Katarakt cerrahisi geçiren ve psödoeksfolyasyonu olan hastaların özellikleri ve karşılaşılabilecek problemler
Abstract
Amaç: Psödoeksfoliasyon(PEKS) Sendromu ve
glokomu olan hastaların demografik özellikleri, cerrahi sırasında
karşılaşılabilecek problemleri ve postoperatif komplikasyonları değerlendirmek.
Gereç ve Yöntem: Çalışmaya son 1 yıl içerisinde
katarakt cerrahisi geçiren hastaların dosyaları retrospektif taranarak, PEKS
tanılı 130 hastanın 147 gözü dahil edildi. Muayene bulguları, cerrahi ve
postoperatif takip bilgileri geriye dönük olarak tıbbi kayıtlardan alındı.
Hastalar PEKS olan ve olmayan olacak şekilde 2 gruba ayrıldı. Ameliyat öncesi
ve sonrası görme keskinlikleri, göz içi basınçları (GİB), pupil dilatasyonu,
zonül zayıflığı olup olmadığı, intraoperatif ve postoperatif komplikasyonlar
ile glokomu olan ve olmayan hastalar ayrı ayrı not edildi
Bulgular: Çalışmaya dâhil edilen hastaları
71’i erkek (%54,6), 59’u(%45,4) kadındı. Yaş ortalaması erkeklerde 68,62±8,04 iken,
kadınlarda 67,84±9,64 idi. Ameliyat öncesi zonül zayıflığı olan göz sayısı 69,
olmayan göz sayısı ise 78 idi. Ameliyat öncesi ve sonrası düzeltilmiş en iyi
görme keskinlikleri açısından karşılaştırıldıklarında her iki grupta da görme
düzeyinde artış vardı ve istatistiksel olarak ileri düzeyde anlamlıydı (p<0.001).
Hastaların ameliyat sonrası GİB değerleri ameliyat öncesi değerlere göre
istatistiksel olarak anlamlı derecede daha düşüktü (p<0.001). Hastalarda
ameliyat öncesi en sık görülen problem pupillanın zayıf dilatasyonu idi ve bu
oran tüm gözler içinde %81,75 (n:112) idi.
Sonuç: PEKS hastalarında
katarakt cerrahisini zorlaştıran birçok faktör bulunmaktadır ve cerrahlar bu
hastalarda katarakt cerrahisinin potansiyel komplikasyonlarının farkında
olmalıdır.
References
- 1. Shingleton BJ, Marvin AC, Heier JS, O'Donoghue MW, Laul A, Wolff B & Rowland A. Pseudoexfoliation: high-risk factors for zonule weakness and concurrent vitrectomy during phacoemulsification. J Cataract Refract Surg. 2010;36: 1261–1269.
- 2. Ritch R, Schlotzer-Schrehardt U. Exfoliation syndrome. Surv Ophthalmol. 2001;45:265–315.
- 3. Pseudoexfoliation syndrome and secondary cataract. Küchle M, Amberg A, Martus P, Nguyen NX, Naumann GO Br J Ophthalmol. 1997; 81(10):862-6.
- 4. Pseudoexfoliation syndrome with poorly dilating pupil: a light and electron microscopic study of the sphincter area. Repo LP, Naukkarinen A, Paljärvi L, Teräsvirta ME Graefes Arch Clin Exp Ophthalmol. 1996; 234(3):171-6.
- 5. Drolsum L, Ringvold A & Nicolaissen B. Cataract and glaucoma surgery in pseudoexfoliation syndrome: a review. Acta Ophthalmol Scand 2007; 85: 810–821.
- 6. Sunay F, Şentürk A, Borataç N, Şendilek B, Erbil H. Katarakt hastalarında eksfoliasyon sıklığı ve cerrahi sonuçlar. T Klin Oftalmoloji. 1997;6:31–5
- 7. Mönestam EI. Incidence of dislocation of intraocular lenses and pseudophakodonesis 10 years after cataract surgery. Ophthalmology 2009;116: 2315–2320
- 8. Schlötzer-Schrehardt U & Naumann GO. Ocular and systemic pseudoexfoliation syndrome. Am J Ophthalmol 2006; 141: 921–937
- 9. Conway RM, Schlotzer-Schrehardt U, Kuchle M & Naumann GO : Pseudoexfoliation syndrome: pathological manifestations of relevance to intraocular surgery. Clin Experiment Ophthalmol 2004;32: 199–210
- 10. Schlötzer-Schrehardt U & Naumann GO. A histopathologic study of zonular instability in pseudoexfoliation syndrome. Am J Ophthalmol 1994.118: 730–743
- 11. Shingleton BJ, Yang Y & O'Donoghue MW. Management and outcomes of intraocular lens dislocation in patients with pseudoexfoliation. J Cataract Refract Surg 2013; 39: 984–993.
- 12. Jehan FS, Mamalis N & Crandall AS . Spontaneous late dislocation of intraocular lens within the capsular bag in pseudoexfoliation patients. Ophthalmology 2001;108: 1727–1731.
- 13. Davis D, Brubaker J, Espandar L, Stringham J, Crandall A, Werner L & Mamalis N. Late in-the-bag spontaneous intraocular lens dislocation: evaluation of 86 consecutive cases. Ophthalmology 2009; 116: 664–670.
- 14. Pseudoexfoliation syndrome and phacoemulsification: a comparative study with a control population]. Aigbe N, Madzou M, Fiqhi A, Abdelkhalek R, Ahmimeche J, El Hamichi S, El Asri F, Karim R, Oubaaz A J Fr Ophthalmol. 2014; 37(6):e91-5.
- 15. Spontaneous late dislocation of intraocular lens within the capsular bag in pseudoexfoliation patients. Jehan FS, Mamalis N, Crandall AS Ophthalmology. 2001; 108(10):1727-31.
Characteristics and the problems that may be encountered in patients with psodoexfoliation who underwent cataract surgery
Abstract
Aim:
To evaluate demographic
characteristics, intraoperative problems and postoperative complications of
cataract surgery in patients with pseudoexfoliation (PEX) syndrome
Material
and Method: The files of patients who underwent cataract surgery
in the last 1 year were retrospectively scanned and 147 eyes of 130 patients
with PEX were included. Examination findings were obtained from medical records
retrospectively with information on surgery and postoperative follow-up
information. Patients were divided into 2 groups with and without PEX.
Preoperative and postoperative visual acuities, intraocular pressure (IOP),
pupil dilatation, presence of zone weakness, intraoperative and postoperative
complications, and patients with and without glaucoma were noted separately.
Results: Among
the patients included in the study were 71 men (54.6%) and 59 women (45.4%).
The mean age man was 68,62 ± 8,04 the mean age of women was 67,84 ± 9,64 for
females. There was an increase in visual acuity in both groups when compared
with the best corrected visual acuity before and after surgery (p<0.001).
The postoperative IOP values of the patients were significantly higher
statistically significantly lower than preoperative values (p<0.001). The
most common preoperative problem was weak dilatation of the pupil, which was
81.75% (n: 112) in all eyes.
Conclusion:
There are many factors that complicate cataract surgery in patients with PEX,
and surgeons should be aware of the potential complications of cataract surgery
in these patients.
References
- 1. Shingleton BJ, Marvin AC, Heier JS, O'Donoghue MW, Laul A, Wolff B & Rowland A. Pseudoexfoliation: high-risk factors for zonule weakness and concurrent vitrectomy during phacoemulsification. J Cataract Refract Surg. 2010;36: 1261–1269.
- 2. Ritch R, Schlotzer-Schrehardt U. Exfoliation syndrome. Surv Ophthalmol. 2001;45:265–315.
- 3. Pseudoexfoliation syndrome and secondary cataract. Küchle M, Amberg A, Martus P, Nguyen NX, Naumann GO Br J Ophthalmol. 1997; 81(10):862-6.
- 4. Pseudoexfoliation syndrome with poorly dilating pupil: a light and electron microscopic study of the sphincter area. Repo LP, Naukkarinen A, Paljärvi L, Teräsvirta ME Graefes Arch Clin Exp Ophthalmol. 1996; 234(3):171-6.
- 5. Drolsum L, Ringvold A & Nicolaissen B. Cataract and glaucoma surgery in pseudoexfoliation syndrome: a review. Acta Ophthalmol Scand 2007; 85: 810–821.
- 6. Sunay F, Şentürk A, Borataç N, Şendilek B, Erbil H. Katarakt hastalarında eksfoliasyon sıklığı ve cerrahi sonuçlar. T Klin Oftalmoloji. 1997;6:31–5
- 7. Mönestam EI. Incidence of dislocation of intraocular lenses and pseudophakodonesis 10 years after cataract surgery. Ophthalmology 2009;116: 2315–2320
- 8. Schlötzer-Schrehardt U & Naumann GO. Ocular and systemic pseudoexfoliation syndrome. Am J Ophthalmol 2006; 141: 921–937
- 9. Conway RM, Schlotzer-Schrehardt U, Kuchle M & Naumann GO : Pseudoexfoliation syndrome: pathological manifestations of relevance to intraocular surgery. Clin Experiment Ophthalmol 2004;32: 199–210
- 10. Schlötzer-Schrehardt U & Naumann GO. A histopathologic study of zonular instability in pseudoexfoliation syndrome. Am J Ophthalmol 1994.118: 730–743
- 11. Shingleton BJ, Yang Y & O'Donoghue MW. Management and outcomes of intraocular lens dislocation in patients with pseudoexfoliation. J Cataract Refract Surg 2013; 39: 984–993.
- 12. Jehan FS, Mamalis N & Crandall AS . Spontaneous late dislocation of intraocular lens within the capsular bag in pseudoexfoliation patients. Ophthalmology 2001;108: 1727–1731.
- 13. Davis D, Brubaker J, Espandar L, Stringham J, Crandall A, Werner L & Mamalis N. Late in-the-bag spontaneous intraocular lens dislocation: evaluation of 86 consecutive cases. Ophthalmology 2009; 116: 664–670.
- 14. Pseudoexfoliation syndrome and phacoemulsification: a comparative study with a control population]. Aigbe N, Madzou M, Fiqhi A, Abdelkhalek R, Ahmimeche J, El Hamichi S, El Asri F, Karim R, Oubaaz A J Fr Ophthalmol. 2014; 37(6):e91-5.
- 15. Spontaneous late dislocation of intraocular lens within the capsular bag in pseudoexfoliation patients. Jehan FS, Mamalis N, Crandall AS Ophthalmology. 2001; 108(10):1727-31.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original article |
| Authors | |
| Publication Date | June 1, 2018 |
| Published in Issue | Year 2018 Volume: 10 Issue: 2 |
e-ISSN: 2548-0251
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