Travmatik kataraktlı olgularda cerrahi sonuçların değerlendirilmesi
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Tarih
2012
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Gazi Göz Vakfı
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Öz:Amaç: Travmatik kataraktlı hastalarda cerrahi sonuçların değerlendirilmesi ve görme keskinliği üzerine etkili faktörlerin araştırılması. Gereç ve Yöntemler: İstanbul Tıp Fakültesi Göz Hastalıkları Anabilim Dalı'nda 1993-2008 yılları arasında kliniğimize göz travması nedeni başvuran hastaların dosyaları geriye dönük olarak incelenmiştir. Hastalar epidemiyolojik özellikler, klinik bulgular ve uygulanan tedaviler açısından değerlendirilmiştir. Bulgular: Toplam 157 hastanın 158 gözü çalışmaya alınmıştır. Hastaların 37'si (%23.5) kadın, 120'si (%76.5) erkekti (p<0.001). Hastaların ortalama yaşı 24.9±12.3 (2-78) yaştı. Ortalama takip süresi 14.2±11.6 (6-102 ay) ay olarak tespit edildi. Hastaların 62'si travmadan sonraki ilk 6 saatte, 25'i 6-24 saat arasında, 20'si ilk hafta içinde, 50'si ise travmadan 1 hafta sonra kliniğimize başvurmuştu. 157 hastanın %63'ünde penetran, %37'sinde ise künt travma ile yaralanma meydan gelmişti. Başlangıç görme keskinlikleri tüm hastalarda 0.3 ve altındaydı. İki hastada başvuru anında görme keskinliği I (-) olarak saptandı. Olguların %21'inde uveal doku prolapsusu, %18'inde hifema, %10'unda travmatik midriasis mevcuttu. Başvuru esnasında dört hastada glob içi yabancı cisim, altı hastada retina dekolmanı, bir hastada koroid dekolmanı saptandı. Travmatik katarakt olguların %28'inde primer (reperasyon ile birlikte) olarak, %72'sinde ise reperasyonu takiben sekonder cerrahi şeklinde tedavi edilmiştir. Takip süresi altı aydan kısa olan beş hastanın uzun dönem sonuçları değerlendirilmemiştir. Snellen eşeline göre en son düzeltilmiş görme keskinlikleri 83 hastada 0.3 ve altı, 38 hastada 0.3-0.6 arasında, 31 hastada ise 0.6 ve üzerindeydi. Künt travmalı olgularda penetran travmalı olgulara göre son görme keskinliklerinin daha iyi olduğu görüldü. Başlangıç görme keskinlikleri daha kötü olan olgularda en son görme keskinliklerinin de daha kötü olduğu saptanmıştır. Sonuç: Travmatik kataraktlı hastalarda son görme keskinliğini belirleyen en önemli faktörlerden biri başlangıç görme keskinliğidir. Travmatik kataraktın tedavisi primer veya sekonder olarak yapılabilir ancak enflamasyonun gerilemesi ve yara yerinin iyileşmesi ile katarakt ekstraksiyonunun sekonder olarak tedavi edilmesi ile daha iyi sonuçlar elde edilebilir.
Abstract:Purpose: To investigate the surgical results in patients with traumatic cataract and assess the prognostic factors on visual acuity. Material and Methods: Files of patients with ocular trauma treated between 1993-2008 in Istanbul University, Istanbul Faculty of Medicine, Department of Ophthalmology were reviewed retrospectively. Patients were analysed according to epidemiological features, clinical findings and applied surgical techniques. Results: 157 eyes of 158 patient were studied. 37 patients (23.5%) were women, 120 (76.5%) were men (p<0.001). The mean age of the patients was 24.9 (2-78). Following trauma, 62 patients in the first 6 hours, 25 patients between 6-24 hours, 20 patients after 24 hours and 50 patients within 1 week after the trauma were admitted to the clinic. Of 157 patients 62.7% had penetrating trauma and 37.2% had blunt trauma. Initial visual acuity was 0.3 and under in all patients. Visual acuity of two patients were I (-) initially. 21% of patients had uveal prolapsus, 18% of patients had hyphema, and 10% of patients had traumatic mydriasis. Four patients had intraocular foreign body, six patients had retinal detachment and one patient has choroidal detachment . 27.8% of traumatic cataract cases was treated primarily and 72.1% was treated secondarily. Five patients with follow-up <6 months were not evaluated. Best corrected visual acuity was &#8804;0.3 in 83 patients, 0.3-0.6 in 38 patients, and >0.6 in 31 patients at final examination. Patients with blunt trauma had better prognosis compared to patients with penetrating injury. Patients with worse initial visual acuity had worse prognosis. Conclusions: One of the most important factors that affect final visual acuity in traumatic cataract patients is initial visual acuity. Traumatic cataract may be treated primarly or secondarly, but better surgical results can be achieved in secondary surgery due to good wound healing and regression of inflammation.
Abstract:Purpose: To investigate the surgical results in patients with traumatic cataract and assess the prognostic factors on visual acuity. Material and Methods: Files of patients with ocular trauma treated between 1993-2008 in Istanbul University, Istanbul Faculty of Medicine, Department of Ophthalmology were reviewed retrospectively. Patients were analysed according to epidemiological features, clinical findings and applied surgical techniques. Results: 157 eyes of 158 patient were studied. 37 patients (23.5%) were women, 120 (76.5%) were men (p<0.001). The mean age of the patients was 24.9 (2-78). Following trauma, 62 patients in the first 6 hours, 25 patients between 6-24 hours, 20 patients after 24 hours and 50 patients within 1 week after the trauma were admitted to the clinic. Of 157 patients 62.7% had penetrating trauma and 37.2% had blunt trauma. Initial visual acuity was 0.3 and under in all patients. Visual acuity of two patients were I (-) initially. 21% of patients had uveal prolapsus, 18% of patients had hyphema, and 10% of patients had traumatic mydriasis. Four patients had intraocular foreign body, six patients had retinal detachment and one patient has choroidal detachment . 27.8% of traumatic cataract cases was treated primarily and 72.1% was treated secondarily. Five patients with follow-up <6 months were not evaluated. Best corrected visual acuity was &#8804;0.3 in 83 patients, 0.3-0.6 in 38 patients, and >0.6 in 31 patients at final examination. Patients with blunt trauma had better prognosis compared to patients with penetrating injury. Patients with worse initial visual acuity had worse prognosis. Conclusions: One of the most important factors that affect final visual acuity in traumatic cataract patients is initial visual acuity. Traumatic cataract may be treated primarly or secondarly, but better surgical results can be achieved in secondary surgery due to good wound healing and regression of inflammation.
Açıklama
Anahtar Kelimeler
Travmatik katarakt, Fakoemulsifikasyon, Göz yaralanmaları, Traumatic cataract, Phacoemulsification, Eye injuries
Kaynak
Glokom Katarakt
WoS Q Değeri
Scopus Q Değeri
Cilt
7
Sayı
2
Künye
Alp, D., Yeniad, B., Erşan, M. C., Cingü, A. K., Tuncer, S., Özgün, C. ve diğerleri. (2012). Travmatik kataraktlı olgularda cerrahi sonuçların değerlendirilmesi. Glokom Katarakt, 7(2), 118-122.
