Muller Kası Konjonktival Rezeksiyon Cerrahisi: Yeni Bir Method İle Cerrahi Sonuçların Değerlendirilmesi

Year 2024, Volume: 46 Issue: 2, 183 - 189, 18.03.2024

Demet Yolcu Fulya Yaylacioglu Tuncay

https://doi.org/10.20515/otd.1390887

Abstract

Çalışmanın amacı Muller kası konjonktiva rezeksiyon (MKKR) cerrahisi sonrasında üst göz kapağı pozisyonunu oto-refraktometre (OR) ön monitör görüntüleri (ÖMG) kullanarak uygulanan daha standardize ve objektif bir method ile değerlendirmektir. Ocak 2020 ile Nisan 2023 tarihleri arasında 6 mm veya 8 mm MKKR cerrahisi uygulanan hastaların tıbbi kayıtları incelendi. Oto-refrektometre ön monitör görüntüleri cerrahi öncesinde ve takip sürecinde olgulardan alındı. Margin reflex distance 1 (MRD1) değeri OR-ÖMG ve ImageJ proğramı kullanılarak ölçüldü. Başarı ölçüsü preoperatif ve postoperatif ortalama OR-MRD1 değerleri kullanılarak belirlendi. Çalışmaya dahil edilen 34 kişiden 14' ü 6 mm MKKR, 20' si 8 mm MKKR cerrahisi geçirmiş idi. Ortalama preoperatif OR-MRD1 değeri 6 mm rezeksiyon grubunda 2.1  0.8 mm ve 8 mm rezeksiyon grubunda 2,3  0,7 mm idi, ancak gruplar arasında istatistiksel olarak anlamlı değildi (p: 0,45). Cerrahi sonrası ortalama OR-MRD1 değeri 6 mm rezeksiyon grubunda 8 mm rezeksiyon grubuna göre daha yüksek idi, ancak fark istatistiksel olarak anlamlı değildi (p: 0.14). Ortalama OR-MRD1 farkı 6 mm rezeksiyon grubunda 1.4  0.2 mm ve 8 mm rezeksiyon grubunda 1.1  0.3 mm idi, ancak fark istatistiksel olarak anlamlı değildi (p: 0.09). Üst göz kapağı pozisyon değişikliği analizine göre (daha kolay ulaşılabilir, kost-effektif ve standardize bir yöntem kullanılarak ölçülen), MKKR cerrahisi sonrasında eksize edilen doku miktarı ile final üst göz kapağı pozisyonu arasında direkt bir ilişki yok idi ve mevcut literatür ile uyumlu olarak MKKR cerrahisi mekanik bir durumdan çok dinamik bir durumu tanımlamaktadır.

Keywords

Müller kası, pitozis, otorefraktometre

Muller’s Muscle Conjunctival Resection Surgery: Assessment of The Surgical Outcomes By Using a Novel Method

Abstract

The aim of the study was to analyze the upper eyelid position following the Muller’s muscle conjunctival resection (MMCR) surgery by using a more standardized and objective method which was obtained by using the autorefractometer (AR) front monitor image (FMI).: Medical records of the patients who underwent either 6 mm or 8 mm MMCR surgery between January 2020 to April 2023 were evaluated. The AR-FMIs were obtained before the surgery and during the follow-up period. The margin reflex distance 1 (MRD1) was measured by using the AR-FMI and ImageJ software. Outcome measures were derived from preoperative and postoperative mean AR-MRD1 values. Out of 34 subjects, 14 underwent 6 mm MMCR surgery and 20 underwent 8 mm MMCR surgery. Mean preoperative AR-MRD1 was 2.1  0.8 mm in the 6 mm resection group, and 2.3  0.7 mm in the 8 mm resection group and there was no statistically significant difference among the groups (p: 0.45). The mean postoperative AR-MRD1 value was higher in the 6 mm resection group when compared with the 8 mm resection group, however the difference was not statistically significant (p: 0.14). The mean AR-MRD1 difference was 1.4  0.2 mm in the 6 mm resection group and 1.1  0.3 mm in the 8 mm resection group, however, the difference was not significant (p: 0.09). According to the upper eyelid position change analysis (which was measured by using an easily evaluable, cost-effective and standardized method), the amount of the excised tissue following the MMCR surgery and final upper eyelid position was not associated directly and the result supported the current literature which propose that, changes in the upper eyelid position following the MMCR is a dynamic process rather than the mechanical process.

Keywords

Müller’s muscle, ptosis, autorefractometer

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