TY - JOUR T1 - SEKONDER GÖZ İÇİ LENS İMPLANTASYONU NEDENLERİ VE CERRAHİ SONUÇLARIMIZ TT - Causes of Secondary Intraocular Lens Implantation and Surgical Outcomes AU - Oğurel, Tevfik AU - Büyüktortop Gökçınar, Nesrin AU - Akbulut, Yaprak AU - Özkal, Fatma AU - Örnek, Nurgül AU - Onaran, Zafer PY - 2019 DA - August DO - 10.24938/kutfd.591109 JF - The Journal of Kırıkkale University Faculty of Medicine JO - Kırıkkale Uni Med J PB - Kirikkale University WT - DergiPark SN - 2148-9645 SP - 249 EP - 253 VL - 21 IS - 2 LA - tr AB - Amaç: Sekonder göz içilens (GİL) implantasyonu yapılan hastalarda, preoperatif oküler risk faktörlerini ve ikincil GİL cerrahisiendikasyonlarını belirlemek ve bu işlemin görsel sonuçlarını karşılaştırmakamacıyla yapılacaktır.Gereç veYöntemler: Kırıkkale Üniversitesi Tıp Fakültesi’nde, Ocak 2018 ve Şubat2019 tarihleri arasında sekonder GİL implantasyonu yapılan ve postoperatif enaz 3 ay takibi olan 19 hasta çalışmaya dâhil edildi. Ameliyat öncesindehastaların sekonder GİL implantasyonu nedenleri; psödoeksfoliyasyon (PEKS),üveit gibi ek oküler patolojiler, travma, sistemik sendromlar, ameliyat öncesive sonrası düzeltilmiş en iyi görme keskinlikleri (DEGK), uygulanan cerrahiyöntem ve olası postoperatif komplikasyonlar ayrı ayrı not edildi.Bulgular: Çalışmaya 19hastanın 19 gözü dahil edildi. Hastaların 11 (%57.9)’i kadın, 8 (%42.1)’ierkekti. Tüm hastaların yaş ortalaması 69.16±6.92 (59-80) idi. Hastalaroperasyon öncesi değerlendirildiğinde, en sık neden, primer cerrahi sonrasıintraoperatif komplikasyonlara sekonder gelişen cerrahi afaki idi (%52.6,n=11). İkinci en sık neden ise 6 hastada görülen GİL subluksasyonu idi. Sulkusdesteği olan hastalara sulkus yerleşimli GİL diğer hastalara ise, iris ya daskleral fiksasyonlu GİL implantasyonu yapıldı. Hastaların cerrahi öncesi DEGK0.223±0.187 iken cerrahi sonrası DEGK 0.702±0.209 idi. Ameliyat öncesi vesonrası görme düzeyleri değerlendirildiğinde aradaki fark istatistiksel olarakileri düzeyde anlamlıydı (p <0.001).Sonuç: Sulkusyerleşimli GİL implantasyonu, iris ve skleral fiksasyonlu GİL implantasyonuyöntemlerine göre daha kolay ve komplikasyon oranı daha düşük bir yöntemdir.Sulkus desteğinin olmadığı durumlarda iris fiksasyonu ya da skleral fiksasyonyönteminin sonuçları da yüz güldürücüdür. KW - Sekonder GİL implantasyonu KW - katarakt KW - GİL subluksasyonu N2 - Objective: Theaim of this study is to determine preoperative ocular risk factors andindications for secondary intraocular lens (IOL) implantation surgery and tocompare the visual outcomes of this procedure.Material and Methods: Nineteenpatients who underwent secondary IOL implantation between January 2018 andFebruary 2019 at Kırıkkale University Faculty of Medicine were included in thestudy. Preoperative causes of secondary IOL implantation, additional ocularpathologies such as pseudoexfoliation (PEX), uveitis, trauma, systemicsyndromes, best corrected visual acuity (BCVA) before and after surgery,surgical procedures and possible postoperative complications were notedseparately.Results: Nineteeneyes of 19 patients were included in this study. Eleven (57.9%) of the patientswere female and 8 (42.1%) were male. The mean age of all patients was 69.16 ±6.92 (59-80) years. When the patients were evaluated preoperatively, the mostcommon cause was surgical aphakia secondary to intraoperative complications dueto primary surgery in 11 patients (52.6%). The second most common cause was IOLsubluxation in 6 patients. IOL implantation with iris or scleral fixation wasperformed in patients who did not have sulcus support and the other IOLs wereinserted to the sulcus. Preoperative mean BCVA was 0.223 ± 0.187, andpostoperative mean BCVA was 0.702 ± 0.209. The difference between preoperativeand postoperative mean BCVA was statistically significant (p <0.001).Conclusion: IOLimplantation in the sulcus is easier and the complication rate is lower thanthe iris and scleral fixation IOL implantation methods. The results of irisfixation or scleral fixation in cases without sulcus support are alsopromising. CR - 1. Elfiky M, Saad H, Elseht R, Selima A. Role of ultrasound biomicroscopy in the planning for secondary implantation of intraocular lens in aphakia. Int Ophthalmol. 2016;36(3):391-400. CR - 2. Chan TCY, Lok JKH, Jhanji V, Wong VWY. Intraocular lens explantation in Chinese patients: different patters and different responses. Int Ophthalmol. 2015;35(5):679-84. CR - 3. Jones JJ, Jones YJ, Jin GJC. Indications and outcomes of intraocular lens exchange during a recent 5-year period. Am J Ophthalmol. 2014;157(1):154-62. CR - 4. Jin GJC, Crandall AS, and Jones JJ. Intraocular lens exchange due to incorrect lens power. Ophthalmology. 2007;114(3):417-24. CR - 5. Fernández-Buenga R, Alió JL, Pinilla-Cortés L, Barraquer RI. Perioperative complications and clinical outcomes of intraocular lens exchange in patients with opacified lenses. Graefes Arch Clin Exp Ophthalmol. 2013;251(9):2141-6. CR - 6. Schulze S, Bertelmann T, Sekundo W. Implantation von Intraokularlinsen in den Sulcus ciliaris. Ophthalmology. 2014;111(4):305-9. CR - 7. Chang SHL, Wu WC, Wu SC. Late-onset secondary pigmentary glaucoma following foldable intraocular lenses implantation in the ciliary sulcus: a long-term follow-up study. BMC Ophthalmol. 2013;13(1):22. CR - 8. Friedman NJ, Khater TT, Koch DD. Secondary intraocular lens implantation. In (eds): Philadelphia, PA: Lippincott, Williams, & Wilkins, 2006. CR - 9. Sorenson R, Scott IU, Tucker SH, Chinchilli VM, Papachristou GC. Practice patterns of cataract surgeons at academic medical centers for the management of inadequate capsule support for intracapsular or sulcus intraocular lens placement during cataract surgery. J Cataract Refract Surg. 2016;42(2):239-45. CR - 10. Drolsum L. Long-term follow-up of secondary flexible, open-loop, anterior chamber intraocular lenses. J Cataract Refract Surg. 2003;29(3):498-503. CR - 11. Lyle WA, Jin JC. Secondary intraocular lens implantation: anterior chamber vs posterior chamber lenses. Ophthalmic Surg. 1993;24(6):375-81. CR - 12. Chen Y, Liu Q, Xue C, Huang Z, Chen Y. Three-year follow-up of secondary anterior iris fixation of an aphakic intraocular lens to correct aphakia. J Cataract Refract Surg. 2012;38(9):1595-601. CR - 13. Rusu I, Chen Z, Zizva J, Myung JS, Wald KJ. Incidence of cystoid macular edema with iris-fixated posterior chamber intraocular lenses in patients presenting with lens dislocation. Int Ophthalmol. 2014;34(5):1153-8. CR - 14. Rho S, Song WK, Sung Y, Kwon HJ, Lew H. Scleral fixation technique using a hydrophobic foldable intraocular lens with ring-shaped connecting bridges. J Cataract Refract Surg. 2015;41(2):262-7. CR - 15. Ganekal S, Venkataratnam S, Dorairaj S, Jhanji V. Comparative evaluation of suture-assisted and fibrin glue-assisted scleral fixated intraocular lens implantation. J Refract Surg. 2012;28(4):249-52. CR - 16. Kjeka O, Bohnstedt J, Meberg K, Seland JH. Implantation of scleral-fixated posterior chamber intraocular lenses in adults. Acta Ophthalmol. 2008;86(5):537-42. CR - 17. Evereklioglu C, Er H, Bekir NA, Borazan M, Zorlu F. Comparison of secondary implantation of flexible open-loop anterior chamber and scleral-fixated posterior chamber intraocular lenses. J Cataract Refract Surg. 2003;29(2):301-8. CR - 18. Mimura T, Amano S, Sugiura T, Funatsu H, Yamagami S, Oshika T et al. 10-year follow-up study of secondary transscleral ciliary sulcus fixated posterior chamber intraocular lenses. Am J Ophthalmol. 2003;136(5):931-3. CR - 19. Price MO, Price FW, Werner L, Berlie C, Mamalis N. Late dislocation of scleral-sutured posterior chamber intraocular lenses. J Cataract Refract Surg. 2005;31(7):1320-6. UR - https://doi.org/10.24938/kutfd.591109 L1 - https://dergipark.org.tr/en/download/article-file/784256 ER -