BARUT Özlem SELVER, Nilüfer KOÇAK, Banu LEBE, Süleyman KAYNAK, Mehmet Özgür ZENGİN

Histological changes in the healing process of sclerotomy sites aft er 20-gauge and transconjunctival 23- and 25-gauge incisions in experimental model

Amaç: Tavşanlarda; 20-gauge sütürlü, 23-gauge ve 25-gauge transkonjonktival sütürsüz yapılan sklerotomilerin yara yeri iyileşmesinin değerlendirilmesi amaçlanmaktadır. Yöntem ve gereç: Çalışmaya alınan 16 tavşanın, 12 tanesinin sağ gözlerine 20-gauge standart, 23-gauge veya 25-gauge transkonjonktival olarak sklerotomiler açıldı, dört tavşan ise kontrol grubu olarak alındı. Çalışma gözleri, klinik olarak ameliyat sonrası birinci günde ve sonrasında da üç günde bir olacak şekilde iki hafta boyunca klinik olarak değerlendirildi. İki hafta sonra tavşanlar sakrifi ye edildi ve globlara enükleasyon uygulanarak histopatalojik değerlendirmeye alındı. Sklerotomi sahaları ışık mikroskobu altında yara iyileşmesi açısından histopatalojik açıdan semikantitatif olarak incelendi. Bulgular: Patolojik kesitler, sklerotomi sahalarının iyileşme paterni açısından incelendi. Ödem, mononükleer inflamatuar hücre infiltrasyonu, fibroplazi, yabancı cisim reaksiyonu, neovaskülarizasyon ve siliyer cisimdeki reaktifrejeneratif değişiklikler açısından değerlendirildi ve skorlandı. 20-gauge standart sklerotomi uygulanan gözlerde, fibroplazi ve siliyer cisimdeki reaktif-rejeneratif değişiklikler açısından istatistiksel anlamlı fark saptandı (P < 0,05). Yabancı cisim reaksiyonu açısından gruplar arasında istatistiksel fark yoktu (P > 0,05). Sonuç: Konjonktival peritomi ve sütürasyon uygulamaları gerektiren geleneksel 20-gauge sklerotomilere göre bu işlemler uygulanmaksızın yapılan transkonjonktival 23-gauge ve 25-gauge sklerotomi kesileri, bu özellikleri ile cerrahi süresini kısaltmakta, sütür materyallerine karşı gelişen lokal inflamatuvar reaksiyondan kaçınmayı sağlamakta, ameliyat sonrası inflamasyonu azaltmakta ve hızlı yara iyileşmesini desteklemektedir.

Deneysel hayvan modelinde 20-gauge ve transkonjonktival 23- ve 25-gauge sklerotomi sahalarının iyileşme sürecindeki histolojik değişiklikler

Aim: To evaluate the healing mechanism and histological changes of the 20-gauge standard, and 23- and 25-gauge transconjunctival sutureless vitrectomy (TSV) incisions in rabbits. Materials and methods: Twelve of 16 albino rabbits’ right eyes underwent sclerotomy of either 20-gauge standard, or 23-gauge or 25-gauge TSV incisions. Four rabbits were tested as controls. The study eyes were examined clinically on the first postoperative day and in 3-day periods for 2 weeks. After 2 weeks, rabbits were euthanized; globes were enucleated and underwent histological examination. The sclerotomy sites were investigated histopathologically under light microscope for wound healing semicantitatively. Results: Pathological sections were examined to monitor the healing course of the sclerotomy sites. Edema, mononuclear infl ammatory cell infiltration, fibroplasia, foreign body reaction, neovascularization, and reactive-regenerative changes on ciliary body were evaluated and scored. Fibroplasia and reactive-regenerative changes on ciliary body were statistically significant in eyes treated with 20-gauge standard sclerotomy (P < 0.05). For foreign body reaction results, there was no statistically significant difference between all groups (P > 0.05). Conclusion: Conventional 20-gauge sclerotomies required conjunctival peritomy and suturing. Transconjunctival 23-gauge and 25-gauge sclerotomy incision procedures without sutures and peritomy decrease overall surgical time, avoid the local inflammatory reaction to the suture materials, decrease postoperative inflammation, and support rapid healing recovery.

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