(sırasıyla p değerleri 0.004, 0.008) Sonuç:IVA grubunda IVR grubuna göre kapalı blefarosta kullanılması ile daha az GİB değişimi sağlanabilmektedir.

Anahtar Kelimeler:

İntravitreal enjeksiyon, göziçi basıncı

Effects of Drug and Eye Speculum on the Intraocular Pressure in Bilateral Simultaneous Intravitreal Injections

Purpose: Investigation of the effects of intraocular pressure (IOP) changes on the eye speculum (blepharosta) in bilateral injections of intravitreal ranibizumab (IVR) and aflibercept (IVA)Material-Methods: Because of diabetic retinopathy and macular edema, 72 eyes of 36 patients with IVR and IVA for the first time were included in the evaluation.Patients with ocular surgery or drug use history were not included in the study. Patients in both groups had blepharosta, open blepharosta (A), and closed eye blepharosta (K). The intraocular pressure was measured by contact intraocular pressure (AEGIB, KEGIB), intraocular pressure (ABGİB, KBGİB) and post injection intraocular pressure (AEGİB, KEGİB) contact hand tonometry before insertion of the blepharostaResults: In the IVR group, 17 males and 19 females, mean age was 67.0 ± 8.5 years, 18 males and 18 females in the IVA group had a mean age of 64.90 ± 6.32 years. There were no statistically significant differences between the groups in the IVR group (p = 0.6, p = 0.12, respectively) In the IVR group, the AOGiB was 18.07 ± 4.60 mmHg, the ABGİB was 19.90 ± 5.59 mmHg, the AEGİB was 47.53 ± 7.25 mmHg, the KÖGİB was 18.93 ± 4.60 mmHg, the KBGİB was 22.33 ± 6.32 mmHg, the KEGİB was 52.07 ± 2.62 mmHg while in the IVA group was AOGİB 17.17 ± 3.24 mmHg and ABGİB 19.70 ± 3.31 mmHg mmHg, AEGİB 48.20 ± 6.46 mmHg, KÖGİB 16.97 ± 2.94 mmHg, KBGİB 19.57 ± 3.21 mmHg and KEGİB 39.70 ± 4.21 mmHg . There was no statistically significant difference between the groups in terms of values of AÖGİB, ABGİB, AEGİB, KÖGİB (p values 0.38, 0.86, 0.86, 0.054 respectively). The values of KBGİB and KEGİB were statistically significantly lower in the IVA group (pvalues 0.037, 0.001 respectively) In the IVR group, the difference between the AÖGİB-ABGİB difference was -1.83 ± 1.85, the difference between the AÖGİB-AEGİB difference -29.46 ± 12.47, ABGİB-AEGİB difference -27.63 ± 12.60, KÖGİB-KBGİB difference -3.40 ± 3.57, KÖGİB-KEGİB -34.13 ± 9.06, -30.73 ± 9.56 while in the IVA group the difference between AÖGİB-ABGİB -2.53 ± 2.40, AÖGİB-AEGİB difference 31.03 ± 16.96, ABGİB-AEGİB difference -28.50 ± 16.89, KÖGİB-KBGİB difference -2.60 ± 2.52, KÖGİB-KEGİB difference -22.73 ± 19.05 , And the difference between the rates of KBGİB-KEGİB was -20.13 ± 18.94. There were no statistically significant differences between the groups in terms of AÖGİB-ABGİB, AÖGİB-AEGİB, ABGİB-AEGİB and KÖGİB-KÖGİB difference values (p values 0.21,0.68,0.82,0.32 respectively). The values of KÖGİB-KEGİB and KBGİB-KEGİB difference were statistically significant (respectively p values of 0.004, 0.008) Conclusion: According to the IVR group in the IVA group, the use of closed blepharosta allows less IOP exchange.

Keywords:

Intravitreal injection, intraocular pressure,

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ISSN: 1309-3878
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 2009
Yayıncı: Düzce Üniversitesi Tıp Fakültesi Aile Hekimliği AD adına Yrd.Doç.Dr.Cemil Işık Sönmez