Akademik Veri Yönetim Sistemi
Türk Oftalmoloji Dergisi, cilt.38, ss.400-405, 2008 (SCI-Expanded)
Amaç: 23 Gauge (G) transkonjonktival dikiflsiz pars plana vitrektomi (PPV) tekniginin anatomik, fonksiyonel sonuçlar›yla komplikasyonlar› belirlemek ve bu sistemin kullan›m avantaj ve dezavantajlar›n› degerlendirmek. Gereç-Yöntem: Yayg›n vitreoretinal disseksiyon, silikon tamponat kullan›lmas› gibi giriflimlerin gerekmeyecegi ve PPV cerrahisinin k›sa sürecegini düflündügümüz, 23-G vitrektomi sisteminin kullan›ld›g› 17 hastan›n (ortalama yafl 60) 17 gözüne ait dosyalar tarand›. Ameliyat esnas›ndaki ve sonras›ndaki komplikasyonlar ile ameliyattan önce ve sonras›ndaki kontrollerde muayene edilerek en iyi görme keskinligi, göz içi bas›nc› ve cerrahinin anatomik sonuçlar› incelendi. Sonuçlar: Ortalama takip süresi 5.4 ayd›. Vitreus içi kanama (n=5), proliferatif diyabetik retinopati (n=7), epimaküler membran (n=3), maküla deligi (n=1), y›rt›kl› retina dekolman› (n= 1) nedeniyle 23G PPV sistemi ile opere edilen gözlerin hepsinde cerrahi baflar›yla tamamland›. Alt› gözde bir ya da iki sklerotomi girifl yerine sütür konuldu. 23G PPV operasyonu sonras› endoftalmi geliflen bir göz ikinci bir operasyona gitti. ‹ki gözde ameliyat sonras› ilaçla kontrol alt›- na al›nan geçici göz içi bas›nç yükselmesi oldu. Proliferatif diyabetik retinopatili 2 gözde ameliyat sonras› takiplerde vikrektomi sonras› vitreus içi kanama geliflti. Hiçbir gözde hipotoni, koroid veya retina dekolman› görülmedi. Ameliyat öncesi Snellen görme keskinligi ortalama (± SEM) 0.07 ± 0.05'den son takipte 0.30 ± 0.08'e yükseldi (P=0.011). Tart›flma: 23G dikiflsiz PPV teknigi, seçilmifl vakalarda etkin bulunmufl, anatomik ve fonksiyonel baflar› saglanm›flt›r. Anahtar Kelimeler: 23 Gauge vitrektomi, epimaküler membran, maküla deligi, proliferatif diyabetik retinopati, vitreus içi kanama
23 Gauge Sutureless Transconjunctival Vitrectomy Surgery: Preliminary Results Purpose: To determine anatomic and functional results with the complications and to evaluate the advantages, disadvantages of 23Gauge (G) transconjunctival sutureless vitrectomy technique. Materials-Methods: Records of 17 eyes of 17 patients (mean age: 60 years) in which interventions like diffuse vitreoretinal dissection, silicone oil injection wouldn't be needed and PPV wouldn't be complicated and long lasting were screened. Intra- and postoperative complications as well as pre- and postoperative best corrected visual acuity, intraocular pressure and anatomical results of the surgery were reviewed. Results: The mean follow-up of the patients were 5.4 months. 23G PPV operation was ended successfully in eyes with vitreous hemorrhage (n=5), proliferative diabetic retinopathy (n= 7), epimacular membrane (n=3), macular hole (n=1), rhegmatogenous retinal detachment (n=1). Suture was needed in one or two sclerotomy entry site in 6 eyes. One eye that developed endophthalmitis following 23G PPV underwent second operation. Two eyes developed intraocular pressure elevation that was controlled by medication. There was not statistically significant difference between preoperative and postoperative mean intraocular pressure values. Postvitrectomy hemorrhage was noted in 2 eyes with proliferative diabetic retinopathy. No hypotonia, choroidal or retinal detachment was noted in any eyes. The average (± SEM) postoperative best corrected visual acuity (0.07 ± 0.05) was found improved (0.30 ± 0.08) at the last follow-up (P= 0.011). Conclusion: In appropriate cases, 23G PPV technique was found effective in achieving successful anatomic and functional outcomes Key Words: 23 Gauge virectomy, epimacular membrane, macular hole, proliferative diabetic retinopathy, vitreus hemorrhage.